Quarterly publication distributed to approximately 36,000 RNs, LPNs and
ARNPs licensed in Iowa
Volume 4 • Number 3
April, May, June 2021
INA’S PRESIDENT’S MESSAGE
The COVID-19 Vaccine:
Is it Safe?
Greetings, I hope that you
are healthy and have had a great
start to the New Year!
One year ago, we were
beginning to learn about this
new coronavirus and what it
would mean to our personal and
professional lives was quickly
becoming a reality. Throughout
this difficult year, Iowa nurses
have been there to care for and
protect Iowans. I know that it
has not been easy and that you
have all worked long hours in
extremely difficult situations. I,
MS, BSN, RN-BC,
like the rest of you, want this to be over. However, there
is still much work to be done before we can return to our
lives as they were before the pandemic.
A sign of hope and the beginning of the end of the
pandemic occurred in December when the first vaccines
were approved for use in the United States. While we
all want to return to “normal,” we must stay the course
and continue with masking, social distancing and hand
hygiene. When it is your turn, get vaccinated. If we all do
our part and continue to follow the precautions, we may
be able to enjoy some of the fall and winter activities that
we missed in 2020.
Switching gears... In December Christina Peterson,
Andrea Starmer, Tobi Lyon and I had the privilege of
representing Iowa at the ANA Leadership Summit. The
event was held virtually with over 107 state leaders. The
evening event was packed with information shared by
ANA leadership. Highlights of the meeting included a
presentation outlining ANA’s strategic plan for the next 12
months. ANA strategic goals are as follows:
Goal 1: Elevate the Profession of Nursing Globally
Goal 2: Grow and diversify our credentialing portfolio
Goal 3: Evolve the Practice of Nursing to transform
Health and Health care
Goal 4: Enable Transformational Capabilities through
Each has several objectives on how the goal will
be achieved for the next 12 months. The INA Board
of Directors will be reviewing our own strategic plan
and discussing what we can do in Iowa to support
the ANA plan. More detailed information on the
ANA strategic plan can be found when you log into
I want to take this opportunity to congratulate Tobi
Lyon, our executive director on being named 2020
Greater Lansing Entrepreneur of the Year! In addition
to that honor, her company Ngage Management
was named a Best of MichBusiness 2020 winner!
Congratulations also go out to Senior Director of
Education and Membership at Ngage, Andrea Starmer.
Andrea presented at the ANA Executive Enterprise
meeting in January. Thank you both for all you do for INA!
In closing, please remember to be kind to each other.
We are all under an enormous amount of stress as we
continue to navigate through the pandemic and a little
kindness can go a long way! Be sure to take time for
yourself to rest and relax. Thank you for all that you do to
care for Iowans and the profession of nursing.
2021 INA Nurses Day at
the Legislature Recap
current resident or
In the February edition of the American Nurse, INA Executive Director,
Tobi Lyon, authored the article, “Uplifting Nurses.” In the article, she
shares how INA was able to quickly respond to members’ needs during
the early days by providing virtual support via Networks of Support
sessions and the INA Nurse to Nurse warm line.
Page 2 • Iowa Nurse Reporter April, May, June 2021
INA LOBBYIST REPORT
Amy Campbell & Craig Patterson
Legislators returned to session on January 11
and laid out an aggressive schedule to complete
the work of the normal 16-week session as quickly
as possible, including a focus on the Governor’s
childcare, housing and broadband priorities. While
the first legislative deadline is still a month away,
both chambers are turning around bills swiftly from
subcommittee to committee to floor debate. Leaders
want to have most policy work done by the time the
state’s Revenue Estimating Conference comes back
to review the condition of the state’s economy and
set new estimates. If things continue to look up,
legislators will wrap up budgets and remaining policy
bills and head home before the April 30th shutdown
Here are a few bills upon which INA has engaged in
the first six weeks of session:
• Spoke in favor of telehealth payment parity for
mental health services (HF 294) and legislation to
instruct professional boards to remove barriers
to the safe use of telehealth and telemedicine
delivery modalities (HF 431). HF 431 passed the
House 92-0; HF 294 is ready for House debate.
• Supported legislation (HF 390) to require the
public and customers be notified when a water
utility stops fluoridation (at least 90 days’ notice).
This bill is also out of committee and ready for
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experiences, there’s a spot for you!
We are looking for kind, patient-focused individuals
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including IPERS, health, dental and life insurance,
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FGH is an equal opportunity employer with
great benefits and a positive work environment.
• Advocated for passage of strong maternal
child health legislation (SF 35), including a bill
to expand Medicaid coverage to 12 months
postpartum (SF 155), to support breastfeeding
(SF 251), and expanded access to up to a
year of contraceptive coverage without a
(HF 434 & SSB 1157). HF 434 is out of
committee and ready for House debate; SSB
1157 will be ready for committee debate this
• Opposed efforts to add exceptions for school
vaccinations (HF 217), prohibit any employer
from requiring vaccinations (HF 217 & SF 193),
and other efforts to undermine the state’s
public health goals.
• Spoke against legislation to place barriers to
access to important health and supportive
services for LGBTQ+ Iowans (HF 193) and low
income individuals (SSB 1125).
• Advocated for a strong sexual assault nurse
examiner and forensic examiner program within
the Attorney General’s Victims Assistance
Division to streamline efforts and expand access
to these services (HSB 179 & SSB 1154). Both
bills are currently in committee but have been
approved by their respective subcommittees
with amendment changes requested by INA.
Looking ahead, the first major legislative deadline
is just a couple weeks away. Bills wanting to continue
the march toward becoming law needed to be out
of their committees of origin by Friday, March 5. Any
non-tax or non-budget bill left in committee after
this time are dead for the remainder of the session.
We know lawmakers will have to come back for
a special session this Fall to do redistricting, since
US Census data has been delayed until September.
