Nevada RNformation - March 2011
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<strong>March</strong> 2021 • Volume 30 • Number 2<br />

www.nvnurses.org<br />

<strong>Nevada</strong><br />

RNFORMATION<br />

Inside<br />

articles<br />

2 NNA’s Call to Serve<br />

6 NNA is recruiting for the position<br />

of Executive Director!<br />

6 Healthy Nurses<br />

7 Get engaged for the 81st <strong>Nevada</strong><br />

Legislative Session!<br />

9 Support the Next Generation of<br />

NV Nurses<br />

15 Welcome Board of Nursing<br />

Director of Education<br />

16 The Quest for Warm and Fuzzies<br />

in the Age of Physical Distancing<br />

17 INTERVIEW: Through the Eyes of a<br />

<strong>Nevada</strong> Nurse<br />

18 Best Practices for Online Meetings<br />

19 UNLV Nursing Program Jumps<br />

into Top 10 Best Online Programs<br />

20 The Effects of COVID-19 on Organ<br />

Donation and Transplantation<br />

21 Focus on Fighting the Pandemic,<br />

Not Each Other<br />

regular features<br />

4 NNA’s Current and New<br />

Members!!<br />

8 Research & EBP Corner<br />

10 NNA Environmental Health<br />

Committee<br />

12 Antimicrobial Stewardship -<br />

Infection Prevention<br />

14 Nurses in the News<br />

22 <strong>Nevada</strong> Nurses Foundation<br />

THE OFFICIAL PUBLICATION OF THE NEVADA NURSES ASSOCIATION<br />

The <strong>Nevada</strong> Nurses Association is a constituent member of the American Nurses Association<br />

Quarterly publication direct mailed to approximately 1,000 RNs and LPNs and<br />

delivered electronically via email to 40,000 RNs and LPNs in <strong>Nevada</strong><br />

The President’s Message<br />

Looking for Some ‘Good Trouble’<br />

Mary Bondmass, Ph.D., RN, CNE, President,<br />

<strong>Nevada</strong> Nurses Association<br />

Mary.bondmass@unlv.edu<br />

The American Nurses Association (ANA) Enterprise<br />

joins the World Health Organization (WHO) and<br />

global colleagues in extending the Year of the Nurse<br />

into 2021. This recognition builds on the increased<br />

visibility of nurses’ contributions from 2020 and ANA’s<br />

expansion of National Nurses Week to Nurses Month<br />

in May.<br />

Dear Colleagues,<br />

Isn’t it great that NNA’s<br />

parent organization (ANA), and<br />

the WHO are extending the<br />

Year of the Nurse into 2021? It<br />

truly is a cause for celebration,<br />

but with this celebration let<br />

us not forget to reflect on our<br />

roots and those that came<br />

before us in our profession. Of<br />

course, upon reflection, the<br />

first name that may come to<br />

most of us might be Florence Nightingale; however,<br />

was Nightingale the paragon of virtue that the majority<br />

of our nursing textbooks indicate, or did she have<br />

racist views and actions, as some of our colleagues at<br />

home and across the globe opine? What, Florence was<br />

a racist?! Say it isn’t so! Well, here is where the ‘good<br />

trouble’ comes begins.<br />

While it may not be comfortable to do so, let's<br />

start this conversation, and you decide the issue of<br />

Nightingale's actions for yourself. Investigating our<br />

roots honestly and transparently makes us all fully<br />

informed to offer our opinions credibly.<br />

My thoughts (not speaking for NNA, but myself) are<br />

that while many of Nightingale’s writings and behaviors<br />

may not have been outright racist, given the time in<br />

history she lived. Still, she was not anti-racist either,<br />

and some may say that if you are not anti-racist, you<br />

may be what you are not against. A more inclusive<br />

and historically correct approach might include other<br />

nurses, who were contemporaries of Nightingale’s, e.g.,<br />

Mary Seacole, as exemplars of our profession’s heroes.<br />

I challenge anyone surprised or shocked by the<br />

previous paragraphs I have written to check out<br />

the resources provided and join me in some 'good<br />

The President’s Message continued on page 3<br />

current resident or<br />

Presort Standard<br />

US Postage<br />

PAID<br />

Permit #14<br />

Princeton, MN<br />

55371<br />

Mark Your Calendars<br />

Nominations for NNA positions Now Open!!<br />

Tea on the Comstock! June 26, 2021

Page 2 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>March</strong>, April, May 2021<br />

NNA Mission Statement<br />

The <strong>Nevada</strong> Nurses Association promotes professional nursing practice through NNA’s Call to Serve<br />

continuing education, community service, nursing leadership, and legislative<br />

activities to advocate for improved health and high quality health care for citizens of<br />

<strong>Nevada</strong>.<br />

NNA State Board of Directors<br />

Mary D. Bondmass, PhD, RN, CNE Mary.bondmass@unlv.edu ..............President<br />

Nicki Aaker, MSN, MPH, RN, CNOR, PHCNS-BC naaker@aol.com .......Vice President<br />

Sherrie Sherk-Olson, BSN .........................................Secretary<br />

Glenn Hagerstrom, PhD, APRN, FNP-BC, CNE ghagersrom@unr.edu .........Treasurer<br />

Arvin Operario ...........................................Director at Large<br />

Christa Secord, MSN, FNP-BC cjsecord@gmail.com ................Director at Large<br />

Norman Wright, RN, BSN, MS info@f441.com ...................Director at Large<br />

Darlene Bujold, BSN, RN darlene.cbrn@gmail.com ...............President, District 1<br />

Margaret Covelli, DPN, RN Margaret.covelli@umcsn.com ..........President, District 3<br />

Editorial Board<br />

Managing Editor, Linda Bowman, RN, lbowman@nvnurses.org<br />

Print Editor, Kathy Ryan, MSN, RN-BC<br />

Dear NNA Member,<br />

NNA invites you to share your talents, insight, and experience to help shape the<br />

future of nursing and healthcare. Consider becoming a candidate for a volunteer<br />

position with <strong>Nevada</strong> Nurses Association!<br />

NNA has been the voice for nursing in <strong>Nevada</strong> for over 100 years. The purposes<br />

of NNA are to advance and uphold excellence, integrity, and autonomy in the<br />

practice of nursing, and to advocate for accessible, quality health care for all. Serving<br />

on an NNA board allows you to actively play a part in activities that impact nursing<br />

practice and health care.<br />

Mary D. Bondmass, PhD, RN, CNE<br />

Tracey Long PhD, APRN-BC<br />

Lisa Pacheco, MSN, RN<br />

Bernadette Longo, PhD, RN, FAAN<br />

Vicki Walker DNP, BS RN<br />

Are you interested in submitting an article for publication in RNFormation?<br />

Please send it in a Word document to us at lbowman@nvnurses.org. Our<br />

Editorial Board will review the article and notify you whether it has been<br />

accepted for publication.<br />

If you wish to contact the author of an article published in RNFormation,<br />

please email us and we will be happy to forward your comments.<br />

www.nvnurses.org<br />

Published by:<br />

Arthur L. Davis<br />

Publishing Agency, Inc.<br />

Goals of NNA:<br />

• Promote and uphold excellence and integrity for the profession of nursing<br />

• Educate and advocate for accessible, affordable quality healthcare for clients/<br />

consumers<br />

• Monitor the evolving role of the professional nurse<br />

The following positions are open for the 2021 year.<br />

• State Level: a candidate for a Director (three-yr term)<br />

• Northern <strong>Nevada</strong> - District One: seeking candidates for the positions of<br />

President-elect (one-year. Then moves into President position for two-year<br />

term) Vice President, and multiple Directors-at Large (all two-yr terms)<br />

• Southern <strong>Nevada</strong> - District Three: Treasurer (two-yr term) and two<br />

Directors at Large<br />

• ANA Membership Assembly (June) in Washington DC: seeking<br />

candidates for one Representative & one alternate (one-yr terms). To<br />

fully represent the goals and mission of NNA, candidates should actively<br />

participate in at least one Committee. This position only serves in the summer<br />

for the Assembly, expenses are covered.<br />

• Nominations Committee: seeking three candidates (one-yr terms)<br />

What are the responsibilities of board members?<br />

The Boards meet monthly for ~90 minutes over the internet for reports and<br />

discussion.<br />

Board members are instrumental in carrying out the goals and objectives of NNA.<br />

All of which benefit <strong>Nevada</strong> nurses. Officers may be asked to volunteer to assist in<br />

committee work.<br />

How do I become a candidate? Self-nominate~!<br />

Click on link below to submit your candidacy form.<br />

Candidacy Forms<br />

Thank you for considering serving the nurses of <strong>Nevada</strong> - you are<br />

appreciated!<br />

If you'd like more information, please contact NNA Director of Operations Linda<br />

Bowman at lbowman@nvnurses.org.

<strong>March</strong>, April, May 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 3<br />

The President’s Message continued from page 1<br />

trouble’ by either submitting an op-ed for the next<br />

RNFormation or making a comment online.<br />

Below is a verbatim article from Nursing Clio, an<br />

open access, peer-reviewed, collaborative blog that<br />

presents the case against Nightingale and a link to<br />

where you can join the conversation. Given that<br />

the ANA and the WHO have continued the Year of<br />

the Nurse into 2021, I believe it is appropriate for us<br />

to carry on the conversation that gained so much<br />

attention with Nightingale’s 200th birthday celebration.<br />

The Racist Lady with the Lamp<br />

By Natalie Stake-Doucet<br />

SOURCE: Nursing Clio 11/5/2020<br />

Nursing historiography is centered on whiteness.<br />

Even worse, nursing history revolves largely around<br />

a single white nurse: Florence Nightingale. This,<br />

unfortunately, doesn’t mean nurses understand who<br />

Nightingale was. There are nurse historians doing<br />

incredible and diverse work, but in general, nursing,<br />

both as a profession and as an academic discipline,<br />

promotes a view of Nightingale based in a culture of<br />

white supremacy rather than historical facts. Here,<br />

I make explicit Nightingale’s role in British colonial<br />

violence by analyzing some of her writings on the<br />

British colonies. This history allows us to better discuss<br />

the consequences of her legacy in nursing.<br />

Indigenous traditions offended the “cleanliness”<br />

ideal of Victorian Britain. Miasma theory conveniently<br />

supported British supremacy and was a pillar of<br />

public health until the end of the 19th century. More<br />

importantly, it was a political weapon to destroy<br />

Indigenous health and wellness traditions, as it labelled<br />

anything non-British or non-Christian as “filthy.” It is<br />

inaccurate to assume that when Nightingale speaks<br />

of “cleanliness” it is somehow detached from its<br />

ideological roots. When she speaks of cleanliness, filth,<br />

or foulness, there is always an implicit Christian bias.<br />

She could never have supported any form Indigenous<br />

health practices because they were not based in<br />

Christian values.<br />

Natalie Stake-Doucet is a registered nurse, activist,<br />

and PhD candidate. She is passionate about nursing<br />

history, and she studies the socio-political structure of<br />

hospitals in relation to nurses and nursing work.<br />

You can add your opinions and start some ‘good<br />

trouble’ for yourself at the link below<br />

https://historynewsnetwork.org/article/178101 or<br />

https://meaww.com/year-of-the-nurse-2020-florencenightingale-racist-anti-feminist-legacy-allegations-innursing-200<br />

An opposite view and a response from the<br />

Nightingale Society can be found at the link below.<br />

http://nightingalesociety.com/published-articles/<br />

defending-florence-nightingales-reputation-kai-tiakinursing-new-zealand/<br />

Some other references are below to help you with<br />

your journey into what may be ‘good trouble’ for you<br />

too.<br />

‘A Letter From Florence Nightingale’. (1924, 1 July). Kai Tiaki:<br />

The Journal of the Nurses of New Zealand, Vol 17(3),<br />

p123. https://paperspast.natlib.govt.nz/periodicals/<br />

KT19240701.2.35<br />

Rodgers, J A. (1985). Nursing Education in New Zealand,<br />

1883 to 1930: The Persistence of the Nightingale<br />

Ethos. MA thesis, Massey University, Palmerston North.<br />

https://mro.massey.ac.nz/handle/10179/6274<br />

McDonald, L. (Ed.). (2004). Florence Nightingale on Public<br />

Health Care – Collected Works of Florence Nightingale,<br />

Volume 6. Waterloo, Canada: Wilfrid Laurier University<br />

Press, pp 183-5.<br />

Nightingale, F., & National Association for the Promotion<br />

of Social Science. (1865). Note on the aboriginal races<br />

of Australia: a paper read at the annual meeting of<br />

the National Association for the Promotion of Social<br />

Science, held at York, September, 1864. Retrieved from<br />

http://hdl.handle.net/2027/uc2.ark:/13960/t07w6pn5d<br />

Waitangi Tribunal. (2019). Hauora – Report on Stage One<br />

of the Health Services and Outcomes Kaupapa Inquiry.<br />

Lower Hutt: Legislation Direct. Retrieved from https://<br />

forms.justice.govt.nz/search/Documents/WT/wt_<br />

DOC_152801817/Hauora%20W.pdf<br />

Please send comments to this article to the<br />

RNFormation Editor (lbowman@nvnurses.org), and let<br />

us know if we can publish your comment,<br />

Respectfully yours,<br />

Nightingale and Colonialism<br />

What is rarely discussed in nursing history is<br />

Nightingale’s racism and her political role in the<br />

genocide of Indigenous people under British rule. She<br />

counseled many key political figures and her writings<br />

on the subject show that she was a staunch supporter<br />

of British colonialism, even with the knowledge of the<br />

death and destruction left in its wake. She believed<br />

Indigenous lives were a small price to pay for the<br />

expansion of the British Empire. Although some of her<br />

contemporaries recognized the brutality of the colonial<br />

system, Nightingale believed imposing British culture<br />

to be necessary. Anything else, she believed, “would<br />

be simply preserving their barbarism for the sake of<br />

preserving their lives.” 1<br />

This racist statement by Florence Nightingale is one<br />

of many. Thanks to digitization efforts, her writings<br />

are now accessible, and it’s easy to find sources that<br />

reveal Nightingale’s racism. She was steadfast in her<br />

belief of the supremacy of white Christian culture. By<br />

her own accounts, Nightingale considered Indigenous<br />

peoples to be inferior, and the British state to be a<br />

“civilizing” force. The quote above is from Nightingale’s<br />

Sanitary Statistics of Native Colonial Schools and<br />

Hospitals, published in 1863, a report commissioned<br />

by the Colonial Office of the British government. In it,<br />

she concluded that the high death rates of Indigenous<br />

people in colonial schools and hospitals reflected the<br />

haste of British authorities to assimilate them. She<br />

felt assimilation should be more gradual in order to<br />

minimize the death toll, but she had no issue with the<br />

death toll itself: “Every society which has been formed<br />

has had to sacrifice large proportions of its earlier<br />

generation to the new conditions of life arising out of<br />

the mere fact of change.” 2<br />

In the report, Nightingale defended the deaths<br />

of Indigenous children in the Canadian precursors<br />

to residential schools: “There is nothing in the school<br />

education as described in the returns, sufficient to<br />

account for the special prevalence of tubercular<br />

diseases in these schools. The causes must probably be<br />

looked for in the close foul atmosphere of the native<br />

dwelling.” 3 Her comments on the Canadian situation<br />

were indicative of her larger position: that the deaths<br />

of Indigenous people was due to habits of Indigenous<br />

people themselves, and that British rule catalyzed a<br />

process of “decay” already in motion.<br />

Victorian “Cleanliness” and Miasma Theory as<br />

Ideological Weapons<br />

It is important to understand the meaning of<br />

cleanliness within the Victorian era and for Nightingale.<br />

Cleanliness was a synonym for purity, and the Victorian<br />

rituals attached to it came with a sense of godly<br />

supremacy. 4 It is beyond the scope of this article to<br />

discuss the ideological roots of the term, but it went<br />

hand in hand with the miasma theory of disease,<br />

which Nightingale believed until the end of her life.<br />

Miasma theory held that bad smells and filth generated<br />

disease. Filth was not just physical, it was also moral.<br />

For example, under miasma theory, Nightingale<br />

believed sex workers embodied evil that spontaneously<br />

generated disease. As Nightingale explained: “When<br />

we obey all God’s laws as to cleanliness,…, health is<br />

the result. When we disobey, sickness.” 5<br />

One of the few pictures of Nightingale<br />

contemporary, Mary Seacole, (above photo by an<br />

unknown author in the public domain)<br />

Mary Bondmass, Ph.D., RN, CNE<br />

President, <strong>Nevada</strong> Nurses Association<br />

Visit nursingALD.com today!<br />

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Page 4 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>March</strong>, April, May 2021<br />

