The Newsletter of the American Nurses Association–Maine
Quarterly publication distributed to approximately 15,600 RNs and LPNs in Maine.
Nurses Week - 2021
Robert Abel, MSN, RN,
CHPH, CCM, CMC
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
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.”
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
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
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
ATTENTION ANA-MAINE MEMBERS!
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:
www.anamaine.org - click on the ‘Become a Member’
button and follow the steps to sign up.
Vacant positions are:
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, FWD.us, National
Immigration Forum, Bipartisan Policy Center, American
Business Immigration Coalition, and The Jewish
Federations of North America.
Click here (https://www.durbin.senate.gov/imo/
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 www.anamaine.org. 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 www.anamaine.org
Arthur L. Davis
Publishing Agency, Inc.
Volume 17 • Number 2
Published by the
AMERICAN NURSES ASSOCIATION-MAINE
a constituent member association of the
American Nurses Association
Web Site: www.anamaine.org
P.O. Box 647
Kennebunk, ME 04043
ANA-MAINE BOARD OF DIRECTORS
Robert Abel, MSN, RN, CHPH, CCM, CMC
Juliana L’Heureux, BS, MHSA, RN
Joanne Chapman, MEd, MSN, RN, NE-BC
Carla Randall, PhD, RN, CNE
Mary Therese Cully-Onoshko, RN, CHPN
Mary Doherty, MSN, APRN, BC-PNP
Patricia Eldershaw, PhD (Soc), MSN, RN
Suzanne Parkman, PhD, RN, CNE
Shannon Stewart, APRN, MSN
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.
ANA-MAINE EDITORIAL COMMITTEE
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 firstname.lastname@example.org.
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, email@example.com. 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
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 firstname.lastname@example.org
The categories of practice for each award is described below. Indicate the
category in the online nomination form found at www.anamaine.org. 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 www.anamaine.org
Deadline: August 1, 2021
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 www.anamaine.org. 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 www.anamaine.org 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
APPLY ONLINE (HOSPITAL WIDE OPENINGS):
If you have questions or would like to speak with our nursing recruiter
Kelly Flagg | Kelly.email@example.com | 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
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,
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)
Northern Light Mayo Hospital is currently seeking a Registered
Nurse in our Obstetrics Unit for 36 hours per week. This position
will be for 7:00 p.m. – 7:00 a.m.
Please apply online at www.northernlighthealth.org,
and/or E-mail resume to firstname.lastname@example.org.
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
Pfizer and BioNTech released their own study,
not yet peer-reviewed, that suggests their vaccine
effectively neutralizes this variant, though was slightly
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
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
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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
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
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
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
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
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
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
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
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
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
Nursing experience in
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
3–5 years in the practice of
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: http://www.kvcc.me.edu/
employment and download form) to email@example.com.
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, Diana.VanVleet@lung.org
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 envirn.org 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.
QUALITY & PATIENT SAFETY
> 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
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
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
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.
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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
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
(Recruitment incentives up to $10K for some positions)
Melissa Lasley, RN
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
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
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Executive, at email@example.com 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
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
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://
www.ncbi.nlm.nih.gov/pmc/articles/PMC4734149/. 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. https://www.ncbi.nlm.nih.gov/pmc/
3. Why It’s Time to Ditch the Phone Before Bed. SCL Health. https://www.sclhealth.org/
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.
https://jcsm.aasm.org/doi/10.5664/jcsm.3170. 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. https://www.sciencedirect.com/science/article/abs/pii/
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. https://medlineplus.gov/ency/patientinstructions/000534.
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
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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
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
“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
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
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 https://nacns.org/get-involved/become-amember/
May, June, July 2021 ANA Maine Journal Page 15