Maine Journal - May 2021




The Newsletter of the American Nurses Association–Maine

Quarterly publication distributed to approximately 15,600 RNs and LPNs in Maine.


President’s Message

Nurses Week - 2021

Robert Abel, MSN, RN,


President, ANA-Maine

Little did any of us think

a year ago at this time that

this pandemic would affect

our lives as it has. Most of

us imagined a few weeks,

perhaps a month or two,

summer 2020 would come

and as often happens with

other viruses, the surge would recede. But that was not

to be.

In some ways our lives have changed irrevocably.

We will not be going back. We have learned new and

efficient ways to shop. We have learned bricks and

mortar may not be as fundamental to our businesses

as we thought they were. We have even learned new

ways of learning! Happy Hour can happen at home, on

Zoom. And marathons can be virtual.

But we have also reaffirmed that nursing is

fundamentally a person-to-person interchange. It is

hands on (even with gloves). That nurses are essential

to health delivery in every setting. That nurses adapt

and change with great skill and our patients are better

because of it. I am reminded that

“we give but little when we give of our possessions, it

is when we give of ourselves that we truly give.”

(K. Gibran)

This is unchanged: Nurses give of themselves.

Through the ups and downs of this pandemic,

nurses continued to care in ways we know and in ways

we will never know. On this Nurses Week in 2021, I

salute you my colleagues and wish you much happiness

and many joys in the coming months.

In the meantime, Wear a Mask – Keep Your Distance

– Wash Your Hands.

Collins, Bipartisan Group Introduce Bill to

Address Shortage of Doctors, Nurses

Washington, D.C. — U.S. Senators Susan

Collins (R-ME), Dick Durbin (D-IL), John Cornyn (R-

TX), Patrick Leahy (D-VT), Todd Young (R-IN), and

Chris Coons (D-DE) introduced bipartisan legislation

to provide a temporary stopgap to quickly address

our nation’s shortage of doctors and nurses. The

Healthcare Workforce Resilience Act would recapture

25,000 unused immigrant visas for nurses and 15,000

unused immigrant visas for doctors that Congress

has previously authorized and allocate those visas

to doctors and nurses to help in the fight against


“COVID-19 has exacerbated the shortage of

doctors and nurses our nation was already facing. As

we continue to respond to this persistent pandemic,

it is vital that we take steps to alleviate the burden

on our health care system and support medical

professionals,” said Senator Collins. “By issuing

unused employment-based visas to immigrant medical

professionals, this bipartisan legislation would help

strengthen our health care workforce and preserve

access to care, particularly in rural and underserved

communities in Maine and across our country.”

Specifically, the Healthcare Workforce Resilience Act


• Recapture unused visas from previous fiscal years

for doctors, nurses, and their families

• Exempt these visas from country caps

• Require employers to attest that immigrants from

overseas who receive these visas will not displace

an American worker

• Require the Department of Homeland Security

and State Department to expedite the processing

of recaptured visas

• Limit the filing period for recaptured visas to 90

days following the termination of the President’s

COVID-19 emergency declaration

The Healthcare Workforce Resilience Act is

supported by dozens of organizations including the

American Academy of Family Physicians, American

Academy of Neurology, American Association of

International Healthcare Recruitment, American

College of Rheumatology, American Geriatrics

Society, American Hospital Association, American

Collins, Partisan Group...continued on page 2

current resident or

Presort Standard

US Postage


Permit #14

Princeton, MN



Nominate a Nurse ..................3

Nurses Week Webinar ...............3

What You Need to Know About the

Coronavirus Variants ..............4

Remembering the Father of Vaccination . 6

Salute to Maine Nursing Military History. 7

Nurses Address Climate Change .......8

ANA-Maine Nursing Student Scholarship

Criteria .........................8

Maine Health Care Workers Travel to

Super Bowl on Patriots Plane ........9

Honoring Maine’s Nurse Educators ....10

Five Ways to Improve Your Sleep ......12

The CNS as Credentialed Provider .....14

Page 2 ANA Maine Journal May, June, July 2021


Nominations for open seats on the board of

directors will begin July 1, 2021.

ANA-MAINE utilizes a secure online nomination and

voting system to elect members to fill open positions

on the board. Nomination submissions will be accepted

through July 24 and the electronic ballot will be

available August 23 – September 20.

Keep an eye on your email inbox for a link to access

the call for nominations form. To be eligible for a place

on the ballot, you must be a member of ANA-Maine.

Enrollment is quick and easy through the website: - click on the ‘Become a Member’

button and follow the steps to sign up.

Vacant positions are:

Position Term

Treasurer 2 Years

Director 2 Years

Director 2 Years

Collins, Partisan Group...continued from page 1

Organization for Nursing Leadership, American Society

of Hematology, Physicians for American Healthcare

Access, American Academy of Pediatrics, National Rural

Health Association, American Medical Association,

Society of Hospital Medicine, Federation of American

Hospitals, American College of Physicians, Ascension

Catholic Health Association of the U.S., Healthcare

Leadership Council, National Kidney Foundation,

Society of Critical Care Medicine, American

Immigration Lawyers Association,, National

Immigration Forum, Bipartisan Policy Center, American

Business Immigration Coalition, and The Jewish

Federations of North America.

Click here (

media/doc/MDM21419.pdf) to read the text of the bill.

As a member of ANA-MAINE, you have the

opportunity to determine the leadership of our

organization. Details about the electronic voting

process will be emailed to members and may be found

on our website at To be eligible

to submit a nomination, you must have an ANA-

MAINE member ID number. If you need assistance with

obtaining this number, log in to the member portal,

also found on our website.

ANA-MAINE eagerly anticipates the activities

planned for the next work year. Your participation in

this process is a way to positively affect the continued

work of your organization.

To request a paper nomination form, please email

Deadline for submitting online nominations is

July 24, 2021

The newly elected board of directors will be

announced at the ANA-MAINE annual business

meeting. More details regarding this event may be

found at

Published by:

Arthur L. Davis

Publishing Agency, Inc.

Volume 17 • Number 2

Published by the


a constituent member association of the

American Nurses Association


Web Site:

P.O. Box 647

Kennebunk, ME 04043


Robert Abel, MSN, RN, CHPH, CCM, CMC

President, Portland

Juliana L’Heureux, BS, MHSA, RN

President-Elect, Topsham

Joanne Chapman, MEd, MSN, RN, NE-BC

Treasurer, Falmouth

Carla Randall, PhD, RN, CNE

Secretary, Auburn

Mary Therese Cully-Onoshko, RN, CHPN

Director, Union

Mary Doherty, MSN, APRN, BC-PNP

Director, Standish

Patricia Eldershaw, PhD (Soc), MSN, RN

Director, Mapleton

Suzanne Parkman, PhD, RN, CNE

Director, Falmouth

Shannon Stewart, APRN, MSN

Director, Hodgdon

Contents of this newsletter are the opinion of the

author alone and do not reflect the official position of

ANA-MAINE unless specifically indicated. We always

invite leaders of specialty organizations to contribute.


Michelle L. Schweitzer (Editor)

Juliana L’Heureux, BS, RN, MHSA (Co-Editor)

Jean Dyer, PhD, MSN, BSN, CNE

We welcome submissions, but we reserve the right to reject

submission of any article. Send to

CE calendar listings are without charge.

Attribution: We do not knowingly plagiarize. We encourage

our authors to fact check their material but we do not assume

responsibility for factual content of ads or articles.

For advertising rates and information, please contact Arthur

L. Davis Publishing Agency, Inc., PO Box 216, Cedar Falls, Iowa

50613, (800) 626-4081, ANA-Maine and

the Arthur L. Davis Publishing Agency, Inc. reserve the right to

reject any advertisement. Responsibility for errors in advertising

is limited to corrections in the next issue or refund of price

of advertisement. Published quarterly every February, May,

August and November.