NNA'S CURRENT AND NEW MEMBERS!!<br />

Aaron Cook<br />

Aaron Bellow<br />

Abbie Purney<br />

Abbigail Holman<br />

Abigail Guevarra<br />

Adaobi Ezeanolue<br />

Aileen Thompson<br />

Akeisha King<br />

Alannah Bradley<br />

Alejandrina Diaz<br />

Alexandria Crossley<br />

Alexis Coe<br />

Aliah Metzger<br />

Alijandra Cruz-Tokar<br />

Alina Aidinova<br />

Alisa Patton<br />

Allison Saunders<br />

Allison Basta<br />

Allyson Waldron<br />

Alonzo Thornton<br />

Althea Bongolan<br />

Alyssa Alden<br />

Amanda Stachlewitz<br />

Amanda Carpenter<br />

Amanda Frazier<br />

Amanda Berumen<br />

Amanda Tye<br />

Amanda Tobey<br />

Amanda Gant<br />

Amanda Horton<br />

Amanda Sweet<br />

Amanda Novick<br />

Amber Federizo<br />

Amie Ruckman<br />

Amy Hamtak<br />

Amy Bitto-Lange<br />

Amy Kunz<br />

Amy Sandstrom<br />

Amy Hollingshead<br />

Amy Cercone<br />

Amy Lelenko-Cain<br />

Amy Chaffin<br />

Amy Lynch<br />

Ana Rizzo<br />

Anastasia Ludel<br />

Andrea Travella<br />

Andrea Felesina<br />

Angela Holdridge<br />

Angela Turner<br />

Angela Hurt<br />

Angela Brock<br />

Angela Amar<br />

Angela Shinoskie<br />

Anita Kuo<br />

Anna Apolonio<br />

Anna Anders<br />

Anna Smith<br />

Anna Marie Zamora<br />

Annabelle Pascual<br />

Anne Wallace<br />

Anne Margaret Bexon<br />

Anne-Marie Schenk<br />

Annette Asbury<br />

Antionette Serrano<br />

Antoinette Carlos<br />

Antoinette Mullan<br />

Antonette Vergara<br />

Antonia Mcnamara<br />

April Sullivan<br />

April Daul<br />

April Hontanosas<br />

Ariana Johnston<br />

Ariana Davis-Leonard<br />

Ariana Monin<br />

Arkay Marie Lising<br />

Arlene Diaz<br />

Arlygen Ring<br />

Arvin Operario<br />

Ashlee Venancio<br />

Ashley Akren<br />

Ashley Rhoades<br />

Ashley Swarowski<br />

Athelda Abrams<br />

Atheni Sevilla<br />

Aubree Carlson<br />

Audrey Hyland<br />

Audry See<br />

Autum Kapinkin<br />

Autumn Gardner<br />

Azeb Gebrekidan<br />

Barbara Barrett<br />

Barbara Parish<br />

Barbara Schneider<br />

Barbara Tanner<br />

Barbara Carlton<br />

Barbara Ruscingno<br />

Barbara Gross<br />

Beatrice Razor<br />

Beatrice Sanders<br />

Becky Czarnik Rn Ms<br />

Becky Tisue<br />

Beena Thomas<br />

Bernadette Sisnorio<br />

Bernadette Longo<br />

Beth Unger<br />

Beth Ennis<br />

Beth Hock<br />

Bethany Viglietta<br />

Bettina Alvarez<br />

Beverly Thielke<br />

Bobbi Shanks<br />

Bobbie Nemetz<br />

Bobette Ready<br />

Bonnie Carlisle<br />

Bonnie Spears<br />

Bonnie Glynn<br />

Brandee Shipman<br />

Brandi Jackson<br />

Brandie Oros<br />

Brandon Young<br />

Brandon Roberts<br />

Brandy Mebane<br />

Breanna Di Pinto<br />

Brenda Leake<br />

Brenda Sanchez<br />

Brenda Bien<br />

Brenda Delgado<br />

Brenda Harding<br />

Brian Gotiangco<br />

Brian Hubbard<br />

Brieanne Anderson<br />

Brittney Allen<br />

Byron Ricana<br />

Camella Stephens<br />

Cameron Duncan<br />

Cami Carr<br />

Camilla Camburn<br />

Candace Grubb<br />

Candace Facio<br />

Candace Camelon<br />

Candi Tondoneh<br />

Carina Deras<br />

Carla Baizas<br />

Carlota Cinco<br />

Carol Vickrey<br />

Carol Rose<br />

Carol Swanson<br />

Carol Panknin<br />

Carol Kutz<br />

Carol Mancilla<br />

Caroline Devano<br />

Carolyn Sabo<br />

Carrie Hintz<br />

Casey Peay<br />

Cassandra Trummel<br />

Catherine Ferguson<br />

Catherine Gonzalez<br />

Catherine Dellinger<br />

Catherine Dinauer<br />

Catherine Fuller<br />

Cathy Fry<br />

Cathy Downey<br />

Cathy Adams<br />

Cecilia Haney<br />

Cecilia Fleming<br />

Celia Lamdagan<br />

Celine Cinq<br />

Chamonix Mcelliott<br />

Charina Mae Picornell<br />

Charissa Sheppeard<br />

Charlice Barrett<br />

Charlton Lovett<br />

Chasity Rodrigues<br />

Chelsea Dague<br />

Chelsea Takara<br />

Chere Gooch-Martin<br />

Cherie Dimaguila<br />

Cherilyn Campbell<br />

Cherry Grace Daelto<br />

Cheryl Martin<br />

Cheryl Lake<br />

Cheryl Dela Cruz<br />

Cheryl Broussard<br />

Chiline Tan-Birket<br />

Christa Secord<br />

Christal Kercheval<br />

Christelle Tchouanang<br />

Christi Keliipio<br />

Christina Mcguire<br />

Christina Dyer<br />

Christina Weinrick<br />

Christine Obregon<br />

Christine Windle<br />

Christine Sterrett<br />

Christine Pebbles<br />

Christine Barnett<br />

Christopher Rice<br />

Christy Raynes<br />

Christy Pacini<br />

Chrystine Revelli<br />

Chukwuemeka Obilor<br />

Chyann Porterfield<br />

Ciara Richman<br />

Cindi Freeborn<br />

Cindy Merkley<br />

Cindy Ramiscal<br />

Clarisse Clutario<br />

Clarizza Tamayo<br />

Claudia Buco<br />

Clem Victor Manrique<br />

Connie Evans<br />

Connie Ngo<br />

Conrado Yutuc<br />

Constance Petronella<br />

Constanza Bridges<br />

Corine Watson<br />

Corrine Pace<br />

Crishiell Calina<br />

Crista Mae Therese<br />

Yamomo<br />

Cristina Mosqueda<br />

Cristy Thomas<br />

Crystal Martinez<br />

Cynthia Sitar<br />

Cynthia Fuentes<br />

Cynthia Brandt<br />

Cynthia Davis<br />

Cynthia Morris<br />

Cynthia Gorham<br />

Cynthia Privitera<br />

Cynthia Veal<br />

Cynthia Repella-Allen<br />

Cynthia Parker<br />

Cynthia Lewis<br />

Dahlia Dixon<br />

Daisy Milan<br />

Damaris Pinto-Florez<br />

Damiana Choi<br />

Dana Soma<br />

Dana Nelson<br />

Daniella Kinyua<br />

Danielle Mcvickers<br />

Danielle Evans<br />

Danielle Smith<br />

Danielle Kockos<br />

Danielle Planas<br />

Danielle Norris<br />

Dao Huynh<br />

Darius Thompson<br />

Darla Brightmon<br />

Darlene Salvo<br />

Darnell Caldwell<br />

Dat Nguyen<br />

Dave Tyrell<br />

David Alvarez<br />

David Troy<br />

David Morrow<br />

Dawn Lipkin<br />

Dawn Cook<br />

Dawn Taylor<br />

Dawn Judman<br />

Dawn Elton<br />

Deanna Schouten<br />

Debi Ingraffia-Strong<br />

Deborah Ain<br />

Deborah Sanborn<br />

Deborah Carrabello<br />

Deborah Miller<br />

Debra Minagil<br />

Debra Toney<br />

Debra Robison<br />

Debra Scott<br />

Debra Ruiz<br />

Debra Fredericks<br />

Demetria Smith-Jordan<br />

Denis Williams<br />

Denise Horvath<br />

Denise Rawson<br />

Denise Dorsa<br />

Denise Rowe<br />

Denise Ortega<br />

Denisha Lang<br />

Desiree Crawford<br />

Destiny Lacefield<br />

Diana Brandes<br />

Diane Mcginnis<br />

Diane Hughes<br />

Diane Paugh<br />

Dianne Bulanadi<br />

Dinah Lynn Sinang<br />

Dionneshele Fears<br />

Dolores Sangiuliano<br />

Dona Rivera<br />

Donna Mattson<br />

Donna Wirthlin<br />

Donna Shiffer<br />

Donna Sandie<br />

Donna Green<br />

Donna Wollman<br />

Donniejoy Henderson<br />

Doretha Smith<br />

Dorita Sondereker<br />

Dorothy Adams<br />

Dorothy Reynolds<br />

Dorshey Dean<br />

Dorthia Daudier<br />

Douglas Turner<br />

Dr. Jon Vrban<br />

Dr. Remeliza Tukay<br />

Draven Martinez<br />

Ebony Balele<br />

Eden Hicks<br />

Edna Dela Cruz<br />

Eghosa Odobo<br />

Eireen Dumlao<br />

Elaine Peneyra<br />

Eldann Galacgac<br />

Elena Ellen Maborang<br />

Elisabeth Higgins<br />

Eliza Fountain<br />

Elizabeth Fildes<br />

Elizabeth Chau<br />

Elizabeth Cogan<br />

Elizabeth Brox<br />

Elizabeth Tissier<br />

Elizabeth Carrasco<br />

Elizabeth Dotson<br />

Elizabeth Kelemen<br />

Elizabeth Temean<br />

Elizabeth Plathe<br />

Elizabeth Wilkes<br />

Eljena Peterson<br />

Ellaine Alvarez<br />

Ellen Williams<br />

Ellen Deprat<br />

Ellen Lumagui<br />

Ellen M. Lewis<br />

Elsie Jimenez<br />

Emelie Grady<br />

Emerald Heldt<br />

Emily Zuch<br />

Emily Sharpe<br />

Emily Darling<br />

Emily Hannemann<br />

Emily Brown<br />

Emlyn Escobar<br />

Emmanuel Umunnakwe<br />

Enrica Lumapas<br />

Eric Ferrari<br />

Erica Daniels<br />

Erickia Thompson<br />

Erin Gostin<br />

Erin Grable<br />

Erin Taranto<br />

Erin Sandoval<br />

Erin Miyashiro<br />

Erlene Cudiamat<br />

Esmeralda Clark<br />

Eugena Umunnakwe<br />

Eunice Ugochukwu<br />

Eunsung Kim<br />

Eva Maria Rivera<br />

Evangeline Gallagher<br />

Evelyn Lundell<br />

Evelyn Bruner<br />

Fatimah Tripathi<br />

Fatina Mcneil-Pitts<br />

Felicia Haywood<br />

Felicia Talamante<br />

Felicidad Taduran<br />

Flora Sayson<br />

Flordelis Delacruz<br />

Frances Meyer<br />

Frances Dacquisto-Sloan<br />

Francis Torres<br />

Franklin Manas<br />

Gabrielle Peterson<br />

Gail Mcguill<br />

Gail Rattigan<br />

Gamaliel Digan<br />

Geneva Watkins<br />

Genoa Vaughn<br />

Geoconda Hughes<br />

Gershon Bernal<br />

Geselle Corpuz<br />

Gina Johnson<br />

Gina Orr<br />

Gina Olson<br />

Gisela Flores<br />

Gladys Easterling<br />

Glenn Hagerstrom<br />

Gloria Castillo<br />

Gloria Williams<br />

Gloria Means<br />

Gloria Mandel<br />

Grace Hills<br />

Greela Joy Yadao<br />

Gregory Walters<br />

Greny Maliakal<br />

Greta Mann<br />

Greta Castro<br />

H Rebecca Fuller Gray<br />

Haley Schwade<br />

Hannah Kohler<br />

Haydee Jeanette Nuno<br />

Heather Bonny<br />

Heather Gingell<br />

Heather Arch<br />

Heather Lopez<br />

Heather Mcintyre<br />

Heather Sabol<br />

Heather Spaulding<br />

Helen Opdyke<br />

Helmi Olsen<br />

Hilary Trumbo-Cress<br />

Hillarie Lara<br />

Holly Pelka<br />

Homer Tuazon<br />

Iana Tongol<br />

Ilene Hobson<br />

Iliana Britt<br />

Ingela Hadad<br />

Ingrid Rivera<br />

Irene Ines<br />

Irene Thompson<br />

Ivonne Cruz<br />

Jackie Chapman<br />

Jackie Alexander<br />

Jacqueline Hartert<br />

Jacqueline Crittendon<br />

Jacqueline Ladanga<br />

Jacqueline Wenceslao<br />

Jacqueline Jeffery<br />

Jacqueline Canteberry<br />

Jacquelyn Niesen<br />

Jacquese Simpson<br />

Jaime Young<br />

Jama Deyoe<br />

Jamie Lewis<br />

Jan Pennington<br />

Jan Michael Arceo<br />

Jana Nerz<br />

Jane Sadorra<br />

Jane Horth<br />

Janecein Amadi<br />

Janee Elliott<br />

Janelle Willis<br />

Janelle Kyles<br />

Janet Bryant<br />

Janet Leinen<br />

Janet Handley<br />

Janet Ford<br />

Janet Purcell Gray<br />

Janice Robert<br />

Janice Owens<br />

Janice Iida<br />

Janice Muhammad<br />

Jannette Balderrama<br />

Jasmin San Luis<br />

Jasmin Matutis<br />

Jasmine Mielnik<br />

Jay Bondoc<br />

Jayanthi Henry<br />

Jayson Paulo Agaton<br />

Jazmyn Duncan<br />

Jean Zlomke<br />

Jean Lyon<br />

Jeanette Lambdin<br />

Jeanette Sivon<br />

Jeanne Reeves<br />

Jeannine Clark<br />

Jeffrey Whetstone<br />

Jemia Martin<br />

Jenifer Krause<br />

Jenifer Enriquez<br />

Jenna Clark<br />

Jennie Supple<br />

Jennifer Mahlberg-Grant<br />

Jennifer Pfannes<br />

Jennifer Obieta<br />

Jennifer Archuleta<br />

Jennifer Brown<br />

Jennifer Finley<br />

Jennifer Han<br />

Jennifer Roy<br />

Jennifer Vernon-<br />

Gonzalez<br />

Jennifer Inocencio<br />

Jennifer Morris<br />

Jennifer Padilla<br />

Jennifer Miceli<br />

Jennifer Abordo<br />

Jennifer Gilligan<br />

Jennifer Grant<br />

Jennifer Vroman<br />

Jennifer Kawi<br />

Jennifer Strawn<br />

Jennifer Millet<br />

Jennifer Harrington<br />

Jennifer Landberg<br />

Jenny Kelly<br />

Jeremy Friend<br />

Jerrilynn Woolston<br />

Jessamine Gale Pantig<br />

Jessica Bliven<br />

Jessica Danyan<br />

Jessica Harbauer<br />

Jessica Grannis<br />

Jessica Richard<br />

Jessica Valle<br />

Jessica Mcintosh<br />

Jessica Robinson<br />

Jessyca Luke<br />

Jesus V Cornelio Catre<br />

Jhouleen Angelika<br />

Tiamzon<br />

Jiaqing Li<br />

Jill Mcatee<br />

Jirair Baghdassarian<br />

Joann Nardoni<br />

Joann Bruno<br />

Joann Rupiper<br />

Joanna Valdes<br />

Joanna Patrice Johnson<br />

Jodi Epp<br />

John Coldsmith<br />

John Lilley<br />

John Reynolds Ii<br />

John Paul Mercado<br />

Jon Failla<br />

Jordana Janjua<br />

Jordyn Belli<br />

Joseph Armbruster<br />

Joseph Barnes<br />

Joseph Taylor Jr<br />

Joy Patrick<br />

Joy Gombeda<br />

Joy Banzon-Villamora<br />

Joyce Tabios<br />

Joyce Damiano<br />

Juancho Trinidad<br />

Juanita Jones<br />

Judith Hochberger<br />

Judy Ward-Bzoskie<br />

Judy Araque<br />

Julia Somerville-Reeser<br />

Julia Olson<br />

Julia Oleary<br />

Julie Johnson<br />

Julie Monteiro<br />

Julie Faulkner<br />

Julie Bassett<br />

Julie Fitzgerald<br />

Julie Worman<br />

Julie Kewanyama<br />

Julius Caezar Henzon<br />

K. Lynberg<br />

Kaela Friedman<br />

Kaitlyn Cummings<br />

Kalita Silvestre<br />

Karen Meskimen<br />

Karen Eisenberg<br />

Karen Lanham-Evans<br />

Karen Bearer<br />

Karen Valdez<br />

Karen Laux<br />

Karen Edwards<br />

Karen Anne Wolfe<br />

Karen Marie Beardsley<br />

Kari Schleidt<br />

Karisa Son<br />

Karma Florence<br />

Katelyne May Atijera<br />

Katherine Kauble<br />

Katherine Visman<br />

Katherine Franco<br />

Kathleen Mohn<br />

Kathleen Zaski<br />

Kathryn Schaller<br />

Kathryn Moran<br />

Kathryn Tickell<br />

Kathy Webb<br />

Kathy Goldsworthy<br />

Katie Bomberger<br />

Katie Green<br />

Katrina Alvarez<br />

Katrina Perkins Davis<br />

Katrina Hardin-James<br />

Katylynn Hymas<br />

Kayla Edwards<br />

Kayla Mcmillen<br />

Keiona Malone<br />

Kelli Wray<br />

Kelly Mecham<br />

Kelly Bucalo<br />

Kelly Sinkovec<br />

Kelly Thompson<br />

Kelly Morrow<br />

Kelly Jane Villaroman<br />

Keri Piper-Colonna<br />

Killeen Bell<br />

Kim Griffin<br />

Kimberlee Bliek<br />

Kimberley Kammann<br />

Kimberly Falco<br />

Kimberly Kandt<br />

Kimberly Cathcart<br />

Kimberly Simpson<br />

Kimberly Maribbay<br />

Kintana Wixom<br />

Kirsten Landis<br />

Kristen Grunerud<br />

Kristie Meacham<br />

Kristienne Porter<br />

Kristin Hayden<br />

Kristin Gillman<br />

Kristina Spitale-Efstratis<br />

Kristine Coleman<br />

Kristine Hafner<br />

Kristyn Cisilino<br />

Kyle Preece<br />

Kylie Lewis<br />

Lanette Kimmel<br />

Lara Carver<br />

Lara Morales<br />

Larissa Africa<br />

Lashawna Franklin<br />

Latricia Perry<br />

Lattrice Dickson<br />

Launa Curtis<br />

Laura Harsh<br />

Laura Martin<br />

Laura Czajkowski<br />

Lauren Olsen<br />

Laurice Jones<br />

Lavon Elias-Jones<br />

Layne Sellars<br />

Lea Pauley<br />

Leah Churchill<br />

Leah Delim<br />

Leah Gaitho<br />

Lee Anna Bristol<br />

Leidy Chavez-Guzman<br />

Leigh Bohn<br />

Leila Cruz-Aguon<br />

Leila Romero<br />

Lena Nguyen<br />

Lenette Mapes<br />

Leona Munro<br />

Leslee Bridget Magnus<br />

Leslie Decrona<br />

Leti Guerra-Scheib<br />

Leticia Faust<br />

Lia Harris<br />

Linda Zahrt<br />

Linda Bowman<br />

Linda Silvestri<br />

Linda Jacks<br />

Linda Jacobson<br />

Linda Andrews<br />

Linda Rittenburg<br />

Linda Banks<br />

Lindsey Butcher<br />

Lindsey Enriquez<br />

Lindsey Wharton<br />

Linetta Barnes<br />

Lisa Dinwiddie<br />

Lisa Thomas<br />

Lisa Eldridge-Murphy<br />

Lisa Dunkelberg<br />

Lisa Brown<br />

Lisa Schaffer<br />

Lisa Todd<br />

Lisa Weinshenker<br />

Lisa Hiatt<br />

Lisa Engleman<br />

Lisa Jonkey<br />

Lisa Marie Pacheco<br />

Lloyzel Faye Yung<br />

Lordlita Wirtz<br />

Lori Roorda<br />

Lori Eustis<br />

Lori Baumann<br />

Lori Marhanka<br />

Lori Candela<br />

Lorraine Noonan<br />

Lorraine Bonaldi<br />

Lorraine Jill De Borja-<br />

Campbell<br />

Lorri Lantz<br />

Lowryanne Vick<br />

Luis Vidana<br />

Luis Rodriguez<br />

Luz Aragon<br />

Lya Taylor<br />

Lynn Taylor<br />

Lynn Von Schlieder<br />

Ma Renzel Therezna<br />

Caparros<br />

Mackenzie Butler<br />

Maddalena Fontein<br />

Madelin Torres<br />

Mae Nekoba<br />

Maelaurece Plaza-Cross<br />

Magdalena Rodriguez<br />

Malcolm Aquino<br />

Manasseh Chibwe

<strong>March</strong>, April, May 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 5<br />

