New Hampshire Nursing News - June 2022
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
Quarterly publication direct mailed to approximately 1,250 Registered Nurses and LPNs and delivered electronically via email to 16,500 Registered Nurses and LPNs in New Hampshire.
New Hampshire
Nursing News
Official Newsletter of New Hampshire Nurses Association
PRESIDENT’S MESSAGE
www.NHNurses.org
June 2022 | Vol. 46 No. 3
Happy Nurses Day/Week to all
of you!
Spring has sprung at the New
Hampshire Nurses Association.
There is so much activity
happening with very busy past
few months.
First, the Commissions have
been very active.
For example, the Commission
Holly McCormack
on Government Affairs
has been watching several bills related to the Covid-19
pandemic, vaccination, and workplace violence. (see
related article Legislative Update)
The NHNA Commission on Government Affairs Members
and the corresponding Legislative Advocacy Committee
(LAC) leaders were instrumental in mobilizing NHNA
membership and colleagues and partners throughout New
Hampshire. Through their diligent efforts, progress is being
made to provide a safer working environment for health
care workers. The Commission held a Legislative Forum
in January for the entire NHNA membership. The highest
rank priority following the 2022 Legislative Town Hall was
establishing a health care facility and workplace violence
prevention program. After several years of advocating for
similar legislation, SB459 passed 220-87 on 5/5/2022.
Members called, texted, wrote, and testified regarding
this vital piece of legislation. We would also like to extend
a special thanks to our executive director Dr. Pamela
Dinapoli, who chaired CGA for the prior six years and
Marcy Doyle, this year’s chair who worked diligently on this
legislation to benefit all New Hampshire Nurses.
The Commission on Nursing Practice held the Early Career
and Graduating Student Nurse Conference on April 14,
2022, at Plymouth State University. The event, Your Future
in Nursing, was a great success. (see related article and
photos)
Lori Shibinette, Commissioner of the NH Department of
Health and Human Services, provided the keynote address.
She shared inspirational words as well as relayed her
journey to becoming a nurse. She also encouraged the new
graduates to identify what matters to them in their future
employment.
Students were given a chance to speak to recent graduates
about their experiences in the first year of practice. They
were also able to talk to various vendors about other
current resident or
Presort Standard
US Postage
PAID
Permit #14
Princeton, MN
55371
educational
experiences and job
opportunities and hear some great
presentations from other members of the NHNA.
The newly formed Commission on Climate Action and
Health introduced themselves at the Early Career and
Graduating Student Nurse Conference with a presentation
on the role of the future nurse in climate action change. The
program was very informative and well-received. Future
plans include developing a CEU program to be presented
at the Fall Annual Meeting. The group also participated
in the NH Healthcare Workers for Climate Action press
conference (see photo) and is working toward a meeting
with federal legislators to speak about climate change and
health. The Commission Chair, Kaitlynn Liset, has been
inducted into the 2022-2023 cohort of the Alliance of
Nurses for Healthy Environments. This training teaches
nurses how to work with communities as they tackle
serious environmental health issues, emphasizing climate
and health equity.
NH Healthcare Workers for
Climate Action Press Conferenc
The Commission on Membership Engagement is currently
seeking energetic new members to help them achieve
their aim of collaboratively creating new opportunities for
members to engage in an effort to increase the NHNA’s
ability to impact the lives of New Hampshire nurses and
the health of the citizens of New Hampshire. Contact
Pam DiNapoli at nhna.ned@gmail.com if interested in this
opportunity.
The Policy Review committee has begun work on its
biennial review of our general, employee and volunteer
policy manuals. Carlene Ferrier and Carmen Petrin are
leading this effort and welcome volunteers interested
in organizational policy. Contact the office if interested
office@nhnurses.org.
Next, on Thursday, May 19, NHNA co-hosted the Excellence
in Nursing Awards with New Hampshire Magazine.
We received 72 nominations across 13 different
categories representing the many facets of nursing.
Please be sure to notify us with address
changes/corrections. We have a very large list
to keep updated. If the nurse listed no longer
lives at this address – please notify us to
discontinue delivery. Thank you!
Index
Please call 603-225-3783 or
email to office@nhnurses.org with
Nursing News in the subject line.
President's Message ....................page 1
Reflections from the ED ................page 3
Legislative Update ...................pages 4-5
Excellence in Nursing Awards ..........pages 6-7
NHNPA 2020 & 2021
Recipients Recognized ..............pages 8-9
Early Career and Graduating Student
Nurse Conference 2022 ..........pages 10-12
Welcome New and Returning
NHNA Members! .................. page 13
Combating Compassion Fatigue .......... page 13
New Nursing Simulation and
Clinical Education Center ............ page 14
It’s Time to Talk About Athletic
Urinary Incontinence ............... page 15
Improving Employee Engagement ....... page 16
Joy in Work Framework ................ page 16
Dropping the Stigma Surrounding
Substance Use Disorder .............`page 18
NHNA Student Nurse of the Year ..........page 19
Giving Care: A Strategic Plan .........pages 20-21
In Memory .......................pages 22-23
It was a pleasure to honor these professionals for their
commitment and dedication to nursing. Look for these nurses
to be celebrated in our fall edition of NH Nursing News.
Finally, a big thank you to all of our members. Your
participation and engagement are essential to NHNA
achieving our mission. If you are interested in learning more
about the commissions or would like to join, please visit our
website.
Thank you for all that you do!
Best,
Holly McCormack DNP RN
President, NHNA
SPECIAL ANNOUNCEMENT
In my column for this issue of NH Nursing News I reflected on the word GROWTH. Consistent with that
word I wanted to let you know about some changes coming to NH Nursing News. We are going DIGITAL.
This will be our last print copy of NH Nursing News. With the change to digital we will have more chances
to send you regular NHNA News with monthly eblasts. The monthly updates will go out in the months
between quarterly editions. With any change we may have some growing pains as we adjust to this new
format but we are confident that this is the right direction for NHNA to take.
– Pamela P. DiNapoli
community
Mission-driven
center jobs. No holiday
health
12-hour shifts or call.
hours,
or no weekend hours.
Few
Page 2 • New Hampshire Nursing News June, July, August 2022
Guidelines for Submissions to NH Nursing News
NH Nursing News (NHNN) is the official publication
of the NH Nurses’ Association (NHNA), published
quarterly – and available in PDF format at our website:
www.nhnurses.org. Views expressed are solely
those of the guest authors or persons quoted and do
not necessarily reflect NHNA views or those of the
publisher, Arthur L. Davis Publishing Agency, Inc. NHNA
welcomes submission of nursing and health related news
items, original articles, research abstracts, and other
pertinent contributions. We encourage short summaries
and brief abstracts as well as lengthier reports and
original works. An “article for reprint” may be considered
if accompanied by written permission from the author or
publisher. Authors do not need to be NHNA members.*
Sign-on bonuses, 401k,
benefits, loan-repayment
options, paths for growth
FT, PT, per-diem
NH Seacoast region
Manuscript Format and Submission:
Articles should be submitted as
double spaced WORD documents
(.doc format vs. .docx, please) in 12
pt. font without embedded photos.
Photos should be attached
separately in JPG format and
include captions.
Submissions should include
the article’s title plus
author’s name, credentials,
organization / employer represented,
and contact information. Authors should state any
potential conflict of interest and identify any applicable
commercial affiliation. Email as attachments to office@
nhnurses.org with NN Submission in the subject line.
Publication Selection and Rights:
Articles will be selected for publication based on the
topic of interest, adherence to publication deadlines,
quality of writing and peer review. *When there is space
for one article and two of equal interest are under review,
preference will be given to NHNA members. NHNA
reserves the right to edit articles to meet style and
space limitations. Publication and reprint rights are
also reserved by NHNA. Feel free to call us with any
additional questions at 877-810-5972.
Advertising:
Product, program, promotional or service
announcements are usually considered advertisements
vs. news. To place an ad, contact: Arthur L. Davis
Publishing Agency, Inc. Email sales@aldpub.com or
call 800-626-4081. Ad sales fund publication and
mailing of NH Nursing News and are not paid to
NHNA.
Vol. 46 No.3
Official publication of the New Hampshire
Nurses’ Association (NHNA), a constituent
member of the American Nurses Association.
Published quarterly every March, June,
September and December. Library subscription
rate is $30. ISSN 0029-6538
Editorial Offices
New Hampshire Nurses Association, 25 Hall St.,
Unit 1E, Concord, NH 03301. Ph (603) 225-3783,
E-mail office@NHNurses.org
Editor: Jessica Reeves, MSN, MPH, APRN
NHNA Staff
Pamela P. DiNapoli, PhD, RN, CNL,
Nurse Executive Director
NURSING NEWS is indexed in the Cumulative
Nursing Index to Nursing and Allied Health
Literature (CINAHL) and International Nursing
Index.
For advertising rates and information, please
contact Arthur L. Davis Publishing Agency,
Inc., PO Box 216, Cedar Falls, Iowa 50613,
(800) 626-4081, sales@aldpub.com. NHNA
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 New Hampshire
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. NHNA 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 NHNA or those of the
national or local associations.
VISION STATEMENT
Inspire New Hampshire nurses as leaders to expand
the power of the nursing profession to improve the
health of the people of New Hampshire.
MISSION STATEMENT
Promote nursing practice and the wellbeing of
New Hampshire nurses by providing professional
development, fostering nurse innovation and
leading in health advocacy to enhance the health
of the people in New Hampshire.
Adopted 11-10-2021.
CORE VALUES
Caring • Integrity • Excellence
Diversity/Inclusion/Belonging
June, July, August 2022 New Hampshire Nursing News • Page 3
REFLECTIONS FROM THE ED
The word I would like to reflect
on for this issue of NH Nursing
News is GROWTH. In this
issue we celebrate the growth
of the profession through our
student nurse conference,
our award winners and MS/
DNP graduating student
capstone projects. But we also
recognize in this issue that
there are significant challenges
and barriers to the growth of
our workforce. By now we all
Pamela P. DiNapoli
recognize that there is a nursing
shortage. Those of us that have been in the profession for
several years have seen shortages come and go. When I
was in school, we were debating entry into practice, and
we were experiencing a nursing shortage. At the time one
of our professors told us not to worry about shortages, that
historically nursing was a “washing machine profession.”
Meaning that nurses would work when they needed a new
“washing machine,” in other words, the workforce was
influenced by economic growth and economic downturns.
Good economy, nursing shortage, bad economy, nursing
saturation. That has always stuck with me. So conventional
wisdom would suggest that because the economy is
heading towards a recession, more nurses will enter the
workforce and the nursing shortage will soon be over, right?
Unfortunately, times have changed, while we still may be
debating entry into practice, the Registered Nurse (RNs)
shortage is now expected to intensify as Baby Boomers age
and the need for health care grows.
We can celebrate that our profession has seen considerable
growth and respect since those “washing machine days,”
giving nurses many and varied career opportunities. Nurses
make up the largest segment of the healthcare workforce.
But the number of nurses entering the workforce has not
kept pace with the need for registered nurses. Despite a
growth in enrollment of 5.1% in entry-level baccalaureate
programs this is not sufficient to meet the demand for
nursing services. Nearly every healthcare encounter
includes an RN to perform history and physicals, to
interpret critical information, to make decisions about
treatments and medication and to coordinate care across
multiple health care disciplines.
So, what are the factors impacting growth? The average
age of nurses is now 50 years old which may signal a large
wave of retirees not likely to reenter the workforce based
on economic pressures. It is projected that more than 1
million nurses will leave the workforce by 2030. And as
the nursing workforce is aging so is the population. The US
census predicts that by 2030 there may be over 82 million
people over the age of 65 with increased needs to care for
chronic illness and comorbidities attributed to aging. There
are also generational attributes contributing to the current
workforce. The current workforce is more mobile, 13% of
newly licensed RNs had changed principal jobs after one
year, and 37% reported that they felt ready to change jobs.
The growth of travel nursing has contributed to a migrant
workforce impacting the work environment.
The result of the lack of growth in the workforce is
ultimately increasing stress on nurses, lowering patient
care quality and causing more nurses to leave the
profession sooner than expected. The news is not all
bad. The face of the workforce has become more diverse
and there will be a need for continued diversity as the
population continues to change. Covid 19 has brought
more attention to the healthcare workforce and the release
of the Nurse of the Future 2020-2030 report has highlighted
the increased number of opportunities for nurses in the
areas of community health, public health and certainly
the focus on social determinants of health has put more
emphasis on population health.
For too long we have focused on economic reasons for
the ebb and flow of the nursing workforce. To sustain
growth in our workforce we need to focus on the root
causes. We need to grow our faculty workforce to build
capacity in our academic programs. Without a growth
in programs like faculty loan repayment nurses are not
incentivized to enter academics. Similarly, the current fee
for services structure and low Medicaid and Medicare
reimbursement rates limit the number of providers
willing to serve as preceptors. We look to funding from
the CARES Act to infuse new money into initiatives that
will grow the workforce like loan repayment. We also
need growth in media such as public service campaigns
to encourage more people to enter the profession. With
these public service campaigns come efforts to adopt
improved staffing policies, higher wages, and other
initiatives designed to improve working conditions.
Finally, we need to embrace the word innovation and
grow opportunities to rethink our practice. Nurses know
nursing! We need to look for innovative ideas from
nurses to solve problems faced at the bedside. Clara
Barton said: “‘It irritates me to be told how things have
always been done. I defy the tyranny of precedent. I go
for anything new that might improve the past.’” Good
ideas and the willingness to disrupt the status quo could
be the answer to growing the workforce. We will not
know if we do not try. Nurses need to be at the table
bringing their innovative ideas and solutions to daily
problems.
One definition of GROWTH is to broaden as to broaden
one’s horizons. In nursing practice, we need to “broaden
our horizons with a change of scenery and culture” by
embracing and diversifying the workforce in a changing
work environment. Another definition of GROWTH is to
widen as “to encompass more people, ideas and things.”
We need to widen the pipeline to ensure an adequate
workforce by increasing educational opportunities.
GROWTH is expansion” as in expansion of the
healthcare industry.” We need to expand and evolve to
face the complex healthcare issues that are and will be
facing us well into the future.
Page 4 • New Hampshire Nursing News June, July, August 2022
LEGISLATIVE UPDATE
TABLE 1: Legislative Town Hall Forum Bill Rankings
Bill TITLE STATUS
HB1017/2013
HB1633/2049
HB1224/2361
HB1233/2426
HB1351/2631
HB255
HB 1210
HB1604/2142
SB 422/HB 103
HB1332/2458
HB1014/2054
SB277/2939
HB1659
HB1030/2372
HB1260/2141
establishing criminal penalties for
harming or threatening to harm an
essential worker.
relative to requiring COVID-19
vaccination for school attendance.
prohibiting state and local governments
from adopting certain mandates in
response to COVID-19; and prohibiting
employers and places of public
accommodation from discriminating on
the basis of vaccination status.
prohibiting higher education institutions
receiving state funds from requiring face
masks and COVID-19 vaccinations for
attendance.
prohibiting certain employers from
requiring a COVID-19 vaccination as a
condition of employment.
relative to prohibiting vaccine mandates
by New Hampshire employers. –
RETAINED from 2020
Relative to exemptions from vaccine
mandates.
including state medical facilities in the
statute providing medical freedom in
immunizations.
