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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 />

PROTECT THE LITTLE<br />

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HEALTHY SMILES FOR LIFE


<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 />

We have openings in:<br />

Community Living Center<br />

(Long term care and dementia units)<br />

Evening and night shift<br />

Float Pool Day and Night shift<br />

Med Surg Night shift | SCU Night shift<br />

...and more!<br />

(Recruitment incentives up to $10K for some positions)<br />

Contact:<br />

Melissa Lasley, RN<br />

Nurse Recruiter<br />

VA <strong>Maine</strong> Healthcare System<br />

Building 203, Room 307B<br />

1 VA Center | Augusta, ME 04330<br />

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 />

Vermont Psychiatric Care Hospital<br />

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• Relocation/Loan Repayment Opportunities<br />

Visit https://www.thinkvermont.com/ today!<br />

At VPCH nurses are leaders of innovation and change and are pivotal in the<br />

delivery of cutting-edge, high quality care that not only meets, but exceeds<br />

our industry standards. To learn more about what a career at VPCH can<br />

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of psychiatric nursing care please contact Stephanie Shaw, Chief Nursing<br />

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

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