Colorado Nurse - May 2021

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association
Volume 121 • No. 2 • May 2021
Quarterly publication distributed to approximately 42,200 RNs and LPNs in Colorado
NURSE
Colorado Nurses
Association President...
Happy National Nurses
Month! The American Nurses
Association has expanded
National Nurses Week to
Nurses Month for the month
of May. This provides additional
opportunities to honor nurses
and acknowledge their
contributions and leadership
in many diverse healthcare
settings and roles.
We enter into this spring Linda Stroup
season with a sense of both
remembrance and hope. Earlier this year, the world marked
the one-year anniversary of the beginning of an historic
global pandemic. None of us realized at that time that the
pandemic would continue well over a year later. As we
reflect upon the past year, we honor the many nurses who
have worked tirelessly for the health of their patients and
communities. We acknowledge our colleagues who have
fallen ill with COVID-19 and extend our best wishes for
their full recoveries. We also remember our colleagues who
have lost their lives to COVID-19. We pause to hold their
memories in our hearts. Their tremendous sacrifices will not
be forgotten.
We continue to have great hope for the health of the
people of Colorado as COVID-19 vaccines are widely
available. Colorado nurses continue to be on the front lines
to support efforts to promote health and well-being for
everyone. We look forward to a time of increased health
for our communities and all of our nursing colleagues and
healthcare partners.
As we look ahead, the Colorado Nurses Association
continues our work to support nurses in three primary
areas of focus: advocacy, education, and engagement.
We encourage you to visit our website and seek
opportunities for involvement with CNA. Nursing
benefits from strong participation and representation.
Thank you to our Colorado nurses for your leadership to
promote the health of Colorado.
From the Desk of
the CNF President
Living in Turbulent Times
More Questions than Answers!
Will all levels of government
work successfully together
to implement new policies
regarding COVID that could
be interpreted as a ‘relief’
from what some may consider
restrictive regulations?
Are lifting some of the
more ‘restrictive’ regulations
a sign that we are returning to
the ‘normal’ we once knew?
Or are we simply moving Sara Jarrett
towards a “new” normal? For
example, should the use of masks become a part of
our understanding of ‘best’ practices for public health.
In addition, should masks be required in places where
public health officials have recognized as high risk?
As more of the population is vaccinated, there still
remains a significant percentage of the population
that chooses not to be vaccinated. A controversial idea
that has been tossed around is making vaccination
mandatory.
Experiencing varying levels of isolation, and
lifestyle changes, the arrival of Spring seems to bring
a renewed sense of hope and purpose. What other
lifestyle changes and community practices should be
considered a part of the ‘new’ normal routine?
Decision makers and influencers in healthcare need
to consider similar questioning. Will there be ‘new’
requirements and regulations as a result of the current
pandemic for employment in the healthcare field?
What might those new requirements include?
Will nursing remain a desirable profession or will
the pandemic have a negative impact on future
recruitment and retention in the profession? How will
the healthcare industry prepare for the future?
Addressing these numerous questions now is the
time to begin to study the future needs for nurses.
What should the education requirements include?
Should licensure requirements follow the education
expectations?
Lastly, how can nurses participate in the evolution of
a changing healthcare system?
Again, there seems to be more questions than
answers at this time.
Sara Jarrett
EdD RN
current resident or
Non-Profit Org.
U.S. Postage Paid
Princeton, MN
Permit No. 14
Executive Director’s Column ................3
Government Affairs & Public Policy Committee ...4
Peer Assistance ..........................5
District and SIG Reports ...................6-7
In Memory ..............................8
Colorado Center for Nursing Excellence .......9
CNF Appoints New Board Members ..........9
INSIDE
Hispanic Nurses: All of Us .................10
Meet the CNA Board of Directors ........... 11
Pharmacy or Farmacy? .................12-13
State Board of Nursing Seeks New Members ....14
Does Shift Length Matter? .................15
CNA Call for Nominations .................16
Nurse Spotlight: Defending Your License ...17-19

2 • Colorado Nurse | May 2021
The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association
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Colorado Nurse Publication
Article Submission
• June 15 for August Issue
• September 15 for November Issue
Colorado Nurses Association in partnership
with the Colorado Nurses Foundation seeks
your regular reports and any content you feel
would be informative for Colorado Nurses.
Submit to:
https://civicamanagement.wufoo.
com/forms/m10eei4p1ds8okp/
Nominations Sought
for CNA Positions
Colorado Nurses Association is seeking candidates for
several elected positions. As a member of the CNA Board,
you will help to achieve the mission and strategic plan
of the association. In addition, you will ensure financial
sustainability of the association and maximize member
services. The CNA Board meets quarterly.
As an ANA Membership Assembly Representative, you
will represent Colorado at American Nurses Association
Membership Assembly meetings, generally held in June.
CNA currently is allotted three representatives. Candidates
not elected will serve as alternates.
CNA Elections are held annually. Terms begin after
the CNA Membership Assembly in October.
The CNA Nominating Committee develops the slate
of candidates for CNA Elections. Available positions for
2021 are:
Secretary
Director, Region 1
Director, Region 3
Director, Region 5
Director at Large, Special Interest Groups
Director at Large, Recent Graduate
American Nurses Association Membership
Assembly Representatives – three representatives
to be elected.
CNA Nominating Committee – three members
to be elected.
See the CNA Website www.coloradonurses.org for
more information and to submit a nomination.
COLORADO NURSE (ISSN-8750-846X) is published 4 times annually,
February, May, August, and November, by the Arthur L. Davis Publishing
Agency, Inc. for the Colorado Nurses Foundation, 2851 South Parker Rd, Ste
1210, Aurora, CO 80014; Mailing: P.O. Box 3406, Englewood, CO 80155-3406.
For advertising rates and information, please contact Arthur L. Davis
Publishing Agency, Inc., PO Box 216, Cedar Falls, Iowa 50613, (800) 626-
4081, sales@aldpub.com. CNF and the Arthur L. Davis Publishing Agency,
Inc. reserve the right to reject any advertisement. Responsibility for errors
in advertising is limited to corrections in the next issue or refund of price of
advertisement.
Acceptance of advertising does not imply endorsement or approval by the
Colorado Nurses Foundation of products advertised, the advertisers, or
the claims made. Rejection of an advertisement does not imply a product
offered for advertising is without merit, or that the manufacturer lacks
integrity, or that this association disapproves of the product or its use.
CNF and the Arthur L. Davis Publishing Agency, Inc. shall not be held liable
for any consequences resulting from purchase or use of an advertiser’s
product. Articles appearing in this publication express the opinions of
the authors; they do not necessarily reflect views of the staff, board, or
membership of CNF or those of the national or local associations.
Colorado Nurses Foundation wants to hear from you and welcomes
letter to the editors. Correspondence may be sent to Colorado Nurses
Foundation, 2851 South Parker Rd, Ste 1210, Aurora, CO 80014;
Mailing: P.O. Box 3406, Englewood, CO 80155-3406; email, info@
coloradonursesfoundation.com.
To submit an article for publication, consider the following guidelines.
1. Topic is current and relevant to RN practice.
2. 500 word limit
3. Individuals may submit articles for consideration by emailing
carolomeara@aol.com.
Material is copyrighted by the Colorado Nurses Foundation and may not
be reprinted without written permission from CNF.
Co-Editors: M. Colleen Casper, RN, MS, DNP (16)
Eve Hoygaard, MS, RN, WHNP (30)
Carol O’Meara, MS, RN, WHNP (20/30)
CNA Executive Director:
Colleen Casper, RN, MS, DNP
COLORADO NURSES FOUNDATION
EXECUTIVE COMMITTEE
President: Sara Jarrett
Vice President: Margaret Mulhall
Secretary: Carol O’Meara
Treasurer: Eve Hoygaard
BOARD MEMBERS
Jeanne Burnkrant, Terry Buxton, Colleen Casper,
Lola Fehr, Linda Stroup, Betsy Woolf, Lisa Zenoni
COLORADO NURSES ASSOCIATION
EXECUTIVE COMMITTEE
President: Linda Stroup
President Elect: Laura Rosenthal
Vice President: Angela Petkoff
Secretary: Nan Morgan
Treasurer: Carol OMeara
Region 1 Director:
Brenda Tousley
Region 2 Director
(DNA 3, 12, 16, 20, 23):
Amanda Chappell
Region 3 Director (DNA 4):
Mary Satre
Region 4 Director (DNA 6):
Glenda Jackson
BOARD OF DIRECTORS
Region 5 Director (DNA 7):
Nora Flucke
Region 6 Director (DNA 5):
Deb Bailey
Director At Large (SIGs):
Karen Lyda (SIG 31)
Director At Large (SIGs):
V. Sean Mitchell (SIG 30)
Director at Large (Recent Graduate)
Jeanna Brewer
DNA PRESIDENTS
SIG #2: Colleen Casper (Liaison) DNA #9: Brenda Tousley
DNA #3: Anne Zobec
Colorado Springs
DNA #4: Kathryn Carpenter
Model, CO
DNA #5:
DNA #6: Charlotte LeDonne
Alamosa, CO
DNA #7: Nora Flucke
DNA #12: Amanda Chappell
DNA #16: Rebecca Sposato
DNA #20: Jean Schroeder
DNA #23: Colleen Casper
SIG #30: Ann Pereira
SIG #31: Ruby Martinez,
PhD, RXN, CNS, PMHCNS-BC
To contact any person listed above, please use the
CNA/CNF office numbers/address/email address.
CNA Contact Information:
Ph: 720-457-1194 • Fax: 303-200-7099
Email: info@coloradonurses.org
CNF Contact Information: Ph: 720-457-1004
Email: info@coloradonursesfoundation.com
www.coloradonurses.org