AN ACT establishing an adult dental
benefit under the state Medicaid
program.
excepting public universities and colleges
from requirements under medical
freedom in immunizations.
allowing public meetings to be
conducted virtually.
relative to emergency or temporary
health care licenses.
relative to criminal history background
checks for certain health care workers.
relative to licensure by alternate
experience for licensed nursing assistant.
making immunization status a protected
class.
Replaced by SB 459FN
(See Below)
House Vote: ITL (21-0) *
House Vote: Refer for Interim Study
(19-0)**
House vote: Lay on Table ***
House Vote: ITL
Amended to HB 1210
House Vote: Lay on Table (213-142)
House Committee OTP/A #0724h (11-10)
****
OTP/A # 2022-0724h (181-155) 3/17/22
Senate Committee Report: Referred to
Interim Study (4-1)
Senate Vote: Interim Study
House Vote:
OTP/A (Vote 176-174) 2/16/22, Referred
to Finance 2/16/22; OTP/A 1160h 3/31/22
Senate Vote:
Committee Report: OTP/A #1566s
4/21/22 (Vote 5-0); Finance Committee
Report: OTP (6-0) 5/5/22
House and Senate Concur: To the
Governor to Sign
Lay on table (172-142) 3/16/22
Lay on Table 175-155 03/16/2022
Ought to Pass with Amendment
Motion Adopted Voice Vote 05/04/2022
Motion Adopted, Voice Vote
Motion Adopted, Voice Bote
ITL 3/10/22
HB1379/2527
HB1358/2789
SB222/2896
HB1606/2150
HB1035/2182
HB1439/2492
SB 459FN
relative to the department of health and
human services' rulemaking authority
regarding immunization requirements.
requiring public and private employers to
establish procedures and exceptions for
the use of mandatory intrusive testing as a
condition of new or continued employment.
permitting licensing boards to conduct
remote meetings.
making the state vaccine registry an optin
program.
relative to exemptions from school
vaccine mandates.
relative to hospital visitation policies.
Relative to healthcare workplace violence
prevention programs
Refer to Interim Study 4/21/22
ITL 3/10/22
Language amended to HB 1210
Motion Adopted Voice Vote
Committee Report: OTP/A #1687s (4-1) 5/5/22
As amended program is opt-in/opt-out
a single time for all vaccines. NHNA
Supports the amendment
Committee Report: OTP 4/21/22
(Vote 5-0)
Amendment Adopted, Voice Vote;
04/21/2022
Motion Adopted: To the Governor for
signing
*ITL refers to inexpedient to legislate indicating there is no benefit to creating rules of
law to implement this bill
**Interim Study means that the bill is not currently in a form that both the house
and senate agree on, while there may be merit to the content there is not currently
consensus. It needs more study.
***Lay on the Table: The bill is killed
****OTP-A this indicates that the bill “ought” to pass. When there is an A attached it
means that the bill has been amended.
The 2022 legislative session was an active one with as many as 47 Covid 19 bills
related to immunizations and masks. NHNA followed all of these bills partnering
with the Healthy 603 Coalition. The Coalition was formed with a large group of
stakeholders from healthcare, business, and education sectors among others. The table
summarizes the house and senate actions up to date at press time. Use the hyperlinks
to read the current status of each bill. The biggest win for NHNA was the passage
by both House and Senate of HB 459 which creates a Workplace Safety Commission
charged with collecting and trending healthcare workplace violence data. The
definition in the final version of the bill includes:
"Workplace violence" means any act or threat of physical violence, harassment,
intimidation, or other threatening behavior.
“Hostile words” means aggressive and belligerent verbal abuse in which the recipient
reasonably believes that the speaker intends to injure or create excessive stress, or in
which the recipient suffers actual psychological trauma.
The Bill now will go to the Governor’s desk. Look for updates on our social media
channels
Instagram: nh.nurses | Twitter: Nhna_nurses | Facebook: @NHnurse
Linked In: NEW HAMPSHIRE NURSES ASSOCIATION
We’re Looking
For The Best.
Come Join Our Team!
We have many opportunities available at Memorial
Hospital in North Conway and the Merriman House.
RN openings:
Clinical Manager, Family Birthing Center
Emergency Department • General Surgery
Heart Health & Wellness • Med Surg
Long Term Care – New Grads Welcome!
LNAs: • Long Term Care
Excellent work/life balance in an outdoor
enthusiasts’ dream location! Memorial
Hospital is critical-access hospital, with
a friendly close-knit vibe, located in New
Hampshire’s White Mountains region.
Candidates can apply online at
www.memorialhospitalnh.org
An Equal Opportunity Employer
100 Saint Anselm Drive
Manchester, NH 03102
(603) 641-7086
www.anselm.edu/cne
Committed to Promoting Excellence
in the Practice of Nursing
Saint Anselm College is approved as a provider of nursing
continuing professional development by the Northeast
Multistate Division, an accredited approver by the American
Nurses Credentialing Center’s Commission on Accreditation
3
3
June, July, August 2022 New Hampshire Nursing News • Page 5
LEGISLATIVE UPDATE
The Honorable Barbara French, BSN, MEd
Reprinting the remarks given on the House floor on May 5, 2022 by Rep. Linda Tanner
in honor of The Honorable Barbara French (see In Memorium)
Today we honor a former Democratic member of the
House, the honorable Barbara Connor French of Henniker,
who passed away at the end of last month at the age of 96
just shy of her 97th birthday.
With us today in the gallery are her daughter, Susan,
son, Michael, and best friends, Eileen Kelly and the
Honorable Beth Rodd. Standing with me are some
fellow Representatives who served with Barbara and her
Representatives from Henniker.
I had the good fortune to work with Barbara in my
freshman term when I helped with a continuing resolution
in her committee, recognizing the Cadet Nurses of WWII
and that resolution became my first floor speech. Barbara
had grown up in that generation we affectionately call
the greatest generation, who answered the call of their
country and accepted responsibilities for the home front
during WWII. She knew people who had joined the Cadet
nurses. At a time when college was not always an option
for women, Barbara was accepted to and graduated from
UNH. She then went on to get a BSN degree in New
York City from the Cornell University Hospital and started
her career as a clinical nurse. She later followed up with a
Masters in Education Degree.
Nursing takes a special type of person: intelligent, strong,
determined, persistent, caring. and compassionate. Barbara
was all that and more. In NH her career continued as
Head Nurse Instructor at the NH State Hospital, as a NH
Child Welfare Social Worker, a Consultant for the NH
Department of Education in Drug Education and as a
school nurse in the Concord schools for 27 years. She
served her community as a member of the Henniker
planning board, as a member of Henniker Peace
Community and was active in the local Democratic party.
She attended weekly peace vigils up to a few weeks before
her hospitalization.
Barbara served for 20 years in this House as the State
Representative from Henniker. Although she was vertically
challenged, her voice was strong and big. She was a
sponsor and co-sponsor of numerous bills - too many to list
here- that were signed into law. These ranged from issues
involving health care, the environment, and her passion,
the well being of children and families as well as a bill for
sampling beer or wine at farmers’ markets.
She took great pride in her work in the creation of the
NH Healthy Kids corporation, which provides healthcare
to thousands of NH children, and the Child and family
resource centers that support wellness and primary
prevention services for children and families at the
community level.
Barabara received many awards recognizing her hard
work, advocacy and service, including recognition awards
from the National Association of School Nurses, the NH
NEA Retired Educators Award, and the prestigious NH
Democratic Party’s Eleanor Roosevelt Award.
In her personal life she was concerned with fitness and
health. She loved to swim in her lake, Massacecum,
and she would persist in a daily swim until October as
long as she was able. Bette Davis once said that "old
age is not for sissies" and Barbara was not a sissy! She
bravely met aging with grace, humor, daily physical
activity and being involved in current events. Long
after she retired from the House, several of us would
get calls from Barbara who wanted more information
or updates on bills she was following or to share her
reaction and opinion on current political news. She
kept involved with the NH School Nurses Association
who created a legislative advocacy award in her name.
When election time rolled around, Barbara was there to
help, give advice and as an advocate for her Democratic
candidates.
She was a force to be reckoned with, highly respected by
those who knew and worked with her, and a dedicated
fighter for quality public education, wellness, accessible
and affordable health care for all, protection of women’s
reproductive rights, and protection for the environment.
She worked to protect and provide for those in need, the
vulnerable - the young and the elderly. We will miss her in
this fight for a better world for all.
For most people I would end a eulogy by saying “rest in
peace." But that doesn’t seem right for Barbara. I think it
should be "Godspeed Barbara," because I know she won’t
rest, she will be directing and keeping all those angels on
their toes and on task.
May your memory be a blessing.
Linda Tanner
NH State Representative
Sullivan District 9
Education Committee
Page
Excellence
6 • New Hampshire Nursing News
in
June, July, August 2022
Nursing Awards
Advanced Practice Registered Nurse
Sandra J. McDonald MSN, ACNP-
BC, APRN, Lead Advanced Practice
Provider, Neurocritical Care
Dartmouth Health’s Dartmouth-
Hitchcock Medical Center, Lebanon
At Dartmouth-Hitchcock Medical
Center, Sandy McDonald is the lead
advanced practice provider in the
Neurocritical Care Unit. She leads
a team of nine APPs in providing
comprehensive care for these patients in collaboration
with physicians, nurses and respiratory therapists.
Sandy stresses the importance of empathy in her role,
and never loses sight of the fact that each patient has
a life outside the walls of the unit. To quote Sandy, she
says that “In NCCU, the expected length of stay is longer
than in other inpatient units. That affords us the unique
opportunity to really get to know our patients and their
families quite well. It’s a privilege and an honor to be
allowed into patients’ lives during what can be one of the
most difficult times they have experienced.”
Ambulatory Care Nursing
Laurie B. Kofstad BSN, MSN, RN,
Nurse Transplant Coordinator
Manchester VA Medical Center,
Manchester
When one of the veterans who has
served our country needs an organ
transplant, Laurie Kofstad is at their
service. She oversees identifying,
evaluating and coordinating their
care at the Manchester VA Medical
Center. Among her many skills, she excels at providing
care and compassion without judgment, listening to her
patients as they share their fears, making sure they feel
heard, and so they know they are not alone.
Laurie began her career in 1995 at Home Health and
Hospice Care in Merrimack after graduating with an
associate’s degree in nursing. Her colleagues in the
profession, both past and present, have inspired her
throughout her journey, especially her nurse mentors
who encouraged her to continue her education and
offered support as she completed her BSN and MSN.
Today, she says, “Being the transplant coordinator has
become my greatest achievement in my nursing career.”
Excellence in Nursing Awards Photos
courtesy of Kendal J. Bush Photography
Cardiovascular Nursing
Monica Matulonis RN, ICU
Clinical Nurse Specialist
Catholic Medical Center,
Manchester
Monica Matulonis’ years of
experience enable her to remain
unruffled in a crisis. She’s
learned that as in ICU nurse, the
most important trait is to remain
calm during emergencies.
For the past eight years, she’s been primarily caring
for post-open heart surgery patients at Catholic
Medical Center, and during the past three years,
she’s been the specialist who gives training and
practical experience to nurses new to their role in
CMC’s nationally renowned unit.
Although she’s an expert cardiac nurse, she had
to take on a new role in 2020 during the height of
the pandemic when she was tasked with being the
charge nurse in the Covid intensive care unit.
Not only is she composed, she is compassionate,
telling us that, “What inspires me to be an excellent
nurse is to utilize empathy with each and every
patient. My goal is to treat every patient and family
member like they are my family or close friend.”
family’s worst day.
Emergency Nursing
Melissa Eastman Resource
Person, CEN, BSN
Concord Hospital, Concord
Melissa Eastman has been a
nurse for 27 years, serving
for the past 15 of them in
Concord Hospital’s emergency
department, where on every
shift she is in situations that put
her in the middle of a patient or
Although she says the last years were especially
challenging, she stays motivated by knowing that
she’s making a difference for patients and their loved
ones.
As the resource nurse, she must be adept at juggling
multiple priorities at once, and she is responsible
for patient flow, resource allocation, and clinical
mentoring and support for ER nurses. She manages
the day-to-day operations in the ER while on shift,
triaging ambulance traffic to make sure that patients
entering the department are getting the appropriate
care by matching clinical experience to patient
assignments and acuity.
Front Line/Administrative Nursing Leader
Anna Ivy M. Park BSN, RN, OCN,
MED-SURG-BC, Unit Nurse
Manager Oncology Inpatient Unit
and Hematology Cellular Therapy
Unit
Dartmouth Health’s Dartmouth-
Hitchcock Medical Center,
Lebanon
Anna Ivy Park has been a nurse
for 14 years, and has been in a
leadership role for the past five. The pandemic made
the last three of those especially demanding, because
all patients in the unit where she is the nurse manager
at Dartmouth-Hitchcock Medical Center are immune
compromised.
Anna’s was the only unit that did not accept Covidpositive
patients, so the team had to be even more
protective than usual. Still, though over-stressed and
over-taxed, they answer every bell.
Anna says it fuels her fire to be a mentor to her fellow
nurses, telling us that she loves to, quote, “See the
sparkle in their eye when they realize, ‘I’ve got this.’”
Hospice-Palliative Care &
Gerontological Nursing
Jacob Fox RN, Nursing Supervisor
Maplewood Nursing Home of
Cheshire County, Westmoreland
After 13 years spent in the
manufacturing sector, Jacob
heard the call and enrolled in
the LNA program at River Valley
Community College in 2007.
His philosophy is to accentuate the
positive. That sets the tone and creates the environment
for patients and staff at the Maplewood Nursing Home of
Cheshire County. Jacob, who has been with Maplewood
since 2008, is a graduate of Vermont Tech’s practical
nurse program and earned his associate’s degree in
the science of nursing in 2018. He’s grateful to the
Maplewood nurses who have guided and supported
him through the years, who have helped him progress,
teaching and mentoring him along the way, and have
inspired him to, as he says, “be the best that I can be.”
Maternal-Child Health Nursing
April Henry MSN, RNC-OB, CNL,
Director of the Family Center and
Center of Reproductive Care and
Maternal Fetal Medicine
Exeter Hospital, Exeter
Though she’s been a maternalchild
nurse for a quarter-century,
each birth remains magical for
April Henry, who is the director
of Exeter Hospital’s Family Center
and the Center of Reproductive Care and Maternal Fetal
Medicine.
In her dual roles, she oversees labor and delivery, postpartum,
pediatrics and the nursery. She has spent 20
years at bedside and worked in underserved areas in
Southern California, high-risk obstetrics in New Jersey
and the community hospital in Exeter.
April’s motivation is her patients and her team,
emphasizing that she is fortunate to lead a wonderful
team who consistently rise to the occasion, despite the
substantial challenges of the last couple of years.
June, July, August 2022 New Hampshire Nursing News • Page 7
Medical Surgical Nursing
Caitlin Kretschmar BSN, RN,
PCCN
Wentworth-Douglass
Dover
Hospital,
In high school, Caitlin Kretschmar
suffered a brain aneurysm and
later a stroke. Crediting the nurses
who cared for her at Boston’s
Children’s Hospital, she decided
she wanted to be a nurse just like
the ones who saved her life.
She started at Wentworth-Douglass after graduating
from UNH’s nursing program in 2015, and now serves
as a nurse/charge nurse on a telemetry/medical surgical
unit but had to adjust to a critical change when it was
transitioned into a Covid unit in March 2020.