Acceptance of advertising does not imply endorsement

or approval by ANA-Maine of products advertised, the

advertisers, or the claims made. Rejection of an advertisement

does not imply a product offered for advertising is without

merit, or that the manufacturer lacks integrity, or that this

association disapproves of the product or its use. ANA-Maine

and the Arthur L. Davis Publishing Agency, Inc. shall not be

held liable for any consequences resulting from purchase

or use of an advertiser’s product. Articles appearing in this

publication express the opinions of the authors; they do not

necessarily reflect views of the staff, board, or membership of

ANA-Maine or those of the national or local associations.

Postal Address corrections: This list of addressees is

obtained from the Maine State Board of Nursing (MSBON)

each issue. To keep your address current for these mailings,

simply notify the MSBON of any needed changes in your postal

mailing address.

Permission must be obtained from ANA-Maine to replicate or

reproduce any content from ANA-Maine Journal.

May, June, July 2021 ANA Maine Journal Page 3

Nominate a Nurse!

Nominations are open for The Agnes E. Flaherty Leadership Award and The

Sister Consuela White Spirit of Nursing Award.

Nominations close August 1, 2021.

Nominations are received by ANA Maine. The nominations are sent to a team

of ANA members from a neighboring New England State Nursing Association

for review and selection. A scoring matrix is used based upon the award criteria.

Awardees are notified prior to the Awards event.

Questions? Please E-mail the Awards Committee at

The categories of practice for each award is described below. Indicate the

category in the online nomination form found at Provide a

letter describing how the nominee exhibits the defining qualities for the award and

upload your descriptive letter for expedient electronic submission. Nominators must

be ANA Maine members.

The Agnes E. Flaherty Leadership Award

This award is targeted for: administrators, educators, public office holders or

nominee, and health care providers and in advanced practice roles.

Defining qualities include the ability to:

• Develop a work environment that fosters autonomy and creativity.

• Value and empower others. Affirm the uniqueness of each individual.

• Motivate others to work toward a common goal.

• Identify common values.

• Be committed to the profession and society.

• Think long-term and be visionary.

• Be politically astute.

• Think in terms of change and renewal.

The Sister Consuela White Spirit of Nursing Award

This award is targeted for: staff nurses in any setting: schools, community, long

term care, acute care, home care etc. Preceptors for students would fall into this


Defining qualities include the ability to:

• Listen on a deep level and to truly understand.

• Keep an open mind and hear without judgment.

• Deal with ambiguity, paradoxes and complex issues.

• Believe that honestly sharing critical challenges with all parties and asking for

their input is more important than personally providing solutions.

• Be clear on goals and good at pointing the direction without giving orders.

• Use foresight and intuition.

• See things whole and sensing relationships and connections.

Online submissions at

Deadline: August 1, 2021

ANA-Maine Partners

with Connecticut Nurses

Association for Continuing


ANA-Maine is excited to join with Connecticut Nurses Association (CNA) in

their Continuing Education Unit. CNA is accredited as an approver of continuing

nursing education by the American Nurses Credentialing Center's Commission on

Accreditation. As an approved provider of Continuing Nurse Education, CNA will

provide ANA-Maine and CNA nurses with lifelong learning opportunities that are

high quality and evidence based.

CNA Continuing Education resources include:

• Individual Activity Approval

• Ability to become an Approved Provider

Please find the Continuing Education resources on the rolling banner or the

left-hand panel of the homepage of our website at We look

forward to supporting Maine nurses and nursing organizations by servicing your

Individual Activity or Approved Provider needs.

Nurses Week Webinar

Climate Change and Population Health:

A Primer for Nurses

May 10, 2021

In response to information received from our state-wide registered nurses survey,

we are excited to announce five new webinars planned for 2021.

The first webinar, Climate Change and Population Health; A Primer for

Nurses, will be offered on May 10, during Nurses Week.

Forthcoming webinars include The Essentials of Identifying and Treating Sepsis.

Please visit our website for more details on the webinars to

be offered in the summer and fall of 2021.

Thank you to all the ANA Nurses of Maine

Happy National Nurses Week!


Our nurses play an integrate role in our team

approach to care, working closely with our

experienced physicians, advanced practice

providers, clinical social workers, rehabilitation

specialist, mental health workers,

peer support specialist, and more.

We are seeking staff nurses to join our

7p – 7a team

Great benefit packages, including $200

monthly student loan reimbursement


If you have questions or would like to speak with our nursing recruiter

Kelly Flagg | | 207-624-4785

Page 4 ANA Maine Journal May, June, July 2021

What you need to know about the coronavirus variants

Marisa Iati and Angela Fritz

**This article is reprinted with permission from the

authors and The Washington Post.

Viruses are always mutating and taking on new

forms. The coronavirus has thousands of variants that

have been identified. But several, including variants first

found in the United Kingdom, South Africa and Brazil,

are highly transmissible and have sparked concerns that

vaccines may be less effective against them.

The same protective measures that have warded

off the virus throughout the pandemic — maintaining

social distance, wearing masks and washing our

hands — are even more critical in the face of more

transmissible variants.

The New York variant (B.1.526)

Where and when was it discovered?

This variant, which was found in samples obtained

as early as November, probably emerged in the

Washington Heights section of New York, Fauci told

reporters in March. By the middle of that month, this

variant made up nearly half of the city’s new infections.

Where is it now?

Officials have reported this variant in at least 14

other states, including Texas, Wyoming and Maryland,

Bloomberg reported.

What makes it different?

Some scientists are concerned that this variant

may be more transmissible than previous versions.

Scott Gottlieb, former director of the Food and Drug

Administration, expressed worry that a mutation on

this variant could enable it to reinfect people who have

already had the virus.

Will vaccines work?

This variant seems to have some resistance to

existing vaccines, although not as much as the variant

first detected in South Africa, Fauci said on CBS News’s

“Face the Nation.” Gottlieb said he was also concerned

that this variant could partly elude the effects of



After weeks of declining cases, echoes of hot spots

emerge in Upper Midwest, New York City area

Registered Nurses (OB-GYN)

Full-Time Nights

Northern Light Mayo Hospital is currently seeking a Registered

Nurse in our Obstetrics Unit for 36 hours per week. This position

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Please apply online at,

and/or E-mail resume to

The South Africa variant (B.1.351)

Where and when was it discovered?

This mutation, also referred to as 501Y.V2, was

found in South Africa in early October and announced

in December, when the country’s health minister said

the strain seemed to affect young people more than

previous strains. This variant may have contributed to

a surge of infections and hospitalizations across South


Where is it?

This mutation has been identified in at least four

dozen countries. On Jan. 28, South Carolina officials

announced that this variant had affected two people

there with no travel history — the first instances of this

strain identified in the United States. It has since been

found in more than two dozen other states.

What makes it different?

This mutation shares some similarities to the variant

first identified in the U.K. and, like that strain, appears

to be more transmissible. There is no evidence that it

is more lethal. Gottlieb has suggested that this variant

might be more resistant to antibody therapies.

There is some evidence that this variant could allow

for reinfection: A man in France was in critical condition

in mid-February after being infected with this strain

four months after he was previously infected with the


Will vaccines work?

The vaccines may have a diminished impact against

this variant, but they probably will still be effective,

top infectious-diseases expert Anthony S. Fauci said in

January. Moderna has said its vaccine protects against

the variant first identified in South Africa, with an

important caveat: The vaccine-elicited antibodies were

also less effective at neutralizing this mutation in a

laboratory dish.

Pfizer and BioNTech released their own study,

not yet peer-reviewed, that suggests their vaccine

effectively neutralizes this variant, though was slightly

less effective.

On Jan. 29, Johnson & Johnson said its single-shot

vaccine was robustly effective in a massive global trial,

but that its protection against sickness was weaker in

South Africa. Biotechnology company Novavax has also

indicated that its vaccine was significantly less effective

during a trial in South Africa.

In South Africa, the distribution of the Oxford-

AstraZeneca vaccine has been halted. The vaccine

did not provide sufficient protection against mild

and moderate cases caused by a new variant, health

officials said.


