Future of Nursing in Michigan - May 2021

THE FUTURE OF NURSING IN MICHIGAN
The Official Publication of the
American Nurses Association Michigan
The Future of Nursing in Michigan will
reach over 5,600 Michigan nurses and
State Legislators through direct mail and over
145,000 by email distribution.
PRESIDENT’S MESSAGE
Volume 7 • Number 2 • May 2021
Celebrating Nursing:
Past, Present & Future
Advocating For Nurses And Patients
- Your Voice Carries Weight!
ANA-Michigan Conference
Recap
Nurse Leadership Academy
Page 3
Page 6
Page 10
The Year of the Nurse gives
us an opportunity to celebrate
the many contributions that
nurses make every day. While
the Year of the Nurse was
designated by the World
Health Assembly for 2020 to
mark the 200th birthday of
Florence Nightingale, I am so
grateful it has been extended
into 2021. This is a fitting
time to recognize our origins
Julia Stocker
Schneider, PhD,
RN, CNL
by honoring Ms. Nightingale, who continues to
inspire us with her vision of nursing that endures
today. Another nursing leader from our past that
I have drawn strength from is Lillian Wald, who
pioneered public health nursing while serving the
poor immigrant community in New York’s Lower
East Side. Ms. Wald founded the Henry Street
Settlement and served the community there
between 1893 and 1933, which included the 1918
Flu Pandemic. Ms. Wald demonstrated to us how
nurses rallied for action during that generation’s
public health crisis to protect everyone - regardless
of race, religion, or class - from that illness.
As we continue to live through our current
pandemic, many nurses we have worked with,
and others who have shared their stories, have
inspired us. Many of these nurses cared for COVID
patients through the multiple surges, others
shifted practice roles as healthcare pivoted,
while others performed contact tracing and
vaccination. Despite the grueling experience of
the last year, everyday nurses in all roles have
risen to the challenge and demonstrated the
importance of the nursing profession to the
health and well-being of the world. As nurses are
celebrated for their dedication, we are seeing a
glimmer of hope as COVID rates are beginning
to fall and vaccination rates continue to grow.
We finally may have the ability to take a muchneeded
pause to take care of ourselves and our
nursing and healthcare colleagues. One way that
ANA-Michigan is supporting nurses in self-care is
through RN-Connect. If you haven’t already signed
up, please do so by texting RNconnectMI to 60298.
Finally, as we celebrate the Year of the Nurse,
we need to look with hope and recognition to
our future nurses. Our nursing students have
endured many challenges as they have pursued
their nursing education to enable them to join
our profession. Many colleges and universities
have closed their campuses to in-person learning,
shifting to online classes. At the beginning of the
pandemic, many nursing students experienced
limited access to clinical sites. When these sites
did open, current students’ experiences have been
shaped by the constraints of the current COVID
environment, adding a unique challenge to their
learning. Despite all this, the 2021 class of nursing
graduates are proud of their accomplishments,
and excited to officially enter our profession. We
celebrate these new nurses, as well as those future
nurses currently applying and enrolling in nursing
programs. Please join me in welcoming our newest
generation of nurses into the profession. We also
extend an invitation to these new nurses to join
our nursing community in ANA-Michigan. We can
benefit from their enthusiasm and vitality as we
work together to foster nursing leadership and
advance the nursing profession in Michigan.
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Page 2 The Future of Nursing in Michigan May, June, July 2021
Federal Assistance for the State of
Michigan in the Fight Against COVID-19
By Evelyn Zois Sweeney
ANA-Michigan Lobbyist,
Muchmore Harrington Smalley
and Associations (MHSA)
The last 17-months have
presented extraordinary
challenges and heartache
across our world. The global
COVID-19 pandemic has impacted virtually every
facet of our lives. The profound toll on human
life, mental and emotional health and economic
disarray to businesses and families alike, is
almost impossible to quantify. The enormity
of the catastrophe, however, has provoked
unprecedented assistance from our federal
government. Six federal COVID relief acts have
passed Congress, the most recent, the American
Rescue Plan Act (ARPA) was enacted into law on
March 11, 2021. ARPA provides significant (mind
boggling?!) levels of investment and support
for the State of Michigan; over $10 billion to be
exact. To put that into context, the state’s entire
annual General Fund is just over $11 billion. Many
have described the funding as “transformative”
or “once in a generation,” but all agree, the
opportunity cannot be squandered. It would be
impossible to provide a comprehensive analysis of
the entire bill given space constraints, but below is
a high-level overview of some of the key funding
priorities included in the legislation.