Despite the rigorous demands of the job and tireless
hours required, Caitlin is like the nurses who inspired
her to join their profession – she continues to provide
excellent care, compassion and empathy for her patients.
Ambulatory Clinical Nurse Educator
Jennifer Miller MSN, RN-BC
Elliot Medical Group, Manchester
In the fourth grade, Jennifer Miller
wrote a book report on Florence
Nightingale, and from that point
on, her heart was set on this
profession. After graduating from
the University of Virginia’s School
of Nursing, she served four years
as a U.S. Air Force nurse, and in
the 25 years since, she’s lived in eight states and worked
in a variety of settings that contributed to her knowledge
and experience.
As the nurse educator for the primary and specialty care
clinics, she creates content and presents the orientation
courses for medical assistants, LPNs, and RNs. For
current staff, she encourages professional development
opportunities and connects them with resources. Jennifer
believes that one of the most important character traits
for someone in her specialty is an attitude of humble
inquiry.
She says educating others is a privilege, one that she
enjoys and takes seriously. Over the years, she says,
she’s kept up with former students and peers, and that
it’s been, quote, “Wonderful to see careers flourish and
dreams come true.”
Pediatric & School Nursing
Jennifer Orbeso Charge Nurse,
DNP, MAN, RN NICU, Nursing
Diversity & Inclusion Specialist/
Clinical Nurse NICU
Dartmouth Health’s Dartmouth-
Hitchcock Medical Center,
Lebanon
At Dartmouth-Hitchcock Medical
Center, Jennifer Orbeso fulfills
dual roles as a clinical nurse in the
neonatal intensive care unit and as the nursing diversity
and inclusion specialist in the office of nursing support.
As the diversity and inclusion specialist, she takes the
lead in improving the recruitment, engagement and
retention needs of nurses who come from culturally
diverse backgrounds, and those who were trained
internationally. In her role as a clinician, she takes care
of premature neonates and other babies born with
a medical condition requiring critical care, and that
expands to taking care of the neonate’s family.
She helps empower parents to take care of their
babies, so they can be prepared to take good care of
them when they go home, knowing that they have
already undergone a stressful experience in their early
parenthood journey.
Psychiatric & Mental Health Nursing
Christina (Tina) Favero RN, Clinical
Nurse Emergency Department
Dartmouth Health’s Dartmouth-
Hitchcock Medical Center,
Lebanon
Tina Favero is a psychiatric RN
working in the Dartmouth-
Hitchcock Medical Center
emergency department with
high-acuity psychiatric patients.
She provides crisis intervention and stabilization for
those with suicidal ideation, anxiety, depression,
substance use disorders and a myriad of other
mental health diagnoses and conditions.
She is proud of the ability to utilize humor and
therapeutic listening when working with patients to
help them see that health care providers recognize
them as individuals and not as their diagnoses. This
facilitates trust and empowers patients to actively
participate in their own care through self-efficacy
and accountability.
Before joining the DHMC staff in 2017, she was a
charge nurse on a 15-bed, LGBTQIA+ adult inpatient
psychiatric unit as well as a clinical nurse leader on a
10-bed inpatient psychiatric unit in Vermont.
Public Health Nursing
Darlene Morse MSN, RN, MEd,
CIC, Public Health Nurse
Program Manager
NH Division of Public Health
Services, Bureau of Infectious
Disease Control, Concord
Before retiring, Darlene Morse
filled several roles. She managed
and worked with seven nurses
who investigate and make
recommendations around reports of infectious
disease. She was the State of New Hampshire
tuberculosis (TB) nurse consultant, providing expert
consultation to providers and nurses regarding TB
case management. During the Covid-19 response,
her role expanded to assisting in the investigation
and contact tracing of cases.
She says nurses in her field need to be extremely
nimble, as it is distinct from any other type of
nursing, especially in disease investigation. Any
Opportunity Awaits
REGISTERED NURSES
Emergency Department
IPCU
Specialty Clinic
Psychiatric Inpatient
Adult Day Program
To view all current job
opportunities, and to apply
please go to:
https://
springfieldhospital.org/
careers/
Equal Opportunity Employer
suspected outbreak, cluster of illness, unusual
occurrence of communicable disease, or other
incident that may pose a threat to the public’s health
must be reported within 24 hours of recognition.
To quote Darlene, “These nurses are the emergency
responders of public health. The nurses may find
themselves working on infectious disease reports
that have come in, and then have an investigation
blossom into a huge investigation that requires
several nurses to participate. Public health nursing is
so different from hospital or long-term care settings
in that we deal with the report of the individual
with an infectious disease and how they affect the
group of people around them. That investigation may
involve situations that may not end at the end of the
workday,” she says.
Senior Nursing Leader
Amy Matthews DNP, RN, CENP,
Chief Nursing Officer and Vice
President of Patient Care
Services
Dartmouth Health’s Cheshire
Medical Center, Keene
Health care is a complex
environment and those on the
top management team face
unique challenges at every
turn. Empathetic leadership is crucial, says Chief
Nursing Officer Amy Matthews. It’s empathy and
compassion, she says, that help nurse leaders create
an environment of value, respect and well-being.
Through interdisciplinary collaboration at the
executive level, she endeavors to make sure that
Cheshire Medical Center advances the health and
wellness of those in the Monadnock Region.
Even after 35 years in the profession, she remains
motivated by her desire to help other nurses follow
her path into leadership roles, and she is continually
inspired by her patients, who give her a deeper
appreciation for the full human experience.
Page 8 • New Hampshire Nursing News June, July, August 2022
New Hampshire Nurse Practitioner Association
2020 & 2021 Recipients Recognized
The New Hampshire Nurse Practitioner Association
dedicated to empowering NH NPs and championing
their practice, recently recognized award recipients
for both 2020 and 2021! Three distinct awards were
presented. NHNPA appreciates the efforts of the
awardees and those who took the time to provide
nominations, which have been shared below.
The NP of the Year for 2021 was recognized for
their significant contribution to the role of the Nurse
Practitioner at the state and/or national level, in the
areas of clinical, legislative, education and/or research.
This year’s NP of the year award went to Bridget
Linehan. Bridget Linehan, PhD, APRN is described as
“truly dedicated to the role of the Nurse Practitioner at
both the state and national level, investing her time in
clinical, educational, and research-based aspects of
patient care.” She has been an APRN since 2006 and
earned her PhD from the University of Massachusetts
Amherst in 2011 with a commitment to excellence in
NP practice. She is a clinical expert in pediatric primary
care and specializes in spina bifida, urinary incontinence
among athletes, bladder dysfunction and adverse
childhood events, bowel and bladder dysfunction, and
nurse practitioner precepting and education. She is
devoted to providing excellent, patient-centered care
while empowering others around her. Below are some
of her many accomplishments: Bridget specializes
in Pediatric Nephrology and Urology at Dartmouth-
Hitchcock Medical Center, providing high-quality care to
pediatric patients. She touches the lives of her patients
through her caring, informative, and patient approach to
care. Her dedication to optimal clinical care is evident
in the way she works to inspire and empower other
members of her team. Bridget Linehan also has a special
interest in athletic urinary incontinence (AUI) and has
previously published a study that she designed and
performed at a local high school near the hospital. She
continues her work in this field through AUI instrument
development and validation. This is just one example
of her commitment to the advancement of healthcare
and overarching goal of improving patients' quality
of life. Bridget Linehan also collaborates with another
NP to organize and implement the iSURF Nursing
program through the NH-INBRE Network providing
undergraduate nursing students, the opportunity to
explore nursing research.
WE HAVE OPPORTUNITIES FOR FULL TIME RNs and LPNs IN KEY ROLES:
• Charge RN- Emergency Room
• Emergency Room
• Primary Care
• Operating Room
• Maternal/Child Health
• OB/GYN Practice
• Cardiology Office
• Pediatrics Practice
The Advocate of The Year Award is given to an
individual who has made a significant contribution
toward increasing awareness and recognition of NPs.
Examples of past recipients have been physicians,
legislators and educators. This year our advocate of
the year award was presented to Debra Fournier, the
Director of Quality and Nurse Practitioner Services
at New Hampshire Hospital. Deb is an advocate for
empowering nurse practitioners, modeling excellence
in clinical practice, fostering respectful collaboration
with varied disciplines, and promoting ongoing quality
care. She supports APRNs working in the full scope of
practice and encourages engagement in leadership
opportunities. She has led the growth of an incredible
and highly skilled NP Team at NHH, a team meeting
the challenges of providing care to some of the most
vulnerable and challenging psychiatric patients in the
state. She has supported and commended the NP Team,
while encouraging a healthy work-life balance for those
providing care. She has championed the expansion of
the psychiatric nurse practitioner preceptor program
at NHH, a valuable asset in our state that will help
to develop and enhance the knowledge and skills of a
developing workforce of psychiatric nurse practitioners.
Although she has a quiet and humble presence,
Deb has led with advanced skills, insight, contextual
understanding, and diplomacy. She empowers the
NPs and those around her and allows for uncovering
continued opportunities where Advanced Practice
Nurses can shine.
The Lifetime of Service Award is presented each year
to an NP who, during their professional career has
made significant contributions to the role, scope and
development of NH Nurse Practitioners. This year,
NHNPA recognized Marcy Ainslie for her dedication
not only in patient care and advocacy but also her
dedication to educating nurses in a Nurse Practitioner
role. Marcy has worked for many years simultaneously
in the clinical setting as well as the classroom with a
clear dedication to healthcare and the role Nurse
Practitioners fill. She has over 22 years of Nurse
Practitioner experience, including in Emergency Room,
Family Medicine, Gero- Psychiatric Behavioral Health,
and Pain Management. She has been an integral part
of the Graduate faculty at both Rivier University and
now the University of NH. Marcy is known for her
intellect, and ability to elicit the clinical transformation
of a bedside nurse to decision making provider. She
never ceases to amaze her students with her valuable
knowledge and her patient who benefit from her
clinical skill and mind. Marcy has dedicated her life to
healthcare.
The recipients of the Advocate of the Year and NP of
the Year awards in 2020 were also nominated for the
2021 American Association of Nurse Practitioner
awards program. We are excited to announce that,
in June, Kim Mohan will receive the AANP NH State
Advocate of the Year award and Siobhan Benham will
receive the AANP NH State NH of the Year award.
You can learn more about these awardees and others
who were recognized for their contribution in 2020
below.
Kim Mohan, the owner, of the Tandem Group LLC,
was recognized as the NP Advocate of the Year. She
initially started working with our organization as a per
diem contractor assisting with moving our organization
to the next level with regard to our annual conference
June, July, August 2022 New Hampshire Nursing News • Page 9
and marketing. She continued to learn and advocate for our organization and
with her background and experience easily transitioned into our first full-time
Executive Director role. She has served as the Executive Director for two years and
has continued to ensure our mission, vision, and goals are clear with a direction
forward. She has continued to elevate our organization by developing processes
and relationships with key personnel from around the state and region, including
the front lines of the statehouse with policy. She sits on all of our board committees
to guide and support our work. She sits on various state-level committees to ensure
the voice of nurse practitioners is at the table. She works closely with our lobbyist to
ensure our goals and advocacy is at the highest level. She has been instrumental in
the growth and steadiness throughout these very challenging years.
Siobhan Benham, owner, and provider of Hearthside Family Health was recognized
as NP of the Year. She is a humble, quiet advocate for nurse practitioner students
and patients. Ms. Benham served as faculty at Rivier University for four years,
serving as lead faculty for women’s health and pediatric curricular development.
Current practice experience enhanced the quality of her teaching. After 12 years
in clinical practice and increasing frustration with a healthcare system designed
around insurance company requirements, she opened Hearthside Family Health
in 2017 under the Direct Access Model. She provides individualized care with
direct communication to and from her patients in an affordable, cost-transparent
model. Families and patients with high insurance deductibles, lack of insurance,
or seeking comprehensive, individualized primary care services are able to
access full-service primary care. She continues to provide evidence-based care,
with compassion and kindness, all while paying attention to the cost and delivery
of every medical choice. She does not compromise care, but advocates for her
patients by finding care that works for each patient all while staying an integral
part of the local medical community. Siobhan is a team player, motivated by
caring for others, and is a personal and professional role model for all who have
the pleasure to work with or know her.
Last year, Mary Sanford, APRN was recognized for the NHNPA Lifetime
Achievement Award. Mary has been an outstanding role model and advocate for
Nurse Practitioners since becoming the first NP to work in the ICU at Catholic
Medical Center. She has been involved in forwarding the profession of Advanced
Practice Nursing since serving on the NHNPA as the vice-president and president
working with the efforts of the NHNPA to acquire full practice authority for NPs in
NH. Mary is an outstanding clinician whose career has been marked by significant
accomplishments. She created a role for Advanced Practice Nurses to oversee
patient management in a busy medical/ surgical ICU. This was at a time when
nurse practitioners were not a mainstay as inpatient hospital providers. She worked
closely with the ICU intensivists and is responsible for a myriad of policies and
procedures that guide the care of these medically complex patients. After building
this unique role her focus shifted to advocacy for the nurse practitioners within
Catholic Medical Center and forged the way for institutional changes that were then
mirrored by area hospitals. She developed the Allied Health committee as a means
to provide a voice for advanced practice providers in an institution where APP was
a new phenomenon. She spent her time educating physician peers regarding the
role and scope of practice of nurse practitioners outlining the valuable resources
an APRN can bring to the inpatient arena. Through her efforts, the prevalence of
APRN’s in the inpatient setting within all disciplines is an example of the confidence
the institution has in the APRN model of care. Based on the development of the
Allied Health Committee this has since evolved to an APP committee, an organized
venue for APP advocacy within the institution now with a dedicated seat on the
Medical Executive Committee and voting rights. Mary is well known as an expert
clinician, admired by all who have had the opportunity to work with her. Mary
went from being the first and only ICU NP to an ICU now managed by a team of
Nurse Practitioners. She is the sole reason that nurse practitioners are sought
after in the inpatient arena, she has demonstrated the value of NP expertise and
has paved the way for all who came in her wake. She has presented at numerous
national conferences on the care of ICU patients specifically post-op management
of coronary artery bypass patients having done original research on the rewarming
protocol of post-surgical patients.
Debra Fournier, Advocate of the Year with
Jillian Belmont, outgoing President of NHNPA.
Marcy Ainslie, recipient of the LIfetime of Service award
with Jillian Belmont, outgoing President of NHNPA.
Bridget Linehan NP of the Year pictured with
Jillian Belmont, outgoing President of NHNPA.
Siobhan Benhamp ‘20 NP of the Year, Mary Sanford ‘20
LIfetime of Service recipient, Kim Mohan ‘20 Advocate of the Year
Page 10 • New Hampshire Nursing News June, July, August 2022
Early Career and Graduating Student Nurse
Conference 2022 – Your Future in Nursing
We were delighted that this year the NHNA Student Nurse Conference was held as
an in-person event on April 14, 2022, at Plymouth State University. In recognition
that the past two years graduating students did not have the opportunity to attend an
in-person event registration was opened to Early Career Students as well. We were
delighted to have over 100 registrants from 6 schools, mostly from the North Country.
We counted on the generous donations from sponsors to support the event. We were
able to defray the costs for lunch and breaks thanks to our lunch sponsor Southern
New Hampshire University and our break sponsors University of Southern Maine
and Cheshire Hospital. (Names of the other Gold, Silver and Friends sponsors can be
found elsewhere in this issue). The annual program is planned by the Commission on
Nursing Practice. Thanks to the Commission members in Table 1 below.
