Maine Journal - May 2021
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ANA-MAINE<br />
JOURNAL<br />
The Newsletter of the American Nurses Association–<strong>Maine</strong><br />
Quarterly publication distributed to approximately 15,600 RNs and LPNs in <strong>Maine</strong>.<br />
SPRING <strong>2021</strong><br />
President’s Message<br />
Nurses Week - <strong>2021</strong><br />
Robert Abel, MSN, RN,<br />
CHPH, CCM, CMC<br />
President, ANA-<strong>Maine</strong><br />
Little did any of us think<br />
a year ago at this time that<br />
this pandemic would affect<br />
our lives as it has. Most of<br />
us imagined a few weeks,<br />
perhaps a month or two,<br />
summer 2020 would come<br />
and as often happens with<br />
other viruses, the surge would recede. But that was not<br />
to be.<br />
In some ways our lives have changed irrevocably.<br />
We will not be going back. We have learned new and<br />
efficient ways to shop. We have learned bricks and<br />
mortar may not be as fundamental to our businesses<br />
as we thought they were. We have even learned new<br />
ways of learning! Happy Hour can happen at home, on<br />
Zoom. And marathons can be virtual.<br />
But we have also reaffirmed that nursing is<br />
fundamentally a person-to-person interchange. It is<br />
hands on (even with gloves). That nurses are essential<br />
to health delivery in every setting. That nurses adapt<br />
and change with great skill and our patients are better<br />
because of it. I am reminded that<br />
“we give but little when we give of our possessions, it<br />
is when we give of ourselves that we truly give.”<br />
(K. Gibran)<br />
This is unchanged: Nurses give of themselves.<br />
Through the ups and downs of this pandemic,<br />
nurses continued to care in ways we know and in ways<br />
we will never know. On this Nurses Week in <strong>2021</strong>, I<br />
salute you my colleagues and wish you much happiness<br />
and many joys in the coming months.<br />
In the meantime, Wear a Mask – Keep Your Distance<br />
– Wash Your Hands.<br />
Collins, Bipartisan Group Introduce Bill to<br />
Address Shortage of Doctors, Nurses<br />
Washington, D.C. — U.S. Senators Susan<br />
Collins (R-ME), Dick Durbin (D-IL), John Cornyn (R-<br />
TX), Patrick Leahy (D-VT), Todd Young (R-IN), and<br />
Chris Coons (D-DE) introduced bipartisan legislation<br />
to provide a temporary stopgap to quickly address<br />
our nation’s shortage of doctors and nurses. The<br />
Healthcare Workforce Resilience Act would recapture<br />
25,000 unused immigrant visas for nurses and 15,000<br />
unused immigrant visas for doctors that Congress<br />
has previously authorized and allocate those visas<br />
to doctors and nurses to help in the fight against<br />
COVID-19.<br />
“COVID-19 has exacerbated the shortage of<br />
doctors and nurses our nation was already facing. As<br />
we continue to respond to this persistent pandemic,<br />
it is vital that we take steps to alleviate the burden<br />
on our health care system and support medical<br />
professionals,” said Senator Collins. “By issuing<br />
unused employment-based visas to immigrant medical<br />
professionals, this bipartisan legislation would help<br />
strengthen our health care workforce and preserve<br />
access to care, particularly in rural and underserved<br />
communities in <strong>Maine</strong> and across our country.”<br />
Specifically, the Healthcare Workforce Resilience Act<br />
would:<br />
• Recapture unused visas from previous fiscal years<br />
for doctors, nurses, and their families<br />
• Exempt these visas from country caps<br />
• Require employers to attest that immigrants from<br />
overseas who receive these visas will not displace<br />
an American worker<br />
• Require the Department of Homeland Security<br />
and State Department to expedite the processing<br />
of recaptured visas<br />
• Limit the filing period for recaptured visas to 90<br />
days following the termination of the President’s<br />
COVID-19 emergency declaration<br />
The Healthcare Workforce Resilience Act is<br />
supported by dozens of organizations including the<br />
American Academy of Family Physicians, American<br />
Academy of Neurology, American Association of<br />
International Healthcare Recruitment, American<br />
College of Rheumatology, American Geriatrics<br />
Society, American Hospital Association, American<br />
Collins, Partisan Group...continued on page 2<br />
current resident or<br />
Presort Standard<br />
US Postage<br />
PAID<br />
Permit #14<br />
Princeton, MN<br />
55371<br />
Index<br />
Nominate a Nurse ..................3<br />
Nurses Week Webinar ...............3<br />
What You Need to Know About the<br />
Coronavirus Variants ..............4<br />
Remembering the Father of Vaccination . 6<br />
Salute to <strong>Maine</strong> Nursing Military History. 7<br />
Nurses Address Climate Change .......8<br />
ANA-<strong>Maine</strong> Nursing Student Scholarship<br />
Criteria .........................8<br />
<strong>Maine</strong> Health Care Workers Travel to<br />
Super Bowl on Patriots Plane ........9<br />
Honoring <strong>Maine</strong>’s Nurse Educators ....10<br />
Five Ways to Improve Your Sleep ......12<br />
The CNS as Credentialed Provider .....14
Page 2 ANA <strong>Maine</strong> <strong>Journal</strong> <strong>May</strong>, June, July <strong>2021</strong><br />
ATTENTION ANA-MAINE MEMBERS!<br />
Nominations for open seats on the board of<br />
directors will begin July 1, <strong>2021</strong>.<br />
ANA-MAINE utilizes a secure online nomination and<br />
voting system to elect members to fill open positions<br />
on the board. Nomination submissions will be accepted<br />
through July 24 and the electronic ballot will be<br />
available August 23 – September 20.<br />
Keep an eye on your email inbox for a link to access<br />
the call for nominations form. To be eligible for a place<br />
on the ballot, you must be a member of ANA-<strong>Maine</strong>.<br />
Enrollment is quick and easy through the website:<br />
www.anamaine.org - click on the ‘Become a Member’<br />
button and follow the steps to sign up.<br />
Vacant positions are:<br />
Position Term<br />
Treasurer 2 Years<br />
Director 2 Years<br />
Director 2 Years<br />
Collins, Partisan Group...continued from page 1<br />
Organization for Nursing Leadership, American Society<br />
of Hematology, Physicians for American Healthcare<br />
Access, American Academy of Pediatrics, National Rural<br />
Health Association, American Medical Association,<br />
Society of Hospital Medicine, Federation of American<br />
Hospitals, American College of Physicians, Ascension<br />
Catholic Health Association of the U.S., Healthcare<br />
Leadership Council, National Kidney Foundation,<br />
Society of Critical Care Medicine, American<br />
Immigration Lawyers Association, FWD.us, National<br />
Immigration Forum, Bipartisan Policy Center, American<br />
Business Immigration Coalition, and The Jewish<br />
Federations of North America.<br />
Click here (https://www.durbin.senate.gov/imo/<br />
media/doc/MDM21419.pdf) to read the text of the bill.<br />
www.nvrh.org/careers<br />
As a member of ANA-MAINE, you have the<br />
opportunity to determine the leadership of our<br />
organization. Details about the electronic voting<br />
process will be emailed to members and may be found<br />
on our website at www.anamaine.org. To be eligible<br />
to submit a nomination, you must have an ANA-<br />
MAINE member ID number. If you need assistance with<br />
obtaining this number, log in to the member portal,<br />
also found on our website.<br />
ANA-MAINE eagerly anticipates the activities<br />
planned for the next work year. Your participation in<br />
this process is a way to positively affect the continued<br />
work of your organization.<br />
To request a paper nomination form, please email<br />
nominations@anamaine.org.<br />
Deadline for submitting online nominations is<br />
July 24, <strong>2021</strong><br />
The newly elected board of directors will be<br />
announced at the ANA-MAINE annual business<br />
meeting. More details regarding this event may be<br />
found at www.anamaine.org<br />
www.anamaine.org<br />
Published by:<br />
Arthur L. Davis<br />
Publishing Agency, Inc.<br />
Volume 17 • Number 2<br />
Published by the<br />
AMERICAN NURSES ASSOCIATION-MAINE<br />
a constituent member association of the<br />
American Nurses Association<br />
E-mail: info@anamaine.org<br />
Web Site: www.anamaine.org<br />
P.O. Box 647<br />
Kennebunk, ME 04043<br />
ANA-MAINE BOARD OF DIRECTORS<br />
Robert Abel, MSN, RN, CHPH, CCM, CMC<br />
President, Portland<br />
robert.abel@anamaine.org<br />
Juliana L’Heureux, BS, MHSA, RN<br />
President-Elect, Topsham<br />
Joanne Chapman, MEd, MSN, RN, NE-BC<br />
Treasurer, Falmouth<br />
Carla Randall, PhD, RN, CNE<br />
Secretary, Auburn<br />
Mary Therese Cully-Onoshko, RN, CHPN<br />
Director, Union<br />
Mary Doherty, MSN, APRN, BC-PNP<br />
Director, Standish<br />
Patricia Eldershaw, PhD (Soc), MSN, RN<br />
Director, Mapleton<br />
Suzanne Parkman, PhD, RN, CNE<br />
Director, Falmouth<br />
Shannon Stewart, APRN, MSN<br />
Director, Hodgdon<br />
Contents of this newsletter are the opinion of the<br />
author alone and do not reflect the official position of<br />
ANA-MAINE unless specifically indicated. We always<br />
invite leaders of specialty organizations to contribute.<br />
ANA-MAINE EDITORIAL COMMITTEE<br />
Michelle L. Schweitzer (Editor)<br />
Juliana L’Heureux, BS, RN, MHSA (Co-Editor)<br />
Jean Dyer, PhD, MSN, BSN, CNE<br />
We welcome submissions, but we reserve the right to reject<br />
submission of any article. Send to publications@anamaine.org.<br />
CE calendar listings are without charge.<br />
Attribution: We do not knowingly plagiarize. We encourage<br />
our authors to fact check their material but we do not assume<br />
responsibility for factual content of ads or articles.<br />
For advertising rates and information, please contact Arthur<br />
L. Davis Publishing Agency, Inc., PO Box 216, Cedar Falls, Iowa<br />
50613, (800) 626-4081, sales@aldpub.com. ANA-<strong>Maine</strong> and<br />
the Arthur L. Davis Publishing Agency, Inc. reserve the right to<br />
reject any advertisement. Responsibility for errors in advertising<br />
is limited to corrections in the next issue or refund of price<br />
of advertisement. Published quarterly every February, <strong>May</strong>,<br />
August and November.<br />
Acceptance of advertising does not imply endorsement<br />
or approval by ANA-<strong>Maine</strong> of products advertised, the<br />
advertisers, or the claims made. Rejection of an advertisement<br />
does not imply a product offered for advertising is without<br />
merit, or that the manufacturer lacks integrity, or that this<br />
association disapproves of the product or its use. ANA-<strong>Maine</strong><br />
and the Arthur L. Davis Publishing Agency, Inc. shall not be<br />
held liable for any consequences resulting from purchase<br />
or use of an advertiser’s product. Articles appearing in this<br />
publication express the opinions of the authors; they do not<br />
necessarily reflect views of the staff, board, or membership of<br />
ANA-<strong>Maine</strong> or those of the national or local associations.<br />
Postal Address corrections: This list of addressees is<br />
obtained from the <strong>Maine</strong> State Board of Nursing (MSBON)<br />
each issue. To keep your address current for these mailings,<br />
simply notify the MSBON of any needed changes in your postal<br />
mailing address.<br />
Permission must be obtained from ANA-<strong>Maine</strong> to replicate or<br />
reproduce any content from ANA-<strong>Maine</strong> <strong>Journal</strong>.
