Montana Pulse - May 2022

May 2022 • Vol. 59 • No. 2
THE OFFICIAL PUBLICATION OF THE MONTANA NURSES ASSOCIATION FOUNDATION
Quarterly publication distributed to approximately 13,000 RNs and LPNs in Montana.
Executive Director Report
What a case like this should do for us…
Shared Governance In The
Health Care Organization: United
We Stand—Divided We Fall
current resident or
Page 10
Legislation Update - HB 707
Page 14
Non-Profit Org.
U.S. Postage Paid
Princeton, MN
Permit No. 14
Many nurses have inquired
about the recent RaDonda
Vaught case, where a nurse,
following a medication error in
late 2017, was convicted by a
jury of negligent homicide and
gross neglect of an impaired
adult.
First and foremost, the
Montana Nurses Association
extends our deepest
sympathies to the family
who has suffered this loss,
furthermore, we extend our
sympathies to all the families
impacted by this tragedy.
Vicky Byrd, MSN, RN
Chief Executive
Officer
What a case like this should do for all of us is give
us pause to reflect on our own practices, reflect on
how we adhere to safe medication administration
practices ourselves, and what do we do to maintain
safe practice?
A difficult but very necessary part of providing care
means disclosing errors when they occur and MNA
is concerned that nurses may now feel intimidated or
fearful about divulging mistakes in their reporting and
documentation.
Nurses need to continue to report through your
institutions’ processes, policies, and procedures,
any errors or safety incidents that deviate from safe
practice or any “near misses” to be proactive. This
allows these incidents to be thoroughly investigated
adhering to the organization’s values, mission,
integrity, and commitment to all affected.
Nurses are taught medication administration rights,
and many situations (flawed systems, cultures of
fear, lack of accountability etc…) can contribute to
a deviation from safe practice and policy. Perhaps
most of these are small deviations, however, the
consequences or outcomes can range from little to
no effect, up to the most devastating effect, a patient’s
death.
Safety, and a Just, fair, and open Culture is within
each of us, within the unit or department, and
the organization as a whole, including all the
healthcare and supportive staff. Shared accountability,
collaboration, and transparency are critical to create
a learning culture, designing safe systems, and
managing behavioral choices.
MNA supports the implementation of safety
systems to foster reporting, learning and a culture of
trust. These systems should include the development
of processes that support the improvement of patient
care. This includes the involvement of direct care
nurses at all levels to be a part of the development of
system changes that enhance the quality of patient
care across the continuum.
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Page 2 Montana Nurses Association Pulse May, June, July 2022
PUBLISHER INFORMATION
& AD RATES
Circulation 18,000. Provided to every registered
nurse, licensed practical nurse, nursing student
and nurse-related employer in Montana. The
Pulse is published quarterly each February, May,
August and November by Arthur L. Davis Publishing
Agency, Inc. for Montana Nurses Association, 20 Old
Montana State Highway, Montana City, MT 59634,
a constituent member of the American Nurses
Association.
For advertising rates and information, please
contact Arthur L. Davis Publishing Agency, Inc.,
517 Washington Street, PO Box 216, Cedar Falls,
Iowa 50613, (800) 626-4081, sales@aldpub.com.
MNA 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 Montana Nurses
Association 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. MNA 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 MNA or those of the national or local
associations.
WRITER’S GUIDELINES:
MNA welcomes the submission of articles and
editorials related to nursing or about Montana nurses
for publication in The PULSE. Please limit word size
between 500 – 1000 words and provide resources
and references. MNA has the Right to accept, edit or
reject proposed material. Please send articles to:
jennifer@mtnurses.org
If you wish to no longer receive
The Pulse please contact Monique:
mheddens@aldpub.com
If your address has changed please
contact Montana Board of Nursing
at: www.nurse.mt.gov
PULSE SUBMISSIONS
We are gathering articles that are relevant
and appealing to YOU as a nurse. What
is happening in your world today? Is there
information we can provide that would be
helpful to you? The Pulse is YOUR publication,
and we want to present you with content that
pertains to your interests.
Please submit your ideas and
suggestions to Jennifer.
Jennifer@mtnurses.org
Enjoy a user friendly layout and access to more
information, including membership material,
labor resources, Independent Study Library,
a new Career Center for Job Seekers &
Employers, and more downloadable information.
Please visit
MNA’s constantly updated website!
www.mtnurses.org
CONTACT MNA
Montana Nurses Association
20 Old Montana State Highway, Clancy, MT 59634
Phone (406) 442-6710 | Fax (406) 442-1841
Email: info@mtnurses.org | Website: www.mtnurses.org
Office Hours: 7:30 a.m.-4:00 p.m. | Monday through Friday
VOICE OF NURSES IN MONTANA
MNA is a non-profit, membership organization that advocates for nurse
competency, scope of practice, patient safety, continuing education, and
improved healthcare delivery and access. MNA members serve on the
following Councils and other committees to achieve our mission:
• Council on Practice & Government Affairs (CPGA)
• Council on Economic & General Welfare (E&GW)
• Council on Professional Development (CPD)
• Council on Advanced Practice (CAP)
MISSION STATEMENT
The Montana Nurses Association promotes professional nursing practice,
standards and education; represents professional nurses; and provides
nursing leadership in promoting high quality health care.
PROFESSIONAL DEVELOPMENT
Montana Nurses Association is accredited with distinction as an approver
of nursing continuing professional development by the American Nurses
Credentialing Center’s Commission on Accreditation.
Montana Nurses Association is accredited with distinction as a provider
of nursing continuing professional development by the American Nurses
Credentialing Center’s Commission on Accreditation.
MNA Staff
Vicky Byrd, MSN, RN, Chief Executive Officer
Kristi Anderson, MN, RN, NPD-BC, CNL
Kelly Hunt, MN, RN, CNL, Director of Professional Development
Jennifer Hamilton, Professional Development Associate
Megan Hamilton, MSN, RN CFRN, NR-P, Nurse Planner & Professional
Development Generalist
Robin Haux, BS, Labor Program Director
Amy Hauschild, BSN, RN, Labor Representative
Leslie Shepherd, BSN,RN, Labor Representative
Emily Peterson, Labor Representative
Makenna Sellers, Labor Organizer
Jill Hindoien, BS, Chief Financial Officer
Position
Board of Directors President
Board of Directors Vice President
Board of Directors Secretary
Board of Directors Treasurer
Board of Directors Member at Large
Board of Directors CPGA
Board of Directors PD
Board of Directors CAP
Board of Directors EGW
MNA Board of Directors
Name
Anna Svendson Ammons, BSN, RN, PCCN
Rachel Clark, BSN, RN
Melissa Anderson, BSN, RN
Audrey Dee, RN
VACANT
Deborah Kalarchik, MSN, BSN, RN
Deborah Lee, BSN, RN-BC, CCRP
Deanna Babb, APRN, FNP-BC, FAANP
Brandi Breth, BSN, RN-BC
Council on Practice & Government Affairs (CPGA)
Lucy Ednie, BA, MBA, ASN, RN-BC Charlotte Skinner, BSN, RN-C
Loni Conley, BSN, RN
Melissa Anderson, BSN, RN
Paul Lee, CCRN
Council on Professional Development (PD)
Joe Poole, BSN, RN, CHSE
Brenda Donaldson, BA, RN, CAPA
Gwyn Palchak, BSN, RN-BC, ACM Janet Smith, MN, MSHS, RN
Rachel Huleatt-Baer, MN, RN, CNL, OCN, Sally (Lisa) Sluder, DNP, APRN,
Charlotte Skinner, BSN, RN-C AGACNP-BC
Stephanie Corder, RN, ND, CHCP
Council on Advanced Practice (CAP)
Chairperson-CAP
Margaret Hammersla, BSN, MS, PhD,
ANP-BC
Chairperson Elect-CAP
Secretary-CAP
Ann Galloway, PhD, FNP-C
Member at Large-CAP
Sally (Lisa) Sluder, DNP, APRN,
AGACNP-BC
Member at Large-CAP
Deven Robinson, MSN, FNP, PMHNP
Council on Economic & General Welfare (E&GW)
Delayne Stahl, RN, OCN
Adrianne Harrison, RN
Stacey Sheehan, BSN, RN
Robin Foley, BSN, RN CEN
Questions about your nursing license?