This will cause issues in Iowa that are yet to be
resolved, since the Iowa Constitution requires new
maps be approved by September 15. Constitutional
scholars and the Iowa Supreme Court will be looking
at Iowa’s options over the next several months, but
legislators will probably want to get redistricting
done quickly when they return for special session
since the candidate filing deadlines in March 2022
will leave little time for recruiting candidates.
The “Iowa Nurse Reporter” is the official
publication of the Iowa Nurses Foundation
and the Iowa Nurses Association, a constituent
member of the American Nurses Association,
published quarterly every January, April, July
For advertising rates and information, please
contact Arthur L. Davis Publishing Agency, Inc.,
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does not imply a product offered for advertising
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April, May, June 2021 Iowa Nurse Reporter • Page 3
MESSAGE from the EXECUTIVE DIRECTOR
Associations respond to member needs in a pandemic.
Tobi Lyon, MBA, CAE
IN 2020, what kept me up
at night was nurses’ well-being
and how they’ve been dealing
with the impact of COVID-19.
Despite the loss of more than
1,400 frontline workers who
have died of this illness, nurses
continue to work long hours
caring for their patients. They
fear contracting the virus and
bringing it home to their loved
ones. On days off, they adhere
to infection prevention and
control guidelines and limit
Tobi Lyon, MBA,
physical contact, putting the needs of others first. If
you asked anyone in healthcare why they keep going,
their answer would probably be “because I care.”
Facing the new year with an ongoing pandemic,
we as leaders must continue to offer stability,
reliable information, and useful resources to nurses.
The American Nurses Association (ANA) and our
constituent/state nurses associations have played a
critical role in serving an emerging and diverse set of
member needs during the pandemic. This also has
been a time of opportunity to explore new modes of
We knew the only way to make a difference
would be to keep our associations relevant to all that
our members were experiencing in 2020. We had
to act quickly and responsively. At ANA-Michigan,
we restructured our association a few years ago,
which proved critical to our ability to pivot operations
overnight and respond to nurses’ needs during
this time of uncertainty. We set aside routine, daily
operations, and the status quo. Our innovative and
proactive approach has been nationally recognized for
establishing new practices and engaging with frontline
nurses and potential association members.
How did we learn what our members’ needs were
during the crisis? We asked, listened, and prioritized.
We heard firsthand how vulnerable nurses are to the
negative mental health effects related to working
under such extreme conditions and went into motion
to provide a resource. In Iowa, we started a 24/7 Nurse
to Nurse Warm Line to allow nurses to reach out to
other nurses to talk and have someone listen.
We also offered a complimentary storytellers’
workshop to teach nurses how they can effectively
share their countless stories and drive conversations
during the pandemic.
Giving members a platform to have their voices
heard is essential. We held several virtual town halls
with elected officials so they could hear firsthand
the many issues nurses in their districts were facing.
This drove direct care and hero pay to our frontline
We created a virtual platform for connecting nurses
across the state with our Networks of Support series.
We offered webinars addressing stress management
and burnout, which provided self-care tools and
referral information to professionals for expert
assistance. These recorded webinars are part of several
resources for members and their nursing colleagues
offered on our websites. ANA-Michigan responded to
community needs and activated nurse experts to offer
a COVID-19 Training Program for K-12 schools.
To all the nurses putting one foot in front of the
other, know that you’re helping to save lives every day.
However, I’m asking you to please take care of yourself
with these steps:
• Pace yourself as much as possible.
• Acknowledge your frustrations because holding in
your feelings can lead to depression and anxiety.
• Let people help. Some people take joy in helping
frontline workers. Let them help you.
Tobi Lyon is the CEO of Ngage Management,
which manages ANA-Michigan and the Iowa,
Oklahoma, and Wyoming Nurses Associations.
SHELL ROCK SENIOR LIVING
920 N. Cherry Street | Shell Rock, IA 50670 | 319-885-4341
We salute our Nurses and entire
staff for the loving care they
provide our people all year.
For more information, contact
Suzette Eveland, Director of Nursing Services,
Suzette.Eveland@accura.healthcare or Christina Hubka,
Executive Director, Christina.Hubka@accura.healthcare
Apply online: www.accura.healthcare
STATE OF IOWA NOW HIRING
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Page 4 • Iowa Nurse Reporter April, May, June 2021
The COVID-19 Vaccine: Is it Safe?
In December 2020, the
FDA approved the use of the
Pfizer and Moderna COVID-19
vaccines under Emergency
Use Authorization (EUA) in the
United States. The Advisory
Committee on Immunization
Practices (ACIP) gave the
final blessing and provided
the priority lists. Health care
workers have had the privilege
of being the first group of
Americans to receive the
vaccine. For many of us the
vaccine is a sign of hope that
MS, BSN, RN-BC,
we are at the beginning of the end of the pandemic.
Pictures of health care workers receiving their first
dose have been shared on multiple media platforms.
For many of us receiving the first dose was a very
emotional moment…. knowing that we had added
another layer of protection and that we are now one
step closer to the return to pre-COVID life.
Even before the vaccine became available there
were many inaccurate news stories circulating on
social media sites. Some of the misinformation
posted was that the vaccine can cause infertility,
pregnancy loss and alter one’s DNA. None of this
is true. A troubling trend noted after healthcare
workers began receiving the COVID-19 vaccine
is showing that many nurses have not taken the
vaccine due to the concerns listed above. While the
decision to take the vaccine is a personal one, that
decision should be made after reviewing vaccine
information from reputable sources and talking
with your healthcare provider about the risks and
benefits of the vaccine.
Both Pfizer and Moderna COVID-19 vaccines are
mRNA vaccines. Many have expressed concerns
that this is new technology, and the vaccine was
developed too quickly. The reality is that while
these are new vaccines, the technology is not new.