Maquette Thompson<br />

Marc Amorelli<br />

Marcie Zajac<br />

Marco Cerda<br />

Margaret Calavan<br />

Margaret Sanger<br />

Margaret Covelli<br />

Margo Baxter<br />

Maria Elario<br />

Maria Sampang<br />

Maria Amezcua-Huerta<br />

Maria Angela Nina Vela<br />

Maria Concepcion<br />

Benito-Spero<br />

Maria Gina Agnir<br />

Maria Mernina April<br />

Montero<br />

Maria Monica Aragon<br />

Maria Rizel Sturgell<br />

Maria Rosario Wood<br />

Mariah Dasilva<br />

Marian Gnandt<br />

Maribel Gomez<br />

Maribeth Fontanilla<br />

Maricel Olan<br />

Marie Luback-Neves<br />

Marie Reyrao<br />

Marie Snook<br />

Marife Aczon-Armstrong<br />

Marilyn Getty<br />

Marisa Wilkinson<br />

Marisa Leah Dela Rosa<br />

Marisela Castorena<br />

Marizel Yukee<br />

Marjeana Lampson<br />

Marjorie Adams<br />

Mark Ferratt<br />

Markeeta Araujo<br />

Markita Griffin<br />

Marlene Kramer<br />

Marphyrose Galang<br />

Marsha Park<br />

Martha Hobby<br />

Martha Drohobyczer<br />

Mary Mackenzie<br />

Mary Courtney<br />

Mary Bondmass<br />

Mary Field<br />

Mary Manoharan<br />

Mary Jingeleski<br />

Mary Whitield<br />

Mary Headley<br />

Mary Huntly<br />

Mary Flint<br />

Mary Mcconville<br />

Mary Earl<br />

Mary Reed<br />

Mary Foster<br />

Mary Denisse Toribio<br />

Maryangelique Sampson<br />

Maryann Tolzien<br />

Maureen Barnes<br />

Maureen Nolen<br />

Mavirginia Espanol<br />

Maya Washington<br />

Maylene Culanag<br />

Meg Hopper<br />

Megan Remien<br />

Megan Gates<br />

Megan Gill<br />

Megan Martinez<br />

Megan Testa<br />

Meia Ford<br />

Meilan Daguman<br />

Melanie Lunghi<br />

Melanie Sharpley<br />

Melanie Lentz<br />

Melany Roque<br />

Melba Schwinghamer<br />

Melisa Smith<br />

Melissa Ridella<br />

Melissa Dorman-Ellis<br />

Melissa Washabaugh<br />

Melissa Cook<br />

Melissa Rosales<br />

Melody Talbott<br />

Melody Tulloss<br />

Mercedes Ocan<br />

Merete Egloff<br />

Merle Williams<br />

Mi’lan Jones<br />

Michael Mcevoy<br />

Michael Bass<br />

Michael Yazinka<br />

Michael Loehr<br />

Michael Basinger<br />

Michael Rice<br />

Michael Cowles<br />

Michele Rath<br />

Michele Arce<br />

Michele Wijangco<br />

Michele (Shelly) Alfaro<br />

Michelle Dunne<br />

Michelle Bland<br />

Michelle Dix<br />

Michelle Albaran<br />

Michelle Sarvela<br />

Michelle Wagner<br />

Michelle Podlesni<br />

Michelle Reynolds<br />

Michelle Dirks<br />

Mika Martin<br />

Mindy Triola<br />

Miriam Volpin<br />

Mojisola Balogun<br />

Mona Beerbower<br />

Moneshia Perkins<br />

Monica Ranada<br />

Monilisa Aquino<br />

Monty Gross<br />

Myra Davis-Alston<br />

Myra Tomas<br />

Nadia Luna<br />

Naitte Jordan<br />

Nanci Quinn<br />

Nancy Bartlett<br />

Nancy Legaspina<br />

Nancy Gubler<br />

Nancy Nurse<br />

Nancy Brewster-Meredith<br />

Nasim Akbari<br />

Natalie Nicholson<br />

Natasha Ross<br />

Natasha Tretheway<br />

Nathan Fowler<br />

Nayeli Melendez<br />

Nelly De Dios<br />

Nemia Chiang<br />

Nethaniah Isip<br />

Ngozi Ajiri<br />

Nicholas Muir<br />

Nichole Fritel<br />

Nicola Aaker<br />

Nicole Caturay<br />

Nicole Gooden<br />

Nicole Courts<br />

Nicole Carr<br />

Nicole Hunt<br />

Nicole Gregorio<br />

Nicole Vaughn<br />

Nicole Miskiewicz-Nelson<br />

Nobuko Wallace<br />

Nonette Chee<br />

Noni Hayman<br />

Norah Lusk<br />

Norman Wright<br />

Nubia Garbutt<br />

Nutchar Ploymee<br />

Odessa Gregorio<br />

Ofelia Esguerra<br />

Ogonnaya Onyema<br />

Okechukwu Olisa<br />

Olga Bienvenue<br />

Oluyemisi Adedotun<br />

Omana Olickal<br />

Ozioma Nwosu<br />

Pamela Johnson<br />

Pamela Adzima<br />

Pamela Guerra<br />

Pamela Burnley<br />

Pamela French<br />

Patrice Gallagher<br />

Patricia Crepps<br />

Patricia Fries<br />

Patricia Strobehn<br />

Patricia Prevosto<br />

Patricia Busch<br />

Patricia Brown<br />

Patricia Alpert<br />

Patricia Correll<br />

Patricia Simmers<br />

Patrick Bucayu<br />

Paula Williams<br />

Peggie Black<br />

Peggy Ince<br />

Peggy Lee<br />

Peggy Kamper<br />

Perla Labastida Espejel<br />

Petal Codrington-Martial<br />

Phoebe Sampang<br />

Precious Achuff<br />

Priscilla Nelson<br />

Priscilla Austin<br />

R Danessa Rebello<br />

Rachel Likes<br />

Rachel Michaels<br />

Rachel Juell<br />

Rachel Moore<br />

Rachel Linnecke-<br />

Councilman<br />

Rachell Ekroos<br />

Rachell Anne Agas<br />

Ramona Chatman<br />

Rannie Deguzman<br />

Raquel Welsh<br />

Raynette John<br />

Rebecca Black<br />

Rebecca Gansberg<br />

Rebecca Roleff<br />

Rebecca Pierce<br />

Rebecca Graham<br />

Rebecca Cormier<br />

Rebecca Hayslett<br />

Regina Mcferren<br />

Reginald Reyrao<br />

Remedios Jallorina<br />

Renate Jeddahlyn Flores<br />

Rene Wood<br />

Renee Villarruel<br />

Renee Page<br />

Renee Hinojosa<br />

Renee Todd<br />

Renegade Scott-Feagle<br />

Rhea Bautista<br />

Rhigel Tan<br />

Rhonda Strunk<br />

Rica Santa Maria<br />

Rich Janel Suanes<br />

Richard Becker<br />

Rita Siu<br />

Rizza Marie Tawatao<br />

Robert Lopez<br />

Robert Welch<br />

Robert Fox<br />

Robert Erickson<br />

Robert Sullivan-Fisher<br />

Robert Briseno<br />

Robin Hoover<br />

Robin Branham<br />

Roger Patricio<br />

Roland Villareal<br />

Rona Yee<br />

Rona Divinagracia<br />

Ronald Mirano<br />

Ronnie Bordador<br />

Rosalba Renteria<br />

Rosalyne Reynolds<br />

Roscelle Jhoyce Minoza<br />

Rose Hettinga<br />

Roseann Colosimo<br />

Rosemary Witt<br />

Rosemary Gharibian<br />

Rosemary Thuet<br />

Rosetta Longstreet<br />

Roshele Ward<br />

Rowena Mananquil<br />

Rowena Dioquino<br />

Ruth Politi<br />

Sabina Grimes<br />

Sabrina Bratcher<br />

Sally Jost<br />

Sally Adams<br />

Samantha Jones<br />

Samantha Thornton<br />

Samantha Chanel De<br />

Vera<br />

Samantha-Rose Threats<br />

Sandra Turner<br />

Sandra Rodriguez<br />

Sandra Talley<br />

Sandra Doolin<br />

Sandra Pierre-Louis<br />

Sara Maul<br />

Sara Mcknight<br />

Sarah Moore<br />

Sarah Johnson<br />

Sarah Linaman<br />

Sarah Webb<br />

Sarah Herbert<br />

Sarah Mccalden<br />

Sarah Maciolek<br />

Sarah Bussmann<br />

Sarah Rose Nelson<br />

Saundra Hart<br />

Savalla Mcleod<br />

Schlene Peet<br />

Sequoyah Tomlinson<br />

Tomlinson<br />

Shana Blakely<br />

Shannon Murray<br />

Shannon Grella<br />

Shannon Chartrey<br />

Sharean Oxley<br />

Sharon Freier<br />

Sharon Szeman<br />

Sharon Mann<br />

Sharon Oetting<br />

Sharon Attaway-Hett<br />

Shasta Taylor<br />

Shaun Hasty<br />

Shauna Aranton<br />

Shaunta Brown<br />

Shawn Deal<br />

Shawn Joseph<br />

Shawna Senart<br />

Sheery Villagracia<br />

Sheila Parker<br />

Sheimon Capiendo<br />

Shelby Temple<br />

Shelia Bien<br />

Shelly Nicola<br />

Shelly Soto<br />

Sheri Park<br />

Shermeka Tubbs<br />

Sheron Williams-Nevens<br />

Sherri Yagoubi<br />

Sherri Lindsey<br />

Sherri Howell<br />

Sherrian Miles<br />

Sherrie Olson<br />

Sherry Stofko<br />

Sheryl Bennett<br />

Sheryl Cipollini<br />

Shirin Nazarian<br />

Shirley Caldwell-Butts<br />

Skyler Basanez<br />

Sonia Wyatt-Wright<br />

Sonja Poppenhagen<br />

Sophia Student<br />

Stacey Earley<br />

Stacey Hunt<br />

Stacey Lea Spahn<br />

Staci Thompson<br />

Staci Garner<br />

Stacy Springgate<br />

Stacy Rust<br />

Stacy Thaler<br />

Stacy Wilson<br />

Stacy Demitropoulos<br />

Stephanie Latta<br />

Stephanie Parker-Hyman<br />

Stephanie Prather<br />

Stephanie Crim<br />

Stephanie Dress<br />

Stephanie Curry<br />

Stephanie Herrera<br />

Stephanie Guerrero<br />

Stephanie Hollister<br />

Stephanie Melcher<br />

Stephanie Neder<br />

Stephen Lester<br />

Steven Knott<br />

Susan Hubbard<br />

Susan Becker<br />

Susan Vanbeuge<br />

Susan Growe<br />

Susan Ervin<br />

Susan Englen<br />

Suzann Gordon<br />

Suzanne Duroy<br />

Suzanne Dessaints<br />

Suzanne Elnagar<br />

Sylvia Fernandez<br />

Tabbly Taylor<br />

Tamara Duff<br />

Tamara Mette<br />

Tamasha Benson<br />

Tamera Allred<br />

Tami Beckett<br />

Tammam Whalen<br />

Tammy Bambic<br />

Tanya Lazorwitz<br />

Tanya Liscio<br />

Tara Alcid<br />

Taylor Perry<br />

Tendai Gombe-Lane<br />

Teresa Mercado<br />

Teresa Praus<br />

Terri Vinson<br />

Terry Stanley<br />

Thelma Pacheco<br />

Theresa Gordon<br />

Theresa Brown<br />

Theresa Spina<br />

Theresa Carr<br />

Therese Rohling<br />

Tiffani Lenzi<br />

Tiffany Febre<br />

Tiffany Ramirez<br />

Tiffany Vincent<br />

Tiffiny Cicero<br />

Timothy Hargrove<br />

Tina Procter<br />

Tina Verret<br />

Todd Erickson<br />

Todd D’braunstein<br />

Todd Isbell<br />

Tomas Walker<br />

Toni Orr<br />

Tonya Bryant<br />

Tori Davis<br />

Toya Lewis<br />

Tracey Mccollum<br />

Tracey Silva<br />

Tracey Johnson-Glover<br />

Tracie Gust<br />

Tracy Harig<br />

Trina Hammond<br />

Trinette Broom<br />

Tristen Wydeman<br />

Trixia Mora<br />

Tymeeka Davis<br />

Tysha Jones<br />

Valan Kam<br />

Valeria Melendez Estrada<br />

Valerie Jakubos<br />

Valerie Castaneda<br />

Vanessa Obando<br />

Vanessa Parker<br />

Vanessa Izquierdo<br />

Veda Sargent<br />

Vera Sverdlovsky<br />

Veronica Dunn-Jones<br />

Veronica Brady<br />

Veronica Niki James<br />

Vicki Walker<br />

Vicki Wolms<br />

Vickie Mcpherson<br />

Vicky Lang-Catlin<br />

Victoria Volz<br />

Virginia Enns<br />

Virginia Williamson<br />

Virginia Hayes<br />

Visminda Tagbo<br />

Vivian Smith<br />

Wanda Sheppard<br />

Wanda Macfarlane<br />

Winnie Chua<br />

Xandee Shirley Bernabe<br />

Xenia Daffodil Valles<br />

Yarleny Roa-Dugan<br />

Yashmine Ballesteros<br />

Yvette Medlin<br />

Yvonne Anderson<br />

Yvonne Modarres<br />

Zachary Bunker<br />

Zachary Ashton<br />

Zhuoya Mai

Page 6 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>March</strong>, April, May 2021<br />

Healthy Nurses<br />

Tracey Long PhD, MSN, APRN-BC, CCRN<br />

Feb 2021<br />

NNA is recruiting for the position of<br />

Executive Director!<br />

The board of the <strong>Nevada</strong> Nurses Association voted to invest in hiring a full-time<br />

Executive Director. (30-39 hours). Below is a link to the job position description.<br />

<strong>Nevada</strong> Nurses Association has such an opportunity to make a difference to nurses<br />

in <strong>Nevada</strong>. Hiring an experienced Executive Director will bring NNA to the forefront<br />

in guiding positive and productive changes for nurses in our state.<br />

At a minimum, the right candidate should have excellent communication skills,<br />

strong organizational and project management skills, the ability to develop detailed<br />

plans, familiarity with association management organizations and processes.<br />

Click here for Job Description<br />

If you are interested in the Executive Director's position, please reach out to<br />

President Mary Bondmass at mary.bondmass@unlv.edu or Director of Operations,<br />

Linda Bowman at Lbowman@nvnurses.org.<br />

Dismantling Systems of Oppression<br />

Patrice Hester-Harper, M.Ed.<br />

Assistant Dean for Administration, Outreach, and Engagement<br />

School of Nursing University of <strong>Nevada</strong>, Las Vegas<br />

This February, UNLV School of Nursing successfully concluded its new speaker<br />

series, “Conversations with Leaders on Dismantling Systems of Oppression.”<br />

Open to all, the limited event consisted of four 1-hour virtual lectures, each with a<br />

different special guest and topic to discuss systemic racism and how to neutralize it.<br />

Through historical and modern examples, speakers presented scenarios and possible<br />

solutions to address these issues.<br />

Our list of special guests comprised of experts from both the U.S. and Canada<br />

who are nationally recognized and leaders in their respective fields. Speakers<br />

included PhD candidate Natalie Stake-Doucet (Examining Florence Nightingale’s<br />

complicated history); Drexel University Professor Dr. Roberta Waite (Achieving Health<br />

Equity); Emory University Associate Professor Dr. Kylie Smith (Race and Racism in<br />

U.S. Healthcare), and UNLV Professor Dr. Tyler Parry (Implicit Bias).<br />

The origin of the Speaker Series was born in the aftermath of renewed national<br />

calls for ending oppression in all societal facets in 2020. School of Nursing Dean<br />

Angela Amar proposed a format to address these issues within SON. But the tools<br />

learned to combat racism had additional value for healthcare professionals and<br />

students; nurses frequently encounter racial disparities on the frontlines. While<br />

the scope of the Series was not specifically for nurses and healthcare, audience<br />

members (which were primarily nursing-related) could use the information and<br />

consider applying the proposed solutions in their own careers.<br />

Furthermore, UNLV Nursing’s Speaker Series reinforced its commitment to<br />

diversity, equity and inclusion in addition to continuing its mission of educating<br />

nurses to meet the health care needs of <strong>Nevada</strong> and beyond. UNLV School<br />

of Nursing offers both undergraduate (traditional and accelerated) tracks and<br />

nationally recognized online graduate programs. In 2021, U.S. News and World<br />

Report ranked the SON Online Master’s program 7th in the nation, up from 11th in<br />

2020. Additionally, UNLV Nursing was named a Center of Excellence in 2019 by the<br />

National League for Nursing.<br />

One lesson we all learned in 2020 was how precious and<br />

fragile our health is. Nurses on the forefront saw firsthand<br />

how delicate life can be as they navigated the challenges<br />

of too many patients and too little personal protective<br />

equipment. We also learned how tender our mental health<br />

can be and many who we never even considered would<br />

have threats to their mental well-being. The silver lining<br />

in a chaotic world threatened by a global pandemic is the<br />

awareness and focus again on our health. Ironically, nurses<br />

who work in the healthcare industry are often not very<br />

healthy individuals. Many of us tend to work too hard, sleep<br />

too little, fail to empty our bladders regularly, eat sugary<br />

comfort foods during difficult shifts to reward ourselves, and justifiably resist aerobic<br />

exercise after a long 12-hour shift. Then its wash, rinse and repeat to do it again<br />

the next day. No wonder nurses often feel exhausted, worn-out and have brain<br />

fog. Even before the pandemic and added emotional trauma and stress on nurses a<br />

study in 2017 revealed up to 63% of hospital nurses claim burnout and are at risk of<br />

compassion fatigue (Crewe, 2017).<br />

The American Nurses Foundation, which is the philanthropic arm of the American<br />

Nurses Association has issued a call to arms to improve the health of our nation’s<br />

nurses. The initiative has given us practical tools to help us succeed. The Wellbeing<br />

initiative was developed for nurses by nurses. The Foundation partnered<br />

with the American Nurses Association (ANA), the Emergency Nurses Association<br />

(ENA), the American Association of Critical Care Nurses (AACN), and the American<br />

Psychiatric Nurses Association (APNA) to address the physical and emotional<br />

stresses our nation’s nurses have experienced due to the worldwide pandemic. The<br />

digital resources include the format to join online groups and express themselves<br />

in narrative journaling. Resources and tools also include online forums such as<br />

peer-to-peer conversations, hotlines, learning cognitive processing techniques and<br />

learning preventive actions such as stress reduction, and mindfulness. The hotlines<br />

and peer conversations are held by volunteer nurses as the healers reach out to heal<br />

each other during the difficult times of the Covid-19 pandemic. The partnership<br />

also developed two apps for easy download on smart phones called the “Happy<br />

App” and “Moodfit” mobile app to support nurses in their individual wellness<br />

goals and habits of health. The apps can be found on your smart phone store or<br />

for download at https://bit.ly/35qLV7x. Additionally, the Well-being Initiative offers a<br />

self-assessment tool and mental health hotlines for nurses.<br />

Information about the full initiative can be accessed at https://www.<br />

nursingworld.org/news/news-releases/2020/american-nurses-foundation-launchesnational-well-being-initiative-for-nurses/<br />

In addition to the mental health and wellness nurses face personally, we also face<br />

questions from patients, friends and neighbors about which supplements should<br />

be taken to hopefully prevent Covid-19 infections or strengthen our own immune<br />

system. There is a wide variety of opinions and limited evidence-based studies to<br />

declare definitively which supplements should be taken. Nurses must be well<br />

educated and informed to effectively educate our public.<br />

Reputable resources to learn about such supplements as Vitamin D3, Zinc,<br />

Vitamin C, Biotin, colloidal silver, herbals and botanicals can be found at the<br />

following sites:<br />

o National Center for Complementary and Integrative Medicine: http://nccih.<br />

nih.gov.<br />

o Natural Medicines: https://naturalmedicines.therapeuticresearch.com/.<br />

o FDA tainted product list: https://www.accessdata.fda.gov/scripts/sda/<br />

sdNavigation.cfm?filter=&sortColumn=1d&sd=tainted_supplements_<br />

cder&page=1.<br />

o Tips for Dietary Supplement Users: https://www.fda.gov/Food/<br />

DietarySupplements/UsingDietarySupplements/ucm110567.htm.<br />

o Tips for Older Dietary Supplement Users: https://www.fda.gov/Food/<br />

DietarySupplements/UsingDietarySupplements/ucm110493.htm.<br />

o HerbList App (free from NIH): https://www.nccih.nih.gov/health/herblist-app.<br />

o Merck Manual Online Chapter on Dietary Supplements (for consumers and<br />

health care professionals): https://www.merckmanuals.com/professional/<br />

special-subjects/dietary-supplements/overview-of-dietary-supplements.<br />

o Dietary Supplements Part 1: https://youtu.be/SwFalkgN_1Q.<br />

o Dietary Supplements Part 2: https://youtu.be/4L-cCzMtKx8.<br />

References<br />

Crewe, C. (2017). The Watson room: Managing compassion fatigue in clinical nurses<br />

on the front line. Virginia Henderson Global Nursing Repository. https://sigma.<br />

nursingrepository.org/handle/10755/621267?show=full<br />

West Hills Hospital located in Reno, NV, a leader in<br />

the treatment of behavioral, mental health care and<br />

substance abuse treatment is seeking FT/PT/PRN<br />

Registered Nurses to implement the nursing process<br />

as it relates to our programs.<br />

Visit www.westhillshospital.net and click on<br />

CAREERS to apply.<br />

To access electronic copies of the<br />

<strong>Nevada</strong> <strong>RNformation</strong>, please visit<br />

http://www.nursingALD.com/publications

<strong>March</strong>, April, May 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 7<br />

Get engaged for the 81st <strong>Nevada</strong> Legislative Session!<br />

powerful and meaningful to your elected official.<br />

A quick search of the <strong>Nevada</strong> legislature NELIS<br />

system revealed nine current bills with the word<br />

"nursing." Another search of "health care" revealed 35<br />

bills. It is still early in the session, and many bill draft<br />

requests are still in progress, and the expectation<br />

is that more bills will come forward, impacting<br />

health care, patient access to care, and nursing as a<br />

profession. The final budgets will also have an impact<br />

on our patients enrolled in Medicaid and other state<br />

programs.<br />

Take time to look at the <strong>Nevada</strong> Legislature website<br />

to learn about the bills in front of your elected officials.<br />

Attend the committee hearings and general sessions<br />

utilizing the YouTube channel the legislature has set<br />

up this year. You may also offer public comment in<br />

hearings to be part of the process.<br />

There are many ways to be engaged in the legislative<br />

process, and this year is no less important. It may feel<br />

a little different this year because we aren’t there in<br />

person on Nurses Day at the Legislature, but your<br />

voices are no less diminished. I would say the opposite.<br />

This year we need to advocate for our profession, our<br />

patients, and our health in every way possible. See you<br />

at the legislature!<br />

Reference:<br />

Sebelius, S. (2020). For <strong>Nevada</strong> lawmakers in 2021, it’s<br />

all about the budget. Las Vegas Review-Journal,<br />

December 28, 2020. Downloaded from https://<br />

www.reviewjournal.com/news/politics-and-<br />

government/2021-legislature/for-nevada-lawmakers-in-<br />

2021-its-all-about-the-budget-2232390/<br />

APRNs at the Legislature 2019<br />

L-R: Susan VanBeuge, DNP, APRN; Maileen Ulep,<br />

APRN; Sheryl Giordano, DNP, APRN; Teresa<br />

Praus, DNP, APRN<br />

Susan S. VanBeuge,<br />

DNP, APRN, FNP-BC, FAANP<br />

As you read this article, the 81st (2021) <strong>Nevada</strong><br />

Legislature has been in session for nearly two months.<br />

While the session's delivery looks a little different<br />

via online meetings and various means to connect,<br />

the work of the legislative process continues to move<br />

forward.<br />

The importance of nurses' engagement in the<br />

legislative process is no different today than in the 1st<br />

session. As a state, we face many challenges in health<br />

care, budgets, and the economy (Las Vegas Review-<br />

Journal, 2020). The pandemic has stretched over the<br />

last year, causing strain on an already overburdened<br />

system and shining a light on the fissures in areas of<br />

access to care.<br />

In 2020, nurses were ranked as the most trusted<br />

profession for the 19th year in a row. This year,<br />

nurses' position rose by 4% since the 2019 poll. Not<br />

surprising, as this year, nurses rolled up their sleeves in<br />

every corner of practice and did their work. From the<br />

bedside, to leadership, advanced practice, and mass<br />

volunteering, nurses performed above and beyond<br />

capacity.<br />

As a group, we have a powerful voice and stories<br />

to share. We are an evidence-based profession and<br />

discipline with our underpinnings in science and<br />

communication. The experiences from bedside to<br />

boardroom make our voices powerful to the legislature<br />

members as subject matter experts. If you have not<br />

looked up your representatives, take time to know who<br />

your State Senator and State Assembly representatives<br />

are. Once identified, send them an email, and introduce<br />

yourself as their constituent. Let them know you are<br />

a nursing professional and what you do and offer<br />

to be their subject matter expert on nursing. Get to<br />

know your elected representative so that when you<br />

have a question, comment, or opinion on how they<br />

should vote on a bill you’re interested in, then you<br />

have established the relationship to have a meaningful<br />

conversation pertinent to the issue on the table. After<br />

you’ve taken time to meet your state elected officials,<br />

next write to your national representatives. They have<br />

your voice in Washington D.C. at our Nations Capitol,<br />

impacting laws and governance over practice, parity in<br />

pay, and many access to care issues affecting advanced<br />

practice nurses.<br />

Our elected officials want to hear your experiences,<br />

stories, and opinions. Your advocacy for the profession<br />

is where the strength lies as an individual citizen. Our<br />

professional groups are out there advocating for us<br />

as nursing professionals, but your individual voice is<br />

Legal Representation for<br />

Medical Professionals<br />

If the board calls, we have the answer!<br />

Our attorneys have been protecting the livelihood of<br />

doctors and nurses in <strong>Nevada</strong> for over 40 years.<br />

Clark Hill is a multidisciplinary, national law firm that<br />

draws on our attorneys’ industry and policy knowledge,<br />

our deeply held shared values, and a global network of<br />

premier firms and advisors to provide innovative legal<br />

solutions and client-service excellence worldwide.<br />

www.clarkhill.com<br />

Contact John A. Hunt, Esq.<br />

702.697.7512<br />

jhunt@clarkhill.com

Page 8 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>March</strong>, April, May 2021<br />

Research & EBP Corner<br />

Nursing Application of Light Sedation for Mechanically<br />

Ventilated Patients<br />

Mary Bondmass, Ph.D., RN, CNE<br />

This RNF feature presents abstracts of research and evidence-based practice (EBP)<br />

projects completed or spear-headed by nurses or student nurses in <strong>Nevada</strong>. The<br />

focus is on new evidence (i.e., research) or the translation of evidence (i.e., EBP) in<br />

Practice, Education, or Research. Submissions are welcome and will be reviewed by<br />

the RNF editorial board for publication; send your abstract submission in a similar<br />

format used below to mary.bondmass@unlv.edu<br />

Kelsey Swanson, DNP(c) University of <strong>Nevada</strong>, Reno<br />

Featured EBP in this edition is Kelsey Swanson’s DNP<br />

project. Kelsey has been a cardiac ICU nurse for five years.<br />

She is currently completing her DNP at Orvis School of<br />

Nursing at the University of <strong>Nevada</strong> Reno. Kelsey is in the<br />

Adult Gerontology Acute Care Nurse Practitioner Track and<br />

will be graduating in May. An abstract of her final project is<br />

below.<br />

Kelsey intends to pursue a career as a hospitalist NP.<br />

Background: Patients with acute respiratory failure are<br />

routinely cared for in intensive care units (ICUs). Decompensation in respiratory<br />

status can be related to a primary pulmonary etiology or secondary to another<br />

acute illness. Many of these patients require the use of a ventilator to maintain<br />

adequate oxygenation. Historically, the use of pharmacologic sedatives in intubated<br />

patients has been common practice. Growing evidence suggests that these<br />

medications extend intubation duration, hospital lengths of stay, delirium, and<br />

long-term cognitive and mood disorders (Peitz et al., 2013). Literature supports<br />

the use of analgosedation, which focuses on pain management before sedation in<br />

mechanically ventilated patients (Devlin et al., 2018).<br />

New research and literature are available that condones the use of lighter sedation<br />

of mechanically ventilated patients. Traditional sedation practices have been shown to<br />

be harmful to patients as they are linked to poor short-term and long-term patient<br />

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outcomes. Intubation times and ICU length of stay are prolonged with heavy sedation<br />

(Treggiari et al., 2009). Heavy sedation puts patients at risk for further complications.<br />

Cognitive function and mood disorders can also be negatively impacted by deep<br />

sedation in mechanically ventilated patients (Treggiari et al., 2009).<br />

Purpose/Methods: This project aimed to advocate and collaborate on behalf of<br />

the nursing discipline in a quality improvement initiative. "Sedation Light" refers to<br />

medication changes to achieve the desired Richmond Agitation and Sedation Score<br />

(RASS) of -1 to +1, as well as the clinical challenges associated with this change.<br />

“Sedation Light” utilizes fentanyl, propofol, and dexmedetomidine. This project<br />

worked to improve nursing care and moral related to “Sedation Light." Specifically,<br />

his project aimed to work with an interdisciplinary team and implement evidencebased<br />

changes to improve nursing care related to "Sedation Light." This project<br />

provided support, education, and advocacy for nursing throughout this transition in<br />

sedation practices to change nursing culture.<br />

Adult learning theory (Knowles, 1973) and Kolcaba’s theory of comfort (Krinsky<br />

et al., 2014) guided this project's implementation.<br />

A special interest group of “Sedation Light Implementation Champions” (SLIC)<br />

was assembled under the DNP student's leadership. This group served as a resource<br />

for nursing staff and was available on most shifts. SLIC supported nursing staff<br />

during shift work and advocated for appropriate application of sedation light<br />

flow sheets compiled by pharmacy. SLIC was closely involved with education and<br />

supportive efforts for staff nurses.<br />

Education for nursing staff was a primary component of this DNP project.<br />

Education was key to nurse endorsement of reducing sedation in mechanically<br />

ventilated patients. Numerous forms of education were offered to allow nurses to<br />

choose which format is most beneficial to them. Presentations of analgosedation,<br />

pain and sedation assessment, and long-term effects of heavy sedation were<br />

presented in unit staff meetings. Pamphlets and tip sheets were created, and SLIC<br />

completed in-services. These individual or small group learning sessions allow for<br />

an intimate discussion of challenges specific to individual patients. Troubleshooting<br />

has been available through these in-services and can help make bedside nurses feel<br />

supported in their challenges.<br />

A unit reference binder for “Sedation Light” was also created. It contains<br />

several original studies for nurses curious about the efficacy of reduced sedation.<br />

This literature can often be difficult and lengthy to read. For that reason, there are<br />

condensed articles explaining the benefits of light sedation, easy-to-read PADIS<br />

guidelines, and copies of "Sedation Light" flowsheets. These quick references allow<br />

for prompt location of applicable information and return to regular nursing duties.<br />