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association May 2021 | Colorado Nurse • 3
Executive Director's Column
Colleen Casper, DNP, RN, MS
Executive Director
Colorado Nurses Association
“No amount of medical
knowledge will lessen the
accountability for nurses to
do what nurses do, that is,
manage the environment
to promote positive life
processes.”
– Florence Nightingale,
Notes on Nursing, 1860.
Happy National Nurses
Week in the 2020-2021 Year
of the Nurse and Midwife!
Colleen Casper
Nurse’s Week has never been my favorite celebration.
As a critical care nurse and then a nurse administrator, I
was concerned that one day or one week of celebration
might suggest that both nurses and administrators would
think that a once a year recognition of the work nurses do
would be sufficient. I knew then, and still know today, that
individual nurses and the work of nursing must be top of
mind every day in critical care, the operating room and post
recovery, emergency departments, medical and surgical
inpatient units, pediatric care, obstetrics and newborn care,
long term care, schools, primary and specialty care offices,
chronic care clinics such as kidney dialysis and wound care,
care managers and quality improvement centers, public
health offices, as faculty at schools of nursing, supervisory
and administrative roles, and importantly at the United
States and Colorado Capitol, guiding and influencing health
care policy changes. Nurses work in correctional facilities,
camps, places of worship, patient’s homes, emergency
response systems, publication companies, war zones and
military base, work-places, and so many more provider
settings. With COVID-19, we all now know we can do
most of with the application of technology and telehealth
or in person!
What is it that we do that defines the value of a nurse?
In a word, we provide for trust. For the 18th year in a
row, Gallup surveyors asked U.S. adults to rate the honesty
and ethics of a list of professions, and 85% of Americans
say nurse’s honesty and ethical standards are “very high”
or “high.” For the last five years, nurses rank 20% greater
than the next profession on the list (new.Gallup.com).
High trust in our honesty and ethics is not by accident.
Nurses begin academic preparation by understanding
that a therapeutic relationship is central to patient healing.
Individual’s experiencing health challenges need to know
they can rely on competent and compassionate nurses
who are available to monitor and inform them of potential
complications and methods of adapting to them. Nurses
are the largest percentage of the healthcare workforce
and are typically the front line, 24 hours/day and seven
days/week professionally assisting individuals dealing with
physical, emotional, and spiritual distress.
As we enter 2021 Year of the Nurse, thank you to all of
my nurse colleagues who have persevered and provided
nursing care when supplies were limited, staff were limited,
and many times you were all alone in your work. I’d like to
share a powerful video that describes specific examples of
how “Nurses Change Lives.” The examples in the video are
exemplary of how the science and art of nursing affords
nursing professionals the capacity to see beyond the illness
and to address contributing factors to prolonged suffering
and their methods to mitigate and support optimal health,
not only the absence of disease.
The Nurses Change Lives video was originally introduced
by Johnson & Johnson in the fall of 2018 and encompasses
what we know to be true: Nurses have been innovating
and improving healthcare on the frontline throughout
history. In the midst of the COVID-19 pandemic, it remains
a very relevant message. Nurses changes lives, and that
changes everything. Take less than two minutes to view
specific examples of nurses changed lives in a moment
and changes that have been sustained. Examples include
Florence Nightingale who improved mortality rates in the
Crimean war through the use of data to change hospital
environments and the creation of infection control
standards for nursing that exist today, Elizabeth Kenny’s
work during the time of Polio that demonstrated the
importance of movement to assist in healing, and, Jean
Ward’s work discovering that sunlight can cure jaundice
in infants. Nurses changed HIV care and these stories are
timely reminders of the heroic work nurses have provided
over this past year, during the COVID-19 pandemic. We
have yet to hear all of those stories. Nurses Change Lives:
Two Minute Version video can be seen here.
In closing, I would like to quote Jennifer Thew, RN, and
her publication in Healthleaders NOW, 2020:
“I am not going to say, “Happy Nurses Week.” Instead, I
am telling nurses:
• You are strong.
• You are amazing.
• You are indispensable.
• You are role models.
• Thank you!“

4 • Colorado Nurse | May 2021
The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association
Government Affairs & Public Policy Committee
Legislation Will Impact Nursing and Health Care
The 2021 Legislative Session opened on February
16th, with a predicted high volume of bills set to
impact nursing and health care. GAPP will monitor
these bills as they pass through the legislature. You
can find the complete list of bills the committee is
following on the CNA Bill Tracker located on CNA’s
website. To access the CNA Bill Tracker, select
“Advocacy/Policy” and “Bill Tracking.” You can
obtain detailed information for each bill, including
information on where the bill is in the process, by
selecting the bill on the tracker. At their meetings on
February 28th and March 10th, the GAPP Committee
voted to support:
HB21-1005 - Health Care Services
Reserve Corps Task Force
• Creates a task force to make recommendations
on the creation of a health care services
reserve corps program to provide service in an
emergency or disaster (participants to receive
student loan relief).
• Passed out of the House Health and Insurance
Committee on 2/24/2021 and referred to the
Committee on Appropriations.
HB21-1068 - Insurance Coverage
Mental Health Wellness Exam
• Requires, as part of mandatory health insurance
coverage of preventive health care services,
coverage of an annual mental health wellness
examination of up to 60 minutes that is
performed by a qualified mental health care
provider.
• Assigned to the House Health & Insurance
Committee.
HB21-1097 Establish Behavioral Health
Administration
• Bipartisan
• Addresses recommendations from the 2019
behavioral task force.
• Creates a single state agency to lead, promote
& administer the state’s behavioral health
priorities.
“
NURSING
Peer Health Assistance Program
RNs and LPNs
Peer Assistance Services, Inc.
Encourage nurses to SEEK HELP EARLY
HB21-1099 Policies & Procedures to
Identify Domestic Abuse
• Bipartisan
• Recognizes domestic abuse as a form of child
abuse or neglect.
• Implements assessment best practices in
identifying child abuse.
HB21-1106 Safe Storage of Firearms
• Consistent with position adopted by CNA
members at annual meeting.
• Creates the offense of unlawful storage.
HB21-1107 Protections for Public
Health Department Workers
• Bipartisan
• Adds the same protections for public health
workers that currently exist for law enforcement
officials & human services workers.
HB21-1119 Suicide Prevention,
Intervention & Postvention
• Bipartisan
• Broadens the state’s priorities and focus on
suicide, suicide attempts, and after-effects.
Colorado Nurses Association Call for Volunteers
Policy Development Sub-Committee
Angela Petkoff, RN, AGNP
Colleen Casper, DNP, RN, MS
Colorado Nurses Association (CNA) has an active
Government Affairs and Public Policy Committee
(GAPP) that regularly reviews and advises CNA
lobbyists on desired action on pending legislation
in Colorado. We work closely with state lawmakers
and provide them with trusted and reliable input on
health care related legislation. More recently, CNA has
formalized a member volunteer effort, 100 Nurses for
100 Legislators, as a mechanism of assuring that every
SAVE LIVES… both practitioners and patients
Help us to EDUCATE the profession
I am a better nurse because of the program; my
employer has been very supportive; I couldn’t have
stayed clean and sober without the program.
SB21-056 Expand Cannabis-based Medicine at Schools.
• Bipartisan
• School nurse association supports.
• Removes discretion from current law and requires
schools to treat cannabis-based medicine
recommendations like prescriptions.
• Provides disciplinary protection to nurses.
SB21-137 Behavioral Health Recovery Act
• Continues the funding for the medication-assisted
treatment expansion pilot program.
• Expands the CSU AgrAbility project by providing
funding for the project’s rural rehabilitation
specialists.
• Appropriates money to the CDPHE to address
behavioral health disorders & priorities across the
state.
• Appropriates money to the harm reduction grant
program.
• Requires Medicaid to include screening for
perinatal mood & anxiety disorders for each child
enrolled in Medicaid.
GAPP Co-chairs: Mary Satre (maryskerwin@gmail.
com) and Judith Burke (judithburke2@msn.com)
Senator and Representative in Colorado knows an RN
in their district.
CNA is now seeking member volunteers to advise
and assist in developing policy on behalf of nurses in
Colorado. We are interested in volunteers to consider
becoming part of our Policy Development Committee
(PDC) that would then inform the CNA GAPP on
priorities for legislative consideration.
The PDC will explore, research, and propose
regulatory or statutory changes that may impact the
nursing profession, nurse work environment, healthcare
access, or patient safety consistent with the priorities of
Colorado Nurses Association. Examples of nurse led
legislation from other states that may be considered
include laws that address safe work environment,
such as establishing a “Safe Harbor” law for Colorado
nurses. Texas and New Mexico have Safe Harbor (SH)
laws that provide nurses with legal protections to
blow the whistle on unsafe patient assignments. SH
establishes a legal process for a nurse to state when
they believe an assignment is unsafe and protects that
nurse from retaliation by their employer or from the
Board of Nursing. The Texas law has been around since
1997 and the New Mexico law was just passed in the
spring of 2019.
This pandemic has highlighted the crucial role of
nurses and the importance of a sustainable nurse
workforce. “Heroic” is the word often used. We know
that nurses have always been heroes, repeatedly
forced to do too much with too little. Now that we’re
finally seeing some reprieve from this pandemic, it’s
time to empower Colorado’s nurses and address work
environment issues for our frontline nurses.
We invite you to consider this important work with
CNA. If you are interested in working with the PDC,
please email info@coloradonurses.org.
START BELIEVING.
303.369.0039
For confidential information: info@peerassist.org
www.PeerAssistanceServices.org
The Colby Community College Nursing Program offers practical and
associate degree nursing programs in two locations.
We are seeking qualified applicants for the following position:
Director of Nursing and Allied Health - Full Time in Colby
QUALIFICATIONS:
• MSN
• Kansas RN license and CPR certification required
For a complete job description visit www.colbycc.edu/employment
To apply, submit a letter of application, resume, all postsecondary transcripts and references to:
Human Resources, Colby Community College
1255 S. Range • Colby, KS 67701, materials may be emailed to hr@colbycc.edu
Review of applications will begin immediately and continue until the position is filled. EOE