Scientists began developing mRNA vaccine several
years ago during another coronavirus outbreak
and because that outbreak ended quickly and had
very little global impact the vaccine was never fully
developed. So mRNA research continued but had
that work not already been underway it would have
taken a lot longer to develop the vaccines available
Common misunderstandings are:
The vaccine will change my DNA.
mRNA does not enter the nucleus of the cell where
DNA material is kept, so the vaccine cannot change
or affect your DNA.
You can get COVID-19 from the vaccine.
The vaccine is not a live virus vaccine. It does not
contain any of the COVID-19 virus.
I have already had COVID-19 so I do not need to
take the vaccine.
The CDC currently recommends that all people receive
that vaccine when it is available. It is unclear at this
time how long a person who has had the disease
is immune. If you have concerns, talk with your
The vaccine may cause fertility issues later.
The CDC and several organizations, such as the
Association of Women’s Health, Obstetric and
Neonatal Nurses, and the American College of
Obstetricians and Gynecologists recommend that all
women who are health care workers are vaccinated.
Links to these recommendations are at the end of the
If I take the vaccine, I do not need to wear a mask
Even though you have received both doses of the
vaccine, you will still need to wear a mask, social
distance and practice good hand hygiene. These
recommendations will likely be in place for several
more months. Public health officials will tell us when it
is safe to return to pre-COVID practices, until then we
must continue to follow their advice.
As I stated previously, you do have the right to not take
the vaccine. That decision should be made after a careful
review of the scientific literature and a discussion with
your health care provider. When providing information
to patients, family or friends we are obligated to provide
accurate information on the vaccine. Both the American
Nurses Association and the Iowa Nurses Association have
published position statements on the vaccine, please take
the time to review them.
Finally, if the opportunity presents itself to you,
consider volunteering at an immunization clinic. It will take
several months to distribute the vaccine and will take all of
us working together to end the pandemic.
INA Statement on Immunizations | Iowa Nurses Association |
Coronavirus Resources| COVID-19 | ANA Enterprise
COVID-19 Vaccines | CDC
COVID-19 Vaccines and Pregnancy | ACOG
Coe College seeks qualified applicants for a full-time non-tenure
track (NTT) appointment in a baccalaureate nursing program
beginning August 2021. Required qualifications include:
MSN degree completed by start date.
A minimum of 1 year of recent teaching experience.
Successful completion of a criminal background check in
accordance with Coe College policy.
To apply, please visit our website at
www.coe.edu and click on Careers
Pursuit of a
INF Scholarship Recipient
The idea of pursuing a
career in nursing has always
been in the back of my
mind. While growing up, I
witnessed my mothers strong
and devoted commitment to
the nursing profession. She
started out as a community
college graduate with an LPN
license. Since then, she has
worked her way up to a BSN
RN, employed at the Iowa
Department of Public Health
(IDPH), while also managing to raise four kids along
the way. She is the most motivated and determined
person I have ever met. The thought of being able
to follow in her footsteps has inspired me every day
since I was a little girl.
Flash forward to today and I am approaching
my graduation in May of 2021 from Des Moines
Area Community College (DMACC). Following
graduation, I plan to take the NCLEX, and continue
working for UnityPoint Methodist Medical Center
in downtown Des Moines. I have worked in
this hospital for about a year as a patient care
technician (PCT) and have already applied for a
position in the registered nurse residency program.
I am really excited about the future that awaits
me here. I feel I have obtained the education and
experience needed to succeed in this program.
From an assisted living facility to a nursing home
and now to working in the hospital environment,
I have grown leaps and bounds in my patient
care experience. I am proud to soon call myself a
DMACC graduate and continue on as a UnityPoint
In the fall I will attend the University of Iowa’s
online RN-to-BSN program to obtain my bachelor’s
degree, and one day progress to earning my
doctorate degree in nursing to ultimately obtain
a nurse practitioner license. The areas of nursing
I’m excited to explore more include pediatrics and
critical care. My dream position would be in a
pediatric intensive care unit (PICU). This is the area
that has always caught my eye and I long for the
ability to have a hand in returning a healthy child to
the playground, where they belong.
I want to express my deepest gratitude to
the Iowa Nurses Foundation for awarding me
this scholarship. It has helped me tremendously
throughout this final year of nursing school,
and overall in achieving my dreams of becoming
a registered nurse. I would also like to extend
a hearty thank you to all the nurses, nursing
assistants and other medical personnel that have
put their lives on the line to care for patients
during the COVID-19 pandemic. I look forward to
continuing the fight against the coronavirus and so
many other diseases that have taken over people’s
lives. I can’t wait to begin my nursing career in
just a few short months. This award from the Iowa
Nurses Foundation was among the final steps to
achieving my dreams. I can’t thank you enough for
believing in me and helping to support my future
RN's and LPN's
Jalissa Winn, Administrator
Rose Haven Nursing Home
1500 Franklyn Ave, Marengo, IA 52301
CHEROKEE MENTAL HEALTH INSTITUTE
The Iowa Department of Human Services’ Cherokee Mental Health
Institute (CMHI) located in Cherokee, Iowa, is seeking full-time
Registered Nurses and Licensed Practical Nurses with various
schedules available. These positions offer competitive salaries with
shift differential and a generous benefit package including Iowa
Public Employees Retirement System (IPERS). CMHI’s mission is to
provide patient care through Treatment, Training and Advocacy.
For more details, please visit
or you can contact Human Resources at 712-225-6927.
Page 6 • Iowa Nurse Reporter April, May, June 2021
Do Nurses Make More Nursing Errors Working 12 Hour Shifts
Without Getting a 30-minute Uninterrupted Break?
Courtney Martin, ISU RN-BSN student
On a cold winter day in
December, Nancy Smith
is headed to work on the
oncology unit as a registered
nurse. She has been working
at Luke’s Hospital for the
past ten years. As she drives
to work she thinks about
everything she needs to
get done. However, she
instantly realizes this is her
third twelve hour shift in a
row and has one more twelve hour shift to work
this week because her floor is short staffed. As
Nancy arrives to work, she pulls into her favorite
parking spot and gathers all her belongings.