Contact Montana Board of Nursing at: www.nurse.mt.gov

May, June, July 2022 Montana Nurses Association Pulse Page 3
Membership reminders….
Please check your membership status.
If you fall into any of the below categories, you could qualify for the
‘Professional Reduced Rate’ $38.65/month. Your rate will not automatically
change. You must let us know.
• You are a new graduate. You must apply within the first six months
after receiving your initial RN licensure and this rate is good for one
year.
• You are an RN in a full-time study program working towards a higher
degree. You will need to provide proof of enrollment and you could
receive this rate for up to three years.
• You are an RN 65+ year of age who is licensed and working. You
could receive this rate for the remainder of your employment.
• If you are a retired RN and are no longer working or hold an RN
licensure you could be eligible for the retired rate of $13.07/month.
If you are working in a collective bargaining position and move into a
non-collective bargaining position, please contact the Montana Nurses
Association to let us know. Your membership dues will continue to be paid
until you authorize them to be discontinued. Please remember, only you
can cancel your membership and membership payments.
To provide MNA with information on your status or to receive
additional information on MNA membership please e-mail Jill Hindoien at
jill@mtnurses.org.
CONGRATULATIONS TO THE FOLLOWING NURSES WHO HAVE
TAKEN ADVANTAGE OF THE SUCCESS PAYS OFFERING BY ANCC
TO MNA MEMBERS!
1. Sarah S Levea, RN-BC-Cardiac/Vascular Nursing
2. Linda Phillips, RN-BC-Medical Surgical Nursing
New Member Benefit: MNA now offers certification
through ANCC’s Success Pays ® Program
> Reduced fee for MNA Members to obtain initial certification
or recertify
> No cost if you don’t pass the exam; you can also take the
exam a second time at no cost
> Pay only when you pass!
> Identify your specialty practice area
How Success Pays ® Works
> Visit nursingworld.org/our-certifications/ to:
• Make sure you’re eligible to sit for the exam
• Look at the test blueprint and test preparation materials
• Make the decision to move forward
> Visit www.mtnurses.org and click on Success Pays ® option
to the left and sign up for the program!
> MNA will contact you regarding how to get the benefit.
Visit nursingALD.com today!
Search job listings
in all 50 states, and filter by location and credentials.
Browse our online database
of articles and content.
Find events
for nursing professionals in your area.
Your always-on resource for
nursing jobs, research, and events.

Page 4 Montana Nurses Association Pulse May, June, July 2022
Fair Contracts Take a Village
In March, I was grateful for the opportunity to join the
members of one of our locals for their contract negotiation
sessions. While the process is ongoing and many topics
are still being discussed at the bargaining table, one thing
impressed me from the onset: the union nurses embody the
principles we teach for effective collective bargaining and
collaborative decision-making. The entire bargaining team
is engaged, committed, respectful, and persistent. They are
welcoming to other local unit nurses outside the bargaining
team as well. Non-bargaining team nurses play a role in the
negotiations process by becoming observers. This large
amount of participation in the process fills me with pride and
gratitude. The constructive energy in the room is palpable.
One nurse mentioned, “I don’t think people realize how much
Labor Reports and News
Makenna Sellers
Labor Organizer
you can contribute to the contract as an observer. My ideas are valued on an equal
playing field with the bargaining team and with other observers as we work to find
creative solutions. The process isn’t always easy, but it is absolutely worth it.”
When nurses come together collectively for shared goals, it is a reminder that
we become part of something bigger than ourselves when we’re part of our union.
Sometimes, that foundational truth about our work can get lost in the hustle and
bustle of zoom meetings, busy lives, full schedules, and seemingly insurmountable
workloads. It is important to remember that our collective goals transcend the scope
of the individual. It is my hope that we see and experience this reminder not only at the
bargaining table, but also each day that we strive together for the best nursing practice
we can offer in the great state of Montana.
If your local unit is interested in having observers present at contract negotiations,
start that conversation by emailing makenna@mtnurses.org.
Congratulations Gabert Clinic Nurses!
The Gabert Clinic Nurses and the MNA Local #21
President and Glendive Medical Center have completed
negotiations and the additional contract language specific
to the clinic nurses has been ratified by the membership!
On October 18, 2021, after a unanimous election, the
National Labor Relations Board NLRB certified the Gabert
Clinic Nurses as being included in MNA Local #21. The
parties then engaged in bargaining over the “effects” of
adding the clinic nurses to the contract. They reached an
agreement during their seventh bargaining session and
were assisted by one of the mediators from the Federal
Mediation and Conciliation Service FMCS.
Previously, the contract did not include the clinic nurses
though it covered the other staff nurses at the hospital. It
is not unusual to have multiple groups of nurses working in
Amy Hauschild,
BSN, RN, Labor
Representative
different areas of a facility covered by the same agreement. Since these negotiations
only covered the effects of adding the clinic nurses, the original expiration date of the
contract remained the same, November 31, 2023.
The Benefits of Your
Pre-Bargaining Survey
As our contract negotiations for 2022 are underway,
your MNA Labor staff begins the task of early negotiation
preparation. One of our favorite tools is a “Pre-Bargaining
Survey” which allows your representatives to get their
finger on the pulse of the local unit as a whole. It allows
for each nurse within a bargaining unit to provide input into
the items a negotiating team will present at the bargaining
table. It provides EVERY nurse the opportunity to provide
input, and that input is greatly beneficial at the bargaining
table.
How do we create the survey? A Pre-Bargaining
survey is created out of pre-bargaining discussions with a
local unit. As your labor representatives begin bargaining
discussions, they listen for the issues the nurses raise
and create survey questions that allow us to gather
Robin Haux, BS
Labor Program
Director
more detailed information on how the majority of the local feels, and what the
best direction to take at negotiations may be. Additionally, we review the existing
contract and create questions that give the nurses the ability to rank issues by
level of importance. We also offer an area that allows for open comments on most
questions. The most important part of creating a survey is input from the nurses.
We encourage every nurse to participate in the creation, drafting, and participation
of the survey. Additionally, peer-to-peer discussions are the best way to encourage
your co-workers to participate.
Why is a pre-bargaining survey important? There are many benefits to a prebargaining
survey. First, as mentioned above, it allows for the MNA labor staff
to gather a more complete picture of the direction the local unit wants to take at
their negotiations and again, provide every nurse the opportunity to have their
thoughts and ideas heard. Any opportunity for your labor representatives and
negotiating team to use phrases such as: “all the nurses feel…” or “90% percent
of the nurses want …” helps your team make a better argument at the table. We
cannot underscore enough the importance of each nurse taking a few minutes to
participate in their survey. A low survey participation rate reduces the effectiveness
of the survey at the table.
When your local unit has upcoming negotiations, remember the importance of
the Pre-Bargaining Survey! Ask your labor representative to help your local develop
the survey and each of you encourage all the nurses to participate! Participation is
crucial towards the effectiveness!
Weingarten Rights
If this discussion could in any way lead to my being
disciplined or terminated, or affect my personal
working conditions, I respectfully request that my
Union/Unit Representative or Nurse Advocate be
present at this meeting.