• The Families First Coronavirus Response Act
allowed states to provide COVID-19 testing for
the uninsured with the federal government
providing 100% of the cost. ARPA would
expand the option to cover vaccines and
COVID-19 treatment without requiring cost
sharing for one year after the public health
emergency.
• State Fiscal Recovery Fund: Michigan is
estimated to receive approximately $5.65
billion. The state is afforded relatively large
latitude in how this tranche of money is
spent. The intent is to help mitigate and
respond to the public health emergency or
its negative economic impacts. Investments
Now Hiring!
RNs and MSWs for our
Behavioral Health Center!
We offer Student Loan Repayment
in water, sewer or broadband infrastructure
including assistance to households, small
businesses, nonprofits and industries like,
tourism, travel and hospitality are all eligible
uses. The bill also allows premium pay for
essential workers (up to additional $13/hour
in addition to base pay, capped at $25,000) –
includes pay to eligible workers of the state,
or by providing grants to eligible employers
that have eligible workers who perform
essential work.
• Grants for Health Care Providers to Promote
Mental and Behavioral Health: the total
allocation in the bill is $40 million. The
investment is grant-based to states and other
entities supporting evidence-based programs
to promote mental health within health care
professionals.
• Emergency Rental Assistance: Michigan is
estimated to receive approximately $570
million. The funds are intended to provide
financial assistance and relief in the form of
rent, rental arrears, utilities, home energy
costs and home energy costs arrears or other
expenses related to housing.
• Homeowner Assistance Fund: the total
allotment in the bill is almost $10 billion.
Michigan’s share is yet to be determined
but intended use of the dollars is for the
prevention of homeowner mortgage
delinquencies, defaults, foreclosures, loss
of utilities or home energy services and
displacements of homeowners experiencing
financial hardship after January 21, 2020.
• Childcare and Development Block
Grant: Michigan is estimated to receive
approximately $439.2 million. This money
is intended to provide child-care assistance
to health care sector employees, emergency
responders, sanitation workers and other
workers deemed essential during the
response to coronavirus by public officials,
without regard to income eligibility
requirements.
• Mental and Behavioral Health Training
(Health Care Professionals): the total
allotment in the bill is $80 million and the
state’s share would be based on applications.
The investment is a grant-based program to
states and other entities to plan, develop,
operate or participate in training to reduce
suicide, burnout, mental fatigue, etc. within
health care professionals.
CONTACT INFORMATION
ANA-Michigan
2501 Jolly Road, Suite 110
Okemos, MI 48864
517-325-5306
nurse@ana-michigan.org
EXECUTIVE DIRECTOR
Tobi Lyon
The Future of Nursing in Michigan is published
quarterly every March, June, September and
December by the Arthur L. Davis Publishing
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For advertising rates and information, please
contact Arthur L. Davis Publishing Agency,
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ANA-Michigan 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 American
Nurses Association Michigan of the products
advertised, the advertisers or the claims
made. Rejection of an advertisement
does not imply that 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. American Nurses Association
Michigan and the Arthur L. Davis Publishing
Agency, Inc. shall not be held liable for any
consequences resulting from purchase or use
of advertisers’ products. Articles appearing
in this publication express the opinions of
the authors; they do not necessarily reflect
views of the staff, board, or membership of
American Nurses Association Michigan, or
those of the American Nurses Association.
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May, June, July 2021 The Future of Nursing in Michigan Page 3
Advocating For Nurses And Patients - Your Voice Carries Weight!
Nurses are one of the most honest and trusted
professions in America. The most recent Gallup poll marks
the 19th consecutive year the nursing profession has topped
the list, rated at 89% for honesty and ethics, four percentage
points greater than last year. Given such a revered opinion
by the public, it makes sense that nurses’ voices should be
used to shape how health care is delivered.
Being a trustworthy, honest and intimately involved in
delivering health care are important in shaping how health
care is delivered. Currently there are many legislative bills
introduced in Michigan and nationally that affect recipients
Donna J. Craig,
RN, JD
and providers of health care. This article will summarize some of the legislative
bills and provide a primer on how to advocate in the legislative process.
National Legislation - H.R. 1195, The Workplace Violence Prevention
for Health Care and Social Service Workers Act, passed the House of
Representatives and has been referred to the Senate’s Committee on Health,
Education, Labor and Pensions. If enacted, the law would require health care
and social services employers develop and implement workplace violence
prevention plans, provide annual training and education to employees,
maintain detailed records of workplace violence risks, hazard assessments
and violent incidents, and submit annual summaries of such incidents to the
Secretary of Labor.