She gets inside the hospital and is screened for
COVID-19 symptoms. Her temperature is taken
and she is asked a series of questions to verify
she does not have any symptoms. After passing
the first check point, she clocks in and goes to
her morning huddle. At the morning huddle
all the patients are assigned, safety issues are
discussed and the unit’s goals are shared. Once
the morning huddle is complete, she gets logged
into her computer and the phone she’ll carry with
her all day then receives reports on her patients
using bed side shift report. The next thing on her
agenda is morning medication pass. She effectively
passes the medications, completes her head-to-toe
assessments and accurately charts her findings.
Nancy finds herself being pulled in several
different directions as she helps answer call lights
and reviews new orders placed by the providers.
With a successful morning behind her, it is now
time for Nancy’s lunch break. As she heads off
the floor to take her 30-minute break, she lets
others know she will be going to get some lunch.
As mentioned before, Nancy carries a phone with
her all day long to keep in touch with her patients,
co-workers, other departments and the providers.
As she puts her lunch in the microwave her phone
rings. It is physical therapy checking in to verify it
would be alright to work with the patient in room
312. She confirms and sits down to eat her lunch.
A few bites into her lunch, she receives another call
from dietary asking if the patient’s blood sugar in
room 322 had been done.
As she finishes up her break the physician calls
to change some orders for the patient in room
308. She scrambles to find something to write on
and digs through her pockets to find a pen. She
wrote everything down and read it back to verify
what she heard. Nancy quickly ate the last few
bites of food and headed back to the floor to put
in the new orders she just received. It has been a
long three days and this lunch break is typical of
the most of her breaks. It is expected she take her
phone to lunch and answer it while eating. She was
exhausted and noticed at this point she was not
thinking as clearly as she was on day one of her
work week. She put the orders in and started the
afternoon medication pass. Except this time was
different. She made a mistake. She forgot to set the
bed alarm on the patient’s bed in room 312. She
started to do her hourly rounding and medication
pass in her next patient’s room when suddenly,
she heard, “HELP!” She went running towards the
voice calling out for help. She arrived to the room
and found her patient on the ground. She assessed
her patient and called for help. The patient was put
back to bed and monitored for any other symptoms
of fall related injuries. The proper paper work for
her patient’s fall was filled out, but she felt terrible
she forgot to set the bed alarm. She knew if she
had been thinking clearly she would not have
forgotten. The rest of the day she carried the guilt
around with her knowing she was not in the best
state of mind to care for her other four patients. At
the end of her shift she knew she needed to get
home and go to bed, so she would be able to be
ready to care for her family the next day.
Like Nancy Smith many nurses across the United
States operate under these conditions. They
work long hours and do not get an uninterrupted
30-minute break. This small amount of time in a 12-
hour period is needed to help nurses relax. If breaks
are not given, it could cost hospitals an extensive
amount of money. Almost all nurses will voice some
level of work-related stress. Consequently there
is increasing attention in the nursing community
and supportive documentation in papers and
articles on the importance of nurse well-being
(Contreras Sallazzo et al., 2020). The welfare of
nurses impacts the nurses themselves, the team,
health organizations and most importantly their
patients (Al Ma’mari et al., 2020). Investing in stress
management techniques, such as breathing, coping
strategies, exercise, mindfulness and social activities
during a break can aid in dealing with stressful
situations (Henson, 2020).
The research or evidence is not well defined in
the literature involving the correlation between
nurses taking breaks and number of nursing errors
made. A few resources provide information about
compassion fatigue and burnout in relation to
errors. Compassion fatigue can lead to high levels
of stress at work, errors in judgment as well as
physical and emotional exhaustion (Henson, 2020).
When individuals are tired, they are more likely to
make nursing errors. Wrong-patient incidents occur
for many reasons, including nurse-related factors
such as tiredness, a lack of skills or negligence and
system-related factors such as rushing or heavy
workloads (Harkanen et al., 2018).
April, May, June 2021 Iowa Nurse Reporter • Page 7
Allowing nursing staff to get a 30-minute break
can impact the overall well-being of patients,
decrease instances of nursing errors, increase
patient safety and satisfaction and increase the
job satisfaction levels of nursing staff. Studies have
been conducted in regard to the benefits of selfcare
in acute care settings and the impact it can
have on the patients. Many places of employment
are implementing and evaluating programs that
address the reduction of a nurse’s stress, burnout
and depression (Contreras Sallazzo & Esposito,
2020). According to Owens (2021), one major
theme emerged during a data analysis that showed
positive work environments decrease staff turnover
and increase staff satisfaction. Moreover, in a
regional hospital in Minnesota a restorative space
known as the “serenity room” was installed in a
busy emergency department (Salmela et al., 2020).
They discovered the tranquil room provided a
reduction in stress levels for the nursing staff and in
turn increased patient safety (Salmela et al., 2020).
Furthermore, research confirms it is important to
care for ourselves both physically and mentally by
participating in proper nutrition and rest, limiting
the number of overtime hours worked, taking time
away from work and spending time doing activities
that bring joy to everyday life (Parrish, 2016). Active
participation in self-care activities will contribute
to decreasing stress levels, allowing one to be
more proactive rather than reactive in problematic
situations (Parrish, 2016). Patient outcomes can be
improved when nurses are able to take their full
break without interruptions and implement self-care
techniques (Jameson & Bowen, 2020). The negative
correlation between fatigue and patient safety
culture indicates nurse fatigue has a detrimental
effect on patient safety.
AL Ma’mari, Q., Sharour, L. A., & Al Omari, O. (2020).
Fatigue, burnout, work environment, workload and
perceived patient safety culture among critical care
nurses. British Journal of Nursing, 29(1), 28–34.