Until my representative arrives, I choose not to
participate in this discussion
When Your Employer Notifies You of a Meeting...
*Immediately ask your Supervisor/Manager/Director:
• “What is the purpose of the meeting?”
• “Is the meeting investigatory?”
• “Will I be asked questions which may possibly lead to discipline?”
• “Will I be asked questions which require me to defend my conduct?”
If the meeting is investigatory or answers may
lead to discipline:
_ #1 – Respectfully inform your employer you are invoking
your Weingarten Rights & will need to have your Union/Unit
Representative or Nurse Advocate present during questioning.
_ #2 – Quickly arrange for your Union/Unit Representative or
Nurses Advocate to attend the meeting.

May, June, July 2022 Montana Nurses Association Pulse Page 5
Labor Reports and News
Grievance Part 4: What’s next?
While the goal of the
grievance process is to find
a resolution at the earliest
possible step, there are
occasions where a resolution
is not found during those first
steps in the process.
Every contract is slightly
different regarding how to
advance a grievance once
you’ve reached the end of the
internal process. The most
common language that I have
seen allows for two options to
move the grievance forward,
mediation and/or arbitration.
Leslie Shepherd,
BSN, RN, Labor
Representative
Mediation is a process that utilizes a neutral thirdparty
mediator to assist the parties in reaching an
agreed upon resolution. The Federation of Mediation
and Conciliation Services (FMCS) is a very commonly
used agency that provides free mediation services
for grievance mediation and mediated contract
negotiations. During mediation, both parties have the
ability to directly influence what the resolution looks
like. The mediator’s role is not to pass judgement or
determine who is right or wrong in the matter. The
mediator’s role is to help facilitate both parties to
reach an agreement. It is imperative that both parties
agree to mediate a grievance, because true mediation
does not work without the willing participation of both
parties.
Arbitration is a process where a third-party arbitrator
hears the case, presented by each of the parties. This is
similar to what you might expect in a court case. Each
party gets to present their case and call witnesses. The
arbitrator, who is typically determined mutually by the
parties, hears the case, and makes a binding decision
on the outcome of the grievance. The arbitrator will
typically consider the case and the resolution listed on
the grievance form into consideration when determining
how a grievance shall be resolved. This process does
not require both parties to agree to participate like
mediation because it is the arbitrator making the final
decision regardless of the opinion of either party.
Some contracts will allow for a grievance to
attempt to be resolved through mediation in an effort
to avoid taking the grievance to arbitration, which is
more costly in the end to both parties. This is solely
dependent on the language in your contract. Typically,
if the parties agree to attempt mediation first, the
timeline to allow for arbitration is put on hold until
mediation is concluded. If a resolution is not found
through mediation, the grievant has the opportunity to
advance to arbitration.
At MNA, arbitration is not guaranteed for every
grievance. Firstly because of the contract language,
some contracts only allow for certain grievances
to advance all the way to arbitration. Secondly
because MNA utilizes an Arbitration Review Panel to
determine if the association will advance a grievance
to arbitration. The arbitration review panel consists
of elected nurse members of the Economic &
General Welfare committee (EGW), the MNA Labor
Program Director, and MNA’s labor attorney. The
panel hears the grievance presented by the labor
representative who has been working with the
grievant and local union. Then, based on the facts
presented, the panel decides if the grievance will
advance. If the panel decides to not advance the
grievance, the grievant may appeal this decision for
additional review.
Either way, the goal of a grievance is always to find
a resolution. Ideally this happens at Step 1, however
the process outlined in your contract creates a
pathway for grievances to be resolved at whatever
level necessary. If you ever have questions about a
potential grievance or contract violation, I encourage
you to consult your contract and reach out to your
union leaders and/or MNA Labor Representative.
Consider a Tax-Deductible
Donation to:
Montana Nurses
Association
Foundation – (MNAF)
➢ Donations to the MNAF foundation
are 100% tax deductible.
➢ MNAF mission statement: “The
Montana Nurses Association
Foundation (MNAF) is the charitable
and philanthropic branch of the
Montana Nurses Association (MNA),
with a mission to preserve the
history of nursing in Montana and
contribute, support and empower the
professional nurse in Montana.”
➢ The purposes for which the
Corporation is organized are as
follows:
“(a) charitable; (b) educational; (c) to
accept healthcare/nursing research
and educational grants; (d) to provide
continuing educational grants to
licensed registered nurses; and (e)
to award scholarships to qualifying
persons.”

Page 6 Montana Nurses Association Pulse May, June, July 2022
2021-2022 MNA Government Relations Platform-
Approved 10/8/21
Montana Nurses’ Association (MNA) is the nonprofit professional association
representing the voice of nearly 18,000 Registered Nurses (RNs) in Montana
including more than 1,000 licensed as Advanced Practice Registered Nurses
(APRNs). MNA is the recognized professional organization, which lobbies for
nursing practice issues to protect the practice of professional nurses and also
protect the public in all areas of health care.
MNA is the recognized leader and advocate for the professional nurse in
Montana.
MNA Mission Statement: The Montana Nurses Association promotes
professional nursing practice, standards and education; represents professional
nurses; and provides nursing leadership in promoting high quality health care.
1. Improve the quality of nursing practice by:
a. Providing educational and professional development opportunities that
contribute to improving practice competency and quality of patient care.
b. Identifying and pursuing funding opportunities to assist in providing
continuing nursing education and nursing continuing professional
development.
c. Identifying and pursuing funding sources that support research/projects
to develop evidence based and innovative nursing practice.
d. Promoting national certification of Registered Nurses.
e. Active representation on local, state and national advisory committees/
boards.
f. Supporting the regulatory authority of and collaborating with the
Montana Board of Nursing (BON) on nursing practice and regulatory
issues.
g. Encouraging transparency and promoting communication from the
Montana Board of Nursing regarding relationship with NCSBN (National
Council of State Boards of Nursing) and votes/legislation/regulatory
policy changes affecting regulation of registered nurses.
h. Providing input into the implementation and enforcement of NCSBN
Nurse Licensure Compact (NLC).
i. Opposing the NCSBN APRN Nurse Licensure Compact legislation.
2. Protect the economic and general welfare of nurses by:
a. Actively engaging in legislation and campaigns that positively contribute
to the economic and general welfare of RNs.
b. Ensuring the right of RNs to engage in collective bargaining in Montana.
c. Opposing any “Right to Work” (anti-collective bargaining, anti-labor)
legislation to uphold the “Blue Eyed Nurse” bill from 1967, authored by
the late Mary Munger, RN, and former MNA member.
d. Addressing workplace environment issues including violence against
healthcare workers, safe staffing, infectious disease, and patient safety.
e. Advocating for legislation prohibiting mandatory overtime.
d. Mandate third party reimbursements directly to RNs from public and
private payers.
e. Remove barriers (financial, governmental, regulatory, and/or institutional)
that deny access to appropriate/qualified health care providers and
approved medical standard of care treatments.
f. Advocate for legislation that is transparent and bipartisan and support
policies that can achieve evidence based real healthcare reform.
g. Promote community and world health by collaborating with other health
professionals to promote health diplomacy and reduce health disparities.
4. Protect human rights by developing and/or supporting public policies which:
a. Promote access to appropriate health services.
b. Preserve individual rights to privacy.
c. Promote, debate and have consideration of ethical dilemmas in health
care
d. Protect nurses, healthcare employees, and the patient (MT community)
from public health emergencies.
5. Protect the environmental health of individuals and communities through:
a. Acknowledging, supporting and addressing environmental impacts on
the health of Montanans.
b. Actively engaging with national organizational affiliates in addressing
environmental health issues in our nation.
c. Supporting and promoting the work, data, and evidence from our public
health nurses.