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association May 2021 | Colorado Nurse • 5
Peer Assistance
Substance use and abuse associated with the behavioral immune system
during COVID-19: The special case of healthcare workers and essential workers
Dean McKay, Gordon J.G. Asmundson, Department of Psychology, Fordham
University, United States Department of Psychology, University of Regina,
Canada
The COVID-19 pandemic has resulted in unprecedented stress on healthcare systems
throughout the world. 1 It has also led to worldwide economic distress. This has resulted in
a splintering of the population, with healthcare workers bearing the burden of caring for
those afflicted with COVID-19, a consequence of which is direct and sustained infection
risk. Essential workers, such as grocery store employees, food delivery service workers, and
postal employees, to name a few, also shoulder significant health risks by ongoing contact
with the public.
As essential workers face these increased infection risks, they also face higher rates
of stress from the pandemic. The recently developed COVID Stress Scales 2 categorizes
stressors from the pandemic into five categories: danger and contamination fear, social
and economic stress, traumatic stress symptoms, checking and reassurance seeking
behavior, and xenophobia. Recent findings suggest that the five factors of the CSS form
a COVID Stress Syndrome. 3 In the general population each of these factors can contribute
to increased substance use and abuse risk. 4 These factors can be compounded in essential
workers and place this group at particularly high risk for substance use and abuse.
Pandemics activate a behavioral immune system. 5 The BIS is an alarm system whereby
individuals show increased monitoring of physical sensations to track possible signs of
infection, which in turn would mobilize action to secure medical care. Recent research
has shown that disgust, an emotion designed to protect from contact with pathogens, is
critically involved in COVID-19 fear for higher levels of interoceptive awareness. 6 According
to the BIS model, activation of this protective system also leads to efforts to identify
tangible infection sources, which in turn promotes xenophobia and stigma.
Essential workers in general, and healthcare workers in particular, who themselves
would have active BIS during the COVID-19 pandemic, face unique pressures from
the general population. While research on disgust suggests that chronic exposure to
pathogens may dampen one’s concern with infection, 7 the other factors of the CSS would
be expected to be highly relevant to healthcare workers and other essential workers in
increasing substance use risk.
Economic stress has been shown to increase the risk of alcohol use in healthcare
workers, particularly for women and lower education workers. 8 Similar findings have been
observed for other drug use, particularly in lower education individuals. 9 Social stress has
long been documented to increase substance use risk in healthcare workers 10 and other
essential workers. 11
Past pandemics have resulted in significant traumatic reactions among healthcare
workers. 12 Trauma symptoms have been found associated with substance use in healthcare
workers, such as following a terror attack. 13 There is emerging evidence that many medical
and non-medical health care workers will develop PTSD stemming from COVID-19-related
experiences. 14
Checking behavior serves as a protective factor during pandemics, such as to inspect
for possible pathogen sources. This in turn can lead to occupational stress, such as
reluctance to work in the face of infection risk, further compounding economic stress.
Checking behaviors also contribute to hypervigilance to infection risk, a specific aversive
consequence of activation of the BIS. Further, checking behavior in this context is a proxy
for obsessive–compulsive actions, another potential substance use risk. 15
Finally, among the factors that form the COVID Stress Syndrome, xenophobia is a
unique and specific stressor for healthcare and essential workers, as they are more likely to
be the targets of discrimination from the general population. For instance, some job titles
of the essential workforce are disproportionately from under-represented groups, thus
allowing a conflation of these groups with both their ethnic or racial status and infection
risk by the general population. Beyond the xenophobia faced by under-represented
groups, the COVID-19 pandemic has resulted in stigmatization of essential workers. 16
Broadly, stigma has been shown to increase risk of alcohol and drug use. 17
Collectively, it appears that the COVID Stress Syndrome, through activation of the
BIS and the unique constellation of stressors, places essential workers at high risk for
alcohol and substance use. Lessons from past pandemics have shown that the need for
additional substance use interventions increases. This has already been noted in relation
to COVID-19. 18 This constellation of stressors warrants unique programs of intervention to
manage drug use and abuse. Research to develop such programs is needed, particularly
in consideration of the broad impact of COVID-19. We encourage researchers to
systematically tackle these important issues in preparation for challenges people may face
with substance use and abuse in the face of present pandemic-related circumstances, post-
COVID-19, and for future pandemics.
1. Tanne J.H., Hayasaki E., Zastrow M., Pulla P., Smith P., Rada A.G. COVID-19: How doctors and
healthcare systems are tackling coronavirus worldwide. British Medical Journal. 2020;368
2. Taylor S., Landry C.A., Paluszek M.M., Fergus T.A., McKay D., Asmundson G.J.G. Development
and initial validation of the COVID Stress Scales. Journal of Anxiety Disorders. 2020;72
3. Taylor, S., Landry, C.A., Paluszek, M.M., Fergus, T.A., McKay, D., & Asmundson, G.J.G. (in press).
COVID Stress Syndrome: Concept, structure, and correlates. Manuscript under review.
4. McKay, D., & Asmundson, G.J.G. (2020). COVID-19 and substance use: Current issues and future
preparations. Manuscript under review.
5. Schaller M., Park J.H. The behavioral immune system (and why it matters) Current Directions in
Psychological Science. 2011;20:99–103. doi: 10.1177/0963721411402596.
6. McKay D., Yang H., Elhai J., Asmundson G. Anxiety regarding contracting COVID-19 related to
interoceptive anxiety sensations: The moderating role of disgust propensity and sensitivity.
Journal of Anxiety Disorders. 2020;72
7. Haidt J., McCauley C., Rozin P. Individual differences in sensitivity to disgust: A scale sampling
seven domains of disgust elicitors. Personality & Individual Differences. 1994;16:701–713.
8. Saridi M., Karra A., Kourakos M., Kyriakos S. Assessment of alcohol use in health professionals
during the economic crisis. British Journal of Nursing. 2016;25:396–405.
9. Carpenter C.S., McClellan C.B., Rees D.I. Economic conditions, illicit drug use, and substance use
disorders in the United States. Journal of Health Economics. 2017;52:63–73.
10. Bennett J., O’Donovan D. Substance misuse by doctors, nurses and other healthcare workers.
Current Opinion in Psychiatry. 2001;14:195–199.
11. Lehman W.E., Simpson D.D. Employee substance use and on-the-job behaviors. Journal of
Applied Psychology. 1992;77:309–321.
12. Marunder R.G., Leszcz M., Savage D., Adam M.A., Peladeau N., Romano D. Applying the
lessons of SARS to pandemic influenze: An evidence-based approach to mitigating the stress
experienced by healthcare workers. Canadian Journal of Public Health. 2008;99:486–488.
13. Bogstrand S.T., Skogstad L., Ekeberg Ø. The association between alcohol, medicinal drug use
and post-traumatic stress symptoms among Norwegian rescue workers after the 22 July twin
terror attacks. International Emergency Nursing. 2016;28:29–33.
14. Tan B.Y., Chew N.W., Lee G.K., Jing M., Goh Y., Yeo L.L.L. Psychological Impact of the COVID-19
pandemic on health care workers in Singapore. Annals of Internal Medicine. 2020 doi:
10.7326/M20-1083.
15. Mancebo M.C., Grant J.E., Pinto A., Eisen J.L., Rasmussen S.A. Substance use disorders in an
obsessive compulsive disorder clinical sample. Journal of Anxiety Disorders. 2009;23:429–435.
16. Gold J.A. COVID-19: Adverse mental health outcomes for healthcare workers. British Medical
Journal. 2020;369
17. Room R. Stigma, social inequality and alcohol and drug use. Drug and Alcohol Review.
2009;24:143–155.
18. Kar S.K., Arafat S.M.Y., Sharma P., Dixit A., Marthoenis M., Kabir R. COVID-19 pandemic and
addiction: Current problems and future concerns. Asian Journal of Psychiatry. 2020;51
Elsevier hereby grants permission to make all its COVID-19-related research that is
available on the COVID-19 resource centre - including this research content - immediately
available in PubMed Central and other publicly funded repositories, such as the WHO
COVID database with rights for unrestricted research re-use and analyses in any form or by
any means with acknowledgement of the original source. These permissions are granted
for free by Elsevier for as long as the COVID-19 resource centre remains active.
Peer Assistance Services, Inc., provides the statewide Nurse Peer Health Assistance
Program through a contract with the Colorado State Board of Nursing.
Katherine Garcia, MA, LAC, MAC, Clinical Manager, kgarcia@peerassistanceservices.org
Bethany Pace-Danley, BSW, MA, CPS II, SBIRT in Colorado Manager, BPace-Danley@
peerassistanceservices.org
Annie Klein, CPS II, Manager, Communications and Program Outreach, aklein@
peerassistanceservices.org
Office locations:
2170 South Parker Road, Suite 229 200 Grand Avenue, Suite 270
Denver, CO 80231 Grand Junction, CO 81501
303 369-0039 970 291-3209
Dean McKay, Gordon J.G. Asmundson. Addict Behav. 2020 Nov; 110: 106522.
Published online 2020 Jun 27. doi: 10.1016/j.addbeh.2020.106522
Eden Milestone 2 Community
Come join our team & love where you work.
We are seeking Nurses and Nurse Leaders to promote
the Eden Alternative.
The goal of the Eden Alternative is Elder-directed care. Aging can
be a time of growth rather than decline. This is accomplished
by creating a human habitat through community design, care
partner training, and organizational redesign. We are home!
Excellent benefits including Health & Dental, Vision,
401(k) with match, Education Reimbursement and more.
To apply, submit your resume/application at
HTTPS://SHALOMPARK.VIKUS.NET
IF YOU ARE AN EDEN ASSOCIATE OR DESIRE TO
BECOME ONE, this is the place for you!

6 • Colorado Nurse | May 2021
The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association
District and Special Interest Group Reports
DNA 6 – San Luis Valley
DNA 16 – East Metro Denver
CNA District 6 supplies Thank You baskets for SLV Nurses
The Colorado Nurses Association District 6 members of the San Luis Valley,
collected and assembled 70 gratitude baskets and mugs for nurses employed at
San Luis Valley health care agencies for Valentine’s Day. They also advertised their
gratitude on marquees in Alamosa, Conejos and Costilla counties.
DNA 16 Virtual Legislative Event
CJ Cullinan, RN, CNS
“May you live in an interesting age.”
English Expression
Colorado Nurses Association (CNA) District Nurses Association of metro-Denver
(DNA-16) has held an annual Legislative dinner for many years. CNA represents
Registered Nurses (RNs), Advanced Practice Registered Nurses (APRN), including Clinical
Nurse Specialists (CNS), Certified Registered Nurse Anesthetist (CRNA), Certified Nurse
Midwives (CNM), and Nurse Practitioners. Legislative and regulatory advocacy is done
in collaboration with all of these specialties as well as over 70,000 RNs in the State of
Colorado.
Upon learning that in person lobby days or legislative dinners would not be possible, CJ
Cullinan, RN, CNS, took the lead on behalf of DNA 16 to pivot and innovate an alternative
method of connecting the Faces of Nursing with our legislature. We felt certain that
now, more than ever, connecting both the faces and work of nursing with legislators was
an important reminder of the work done by nurses in all of our Colorado communities,
urban, rural and done twenty-four hours a day, seven days a week.
In collaboration with CNA’s 100 Nurses for 100 Legislators initiative, a call went out
seeking nurses to submit their professional photo with a brief statement about their type
of nursing practice. Over 120 nurses submitted photos that are included in both posters
and booklets. The Faces of Nursing booklets were distributed to every Senator and
Representative and we were assisted in that effort by Representative Kyle Mullica, RN.
Additional planning went in to working with the Capitol staff to plan a safe poster
presentation on the West Side Capitol steps on April 5, 2021 over the lunch hour. We
limited the number of participants and specially designed masks were donated with
“health by example” imprints recognizing the important role we all serve in modeling
public health practices.
This work could not have been accomplished without the dedication and time of
many. That group includes Judy Anderson, Graphic Designer, ABC Imaging providing
significant discount in poster production, and, National Teleprinting significant discounts
and a personal note of thanks to nursing. Collaborative funding came from the Colorado
Center for Nursing Excellence, multiple DNAs, Colorado Advanced Practice Nurses and
Advanced Practice Psychiatric Nurses of CNA and CNA lobbyist Gil Romero of Capitol
Success. I would like to acknowledge the work of friends of nursing Susan Goldstein and
Jane Dodge. We are also grateful to Kayla Koeune, artist, who provided permission to use
her “Modern Hero” print for the cover. Her artwork can be found on Etsy.com.
Nurses innovate every day. We have had many “pivots” in this process, and I am proud
of how we have been able to continue our connection with the legislature and reminding
them of the critical role nurses have in providing care, in education, in every facet of
community life.
Left to right- Helen Lester, Sue Foster and
Glenda Jackson. Not pictured- Charlotte Ledonne
Charlotte Ledonne and Sue Foster are volunteering their time to assist with the
COVID mass vaccination clinics in Alamosa County.
Respectfully submitted,
Charlotte Ledonne, RN, BSN, MA, LPC
President DNA 6
Bev RN A Registered Nurse since 1983, my specialty area is Public
Health-HIV/STI Treatment and Prevention working as a Nurse
Field Consultant and Trainer with the Patient Navigation Training
Collaborative. I am a member of the Colorado Council of Black Nurses
and attend Graduate Nursing School. I have a passion for health and
racial equity, along with improving care systems for all patients.
House District 39 Senate District 4
RNs
Crystal RN I am an Orthopedic-Surgical Registered Nurse, and
have been a Nurse for 4 years. I love working in the Hospital
because of so many opportunities to have many other experiences as
a Nurse. I’ve been able to Float and Train on other floors and had
the opportunity to work the COVID Vaccine Clinics as well.
House District 29 Senate District 19
More News from DNA 16
You can make a tangible impact on public health in
Colorado by joining our staff of nurse compliance inspectors.
Critical thinking, clinical experience and health care system assessment
skills are keys to success for ideal candidates.
No weekends or on-call. Great benefits and job satisfaction.
Check the State of Colorado website at
www.governmentjobs.com/careers/colorado/jobs/2501325/nursehealth-facilities-compliance-inspector-health-professional-iii
for positions with the department.
Rebecca Sposato MS, RN
This June, members of DNA 16 kept an annual tradition of volunteering at Project
C.U.R.E. The small group sorted several boxes of donated medical supplies. This charitable
organization is the world’s largest non-profit distributor of medical supplies to clinics in
developing nations.
Due to Covid-19 restrictions, DNA 16 modified its annual Healthcare Appreciation Night
at the Rockies. Traditionally, the event occurred in May during Nurse Appreciation Week.
The event was rescheduled for Thursday, August, 20; Colorado Rockies versus Arizona
Diamondbacks. DNA 16 distributed nurse CNA themed facemasks.