Michigan House Bills - The following legislation has passed the House
and has been referred to the Senate’s Health Policy and Human Services
Committee.
HB 4345 would require drug plans to give cost savings credits to
individuals when they purchase certain less expensive drugs from an out-ofnetwork
pharmacy.
HB 4346 would cap the cost of insulin and require health insurance plans
to cap the total amount a patient has to pay for insulin to $50 per 30 day
supply regardless of the amount or type of insulin.
HB 4352, would allow a pharmacist to provide the current selling price
of a drug or comparative current selling prices of generic and brand name
drugs without having to be asked by a patient. The bill would also prohibit
a pharmacy or pharmacist from entering into a contract prohibiting the
disclosure this information to patients. Penalties for violating this law include
imprisonment for up to 90 days or a fine of up to $100, or both, for a first
offense. For a second or subsequent offense, a person may be imprisoned
for at least 90 days, up to six months, or a fine of $200 to $500, or both.
HB 4356 would allow eye examinations and evaluations to be conducted
through telemedicine if both of the following requirements are met: (1) The
standard of care is maintained at the same level as if the examination and
evaluation were performed in person; and (2) The patient had an in-person
evaluation and examination within the immediately preceding five years.
HB 4358 would prohibit insurers that provide prescription drug coverage
from removing a covered prescription drug from its list of prescription drug,
add utilization management restrictions to a formulary or reclassify a drug
to a more restrictive drug tier, or move a drug to a higher cost-sharing tier
or a tier with a larger deductible, copayment, or coinsurance unless the Food
and Drug Administration (FDA) issues statements or labeling changes that
touch on safety questions of the drug, other generic equivalent or biosimilar
alternative drugs are approved by the FDA, or the drug changed from
prescription to over-the-counter.
HB 4359 would expand the scope of practice for certified registered nurse
anesthetists. Under the bill a CRNA’s scope of practice would be expanded to
allow a CRNA to provide anesthesia or analgesia services without supervision
and as the sole and independent anesthesia provider.
maintain such record for no less than 3 years. The record must include the
number of patients in each unit and the identity and duty hours of each direct
care registered nurse assigned to each patient in each unit for each shift. The
hospital would be required to make the record available to the Department
of Licensing and Regulatory Affairs, registered nurses at the hospital, and if
applicable, their collective bargaining representatives, and the public.
How To Become An Informed Advocate –
Michigan - Start your search by going to: http://www.legislature.mi.gov/
(S(ut2myg5h5yzeopx41euttvu5))/mileg.aspx?page=CategorySearch
• Choose a category to research
• Click on “Show Bills”
• A list of all House and Senate bills will be displayed
Advocating For Nurses And Patients...continued on page 11
Michigan Senate Bills
SB 205 (HB 4483, the identical bill) – the legislation would allow
a registered nurse to refuse a hospital’s request to work more than
predetermined regularly scheduled hours. The legislation would require
hospitals to provide registered nurses with eight consecutive hours of offduty
time immediately after registered nurses complete 12 hour shifts. The
limitation on hours would not apply if: (1) there is an unforeseen emergent
situation; (2) the registered nurse is assisting with a patient-care procedure
that extends beyond the registered nurse’s regularly scheduled hours and
the registered nurse’s immediate supervisor (not charge nurse) determines
the absence of the registered nurse during the procedure could have an
adverse effect on the patient; and (3) a registered nurse voluntarily accepts
a work assignment exceeding regular scheduled hours. The hospital could
not discharge or discipline, threaten to discharge or discipline, or otherwise
discriminate against an employed registered nurse for refusing to work
additional non-scheduled hours. A hospital that violates this law would be
subject to administrative sanctions of $1,000 per violation.
SB 206 – this legislative bill requires hospitals to create a record of actual
direct care registered nurse-to-patient ratios for each unit, for each shift, and

Page 4 The Future of Nursing in Michigan May, June, July 2021
Meet Your 2021 ANA-Michigan
Board Members
Your Input is
Needed!
Survey Assessing
Michigan Nurses’
Experience with
Electronic Health
Records
Documentation burden contributes to
burnout and workplace dissatisfaction. Nurses
know best what the challenges are and what
needs to be improved. If you use electronic
health records in your nursing practice, we
need your input!
ANA-Michigan is collaborating with the
Michigan Organization of Nurse Leaders
(MONL) on a research study that evaluates
nurses’ perspectives related to the usability
and usefulness of clinical information systems
used in patient care delivery. Your feedback
on the survey will help researchers, clinicians
and policymakers better understand nurses’
documentation burden and will inform
potential policies to reduce burnout and
improve care delivery. This study is part of a
larger collaboration with the Texas Nurses
Association and the Texas Organization for
Nursing Leadership that will allow for a stateto-state
comparison of data. Survey responses
are voluntary and confidential.