6. Protecting and promoting the future of healthcare and nursing practice
through:
a. Actively engaging in legislation that supports professional scope
of nursing practice to the fullest extent of the nurses’ education,
professional development, and training.
b. Actively promoting programs and efforts that encourage professional
development and educational progression of professional nursing
practice at local, state, and national levels.
c. Representation on boards, committees and advisory groups which
influence the future of the nursing profession and the future of our state
and national healthcare system.
d. Engaging with healthcare partners and associations to work
collaboratively to ensure healthcare as a right for all American
populations.
e. Actively support science and evidence based data to drive strong
investment in safe quality public health programs at state and national
levels.
3. Improve access to quality, cost effective health care by developing and/or
supporting public policies which:
a. Identify the nurse’s primary commitment is to the patient, whether an
individual, family, group, community, or population.
b. Respond to the needs of the unserved and underserved populations by
promoting access to health care and healthcare coverage.
c. Identify or develop alternative health care delivery systems that are costeffective
and provide quality health care.
Montana’s Healthcare Mutual Aid System (MHMAS) is the Emergency System for the
Advance Registration of medical professionals and non-medical responders for the state of
Montana. MHMAS is a secure, web-based online registration system used to register, verify,
and credential volunteers before a major disaster or public health emergency occurs.
Registration is open to health and medical professionals, as well as non-medical volunteers
who would like the opportunity to volunteer to respond to “all-hazards” incidents. Your
involvement as a responder will help ensure that people affected by a disaster will receive the
public health and medical care they need. You will be able to update this information at any
time as changes occur. If approved, you will receive notification of your acceptance into the
system. You will from time to time receive notifications for upcoming educational and training
opportunities.
Please remember that “volunteer” truly means volunteer. You can choose, at any time,
to decline any request that you may receive for your deployment. Even though you are
volunteering your time, a majority of the deployment requests will be paid positions. The pay
for each deployment varies and will be announced at the time of the request.
Thank you for your interest in lending your skills and expertise to assist Montana during an
emergency.
If you would like more information or to register, please visit our web page:
https://dphhs.mt.gov/publichealth/PHEP/mhmas

May, June, July 2022 Montana Nurses Association Pulse Page 7
Professional Development Department
Nurse and Health Care Worker Well-Being – Additional Resources
There are two new resources to support nurse and
healthcare worker well-being:
1. The National Academy of Medicine Action Collaborative
on Clinician Well-Being and Resilience recently
provided tools for health care workers and leaders to
address burnout and improve well-being. The Resource
Compendium for Health Care Worker Well-Being
provides resources including six essential elements:
a. Advance Organizational Commitment-Organizational
commitment involves visible actions and investments
to show that a systematic approach to well-being is
being undertaken.
b. Strengthen Leadership Behaviors-Executive leaders
drive key decisions on managing staff and resources,
and health care workers can champion healthy
environments for their care teams and their patients.
Kristi Anderson,
MN, RN, NPD-BC, CNL
Director of Professional
Development
c. Conduct Workplace Assessment-Assessment is essential to understanding
the extent and severity of burnout, and the well-being of the members of any
workforce.
d. Examine Policies and Practices-Health care workers may experience moral
distress when the policies and practices of their organization conflict with their
professional commitment to patient care and ability to do their work. A resilient
organization will periodically reassess its policies and practices and eliminate
those that are no longer relevant or no longer required.
e. Enhance Workplace Efficiency-Workplace efficiency embodies practices that are
geared toward facilitating and streamlining staff duties while maintaining clinical
excellence.
f. Cultivate a Culture of Connection and Support-An organization can best support
its health care workforce by giving people the ability to do their jobs and then
allowing them to return safely home with time and emotional energy to engage in
their personal lives with their family, friends, and community.
2. The National Academy of Medicine highlights the factors impacting nurse well-being
while integrating interventions from employers, nursing education, nurse leaders,
licensing boards, and nursing organizations. The Future of Nursing 2020-2030:
Montana Nurses Association
Approved Providers
MNA thanks all of the Approved Provider Units we work with for their
commitment to advancing and promoting quality nursing practice through
continuing nursing education.
Alaska Native Tribal Health Consortium
Anchorage, AK
Alaska Nurses Association
Anchorage, AK
Alzheimer’s Resource of Alaska
Anchorage, AK
Bartlett Regional Hospital
Juneau, AK
Benefis Healthcare Systems
Great Falls, MT
Billings Clinic
Billings, MT
Boise State School of Nursing
Boise, ID
Bozeman Health
Bozeman, MT
Cardea Services
Seattle, WA
Caring for Hawai’i Neonates
Honolulu, HI
Central Montana Medical Center
Lewistown, MT
Central Peninsula General Hospital
Soldatna, AK
Community Medical Center
Missoula, MT
Confluence Health
East Wenatchee, WA
Evergreen Health
Kirkland, WA
Foundation Health Partners
Fairbanks, AK
Kootenai Health
Coeur d’Alene, ID
Logan Health
Kalispell, MT
With Distinction
With Distinction
Midland Memorial Hospital
Midland, TX
Montana Health Network
Miles City, MT
Montana VA Health Care System
Helena, MT
Mountain Pacific Quality Health
Helena, MT
Logan Health
Whitefish, MT
With Distinction
Office of Professional Nursing Development-
University of Florida
Gainesville, FL
Pacific Lutheran University
Tacoma, WA
Planned Parenthood of the Great Northwest
and the Hawaiian Islands
Seattle, WA
Providence Alaska Learning Institute
Anchorage, AK
South Dakota Nurses Association
Pierre, SD
South Peninsula Hospital
Homer, AK
St. Luke’s Health System
Boise, ID
St. Peter’s Health
Helena, MT
St. Vincent Healthcare
Billings, MT
UF Health Shands Hospital
Gainesville, FL
Western State Hospital
Lakewood, WA
With Distinction
With Distinction
Wisconsin Nurses Association
Madison, WI
With Distinction
Supporting Nurse Well-being–Resource & Social Media Toolkit aids in facilitation of
discussions that affect the health and well-being of nurses including:
a. Factors impacting nurse well-being
b. Opportunities to reduce burnout and improve nurse well-being
c. Provide additional evidence-based resources
In addition to these new resources, there are several other educational opportunities
that continue to support nurses:
• CNEbyMNA-Resiliency, Wellness, and Self-Care Resources: https://courses.
cnebymna.com/courses
• ANA: Covid-19 Self-Care Package for Nurses: https://www.nursingworld.org/
continuing-education/anas-covid-19-self-care-package-for-nurses/
• Association for Nursing Professional Development-COVID-19 Resources: https://
www.anpd.org/page/covid-19-resources
These important resources provide additional information including toolkits,
instruments, courses, articles, and more. Education remains key in incorporating the
resources to promote well-being. Nurses continue to play an important role in influencing
areas that reduce burnout and advance clinician well-being and resiliency.
References:
National Academy of Medine (2021). Resource Compendium for Health Care Worker Well-Being.
Retrieved from: https://nam.edu/compendium-of-key-resources-for-improving-clinician-
well-being/?utm_source=National+Academy+of+Medicine&utm_campaign=00754e22bc-
Top+10+Perps_COPY_01&utm_medium=email&utm_term=0_b8ba6f1aa1-
00754e22bc-151171322
National Academy of Medine (2022). The Future of Nursing 2020-2030: Supporting Nurse Wellbeing--Resource
& Social Media Toolkit. Retrieved from: https://nam.edu/publications/thefuture-of-nursing-2020-2030/nurse-well-being-resource/
Welcome Director of
Professional Development!