Offering extensive studies and condensed tip sheets allow nurses to seek the level of<br />

knowledge they desire without overwhelming.<br />

Results: This project resulted in an order set that decreased variability in<br />

sedation drugs used. Implementing a facility-wide policy to support the efforts of<br />

"Sedation Light" was a primary objective of this DNP project, and this objective was<br />

accomplished. Qualitative data related to “Sedation Light” was collected during<br />

daily ventilator rounds. These data include Richmond Agitation and Sedation Score<br />

(RASS), standardized sedation awakening trials (SAT), spontaneous breathing trials<br />

(SBT), and mobility as it relates to sedation strategies. Early on in this project, in<br />

April 2019, all patients that qualified for a SAT had one done. In February 2020,<br />

79% of patients qualified for a SAT, and 74% completed them. In July 2020, 86%<br />

of patients were eligible for SAT, but only 74% had an SAT. From this data set, even<br />

fewer patients are having these SATs paired with an SBT. The best month of paired<br />

SAT and SBT performance is April of 2019, where 57% of eligible patients received<br />

an SAT and SBT.<br />

Conclusion/Implication for Practice: This project aimed to directly change<br />

nursing culture and implement scholarly literature and research into practice.<br />

Creating a culture change related to sedation levels in mechanically ventilated<br />

patients is invaluable for patient outcomes. The nursing discipline must realize its<br />

responsibility to evolve practice in the clinical setting. The nursing discipline has<br />

valuable input for quality improvement initiatives. Nurses should seek involvement<br />

in large practice changes, even when initiated by other disciplines. Interdisciplinary<br />

collaboration is key to organizational success and improved patient outcomes.<br />

Abbreviated References<br />

Devlin, J. W., Skrobik, Y., Gélinas, C., Needham, D. M., Slooter, A. J. C., Pandharipande,<br />

P. P., Watson, P. L., Weinhouse, G. L., Nunnally, M. E., Rochwerg, B., Balas, M. C.,<br />

Boogaard, M., Bosma, K. J., Brummel, N. E., Chanques, G., Denehy, L., Drouot, X.,<br />

Fraser, G. L., Harris, J. E., …, Alhazzani, W. (2018). Clinical practice guidelines for the<br />

prevention and management of pain, Agitation/Sedation, delirium, immobility, and<br />

sleep disruption in adult patients in the ICU. Critical Care Medicine, 46(9), e825-e873.<br />

doi:10.1097/CCM.0000000000003299<br />

Knowles, M. S. 1. (1973). The adult learner: A neglected species. Houston [Tex.]: Gulf Pub.<br />

Co.<br />

Krinsky, R., Murillo, I., & Johnson, J. (2014). A practical application of Katharine Kolcaba's<br />

comfort theory to cardiac patients. Applied Nursing Research, 27(2), 147-150.<br />

doi:10.1016/j.apnr.2014.02.004<br />

Peitz, G. J., Balas, M. C., Olsen, K. M., Pun, B. T., & Ely, E. W. (2013). Top 10 myths<br />

regarding sedation and delirium in the ICU. Critical Care Medicine, 41(9 Suppl 1),<br />

S46-S56. doi:10.1097/CCM.0b013e3182a168f5<br />

Treggiari, M. M., Romand, J., Yanez, N. D., Deem, S. A., Goldberg, J., Hudson, L.,<br />

Heidegger, C., & Weiss, N. S. (2009). Randomized trial of light versus deep sedation<br />

on mental health after critical illness. Critical Care Medicine, 37(9), 2527-2534.<br />

doi:10.1097/CCM.0b013e3181a5689f

<strong>March</strong>, April, May 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 9<br />

Support the Next Generation of NV Nurses<br />

Iris Isabel Martinez<br />

Karen Nava<br />

The <strong>Nevada</strong> Nursing Student Association (NVNSA)<br />

is holding their 3rd Annual Virtual Conference on<br />

Saturday, May 29th, from 8 a.m. to 2 p.m., and you are<br />

absolutely welcome to join the next generation of NV<br />

nurses! This year's convention motto is "No limits to<br />

success," and we hope students leave the conference<br />

empowered and eager to start their nursing careers!<br />

We will offer the first NVNSA Conference scholarship<br />

to a nursing student, and the funds raised from<br />

registration fees will help supplement this scholarship.<br />

For the first time, we will be inviting high school<br />

students to learn more about the life of a nursing<br />

student and the beauty of the nursing profession. The<br />

conference will include a resilience key-note speaker,<br />

an NCLEX review, a guest panel of hospital recruiters,<br />

resume and interview advice, nursing vendors, raffle<br />

prizes, and much more!<br />

How to Support NVNSA:<br />

1. Join us on May 29th: Your presence will<br />

inspire students because we look up to you. At<br />

a certain point in our lives, we have interacted<br />

with a nurse or nurse(s) who have changed<br />

our lives. NVNSA and its members would be<br />

honored to include you in our conference. The<br />

registration fee for RN’s is $25. Register Here!<br />

2. Donate to NVNSA: We kindly welcome all<br />

donations. If you would like to donate, please<br />

email conference.nvnsa@gmail.com that way, we<br />

can adequately thank you at the conference and<br />

spotlight you in our virtual convention booklet.<br />

3. Please write an article for our 2021<br />

Virtual Convention Booklet: The beauty of<br />

nursing includes a lifetime of learning and the<br />

opportunity to engage with different specialties<br />

and providers. With that being said, if you<br />

would like to write an article regarding the<br />

nursing profession or even an article to support<br />

students, we would love for you to please reach<br />

out. We will be happy to include your article in<br />

the convention booklet and our website! Please<br />

email conference.nvnsa@gmail.com for more<br />

information.<br />

4. Follow us on Social Media: Stay up to date<br />

with all things NVNSA via our social media<br />

platforms: @nevadansa on Instagram & @<br />

NVStudentNurses on Facebook.<br />

Sponsorship Plans: Professional nursing<br />

organizations, hospital recruiters, nursing schools<br />

(undergraduate and graduate), companies, and vendors<br />

are encouraged to engage with the future generation<br />

of <strong>Nevada</strong> nurses. A highlight of our conference is<br />

allowing exhibitors to advertise their services and<br />

network with students. If your organization/company<br />

is interested in participating in the conference, please<br />

register at the following link: http://events.r20.<br />

constantcontact.com/register/event?llr=vuz87kdab&oei<br />

dk=a07ehl4fow20bd79667.<br />

Kobe Bryant once said, “The most important thing<br />

is to try and inspire people so that they can be great<br />

in whatever they want to do,” the NVNSA team strives<br />

to uplift one another and provide as much guidance,<br />

wisdom, and opportunities as possible because we<br />

all are a team. Nursing is not an individual profession.<br />

Nursing requires teamwork, trust, and the ability to<br />

know that you are not alone and that you can ask<br />

for help. This conference serves as a "New Grad RN<br />

Bootcamp," a "Get to know the nursing profession,"<br />

but most importantly, this conference is meant to serve<br />

as a reminder that there is NO LIMIT TO SUCCESS!

Page 10 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>March</strong>, April, May 2021<br />

NNA Environmental Health Committee<br />

Sustainable Fashion: moving from disposable fashion consumption to<br />

ecological conservation and ethical labor practices<br />

The fashion industry has one of the highest<br />

environmental impacts of a commercial business on<br />

the planet. The production of clothing results in the<br />

use of agricultural fertilizers, pesticides, and fresh water<br />

sources to grow the crops for fibers, along with toxic<br />

chemicals used in dyeing and fabric preparation.<br />

Did you know that Americans toss ~14 million tons<br />

of clothing each year, or an astounding 80 pounds per<br />

person (Miller, 2016; Council for Textile Recycling)? This<br />

fabric waste and the eventual disposal of clothing through<br />

incineration or landfill deposits are hazardous to the<br />

environment. Incineration of clothing releases airborne<br />

pollution from the chemical dyes or fibers, and degrading<br />

cloth in a landfill releases methane gas and chemicals into<br />

the water shed. Therefore, efforts are needed to reduce<br />

environmental contamination from the fashion industry.<br />

Keys to reducing these adverse impacts include (a) limiting<br />

the amount of clothing produced to what is actually<br />

needed by the population, (b) reusing or recycling existing<br />

clothing and fabrics, (c) sustaining the life of a garment,<br />

and (d) manufacturing garments from eco-friendly fiber<br />

sources. All these actions can lower the carbon footprint<br />

from the industry. To bring these actions to fruition, it is<br />

first important to understand the barriers faced to making<br />

a change to a more sustainable clothing industry.<br />

Temporal Aspects of Fashion<br />

Historically, seasonal changes in fashion were<br />

driven by top designers and released to the industry<br />

through the infamous “runway’ fashion shows. These<br />

new “high end” style releases were made far ahead<br />

of time and the subsequent copycats needed months<br />

to manufacture cheaper replicas and get them on<br />

the racks in retail stores. “Slow fashion” reflected the<br />

significant time lag that occurred. Fashion was seasonal<br />

and challenged the consumer with spending more each<br />

year to stay in style.<br />

Nowadays, the speed of changes in fashion has<br />

accelerated across the whole industry – from highend<br />

to inexpensive in-style clothing. “Fast fashion” is<br />

manufacturing replicas of high-end style clothes that<br />

are cheaply produced and cheaply priced. These clothes<br />

are sourced through global production chains then<br />

sold through store chains to consumers. The result is<br />

excessive fabric waste that causes global toxic pollution.<br />

Ethics of Labor Practices in Fashion Manufacturing<br />

Every piece of clothing requires someone to sew<br />

it, even putting in a zipper. There are no automated<br />

machines that make garments. So, basically all<br />

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garments are handmade or sewn on machines by<br />

factory workers. Despite the value of the skilled<br />

seamstress for the industry, they are often poorly<br />

compensated. For example, a $4 t-shirt is offered at a<br />

retail store. How much is the worker being paid that<br />

sewed it together? Consider the pay out to the chain<br />

of manufacturing from the farmer who grows the<br />

crop, the production of the fiber into cloth, the fashion<br />

designer, the seamstress who makes the garment, the<br />

transportation crew, and finally the salesperson. Do the<br />

math, it’s not much profit to go around.<br />

Developing countries aim to become a part of the<br />

world's “fast fashion” apparel market despite poor<br />

working conditions and low pay to their workers.<br />

Countries such as China, Honduras, Bangladesh, Sri<br />

Lanka, and Indonesia export large amounts of clothing<br />

into the United States every year. Look at the tags on<br />

your garments for their origin. The incentive to the<br />

American consumer is to buy more due to the low<br />

price. In honest, more clothing is bought by Americans<br />

than what is really needed.<br />

Despite the publicity decades ago, many popular<br />

fashion brands are still using sweatshops to<br />

manufacture and sew their clothing (see Resources<br />

for a list). In 2021, child labor and modern slavery<br />

still occurs in clothing factories. Sweatshops are<br />

known to have poor working conditions, unfair<br />

wages, unreasonable hours, child labor, and a lack of<br />

benefits for the workers. To protect these workers,<br />

clothing companies can become Fair Trade USA<br />

Apparel and Home Goods Factory certified. This<br />

nonprofit organization offers the trusted Fair Trade<br />

Certified seal on a product, which signifies that it was<br />

made according to rigorous standards that promote<br />

sustainable livelihoods and safe working conditions,<br />

protection of the environment, and strong, transparent<br />

supply chains. Nonetheless, until the consumption<br />

of “fast fashion” declines, there is no incentive for<br />

change. Consumers drive fashion production; therefore,<br />

consumers can influence the transformation to<br />

sustainable fashion trends.<br />

The Principals of Sustainable Fashion<br />

A transformation of the fashion industry is now<br />

underway because of increased ecological awareness<br />

and stewardship of the environment by the public.<br />

Consumers and companies alike want industries that<br />

respect human living conditions, protect biological life<br />

and the environment, support cultural diversity, and<br />

appropriately use scarce global resources. The principles<br />

of 'green' or 'eco fashion’ consider what garments<br />

are made of and how long the garment is used. This<br />

fashion shift strives for garments that are seasonless<br />

and aesthetic in style and can last a long time.<br />

Therefore, more ”slow fashion” is making a comeback<br />

in a new way.<br />

The foundational concepts for sustainable fashion<br />

are to reuse, reform or reprocess fibers from existing<br />

garments or leftover fabrics.<br />

• Recycled or reclaimed fibers are recovered<br />

from either pre- or post-consumer sources.<br />

Pre-consumer sources are unworn and<br />

unused textile wastes from different stages<br />

of manufacturing. For example, bundles of a<br />

certain fabric are ordered for a dress but cutting<br />

the pattern leaves scrapes of leftover fabric<br />

unused. Instead of throwing it out, it can be<br />

reprocessed. Post-consumer textiles are any<br />

garment that has been worn and then donated<br />

to charities to sell as bulk fabric or returned to<br />

companies for recycling. An example is a jacket<br />

returned to the outdoor clothing company<br />

Patagonia.<br />

• “Upcycling” in fashion is the process of reusing<br />

these unwanted and discarded materials that are<br />

made into new materials or products without<br />

compromising the value and the quality of the<br />

used material.<br />

• “Closed-loop technology” is where a product is<br />

recycled back into almost the same product, such<br />

as an outdoor jacket’s fibers reprocessed into a<br />

new outdoor jacket of similar style. Technology<br />

exists to chemically reprocess polyester into its<br />

core components and then spin it back into<br />

polyester thread to make new garments. In<br />

addition, plastic bottles can now be recycled into<br />

synthetic polyester fiber used for clothing.<br />

Extending the lifespan of garments is also<br />

foundational to sustainable fashion. Donations of<br />

clothing to thrift shops allow consumers to re-wear a<br />

garment. Yet, about 70% of what is donated never<br />

makes it to the rack. Instead, it is sold as bulk fabric<br />

or made into rags and cleaning cloths. In addition,<br />

lengthening the lifespan can include re-waxing of<br />

outdoor jackets, replacing a zipper, or repairing<br />

expensive handbags. It’s not waste until it is wasted!<br />

COVID-19’s Impact on the Fashion Industry<br />

The onset of the pandemic literally shut down the<br />

fashion industry. Orders for garments by fashion chains<br />

were abruptly cancelled. Fashion shows were conducted<br />

virtually across the Web. The resulting economic impact<br />

of the pandemic forced consumers to rethink their<br />

purchases and thereby realize they did not need as much<br />

clothing as they use to buy. Designers and manufacturers<br />

together were forced to reevaluate the fashion culture<br />

and manufacturing processes of the industry. Therefore,<br />

the pandemic helped the industry rethink “slow fashion”<br />

with a transformation towards sustainability.<br />

Today, many people want to wear their clothing<br />

over time and have smaller collections that express<br />

their personality. Designers are moving towards<br />

green fashion and are using fibers such as hemp and<br />

bamboo, which are softer than cotton, retain dyes<br />

longer and are more durable for a garment’s lifetime.<br />

Additionally, consumers have the opportunity to<br />

support ethical practices within the fashion industry by<br />

being thoughtful and practical in their spending.<br />

Becoming a Sustainable Clothing Role-Model<br />

There are many ways you can improve the<br />

sustainability rating of your own wardrobe:<br />

1. Rediscover your own personal style. Assess your<br />

wardrobe and keep what you like and need and<br />

donate the rest. Never throw fabrics out in the<br />

trash, instead repurpose, or recycle them.<br />

2. Wear your clothes for a long time. Embrace and<br />

care for them.<br />

3. When you need to, only invest in buying new<br />

“sustainable” clothes and fabrics. Think about<br />

where you buy from and the “Made in …” tag.<br />

4. Research ahead of time and buy from fashion<br />

companies that are more thoughtful on fabric<br />

choices and support fair worker’s conditions.<br />

5. Buy used clothing. Respectable charity thrift<br />

stores support their organization’s mission and<br />

clients in need, but they need your money and<br />

support.<br />

6. Repair your clothing instead of throwing it away.<br />

Yes, you can sew up the holes and tears or take<br />

it to a seamstress. Zippers can be replaced.<br />

7. Use old, non-donatable clothing as rags for<br />

household and car cleaning.<br />

8. Wash clothes on Quick cycles and use cooler<br />

water settings to decrease your carbon footprint.<br />

References & Resources<br />

• Environmental impact of the textile and clothing<br />

industry: What consumers need to know https://<br />

www.europarl.europa.eu/RegData/etudes/<br />

BRIE/2019/633143/EPRS_BRI(2019)633143_<br />

EN.pdf<br />

• Fair Trade Certification: https://www.<br />

fairtradecertified.org/<br />

• 13 fashion brands that still use sweatshops in<br />

2021. Written by Alex Assoune. https://www.<br />

panaprium.com/blogs/i/fashion-brands-that-stilluse-sweatshops<br />

• The Council for Textile Recycling: http://www.<br />

weardonaterecycle.org/<br />

• Top 13 Sustainable Fashion Designers Making<br />

a Change in 2020: https://motif.org/news/topsustainable-fashion-designers/<br />

• The World Counts: https://www.<br />

theworldcounts.com/challenges/people-andpoverty/slavery-and-sweatshops

<strong>March</strong>, April, May 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 11<br />

NNA Environmental Health Committee<br />

• Love Faustine: https://lovefaustine.com/<br />

• Patagonia Recycling of Clothing: https://www.patagonia.com/recycling.html<br />

Authors<br />

Bernadette M. Longo, Ph.D.,<br />

RN, APHN-BC, CNL, FAAN<br />

Chair, NNA’s Environmental<br />

Health Committee<br />

President-Elect, NNA District 1<br />

Valerie Werner-Longo<br />

Founder and Creative Director,<br />

Love Faustine<br />

Garment Fibers & their Environmental Impacts<br />

Natural Cellulose Fibers<br />

Cotton: the most common worldwide<br />

fiber used for garments<br />

Bt Cotton: a genetically modified<br />

cotton plant resistant to pest<br />

infestations. Inserted with the Bt<br />

(Bacillus thuringiensis) gene.<br />

Organic Cotton: special farming<br />

is required to meet strict federal<br />

regulations<br />

Natural Colored Cotton: grows as<br />

shades of red, mauve, yellow, and<br />

orange.<br />

Soy fabrics: derived from the hulls of<br />

soybeans<br />

Bamboo fabrics: made from heavily<br />

pulped fast-growing bamboo grass<br />

Hemp fabrics: the fibers are more<br />

durable and stronger than cotton<br />

High water usage to grow cotton.<br />

Production of cotton uses large<br />

amounts of insecticides and synthetic<br />

fertilizers. Cotton fibers contain potent<br />

insecticide residues (wash before you<br />

wear). Cotton is usually bleached white<br />

from its natural beige color.<br />

In theory, Bt cotton did not require<br />

insecticide applications. However,<br />

problems in farming have occurred.<br />

Also, there is a high cost for GMO<br />

seeds.<br />

Grown without the use of genetic<br />

modification to the seeds, without<br />

use of fertilizers, pesticides, or other<br />

synthetic agricultural chemicals.<br />

It is already colored and does<br />

not require synthetic dyes during<br />

processing. Also, it will not fade.<br />

Soy-based fabrics are mostly<br />

biodegradable, so minimal impact on<br />

the environment and landfills.<br />

Pest resistant: does not need pesticides<br />

or agrochemicals. Often bleached<br />

white.<br />

Uses little water to grow and naturally<br />

pest resistant.<br />

Other cellulose fibers: Kombucha: a gel-like film from bacteria/yeast. Pineapple<br />

leaves: an alternative to leather. Piñatex® is a natural, sustainably sourced, cruelty<br />

free material. Coconut parts: leather-like fabrics<br />

Natural Protein Fibers<br />

Wool: known for warmth; consists of<br />

protein and lipids (lanolin); obtained<br />

mainly from sheep. Angora from<br />

rabbits. Alpaca fleece is also soft,<br />

smooth, warm, strong & durable.<br />

Cashmere & Mohair: soft and fine<br />

hairs of a goat's underbelly – rare goats<br />

from Asia.<br />

Silk: strong fiber and considered a<br />

prestigious fabric.<br />

Sheep are treated with injectable or<br />

dermal insecticides. Pesticides are used<br />

in wool cultivation. Toxic chemicals are<br />

often used to preserve wool.<br />

As demand increases, more of these<br />

goats are herded thus affecting land<br />

degradation.<br />

Mulberry trees are grown to act as<br />

homes for the silkworms. Does not<br />

require pesticides or fertilizers.<br />

MuSkin: 100 % vegetable layer alternative to animal leather. It comes from the<br />

Phellinus ellipsoideus, a big parasitic fungus that grows in the wild on trees in<br />

subtropical forests.<br />

Manufactured Fibers<br />

Polyester fabrics: made from fossil<br />

fuels<br />

PET Plastics: also known as<br />

polyethylene terephthalate<br />

Manmade cellulosics (MMCs):<br />

cellulose made from dissolved wood<br />

pulp of trees (e.g. rayon).<br />

Non-biodegradable. Laundry discharges<br />

micro-plastic fibers that release toxins<br />

and can end up in the water system,<br />

oceans and the food chain.<br />

PET plastic clothing comes from recycled<br />

plastics (usually bottles); keeps plastics<br />

out of landfills.<br />

Biodegradable<br />

Deadstock (leftover fabric from orders) can be used instead of thrown<br />

away in landfills.