<strong>May</strong>, June, July <strong>2021</strong> ANA <strong>Maine</strong> <strong>Journal</strong> Page 3<br />
Nominate a Nurse!<br />
Nominations are open for The Agnes E. Flaherty Leadership Award and The<br />
Sister Consuela White Spirit of Nursing Award.<br />
Nominations close August 1, <strong>2021</strong>.<br />
Nominations are received by ANA <strong>Maine</strong>. The nominations are sent to a team<br />
of ANA members from a neighboring New England State Nursing Association<br />
for review and selection. A scoring matrix is used based upon the award criteria.<br />
Awardees are notified prior to the Awards event.<br />
Questions? Please E-mail the Awards Committee at awards@anamaine.org<br />
The categories of practice for each award is described below. Indicate the<br />
category in the online nomination form found at www.anamaine.org. Provide a<br />
letter describing how the nominee exhibits the defining qualities for the award and<br />
upload your descriptive letter for expedient electronic submission. Nominators must<br />
be ANA <strong>Maine</strong> members.<br />
The Agnes E. Flaherty Leadership Award<br />
This award is targeted for: administrators, educators, public office holders or<br />
nominee, and health care providers and in advanced practice roles.<br />
Defining qualities include the ability to:<br />
• Develop a work environment that fosters autonomy and creativity.<br />
• Value and empower others. Affirm the uniqueness of each individual.<br />
• Motivate others to work toward a common goal.<br />
• Identify common values.<br />
• Be committed to the profession and society.<br />
• Think long-term and be visionary.<br />
• Be politically astute.<br />
• Think in terms of change and renewal.<br />
The Sister Consuela White Spirit of Nursing Award<br />
This award is targeted for: staff nurses in any setting: schools, community, long<br />
term care, acute care, home care etc. Preceptors for students would fall into this<br />
category.<br />
Defining qualities include the ability to:<br />
• Listen on a deep level and to truly understand.<br />
• Keep an open mind and hear without judgment.<br />
• Deal with ambiguity, paradoxes and complex issues.<br />
• Believe that honestly sharing critical challenges with all parties and asking for<br />
their input is more important than personally providing solutions.<br />
• Be clear on goals and good at pointing the direction without giving orders.<br />
• Use foresight and intuition.<br />
• See things whole and sensing relationships and connections.<br />
Online submissions at www.anamaine.org<br />
Deadline: August 1, <strong>2021</strong><br />
ANA-<strong>Maine</strong> Partners<br />
with Connecticut Nurses<br />
Association for Continuing<br />
Education<br />
ANA-<strong>Maine</strong> is excited to join with Connecticut Nurses Association (CNA) in<br />
their Continuing Education Unit. CNA is accredited as an approver of continuing<br />
nursing education by the American Nurses Credentialing Center's Commission on<br />
Accreditation. As an approved provider of Continuing Nurse Education, CNA will<br />
provide ANA-<strong>Maine</strong> and CNA nurses with lifelong learning opportunities that are<br />
high quality and evidence based.<br />
CNA Continuing Education resources include:<br />
• Individual Activity Approval<br />
• Ability to become an Approved Provider<br />
Please find the Continuing Education resources on the rolling banner or the<br />
left-hand panel of the homepage of our website at www.anamaine.org. We look<br />
forward to supporting <strong>Maine</strong> nurses and nursing organizations by servicing your<br />
Individual Activity or Approved Provider needs.<br />
Nurses Week Webinar<br />
Climate Change and Population Health:<br />
A Primer for Nurses<br />
<strong>May</strong> 10, <strong>2021</strong><br />
In response to information received from our state-wide registered nurses survey,<br />
we are excited to announce five new webinars planned for <strong>2021</strong>.<br />
The first webinar, Climate Change and Population Health; A Primer for<br />
Nurses, will be offered on <strong>May</strong> 10, during Nurses Week.<br />
Forthcoming webinars include The Essentials of Identifying and Treating Sepsis.<br />
Please visit our website www.anamaine.org for more details on the webinars to<br />
be offered in the summer and fall of <strong>2021</strong>.<br />
Thank you to all the ANA Nurses of <strong>Maine</strong><br />
Happy National Nurses Week!<br />
WE’RE HIRING!<br />
Our nurses play an integrate role in our team<br />
approach to care, working closely with our<br />
experienced physicians, advanced practice<br />
providers, clinical social workers, rehabilitation<br />
specialist, mental health workers,<br />
peer support specialist, and more.<br />
We are seeking staff nurses to join our<br />
7p – 7a team<br />
Great benefit packages, including $200<br />
monthly student loan reimbursement<br />
APPLY ONLINE (HOSPITAL WIDE OPENINGS):<br />
maine.gov/dhhs/riverview/employment/index.shtml<br />
If you have questions or would like to speak with our nursing recruiter<br />
Kelly Flagg | Kelly.flagg@maine.gov | 207-624-4785
Page 4 ANA <strong>Maine</strong> <strong>Journal</strong> <strong>May</strong>, June, July <strong>2021</strong><br />
What you need to know about the coronavirus variants<br />
Marisa Iati and Angela Fritz<br />
**This article is reprinted with permission from the<br />
authors and The Washington Post.<br />
Viruses are always mutating and taking on new<br />
forms. The coronavirus has thousands of variants that<br />
have been identified. But several, including variants first<br />
found in the United Kingdom, South Africa and Brazil,<br />
are highly transmissible and have sparked concerns that<br />
vaccines may be less effective against them.<br />
The same protective measures that have warded<br />
off the virus throughout the pandemic — maintaining<br />
social distance, wearing masks and washing our<br />
hands — are even more critical in the face of more<br />
transmissible variants.<br />
The New York variant (B.1.526)<br />
Where and when was it discovered?<br />
This variant, which was found in samples obtained<br />
as early as November, probably emerged in the<br />
Washington Heights section of New York, Fauci told<br />
reporters in March. By the middle of that month, this<br />
variant made up nearly half of the city’s new infections.<br />
Where is it now?<br />
Officials have reported this variant in at least 14<br />
other states, including Texas, Wyoming and Maryland,<br />
Bloomberg reported.<br />
What makes it different?<br />
Some scientists are concerned that this variant<br />
may be more transmissible than previous versions.<br />
Scott Gottlieb, former director of the Food and Drug<br />
Administration, expressed worry that a mutation on<br />
this variant could enable it to reinfect people who have<br />
already had the virus.<br />
Will vaccines work?<br />
This variant seems to have some resistance to<br />
existing vaccines, although not as much as the variant<br />
first detected in South Africa, Fauci said on CBS News’s<br />
“Face the Nation.” Gottlieb said he was also concerned<br />
that this variant could partly elude the effects of<br />
vaccination.<br />
Related<br />
After weeks of declining cases, echoes of hot spots<br />
emerge in Upper Midwest, New York City area<br />
Registered Nurses (OB-GYN)<br />
Full-Time Nights<br />
Northern Light <strong>May</strong>o Hospital is currently seeking a Registered<br />
Nurse in our Obstetrics Unit for 36 hours per week. This position<br />
will be for 7:00 p.m. – 7:00 a.m.<br />
Please apply online at www.northernlighthealth.org,<br />
and/or E-mail resume to nkusnierz@northernlight.org.<br />
The South Africa variant (B.1.351)<br />
Where and when was it discovered?<br />
This mutation, also referred to as 501Y.V2, was<br />
found in South Africa in early October and announced<br />
in December, when the country’s health minister said<br />
the strain seemed to affect young people more than<br />
previous strains. This variant may have contributed to<br />
a surge of infections and hospitalizations across South<br />
Africa.<br />
Where is it?<br />
This mutation has been identified in at least four<br />
dozen countries. On Jan. 28, South Carolina officials<br />
announced that this variant had affected two people<br />
there with no travel history — the first instances of this<br />
strain identified in the United States. It has since been<br />
found in more than two dozen other states.<br />
What makes it different?<br />
This mutation shares some similarities to the variant<br />
first identified in the U.K. and, like that strain, appears<br />
to be more transmissible. There is no evidence that it<br />
is more lethal. Gottlieb has suggested that this variant<br />
might be more resistant to antibody therapies.<br />
There is some evidence that this variant could allow<br />
for reinfection: A man in France was in critical condition<br />
in mid-February after being infected with this strain<br />
four months after he was previously infected with the<br />
virus.<br />
Will vaccines work?<br />
The vaccines may have a diminished impact against<br />
this variant, but they probably will still be effective,<br />
top infectious-diseases expert Anthony S. Fauci said in<br />
January. Moderna has said its vaccine protects against<br />
the variant first identified in South Africa, with an<br />
important caveat: The vaccine-elicited antibodies were<br />
also less effective at neutralizing this mutation in a<br />
laboratory dish.<br />
Pfizer and BioNTech released their own study,<br />
not yet peer-reviewed, that suggests their vaccine<br />
effectively neutralizes this variant, though was slightly<br />
less effective.<br />
On Jan. 29, Johnson & Johnson said its single-shot<br />
vaccine was robustly effective in a massive global trial,<br />
but that its protection against sickness was weaker in<br />
South Africa. Biotechnology company Novavax has also<br />
indicated that its vaccine was significantly less effective<br />
during a trial in South Africa.<br />
In South Africa, the distribution of the Oxford-<br />
AstraZeneca vaccine has been halted. The vaccine<br />
did not provide sufficient protection against mild<br />
and moderate cases caused by a new variant, health<br />
officials said.<br />
Related<br />
First known patient reinfected with South Africa<br />
coronavirus variant is in critical condition<br />
South Africa suspends Oxford-AstraZeneca vaccine<br />
rollout after researchers report ‘minimal’ protection<br />
against coronavirus variant<br />
Mutated virus may reinfect people already stricken<br />
once with covid-19, sparking debate and concerns<br />
Coronavirus variant identified in South Africa seen<br />
for first time in United States<br />
U.K. variant (B.1.1.7)<br />
Where and when was it discovered?<br />
This variant was first found in the United Kingdom,<br />
specifically in London and the nearby county of<br />
Kent, in September. It is sometimes referred to as the<br />
