Virginia Nurses Today - August 2022

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The Official Publication of the <strong>Virginia</strong> <strong>Nurses</strong> Foundation<br />

<strong>August</strong> <strong>2022</strong> Quarterly publication distributed to approximately 111,000 Registered <strong>Nurses</strong><br />

Volume 30 • No. 3<br />

We are pleased to provide every registered nurse in <strong>Virginia</strong> with a copy of <strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong>.<br />

For more information on the benefits of membership in of the <strong>Virginia</strong> <strong>Nurses</strong> Association,<br />

please visit www.virginianurses.com!<br />

Page 3<br />

VNF Underwrites Training of<br />

Nearly 200 School <strong>Nurses</strong><br />

Retired<br />

Registered<br />

Nurse and<br />

Centenarian<br />

Gertrude<br />

Clarke Still<br />

Loves Nursing<br />

Page 10 Page 18<br />

Register now for 2023 Class!<br />

Page 24<br />

Dr. Loressa Cole to be honored<br />

with the <strong>Virginia</strong> <strong>Nurses</strong><br />

Foundation’s <strong>2022</strong> Nancy<br />

Vance Award at annual gala,<br />

September 10<br />

The <strong>Virginia</strong> <strong>Nurses</strong> Foundation (VNF) is pleased to<br />

announce Dr. Loressa Cole as the <strong>2022</strong> Nancy Vance<br />

Award recipient. The Nancy Vance Award is the <strong>Virginia</strong><br />

<strong>Nurses</strong> Foundation's highest honor and is awarded<br />

biennially at the <strong>Virginia</strong> <strong>Nurses</strong> Foundation’s Gala.<br />

This is the highest award given by VNA and honors<br />

and continues the legacy of Nancy Vance’s excellence<br />

in service. It is bestowed upon a VNA member who<br />

has made significant contributions to our community<br />

through their exceptional leadership, sustained<br />

dedication and inspiring achievements.<br />

Dr. Loressa Cole, DNP, MBA, RN, NEA-BC, FAAN is<br />

Chief Executive Officer of the American <strong>Nurses</strong> Association (ANA) Enterprise,<br />

which consists of the ANA membership organization representing the nation’s<br />

4.3 million registered nurses; the American <strong>Nurses</strong> Credentialing Center<br />

(ANCC), which promotes excellence in nursing and health care globally through<br />

credentialing programs; and the American <strong>Nurses</strong> Foundation, ANA’s charitable<br />

arm. Prior to assuming this role, Dr. Cole was the ANCC Executive Director and<br />

Executive Vice President.<br />

Dr. Cole is an accomplished health care leader with more than 30 years of<br />

nursing and management experience. Before joining the ANA Enterprise, she<br />

served as the Chief Nursing Executive for LewisGale Regional Health System in<br />

Salem, <strong>Virginia</strong>, where she directed system-wide clinical operations, partnering<br />

with other C-suite leaders on strategic and tactical planning, and execution.<br />

Previously, she served as Chief Nursing Officer at Lewis Gale Montgomery<br />

Hospital in Blacksburg, <strong>Virginia</strong>, where she led the hospital to achieve its initial<br />

Magnet® designation in 2009 and its redesignation in 2013. Dr. Cole began her<br />

career as a staff nurse in medical/surgical and critical care settings.<br />

Active in many professional organizations, Dr. Cole served as President of<br />

the <strong>Virginia</strong> <strong>Nurses</strong> Association from 2012 until 2014. She is a member of the<br />

American Organization of Nurse Executives, the <strong>Virginia</strong> Organization of Nurse<br />

Executives, and the American College of Healthcare Executives.<br />

She has presented at a wide range of conferences, including the 2011 and<br />

2012 ANCC National Magnet Conference. She earned her DNP at Case Western<br />

current resident or<br />

Dr. Loressa Cole to be honored with...continued on page 2<br />

Non-Profit Org.<br />

U.S. Postage Paid<br />

Princeton, MN<br />

Permit No. 14<br />

US Supreme Court’s Decision<br />

to Overturn Roe vs. Wade<br />

is a Serious Setback for<br />

Reproductive Health and<br />

Human Rights<br />

“The recent Supreme Court decision to overturn Roe v Wade is deeply<br />

troubling,”says VNA President Linda Shepherd, MBA, BSN, RN, NEA-BC.<br />

“Regardless of individual beliefs, political affiliations or conservative vs liberal<br />

leanings, the decision represents a serious setback for reproductive and human<br />

rights and runs counter to the nurse’s ethical duty to advocate for patients.”<br />

“In the wake of this decision,” added VNA & VNF CEO Janet Wall, MS, “we<br />

anticipate a sharp increase in the health risks associated with reproductive<br />

health for patients with little to no economic means and an exponential<br />

worsening in health disparities within already marginalized communities.”<br />

According to the Pew Research Center, “A majority of Americans disapprove<br />

of the U.S. Supreme Court’s landmark ruling overturning the Roe v. Wade<br />

decision... Public support for legal abortion remains largely unchanged since<br />

before the decision, with 62% saying it should be legal in all or most cases.”<br />

The American <strong>Nurses</strong> Association, like the <strong>Virginia</strong> <strong>Nurses</strong> Association, is<br />

deeply concerned by the Supreme Court’s decision. In a recent response to the<br />

action, ANA states:<br />

“The ruling removes the right of all women to access high-quality healthcare<br />

and make personal decisions about their sexual and reproductive health care.<br />

In doing so, it potentially paves the way for laws that will fundamentally come<br />

between patients and health care professionals, including nurses, who must be<br />

guided by ethical obligations to their patients and the profession.”<br />

Past VNA President and current ANA Enterprise CEO Loressa Cole, DNP,<br />

MBA, RN, FAAN, NEA-BC had this to say: “<strong>Nurses</strong> have an ethical obligation<br />

to safeguard the right to privacy for individuals, families, and communities,<br />

allowing for decision making that is based on full information without coercion.<br />

As the largest group of healthcare professionals, nurses have for decades<br />

assisted their patients with weighing the benefits, burdens, and available<br />

options, including the choice of no treatment, when discussing sexual health<br />

issues and pregnancy.<br />

In March <strong>2022</strong>, ANA affirmed that abortion is a reproductive health<br />

alternative that nurses can discuss when counseling patients. <strong>Nurses</strong> have a<br />

duty to respect the decisions of their patients, including those decisions that are<br />

related to sexual health and pregnancy. Respect for patient decisions does not<br />

mean that the nurse must agree or support the decision. <strong>Nurses</strong> can exercise<br />

their right to refuse to participate in sexual and reproductive health care based<br />

on ethical grounds, as long as patient safety is assured and care by others has<br />

been arranged.<br />

“No matter their philosophical differences or belief systems, all nurses must<br />

strive to remain consummate health care professionals and display empathy<br />

and respect to all,” said Cole. “This is a complicated issue and deeply personal<br />

for all, including nurses. <strong>Nurses</strong>, leaders, all health care professionals, and the<br />

public must engage on this issue with empathy and respect.”<br />

ANA and VNA will continue to advocate for reproductive justice and sexual<br />

health that supports a patient’s decision and rights in a just society.

Page 2 | <strong>August</strong>, September, October <strong>2022</strong><br />

Join nurses from throughout <strong>Virginia</strong> for a<br />

grand celebration of nursing!!<br />

<strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> | www.<strong>Virginia</strong><strong>Nurses</strong>.com<br />

Please plan to join us at the Westfields Marriott<br />

in Chantilly, VA (NOVA) on September 10 for the<br />

much-anticipated return of our in-person awards<br />

ceremony! Camaraderie with long-missed colleagues,<br />

recognition of the incredible accomplishments of<br />

nurses from throughout the commonwealth with our<br />

“Leadership Excellence” awards and more… It’s all<br />

on the evening’s agenda! This event is long overdue<br />

and not-to-be-missed!<br />

Dining tables (each of which can accommodate<br />

10 guests) and individual tickets are now on sale at<br />

https://virginianurses.com/mpage/Gala<br />

Purchase<br />

Tables &<br />

Individual<br />

Tickets Here.<br />

is the official publication of the <strong>Virginia</strong> <strong>Nurses</strong><br />

Foundation: PO Box 13619, Richmond, <strong>Virginia</strong><br />

23225, VNF’s affiliate, the <strong>Virginia</strong> <strong>Nurses</strong><br />

Association, is a constituent of the American<br />

<strong>Nurses</strong> Association.<br />

www.<strong>Virginia</strong><strong>Nurses</strong>.com<br />

admin@virginianurses.com<br />

Phone: 804-282-1808<br />

The opinions contained herein are those of the<br />

individual authors and do not necessarily<br />

reflect the views of the Foundation.<br />

<strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> reserves the<br />

right to edit all materials to its style<br />

and space requirements and to<br />

clarify presentations.<br />

VNF Mission Statement<br />

VNF is committed to improving the health<br />

of <strong>Virginia</strong>’s communities by developing an<br />

educated and diverse nursing workforce<br />

through leadership development, research,<br />

and innovation.<br />

VNT Staff<br />

Janet Wall, CEO<br />

Elle Buck, Managing Editor<br />

<strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> is published quarterly<br />

every February, May, <strong>August</strong> and November by<br />

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We are going totally DIGITAL. This will be our<br />

last print copy of <strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong>. As with any<br />

changes, we may have some growing pains as we<br />

adjust to this new format but we are confident that this<br />

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by the <strong>Virginia</strong><br />

Board of Nursing?<br />

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endorsement or approval by the <strong>Virginia</strong><br />

<strong>Nurses</strong> Foundation of the products advertised,<br />

the advertisers or the claims made. Rejection<br />

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Articles appearing in this publication express<br />

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necessarily reflect views of the staff, board, or<br />

membership of VNF, or those of the national<br />

or local chapters.<br />

Eileen M. Talamante, Esq., R.N.<br />

Eileen is a nurse and an attorney, and is<br />

here to help you with licensing issues,<br />

investigations, and disciplinary matters<br />

before the <strong>Virginia</strong> Board of Nursing.<br />

2020 Outstanding<br />

Advocate Award<br />

goodmanallen.com<br />

ETalamante@goodmanallen.com<br />

(804) 565-3526<br />



Dr. Loressa Cole to be honored with...continued from page 1<br />

Reserve University, her Master's in Business<br />

Administration (MBA) at Averett University, and<br />

her BSN at <strong>Virginia</strong> Commonwealth University. Dr.<br />

Cole is ANCC board-certified as a nurse executive,<br />

advanced, and was inducted as a fellow into the<br />

American Academy of Nursing in 2020.<br />

Celebrate Nursing on September 10<br />

Dr. Cole will be honored during VNF’s annual<br />

gala on September 10 at the Westfields Marriott<br />

in Chantilly, VA. Camaraderie with longmissed<br />

colleagues, recognition of the incredible<br />

accomplishments of nurses from throughout the<br />

commonwealth with our Leadership Excellence<br />

awards, accolades to legislator advocates for nurses<br />

and more… It’s all on the evening’s agenda! This<br />

event is long overdue and not-to-be-missed!<br />

More on Nancy Vance:<br />

• Click here to learn more about Nancy Vance's<br />

exceptional life and career.<br />

• Click here to view the list of previous awards<br />


www.<strong>Virginia</strong><strong>Nurses</strong>.com | <strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> <strong>August</strong>, September, October <strong>2022</strong> | Page 3<br />

Legislative Update<br />

Save the Date for VNA’s <strong>2022</strong> Virtual Legislative Summit!<br />

Are you ready for the November 8 Election?<br />

More information to come at:<br />

virginianurses.com/legislativesummit<br />

Join us VIRTUALLY for our annual<br />

Legislative Summit on November 15, <strong>2022</strong>.<br />

Learn how to be a powerful advocate for nursing and for the health of<br />

all <strong>Virginia</strong>ns! Plus, you’ll want to join us as we examine the critical issues<br />

facing nursing and healthcare and discuss the statewide impact of the<br />

results of the November 8 election. You'll get a detailed look into upcoming<br />

nursing legislation and nursing’s 2023 legislative priorities for next year.<br />

We’ll be talking about legislative solutions for our nurse staffing shortage,<br />

school nurses, APRN issues, reproductive and human rights and more!! Be<br />

sure to check out the full agenda on our website, www.virginianurses.com/<br />

page/LegislativeSummit, later this fall!<br />

The conference will be professionally produced and live streamed directly<br />

to your computer, tablet, or phone on November 15, <strong>2022</strong>. We're providing<br />

fantastic content related to nursing and healthcare legislative issues and<br />

advocacy, and we’re using a variety of interactive strategies to ensure an<br />

engaging opportunity for all participants. When you register for the live<br />

Legislative Summit, you will also receive access to the conference recording<br />

on-demand for three months, giving you the flexibility to view the program at<br />

your convenience!<br />

Make a Plan to Vote!<br />

Election Day is November 8! Making sure you have a plan to vote is essential<br />

for casting your ballot! Answer the questions below to make sure you're<br />

prepared!<br />

Do you know your polling location?<br />

If you don't know, you can find out here:<br />

Find your polling location<br />

What time will you vote?<br />

Figuring out what time during your busy day to vote is essential? Will you go<br />

before work, after work, or during lunch?<br />

Do you need a ride?<br />

Some political parties and local entities arrange ride services for voters who<br />

cannot get to the polls themselves. To find a ride near you, simply do a web<br />

search for “[your county] <strong>Virginia</strong>, rides to the polls <strong>2022</strong>!”<br />

Do you have young children?<br />

Having children definitely impacts your plan to vote! Will they be in school or<br />

daycare? Do you need to take them with you to the polls or can you drop them<br />

off with a family member or babysitter?

Page 4 | <strong>August</strong>, September, October <strong>2022</strong><br />

VNA President's Message<br />

Disengaged <strong>Nurses</strong> Speak Out!<br />

<strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> | www.<strong>Virginia</strong><strong>Nurses</strong>.com<br />

As we examine the staffing crisis and how to tackle this<br />

complex issue in both the short- and long-term, it seems<br />

obvious that we reach out to the approximately 115,000<br />

registered nurses whose licenses are either identified as<br />

inactive or expired in the past four years. Some of these<br />

nurses, we knew, had left the nursing workforce during<br />

the pandemic. We sought to understand why nurses have<br />

left their careers, what we can learn from them and apply<br />

to the current workforce challenges, and what it might<br />

take – if anything – to entice them back to the workforce.<br />

VNA recently conducted a survey of these nurses and<br />

received 2,684 responses.<br />

Top Reasons Why <strong>Nurses</strong> Disengaged<br />

<strong>Nurses</strong> Working in Hospitals vs All Respondents<br />

Who They Are<br />

57% of the responding nurses hold licenses that have<br />

expired in the past four years, while 35% have inactive<br />

licenses, and another 7% continue to work under a<br />

multistate license. Some further demographics about<br />

our respondents:<br />

• Age: 86% are 51+ years old, 7% are 31-40, 5% are<br />

41-50 and nearly 2% (54) are 20-30<br />

• 74% practiced nursing for more than 21 years,<br />

21% had practiced 6-20 years, and 5% had only<br />

practiced 0-5 years.<br />

• The highest degree earned was bachelor’s (40%),<br />

associate’s (34%), master’s (22%), and 3.5% their<br />

doctorate. 3.5% had earned their doctorate, while<br />

the highest degree<br />

earned by other<br />

respondents included:<br />

• The vast majority<br />

of respondents selfidentified<br />

as caucasian<br />

(89%), followed by<br />

Black (5%), Asian<br />

(2.5%) and Hispanic/Latino (2.5%)<br />

Linda M. Shepherd,<br />

MBA, BSN, RN,<br />

NEA-BC<br />

• They most recently work in hospitals (44%),<br />

ambulatory care (9%), long , and another 7.3%,<br />

long term term care facilities (5%), and k-12/<br />

academia and public health (4-4.5% each).<br />

Answering the ‘Why”<br />

Seventy percent have simply retired, while health<br />

concerns unrelated to the pandemic account for another<br />

12.2%, and family obligations rank third at 11.5%.<br />

Interestingly, 7.3% of respondents told us they are<br />

taking a break from nursing, but may return to the<br />

profession, while another 7.3% sadly reported that they<br />

are pursuing a non-nursing career. Another 6.2% are<br />

seeking a slower career pace, and 5.2% are not working<br />

due to mental and physical health concerns related to<br />

the pandemic.<br />

What would it take?<br />

When we removed those who had indicated that they<br />

were retired, and looked at all remaining respondents,<br />

the top six responses they indicated for leaving nursing<br />

are:<br />

1. Competitive pay<br />

2. Greater flexibility<br />

3. An employment contract<br />

4. A voice in which departments I work<br />

5. Zero-tolerance workplace violence and incivility<br />

policy<br />

6. Nothing could entice me to return to work<br />

Reasons <strong>Nurses</strong> Working in Hospitals Disengaged<br />

Taking a deeper dive, we examined the responses<br />

of those nurses who had most recently worked in a<br />

hospital or acute care setting and found that, when<br />

compared with all respondents:<br />

• A lesser percentage (6.87%) of hospital<br />

respondents left in order to retire<br />

• Family Obligations topped the hospital<br />

respondents’ list at 13.6% of reasons other than<br />

retirement<br />

• 9.65% of hospital respondents, compared with<br />

7.29% of all respondents, are pursuing a nonnursing<br />

career<br />

• 9.21% of hospital respondents, compared with<br />

7.29% of all respondents, are taking a break, but<br />

may return to nursing<br />

The results attest to the fact that nurses employed<br />

in acute care, many of whom cared for patients with<br />

COVID, have struggled significantly more with the<br />

hospital work environment both related and unrelated<br />

to the pandemic, including their ability to juggle work<br />

and family obligations and maintain their mental and<br />

physical health.<br />

What Would it Take?<br />

Removing from consideration those nurses who have<br />

retired, what would nurses who have left the workforce<br />

need in order to consider returning? The top two<br />

issues are the same across the board. All respondents,<br />

including those working in hospitals, expect competitive<br />

pay and greater scheduling flexibility. They also<br />

want a voice in which departments they work and an<br />

employment contract that leaves no room for confusion<br />

on these points and more. <strong>Nurses</strong>, like all healthcare<br />

professionals, also deserve an employer that not only<br />

doesn’t condone violence and incivility in the workplace,<br />

but takes actions to back up their words (#5 on the list)!<br />

<strong>Nurses</strong> are well-educated professionals who bring<br />

tremendous knowledge and expertise to the practice<br />

setting, and should be treated accordingly! In the<br />

months ahead, VNA will be developing contract templates<br />

and coaching nurses on how to negotiate a contract,<br />

including developing messaging that will resonate with<br />

CEOs and CFOs. We also plan to convene nurse leaders,<br />

CFOs and other leadership from various practice settings<br />

for a meeting of the minds. And we will take legislative<br />

action where needed. Be sure to participate in our fall<br />

conference, September 9-10 at the Westfields Marriott in<br />

Chantilly (NOVA), because The Time is NOW!<br />

Together, we have tremendous influence and can<br />

effect change! Join us!