First known patient reinfected with South Africa

coronavirus variant is in critical condition

South Africa suspends Oxford-AstraZeneca vaccine

rollout after researchers report ‘minimal’ protection

against coronavirus variant

Mutated virus may reinfect people already stricken

once with covid-19, sparking debate and concerns

Coronavirus variant identified in South Africa seen

for first time in United States

U.K. variant (B.1.1.7)

Where and when was it discovered?

This variant was first found in the United Kingdom,

specifically in London and the nearby county of

Kent, in September. It is sometimes referred to as the

Millinocket Regional Hospital, a Critical Access Hospital

nestled at the base of Mt. Katahdin and Baxter State Park, has

immediate openings for the following positions:


Emergency Department RN Positions Available:



Inpatient Unit RN Positions Available:




Qualified applicants please apply online at


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“Kent” variant. It has been spreading rapidly in Britain,

Denmark and Ireland since December.

Where is it?

Dozens of countries, including the United States,

have seen infections from this variant of the virus. It

is by far the most prevalent variant of concern in the

United States, with thousands of cases across the


The Centers for Disease Control and Prevention

released a model forecast in early January that

indicated the variant could become the dominant strain

in the United States by some point in March. A recent

study showed this variant was spreading rapidly in the

United States by early February.

What makes it different?

The variant first identified in the U.K. appears more

transmissible than the more common strain. Preliminary

data also suggests that this strain may be 30 to 70

percent more lethal than previous mutations.

Will vaccines work?

The scientific consensus is that the vaccines will

remain effective against this mutation because those

inoculations provoke an array of neutralizing antibodies

and other immune-system responses. Biotechnology

companies Pfizer, Moderna and Novavax have said their

vaccines appear to work against this variant.

Ravindra Gupta, a professor of clinical microbiology

at the University of Cambridge, found in a study of

older adults that the immune response triggered by the

Pfizer vaccine was modestly less effective against the

variant first identified in the U.K.


Virus variant first detected in the U.K. has been

deadlier, study confirms

U.K. coronavirus variant spreading rapidly through

United States, study finds

Denmark is sequencing all coronavirus samples and

has an alarming view of the U.K. variant

CDC warns highly transmissible coronavirus variant

to become dominant in U.S.

The ‘Eeek’ mutation (E484K)

Where and when was it discovered?

This might best be described as a mutation

within a mutation. It’s called E484K — or “Eeek,” as

epidemiologists refer to it — and it’s appearing on

some of the variants we describe below. It’s not brand

new; it has appeared many times since the start of the

pandemic, but experts have been concerned about

it. It gained mainstream attention when it started to

coincide with other variants that are more contagious.

Where is it?

Eeek has been seen in the variants first discovered

in the U.K., South Africa and Brazil. It has also been

detected in more than 200 samples of the virus

sequenced in the United States since May.

What makes it different?

The Eeek mutation changes the virus’s spike protein,

which is what vaccines target. By itself, this mutation

does not change the virus significantly. The concern

with this mutation is when it’s paired with the other

variants, which could help the virus evade detection

and make neutralization by the human immune system

less efficient.

Will vaccines work?

Scientists are actively trying to answer this question.

Clinical trial data have indicated that vaccines were

less effective in preventing infections with variants in

South Africa featuring the mutation. But the vaccines

still dramatically lowered the chance of severe illness or


Semi-related to the vaccine question: One study

found preliminary evidence that patients in South

Africa who had survived an earlier bout with the more

common coronavirus were becoming infected a second

time — though not severely ill — after exposure to the

variant with this mutation.

May, June, July 2021 ANA Maine Journal Page 5


Worrisome E484K coronavirus mutation seen in U.K. variant and in some U.S.


Brazil variant (P. 1)

Where and when was it discovered?

Sequencing studies found the variant in Brazil, mainly in Rio de Janeiro, as early as

July. Researchers in Japan discovered it in travelers from Brazil in January.

Where is it now?

It has been confirmed in more than two dozen countries, including Japan, Spain

and New Zealand. On Jan. 25, Minnesota health officials confirmed the first U.S.

case of this variant in a resident with recent travel history to Brazil. It has since been

found in at least 18 states.

What makes it different?

The variant has more than a dozen alterations, several of which are found on

the virus’s spike protein, which binds the virus to a cell. Because of that, researchers

think the strain is probably more transmissible. There is also some early evidence

that antibodies might not recognize the P.1 variant, which could lead to reinfection.

Will vaccines work?

There’s no strong evidence right now suggesting that vaccines won’t work

against the variant first identified in Brazil. However, scientists have raised the

possibility that this variant can evade antibodies, which would impact the current

vaccines’ effectiveness.

A study of the Pfizer-BioNTech vaccine published in March determined that it was

highly effective at neutralizing the variant found in Brazil. Moderna has announced

that it would develop a new vaccine tailored to a similar variant in case an updated

shot becomes necessary.


The Amazonian city that hatched the Brazil variant has been crushed by it

First U.S. case of highly transmissible Brazil coronavirus variant identified in


The Denmark/California mutation (L452R)

Where and when was it discovered?

This mutation was detected in Denmark in March.

Where is it now?

A variant with this mutation was found in California this winter and became

dominant there over five months, eventually making up more than half of infections

in 44 of the state’s 58 counties. This mutation has also been confirmed in several

other states.

British officials identify coronavirus mutations, but significance remains unclear

How can we protect ourselves from the variants?

The same protective measures that have warded off the virus throughout the

pandemic — maintaining social distance, wearing masks and washing our hands —

are even more critical in the face of more transmissible variants. Those guidelines

will simultaneously keep you from becoming ill from one of those variants, while

making it harder for the virus to mutate in the first place.

“Viruses don’t mutate unless they replicate,” Fauci said in January.

But it’s also important for scientists to learn as much as they can about these

variants, in case there are specific ways we can slow their spread. Until the research

exists, we can’t make assumptions about what new variants will do.

What do the variants mean for vaccines?

“We need to get as many people vaccinated with the current vaccine that we

have as we possibly can … and prepare for the potential eventuality that we might

have to update this vaccine sometime in the future.” — Fauci in January

As more significant variants are reported, the obvious (and arguably most

important) question is whether the vaccines will work on them. Some of the

mutations have sparked particular concern because they affect the spikes on the

virus, which is what the vaccines target.

In short, the pharmaceutical companies are testing new variants against their

vaccines and spinning up new trials. Moderna and Pfizer-BioNTech can update their

vaccines quickly because of their mRNA technology, which can be reprogrammed to

target new variants.

Pfizer and Moderna have run tests on the variants and while the vaccines still

triggered a response, they appeared to be less effective.

A growing number of scientists anticipate that we will eventually need something

similar to the annual flu shot — companies will periodically update their vaccines to

match the prevalent coronavirus variants, and we will need to get boosters to stay


“With flu, we need to adapt the vaccines. We can see that already,” said

Ravindra Gupta, a professor of clinical microbiology at the University of Cambridge.

“The companies do realize there is a problem in the longer term, and they will deal

with it just as we have done with flu every year.”


New coronavirus variants accelerate race to make sure vaccines keep up

Joel Achenbach, William Booth, Carolyn Y. Johnson, Sarah Kaplan, Laurie

McGinley and Fenit Nirappil contributed to this report.

What makes it different?

There is evidence that this mutation enhances the virus’s ability to bind to human

receptor cells, making it more transmissible. Some scientists are urging public-health

officials to declare the variant with this mutation circulating in California a “variant

of concern,” which would make it the first homegrown variant with this label.

Will vaccines work?

Some scientists think this mutation might make the virus more resistant to

vaccines because the mutation is in the spike protein, which enables the virus to

attach to cells. But scientists also say that more study is needed before they can

draw conclusions.


New research shows California coronavirus variant is more transmissible

Another coronavirus variant linked to growing share of cases, several large

outbreaks, in California

The original variant (D614G)

Where and when was it discovered?

This mutation, known to scientists simply as “G,” was discovered in China in

January 2020. It soon spread through New York City and Europe.

Where is it?