Table 1: Commission on Nursing Practice Members
Carol Allen-Chair
Teresa Knight
Jamye Cutter
Kerriann Reynolds
Shelley Freidman-Davis
Pamela Kallmerten
Bonnie Aybar-Crumley
This year’s program was based on the theme “Your Future in Nursing.” The idea
emerged organically from conversations the commission members engaged in
related to the challenges and realities of the nursing profession. Considering the
National Institute of Medicine’s publication of the Nurse of the Future 2020-2030
document the Commission wanted to focus on the themes identified including
a focus on opportunities in public health and community health post pandemic,
social determinants of health and climate action. This cohort of students has been
presented with challenges and they have proven their resilience. The Commission
wanted to focus on the many innovative opportunities students will encounter in
their careers as professional nurses. We thank our agenda of speakers for a very
engaging day.
Holly McCormack, RN DNP the current president of NHNA began the program
with her opening remarks congratulations to the attendees and acknowledged
all they have endured during their education. She also referenced how grateful
NHNA was to be able to have an in person event. As President and CEO of Cottage
Hospital she recognized the unique needs of the north country and was delighted to
be able to host an event at Plymouth.
Dr. McCormack then introduced the director of the Plymouth State University
Nursing Department, Donna Driscoll who introduced the PSU President Dr. Donald
L. Birx, Ph.D who humorously referred to himself as Dr. Birx’s sister (the American
physician and diplomat who served as the White House Coronavirus response
coordinator). He recalled the healthcare service by several of his family members
and thanked the students for choosing nursing and wished them well.
Shelley Friedman
with Caitlin Yazel
Julie Cote
Lori Shibinette –
Keynote
The keynote speaker was the Commissioner of the Department of Health and Human
Services, Lori Shibinette. The Commissioner gave a very engaging presentation about her
trajectory in nursing. Starting as a nurse at NH Hospital not realizing it was a psychiatric
facility, she wanted to be a Maternity Nurse. She eventually fell in love with psychiatric
nursing. When she found that she was looking for advancement opportunities she
ended up leaving NH Hospital and the rest is history. The key point that she made to
the audience was the importance of life work balance. Her message stressed that finding
the perfect job did not necessarily mean finding the job that offered the most money but
students were asked to consider all of the other factors that would influence their longevity
in the profession. She asked them to consider continuing education opportunities, flexible
benefits, advancement opportunities and other non-monetary considerations.
In advance of a Workforce Roundtable that the Commissioner was hosting on April
18, 2022 (see Giving Care: A Strategic Plan to Expand NH Workforce in this issue),
she asked the audience for ideas. She asked: If you could present a package to the
Governor that would expand the workforce what should it include? The major themes
that emerged were loan repayment and expanded pathways to becoming a nursing.
Many commented on the many barriers to nursing program admission, while others
felt that advancement through education is not attainable because they will have
outstanding loans that will in themselves be difficult to repay. The Commissioner
promised to take these ideas back to the roundtable.
The perennial program favorite was a panel discussion with recent graduates. This year
there were two recent graduates Benson Canfield RN, who currently works at Cottage
Hospital and Abigail Buchanan RN who currently works at Dartmouth Health. They both
clearly love their jobs. Carol Allen, Chair of the Commission facilitated the discussion. The
biggest take home point the new graduates shared was: ask for help. They talked about
how one day you are a student and the next you are “the nurse.” Asked how they flipped
the switch they both stated that they had to remind themselves to use and be confident in
the knowledge and skills they learned in school. They also cautioned though that there are
times that you need to use your resources. “There may be tears!”
Students in the audience were most interested in how to pass NCLEX. Both panelists
passed the exam on their first attempt (not without angst) using different testing strategies,
Abigail was determined to pass because she had a job waiting for her, so she used UWorld
and maxed out on the number of practice questions she took. Benson used the program
June, July, August 2022 New Hampshire Nursing News • Page 11
he used in school, ATI. Benson noted that he thought that
ATI was harder than NCLEX but was still sure leaving the
testing center that he had failed. Fortunately, both passed
the exam and are currently licensed. We wish them both
long and successful careers.
There were three live presentations based on the theme of
Your Future in Nursing
Caitlin Yazel BSN, APRN, CPNP, Nurse Manager
& Pediatric Nurse Practitioner in the Department of
Dermatology – Dartmouth Hitchcock Medical Center
focused her presentation on Your Future in Nursing
Ambulatory Care. Here are her key messages
1. There is a gap between the world of in-patient nursing
and outpatient nursing and we have to find where
these two worlds collide. We know what the day-today
work of the inpatient nurse is but we have to find
a way to define the role of the ambulatory care nurse.
The ambulatory care nurse role is to help patients
adhere to treatment with the restrictions the pandemic
places on the system.
2. There is good news we are on the cusp of a massive
change in healthcare! It scares some, but it shouldn’t!
Change=powerful Nursing talents are becoming
highlighted now more than ever because of the
shortage.
3. How nurses can get involved: Nurses on Boards,
Nurses as authors, Nurses in leadership positions (find
a mentor) and Nurses as innovators
Kaitlyn Liset, RN, MS Chair of the Commission on Climate
Action and Health and her panel of Brooke and Jacob
McGinnis and Brooke Hall, both student members from
UNH DEMN program presented: Your Future in Nursing:
Climate Action and Health. Their key messages included
1. The link between climate change and health:
“Between 2030 and 2050, climate change is expected
to cause approximately 250,000 additional deaths
per year, from malnutrition, malaria, diarrhea and
heat stress.” https://www.who.int/news-room/factsheets/detail/climate-change-and-health.
“We in
New Hampshire are no longer immune to poor air
quality, extreme heat, flash flooding and its associated
soil erosion and run-off contamination, unexpected
drought as happened this year, warming waters and
their effect on fish, shellfish and food safety, longer
pollen and allergy seasons, more weeds and pests,
increased tick and mosquito hosts for Lyme disease,
West Nile and Eastern Equine Encephalitis, let alone
the inevitable coastal flooding from sea level rise.”
2. An example of how climate change is linked to health
is the increasing risk for Lyme Disease as the climate
in our area is warming, is wetter, and LD is already
endemic. We do have opportunities to provide better
education and increased awareness among patients
and the population. Early recognition and treatment
are highly effective in preventing the downstream
consequences of Lyme Disease. Nurses can:
- Increase awareness
- Prevent exposure
- Assist in diagnosis and prompt treatment through
identification
- Assess and monitor risks
- Report for tracking and trending
For more information about Climate Action and Health
visit: https://www.nhclimatehealth.org/
Julie Cote, DNP, MBA, RN, CNE focused her presentation
on: The Future of Nursing: Advancing Health and Health
Equity. Dr. Cote centered her remarks on the Upstream/
Downstream Parable of Health Equity. Here are her key
messages:
• Downstream. Chronic disease treatment—
emergency services, pharmacology, surgery, and
dialysis.
• Mid-stream. Modifying individual behavior—physical
activity, nutrition, tobacco use, maternal health, high
school graduation, and violence control.
• Upstream. Addressing social determinants of
health—conditions in which people are born, grow,
live, work, and play.
The point being that in healthcare we need to consider
the Social Determinants of health and being to shift our
focus from downstream (individual treatment) to upstream
(prevention strategies for the whole community, with a
focus on the vulnerable). Dr. Cote engaged the student
with her own experiences illustrating the parable.
ANA was offering a webinar presentation on the Top
Ten Workplace Hazards, a program designed for New
Graduates and Early Career Nursing. The 90 minute
live webinar was streamed during the program. The
common workplace hazards including commonly cited
hazards and how to avoid them included slips, trips
and falls, ergonomic or back injury, needlestick injury,
chemical hazards but most importantly was the hazard
of workplace violence. Attendees were sent the link to
access and share the webinar after the program. We
received positive feedback from the conference attendees
and also some feedback on how we can improve the
conference in the future which we will consider for our
2023 in person conference. The date and location will be
announced well in advance to encourage as many schools
as possible to send students for this important professional
opportunity.
Page 12 • New Hampshire Nursing News June, July, August 2022
Early Career and 2022 Graduating
Student Nurse Conference
NHNA WISHES TO EXTEND A THANK YOU TO 2022
CONFERENCE SPONSORS:
Catholic Medical Center – Manchester
Jennifer.Torosian@cmc-nh.org
New Hampshire Hospital
http://www.dhhs.nh.gov/dcbcs/nhh
Rivier University
landing.online.rivier.edu
Cheshire Medical Center -- Keene
http://www.cheshiremed.org/careers
Solution Health: Elliot Health System
& Southern New Hampshire Health –
Manchester and Nashua
www.ElliotHospital.org
www.SNHCareers.org
Saint Joseph's College of Maine
http://www.sjcme.edu/nursing
Cottage Hospital
www.cottagehospital.org/careers
Granite VNA --Concord
http://www.granitevna.org/
Southern New Hampshire University
snhu.edu/nursing
Dartmouth-Hitchcock –
Lebanon – Concord – Manchester – Nashua
www.DHnursing.org/NRP
Grand Canyon University
www.gcu.edu
University of New Hampshire
https://chhs.unh.edu/nursing/graduateprograms
Encompass Health – Concord NH
and Massachusetts
http://www.encompasshealth.com/
Quinnipiac University
Qu.edu/nursing
University of Southern Maine
kate.flanders@apdegrees.com
June, July, August 2022 New Hampshire Nursing News • Page 13
WELCOME NEW and RETURNING NHNA MEMBERS!
NHNA welcomes these new and returning members. Thank you!!! What do these 45 nurses and over 1,100 NHNA members know that you don’t?
If you are not a member ask your neighbor on this list why they joined! Go to nhnurses.org where joining is easy and one of the best
professional values for your money! We want to see your name here in the next issue of the NH Nursing NEWS!
Amherst
Nicole Maher-
Whiteside
Antrim
Monica Stevens White
Atkinson
Michelle Dianne
Chianca
Barrington
Jillian Fitzpatrick
Bartlett
Mary O'Keefe
Belmont
Heather Jean Phelan
Bethlehem
Tina Williamson
Canterbury
Kerrie Haynes
Claremont
Ryan Terry
Colebrook
Sharon W. Milan-Snow
Concord
Angelique Catherine
Carrier
Derry
Deanna L Benjamin
East Hampstead
Jennifer Denise
Thebodeau
Farmington
Briana Posanka
Goffstown
Bobbi Harrington
Hillsboro
Mary Marciniak
Hopkinton
Glennis McKinley
Hudson
Joy A Baum
Colin Evans
Kristen Veneman
Laconia
Patricia J O'Connor
Lisbon
Mary I Carlson
Manchester
Gale Lyman
Alicia Colleran
Merrimack
Grace Desrosiers
Marylee Verdi
Christopher Malachite
Milton Mills
Jane Rosa
Nashua
Kathleen Hughson
New Ipswich
Emily Spenski
New London
Gia Paone
Maura C Marshall
Newmarket
Melody I Gibson
Newton
Roxanne Ashby
North Haverhill
Laura Hitchmoth
Pembroke
Susan Lynn Rooks
Pittsburg
Monique Blair
Pittsfield
Danielle Lemieux
Rindge
Natalie Kennett
Rochester
Virginia Lawrence
Rumney
Brittany Hilton
Strafford
Spofford Wilkinson
Warner
Valerie Smith
Windham
Dierdre H Gilroy
Wonalancet
Amy Russell
Combating Compassion Fatigue and Burnout During the Pandemic
Two years into the COVID-19 crisis, healthcare professionals have continually seen and
dealt with the dramatic changes that the pandemic has brought. Specifically, the nursing
profession has felt the pressures of the severity of the situation with ongoing shortages and
what has felt like a lack of permanent relief efforts. Even before the ongoing pandemic,
healthcare workers were dealing with an internal epidemic; a nursing shortage that has led
to continual burnout and compassion fatigue (CF). With the constant stress of increased
workloads, high infection risks, and unsafe working conditions, nurses are calling for a
need of advocacy and support for those once known as healthcare heroes.
Nursing burnout and CF are areas in healthcare that are often spoken of, but little less
than acted upon. With the exacerbation of the pandemic and the strain of an already
demanding population, the mental health aspect associated with the lack of solutions
can be cause for exponential consequences in an already failing system. As the average
age of nurses continues to climb, the U.S. Bureau of Labor Statistics predicts over one
million nurses to retire by 2030, furthering the burden on healthcare needs (U.S. Bureau of
Labor Statistics, 2021). Obtaining and retaining nurses at this time should be a priority for
healthcare institutions, yet those experiencing burnout and CF voice their concerns over
the lack of value seen and felt within recent years. For Barnabas Crozby*, who works in
the float pool at Northern Light Eastern Maine Medical Center (NL-EMMC), there is a lack
of concern felt, as little has been done by the facility to retain nurses or provide mental
health support. “They’ve done nothing. [Eventually] the minimum wage was raised, but
this wasn’t done until after we lost a lot of techs, dietary, housekeeping, etc.” states Crozby,
“So, naturally, nursing is filling all these gaps while still being expected to continue taking
the same number of patients, often at higher acuity.” The realities of burnout and CF are an
ongoing concern for the general nursing population due to the increased difficulties that
lead to burnout. For Crozby, the lack of acknowledgment and support from management
has been detrimental to what was once a passion for quality care in nursing. After over five
years working as a bedside nurse at NL-EMMC, Crozby is left questioning their career: “I
am not entirely sure I want to be a nurse anymore.”
A career in nursing comes with the burden of mental, physical, and emotional stress.
With the already known shortages in addition to burnout and CF, the pandemic has
simply exacerbated and shed light on the epidemic of mental health in nursing. Nursing
quality of life has rapidly declined since the start of the pandemic, with studies showing
the number one component for the rise of mental health in nursing being that of poor
working conditions (Havaei et al., 2022). This can be seen as due to increasing nurse-topatient
ratios, higher acuity patients, lack of support and resources, as well as requirements
to work overtime. Overworking nurses causes mental and emotional exhaustion,
which many are currently experiencing in addition to increased stress and depression
levels (Murat, Köse & Savaser, 2020). Largely, the core of the issue not only comes from
a nursing shortage but also due to the focus of healthcare administration being that
of profit over safety in patient care. This is what has led to a healthcare system creating
liability due to the inconsistencies of health support for the caregivers who provide care.
The consequences of allowing nurses to continue to work in harsh environments will
only further impair the healthcare system by facilitating shortages as burnout has been
associated with lack of sleep, depression, anxiety, PTSD, and even suicide (Schlak et al.,
2022). Burnout has also been related to increasing losses in revenue as a 2019 study by
Annals of Internal Medicine estimated that burnout costs the healthcare industry up to $4.6
billion a year (Han et al., 2019).
Advocating for safety in nursing leads to the promotion of quality of care in
patients as burnout and compassion fatigue are seen to be linked to decreased
patient satisfaction, high infection rates, increased risk of errors, poorer quality
care, longer hospitalizations, and increased risk of mortality (Schlak et al.,
2022). The need to implement mental health policies to mitigate burnout and
CF is crucial to effectively support professional quality of life in nursing and
increase patient safety. Developing strategies to combat burnout and CF requires
immediate action to remedy the issue at the core and will further decrease
healthcare costs and increase retention in healthcare. Strategies include
increasing promoting self-care, recruitment efforts, acknowledging good work
ethic, building a sense of community, and pushing for safe staffing regulations
(American Nurses Association, 2019). Providing a culture of well-being and peer
support into the work and home environment allows for a sense of appreciation
in a job that has little acknowledgment.