The survey will take 10-15 minutes
to complete and may be taken at your
convenience via the Internet. Survey
participation is voluntary, responses are
confidential, and results will be reported
as aggregated data. When the analysis is
complete, you can review the results in a
report posted on the ANA-Michigan or MONL
website.
If you use an electronic health record in
your practice, no matter what setting you
work in, please take this survey today to
make your voice heard. Please also encourage
your Michigan nurse colleagues to complete
the survey. We need nurses from all practice
settings and clinical roles to share their
perspectives.
The survey is available at: https://nursing.
ttuhsc.edu/surveys/ehr-michigan/ or from
the links available on the ANA-Michigan
and MONL websites. Thank you for your
willingness to share your valuable insights!

May, June, July 2021 The Future of Nursing in Michigan Page 5
Making Meaning of Nursing Workforce Data
Deborah Bach-Stante, RN, MPH
Office of Nursing Safety and
Workforce Planning
Michigan Department of
Health & Human Services
Since 2004, the state of
Michigan has supported
collection and analysis
of nursing workforce data. The information
contained in the associated reports are applied
for many purposes including state, regional
and local workforce planning, academic and
practice research, and grant writing efforts as
well as informing resource allocation. Over the
past several years the MDHHS Office of Nursing
Safety and Workforce Planning (ONP) has
worked with nursing stakeholders to improve
the alignment of the Michigan Nursing Licensure
Survey with national nursing workforce data
collection efforts to provide more actionable
data.
To further support the production of
actionable data, we will be enhancing the 2021
analysis to include a longitudinal comparison of
certain characteristics of the nursing workforce.
This longitudinal analysis will seek to elucidate
change in the diversity and educational
characteristics of the nursing workforce over
the past few years and further, to project how
continuation of current trends would impact
the nursing workforce of the future. Upon initial
review of the longitudinal data, we will devise
forums for seeking stakeholder input into an
analysis of the impact of recent shifts in the
healthcare academic and practice environments
and policies on the nursing workforce in
Michigan and determination of priorities for the
future of nursing.
Believing that it is not enough to say that
“we welcome the input of all stakeholders as
well as your participation in our stakeholder
meetings,” we will be working with a wide
variety of nursing organizations throughout
the state to provide multiple opportunities for
enhancing the diversity of the nurses engaged
in providing input into our review of the data
and determination of additional data needs. I
believe that broader representation from nurses
who may not typically use the data produced
from the survey in their own work, education,
or research efforts, will lead to a better
understanding of the factors impacting the
entire nursing workforce. To that end, I hope
that many of you will attend one of our listening
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sessions and share your insights with us as we
analyze the data collected in the 2021 survey
and the meaning of the longitudinal patterns in
the nursing workforce. More robust analysis of
the data will support the production of more
comprehensive recommendations and the
potential for more diversified actions to support
the future of nursing in Michigan through and
beyond 2030. Please reach out to your nursing
professional organizations in Michigan to learn
about opportunities to participate in listening
sessions as they are scheduled in the summer
and fall months of 2021.
You may also send an email to the MDHHS-
ONP to the attention of Michelle McNure,
McNurem@michigan.gov with your name,
and the email address at which you wish to be
notified of scheduled listening sessions, so you
may select a listening session that suits your
interests and availability.
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Page 6 The Future of Nursing in Michigan May, June, July 2021
The 2021 ANA-Michigan Conference was held virtually this year. Though it
was a first for virtual, it was not for innovative and captivating speakers. Dr.
Bonnie Clipper is always a font of innovative knowledge, keeping us all up to
date on her findings and technology best practices. Mr. Anton Gunn, Former
Senior Advisor to President Barack Obama, presented to us, How to be Like
Steel in the Hour of Chaos. Two notions Michigan nurses have been living by
this past year of the pandemic. The panel discussions went over unanimously
as we took a deep, intimate dive into microaggressions and trauma through
a nurse’s eyes. Both panels were active in the chat and by the end of each
session, we came up with a page of resources for attendees that we pushed
out on our very own virtual platform. Collectively, there were 22 virtual video
posters and best poster was awarded to Michael Martel, MSN, RN, AGCNS-
BC on, Providing Nurses with a Structured Approach to Emotional Support
During COVID-19. Nice work Michael! The day ended with a virtual happy
hour with prizes and smiles. Though we could not be together in-person,
networking and laughing together was bound to happen and proves to be
the glue that holds us together as an association.