Millinocket Regional Hospital, a Critical Access Hospital<br />
nestled at the base of Mt. Katahdin and Baxter State Park, has<br />
immediate openings for the following positions:<br />
$5,000 SIGN-ON BONUS FOR FULL TIME POSITIONS!!!<br />
Emergency Department RN Positions Available:<br />
FULL TIME- NIGHT SHIFT<br />
PART TIME- NIGHT SHIFT<br />
Inpatient Unit RN Positions Available:<br />
FULL TIME SCU- NIGHT SHIFT<br />
FULL TIME- DAY SHIFT<br />
*FULL TIME NURSING SUPERVISOR NEEDED FOR NIGHT SHIFT*<br />
Qualified applicants please apply online at www.mrhme.org/careers<br />
MILLINOCKET REGIONAL HOSPITAL - 200 Somerset Street,<br />
Millinocket, <strong>Maine</strong> 04462<br />
(207) 723-7275 | www.mrhme.org<br />
E.O.E. Access to Excellence in Healthcare<br />
“Kent” variant. It has been spreading rapidly in Britain,<br />
Denmark and Ireland since December.<br />
Where is it?<br />
Dozens of countries, including the United States,<br />
have seen infections from this variant of the virus. It<br />
is by far the most prevalent variant of concern in the<br />
United States, with thousands of cases across the<br />
country.<br />
The Centers for Disease Control and Prevention<br />
released a model forecast in early January that<br />
indicated the variant could become the dominant strain<br />
in the United States by some point in March. A recent<br />
study showed this variant was spreading rapidly in the<br />
United States by early February.<br />
What makes it different?<br />
The variant first identified in the U.K. appears more<br />
transmissible than the more common strain. Preliminary<br />
data also suggests that this strain may be 30 to 70<br />
percent more lethal than previous mutations.<br />
Will vaccines work?<br />
The scientific consensus is that the vaccines will<br />
remain effective against this mutation because those<br />
inoculations provoke an array of neutralizing antibodies<br />
and other immune-system responses. Biotechnology<br />
companies Pfizer, Moderna and Novavax have said their<br />
vaccines appear to work against this variant.<br />
Ravindra Gupta, a professor of clinical microbiology<br />
at the University of Cambridge, found in a study of<br />
older adults that the immune response triggered by the<br />
Pfizer vaccine was modestly less effective against the<br />
variant first identified in the U.K.<br />
Related<br />
Virus variant first detected in the U.K. has been<br />
deadlier, study confirms<br />
U.K. coronavirus variant spreading rapidly through<br />
United States, study finds<br />
Denmark is sequencing all coronavirus samples and<br />
has an alarming view of the U.K. variant<br />
CDC warns highly transmissible coronavirus variant<br />
to become dominant in U.S.<br />
The ‘Eeek’ mutation (E484K)<br />
Where and when was it discovered?<br />
This might best be described as a mutation<br />
within a mutation. It’s called E484K — or “Eeek,” as<br />
epidemiologists refer to it — and it’s appearing on<br />
some of the variants we describe below. It’s not brand<br />
new; it has appeared many times since the start of the<br />
pandemic, but experts have been concerned about<br />
it. It gained mainstream attention when it started to<br />
coincide with other variants that are more contagious.<br />
Where is it?<br />
Eeek has been seen in the variants first discovered<br />
in the U.K., South Africa and Brazil. It has also been<br />
detected in more than 200 samples of the virus<br />
sequenced in the United States since <strong>May</strong>.<br />
What makes it different?<br />
The Eeek mutation changes the virus’s spike protein,<br />
which is what vaccines target. By itself, this mutation<br />
does not change the virus significantly. The concern<br />
with this mutation is when it’s paired with the other<br />
variants, which could help the virus evade detection<br />
and make neutralization by the human immune system<br />
less efficient.<br />
Will vaccines work?<br />
Scientists are actively trying to answer this question.<br />
Clinical trial data have indicated that vaccines were<br />
less effective in preventing infections with variants in<br />
South Africa featuring the mutation. But the vaccines<br />
still dramatically lowered the chance of severe illness or<br />
death.<br />
Semi-related to the vaccine question: One study<br />
found preliminary evidence that patients in South<br />
Africa who had survived an earlier bout with the more<br />
common coronavirus were becoming infected a second<br />
time — though not severely ill — after exposure to the<br />
variant with this mutation.
<strong>May</strong>, June, July <strong>2021</strong> ANA <strong>Maine</strong> <strong>Journal</strong> Page 5<br />
Related<br />
Worrisome E484K coronavirus mutation seen in U.K. variant and in some U.S.<br />
samples<br />
Brazil variant (P. 1)<br />
Where and when was it discovered?<br />
Sequencing studies found the variant in Brazil, mainly in Rio de Janeiro, as early as<br />
July. Researchers in Japan discovered it in travelers from Brazil in January.<br />
Where is it now?<br />
It has been confirmed in more than two dozen countries, including Japan, Spain<br />
and New Zealand. On Jan. 25, Minnesota health officials confirmed the first U.S.<br />
case of this variant in a resident with recent travel history to Brazil. It has since been<br />
found in at least 18 states.<br />
What makes it different?<br />
The variant has more than a dozen alterations, several of which are found on<br />
the virus’s spike protein, which binds the virus to a cell. Because of that, researchers<br />
think the strain is probably more transmissible. There is also some early evidence<br />
that antibodies might not recognize the P.1 variant, which could lead to reinfection.<br />
Will vaccines work?<br />
There’s no strong evidence right now suggesting that vaccines won’t work<br />
against the variant first identified in Brazil. However, scientists have raised the<br />
possibility that this variant can evade antibodies, which would impact the current<br />
vaccines’ effectiveness.<br />
A study of the Pfizer-BioNTech vaccine published in March determined that it was<br />
highly effective at neutralizing the variant found in Brazil. Moderna has announced<br />
that it would develop a new vaccine tailored to a similar variant in case an updated<br />
shot becomes necessary.<br />
Related<br />
The Amazonian city that hatched the Brazil variant has been crushed by it<br />
First U.S. case of highly transmissible Brazil coronavirus variant identified in<br />
Minnesota<br />
The Denmark/California mutation (L452R)<br />
Where and when was it discovered?<br />
This mutation was detected in Denmark in March.<br />
Where is it now?<br />
A variant with this mutation was found in California this winter and became<br />
dominant there over five months, eventually making up more than half of infections<br />
in 44 of the state’s 58 counties. This mutation has also been confirmed in several<br />
other states.<br />
British officials identify coronavirus mutations, but significance remains unclear<br />
How can we protect ourselves from the variants?<br />
The same protective measures that have warded off the virus throughout the<br />
pandemic — maintaining social distance, wearing masks and washing our hands —<br />
are even more critical in the face of more transmissible variants. Those guidelines<br />
will simultaneously keep you from becoming ill from one of those variants, while<br />
making it harder for the virus to mutate in the first place.<br />
“Viruses don’t mutate unless they replicate,” Fauci said in January.<br />
But it’s also important for scientists to learn as much as they can about these<br />
variants, in case there are specific ways we can slow their spread. Until the research<br />
exists, we can’t make assumptions about what new variants will do.<br />
What do the variants mean for vaccines?<br />
“We need to get as many people vaccinated with the current vaccine that we<br />
have as we possibly can … and prepare for the potential eventuality that we might<br />
have to update this vaccine sometime in the future.” — Fauci in January<br />
As more significant variants are reported, the obvious (and arguably most<br />
important) question is whether the vaccines will work on them. Some of the<br />
mutations have sparked particular concern because they affect the spikes on the<br />
virus, which is what the vaccines target.<br />
In short, the pharmaceutical companies are testing new variants against their<br />
vaccines and spinning up new trials. Moderna and Pfizer-BioNTech can update their<br />
vaccines quickly because of their mRNA technology, which can be reprogrammed to<br />
target new variants.<br />
Pfizer and Moderna have run tests on the variants and while the vaccines still<br />
triggered a response, they appeared to be less effective.<br />
A growing number of scientists anticipate that we will eventually need something<br />
similar to the annual flu shot — companies will periodically update their vaccines to<br />
match the prevalent coronavirus variants, and we will need to get boosters to stay<br />
protected.<br />
“With flu, we need to adapt the vaccines. We can see that already,” said<br />
Ravindra Gupta, a professor of clinical microbiology at the University of Cambridge.<br />
“The companies do realize there is a problem in the longer term, and they will deal<br />
with it just as we have done with flu every year.”<br />
Related<br />
New coronavirus variants accelerate race to make sure vaccines keep up<br />
Joel Achenbach, William Booth, Carolyn Y. Johnson, Sarah Kaplan, Laurie<br />
McGinley and Fenit Nirappil contributed to this report.<br />
What makes it different?<br />
There is evidence that this mutation enhances the virus’s ability to bind to human<br />
receptor cells, making it more transmissible. Some scientists are urging public-health<br />
officials to declare the variant with this mutation circulating in California a “variant<br />
of concern,” which would make it the first homegrown variant with this label.<br />
Will vaccines work?<br />
Some scientists think this mutation might make the virus more resistant to<br />
vaccines because the mutation is in the spike protein, which enables the virus to<br />
attach to cells. But scientists also say that more study is needed before they can<br />
draw conclusions.<br />
Related<br />
New research shows California coronavirus variant is more transmissible<br />
Another coronavirus variant linked to growing share of cases, several large<br />
outbreaks, in California<br />
The original variant (D614G)<br />
Where and when was it discovered?<br />
This mutation, known to scientists simply as “G,” was discovered in China in<br />
January 2020. It soon spread through New York City and Europe.<br />
Where is it?<br />
The “G” mutation has become ubiquitous. By July, about 70 percent of the<br />
50,000 genomes of the coronavirus uploaded by researchers worldwide to a shared<br />
database carried the variant.<br />
What makes it different?<br />
Some scientists think this mutation is significantly more transmissible than the<br />