Page 12 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>March</strong>, April, May 2021<br />

Antimicrobial Stewardship – Infection Prevention<br />

It’s time to join forces and defeat Sars-CoV-2<br />

Norman Wright, RN, BSN, MS<br />

It is February 19, 2021<br />

and last year, on this date,<br />

I was attending <strong>Nevada</strong>’s<br />

Legislative Committee<br />

on Health Care providing<br />

information regarding the<br />

Pan Drug Resistant Organism<br />

(PDRO), Carbapenem Resistant<br />

Enterobacteriaceae (CRE) and<br />

other Multiple Drug Resistant<br />

Organisms (MDRO). I was<br />

promoting legislation to mandate use of the Inter-<br />

Facility Infection Prevention Transfer Form. (1), (2)<br />

During the February 19, 2020 session <strong>Nevada</strong>’s<br />

State Epidemiologist, Melissa Peek, presented<br />

<strong>Nevada</strong>’s “Update Concerning the Novel<br />

Coronavirus COVID-19 Outbreak.” Her<br />

comprehensive PowerPoint showed <strong>Nevada</strong>’s quick<br />

response and preparedness efforts to combat<br />

Coronavirus even though she documented that there<br />

were no confirmed cases in <strong>Nevada</strong> yet. A more<br />

detailed account of <strong>Nevada</strong>’s DPBH initial response<br />

can be found in my May, 2020 <strong>RNformation</strong> article.<br />

The May article, written in February, 2020,<br />

documented the confusion that mixed messaging<br />

was generating. This statement was included:<br />

“COVID-19 stories and predictions are ubiquitous<br />

ranging from a USA Today headline, “Trump<br />

says Coronavirus will be gone by April when the<br />

weather gets warmer”, to a February 11th New<br />

York Post article with this lead, “The coronavirus<br />

epidemic could grip about two-thirds of the world’s<br />

population if the deadly bug is not controlled.” (3)<br />

Unfortunately, the latter is happening. As of<br />

February 19, 2021, worldwide cases total over one<br />

hundred eleven million (111,000,000) and over two<br />

million four hundred thousand (2,4000,000) have<br />

died. <strong>Nevada</strong> has not been spared. We have over<br />

290,000 confirmed cases and 4,831 deaths to date.<br />

Last year we were “all in this together” until<br />

around mid-April, when unity evaporated and<br />

we began to choose sides. The divide widened<br />

throughout the summer and it continues to date.<br />

Which side you are on, in large part, depends on<br />

the political party that you belong to and what news<br />

sources you obtain your information from.<br />

The red vs. blue divide widened, in large part<br />

due to certain media outlets that promote disputed<br />

science, mis-information, conspiracy theories<br />

disguised as medical research, fake “cures,” and<br />

repeating that the virus will “just disappear.” Basic<br />

public health recommendations to socially distance<br />

and wear a mask were disputed and fights even<br />

erupted when someone was asked to put on a mask.<br />

Please refer to my August, 2020 article: Coronavirus<br />

and PDRO – Fake, Faux and Phony News which<br />

delves into this in greater depth. The main thrusts<br />

of the article were to use the five step “Nursing<br />

Process”, and critical thinking, to sort truth from<br />

fiction and that obtaining accurate, straightforward,<br />

data is essential to accomplish this.<br />

My September 2020 article began with the<br />

Serenity Prayer:<br />

God Grant me the serenity<br />

to accept the things I cannot change,<br />

The courage to change the things I can,<br />

and the wisdom to know the difference.<br />

And I still must say it because I am angry at how<br />

this pandemic, in my opinion, has been mishandled.<br />

By Memorial Day the political lines were drawn<br />

and the divide was exacerbated by the politics of the<br />

November elections, political divides that remain.<br />

Now, a year later, the virus that was supposed<br />

to be gone by last April is still ravaging us. Yes, the<br />

rates have gone down from January 14th when the<br />

7-day moving average of deaths was 46 per day and<br />

the average number of positive cases is also down.<br />

(4)<br />

Although this is good news, there is a danger<br />

because each time we thought the pandemic<br />

was over mandates were relaxed and Sars-CoV2<br />

infections roared back. Now there are new viral<br />

strains that are more contagious and possibly more<br />

deadly, and a man with the South Africa strain was<br />

just discovered in Reno.<br />

Some of the deaths that occurred during the past<br />

year could not have been prevented, but if we all<br />

simply agreed to wear a mask and socially distance<br />

for the past year our number of infections and<br />

deaths would have been much lower.<br />

One way to illustrate this is to use a projection<br />

that IHME made last June. The lower green line<br />

represents a flattening of the curve if 95% of<br />

us wore masks and the upper red line shows a<br />

continued upward trend if we didn’t. Reality was<br />

many refused to wear masks or socially distance<br />

and the red trend line never went down. The result,<br />

<strong>Nevada</strong> will soon experience it’s 5,000th COVID-19<br />

death.<br />

Another way to show that masks work is to<br />

compare Japan’s infection and death rates to<br />

<strong>Nevada</strong>’s. To date Japan, a nation of over 126 million<br />

people has only had 7,274 deaths from COVID-19,<br />

which averages out to 58 deaths per million.<br />

Compare that to <strong>Nevada</strong>, with a population of just<br />

over three million, and we have had 4,831 deaths,<br />

equaling 1,568 deaths per million. Space does not<br />

allow me to expand on reasons for the disparity<br />

beyond documenting that in Japan wearing a mask<br />

to avoid getting, or passing on, an infection has<br />

been a common practice for decades and groups like<br />

“No Mask <strong>Nevada</strong>” do not exist.<br />

On February 23rd I will be giving an hour-long<br />

presentation for Immunize <strong>Nevada</strong> titled, “How<br />

Politicization and Disinformation Impacted the<br />

Mitigation of COVID-19” which will expand on<br />

the reasons for the disparity in Sars-CoV-2 infections<br />

and deaths comparing the United States with other<br />

nations in the world. By the time you read this article<br />

that webinar will be history, but the presentation<br />

will be archived and found at this link: https://www.<br />

immunizenevada.org/nile-webinars.<br />

Flash forward to 2021. We now have two<br />

vaccines, Pfizer and Moderna, and more may be<br />

on the way, which brings me back to February 19,<br />

2020, when I was advocating for codification of<br />

the Infection Prevention Transfer Form and laws to<br />

enforce mandates regarding accurate communication<br />

of infectious concerns when a patient is transferred<br />

from one facility to another.<br />

The February 2020 session date was the third time<br />

I appeared before the Legislative Health Committee<br />

and one recurring theme during all three sessions<br />

that I witnessed was promoted by group of women,<br />

and a few men, who repeatedly testified about the<br />

dangers of vaccinations. This group, commonly<br />

known as Anti-Vaxxers told personal stories along

<strong>March</strong>, April, May 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 13<br />

with other comments that focused on these main<br />

areas of criticisms to vaccination:<br />

1) Discredited autism/mercury/thimerosal statements<br />

2) Pseudo-science, fake news and alternative<br />

facts<br />

3) That Immunize <strong>Nevada</strong> is a shill for bigpharma<br />

vaccine companies<br />

4) That people promoting vaccines will “burn<br />

in hell” because vaccines are made from<br />

aborted fetus. Vaccine proponents were even<br />

compared to Nazis.<br />

5) And that the lawmakers should “do more<br />

research.”<br />

That last statement about doing research I agree<br />

with, but the research must be from valid sources,<br />

not conspiracy theorists. All of the legislative<br />

committee hearings are taped and if you want to<br />

spend some time you can view their comments by<br />

going to <strong>Nevada</strong> Legislative archived videos that<br />

is found at this link: https://www.leg.state.nv.us/<br />

Video/. All you have to do is put in the date of the<br />

session you are interested to view and it will come<br />

up. And the anti-vaxxers are at it again to the point<br />

of disrupting a mass vaccination site at Dodger<br />

Stadium in California.<br />

A few anti-vaxxers brought up “herd immunity”<br />

and that is the danger of their movement. If they<br />

convince a large enough portion of our population<br />

that vaccines are dangerous and discourage enough<br />

of us from becoming vaccinated the pandemic<br />

could slam us again with a fourth wave, possibly<br />

bigger than the one we have just been through. If<br />

that occurs not only will more physical suffering<br />

and death occur, but <strong>Nevada</strong>’s economy, which is so<br />

dependent on tourism, will not recover either.<br />

A good resource to address the anti-vaccination<br />

movement is a website called, “Shots Heard Round<br />

the World.” It provides resources to combat the disinformation<br />

and intimidation that some members of<br />

this group distribute. (6) https://www.shotsheard.<br />

org/<br />

It is time for our red vs. blue, North against South,<br />

rural vs. urban, us against them – mentality to end.<br />

It is time for us to put aside our political divides, join<br />

forces and work together in unison to fight the war<br />

on Sars-CoV-2. It is time to create common goals and<br />

defeat the virus that has been ravaging us for the<br />

past year.<br />

Citations:<br />

1) http://dpbh.nv.gov/Programs/HAI/dta/Forms/<br />

Healthcare_Associated_Infection_Prevention_and_<br />

Control_(HAI)_-_Forms/<br />

2) http://dpbh.nv.gov/uploadedFiles/dpbh.nv.gov/<br />

content/Programs/HAI/dta/CRE%20technical%20<br />

bulletin.pdf<br />

3) https://nypost.com/2020/02/11/expert-warnscoronavirus-could-infect-60-of-worlds-population/<br />

4) https://www.worldometers.info/coronavirus/usa/<br />

nevada/<br />

5) https://www.nytimes.com/2021/02/06/us/californiacovid-vaccine.html<br />

6) https://www.shotsheard.org/

Page 14 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>March</strong>, April, May 2021<br />

Nurses in the News<br />

Tracey Long PhD, MS, MSN, APRN-BC, CCRN<br />

The daily work of nurses is often unseen but deeply felt by the souls they serve.<br />

We have all recently seen disturbing national and world events that can leave you<br />

feeling paralyzed, hopeless and insignificant. Seeing that one stone thrown into a<br />

pond can send endless ripples to be felt on the other side of the water far away, can<br />

help us remember the power for good of one nurse’s actions.<br />

One example of the positive impact of one person’s actions on many others<br />

is that of a humble nursing student who chose to turn sorrow and grief into<br />

goodness. Jacklyn Lemoine knows the fatal effects of cancer too well. Her mother<br />

died of breast cancer and her father died after battling prostate cancer for years.<br />

Her brother chose to deal with the stress and trauma of those losses in maladaptive<br />

ways by covering the sorrow with drugs and alcohol. Jacklyn decided to transform<br />

her sorrow into tangible gifts that would be given to other women also experiencing<br />

cancer and created “Debbie’s Glam Baskets” in honor of her mother Debbie. With<br />

donations from family and friends and generosity of others who responded to her<br />

GoFundMe project, she purchased and put together helpful care kits designed<br />

with natural products that a woman going through breast cancer would use and<br />

appreciate. Each bag is worth $150 and includes natural products without pesticides<br />

or colorings such as deodorant, nail polish, bath treatments, dietary supplements,<br />

a hand crocheted hat, socks, hair pins, nail and lip care, wipes and more that are<br />

gentle on a fragile body fighting cancer. She recently donated seven bags to the<br />

oncology unit at Summerlin Hospital in Las Vegas where the bags will be gifted<br />

to women actively receiving chemotherapy. To watch videos about her mission,<br />

to donate or help assemble these glam bags, please contact her at https://www.<br />

facebook.com/Debbiesglambaskets/<br />

Another organization that sends out ripples of impact for good is the <strong>Nevada</strong><br />

Nurses Foundation, which is the charitable and philanthropic arm of the <strong>Nevada</strong><br />

Nurses Association (NNA). Their mission is to increase access to quality health care<br />

for <strong>Nevada</strong> citizens by promoting professional development of nurses through<br />

recognition, grants, and scholarships. Each one volunteer ripples positive blessing<br />

to our own <strong>Nevada</strong> Nurses. To learn more about this organization and become<br />

involved go to: https://nvnursesfoundation.org<br />

The art and science of nursing heroes begins in nursing school and an<br />

organization that helps grow these young nurses, who will quickly become our<br />

nursing colleagues is the Student Nurse Association. Most <strong>Nevada</strong> nursing schools<br />

have a chapter where students learn organizational skills and leadership and are the<br />

boots on the ground for dozens of community service projects each year including<br />

blood, food and clothing drives. If you have an organization that is looking for<br />

young volunteer health care workers, you can reach out to any of our Colleges of<br />

Nursing and speak to the faculty advisor to create connections. If you are looking for<br />

a worthwhile organization to share your expertise and volunteer hours, you can also<br />

go online to www.justserve.org to identify an organization you share an interest<br />

with and be a movement for good. More than ever, a world-wide pandemic has<br />

taught us all that we are all connected with each other and the positive actions of<br />

one can truly make an impact for good on countless others around us.<br />

Jacklyn Jemoine with her Glam Baskets Feb. 2021

<strong>March</strong>, April, May 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 15<br />

Welcome Board of Nursing Director of Education<br />

Vicki Walker DNP, RN, BS<br />

You are on the job less than<br />

a month, and pandemic hits.<br />

This was the situation for the<br />

Board of Nursing's (BON) new<br />

Director of Nursing Education,<br />

Dr. Michelle Johnson, EdD,<br />

RN, CPNP-PC. Shortly after<br />

starting in a new role with<br />

the <strong>Nevada</strong> BON, Dr. Johnson<br />

had to transition to a remote<br />

work structure within the<br />

evolving parameters to prevent the spread of COVID.<br />

This transition left Dr. Johnson in a frustrating situation<br />

because a large portion of her job is to physically assess<br />

programs around the state.<br />

Many nurses in <strong>Nevada</strong> may not even recognize that<br />

the BON even has a Director of Education position. The<br />

BON itself is appointed by the Governor of <strong>Nevada</strong> and<br />

has executive, legislative (i.e., advising on and enforcing<br />

legislation), and judicial responsibilities for the oversight<br />

of the nursing profession in <strong>Nevada</strong>. The BON staff<br />

work for the Board to carry out the daily functions like<br />

issuing licenses. They also serve to advise the Board on<br />

the health of nursing in <strong>Nevada</strong>.<br />

The Director of Education position functions mainly<br />

to monitor the health of nursing education in our state.<br />

There are several layers of nursing education in <strong>Nevada</strong><br />

which include CNA, LPN, ADN, and BSN programs.<br />

While the state doesn't accredit programs, it does<br />

approve new programs and reviews existing programs<br />

on a regular basis. Dr. Johnson serves as the lead for<br />

this approval and review process.<br />

Dr. Johnson has nearly 30 years of experience<br />

in nursing, administration, and academia. Before<br />

coming to the BON, she served as the Chief Nurse<br />

Administrator for Hawaii Pacific University. She<br />

is thrilled to bring her experience to <strong>Nevada</strong> in<br />

safeguarding that educational programs uphold the<br />

Nurse Mentorships: Growing Our Own, Versus<br />

Eating Our Young<br />

Dr. Susan Rux, PhD, MSN, RN, PHN, ACNS-BC,<br />

CHEP, CNE, CPRW, NEA-BC<br />

Gretta Williams, AS, RN<br />

Reprinted with permission from<br />

New Jersey Nurse October 2020<br />

Nursing is an incredibly inspirational and rewarding<br />

profession unlike any other. However, for all the<br />

momentous experiences, our profession has its<br />

share of challenges, stemming from personal and<br />

interprofessional conflict. Consider the climate of<br />

today’s acute care environment, heavy workloads,<br />

increased patient acuity, and limited resources – the<br />

perfect storm to add to feelings overwhelmingness of<br />

nurses trying to find and maintain balance – who can<br />

the nurse rely on for support and guidance? This is a<br />

quintessential occasion where mentors can offer the<br />

necessary collegial support by modelling a genuine<br />

interest of the success of their fellow nurse. Nurses are<br />

devoted to delivering high quality and compassionate<br />

care to their patients.<br />

Effective mentorship require commitment to<br />

developing the mentoring relationship between the<br />

mentee and mentor (Andrews & Wallis, 1999; Bally,<br />

2007; McDonald, Mohan, Jackson, Vickers, & Wilkes,<br />

2010). Many forms of nurse mentorships exist, with<br />

experienced nurses taking a new nurse under their<br />

wings as a prominent example. The transition from<br />

nursing school to becoming a novice professional<br />

nurse can be an intimidating experience – the new<br />

responsibilities, requisite knowledge, and ethical<br />

principles to uphold. Nursing school provides a<br />

foundational education to prepare students for the<br />

career of professional nurse, but when faced with the<br />

reality of integrating that knowledge into practice,<br />

new nurses may feel unprepared. Incivility, and<br />

related terms such as horizonal violence, underscore<br />

the importance of mentoring in the context of the<br />

overall organizational performance and stability (Bally,<br />

2007). All too often nurses begin their first position<br />

with minimal guidance, leaving that feeling of being<br />

unsupported. A qualitative study by Simons and Mawn<br />

(2010) found that newly licensed registered nurses felt<br />

as though they experienced hostility and were working<br />

with a pack of barracudas that ate their young.<br />

When we consider how to grow our next generation<br />

of nurses, incorporating mentoring into the ongoing<br />

responsibilities of nurses is critical for the development<br />

of elf and social awareness as well as relationship<br />

management acumen. Tomajan (2012) noted that<br />

nurses in staff development roles contribute to role<br />

transition by serving as mentors to nurses in practice.<br />

Mentoring contributes to job satisfaction and a healthy<br />

work environment (Lee, Dennis, & Campbell, 2007).<br />

Nursing mentorship programs are ways to socialize<br />

and prepare nurses for the transition into the nursing<br />

profession. Chan, Glass & Phang (2020) identified,<br />

through a systematic review, three characteristics for<br />

nurse mentorship success: higher level of experience<br />

in nursing, provision of personalized support in<br />

accordance to the mentees’ requirements, and<br />

establishment of a relationship marked by a sense<br />

of mutual gain, engagement, and commitment (p.<br />

47). When considering the phrase, “nurses eating<br />

their young” (Bartholomew, 2006; Rowe & Sherlock,<br />

2005; Simons & Mawn, 2010), one may think of an<br />

experienced nurse being too critical of a new nurse as<br />

a strategy to help them learn or gain competence more<br />

expeditiously, however, this tactic leaves new nurses<br />

feeling discouraged. As nurses, why eat our young<br />

when we can grow our own? With confidence in the<br />

mentoring relationship, the new nurse will be more<br />

confident in asking questions to enrich their nursing<br />

practice, seek advancement in their career goals,<br />

inclusive of serving as a future nurse mentor.<br />

Confucius, a Chinese philosopher and politician<br />

who emphasized personal and governmental morality,<br />

correctness of social relationships, justice, kindness,<br />

and sincerity — “Acquire new knowledge whilst<br />

thinking over the old, and you may become a teacher<br />

of others.”<br />

References<br />

Andrews, M., & Wallis, M. (1999). Mentorship in nursing:<br />

A literature review. Journal of Advanced Nursing, 29,<br />

201-207.<br />

Bally, J. M. G. (2007). The role of nursing leadership<br />

in creating a mentoring culture in acute care<br />

environments. Nursing Economic$, 25, 143-148.<br />

Bartholomew, K. (2006). Ending nurse-to-nurse hostility:<br />

Why nurses eat their young and each other.<br />

Marblehead, MA: HCPro, Inc.<br />

Chan, E.-Y., Glass, G. F., & Phang, K. N. (2020). Evaluation of<br />

a hospital-based nursing research and evidence-based<br />

practice mentorship program on improving nurses’<br />

knowledge, attitudes, and evidence-based practice.<br />

Journal of Continuing Education in Nursing, 51(1), 46–<br />

52. Retrieved from https://doi.org/10.3928/00220124-<br />

20191217-09<br />

Lee, A., Dennis, C., & Campbell, P. (2007). Nature's guide<br />

for mentors: Having a good mentor early in your career<br />

can mean the difference between success and failure<br />

in any field. Nature, 44, 791-797. doi: 10.1038/447791a<br />

McDonald, G., Mohan, S., Jackson, D., Vickers, M. H.,<br />

& Wilkes, L. (2010). Continuing connections: The<br />

experiences of retired and senior working nurse<br />

mentors. Journal of Clinical Nursing, 19, 3547-3554.<br />

Rowe, M. M., & Sherlock, H. (2005). Stress and verbal abuse<br />

in nursing: Do burned out nurses eat their young?<br />

Journal of Nursing Management, 13, 242-248.doi:<br />

10.1111/j.1365-2834.2004.00533.x<br />

Simons, S. R., & Mawn, B. (2010). Bullying in the workplace:<br />

A qualitative study of newly licensed Registered<br />

Nurses. American Association of Occupational Health<br />

Nurses Journal, 58, 305-311. doi: 10.3928/08910162-<br />

20100616-02<br />

Tomajan, K. (2012). Advocating for nurses and nursing.<br />

Online Journal of Issues in Nursing, 17(1), doi: 10.3912/<br />

OJIN.Vol17No01Man04<br />

state's regulatory standards to ensure the public's<br />

health and safety.<br />

In the midst of a pandemic, Dr. Johnson has found a<br />

positive perspective for the future of Nursing Education<br />

in <strong>Nevada</strong>. "I am hoping that COVID will not have<br />

a negative impact, but instead, schools will see the<br />

value of online and virtual education environments,"<br />

said Dr. Johnson. "Because every student isn't equal,<br />

we may see more adoption of a variety of education<br />

environments in the future. COVID has forced us to<br />

embrace the value of online."<br />

For those considering entering the nursing<br />

profession, Dr. Johnson advises, “Do your homework,<br />

understand what is involved in a program and what<br />

the profession of nursing entails. You have to be<br />

committed to the educational process and treat it like<br />

it’s a job.” She also draws attention to <strong>Nevada</strong> school’s<br />

2020 NCLEX pass rates for nursing, which are among<br />

the highest in the nation.<br />

Report on District 1<br />

(Northern)<br />

Darlene Bujold, President, District 1<br />

NNA’s District 1,<br />

incorporating Northern <strong>Nevada</strong><br />

and its Rural Areas, is anxious<br />

to move into 2021 as a dynamic<br />

presence. This past year has<br />

driven change and innovation<br />

for all, the NNA included.<br />

Interaction became more<br />

virtual, but we were undeterred<br />

in the continued advancement<br />

of member support via<br />

webinars and zoom meetings. Of course, we continue<br />

to provide this popular publication quarterly to keep all<br />

licensed <strong>Nevada</strong> nurses informed.<br />

This Northern <strong>Nevada</strong> District is always proud to<br />

promote and host our biannual Nurses Day at the<br />

Legislature during session held here in Carson City.<br />

Again, this event has been reimagined thanks to the<br />

pandemic. Rather than a one-day live event, we will<br />

promote understanding of processes and encourage<br />

nurse involvement throughout the session by<br />

recognizing and explaining bills and drafts as they arise<br />

that are of special interest to the nursing population.<br />

Several presentations will be offered free of charge<br />

during the legislative session.<br />

This year will mark a transition in leadership as<br />

nominations open to "new blood." My tenure as<br />

President comes to an end in the fall. Dr. Bernadette<br />

Longo has been elected President-Elect and is poised<br />

to take on this leadership role seamlessly. "Bernie" has<br />

a long and illustrious history of volunteerism with both<br />

local and State appointments. She holds a doctorate<br />

in Nursing Education and is a professor emeritus who<br />

continues to teach at the Orvis School of Nursing.<br />

I encourage all who wish to contribute to our<br />

proud profession to consider running for office. My<br />

experience has been one of making lifelong friendships<br />

with amazingly learned colleagues who have never<br />

failed to provide encouragement, support, and<br />

opportunities for personal and professional growth.<br />

2021 offers hope and a light at the end of this Covid<br />

tunnel. Let’s move forward united and take advantage<br />

of what we have learned to make our profession<br />

stronger and more resilient!<br />

NursingALD.com can point you<br />

right to that perfect NURSING JOB!<br />

NursingALD.com<br />

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Page 16 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>March</strong>, April, May 2021<br />

The Quest for Warm and Fuzzies in the Age of Physical Distancing<br />

20 ways to release oxytocin, many of which do not require you to be in close proximity to another human.<br />