The “G” mutation has become ubiquitous. By July, about 70 percent of the

50,000 genomes of the coronavirus uploaded by researchers worldwide to a shared

database carried the variant.

What makes it different?

Some scientists think this mutation is significantly more transmissible than the

original strain of the virus. That’s because this variant has four to five times more

spikes on its surface. Those spikes enable the virus to latch onto and infect cells. But

other scientists still contest the greater transmissibility.

Will vaccines work?

The G variant was the dominant strain when 2020 vaccine trials took place. The

Pfizer and Moderna vaccines showed a 95 percent efficacy in trials.


This coronavirus mutation has taken over the world. Scientists are trying to

understand why.

Massive genetic study shows coronavirus mutating and potentially evolving amid

rapid U.S. spread

Page 6 ANA Maine Journal May, June, July 2021

Remembering the Father of Vaccination

Professor Richard Gunderman, M.D., Ph.D.

**This essay was published

in the History News

Network and reprinted

with the permission of the


As the US COVID-19

vaccination program reaches

full stride, approaching

two million shots per day,

the time is ripe to recall

the contributions of the

physician-scientist who first put vaccines on the map,

Edward Jenner. Some claim that Jenner saved the lives

of more people than any other figure in history, yet his

contributions are often poorly understood.

Jenner did not invent inoculation

Born in England in 1749, Jenner was inoculated as

a child against smallpox, a dread disease that appears

to have scarred 3,000-year-old Egyptian mummies.

Caused by the Variola virus, the disease manifested

as fever and the development of a blistering skin rash

referred to as pox. It is thought that about 30% of

infected people died of the disease, especially infants

and young children.

In Jenner’s day, inoculation was by variolation. The

skin was scratched and the smallpox scabs or fluid

from an infected person were rubbed into it. When it

worked appropriately, this would cause the variolated

individual to develop a mild case of smallpox which

usually lasted several weeks, after which the patient

would be immune. But small percentages of variolated

individuals died.

The technique had been popularized by Lady Mary

Wortley Montagu, who both lost her brother to the

disease and suffered severe facial scarring herself.

While traveling in Turkey, she witnessed variolation,

and in 1718 she had it performed on her young son.

By the time Jenner was born, variolation had become

been widely incorporated into English medicine.

Other physicians studied vaccination

Jenner was not the first to suspect that prior

infection with cowpox provided immunity against

smallpox. At least five physicians had tested cowpox,

and even a farmer named Benjamin Jesty had used

cowpox to vaccinate his wife and children during a

smallpox epidemic. Jenner, however, was the first to

study vaccination in a scientifically rigorous way.

Knowing that milkmaids were generally immune

to smallpox, Jenner hypothesized that the pustules

on the hands of milkmaids could be used to confer

immunity. In 1796, he tested the idea by inoculating

James Phipps, the eight-year-old son of his gardener.

He scraped material from the hands of Sarah Nelmes,

a milkmaid with smallpox, and inoculated Phipps in

both arms.

After several weeks, he variolated Phipps (i.e.,

deliberate inoculation of an uninfected person with

the smallpox virus). Although the boy did develop a

mild fever, he did not develop full-blown smallpox.

After a time, Jenner variolated him again, with no

effect. The procedure had apparently conferred

immunity. We now know that the viruses that cause

cowpox and smallpox are sufficiently similar that the

immune response to one can confer immunity to the


Jenner died long before viruses were discovered

Today we talk easily of viruses, but in Jenner’s

day they were completely unknown. The great

microscopist Antony van Leeuwenhoek had discovered

bacteria around 1676, but viruses are far too small to

be seen through light microscopes. It was not until

the invention of the electron microscope in 1931 that

viruses were visualized for the first time.

Unanswered questions about the mechanism

of vaccination led the Royal Society not to publish

Jenner’s first manuscript, but after he conducted other

trials, including one on his infant son, his paper was

published. Perhaps his greatest contribution was his

insistence on challenging those who had received the

cowpox inoculation with smallpox to prove they were


The term vaccination betrays its origin. Vacca is

Latin for cow, the source of the cowpox material that

Jenner and others used to inoculate against smallpox.

Some decades before Jenner’s work, US founding

father Ben Franklin decided not to variolate his young

son Francis, a decision he regretted the rest of his life

because the boy died of the disease at age four in


Jenner’s legacy exceeded even his own dreams

Smallpox vaccination quickly spread around the

world. Spanish expeditions carried it to far-flung lands

such as America and China. Napoleon had his troops

vaccinated. Jenner received a host of domestic and

foreign honors. To allow him to focus his attention on

his investigations, Parliament awarded him huge grants

of 10,000 and 20,000 pounds.

But Jenner could not have anticipated where his

work would lead. Immunization by cowpox held sway

until the 19th century, when a more modern live-virus

vaccine was developed using the lymph of calves.

Today versions of smallpox vaccine are available that

do not use live viruses and thus cannot cause disease.

Yet no one is being immunized against smallpox

today, because of a worldwide immunization program

that led the World Health Organization to declare the

disease eradicated in 1980. US vaccination ceased

in 1972, though many older adults still bear scars.

Today the smallpox virus is found only in a few secure

laboratories, where it is used to prepare against the

use of smallpox as a bioweapon.

Jenner died of a stroke in 1823 at the age of 73.

He continued his scientific investigations until the end,

presenting a paper on bird migration to the Royal

Society in the year of his death. Whether or not Jenner

truly saved more lives than any other person, there is

no doubt that his pioneering work on immunization

laid the groundwork for today’s most effective tool

against COVID-19, the vaccine.

Professor Richard Gunderman, M.D., Ph.D., is the

Chancellor’s Professor of Radiology, Pediatrics, Medical

Education, Philosophy, Liberal Arts, Philanthropy, and

Medical Humanities and Health Studies at Indiana

University. He gave permission to reprint this article.

Best Summer Job Ever!

Be a summer camp nurse at Camp Wigwam

in southwestern Maine – 6 weeks, 6/20-8/12

Private accommodations, one of three nurses on staff.


May, June, July 2021 ANA Maine Journal Page 7

Salute to Maine Nursing Military History

Juliana L’Heureux

WATERVILLE, ME- In May, we remember all nurses

and those who served in the military. Susan White

saved her family’s information, about her aunt, Lt.

Gabrielle Giroux, who was a graduate of the Sisters

Hospital nursing class of 1941, in Waterville. On August

14, 2006, Lt. Gabrielle Giroux was recognized for her

military service by Maine’s former Congressman Mike

Michaud, at ceremonies held at Mount St. Joseph

Nursing Home in Waterville.

A modern hospital, it was described in a vintage

postcard as having a capacity of 120 beds, situated

on an elevation exposed to air and sunshine. It was

approved by the American College of Surgeons and by

the State Board of Registration of Nurses. The hospital

was conducted by the Daughters of Charity of St.

Vincent de Paul.

In the April 4, 1944 edition of the Waterville

Morning Sentinel, Mr. and Mrs. Joseph B. Giroux,

of 30 Western Avenue, reported that their daughter

Lieutenant Gabrielle M. Giroux, a member of the Army

Nurse Corps, had arrived safely in England. “Upon

entering the service in March, 1943, Lt. Giroux received

her commission. She received six months training at

Fort Williams, Maine and was then assigned to the

96th Evacuation hospital in Shreveport, Louisiana. Lt.

Giroux was transferred to Camp Shelby, Mississippi

with the Evacuation hospital. She received general

hospital training at Camp Shelby and was then sent

overseas. Lt. Giroux was a graduate of the Sisters

Hospital in Waterville, in the class of 1941.”

Her niece said she married Walter Gorski on Sept.

28, 1946 in Waterville. They lived in Armonk NY and

had a son & daughter.

Gabrielle Giroux Gorski died in Maine, on August

22, 2009.

Former Congressman Mike Michaud of Maine recognized Lt. Gabrielle Giroux for her military service.