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association May 2021 | Colorado Nurse • 7
District and Special Interest Group Reports
DNA 20 – West Metro Denver
SIG 31 – CO Advanced Practice
Psychiatric Nurses
Norma Tubman RN, MScN
Fifteen members and guests attended our February
Virtual Meeting. Annette Cannon, DNA 20 member
and Jefferson County Coroner gave an overview
of the Coroner’s Office. She discussed the coroner,
investigator and forensic pathologist roles; the causes
and manners of death in the county; and how the
staff works with families. The presentation included a
virtual tour of the office including the autopsy suite.
Dr. Cannon and her department was recognized by the
Jefferson County Treasurer, Jerry DiTullio, in his March
Update for the work they have performed supporting
Jefferson County families during life-loss tragedies,
especially during the COVID pandemic. He noted
that Dr. Cannon has demonstrated professionalism,
resiliency and empathy to the families.
March’s virtual meeting speaker was Joanne
Clavelle, DNP, RN, NEA-BC, FACHE, FAAN, who spoke
on Professional Governance: Evolution of Structural
Empowerment. Dr. Clavelle is the Chief Executive
Officer of Clavelle Consulting based in Denver and is an
Adjunct Professor for the University of Colorado College
of Nursing. She described the evolution of shared to
professional governance. She distinguished the attributes
and characteristics of professional governance; identified
how the structural framework for governance supports
nursing professional practice and behaviors that improve
outcomes; and outlined how nurse leaders can measure
professional governance and intentionally cultivate a
work environment that supports a positive professional
environment.
DNA 20 was a $200 sponsor of DNA 16 and SIGs
30 and 31 100 Nurses for 100 Legislators Project
Colorado Nurses Association Faces of Nursing: A Day
of Remembrance held April 5 at the Capitol. The
project recognized over 100 nurses with a booklet of
the faces of nurses, posters, and custom face masks
saying Colorado Nurse. DNA 20 was proud to be part
of the event which showed incredible appreciation
and support for the efforts of our frontline colleagues
in every health care setting during COVID. Thank
you to DNA 20 members Olivia Martinez, Allison
Windes and Irene Drabek who have worked COVID
Vaccination Clinics.
Congratulations to Annette Cannon who was
elected Chair of the Sig Group for Death Investigations
through the Academy of Forensic Nurses for 2021-23.
In support of nursing students, DNA 20 approved
a $1500 scholarship for 2022 to be awarded by the
Colorado Nurses Scholarship Committee in December.
For information on DNA 20 meetings see the
CNA website or contact president Jean Schroeder at
jschroeder002@regis.edu.
We experience the world around us through a lens
that has been shaped and polished by our families,
teachers and the environment. For better, and
sometimes worse, these influences predisposed us to
hold biases, prejudices and perceptions that are unfair
and harmful. The nurses of SIG 31 recognize that we
must explore our own preconceptions of others and
how they can influence the therapeutic relationships
we have with them. Further, we must use the privilege
and power of our positions as community leaders
to model and advocate for social justice, fairness and
equity.
SIG 31 sponsored three virtual seminars related
to racism, oppression and bias in January, March and
April, and we hope to continue as long as the interest
continues.
Nurses can change the world and we are starting
with ourselves. Please join us for our no shame, no
blame presentations. If you registered for the first
program, you will be invited to all future programs. If
you wish to get registered for future programs, contact
Ruby Martinez at MartinezRJ789@gmail.com.
Mary Ann Bolkovatz,
Marlene Pino and
Ruby Martinez

8 • Colorado Nurse | May 2021
The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association
In Memory
Eve Cook Hoygaard, MS,RN, WHNP
If you are a nurse who has read previous issues
of the Colorado Nurse, you have probably read this
column about nurses who have passed away that
you have worked with or otherwise known at some
time in your career. Did you wonder how we knew
about these losses? We depend upon receiving from
families and friends of these departed nurses. We
depend on other people... like you!
Our criteria for information to be included requires
it being about a RN or an LPN who has been educated
in, lived in and/or worked in Colorado plus the date
and, if available, of where they lived at the time they
passed away. We appreciate provision of additional
information as to where and when, they received
their nursing education, degree(s), age, where they
were employed, special awards (as being a Nightingale
Award or nominee) are examples we consider
including. For women, the issue of including their birth
name sometimes is included if known... if it desired we
would not include this information.
We Remember
Braden, Cynthia RN, BSN (73) passed away in
December 2020 in Metro, Denver. She received her
Bachelors Degree from the University of Michigan.
Her nursing career included Ft. Logan Mental
Health, Jefferson County Mental Health, National
Jewish Hospital, University Physicians prior to 10
years at the University of Colorado Hospital where
she worked in Oncology.
Davison, Richard Keith, RN (39) passed away in
Aurora Colorado in March 2021. He was a graduate of
Concord Career College in 2014.
Henning, Mary Boland, RN (69) passed away in
January 2021. She was a nurse for many years at Knapp
Elementary School, Denver.
Judd, Janis B., RN, BS (77) passed away in December
2020 in Grand Junction. She was a 1966 Graduate of
Presbyterian Hospital School of Nursing (1966) and
worked as a surgical nurse. Later, she completed a BS-
Technical Management/Business from Regis College in
1985. She had lived in Boulder, CO and in Dallas, TX
Light, Nedra, RN (90) passed away in Denver in
March 2021. She had received her nursing license in
1946 and was an active nurse for 46 years. Her career
included the Operating Room and Recovery Room
areas and also as a Float Nurse. She had worked at
Rose Medical Center.
Mendozza, Carol Parchinski, RN (70) She was
a nurse and lactation consultant. She passed away in
February 2021.
Morgan, Alice L, RN, (91) passed away In
Colorado Springs in December 2020. While she was in
High School, she worked as a nursing assistant during
a polio epidemic. Next, she applied to Beth El School
of Nursing, Colorado Springs where she was the first
black student to be accepted. Next, she became the
first black graduate of the school. Later, she became
the first black head nurse hired at Memorial Hospital
in Colorado Springs. She retired after a 21 year
career with the El Paso County Health Department.
Payne, Kathryn Lynette, RN, (63) BSN – Rush
University, Chicago, IL and a BS-Biological Sciences
from Colorado State University, Ft. Collins, CO.
She later earned a law degree from Pepperdine
Law School, Malibu, California. She passed away
in January in Nashville, TN where she was a nurse
educator and ethicist for 38 years at Vanderbilt
University. At Vanderbilt University, she was an
Associate Professor of Nursing in the Center for
Biomedical Ethics.
Ridge, Helen, RN, MSN SN, BS (88), passed
away in Littleton CO in January 2021. She completed
her BSN (1950) from Stanford University in California
and later received an MSN from the University of
Colorado. She worked as a School Nurse in Denver
from 1959 to 1987 when, as supervisor of the school
nurse program, she retired.
Thompson, Mary Agnes Black, RN (80) A Nurse…
passed away in Aurora Colorado in January 2021.
We reserve the right to edit material submitted
and endeavor to verify all information included in
this column. If you notice an error, please advise
us and a correction will be published in the next
available We appreciate your providing informations
for this column. To submit information, please
contact Eve Hoygaard at hoygaard@msn.com.