Sherry Stofko, MSN, RN<br />

I’m a hugger. A long hugger.<br />

Sometimes, an uncomfortably<br />

lingering hugger. I like to get<br />

close to people and really<br />

look into their eyes when<br />

they talk. I’m not afraid of the<br />

“personal bubble.” I prefer to<br />

touch another person’s hand<br />

while I listen empathetically<br />

to their struggles. I share<br />

smiles, laughter, and tears.<br />

These needs and preferences<br />

made 2020 that much<br />

tougher to bear. Aside from<br />

the unrelenting feeling of<br />

uncertainty, the lack of hugging<br />

and close physical contact is, for me, the toughest<br />

aspect of this pandemic.<br />

Close physical connection such as hugs is the core<br />

language of compassion and caring (Psychology Today,<br />

2020). Why do embraces, hand holding, and caresses<br />

- both platonic and romantic - feel so yummy? Likely<br />

it’s the natural release of the neurochemical oxytocin<br />

associated with these activities. Let’s look closer at<br />

oxytocin, which you undoubtedly learned about in your<br />

neuro, endocrine, or OB studies.<br />

Oxytocin is a hormone and neuropeptide<br />

produced in the hypothalamus and secreted into the<br />

bloodstream through the posterior pituitary gland. This<br />

neurochemical works in a positive feedback loop and<br />

has immediate effects on the brain. It may be most<br />

well-known for its role in female reproduction, causing<br />

uterine contractions during childbirth and increasing<br />

milk supply during lactation. Oxytocin is also known<br />

for eliciting feelings of trust, emotional openness,<br />

generosity, relaxation, and pain suppression (Wu,<br />

2020). Studies show promise for oxytocin in treating<br />

depression and anxiety (Han et al., 2018). Recent<br />

research shows that oxytocin has anti-inflammatory<br />

and immunosupportive properties and may even be<br />

helpful in treating the cytokine storm associated with<br />

COVID-19 infections (Imami, 2020).<br />

In addition to being generated naturally in the body<br />

during childbirth and breast feeding, oxytocin is also<br />

released during sexual orgasm, during close physical<br />

contact with loved ones, during activities that stimulate<br />

skin, while crying, and when feeling empathy for<br />

another (Wu, 2020). The warm and fuzzy feeling we<br />

get when cuddling an infant or hugging a friend can be<br />

attributed to this amazing hormone. Because of these<br />

pleasing effects, oxytocin is often grouped with other<br />

feel-good chemicals like dopamine and serotonin and<br />

has assumed nicknames such as “the love molecule,”<br />

“cuddle chemical,” or the “life hormone.”<br />

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So here we are, in this dreadful pandemic that<br />

forces us to limit our physical contact with others,<br />

isolate in our homes, and certainly not hug or kiss<br />

anyone outside our very small quarantine bubble.<br />

During daunting times of fear, uncertainly, grief, and<br />

sadness, humans rely on connection, hugging, and<br />

human contact to sooth the heartbreak (Levoy, 2020).<br />

Over the past twelve months, the lack of platonic<br />

physical touch has been taking its toll on us in the<br />

way of deteriorating mental health and self-esteem;<br />

worsening loneliness, depression, and anxiety; and<br />

increasing suicide rates (Jha, 2020). “In the 1950s,<br />

the University of Wisconsin psychologist Harry Harlow<br />

showed that baby rhesus monkeys raised by surrogate<br />

mothers preferred one that was made of soft terrycloth<br />

but offered no food to one that had food but was<br />

made of wire. Touch was more important than food!”<br />

(Levoy, 2020). Jha (2020) reports on a Carnegie Mellon<br />

University study that demonstrates hugging and<br />

interpersonal touch can boost the immune system. In<br />

a recent study, mice demonstrated signs of depression<br />

and anxiety after only three-to-five weeks of social<br />

separation (Han et al., 2018). Need I remind you how<br />

long we have been socially isolating?<br />

What can we do about the lack of oxytocin on our<br />

systems if we still cannot cuddle or even visit extended<br />

family or friends? How can we boost our body’s natural<br />

secretion of this delightful and pleasing neurochemical,<br />

save for giving birth or renting a breast pump? It’s<br />

actually a lot easier than you may think to self-generate<br />

oxytocin, even when you’re all alone.<br />

Oxytocin release is easily triggered during<br />

interpersonal physical touch: embracing, holding<br />

hands, sex intimacy - orgasms in particular. But we<br />

can also have the same effects while receiving a<br />

professional massage or pedicure, snuggling a body<br />

pillow, massaging your own scalp, or rubbing your<br />

own feet (Levoy, 2020). Stroking and cuddling a pet<br />

can stimulate the same effects; in fact, research shows<br />

that dogs also receive a bump in oxytocin while being<br />

petted (Raypoole, 2020).<br />

Spending time with friends can increase oxytocin<br />

production. Cooking together, listening empathetically,<br />

smiling and laughing all lead to higher levels of<br />

this feel-good hormone (Power of Positivity, n.d.;<br />

Psychology Today, 2013; Wu, 2020). Opening up<br />

emotionally, sharing feelings, encouraging others,<br />

and saying statements of affection or gratitude can<br />

also bump oxytocin levels (Psychology Today, 2013;<br />

Raypoole, 2020). Even if the conversation gets heavy,<br />

know that crying also stimulates oxytocin production<br />

(Power of Positivity, n.d.) and decreases blood levels<br />

of the stress hormone cortisol. Connecting on social<br />

media and “liking” others’ posts can also create a<br />

feeling of connection with others.<br />

Sharing meals with others stimulates bonding as<br />

well. When preparing the menu, remember dark<br />

chocolate and foods containing tryptophan are<br />

known to promote oxytocin (Life Coach Code, 2017).<br />

Tryptophan-laden foods include chicken, turkey,<br />

beef, pork, eggs, fish, tofu, legumes, milk products,<br />

nuts, seeds, and oatmeal (Whitbread, 2021). One<br />

author suggests vitamin B complex and magnesium<br />

supplements may increase oxytocin release (Life Coach<br />

Code, 2017).<br />

Physical exercise is another way to increase oxytocin<br />

release. Swimming, hiking in nature, and dancing to<br />

music were specific activities mentioned as beneficial<br />

(Raypoole, 2020). Relaxing activities such as soaking<br />

in a hot tub, listening to music, spending quiet time<br />

alone, practicing gentle yoga, or engaging in a lovingkindness<br />

meditation have also been encouraged as<br />

ways to generate oxytocin (Life Coach Code, 2017;<br />

Power of Positivity, n.d.; Psychology Today, 2013).<br />

Finally, get creative! Spending time doing a hobby<br />

like knitting, drawing, or playing an instrument has<br />

also been shown to increase oxytocin while releasing<br />

other fell-good endorphins… added bonus when<br />

you give away these created items (Life Coach Code,<br />

2017; Power of Positivity, n.d.). Trying something new,<br />

unique, or scary, especially with someone else, will also<br />

generate a feeling of bondedness (Psychology Today,<br />

2013; Raypoole, 2020).<br />

Putting all this together, I’ve created an itinerary for<br />

a day saturated with the “love molecule.” Don’t have<br />

a puppy or a friend like “Sam”? No problem: use the<br />

power of imagination or practice some self-love.<br />

The ‘Rona has profoundly changed the ways we give<br />

and receive affection. Hugs, which make us feel safe<br />

and loved, are now taboo. Spending time with friends<br />

makes us feel less lonely as we navigate this new world<br />

but is generally discouraged. Love, safety, connection,<br />

trust… these are much needed feelings these days, so<br />

it is crucial we practice alternative methods to generate<br />

oxytocin and improve our mental health. I believe you<br />

can see boosting natural oxytocin levels is much more<br />

accessible than you may have realized. Don’t forget to<br />

pass these tips onto your family and patients.<br />

References:<br />

Han et al. (2018). Long-term isolation elicits depression and<br />

anxiety-related behaviors by reducing oxytocin-induced<br />

GABAergic transmission in central amygdala. Frontiers<br />

on Molecular Science. https://www.ncbi.nlm.nih.gov/<br />

pmc/articles/PMC6104450/<br />

Imami, A., et. al (2020). Oxytocin’s anti-inflammatory and<br />

proimmune functions in COVID-19: A transcriptomic<br />

signature-based approach. https://journals.physiology.<br />

org/doi/full/10.1152/physiolgenomics.00095.2020<br />

Levoy, G. (2020). The pandemic and the pain of losing<br />

touch. https://www.psychologytoday.com/us/blog/<br />

passion/202003/the-pandemic-and-the-pain-losingtouch<br />

Life Coach Code (2017). 29 ways to trick your brain to<br />

create oxytocin naturally [the love chemical]. https://<br />

www.lifecoachcode.com/2017/06/30/29-ways-tocreate-oxytocin-naturally/<br />

Power of Positivity (n.d.). 10 ways to increase the oxytocin<br />

in your body. https://www.powerofpositivity.com/<br />

increase-oxytocin-levels/<br />

Psychology Today (2013). The top 10 ways to boost good<br />

feelings. https://www.psychologytoday.com/us/blog/<br />

the-moral-molecule/201311/the-top-10-ways-boostgood-feelings<br />

Raypoole, C. (2020). 12 ways to boost oxytocin. https://<br />

www.healthline.com/health/how-to-increase-oxytocin<br />

Whitbread, D. (2021). Top 10 foods highest in tryptophan.<br />

https://www.myfooddata.com/articles/hightryptophan-foods.php<br />

Wu, J. (2020). Why oxytocin is incredible and how to get<br />

more of it. https://www.quickanddirtytips.com/healthfitness/mental-health/oxytocin<br />

About the author:<br />

Sherry is a hospital clinical educator and the CEO<br />

of Capricorn Healthcare Consultants. Her passions<br />

are emergency medicine, resiliency development,<br />

and education. She teaches CEU classes on gratitude,<br />

perfectionism, and self-compassion in healthcare and<br />

now offers adventure CEU travel trips to Ecuador.<br />

www.CapricornHealthcareConsultants.com<br />

2375 E. Prater Way,<br />

Sparks, NV 89434

<strong>March</strong>, April, May 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 17<br />

INTERVIEW: Through the Eyes of a <strong>Nevada</strong> Nurse<br />

Submitted and Interviewed by Dr. Bernadette<br />

Longo, RNFormation Editorial Team<br />

“We have to leave our discipline better than the way<br />

we found it.”<br />

Nurse’s Name:<br />

Timothy Martin, BSN, RN<br />

Time in Nursing: 9 yrs<br />

Practice Location: North Las<br />

Vegas VA Medical Center, V.A.<br />

Southern <strong>Nevada</strong> Health Care<br />

System<br />

Position/Role: ICU Relief<br />

Charge Nurse<br />

Clients you serve: Veterans<br />

in need of critical care services<br />

(COVID-19 ICU & regular ICU)<br />

What is your typical day like?<br />

“Recently, I have been the lead ICU nurse on the<br />

non-COVID unit. I work 12-hr days and arrive 30-45<br />

mins early to check my assignment. I have two to three<br />

RNs and additional augment staff. The assignments<br />

for nurses have gotten heavier as the epidemic’s surge<br />

has hit us. So, typically the ICU nurses are taking two<br />

ICU patients and two step-down patients, along<br />

with having two augment staff to assist them with<br />

tasks. A team nursing model is used. I make sure the<br />

assignment is balanced and fair. I make sure they’re not<br />

overwhelmed.”<br />

“As the lead ICU nurse, I have to make myself<br />

available for Rapid Responses and Codes that occur<br />

both inpatient, outpatient and on the grounds. This<br />

happens about 1.5 times per shift. Most of them are<br />

either inappropriate activation of the Rapid Response<br />

system or some brief resolving issues. But there<br />

are persons who experience code whites (strokes),<br />

anaphylaxis, heart rhythm disturbances (afib, v-tact)<br />

for example, that occur in different departments at the<br />

VA.”<br />

What has been the impact of the COVID-19<br />

pandemic on your nursing?<br />

“So, COVID-19 has made me a better nurse in a<br />

number of ways. At the VA we are very fortunate that<br />

typically our patient ratios are very low. COVID has<br />

changed all that. COVID has reinvigorated my time<br />

management and being able to pass on to our younger<br />

nurses – the next generation – just these strategies for<br />

time management and planning out your day. So, that<br />

has made me stronger.”<br />

“We are doing a lot of bedside procedures that<br />

we never did (trachs, pegs). We are doing a lot more<br />

ultrasounds at the bedside looking for DVTs and those<br />

microthrombi. My critical thinking skills have sharpened<br />

because of all the sequalae and symptoms that these<br />

patients experience. One of the earliest practice things<br />

I noticed during COVID-19 was when we were sedating<br />

or anesthetizing a patient. We are now using these<br />

great tools like BIS monitoring (bispectral monitoring<br />

for effects of anesthesia on the brain) and Train of<br />

four (assesses nerve function in patients receiving<br />

neuromuscular blockers). So, we can tell how deep we<br />

have these patients. We need to know this considering<br />

the risks for delirium and because we know deep<br />

sedation increases many risks for these patients. It is<br />

part of the bundle of care and will likely continue for<br />

all patients needing intubation (standard of practice)<br />

going forward.”<br />

“Besides my assessment skills improving, there has<br />

been more of trusting my gut. Like, we all have those<br />

feelings when the patient is going to go south - a bad<br />

feeling we are heading in the wrong direction with the<br />

patient. Yet, all the numbers contradict the way you<br />

feel. Like, it doesn’t look it. But as a bedside nurse,<br />

you can just tell that the patient is going to turn and<br />

that definite sense that death is standing in the room<br />

with you – that you know they are there. I think those<br />

two senses - I have become much more aware of them<br />

during COVID.”<br />

“I had an interesting conversation the other day<br />

with a physician. We got a new patient and he just<br />

didn’t look good yet his stats and ABGs were OK, but<br />

everything was trending flat. He had been improving,<br />

but now flat. I said to myself, ‘I just don’t feel good<br />

about this.’ So, I called the doc at home and asked<br />

that he make his first stop here. I shared my feelings.<br />

In 30 minutes, he was on the floor and the patient had<br />

turned. I said, ‘Oh you’re here so soon.’ He replied, ‘I<br />

was thinking about it and you had never called me at<br />

home before.”<br />

In your opinion, what is the future for nursing?<br />

“The future for nursing is our continuation of the<br />

nursing discipline. As we become novice nurses, we<br />

take this oath of providing care and being nurses and<br />

doing no harm. We need to remember the oath we<br />

took. Part of that oath should be furthering the nursing<br />

discipline. We have to leave our discipline better than<br />

the way we found it. We have to improve it, to grow it<br />

and to nurture it.”<br />

Why are you still choosing to be a nurse today?<br />

“It’s funny, I choose nursing because being a<br />

paramedic didn’t pay enough. Now, nursing has chosen<br />

me! I could no more turn my back on it than it could<br />

turn it’s back to me. Nursing and I are now married<br />

to each other. We are very committed to each other. I<br />

could not imagine being married to another career. The<br />

ability to learn every day, to teach every day, to impact<br />

my patients lives either through direct patient care or<br />

indirectly by helping develop my nurses and through<br />

leadership. I couldn’t imagine choosing another career!<br />

Afterthought: Timothy Martin is an Army veteran<br />

who defended our country for 14 years. He served in<br />

the Bosnia mission as a combat engineer who cleared<br />

land mines and rigged explosives. It inspired him to<br />

become a nurse. He described that the best “coolest”<br />

job in the military was to serve as Team Leader on the<br />

Honor Guard. He was the last voice of the military<br />

thanking the spouse for their loved one’s service.<br />

Today, his coolest memories as a nurse are helping<br />

our veterans heal or transition from this life to the<br />

next, along with seeing a veteran’s family take them<br />

home. He is currently a DNP student at Orvis School of<br />

Nursing (UNR) with the goal of becoming an acute care<br />

nurse practitioner. Thank you, Tim, for your past and<br />

ongoing service!<br />

Greater Inclusion of Nursing Students with Disabilities<br />

Alyssa Macleod<br />

UNLV Level 3 Nursing Student<br />

When life gets hard, you<br />

fight back harder. When I was<br />

born, my parents were told I<br />

would never walk, never talk<br />

and I would be in a wheelchair<br />

for life. Now I am a Level 3<br />

UNLV nursing student trying to<br />

help others in similar roles have<br />

their voices heard. I’ve been<br />

called a hero, a role modelyou<br />

name it, and I am none of<br />

those things. I am someone who just wants to make<br />

the world a little easier for the children of today.<br />

GROWING UP RESILIENT<br />

I had a seizure shortly after I was born. I was two<br />

months early weighing just over four pounds. I did<br />

not take my first steps until I was three years old. It is<br />

thanks to a selective dorsal rhizotomy [SDR] (a surgery<br />

that involved opening my spine and burning some of<br />

the nerves leading to my legs) and countless hours of<br />

physiotherapy that I am able to walk today.<br />

I was born with Cerebral Palsy (CP), the most<br />

common motor disability in childhood, according to<br />

the Centers for Disease Control and Prevention. It<br />

affects my ability to move and maintain balance. While<br />

there are different types of CP, the type I have only<br />

affects my legs. With the help of Shriners Hospitals for<br />

Children in Montreal, Canada, and with many surgeries<br />

and Botox treatments in my legs, I defied the odds, and<br />

I am proud to say I now walk unassisted, albeit a little<br />

differently than everyone else.<br />

I have bad days when it’s hard, and my legs don’t<br />

want to work. On my bad days when I’m really stiff<br />

and falling over nothing, these thoughts run through<br />

my head: “Why am I here?,” “What am I supposed to<br />

do?,” “Why is this so hard sometimes”? Then I snap<br />

out of it and realize how far I’ve come (which isn’t easy<br />

for me to do either).<br />

LEARNING TO SUPPORT OTHERS<br />

Being a disability advocate started in 2014 when<br />

I was crowned Miss Canada International. I chose<br />

the platform, “Power of Perseverance” (inspiring<br />

people with disabilities to reach their dreams). I<br />

travelled all over Canada and the USA doing speaking<br />

engagements and attending special events as well<br />

as visiting hospitals and nursing homes among many<br />

others for 15 months. After I was crowned Miss<br />

Canada and CP Ambassador, I was asked to talk to<br />

parents and young kids with CP. That’s when I first<br />

thought maybe I’m supposed to be the light at the end<br />

of the tunnel for others. Maybe I’m meant to show<br />

them that CP isn’t the end of the world (although it<br />

really does suck some days). I still haven’t found my<br />

true purpose yet, but I think I’m close.<br />

After spending 20 years as a Shriners patient, I knew<br />

I wanted a career in healthcare when I grew up. The<br />

nurses and doctors at Shriners took such excellent<br />

care of me after all my surgeries and treatments;<br />

they became my second family. I loved going to my<br />

appointments (no one says that, right?). The hospital<br />

staff made such an impact on me, and I knew I wanted<br />

to give back to a community that has given me so<br />

much. But it didn’t come easy.<br />

After my reign as Miss Canada ended, I went to<br />

medical school in the Caribbean. There, I felt like<br />

I didn’t belong. I later found out the school was<br />

changing my passing grades to failing grades and<br />

forcing me out because they didn’t like that I was<br />

disabled. After fighting a losing battle, I returned home<br />

to Canada and decided to apply to nursing. I applied<br />

twice and was not accepted. The director of the<br />

nursing program told me she did not believe I would be<br />

able to perform the required duties because of my CP.<br />

That’s when I turned to UNLV.<br />

AMPLIFYING MY FOCUS AND INNER STRENGTH<br />

I applied to UNLV after reading reviews about how<br />

great their nursing program was. I was very transparent<br />

about my CP, and I got accepted right away, no<br />

questions or discrimination. The SON has been the<br />

most supportive and amazing people I’ve met in my<br />

education journey, and I mean that wholeheartedly. I’ve<br />

been fully accepted here, and it feels amazing to have<br />

so many faculty and classmates in my corner.<br />

For my Community health class, we had to record<br />

a video discussing an issue we would like the <strong>Nevada</strong><br />

State Board of Nursing to address. I chose the topic of<br />

greater inclusion of nursing students with disabilities.<br />

Due to my experience of being rejected, I felt like the<br />

myths of disabilities needed to be addressed. One<br />

myth is that since CP affects the brain, many people<br />

also believe that people with the disability are not as<br />

intelligent. That video evolved into a National Student<br />

Nurses Association resolution on the same topic, asking<br />

for greater inclusion. A resolution is a motion that is<br />

adopted by a deliberative body and can potentially<br />

be written into regulation. In my experience, many<br />

people think having CP automatically means you are in<br />

a wheelchair and are then labelled by society as being<br />

less than even if you are not in a wheelchair.<br />

The truth is, I can do what everyone else can do.<br />

I may do it a little differently and some things may<br />

take me a little longer to accomplish but I will do it;<br />

all I need is a chance to show you. In my time doing<br />

clinical rotations, I have not seen another physically<br />

disabled nurse on the floor. I wrote the resolution to<br />

bring attention to how disabilities are perceived and<br />

to make progress towards changing it. Nurses with a<br />

disability have so much to offer, and we can relate to<br />

patients in unique ways due to shared experiences.<br />

We deserve a chance. We should not be scared to go<br />

after our dreams simply because we are afraid of being<br />

rejected or being the first disabled nurse on a unit. BE<br />

THE FIRST. CHANGE THE STEREOTYPE.<br />

UNLV SON has supported and helped me in more<br />

ways I can count. They gave me that chance, and it’s<br />

my pleasure to help them gain recognition for all<br />

they’ve done. It took me a long time to find my place<br />

but I’m so happy I didn’t give up. A disability doesn’t<br />

define you; you define the disability!