August 14, 2006

Kennebec Valley Community College

is seeking two Nursing positions

Nursing Faculty/Department Chair


A minimum of a Master’s degree in nursing

An unencumbered Maine

RN license

Nursing experience in


Administrative/budgeting skills

Experience in the academic administration of a nursing program

Experience with ACEN accreditation

Nursing Faculty: Medical-Surgical Specialist


A Master’s degree in nursing

(or currently enrolled in a graduate nursing program)

An unencumbered Maine

RN license

3–5 years in the practice of

adult nursing

Teaching experience is preferred

(didactic and/or clinical)

Effective/engaging presentation skills

Both complete job descriptions can be found on the website:


Sisters Hospital in Waterville, Maine vintage postcard

To submit a complete application file, please send the following: cover

letter, resume, official transcript of highest degree earned, and the

KVCC Application for Employment (visit:

employment and download form) to

Page 8 ANA Maine Journal May, June, July 2021

Nurses Address Climate Change

Cara Cook, MS, RN, AHN-BC, Climate & Health

Program Manager, Alliance of Nurses for Healthy


Barbara Sattler, RN, DrPH, FAAN, Professor

Emeritus, University of San Francisco, bsattler@

Diana Van Vleet, National Director of Outreach and

Engagement, Healthy Air Campaign, American

Lung Association,

The Earth’s temperature has historically been

modulated by the sun’s rays beating down, warming

the land and water, and then radiating heat back out

beyond the Earth’s atmosphere. This process has kept

the Earth at a livable temperature for humans and

other lifeforms to flourish. However, we now have a

“blanket” of gases that are surrounding the Earth -

gases created substantially by human activities such as

transportation, energy production, industry, cooking/

heating, and agriculture. Primarily generated from the

burning of fossil fuels, these gases are called greenhouse

gases because they create the same warming effect as

a greenhouse and are slowly warming the Earth – both

the land and particularly the oceans. In the process, they

are changing our climate. Climate is distinguished from

weather in that weather is what occurs from day to day

or week to week, but climate is what occurs over longer

periods of time, month to month and year to year.

Just as there is a small range of body temperatures

at which humans can be healthy, the same is true

for all species on Earth. As the Earth warms, we are

beginning to see shifts in climate which are resulting

in some areas seeing much more rain and others

much less, some colder winters, some hotter, drier

summers. As we encounter more extreme heat days

and extended heat waves, we are going to see many

more heat-related illnesses and even deaths in humans.

People who work outside in agriculture, utilities,

construction, gas/oil, and many other fields will be

at higher risk for hyperthermia. Extreme storms and

wildfires fueled by climate change have already taken

an enormous toll on human and ecological health.

This is why leading health organizations have declared

climate change a public health emergency and called

for immediate action. For an extensive list of how

climate change affects human health, visit https://

While there are some natural sources of greenhouse

gases, the ones that we have the most capacity to reduce

are those that are man-made. The International Council

of Nurses announced its position statement on climate

change in September 2018 and calls on all nurses to help

address climate change (see: Nurses, climate change and

health). It calls for us to heed the scientific evidence which,

in the case of climate change, is abundant.

Nurses can engage both individually and as a

profession to advocate for policies and practices that

will decrease greenhouse gas production from a wide

range of its sources, and thereby improve air quality,

slow climate change and protect human health. The

truth is climate change is a health issue and that’s what

nurses are all about.

The Alliance of Nurses for Healthy Environments

(ANHE) is a national nurse-led organization working to

tap into the power of nurses to address climate change.

ANHE has developed a variety of resources specifically

for nurses. These resources are available free of charge

at and include a Climate and Health Toolkit,

an online repository of resources and tools for nurses to

learn about climate and health and how to take action.

Learn more about ANHE’s Global Nurses Climate Change

Committee and join our monthly calls here. Additionally,

you can learn more about important ways you can make

a difference at the American Lung Association’s Health

Professionals for Clean Air and Climate Action page. To

share your own story about why you fight for clean air

and climate action, visit your Share Your Story.

ANA-ME Nursing Scholarship Application Period is Open

ANA-Maine Nursing Student Scholarship Criteria

What is this scholarship?

• ANA-Maine is pleased to award two annual

nursing education scholarships. Funding for

the scholarships are provided by ANA-Maine

members, community members, and the Arthur

L. Davis Publishing Agency.

• The recipients will be acknowledged at the

annual business meeting in the fall of each year.

One (1) $1,000 scholarship will be awarded to a

student enrolled in an accredited pre-licensure

registered nursing program. One (1) $1,000

scholarship will be awarded to a registered nurse

enrolled in a master's in nursing or doctorate


Who is eligible?

• Individuals currently enrolled and matriculated

in a Maine state-approved, accredited registered

nursing program leading to an associate degree,

baccalaureate, masters or doctoral degree in


• Doctoral candidates in out of state programs may

apply with permanent residency in Maine

• Enrolled in at least half-time status and has

successfully completed 30 credits of program


• Must have a minimum of 3.0 GPA and be in good

standing with academic institution

• Must be a member of ANA or ANA-Student


When will the scholarship(s) be awarded?

Awardees are notified by September 1 and invited to

attend the annual Fall Annual Business Meeting to be

recognized and receive the award.

Who chooses the recipient(s)?

Student affairs committee chair and three other

members will complete a rubric for each application.

A blind review is completed by the student affairs

committee. Awardees are announced to the ANA-

Maine Board prior to the fall annual meeting.



> Supports strategic objectives of clinical quality and

safety to assist with achieving the goals of high

quality, cost effective, patient care and service

> 3-5 years of experience in process improvement

with clinical operations

> Hospital quality/risk experience

> Quality improvement, patient safety, process

improvement, and/or risk management

certification such as CPHQ, CPPS, CPHRM (highly


South Portland

What documents are required with the


• Copy of the most recent transcript and degree


• Proof of ANA-Maine membership or Student

Nurses’ Association Membership

• Essay describing how nursing will/has impacted

your life (one page and single spaced)

• One professional/academic letter of


Applications may be accessed beginning May 1st

Application deadline is August 15

Please mail completed packet to: ANA-Maine

Membership Committee. PO Box 647,

Kennebunk, ME 04043

Click Below to Apply for Maine-Nursing Student-


Congratulations to the 2020 Scholarship Winners:

• Michelle Twitchell, Turner, ME. Maine College

of Health Professionals, AA/RN. Anticipated grad

year: 2021. Combining nursing degree with her

BS in Exercise Science and hopes to work with the

elderly, getting that population moving and more

active to increase bone and functional health.

• Rhonda Babine, Old Orchard Beach, ME.

Thomas Edison State University, DNP Systems

Leadership. Anticipated grad year: 2022. As a

practicing nurse for the past 34 years, Rhonda

has been an advocate for the progression of

nursing through continued education, research,

and leadership. She is very interested in the

translation of evidence into clinical practice.

May, June, July 2021 ANA Maine Journal Page 9

Four Maine health care workers travel to the Super Bowl on the

Patriots plane

Maine Hospital Association

Cathy Bean, R.N., was one of three nurses who

was invited to the Super Bowl along with four

front line health care workers from Maine. She

immunized volunteers including Mike Reynolds, at

the Maine State House during the annual Maine

Nurses in the Hall of Flags at the State House.

AUGUSTA, ME- A plan to fly 76 frontline workers

from New England to Tampa for an all-expenses-paid

Super Bowl experience on February 7, included four

health care workers from Maine. The Patriots owner

Robert Kraft and family announced that it will fly the

selected health care "superheroes" in the Patriots

football team plane to Tampa, for an all-expenses-paid

trip, including: One ticket to the game, a police escort

from Gillette Stadium to Logan Airport, an exclusive

ticket to the NFL TikTok Tailgate concert headlined by

Miley Cyrus, a two-night complimentary hotel stay,

a Patriots gift bag, a $100 VISA gift card to spend at

Raymond James Stadium and ground transportation in

Tampa. The four COVID vaccinated recipients for this

experience who are from Maine were:

Joe Looper, Emergency Department Nurse at

Mercy Hospital: He is a Certified Emergency Nurse at

Mercy Hospital where he has been on the frontline

during the COVID-19 pandemic, caring for Maine

people. He has also obtained his Trauma Nurse

certification and is a Basic Life Support instructor

through the American Red Cross. In addition to caring

for emergency room patients, he is also a member of

the Maine National Guard, has been deployed to Iraq

and Afghanistan, and has been awarded the Army

Achievement Medal twice, the State Safety Award,

Valorous Unit Award, Combat Medical Badge, Army

Commendation Medal and Army Achievement Award.