Contreras Sollazzo, L., & Esposito, C. L. (2020).
Nurses’ Unions Can Help Reduce Stress, Burnout,
Depression, and Compassion Fatigue Part 1: The
Background. Journal of the New York State Nurses
Association, 47(1), 18–44.
Harkanen, M., Tiainen, M., & Haatainen, K. (2018).
Wrong-patient incidents during medication
administrations. Journal of Clinical Nursing (John
Wiley & Sons, Inc.), 27(3-4), 715-724. https://doi.
Henson, J. S. (2020). Burnout or Compassion Fatigue: A
Comparison of Concepts. MEDSURG Nursing, 29(2),
Jameson, B. E., & Bowen, F. (2020). Use of the
Worklife and Levels of Burnout Surveys to Assess
the School Nurse Work Environment. Journal
of School Nursing, 36(4), 272–282. https://doi.
Owens, R. A., Burwell, P. M., Deese, S., & Petros, T.
(2021). Graduating Nursing Student and Practicing
Nurse Perceptions on Promoting Recruitment,
Work Satisfaction, and Intent to Stay: A Qualitative
Study. Journal of Nursing Regulation, 11(4), 41–50.
Parrish, E. (2016). Civility and Self-Care in Nursing Go
Hand in Hand. Perspectives in Psychiatric Care, 52(2),
Salmela, L., Woehrle, T., Marleau, E., & Kitch, L. (2020).
Implementation of a “Serenity Room” Promoting
resiliency in the ED. Nursing, 50(10), 58–63. https://
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nursing adjunct faculty.
Please visit our website for more information.
Page 8 • Iowa Nurse Reporter April, May, June 2021
PUBLIC POLICY UPDATE
The Voice of Iowa Nurses: Shaping Policy, Advancing Health
Dawn Bowker, PhD, RN, ARNP-BC, SANE
INA Director of Public Policy
The voice of Iowa nurses
and future nurses positively
influence our profession, patients
and policy. It is both powerful
and a privilege to work with
informed nurses to shape the
future of nursing and policy in
Iowa. Each year the Iowa Nurses
Association (INA) identifies
legislative priorities that align
with our mission to “connect,
support, advocate for nurses
and healthcare in Iowa,” and
our vision to “…promote the
growth of the profession, guide
PhD, RN, ARNP-
nursing practice and monitor current issues in nursing.
Our strength is to stay engaged by advocating for and
connecting with Iowa nurses in the diverse, dynamic
health care environment.”
A coordinated effort with the American Nurses
Association, Ngage Management, Advocacy Cooperative
and Iowa nurses will guide INA to identify, define and
direct efforts to broadly address legislative priorities that
are relevant to Iowa and Iowa nurses.
This year the INA Public Policy Committee identified
nine legislative priorities:
1. Support adding nurse residency programs for all
Iowa hospitals that include:
• Fund programs to help new nursing graduates’
transition into practice.
• Recognize that nurse residency programs help to
attract and retain nurses, reduce turnover costs,
provides new nurses the opportunity to improve
and learn skills.
2. Support increased funding for public health,
both state and federal funding that include:
• Increase appropriations to the Essential Public Health
Services line item in the Health and Human Services
• Support actions that serve to promote health,
reduce health inequities and protect groups
that have been socially and/or economically
• Assure that any major changes to the governmental
public health system are done with the input of
public health professionals and with a vision that
promotes a culture of health in Iowa.
3. Support increased access to mental health
services and support that include:
• Offering a full array of affordable, accessible
treatment options including recovery-oriented
systems for prevention, early intervention and
• Increasing the number of mental health treatment
beds across the state.
• Expanding the psych/mental health nursing
workforce and increasing the number of psych/
mental health nurse practitioners across the state.
• Supporting reimbursement parity for mental health
• Supporting continuation of public health
emergency proclamations that allows for 3rd party
reimbursement for telehealth visits that increases
flexibility, convenience and access as a long-term
4. Support increased funding for nurses related to
protect and recover from COVID-19 that include:
• Fund compensation for nurses who are unable to
work due to a positive or pending COVID-19 test
• Provide support services for nurses who are suffering
with trauma (PTSD) from the COVID-19 pandemic.
• Increase funds, access and support for telehealth
access and reimbursement.
• Ensure an adequate amount of appropriate PPE
for all facilities providing care to patients at risk for
• Ensure COVID-19 priorities include Long Term Care
5. Support programs that address violence against
health care workers that include:
• Support detain and restrain orders (therapeutic hold)
for any patient who poses imminent threat to self or
• Given the imminent threat and need for immediate
action, endorse nurse clinical judgment and
authority to implement a therapeutic hold without
first requiring a physician order. Situations posing
threats to patients, nurses and/or others put these
individuals at imminent risk for injury from a patient
• Support programs that address lateral violence,
incivility and bullying among and between nurses.
6. Support and fund Midwifery in Iowa that
• Support and fund programs that improve maternal/
• Support and fund one-year Medicaid eligibility postpartum
(most people lose access after 30 days).
• Recognize that in Iowa, women of color are six times
more likely to die from childbirth (national average
three to four times).
• Support mandates of hospital privileges for nurse
Of note: Nurse Midwife on Governor’s COVID task
7. Support increased funding for healthcare access
and coverage LGBTQ+ individuals that includes:
• Increased Access to LGBTQ-centered care and clinics.
• Improve/Increase education of LGBTQ health
disparities to health care workers.
• Ban conversion therapy for minors.
8. Support, protect and fund having a school nurse
in each district in Iowa that include:
• Physical, social and emotional needs of Iowa
youth are different than previous generations.
• Physical, social and emotional needs must be met
for youth to reach their fullest potential.
• School nurses are trained to evaluate youth for
somatic complaints/symptoms. The somatic
complaints/symptoms are often secondary to
the underlying primary mental, physical and
psychosocial health need.