original strain of the virus. That’s because this variant has four to five times more<br />
spikes on its surface. Those spikes enable the virus to latch onto and infect cells. But<br />
other scientists still contest the greater transmissibility.<br />
Will vaccines work?<br />
The G variant was the dominant strain when 2020 vaccine trials took place. The<br />
Pfizer and Moderna vaccines showed a 95 percent efficacy in trials.<br />
Related<br />
This coronavirus mutation has taken over the world. Scientists are trying to<br />
understand why.<br />
Massive genetic study shows coronavirus mutating and potentially evolving amid<br />
rapid U.S. spread
Page 6 ANA <strong>Maine</strong> <strong>Journal</strong> <strong>May</strong>, June, July <strong>2021</strong><br />
Remembering the Father of Vaccination<br />
Professor Richard Gunderman, M.D., Ph.D.<br />
**This essay was published<br />
in the History News<br />
Network and reprinted<br />
with the permission of the<br />
author.<br />
As the US COVID-19<br />
vaccination program reaches<br />
full stride, approaching<br />
two million shots per day,<br />
the time is ripe to recall<br />
the contributions of the<br />
physician-scientist who first put vaccines on the map,<br />
Edward Jenner. Some claim that Jenner saved the lives<br />
of more people than any other figure in history, yet his<br />
contributions are often poorly understood.<br />
Jenner did not invent inoculation<br />
Born in England in 1749, Jenner was inoculated as<br />
a child against smallpox, a dread disease that appears<br />
to have scarred 3,000-year-old Egyptian mummies.<br />
Caused by the Variola virus, the disease manifested<br />
as fever and the development of a blistering skin rash<br />
referred to as pox. It is thought that about 30% of<br />
infected people died of the disease, especially infants<br />
and young children.<br />
In Jenner’s day, inoculation was by variolation. The<br />
skin was scratched and the smallpox scabs or fluid<br />
from an infected person were rubbed into it. When it<br />
worked appropriately, this would cause the variolated<br />
individual to develop a mild case of smallpox which<br />
usually lasted several weeks, after which the patient<br />
would be immune. But small percentages of variolated<br />
individuals died.<br />
The technique had been popularized by Lady Mary<br />
Wortley Montagu, who both lost her brother to the<br />
disease and suffered severe facial scarring herself.<br />
While traveling in Turkey, she witnessed variolation,<br />
and in 1718 she had it performed on her young son.<br />
By the time Jenner was born, variolation had become<br />
been widely incorporated into English medicine.<br />
Other physicians studied vaccination<br />
Jenner was not the first to suspect that prior<br />
infection with cowpox provided immunity against<br />
smallpox. At least five physicians had tested cowpox,<br />
and even a farmer named Benjamin Jesty had used<br />
cowpox to vaccinate his wife and children during a<br />
smallpox epidemic. Jenner, however, was the first to<br />
study vaccination in a scientifically rigorous way.<br />
Knowing that milkmaids were generally immune<br />
to smallpox, Jenner hypothesized that the pustules<br />
on the hands of milkmaids could be used to confer<br />
immunity. In 1796, he tested the idea by inoculating<br />
James Phipps, the eight-year-old son of his gardener.<br />
He scraped material from the hands of Sarah Nelmes,<br />
a milkmaid with smallpox, and inoculated Phipps in<br />
both arms.<br />
After several weeks, he variolated Phipps (i.e.,<br />
deliberate inoculation of an uninfected person with<br />
the smallpox virus). Although the boy did develop a<br />
mild fever, he did not develop full-blown smallpox.<br />
After a time, Jenner variolated him again, with no<br />
effect. The procedure had apparently conferred<br />
immunity. We now know that the viruses that cause<br />
cowpox and smallpox are sufficiently similar that the<br />
immune response to one can confer immunity to the<br />
other.<br />
Jenner died long before viruses were discovered<br />
Today we talk easily of viruses, but in Jenner’s<br />
day they were completely unknown. The great<br />
microscopist Antony van Leeuwenhoek had discovered<br />
bacteria around 1676, but viruses are far too small to<br />
be seen through light microscopes. It was not until<br />
the invention of the electron microscope in 1931 that<br />
viruses were visualized for the first time.<br />
Unanswered questions about the mechanism<br />
of vaccination led the Royal Society not to publish<br />
Jenner’s first manuscript, but after he conducted other<br />
trials, including one on his infant son, his paper was<br />
published. Perhaps his greatest contribution was his<br />
insistence on challenging those who had received the<br />
cowpox inoculation with smallpox to prove they were<br />
immune.<br />
The term vaccination betrays its origin. Vacca is<br />
Latin for cow, the source of the cowpox material that<br />
Jenner and others used to inoculate against smallpox.<br />
Some decades before Jenner’s work, US founding<br />
father Ben Franklin decided not to variolate his young<br />
son Francis, a decision he regretted the rest of his life<br />
because the boy died of the disease at age four in<br />
1736.<br />
Jenner’s legacy exceeded even his own dreams<br />
Smallpox vaccination quickly spread around the<br />
world. Spanish expeditions carried it to far-flung lands<br />
such as America and China. Napoleon had his troops<br />
vaccinated. Jenner received a host of domestic and<br />
foreign honors. To allow him to focus his attention on<br />
his investigations, Parliament awarded him huge grants<br />
of 10,000 and 20,000 pounds.<br />
But Jenner could not have anticipated where his<br />
work would lead. Immunization by cowpox held sway<br />
until the 19th century, when a more modern live-virus<br />
vaccine was developed using the lymph of calves.<br />
Today versions of smallpox vaccine are available that<br />
do not use live viruses and thus cannot cause disease.<br />
Yet no one is being immunized against smallpox<br />
today, because of a worldwide immunization program<br />
that led the World Health Organization to declare the<br />
disease eradicated in 1980. US vaccination ceased<br />
in 1972, though many older adults still bear scars.<br />
Today the smallpox virus is found only in a few secure<br />
laboratories, where it is used to prepare against the<br />
use of smallpox as a bioweapon.<br />
Jenner died of a stroke in 1823 at the age of 73.<br />
He continued his scientific investigations until the end,<br />
presenting a paper on bird migration to the Royal<br />
Society in the year of his death. Whether or not Jenner<br />
truly saved more lives than any other person, there is<br />
no doubt that his pioneering work on immunization<br />
laid the groundwork for today’s most effective tool<br />
against COVID-19, the vaccine.<br />
Professor Richard Gunderman, M.D., Ph.D., is the<br />
Chancellor’s Professor of Radiology, Pediatrics, Medical<br />
Education, Philosophy, Liberal Arts, Philanthropy, and<br />
Medical Humanities and Health Studies at Indiana<br />
University. He gave permission to reprint this article.<br />
Best Summer Job Ever!<br />
Be a summer camp nurse at Camp Wigwam<br />
in southwestern <strong>Maine</strong> – 6 weeks, 6/20-8/12<br />
Private accommodations, one of three nurses on staff.<br />
Contact: bob@campwigwam.com<br />
www.campwigwam.com
<strong>May</strong>, June, July <strong>2021</strong> ANA <strong>Maine</strong> <strong>Journal</strong> Page 7<br />
Salute to <strong>Maine</strong> Nursing Military History<br />
Juliana L’Heureux<br />
WATERVILLE, ME- In <strong>May</strong>, we remember all nurses<br />
and those who served in the military. Susan White<br />
saved her family’s information, about her aunt, Lt.<br />
Gabrielle Giroux, who was a graduate of the Sisters<br />
Hospital nursing class of 1941, in Waterville. On August<br />
14, 2006, Lt. Gabrielle Giroux was recognized for her<br />
military service by <strong>Maine</strong>’s former Congressman Mike<br />
Michaud, at ceremonies held at Mount St. Joseph<br />
Nursing Home in Waterville.<br />
A modern hospital, it was described in a vintage<br />
postcard as having a capacity of 120 beds, situated<br />
on an elevation exposed to air and sunshine. It was<br />
approved by the American College of Surgeons and by<br />
the State Board of Registration of Nurses. The hospital<br />
was conducted by the Daughters of Charity of St.<br />
Vincent de Paul.<br />
In the April 4, 1944 edition of the Waterville<br />
Morning Sentinel, Mr. and Mrs. Joseph B. Giroux,<br />
of 30 Western Avenue, reported that their daughter<br />
Lieutenant Gabrielle M. Giroux, a member of the Army<br />
Nurse Corps, had arrived safely in England. “Upon<br />
entering the service in March, 1943, Lt. Giroux received<br />
her commission. She received six months training at<br />
Fort Williams, <strong>Maine</strong> and was then assigned to the<br />
96th Evacuation hospital in Shreveport, Louisiana. Lt.<br />
Giroux was transferred to Camp Shelby, Mississippi<br />
with the Evacuation hospital. She received general<br />
hospital training at Camp Shelby and was then sent<br />
overseas. Lt. Giroux was a graduate of the Sisters<br />
Hospital in Waterville, in the class of 1941.”<br />
Her niece said she married Walter Gorski on Sept.<br />
28, 1946 in Waterville. They lived in Armonk NY and<br />
had a son & daughter.<br />
Gabrielle Giroux Gorski died in <strong>Maine</strong>, on August<br />
22, 2009.<br />
Former Congressman Mike Michaud of <strong>Maine</strong> recognized Lt. Gabrielle Giroux for her military service.<br />
August 14, 2006<br />
Kennebec Valley Community College<br />
is seeking two Nursing positions<br />
Nursing Faculty/Department Chair<br />
requirements:<br />
A minimum of a Master’s degree in nursing<br />
An unencumbered <strong>Maine</strong><br />
RN license<br />
Nursing experience in<br />
education/practice<br />
Administrative/budgeting skills<br />
Experience in the academic administration of a nursing program<br />
Experience with ACEN accreditation<br />
Nursing Faculty: Medical-Surgical Specialist<br />
requirements:<br />
A Master’s degree in nursing<br />
(or currently enrolled in a graduate nursing program)<br />
An unencumbered <strong>Maine</strong><br />
RN license<br />
3–5 years in the practice of<br />
adult nursing<br />
Teaching experience is preferred<br />
(didactic and/or clinical)<br />
Effective/engaging presentation skills<br />
Both complete job descriptions can be found on the website:<br />
https://www.kvcc.me.edu/about-kvcc/overview/<br />
employment-opportunities/.<br />
Sisters Hospital in Waterville, <strong>Maine</strong> vintage postcard<br />
To submit a complete application file, please send the following: cover<br />
letter, resume, official transcript of highest degree earned, and the<br />
KVCC Application for Employment (visit: http://www.kvcc.me.edu/<br />
employment and download form) to mbrennan@kvcc.me.edu.