School of Nursing – MSN – PMHNP<br />

Psychiatric Mental Health<br />

Nurse Practitioner and postprofessional<br />

Psych-Mental Health<br />

Nurse Practitioner Certificate<br />

Psychiatric Mental Health Nurse Practitioner is an advanced practice nursing role. Graduate<br />

education prepares the Psychiatric Mental Health Nurse Practitioner (PMHNP) to become a<br />

licensed independent health care provider with prescriptive authority and the post-professional<br />

PMH Nurse Practitioner Certificate program is designed for advanced practice nurses with<br />

Master’s Degrees who wish to advance their psychiatric mental health knowledge base. The<br />

PMHNP provides mental health care throughout the lifespan. This program provides the<br />

knowledge, skills, values and experience to assume the role of PMHNP in a variety of settings.<br />

Preparation includes content necessary to provide psychotherapy and medication to individuals,<br />

families and groups within hospitals and community settings. This role incorporates skills to:<br />

• Assess, diagnose and treat individuals and families with mental health challenges or<br />

psychiatric illnesses<br />

• Identify risk factors for psychiatric illness<br />

• Contribute to policy development, quality improvement, practice evaluation and<br />

healthcare reform<br />

Completion of a graduate nursing program allows for certification by the<br />

American <strong>Nurses</strong> Credentialing Center (AACN) to obtain a PMHNP certification<br />

which is required to obtain a state license to practice.<br />

Learn More<br />

https://odu.edu/nursing/graduate/msn/nurse-practitioner<br />

MSN – Family Nurse Practitioner<br />

Family<br />

Nurse<br />

Practitioner<br />

Enhance your expertise in theory, research, and advanced nursing<br />

practice through academic courses and clinical experiences that take a<br />

holistic approach to health and nursing care. You will be taught by ODU<br />

faculty who bring innovative solutions to improve healthcare in rural<br />

and underserved communities through telehealth and interprofessional<br />

education. The program bridges to the Doctor of Nursing Practice (DNP)<br />

program. Full-time and part-time options.<br />

Learn More<br />


Page 6 | <strong>August</strong>, September, October <strong>2022</strong><br />

<strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> | www.<strong>Virginia</strong><strong>Nurses</strong>.com<br />

CEO Reflections<br />

Positioning <strong>Nurses</strong> to be Influencers!<br />

Every nurse is or has the ability to be a leader<br />

in their own right. Leadership does not necessitate<br />

a list of credentials behind your name, nor does it<br />

require that you are part of the C-suite. Leadership<br />

is about advocacy of your patients or clients, on<br />

behalf of your colleagues, and for nursing as a<br />

profession. Leadership is about using your voice,<br />

be it at the bedside or in a legislative committee<br />

hearing, because you have important knowledge<br />

and perspectives to share. Because you have a voice.<br />

Does every nurse have a responsibility to flex that<br />

knowledge and influence pivotal conversations? I<br />

would suggest “yes.” It is together that we can best<br />

advance nursing to the benefit of both the profession<br />

and the communities we serve.<br />

Five years ago, the <strong>Nurses</strong> on Boards Coalition<br />

was founded. Its members include the American<br />

<strong>Nurses</strong> Association, the American <strong>Nurses</strong><br />

Foundation and a host of other national nursing<br />

organizations, and its mission is to improve the<br />

health of communities through the service of nurses<br />

on boards.<br />

NOBC is committed to increasing nurses’<br />

presence and influence on boards, panels, and<br />

commissions possessing the strategic influence to<br />

improve the health of communities and the nation.<br />

This includes corporate, governmental, non-profit,<br />

advisory or governance boards or commissions that<br />

have fiduciary or strategic responsibility.<br />

Having already achieved the key strategy of<br />

placing 10,000 nurses on boards, NOBC can now<br />

measure nurses’ impact on boards and raise<br />

broader awareness that all boards would benefit<br />

from the unique perspective of nurses to achieve the<br />

goals of improved health and efficient and effective<br />

healthcare systems at the local, state, and national<br />

levels.<br />

The pandemic has placed a harsh spotlight<br />

on health disparities within our marginalized<br />

communities, as well as racism in nursing. So, in<br />

addition to exponentially increasing the number of<br />

all nurses participating on boards of influence, it<br />

is particularly important that our communities are<br />

represented in the makeup of these boards, and that<br />

boards be inclusive so as to yield greater opportunity<br />

for all nurses, regardless of age, gender, ethnicity,<br />

sexual orientation, religion, etc.<br />

As Sue Hassmiller, PhD, RN, FAAN, known for<br />

her extensive work and leadership with the Robert<br />

Wood Johnson Foundation and the Center to<br />

Champion Nursing in America, once said, “Board<br />

service can be rewarding to nurses both personally<br />

and professionally. It not only requires them to<br />

exercise leadership; it expands those skills and<br />

advances their capabilities and knowledge. It gives<br />

nurses the chance to meet people and enhance their<br />

professional networks. And it can be inspirational<br />

and empowering.”<br />

Not currently serving on a board, but interested?<br />

Add your name to the NOBC database, and review<br />

the many resources on board service included on the<br />

site.<br />

Already serving on a board or other entity that<br />

has the ability to influence community health? Make<br />

sure to add your name to the NOBC list so that we<br />

can accurately track nurses progression.<br />

Join VNA / ANA (https://www.<br />

nursingworld.org/MbrApps/JoinProfile)<br />

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<strong>Nurses</strong> Foundation’s Nurse Leadership Academy.<br />

The Academy, which offers a robust year-long<br />

program of didactic learning and leadership project<br />

development, consistently receives rave reviews<br />

from participants, and will graduate its first class<br />

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for our 2023 class! The cost for this comprehensive<br />

[virtual] year-long program is $1,295/registrant<br />

or, for employers registering three or more nurses,<br />

$1,195/registrant.<br />

We’ve also planned a great Leadership<br />

Development Pre-Conference program to<br />

coincide with our September 9 & 10 in-person Fall<br />

Conference, The Time for Change is Now, which<br />

will be held at the stunning Westfields Marriott in<br />

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led by Bullying & Incivility Content Expert Diane<br />

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Workforce. Join us the morning of September 9 as<br />

we learn how to develop assertive communication<br />

skills among the healthcare team, incorporate<br />

body language techniques to strengthen<br />

team relationships, and create standards and<br />

systems that foster collegiality. Fall Conference<br />

registration fees are $249 for members and $295<br />

for nonmembers. Add the leadership development<br />

pre-conference and your total package rate will<br />

be $300 for members and $375 for nonmembers.<br />

Rooms at the Westfields Marriott are a very<br />

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www.<strong>Virginia</strong><strong>Nurses</strong>.com | <strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> <strong>August</strong>, September, October <strong>2022</strong> | Page 7<br />

Rest, Relax, Laugh:<br />

Spending Time with Yourself<br />

Dr. Phyllis Lawrence, DNP, RN, NEA-BC<br />

Reprinted with permission from<br />

Tennessee Nurse February <strong>2022</strong> issue<br />

Rest and Relax<br />

How many times have you been told that you need<br />

to get plenty of sleep for good physical health? Sleep<br />

is also instrumental in maintaining sound mental<br />

and emotional health. Rest is not only the act of<br />

sleeping, but you can rest your body, mind, and tap<br />

into your spirit simply by feeling renewed. Waking<br />

up and feeling that you have run a marathon is a<br />

sign of significant activity during your rest period.<br />

Either the mind continues to cycle, or you may be<br />

suffering from a sleep disorder. In either case, you<br />

are not at rest.<br />

To rest the mind, you must relax. Relaxation is<br />

defined as the state of being free from tension and<br />

anxiety (Google dictionary, <strong>2022</strong>). The Cambridge<br />

Dictionary defines relaxation as a pleasant activity<br />

that makes you become calm and less worried. This<br />

definition supports the concept of complementary<br />

and alternative interventions and modalities.<br />

Relaxation can really be a state of mind. One of<br />

the most effective holistic modalities that promotes<br />

relaxation is meditation. Meditation is reflected<br />

in many forms, including guided imaginary,<br />

mindfulness, Zen meditation, Mantra meditation,<br />

Transcendental meditation, and Yoga meditation,<br />

just to name a few. Mindfulness has become popular<br />

over the last few years. Being mindful is the basic<br />

human ability to be fully present in the moment,<br />

aware of your surroundings, feelings, and emotions.<br />

Try it, sit still in a quiet place. Place your hands in<br />

your lap. Now close your eyes. What do you hear?<br />

What do you smell? Breathe slow and steady while<br />

maintaining the rhythm. Continue this practice for<br />

approximately 10-15 minutes. Notice the change<br />

in your stress level or anxiety. This simple exercise<br />

can alleviate stress and anxiety, and if engaged in<br />

regularly, lead to an optimistic outlook.<br />

Laugh for a Healthier You<br />

Have you noticed that when you laugh, you feel<br />

better? It is harder to cry while you are laughing.<br />

Research has found that laughing triggers the<br />

release of endorphins (nature’s feel-good chemicals).<br />

It has also been reported that laughter decreases<br />

stress hormones and increases immune cells. We<br />

have a natural response to infection, which helps<br />

produce antibodies, improving our resistance to<br />

disease and promoting our overall well-being. What<br />

makes you laugh? Is it a funny commercial, your<br />

loved one(s), maybe your co-workers? Laughter is<br />

the best medicine. In an article by Robinson, Smith,<br />

& Segal (July 2021), learn to create opportunities<br />

to laugh, watch a funny movie, TV show, or<br />

YouTube video, check out a comedy club, read the<br />

funny pages, check out the humor section in your<br />

bookstore, play with a pet, better yet host a game<br />

night with friends.<br />

I would like to share with you some of the things<br />

that make me laugh. Watching my favorite comedy<br />

movies, even though I know the punch line, dancing<br />

to my favorite 80’s jam on YouTube, and serving with<br />

a grateful heart. When I see someone smile, I smile!<br />

During hard times, laughter has been a saving<br />

grace for many. Whitman (2017) A new study reveals<br />

how laughter affects the brain, which may be an<br />

explanation why giggles play an important role in<br />

social bonding.<br />

When you take time for yourself, you validate your<br />

worthiness and value. Make it a point to celebrate<br />

your life. Buy that neat sweater, go to the movies<br />

with your spouse, family, or friends. Do something<br />

that you enjoy, and that makes you feel good. How<br />

about butter pecan ice cream? Take care of yourself<br />

so that you can take care of others. The first step<br />

to self-care is accepting that you are worthy of that<br />

care. The care you require may need to come from<br />

a professional source, and that’s okay. There are<br />

services available through most healthcare facilities<br />

and organizations. Sometimes you just might need to<br />

talk. It may be a good time to phone a friend.<br />

Take a moment and plan to rest, relax, and laugh.<br />

Try to include at least one activity to cover each one<br />

of the components. Start with resting and relaxing,<br />

then let the laughter begin. Remember, you are<br />

worthy, valuable, and appreciated. Self-worth can<br />

only be measured by you. So make every moment<br />

count, and be mindful of your value. I can sum it up<br />

in one word, priceless!!<br />

References<br />

L. Robinson, M. Smith & J. Segal (2021). Laughter<br />

is the Best Medicine. https://www.helpguide.<br />

org/articles/mental-health/laughter-is-the-bestmedicine.htm<br />

Mindful: healthy mind, healthy life (<strong>2022</strong>).<br />

https://www.mindful.org/meditation/mindfulnessgetting-started/<br />

Whiteman, H. (2017). Laughter releases ‘feel good<br />

hormones’ to promote social bonding. https://www.<br />

medicalnewstoday.com/articles/317756<br />

Meet our newest Fall Conference<br />

presenter, Dr. Adrianna Nava<br />

Find your dream job now.<br />

We’re excited to announce<br />

Dr. Adrianna Nava, PhD,<br />

MPA, MSN, RN, President<br />

of the National Association<br />

of Hispanic <strong>Nurses</strong> (NAHN),<br />

will be joining us as a Fall<br />

Conference presenter!<br />

Dr. Nava is an advocate<br />

for increasing access<br />

to care for underserved<br />

populations. As a registered<br />

nurse, she witnessed<br />

firsthand how access-related disparities led to<br />

poor health outcomes, especially for racial/ethnic<br />

minority groups. In serving her patients, she saw<br />

an opportunity to contribute to decreasing Latino<br />

health disparities by building the leadership<br />

capabilities of nurses. She currently serves as<br />

President of the National Association of Hispanic<br />

<strong>Nurses</strong> (NAHN) and is focused on building the<br />


DEAN – School of Nursing-12 Month Administrative Position-<br />

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SUBMIT: Curriculum Vita, contact<br />

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for three professional references<br />

CONTACT: Dr. Arlene J. Montgomery, Search Committee<br />

Hampton University School of Nursing<br />

200 William R. Harvey Way, Hampton, VA 23668<br />

arlene.montgomery@hamptonu.edu | 757-727-5654<br />

leadership capacity of nurses, specifically Latino<br />

nurses, who continue to be underrepresented in<br />

nursing and healthcare leadership positions across<br />

the country.<br />

Dr. Nava will be presenting for the General<br />

Session: Combatting Racism in Nursing. The<br />

National Commission to Address Racism in Nursing<br />

conducted a survey that found that 63% of nurses<br />

surveyed had experienced an act of racism from<br />

a peer or superior in the workplace. Dr. Adrianna<br />

Nava, Co-Lead of the Commission, will discuss how<br />

nurses must help combat racism in nursing by first<br />

examining their own personal biases and beliefs and<br />

then working together to address systemic issues.<br />

Learn more about the work of the commission and<br />

what you can do to improve the well-being of our<br />

workforce by ensuring an inclusive and supportive<br />

work environment for all nurses.<br />

To view the full program or register for The Time<br />

for Change is NOW! click here!<br />

Now Hiring:<br />

Public Health Nurse II<br />

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The School Public Health Nurse works in the school health<br />

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supervision and evaluation of unlicensed assistive personnel.<br />

This position includes a signing bonus of<br />

$2,000 for new hires.