ANA-Michigan’s Annual Meeting also took place during the virtual
conference. We are always honored to pay tribute to our outgoing board
members, the leadership pillars of our association. They show the way to our
incoming board members who bring new perspectives and experiences. We
would like to thank:
• Nancy Martin, Treasurer
• Margaret Calarco, Director
• Suzanne Keep, Director
We are always grateful for the sponsors and exhibitors who support our
mission and events. Much gratitude to our Champions of Nursing Partners
for this year’s conference.
Big shout out to our sponsors and exhibitors:
• American College of Education
• Chamberlain University
• Michigan Beef Industry Commission
• Michigan Clinicians for Climate Action (MiCCA)
• Michigan Health Council
• Nexcare Health System
• Ohio University
• Saginaw Valley State University
• U.S. Food & Drug Administration
• University of Michigan School of Nursing
To access electronic copies of
The Future of Nursing in Michigan, please visit
http://www.nursingALD.com/publications

May, June, July 2021 The Future of Nursing in Michigan Page 7
All of Us Research Program
Strives for More Inclusive
Health Care
By Gerardo O. Infante BSN, RN
President - National Association of Hispanic Nurses Michigan Chapter
Newly Licensed Director - American Nurses Association Michigan Chapter
Hispanic nurses embrace precision medicine and ensures Hispanics are
represented in medical research through the All of Us Research Program.
Since 2018, nurses from the National Association of Hispanic Nurses
Michigan Chapter (NAHN-MI) began educating Latino 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 individual populations
and 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 under-served 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 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 Michigan, along with
other Michigan professional organizations, are working hard to impact
change.
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 in this
database, researchers may uncover paths toward delivering personalized
preventative care and treatment for all populations.
Together, Hispanic nurses and other professional and community
organizations have educated and encouraged hundreds of diverse
community members and health care professionals to participate in this
initiative.
So far, over 370,000 individuals from all walks of life and around the
country 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 Michigan.
Visit www.ana-michigan.org

Page 8 The Future of Nursing in Michigan May, June, July 2021
Will Your Next Prescription be for the Pharmacy or the Farmacy?
Joanne Evans MEd, RN, PMHCNS-BC
Reprinted with permission by the
Indiana State Nurses Association
Almost 2500 years ago, Hippocrates said, “Let food be thy medicine and
medicine be thy food” (Smith, 2004). These words are still relevant today.
The leading causes of death in the United States from disease are heart
disease, followed by cancer, chronic lung disease, stroke, Alzheimer’s,
diabetes, and chronic kidney disease. (National Center of Health Statistics,
2021). Diabetes is increasing at a rapid rate in the U.S. (Diabetes Research
Institute, 2020). According to the Food and Drug Administration (FDA),
over 20,000 prescription drug products are approved for marketing (U.S.
Food and Drug Administration, 2018). The National Health and Nutrition
Examination Survey in 2015–2016 shows 45.8% of the U.S. population uses
prescription drugs (Martin, et al., 2019). Nearly 40% of older adults take five
or more prescription drugs. All medications, whether over-the-counter or
prescription medications, may have side effects, including nausea, fever,
chills, headaches, itching, wheezing, tightness in the chest, vomiting, red and
irritated eyes, and the list goes on. Pharmaceutical companies are the ones
that benefit the most from people being sick.
Is it possible that some chronic diseases could be prevented or reversed
through 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. Campbell and Campbell (2006), Esselstyn (2008), McDougall (2013),
Greger (2015), and Barnard (2020) have all discussed this in their publications.
Their research shows that plant-based nutrition prevents and reverses
heart disease, diabetes, and some cancers, decrease cholesterol, and
reduces blood sugar levels. Plant-based nutrition also decreases obesity and
complications from being overweight and improves mood, sleep, energy,
depression, and anxiety; reverses many chronic diseases and increases work
productivity.
In a research study conducted at ten corporate locations in the U.S., those
participants practicing plant-based nutrition (PBN) showed improvement in
body weight, blood sugar levels, and emotional state, including depression
and anxiety (Agarwal et al., 2015). 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, and the
longer the participants adhered to a healthy plant-based diet, the lower
their risk of cardiovascular disease (Esselstyn et al., 2014). Research shows
that obese patients who followed a plant-based diet had more weight loss
compared to those who followed a vegetarian and non-vegetarian diet that
included dairy, eggs, fish, or meat at two-month and six-month intervals
(Turner-McGrievy et al., 2015).
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, chickpeas, etc.