Cathy Bean, Manager of Clinical and Community

Health Services Northern Light Home Care & Hospice:

She was recently honored by the Home Care & Hospice

Alliance of Maine with its Distinguished Service Award,

has been on the frontlines, helping to take care of

Maine’s most vulnerable and underserved. For more

than a decade, she has been the leader in coordinating

the influenza vaccination efforts in schools, businesses,

homeless shelters and migrant communities. When

the pandemic took hold, she used her experience

to design and stand up COVID-19 testing sites and

to develop a daily COVID screening process for those

residing at multiple homeless shelters and quarantine

Four Maine health care workers...continued on page 11

Page 10 ANA Maine Journal May, June, July 2021

Honoring Maine’s Nurse Educators – Jenny Radsma

Patricia Lynn Eldershaw PhD, MSN, RN

One Career, Many Paths

After a career that has

spanned four decades, Dr.

Jenny Radsma is celebrating

her retirement from the

University of Maine at Fort

Kent (UMFK). Jenny joined

UMFK in 1997 in what then

was a small nursing program

that annually graduated

between 10 to 15 students.

Fast forward to this year’s

graduating class of over 160

Jenny Radsma

BSN-trained nurses. Jenny has been an integral part of

the growth and development of the nursing program,

now the largest in the region, drawing students from

all over the country, Canada and beyond. “Jenny has

had a transformative influence on nursing education

and public health,” said Dr. Erin Soucy, Dean of the

nursing program at UMFK and longtime colleague.

“She is a staunch advocate of high quality nursing

education and professional practice. Her contributions

to the program, the campus and the St. John Valley

have been outstanding. It has been a pleasure and an

honor to work with her.”

For those familiar with the Fort Kent campus,

the main hallways are lined with photos of previous

graduating classes. In the nursing wing, one cannot

overlook the many years Jenny has stood with the

students she has supported through to graduation.

Twenty five in total, with a rough estimate of well

over 2,000 students. Jenny reckons she has former

students in almost every State in the nation. In fact, a

student graduating in this year’s class is the daughter

of a student who was in her first graduating class of

1997. At a time when nurses are in desperate short

supply, her contributions to the profession are cause

for celebration. “Nursing education has just been the

exact challenge that I needed in the sense that no

two semesters are ever the same and no two students

are ever the same. There's something really satisfying

about knowing that you're launching people, for

a meaningful career with which they can support

themselves, their families and ultimately make a

difference in society and to humanity.”

I became a nurse because of Jenny, although not in

the usual course of life. We met while both pursuing

a postdoctoral fellowship at the International Institute

for Qualitative Methodology, in Edmonton Alberta -

Jenny, a nurse educator, I a sociologist. The institute

was unique for its interdisciplinary focus long before

academic collaboration became an ideal model for

health care and research. I was so impressed by the

impact nurses had on the lives of people in their care;

when I found myself contemplating a career change,

Jenny said, “Why not pursue nursing?” And so began

my career as a nurse, for which I am indebted.

Jenny said, “I’ve always wanted to be a nurse. I can’t

remember a time when I didn’t want to be a nurse.”

The daughter of Dutch immigrants escaping postwar

Europe for a new life in Canada, Jenny was born

with a cleft lip palate for which she underwent several

hospitalizations over the course of her young life. What

might have evoked aversion in another instilled in Jenny

a clear purpose. “I actually liked going into the hospital.

I loved the clinical smell! The clean order and sense of

urgency. Even as a child, it excited me.”

Jenny’s professional career parallels the growth

and academic advancement of the profession itself,

initially obtaining an LPN in 1979 and, wanting “to do

more,” she pursued her BSN eventually earning a MN

in 1989. Much of her early nursing experience was in

the remote northern Alberta town of High Level where

she provided the whole spectrum of health care from

a small 25 bed hospital that served a large region of

diverse patients including several Native communities,

Mennonite farm families, as well as, workers from the

oil and lumber industry. She said, you never knew what

would come through the hospital door, an industrial

or logging injury or a woman in labor. Jenny helped

to deliver over 250 babies annually and routinely

accompanied patients for the long journey south in a

twin engine prop-plane to larger city centers for urgent

treatment. Jenny said, “Nursing has always kept me

stimulated and challenged. I've loved the fact that I

have always been able to learn about people, about

humanity, society and about myself.”

Jenny left High Level to pursue an academic

career at UMFK and proceeded to earn a PhD from

Barry University in Florida in 2005. Her teaching and

academic work integrates a wide range of influences

that express her joy of life and learning - literature,

cinema, culture and history - that has led to a creative

and unique field of study evident in her substantial

CV. Some of her many accomplishments include more

than a dozen teaching areas that span the nursing

curriculum, over 30 publications and memoirs that

culminated in an anthology published in 2018. She

is also a longtime volunteer for literacy and strong

advocate on smoking cessation in the region. And

somehow, in the midst of doing all this and more,

she managed to walk over 1,500 miles of the historic

Camino pilgrimage trails through France, Spain and


Although Jenny will be missed at UMFK, she has no

plans on stopping her academic and creative ventures.

In the works are writings on diversity education

in nursing and memoirs about some of the many

students she has known over her years teaching. Her

commitment to the nursing profession and health

care is impressive. Jenny has always “worked with

pleasure.” She says, “I count myself incredibly blessed

to have been employed with work that stimulated

and challenged me while simultaneously allowing me

to make a difference in the lives of others, whether

as a staff nurse or as a nursing educator. So after a

career in nursing that spans more than four decades,

I can honestly say I have almost always worked with


Patricia Lynn Eldershaw PhD, MSN, RN is an Assistant

Professor of Nursing at Husson University in Bangor.



Virtual Training for CME Credit

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May, June, July 2021 ANA Maine Journal Page 11

Nursing History in Poetry

This poem was found among prose and poetry that

was saved by Maine nurses in a collection of history



As seen from a hospital window.

City lights, you fascinate me.

Always blinking, through the night.

As my lonely watch I’m keeping.

There is comfort in your light.

Other lights within my memory

Return scenes from out the past,

Of patients, nurses, doctors

Who built values that could last.

One finds within these walls

A courage, and a dedication, too,

That all mankind manifest,

New life, be they Gentile or a Jew.

Here one needs an understanding

Of a very special kind.

One’s own wisdom becomes greater

From dependence on God’s mind.

Tolerance and understanding

Have been born of patience tried.

Time enough to strengthen it,

Bridging gulfs that seem too wide.

For lights of cities or memories

From whatever source it came.

To repay in fullest measure

Means fulfillment in life’s game.

Althea Poland Woodward

Class of 1936

Maine General Hospital School of Nursing

Jean Caron, a Mercy Hospital School of Nursing

alumna, found the poem, "The Gift", by Darcy L.

Record Landry, class of 1968, among the documents

she saved from when she was working and teaching

at Mercy Hospital, in Portland. For the occasion of the

60th anniversary of her class of 1953, at their 60th

reunion, she created this memento, a printed card

including the poem, to give to alumna and attendees.

This Memento and poem are printed with her


Four Maine health care workers...continued from page 9

locations. She is also putting that experience to use

for developing COVID-19 vaccination sites. Cathy also

serves as the Chair of the Cumberland District Public

Health Council where she is integral in fighting inequity

to create equal access to health care across the county

and state.

Lisa Ireland, Registered Nurse at RiverRidge

Center: Lisa is a registered nurse at RiverRidge Center

where she has been on the frontlines throughout

the pandemic. She often works every day of the

week, across multiple shifts, performing hundreds of

COVID-19 tests on other frontline staff and patients.