The need to advocate for healthcare professionals is higher now than ever.
The demand for nursing retention requires providing empathetic nurse leaders,
increasing pay, and engaging nurses in decision-making efforts (Hoang, 2021).
Effective communication between management and staffing, as well as
supporting safe-staffing ratios and implementing mental health support, will
further enhance professional quality of life. We must make these changes that
can save the lives of nurses, patients, and the communities that we serve. We
must promote patient outcomes, and that begins with nurturing the lives of our
healthcare heroes.
*Name has been changed for privacy
References:
American Nurses Association. (2019). Nurse Staffing Advocacy. ANA. Retrieved from https://www.
nursingworld.org/practice-policy/nurse-staffing/nurse-staffing-advocacy/?__hstc=249295192.
b37650795b2320ea68fe4b88d63e7eaf.1646575636791.1646575636791.1646577542605.2&__hs
sc=249295192.1.1646577542605&__hsfp=999455785
Han, S., Shanafelt, T. D., Sinsky, C. A., Awad, K. M., Dyrbye, L. N., Fiscus, L. C., Trockel,
M., & Goh, J. (2019). Estimating the attributable cost of physician burnout in the
United States. Annals of Internal Medicine, 170(11). https://doi.org/10.7326/m18-1422
Havaei, F., Tang, X., Smith, P., Boamah, S. A., & Frankfurter, C. (2022). The association
between mental health symptoms and quality and safety of patient care before
and during COVID-19 among Canadian nurses. Healthcare, 10(2), 1–13. https://doi.
org/10.3390/healthcare10020314
Hoang, S. (2021). 3 strategies for combating nurse burnout during and after the
pandemic. Oncology Nurse, 14(1), 14.
Murat, M., Köse, S., & Savaser, S. (2020). Determination of stress, depression and burnout
levels of front-line nurses during the Covid-19 pandemic. International Journal of
Mental Health Nursing, 30(2), 533–543. https://doi.org/10.1111/inm.12818
Schlak, A. E., Rosa, W. E., Rushton, C. H., Poghosyan, L., Root, M. C., & McHugh, M.
D. (2022). An expanded institutional- and national-level blueprint to address nurse
burnout and moral suffering amid the evolving pandemic. Nursing management,
53(1), 16–27. https://doi.org/10.1097/01.NUMA.0000805032.15402.b3
U.S. Bureau of Labor Statistics. (2021, September 8). Registered nurses : Occupational
outlook handbook. U.S. Bureau of Labor Statistics. Retrieved from https://www.bls.
gov/ooh/healthcare/registered-nurses.htm
Page 14 • New Hampshire Nursing News June, July, August 2022
Rivier University’s new Nursing Simulation and Clinical Education
Center is transforming the delivery of nursing education
Rivier University’s nursing labs have been
transformed with a $5 million total renovation.
The Nursing Simulation and Clinical Education
Center is open and fully operational for handson
learning and high-tech simulation for nurses
and nurse practitioners. State-of-the-art skills and
simulation labs offer the newest technology for
clinical assessment, community nursing, and telehealth simulation. The 17,825-squarefoot
facility provides students the opportunity to gain real-world experience in
controlled clinical settings and is the most recent advancement in the University’s
multi-year campus enhancement plan.
“The future of nursing education is here,” says Sister Paula Marie Buley, IHM, Rivier’s
President. “Rivier has long been at the forefront of simulation-based learning, and
the new center offers nearly limitless opportunities for students to gain sophisticated
clinical skills in our fully accredited ASN, BSN, RN-BSN, MSN, and DNP programs.”
The center spans the second level of Sylvia Trottier Hall and includes six simulation
labs and assessment areas, two classrooms, a lecture hall, a suite of nursing
administrative and faculty offices, and several areas for faculty-student collaboration.
Simulation labs mirror the settings in which nurses most often provide care: medical/
surgical and pediatric/neonatal hospital rooms, an obstetrics room, examination
rooms, and telehealth offices. Designated labs accommodate undergraduate nursing,
public health, and advanced nurse practitioner training.
“As healthcare advances, Rivier adapts,” shares Dr. Paula Williams, Dean of the
Division of Nursing and Health Professions. “The new center is fully equipped with
state-of-the-art technology, which allows us to manage, record, and assess simulation
training for practice in real-world health environments. We have a wide variety of
high-fidelity simulators including pediatric Hal, the world’s most advanced wireless
pediatric simulator and the first to simulate lifelike emotions through dynamic facial
expressions, movement, and speech.”
The University is a nationally ranked top 100 nursing school out of 3,000
institutions evaluated across the country by Nursing Schools Almanac and
honored as the #1 private nursing school in New Hampshire. The RN-BSN
online program is ranked #1 in the state by RegisteredNursing.org. Additionally,
Intelligent.com has ranked Rivier in the Top 50 for Best Nurse Practitioner
Degree programs nationally.
Focused on continuous improvement and innovative technology, the University
has launched a $5 million renovation of facilities for business and security
studies. The enhanced facility will welcome students for the fall semester and
will mirror modern business environments with cybersecurity labs, an Enterprise
Zone fostering interaction and innovation, an office suite and conference room,
and university technology services. The facility will support the education
of management, finance, marketing, sport management, cybersecurity
management, and homeland and international security majors.
The University is accepting applications for all programs and offers on-the-spot
admission decisions. Test scores are not required, and there is no application fee.
Interested students can access more information at www.rivier.edu and contact
the Office of Admissions at (603) 897-8507 or admissions@rivier.edu. Oneon-one
virtual meetings with enrollment advisors can be arranged by visiting
www.rivier.edu/admissions/team/.
Rivier University www.rivier.edu
420 South Main Street
Nashua, NH 03060
WE ARE HIRING
COTTAGE HOSPITAL. WOODSVILLE . NEW HAMPSHIRE
REGISTERED NURSES
FULL-TIME, PART-TIME AND PER DIEM
DAY AND NIGHT SHIFT - BENEFIT ELIGIBLE
MED SURG/ICU
SURGICAL SERVICES
EMERGENCY DEPARTMENT
GERIATRIC PSYCH
SIGN-ON BONUSES OFFERED FOR SOME POSITIONS!
WHY COTTAGE? FOR MORE THAN 115 YEARS, COTTAGE HOSPITAL HAS SERVED
THE RESIDENTS OF THE UPPER CONNECTICUT VALLEY. TODAY, COTTAGE HOSPITAL IS A LEVEL IV
TRAUMA CENTER AND MODERN 35-BED CRITICAL ACCESS HOSPITAL THAT HAS BEEN RECOGNIZED
FOR PROVIDING EXEMPLARY CARE. OUR HOSPITAL OFFERS LOW-COST, HIGH-QUALITY HEALTHCARE
DESIGNED FOR YOUR SCHEDULE. “WE’VE CREATED AN ATMOSPHERE WHERE EVERYONE STRIVES FOR
EXCELLENCE.” THIS “CULTURE OF EXCELLENCE” IS EVIDENT IN THE HOSPITAL’S QUALITY CARE RESULTS!
We are an equal opportunity employer
APPLY TODAY! COTTAGEHOSPITAL.ORG/CAREERS
About Rivier University
Founded in 1933 by the Sisters of the Presentation of Mary, Rivier University
is a Catholic institution recognized for distinctive academic programs, offering
many of the region’s leading programs at the undergraduate, professional
studies, graduate, and doctoral levels with on-campus and online options. The
Rivier experience ensures that students develop leadership skills as well as an
awareness and appreciation of diverse cultures in New England and around the
world.
Registered Nurses
Full Time – 3 day work week
Part Time – All Shifts
Psychiatric Specialty Areas:
Young Adult, Adult, Geriatric & Crisis Stabilization
Competitive Benefits & Pay Scale
Extensive Paid Orientation | Recent Graduates Welcome!
View job specifications and how to
apply for external RN postings:
http://das.nh.gov/jobsearch/Employment.aspx
New Hampshire Hospital
NH Department of Health and Human Services
36 Clinton Street Concord, NH 03301
Human Resources 603-271-5855
June, July, August 2022 New Hampshire Nursing News • Page 15
It’s Time to Talk About Athletic Urinary Incontinence
Hailey Stevens & Bridget Linehan, PhD, APRN
Most women are familiar with the concept of stress urinary incontinence, in which the
pressure or ‘stress’ on the bladder causes a person to leak urine. Stress incontinence
affects 29 million women in the United States (Patel et al., 2022). Along the same lines,
many women experience stress incontinence during exercise. The forces that occur
during exercise increase intra-abdominal pressure, overcoming the resistance provided
by the pelvic floor, increasing the chance that women will have urinary incontinence
during exercise.
This leakage of urine during activity or exercise has been named Athletic urinary
incontinence (UI), and this topic has become an increasingly popular focus of study
in the past three decades, particularly since 2019. The prevalence of Athletic UI
varies dramatically from sport to sport, with low rates in low-impact sports such
as swimming and golf, and high rates in high-impact sports such as gymnastics,
trampoline, and volleyball (Bø & Nygaard, 2020; see figure 1).
Athletic UI is not a small concern for many women, and there can be a significant
social stigma about incontinence. It can cause worry, frustration, and embarrassment
for female athletes and active women. Visible leaks are bothersome for athletes,
especially in gymnastics and other sports where uniforms provide minimal coverage.
Greater than 60% of gymnasts and cheerleaders reported that urine leakage caused
them embarrassment (Skaug et al., 2021). Exercising in public and knowing they might
leak at any moment can make women feel vulnerable. As one female weightlifter
explained, “It sucks having this issue, it affects my confidence, security, and potential
of missing or making lifts” (Wikander et al., 2021).
The stigma, worry, and embarrassment about incontinence causes many women to
exercise less, exercise only in particular locations or at certain times, or stop exercising
altogether. One out of every five athletes with UI occasionally avoids training and
specific exercises due to leakage (Skaug et al., 2021). Physical activity and exercise are
known to improve health and reduce the risk of developing many chronic diseases,
such as hypertension, diabetes, and hypercholesterolemia. Therefore, if Athletic UI
causes women to reduce the amount or type of physical exercise or stop exercising
altogether, there is a risk that it could negatively affect their overall health.
Prior studies have shown that women are very private about their Athletic UI and do
not talk to anyone about it. In our recent study of 61 active women, only one-third
talked about their incontinence with a healthcare professional. As nurses, we can help
by asking about incontinence and encouraging women to seek help. Each time we
reach out to ask a woman about incontinence, we are supporting her ability to stay
engaged in exercise and self-care, enabling her to reap the many physical and mental
health benefits of regular exercise.
References
Bø, K., & Nygaard, I. E. (2020). Is Physical Activity Good or Bad for the Female Pelvic Floor?
A Narrative Review. Sports Medicine (Auckland, N.Z.), 50(3), 471–484. https://doi.
org/10.1007/s40279-019-01243-1
Nygaard, I. E., Thompson, F. L., Svengalis, S. L., & Albright, J. P. (1994). Urinary incontinence in
elite nulliparous athletes. Obstetrics and gynecology, 84(2), 183–187.
Patel, U. J., Godecker, A. L., Giles, D. L., & Brown, H. W. (2022). Updated Prevalence of
Urinary Incontinence in Women: 2015-2018 National Population-Based Survey Data.
Female pelvic medicine & reconstructive surgery, 28(4), 181–187. https://doi.org/10.1097/
SPV.0000000000001127
Skaug, K. L., Engh, M. E., Frawley, H., & Bø, K. (2021). Urinary and anal incontinence among
female gymnasts and cheerleaders-bother and associated factors. A cross-sectional study.
International Urogynecology Journal. https://doi.org/10.1007/s00192-021-04696-z
Wikander, L., Kirshbaum, M. N., Waheed, N., & Gahreman, D. E. (2021). Urinary Incontinence
in Competitive Women Weightlifters. Journal of Strength and Conditioning Research.
https://doi.org/10.1519/JSC.0000000000004052
We have recently begun a study to test out a questionnaire that assesses UI in active
women, called the Active Women’s Incontinence Screening Tool (AWIST). This
questionnaire was designed to serve as a comprehensive assessment of the many
variables that affect UI, including activity level, type of activity, embarrassment, bowel
and bladder habits, fluid intake habits, obstetric history, and other important factors. If
you would like to participate in the AWIST validation study, please scan the QR code
below.
It is our hope that nurses and other healthcare providers will ask women about
incontinence and help them connect with skilled nurse practitioners and midwives,
pelvic floor physical therapists, gynecologists, and urologists who can help treat their
symptoms and keep them active and engaged in life as they would like to be.
Figure 1.
Percentage of Women Who Experience UI by Activity Type
Note. Graph created by Jess Perkins. Percentages from Nygaard et al. (1994).
Page 16 • New Hampshire Nursing News June, July, August 2022
Improving Employee Engagement
on an Inpatient Unit: A Quality
Improvement Project
Holly A. McCormack DNP RN
Abstract
BACKGROUND: Engaged employees are paramount
to the success of an organization. They are more
invested in their organization and the unit on which
they work. This investment in the organization results
in higher patient satisfaction and safety, less staff
turnover, and improved quality. According to the
literature, generational differences may be necessary
to consider when improving employee engagement.
To successfully lead a multigenerational workforce,
nurse leaders should consider these differences
and incorporate them into their strategic plan for
employee engagement.
METHODS: A pilot survey was conducted on a
medical-surgical unit to assess a perceived lack of
engagement. Subsequently, work engagement was
evaluated utilizing a validated tool called the Utrecht
Work Engagement Scale. This quantitative tool was
combined with four qualitative questions to assess
the demographics of the respondents. Eighty-six staff
received the link for the anonymous survey; 28 staff
responded to the survey, a 32% return rate.
INTERVENTIONS: A Think Tank, via the Zoom platform,
was organized as a method that enabled a broader reach
to a larger audience. Nursing leaders from two participating
organizations were invited to attend. The Think Tank
provided an opportunity to collaborate on employee
engagement and the recommendations surrounding the
issue. Generational implications of employee engagement
were a highlight. Including the project lead, eight nursing
leaders participated in the Think Tank.
RESULTS: The Utrecht Work Engagement Scale
demonstrated an average employee engagement
at each participating organization. The additional
qualitative questions showed a trend in generational
response and participation in the engagement survey.
These responses provided the subject matter for the
ensuing Think Tank with the hospital nursing leaders.
CONCLUSION: The Utrecht Work Engagement Scale
demonstrated that the respondents to the survey were
engaged at an average level. The demographical
questions suggested that there may be a link between
the generational cohort and survey response. This
link is essential for nursing leadership as the Baby
Boomer and Generation X nurses exit the workforce.
Additional research on this topic is warranted.
Utilizing a Think Tank to collaborate on shared
experiences and recommendations for improving
employee engagement of a multigenerational medical
surgical staff is an effective strategy for reaching a
broad audience.
Keywords: employee engagement generational cohort,
nursing, generations, quality improvement, medicalsurgical,
think tank
Florence
Nightingale.
Clara Barton.
Radonda Vaught?
The guilty verdict in the
Radonda Vaught trial has the
very real capacity to shape
nursing for decades.