The MNA staff team is pleased to welcome Kelly Hunt,
MN, RN, CNL, who is transitioning to the role of Director
of Professional Development. Kelly Hunt started full time
with MNA on March 28th. Her responsibilities will include
accountability for the operation of the ANCC-accredited
approver and provider units to support professional
development and quality of nursing practice.
Kelly comes to us from her most recent position as
Clinical Care Manager, Population Health, St. Peter’s Health
Medical Group in Helena, MT Prior to that role, she worked
in a variety of clinical settings in inpatient and outpatient
areas including staff education. She has a master’s degree
in nursing from Montana State University in Bozeman, MT.
Kristi will be working closely with Kelly over the next several
weeks to facilitate a smooth transition.
Kelly’s email is kelly@mtnurses.org
Kelly Hunt, MN, RN, CNL
Director of Professional
Development

Page 8 Montana Nurses Association Pulse May, June, July 2022
ANA Excerpts

May, June, July 2022 Montana Nurses Association Pulse Page 9
APRN Corner
Happy Spring! Thanks to
the more than 80+ NPs that
attended the 15th annual MNA
APRN Spring Conference
via remote learning (Zoom).
And of course, the incredible
speakers, as every year I am
just amazed at the quality and
incredible knowledge of our
speakers and their willingness
to share their expertise. The
majority of attendees indicated
they would like to continue
the remote, off-site format,
Keven Comer
MN, APRN, FNP-BC
stating that convenience with work/life balance and
ability to log back in and listen to sessions that were
missed. We will continue the remote format for 2023. The
ability to get speakers from all over the country without
worrying about travel and time expenditures for was a
large contributing factor as well. If you would like to be
involved as a member of the planning committee, please
reach out megan@mtnurses.org. We meet about once a
month via zoom. If you would like to be a speaker, please
contact Megan as well.
The 2021 Montana Legislature enacted Senate Bill
374, signed by the governor Gianforte, May 2021. SB 374
allows the Montana Board of Pharmacy to implement
a new ‘dispenser registration’ regarding dispensing of
drugs by medical practitioners.
This law will allow the board of pharmacy to
better regulate medications that are not dispensed
by a pharmacy or through a pharmaceutical drug
sample program.
The new Medical Practitioner Dispenser application
through the Board of Pharmacy will be available for
medical practitioners who want to dispense prescription
medications directly to their own patients from their
medical office or practice location in Montana, with the
intent that patients take medications home and NOT
have a prescription filled at a pharmacy. Physicians,
Dentists, Optometrists, Podiatrists, Physician
Assistants, and Advanced Practice Registered Nurses
(APRN) with Prescriptive Authority are eligible to apply.
You must be located in Montana. See 37-2-101(7), MCA,
for more information.
The Board of Pharmacy has more recent information
on this posted here: https://urldefense.proofpoint.com/
v2/url?u=https-3A__boards.bsd.dli.mt.gov_pharmacy_&
d=DwIGaQ&c=euGZstcaTDllvimEN8b7jXrwqOf-v5A_Cd
pgnVfiiMM&r=RLj0I2pITY78uf119sL4bMIfAQv4hcRudK
W1Z9bI7cM&m=vw4ZnEjiFbmAZyhKADIAi-EIMeqZMKQ
LcEb2plUmuRA&s=H9nADLbPpLW8I6VFps6E8TgND_
dQjOgh46DCmSMGWA8&e=
This registration is NOT related to or needed for the
following:
• Writing prescriptions for medications, including
controlled substances, or related prescriptive
authority license or renewal requirements
• The Montana Prescription Drug Registry (MPDR)
program and related mandatory registration and
use requirements
• Providing drug samples to patients In-office
administration of medications to patients
• Inpatient practice locations
• Emergency services and related dispensing
managed through a pharmacy
• Occasional dispensing of medications by a
medical practitioner but not as a usual course of
doing business
Please read the eligibility questions below for the
application to see if you qualify:
1 - Is your medical office or practice location
physically located in the State of Montana?
If NO– You do not need to apply. You must have a
physical dispensing location in the State of Montana to
qualify for this license.
2 - Do you only write prescriptions for your patients
to be filled at a pharmacy?
If YES – You do not need to apply. This registration
is not needed for providing prescriptions to be filled at
a pharmacy.
3 - Do you only provide drug samples to your
patients from your practice location and/or is your
dispensing limited to providing drug samples?
If YES– You do not need to apply. This registration
is not needed for providing drug samples directly to
your patients.
4 - Do you plan to dispense prescription
medications directly to your patients from your medical
office or practice location and NOT have the patient fill
a prescription at a pharmacy?
If NO - You do not need to apply. This registration
is intended only for medical practitioners who
dispense from their practice locations.
Statutes and Rules
Registrants must comply with dispensing authority
requirements outlined in statute and rule:
- Statute: 37-2-104(1)-(7), MCA, Dispensing Of
Drugs By Medical Practitioners – Registration –
Exceptions.
- Rules: ARM 24.174.1801, 1802, and 1803, Medical
Practitioner Dispensing, issued by the Montana
Board of Pharmacy regarding qualifications,
dispenser requirements, and recordkeeping
requirements.
I hope you are all feeling a bit of a reprieve from the
past two years – stay healthy and happy. When we take
care of ourselves, we are better able to care for our
patients.
Reach out if you have any questions or comments.
Thank you. keven.comer@gmail.com
*NEW MEMBER BENEFIT*
FOR APRN’s
If you are an APRN, membership to Montana
Nurses Association (MNA) includes three professional
memberships for one low membership rate.
o MNA – Montana Nurses Association
o ANA – American Nurses Association
o AANP – American Association of Nurse Practitioners
If you are currently an MNA member who is also an
APRN, please e-mail Jill at jill@mtnurses.org so she can
sign you up for your AANP membership or if you have
any questions.
Everyone Deserves A Job They Love!!
Let Us Help Today,
Call 406.228.9541
Prairie Travelers is recruiting Traveling
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Prairie Travelers Recruitment Department
130 3rd Street South, Suite 2 • Glasgow, MT 59230
For an application or more information, visit
www.prairietravelers.com

Page 10 Montana Nurses Association Pulse May, June, July 2022
State Wide Nursing News
Shared Governance In The Health Care Organization:
United We Stand—Divided We Fall
United We Stand –
Divided We Fall is one of
the most used phrases to
promote unity and strength!
The words encourage and
inspire, and being alone
is harder and encourages
failure. From Greek history,
in the 6th century BC, we are
introduced to two of Aesop’s
fables—The Bundle of Sticks
and the Four Oxen and the
Lion. My favorite—the lion
pursued the oxen without
success in overtaking an ox.
Carolyn Taylor
Ed.D, MN, RN
But then, when the pack of oxen dispersed and went
their own way—well, you guessed it—the lion caught his
ox! United We Stand—Divided We Fall has also been
heard in the Liberty Song by John Dickinson (1768) and
George Pope Morris’s words in 1853. It all supports that
we are more likely to succeed when we work together—
UNITY IS STRENGTH!
DEFINITION OF SHARED GOVERNANCE
The definition of a healthcare organization’s shared
governance program involves the ongoing experience
of unified sharing of council/group members to
improve quality healthcare.
PROCESS OF SHARED GOVERNANCE
Quality healthcare processes are established
through shared governance. The process involves
sharing ideas, concerns, and recommendations for
improving healthcare processes.
Shared governance is a process used universally
in many endeavors, from marriages to the most
magnificent and complicated businesses and
educational efforts. It is a significant part of leadership/
administration for the survival of the fittest. For example,
the Stanford Health Care and Magnet Recognition
Award processes were developed by the American
Nurses Credentialing Center (ANCC). Both systems
(Stanford Health Care and Magnet Recognition Award)
are known for their extensive shared governance
culture, including collaboration and teamwork.