• Youth physical health complaints or behavioral
challenges are often related to exposure
to Adverse Childhood Experiences, (ACEs),
traumatic experiences, including and not
limited to, abuse and neglect. Exposure to
ACEs is associated with school failure as well
as leading causes of morbidity and mortality in
April, May, June 2021 Iowa Nurse Reporter • Page 9
• Youth are the future of Iowa and their health
needs can be addressed with one school nurse
in every building, every day, all day.
• One school nurse in every building, every day, all
day allows youth access to healthcare 180 days
of the year.
• School nurses are knowledgeable, skilled and
qualified to provide comprehensive evidencebased
health care (including health promotion
and disease prevention) to youth.
• School nurses should not be viewed as only for
emergencies and chronic health concerns.
• School nurses are the “connectors” between
youth/families, health care and academics.
• Youth have the value of health reinforced by a
• Research shows attendance is better when a
school nurse is present to evaluate health related
complaints. When youth stay in school, parents
remain productive at work.
• Healthy youth make better learners.
• Per Iowa Department of Education School Nurse
Consultant, there are 702 school nurses in Iowa
and there are approximately 1,415 public school
buildings in Iowa (personal communication
February 21, 2020).
9. Support funding and program development
for Adverse Childhood Events (ACE) screening
and interventions that include:
• Support routine screening of all children at
annual exam visits.
• Support referrals for appropriate interventions
for children who score four or higher on routine
assessment for ACEs.
• Recognize ACEs directly correlate to a higher risk
of depression, diabetes, heart disease, stroke,
cancer, suicide, alcoholism, illegal drug abuse,
poorer health outcomes and decreased life
expectancy as an adult.
Thank you to the nursing leaders who lead the
charge by researching and defining the INA legislative
priorities Anita Leveke, RN, MSN; Pam Diechmann,
MPH, BSN, RN; Lisa Caffrey, MS, BSN, RN, MEDSURG-
BC, CIC, FAPI; Sue Whitty, MA, ARNP, Child/
Adolescent Psychiatric-Mental Health CNS, PMHNP-
BC; Rebecca Devine, DNP, ARNP, PMHNP-BC; Virginia
Wangerin, PhD, MSN, RN, CNE; Lynne Himmelreich,
CNM; Kate Pace, RN, BSN; Luke Stalzer, RN, BSN;
Sharon Guthrie, PhD, ARNP, CPNP, NCSN, RN-BC; Teri
Schloss, MSN, RN, NCSN; Esther Huston, RN, SANE,
Nurses are a powerful force in the policy-making
process. Our voices and experiences are vital
components in advancing INA’s legislative priorities,
realizing our mission and vision and positively
impacting the future of nursing.
Support adding nurse residency programs for all Iowa hospitals.
Support increase funding for public health, both state and
Support access of affordable mental health services.
Support increased funding for nurses related to protect and
recover from COVID-19.
Support programs that address violence against health care workers.
Support increased funding for healthcare access and coverage for
Support access to Nurse-Midwifery Care as a partial solution to the
maternity care crisis in Iowa.
Support funding and program development for Adverse Childhood
Events (ACE) screening and intervention.
Support, protect, and fund having a school nurse in every building,
every day, all day.
Page 10 • Iowa Nurse Reporter April, May, June 2021
Andrea Starmer, CMP
Director of Education & Membership
While we couldn’t be together in person at the capitol this year for the INA Nurses
Day at the Legislature, attendees enjoyed a rich, interactive virtual experience! The
day kicked off with our opening Keynote speaker Ann Meyer with her informative
presentation, The Power of Your Nursing Voice. Next up was Dr. Dawn Bowker, INA
Director of Public Policy with an informative introduction into INA’s legislative priorities
for the coming year.
After a short break to visit exhibitors and the INA discussion forum, attendees
could choose one of four breakout sessions which offered an informative presentation
followed by open discussion on each topic:
1. How a Bill Becomes a Law and Legislative Q&A -Amy Campbell & Craig
2. Increase Public Health Funding – Lisa Caffery, MS, BSN, RN, MEDSURG-BC, CIC,
FAPIC and Pam Deichmann, MPH, BSN, RN
3. Nurse Residency Programs in Iowa Hospitals – Anita Leveke, RN
4. Mental Health Support for All Iowans – Susan Whitty, RN and Rebecca Devine, RN
After a short lunch break, where attendees were able to attend exhibitor zoom
sessions, Amy Campbell and Craig Patterson shared this year’s comprehensive
legislative update. Afterward, the breakout sessions were repeated.
The final segment of the day was a Legislative Townhall with Representative Chris
Hall, Senator Carrie Koelker, and Senator Liz Mathis, moderated by Dr. Dawn Bowker.
Attendees were both educated and energized by the information exchange on
trending topics and legislative policy facing Iowa nurses.
INA thanks all who participated: our 263 attendees, presenters, exhibitors and our
sponsor for this program, Purdue Global. We can’t wait to get together in person next
2021 INA Nurses Day at the Legislature Recap
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April, May, June 2021 Iowa Nurse Reporter • Page 11
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St. Anthony Regional Hospital
RN’s, LPN’s, DON
View openings and apply online at
IOWA LAKES COMMUNITY COLLEGE,
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Page 12 • Iowa Nurse Reporter April, May, June 2021
Esther Huston, RN, SANE, RN-BSN Student
One of the INA legislative
priorities calls for support
for funding and program
development for Adverse
Childhood Experiences (ACEs)
screening and interventions.
What are ACEs or childhood
trauma, and why is program
development so vitally
Ten years ago I was unaware
of what ACEs were and their
prevalence in our society.
Since that time, my life has been changed by learning
and understanding what ACEs are, and how they affect
children and children’s future life and health outcomes.