• Nuts and seeds
• Limited processed foods
• Avoiding oil, flour, and sugar
According to the American Association of Colleges of Nursing (2021),
there are over 3 million nurses, therefore it seems we could make a dramatic
change in health care for people in the U.S. if we shared information about
plant-based nutrition. Nurses 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 more.
I have conducted several 21-day plant-based programs utilizing the
free, online Kickstart Program published by the Physicians Committee for
Responsible Medicine (2021). The results were published in the American
Journal of Nursing (Evans et al., 2017) and the Holistic Nursing Association
Journal (2015). Laboratory data was collected and analyzed, and it found that
several participants lowered their cholesterol by as much as 59 points within
a 21-day period, while others lost weight and reported an improvement in
energy and sleep. (Evans, 2015).
In talking with nurses around the country, there seem to be many
reasons nurses do not share information about PBN. Some of the primary
reasons reported include nurses feel they did not know enough and were
worried they could not answer the patient’s questions; they thought it was
too difficult; did not know whom to refer patients to; thought it may be
too expensive to adhere to a PBN diet; and thought patients may not be
interested (Evans, 2020).
When I spoke with nurses around the U.S., they shared that this form of
nutritional information was not presented to them in nursing schools. All
the nurses who interviewed for my book, Cultivating Seeds of Health with
Plant-Based Nutrition, Nurses Share Educational Approaches to Prevent and
Reverse Chronic Disease (Evans, 2020), 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 (2006) or saw the
movie Forks Over Knives, both of which convinced them that PBN was the
way to treat many chronic diseases (Evans, 2020).
Once nurses become knowledgeable about PBN, they have many
opportunities to share this information, including:
- Talking with colleagues about plant-based nutrition
- Having plant-based food at all meetings and conferences
- Hosting monthly potlucks or lunches with colleagues and community
groups
- Showing movies on PBN and discuss the information provided
- Asking more detailed questions about nutrition on intakes with
patients, including:
• How many fruits did you eat in the past 24-48 hours?
• How many vegetables did you eat in the past 24-48 hours?
• How many portions of dairy food did you eat in the past 24-48 hours?
• How many portions of meat did you eat in the past 24-48 hours?
• Have them complete a nutritional assessment - http://4leafsurvey.com
- Having discharge and care plans include plant-based nutrition
- Requesting PBN guest speakers in educational settings for
undergraduate and graduate level nursing programs
- Incorporating PBN into all discussions about chronic diseases
- Collaborating with other health care providers interested in plant-based
nutrition
- Encouraging hospitals to have plant-based foods at all meals
- Hosting a free online 10-day plant-based program https://www.
drmcdougall.com/health/education/free-mcdougall-program/ or hosting
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 for nurses interested in learning more
about plant-based nutrition. PCRM hosts the Nurses Nutrition Network,
which provideseducational programs for nurses (https://www.pcrm.org/
good-nutrition/nutrition-for-clinicians/nurses-nutrition-network).
The American College of Lifestyle Medicine has a nurse support group
and provides educational presentations open to all nurses. https://
lifestylemedicine.org/What-is-Lifestyle-Medicine.
Our patients need to have a choice on how they will resolve their
chronic health issues, and nurses are well-positioned to educate patients
on nutritional options to help prevent and possibly reverse many chronic
diseases. Patients should be given all the options to make an educated
decision about their health. Sometimes it starts with medications while

May, June, July 2021 The Future of Nursing in Michigan Page 9
they are making nutrition and lifestyle changes.
Eventually, it may be the nutritional changes that
reverse the chronic disease process. Let 2021 be
the year of change!
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 meatfree
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:
• Davis, B., & Vesanto, M. (2013). Becoming
vegan, express edition: The everyday guide to
plant-based nutrition. Book Pub Co.
• Campbell, T. C., & Campbell,T. (2004). The
China Study. Startling implications for diet,
weight loss and long-term health. BenBella
Books.
• Greger, M., & Stone, G. (2015). How not to diet:
Discover the foods scientifically to prevent and
reverse disease. Flatiron Books.
• Greger, M. (2019). How not to diet. Flatiron
Books.
• McDougall, J. (2013). The starch solution.
Rodale Books.
• Barnard, N. (2018). The vegan starter kit:
Everything you need to know about plantbased
eating. Grand Central Publishing.
• Esselstyn, C. (2007). Prevent and reverse heart
disease. Avery Publishing.
Cookbooks include:
• Barnard, N, Burton, D. (2018). Dr. Neal
Barnard's cookbook for reversing diabetes: 150
recipes scientifically proven to reverse diabetes
without drugs. Rodale Books.