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association May 2021 | Colorado Nurse • 9
COLORADO CENTER FOR NURSING EXCELLENCE
Nurses - How Are We Doing?
Ingrid Johnson DNP, MPP, RN
President and CEO –
Colorado Center for Nursing Excellence
There is more and more evidence that nurses
have struggled through COVID in ways that we are
only now beginning to understand. It is likely that
the information around our profession’s response
to the pandemic will evolve significantly over the
coming year or two. It is about time for the Center,
as the state’s nursing workforce center, to complete
a supply/demand survey so we can more fully
understand who is planning to leave the workforce
in the coming years, allowing us to strategize on
how to ensure we have the needed pipeline.
A recent article in Medpage Today is titled:
“Nurses Are Not Alright” (https://www.
medpagetoday.com/nursing/nursing/91605). The
article received survey responses from 22,000
nurses from around the country and found that
24% of nurses over the age of 34 and 36% of
nurses under the age of 34 have sought mental
health support since the pandemic hit last March.
Additionally, 70% of nurses are in the process of
getting vaccinated with another 14% planning to
get vaccinated. However, the remaining 16% of
survey respondents stated they either may not or
will not get vaccinated at all. There seems to be a
continued trend of distrust among the population
regarding the vaccinations, even among nurses. This
is concerning when you consider the severity of this
contagion.
Recently I heard someone scoffing at the
general response that this pandemic has created.
He suggested that because the mortality rate
of the illness is generally low, a vaccine will not
make much of a difference. He showed a statistic
that “only” 1.8% of people die from this illness
and with the vaccine the death rate will decrease
to an estimate of about 1%. What he missed is
that 30,000,000 people in the United States have
been diagnosed with COVID since the pandemic
began. Over 545,000 people in the US have died.
Lowering the mortality rate to 1% from the current
stats would save 245,000 lives. That is significant.
Additionally, worldwide over 126,000,000 people
have been infected and 2,760,000 people have
died. That is a higher mortality rate (2.2%) than
we are experiencing in the US, and I suspect our
lower morality rate is related to the high quality of
nursing care provided in this country.
Nurses understand that the reason public
health officials have taken such a strong stance
in approaching this virus is that it is highly
contagious. The more people that are infected, the
more people will die, even with a generally low
mortality rate. High infection rates have created
high levels of stress on our healthcare system
and on our profession. The health systems across
Colorado are stretching themselves to try and find
opportunities to support their staffs. One chief
CNF Appoints New
Board Members
Colorado Nurses Foundation is pleased to
announce the appointment of three new members to
the CNF Board of Directors. The new directors joined
the board in January and are already hard at work
on foundation activities. They are:
Jeanne Burnkrant, RN, DNP, an Adult and Geriatric
Nurse Practitioner and Senior Instructor at University
of Colorado College of Nursing. She has more than 23
years of experience in health care and post-secondary
education.
Betsy Woolf, RN, MSN, owner of Paincare RN,
provides individualized chronic pain care for persons
with limited access to non-pharmaceutical modalities.
She is certified in both Pain Management Nursing
and Medical-Surgical Nursing. Betsy is also a Clinical
Instructor at PIMA Medical Institute.
Lisa Zenoni, RN, PhD, an Associate Professor at
Loretto Heights School of Nursing at Regis University.
She is the Director of Undergraduate Nursing
Programs and is a Certified Rehabilitation Registered
Nurse.
CNF is pleased to have these talented nurses on
their Board of Directors.
nursing executive told me that they are adding a
self-care component to some of the performance
evaluations on some of the units to test and see if
self-care is considered part of a nurses job, will we
begin to care for ourselves as well as we care for
our patients. The Center offers a self-care support
program to all health professionals across the state.
Please, if you are struggling, reach out to us and
participate in the “Ripple Effect” program designed
to support Colorado’s nurses. We are so grateful to
the wonderful nurses across Colorado and proud
of how nurses have stepped up during this crisis. If
you need support, we are here. Thank you for all
you do!
Nurse Family Partnership
Nurse Home Visitor
We are seeking a nurse to join our Nurse Family
Partnership team. Responsibilities include case
management and care coordination through home
visitation for low-income, first time pregnant women and
their families from early pregnancy up to the child's second
birthday. This is a 20 hour a week regular position.
This position requires travel within Grand County as
well as some travel to Summit County.
Please see program website:
https://www.nursefamilypartnership.org/
MINIMUM QUALIFICATIONS:
• BSN required
• Current RN license (in good standing) required in the state
of Colorado or an active RN license with a compact state.
• Current CPR required
• Two years recent experience in maternal/child health,
public health, home visiting or mental/behavioral
nursing preferred.
• Home visiting experience preferred
• Excellent written and verbal communication skills.
• Basic computer skills.
• Valid driver’s license and insured automobile required.
• Fluent bilingual (English/Spanish) preferred
Please submit resume, cover letter & Summit
County Job application online at
http://www.summitcountyco.gov/jobs
For more information call (970) 668-9711
Equal Opportunity Employer

10 • Colorado Nurse | May 2021
The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association
Hispanic Nurses Embrace Precision Medicine and Ensures
Hispanics Are Represented in Medical Research Through All of Us
Amanda D. Quintana DNP, RN, FNP; Immediate Past President,
National Association of Hispanic Nurses – Denver Chapter
Nate Glass, Junior Associate; Clyde Group
In 2019, nurses from the National Association of Hispanic Nurses – Denver Chapter
(NAHN) began educating Latinx communities, health care workers, and other community
members about the importance of precision medicine. Precision medicine is a method
used to specifically focus disease prevention and treatment measures to all populations.
To tailor treatments to individual needs, precision medicine considers the unique factors
that make individuals who they are - such as lifestyle, socioeconomics, environment, and
biology. Until now, little research of this kind has been completed on minority and underserved
populations.
Funding from the All of Us Research Program, part of the nationwide Precision
Medicine Initiative from the National Institutes of Health (NIH), provided NAHN with an
opportunity to launch an educational campaign to spread the word about this important
Weld County Public Health
(Greeley, CO)
invite applicants to apply:
Public Health Nurse I or II
• Generalist
• TB & Communicable Disease
Program
To view the complete job
announcements and apply online:
https://www.governmentjobs.com/
careers/weld
research. Most would agree that the traditional “one size fits all” model of health care
does not adequately address the health care needs of our diverse population. Through
the work of the All of Us Research Program, Hispanic nurses in Denver, along with other
Colorado professional organizations, are working hard to impact change.
Together, NAHN nurses, Promotoras from Vuela for Health, YMCA of Metro Denver
staff, Colorado Council of Black Nurses, Central Colorado Area Health Education Center
and members of the Colorado Rural Health Center have educated and encouraged
hundreds of diverse community members and health care professionals to participate in
this research initiative.
All of Us is a historic effort to gather data from one million or more people living in
the United States to ensure medical researchers have a data source that represents us all.
By considering individual life differences, researchers may uncover paths toward delivering
personalized preventative care and treatment for all populations.
So far, over 370,000 people from all walks of life, nationally, have joined the program.
NIH’s goal of reaching one million people from diverse backgrounds is impressive and
achievable with help from nurses who work with patients every day who can benefit from
this type of research. For them, for our families, for our communities, and for our future,
please help us spread the word about All of Us.
To learn more about the All of Us Research Program please go to: https://allofus.
nih.gov/ or contact NAHN-Denver Chapter nurses at https://www.hispanicnursesdenverchapter.org/.

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association May 2021 | Colorado Nurse • 11
Meet the Colorado Nurses Association Board of Directors:
Linda Stroup,
2019-2021, 1st term
President
Laura Rosenthal,
2020-2021, 1st term
President - Elect
Angela Petkoff,
2020-2022, 1st term
Vice President
Nan Morgan,
2019-2021, 1st term
Secretary
Carol O’Meara,
2020-2022, 2nd term
Treasurer
Brenda Tousley, 2019-
2021, 1st term
Region 1 Director
(DNA 8 & 9)
Amanda Chappelle
2020-2022, 1st term
Region 2 Director
(DNA 3, 12, 16, 20, 23)
Mary Satre,
Appointed 2020-2021
Region 3 Director
(DNA 4)
Glenda Jackson,
2020-2022, 1st term
Region 4 Director
(DNA 6)
Nora Flucke, 2019-
2021, 1st term
Region 5
Director (DNA 7)
Deb Bailey, 2020-
2022, 1st term
Region 6
Director (DNA 5)
Karen Lyda, 2019-
2021, 1st term
Director at Large (SIG)
V. Sean Mitchell,
2020-2022, 2nd term
Director at Large (SIG)
Jeanna Brewer,
February-October
2021, 1st Term Director
Recent Graduate
Mary M. Ciambelli
ANA Membership
Representative
Jennifer Gabel-Adney
ANA Membership
Representative
Carol O’Meara
ANA Membership
Representative
(Alternate)
Colleen Casper
Executive Director