Page 8 | <strong>August</strong>, September, October <strong>2022</strong><br />

<strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> | www.<strong>Virginia</strong><strong>Nurses</strong>.com<br />

Report on the Statement of Racial Reckoning at the<br />

ANA Membership Assembly<br />

VNA Secretary<br />

Tiffany<br />

Covarrubias-Lyttle<br />

BS, BSN, RN, PCCN<br />

VNA President-Elect<br />

Sherri Wilson DNP,<br />

MPA, RN<br />

The <strong>2022</strong> American <strong>Nurses</strong> Association (ANA)<br />

Membership Assembly was held in-person this June<br />

in our nation’s capital. Spirited debate took place<br />

around staffing standards, work-place violence<br />

and climate control. Unique to any dialog is the<br />

nurse’s ability to not only advocate for themselves,<br />

but to maintain a clearly determined stance to also<br />

advocate for those they serve.<br />

One particular motion brought forward<br />

for consideration was the Statement of Racial<br />

Reckoning. This statement was passed<br />

unanimously without any opposition. However, it<br />

is worth examining what racial reckoning means,<br />

particularly in the noble profession of nursing.<br />

According to Merriam-Webster’s Dictionary,<br />

reckoning is “a settling of accounts.” [1] As this<br />

relates to the topic of race, a statement, while<br />

hardly able to reconcile a long history of slavery and<br />

systemic inequities in our country, is the foundation<br />

that can begin to have great visions built upon<br />

it. Just as developers would seek to build upon a<br />

terrain that has long been fallow, the foundation<br />

must be leveled and stabilized before anything can<br />

be built. This is what this statement brings, an<br />

opportunity for the leveling of unsettled terrain, and<br />

the stabilizing of the foundation. The call to build on<br />

this foundation is now an urgent one as we continue<br />

to see the health and wellness of those we serve<br />

being affected.<br />

The ANA’s National Commission to address<br />

Racism in Nursing conducted a comprehensive<br />

report series on Racism in Nursing. [2] The report<br />

explored the historical context of nursing’s role at<br />

the intersection of the following events in American<br />

history: the era of enslavement, colonialism and<br />

the Indigenous in the United States, American<br />

imperialism beyond the continental United States,<br />

and imperialism and racism in Latino nursing.<br />

The recent social and political climate has also<br />

highlighted the public policies, institutional<br />

practices, and cultural norms that make up<br />

structural racism, all catalysts to health inequities.<br />

An article published through the Journal of<br />

Nursing Administration highlights that minority<br />

populations, compared to white populations, have<br />

higher incidences of avoidable health disparities,<br />

chronic diseases, and more frequently experience<br />

delays in care. This in turn creates higher costs<br />

and exacerbates negative health outcomes. [3] The<br />

answer to this health crisis may just be nurses!<br />

The Future of Nursing 2020-2030 report clearly<br />

identifies that nurses can be the solution to racial<br />

health disparities through awareness, adjustment,<br />

assistance, alignment and advocacy. [4] But the<br />

bedside is not the only place in healthcare that<br />

minorities need to be represented; we should also<br />

be mirrored in administration to help make the<br />

decisions that will affect our communities, in<br />

academia to promote and mentor our future nurses,<br />

and research so that a complete understanding can<br />

be obtained from a whole population.<br />

“Promoting health and well-being has long been an<br />

essential role of nurses—they are bridge builders and<br />

collaborators who engage and connect with people,<br />

communities, and organizations to ensure people from<br />

all backgrounds have what they need to be healthy<br />

and well.” -Future of Nursing 2020-2030 [5]<br />

The health of our profession, patients and<br />

communities are dependent upon our ability to<br />

build our visions of equity. Where are we currently<br />

as a profession? According to the 2021 United States<br />

Census the general profile for race consists of: 13.4%<br />

African American/Black, 18.5% Hispanics/Latinos,<br />

and 6.9% Asian. [6] However, according to an HRSA<br />

National Sample Survey of <strong>Nurses</strong>, the race of our<br />

communities is not effectively represented within<br />

the nursing workforce, with only 7.8% African<br />

American/Black, 10.2% Hispanics/Latinos, and<br />

5.2% Asian. [5] A report put out by the American<br />

College of Healthcare Executives also demonstrates<br />

that while the population of patients that were<br />

also minorities grew from 21-31%, the reflection of<br />

diversity in the C-Suite remained a combined 14%<br />

[7] according to The Minority Nurse, with 63% of<br />

minorities in nursing being employed within hospital<br />

settings. [8]<br />

Here in the Commonwealth of <strong>Virginia</strong>,<br />

nurses are 110,000+ strong [5] but even in our<br />

great commonwealth, which does have better<br />

representation than many other states and<br />

commonwealths in the nation, there are disparities<br />

among the populations represented: 19% African<br />

American/Black, 10% Hispanic/Latino and 7%<br />

Asian. [9]<br />

What are the practical approaches for nurses<br />

to build a greater future? The Commission’s<br />

comprehensive Report on Racism in Nursing serves<br />

as a first step in helping our profession gain a better<br />

understanding of nursing’s role in the landscape<br />

of systemic racism, which will in turn, lay the<br />

foundation for healing. The Commission also seeks<br />

to collaborate with the broader nursing community<br />

and other stakeholders to seek to dismantle<br />

racism in nursing through continued engagement.<br />

Additional strategies promoted by the Commission<br />

include using the ANA’s Scope of Practice Statement<br />

to set antiracist behaviors and standards of practice<br />

within healthcare institutions. In addition, The<br />

Future of Nursing 2020-2030 report outlines a<br />

framework for addressing social needs: awareness,<br />

adjustment, assistance, alignment and advocacy.<br />

Awareness is the ability for each of us to<br />

understand the issues and to be bold enough to<br />

hold these issues with the same respect that we<br />

would any other area of practice. This is having a<br />

questioning attitude in areas of discrimination and<br />

under-representation, and diving into the research<br />

and evidence base. Do you know and understand the<br />

race-driven aspects of social determinants of health<br />

and how discrimination in your service area affect<br />

your patient populations?<br />

Adjustment is identifying the issue and making<br />

needed changes. When areas of discrimination and<br />

disparity are occurring, it is never enough to just<br />

be aware of the situation. We must be brave to call<br />

out the issues and make the necessary adjustments<br />

in collaboration with all those the adjustments will<br />

affect.<br />

Assistance is showing up and connecting the<br />

issue with those that can remedy it. As nurses, we<br />

can make an impact by making connections in our<br />

profession and in our patients with services that can<br />

help bring about change. Within nursing, we can<br />

find toolkits for addressing race and discrimination<br />

through organizations like the CDC, The <strong>Virginia</strong><br />

Department of Health and commonwealth-based<br />

professional nursing organizations. Teaming with<br />

these organizations will help keep you informed and<br />

assist in the dialog for these crucial conversations<br />

while also giving you opportunities to get involved.<br />

Alignment is the act of supporting and being<br />

involved with and using your resources to promote<br />

healing and change. For nurses, this means being<br />

involved in your area of practice, system, and<br />

professional nursing organization, such as the<br />

<strong>Virginia</strong> <strong>Nurses</strong> Association (VNA) and American<br />

<strong>Nurses</strong> Association (ANA). Showing up isn’t just<br />

about networking; it is prioritizing resources to<br />

align with the needs for equity and inclusion. A<br />

very important area of alignment is mentoring<br />

which is emerging as an effective treatment to the<br />

crippling chronic disease of racism. [10] Not only is<br />

the mentor relationship beneficial for both parties,<br />

but the mentee has demonstrated better long-term<br />

projections in salaries, promotions, satisfaction and<br />

organizational commitment. [3]<br />

Advocacy is the powerful and meaningful action<br />

of collaboration between nurses and communities, to<br />

have a shared vision and then pushing that vision<br />

to spark social change. In this case, nurses have<br />

been granted the trust of their communities and<br />

with our strong collective voice, we can advocate for<br />

both the individual and the community. We can no<br />

longer tolerate discrimination, of any sort, and this<br />

is universally applicable for any practice setting. We<br />

are stronger together!<br />

As nurses, it is our duty to remove barriers to<br />

healing and promote the health of our profession<br />

and our communities. Just as we would speak up for<br />

our patients and take pride in their care, we must<br />

also speak up for our profession. We must end the<br />

disabling disease of racism and discrimination<br />

as it holds us back from the visions we have for<br />

health within our communities and profession.<br />

Collectively, we must align our voice, resources,<br />

and positions with practices that are inclusive and<br />

promote a healthy and diverse workforce, academia<br />

and research. It is imperative to mentor our future<br />

generations of nurses and show them that the<br />

sky isn’t the limit, it is only the beginning. We are<br />

starting this journey, but this time together, as<br />

nurses.<br />

Works Cited<br />

[1] Merriam-Webster, "Merriam Webster Dictionary," 18<br />

June <strong>2022</strong>. [Online]. Available: https://www.merriamwebster.com/dictionary/reckoning.<br />

[2] P. D’Antonio and D. Tobbell, "Report Series: Racism<br />

in Nursing.," National Commission to Address Racism<br />

in Nursing , <strong>2022</strong>. [Online]. Available: https://<br />

www.nursingworld.org/~49c4d0/globalassets/<br />

practiceandpolicy/workforce/commission-to-addressracism/racism-in-nursing-report-series.pdf.<br />

[Accessed<br />

19 June <strong>2022</strong>].<br />

[3] T. Harris, "The Reality for Minorities Exploring<br />

Nurse," JONA, vol. 51 , no. 6, pp. E18-E19, 2021.<br />

[4] National Academies of Sciences, Engineering, and<br />

Medicine, "5 The Role of <strong>Nurses</strong> in Improving Health<br />

Equity.," National Academy Press, Washington D.C.<br />

doi: 10.17226/25982., 2021.<br />

[5] U.S Department of Health and Human<br />

Services, Health Resources and Services<br />

Administration,Bureau of Health Workforce, National<br />

Center for Health Workforce Analysis, "2018 National<br />

Sample Survey of Registered <strong>Nurses</strong>," HRSA Health<br />

Workforce, , Rockville, Maryland, 2019.<br />

[6] United States Census Bureau , "United States<br />

Department of Commerce," 2021. [Online]. Available:<br />

https://www.census.gov/quickfacts/fact/table/VA,US/<br />

PST045221. [Accessed 18 June <strong>2022</strong>].<br />

[7] R. Zambrano, "The Value and Imperative of<br />

Diversity Leadership Development and Mentoring<br />

in Healthcare," Journal of Healthcare Management,<br />

vol. 64, no. 6, pp. p 356-358 doi: 10.1097/<br />

JHM-D-19-00209, 2019.<br />

[8] Minority Nurse , "Nursing Statistics," Springer<br />

Publishing Company, <strong>2022</strong>. [Online]. Available:<br />

https://minoritynurse.com/nursing-statistics/.<br />

[Accessed 18 June <strong>2022</strong>].<br />

[9] <strong>Virginia</strong> Department of Health Professions, "<strong>Virginia</strong>’s<br />

Registered Nurse Workforce: 2020," Healthcare<br />

Workforce Data Center, 2020. [Online]. Available:<br />

https://www.dhp.virginia.gov/media/dhpweb/docs/<br />

hwdc/nurse/0001RN2020.pdf. [Accessed 18 June<br />

<strong>2022</strong>].<br />

[10] C. Vassie, S. Smith and K. Leedham-Green,<br />

"Factors impacting on retention, success and<br />

equitable participation in clinical academic careers:<br />

a scoping review and meta-thematic synthesis,"<br />

BMJ Open , Vols. 10(3):e033480 doi:10.1136/<br />

bmjopen-2019-033480, 2020.<br />

[11] National Academies of Sciences, Engineering, and<br />

Medicine., "The Future of Nursing 2020-2030: -<br />

Charting a Path to Achieve Health Equity: Report<br />

Brief," The National Academies Press. https://nap.<br />

nationalacademies.org/resource/25982/FON%20<br />

One%20Pagers%20Valuing%20Community%20<br />

and%20Public%20Health%20Nursing.pdf,<br />

Washington D.C., 2021.

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Page 10 | <strong>August</strong>, September, October <strong>2022</strong><br />

<strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> | www.<strong>Virginia</strong><strong>Nurses</strong>.com<br />

What’s all the buzz: Future of Nursing 2020-2030,<br />

Charting a Path to Achieve Health Equity<br />

The Future of Nursing, first published by the<br />

Institute of Medicine in 2010, explores how nurses'<br />

roles, responsibilities, and education must change<br />

significantly to meet the increased demand for care<br />

that will be needed to advance improvements in<br />

America's increasingly complex health system.<br />

In the decade since, the world has come to<br />

understand the critical importance of health to<br />

all aspects of life, particularly the relationship<br />

among what are termed social determinants of<br />

health (SDOH), health equity, and health outcomes.<br />

In a year that was designated to honor and uplift<br />

nursing (the International Year of the Nurse and the<br />

Midwife 2020), nurses were placed in unimaginable<br />

circumstances by the COVID-19 pandemic. The<br />

decade ahead will demand a stronger, more<br />

diversified nursing workforce that is prepared to<br />

provide care; promote health and well-being among<br />

nurses, individuals, and communities; and address<br />

the systemic inequities that have fueled wide and<br />

persistent health disparities.<br />

The vision of the Committee on the Future of<br />

Nursing 2020–2030, which informed the current<br />

report, is the achievement of health equity in<br />

the United States built on strengthened nursing<br />

capacity and expertise. By leveraging these<br />

attributes, nursing will help to create and contribute<br />

comprehensively to equitable public health and<br />

health care systems that are designed to work for<br />

everyone. To achieve health equity, the committee<br />

also envisions a major role for the nursing profession<br />

in engaging in the complex work of aligning public<br />

health, health care, social services, and public<br />

policies to eliminate health disparities and achieve<br />

health equity.<br />

Specifically, with implementation of the<br />

Future of Nursing 2020-2030 (https://nam.edu/<br />

publications/the-future-of-nursing-2020-2030/)<br />

report recommendations, the committee envisions<br />

10 outcomes that position the nursing profession to<br />

contribute meaningfully to achieving health equity.<br />

Those outcomes are identified in the chart at right.<br />

Achieving Health Equity Through Nursing:<br />

Desired Outcomes<br />

• <strong>Nurses</strong> are prepared to act individually,<br />

through teams, and across sectors to meet<br />

challenges associated with an aging population,<br />

access to primary care, mental and behavioral<br />

health problems, structural racism, high<br />

maternal mortality and morbidity, and<br />

elimination of the disproportionate disease<br />

burden carried by specific segments of the U.S.<br />

population.<br />

• <strong>Nurses</strong> are fully engaged in addressing the<br />

underlying causes of poor health. Individually<br />

and in partnership with other disciplines and<br />

sectors, nurses act on a wide range of factors<br />

that influence how well and long people live,<br />

helping to create individual- and communitytargeted<br />

solutions, including a health in all<br />

policies orientation.<br />

• <strong>Nurses</strong> reflect the people and communities<br />

served throughout the nation, helping to ensure<br />

that individuals receive culturally competent,<br />

equitable health care services.<br />

• Health care systems enable and support nurses<br />

to tailor care to meet the specific medical and<br />

social needs of diverse patients to optimize their<br />

health.<br />

• <strong>Nurses</strong>’ overarching contributions, especially<br />

those found beneficial during the COVID-19<br />

pandemic, are quantified, extended, and<br />

strengthened, including the removal of<br />

institutional and regulatory barriers that<br />

have prevented nurses from working to the<br />

full extent of their education and training.<br />

Practice settings that were historically<br />

undercompensated, such as public health and<br />

school nursing, are reimbursed for nursing<br />

services in a manner comparable to that of<br />

other settings.<br />

• <strong>Nurses</strong> and other leaders in health care and<br />

public health create organizational structures<br />

and processes that facilitate the profession’s<br />

expedited acquisition of relevant content<br />

expertise to serve flexibly in areas of greatest<br />

need in times of public health emergencies and<br />

disasters.<br />

• <strong>Nurses</strong> consistently incorporate a health equity<br />

lens learned through revamped academic and<br />

continuing education.<br />

• <strong>Nurses</strong> collaborate across their affiliated<br />

organizations to develop and deploy a<br />

shared agenda to contribute to substantial,<br />

measurable improvement in health equity.<br />

National nursing organizations reflect an<br />

orientation of diversity, equity, and inclusion<br />

within and across their organizations.<br />

• <strong>Nurses</strong> focus on preventive person-centered<br />

care and have an orientation toward<br />

innovation, always seeking new opportunities<br />

for growth and development. They expand<br />

their roles, work in new settings and in new<br />

ways, and markedly expand their partnerships<br />

connecting health and health care with all<br />

individuals and communities.<br />

• <strong>Nurses</strong> attend to their own self-care and help<br />

to ensure that nurse well-being is addressed<br />

in educational and employment settings<br />

through the implementation of evidence-based<br />

strategies.<br />

Source: The National Academy of Sciences<br />

The <strong>Virginia</strong> <strong>Nurses</strong> Association and <strong>Virginia</strong><br />

<strong>Nurses</strong> Foundation met at the end of June to<br />

identify new three-year strategic imperatives, and<br />

will include details of the new strategic plan in<br />

the November issue of <strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong>.<br />

Source: https://campaignforaction.org/<br />

resource/recommendations-at-a-glance/<br />

Source: The National Academy of Sciences<br />

W e’re H iring!<br />

RNs, LPNs, CNAs, and more!<br />

Various shifts (full time, part-time, per diem)<br />

5 Star Staffing, First Day Benefits, Tuition Assistance,<br />

Student Loan Repayment<br />

www.wcbay.com/careers<br />

3100 Shore Drive,<br />

<strong>Virginia</strong> Beach, VA 23451<br />

VNF supports the Youth Mental Health First Aid training<br />

of nearly 200 school nurses from throughout <strong>Virginia</strong><br />

Last month, <strong>Virginia</strong> <strong>Nurses</strong><br />

Foundation Ambassador and<br />

Richmond Public Schools<br />

Coordinator of Health Services<br />

Na-Keisha White, MSN-PH,<br />

RN, NBCSN led the training<br />

of nearly 200 school nurses in<br />

Youth Mental Health First Aid.<br />

This follows several smaller<br />

training programs she has led<br />

for the foundation. The training<br />

was held in Roanoke as part of the <strong>Virginia</strong> Departments<br />

of Education and Health’s Summer Institute for School<br />

Nursing, and is a huge stride forward in VNF ensuring<br />

that nurses and other leaders at K-12 schools are better<br />

prepared to respond to the needs of the commonwealth’s<br />

youth. VNF had previously supported Na-Keisha’s<br />

participation in the instructor-level training, thanks<br />

to funding from a Robert Wood Foundation (RWJF)<br />

Innovations Award, and is incredibly appreciative of this<br />

collaboration and her passion for ensuring the mental<br />

health of our youth.<br />


Prince William-Manassas Regional Adult Detention<br />

Center, located in Manassas, <strong>Virginia</strong>, are hiring<br />

Licensed Practical <strong>Nurses</strong> (LPN), Registered <strong>Nurses</strong><br />

(RN) and Senior Registered <strong>Nurses</strong> (SRN) to provide<br />

inmate daily sick call, administer medication and<br />

treatment, record keeping, and as well as additional<br />

nursing duties to meet position, department and<br />

agency needs. These positions are night shift.<br />

Excellent Benefits: 401a/457 VRS Hybrid retirement<br />

plan, health and dental insurance plans, paid<br />

holidays, and annual/sick leave accruals.<br />

See full job description and apply on-line:<br />

https://www.pwcgov.org/jobs<br />

Questions: Please call the<br />

ADC Human Resources at (703) 792-5840.<br />

Prince William County is an Equal Opportunity Employer and supports workforce diversity.

www.<strong>Virginia</strong><strong>Nurses</strong>.com | <strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> <strong>August</strong>, September, October <strong>2022</strong> | Page 11<br />