Page 8 ANA <strong>Maine</strong> <strong>Journal</strong> <strong>May</strong>, June, July <strong>2021</strong><br />
Nurses Address Climate Change<br />
Cara Cook, MS, RN, AHN-BC, Climate & Health<br />
Program Manager, Alliance of Nurses for Healthy<br />
Environments, cara@enviRN.org<br />
Barbara Sattler, RN, DrPH, FAAN, Professor<br />
Emeritus, University of San Francisco, bsattler@<br />
usfca.edu<br />
Diana Van Vleet, National Director of Outreach and<br />
Engagement, Healthy Air Campaign, American<br />
Lung Association, Diana.VanVleet@lung.org<br />
The Earth’s temperature has historically been<br />
modulated by the sun’s rays beating down, warming<br />
the land and water, and then radiating heat back out<br />
beyond the Earth’s atmosphere. This process has kept<br />
the Earth at a livable temperature for humans and<br />
other lifeforms to flourish. However, we now have a<br />
“blanket” of gases that are surrounding the Earth -<br />
gases created substantially by human activities such as<br />
transportation, energy production, industry, cooking/<br />
heating, and agriculture. Primarily generated from the<br />
burning of fossil fuels, these gases are called greenhouse<br />
gases because they create the same warming effect as<br />
a greenhouse and are slowly warming the Earth – both<br />
the land and particularly the oceans. In the process, they<br />
are changing our climate. Climate is distinguished from<br />
weather in that weather is what occurs from day to day<br />
or week to week, but climate is what occurs over longer<br />
periods of time, month to month and year to year.<br />
Just as there is a small range of body temperatures<br />
at which humans can be healthy, the same is true<br />
for all species on Earth. As the Earth warms, we are<br />
beginning to see shifts in climate which are resulting<br />
in some areas seeing much more rain and others<br />
much less, some colder winters, some hotter, drier<br />
summers. As we encounter more extreme heat days<br />
and extended heat waves, we are going to see many<br />
more heat-related illnesses and even deaths in humans.<br />
People who work outside in agriculture, utilities,<br />
construction, gas/oil, and many other fields will be<br />
at higher risk for hyperthermia. Extreme storms and<br />
wildfires fueled by climate change have already taken<br />
an enormous toll on human and ecological health.<br />
This is why leading health organizations have declared<br />
climate change a public health emergency and called<br />
for immediate action. For an extensive list of how<br />
climate change affects human health, visit https://<br />
nca2018.globalchange.gov/.<br />
While there are some natural sources of greenhouse<br />
gases, the ones that we have the most capacity to reduce<br />
are those that are man-made. The International Council<br />
of Nurses announced its position statement on climate<br />
change in September 2018 and calls on all nurses to help<br />
address climate change (see: Nurses, climate change and<br />
health). It calls for us to heed the scientific evidence which,<br />
in the case of climate change, is abundant.<br />
Nurses can engage both individually and as a<br />
profession to advocate for policies and practices that<br />
will decrease greenhouse gas production from a wide<br />
range of its sources, and thereby improve air quality,<br />
slow climate change and protect human health. The<br />
truth is climate change is a health issue and that’s what<br />
nurses are all about.<br />
The Alliance of Nurses for Healthy Environments<br />
(ANHE) is a national nurse-led organization working to<br />
tap into the power of nurses to address climate change.<br />
ANHE has developed a variety of resources specifically<br />
for nurses. These resources are available free of charge<br />
at envirn.org and include a Climate and Health Toolkit,<br />
an online repository of resources and tools for nurses to<br />
learn about climate and health and how to take action.<br />
Learn more about ANHE’s Global Nurses Climate Change<br />
Committee and join our monthly calls here. Additionally,<br />
you can learn more about important ways you can make<br />
a difference at the American Lung Association’s Health<br />
Professionals for Clean Air and Climate Action page. To<br />
share your own story about why you fight for clean air<br />
and climate action, visit your Share Your Story.<br />
ANA-ME Nursing Scholarship Application Period is Open<br />
ANA-<strong>Maine</strong> Nursing Student Scholarship Criteria<br />
What is this scholarship?<br />
• ANA-<strong>Maine</strong> is pleased to award two annual<br />
nursing education scholarships. Funding for<br />
the scholarships are provided by ANA-<strong>Maine</strong><br />
members, community members, and the Arthur<br />
L. Davis Publishing Agency.<br />
• The recipients will be acknowledged at the<br />
annual business meeting in the fall of each year.<br />
One (1) $1,000 scholarship will be awarded to a<br />
student enrolled in an accredited pre-licensure<br />
registered nursing program. One (1) $1,000<br />
scholarship will be awarded to a registered nurse<br />
enrolled in a master's in nursing or doctorate<br />
program.<br />
Who is eligible?<br />
• Individuals currently enrolled and matriculated<br />
in a <strong>Maine</strong> state-approved, accredited registered<br />
nursing program leading to an associate degree,<br />
baccalaureate, masters or doctoral degree in<br />
nursing<br />
• Doctoral candidates in out of state programs may<br />
apply with permanent residency in <strong>Maine</strong><br />
• Enrolled in at least half-time status and has<br />
successfully completed 30 credits of program<br />
curriculum<br />
• Must have a minimum of 3.0 GPA and be in good<br />
standing with academic institution<br />
• Must be a member of ANA or ANA-Student<br />
Subscriber<br />
When will the scholarship(s) be awarded?<br />
Awardees are notified by September 1 and invited to<br />
attend the annual Fall Annual Business Meeting to be<br />
recognized and receive the award.<br />
Who chooses the recipient(s)?<br />
Student affairs committee chair and three other<br />
members will complete a rubric for each application.<br />
A blind review is completed by the student affairs<br />
committee. Awardees are announced to the ANA-<br />
<strong>Maine</strong> Board prior to the fall annual meeting.<br />
QUALITY & PATIENT SAFETY<br />
NURSE SPECIALIST<br />
> Supports strategic objectives of clinical quality and<br />
safety to assist with achieving the goals of high<br />
quality, cost effective, patient care and service<br />
> 3-5 years of experience in process improvement<br />
with clinical operations<br />
> Hospital quality/risk experience<br />
> Quality improvement, patient safety, process<br />
improvement, and/or risk management<br />
certification such as CPHQ, CPPS, CPHRM (highly<br />
desired)<br />
South Portland<br />
What documents are required with the<br />
application?<br />
• Copy of the most recent transcript and degree<br />
audit<br />
• Proof of ANA-<strong>Maine</strong> membership or Student<br />
Nurses’ Association Membership<br />
• Essay describing how nursing will/has impacted<br />
your life (one page and single spaced)<br />
• One professional/academic letter of<br />
recommendation<br />
Applications may be accessed beginning <strong>May</strong> 1st<br />
Application deadline is August 15<br />
Please mail completed packet to: ANA-<strong>Maine</strong><br />
Membership Committee. PO Box 647,<br />
Kennebunk, ME 04043<br />
Click Below to Apply for <strong>Maine</strong>-Nursing Student-<br />
Scholarship-Program<br />
https://form.jotform.com/anamaineforms/anamaine-scholarship-application<br />
Congratulations to the 2020 Scholarship Winners:<br />
• Michelle Twitchell, Turner, ME. <strong>Maine</strong> College<br />
of Health Professionals, AA/RN. Anticipated grad<br />
year: <strong>2021</strong>. Combining nursing degree with her<br />
BS in Exercise Science and hopes to work with the<br />
elderly, getting that population moving and more<br />
active to increase bone and functional health.<br />
• Rhonda Babine, Old Orchard Beach, ME.<br />
Thomas Edison State University, DNP Systems<br />
Leadership. Anticipated grad year: 2022. As a<br />
practicing nurse for the past 34 years, Rhonda<br />
has been an advocate for the progression of<br />
nursing through continued education, research,<br />
and leadership. She is very interested in the<br />
translation of evidence into clinical practice.