• Campbell, L. (2018). The China study cookbook.
Benbella Books.
• Esselstyn, R., & Esselstyn, J. (2017). Engine 2
cookbook. Grand Central Publishing.
• Sroufe, D., Moskowitz, I., Hever, J., Thacker,
D., & Micklewright, J.(2012). Forks over
knives―The Cookbook: Over 300 recipes for
plant-based eating all through the year. The
Experiment.
• Barnard, N. (2010). The get healthy, go vegan
cookbook: 125 easy and delicious recipes to
jump-start weight loss and help you feel great.
Da Capo Lifelong Books.
• Greger, M. (2017). How not to diet cookbook.
Flatiron Books.
• McDougall, J., & McDougall, M. (1999). The
McDougall quick and easy cookbook: Over 300
delicious low-fat recipes you can prepare in
fifteen minutes or less. Plume Publishing.
• Esselstyn, A., & Esselstyn, J. (2014). Prevent
and reverse heart disease cookbook. Avery
Publishers.
Websites:
• 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, and handouts
for offices
• Forks Over Knives - https://www.
forksoverknives.com/ - recipes, plant-based
news, meal plans, success stories, and
cooking courses
• Plantrician Project - https://plantricianproject.
org/vision - list of plant-based doctors, peer
review journal, conferences, cooking class,
research, and more
Apps:
• 21-Day Vegan Kickstart – PCRM
• Dr. McDougall Mobile Cookbook
• Forks Over Knives
• Michael Greger - Dr. Gregers’ Daily Dozen
Will Your Next Prescription be for..continued on page 10

Page 10 The Future of Nursing in Michigan May, June, July 2021
Nurse Leadership Academy
Effective leadership in today’s healthcare
environment has never been more challenging
or rewarding. Nurse leaders are called upon
to juggle multiple priorities, make numerous
decisions, ensure safe, quality patient care, coach
and mentor staff and the list goes on and on.
Development of long lasting, effective leadership
and management skills is essential for nurses and
the organizations for which they work.
The ANA-Michigan Nurse Leadership
Academy is a six-day intensive program that
is designed to help nurses on a leadership
trajectory learn from leading experts in an
interactive, collaborative environment. Through
classroom experiences, ongoing interaction
with the faculty, networking with peers and
project development, participants will become
part of the growing community of Michigan
nurse leaders.
This program will provide emerging
and seasoned nurse leaders with many
opportunities to acquire new skills and build
upon existing ones – a proven formula for
success.
Register today at http://bit.ly/
ANAMILeadershipAcademy
Count Me In
Campaign
The COVID-19 Vaccine Education and Equity
Project now counts more than 175 patient,
provider, employer and public health organizations
that have come together to advance public
education and equity around COVID-19 vaccines.
One of the goals of the “Count Me In” campaign
is to motivate and inspire people to collectively
fight the pandemic. With the campaign’s
online photo wall and spotlight stories we are
highlighting the individuals and organizations
stepping up to share the reasons why they want to
be “counted in” for COVID-19 vaccination.
We want to encourage ANA-Michigan members
to add their photo and story to the wall. Share
your story here: covidvaccineproject.org/
CountMeIn
Will Your Next Prescription be for..continued from page 9
Plant-based movies include:
• 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
References
Agarwal, U., Mishra, S., Xu., J., Levin, S., Gonzales, J.,
& 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. American
Journal of Health Promotion, 29(4), 245-5. doi:
10.4278/ajhp.130218-QUAN-72
American Association of Colleges of Nursing. (2021).
Nursing fact sheet. https://www.aacnnursing.org/
news-Information/fact-sheets/nursing-fact-sheet
Barnard, N. (2020). Your body in balance: The new
science, of food, hormones, and health. Grand Central
Publishing.
Campbell, T. C., & Campbell, T. (2006). The China study.
Benbella books.
Diabetes Research Institute. (2020). Diabetes statistics.
https://www.diabetesresearch.org/diabetesstatistics
Esselstyn, C. B. Gendy, G., Doyle, J., Golubic, M., &
Roizen, M. F. (2014). A way to reverse CAD? Journal of
Family Practice; 63(7):356-64.
Esselstyn, C. (2008). Prevent and reverse heart disease.
Avery Publishing.
Evans, J. (2015). Plant-based nutrition: Will the next
prescription be from the farmers market or the
pharmacy. American Journal of Holistic Nursing,
35(2):28-9.