Jessica Reeves, MSN, MPH, APRN
Editor, New Hampshire Nursing News
Mistakes and errors are regrettable but inevitable risks of
the job. As nurses, we are trained to report mistakes and
errors when they happen; maintenance of transparency in
this way is an important element of our profession and is
intended to inform improvements that will, in turn, reduce
the likelihood of a recurrence of the error.
The context in which Radonda’s error occurred may be a
familiar one to many nurses. Overworked and understaffed.
Unsustainable staffing ratios and workload. Ever-changing
workflows, technology updates and unofficial shortcuts and
workarounds. All of this is a recipe for disaster – not only for
patients, but for nurses as well.
When this error came to light, Radonda’s employer was
also investigated. Serious gaps in patient safety policies and
systems were found, determined to present an immediate
danger to patients. Radonda’s employer did not face
criminal charges (civil charges were brought, and settled out
of court with the family), and received no punishment from
the state health department.
Will the Implementation of the
Joy in Work Framework Improve
Nurse Leader Resiliency?
Susan Santana, DNP, MBA, RN, NE-BC
Vice President of Patient Care Services and
Chief Nursing Officer
Southern NH Medical Center
Abstract
Introduction: Nurse leaders are a critical part of
the healthcare team and are faced with increasing
responsibilities and multiple ongoing stressors that
have a daily and damaging impact on the leader’s
ability to succeed. Nurse leaders are at high risk for
burnout and at risk for leaving the profession and
as a result, nurse leaders must develop and sustain
a significant capacity of resilience to thrive and
succeed as transformational leaders in healthcare.
The purpose of this study is to use the Institute for
Healthcare Improvement’s Joy in Work Framework
to help discover and improve the conditions that
contribute to nurse leader’s joy in the workplace.
Methods: An interventional mixed methods design
was used for this study. The intervention included
the introduction and implementation of the Joy
in Work Framework. The quantitative design
utilized the Connor Davidson Resilience Scale
(CD-RISC) and a Paired Samples t-Test was used
to compare the data points from the CD-RISC 25
tool pre and post intervention. The qualitative
design assessed the nurse leader’s responses to
the Framework during group interview sessions.
The implementation included two 1-hour sessions
conducted with 27 nurse leaders over a 2-month
time-frame.
Results: The Paired Samples t-Test indicated a
statistically significant increase in the total CD-
RISC-25 score after the intervention compared
to pre-intervention (81.81 post vs. 76.85 pre, t=-
2.16, p=0.04/p
June, July, August 2022 New Hampshire Nursing News • Page 17
Do We Really Know What is In Our
Food? The Connection Between
Dietary Mycotoxin Exposure and
Pediatric Crohn’s Disease
Susan Gonya, MA, RD, RN, CCRN
Upper Valley Community Nursing Project has some exciting news. We have
changed our name to Community Nurse Connection. Kristin Barnum, RN, BSN,
MBA is our new Executive Director and Jill M. Lord, RN, MS is our new Board
Chair.
Our aim is to unite, strengthen and support regional Community Nursing
Programs.
Our beliefs are based on a holistic philosophy of nursing, which dates
back to the mid 19th century—a time when nurses focused on the health of
individuals, families, and groups within a community.
Our focus is on the health people drawn together by such commonalities as
location, religious affiliation, social connections, or fraternal association.
We believe every community deserves access to a community nurse.
Please visit our website: communitynurseconnection.org or email
kristin@communitynurseconnection to learn more about connecting more
communities with nurses.
NHNA Supports MCED Legislation
Pamela P. DiNapoli, PhD, RN, CNL
Executive Director, NHNA
Unity in politics, we hear all too often, is something more honored in the breach
than the observance. But it does happen, and it should be celebrated when it
occurs—especially if it helps to save lives.
Congress has a number of urgent priorities, but the fact remains that cancer
will take the lives of more than 600,000 Americans this year alone. Recently, I
am happy to note, the entire New Hampshire delegation to Congress signed the
Medicare Multi-Cancer Early Detection Screening Act (https://www.congress.
gov/bill/117th-congress/house-bill/1946/all-info?r=6&s=1), legislation that will,
ultimately, enable millions of Americans to detect cancer in its earlier, more
treatable stages. As an exemplar of unity in politics, it does not get much better
than this.
As registered nurses, patient care and interactions place us in the front row to the
emotional and physical cost cancer patients, and their families, endure. Therefore,
as a the executive director of New Hampshire Nurses Association, a membership
organization that values caring and the health of the NH population, I am happy
to see that our Congressional Delegation took notice and acted with patients in
mind. Here in New Hampshire, cancer is the leading cause of death. There were
an estimated 2800 deaths from cancer this year with an estimated 9,340 more of
our citizens diagnosed with the disease this year alone. Cancer remains the second
leading cause of death in America and early diagnosis and treatment are our best
weapons in the battle against cancer.
There is no doubt that the right thing to do is to take advantage of all available
cancer screenings. Tests like pap smears, mammograms and colonoscopies save
lives with early diagnosis. Identification of cancer in its earliest stages yields a fiveyear
survival rate of 89%.
Sadly, there is a lack of early screening for most cancer types. At present, we only
have the ability to test for five of the more than 100 common cancers. There is
hope on the horizon. Multi-cancer early detection (“MCED”) technologies,
currently in front of the Food and Drug Administration, will allow healthcare
professionals to test for dozens of cancer types with a single cancer. The Medicare
Multi-Cancer Early Detection Screening Coverage Act, supported by our NH
delegation, would create a pathway for Medicare to cover these potentially
lifesaving innovations upon approval by the FDA with a single screening.
President Joe Biden announced a challenge to his own administration and those
that follow to: reduce the cancer mortality rate by 50% over the next quarter
century. He dubbed this the “Cancer Moonshot,” something akin to the challenge
President John F. Kennedy posed to Americans that resulted in our landing on the
moon. A crucial component of this moonshot, President Biden noted, would be
“a call to action for cancer screening and early detection.” Additionally, President
Biden spoke to the promise of new multicancer technologies.
As the president then exclaimed, “When we work together in America, there is
nothing — nothing beyond our capacity. Nothing. So, let’s show the world what’s
possible. Let’s show the world that we’re committed.”
Abstract
BACKGROUND: The incidence of pediatric Crohn’s disease (CD) has increased
over the past few decades. The etiology of CD has not yet been elucidated. Still,
researchers have identified variables associated with the disease process, including
genetic predisposition, environmental triggers like a poor-quality diet, air pollution,
water pollution, and a dysbiotic microbiome with increased fungal diversity as
predisposing factors. Fungal mycotoxin contamination in the food supply from
toxicants like Deoxynivalenol (DON), a highly prevalent gastrointestinal irritant,
has largely been ignored as a potential factor influencing the fungal dysbiosis
and symptoms associated with the disease process. It is hypothesized that global
and intermittent exposure to mycotoxins like DON may negatively affect the
gastrointestinal health of pediatric CD patients.
OBJECTIVE: The objective of this two-part thesis project was to search the literature
for evidence of widespread mycotoxin contamination in the food supply. Then, to test
local food commodities for mycotoxins to assess the need to develop a low-mycotoxin
diet as a potential treatment modality for pediatric CD.
METHODS: An integrative review of studies measuring global DON prevalence was
conducted and presented in table and narrative format. With evidence that wheat and
corn crops are routinely contaminated with mycotoxins, these flours were directly
tested for DON using lateral flow screening technology. Wheat bread and pasta
samples were also analyzed and sent to Trilogy laboratory for liquid chromatography,
mass spectrometry-mass spectrometry mycotoxin testing. Descriptive statistics were
used to quantify chemical testing results.
RESULTS: Results showed that globally, wheat, corn, bakery products, pasta, and
mothers’ milk were routinely contaminated with DON. There was sufficient evidence
to suggest that other grain-based crops, soy, coffee, tea, dried spices, nuts, certain
seed oils, animal milk, and various water reservoirs are intermittently contaminated.
Direct measurement of foods in a typical child’s diet, such as pasta, bread, and
raw ingredients such as wheat- and corn-based flours, also demonstrated routine
contamination with DON. Some pasta samples were also contaminated with HT-2
toxin. Contamination rates were significantly higher in 2021 than in 2019, showing the
problem may be escalating.
DISCUSSION AND CONCLUSIONS: Universally, children appear to be at risk
for higher exposures to DON than adults due to their increased intake of cerealbased
foods relative to their lower body weight. This study suggests that mycotoxin
contamination in the food supply is common. The cumulative effects of multiple
mycotoxin exposures by pediatric CD patients may pose serious health risks.
Further investigation into the role mycotoxin contamination plays in the disease
process, microbial perturbations, and fungal dysbiosis inherent in CD is needed. The
information obtained here demonstrates a need to develop a “Low Mycotoxin Diet”
for pediatric CD patients to help mitigate the common occurrence of these biohazards.
KEYWORDS: Crohn’s disease, Pediatrics, Deoxynivalenol, Diet, and Mycotoxin
NursingALD.com can point you
right to that perfect NURSING JOB!
NursingALD.com
Free to Nurses
Privacy Assured
Easy to Use
E-mailed Job Leads
Thank you to our NH delegation for support on this important legislation and the
promise for advances in early detection and treatment leading to increases survival
rates.
Page 18 • New Hampshire Nursing News June, July, August 2022
Dropping the Stigma Surrounding
Substance Use Disorder
There once lived a beautiful, astute, and kind
Advanced Practice Registered Nurse (APRN). She
was very frustrated with her pervasive religion and
family life expectations. She wanted a divorce from
a 20-year marriage to her husband and friend; she
was not in love with him anymore, and, they had no
children to unite them. She struggled with the threat
of admonishment and rejection in her personal life
for years. She put her affairs in order, diverted drugs
from the hospital, rented a hotel room, started an
intravenous line, and left us behind.
One fine sunny day, a different APRN broke her leg
while skiing. After surgery, she became addicted
to narcotics prescriptions. Upon returning to work,
struggling with the withdrawal symptoms from
oxycontin, she diverted unused fentanyl instead of
wasting it. Her addiction quickly escalated. When
her family and coworkers noticed a behavior
change, they collaborated with a professional and
planned an intervention. Despite resistance to help
and fear of the unknown, this brave nurse allowed
them to take her to inpatient treatment, followed
by intensive outpatient treatment, counseling,
and immersion into a 12-step recovery program.
She reported to her states’ monitoring program,
completed probation, and safely returned to work.
She is now 22 years sober, still active in a 12-step
recovery program, and happily dedicated to helping
others find help and hope from addiction.
Nursing is a challenging profession where situations
change at a moment’s notice, and reactions can
be very critical. RNnetwork surveys from 2016
and 2018 recognize burnout, staffing shortages,
and harassment as job-related impacts on nurses’
mental health and report that about half of all
respondents (49%) have considered leaving
nursing in the past two years (Cornwall, 2018,
December 12; Sutherland, 2017, February 28).
Sadly, researchers at the University of California,
San Diego, found that nurses have a higher risk of
suicide than the general population, with female
nurse 1.4 times more likely than female non-nurses
and male nurses 1.2 times more likely than male
non-nurses (Davidson et al., 2020). The probable
impact of COVID-19 on these numbers is cause for
alarm.
Although many choose nursing as a career for the
benefits of it being a rewarding profession with
steady, reliable work and income, a healthcare
career comes with some inherent stressors that
mingle with everyday life challenges. Nurses
experience on the job violence, patient deaths,
and work compression, that contributes to physical
and mental pain. Dupont & Merlo (2018) indicate
that the reasons healthcare providers are at risk for
Substance Use Disorder (SUD) include high-stress
environments, difficulty seeking help from others,
and access to drugs. Stone et al. (2021) define
SUD as “a chronic, relapsing, potentially deadly
condition [which] occurs when the recurrent use
of substances significantly impairs an individual’s
health and the ability to meet major vocational,
academic, or personal responsibilities.” Over
time, the disease of addiction results in long-term
changes to the brain’s neurotransmitter circuitry
(e.g., dopamine, serotonin) (Bartlett et al., 2013).
The condition can be mild, moderate, or severe
depending on the number of behavioral and
physiological criteria met per the Diagnostic and
Statistical Manual of Mental Disorders, Fifth Edition.
Despite SUD being a known occupational hazard
among healthcare workers, the prevalence may
be challenging to exact, ranging from 8% to 20%
(Mumba & Kraemer, 2019; Wright et al., 2012).
Complicating the landscape are mental health
concerns that may be independent or coexist with
substance misuse and SUD.
Courtright (2010) recognizes that historically,
society viewed addicted persons as morally
flawed or lacking self-control. Fortunately, this
stigma is changing. In 2018, Governor Chris
Sununu authorized the New Hampshire Board
of Nursing (NHBON) to establish an alternative
recovery monitoring program. The New Hampshire
Professionals Health Program (NHPHP) was
tasked in July 2019 to carry this out. The NHPHP
encourages self-reporting of drug misuse, including
alcohol, and referral to treatment with monitored
recovery that continues when a nurse returns to
duty. Self-reporting along with a leave of absence
is a voluntary, non-punitive option that protects
patients by establishing the addiction treatment
impaired providers need while potentially
preserving licenses. The NHPHP provides free
education and resources to institutions and
organizations. Although the NHPHP does not offer
treatment, they provide assessments, treatment
referrals, ongoing support, and monitoring.
Engagement in NHPHP lasts three to five years
and can include random drug testing, stopping
work until cleared, and attending peer support
groups. The Office of Professional Licensure Annual
Report stated that for Fiscal Year 2019, the NHBON
received 179 complaints, of which 37 were related
June, July, August 2022 New Hampshire Nursing News • Page 19
to diversion of medication, impairment, alcohol,
and other drugs. For Fiscal Year 2020, the NHBON
received 310 complaints; however, the data for
categorizing and tallying the complaints was not
listed on the OPLC Annual Report or captured by
the NHBON (L. Courtney, personal communication,
January 22, 2021). The NHPHP is currently
monitoring 23 nurses and four Licensed Nursing
Assistants known to the NHBON, and they also
have four nurses under voluntary monitoring that
are unknown to the NHBON (S. Garhart, personal
communication, November 9, 2020).
Diverting controlled substances is a tactic that
healthcare providers with SUD sometimes employ.
Communication, interventions, and programs for
people in crisis or who misuse substances are not
benign. In the past, impairment and diversion were
often met with only discriminatory and punitive
practices where the process of being worked up
for SUD in the workplace or licensure board led to
bad outcomes. The thought of losing one’s license
and means of making a living, not having money
for treatment, medications, or legal fees can be
devastating. The result is individuals do not seek
help. This alienates colleagues, co-workers, and/or
work supervisors whou could assist the individual,
by connecting them to a non-punitive pathway
of self-reporting and treatment options through
the NHPHP. Workplace policies can outline these
non-punitive pathways. Today, we can empower
our nursing workforce to self-report rather than
gamble with broadly administered discipline once
misconduct is reported or risk patient harm. Much
time, energy, and money go into shaping highquality
providers, as the healthcare workers’
shortage exemplifies. Access to quality treatment
for nurses and healthcare workers who struggle with
SUD needs to be readily available to protect the
public, the families of the providers, and hopefully,
allow for a return to safe practice.