<strong>May</strong>, June, July <strong>2021</strong> ANA <strong>Maine</strong> <strong>Journal</strong> Page 9<br />
Four <strong>Maine</strong> health care workers travel to the Super Bowl on the<br />
Patriots plane<br />
<strong>Maine</strong> Hospital Association<br />
Cathy Bean, R.N., was one of three nurses who<br />
was invited to the Super Bowl along with four<br />
front line health care workers from <strong>Maine</strong>. She<br />
immunized volunteers including Mike Reynolds, at<br />
the <strong>Maine</strong> State House during the annual <strong>Maine</strong><br />
Nurses in the Hall of Flags at the State House.<br />
AUGUSTA, ME- A plan to fly 76 frontline workers<br />
from New England to Tampa for an all-expenses-paid<br />
Super Bowl experience on February 7, included four<br />
health care workers from <strong>Maine</strong>. The Patriots owner<br />
Robert Kraft and family announced that it will fly the<br />
selected health care "superheroes" in the Patriots<br />
football team plane to Tampa, for an all-expenses-paid<br />
trip, including: One ticket to the game, a police escort<br />
from Gillette Stadium to Logan Airport, an exclusive<br />
ticket to the NFL TikTok Tailgate concert headlined by<br />
Miley Cyrus, a two-night complimentary hotel stay,<br />
a Patriots gift bag, a $100 VISA gift card to spend at<br />
Raymond James Stadium and ground transportation in<br />
Tampa. The four COVID vaccinated recipients for this<br />
experience who are from <strong>Maine</strong> were:<br />
Joe Looper, Emergency Department Nurse at<br />
Mercy Hospital: He is a Certified Emergency Nurse at<br />
Mercy Hospital where he has been on the frontline<br />
during the COVID-19 pandemic, caring for <strong>Maine</strong><br />
people. He has also obtained his Trauma Nurse<br />
certification and is a Basic Life Support instructor<br />
through the American Red Cross. In addition to caring<br />
for emergency room patients, he is also a member of<br />
the <strong>Maine</strong> National Guard, has been deployed to Iraq<br />
and Afghanistan, and has been awarded the Army<br />
Achievement Medal twice, the State Safety Award,<br />
Valorous Unit Award, Combat Medical Badge, Army<br />
Commendation Medal and Army Achievement Award.<br />
Cathy Bean, Manager of Clinical and Community<br />
Health Services Northern Light Home Care & Hospice:<br />
She was recently honored by the Home Care & Hospice<br />
Alliance of <strong>Maine</strong> with its Distinguished Service Award,<br />
has been on the frontlines, helping to take care of<br />
<strong>Maine</strong>’s most vulnerable and underserved. For more<br />
than a decade, she has been the leader in coordinating<br />
the influenza vaccination efforts in schools, businesses,<br />
homeless shelters and migrant communities. When<br />
the pandemic took hold, she used her experience<br />
to design and stand up COVID-19 testing sites and<br />
to develop a daily COVID screening process for those<br />
residing at multiple homeless shelters and quarantine<br />
Four <strong>Maine</strong> health care workers...continued on page 11
Page 10 ANA <strong>Maine</strong> <strong>Journal</strong> <strong>May</strong>, June, July <strong>2021</strong><br />
Honoring <strong>Maine</strong>’s Nurse Educators – Jenny Radsma<br />
Patricia Lynn Eldershaw PhD, MSN, RN<br />
One Career, Many Paths<br />
After a career that has<br />
spanned four decades, Dr.<br />
Jenny Radsma is celebrating<br />
her retirement from the<br />
University of <strong>Maine</strong> at Fort<br />
Kent (UMFK). Jenny joined<br />
UMFK in 1997 in what then<br />
was a small nursing program<br />
that annually graduated<br />
between 10 to 15 students.<br />
Fast forward to this year’s<br />
graduating class of over 160<br />
Jenny Radsma<br />
BSN-trained nurses. Jenny has been an integral part of<br />
the growth and development of the nursing program,<br />
now the largest in the region, drawing students from<br />
all over the country, Canada and beyond. “Jenny has<br />
had a transformative influence on nursing education<br />
and public health,” said Dr. Erin Soucy, Dean of the<br />
nursing program at UMFK and longtime colleague.<br />
“She is a staunch advocate of high quality nursing<br />
education and professional practice. Her contributions<br />
to the program, the campus and the St. John Valley<br />
have been outstanding. It has been a pleasure and an<br />
honor to work with her.”<br />
For those familiar with the Fort Kent campus,<br />
the main hallways are lined with photos of previous<br />
graduating classes. In the nursing wing, one cannot<br />
overlook the many years Jenny has stood with the<br />
students she has supported through to graduation.<br />
Twenty five in total, with a rough estimate of well<br />
over 2,000 students. Jenny reckons she has former<br />
students in almost every State in the nation. In fact, a<br />
student graduating in this year’s class is the daughter<br />
of a student who was in her first graduating class of<br />
1997. At a time when nurses are in desperate short<br />
supply, her contributions to the profession are cause<br />
for celebration. “Nursing education has just been the<br />
exact challenge that I needed in the sense that no<br />
two semesters are ever the same and no two students<br />
are ever the same. There's something really satisfying<br />
about knowing that you're launching people, for<br />
a meaningful career with which they can support<br />
themselves, their families and ultimately make a<br />
difference in society and to humanity.”<br />
I became a nurse because of Jenny, although not in<br />
the usual course of life. We met while both pursuing<br />
a postdoctoral fellowship at the International Institute<br />
for Qualitative Methodology, in Edmonton Alberta -<br />
Jenny, a nurse educator, I a sociologist. The institute<br />
was unique for its interdisciplinary focus long before<br />
academic collaboration became an ideal model for<br />
health care and research. I was so impressed by the<br />
impact nurses had on the lives of people in their care;<br />
when I found myself contemplating a career change,<br />
Jenny said, “Why not pursue nursing?” And so began<br />
my career as a nurse, for which I am indebted.<br />
Jenny said, “I’ve always wanted to be a nurse. I can’t<br />
remember a time when I didn’t want to be a nurse.”<br />
The daughter of Dutch immigrants escaping postwar<br />
Europe for a new life in Canada, Jenny was born<br />
with a cleft lip palate for which she underwent several<br />
hospitalizations over the course of her young life. What<br />
might have evoked aversion in another instilled in Jenny<br />
a clear purpose. “I actually liked going into the hospital.<br />
I loved the clinical smell! The clean order and sense of<br />
urgency. Even as a child, it excited me.”<br />
Jenny’s professional career parallels the growth<br />
and academic advancement of the profession itself,<br />
initially obtaining an LPN in 1979 and, wanting “to do<br />
more,” she pursued her BSN eventually earning a MN<br />
in 1989. Much of her early nursing experience was in<br />
the remote northern Alberta town of High Level where<br />
she provided the whole spectrum of health care from<br />
a small 25 bed hospital that served a large region of<br />
diverse patients including several Native communities,<br />
Mennonite farm families, as well as, workers from the<br />
oil and lumber industry. She said, you never knew what<br />
would come through the hospital door, an industrial<br />
or logging injury or a woman in labor. Jenny helped<br />
to deliver over 250 babies annually and routinely<br />
accompanied patients for the long journey south in a<br />
twin engine prop-plane to larger city centers for urgent<br />
treatment. Jenny said, “Nursing has always kept me<br />
stimulated and challenged. I've loved the fact that I<br />
have always been able to learn about people, about<br />
humanity, society and about myself.”<br />
Jenny left High Level to pursue an academic<br />
career at UMFK and proceeded to earn a PhD from<br />
Barry University in Florida in 2005. Her teaching and<br />
academic work integrates a wide range of influences<br />
that express her joy of life and learning - literature,<br />
cinema, culture and history - that has led to a creative<br />
and unique field of study evident in her substantial<br />
CV. Some of her many accomplishments include more<br />
than a dozen teaching areas that span the nursing<br />
curriculum, over 30 publications and memoirs that<br />
culminated in an anthology published in 2018. She<br />
is also a longtime volunteer for literacy and strong<br />
advocate on smoking cessation in the region. And<br />
somehow, in the midst of doing all this and more,<br />
she managed to walk over 1,500 miles of the historic<br />
Camino pilgrimage trails through France, Spain and<br />
Italy.<br />
Although Jenny will be missed at UMFK, she has no<br />
plans on stopping her academic and creative ventures.<br />
In the works are writings on diversity education<br />
in nursing and memoirs about some of the many<br />
students she has known over her years teaching. Her<br />
commitment to the nursing profession and health<br />
care is impressive. Jenny has always “worked with<br />
pleasure.” She says, “I count myself incredibly blessed<br />
to have been employed with work that stimulated<br />
and challenged me while simultaneously allowing me<br />
to make a difference in the lives of others, whether<br />
as a staff nurse or as a nursing educator. So after a<br />
career in nursing that spans more than four decades,<br />
I can honestly say I have almost always worked with<br />
pleasure.”<br />
Patricia Lynn Eldershaw PhD, MSN, RN is an Assistant<br />
Professor of Nursing at Husson University in Bangor.<br />
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<strong>May</strong>, June, July <strong>2021</strong> ANA <strong>Maine</strong> <strong>Journal</strong> Page 11<br />
Nursing History in Poetry<br />
This poem was found among prose and poetry that<br />
was saved by <strong>Maine</strong> nurses in a collection of history<br />
articles<br />
Fulfillment<br />
As seen from a hospital window.<br />
City lights, you fascinate me.<br />
Always blinking, through the night.<br />
As my lonely watch I’m keeping.<br />
There is comfort in your light.<br />
Other lights within my memory<br />
Return scenes from out the past,<br />
Of patients, nurses, doctors<br />
Who built values that could last.<br />
One finds within these walls<br />
A courage, and a dedication, too,<br />
That all mankind manifest,<br />
New life, be they Gentile or a Jew.<br />
Here one needs an understanding<br />
Of a very special kind.<br />
One’s own wisdom becomes greater<br />
From dependence on God’s mind.<br />
Tolerance and understanding<br />
Have been born of patience tried.<br />
Time enough to strengthen it,<br />
Bridging gulfs that seem too wide.<br />
For lights of cities or memories<br />
From whatever source it came.<br />
To repay in fullest measure<br />
Means fulfillment in life’s game.<br />
Althea Poland Woodward<br />
Class of 1936<br />
<strong>Maine</strong> General Hospital School of Nursing<br />
Jean Caron, a Mercy Hospital School of Nursing<br />
alumna, found the poem, "The Gift", by Darcy L.<br />
Record Landry, class of 1968, among the documents<br />
she saved from when she was working and teaching<br />
at Mercy Hospital, in Portland. For the occasion of the<br />
60th anniversary of her class of 1953, at their 60th<br />
reunion, she created this memento, a printed card<br />
including the poem, to give to alumna and attendees.<br />
This Memento and poem are printed with her<br />
permission.<br />
Four <strong>Maine</strong> health care workers...continued from page 9<br />
locations. She is also putting that experience to use<br />
for developing COVID-19 vaccination sites. Cathy also<br />
serves as the Chair of the Cumberland District Public<br />
Health Council where she is integral in fighting inequity<br />
to create equal access to health care across the county<br />
and state.<br />
Lisa Ireland, Registered Nurse at RiverRidge<br />
Center: Lisa is a registered nurse at RiverRidge Center<br />
where she has been on the frontlines throughout<br />
the pandemic. She often works every day of the<br />
week, across multiple shifts, performing hundreds of<br />
COVID-19 tests on other frontline staff and patients.<br />
Lisa also serves as the infection prevention and control<br />
leader for RiverRidge.<br />
Patrick Keaney, Pulmonary Physician at Mid Coast<br />
Hospital: Patrick is a pulmonary physician at Mid Coast<br />
Hospital where he has been key to the organization’s<br />
COVID-19 preparation and response efforts. As the<br />
pandemic took hold, Dr. Keaney took on the dual role<br />
of caring for all COVID-19-positive patients at Mid<br />
Coast Hospital during the first several weeks of the<br />
pandemic while also serving tirelessly as one of the<br />
hospital’s sources of information about the disease.<br />
For six straight weeks without a break, he arrived<br />
each morning to care for ill patients, share the latest<br />
information on treatment options, and offer words of<br />
encouragement to those around him.<br />
<strong>Maine</strong> Governor Janet Mills recognized the health<br />
care workers for their dedication to leading public<br />
health and patient care during the COVID19 pandemic.<br />
“I am grateful to the Kraft family for providing this<br />
special gift to our frontline COVID health care workers<br />
as a measure of our enduring gratitude,” said Mills...<br />
“I ask all <strong>Maine</strong> people to join me in thanking all of<br />
our health care workers who have heeded the call of<br />
duty and worked long hours, days, and weeks, often<br />
at great sacrifice to themselves and their families, to<br />
protect <strong>Maine</strong> people during this extraordinary crisis.<br />
The mission of this trip is two-fold: to recognize and<br />
thank a representative group of the countless health<br />
care superheroes in New England and to celebrate and<br />
spread the important message of getting vaccinated.