The Time for Change is NOW!<br />

By VNA & VNF DEI Council<br />

Chair Vivienne McDaniel,<br />

DNP, MSN, RN<br />

“A toxic combination of<br />

poor social policies and<br />

programs, unfair economic<br />

arrangements, and bad<br />

politics is responsible for the<br />

fact that a majority of people<br />

in the world do not enjoy the<br />

good health that is biologically<br />

possible.” - Commission on SDOH<br />

The time for change is now! It is time for all nurse<br />

professionals to move from thoughts, ideas, and<br />

theories about achieving equity and health equity<br />

to “walking the talk,” taking action, and being<br />

intentional in their walk. There are several tools<br />

that have been developed to help us actualize our<br />

equity and health equity initiatives but none greater<br />

than the seminal National Academies of Medicine<br />

masterpiece, the Future of Nursing 2020-2030:<br />

Charting a Path to Achieve Health Equity report.<br />

During the 2021 National Association of<br />

Nigerian <strong>Nurses</strong> in North America conference<br />

I was a co-presenter with Dr. Grace Ogiehor-<br />

Enoma. We discussed pertinent information and<br />

recommendations from the Future of Nursing 2020-<br />

2030: Charting a Path to Achieve Health Equity<br />

report. Dr. Grace touched on five key messages<br />

garnered from the report:<br />

• Key Message 1: Policymakers need to<br />

permanently lift unnecessary regulatory<br />

and practice barriers that keep nurses from<br />

practicing within the scope of their education<br />

and training, and that restrict people’s access<br />

to high quality care.<br />

• Key Message 2: Public and private payers<br />

need to establish sustainable and flexible<br />

payment models to support nurses in health<br />

care and public health, including school<br />

nurses, so that they can effectively address the<br />

medical and social needs of people, families,<br />

and communities.<br />

• Key Message 3: Nursing schools need to<br />

strengthen education curricula and expand<br />

the environments where nurses train, better<br />

prepare nurses to work in and with diverse<br />

communities, and diversify nursing school<br />

classes and faculty so nurses at all levels<br />

reflect the communities they care for and<br />

serve.<br />

• Key Message 4: Employers must support<br />

nurse well-being so they can in turn support<br />

the well-being of others.<br />

• Key Message 5: <strong>Nurses</strong> need to leverage their<br />

own power to advance health equity by making<br />

sure they are well prepared to bridge medical<br />

and social needs; taking care of their own<br />

mental and physical health so they can care<br />

for others; and advocating for policies that<br />

address poverty, racism and other conditions<br />

that stand in the way of health and well-being.<br />

The presentation also included discussions on<br />

the social determinants of health (SDOH). Social<br />

determinants of health (SDOH) are the conditions in<br />

the environments where people are born, live, learn,<br />

work, play, worship, and age that affect a wide range<br />

of health, functioning, and quality-of-life outcomes<br />

and risks (Healthy People 2030, <strong>2022</strong>). SDOH can<br />

be grouped into five domains: economic stability,<br />

education access and quality, healthcare access<br />

and quality, neighborhood and built environment,<br />

and social community context. Because SDOH<br />

contributes significantly to health disparities<br />

and inequities, it is pivotal that nurses become<br />

knowledgeable about the content of the 2020-2030<br />

Future of Nursing report. The report considers how<br />

nurses should best address SDOH, and advance<br />

effective, efficient, and equitable care for all across<br />

the healthcare continuum.<br />

Health inequities would not exist if there were no<br />

discrimination, prejudices or racism in healthcare<br />

(National Commission to Address Racism in Nursing,<br />

<strong>2022</strong>). To address inequities and disparities you<br />

must first work to dismantle inequitable ideology.<br />

For our country to advance health equity for all, the<br />

systems that educate, pay and employ nurses need<br />

to permanently remove barriers to allow them to do<br />

this work, value their contributions, prepare them to<br />

understand and tackle issues that impede advancing<br />

equity, and diversify the nursing workforce (Future<br />

of Nursing Campaign for Action, <strong>2022</strong>). Those were<br />

among the four key takeaways suggested during a<br />

May <strong>2022</strong> Campaign for Action Summit.<br />

It is honorable to ensure that everyone gains<br />

access to the same resources according to their<br />

needs but true health equity requires nurses to<br />

always address the disparities and inequities that<br />

can prevent people from living full and healthy lives.<br />

It is incumbent on all nurses to challenge injustices<br />

that contribute to negative care outcomes. It will not<br />

happen unless nurses identify system facilitators<br />

and barriers to health equity and take action.<br />

Examine your readiness or your organization’s<br />

willingness to chart a path to achieve health<br />

equity, then download the Future of Nursing 2020-<br />

2030 report from the National Academies Sciences<br />

Engineering Medicine website at https://nap.<br />

nationalacademies.org/catalog/25982/the-future-ofnursing-2020-2030-charting-a-path-to.<br />

In an effort to build healthier communities<br />

through nursing and to guide you on your path to<br />

achieve health equity, the Campaign for Action<br />

has drafted action plans that provide a solid<br />

foundation of actionable recommendations and subrecommendations<br />

for organizations and for nurses<br />

in roles of education, leadership, practice, research<br />

and policy and advocacy. Drs. Sue Hassmiller and<br />

Susan Reinhard suggest selecting at least two of the<br />

Recommendations for implementation based on your<br />

individual or organizational needs.<br />

Draft Action Plans<br />

• Recommendation #1: CREATING A SHARED<br />

AGENDA<br />

• Recommendation #2: SUPPORTING NURSES<br />


• Recommendation #3: PROMOTING NURSES’<br />


• Recommendation #4: CAPITALIZING ON<br />


• Recommendation #5: PAYING FOR NURSING<br />

CARE<br />

• Recommendation #6: USING TECHNOLOGY<br />




• Recommendation #7: STRENGTHENING<br />


• Recommendation #8: PREPARING NURSES<br />



• Recommendation #9: BUILDING THE<br />


The VNA-VNF Diversity, Equity, and Inclusion<br />

Council (DEIC) has taken the Campaign for<br />

Action challenge and has selected two of the<br />

recommendations/sub-recommendations to implement.<br />

DEIC believes that nurses should mirror the population<br />

they serve. Increasing the number of nurses from<br />

underrepresented populations on boards is another<br />

important goal of DEIC. Being a board member gives<br />

nurses a seat and a voice at the decision-making<br />

table. The DEIC is pleased at the progress being made<br />

and encourages those in positions of decision making<br />

to improve their diversity and inclusion efforts by<br />

appointing nurses who are historically marginalized<br />

and underrepresented on boards. DEIC is also<br />

encouraging nurses to be on boards outside of nursing<br />

and healthcare as well. Using the Future of Nursing<br />

2020-2030: Charting a Path to Achieve Health Equity<br />

report recommendations as a framework we can move<br />

from thoughts, ideas, and theories about achieving<br />

equity and health equity to intentional action. Wisdom<br />

lies in knowing when to cease talking and start acting.<br />

The time for change is now!<br />

References<br />

Future of Nursing Campaign for Action. (<strong>2022</strong>). The<br />

Campaign for Action May summit webinar. https://<br />

campaignforaction.org/webinar/may-<strong>2022</strong>-summit/.<br />

Healthy People 2030. (<strong>2022</strong>). Social determinants of health.<br />

https://health.gov/healthypeople/priority-areas/socialdeterminants-health<br />

National Commission to Address Racism In Nursing.<br />

(<strong>2022</strong>). Racism in nursing. https://www.nursingworld.<br />

org/practice-policy/workforce/clinical-practicematerial/national-commission-to-address-racism-innursing/commissions-foundational-report-on-racism--<br />

in-nursing/<br />

Wakefield, M. K., Williams, D. R. Le Menestrel, S., &<br />

Flaubert, J. L. (Eds.). (2021). The future of nursing<br />

2020-2030: Charting a path to achieve health equity.<br />

National Academies Press.<br />

Additional Resources<br />

Action Coalition May <strong>2022</strong> Summit Deck https://<br />

campaignforaction.org/resource/action-coalitionmay-<strong>2022</strong>-summit-deck/<br />

Equity Toolkit Helps Communities Take on Social<br />

Determinants of Health https://campaignforaction.<br />

org/resource/equity-toolkit/<br />

The Future of Nursing 2020-2030: Charting<br />

a Path to Achieve Health Equity. https://nap.<br />

nationalacademies.org/read/25982/chapter/1<br />

Grace Ogiehor-Enoma, DHA, MSN, MPH, NE-<br />

BC, RN is an adjunct associate professor at Hunter<br />

College, and the executive director of the National<br />

Association of Nigerian <strong>Nurses</strong> in North America.<br />

Vivienne Pierce McDaniel, DNP, MSN, RN is an<br />

adjunct assistant professor at Aspen University<br />

School of Nursing and Health Sciences, a diversity,<br />

equity, and inclusion consultant for James Madison<br />

University School of Nursing and president of the<br />

Central <strong>Virginia</strong> Chapter of the National Black<br />

<strong>Nurses</strong> Association.<br />


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Page 12 | <strong>August</strong>, September, October <strong>2022</strong><br />

Be a JEDI: Focus on the B<br />

<strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> | www.<strong>Virginia</strong><strong>Nurses</strong>.com<br />

Dr. Nina Beaman<br />

Dr. Marsha<br />

Hughes-Rease<br />

In an October 2021 study on racism in nursing fielded by the National<br />

Commission to Address Racism in Nursing, 94% of respondents indicated<br />

agreement with the statement “there is some or a lot of racism in the nursing<br />

profession;” 76% of respondents attested to witnessing racism in the workplace;<br />

and 63% reported personally experiencing racism in the workplace, with<br />

Black nurses (92%) reporting having experienced racism the most (National<br />

Commission, 2021). In the recently published Racism in Nursing report,<br />

racism is identified as a preventable harm and can be mitigated by intentional<br />

actions to change belief systems and social and organizational practices that<br />

contribute to dual harm from structural racism, which is invisible unless one<br />

looks for it, as it is ingrained in the structures, beliefs, policies, and practices<br />

of our healthcare system (Nardi et al., 2020). And there is significant research<br />

that supports that belonging is probably one of the most powerful ways to create<br />

an inclusive environment. Belonging is an interpretation of cues that suggests<br />

that one fits in and is welcome in a given context; it is an inference based on<br />

observations, interactions, values, and past events that define the culture and<br />

environment (Walton, et al., 2017)<br />

So, how can nurses build work environments that promote belonging along<br />

with justice, equity, diversity, and inclusion or JEDI? Let’s unpack the acronym<br />

JEDI first.<br />

Social justice, put simply, is the paradigm that everyone deserves equal<br />

rights and opportunities (American Public Health Association). Considering<br />

your workplace, is everyone treated fairly and equally? If some need to build<br />

more skills, are they given the opportunity? Or do some receive special benefits<br />

because they demand them, while others do not get what they need to do their<br />

jobs?<br />

Equity is distinguished from equality in that it refers to fairness and justice,<br />

not just providing the same to all (National Association of Colleges and Employers).<br />

The same source emphasized that equity acknowledges that everyone does not<br />

start at the same place, so sometimes adjustments need to be made to account for<br />

imbalances. According to Pat Benner’s theory, mentoring is needed to help nurses<br />

move from novices to become experts (Thomas & Kellgren, 2017). So, each nurse<br />

may be at a different point in their career journey, needing different resources<br />

and guidance. There should be no stigma in nurses asking for what they need to<br />

become better nurses.<br />

Diversity is not just about skin tone. The true focus of diversity is<br />

an understanding and appreciation for people who come from different<br />

backgrounds and cultures (American Library Association). A workplace that<br />

embraces diversity has diverse viewpoints of problem solving and ways to<br />

communicate solutions. A diverse nursing workforce can serve a diverse patient<br />

population in more appropriate ways.<br />

Inclusion involves not just adding diverse individuals to the workforce,<br />

but including them on every level to participate actively in the culture of the<br />

organization. The NeuroLeadership Institute found data that showed that<br />

benefits of inclusivity in the workplace included improving team collaboration,<br />

greater efficiencies, increased performance, and higher employee engagement<br />

(Strup, 2019). In order to reap the benefits of inclusion, you have to create an<br />

environment of belonging. Inclusion and belonging are connected. Inclusion<br />

involves efforts and behaviors that can be fostered by the organization or<br />

actually by the people in it. Belonging is something that employees themselves<br />

feel and results from your inclusion efforts.<br />

Inclusive behaviors should result in a sense of belonging as an outcome. And<br />

here are some of these behaviors:<br />

• recognize that each individual has unique perspectives and talents by<br />

amplifying these differences as strengths<br />

• broaden your understanding of how your biases show up in your<br />

micro behaviors and how your behaviors may advantage some while<br />

disadvantaging others<br />

• practice allyship by being an upstander rather than a bystander<br />

• develop inclusive leadership skills to leverage diversity for innovative<br />

problem solving and solution finding<br />

Although improving JEDI at the workplace is a good strategy, the ultimate<br />

goal for any nursing organization must be to focus on the Belonging. Other<br />

initiatives will not promote a positive workplace unless the employees feel a<br />

sense that they belong to the work culture. Belonging builds collaboration,<br />

loyalty, and dedication—traits nurses are known to be able to foster if they are<br />

in environments where their voices are heard, their contributions are noticed,<br />

and they feel that whoever they are—they are valued.<br />

References<br />

American Library Association. (n.d.). Defining diversity—Strategic planning for diversity.<br />

Retrieved May 22, <strong>2022</strong>, from https://www.ala.org/advocacy/diversity/workplace/<br />

diversityplanningdefinitions<br />

American Public Health Association. (n.d.). Social justice and health. Retrieved May 22,<br />

<strong>2022</strong>, from https://www.apha.org/what-is-public-health/generation-public-health/ourwork/social-justice<br />

National Association of Colleges and Employers. (n.d.). Equity. Retrieved May 22, <strong>2022</strong>,<br />

from https://www.naceweb.org/about-us/equity-definition/<br />

Nardi, D., Waite, R., Nowak, M., Hatcher, B., Hines-Martin, V., & Stacciarini, J.-M. R.<br />

(2020). Achieving health equity through eradicating structural racism in the United<br />

States: A call to action for nursing leadership. Journal of Nursing Scholarship: An<br />

Official Publication of Sigma Theta Tau<br />

International Honor Society of Nursing. 52(6), 696-704. https://doi.org/10.1111/jnu.12602.<br />

Strup, R. (2019). Active inclusion. TD: Talent Development, 73(5), 26–28.<br />

Thomas, C. M., & Kellgren, M. (2017). Benner’s novice to expert model: An application for<br />

simulation facilitators. Nursing Science Quarterly, 30(3), 227–234.<br />

Walton GM, Brady ST. Elliot AJ, Dweck CS, Yeager DS. The many questions of belonging.<br />

In: Handbook of Competence and Motivation: Theory and Application. 2017:2nd ed.<br />

New York, NY: Guilford Press; 272–293.<br />

Bookmark VNA’s Website<br />

Calendar for Virtual Legislative<br />

Advocacy Hours<br />

In order to accommodate both legislators’ and nurses’ busy schedules, VNA<br />

will continue to hold the multiple [free] Legislative Advocacy Hours virtually.<br />

The 10 anticipated Legislative Advocacy Hours will be held in all areas of<br />

the commonwealth in the weeks following the November elections. Nurse<br />

participants will receive their chapter’s legislative guide, a copy of VNA’s public<br />

policy platform, and will be able to meet virtually with the legislators in their<br />

area. Ample time will be planned for Q&A.<br />

To find a legislative reception near you, visit our events calendar at<br />

virginianurses.com/events/event_list.asp.<br />

VNA members can expect to receive an email in the coming months with<br />

the dates and registration links for the Legislative Advocacy Hours. This<br />

information will also be posted to VNA’s Facebook page, www.facebook.com/<br />

vanurses. Questions? Contact VNA Membership Manager MJ Gearles at<br />


Page 14 | <strong>August</strong>, September, October <strong>2022</strong><br />

VNF President's Message<br />

<strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> | www.<strong>Virginia</strong><strong>Nurses</strong>.com<br />