As a nurse and an adoptive mother, I have witnessed firsthand
the effect trauma has on children. I have seen the
direct impression ACEs leave on children and how ACEs
affect how a child learns, grows and develops. ACEs
have profound implications on children’s future physical
health, mental health and life outcomes. ACEs can be
neglect, emotional, physical, or sexual abuse, household
dysfunction such as divorce or parental separation that
leads children to feelings of instability (CDC, 2020). As an
adoptive mother of four children, I have had to dive deeply
into what ACEs are and how they affect my children
because ACE screening is not done in Iowa. As a nurse, I
Lutheran Living is currently seeking dedicated and
compassionate RN’s and/or LPN’s to join our 2nd shift
nursing team. Competitive health insurance packages
available, along with 401k and accumulating PTO.
Shift: 2-10pm | Rotating weekends with weekend differential
For more information and to apply, please visit:
INA Legislative Priority Hits Close to Home
started to see how childhood trauma affected my patients
too. The implications of ACEs are staggering.
ACEs have been shown to increase the risk of diabetes,
severe obesity, depression, anxiety, stroke, heart and lung
disease, drug abuse and suicide in adulthood (Felitti et al.,
1998). ACEs can also lead to a decrease in life expectancy
(Brown et al., 2009). For children, knowing how to deal
with stress is a learned response. Cortisol, which is released
as a response to stress, can adversely affect the brain’s
development and structure, leading to learning delays and
behavior issues (Jacob et al., 2019). Children with more
ACEs can have problems paying attention in class, anxiety,
depression and oppositional defiant disorders (Jacob et
al., 2019). Prolonged unrelieved stress can cause immune
suppression and leave a molecular mark on the way genes
are expressed (Jacob et al., 2019). Some adult diseases can
be traced back to trauma experienced as a child (Shonkoff
et al., 2009). High ACE scores have also been correlated to
those within the prison population (Stensrud et al., 2019).
Screening children for ACEs is not a routine practice
in pediatric care. A current practice change to screening
children’s ACE scores would enable providers to initiate
and start interventions for children that could otherwise
lead to developmental delays (McKelvey et al., 2017).
Physiological embedding of childhood adversity makes
adults’ treatment with ACEs a far more difficult challenge
due to decreased ability to change (Shonkoff et al., 2009).
The impact of screening children for ACEs could be one of
the most critical health promotion and disease prevention
avenues that health care has. Providers, however, cannot
treat something they do not know is present. This stresses
the importance that providers should routinely screen
children for ACEs.
In Iowa, ACEs are common. 64% of adults in Iowa
state experiencing one or more ACEs (Iowa ACEs 360,
2020). The percentage of Iowan adults who report living
through four or more ACEs is 17%. (Iowa ACEs 360,
2020). It has been over twenty years since the Adverse
Childhood Experiences Study was published and first
correlated ACEs to decreased long term health outcomes
(Felitti et al., 1998). It is scientifically known that ACEs
affect children’s health and development and long-term
health outcomes. However, if providers do not know that
children in their care have ACEs, they cannot educate
parents and initiate appropriate interventions. In order
to decrease the long-term effects of ACEs, health care
organizations need to regularly screen children in pediatric
settings. Expanding ACE screenings could support direct
intervention by linking families to assistance, home-visiting
services and therapies that support child development
(McKelvey et al., 2017). As health care providers, we must
use what we know about ACEs and apply it to promote
better health outcomes for children.
Brown, D. W., Anda, R. F., Tiemeier, H., Felitti, V. J., Edwards,
V. J., Croft, J. B., & Giles, W. H. (2009). Adverse childhood
experiences and the risk of premature mortality. American
Journal of Preventive Medicine, 37(5), 389–396. https://doi.
Centers for Disease Control and Prevention. (2020, April 13).
Violence prevention: About the CDC-Kaiser ace study.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F.,
Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998).
Relationship of childhood abuse and household dysfunction
to many of the leading causes of death in adults. The
Adverse Childhood Experiences (ACE) Study. American
Journal of Preventive Medicine, 14(4), 245–258. https://doi.
Iowa ACE 360 (2020). Healing Iowa: How Iowans are
reshaping systems and communities for children to thrive
in response to Adverse Childhood Experiences. https://
Jacob, G., van den Heuvel, M., Jama, N., Moore, A. M., Ford-
Jones, L., & Wong, P. D. (2019). Adverse childhood
experiences: Basics for the paediatrician. Paediatrics & Child
Health, 24(1), 30–37. https://doi.org/10.1093/pch/pxy043
McKelvey, L. M., Conners Edge, N. A., Fitzgerald, S., Kraleti,
S., & Whiteside-Mansell, L. (2017). Adverse childhood
experiences: Screening and health in children from birth
to age 5. Families, Systems & Health: The Journal of
Collaborative Family Healthcare, 35(4), 420–429. https://doi.
Shonkoff, J. P., Boyce, W. T., & McEwen, B. S. (2009).
Neuroscience, molecular biology, and the childhood roots
of health disparities: building a new framework for health
promotion and disease prevention. JAMA, 301(21), 2252–
Stensrud, R. H., Gilbride, D. D., & Bruinekool, R. M. (2019).
The childhood to prison pipeline: Early childhood trauma
as reported by a prison population. Rehabilitation
Counseling Bulletin 62(4) 195-208. https://doi.
WE’D LIKE YOU TO JOIN OUR TEAM
The State of Iowa is hiring:
Registered Nurses &
Licensed Practical Nurses
The Iowa Department of Corrections, an Equal Opportunity
Organization, is accepting applications for RNs and LPNs
caring for those individuals that are incarcerated who may
have medical and mental health concerns.
Competitive starting salaries and State of Iowa benefits.
To see current RN and LPN openings,
access this link regularly:
Questions can be emailed to Pam Shepherd at
April, May, June 2021 Iowa Nurse Reporter • Page 13
BECOME A MEMBER NOW!
Now Hiring RNs!
Come join our team today!