Page 12 ANA <strong>Maine</strong> <strong>Journal</strong> <strong>May</strong>, June, July <strong>2021</strong><br />
Nurses: Five Ways to Improve Your Sleep<br />
Reprinted with permission from Confident Voices in Healthcare https://www.<br />
confidentvoices.com/<strong>2021</strong>/03/15/nurses-5-ways-to-improve-your-sleep<br />
By Dr. Tadeh Vartanian<br />
INTRO<br />
Each one of us has a unique sleep requirement. Nurses<br />
specifically have even more unique requirements for<br />
sleep. Long hours at work, odd hours throughout the<br />
night, high-stress environment that makes relaxing after<br />
work much harder, and the tendency to constantly pick<br />
up more shifts are all reasons why 27% of nurses take<br />
sleep aids on a regular basis.<br />
We know that sleep has an impact on our immune<br />
system, enabling us to fend off infections. It also<br />
improves our motor function and ensures we don’t get<br />
into a car accident while driving. It regulates our body Dr. Tadeh Vartanian<br />
weight and ensures our blood sugar and fat deposits<br />
are regulated as normal. Good sleep allows us to form memories, not only when<br />
learning but when making long-lasting impressions of our lives and really living it to<br />
the best way we can.<br />
Good sleep also enables nurses to do the crucial work they have on hand.<br />
Treating patients requires a sharp mind for catching errors, documenting properly,<br />
administering time-sensitive medications, and more. Poor sleep is not something<br />
that nurses and their patients can afford.<br />
So how do nurses get the crucial seven to nine hours of sleep that is<br />
recommended by the National Sleep Foundation?<br />
LIGHT<br />
Light plays a large role in how our bodies decide when to prepare for sleep or<br />
prepare to be awake. 1 While sunlight is the main thing that signals our brain to stay<br />
awake, the devices that live in our pockets, on our walls, and in our rooms can have<br />
a similar effect.<br />
A recent report found that using an electronic device with blue LED light, like<br />
an iPad, for two hours prior to bed blocked the rise of melatonin. 2 Compared to<br />
reading a printed book, reading an iPad suppressed melatonin by a significant 23%.<br />
Not only did sleep onset become more difficult, but the sleep quantity and quality of<br />
the participants were made worse too.<br />
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Med Surg Night shift | SCU Night shift<br />
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(Recruitment incentives up to $10K for some positions)<br />
Contact:<br />
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Melissa.lasley@va.gov<br />
207-387-3870<br />
So, do we get rid of all our electronic devices? Of course not. But we’ll do well<br />
to eliminate the use of them one hour prior to bedtime. 3 We can fill that hour<br />
with other duties such as preparing lunch for the next day, cleaning up our home,<br />
reading, writing, or speaking with people around us.<br />
CAFFEINE<br />
Caffeine, the most widely<br />
used (and abused) psychoactive<br />
stimulant in the world, can be<br />
found in coffee, sodas, foods,<br />
supplements, and more. It works<br />
by battling with adenosine for<br />
the binding sites (receptors) in<br />
the brain that provide the urge<br />
to sleep. 4 By urge, we mean<br />
propensity or the strong desire to<br />
sleep, as increased adenosine in<br />
one’s body provides the urge for<br />
wanting to sleep.<br />
Here’s something else you<br />
may not have known: caffeine<br />
has an average half-life of five<br />
to seven hours. That means after<br />
having a morning cup of coffee, about half of the caffeine is still in your body by<br />
early afternoon, and one quarter of it is still there in the evening.<br />
What we are hinting at, however, is that limiting your consumption as it gets later<br />
in the day will help set up a situation optimal for uninterrupted sleep. In a study<br />
published in the <strong>Journal</strong> of Clinical Sleep Medicine, a team of scientists concluded<br />
that consumption of caffeine beyond six hours prior to your desired sleep time will<br />
be disruptive to your sleep. 5 For example, if your target time to sleep is at 9:00 p.m.,<br />
you should aim to stop any consumption of caffeine by 3:00 p.m.<br />
ROUTINE<br />
So, what are some routines you can practice to enhance your sleep at night?<br />
Go to bed at the same time each night on most nights. We have a set bedtime<br />
for patients, and you should too. That routine allows your body to anticipate sleep<br />
over time, and having your body do the work naturally is always much easier than<br />
forcing a bedtime. On the other end, having a reasonable wake up time each<br />
morning will also give your body a routine it can count on. Nothing too aggressive,<br />
but something reasonable is best.<br />
Take a relaxing shower or bath. Read before you turn off the lights, on a nonelectronic<br />
device. Easier said than done with our crazy work hours, but as best that<br />
we can do it is always a plus. Anything that can also be done on your work days is<br />
what counts.<br />
NOISE<br />
First, it’s important to differentiate white noise from disruptive noise. White<br />
noise can be highly beneficial for sleep and the reason for that is it can help drown<br />
out disruptive noise that might signal to our body to wake up out of defense. 6 If<br />
you’ve ever been startled by an unexpected noise, you’ve experienced the reaction<br />
we have to noises. This same experience can occur while we’re sleeping and while<br />
it’s important to know what is going on around you, limiting disruptive noise in<br />
your bedroom will help you fall asleep and stay asleep longer. Start by putting your<br />
phone on silent, putting your TV on a sleep timer if you use it as white noise, and<br />
soundproofing windows if you’re near noisy roads.<br />
In essence, treat your sleep room and area as a quiet sanctuary. Do all that you<br />
can to reduce noise to get a good night’s sleep. This is where those living with you<br />
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Executive, at stephanie.s.shaw@vermont.gov or (802)828-3059.