Mental Health Roundtable:<br />

A Special Focus on Youth Mental Health<br />

Phyllis Whitehead, PhD, APRN/CNS, ACHPN,<br />


I am excited to share that our special focus<br />

on Youth Mental Health on May 5, <strong>2022</strong> was a<br />

huge success with 196 participants from multiple<br />

organizations throughout the commonwealth.<br />

A special thanks to the <strong>Virginia</strong> Association of<br />

School <strong>Nurses</strong> for their collaboration on this event.<br />

Additionally, we collaborated with the Public<br />

Health <strong>Nurses</strong> of the Commonwealth of <strong>Virginia</strong><br />

and the <strong>Virginia</strong> Association of Community Service<br />

Boards.<br />

The day was packed with excellent<br />

presentations from a variety of speakers. Angela<br />

Ransom Jones started off the roundtable by<br />

sharing “Themes in K-12 Mental Health, Resource<br />

Gaps and Successes.” Dr. Jones serves as the<br />

Director of Culture, Climate & Student Services<br />

at Richmond City Public Schools, which has a<br />

student population in excess of 20,000. Dr. Jones<br />

is trained as a Psychologist both in School and<br />

Counseling Psychology.<br />

Dr. Jones launched offered a 5,000’ look at K-12<br />

mental health supports, and what we can learn<br />

from the gaps and “gold” of current trends and<br />

infrastructure. To be clear, she said, the pandemic<br />

has exacerbated a mental health crisis among our<br />

children that already existed.<br />

“Schools,” she said, “are often considered<br />

the natural and best setting for comprehensive<br />

prevention and early intervention services for<br />

all students.” Recognizing that more than 75%<br />

of children and youth do not receive the mental<br />

health services they need,” she examined the<br />

promising practices that DO work, including:<br />

• Safe and welcoming school cultures<br />

• Promoting the understanding that positive<br />

mental health and positive physical health<br />

are inextricably link<br />

• intentional identification and naming of<br />

emotions and feelings, educating parents,<br />

teachers and staff / nursing staff.<br />

Dr. Jones underscored the importance of the<br />

number of nurses, psychologists, social workers,<br />

and counselors working in schools be increased to<br />

address the growing needs of our youth and meet<br />

nationally recommended ratios. Concurrently, it is<br />

essential that we lean on our community partners,<br />

she said, such as the local community service<br />

boards (CSBs) throughout <strong>Virginia</strong> for those<br />

children in crisis. Doing so will enable school<br />

staffs to better focus on early intervention and<br />

non-crisis support of all children.<br />

Na-Keisha White, RN, Coordinator of School<br />

Health for Richmond City Public Schools, a<br />

position she has held for four years, shared her<br />

passion on the importance of amplifying the<br />

role of the school nurse in mental healthcare. In<br />

2019, VNF was given a Robert Wood Johnson<br />

Foundation Innovations Fund Award to advance<br />

our work in mental healthcare. We used some of<br />

the grant monies to enable a nurse, Na-Keisha<br />

White, MSN-PH, RN, NBCSN, to participate in the<br />

Mental Health First Aid Instructor Training, Youth<br />

Module. Na-Keisha, coordinator of health services<br />

with Richmond Public Schools, will now serve as<br />

instructor for three groups of RPH school nurses,<br />

counselors, and behavioral health professionals<br />

participating in the program in the coming<br />

months. We’re excited to be furthering the mental<br />

health education of these professionals and hope<br />

to expand our reach to other school districts in the<br />

commonwealth.<br />

Ms. White discussed the interventions in<br />

place at RPS and the importance of amplifying<br />

the school nurses role in mental healthcare and<br />

recognizing school nurses as essential members<br />

of the care coordination team who are able to<br />

effectively assist students and families, meeting<br />

them at the point of their needs. School nurses,<br />

she added, should be positioned to facilitate the<br />

division’s trauma responsive culture to fosters<br />

resilience.<br />

During the afternoon session, Congresswoman<br />

Bonnie Watson Coleman shared her vision for<br />

equity as she is known for her advocacy work and is<br />

serving her fourth term in the United States House<br />

of Representatives. She has had an impressive<br />

career in public service advocating for the needs of<br />

New Jersey families and the equitable treatment of<br />

all people. She is the first Black woman to represent<br />

New Jersey in Congress and serves on several<br />

committees as chair or co-chair and is vice chair<br />

at large of the Congressional Progressive Caucus.<br />

Representative Watson Coleman shared that her<br />

work in the House centers on her belief that, in<br />

the United States of America, there’s a floor below<br />

which we should never allow any child, any family,<br />

or any person to fall, therefore her legislative work<br />

seeks to bridge the gap<br />

for socially disadvantaged<br />

populations, and other<br />

vulnerable groups in our<br />

society.<br />

Phyllis Whitehead,<br />

PhD, APRN/CNS,<br />


FNAP<br />

Congresswoman Coleman introduced the<br />

Pursuing Equity in Mental Health Act, which<br />

addresses the disparities in access, care, and the<br />

study of mental health issues among people of<br />

color. On April 30, 2019, Representative Watson<br />

Coleman established the Congressional Black<br />

Caucus (CBC) Emergency Taskforce on Black<br />

Youth Suicide and Mental Health, empowering<br />

a working group of experts composed of the<br />

country’s leading Black academic, advocacy<br />

and practicing experts, all who had the same<br />

passion for closing the mental health care gap<br />

for black youth. Over the span of eight months,<br />

the taskforce and working group held hearings,<br />

forums, events and listening sessions to identify<br />

both the causes and potential solutions to<br />

this burgeoning crisis. On December 17, the<br />

taskforce released the report, Ring the Alarm:<br />

The Crisis of Black Youth Suicide in America,<br />

and simultaneously introduced legislation aimed<br />

at closing the mental health care gap for that<br />

population.<br />

Much more attention and action are needed<br />

to better care for our youth’s mental health.<br />

Current mental health focusing on substance<br />

abuse and early intervention strategies, selfharm,<br />

transgender and LGBTQ+ issues (including<br />

legal considerations), more suicide interventions<br />

and case studies, bullying, and psychosomatic<br />

management.<br />

The <strong>Virginia</strong> <strong>Nurses</strong> Foundation is committed<br />

to improving the health of <strong>Virginia</strong>’s communities<br />

by developing an educated and diverse nursing<br />

workforce through leadership development,<br />

research, and innovation. We know that nurses<br />

are and will continue to make a crucial impact<br />

on improving the mental health of our youth.<br />

If you are interested in becoming involved with<br />

the work of the <strong>Virginia</strong> <strong>Nurses</strong> Foundation<br />

and/or the Mental Health Roundtable, please<br />

contact VNA Membership Manager MJ Gearles<br />

at mgearles@virginianurses.com. For more<br />

information on the Mental Health roundtable,<br />

visit: https://virginianurses.com/mpage/Mental<br />

HealthInitiatives.<br />

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Page 16 | <strong>August</strong>, September, October <strong>2022</strong><br />

<strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> | www.<strong>Virginia</strong><strong>Nurses</strong>.com<br />

How nurses can counter health misinformation<br />

The wealth of health information available online<br />

can be beneficial for patients, but only if that<br />

information is accurate. Although recent issues<br />

on misinformation have centered on the COVID-19<br />

pandemic, misinformation has been a problem in<br />

many other areas related to wellness and healthcare,<br />

such as dieting, exercise, and vitamins and<br />

supplements. Although misinformation isn’t new,<br />

the internet and social media have supercharged the<br />

ability for it to spread.<br />

<strong>Nurses</strong> and nurse practitioners have the power<br />

to counteract misinformation, but first, they need<br />

to understand the nature of the problem and why<br />

people may be inclined to believe information that is<br />

not grounded in science.<br />

Misinformation overview<br />

Two definitions help better understand this issue.<br />

Misinformation refers to claims that conflict with<br />

the best available scientific evidence. Disinformation<br />

refers to a coordinated or deliberate effort to<br />

spread misinformation for personal benefit, such<br />

as to gain money, power, or influence. An example<br />

of misinformation is the false claim that sugar<br />

causes hyperactivity in children. An example of<br />

disinformation is a company that makes false<br />

scientific claims about the efficacy of their product to<br />

boost sales. This article focuses on misinformation.<br />

People increasingly seek health information<br />

online through sources such as search engines,<br />

health-related websites, YouTube videos, and apps.<br />

Unfortunately, misinformation can occur at all these<br />

points, as well as via blogs, social media platforms,<br />

and user comments on articles or posts. Even when<br />

not actively seeking health information, people can<br />

be exposed to it through media outlets such as print,<br />

TV, and streaming networks.<br />

Why do people believe misinformation?<br />

Several factors can lead to people accepting<br />

misinformation:<br />

Health literacy. Health literacy refers not<br />

only to the ability to read and understand health<br />

information, but the appraisal and application of<br />

knowledge. People with lower levels of health literacy<br />

may be less able to critically assess the quality<br />

of online information, leading to flawed decisionmaking.<br />

One particular problem is that content is<br />

frequently written at a level that is too high for most<br />

consumers.<br />

Distrust in institutions. Past experiences with<br />

the healthcare system can influence a person’s<br />

willingness to trust the information provided. This<br />

includes not only experiences as an individual<br />

but also experiences of those in groups people<br />

affiliate with. Many people of color and those with<br />

disabilities, for example, have had experiences with<br />

healthcare providers where they did not feel heard<br />

or received substandard care, eroding trust. In<br />

some cases, healthcare providers have lied, as was<br />

the case with the Tuskegee syphilis study of Black<br />

men; the men were not told they had the disease or<br />

offered treatment. In addition, some people have an<br />

inherent distrust of government, leading them to<br />

turn to alternative sources of information that state<br />

government-provided facts are not correct.<br />

Emotions. Emotions can play a role in both<br />

the spread and acceptance of misinformation.<br />

For example, false information tends to spread<br />

faster than true information, possibly because of<br />

the emotions it elicits. And Chou and colleagues<br />

note that during a crisis when emotions are high,<br />

people feel more secure and in control when they<br />

have information—even when that information is<br />

incorrect.<br />

Cognitive bias. This refers to the tendency to<br />

seek out evidence that supports a person’s own point<br />

of view while ignoring evidence that does not. If<br />

the misinformation supports their view, they might<br />

accept it even when it’s incorrect.<br />

How to combat misinformation<br />

Recommending resources, teaching consumers<br />

how to evaluate resources, and communicating<br />

effectively can help reduce the negative effects of<br />

misinformation.<br />

Recommendations. In many cases, patients and<br />

families feel they have a trusting relationship with<br />

their healthcare providers. <strong>Nurses</strong> can leverage<br />

that trust by recommending credible sources of<br />

health information. Villarruel and James note<br />

that before making a recommendation, nurses<br />

should consider the appropriateness of the source.<br />

For example, a source may be credible, but the<br />

vocabulary used may be at too high a level for the<br />

patient to understand. And someone who prefers<br />

visual learning will not appreciate a website that<br />

is dense with text. Kington and colleagues suggest<br />

using these foundational principles when evaluating<br />

sources:<br />

• Science-based: The source provides information<br />

consistent with the best scientific evidence<br />

available and meets standards for creation,<br />

review, and presentation of scientific content.<br />

• Objective: The source takes steps to reduce<br />

the influence of financial and other forms<br />

of conflict of interest or bias that could<br />

compromise or be perceived to compromise the<br />

quality of the information provided.<br />

• Transparent and accountable: The source<br />

discloses limitations of the provided<br />

information, conflicts of interest, content<br />

errors, or procedural missteps.<br />

• Each principle has specific attributes, which<br />

are listed in the article available for download<br />

at https://www.ncbi.nlm.nih.gov/pmc/articles/<br />

PMC8486420/.<br />

Another tool for evaluating sources of health<br />

information is the CRAAP test (Currency, Relevance,<br />

Authority, Accuracy, and Purpose), which focuses<br />

on evaluating the accuracy of research. It consists<br />

of multiple questions in each category (see https://<br />

researchguides.ben.edu/source-evaluation). For a<br />

more concise tool, nurses can turn to the algorithm,<br />

developed by Kington and colleagues, for assessing<br />

the credibility of online health information.<br />

Although the tendency is to recommend<br />

government sources such as the Centers for Disease<br />

Control and Prevention and National Institutes<br />

of Health, as noted earlier, some people do not<br />

trust the government. In this case, sources such<br />

as MedlinePlus, World Health Organization, and<br />

condition-specific nonprofit organizations (e.g., the<br />

American Heart Association, American Cancer<br />

Society, Alzheimer’s Association) might be preferred.<br />

Education. The sheer scope of the information<br />

found online can make it difficult for even the most<br />

astute consumer to determine what is accurate.<br />

<strong>Nurses</strong> can help patients by providing tools they<br />

can use to evaluate what they read. The website<br />

Stronger suggests a four-step process for checking<br />

for misinformation (https://stronger.org/resources/<br />

how-to-spot-misinformation).<br />

• Check the source. Is the website or person<br />

known for conflating facts and opinions?<br />

• Check the date. Is it implied that the<br />

information is recent even though it’s not?<br />

Is there more current information available<br />

elsewhere?<br />

• Check the data and motive. What is the original<br />

source of the information? Are they just<br />

looking for anything that supports their own<br />

worldview?<br />

• If still unsure, use a reputable, fact-checking site<br />

such as Snopes.com or FactCheck.org.<br />

UCSF Health (https://www.ucsfhealth.org/<br />

education/evaluating-health-information) provides<br />

a useful short overview for patients on how to<br />

evaluate the credibility (e.g., authors’ credentials)<br />

and accuracy (e.g., whether other sources support<br />

the information) of health information and red flags<br />

to watch for (e.g., outdated information, no evidence<br />

cites, poor grammar).<br />

Communication. Communication is the best way<br />

to correct misinformation and stop its spread. This<br />

starts with the nurse clearly explaining the evidence<br />

for recommended interventions. From the start,<br />

the nurse should establish the principle of shared<br />

decision-making, which encourages open discussion.<br />

A toolkit from the U.S. Surgeon General on<br />

misinformation (https://www.hhs.gov/sites/default/<br />

files/health-misinformation-toolkit-english.pdf)<br />

recommends that nurses take time to understand<br />

each person’s knowledge, beliefs, and values<br />

and to listen with empathy. It’s best to take a<br />

proactive approach and create an environment that<br />

encourages patients and families to share their<br />

thoughts and concerns (see “A proactive approach”).

www.<strong>Virginia</strong><strong>Nurses</strong>.com | <strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> <strong>August</strong>, September, October <strong>2022</strong> | Page 17<br />

<strong>Nurses</strong> should remain calm, unemotional, and<br />

nonjudgmental.<br />

A proactive approach<br />

Villarruel and James provide the following<br />

suggestions for talking with patients about<br />

misinformation:<br />

• Acknowledge the barrage of health information<br />

that is available online and through other<br />

sources and the difficulty of “knowing who and<br />

what to trust.” (“I know there’s a great deal of<br />

information about COVID-19 and not all of it<br />

is the same. Sometimes, it’s hard to sort it out<br />

and know what to trust.”)<br />

• Assess where patients and families obtain<br />

their health information and what sources they<br />

trust. Keep in mind that even when a source<br />

is credible, a person may not trust it, and a<br />

person may trust a site that is not credible.<br />

(“Where do you get most of your information<br />

about COVID-19? What makes that a trusted<br />

source for you?”)<br />

• Provide alternative and accurate sources<br />

of information. (“I’m not familiar with that<br />

website, but I’ll look at it and let you know<br />

what I think. In the meantime, here’s where I<br />

get information and why I trust it.”)<br />

• When correcting misinformation be<br />

nonjudgmental. (“I’ve heard similar information<br />

about not getting vaccinated. Here’s what I’ve<br />

learned from the science and why I believe<br />

getting vaccinated is important and safe.”)<br />

Health and Human Services. 2021. https://www.hhs.<br />

gov/sites/default/files/health-misinformation-toolkitenglish.pdf<br />

Stronger. How to spot misinformation. n.d. https://<br />

stronger.org/resources/how-to-spot-misinformation<br />

Schulz PJ, Nakamoto K. The perils of misinformation:<br />

When health literacy goes awry. Nat Rev Nephrol. <strong>2022</strong>.<br />

https://www.nature.com/articles/s41581-021-00534-z<br />

Swire-Thompson B, Lazer D. Public health and online<br />

misinformation: Challenges and recommendations.<br />

Annu Rev Public Health. 2020;41:433-451.<br />

UCSF Health. Evaluating health information. n.d. https://<br />

www.ucsfhealth.org/education/evaluating-healthinformation<br />

Villarruel AM, James R. Preventing the spread of<br />

misinformation. Am Nurs J. <strong>2022</strong>;17(2):22-26. https://<br />

www.myamericannurse.com/preventing-the-spread-ofmisinformation/<br />

Disclaimer: The information offered within this<br />

article reflects general principles only and does<br />

not constitute legal advice by <strong>Nurses</strong> Service<br />

Western State Hospital<br />

Organization (NSO) or establish appropriate or<br />

acceptable standards of professional conduct. Readers<br />

should consult with an attorney if they have specific<br />

concerns. Neither Affinity Insurance Services, Inc. nor<br />

NSO assumes any liability for how this information<br />

is applied in practice or for the accuracy of this<br />

information. Please note that Internet hyperlinks cited<br />

herein are active as of the date of publication but may<br />

be subject to change or discontinuation.<br />

This risk management information was provided<br />

by <strong>Nurses</strong> Service Organization (NSO), the nation's<br />

largest provider of nurses’ professional liability<br />

insurance coverage for over 550,000 nurses since<br />

1976. The individual professional liability insurance<br />

policy administered through NSO is underwritten<br />

by American Casualty Company of Reading,<br />

Pennsylvania, a CNA company. Reproduction<br />

without permission of the publisher is prohibited. For<br />

questions, send an e-mail to service@nso.com or call<br />

1-800-247-1500. www.nso.com.<br />

Source: Villarruel AM, James R. Preventing the spread of<br />

misinformation. Am Nurs J. <strong>2022</strong>;17(2):22-26. https://<br />

www.myamericannurse.com/preventing-the-spread-ofmisinformation/<br />

<strong>Nurses</strong> also can prepare for conversations<br />

where they know misinformation may occur such<br />

as vaccination. For example, the CDC has a page<br />

on its website that addresses infant vaccination<br />

(https://www.cdc.gov/vaccines/hcp/conversations/<br />

conv-materials.html). It includes resources such as<br />

responses to possible questions.<br />

Listening and providing information may not<br />

be enough. In some cases, a patient may not want<br />

to hear what the nurse is saying. When patients<br />

become angry or frustrated, the nurse should<br />

remain calm. It can be helpful to acknowledge<br />

the frustration (“I can see that you are upset.”)<br />

Depending on the situation, it may be possible to<br />

briefly summarize key points before reinforcing the<br />

desire to provide information to support the patient<br />

and then move on to another topic. The goal is to<br />

maintain a positive nurse-patient relationship, which<br />

leaves the door open to further conversation.<br />

Documentation<br />

As with any patient education, it’s important to<br />

document discussions related to misinformation<br />

in the patient’s health record. <strong>Nurses</strong> should<br />

objectively record what occurred and include any<br />

education material they provided. Should the<br />

patient experience harm as a result of following<br />

misinformation instead of the recommended<br />

treatment plan, this documentation would<br />

demonstrate the nurse’s efforts and could help avoid<br />

legal action.<br />

A positive connection<br />

<strong>Nurses</strong> can serve as a counterbalance to the<br />

misinformation that is widely available online.<br />

Providing useful resources, educating consumers,<br />

and engaging in open dialogue will promote the<br />

ability of patients to receive accurate information so<br />

they can make informed decisions about their care.<br />

By Georgia Reiner, MS, CPHRM, Risk Analyst,<br />

<strong>Nurses</strong> Service Organization (NSO)<br />

References<br />

CDC. How to address COVID-19 vaccine misinformation.<br />

2021. https://www.cdc.gov/vaccines/covid-19/healthdepartments/addressing-vaccine-misinformation.html<br />