The appropriate treatment level for someone with
SUD may include residential care or intensive
outpatient therapy; an extended monitoring
program follows both. In a meta-analysis, Geuijen
et al. (2021) found that monitoring programs, like
NHPHP, demonstrated pooled success rates of 72%
for abstinence and 77% for work retention. Much
less is known about those who have fallen through
the cracks or were lost to suicide. Organizations
that successfully incorporate recovered nurses
foster support rather than stigma, provide exemplars
who have overcome addiction, and better detect
undiagnosed addictions, improving workforce
quality (Parsa, 2011). Stigma and lack of awareness
may result in the underutilization of alternative to
discipline programs like the NHPHP. Preserving
professional viability by facilitating treatment and
reducing discipline benefits the healthcare system
and the public.
Does your organization have a comprehensive
program that speaks to suspicion of impairment and
diversion? Is there routine education of all providers
on the clinical presentation of SUD and resources
to approach it? If not, there are resources to
develop and institute a process for safely addressing
situations. A milieu can be established where
nurses know that facing seemingly unbearable
personal or professional challenges can happen
and that seeking support is the right thing to do.
There is hope. Those suffering from SUD are not
alone; they can get help and arrive in a better
place. As with many diseases, the sooner signs and
symptoms are addressed, the more opportunity
there is to circumvent catastrophic consequences.
You can spread the word that addiction benefits
from treatment, notice and address concerning
behavior in your family, friends, and colleagues,
and support the alternative to discipline approaches
for concerns related to alcohol and other drugs.
Ensure that your team and our nursing workforce
understand that NHPHP is confidential and ready
to support practitioners experiencing various
difficulties, including SUD (nhphp.org). National
resources include the Substance Abuse and Mental
Health Services Administration’s national helpline
(1-800-662-HELP), Narcotics Anonymous (na.
org), Alcoholics Anonymous (aa.org), and the
National Suicide Prevention Lifeline (1-800-273-
8255). Because patient safety is a priority, we as a
community can better protect patients, preserve
careers, and save lives when the risks of SUD in
healthcare providers are addressed early.
Kisha Thompson MS, CRNA, is a per-diem Nurse
Anesthetist at Cheshire Medical Center in Keene,
NH. She is a Board Trustee for the New Hampshire
Association of Nurse Anesthesiology. She is also a
State Peer Advisor for the American Association of
Nurse Anesthesiology. As such, she is available to
provide support and information for those engaged
in substance misuse. Her past education includes
a Bachelor of Science degree from Johns Hopkins
University and a Master of Science degree from
Georgetown University. Additionally, she retired, at
the rank of major, from the Army Reserve.
I have no conflicts of interest nor any commercial
affiliation.
Contact Info:
Kisha Thompson MS, CRNA
Kisha.lifgren@gmail.com
914-260-2218
References
Cornwall, L. (2018, December 12). RNnetwork 2018
Portrait of a Modern Nurse Survey. RNnetwork.
https://rnnetwork.com/blog/rnnetwork-2018-portraitof-a-modern-nurse-survey/
Davidson, J. E., Proudfoot, J., Lee, K., Terterian, G.,
& Zisook, S. (2020). A longitudinal analysis of
nurse suicide in the united states (2005-2016)
with recommendations for action. Worldviews on
NHNA Student Nurse of the Year
Sara Fazzi Garcia
The NHNA Commission on Nursing Practice hosts
an annual graduating student nurse conference at
which time we award the NH Student Nurse of the
Year Award. Commission members have identified
five qualities that should be exemplified by the
professional nurse these include: Professionalism
(Competence and Qualities), Patient Advocacy,
Leadership, and Involvement in Nursing/Community
ANA Enterprise. This year’s award winner was Sara
Fazzi Garcia, a second year Direct Entry Master’s
Student from the University of New Hampshire. Sara
was nominated by her advisor Pamela Kallmerten,
RN, DNP, PHD. The nomination narrative included
the following:
Ms. Fazzi Garcia entered the Direct Entry Master's
in Nursing (DEMN) program with a previous degree
in Fashion Technology and from the beginning, it
was clear that she had made the right decision for
nursing. While she has had faculty report that she
needs support for caring for her patients through
psychomotor skills due to the disparate competencies
between her previous program of study and nursing,
there is never any doubt for her caring about her
patients well-being. She constantly nurtures those
in her care in the professional as well as informal
Evidence-Based Nursing, 17(1), 6-15. https://doi.
org/10.1111/wvn.12419
DuPont, R. L., & Merlo, L. J. (2018). Physician health
programs: A model for treating substance use
disorders. Judges' Journal, 57(1), 32-35.
Geuijen, P. M., van den Broek, S. J. M., Dijkstra, B. A.
G., Kuppens, J. M., de Haan, H. A., de Jong, C. A.
J., Schene, A. H., Atsma, F., & Schellekens, A. F. A.
(2021). Success Rates of Monitoring for Healthcare
Professionals with a Substance Use Disorder: A
Meta-Analysis. Journal of Clinical Medicine, 10(2).
https://doi.org/10.3390/jcm10020264
Mumba, M. N., & Kraemer, K. R. (2019). Substance use
disorders among nurses in medical-surgical, longterm
care, and outpatient services. MEDSURG
Nursing, 28(2), 87-118.
Parsa, N. (2011). Reasons to Hire Recovered Physicians.
Physician Executive, 37(4), 58-61.
Stone, L., Rice, J., & Garcia, R. (2021). Addressing
substance use disorder and diversion in the
healthcare environment. American Nurse Journal, 16
(2). https://www.myamericannurse.com/addressingsubstance-use-disorder-and-diversion-in-thehealthcare-environment/
Sutherland, S. (2017, February 28). Portrait of a modern
nurse survey finds half of nurses consider leaving the
profession. RNnetwork. https://rnnetwork.com/blog/
rnnetwork-nurse-survey/
Wright, E. L., McGuiness, T., Moneyham, L. D.,
Schumacher, J. E., Zwerling, A., & Stullenbarger, N.
E. N. (2012). Opioid abuse among nurse anesthetists
and anesthesiologists. AANA Journal, 80(2), 120-128.
caregiver roles. She is an authentic listener and
manages to care for her family, their friends, her
peers and her patients.
The ideal nurse has an appreciation for the skills for
entry into practice and she (Sara) is competent in this
regard. She reflects in the moment as well as after the
moment has passed-the ability to reflect in action and
on action. She verbalizes "how could I have improved
my care?" She goes beyond what is competent
to what is exemplary practice during a time of
compassion fatigue. It is clear that the tenets of
diversity, equity and inclusion are woven throughout
her practice. It is clearly demonstrated with her
actions that her sense of social justice and health
equity are foremost in her mind. She has an uncanny
ability to stop everything and ask "what really matters
here" and is not afraid to let things go to prioritize
the needs of the vulnerable person whether it be a
patient, their family or someone from her personal
encounters. She is always a nurse, demonstrating that
she sees her role as their advocate.
She is an authentic, humble leader who will do
doubt continue to represent the best of nursing
during these challenging times. Like her peers,
she has had many opportunities for community
based care including vaccination clinics. She was
also recently inducted into the Eta Iota At Large
Chapter of Sigma Theta Tau International. She is a
certified lactation consultation and is leveraging
this knowledge for a quality improvement project to
support the Baby Friendly Hospital Initiative at her
organization. She was invited to apply to become
a member of the organizational team before midsemester
of her immersion. It is my belief that they
recognize her potential as I do for a life-long career
in service to her community.
Like her peers, she has had many opportunities for
community based care including vaccination clinics.
She was also recently inducted into the Eta Iota At
Large Chapter of Sigma Theta Tau International. She
is a certified lactation consultation and is leveraging
this knowledge for a quality improvement project to
support the Baby Friendly Hospital Initiative at her
organization. She was invited to apply to become
a member of the organizational team before midsemester
of her immersion. It is my belief (Dr.
Kallmerten) that they recognize her potential as I do
for a life-long career in service to her community.
CONGRATULATIONS SARA
Page 20 • New Hampshire Nursing News June, July, August 2022
Giving Care: A Strategic Plan to Expand and Support
New Hampshire’s Health Care Workforce
Executive Summary—March 2022
Prior to the pandemic, New Hampshire was second
among states hardest hit by labor shortages overall. 1 In
2019, New Hampshire employed an average of 94,100
workers in its health care and social assistance industry. 2
The industry’s average growth of 1.6 percent between
2017 and 2019 outpaced that of the state’s workforce
overall, which grew an average of one percent during the
same time period. 2 In addition to being the fastest growing
industry, the health care sector had the most unfilled jobs. 3
The pandemic exacerbated both the need for and strain
on health care personnel. In the Granite State, burnout
led to staff losses across the health care spectrum,
but especially in nursing homes, home health, and
community care settings. 4 In its November 2021 letter to
the Governor and Commissioners of the New Hampshire
Departments of Health and Human Services and Business
and Economic Affairs, the Health Care Workforce
Coalition explained that “the difficulty to recruit, retain,
and fully staff facilities and programs is seriously impinging
on patients’ access to care and deepening financial stress
for our state’s health care providers.” 5 The aging of the
state’s primary care provider workforce also complicates
recruitment and retention; 24% of its nurse practitioners
and 27% of its primary care providers are over age 60. 6,7
As well, New Hampshire is projected to be 10th among
U.S. states with the most severe nursing shortages. 8
According to the Health Care Workforce Coalition,
such shortages exist across the health care spectrum,
including all provider types and those providing other
vital support functions. 9 Ensuring an adequate supply
of qualified workers is essential to meet the needs of
the state’s aging residents and its increasingly diverse
population. Given its size and rate of growth, the
strength of the health care sector is critical to New
Hampshire’s overall economy. 10
While the bench of health care workers is simply not deep
enough, it also lacks sufficient diversity to address the
needs of the state’s increasingly diverse population. The
workforce is also impacted by:
• Stress, mental health, and barriers to care. Health
care workers have endured heightened stress due
to risks the pandemic posed to their own health,
caring for critically ill patients, too few resources,
and a constantly evolving understanding of the virus,
prevention measures, and treatment options. Workers
experiencing mental health issues experienced the
challenges that face the general population, namely
stigma and problems accessing care.
• Low wages and high costs to live in New
Hampshire. Many health care workers in low-paid
entry-level and support positions that put them
at risk for exposure to COVID-19 were forced to
work multiple jobs to make ends meet while others
transferred to other industries for more money and
less risk. Low wages also make it difficult for health
care employers to compete with employers in other
states and other professions. Health care workers
struggle to afford a range of necessities to live in
New Hampshire, including quality and affordable
housing, transportation, and childcare, all issues that
should be addressed by public policy.
• A thin pipeline and barriers to post-secondary
education and training. Too few potential workers
have an interest in or adequate understanding of
the range of roles available within health care.
Investment in efforts to diversify the workforce,
including outreach and marketing, have been
insufficient. The high cost of education poses a
barrier to entry and advancement in health care
roles. Too few training and education opportunities
exist (e.g., apprenticeships, post-secondary
programs, clinical placements), as well as too few
supervisors to train health care workers. There
is poor alignment of existing education/ training
programs with workforce shortages. Employers lack
capacity to ensure an adequate pipeline of workers
for their organizations. Competition for employees
creates a barrier to collaboration among health care
organizations to share best practices and address
their common workforce challenges.
...the strength of the health
care sector ıs critical to New
Hampshire's overall economy.
• Reimbursement issues. Low reimbursement rates;
lack of reimbursement for critical services; and a
lack of parity for mental health services affect the
wages employers can offer and their ability to recruit
and retain workers, as well as the ability of health
care workers to make ends meet. By rewarding
procedures and quantity over outcomes and quality,
current reimbursement structures do not incentivize
coordination and integration of care, practices that
are essential to quality outcomes. By pressuring
providers to maximize the number of patients they
see, the current structure adds to provider stress
and discourages their participation in professional
development opportunities and providing clinical
placements and supervision.
• Regulatory barriers and constraints. Complying with
burdensome regulations and documentation means
providers have less time to spend with patients and
presents additional barriers to attracting and retaining
staff. Licensing and credentialing processes and
requirements discourage qualified professionals from
seeking employment in New Hampshire and cause
major delays in being able to recruit, on-board, and bill
for services provided by new employees, particularly
those from other states.
• Policy barriers. Multiple policy-related challenges
exist. Insufficient funding for the state’s community
college and university systems, health care
apprenticeship programs, and help to relieve students
of education-related debt impede the ability to
train an adequate number of workers. Government
employment policies, such as prohibiting the filling of
positions until vacancies exist, cause delays in hiring
and create gaps in staffing. Temporary policy and
regulatory changes that supported telehealth during the
pandemic should be made permanent.
• Siloed workforce development efforts. While many
initiatives exist within the state to bolster the health
care workforce, they are largely siloed and lack
coordination.
• Data challenges. Data on the health care workforce
are collected by multiple entities in varying ways. No
central repository exists. Thus, it is difficult to know
which data exist and where they can be found. Data
can be hard to access, interpret, and use to inform
policy and planning. There is a lack of common
vocabulary and definitions, an insufficient level
of detail, and too few data scientists to assist with
understanding and interpreting data.
Beginning in 2020, given the current and anticipated impact
of workforce shortages on the health of the population and
the state’s economic well-being, the Forward Fund at the
Endowment for Health prioritized the creation of an actionoriented
state plan for health care workforce development.
SAVE SENIOR CARE FROM
Paid for by the
New Hampshire Health Care Association
June, July, August 2022 New Hampshire Nursing News • Page 21
The assessment phase engaged over 50 stakeholders
and led to a shared understanding of workforce needs
and activities across the state. Thereafter, in a series of
facilitated meetings, a diverse group of over 60 stakeholders
participated in four workgroups to develop the plan’s
goals, objectives, and strategies. The plan, intended for
implementation within two years, includes 107 strategies
to address the pipeline, recruitment, and retention needs
facing the state; critical policy and regulatory issues; and
data needs, and provides a mechanism for coordination
and governance of workforce development efforts.
The strategic plan is intended for multiple (sector)
audiences, including state government, legislators, the
health care industry/employers, health and behavioral
health professional associations, health insurance/ payers,
educators and trainers of health care personnel and those
that contribute to the pipeline of health care workers (e.g.,
high schools, vocational/technical schools, community
colleges, universities, employer- based training programs,
Area Health Education Centers), advocacy groups/
organizations, the business community (i.e., private
industry, both associated with health care and not), and
philanthropy. To learn more about the strategies and how
you can support health care workforce development in
New Hampshire, please contact the Endowment info@
endowmentforhealth.org.
The Vision
The New Hampshire health care workforce is
strong and diverse due to factors that include
competitive, equitable wages commensurate
with experience, training, education and an
environment that supports diversity, quality care
and continuous professional growth. As a result,
community outcomes are improved and patients,
clients, and the workforce are engaged and healthy.
1 Dean, Grace. (2021). Nebraska, New Hampshire, and
Vermont are states struggling hardest to fill jobs in the US
labor shortage, new research suggests. Business Insider
(September 24). https://www.businessinsider.com/laborshortage-dc-nebraska-new-hampshire-vermont-jobshawaii-employment-2021-9
2 New Hampshire Economic Conditions. (2021). Temporary
Staffing in New Hampshire’s Health Care Industry.
(September). https://www.nhes.nh.gov/elmi/products/
documents/ec-0921-article.pdf
3 Presentation by Brian Gottlob to the Foundation for
Healthy Communities, Concord, NH, June 2021.