12 • Colorado Nurse | May 2021
The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association
Will Your Next Prescription Be For the Pharmacy or the Farmacy?
Joanne Evans MEd, RN, PMHCNS
Almost 2500 years ago Hippocrates said “Let food
be your medicine and medicine be your food.” These
words are still relevant today. Some diseases are acute
while others are chronic. Those that are chronic may
include heart disease, hypertension, diabetes, asthma,
arthritis, COPD, kidney disease and some cancers.
The leading causes of death in the US from disease
are heart disease, followed by cancer, chronic lung
disease, stroke, Alzheimer’s, diabetes and chronic
kidney disease. Diabetes is actually the fastest growing
chronic disease in the US. In 2017, Indiana was ranked
6th in the country with diabetes being the leading
cause of death and 13th in the country with heart
disease as the leading cause of death.
In 2014, they counted over 6600 medication
prescriptions plus over the counter medications.
We can only imagine what the number is today.
According to the data from the National Health
and Nutrition Examination Survey in 2015–2016,
45.8% of the U.S. population used prescription
drugs. Nearly 40% of older adults take five or more
prescription drugs. All these medications have side
effects including nausea, fever, chills, headaches,
itching, wheezing, tightness in chest, vomiting,
red and irritated eyes and the list goes on and on.
Pharmaceuticals are actually the ones that benefit the
most from people being sick.
Is it possible that some of these chronic diseases
could be prevented or reversed by nutrition? There has
been extensive research for well over 40 years showing
how food can be used to treat and sometimes reverse
many chronic diseases. There is continual research
showing that plant-based nutrition :
• Prevents and reverses heart disease, diabetes and
some cancers
• Decreases cholesterol and reduce blood sugar levels
• Decreases obesity and complications from being
overweight
• Improves mood, sleep, energy, depression, anxiety
• Reverses many chronic diseases
• Increases work productivity
In a research study in five corporate locations in
the US, those practicing plant-based nutrition (PBN)
showed improvement in body weight, blood sugar
levels, and emotional state including depression and
anxiety. In another study, diets that were higher in
plant foods and lower in animal foods were associated
with a lower risk of cardiovascular morbidity and
mortality in a general population. The more people
adhered to a healthy plant-based diet, the lower their
risk of cardiovascular disease. In regards to obesity,
research shows that those who followed a plant-based
diet had more weight loss compared to those who
followed a vegetarian and non-vegetarian diet that
included diary, eggs, fish, or meat at two-month and
six-month intervals.
What specifically is plant- based nutrition (PBN)?
What does it include?
• Vegetables – dark greens, dark yellows and
orange, sweet potato etc.
• Whole Grains – pasta, rice, corn, whole grain
bread, tortilla etc
• Fruit – whole fruit which is better than juice due
to fiber
• Legumes – beans, peas, lentils, tofu, soymilk,
chick peas etc.
• Nuts and seeds
• limited processed foods
• avoiding oil, flour and sugar
With over three million nurses, it seems we could
make a dramatic change in health care for people in
the US, including Indiana, if we shared information
about plant-based nutrition. We all work in a wide
variety of settings including hospitals, (state, local and
private), ambulatory clinics, outpatient offices, home
healthcare, regulatory agencies, organizations, schools,
residential care and etc.
I have volunteered to conduct several 21-day plant
-based programs utilizing the Physicians Committee
for Responsible Medicine (PCRM) which is a free online
Kickstart program. The results were published
in the American Journal of Nursing and the Holistic
Nursing Association Journal. I collected lab work on
two occasions which supported the research already
published. Some people dropped up to 59 points in
cholesterol in 21 days while others also lost weight,
improved their energy and were sleeping better.
In talking with nurses around the country, there
seem to be many reasons nurses do not share
information about plant-based nutrition. They reported
the following:
• Feel they do not know enough and were worried
they could not answer patient’s questions
• Think it was too difficult
• Did not know who to refer patients to
• Thought it may be too expensive
• Thought patients may not be interested
When I spoke with nurses around the US, they
shared that this form of nutritional information was
not given to them in nursing schools. All the nurses
interviewed for my book, Cultivating Seeds of Health
With Plant Based Nutrition, Nurses Share Educational
Approaches to Prevent and Reverse Chronic Disease
(available on Amazon) learned about PBN after
graduation from their nursing programs. Some
learned about it after their own illness and others
when a family member became ill. Several nurses saw
their patients taking the recommended medications
and they were still not getting well. Others recognized
that “everything in moderation” was not working.
Another group of nurses read the China Study by Dr
Colin Campbell or saw the movie Forks Over Knives,
both of which convinced them that PBN was the way
to treat many chronic diseases.
Once nurses become knowledgeable about plantbased
nutrition, they have many options to share this
information including:
• Talking with colleagues about plant-based
nutrition (PBN)
• Having plant-based food at all meetings and
conferences
• Hosting monthly pot lucks with colleagues and
community groups (post Covid)
• Show movies on PBN and discuss the information
provided
• Ask more detailed questions about nutrition on
intakes with patients including
◦ How many fruits did you eat in past 24-48
hours
◦ How may vegetables did you eat in past 24-48
hours
◦ How many portions of dairy food did you eat I
past 24-48 hours
◦ How many portions of meat did you eat in past
24-48 hours
◦
Have them complete a nutritional assessment -
http://4leafsurvey.com
• Have care plans include PBN
• Have discharge summaries include PBN
• Request PBN guest speakers in educational
settings for undergraduate and graduate level
nursing programs
• Incorporate PBN into all discussions about chronic
diseases
• Join a community PBN group or start one
• Collaborate with other health care providers
interested in PBN
• Encourage hospitals to have plant-based foods at
all meals
• Monthly lunches with discussions on various PBN
topics (post Covid)
• Host a free online 10-day (McDougall) plantbased
program https://www.drmcdougall.com/
health/education/free-mcdougall-program/ or
host a free 21-day (PCRM) online plant-based
program – including menus, recipes, cooking
classes, and additional Information - https://
kickstart.pcrm.org/en
There are several groups available specifically for
nurses interested in learning more about plant- based
nutrition. PCRM hosts the Nurses Nutrition Network
which provides educational programs for nurses.
https://www.pcrm.org/good-nutrition/nutrition-forclinicians/nurses-nutrition-network.
The American
College of Lifestyle Medicine has a nurses’ support
group and has presentations open to all nurses. https://
lifestylemedicine.org/What-is-Lifestyle-Medicine. There
is also a new health care professionals group forming
in Indiana focusing on PBN and lifestyle to prevent and
reverse chronic diseases.
There are about 110,00 nurses in Indiana. Our
patients need to have a choice on how they will resolve
their chronic health issues and nurses can educate
patients so they hear for the first time that there is a
nutritional option to prevent and reverse many chronic
diseases. Patients should be given all the options
to make an educated decisions about their health.
Sometimes it starts with medication while they are
making nutrition and lifestyle changes. Eventually it
may be the nutritional changes alone that reverse the
chronic disease process. Nurses have an opportunity to
educate people to be healthier in Indiana. Let 2021 be
the time that it happens!
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The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association May 2021 | Colorado Nurse • 13
Resources
Some examples of breakfast might be the following:
• Cold cereal – with soymilk or rice milk with
peaches, berries or another fruit
• Whole grain toast with jam and fruit
• Oatmeal with non-dairy milk with cinnamon and
raisins
• Blueberry buckwheat pancakes and meat-free
bacon
For lunch, you might consider:
• Veggie burger with whole grain bun and salad
• Bean burrito, fruit
• Soy yogurt, fruit, vegetable soup, whole wheat
bread
• Hummus wrap with whole wheat pita, shredded
carrots, cucumber, tomato
Some options for dinner might include:
• Black bean chili with cornbread, salad, greens
• Whole grain pasta marinara with mixed
vegetables, salad
• Fajitas with peppers, onions, tomatoes, beans,
broccoli
• Beans and rice with salsa, corn, salad
Resources for learning about plant-based
nutrition are the following:
• Becoming Vegan, Express Edition: The Everyday
Guide to Plant-based Nutrition, Brenda Davis RD
and Melina Vesanto MS RD
• The China Study. Startling Implications For Diet,
Weight Loss and Long-Term Health. T. Colin
Campbell, PhD and with Thomas M. Campbell II,
MD
• How Not to Die: Discover the Foods Scientifically
Proven to Prevent and Reverse Disease, Michael
Greger MD. FACLM and Gene Stone
• How Not To Diet, Michael Greger MD
• The Starch Solution, John McDougall MD
• The Vegan Starter Kit: Everything You Need to
Know About Plant-Based Eating, Neal Barnard MD
• Prevent and Reverse Heart Disease , Dr Caldwell
Esselstyn
Some good cookbooks are:
• Dr. Neal Barnard’s Cookbook for Reversing
Diabetes: 150 Recipes Scientifically Proven to
Reverse Diabetes Without Drugs, by Neal Barnard
MD and Dreena Burton
• The China Study Cookbook by Leanne Campbell,
PhD
• Engine 2 Cookbook by Rip Esselstyn and Jane
Esselstyn
• Forks Over Knives – The Cookbook: Over 300
Recipes for Plant-Based Eating All Through the
Year, by Del Sroufe, Isa Chandra Moskowitz,
Julieane Hever MS, RD, CPT, Darshana Thacker,
Judy Micklewright
• The Get Healthy, Go Vegan Cookbook: 125 Easy
and Delicious Recipes to Jump-Start Weight Loss
and Help You Feel Great, Neal Barnard, MD
• How Not to Die Cookbook, Michael Greger MD
• The McDougall Quick and Easy Cookbook: Over
300 Delicious Low-Fat Recipes You Can Prepare in
Fifteen Minutes or Less, John McDougall MD and
Mary McDougall
• Prevent and Reverse Heart Disease Cookbook,
Ann Crile Esselstyn and Jane Esselstyn
Nurses interested in websites might consider:
• Dr. Greger – https://nutritionfacts.org – updated
research on nutrition and disease – many short
videos
• American College of Lifestyle – https://www.
lifestylemedicine.org
• Dr. McDougall – www.drmcdougall.com – free
newsletters, testimonials, current research, Starch
Based Solution Certificate Program, 10-day
residential programs
• Physicians Committee for Responsible Medicine –
www.pcrm.org – free monthly Kickstart programs,
newsletters, current research, multiple languages,
handouts for offices
• Forks Over Knives – https://www.forksoverknives.
com/ – recipes, plant-based news, meal plans,
success stories, cooking course
• Plantrician Project – https://plantricianproject.org/
vision – list of plant-based doctors, peer review
journal, conferences, cooking class, research and
more
Nurses looking for apps may be interested in:
• 21-DayVegan Kickstart – PCRM
• Dr. McDougall Mobile Cookbook
• Forks Over Knives
• Michael Greger - Dr. Gregers’ Daily Dozen
Some good plant-based movies are:
Forks Over Knives – especially for diabetes, heart
disease and chronic health issues
Code Blue – focusing on medical training and health
care system
Game Changers- focus on vegan athletes
Cowspiracy – focus on the environment
Food Inc – food supply and industry
Eating You Alive – food connected to chronic disease
Meat the Truth – livestock farming and the
environment
Joanne Evans MEd, RN, PMHCNS is an advanced
practice nurse and has been practicing for almost 50
years. She is certified in plant-based nutrition by 2
national organizations and has been a speaker at many
national, state, and local nursing conferences. She has
published on this topic in several journal in nursing
organizations. She recently published Cultivating Seeds
of Health With Plant Based Nutrition, Nurses Share
Educational Approaches to Prevent and Reverse Chronic
Disease which is available on Amazon. She can be
reached at healthynursesandcommunities@gmail.com.
References
American Association of Nurse Practitioners Journal. A wholefood
plant-based experiential education program for
health care providers results in personal and professional
changes. Oct 2019. A. Lessem, S. Gould, J. Evans et al.
American Journal of Nursing, March 2017 – A Plantbased
program – Nurses experience the benefits and
challenges of following a plant-based diet
American Journal of Holistic Nursing, April 2015 - Plant-based
nutrition: Will your next prescription be for the farmers
market OR the pharmacy
Martin CB, Hales CM, Gu Q, Ogden CL. Prescription drug
use in the United States, 2015–2016. NCHS Data Brief,
no 334. Hyattsville, MD: National Center for Health
Statistics. 2019. https://www.cdc.gov/nchs/products/
databriefs/db334.htm
Katcher, H.I., Ferdowsian, H.R., Hoover, V.J., et al. (2010)
A worksite vegan nutrition program is well accepted
and improves health-related quality of life and work
productivity. Ann Nutr Metab, 56(4), 245-52
Agarwal, S., Mishra, S., Xu, J., Levin, S., Barnard, N.D., (2015)
A multicenter randomized controlled trial of a nutrition
intervention program in a multiethnic adult population
in the corporate setting reduces depression and anxiety
and improves quality of life: The GEICO Study. Am J
Health Promot 29(4), 245-54.
Trapp, C., Barnard, N., Katcher, H. A Plant-based
diet for type 2 diabetes. (2010, February, 25).
Diabetes Educator. https://journals.sagepub.com/
doi/10.1177/0145721709357797
Roberts, W.C., (2010) It’s the cholesterol, stupid! Am J
Cardiology. 106(9),1364-6.
Esselstyn CB, Jr., et al. A way to reverse CAD? J Fam Pract
2014;63(7):356-64.
Turner-McGrievy, G.M., et al. (2015). Comparative effectiveness
of plant-based diets for weight loss: a randomized
controlled trial of five different diets. Nutrition 31(2), 350-8.

14 • Colorado Nurse | May 2021
The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association
State Board of Nursing Seeks
New Members
The State Board of Nursing is seeking five new
members to begin four-year terms starting this
summer. Board vacancies include:
• One Licensed Practical Nurse (LPN);
• One Registered Nurse (RN) or LPN working in a
Nursing Home or Intermediate Care Facility.
• One RN or LPN working in a Home Health
setting;
• One RN serving as a Nurse Administrator;
• One RN hospital staff nurse.
The time commitment includes one monthly
Board meeting, quarterly full Board meetings, and
occasional emergency meetings to act on nursing
education program applications, complaints,
licensing applications, and rulemaking as authorized
in the Nurse and Nurse Aide Practice Act. Selected
To access electronic copies of
Colorado Nurse, please visit
http://www.NursingALD.com/
publications
Board members will be expected to prepare in
advance for these meetings, attend annual ethics
training, and participate in the decision-making
process at meetings. Members are reimbursed for
travel expenses and paid a small stipend for their
participation.
Meetings are held remotely or in-person at 1560
Broadway, Denver, CO 80202.
Interested parties may contact Roberta.Hills@
state.co.us to express an interest in applying or
to ask any questions. The formal application is
processed and accepted by the Governor’s Office of
Boards and Commissions. The Governor’s Office is
continually seeking qualified candidates to serve on
almost 300 boards and commissions that oversee
a large variety of subjects and make a wide range
of decisions affecting the daily lives of Coloradans.
These boards are a tremendous opportunity for you
to help govern and give back to the state.
Applicants should not be concerned if they are
not immediately notified of their status. Selected
members will be contacted.
---
The State Board of Nursing wants to
inform licensees of recently updated reporting
requirements.
Colorado statute now requires 30-day reporting
of adverse actions by all Registered Nurses,
Licensed Practical Nurses, Licensed Psychiatric
Technicians, and Certified Nurse Aides.
These categories include:
• Final convictions;
• Malpractice settlements;
• Action taken by a government agency, law
enforcement agency, healthcare institution,
or peer review committee for acts that are
grounds for discipline;
• License discipline in another state, whether
within or outside a compact;
• License revocation, suspension, or surrender
in another state, whether within or outside a
compact.
Please submit reports to dora_nursingboard@
state.co.us. Those failing to report these actions are
subject to discipline by the Board. Further details
are available here.
Please contact Roberta.Hills@state.co.us with any
questions.
SAVE THE DATE
Colorado Nurses Association
Annual Conference and
Membership Assembly
October 1 & 2, 2021
2021 Year of the Nurse –
Nurses Make a Difference
Call for Speakers
2021 has demonstrated the power and value
of nursing. Colorado Nurses Association is issuing
an invitation to individuals who would like to
contribute to our annual conference as a speaker to
share content with nurses, student clinical nurses,
nurse leaders, and advance practice nurses.
The annual conference will be held at the Hilton
Inverness Hotel in Englewood, Colorado, just south
of Denver.
Conference attendees are looking for leading
edge practice, research, self-care, and career
development content.
Please submit your content for
consideration by June 15, 2021 at:
2021 Call for Presenters
or
www.coloradonurses.org