Lisa also serves as the infection prevention and control

leader for RiverRidge.

Patrick Keaney, Pulmonary Physician at Mid Coast

Hospital: Patrick is a pulmonary physician at Mid Coast

Hospital where he has been key to the organization’s

COVID-19 preparation and response efforts. As the

pandemic took hold, Dr. Keaney took on the dual role

of caring for all COVID-19-positive patients at Mid

Coast Hospital during the first several weeks of the

pandemic while also serving tirelessly as one of the

hospital’s sources of information about the disease.

For six straight weeks without a break, he arrived

each morning to care for ill patients, share the latest

information on treatment options, and offer words of

encouragement to those around him.

Maine Governor Janet Mills recognized the health

care workers for their dedication to leading public

health and patient care during the COVID19 pandemic.

“I am grateful to the Kraft family for providing this

special gift to our frontline COVID health care workers

as a measure of our enduring gratitude,” said Mills...

“I ask all Maine people to join me in thanking all of

our health care workers who have heeded the call of

duty and worked long hours, days, and weeks, often

at great sacrifice to themselves and their families, to

protect Maine people during this extraordinary crisis.

The mission of this trip is two-fold: to recognize and

thank a representative group of the countless health

care superheroes in New England and to celebrate and

spread the important message of getting vaccinated.

Page 12 ANA Maine Journal May, June, July 2021

Nurses: Five Ways to Improve Your Sleep

Reprinted with permission from Confident Voices in Healthcare https://www.

By Dr. Tadeh Vartanian


Each one of us has a unique sleep requirement. Nurses

specifically have even more unique requirements for

sleep. Long hours at work, odd hours throughout the

night, high-stress environment that makes relaxing after

work much harder, and the tendency to constantly pick

up more shifts are all reasons why 27% of nurses take

sleep aids on a regular basis.

We know that sleep has an impact on our immune

system, enabling us to fend off infections. It also

improves our motor function and ensures we don’t get

into a car accident while driving. It regulates our body Dr. Tadeh Vartanian

weight and ensures our blood sugar and fat deposits

are regulated as normal. Good sleep allows us to form memories, not only when

learning but when making long-lasting impressions of our lives and really living it to

the best way we can.

Good sleep also enables nurses to do the crucial work they have on hand.

Treating patients requires a sharp mind for catching errors, documenting properly,

administering time-sensitive medications, and more. Poor sleep is not something

that nurses and their patients can afford.

So how do nurses get the crucial seven to nine hours of sleep that is

recommended by the National Sleep Foundation?


Light plays a large role in how our bodies decide when to prepare for sleep or

prepare to be awake. 1 While sunlight is the main thing that signals our brain to stay

awake, the devices that live in our pockets, on our walls, and in our rooms can have

a similar effect.

A recent report found that using an electronic device with blue LED light, like

an iPad, for two hours prior to bed blocked the rise of melatonin. 2 Compared to

reading a printed book, reading an iPad suppressed melatonin by a significant 23%.

Not only did sleep onset become more difficult, but the sleep quantity and quality of

the participants were made worse too.

We have openings in:

Community Living Center

(Long term care and dementia units)

Evening and night shift

Float Pool Day and Night shift

Med Surg Night shift | SCU Night shift

...and more!

(Recruitment incentives up to $10K for some positions)


Melissa Lasley, RN

Nurse Recruiter

VA Maine Healthcare System

Building 203, Room 307B

1 VA Center | Augusta, ME 04330


So, do we get rid of all our electronic devices? Of course not. But we’ll do well

to eliminate the use of them one hour prior to bedtime. 3 We can fill that hour

with other duties such as preparing lunch for the next day, cleaning up our home,

reading, writing, or speaking with people around us.


Caffeine, the most widely

used (and abused) psychoactive

stimulant in the world, can be

found in coffee, sodas, foods,

supplements, and more. It works

by battling with adenosine for

the binding sites (receptors) in

the brain that provide the urge

to sleep. 4 By urge, we mean

propensity or the strong desire to

sleep, as increased adenosine in

one’s body provides the urge for

wanting to sleep.

Here’s something else you

may not have known: caffeine

has an average half-life of five

to seven hours. That means after

having a morning cup of coffee, about half of the caffeine is still in your body by

early afternoon, and one quarter of it is still there in the evening.

What we are hinting at, however, is that limiting your consumption as it gets later

in the day will help set up a situation optimal for uninterrupted sleep. In a study

published in the Journal of Clinical Sleep Medicine, a team of scientists concluded

that consumption of caffeine beyond six hours prior to your desired sleep time will

be disruptive to your sleep. 5 For example, if your target time to sleep is at 9:00 p.m.,

you should aim to stop any consumption of caffeine by 3:00 p.m.


So, what are some routines you can practice to enhance your sleep at night?

Go to bed at the same time each night on most nights. We have a set bedtime

for patients, and you should too. That routine allows your body to anticipate sleep

over time, and having your body do the work naturally is always much easier than

forcing a bedtime. On the other end, having a reasonable wake up time each

morning will also give your body a routine it can count on. Nothing too aggressive,

but something reasonable is best.

Take a relaxing shower or bath. Read before you turn off the lights, on a nonelectronic

device. Easier said than done with our crazy work hours, but as best that

we can do it is always a plus. Anything that can also be done on your work days is

what counts.


First, it’s important to differentiate white noise from disruptive noise. White

noise can be highly beneficial for sleep and the reason for that is it can help drown

out disruptive noise that might signal to our body to wake up out of defense. 6 If

you’ve ever been startled by an unexpected noise, you’ve experienced the reaction

we have to noises. This same experience can occur while we’re sleeping and while

it’s important to know what is going on around you, limiting disruptive noise in

your bedroom will help you fall asleep and stay asleep longer. Start by putting your

phone on silent, putting your TV on a sleep timer if you use it as white noise, and

soundproofing windows if you’re near noisy roads.

In essence, treat your sleep room and area as a quiet sanctuary. Do all that you

can to reduce noise to get a good night’s sleep. This is where those living with you

Vermont Psychiatric Care Hospital

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• Nurse:Patient Ratios Below National Averages

• Lowest Rates of Seclusion/Restraint State-Wide

• Competitive Pay and Comprehensive Benefits

• New Graduate Nurse Residency Program

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delivery of cutting-edge, high quality care that not only meets, but exceeds

our industry standards. To learn more about what a career at VPCH can

offer you and how you can make a difference in the evolving landscape

of psychiatric nursing care please contact Stephanie Shaw, Chief Nursing

Executive, at or (802)828-3059.

May, June, July 2021 ANA Maine Journal Page 13

play a big role in this. Ensure everyone is on the same page, and frame it so that

they benefit from it too with a good night’s sleep.


healthcare provider to find out the best way to take them, and make that a part of

your routine.

We found the best way to take sleeping aids with the patients we’ve consulted

is to associate it with a sleeping cue you normally would do anyways. Having the

bottle next to your nightstand is a great option. We don’t recommend storing it

(and most supplements and medications for that matter) in the bathroom, as the

humidity could degrade the product quicker than usual. 9

Our flagship product, SLUMBER, contains four of the top eight ingredients

listed, at doses and potencies that are optimized for good outcomes and backed

by research. The melatonin provides a calm way to induce sleep, at a dose of 3mg,

it does so without morning after grogginess. The magnesium bisglycinate provides

both the magnesium and glycine components of good sleep, the former allowing

for a deep, restorative night and the latter allowing one to adjust to a good sleep

rhythm. Finally, the jujube fruit reduces your body’s cortisol and allows you to drift

off in a calm manner. With all these combined, you not only sleep well at night, but

you’ll also wake up the next morning with a refreshed sense of accomplishment.


Within a span of about a hundred years, humans have abandoned their

biologically-mandated need for adequate sleep. As a result, the decimation of

sleep throughout society is very real in its impact on health, life expectancy, safety,

productivity, and happiness.