CDC. Talking with parents about vaccines for infants.<br />

2021. https://www.cdc.gov/vaccines/hcp/conversations/<br />

conv-materials.html<br />

CDC. The U.S. public health service syphilis study at<br />

Tuskegee. 2021. https://www.cdc.gov/tuskegee/index.<br />

html<br />

Chou W-YS, Gaysynsky A, Vanderpool RC. The COVID-19<br />

misinfodemic: Moving beyond fact-checking. Health<br />

Educ Behav. 2020;1090198120980675:1-5.<br />

Kington RS, Arnesen S, Chou W-YS, Curry SJ, Lazer D,<br />

and Villarruel AM. Identifying credible sources of health<br />

information in social media: Principles and attributes.<br />

NAM Perspect. 2021:10.31478/202107a. https://www.<br />

ncbi.nlm.nih.gov/pmc/articles/PMC8486420/<br />

Kurpiel S. Evaluating Sources: The CRAAP Test.<br />

Benedictine University. <strong>2022</strong>. https://researchguides.<br />

ben.edu/source-evaluation<br />

Office of the Surgeon General. A Community Toolkit for<br />

Addressing Health Misinformation. US Department of<br />

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Page 18 | <strong>August</strong>, September, October <strong>2022</strong><br />

<strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> | www.<strong>Virginia</strong><strong>Nurses</strong>.com<br />

Retired Registered Nurse and<br />

Centenarian Gertrude Clarke Still Loves Nursing<br />

By VNA & VNF DEI Council Chair Vivienne McDaniel, DNP, MSN, RN<br />

Retired mental health professor Gertrude Clarke turned 100 years old in<br />

June. She said, “don’t put the actual date because, you know, they have those<br />

identity thieves out there.” Ms. Gertrude is a delightful, spry young lady and<br />

doesn’t look or act anything like what you may expect of a centenarian. She was<br />

a 1946 graduate of the Saint Philip School of Nursing. During the time of her<br />

attendance, southern laws and social practices did not allow entry of “Negroes”<br />

into nursing schools with White students.<br />

Since healthcare facilities were segregated, the Medical College of <strong>Virginia</strong><br />

established a separate school of nursing for Women of Color to provide trained<br />

nurses to serve the underserved Black patients admitted to Saint Philip<br />

Hospital. Gertrude said, “I purchased a bus ticket to go to New York and left<br />

immediately after graduation to go work somewhere that welcomed me.” Ms.<br />

Gertrude credits her longevity to her serving God and humanity. She said she<br />

still loves nursing and would do it all over again minus the segregation. Her<br />

advice to current and future nurses is to use your voice to advocate for patients<br />

and the profession of nursing, and to “keep God in everything you do.” Teaching<br />

is in her DNA; at 100, Ms. Gertrude still teaches Sunday School at her church.<br />

Learn more about Ms. Gertrude in the February 2023 issue of the <strong>Virginia</strong><br />

<strong>Nurses</strong> <strong>Today</strong>.<br />

With Ms. Gertrude Clarke (in pink) from left to right are Drs. Vivienne<br />

McDaniel, Karen Faison and Stephanie Terry, (all professors of nursing).<br />

(Photo credit: Vivienne Pierce McDaniel)<br />

St. Philip Hospital photo courtesy of<br />

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www.<strong>Virginia</strong><strong>Nurses</strong>.com | <strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> <strong>August</strong>, September, October <strong>2022</strong> | Page 19<br />

Reminder to VNA Members – Vote for the Leaders of<br />

the <strong>Virginia</strong> <strong>Nurses</strong> Association by <strong>August</strong> 22!<br />

For VNA members, voting will open June 27 -<br />

<strong>August</strong> 22. A link to the ballot has been sent to all<br />

members by email. Here are the slate of candidates<br />

and profiles on each of our candidates running for<br />

office! If you’re a member and haven’t received your<br />

ballot by email for voting, please first check your<br />

spam folder and if you’re still unable to locate it<br />

contact VNA Membership Manager MJ Gearles at<br />

mgearles@virginianurses.com.<br />

The following board positions are open for the<br />

<strong>2022</strong> Election (2-year terms):<br />

• Secretary<br />

• Commissioner on Nursing Education<br />

• Commissioner on Workforce Issues<br />

• Commissioner on Nursing Practice*<br />

• Director-at-Large, Frontline Nurse<br />

• Director-at-Large, APRN**<br />

• Three (3) members will also be elected to the<br />

Committee on Nominations<br />

* The Commissioner on Nursing Practice serves<br />

ex-officio in the same position on the <strong>Virginia</strong><br />

<strong>Nurses</strong> Foundation Board of Trustees.<br />

** The Director-at-Large, APRN position is a oneyear<br />

term to conclude on December 31, <strong>2022</strong>.<br />

The position will be on the ballot again in 2023<br />

for a two-year term.<br />

Click here to review the position descriptions,<br />

nominations policies, and Procedures Manual!<br />

<strong>2022</strong> Election Timeline<br />

• Call for Nominations - April 1 - May 27<br />

• Nominating Committee prepares slate of<br />

candidates - June 7<br />

• VNA Board of Directors votes to approve slate<br />

of candidates - June 15<br />

• Slate of Candidates published and distributed -<br />

June 20<br />

• Online voting begins (online and paper) -<br />

June 27<br />

• Deadline for ballot requests - <strong>August</strong> 12<br />

• Voting ends - 11:59 pm on <strong>August</strong> 22<br />

• Election results shared at VNA Membership<br />

Assembly - date TBD<br />

<strong>2022</strong> Slate of Candidates<br />

Secretary<br />

Tiffany Covarrubias-Lyttle, BS, BSN, RN, PCCN<br />

(Incumbent) Chapter 3<br />

Commissioner on Nursing Education<br />

Shanna Akers, EdD, MSN/MBS-HC,<br />

RN, CNE, NEA-BC Chapter 3<br />

Caryn Brown, MSN, MHA, RN,<br />

NPD-BC, NEA-BC Chapter 3<br />

Commissioner on Workforce Issues<br />

June Noel, MSN, RN Chapter 5<br />

Richard Ridge, PhD, RN,<br />

NEA-BC, CNL (Incumbent) Chapter 7<br />

Commissioner on Nursing Practice<br />

Mesha Jones, MSN, RN, CCRN, CWON Chapter 7<br />

Erin Keister, MSN, CPPS,<br />

CPHQ, NE-BC (Incumbent) Chapter 5<br />

Director-at-Large, Frontline Nurse<br />

Ericka Daley, BSN, RN, VAEMT-P Chapter 5<br />

Director-at-Large, APRN<br />

Sarah Birch, DNP, APRN, CPNP-PC Chapter 8<br />

VNA’s Committee on Nominations<br />

April Howell, MSN, RN, NE-BC Chapter 5<br />

Vanessa Moore, RN, BSN, CDON, LNHA Chapter 4<br />

Jeanell Webb-Jones, BSN, RN, RN-BC Chapter 7<br />

Dana Woody, RN, MSN, DNP Chapter 3

Page 20 | <strong>August</strong>, September, October <strong>2022</strong><br />

<strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> | www.<strong>Virginia</strong><strong>Nurses</strong>.com<br />

Occupational Stress: Definition, Impact, and Strategic Mitigation<br />

Richard Ridge, PhD, RN, NEA-BC, CNL<br />

Commissioner of Workforce<br />

<strong>Virginia</strong> <strong>Nurses</strong> Association<br />

Occupational stress is well known as a health risk<br />

for a wide range of psychological, behavioral, and<br />

medical disorders and diseases. The National Institute<br />

for Occupational Safety and Health (NIOSH) established<br />

a national priority agenda for policy and research 20<br />

years ago that still guides efforts to better understand<br />

occupational stress in general and to mitigate its<br />

impact on the U.S. workforce across industries. 1 The<br />

recent Covid-19 pandemic has uncovered and exacerbated numerous sources of<br />

occupational stress within healthcare, including nursing. This article will define<br />

occupational stress within a nursing context, describe the impact of this stress<br />

on nurses as individuals and as a workforce, and identify several strategies to<br />

mitigate its impact.<br />

Occupational stress, like all forms of stress, may not be inherently<br />

destructive or harmful. One of occupational health’s foundational principles<br />

is that the response to stress is a normal and naturally occurring reaction<br />

to stress of all types, including stress caused by work-related factors. 2 The<br />

epidemiology of stress recognizes that the stress response manifests differently<br />

depending on a wide variety of variables that may serve as protective or as<br />

additional individual risk factors. Simply put, work is stressful to a harmful<br />

extent when demands exceed the individual’s resources to effectively adapt.<br />

Why is this important?<br />

Two years into the Covid-19 pandemic, the nursing workforce supply is under<br />

extreme threat. In a recent analysis, Auerbach and colleagues identified an<br />

alarming decrease of 100,000 RNs in 2021, the greatest drop in a single year<br />

over the past four decades. 3 Especially distressing is that the decrease stemmed<br />

primarily from nurses younger than age 35. The overall reduction in supply<br />

was due primarily to losses of hospital-employed RNs. This loss of younger RNs<br />

will be felt for a generation in contrast to the attrition of nurses at retirement<br />

age. The loss of frontline hospital RNs will not only mean a labor disruption<br />

for hospitals, but also for many other care settings that depend on experienced<br />

hospital nurses for specialty settings and practices.<br />

What we know about nurses’ stress and their ability to adapt and function.<br />

Several major recent surveys of nurses provide some insight into the recent<br />

exodus of younger nurses and to understanding occupational stress from an<br />

actionable perspective. The American <strong>Nurses</strong> Association Second Year Covid-19<br />

Impact Assessment Survey received responses from 11,964 nurses in January<br />

<strong>2022</strong>. 4 This survey built upon previous surveys and included questions on<br />

mental health, well-being, financial impact, perceived organizational support<br />

and intent to leave their current position. The responses to many items seem<br />

to reflect opposing opinions. For example, for the question regarding intent to<br />

leave your position within six months, 52% answered yes or maybe, and 48%<br />

replied no. In another example, 30% of nurses rated their emotional health as<br />

not or not at all healthy, and 37% rated theirs as emotionally healthy or very<br />

healthy. While this survey identified numerous activities to strengthen wellbeing,<br />

a similar distribution is seen in regard to nurses’ perceptions of their<br />

organizations’ caring with respect to well-being. 43% of nurses disagreed<br />

or strongly disagreed that their organizations cared about their well-being,<br />

as compared to 32% who agreed or strongly agreed. Staffing shortages not<br />

surprisingly were reported by 89% of acute care nurses, predominately at a<br />

moderate or highly serious level. The majority of acute care nurses experienced<br />

bullying and incivility from patients and families. And 20-25% experienced<br />

incivility and bullying from colleagues, managers, and supervisors.<br />

The ANA’s Mental Health and Wellness Survey compiled responses from<br />

9,572 nurses in the early Fall of 2021. 5 On a scale of 1-10 rating the ability of<br />

nurses to recover or adjust to the impact of Covid-19 on their well-being, the<br />

average score was 6.2. But again, the survey showed high levels of responses to<br />

items at each end of the spectrum with 42% of nurses reporting having had an<br />

extremely stressful, disturbing, or traumatic experience due to COVID-19, and<br />

52% reporting they had not experienced this. Thus, the impact of the trauma of<br />

work during the pandemic was perceived differently, as one would expect from<br />

the epidemiology of stress and its impact on health.<br />

The third survey, undertaken by AMN Healthcare in Spring 2021, reported<br />

data received from 6,562 active and practicing nurses who had provided direct<br />

care within the previous year. 6 Focused on understanding nurses’ perspectives<br />

during the pandemic, they reported the findings relative to whether they had<br />

Covid, and whether they cared for Covid-19 patients. Over 50% of nurses<br />

reported feeling burnt out to some degree, feeling emotionally drained, and that<br />

their job was adversely impacting their health. Almost 40% felt misunderstood<br />

by their employer, and over half reported not getting what they wanted from<br />

their job. Many of these findings were worse for nurses who either had Covid-19<br />

or who cared for Covid-19 patients.<br />

Thus, based on the findings from these three surveys it is reasonable to<br />

conclude, within the limitations of these individual studies, that many nurses<br />

are adapting and coping well, while many are not. In terms of the nursing<br />

workforce, it is not an overstatement to say that each nurse who leaves the<br />

profession is one too many. System solutions must be strengthened where<br />

already in place and introduced where they are missing.<br />

Strategic Mitigation (Taking Action)<br />

Recognizing occupational stress in nursing as a public health issue can<br />

frame a comprehensive and systematic approach to address immediate, midrange,<br />

and long-term needs. Effective mitigation of occupational stress for<br />

nurses requires three levels of interventions: primary, secondary, and tertiary.<br />

Primary interventions aim to prevent occupational stress harm before it<br />

occurs. Secondary prevention aims to reduce the impact of stress once harm<br />

has occurred, and tertiary prevention aims to lessen the long-term impact of<br />

nurses who experience persistent harmful effects. Each of these three levels of<br />

prevention must be addressed in a systematic way at all levels, including the<br />

policy and population level, organization level, and by the individual nurses.<br />

At a fundamental policy level, as envisioned in the FON report, major changes<br />

are needed in payment systems to healthcare organizations that shift away<br />

from incorporating nurses in the room rate. Such mechanisms incentivize<br />

minimization of nurse resources, rather than recognizing and paying for the<br />

value that nursing contributes to healthcare. The current pay for performance<br />

structures may be a good beginning, but they are insufficient to fully incentivize<br />

organizations to optimize rather than minimize nurse resources. This should<br />

have a positive influence on nurse workload. Other policies, with associated<br />

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www.<strong>Virginia</strong><strong>Nurses</strong>.com | <strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> <strong>August</strong>, September, October <strong>2022</strong> | Page 21<br />

regulatory requirements, could strengthen and<br />

make more consistent, organization-level programs<br />

to promote healthy workplaces and reduce the<br />

threats from workplace violence and lateral incivility.<br />

Increased funding provided through national<br />

and state level policy change would help support<br />

organization-level efforts.<br />

Organizations should implement programs that<br />

address the three levels of prevention to help those<br />

nurses not yet affected, those nurses in the early<br />

stages of harm, and those nurses who have incurred<br />

chronic adverse effects. One example of this is the<br />

Stress First Aid (SFA) program, initially developed<br />

by the U.S. military, and now available through the<br />

Schwartz Center for Compassionate Healthcare. This<br />

program helps leaders and staff create customized<br />

implementation plans.<br />

As seen from the nurse survey data, programs<br />

are needed to address bullying, lateral incivility,<br />

and workplace violence. Organizations can adapt<br />

programs and toolkits already in place. For example,<br />

the recently published VHHA Workplace Violence<br />

Prevention Toolkit, developed with input from<br />

the VNA, provides information about applicable<br />

state laws, background information, and detailed<br />

guidelines to support organizations in developing,<br />

implementing, evaluating, and sustaining workplace<br />

violence prevention programs. Another example<br />

of an adaptable toolkit is the PACERS program,<br />

funded by the Robert Wood Johnson Foundation.<br />

This toolkit provides a systematic and multi-level<br />

approach to create care environments of respect<br />

and civility; both issues are specifically identified<br />

as highly problematic in the recent nurse surveys.<br />

Organizational guidance for developing resiliency<br />

to prevent nurse burnout is available from many<br />

sources. The Joint Commission published a guide<br />

for healthcare leaders in 2019 that guides leaders<br />

to empower employees’ ability to access resources,<br />

information, and support needed to perform their<br />

work and to gain the opportunity to develop. 7<br />

Inadequate staffing is a major source of<br />

occupational stress for nurses, which was<br />

exacerbated by the pandemic. Minimum staff<br />

ratios are seen as a solution by some and by<br />

others as a solution with many unintended and<br />

negative consequences for patients, nurses, and<br />

other employees. But from an occupational stress<br />

perspective, appropriate and effective nurse staffing<br />

is a prerequisite for addressing occupational stress.<br />

At a minimum, nurse-led groups should create unitlevel<br />

staffing plans based on a patient population’s<br />

acuity and needs, and matched with staff’s skills<br />

and experience. (ANA, https://www.nursingworld.<br />

org/practice-policy/nurse-staffing/nurse-staffingadvocacy/)<br />

While building resilience and promoting adaptive<br />

coping skills are important for individual nurses, the<br />

burden and responsibility cannot be borne solely by<br />

the nurse. Effective occupational stress mitigation<br />

must occur at the policy and organizational level for<br />

individual nurses to be successful. However, several<br />

evidence-based key strategies for nurses to prevent<br />

stress injury emerge from the occupational stress<br />

literature:<br />

• Identify and understand your own<br />

vulnerabilities and the specific sources of your<br />

job stress.<br />

• Regularly assess stress-levels and the presence<br />

of stress injury signs and symptoms using an<br />

established scale such as the Stress First Aid<br />

framework.<br />

• Be aware that stress injury may manifest as<br />

medical condition, psychological distress, or<br />

as tobacco abuse, alcohol and drug abuse,<br />

aggression, and violence.<br />

• Identify support resources available through a<br />

professional organization, other peer groups,<br />

your organization, or through your health plan.<br />

• Identify and implement individual stress<br />

management strategies.<br />

• Develop and use social support, at work and<br />

at home. (Being part of a cohesive health<br />

workgroup and networks have significant<br />

protective impact.)<br />

• If injury has occurred, emphasis must be<br />

first placed on healing in the short-term.<br />

Discontinuing employment in the current<br />

setting may be indicated. Use support<br />

networks in making any critical decisions<br />

about your employment, career, or personal<br />

life.<br />

nurses, the profession, and to the overall healthcare<br />

system. Occupational stress has become more<br />

pronounced during the Covid-19 pandemic but the<br />

underlying causes are not new and are generally<br />

well-known. Systematic mitigation is required to<br />

address underlying causes, prevent stress injury<br />

from occurring, minimize the extent of harm to<br />

individual nurses and the profession, and to help<br />

nurses with significant stress injury recover and<br />

return fully to the healthcare workforce.<br />

1 Sauter, S.L. et al., (NORA Organization of Work Team<br />

Members). (2002). The Changing organization of work<br />

and the safety and health of working people: Knowledge<br />

gaps and directions. National Institute for Occupational<br />

Safety and Health.<br />

2 Quick, J.C. & Henderson, D.F. (2016). Occupational<br />

stress: Preventing suffering, enhancing wellbeing.<br />

International Journal of Environmental Research and<br />

Public Health, 13(4):1-11. doi:10.3390/ijerph13050459<br />

✓<br />

3 Auerbach, D.I., Buerhaus, P.I., Donelan, K. &<br />

Staiger, D.O. (<strong>2022</strong>). A worrisome drop in the<br />

number of young nurses. Health Affairs Forefront.<br />

https://w w w.healthaffairs.org/do/10.1377/<br />

forefront.<strong>2022</strong>0412.311784/<br />

4 American <strong>Nurses</strong> Foundation. (<strong>2022</strong>). COVID-19 Two-<br />

Year Impact Assessment. American <strong>Nurses</strong> Foundation<br />

& Joslin Insight.<br />

5 American <strong>Nurses</strong> Foundation. (2021). Mental Health<br />

and Wellness Survey Report. American <strong>Nurses</strong><br />

Foundation & Joslin.<br />

6 AMN Healthcare. (2021). Nursing and the nation:<br />

Extreme challenges, extraordinary impact. 2021 Survey<br />

of Registered <strong>Nurses</strong>. AMN Healthcare. https://www.<br />

amnhealthcare.com/siteassets/amn-insights/surveys/<br />

amn-healthcare_2021-rn-survey.pdf<br />

7 The Schwartz Center for Compassionate Healthcare.<br />

Stress First Aid. Accessed 6/22/22, https://www.<br />

theschwartzcenter.org/stress-first-aid-private/<br />

The Joint Commission (2019). Developing resilience to<br />

combat nurse burnout. Quick Safety, Issue 50. The<br />

Joint Commission, Division of Healthcare Improvement.<br />


Two starts per year<br />

(Jan., Aug.)<br />

Online format with<br />

two clinical courses<br />




Clinical Nurse Leader<br />

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For RNs with their BSN who wish to become<br />