Page 18 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>March</strong>, April, May 2021<br />

Best Practices for Online Meetings<br />

Bernadette Longo, Ph.D., RN, CNL, FAAN<br />

Virtual meetings are now commonplace.<br />

These online venues present similar challenges for<br />

professional interactions as in-person meetings often<br />

did. Yet now, you cannot hide in the back of the room.<br />

Virtual meetings accentuate the image of you being<br />

a tile on a screen. Everyone knows that nonverbal<br />

communication is extraordinarily powerful. Therefore,<br />

use these meetings for your career growth! Show up<br />

as the person and professional you want to be! Here<br />

are some tips to assist you with being effective and<br />

professional during online meetings.<br />

Preparing for the Meeting<br />

• Get in the mood: reflect on what you may<br />

learn or contribute to the upcoming meeting.<br />

It’s an opportunity for you to be with others and<br />

show your worth. Smile or laugh because this<br />

energy comes into the meeting and positively<br />

affects others.<br />

• Clean up the area around your computer:<br />

organize key documents for the meeting and<br />

use “bullet point” notes. Use a document stand<br />

that is placed at the side of the computer and<br />

elevates your notes. This allows you to see them<br />

without having to glance down or look far away<br />

from the camera.<br />

• Minimize distractions: choose a location that<br />

is quiet and distraction-free.<br />

• Check the lighting: Have enough light that you<br />

have a natural skin tone and can be clearly seen<br />

(avoid bright lights or facial shadows). Turn off<br />

any overhead lighting. Face a window for natural<br />

light during day meetings (pull down the shade<br />

if too bright). Use light from well above eye level<br />

and a smaller secondary light from behind and<br />

above you (or light reflecting off the ceiling).<br />

This lighting highlights your hair and eliminates<br />

shadows.<br />

• Turn-off or mute your cell phone. If you have<br />

a weak internet connection, turn off the Wi-Fi to<br />

your cell phone.<br />

• Do a sound-check: rooms with high ceilings<br />

can have an echo. Turn off or avoid noisy<br />

appliances and heater or AC vents. You may<br />

need to use a headset with a microphone.<br />

• Check your background: tailor your<br />

background based on the type of meeting and<br />

audience.<br />

o<br />

o<br />

Set the mood. Avoid visual clutter and<br />

ensure your background does not have any<br />

embarrassing details.<br />

If using Zoom, consider using a virtual<br />

background that is pleasant and nondistracting.<br />

• Position the camera face on. Elevate the<br />

computer as needed to a face level by raising the<br />

laptop (use books or boxes).<br />

• Check your appearance: style your look based<br />

on the type of meeting and audience. Dressing<br />

up helps you get into a professional mood.<br />

o Hair & Makeup: Comb your hair to avoid<br />

flyaway strands. The camera tends to wash<br />

out facial color. Use facial moisturizer to<br />

accent a skin glow. If you choose to wear<br />

makeup - keep it simple with basic mascara,<br />

light blush, and concealer. Light-shaded<br />

lipstick is best. Avoid heavy eye makeup.<br />

o Clothes & Jewelry: If it is an interview, dress<br />

as you would in person. The same goes for<br />

dress in your workplace. Wear long sleeve<br />

tops or blazers that are solid in color. Keep<br />

jewelry simple and classic.<br />

• Set up name/photo: If you have Zoom, set up<br />

your “name” in a professional manner (Name,<br />

RN…). Set up a professional photo of yourself<br />

in the system because it appears when you first<br />

join the meeting.<br />

Joining the Meeting<br />

• Be on time: within 3 to 5 minutes early.<br />

• Smile, unmute and announce or introduce<br />

yourself. Then mute yourself but keep your<br />

camera on.<br />

• If you are the Leader: Join ahead of time.<br />

Verbally greet each person who enters with a<br />

smile (large meetings: welcome as you can).<br />

Quickly review the purpose of the meeting & the<br />

agenda. Be a role model!<br />

During the Meeting<br />

Be Attentive & Participate<br />

• Keep your camera on through the entire<br />

meeting but mute your voice.<br />

• Establish a focal point on the screen near<br />

the camera. Look and speak directly towards this<br />

area. It is natural to want to look at the speaker<br />

or yourself on the screen, but this creates<br />

the appearance of avoiding eye-contact and<br />

disinterest.<br />

• Maintain erect posture. Sit in a straight<br />

chair is best and leaning slightly forward when<br />

speaking helps you project better. Consider<br />

standing for the meeting. This supports your<br />

cardiovascular health!<br />

• Raise your hand to contribute. In small<br />

meetings, you can raise your hand on the screen<br />

at appropriate pauses. In larger meetings,<br />

select Raise your Hand in the meeting controls.<br />

Everyone in the meeting will see that you have<br />

your hand up. Sometimes you may need to use<br />

the chat feature and communicate to the leader<br />

that you have something to add.<br />

• Participate & monitor your Speaking<br />

Style. Speak clearly and not too fast. If you are<br />

nervous, intentionally speak slower until you<br />

relax. Use vocal intonations and a pleasant tone.<br />

• Be kind and considerate: thoughtfully choose<br />

your tone, words, input, and feedback.<br />

• Avoid getting up and leaving. If necessary,<br />

turn off your camera. Be brief.<br />

• Give technology feedback: If malfunctions<br />

with technology occur (e.g., poor connections,<br />

muted but trying to speak), let the person know<br />

and have them repeat their question or assist<br />

them in resolving the issue.<br />

Be Intentional with your Non-verbal Communication<br />

• Smile genuinely: a smile complements the<br />

words spoken and reflects your attitude.<br />

• Nod as you are listening: nodding serves to<br />

reinforce what is being said and is one of the<br />

most universal cultural gestures.<br />

• Use your hands to express when speaking:<br />

when you use your hands, your face lights up<br />

and your voice has energy. Keep your gestures<br />

below your shoulders and away from your face.<br />

• Avoid crossing your arms when listening;<br />

instead, place one arm on the table or both at<br />

your side, or fold your arms on your lap.<br />

• Avoid leaning back or rocking back and forth<br />

in a chair; it communicates that you are bored.<br />

• Avoid multi-tasking; same as in an in-person<br />

meeting.<br />

• Turning off your camera is unprofessional<br />

and rude to the leader and those who are<br />

contributing. Besides, it communicates that you<br />

may not even still be listening. If your internet<br />

connection is weak and problematic, turn off<br />

your camera and send a chat message to the<br />

leader indicating the problem.<br />

• It’s OK to laugh and enjoy. Virtual meetings<br />

are a time to connect with others and are<br />

important for your mental health.<br />

Ending the Meeting<br />

• Wave your hand to say goodbye! Say thank you.<br />

• If you are the leader: Summarize the key<br />

points, state any follow-up tasks, and especially<br />

thank everyone for attending and contributing.<br />

Learning & Growing<br />

• Reflect by asking: How was I perceived in<br />

the meeting? Could I have done something<br />

differently? Were people interested and<br />

attentive to what I said? Did I listen well to<br />

others? Should I follow-up on anything or with<br />

anyone?<br />

• Be kind and honest to yourself. Having an<br />

intention to be the person you want to be is the<br />

most important step. Stay on the journey!

<strong>March</strong>, April, May 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 19<br />

UNLV Nursing Program<br />

Jumps into Top 10 Best<br />

Online Programs<br />

Joseph Gaccione, Communications & Outreach<br />

Specialist School of Nursing, University of<br />

<strong>Nevada</strong>, Las Vegas<br />

joseph.gaccione@unlv.edu<br />

The UNLV School of Nursing continues to ascend<br />

among the nation's top-rated online graduate and<br />

professional programs. Per its January 2021 survey,<br />

U.S. News and World Report ranks UNLV Nursing's<br />

online master's program as the 7th best in the country,<br />

moving up from 11th in 2020. UNLV has ranked in the<br />

top 30 each year since U.S. News began rating online<br />

nursing programs in 2012.<br />

“We appreciate that U.S. News & World Report<br />

continues to highlight our stellar faculty, staff, and<br />

curricula as among the best in the country," said Dr.<br />

Angela Amar, dean of the School of Nursing. "Our<br />

wonderful online students receive a high-quality<br />

education that prepares them to meet the rapidly<br />

changing health needs of our community. During the<br />

COVID-19 pandemic, the importance of nurses has<br />

been reinforced, and we are meeting the challenge of<br />

preparing our students to enter the frontlines and make<br />

a positive impact.”<br />

Among the most impactful changes to the MSN<br />

program’s recent growth include improved graduation<br />

and board certification pass rates, more faculty and<br />

student resources, and alumni engagement.<br />

All of UNLV Nursing’s graduate school courses are<br />

online. In 2020, UNLV Nursing’s MSN program and<br />

Doctor of Nursing Practice (DNP) Programs catapulted<br />

into the Top 50 of U.S. News and World Report’s Best<br />

Graduate Programs (after ranking in the Top 100 the<br />

year before). Each ranked 40th in the nation.<br />

UNLV’s School of Nursing currently offers two<br />

master's tracks — family nurse practitioner (FNP) and<br />

nurse educator (NE) — that prepare advanced clinicians<br />

and educators in nursing to serve the community's<br />

health needs and educate future nursing care<br />

providers. The school will offer a master’s track for<br />

nurse practitioners in psychiatric mental health in Fall<br />

2021.<br />

“We strive to offer a rigorous and engaging online<br />

MSN experience for our students that prepares them to<br />

be culturally responsive and innovative practitioners,”<br />

said Dr. Steven Palazzo, the school’s associate dean for<br />

academic affairs. “Our graduates translate evidence<br />

into practice in ways that promote both healthy<br />

communities and quality improvement at the systems<br />

level."<br />

UNLV Nursing faculty and staff altered their<br />

procedures in 2020 to maintain productive graduate<br />

clinical experiences during the coronavirus pandemic.<br />

Through virtual clinicals and evaluations, FNP students<br />

simulated telehealth scenarios while receiving the<br />

necessary feedback for their performances.<br />

UNLV Nursing’s graduate course catalog also<br />

includes the only Ph.D. in Nursing program in <strong>Nevada</strong><br />

and multiple Post-Master’s tracks for Nursing Education<br />

and Psychiatric Mental Health Nurse Practitioner.<br />

U.S. News and World Report ranks online graduate<br />

programs on various criteria, including faculty<br />

engagement; faculty credentials and expertise; services<br />

and technologies that allow for flexible distance<br />

learning; and resulting student excellence.<br />

A Local Chapter Organization Supporting Men in<br />

Nursing<br />

Andrew Thomas Reyes, Ph.D., MSN, RN<br />

Men in the nursing profession are steadily rising.<br />

In the 1970s, only 2.7% of the nurses were male.<br />

However, in a 2019 report from the U.S. Labor Bureau<br />

of Statistics, about 12% of the registered nurses were<br />

male. As the numbers of men in nursing are also<br />

growing in <strong>Nevada</strong>, a new chapter of the American<br />

Association for Men in Nursing (AAMN) has been<br />

created in 2018 to support male nurses' professional<br />

development and continue the campaign of increasing<br />

men in the nursing profession. This new AAMN chapter<br />

is the Men in Nursing of Southern <strong>Nevada</strong> (MNSN).<br />

The MNSN was founded by three faculty members<br />

of the School of Nursing at the University of <strong>Nevada</strong>,<br />

Las Vegas (UNLV) – Dr. Andrew Thomas Reyes, Dr.<br />

Rhigel A. Tan, and Dr. Reimund Serafica. Together, they<br />

spearheaded providing a framework for nurses, as a<br />

group, to meet, discuss, and influence factors, which<br />

affect men as nurses.<br />

The first election of the MNSN was held last August<br />

22, 2018. The following are the founding officers of<br />

the MNSN: Dr. Andrew Thomas Reyes (President), Dr.<br />

Rhigel A. Tan (President-Elect), Dr. Reimund Serafica<br />

(Vice-President), Stephen Ingerson of the University<br />

Celebrating Men in Nursing!<br />

Medical Center (Treasurer), Anthony Irvey of the<br />

College of Southern <strong>Nevada</strong> (Secretary), Douglas Foley<br />

of the University Medical Center (Bylaws Committee<br />

Chair), Arvin Operario of Optum (Membership<br />

Committee Chair), and Dr. Marife Aczon-Armstrong of<br />

the Roseman University (Education Committee Chair).<br />

The membership of the MNSN is unrestricted by<br />

consideration of age, color, creed, handicap, sexual<br />

orientation, lifestyle, nationality, race, religion, or<br />

gender. Currently, the MNSN has three female<br />

members.<br />

On September 21, 2019, the MNSN received the<br />

2019 Community Achievement Award as the new<br />

emerging organization promoting diversity given<br />

by Governor Sisolak and the Asian American Group<br />

(AAG). The MNSN, as a local chapter for men in<br />

nursing, continues to support men who are nurses<br />

to grow professionally, to advocate for continued<br />

research, education, and dissemination of information<br />

about men's health issues and men in nursing, and to<br />

facilitate the members' full participation in the nursing<br />

profession and its organization.<br />

More information about the MNSN is found on our<br />

Facebook page (facebook.com/MenInNursing<strong>Nevada</strong>)<br />

and our website (www.MenInNursing<strong>Nevada</strong>.com).

Page 20 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>March</strong>, April, May 2021<br />

The Effects of COVID-19 on Organ Donation and Transplantation<br />

John A. Lilley, MBA, BSN, RN, CPTC<br />

Vice President of Organ Operations<br />

DonorNetworkwest.org<br />

In December 2020, the<br />

Merriam-Webster English<br />

Dictionary announced<br />

“pandemic” as the word of the<br />

year due to its increased use<br />

and investigation of meaning.<br />

At the same time, Dictionary.<br />

com announced the People’s<br />

Choice 2020 Word of the Year<br />

to be “unprecedented.” The<br />

site’s Senior Research Editor, John<br />

Kelly, described the use of unprecedented in the form of<br />

“...the pandemic, the protests, the presidential election,<br />

the extreme climate episodes – 2020 sent us searching for<br />

a word that could do justice to the scale and pace of all<br />

this upheaval” (Minegar, 2020). For those of us in health<br />

care, unprecedented in 2020 meant the added daily stress<br />

in witness of suffering and death from COVID-19, the<br />

emphasis and availability of personal protective equipment<br />

to safeguard the provider, patient, and community, along<br />

with navigating the use of precious resources to maintain<br />

quality for as many patients as possible.<br />

For professionals working in organ donation for<br />

transplantation, unprecedented is also a word that<br />

was commonly used during the tumultuous year of<br />

2020 and over the last several years. As a community<br />

of Organ Procurement Organizations (OPO), transplant<br />

centers, and donor hospitals where a potential donor is<br />

identified, the number of deceased organ donors has<br />

experienced unprecedented growth in the last decade.<br />

Since <strong>2011</strong>, there has been a 54.9% (4,463) growth in<br />

the number of recovered donors in the United States.<br />

During the year of the SARS-CoV-2 pandemic, there<br />

was a 6.1% (718) growth of recovered deceased donors<br />

compared to 2019 (U.S. Department of Health & Human<br />

Services, 2021). This increase in deceased donors<br />

equated to more transplants. Since <strong>2011</strong>, there has<br />

been an increase in transplants from deceased donors<br />

by 47.8% (10,778) and a growth from 2019 of 3.1%<br />

(987). Considering the pandemic’s effect on donation<br />

and transplantation, one can call these increases<br />

unprecedented in the number of lives impacted and<br />

saved through the incredible gift of organ donation (U.S.<br />

Department of Health & Human Services, 2021).<br />

Nevertheless, there was also a discouraging change<br />

in transplantation in 2020 due to COVID-19. In <strong>March</strong><br />

2020, out of the uncertainty of the effects of the virus<br />

and concern for patients, along with centers focusing<br />

their resources on emergent needs, 72% of transplant<br />

centers in the U.S. suspended their living-donor<br />

transplant programs (Boyarski, et al., 2020). Considered<br />

“non-essential” elective medical procedures, kidney<br />

transplants, especially from living donors, were placed<br />

on hold. In a letter to the Department of Health and<br />

Human Services (HHS) in <strong>March</strong> 2020, the National<br />

Kidney Foundation urged centers and specifically<br />

HHS to stress the importance of defining “nonessential”<br />

procedures that included access to kidney<br />

transplantation. “The National Kidney Foundation<br />

urged the Administration to distinguish which<br />

procedures are truly elective and non-essential from<br />

procedures – like organ recovery and kidney transplant<br />

– that have immediate, significant, and life-long<br />

benefits for patients. These delays and barriers would<br />

effectively preclude most life-saving kidney transplants<br />

for the near term” (National Kidney Foundation,<br />

2020). Overall, for 2020, national living donation<br />

and transplant rates declined by 22.4% (1,655) in<br />

comparison to the previous year (U.S. Department of<br />

Health & Human Services, 2021).<br />

There are currently over 108,000 candidates in<br />

the U.S. waiting for a solid organ transplant (Organ<br />

Procurement & Transplant Network, 2021). The vast<br />

majority (84.5%) of these patients hope for a kidney<br />

from the generous gift of either a living or deceased<br />

donor. Others are looking forward to a new heart,<br />

lungs, liver, pancreas, or intestine to save, heal, and<br />

enhance their life. In <strong>Nevada</strong>, over 600 patients are<br />

hoping for a transplant.<br />

<strong>Nevada</strong> has also seen unprecedented growth in<br />

donation and transplantation. Since <strong>2011</strong>, the number<br />

of deceased donors from <strong>Nevada</strong> residents has<br />

increased an extraordinary 206.2% (134), resulting in<br />

thousands of transplants across the country, including<br />

over 500 <strong>Nevada</strong>ns (U.S. Department of Health &<br />

Human Services, 2021). In 2020, twenty additional<br />

deceased organ donors from the previous record year<br />

represented an 11.2% increase (U.S. Department of<br />

Health & Human Services, 2021). These are remarkable<br />

accomplishments.<br />

Unfortunately, there are still too many deaths for<br />

those who require a solid organ transplant in the U.S.<br />

and <strong>Nevada</strong>. On average, 17 people die every day waiting<br />

for a transplant, and another person is added to the<br />

national waitlist every nine minutes (Health Resources &<br />

Services Administration, 2020). Although these numbers<br />

do not compare to our experiences of death during the<br />

COVID-19 pandemic, they have been consistent year over<br />

year, resulting in tens of thousands of deaths.<br />

With the world realizing a death toll from the SARS-<br />

CoV-2 virus projected at close to three million and the<br />

U.S. over 550,000 by May 1, 2021 (Institute of Health<br />

Metrics and Evaluation, 2021), we find ourselves<br />

focused on another phrase. What is our “new normal”<br />

going to be in 2021 and beyond? Many of us have a<br />

current “normal” allowing us to go to restaurants that<br />

are restricted to a lower than standard capacity. We<br />

have access to grocery stores and our favorite big box<br />

store. Moreover, we can enjoy the relative freedom to<br />

move about while following mask-wearing guidelines,<br />

social distancing, and avoiding crowds outlined by the<br />

Centers for Disease Control and our state government.<br />

Our “normal” is very different from those in our nation<br />

and state awaiting a solid organ transplant. The impact<br />

of COVID-19 on donation and transplantation in the<br />

U.S. has yet to be fully realized. The initial examination<br />

has shown a probable loss of life of those on the<br />

waiting list due to the virus’s overall impact. Additional<br />

research is needed. All healthcare entities involved in<br />

providing transplants are focused on improvement.<br />

Also, upcoming governmental changes are pushing for<br />

increasing the recovery and transplant of organs.<br />

In July 2019, the “Advancing American Kidney Health”<br />

presidential executive order was enacted, promoting<br />

several goals in improving kidney health, including<br />

doubling the number of kidneys available for transplant by<br />

2030. This order put in motion an extensive governmental<br />

review of the country’s 58 OPOs. The review included<br />

what measures and how all not-for-profit OPOs are<br />

evaluated and certified. In November 2020, this evaluation<br />

led to the Centers for Medicare and Medicaid Services<br />

(CMS) updating guidelines and conditions for coverage<br />

for OPOs. The new measures are designed to “…improve<br />

the quality of OPO services and hold underperformers<br />

accountable” (CMS, 2020). OPOs will be focused on<br />

meeting overall donation rates and transplantation rates,<br />

with the new proposal estimating the addition of 8000<br />

annual transplants. These measures include a higher<br />

level of transparency using reliable data to evaluate<br />

each procurement agency and place requirements for<br />

quality assurance and performance improvement on<br />

underperforming OPOs. These changes continue to<br />

focus all OPOs on providing as many organs as possible<br />

to reduce the suffering and deaths of those experiencing<br />

end-stage organ failure. However, OPOs cannot do this<br />

alone.<br />

OPOs are reliant upon hospital partners to identify<br />

and refer all possible donor candidates. State and<br />

federal statutes outline the need for hospitals to refer<br />

patients promptly to their affiliated OPO. Studies show<br />

that there must be “…a universal understanding that<br />

timely referrals provide both the organ procurement<br />

and the bedside teams with the time they need<br />

to optimally support the family while preserving<br />

their opportunity to donate” (Wojda, et al., 2017).<br />

Allowing time for OPOs to mobilize their resources for<br />

collaborative evaluation, determination of suitability,<br />

and families’ interactions is crucial for increasing the<br />

number of available organs to waiting recipients.<br />

With OPOs and donor hospitals doing everything<br />

they can to ensure organ availability, transplant centers<br />

should be driven to ensure every healthy and safe organ<br />

is implanted. In <strong>March</strong> 2021, new guidelines outlined<br />

by the U.S. Public Health Service (PHS) for assessing<br />

donors and recipients for HIV, Hepatitis B virus, and<br />

Hepatitis C virus will be implemented. The guidelines<br />

remove the term “increased risk” from donors who have<br />

previously been classified as posing a possible higher<br />

risk of transmitting these viruses through a solid organ<br />

transplant. Since 2013, this label is thought to have led<br />

to the discard of hundreds of organs annually (Volk,<br />

Wilk, Wolfe, & Kaul, 2017). The dramatic improvement<br />

in evaluation and testing in the last several decades for<br />

potential organ donors has led to the PHS changes for<br />

risk assessment in hopes that more organs will help<br />

waiting recipients (Jones et al., 2020).<br />

Patients waiting for a transplant who were already<br />

facing daily challenges of managing chronic and acute<br />

demands of living with organ failure such as dialysis,<br />

ventricular assist devices, oxygen therapy, and frequent<br />

lab and medical assessments did not decrease in 2020<br />

during the COVID-19 pandemic. With over 91,000<br />

patients on the national kidney waiting list, the majority<br />

of whom receive maintenance dialysis, merely managing<br />

the exposure of COVID-19 while trying to provide safe<br />

transplants for these vulnerable patients has been<br />

challenging. COVID-19 has affected potential recipient<br />

patients around the country and here in our local<br />

communities within <strong>Nevada</strong>. The precious gifts from<br />

deceased and living donors continue to trend upward, but<br />

we, as a collective of donor hospitals, transplant centers,<br />

and OPOs, have an obligation to those waiting recipients<br />

that most of us will never meet. Are you doing your part?<br />

References<br />

Boyarski, B. J., Werbel, W. A., Durand, C. M., Avery, R.<br />

K., Jackson, K. R., Kernodle, A. B., . .. Massie, A. B.<br />

(2020). Early national and center-level changes to<br />

kidney transplantation in the United States during<br />

the COVID-19 epidemic. American Journal of<br />

Transplantation, 20(11), 3131-3139. doi:10.1111/ajt.16167<br />

Centers for Medicare & Medicaid Services. (2020, November<br />

20). CMS finalizes policy that will increase the number of<br />

available lifesavings organs by holding organ procurement<br />

organizations accountable through transparency and<br />

competition. Retrieved from CMS.gov: News Room:<br />

https://www.cms.gov/newsroom/press-releases/cmsfinalizes-policy-will-increase-number-available-lifesavingsorgans-holding-organ-procurement#:~:text=The%20<br />

first%20new%20measure%20is,an%20organ%20<br />

transplantation%20rate%20measure.<br />

Centers for Medicare & Medicaid Services. (2020,<br />

November 20). Organ Procurement Organization<br />

(OPO) Conditions for Coverage Final Rule: Revisions to<br />

Outcome Measures for OPOs CMS-3380-F. Retrieved<br />

from CMS.gov: Newsroom Fact Sheet: https://www.<br />

cms.gov/newsroom/fact-sheets/organ-procurementorganization-opo-conditions-coverage-final-rulerevisions-outcome-measures-opos<br />

Health Resources & Services Administration. (2020,<br />

September). Organ Donation Statistics. Retrieved from<br />

Organdonor.gov: U.S. Government Information on<br />

Organ Donation and Transplantation: https://www.<br />

organdonor.gov/statistics-stories/statistics.html<br />

Institute of Health Metrics and Evaluation. (2021, January 15).<br />

IHME: COVID-19 Projections. Retrieved from Institute of<br />

Health Metrics and Evaluation: http://www.healthdata.org/<br />

Jones, J. M., Kracalik, I., Levi, M. E., Bowman, J. S., Berger,<br />

J. J., Bixler, D., . . . Basavaraju, S. V. (2020). Assessing<br />

solid organ donors and monitoring transplant recipients<br />

for human immunodeficiency virus, hepatitis B virus,<br />

and hepatitis C virus infection — U.S. public health<br />

service guideline, 2020. MMWR. Recommendations and<br />

Reports, 69(4), 1-16. doi:10.15585/mmwr.rr6904a1<br />

Minegar, A. (2020, December 16). Merriam-Webster's<br />

2020 Word of the year is 'pandemic,' people choose<br />

'unprecedented'. Retrieved from WWMT News - West<br />

Michigan: https://wwmt.com/news/offbeat/merriamwebsters-2020-word-of-the-year-is-pandemic-peoplechoose-unprecedented<br />