Evans, J. (2020). Cultivating seeds of health with plantbased
nutrition: Nurses share educational approaches
to prevent and reverse chronic disease. https://www.
amazon.com/Cultivating-Seeds-Health-Plant-based-
Nutrition/dp/B08GFSYGJJ
Evans, J., Magee, A., Dickman, K., Sutter, R., & Sutter,
C. (2017, March). A plant-based program – nurses
experience the benefits and challenges of following
a plant-based diet. American Journal of Nursing,
117(3), 56-61.
Greger, M. (2015). How not to diet. Flatiron Books
Martin, C. B., Hales, C. M., Gu, Q., & Ogden, C. L. (2019).
Prescription drug use in the United States, 2015–2016.
(Issue Brief No. 334). NCHS Data Brief. Hyattsville,
MD: National Center for Health Statistics. https://
www.cdc.gov/nchs/products/databriefs/db334.htm
McDougall, J. (2013). The Starch solution. Rodale Books.
National Center of Health Statistics. (2021, March 1).
Leading causes of death. https://www.cdc.gov/nchs/
fastats/leading-causes-of-death.htm
Physicians Committee for Responsible Medicine
(PCRM). (2021). Start your journey to health. https://
kickstart.pcrm.org.
Smith, R. (2004). Let food be thy medicine. BMJ,
328(7433). https://www.ncbi.nlm.nih.gov/pmc/
articles/PMC318470/
Turner-McGrievy, G. M., Davidson, C. R., Wingard, E.
E., Wilcox, S., & Frongillo, E. A. (2015). Comparative
effectiveness of plant-based diets for weight loss: A
randomized controlled trial of five different diets.
Nutrition, 31(2), 350-8. https://doi.org/10.1016/j.
nut.2014.09.002
U.S. Food and Drug Administration. (2018). Fact Sheet –
FDA at a glance. https://www.fda.gov/about-fda/fdabasics/fact-sheet-fda-glance

May, June, July 2021 The Future of Nursing in Michigan Page 11
Advocating For Nurses And Patients...continued from page 3
• Click on any Document to learn more about
the legislation, such as:
o When the bill was introduced and who
sponsored the legislation
o The current committee assigned the bill
o The progress of the bill
o When the bill passes the Senate, House and
when it is signed into law
o To learn more about who sits on and chairs
committees, click on the name of the
respective committee
o Depending on where the bill is in the
legislative process, an analysis of the bill
may also be available.
Federal Legislation – To learn more about
federal legislation, go to: https://www.congress.
gov/
The link provides a wealth of information,
including:
• The legislative bills most viewed (Top 20)
• Bills being considered by the House and
Senate
• On the right side of the page, are links to the
text of bills, sponsorships, etc.
• On the left side of the page, click on “Bills
to be Considered” to review PDF files of the
bills’ text.
Contacting your Legislator – If there is particular
legislation that you have an opinion on, let your
legislator know. You can either call a legislator’s
office and provide your opinion or contact them
by email. I have found the most effective way to
make your opinion known is to participate in the
legislators’ office hours or district hours/coffee
hours. Currently they are being conducted by
Zoom instead of in person. I make it a practice to
attend my legislator’s monthly briefings and coffee
hours. This allows me and my legislators to get
to know each other so when an important piece
of legislation is introduced, we can build on an
established relationship.
Reaching out to your legislator in a respectful
manner allows for better dialogue going forward.
This dialogue also sends a very strong message
that what legislators do and how they vote affects
their constituents. Building a relationship with
your legislators also lets them know they will be
held accountable. If you decide to personally talk
with your legislators remember they are very busy,
so you need to limit your time to 10-15 minutes.
Be succinct, ask specific, targeted questions,
know the details of the legislation, tell them why
you oppose or support legislation, and offer
background information or documents to support
your position. If you follow these simply rules, you
will be an effective advocate.
Donna J. Craig, RN, JD is legal counsel to the ANA-
Michigan Chapter and the Michigan Council of Nurse
Practitioners. She practiced as a cardiac care nurse
for several years before a chance opportunity to
audit a graduate course in health care law and ethics
changed her career path. That course propelled
her to earn her law degree. After law school Ms.
Craig joined a medical malpractice defense law
firm before transitioning her focus to health care
corporate and administrative law matters. For over
20 years she has maintained her private health
law practice, representing health care providers
and facilities in business, licensure and compliance
matters. For her expertise and accomplishments,
Detroit’s dbusiness Magazine awarded Ms. Craig
its Top Lawyer in Health Care Law award on three
occasions. Ms. Craig has the distinction and is proud
of being a bar member of the Supreme Court of the
United States of America. For more information
about The Health Law Center, go to www.
healthlawcenterplc.com.

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