NOW HIRING RN’s & LPN’s
Full- Time positions, Competitive Salary,
Retirement, Great Benefits
To discuss our current opportunities
call (406)843-4201 or
email hr@madisoncountymt.gov.
Visit us at
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THE ORGANIZATION’S BASIC LEADER/
ADMINISTRATOR SHARED GOVERNANCE
STANDARDS
No one claims that sharing and unity in an
organization are easy, and it is somewhat difficult,
as many health care professionals have strong
personalities and opinions. However, the effort to
communicate collectively on behalf of every patient/
resident or the organization has its rewards!
Shared governance councils/groups have
documented standards to measure expected and
competent outcomes.
The standards include:
- Council/Group Title – The representing of a
general category of concern–Identified as a
council, group, or committee.
- Philosophy – The belief system related to the
need–Paragraph starting with, “We believe.”
- Goals – The ultimate and intended end-point(s)
to be attained – Each goal starts with a Bloom’s
Taxonomy action verb related to the cognitive,
psychomotor, or affective domain.
- Purpose/Mission – The intended “good” to
be accomplished—Each purpose or mission
statement starting with the word “To.”
- Objectives – The success incremental “markers”
along the way to the ultimate end-points or goal(s)–
Each objective starts with an action verb.
- Policies – The “rules” of the council keep
entropy (the movement of all universal things
and happenings toward randomness and
deterioration) under control.
ADMINISTRATIVE EXPECTATIONS RELATED TO
SHARED GOVERNANCE (Random placement of
expectations as to order of importance.)
* Knows the difference between leadership and
management. Leadership involves others in the
problem-solving process, and management tells
others what to do. The use of shared governance
in an organization is LEADERSHIP.
* Knows the concept of entropy and how this
natural universal movement toward deterioration
and change can alter councils/groups’ intended
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standards (the expectations by which a council’s/
group’s success is measured).
* Determines, documents, and updates overall/
all standards related to the entire organization–
philosophy, goals/mission, purpose, objectives,
policies, shared governance recommendations,
and organizational job descriptions according
to Benjamin Bloom’s Taxonomy. It provides
the basis of all council/group expectations as
an extension of the healthcare organization’s
supportive endeavors.
* Determines, documents and updates shared
governance standards of councils/groups,
involves healthcare employees by name and title,
and assigned counsel/group leader.
* Understands that shared governance councils/
groups are developed and assigned to meet
an organization’s specific and unique needs
according to their stated standards.
* Incorporates and maintains shared governance
principles into the everyday employee activities of
a healthcare corporation.
* Performs (or at least reviews) all organizational
employee and council/group member evaluations
related to their job descriptions.
* Understands the potential good, problems,
challenges, and concerns related to implementing
and maintaining shared governance.
* Performs to be legally accountable for
organizational and council/group standards.
* Knows where the “BUCK STOPS”—It stops
with the leader/administrator and the LAW! The
organization’s job descriptions’ expectations and
maintenance, council/group job descriptions,
and associated job description evaluations
will help prevent litigation, and it is evidence of
leadership prowess.
BENEFITS OF SHARED GOVERNANCE
There is no question that professional health care
staff’s involvement improves patient/resident healthcare
outcomes and safety. It encourages professional health
care employee partnership, equity, accountability, and
ownership of results. Leaders/Administrators claim
that it optimizes efficiency and potential for meeting
the organization’s established standards. There is an
improvement in the retention of nurses. Teamwork also
is improved through council/group “rounding” (bedside
conferencing) on patient/resident care areas.
Determination of significant patient/resident health
care decisions is accomplished by health care and
administrative councils/groups. Because of involvement
for the good of patients/residents and the healthcare
environment in which healthcare occurs, employees
become positively energized. There is shared energy
as staff see and feel the evidence of making a positive
difference due to their involvement.
Using the Rule of Three provides an uneven number
on every council/group to determine major decisions.
There is no magic in the number three. However, a
majority determination of a varying number of council
members democratically determines the best options
for an organization and patient/residential health
promotion. Suppose there must be/needs to be an
even number of health care providers on a council,
thereby an uneven number of council members making
a council decision. In that case, there is a possibility of a
voting tie, and the uninvolved leader/administrator of the
organization breaks the tie. Therefore, there is always a
final council/group decision. The benefits of a majority
decision positively impact the desire to have shared
governance decisions. It determines professional
practice and strategic plans through multiple and
collaborative efforts.
With the guidance and determination of the astute
health care leader/administrator who understands the
legal and ethical implications of shared governance,
positive healthcare administration and application
escalates. Leader/administrative support says that
professional input is valued.

May, June, July 2022 Montana Nurses Association Pulse Page 11
State Wide Nursing News
Leaders/administrators can change the complex health
care world for the better. Who else would recognize that
entropy (universal automatic deterioration of everything in
the universe) occurs without positive administrative and
watchful collaborative leadership? The strength, ability,
and fortitude to “tie” the sharing of healthcare shared
governance into a consistent working and ongoing
healthcare endeavor truly belongs to the health care
leader/administrator. Such effort makes the organization
an integrative system that is something to behold! And—
the benefits are covertly too many to identify!
This concept applies – To know the good/benefits
of shared governance, we have experienced the notso-good
(no shared governance – like to understand
light, you must also know dark. )
EXAMPLES OF POSSIBLE COUNCILS/GROUPS
REPRESENTING SHARED GOVERNANCE
1. NURSING CARE COUNCIL (NCC) – (Building
and Implementing a Nursing Care Plan)
PHILOSOPHY: We believe that every
patient/resident deserves a unique/
individualized nursing care plan that results
from professional nursing health care input.
GOAL/MISSION/PURPOSE: Determine and
review individualized nursing care plans
that meet each patient/resident’s unique
healthcare needs.
OBJECTIVE: To meet regularly or as needed
as professional nurses to identify and support
nursing behaviors that enhance nursing health
care for individual patients/residents.
A Nursing Patient Care Council/group is
responsible for the professional sharing, review,
adjustments, implementation, and coordination of
individual patient/resident health care plans. Selected
health care standards for particular patients/residents
become the documented patient’s/resident’s care
plan, nursing diagnosis, realistic healthcare goals, and
intended nursing interventions to meet the healthcare
goals.
Let us not forget the human variable that says
every patient’s goals and needs (due to individual
uniqueness) are somewhat different. Thereby, we have
a basic guideline (standard of care) to commence with
patients/residents’ treatment. Yet, as a council/group
commissioned to determine professional health care,
we do so humanely and individually. It means that the
ultimate patient care council’s/group’s responsibility is
to determine individual care plans according to proven
standards of care. It also enhances the care plan
to include a more individualized plan representing a
patient’s uniqueness and several additional healthcare
disciplines that help reach patient/resident healthcare
goals.
*Members are professional nurses.
2. SHARED MULTI-DISCIPLINARY COUNCIL
(SMC) – (Building and Implementing an
Interdisciplinary Care Plan)
PHILOSOPHY: We believe that every patient/
resident deserves a unique/individualized care
plan with an interdisciplinary health care input
outcome.
GOAL/MISSION/PURPOSE: Determine and
review individualized interdisciplinary care
plan that meets each patient/resident’s unique
healthcare needs.
OBJECTIVE: To meet regularly or as
needed as multidisciplinary healthcare
providers to identify and support the specific
interdisciplinary health care needs of individual
patients/residents.