National Kidney Foundation. (2020, <strong>March</strong> 19). National<br />

kidney foundation urges clarity and flexibility on<br />

elective surgery procedures during COVID-19 outbreak.<br />

Retrieved from National Kidney Foundation: https://<br />

www.kidney.org/news/national-kidney-foundationurges-clarity-and-flexibility-elective-surgeryprocedures-during<br />

Organ Procurement & Transplant Network. (2021, January<br />

21). Organ Procurement & Transplantation Network:<br />

Data. Retrieved from U.S. Department of Health &<br />

Human Services: https://optn.transplant.hrsa.gov/data/<br />

U.S. Department of Health & Human Services. (2021,<br />

January 21). National Data: Donors Recovered in the<br />

U.S. by Donor Type. Retrieved from Organ Procurement<br />

and Transplantation Network: https://optn.transplant.<br />

hrsa.gov/data/view-data-reports/national-data/#<br />

U.S. Department of Health & Human Services. (2021,<br />

January 21). National Data: Transplants by Donor Type.<br />

Retrieved from Organ Procurement & Transplantation<br />

Network: https://optn.transplant.hrsa.gov/data/viewdata-reports/national-data/#<br />

U.S. Department of Health & Human Services. (2021,<br />

January 21). State Data: Donors Recovered in the U.S.<br />

by Donor Type. Retrieved from Organ Procurement and<br />

Transplantation Network: https://optn.transplant.hrsa.<br />

gov/data/view-data-reports/state-data/#<br />

U.S. Department of Health & Human Services. (2021, January 21).<br />

State Data: Transplants by Donor Type. Retrieved from Organ<br />

Procurement and Transplantation Network: https://optn.<br />

transplant.hrsa.gov/data/view-data-reports/state-data/<br />

Volk, M. L., Wilk, A. R., Wolfe, C., & Kaul, D. R. (2017).<br />

The “PHS increased risk” label is associated with<br />

non-utilization of hundreds of organs per year.<br />

Transplantation, 101(7), 1666-1669. doi:10.1097/<br />

TP.0000000000001673<br />

Wojda, T. R., Stawiski, S. P., Yandle, K. P., Bleil, M.,<br />

Axelband, J., Wilde-Onia, R., . . . Shultz, J. (2017). Keys<br />

to successful organ procurement: An experience-based<br />

review of clinical practices at a high-performing healthcare<br />

organization. International Journal of Critical<br />

Illness & Injury Science, 7(2), 91-100. doi:10.4103/IJCIIS.<br />

IJCIIS_30_17

<strong>March</strong>, April, May 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 21<br />

Focus on Fighting the Pandemic, Not Each Other<br />

Angela Fountain, RN<br />

Reprinted with permission from<br />

Arizona Nurse January 2021<br />

With the stress of fighting the yearlong pandemic<br />

while nurses are being stretched to new lengths in their<br />

work environments, it is a good time to revisit the topic<br />

of incivility. What is it? Does it really matter? How can<br />

I prevent my work environment from having the toxic<br />

effect of incivility?<br />

Incivility – What is it?<br />

Incivility has been referred to as lateral violence,<br />

horizontal violence, and bullying (Blair, 2013). Incivility<br />

has further been defined as “any behavior toward a<br />

coworker that is perceived as or intended to humiliate,<br />

demean, belittle, diminish, and/or isolate and leads<br />

to a power relationship in which the abuser attempts<br />

to control the victim” (Bunk & Magley, 2013, p. 87).<br />

Incivility violates social norms of workplace etiquette<br />

and can involve being condescending, displaying<br />

impatience, refusing to answer questions and general<br />

disrespect toward another co-coworker (Kaiser, 2017).<br />

We, as nurses, should focus on understanding the<br />

impact of uncivil behaviors as incivility affects all<br />

personnel and can diminish communication, which is<br />

vital to promoting the delivery of safe patient care.<br />

Incivility – Who does it? Does it really matter?<br />

Incivility has the potential to occur in all workplaces<br />

in all parts of the world. Healthcare has had especially<br />

high incidences of reported bullying worldwide and the<br />

subject of incivility has been studied in undergraduate<br />

programs, advanced practice specialties, medical school<br />

programs, residencies, and some advanced practice<br />

student roles in all areas of the world (Winston, 2017).<br />

Within the United States, incivility has been studied<br />

specifically within the nursing profession and has<br />

been reported to be as high as 48% (Keller, Budin, &<br />

Allie, 2016). Professional advocacy agencies, like the<br />

American Nurses Association, (ANA) have taken strong<br />

positions against bullying in an attempt to reduce<br />

medical errors and improve the health care and safety<br />

of patients (ANA, 2015).<br />

In order for us to know about whether there is<br />

incivility within our workplace, workplace culture<br />

should be assessed periodically as culture can change<br />

rapidly. As nurses, we recognize that for every action,<br />

there is a reaction. This should prompt us to think<br />

about the collateral damage uncivil work cultures<br />

cause. Not only can errors be made, or patients<br />

harmed, there are physical consequences for persons<br />

exposed to incivility. Sauer et al., (2017), found that<br />

nurses who experience bullying, have decreased<br />

physical functioning, have more complaints of body<br />

pain, and overall felt in poorer general health. Healthy<br />

nurses are better able to care for patients, have fewer<br />

complaints of burnout and display less compassion<br />

fatigue. By assessing and understanding the direct<br />

relationship between perceived bullying and burnout,<br />

we can prevent burnout, keep our patients safe and<br />

our staff healthy.<br />

Feng et al., (2016) found that varying levels of<br />

experience and work areas are key contributors of<br />

workplace bullying. Areas that are highly stressful<br />

such as intensive care units, emergency departments,<br />

and operating theaters yield a higher perceived<br />

level of incivility. Novice nurses also perceived more<br />

incivility than did more experienced nurses. While<br />

this has a variety of factors that can be the cause, it<br />

is important to recognize and support novice nurses<br />

as they begin their practice while providing ongoing<br />

support for more experienced nurses. Through the<br />

study of incivility, it has been identified that colleague<br />

support and promoting professional competence<br />

reduce incivility in the workplace while increasing job<br />

performance and satisfaction.<br />

How can I prevent the ill effects of incivility in my<br />

workplace?<br />

It takes work but promoting a civil work<br />

environment is not only personally rewarding by having<br />

a work environment where we enjoy, it promotes<br />

better patient care, better outcomes and less attrition.<br />

Reforming flawed processes of tolerating incivility<br />

may help reduce chronically high turnover which<br />

also helps reduce the costs associated with turnover.<br />

Promoting civil work environments supports effective<br />

communication which yields to greater patient safety<br />

and the promotion of an effective team environment.<br />

An effective team environment may result in a decrease<br />

in attrition with the possibility of providing greater<br />

productivity. Creating a positive workplace culture is a<br />

win-win-win. You win, patients win, the hospital wins.<br />

Don’t let your workplace culture become tainted by<br />

incivility. This pandemic is hard enough on us- take care<br />

of each other.<br />

Angela Fountain, DNP, CRNA<br />

References<br />

American Association of Nurse Anesthetists [AANA].<br />

(2014). Promoting a culture of safety and healthy work<br />

environment practice considerations. Retrieved from:<br />

http://www.aana.com/resources2/professionalpractice/<br />

Documents/PPM Promoting a Culture of Safety and<br />

Healthy Work Environment.pdf<br />

Apt, C. (2016). The bullying of nurses by nurses. Psychology<br />

and Education: An Interdisciplinary Journal, 53(1-2), 50-<br />

55. Retrieved from http://login.ezproxy1.lib.asu.edu/<br />

login?url-https://search-proquest-com.ezproxy1.lib.asu.<br />

edu/docview/1835035530?accountid-4485<br />

Blackstock, S., Harlos, K., Macleod, M. L. P., & Hardy,<br />

C.L. (2015). The impact of organizational factors on<br />

horizontal bullying and turnover intentions in the<br />

nursing workplace. Journal of Nursing Management,<br />

23(8), 1106-1114. http://dx.doi.org.exproxy1.lib.asu.<br />

edu/10.1111/jonm.12260<br />

Blair, P. (2013). Lateral violence in nursing. Journal of<br />

Emergency Nursing, 39(5), e75-e78. Doi: 10.1016/j.<br />

jen.<strong>2011</strong>.12.006<br />

Boyd, D., & Poghosyan, L. (2017). Certified registered nurse<br />

anesthetist working conditions and outcomes: A<br />

review of the literature. American Association of Nurse<br />

Anesthetist Journal, 85(4), 261-270.<br />

Bunk, J. A. & Magley, V. J. (2013). The role of appraisals and<br />

emotions in understanding experiences of workplace<br />

incivility. Journal of Occupational Health Psychology,<br />

18(1), 87-105. http://dx.doi.org.ezproxy1.lib.asu.<br />

edu/10.1037/a0030987<br />

Chrysafi, P., Simou, E., Makris, M., Malietzis, G., & Makris,<br />

G. C. (2017). Bullying and sexual discrimination in<br />

the Greek health care system. Journal of Surgical<br />

Education, 74(4), 690-697. 10.1016/j.jsurg.2016.12.005<br />

Clark, C. M. (<strong>2011</strong>). Pursuing a culture of civility: An<br />

intervention study in one program of nursing.<br />

Nurse Educator, 36, 98-102. Doi:10.1097/<br />

NNE.0b013c3182161238<br />

Cuff, P. A, & Institute of Medicine. (2014). Establishing<br />

transdisciplinary professionalism for improving health<br />

outcomes: Workshop summary. Washington, D. C.:<br />

National Academies Press. Retrieved from http://www.<br />

napedu/catalog/php?record_id=18398<br />

Elblad, R., Kodjebacheva, G., & Lebeck, L. (2014). Workplace<br />

incivility affecting CRNAs: A study of prevalence,<br />

severity, consequences with proposed interventions.<br />

AANA Journal, 82(6), 437-445.<br />

Giorgi, G., Mancuso, S., Perez, F., D’Antonio, C. A,<br />

Mucci, N., Cupelli, V. & Arcangeli, G. (2016). Bullying<br />

among nurses and its relationship with burnout and<br />

organizational climate. International Journal of Nursing<br />

Practice 22(2), 160-168. http://dx.doi.org.ezproxy1.<br />

ib.asu.edu/10.1111/ijn.12376<br />

Guidroz, A., Geimer, J., Clark, O., Schwetschenau, H. &<br />

Jex, S. (2010). The Nursing Incivility Scale: Development<br />

and Validation of an Occupation-Specific Measure.<br />

Journal of Nursing Measurement. 18. 176-200.<br />

10.1891/1061-3749.18.3.176.<br />

Henson, R. (2001). Understanding Internal Consistency<br />

Reliability Estimates: A Conceptual Primer on<br />

Coefficient Alpha. Measurement and Evaluation in<br />

Counseling and Development, 34. 177-89.<br />

Hutchinson, M., & Hurley, J. (2013). Exploring leadership<br />

capability and emotional intelligence as moderators of<br />

workplace bullying. Journal of Nursing Management,<br />

21(3), 553-562. http://dx.doi.orgezproxy1.lib.asu.<br />

edu/10.1111/j.1365-2834.2012.01372.x<br />

Kaiser, J. A. (2017). The relationship between leadership<br />

style and nurse to nurse incivility: Turning the lens<br />

inward. Journal of Nursing Management, 25(2), 110-<br />

118. http://dx.doi.org.ezproxy1.lib.asu.edu/10.1111/<br />

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Keller, R., Budin, W. C., & Allie, T. (2016). A task force<br />

to address bullying. American Journal of Nursing,<br />

116(2), 52-58. http://dx.doi.org/10.1097/01.<br />

NAJ.0000480497.63846.d0<br />

Krathwohl, D.R., Bloom, B.S., Masia, B.B., (1964). Taxonomy<br />

of educational objectives: The classification of<br />

educational goals. Handbook II: Affective Domain.<br />

David McKay Co., Inc: New York.<br />

Li, Y., & Zhang, L. (2016). Workplace bullying among nurses<br />

in south Taiwan. Journal of Clinical Nursing. 25(8).<br />

2450-2456. Retrieved from http://login.ezproxy1.<br />

lib.asu.edu/login?url=https://search-proquest-com.<br />

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id=4485<br />

Livine, Y., & Goussinsky, R., (2017). Workplace bullying and<br />

burnout among healthcare employees: The moderating<br />

effect of control-related resources. Nursing & Health<br />

Sciences, 1-10. 10.1111/nhs.12392<br />

Logan, T. R., & Malone, M. D. (2018). Nurses perceptions of<br />

teamwork and workplace bullying. Journal of Nursing<br />

Management Jan 2018. 10.1111/jonm.12554<br />

Mangold, K., Denke, N., Gorombei, C., Ostroski, T., & Root,<br />

L. (2014) Principles of successful partnerships. Nursing<br />

Administration Quarterly. 38(4), 340-347.<br />

Occupational Safety and Health Administration. (n.d.)<br />

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from https://www.osha.gov/SLTC/workplaceviolence/<br />

Sciences, (3)2, 13-222.<br />

Olsen, E., Bjaalid, G., & Mikkelsen, A. (2017). Work climate<br />

and the mediating role of workplace bullying related<br />

to job performance, job satisfaction, and work ability:<br />

A study among hospital nurses. Journal of Advanced<br />

Nursing, 73(11), 2709-2719. Retrieved from http://<br />

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24?accountid=4485<br />

Quinn, L. P. (2017). Bullying and nurses’ work experience,<br />

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to leave one’s job (Ph.D.) Available from PsycINFO.<br />

(18789901724; 2016-47717-284). Retrieved from<br />

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2936936?accountid=4485<br />

Sauer, P. A., & McCoy, T. P., (2017). Nurse bullying: Impact<br />

on nurses’ health. Western Journal of Nursing research<br />

39(12) 1533-1546. 10.1177.0193945916681278<br />

Srabstein, J. C., & Leventhal, B. L. (2010). Prevention of<br />

bullying-related morbidity and mortality: a call for<br />

public health policies. Retrieved from www.who.imt/<br />

bulletin/volumes/88/6/10-077123/en/<br />

Trepaier, S., Fernet, C., Austin, S., & Boudrias, V. (2016).<br />

Work environment antecedents of bullying: A review<br />

and integrative model applied to registered nurses.<br />

International Journal of Nursing Studies, 55, 85-<br />

97. http://dx/doi.org.ezproxy1.lib.asu.edu/10.1016/j.<br />

ijnurstu.2015.10.001<br />

Vessey, J. A., Demarco, R. F., Gaffney, D. A., & Budin, W.<br />

C. (2009). Bullying of staff registered nurses in the<br />

workplace: a preliminary study for developing personal<br />

and organizational strategies for the transformation of<br />

hostile to healthy workplace environments. Journal of<br />

Professional Nursing, 16(1), 47-56.<br />

Winston, M. E. (2017). Student registered nurse<br />

anesthetists’ perceptions of bullying and its impact<br />

on learning (D.N.P.) Available from PsycINFO<br />

(1987917782; 2017-54451-193). Retrieved from http://<br />

login.zproxy1.lib.asu.edu/login?url=https://searchproquest-com.exproxy1lib.asu.edu/docview/195146745<br />

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Wood, R. M. W. (2016). Workplace bullying between<br />

registered nurses; Occurrence and perceived effects<br />

on work productivity (Ph.D.). Available from PsycINFO.<br />

(1951467454; 2017-23163-151). Retrieved from http://<br />

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54?accountid=4485<br />

Yanofsky, S. D. & Nyquist, J. G. (2010). Using the<br />

affective domain t enhance teaching of the ACGME<br />

competencies in anesthesiology training. Journal of<br />

Education Perioperative Medicine 12 (1). Retrieved<br />

from: https://www.ncbi.nlm.nih.gov/pmc/articles/<br />

PMC4719552/.

Page 22 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>March</strong>, April, May 2021<br />

<strong>Nevada</strong> Nurses Foundation EST 2014<br />

Thank you to the wonderful Rural & Frontier Nursing<br />

symposium guest speakers on January 22 -23, 2021.<br />

• Karen Bearer<br />

• Brian Dankowski<br />

• Judy Henderson<br />

• Denyse Ogletree McGuinn<br />

• Kim Simpson<br />

• Eloise Theisen<br />

• Allyson Waldron<br />

The fantastic <strong>Nevada</strong> Nurses Foundation volunteers<br />

& partners created an interesting and exciting<br />

educational opportunity.<br />

• Dr. Mary Bondmass<br />

• Linda Bowman<br />

• Dr. Vicky Lang Catlin<br />

• Kelly Farley<br />

• Dr. Glenn Hagerstrom<br />

• Kate Hirsch<br />

• Rev Dr. Denyse Ogletree McGuinn<br />

• Dr. Sandy Olguin<br />

• Jessica Rasaminanana<br />

• Kim Simpson<br />

• Veloma Wolfe<br />

• American Cannibus Association<br />

• Great Basin AACN<br />

• NCEDSV<br />

• <strong>Nevada</strong> Nurses Association

<strong>March</strong>, April, May 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 23<br />

<strong>Nevada</strong> Nurses Foundation EST 2014<br />

Congratulations to Martha Drohobyczer and Laurie<br />

Shultz for being the 2021 Rural & Frontier Symposium<br />

Raffle Prize winners! We appreciate you and your<br />

support.<br />

Speaking of raffle…It is time to buy your 2021 Tea<br />

on the Comstock Big Hat High Tea raffle tickets!! The<br />

wonderful prizes include:<br />

$500 Visa Gift Card<br />

$300 Southwest Airline Voucher<br />

$250 Amazon Gift Card<br />

$250 Target Gift Card<br />

$200 Best Buy Gift Card<br />

hosted a Big Hat High Tea at the <strong>Nevada</strong> Governor’s<br />

Mansion to raise money for nursing scholarships and<br />

grants. Previous Big Hat High Tea themes include My<br />

Fair Lady (2015), Mary Poppins (2016), Mad Hatter<br />

(2017), Over the Rainbow (2018), Crowns and Tiaras<br />

(2019) and the Wild West Tea on the Comstock (2020).<br />

In 2020, the Tea was held virtually. The most amazing<br />

local entertainers donated their time and talent to<br />

deliver sensational performances. We had a virtual<br />

silent auction and had a wonderful raffle!<br />

The 7th annual BIG HAT HIGH TEA fundraiser will<br />

be in June 2021 and this year’s theme is Tea on the<br />

Comstock. Fingers crossed, prayers and good thoughts<br />

appreciated to actually be in the heart of the Comstock<br />

in June. More information will be announced soon!<br />

It is always the season to be…MERRY! Buy local and<br />

support local NV HEROES! We are grateful to Threads<br />

of eNVy for donating the proceeds to the <strong>Nevada</strong><br />

Nurses Foundation.<br />

Thank you Jessica Rasmaninana and Veloma Wolfe<br />

for being our <strong>Nevada</strong> student nurse models!!<br />

Visit https://threadsofenvy.com/<br />

Thank you for supporting the <strong>Nevada</strong> Nurses<br />

Foundation. We know there are many foundations<br />

and services competing for funds and we appreciate<br />

you recognizing the NNF’s contributions to nursing,<br />

healthcare, and our community.<br />

Thank you and have great days,<br />

Sandy Olguin, DNP, MSN, RN<br />

President/CEO<br />

<strong>Nevada</strong> Nurses Foundation<br />

https://NVNursesFoundation.org<br />

“Success has nothing to do with what you gain in life<br />

or accomplish for yourself. It’s what you do for others.”<br />

~ Danny Thomas<br />

Raffle Tickets are 1 for $10, 4 for $20, and 25 for<br />

$100. Call or text us at 775-560-1118.<br />

In 2014, when the NNF was first established,<br />

Margaret Curley, Founding Member & past NNF/NNA<br />

Liaison, suggested we host a High Tea, Betty Razor,<br />

Founding Member & past NNF Treasurer, suggested we<br />

wear big hats, Ian Curley introduced our first Big Hat<br />

High Tea in 2015 and Darlene Bujold sang the first song<br />

in 2015.<br />

It is exciting to see the NNF grow, evolve, and make<br />

a difference in healthcare and the lives of our <strong>Nevada</strong><br />

providers. Every year since 2015, the Foundation has<br />

Kudos to <strong>Nevada</strong>’s Nursing School for conferring doctoral degrees to over 65 nurses during 2020.<br />

Congratulations to all the nurses listed below earning those degrees!<br />

Chamberlain University<br />

DNP graduates<br />

Maisha Moore<br />

Although Chamberlain had only<br />

one DNP graduate from <strong>Nevada</strong>,<br />

Chamberlain University has nationwide<br />

programs at multiple campus<br />

sites. During 2020, Chamberlain<br />

University granted over 460 DNP<br />

degrees!<br />

Touro University<br />

DNP Graduates<br />

Margo Wallace<br />

Sussie Akrong<br />

Lea Ramos<br />

Adriene Rivera<br />

Brandon Lowe<br />

Alyssa Sturm<br />

Ibhalukholor Sedenu<br />

Jesus Macanas<br />

Jeoffrey Tinapay<br />

Minjung Hong-Decapio<br />

Tamara Schwing<br />

Margaret Schwimer<br />

Joseph Eslao<br />

Billy Leonardo<br />

Brittani Hicks<br />

Alana Swift<br />

Anna Mark<br />

Rosalyn Phan<br />

Catherine Nitafan-Young<br />

Janell Ocampo<br />

Habtamu Egata<br />

Medard Sison<br />

Bernice Ivoko<br />

Suzette Ryan<br />

Sloane Bowsher<br />

Elizabeth Dania<br />

University of <strong>Nevada</strong> Las Vegas<br />

DNP and PhD Graduates<br />

DNP:<br />

Jocelyn Allen<br />

Kaylie Humphreys<br />

Kristen Grunerud<br />

Sarah Deredza<br />

Mary Nara<br />

Teresa Praus<br />

Mailo Branter<br />

Valerie Barboa<br />

Tonya Bryant<br />

Beth Hock<br />

Jud Simons<br />

PhD:<br />

Susan Belliston<br />

Kelly Ann Garthe<br />

Lynn Senette<br />

Adrian Stamps<br />

Rhiannon Sullivan<br />

Anna Wendel<br />

University of <strong>Nevada</strong> Reno<br />

DNP Graduates<br />

Adeline Abam<br />

Laura Breu<br />

Kathleen Burns<br />

Susan Cocores<br />

Richard Crisostomo<br />

Anna Froelich<br />

Caren Jaggers<br />

Marjaana Krieger<br />

Rustin Park<br />

Jana Elliott<br />

Jessica Grote<br />

Kelly Lau<br />

Danielle Planas<br />

Jaskaranjeet Bhullar<br />

Diana Kaydee Carrol<br />

Rebecca Edwards<br />

Kathy Goldsworthy<br />

Jennifer Griffo<br />

Cristina Mosqueda<br />

Christine Pebbles<br />

Kristen Seeley<br />

Jamie Young<br />

Alana Rogne<br />

Brandee Shipman

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