advanced practitioners<br />

Part-time curriculum<br />

for busy RNs<br />

Accreditations & Certifications:<br />

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No preadmissions test<br />

Finish in only two years<br />

Certified by SCH EV to operate in <strong>Virginia</strong>,<br />

accredited by ABHES & approved by NC-SARA.<br />

In summary, occupational stress is an emerging<br />

public health issue that poses a significant threat to

Page 22 | <strong>August</strong>, September, October <strong>2022</strong><br />

<strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> | www.<strong>Virginia</strong><strong>Nurses</strong>.com<br />

FALL<br />


AGENDA<br />

Leadership Development Pre-Conference Session<br />

Developing Effective Communication for a Healthier Workforce<br />

Diane Salter, MSN, RN, CPAN, NE-BC<br />

Bullying & Incivility Content Expert, Healthy Workforce Institute<br />

Ineffective communication is cited as the most common cause of<br />

medical error. Yet, we don’t often teach healthcare leaders how to<br />

develop and foster good communication skills in themselves and their<br />

teams.<br />

The Time for Change is NOW!<br />

<strong>2022</strong> VNA & VNF Fall Conference<br />

The <strong>Virginia</strong> <strong>Nurses</strong> Association invites you to join us IN-PERSON for our <strong>2022</strong><br />

Fall Conference, The Time for Change is NOW! This program will be held<br />

September 9-10, <strong>2022</strong> at the Westfields Marriott in Chantilly, <strong>Virginia</strong>. We<br />

hope you’ll join us for what will be our 1st IN-PERSON event since prepandemic!!<br />

Nursing is at a precipice. The pandemic has debilitated an already failing<br />

and antiquated structure. We continue to struggle with appropriate staffing,<br />

unhealthy work environments, and developing the workforce we need for<br />

the future. All of this leaves the nurses disengaged and our patients<br />

disadvantaged. How can we change this?<br />

The Time for Change is NOW! During this conference, we will address how nurses can and must lead<br />

the next evolution of healthcare through innovation and collaboration. Dr. Oriana Beaudet, Vice<br />

President of Innovations at the American <strong>Nurses</strong> Association Enterprise, will help us explore how<br />

every nurse can contribute to transforming nursing so that we can better serve the people behind<br />

our purpose. We will hear from innovators in nursing and healthcare that are taking chances, trying<br />

new approaches, and transforming the work we do. After we learn from change makers, Dr. Oriana<br />

Beaudet will lead conference participants through a Design Challenge where we will develop big<br />

solutions to address nurse staffing and unhealthy work environments. Let’s work together to change<br />

the future of nursing!<br />

When<br />

Rates<br />

September 9 & 10<br />

Pre-conference & Fall Conference VNA Member | $300<br />

Pre-conference & Fall Conference Nonmember | $375<br />

Fall Conference only VNA Member | $249<br />

Fall Conference only Nonmember | $295<br />

Photos courtesy of Westfields Marriott<br />

Where<br />

https://virginianurses.com/page/FallConference<br />

8.25<br />

Contact<br />

Hours<br />

Westfields Marriott Washington Dulles<br />

14750 Conference Center Drive<br />

Chantilly, VA 20151<br />

3.75<br />

Contact<br />

Hours<br />

The message is clear - communication skills may be as important, if not more important,<br />

than clinical skills. This workshop is designed to teach healthcare leaders the essential<br />

strategies and tactics they need to develop better communication skills for a safe and<br />

healthy workforce.<br />

Join the Healthy Workforce Institute’s Bullying & Incivility Expert, Diane Salter, to learn<br />

how to develop assertive communication skills among the healthcare team, incorporate<br />

body language techniques to strengthen team relationships, and create standards and<br />

systems that foster collegiality.<br />

Day 1 Keynote Address: <strong>Nurses</strong> are Positioned to Lead Healthcare’s Transformation<br />

Oriana Beaudet, DNP, RN, PHN, Vice President of Nursing Innovation, American <strong>Nurses</strong> Association Enterprise<br />

The dynamic nature of change happening across healthcare will impact every aspect of care-and nursing. We’ll be unpacking<br />

system level changes to identify how barriers can be scaled to transform healthcare. The future of health is going to require the<br />

novel thinking and holistic ecosystem perspective unique to nursing.<br />

Day 2 Keynote Address: H.O.P.E. for Happy - Workforce Strategies from America’s Frontlines<br />

April Hansen, MSN, RN, President of Workforce Solutions, Aya Healthcare<br />

After helping to lead the largest deployment of healthcare workers in our nation’s history, workforce expert April Hansen leans on<br />

lessons learned from America’s fractured frontlines to share powerful strategies for organizations to rebuild and repair their teams.<br />

Ultimately, April’s insights allow organizations to take actionable steps towards a happy work environment where individuals thrive<br />

and organizations grow.<br />

General Session: Value-based Reimbursement: What <strong>Nurses</strong> Need to Know<br />

Betty Rambur, PhD, RN, FAAN, Professor of Nursing and Routhier Endowed Chair for Practice, University of<br />

Rhode Island<br />

Payment reform focused on shifting reimbursement from a reactive volume-based system that is riddled with quality gaps to a<br />

proactive value-based system holds great promise for nurses. This presentation describes the context for payment reform as well as<br />

the economic impetus and ethical imperative for change. It details an array of payment models that can foster nurse innovation<br />

and better population health, if nurses can seize the opportunities presented. Participants will gain enhanced understanding of<br />

and capacity to lead value-informed nursing practice and demonstrate the value of nursing in tangible, quantifiable ways.<br />

Additional Fall Conference Sessions:<br />

(More info to come at www.virginianurses.com!)<br />

Rapid Fire Innovation Presentations<br />

Combatting Racism in Nursing<br />

Design Challenge: Designing Innovative Possibilities for <strong>Virginia</strong> <strong>Nurses</strong><br />


www.<strong>Virginia</strong><strong>Nurses</strong>.com | <strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> <strong>August</strong>, September, October <strong>2022</strong> | Page 23<br />

Thank you to our<br />

<strong>2022</strong> Fall Conference<br />

sponsors!<br />

Diamond Sponsor<br />

Thank you to our<br />

<strong>2022</strong> Gala Sponsors!<br />

Diamond Sponsors<br />

Platinum Sponsor<br />

Platinum Sponsor<br />

Gold Sponsors<br />

Gold Sponsor<br />

President’s Reception Sponsor<br />

Photo Booth Sponsor<br />

Poster Session Sponsor

Page 24 | <strong>August</strong>, September, October <strong>2022</strong><br />

Looking to Level Up? Join Our<br />

Nurse Leadership Academy in 2023!<br />

<strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> | www.<strong>Virginia</strong><strong>Nurses</strong>.com<br />

Lindsey Cardwell, MSN, RN, NPD-BC,<br />

Director of Professional Development<br />

As you read in Janet Wall’s CEO Report in the<br />

February edition of <strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong>, the Nurse<br />

Leadership Academy kicked off its inaugural year in<br />

January of <strong>2022</strong> with some fabulous presenters and<br />

content!<br />

The Academy’s flagship year has continued<br />

flawlessly with four additional virtual sessions<br />

to develop the 39 nurse fellows. This content has<br />

been presented by healthcare leaders with amazing<br />

expertise and knowledge! Our fellows have examined<br />

their personal leadership and communication styles<br />

through a DiSC Leadership Profile assessment and<br />

explored topics such as providing and receiving<br />

effective feedback, authentic leadership in<br />

healthy work environments, leading with cultural<br />

humility, facilitating a high reliability environment<br />

through patient safety, a spirit of inquiry, and<br />

process improvement, and the influencer role in<br />

change management. Fellows will participate in<br />

a final virtual session in June focused around<br />

examining the finances of healthcare. Following<br />

this session, the 39 fellows will embark on their<br />

individual applied leadership projects within their<br />

organizations under the guidance of their chosen<br />

mentor. In December <strong>2022</strong>, all nurse fellows will<br />

share their leadership projects and the outcomes<br />

they have achieved and we plan to have an<br />

opportunity for the Academy fellows to disseminate<br />

their work to you!<br />

“Most training offered by<br />

my organization is aimed at<br />

discussing tools or strategies<br />

for specific programs. The NLA<br />

reaches us on a personal level to<br />

develop our professional skills!”<br />

Nurse Leadership Academy fellows have shared<br />

that the Academy goes well beyond the development<br />

provided by their organizations and “reaches us on a<br />

personal level to develop our professional skills!” The<br />

feedback underscores that the program has been<br />

meeting and exceeding professional development<br />

needs and that all nurse leaders should attend the<br />

Academy!<br />

If you are a new or emerging nurse leader, we<br />

encourage you to learn more about the Nurse<br />

Leadership Academy at https://virginianurses.com/<br />

mpage/VNFNLA! This program was meticulously<br />

designed by experienced nurse leaders of varying<br />

backgrounds across the commonwealth to meet<br />

the professional development needs of nurses<br />

transitioning into leadership roles across ALL<br />

healthcare practice environments. The first six<br />

months of this year-long program are dedicated to<br />

live virtual didactic sessions focused on the following<br />

core topics:<br />

• Fundamentals of effective leadership<br />

• Organizational culture<br />

• Facilitating a high reliability environment<br />

• Influencing change: Driving outcomes through<br />

strategic action<br />

• No margin no mission – Examining the<br />

finances of healthcare.<br />

“I am really enjoying reflecting<br />

on myself and seeing my<br />

opportunities to grow and lead<br />

my team in a positive, effective<br />

manner!”<br />

The second six months are focused on applying<br />

the concepts learned in an applied leadership project<br />

in the fellow’s organization under the direction<br />

of their mentor. The goal of this program is to<br />

prepare emerging and new nurse leaders with the<br />

foundational leadership skills needed to lead change<br />

and teams in their organizations.<br />

VNF’s Nurse Leadership Academy inaugural<br />

launch was kicked off with ANA Enterprise CEO<br />

and past VNA President Dr. Loressa Cole, with the<br />

compelling story of her leadership path from her<br />

childhood in the Appalachians of West <strong>Virginia</strong> to<br />

her present-day success.<br />

Next Rose Markey, senior learning and<br />

development consultant at the University of <strong>Virginia</strong>,<br />

discussed the four skill sets of courage during her<br />

“Introduction to Courageous Leadership.” Rose<br />

is also a member of the global team of Certified<br />

Dare to Lead Facilitators based on the work of<br />

researcher and New York Times best-selling author<br />

Dr. Brené Brown, and the learning and dialogue<br />

“I am absolutely enjoying every<br />

single session and find myself<br />

looking forward to the next.”<br />

“It’s hitting all the topics I need<br />

in my leadership role.”<br />

was fascinating! We discussed “Armored vs. Daring<br />

Leadership,” how to practice our values, not just<br />

profess them, and why “vulnerability” has gotten a<br />

bad rap! Rose also examined how to master difficult<br />

conversations; a discussion the Academy’s Nurse<br />

Fellows examined in greater depth during the<br />

February program.<br />

The ever-popular Dr. Eileen O’Grady closed the<br />

day for us with a focus on how Nurse Leadership<br />

Hinges on Well-being. Dr. O’Grady is a certified Adult<br />

Nurse Practitioner and ICF-Certified Wellness Coach.<br />

She is Founder of The School of Wellness, and holds<br />

a master’s degree in public health from The George<br />

Washington University, as well as a master’s degree<br />

in nursing and a PhD in nursing from George Mason<br />

University.<br />

“I feel that every leader should<br />

take this course!”<br />

Dr. O’Grady is also author and editor of six<br />

books, most recently, Advanced Practice Nursing:<br />

An Integrative Approach and Intentional Therapeutic<br />

Relationships: Advancing Caring in Health Care, a<br />

how-to book on placing relationships at the center<br />

of health care. Her most recent book is her most<br />

personal, Choosing Wellness: Unconventional Wisdom<br />

for the Overwhelmed, the Discouraged, the Addicted,<br />

the Fearful or the Stuck, (2021).<br />

If this has piqued your curiosity, or you think a<br />

colleague might be interested, please bookmark<br />

our Academy web page, https://virginianurses.<br />

com/mpage/VNFNLA. Questions? Contact our<br />

Director of Professional Development Lindsey<br />

Cardwell who, along with the Steering Committee,<br />

was instrumental in creating this highly dynamic<br />

program! lcardwell@virginianurses.com.<br />

Register today for the 2023 virtual Nurse<br />

Leadership Academy!

www.<strong>Virginia</strong><strong>Nurses</strong>.com | <strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> <strong>August</strong>, September, October <strong>2022</strong> | Page 25<br />

<strong>Virginia</strong> <strong>Nurses</strong> Foundation Announces<br />

<strong>2022</strong> Award Finalists<br />

The <strong>Virginia</strong> <strong>Nurses</strong> Foundation (VNF) announced the finalists of annual<br />

awards honoring those in the commonwealth who made special contributions to<br />

the nursing profession. Winners will be announced at the VNF Gala, held at the<br />

Westfields Marriott Washington Dulles on September 10, <strong>2022</strong>.<br />

Chief Nursing Officer Finalists<br />

• Yolanda Maurice, Bon Secours Mercy Health St. Mary's Hospital<br />

• Robert Boesch, Centra Health<br />

• Sadie Thurman, Riverside Regional Medical Center<br />

• Christina Grabus, Sentara Northern <strong>Virginia</strong> Medical Center<br />

Direct Patient Care Leader - Patient Experience Finalists<br />

• Jennifer Gorman, Bon Secours Memorial Regional Medical Center<br />

• Erin Stacy, Bon Secours St. Mary's Hospital<br />

• Teresa Doss, Centra<br />

• Belinda Tomlin, Centra Medical Group<br />

• Rebekah Miller, Inova Mount Vernon Hospital<br />

• Jennifer Redd, LewisGale Hospital Montgomery (HCA)<br />

• Kimberly Williams, Sentara Norfolk General Hospital<br />

• Samantha Paquette, Sentara Obici Hospital<br />

• Stephanie Newman, UVA Culpeper Hospital<br />

• Karri Bishop, UVA Health<br />

Direct Patient Care Leader - Patient Safety Finalists<br />

• Amber Sawyer, Carilion Children's<br />

• Tamara Kelejian, Central <strong>Virginia</strong> Healthcare System<br />

• Loretta Nisly, Culpeper Hospital / UVA Health<br />

• Susan Breisch, Inova Mount Vernon Hospital<br />

• Latoia Kidd, Sentara Norfolk General Hospital<br />

• Lucy Vinson, Sentara Norfolk General Hospital<br />

• Kristi Wilkins, UVA Health<br />

• Tracy-Ann Clarke, Valley Health Winchester Medical Center<br />

• Sam Rowland, VCU Medical Center<br />

• Emily Warwick, VCU Medical Center<br />

Nurse Educator Finalists<br />

• Jeannie Corey, James Madison University<br />

• Holly Buchanan, James Madison University School of Nursing<br />

• Adrienne Hartgerink, Old Dominion University<br />

• Ashley Chrisman, Sentara Obici Hospital<br />

• Keshia Blakeney, Sentara Norfolk General Hospital<br />

• Victoria Buffmire, UVA Health<br />

• Jessica Wisecarver, VHC Health<br />

Nurse Manager/Director Finalists<br />

• Kristina Massey, Carilion Roanoke Memorial Hospital<br />

• Johanna Derrenbacker, Centra<br />

• Carrie White, Centra<br />

• Shannon Miles, Centra<br />

• Zewdensh Bryant, Inova Mount Vernon Hospital<br />

• Deidre Thomas, Sentara Northern <strong>Virginia</strong> Medical Center<br />

• Taralyn Wear, UVA Health<br />

• Marie Wilborn, VA Medical Center / Hunter Holmes McGuire VA Medical<br />

Center<br />

• Martha Brooks, VCU Health<br />

• Nina Carter, VCU Health<br />

• Emily League, VCU Health<br />

• Laura Reitmeier, VCU Medical Center<br />

Nurse Researcher Finalists<br />

• Samantha McClure, HCA - LewisGale Hospital Montgomery<br />

• Kathryn Reid, Sentara Martha Jefferson Hospital<br />

• Joanne Williams-Reed, Sentara Norfolk General Hospital<br />

• Elizabeth Epstein, University of <strong>Virginia</strong> School of Nursing<br />