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association May 2021 | Colorado Nurse • 15
Reprinted from The North Dakota Nurse
January, February, March 2021
Appraised by: Jannelle Stevens, RN, LeAnn Bingham,
RN, & Dylan Gjerde, RN Mayville State University RN-
BSN students
Clinical Question:
Do nurses who work 12-hour shifts have a higher
rate of burnout than nurses who work 8-hour shifts?
Articles:
Dallora, C., Griffiths, P., Ball, J., Simon, M., & Aiken, L. H.
(2015). Association of 12 h shifts and nurses’ job
satisfaction, burnout and intention to leave. Findings
from a cross-sectional study of 12 European countries.
BMJ Open, 5(9). doi:10.1136/ bmjopen-2015-008331
Khammar, A., Amjad, R. N., Rohani, M., Yari, A., Noroozi, M.,
Poursadeghian, A., Mahsa, H., Poursadeghiyan, M. (2017).
Survey of shift work disorders and occupational stress
among nurses: A cross-sectional study. Annals of Tropical
Medicine & Public Health, 10(4), 978–984.
Ruotsalainen, J. H. (2015). Preventing occupational stress
in healthcare workers. Cochrane Database of
Systematic Reviews, (4). John Wiley & Sons, Ltd. doi:
10.1002/14651858.CD002892. pub5
Thompson, B. J. (2019). Does work-induced fatigue
accumulate across three compressed 12 hour shifts in
hospital nurses and aides? PLoS ONE, 14(2), 1–15.
Synthesis of evidence:
This synthesis includes four studies related to
evidence supportive of the proposed research question.
The first study was conducted by Dallora, Griffiths, Ball,
Simon, & Aiken (2015), and focused on the concern
that nurses who work 12-hour shifts have a higher job
dissatisfaction and burnout rate compared to nurses
who work 8-hour shifts. A cross-sectional survey
was done on 31,627 RN’s in 2,170 general medical/
surgical units within 488 hospitals across 12 European
countries. The study concluded that nurses who work
12-hours shifts experience an increased rate of job
dissatisfaction when compared to a nurse working
an 8-hour shift. The same results were reported
for burnout described as, emotional exhaustion,
depersonalization, and low personal accomplishment.
The second study was conducted by Khammar,
Amjad, Rohani, Yari, Noroozi, Poursadeghian, Mahsa,
& Poursadeghiyan (2017). This study performed a crosssectional
study on 100 randomly selected shift-working
nurses from three hospitals in Iran. The study focused
on the correlation of shiftwork-related problems and
occupational stress, shiftwork, and job dissatisfaction.
The conclusion of this study showed a high prevalence
of shift work related problems such as, psychological
disorders, digestive problems, sleep disorders, and
DOES SHIFT LENGTH MATTER?
musculoskeletal complaints. The study did show there
was a higher rate of job satisfaction when nurses were
able to choose their shiftwork. Stress-related issues
were more prevalent when there was a conflict with
coworkers.
The third study was conducted by Ruotsalainen
(2015). This study addressed the concern for healthcare
workers suffering from occupational stress resulting
in distress, burnout, psychosomatic problems,
deterioration in quality of life, and lack of patient
care. The purpose of this Cochrane review was to
evaluate the effectiveness of work- and persondirected
interventions compared to no intervention or
alternative interventions in preventing stress at work
in healthcare workers. A total of 58 studies (54 RCTs
and four CBA studies), with 7,188 participants were
reviewed. Organizational interventions discussed were
changing working conditions, improving support
or mentoring, changing content of care, improving
communication skills, and improving work schedules.
The study concluded that cognitive-behavioral training
as well as mental and physical relaxation reduced stress
moderately. Changing work schedules and having
shorter work schedules also reduced stress. Other
organizational interventions have no clear effects.
The purpose of the final study conducted
by Thompson (2019), was to determine what
performance-based fatigue symptoms presented after
three consecutive 12-hour nursing shifts compared to a
single 12-hour nursing shift. Participants were mentally
tested on their reaction time and monitored for lapses
of attention. Physical testing consisted of three vertical
jumps and isometric strength assessments on the knee
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extensor/flexor, and wrist flexor muscle groups. The
results showed fatigue-based impairments in several
mental and physical performance tasks which occurred
after a single 12-hour shift however, the impairments
were exacerbated following three consecutive 12-hour
shifts.
Bottom Line:
Evidence suggests that there is a correlation
between the length of shift worked and an increased
rate of burnout. It is necessary for healthcare
institutions and nurses to evaluate the potential cause
for burnout and make the appropriate changes.
Institutions that implemented shorter shifts with
stress intervention and prevention programs tend to
have a lower nurse burnout rate than those without.
Additionally, nurses who can be proactive with
recognizing burnout in themselves and their coworkers
will assure an optimal working environment and
continue to provide our patients with exceptional care.
Implications for nursing practice:
It has become increasingly apparent that nurses
are suffering from burnout. Healthcare institutions
and nurses need to take the appropriate steps to
recognize, reduce, and prevent burnout. Some steps
aimed at reducing burnout are, developing modified
shift-working programs, avoiding consecutive 12-hour
shifts, provide education on stress reducing measures,
reviewing workload, improving staff support,
mentoring, and improving communication. Having
these proactive interventions in place will be beneficial
for the institution, nurses, and patients.
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16 • Colorado Nurse | May 2021
The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association
CNA Call for Nominations
for Annual Awards
Carol O’Meara, Chair, CNA Awards Committee
The CNA Awards Committee is seeking nominations
for the 2021 CNA Awards. The Awards will be presented
during the 2021 Membership Assembly Meeting. The
awards are:
• Margie Ball Cook Award for a CNA member who
has advanced equal opportunities in nursing for
members of minority groups.
• Sara Jarrett Award for a CNA member who has
contributed to nursing practice and health policy
through political and legislative activity.
• CNA Leadership Award for a CNA member who
has served as a leader in CNA through service on
the Board of Directors or on a committee or task
force.
• CNA Emerging Leader Award for a CNA member
who has been a nurse for no more than ten
years and who is emerging as a leader in CNA or
a DNA.
• Carol O’Meara Award for a CNA member who
has made sustained contributions to CNA.
Nominations will also be accepted for the CNA Hall
of Fame. The CNA Hall of Fame was established in
2004 to honor CNA Members whose dedication and
achievements have significantly affected the Colorado
nursing profession. Nominees for the Hall of Fame
may be living or deceased. Criteria for the Hall of
Fame are:
1. The nominee must have demonstrated
leadership that affected the health and/or
social history of Colorado through sustained,
lifelong contributions in or to nursing practice,
education, administration, research, economics,
or literature.
2. The achievements of the nominee must have
enduring value to nursing beyond the nominee’s
lifetime.
3. The nominee must have been prepared in a
formal nursing program.
4. The nominee must have worked in or
represented Colorado.
5. The nominee must be or have been a CNA
member.
To nominate an individual for any of these awards,
send a statement to the CNA Awards Committee,
which describes why your nominee should receive
the award. Include the name of your nominee as well
as your name and contact information. Please limit
your statement to two double-spaced pages. Email
your statement to carolomeara@aol.com. Deadline
for receipt of nominations is August 15, 2021. The
Awards Committee may seek additional information
regarding the nomination.
In addition to these state level awards; each DNA/
SIG is invited to designate a DNA/SIG Nurse of the
Year. The DNA/SIG determines selection of the DNA
Nurse of the year. DNA/SIG Nurses of the Year will
be honored at the Membership Assembly meeting in
October. DNA/SIGs should submit the name of their
Nurse of the Year, along with a statement about why
the nurse was selected, to the Awards Committee
by August 15, 2021. Email this information to
carolomeara@aol.com.
Did You Know...
Colorado Nurses Association (CNA) worked
with the Colorado Hospital Association
(CHA), the Colorado Organization of
Nurse Leaders (CONL), as well as members
of the public and the staff at the Colorado
Department of Public Health & Environment
(CDPHE) to revise and modernize the nurse staffing
regulations for hospital licensure in Colorado. The
work occurred over a six to eight month timeframe,
with weekly meetings negotiating regulations to
advance assurances that clinical staff will have
a safer working environment. A key change is
described here.
CDPHE Hospital Licensing
Regulations for Nurse Staffing
Master Nurse Staffing Plans now state that
each open patient care unit will be staffed by a
minimum one RN and one auxiliary personnel,
including Emergency Departments.
Unit-based Master Nurse Staffing Plans must be
reviewed annually with, minimally, every RN.
Master Nurse Staffing Plans Effectiveness
Measures must be shared annually with the
facility governing board.
Master Nurse Staffing Plans and Effectiveness
monitoring must be available to CDHPE
surveyors upon request.
In the event that any employee or provider
(RN, MD, RT, PT) feels that their current work
environment is Unsafe or impacting Quality
of Care, you are encouraged to report the
incidence to the CDPHE Complaint Line.
These complaints can be made anonymously
and the information is not shared upon any
follow up surveys.
The CDPHE Complaint Line is found
at the Colorado Department of
Public Health & Environment Health
Facilities Division Web Site.
Colorado Nurses Association
Calls for Reference Proposals
and Bylaws Amendments
Carol OMeara, Chair, CNA Bylaws
and Reference Committee
Reference Proposals on Professional Issues are
requested for discussion and action at the CNA
Membership Assembly Business Meeting in October.
These proposals can be on any topic of concern
to nurses. Proposals for amendments to the CNA
Bylaws are also being requested. Proposals should be
submitted by August 15, 2021.
Contact Carol O’Meara, Bylaws and Reference
Committee Chair, at carolomeara@aol.com with any
questions or to submit proposals.
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The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association May 2021 | Colorado Nurse • 17
Nurse Spotlight: Defending Your License
Nurses Service Organization (NSO), in collaboration
with CNA, has published our Nurse Liability Claim Report:
4th Edition. It includes statistical data and case scenarios
from CNA claim files, as well as risk management
recommendations designed to help nurses reduce their
malpractice exposures and improve patient safety.
You may access the complete report, and
additional Risk Control Spotlights, at: www.nso.com/
nurseclaimreport.
This Nurse Spotlight focuses on our analysis and risk
recommendations regarding one of the most significant
topics in the report: Defending Your License.
A nurse’s license is one’s livelihood, so protecting
it is paramount. A nurse’s practice and behavior
is expected to be safe, competent, ethical and in
compliance with applicable laws and rules. The State
Board of Nursing (SBON) serves to protect the public
and promote the progress of the profession, and
thus should be respected for its work in these areas.
However, when a complaint is made against a nurse to
the SBON, nurses must be equipped with the resources
to adequately defend themselves. Being unprepared
may represent the difference between a nurse retaining
or losing their license. This Spotlight provides an
overview of the role of the SBON in the legal/regulatory
system, describes the disciplinary process, and imparts
helpful recommendations on defending yourself if you
were to receive a complaint summons.
The 4th Edition of the NSO/CNA Nurse Liability Claim
Report revealed a total of 1,377 closed license protection
matters with payment in the five-year analysis, with an
average defense expense of $5,330. This data reflects an
increase over the previous data set.
The chart below represents the 2020 distribution of
license protection matters by license type. The average
total payment represents only the legal fees and other
expenses involved in defending the nurse against the
complaint. Any costs or expense associated with fines
or indemnity/settlement payments to a plaintiff are not
included. The percentage of license protection matters
correlates to the proportion of RNs and LPNs/LVNs
within the overall CNA/NSO-insured nurse population.
Understanding the Legal System
There are three types of law, the third of which
comes into play during licensing complaints.
• Civil law protects the rights of citizens and offers
legal remedies. Civil actions typically involve a
plaintiff suing to collect money to compensate
for an injury. One example of a civil action would
be a medical malpractice lawsuit. The outcome of
civil cases is determined by the preponderance of
evidence in favor of one party.
• Criminal law involves the system of legal rules
that define conduct that is classified as a crime.
Examples include driving under the influence,
theft or assault. Criminal cases are determined by
proving guilt beyond a reasonable doubt.
• Administrative law governs the rules and regulations
made and enforced by government agencies—such
as your state Board of Nursing. Administrative cases
are determined by the state providing ‘clear and
convincing’ evidence of the allegations, though this
language may vary by state.
The Nurse Practice Act
Every state has enacted laws and regulations that govern
the conduct of licensed professionals. The law specific to
licensed nursing professionals is the Nurse Practice Act. All
nursing professionals should become conversant with their
relevant state Nurse Practice Act. The Nurse Practice Act
gives your state Board of Nursing and professional license
regulatory agency the authority to:
• Provide nurses with certain rights and responsibilities;
• Develop practice and education standards,
policies, and administrative rules and regulations;
• Educate nurses regarding nursing practice;
• Credential and issue nursing licenses; and
• Enforce the laws pertaining to nursing practice by
investigating reports of professional misconduct
and making decisions regarding discipline.
Licensee Rights During the
Disciplinary Process
If you are named in a licensing complaint, the state will
not provide nor recommend an attorney, but gives you
the right to retain an attorney. The state also permits you
the opportunity to present evidence to defend yourself
during a hearing.
Nurse Spotlight
For risk control strategies related to:
• Documentation
• Medication Administration
• Liability for Nurse Managers
• Depositions
• Communications
• Home Care
Visit nso.com/nurseclaimreport
The Disciplinary Process
A board complaint can be filed against a nurse by
anyone, for example, a patient, a patient’s family member,
a colleague or an employer. You may or may not know
the identity of your accuser and the complaint can be filed
anonymously.
In addition, many states require self-reporting of
certain violations, such as misdemeanors, felonies, and
plea agreements.
Involvement in a disciplinary action will take time to
resolve, which can make the entire process stressful.
The process is illustrated by the graphic below.
Investigative Stage
While the procedures may vary by state, all
complaint reports are investigated, including those that
are anonymous. Many if not all SBONs are required to
investigate every complaint they receive. However, the
SBON may not be permitted to tell you how it received
the report, or give you any information or documents.
Some SBONs use board-appointed investigators
who may or may not be nursing professionals. The
investigator will use various methods to determine
the facts, such as interviewing parties who were
present, reviewing documentation and records,
performing drug screens (if impairment is alleged), and
compiling any pertinent facts related to the events and
circumstances surrounding the complaint.
You may receive a letter, email or a phone call from the
SBON asking you to submit a written statement explaining
the reported incident. Or, the SBON may require you to
appear at a certain time and date for an interview with
the investigator. Never ignore a request from the SBON.
If you are contacted during the investigative stage,
consult with an attorney before you respond to the
SBON within the deadline set by the Board. You must
be cooperative, but be aware that whatever you
share is evidence the investigator will provide to a
prosecuting attorney or the SBON.
Nurses should not appear at proceedings without
legal counsel present. Look to your legal counsel for
guidance before answering questions from or making
statements to the SBON or the investigator. Your
attorney may be able to speak to the investigator, learn
more about your matter, and help you navigate the
entire process in a positive direction.
Prosecution Phase
Upon completion of the investigation, the
prosecuting attorney or state agency will determine
how to proceed. One option is an informal conference.
Although less formal than an actual hearing, informal
conferences are official proceedings. During the
conference, you will be interviewed by a member of
the SBON and possibly its attorney. Your attorney
should be present with you during all proceedings.
• You will have an opportunity to produce any
evidence that supports your case.
• A resolution may be offered, ending the matter.
If the SBON believes it has significant evidence
against you, the matter may proceed directly to a
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Defending Your License continued from page 17
formal hearing where a discipline action may be proposed. The hearing is similar
to a civil trial. It may take place in a courtroom-like setting before an administrative
law judge and hearing panel. The hearing panel may include several SBON board
members, or the entire SBON, depending upon the state. A court reporter records
the entire proceeding and a transcript is made. When both sides have presented
their cases, the hearing is concluded.
• Information is exchanged, known as discovery, and you are entitled to the
documents possessed by the prosecutor.
• Witnesses may be called to testify.
• The nurse undergoes cross-examination.
The outcome of the formal hearing is a ruling by the administrative law judge and
the SBON. The process can take months or even years to fully resolve – lengthening
the process – and increasing the cost.
Allegations
Comprising 32.5 percent of license protection matters, professional conduct
allegations are the most frequent allegations asserted against nurses in license
protection matters. Collectively, professional conduct, scope of practice and
documentation error or omission account for 67.0 percent of all license protection
closed matters, see Figure 24.
State Board of Nursing Actions
SBON disciplinary actions can range from no action against the nurse, up to and
including revocation of the nurse’s license to practice.
The majority of matters in the 2020 analysis, 45.6 percent, resulted in the SBON
deciding to take no action. In 15.5 percent of matters the nurse received a letter of
concern which is considered a ‘warning’ or reprimand. The more serious outcomes
include: Probation 12.0 percent, Surrender 4.8 percent, Suspension 3.2 percent, and
Revocation 1.5 percent, see Figure 28.
In some cases, the SBON may impose multiple disciplinary actions, such as receiving
a reprimand coupled with a fine. Depending upon the state in which you practice,
most outcomes involving discipline against a nurse’s license are permanently a matter
of public record and reported to the National Practitioner Data Bank (NPDB). The SBON
also may report that disciplinary action to other agencies, regulatory authorities, or other
SBONs, which may decide to initiate their own investigation and take action.
Nurses who have had adverse disciplinary actions may appeal those decisions. The
standards for appealing a SBON decision are defined by your state and will outline the
specific requirements, time frames, and processes.
According to the National Practitioner Data Bank, nursing
professionals were on average more than 62 times
more likely to be involved in an adverse licensing
action than a medical malpractice payment in 2019.*
Risk Management Recommendations
Below are some proactive concepts and behaviors to include in your customary
nursing practice, as well as steps to take if you believe you may be involved in a
SBON matter related to your practice of nursing:
Everyday Practice
• Practice within the requirements of your state nurse practice act, in
compliance with organizational policies and procedures, and within the
national standard of care. If regulatory requirements and organizational scope
of practice differ, comply with the most stringent of the applicable regulations or
policy. If in doubt, contact your SBON or specialty professional nursing association
for clarification.
• Document your patient care assessments, observations, communications
and actions in an objective, timely, accurate, complete, and appropriate
manner. Never alter a record for any reason or add anything to a record
after the fact unless it is necessary for the patient’s care. If it is essential to add
information to the record, properly label the delayed entry, but never add any
documentation to a record for any reason after a complaint has been made. If
additional information related to the patient’s care emerges after you become
aware that SBON action is pending, discuss the need for additional documentation
with your manager, the organization’s risk manager and your legal counsel.
• Maintain files that can be helpful with respect to your character. Retain
copies of letters of recommendation, performance evaluations, thank-you letters
from patients, awards, records of volunteer work and continuing education
certificates.