A Shared Multi-Disciplinary Council is responsible
for assessing, implementing, and maintaining
current practice standards related to appropriate
interdisciplinary care plans. The council supports
and enhances the vision and identifies strategic and
individualized care plans set forth by professional
nurses. Suppose the SMC identifies a professional
concern or a needed individualized multidisciplinary
health care in addition to the nursing care plan. In that
case, a representative of this council meets with the
NCC to clarify or adjust the care plan.
*Interdisciplinary healthcare members are a
combination of nurses, physicians, and multidisciplinary
health care specialists.
3. COORDINATING COUNCIL (CC) – (Patient/
Resident Safety and Quality Check)
PHILOSOPHY: We believe that every patient/
resident deserves a unique/individualized care
plan with medical oversite.
GOAL/MISSION/PURPOSE: Determine and
review individualized care plans for correct
medical protocols that meet each patient/
resident’s healthcare needs.
OBJECTIVE: To meet regularly or as needed
as medical healthcare providers to identify,
support, and medically monitor the specific
interdisciplinary health care needs of
individual patients/residents.
Shared Governance continued on page 12

Page 12 Montana Nurses Association Pulse May, June, July 2022
State Wide Nursing News
Shared Governance continued from page 11
A Coordinating Council monitors other councils/groups and unsolved medical
issues within or between councils. Care plans are strategically reviewed from a
medical perspective for efficacy. Documentation is checked to ensure that care
plans are implemented and appropriately documented. Council members are
considered a necessary resource for understanding potential medical (positive
or negative) effects and unresolved issues regarding implementation and varied
disciplinary practice(s) as stated on the care plan developed by the NCC and SMC.
*Members are medical staff.
4. RESEARCH AND INNOVATION COUNCIL (RIC) – (Research and
Application of Identified Patient Care Research)
PHILOSOPHY: We believe that every patient/resident deserves the use
of the most current and researched quality healthcare evidence.
GOAL/MISSION/PURPOSE: Review relevant literature and apply the
researched findings to individual care plans for patients/residents’ most
effective healthcare management of patients/residents.
OBJECTIVE: To meet regularly or as needed as multidisciplinary
healthcare providers to review research findings for appropriate
recommendations and applications to individual patients/residents’ care
plans.
A Research and Innovation Council is responsible for researching evidencebased
healthcare practices. It helps to assure current and effective healthcare
practices. Communication with other councils/groups provides researched and
updated information to all healthcare disciplines to ensure safety and quality care
decisions. It assures that healthcare practice is evidenced-based using quality
healthcare practice.
*Members are healthcare-supportive disciplines, such as nurses, physicians,
and multidisciplinary healthcare specialists.
5. EXECUTIVE COUNCIL (EC) – (Leadership Recommendations and
Coordination for Organizational Behaviors, Educational Services,
Lectures, and On-Hand Practice of Healthcare Providers.)
PHILOSOPHY: We believe that leadership is enhanced by sharing
creative administrative ideas. Education/services/lectures/on-hand
practice of health care providers increases professional healthcare
competence.
GOAL/MISSION/PURPOSE: Contribute to the healthcare organization’s
positive administrative efforts and functions.
OBJECTIVE: To meet regularly or as needed as a multidisciplinary
healthcare team to identify potential new and supportive administrative
happenings to support or improve the healthcare organization.
Conducts problem-solving groups with follow-up meetings/forums to assure
continued compliance or appropriate modifications of group decisions. Decisions
require leader/administrative approval before implementation.
*Members are “second-line” leaders, at least one member from all shared
governance councils, and the organizational leader/administrator.
6. CLINICAL EDUCATION COUNCIL (CEC)–Collaborative recommendations
between a nursing education program and a clinical facility used for
clinical nursing education)
PHILOSOPHY: We believe that nursing education and clinical nursing
practice are mutually enhanced by collaboration between nursing
education programs and clinical healthcare facilities. It encourages
the nursing practice expertise of the nurse preceptor and effectively
teaches student nurses. Student nurses are more inclined to be
employed in a healthcare facility where they receive a preceptor nursing
experience.
GOAL/MISSION/PURPOSE: Contribute to nursing students’ clinical
practice as collaborative healthcare educators and clinical nursing
providers.
OBJECTIVE: To meet regularly or as needed as a multidisciplinary
healthcare team to determine educational opportunities and
requirements that support nursing education and ultimately retain
graduating nurses to work in the associated healthcare organization.
Nursing faculty often assign student nurses to clinical nurses employed in a
specific healthcare area. There, at times, is no criteria established for being the
nurse preceptor. Careful selection of a practicing nurse preceptor for a nursing
student provides the nursing role model immolated by the student nurse. It
is important to require the nurse preceptor to review techniques expected to
supervise or demonstrate to nursing students. There is a correct carry-over of
principles from the classroom to the clinical setting. Positive reinforcement (reward)
is given to approved nurse preceptors by wearing a name tag with the school’s
name and name, indicating they are currently a “Student Nurse Preceptor” for the
day. Preceptor identification establishes nursing prowess on a nurse’s resume. A
plaque on the hall wall with the engraved names of clinical nurses who meet the
preceptor criteria is recognized and increases the nurse preceptor’s professional
image. This positive reinforcement increases more positive nursing outcomes!
Nursing students who receive quality nurse preceptor support are more inclined
to apply for employment at the same clinical area post-graduation—decreasing the
possible need for so many “traveling nurses.”
*Members are nursing faculty who teach clinical nursing skills at the academic
level and nursing healthcare administrator(s) of a clinical healthcare facility used by
nursing students for direct patient/resident application of clinical skills.
PERSONALIZATION OF SELF-GOVERNANCE
NOW—With all the previous examples of the possible use of shared governance
councils/groups– let us be “real.” Think carefully and creatively about how your
healthcare staff/team can share knowledge and experiences to better the
healthcare organization and the patients/residents.
What has been presented in this document might not mean what your
organization needs as you pursue your shared governance quest. You might
want to have committees instead of counsels/groups—even though they can
mean the same. Make up your own council/group/committee titles, standards,
and participants that best suit you and your administrative needs. Perhaps
selected organizational or academic members could determine each council/
group/committee’s labels and standards. You will benefit by using your personally
designed shared governance counsels/groups as a powerful means of collecting
previously unspoken and changing healthcare information. Then, you will truly
understand the meaning of TOGETHER WE STAND!
RECOMMENDED READING
- Shared Governance (concepts available online)
- Entropy by this author
- Job Descriptions by this author
- Benjamin Bloom’s Taxonomy (concepts of the domains cognitive,
psychomotor, and affective (attitude) in the document on Job Descriptions by
this author and variations of the concepts online)
- Magnet Hospital Journey (access online)
- Stanford Health Care (access online)
Leadershippoweronline.com

May, June, July 2022 Montana Nurses Association Pulse Page 13
State Wide Nursing News
CI-121 Basic Analysis – Montana Nurses Association - March 31, 2022
What is it? CI-121 is a ballot initiative that puts
sideboards on residential property taxes and property
tax valuations via a constitutional amendment to
the Montana State Constitution. Constitutional
amendments are a very serious endeavor, and nearly
impossible to remove. The consequences of any
change to the constitution could have a ripple effect
for years thereafter. The limitations via CI-121, if
passed, would be as follows:
• In 2024, the residential property assessed values
would revert back to 2019 valuations.
• The Dept of Revenue’s ability to increase
property valuations from year to year would be
capped 2% or the rate of inflation, whichever is
less.
• Residential property taxes would always be
capped at 1% the value of the property. The
current residential property tax rate in Montana
is around 1.35%, but residential tax rates will
range depending on how much money the
county and municipal governments need in
order to function from place to place. Some
counties also have imposed more mill levies
than others, so a hard and fast rule is difficult to
calculate.