4 Wagner, E., Amin, K., Cox, C. & Hughes-Cromwick, P.
(2021). Health Spending: What Impact has the Corona
Virus had on Health Employment. Peterson/ Kaiser
Family Foundation Health System Tracker. (December
10). https://www.healthsystemtracker.org/chartcollection/what-impact-has-the-coronavirus-pandemichad-on-healthcare-employment/
5 November 2021 Health care Workforce Coalition
letter available at: http://dupontgroup.com/covid-19-
resources/workforce-letter/
6 Nurse Practitioner Data available at: https://
dashboard.nh.gov/t/DHHS/views/2018-
19APRNWorkforceDataReport/ Demographics?%3Aiid
=1&%3AisGuestRedirectFromVizportal=y&%3Aembed
=y
7 Primary Care Physician Data available at: https://
dashboard. nh.gov/t/DHHS/views/2019PhysicianWorkf
Nursing Career Path
At Amedisys, we build on skills throughout
our careers and provide opportunities for
growth with ongoing training and support.
Join our family and see how you can step into
a new role and make a difference today!
Learn more at amedisys.com/careers.
THINK OUTSIDE THE HOSPITAL
orceDataReport/ Demographics?%3Aiid=1&%3AisGues
tRedirectFromVizportal=y&%3Aembed=y
8 University of St. Augustine for Health Sciences. (2021).
The 2021 American Nursing Shortage: A Data Study.
Online Blog Post. (May). https://www.usa.edu/blog/
nursing- shortage/
9 https://www.nhproviders.org/new-hampshire-health-careworkforce-coalition
10 Institute on Assets and Social Policy, The Heller School
for Social Policy and Management, Brandeis University.
(2014). Strengthening New Hampshire’s Health Care
Workforce: Strategies for Employers and Workforce
Development Leaders. (December). https://heller.
brandeis.edu/iere/pdfs/jobs/NH-health-care-workforce.
pdf
RN’s, LPN’s & LNA’s WANTED!
Full-time openings 2nd & 3rd shifts!
Great starting pay with raise
in 90 days! Earn additional $2
on weekends on top of great
shift differentials! Excellent
benefit package for those
who qualify including health,
dental, life, 401k with employer
match, disability, prepaid
legal, referral & longevity
incentives, generous PTO plan,
professional development
reimbursements and more!
Must have valid NH license.
Please apply online at
www.websteratrye.com
Page 22 • New Hampshire Nursing News June, July, August 2022
IN MEMORY OF OUR COLLEAGUES
The New Hampshire Nurses Association honors the
memory of and acknowledges the practice of deceased
nurses who have graduated from New Hampshire
nursing schools or who have actively practiced in New
Hampshire during her career. Sharing their names and
information about their career is one way we honor
their contribution to the profession. Brief submissions
are welcome.
Viet Nam Vet
Madeline Ann Blidberg, 82, died on
December 14, 2021. She attended Mary
Hitchcock School of Nursing in
Hanover, NH where she received her
RN and Boston University where she
received her BSN. She later attended the
Frontier School of Nursing in KY and
became a midwife. She joined the Army
and was a Viet Nam War veteran and
also served in Germany and several
places in the United States. She retired
from the Army Reserves as a Lt. Colonel.
She was a Labor and Delivery room nurse at the Elliot
Hospital in Manchester for more than 35 years.
Madeline was a private pilot and was licensed in both
single and twin-engine aircraft.
Concord Hospital Grad
Sandra Rae (Palmer) Rhodes, passed
away on January 29, 2022. She
graduated from the Concord Hospital
School of Nursing with the class of 1960.
She practiced as a pediatric nurse at
Concord Hospital, then at the NH State
Hospital. She also practiced as a school
nurse, a private nurse and visiting nurse.
When her children entered school, she returned to full
time nursing at Concord Urology until her retirement.
School Nurse
Carol Ann (Walsh) Edmunds, 78, Florida
passed away on February 8, 2022, in
Florida. She practiced at the Barrington,
NH District School many years as a
school nurse and retired in 2002.
Psych Nurse
Winona (Witham) Blake, 84, died on
February 9, 2022. A Plymouth native,
she obtained a Bachelor of Science in
Nursing in 1959 and went on to attain a
master’s degree in Adult Psychiatric
Nursing in 1978, both from Boston
University. She started her nursing career
at Memorial Hospital in Nashua, NH, as
an obstetrics nurse and a teacher for incoming nurses.
She later moved to being a head nurse at Head Start in
Nashua, NH. She became a Certified Psychiatric Nurse
Clinical Specialist and continued her work in
Massachusetts in mental health.
OR Nurse
M. Beryle Johnston, 90, passed away
February 11, 2022. She obtained a
nursing diploma in 1953 from the New
England Deaconess School of Nursing in
Boston. She practiced at Mary Hitchcock
Memorial Hospital in the Fall of 1953,
progressively working her way up in the
Surgical Department of the Operating
Room, from a Surgical "Scrub" Nurse and retiring in the
Spring of 1989 as a Surgical Buyer.
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.
School Nurse
Jeanne (Bonenfant) Descoteaux, 90,
passed away on February 18, 2022. A
Manchester native she obtained a
nursing diploma from the Notre Dame
Hospital School of Nursing and later
earned a degree in Psychology from
New England College. She practiced at
Notre Dame and then the Allenstown
School system as a school nurse for over 20 years. She
also volunteered her time as a nurse for the Pine Haven
Boys School and for the Community Action Program.
VA Nurse
Jean C. Acton, 92, died on February 19,
2022. She obtained her nursing diploma
in Massachusetts in 1951 and moved to
Manchester in 1962. She had a 32-year
nursing career at the VA Medical Center
in Manchester where she was, among
other roles, the nursing supervisor for the
busy medical/surgical floor.
Moore General Grad
Ann Rebecca (Shirley) Toll, 87, died on
February 21, 2022. A Manchester native,
she obtained her nursing diploma from
the Moore General Hospital in
Goffstown, in 1955.
Care Management Nurse
Patricia "Pat" A. (Guercio) Davis, 74,
passed away March 2, 2022. She earned
her LPN in 1967 and practiced at
Memorial Hospital (now Southern NH
Medical Center). She continued her
career at the Matthew Thornton Health
Plan, the First HMO in NH, which was
acquired by Dartmouth-Hitchcock
Clinic, where she headed the Care Management
Department, retiring after 25 years. While at
Dartmouth, Pat obtained an associate degree as an RN
from Rivier College.
Notre Dame Grad
Helene Claudette Tremblay, 85, died on
March 4, 2022, in North Carolina. A
Manchester native she obtained a nursing
diploma in 1957 from the Notre Dame
Hospital School of Nursing. She later
earned a Bachelor of Science from the
State University of New York-Oneonta.
She retired from nursing in 2004.
Concord Nurse
Noreen Margaret (Teehan) Falzone, 62,
died unexpectedly March 6, 2022. She
obtained a BSN from Salem State
University in 1981. As a nurse for over
40 years, she practiced as a VNA nurse,
school nurse at Pittsfield High, and triage
nurse for Concord Hospital.
St. Joes Nurse
Lorraine T. (Maxfield) Duval, 90,
passed away March 9, 2022. She was a
graduate of the St. Joseph Hospital
School of Nursing in Nashua. She had a
lengthy career as a registered nurse at
the St. Joseph Hospital.
Nurse Entrepreneur
Bernadine (Blasczak) Herron, 80,
passed away March 9, 2022. She
obtained a nursing diploma in West
Virginia and practiced at the Elliot
Hospital. Later she went on to become a
co-founder of Herron and Smith medical
equipment and services company in
Hooksett, N.H.
Community Nurse
Shirley Jean (Jasper) Stockwell, 87, died
March 15, 2022. She received a B. A. in
Nursing from Worcester State College.
She retired from Community Health and
Hospice of Laconia, NH.
Psych Nurse
Gero Nurse
Virginia I. (Jones) Williams, 91, died
March 16, 2022. She obtained a nursing
diploma in 1952 and a BS in Psychology
in 1955, both in Pennsylvania. After
moving to New Hampshire, she
practiced as a substance abuse nurse at
Seminole Point in Sunapee and Catholic
Medical Center in Manchester.
Cheryl Ann (Roberts) True, 65, died
unexpectedly on March 19, 2022. As a
RN she practiced at Rochester Manor,
Goodwin's, Langdon Place of Exeter, and
Webster at Rye.
Concord Nurse
Madeline (Finley) Morgan, 93, died
March 24, 2022. She obtained a nursing
diploma from the Margaret Pillsbury
School of Nursing in Concord.
Madeline's career spanned over 30 years
as Registered Nurse and caregiver at
Concord Hospital.
Rivier Grad
Lisa (King) Lull, 68, died March 27,
2022. She obtained her nursing diploma
in Boston and earned her bachelor’s
degree from Rivier University. She
practiced at the New London Hospital,
Dartmouth Hitchcock Medical Center,
Kearsarge Regional Elementary School in
New London and Woodcrest Village.
Concord Nurse
Joan E. (Glidden) Doucette, 75 passed
away on March 27, 2022. She practiced
as a registered nurse for over 41 years at
Concord Hospital.
Goffstown Nurse
Elaine (Colby) Emerton, 94, passed
away on April 1, 2022. She obtained her
nursing diploma in Massachusetts and
practiced at Concord Hospital, Moore
General Hospital, and the Lemire
Nursing Home in Goffstown. After her
nursing career, Elaine worked for the
Town of Goffstown for over 20 years,
first as the Deputy Town Clerk and then was elected as
the Town Clerk until her retirement.
NHTI Grad
Jo-Ann E. (Lyons) Nolan, 59, passed
away on April 7, 2022. She was a 1997
nursing graduate of the NHTI. She
practiced for 22 years at Lakes Regional
General Hospital and then the Laconia
Clinic until her breast cancer diagnosis.
Med-Surg Nurse
Sally A. (Crowell) LaBarre, 87, passed
away on April 7, 2022. She was a
graduate of the Mary Hitchcock
Memorial Hospital School of Nursing.
She practiced in orthopedics at Mary
Hitchcock Memorial Hospital, for six
months. She then transferred to the
former Elliot Community Hospital (now
Cheshire Medical Center) in Keene, taking a position as
June, July, August 2022 New Hampshire Nursing News • Page 23
IN MEMORY OF OUR COLLEAGUES
Head Nurse in the Medical-Surgical area, leading to the
role of Night Supervisor. She was instrumental in
developing and heading up the Elliot Hospital's first
post-anesthesia recovery unit in 1958. Sally transitioned
to the clinic setting, working for 34 years as a
Registered Nurse at the Keene Clinic, now Dartmouth
Hitchcock Clinic in Keene. She spent her last 28 years
as a urology nurse working alongside Dr. Arthur
Cohen. She retired in 1998.
Barbara Anne (Connor) French
Notre Dame Grad
Gabrielle ‘Gaby’ L. (Pratte) Drouin, 93,
passed away on April 14, 2022. She
graduated from the Notre Dame
Hospital School of Nursing with her
nursing diploma in 1949. She enjoyed
going out regularly with the
"Nightingales," her fellow retired RNs.
St. Joes Nurse
Frances (Catoggio) Parrott, 83, passed
away on April 17, 2022. She practiced
for many years at the St. Joseph Hospital
in Nashua.
St. Joes Nurse
Lois D. (Mowrey) Velcheck, 80, passed
away on April 18, 2022. She practiced in
the delivery room, as an elementary
school nurse and then an orthopedic
nurse for many years for St. Joseph's
Hospital in Nashua before retiring in
2005.
Psych Nurse
CMC Nurse
Janice I. Smith, 79, passed away April
22, 2022. She practiced as a RN at the
NH State Hospital for many years.
Dorothy J. (Feeney) McCarthy, 84, died
April 23, 2022. She obtained her nursing
diploma in Maine in 1958 and practiced at
Catholic Medical Center, Lakeshore
Hospital, and VNA Hospice. Following her
retirement, she dedicated her time and
talents to volunteering for the Catholic
Medical Center Parish Nurse Program.
State Representative
Barbara Anne (Connor) French,
95, died on April 16, 2022. A New
Hampshire native, she obtained a BS in
biology from UNH in 1947. She went on
to Cornell University, affiliated with the
New York Hospital School of Nursing,
and obtained a BSN in 1950. She first
practiced as an RN at the NH State
Hospital, as a head nurse and nursing
instructor for the School of Nursing. She
went on to practice as a child welfare
social worker for the State of New
Hampshire Department of Welfare and
drug education consultant at the New Hampshire
Department of Education. In 1963 she began a
lengthy career as a school nurse serving the Concord
School District for over 35 years with 15 years spent
at the Rundlett Junior High School. In 1967 she
obtained a Master’s in Education from Mount St Mary
College in Hooksett.
During her years as a school nurse, Barbara served
as a member of the National Association of School
Nurses (NASN). In 1968, she was the first secretary
for the just formed NASN. In appreciation of her
service to the children of New Hampshire, she was
the recipient of the NHNSA School Nurse of the
Year Award in 1990. Today, the NHSNA recognizes
important contributions to school nursing by
presenting the Barbara French Award.
Barbara was active in her hometown
politics of Henniker, New Hampshire.
She was a member of the Henniker
Planning Board as well as a member
and chair of the Henniker Democratic
Committee. She was elected to her first
term in the New Hampshire House of
Representatives in the 1992, representing
Merrimack, District 5. Though defeated
in the 1994 election she ran for office
again, and served as representative from
1996 to 2010, and from 2012 to 2016.
Representative French served for ten
elected terms, a total of 20 years. While
in the legislature she served on numerous committees
including the NH Women's Lobby Board of Directors
and was a member of Advocates for Women and
Families and the Children's Caucus.
She became a member of the New Hampshire
Nurses Association upon her graduation from Cornell
and RN licensure in 1963, a membership she held
continuously. She was active in NHNA’s Commission
on Government Affairs attending and frequently
speaking during nurse legislative day programs.
She never forgot her roots as a school nurse and
combined her legislative talents focusing on the health
needs of children and their families. In honor of her
achievements the policy and practice arena nurses of
New Hampshire recognized French as the 1998 New
Hampshire Nurses' Association Legislator of the Year.
Lifelong Learner
Donna Louise (Carvalho) Moody, 76,
passed away on April 26, 2022, in
Vermont. She worked in various
settings as an LPN for 15 years. In
1982, she graduated from the NHTI in
Concord having earned an associate
degree and her RN. She practiced for
42 years in active nursing working in
Med/Surg, ICU, Home Health Care, and Hospice.
After leaving the Wonderful World of Nursing,
Donna earned a BA in 2011, a MA in 2013 and her
PhD in 2016 in Anthropology from UMass Amherst.
Donna taught at UMass Amherst as a Graduate
Student and most recently at Franklin Pierce
University. Donna worked tirelessly for 20 years with
local, State, and Federal entities as the Repatriation
Coordinator for the Abenaki Nation. Those efforts
culminated in the return and reburial of over 200
Abenaki Ancestors
Exeter Nurse
Sandra ‘Sandy’ (MacDougall) Cross, 83,
passed away on April 27, 2022. She
obtained her nursing diploma from
Boston City Hospital and went on to
obtain a BSN from UNH. She practiced at
Exeter Hospital, for many years, as an RN
in the OR, and eventually working at
Eventide Home as an administrator for 30
years, assisting the Elderly, where she retired in 2003.
Advance your nursing career in our state-of-the-art
Health Sciences Simulation Center
For more info: chhs.unh.edu/graduate-nursing
Online and in-person degree and certificate
programs, MS through DNP
Highest ranked nursing master’s program in
northern New England – U.S. News &
World Report