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association May 2021 | Colorado Nurse • 19
• Immediately contact your professional
liability insurer if you:
• Become aware of a filed or potential professional
liability matter against you.
• Receive a subpoena to testify in a deposition
or trial.
• Have any reason to believe that there may
be a potential threat to your license to
practice nursing.
• Refrain from discussing the matter with
anyone other than your defense attorney
or the professionals managing your
matter.
• Promptly return calls from your defense
attorney and professionals. Contact your
attorney or designated professional before
responding to calls, e-mail messages or
requests for documents from any other party.
• Provide your insurer with as much
information as you can when reporting
such matters, including contact information.
• Never testify in a deposition without first
consulting your insurer or legal counsel.
• Copy and retain all legal documents for
your records, including:
• The summons and complaint
• The subpoena
• Attorney letter(s)
• Any other legal documents pertaining to the
matter
This information is designed to help nurses
evaluate risk control exposures associated with their
current practice. It is not intended to represent
a comprehensive listing of all actions needed to
address the subject matter, but rather is a means of
initiating internal discussion and self-examination.
Your clinical procedures and risks may be different
from those addressed herein, and you may wish to
modify the tool to suit your individual practice and
patient needs. The information contained herein is
not intended to establish any standard of care, serve
as professional advice or address the circumstances
of any specific entity. These statements do not
constitute a risk management directive from CNA.
No organization or individual should act upon this
information without appropriate professional advice,
including advice of legal counsel, given after a
thorough examination of the individual situation,
encompassing a review of relevant facts, laws
and regulations. CNA assumes no responsibility
for the consequences of the use or nonuse of this
information.
This information was excerpted from NSO and
CNA’s full report, Nurse Liability Claim Report: 4th
Edition. www.nso.com/nurseclaimreport