The result? CI-121 would result in less money in our
local communities for essential services. With a smaller
pot of money to work with, state and local governments
will either 1) cut budgets and essential services or 2) get
the money to fill in their budgets using other tax revenue
sources. Revenue for things like schools and teachers,
roads, city government, public health, emergency
services, etc would either have to be cut, or the money
would have to come from somewhere else. CI-121 could
result in $100 million to $265 million in lost state and local
revenue. The state could also lose ~ $30 million per year
in revenue according to the Montana Budget and Policy
Center.
How would this affect the public health nurses
of MNA? – Montana, as a whole, may have less funding
to recruit and retain public health nurses and nurses
employed by public institutions. The ballot initiative would
also have detrimental effects to our union brothers and
sisters in other publicly funded professions.
What’s the process? Proponents of CI-121 have to
gather 60,359 signatures in support of the ballot initiative
by 06-17-2022 in order for the initiative to be eligible for
a vote in the November election. We must DECLINE
TO SIGN CI-121 to keep this bad policy with unknown
repercussions out of Montana.
Proponents of the initiative:
• Al Olszewski (R), former legislator, former gubernatorial
candidate, and now congressional candidate
• Troy Downing (R), State Auditor
• Matt Monforton, a Bozeman attorney
• Rep. Matt Regier (R)
• Rep. Brad Tschida (R)
• Sen. Brad Molnar (R)
• Rep. Derek Skees (R)
• Joe Dooling (R)
Opponents of the initiative:
• Montana Bankers Association
• Montana Chamber of Commerce
• Montana Farm Bureau
• Montana Federation of Public Employees
• Montana AFL-CIO
• Montana Association of Counties
• Montana Association of REALTORS
• Montana Budget and Policy Center
• Montana Farmers Union
• Montana Human Rights Network
• Montana Infrastructure Coalition
• Montana League of Cities and Towns
• Montana Quality Education Coalition
• Montana Rural Education Association
• Montana Women Vote
• Montana Nurses Association
• Sen. Jill Cohenour (D)
• Sen. Greg Hertz (R)
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Page 14 Montana Nurses Association Pulse May, June, July 2022
Cancer Control Program Update
Did you know??
• Colorectal cancer incidence is increasing among younger Montanans (aged 44
and under) even while rates are decreasing among adults aged 65 or older.
• Five types of cancer (liver, stomach, kidney, lung, and colorectal cancer) account
for the higher cancer incidence and mortality seen among American Indian
Montanans.
• Prostate cancer incidence has increased among Montana men since 2014 and the
rate in Montana is significantly higher than in the U.S. overall.
Learn more about the cancer incidence and mortality trends in Montana in the
Montana Central Tumor Registry Annual Report covering diagnosis years 2015 to 2019.
If you have questions or comments about the report or any other cancer statistic contact
cancer epidemiologist, Heather Zimmerman, 406-444-2732 or hzimmerman@mt.gov
Does this legislation only apply to vaccination status regarding the
vaccines for COVID-19?
• No. HB 702 applies to all vaccines (example: MMR & DPT) and is not limited
to COVID-19 vaccines.
Can a health care facility require all employees, patients, visitors, or other
persons on their premises to wear a mask?
• YES! Nothing in HB 702 prohibits a health care facility from requiring
everyone to wear masks, including employees, patients, visitors, and other
persons on their premises regardless of vaccination status, as long as there is
a provision for accommodations for persons based on sincerely held religious
beliefs or medical disability.
*************************
1. What factors lead MNA make the decision the join in with other parties
(MMA, Etc) and intervene on the HB702 lawsuit?
***Many factors contributed to the MNA involvement with HB702***
o Legislative/Governmental Relations platform-approved by House of
Delegates yearly at annual Convention
o Executive board-MNA Board of Directors
o Survey members
o MNA member feedback
o Code of Ethics for Nurses
o Resolutions-voted on by House of Delegates
o Scientific evidenced-based data
o Legal advice
• Historically, the Montana Nurses Association (MNA) has strongly supported
immunizations to protect the public from highly communicable and deadly
diseases such as measles, mumps, diphtheria, pertussis, and influenza,
moreover, has supported appropriate evidenced-based vaccination policies
for registered nurses and health care workers.
• Under certain circumstances, MNA understands the need for mandatory
vaccines as a job requirement (with sincere religious/medical exemptions
noted) especially due to the several recent and significant measles outbreaks
in the United States, as well as the global pandemic of COVID-19.
• Vaccination requirements for employment as a professional nurse are
not new to nurses. MNA strongly recommends that registered nurses be
vaccinated against COVID-19, especially now with FDA approval.
• See MNA position statement regarding vaccinations Sept. 27th, post FDA
approval of Covid vaccine under advocacy tab at www.mtnurses.org.
• The misunderstanding and disconnect with HB702 is that it is not just about
the COVID vaccine, it far exceeds COVID and applies to ALL vaccines.
• MNA continues to advocate for a safe working environment for all nurses,
healthcare workers and ultimately, our patients. Montana Nurses and healthcare
workers are already REQUIRED, as employment conditions, to receive other FDA
approved vaccines and annual testing, such as Measles, Mumps, Rubella (MMR),
hepatitis, and yearly Tuberculosis screening , etc to keep themselves, their patients,
and others safe. HB702 interferes with these long standing vaccine requirements.
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To apply for consideration go to our website
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2. Does MNA support a COVID vaccine mandate??
• MNA advocates for and supports a safe work environment and fair workplace
policies surrounding the implementation of any employer vaccine mandate as
part of their job requirements. Many healthcare facilities have mandated flu
vaccines, especially since H1N1 outbreak, and MNA nurses are at the table to
assist with policies that define exemptions and ensure appropriate protective
measures and Personal Protective Equipment (PPE) are available to keep
unvaccinated nurses, healthcare workers, and patients safe.
• MNA supports a fair process surrounding mandatory vaccines, moreover, in
facilities with collective bargaining agreements, nurses have bargained over
fair policies (which include exemptions noted in our position statement and
resolution-www.ntnurses.org/advocacy) and will continue to do so for COVID
and other FDA approved vaccines that may arise.
• See MNA position statement regarding vaccinations Sept. 27th, post FDA
approval of COVID vaccine under advocacy tab at www.mtnurses.org.
MCDC provides in-patient addiction treatment, including withdrawal
management, for substance use disorders and treatment for cooccurring
mental health disease. MCDC is a 48 bed facility, serving
individuals 18 years and older. The nursing staff work alongside an
interdisciplinary team to provide quality patient care. Must possess
a current Montana or Compact Nursing License.
Positions available are a Full-time Registered Nurse (Sunday,
Monday, Tuesday 7p-7a) and Part time LPN (Saturday and
Sunday 7p-7a). Shift differential for nights and weekends.
Log on to: www.mt.gov
State Government Jobs State Job Listing

May, June, July 2022 Montana Nurses Association Pulse Page 15
MEMBERSHIP
MATTERS!
Montana Nurses Association would like to
invite you to join us today!
BENEFITS INCLUDE:
• EMPOWERING RNs TO USE THEIR
VOICES IN THE WORKPLACE
• IMPROVING PATIENT CARE
• HAVING INPUT REGARDING
WAGES & BENEFITS
• CONTINUING EDUCATION OPPORTUNITIES
• LEGISLATIVE REPRESENTATION
Call or email today
jill@mtnurses.org
(406) 442-6710
Applications also available on
our website.
mtnurses.org
Has your contact
information changed?
New name? New address?
New phone number?
New email address?
To update your contact information,
please email or call
Montana Nurses Association:
jill@mtnurses.org or 406-442-6710
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