<strong>May</strong>, June, July <strong>2021</strong> ANA <strong>Maine</strong> <strong>Journal</strong> Page 13<br />
play a big role in this. Ensure everyone is on the same page, and frame it so that<br />
they benefit from it too with a good night’s sleep.<br />
SLEEP AIDS<br />
healthcare provider to find out the best way to take them, and make that a part of<br />
your routine.<br />
We found the best way to take sleeping aids with the patients we’ve consulted<br />
is to associate it with a sleeping cue you normally would do anyways. Having the<br />
bottle next to your nightstand is a great option. We don’t recommend storing it<br />
(and most supplements and medications for that matter) in the bathroom, as the<br />
humidity could degrade the product quicker than usual. 9<br />
Our flagship product, SLUMBER, contains four of the top eight ingredients<br />
listed, at doses and potencies that are optimized for good outcomes and backed<br />
by research. The melatonin provides a calm way to induce sleep, at a dose of 3mg,<br />
it does so without morning after grogginess. The magnesium bisglycinate provides<br />
both the magnesium and glycine components of good sleep, the former allowing<br />
for a deep, restorative night and the latter allowing one to adjust to a good sleep<br />
rhythm. Finally, the jujube fruit reduces your body’s cortisol and allows you to drift<br />
off in a calm manner. With all these combined, you not only sleep well at night, but<br />
you’ll also wake up the next morning with a refreshed sense of accomplishment.<br />
CONCLUSION<br />
Within a span of about a hundred years, humans have abandoned their<br />
biologically-mandated need for adequate sleep. As a result, the decimation of<br />
sleep throughout society is very real in its impact on health, life expectancy, safety,<br />
productivity, and happiness.<br />
This silent sleep loss epidemic is the greatest public health challenge we face in<br />
this century. A radical shift in our personal appreciation of sleep must occur, and<br />
you’ve taken the first step as nurses to do better with your health, so you can<br />
provide exceptional care to your patients.<br />
I believe it is time for us to reclaim our right to a full night’s sleep, without the<br />
stigma of laziness. Sleep is the most powerful elixir of wellness and vitality, allowing<br />
us to be truly awake during the day, infused with the very deepest plentitude of<br />
being.<br />
Author Bio:<br />
Dr. Tadeh Vartanian is the founder and Director of Operations of completeblue,<br />
America’s leading pharmacist-owned and operated dietary supplements company.<br />
Resources<br />
1. Tosini G et al. Effects of blue light on the circadian system and eye physiology. https://<br />
www.ncbi.nlm.nih.gov/pmc/articles/PMC4734149/. Accessed December 2020.<br />
2. Gradisar M et al. The Sleep and Technology Use of Americans: Findings from the National<br />
Sleep Foundation’s 2011 Sleep in America Poll. https://www.ncbi.nlm.nih.gov/pmc/<br />
articles/PMC3836340/#:~:text=Results%3A,16%25%20of%20older%20adults). Accessed<br />
January <strong>2021</strong>.<br />
3. Why It’s Time to Ditch the Phone Before Bed. SCL Health. https://www.sclhealth.org/<br />
blog/2019/09/why-it-is-time-to-ditch-the-phone-before-bed/#:~:text=Tips%3A,and%20<br />
start%20reading%20before%20bed. Accessed January <strong>2021</strong>.<br />
4. Riberio JA and Sebastiao AM. Caffeine and adenosine. https://pubmed.ncbi.nlm.nih.<br />
gov/20164566/. Accessed January <strong>2021</strong>.<br />
5. Drake C et al. Caffeine Effects on Sleep Taken 0, 3, or 6 Hours before Going to Bed.<br />
https://jcsm.aasm.org/doi/10.5664/jcsm.3170. Accessed January <strong>2021</strong>.<br />
6. Pickens TA et al. White noise as a possible therapeutic option for children with ADHD.<br />
https://www.sciencedirect.com/science/article/abs/pii/S0965229918309683?via%3Dihub.<br />
Accessed January <strong>2021</strong>.<br />
7. Sweetman A et al. The effect of cognitive behavioral therapy for insomnia on sedativehypnotic<br />
use: A narrative review. https://www.sciencedirect.com/science/article/abs/pii/<br />
S1087079220301477?via%3Dihub. Accessed January <strong>2021</strong>.<br />
8. Chung S et al. Sleeping Pill Administration Time and Patient Subjective Satisfaction.<br />
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4702191/#:~:text=Although%20<br />
most%20patients%20take%20hypnotics,on%20their%20sleep%2Dwake%20cycle.<br />
Accessed January <strong>2021</strong>.<br />
9. Storing your medicines. MedlinePlus. https://medlineplus.gov/ency/patientinstructions/000534.<br />
htm. Accessed January <strong>2021</strong>.<br />
I’m going to make a profound confession that many of you already know: sleep<br />
is one of the most difficult aspects of one’s health to improve on with prescription<br />
medications that have been available on the market.<br />
Many individuals have tried prescription sleeping pills, only to hear that they can<br />
cause dependency, have rebound insomnia, and are linked to numerous short- and<br />
long-term side effects. 7 On top of that, many people don’t get much benefit from<br />
them after some time has passed, making them a tough pill to swallow (literally and<br />
figuratively) in their quest to better sleep health.<br />
Natural health supplements are each different, and it’s important to get the right<br />
combination of products and ingredients to achieve that optimal sleep. You’ll want<br />
to look for one that contains pure ingredients, is lab tested, and has certifications in<br />
place to ensure you’re getting the highest pedigree of product possible.<br />
The eight most common sleep supplements can be found on the infographic<br />
above. Not only should the sleep aid contain the ingredients that are right for you,<br />
but should also be at doses that are appropriate in achieving that optimal sleep<br />
without causing any issues long-term.<br />
Regardless of what you decide to take, make sure to take it appropriately.<br />
Usually, sleeping aids should be taken 30-60 minutes before bedtime, ideally on an<br />
empty stomach to ensure rapid absorption. 8 Check with the manufacturer or your<br />
To access electronic copies of the<br />
ANA <strong>Maine</strong> <strong>Journal</strong>, please visit<br />
http://www.nursingALD.com/publications
Page 14 ANA <strong>Maine</strong> <strong>Journal</strong> <strong>May</strong>, June, July <strong>2021</strong><br />
Success Story: The CNS As Credentialed Provider<br />
Jan Powers PhD, RN, CCNS, CCRN, NE-BC,<br />
FCCM, President, National Association of Clinical<br />
Nurse Specialists (NACNS)<br />
The University of Virginia Health (UVA Health),<br />
serving the Greater Charlottesville/Albemarle region<br />
of Virginia, took the important step this month to<br />
validate its 14 clinical nurse specialists (CNSs) as<br />
“credentialed providers.” This step formally recognizes<br />
CNSs as Advanced Practice Registered Nurses (APRN).<br />
UVA Health System includes a 631-bed hospital, level I<br />
trauma center, nationally recognized cancer and heart<br />
centers and primary and specialty clinics throughout<br />
Central Virginia.<br />
The entire credentialing approval process took four<br />
months and, today, CNSs at UVA Health can practice<br />
with full practice authority, ordering many services for<br />
patients based on their own professional assessment<br />
rather than relying exclusively on physician approval.<br />
Kimberley Elgin, DNP, RN, ACNS-BC, PCCN,<br />
CMSRN, lead clinical nurse specialist of UVA Health,<br />
coordinated the credentialing effort. According to Elgin,<br />
the other three APRN roles (nurse practitioners, nurse<br />
midwives and nurse anesthetists) were already bundled<br />
underneath the credentialed provider structure and<br />
there was a growing need to recognize CNSs and align<br />
their level of responsibility and scope of practice with<br />
that of their APRN counterparts.<br />
Beyond the interest in improving patients’<br />
experiences, the ascension of CNSs to the status of<br />
credentialed providers means that UVA Health is in line<br />
with the CNS professional standards of practice. The<br />
change also will provide mechanisms for third-party<br />
billing of services provided by a CNS. At the same time,<br />
there is legislation in the Virginia General Assembly to<br />
elevate the scope of practice of the CNS to allow for<br />
prescriptive authority.<br />
“There was a real need for credentialing CNSs,”<br />
said Elgin. “The fluidity of the CNS role is important,<br />
but it could lead to role confusion for colleagues. After<br />
centralizing the CNS team, I performed a systematic<br />
gap analysis, comparing our practice to the National<br />
Association of Clinical Nurse Specialists (NACNS) core<br />
competencies. Being able to validate our CNSs were<br />
‘aligning with and meeting national standards’ is<br />
actionable language that is meaningful and powerful to<br />
an organization.”<br />
NACNS core competencies can be found at https://<br />
nacns.org/professional-resources/practice-and-cns-role/<br />
cns-competencies/core-competencies/. They include<br />
competencies in Direct Care, Consultation, Systems<br />
Leadership, Collaboration, Coaching, Research and<br />
Ethical Decision-Making, Moral Agency, and Advocacy.<br />
The Benefits of Credentialing the CNS<br />
As a credentialed provider, CNSs’ validation as<br />
an APRN by the UVA Health nursing body and<br />
interdisciplinary colleagues is helping to build the<br />
structures and processes that are necessary to<br />
facilitate reimbursement practices. Another significant<br />
improvement will be CNSs’ ability to formally consult<br />
other interdisciplinary clinicians without a physician<br />
co-signature. This efficient approach to patient care<br />
leverages the CNSs’ ability to generate revenue for the<br />
organization for the work they perform. Finally, and<br />
most importantly, validating a CNS as a credentialed<br />
provider creates an opportunity to rethink processes<br />
and structures around interprofessional practice and<br />
develop different and more efficient methods to work<br />
together in a healthcare setting.<br />
A CNS-Credentialed Provider “How To”<br />
The entire formal credentialing process at UVA<br />
Health took four months and involved the entire<br />
organization.<br />
The process included working with stakeholders to<br />
obtain subcommittee approvals, a full vote by all of<br />
the organization clinical staff, and final approval by the<br />
UVA Health Board. Critical to the success of this effort<br />
was securing support from the chief nursing officer,<br />
director for advanced practice, as well as buy-in from<br />
the CNS team.<br />
“Our CNSs had a vision for it, but we still put a lot<br />
of energy and effort into securing their buy-in,” said<br />
Elgin. “The change will create different workflows<br />
for our CNSs, so I needed them to be engaged in the<br />
credentialing process from the beginning if we were to<br />
be successful.”<br />
The approval process started with the proposal<br />
being presented to the Advanced Practice Provider<br />
Subcommittee of the Organizational Credentialing<br />
Committee. Once approved, a recommendation was<br />
made to the Credentialing Committee to add CNSs as<br />
a provider type. Next, it was voted on and approved<br />
at the Credentialing Committee and the Credentialing<br />
Committee made their recommendation to the Clinical<br />
Staff Executive Committee. This executive committee<br />
also approved the proposal and sent it to the entire<br />
clinical staff for a vote. Finally, the last step, was the<br />
UVA Health Board’s approval validating the CNS<br />
position as a credentialed provider.<br />
Elgin credits her relatively smooth approval process<br />
to never underestimating the importance of engaging<br />
stakeholders both in formal and informal settings<br />
and really taking time to listen to them and hear their<br />
concerns.<br />
Kimberley Elgin, DNP, RN, ACNS-BC, PCCN, CMSRN<br />
is a Director at Large for NACNS, the only national<br />
organization representing the 89,000 CNSs in the<br />
US. CNSs are the most versatile advanced practice<br />
registered nurses and work in a variety of health care<br />
specialties to ensure delivery of high-quality, evidencebased,<br />
patient-centered care. As leaders in the acute,<br />
post-acute, and ambulatory health care settings, CNSs<br />
impact direct patient care, nurses and nursing practice,<br />
and organizations and systems to optimize care and<br />
drive outstanding clinical outcomes.<br />
NACNS is dedicated to advancing CNS practice and<br />
education and removing unnecessary and limiting<br />
regulatory barriers, while assuring public access to<br />
quality CNS services. For more information or to join<br />
NACNS visit https://nacns.org/get-involved/become-amember/
<strong>May</strong>, June, July <strong>2021</strong> ANA <strong>Maine</strong> <strong>Journal</strong> Page 15<br />
Membership