This silent sleep loss epidemic is the greatest public health challenge we face in

this century. A radical shift in our personal appreciation of sleep must occur, and

you’ve taken the first step as nurses to do better with your health, so you can

provide exceptional care to your patients.

I believe it is time for us to reclaim our right to a full night’s sleep, without the

stigma of laziness. Sleep is the most powerful elixir of wellness and vitality, allowing

us to be truly awake during the day, infused with the very deepest plentitude of


Author Bio:

Dr. Tadeh Vartanian is the founder and Director of Operations of completeblue,

America’s leading pharmacist-owned and operated dietary supplements company.


1. Tosini G et al. Effects of blue light on the circadian system and eye physiology. https:// Accessed December 2020.

2. Gradisar M et al. The Sleep and Technology Use of Americans: Findings from the National

Sleep Foundation’s 2011 Sleep in America Poll.

articles/PMC3836340/#:~:text=Results%3A,16%25%20of%20older%20adults). Accessed

January 2021.

3. Why It’s Time to Ditch the Phone Before Bed. SCL Health.


start%20reading%20before%20bed. Accessed January 2021.

4. Riberio JA and Sebastiao AM. Caffeine and adenosine. https://pubmed.ncbi.nlm.nih.

gov/20164566/. Accessed January 2021.

5. Drake C et al. Caffeine Effects on Sleep Taken 0, 3, or 6 Hours before Going to Bed. Accessed January 2021.

6. Pickens TA et al. White noise as a possible therapeutic option for children with ADHD.

Accessed January 2021.

7. Sweetman A et al. The effect of cognitive behavioral therapy for insomnia on sedativehypnotic

use: A narrative review.

S1087079220301477?via%3Dihub. Accessed January 2021.

8. Chung S et al. Sleeping Pill Administration Time and Patient Subjective Satisfaction.


Accessed January 2021.

9. Storing your medicines. MedlinePlus.

htm. Accessed January 2021.

I’m going to make a profound confession that many of you already know: sleep

is one of the most difficult aspects of one’s health to improve on with prescription

medications that have been available on the market.

Many individuals have tried prescription sleeping pills, only to hear that they can

cause dependency, have rebound insomnia, and are linked to numerous short- and

long-term side effects. 7 On top of that, many people don’t get much benefit from

them after some time has passed, making them a tough pill to swallow (literally and

figuratively) in their quest to better sleep health.

Natural health supplements are each different, and it’s important to get the right

combination of products and ingredients to achieve that optimal sleep. You’ll want

to look for one that contains pure ingredients, is lab tested, and has certifications in

place to ensure you’re getting the highest pedigree of product possible.

The eight most common sleep supplements can be found on the infographic

above. Not only should the sleep aid contain the ingredients that are right for you,

but should also be at doses that are appropriate in achieving that optimal sleep

without causing any issues long-term.

Regardless of what you decide to take, make sure to take it appropriately.

Usually, sleeping aids should be taken 30-60 minutes before bedtime, ideally on an

empty stomach to ensure rapid absorption. 8 Check with the manufacturer or your

To access electronic copies of the

ANA Maine Journal, please visit

Page 14 ANA Maine Journal May, June, July 2021

Success Story: The CNS As Credentialed Provider

Jan Powers PhD, RN, CCNS, CCRN, NE-BC,

FCCM, President, National Association of Clinical

Nurse Specialists (NACNS)

The University of Virginia Health (UVA Health),

serving the Greater Charlottesville/Albemarle region

of Virginia, took the important step this month to

validate its 14 clinical nurse specialists (CNSs) as

“credentialed providers.” This step formally recognizes

CNSs as Advanced Practice Registered Nurses (APRN).

UVA Health System includes a 631-bed hospital, level I

trauma center, nationally recognized cancer and heart

centers and primary and specialty clinics throughout

Central Virginia.

The entire credentialing approval process took four

months and, today, CNSs at UVA Health can practice

with full practice authority, ordering many services for

patients based on their own professional assessment

rather than relying exclusively on physician approval.

Kimberley Elgin, DNP, RN, ACNS-BC, PCCN,

CMSRN, lead clinical nurse specialist of UVA Health,

coordinated the credentialing effort. According to Elgin,

the other three APRN roles (nurse practitioners, nurse

midwives and nurse anesthetists) were already bundled

underneath the credentialed provider structure and

there was a growing need to recognize CNSs and align

their level of responsibility and scope of practice with

that of their APRN counterparts.

Beyond the interest in improving patients’

experiences, the ascension of CNSs to the status of

credentialed providers means that UVA Health is in line

with the CNS professional standards of practice. The

change also will provide mechanisms for third-party

billing of services provided by a CNS. At the same time,

there is legislation in the Virginia General Assembly to

elevate the scope of practice of the CNS to allow for

prescriptive authority.

“There was a real need for credentialing CNSs,”

said Elgin. “The fluidity of the CNS role is important,

but it could lead to role confusion for colleagues. After

centralizing the CNS team, I performed a systematic

gap analysis, comparing our practice to the National

Association of Clinical Nurse Specialists (NACNS) core

competencies. Being able to validate our CNSs were

‘aligning with and meeting national standards’ is

actionable language that is meaningful and powerful to

an organization.”

NACNS core competencies can be found at https://

cns-competencies/core-competencies/. They include

competencies in Direct Care, Consultation, Systems

Leadership, Collaboration, Coaching, Research and

Ethical Decision-Making, Moral Agency, and Advocacy.

The Benefits of Credentialing the CNS

As a credentialed provider, CNSs’ validation as

an APRN by the UVA Health nursing body and

interdisciplinary colleagues is helping to build the

structures and processes that are necessary to

facilitate reimbursement practices. Another significant

improvement will be CNSs’ ability to formally consult

other interdisciplinary clinicians without a physician

co-signature. This efficient approach to patient care

leverages the CNSs’ ability to generate revenue for the

organization for the work they perform. Finally, and

most importantly, validating a CNS as a credentialed

provider creates an opportunity to rethink processes

and structures around interprofessional practice and

develop different and more efficient methods to work

together in a healthcare setting.

A CNS-Credentialed Provider “How To”

The entire formal credentialing process at UVA

Health took four months and involved the entire


The process included working with stakeholders to

obtain subcommittee approvals, a full vote by all of

the organization clinical staff, and final approval by the

UVA Health Board. Critical to the success of this effort

was securing support from the chief nursing officer,

director for advanced practice, as well as buy-in from

the CNS team.

“Our CNSs had a vision for it, but we still put a lot

of energy and effort into securing their buy-in,” said

Elgin. “The change will create different workflows

for our CNSs, so I needed them to be engaged in the

credentialing process from the beginning if we were to

be successful.”

The approval process started with the proposal

being presented to the Advanced Practice Provider

Subcommittee of the Organizational Credentialing

Committee. Once approved, a recommendation was

made to the Credentialing Committee to add CNSs as

a provider type. Next, it was voted on and approved

at the Credentialing Committee and the Credentialing

Committee made their recommendation to the Clinical

Staff Executive Committee. This executive committee

also approved the proposal and sent it to the entire

clinical staff for a vote. Finally, the last step, was the

UVA Health Board’s approval validating the CNS

position as a credentialed provider.

Elgin credits her relatively smooth approval process

to never underestimating the importance of engaging

stakeholders both in formal and informal settings

and really taking time to listen to them and hear their


Kimberley Elgin, DNP, RN, ACNS-BC, PCCN, CMSRN

is a Director at Large for NACNS, the only national

organization representing the 89,000 CNSs in the

US. CNSs are the most versatile advanced practice

registered nurses and work in a variety of health care

specialties to ensure delivery of high-quality, evidencebased,

patient-centered care. As leaders in the acute,

post-acute, and ambulatory health care settings, CNSs

impact direct patient care, nurses and nursing practice,

and organizations and systems to optimize care and

drive outstanding clinical outcomes.

NACNS is dedicated to advancing CNS practice and

education and removing unnecessary and limiting

regulatory barriers, while assuring public access to

quality CNS services. For more information or to join

NACNS visit

May, June, July 2021 ANA Maine Journal Page 15


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