DENISON JOB CORPS CENTER
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Contact Isaiah Nieuwsma, HR Manager
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The benefits of working at
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- Health Insurance
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to see all job openings
Page 14 • Iowa Nurse Reporter April, May, June 2021
IOWA NURSES FOUNDATION
The Iowa Nurses Foundation (INF) is the
charitable and philanthropic arm of the Iowa Nurses
Association with a mission to promote and support
the professional and educational development of
registered nurses in Iowa. The year 2020 was difficult
for so many, but the INF was still able to secure just
under $3,000 in new charitable donations. A sincere
thank you to all that donated, either with a cash
gift or through participation in one of our annual
The first fundraiser of 2021 was the T-Shirt
Fundraiser/First Run held in February and March,
which raised $595 for the INF. If you missed out on
getting your custom INF “Iowa Nurses – We Are All
In This Together” t-shirt, don’t worry, as you’ll get
another chance to participate in the second run of
this fundraiser right before the Annual Conference
this Fall. An additional opportunity to donate to INF
awaits in May, for our Move-A-Thon Fundraiser held
in honor of Nurse’s Month.
These important fundraisers are more than just an
opportunity for you to show your loyalty and pride in
this most honorable profession, it is a way for you to
hold the door open behind you for the future nurses
of Iowa through critical scholarships funded by INF.
In 2020 alone, INF awarded $7,000 in scholarships
to hardworking well-deserving students seeking to
add their skills, energy and intelligence to the Iowa
Please consider donating this year to INF to help
support education and development opportunities
for Iowa nurses – those serving now and in the
future. Donations can be made conveniently online at
any time at https://iowanurses.nursingnetwork.com/
RNs, LPNs & CNAs
Mercy Iowa City
is now hiring!
• Surgical Tech
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Reasons to join our team!
• Very competitive salary and benefits package
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• Awesome culture and work environment
Ottumwa Regional Health Center is
looking for RNs, LPNs and CNAs
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Must have current license.
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Phone: 641-684-2372 • Email: firstname.lastname@example.org
April, May, June 2021 Iowa Nurse Reporter • Page 15
Leadership Visited and Revisited
Joyce J. Fitzpatrick, PhD, MBA, RN, FAAN, FNAP, FAANP (hon)
Director, Marian K. Shaughnessy Nurse Leadership Academy
Elizabeth Brooks Ford Profession of Nursing | Frances Payne Bolton School of Nursing
Distinguished University Professor | Case Western Reserve University
“So what is leadership?” This is the simple (yet complex) question that I am
Here are the answers I provide:
Leadership is part of your being, the moral compass that permeates all that you
do, say and believe.
Leadership is an attribute that is reflected in your everyday interactions with
everyone in your orbit, your family and friends, your co-workers, and those who
you barely know, but with whom you have contact.
Leadership is being authentic in the way you behave with others, the
communication that you share and the feelings and thoughts that you have.
Leadership is also a set of skills, learned behaviors that encourage others toward a
shared vision, common goals, and a greater purpose.
Leadership is finding meaning and purpose in your work.
Leadership is modeling the way in everything that you do and say.
Leadership is self-awareness, listening to yourself, reflecting on your own beliefs,
your knowledge and skills.
Leadership is doing what you can to actualize your unused potential.
Leadership is managing conflict to create true win-win situations.
Leadership is learning from others, the children in the playground who are
spontaneous in their support of each other, and the board members in the
meeting who are supportive in their own way.
Leadership is humility, knowing that none of us is infallible.
Leadership is a belief in the power of our collective humanity, working together
for the good of all.
Leadership is sharing your deepest convictions about the way that nursing and
health can and should be, reaching for the stars that promote health as a right
and not a privilege.
Leadership is caring for those most vulnerable, the neglected, the ill, the downtrodden,
the marginalized…just as nurses do every day in every organization.
Leadership is listening to those whose views are radically different from yours and
trying to find a common purpose and a common ground for the good of all.
Leadership is professionalism, understanding the social contract that we as nurses
have with the public, upholding our ethical obligations to all in our care, and living
our professional nursing standards.
Leadership is assuming responsibility for our own actions, being accountable for our
actions and understanding the consequences.
Leadership is pushing the boundaries when the boundaries need to change.
Leadership is investing in others’ greatness.
Leadership is identifying needed change and creating the vision and processes to
Leadership is providing guidance, to individuals, groups, and organizations.
Leadership is active and decisive decision-making to achieve shared goals.
Leadership is taking a risk, to implement a vision and achieve goals.
Leadership is understanding yourself, being aware of your potential and the power
of intentional communication.
Leadership is building relationships with those who can help you and those you can
help, building relationships for the purpose of helping others to actualize their potential.
Leadership is mentoring others, and allowing yourself to be mentored.
Leadership is promoting collaboration and building community.
Leadership is knowing when to step back, when there is an affront to your integrity.
Leadership is being transformational.
Leadership is being an advocate, for patients, for colleagues, and for the public health.
Leadership is being a trusted professional.
Leadership is motivating others to act.
Leadership is embracing change and effecting change as needed.
Leadership is acclaiming others’ successes and assisting them to achieve their
Leadership is YOU!
How many of these leadership attributes describe you?
Which of these leadership attributes do you want to develop or strengthen?
What is your plan to make it happen?
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Better Vision, for a better life!
In medical practice since 1919, Wolfe Eye Clinic is a multi-specialty clinic providing
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At Wolfe Eye Clinic, we create Better Vision for a Better Life.
Due to growth, Wolfe Eye Clinic and Wolfe Surgery Center has immediate openings
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Employees receive great wages, paid travel time and mileage, along with a
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We are looking for motivated candidate that desire to learn in a fast-paced
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Responsibilities include rooming patients, administering injections, assisting
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Current Iowa nursing license is required, and clinical nursing experience is preferred.
If you are interested in being a part of a quality driven organization while receiving
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