• Claiborne Miller-Davis, UVA Health<br />

Nursing Informatics Finalists<br />

• Jenna Lloyd Fisher, Centra<br />

• Jenna Dziuba, Centra<br />

• Trina Trimmer, VCU Health<br />

Nursing School Dean/Director Finalists<br />

• Suzanne Wright, Old Dominion University<br />

• Deborah Sullivan-Yates, Riverside College of Health Careers<br />

Public Health Nurse Finalists<br />

• Student Health <strong>Nurses</strong> in Roanoke City Public Schools, Carilion Children's<br />

• Barbara Kelly-Gibbs, Sentara Obici Hospital<br />

• Lori White, Sentara Obici Hospital<br />

• Vickie Southall, University of <strong>Virginia</strong> School of Nursing<br />

• Katherine Kois, UVA Health<br />

• Dee Dee Yoder, UVA Health<br />

Public/State Government Service Finalists<br />

• Board of Nursing Team: Claire Morris, Jacquelyn Wilmoth, Robin Hills and<br />

Christina Bargdill, <strong>Virginia</strong> Board of Nursing<br />

• Corri Miller-Hobbs, VCU Medical Center<br />


<strong>Virginia</strong> Oncology Associates 5th Annual Nursing Conference<br />

Trends in Oncology Nursing<br />

Space is limited!<br />

When: Saturday, September 17, <strong>2022</strong> | 7:00 AM – 2:50 PM<br />

Where: The Westin <strong>Virginia</strong> Beach Town Center | <strong>Virginia</strong> Beach, VA<br />

To register: virginiacancer.com/nursingconference<br />

For more information, please call (757) 274-8847

Page 26 | <strong>August</strong>, September, October <strong>2022</strong><br />

<strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> | www.<strong>Virginia</strong><strong>Nurses</strong>.com<br />

Challenges in the Nursing Workforce, Graduate Nursing<br />

Education, and Future of Nursing<br />

Georgianna Thomas, D.Ed., MSN, RN<br />

Somi Nagaraj, DNP, MSN, RN, CSSGB, CONTL<br />

Reprinted with permission from<br />

Illinois The Nursing Voice September 2021 issue<br />

The healthcare sector is an intricate, albeit<br />

fundamental, part of ancient and modern societies.<br />

It comprises a long list of agents, from the individual<br />

seeking healthcare services to the medical staff<br />

and nurses, all operating within a legal framework<br />

involving providers, consumers, insurance<br />

companies, government, medical schools, nursing<br />

schools, and regulatory institutions (Amorim Lopes<br />

et al., 2015).<br />

The healthcare market is always composed<br />

of both suppliers of health services and patients<br />

demanding their services. On the one side is the<br />

workforce of physicians, nurses, and remaining<br />

clinical staff educated according to standards and<br />

criteria, ready to assist those in need. On the other<br />

side stand the forces that drive the demand for<br />

medical services, strongly related to demographic,<br />

socioeconomic, and epidemiological factors.<br />

Analyzing these two market forces is a critical step<br />

in assessing whether the available health care<br />

human resources are enough in quantity and skills<br />

to meet the current and future demand in due time<br />

and may lay solid foundations for further research,<br />

considering perhaps changes to the existing health<br />

policy framework (Amorim Lopes et al., 2015).<br />

A high degree and extent of uncertainty affect<br />

supply and demand: asymmetric information<br />

between physicians, nurses, and patients,<br />

restrictions on competition, an aging workforce<br />

in all areas, strong government interference, and<br />

supply-induced demand are some of the most<br />

glaring differences that can be pinpointed. These<br />

may be relevant when assessing the impact of any<br />

policy involving Healthcare Human Resource [HHR]<br />

planning (Amorim Lopes et al., 2015).<br />

Supply<br />

Supplying human capital with the appropriate<br />

expertise to enable workers to perform and satisfy<br />

the demand for health care is no simple task. The<br />

time and effort required to equip HHR, especially<br />

physicians and advanced nurse practitioners,<br />

exceeds most other professions. In some particular<br />

healthcare professions, the set of necessary skills<br />

to qualify for medical practice is acquired through<br />

extensive academic learning, which involves<br />

enrollment in long courses that may take up decades<br />

to complete due to a strict licensing process. The<br />

analysis of the medical and nurse education process<br />

is relevant but may be insufficient, as several other<br />

factors may affect the efficiency and effectiveness<br />

of the care services delivered (Amorim Lopes et al.,<br />

2015).<br />

Despite the limitations, some measures to<br />

overcome imbalances in the quantity (number)<br />

of physicians and nurses have already been<br />

identified in the health policy literature (Chopra<br />

et al., 2008), namely the following: increasing the<br />

number of domestic- and foreign-trained medical<br />

graduates or increasing the number of medical and<br />

nursing schools and classroom sizes; increasing<br />

the enrollment limits; reducing the requirements<br />

for entry to medical and nursing schools; raising<br />

the wages of the medical and nursing staff, as well<br />

as the perspectives for their future career path; or<br />

reducing the costs of attending medical and nursing<br />

school, which may encourage potential students to<br />

enroll. These proposals are short-term measures to<br />

alleviate the immediate stress put on the healthcare<br />

system triggered by an undersupply of personnel<br />

and may not be suitable for tackling long-term<br />

imbalances due to huge shortages or surpluses<br />

of medical and nursing staff (Amorim Lopes et al.,<br />

2015).<br />

Demand<br />

Demand for health care is a derived demand<br />

(Grossman, 1972), which means that people do<br />

not seek health care services as a final good for<br />

consumption but as an intermediate service allowing<br />

them to be healthy and to improve their stock of<br />

health capital (well-being). They want to improve<br />

their health, and to do so; they seek healthcare<br />

services (Amorim Lopes et al., 2015).<br />

The concept of needs in health care is not<br />

consensual in the health literature, with a semantic<br />

confusion arising from its use in health economics<br />

(Hall & Mejia, 2009). While the economic or effective<br />

demand translates the actual, observed demand,<br />

usually measured in terms of service utilization<br />

ratios such as bed occupancy rates, number of<br />

inpatients, the needs component tries to fully<br />

encompass the epidemiological conditions that<br />

characterize a given population, measured through<br />

morbidity and mortality rates or by the opinion of<br />

a panel of experts, and how that may translate into<br />

a given quantity of required healthcare services.<br />

Therefore, we see that the classical concept of<br />

economic demand may not reflect the biological<br />

needs of the population, as it may leave out the<br />

necessities of the population regardless of their<br />

ability to pay (Amorim Lopes et al., 2015).<br />

An integrated approach uses a dynamic, systemlevel<br />

perspective covering key drivers of supply and<br />

demand that includes manpower planning and<br />

workforce development is critical to overcoming such<br />

challenges (Stordeur et al., 2010). The importance<br />

of paying attention to needs is also continuously<br />

stressed, as changes in the health patterns of the<br />

populations take place (Tomblin et al., 2009). The<br />

impact of microeconomic and organizational changes<br />

in productivity and the skill mix, of the evolution<br />

of demand for healthcare services, and also of<br />

the evolution of health diseases and its potential<br />

impact on the health system. The given quantity<br />

of workers may provide more or less healthcare<br />

services depending on their productivity and skill<br />

mix, influencing the conversion from headcounts<br />

to full-time equivalents (FTEs). Such conversion is<br />

critical to properly assess the healthcare workforce,<br />

as a significant number of physicians and nurses<br />

work part-time only. For this reason, FTE is a more<br />

accurate measure as it normalizes headcounts.<br />

On the demand side, economic (effective) demand<br />

can be initially measured by analyzing utilization<br />

indicators. How this demand will evolve in the future<br />

will then be subject to typical economic factors such<br />

as demography and the growth of the income/GDP<br />

(Amorim Lopes et al., 2015).<br />

In parallel, potential needs can be assessed<br />

by incorporating the incidence and prevalence of<br />

diseases and then mapping a given disease to an<br />

estimate of FTE requirements. Whether future<br />

supply forecasts should tackle all of the estimated<br />

needs is a decision left to the consideration of the<br />

policymaker, as the analysis does not incorporate<br />

financial constraints. Despite the abundance of<br />

approaches and techniques to determine supply and<br />

need for professionals, none of the methodologies has<br />

ultimately proved to be superior (Ricketts, 2011).<br />

Recent studies testing current forecasting<br />

models show that there is still plenty of room for<br />

improvement given the gap between projected and<br />

actual results (Greuningen et al., 2013). It becomes<br />

even clearer that workforce planning should be<br />

accurate and performed in due time, given the<br />

attritions and the delays in enacting policies in the<br />

healthcare sector. Adapting medical and nursing<br />

schools, altering legislation, and changing roles is an<br />

effort that may take years to bring forth. Therefore,<br />

planning has to target a long enough time horizon<br />

to be useful and applicable and has to be done preemptively<br />

(Amorim Lopes et al., 2015).<br />

Accurate HHR planning requires an approach<br />

that is both integrated and flexible, featuring<br />

supply and demand (potential and effective) and<br />

incorporating less tangible factors, such as skill mix<br />

and productivity (Amorim Lopes et. al., 2015).<br />

Academia<br />

Looking at the area of academia, there are<br />

many issues at hand that present challenges for<br />

nursing education at the doctoral level. Having<br />

enough faculty to provide quality education to those<br />

interested in pursuing a doctoral degree in nursing<br />

relies on competent individuals. Presently there are<br />

two types of doctoral degrees one can earn, both are<br />

terminal degrees, and both allow nurses to continue<br />

to practice in the clinical field. The Doctor of Nursing<br />

Practice (DNP) has a clinical focus that allows the<br />

nurse to possess expert knowledge to influence<br />

healthcare outcomes across direct patient care,<br />

advocating for healthcare policy implementation, and<br />

collaborating with organizational leadership (Leveck,<br />

2020, Chism 2010). The Doctor of Philosophy (PhD)<br />

focuses on research in advancing the nursing<br />

profession and change the quality of patient care<br />

and outcomes in the field. PhD nurses also teach<br />

and mentor nurses at the college and university<br />

level, growing the next cohorts of professional<br />

nurses. There is a difference between these two<br />

degrees in their primary foci and length of education<br />

(registerednursing.com). However, the DNP degree<br />

has become the more sought-after degree, and<br />

individuals who have earned it are considered<br />

equal at many institutions in academia in relation<br />

to tenure attainment and administrative positions.<br />

It was more common to see the individual with a<br />

PhD in the academic setting. However, individuals<br />

seeking this degree are decreasing in number, and<br />

some individuals are having difficulty completing<br />

their dissertation. This adds to the faculty shortage<br />

we continue to experience in the profession. There is<br />

a distinction between the two degrees and needs to<br />

be recognized and valued in advancing new nurses,<br />

however, the DNP graduate is more prepared for the<br />

clinical arena.<br />

According to Drs. Di Fang and Karen Kesten,<br />

one-third of the current nursing faculty workforce<br />

in all levels of education are expected to retire by<br />

2025 (ANA Fact Sheet, 2020). This will certainly<br />

have an effect on the numbers of students who will<br />

be accepted when they apply for nursing education<br />

overall.<br />

Continuous changes in the nursing and<br />

medical fields have been rapidly evolving because<br />

of technology and studies such as the genome<br />

project. Graduate student feedback to courses and<br />

discussions with clinical affiliates to the college/<br />

university are two ways that information can be<br />

ascertained in relation to curricular issues for<br />

content. Accreditation standard revisions and the<br />

recently adopted Essentials with emphasis on<br />

outcomes and competencies in learning have also<br />

added to many of the changes schools are making to<br />

revise overall curriculums (AACN, 2021). Learning<br />

theories are used to expose students to various<br />

learning experiences. Online teaching, simulation,<br />

inter-professional learning, case studies, and other<br />

teaching formats take much time to prepare and<br />

grade and may not all be familiar for present faculty<br />

to fulfill.<br />

Interdisciplinary education (IPE) among the<br />

various healthcare providers is expected to<br />

be utilized in schools. This type of education<br />

provides shared experiences that allow for better<br />

understanding, improved engagement, and clearer<br />

insight into cooperation in the work environment<br />

and quality patient care. This activity in schools<br />

with major medical affiliations has an edge in<br />

providing this type of learning while many smaller<br />

colleges and universities struggle to gain this<br />

opportunity. Many IPE opportunities that do exist<br />

are noted through simulation-enhanced activity<br />

(Fawaz, 2018). Although simulation is helpful, realtime<br />

situations may affect the learner differently<br />

when exposed.<br />

Technology has become more influential in our<br />

lives, especially after the past year and a half of<br />

pandemic experiences. However, online education<br />

is not a new concept in education. Use of learning<br />

platforms, Zoom meetings, Wiki’s, Google docs,<br />

social media, Electronic Health Records, and so<br />

on have not been mastered by all in education,<br />

faculty, or student. Many students like the idea<br />

behind online learning in that they can study<br />

at their own pace often or at a time that is most<br />

convenient for them. This strategy for education<br />

allows for flexibility to view course material in<br />

both an asynchronous and, at times, synchronous<br />

format. Faculty find this learning takes more time<br />

in their schedule for preparation and grading than<br />

when classes met traditionally. Class size is not<br />

always capped. Lack of support staff with course<br />

development and difficulty managing technological<br />

changes have been identified as barriers to distance<br />

education (Iwasiw et al., 2020). This becomes<br />

frustrating to both teacher and student in that the<br />

partnership that develops in learning is not fully<br />

developed.<br />

Future of Nursing<br />

The Future of Nursing 2020-2030: Charting a<br />

Path to Achieve Health Equity, study sponsored by<br />

Robert Wood Johnson Foundation identified, that<br />

a nation cannot thrive fully until everyone can live

www.<strong>Virginia</strong><strong>Nurses</strong>.com | <strong>Virginia</strong> <strong>Nurses</strong> <strong>Today</strong> <strong>August</strong>, September, October <strong>2022</strong> | Page 27<br />

their healthiest possible life, and helping people<br />

live their healthiest life is and has always been<br />

the essential role of nurses. The ultimate goal is<br />

to achieve health equity in the United States built<br />

on strengthened nursing capacity and expertise<br />

(National Academies of Sciences, Engineering, and<br />

Medicine, 2021).<br />

The committee developed a framework identifying<br />

the key areas for strengthening the nursing<br />

profession to meet the challenges of the decade<br />

ahead. These areas include the nursing workforce,<br />

leadership, nursing education, nurse well-being, and<br />

emergency preparedness and response, as well as<br />

responsibilities of nursing with respect to structural<br />

and individual determinants of health (National<br />

Academies of Sciences, Engineering, and Medicine,<br />

2021).<br />

In 1998 the Pew Health Professions Commission,<br />

a group of healthcare leaders charged with assisting<br />

health policymakers and educators teaching<br />

health professionals to meet the changing needs<br />

of healthcare systems, completed a report listing<br />

competencies healthcare providers of the future<br />

would need. The competencies are listed in the<br />

Fourth Report of the Pew Health Professions<br />

Commission (O’Neal & Pew Health Professions<br />

Commission, 1998).<br />

The book To Err Is Human: Building a Safer<br />

Health System (Kohn, Corrigan, & Donaldson, 1999)<br />

brought national attention to the issue of patient<br />

safety by discussing the number of people who<br />

die each year from medical errors. This, in turn,<br />

sharpened the focus of patient safety in nursing<br />

education (Scheckel, 2008).<br />

Despite the practice setting in which students<br />

learn nursing care, it will include using various<br />

technologies and knowledge of informatics to assist<br />

with patient care. These technologies can include<br />

but are not limited to medical devices patients will<br />

use to provide self-care, as well as information<br />

retrieval, clinical information management, and<br />

documentation technologies (Scheckel, 2008).<br />

Students’ use of these devices has important<br />

implications for improving their clinical judgment<br />

(Newman & Howse, 2007). <strong>Nurses</strong> are also being<br />

exposed to the use of variety of clinical management<br />

systems, like patient surveillance systems many of<br />

which have implications for ensuring quality and<br />

safety.<br />

A significant movement that accompanied the<br />

curriculum revolution involved using pedagogies<br />

to ensure students could think critically in clinical<br />

practice. Traditionally, students who learned the<br />

nursing process were thought to be learning critical<br />

thinking. During the past few decades, the nursing<br />

process has been challenged as the best approach<br />

to developing students’ critical thinking (Scheckel,<br />

2008). However, current research in nursing<br />

education suggests that students also need to<br />

engage in thinking processes that promote reflective<br />

thinking, where they build practical knowledge,<br />

embodied thinking, where they learn the importance<br />

of intuition and pluralistic thinking, where they<br />

consider a clinical situation using many perspectives<br />

(Scheckel & Ironside, 2006).<br />

Innovations<br />

As nurses assume increasing responsibility<br />

for patient care in primary care settings, the<br />

combination of increased clinical and systems<br />

knowledge, as well as the capability to apply and<br />

evaluate evidence to practice innovations, can<br />

only have a positive impact. The presence of DNPprepared<br />

APRNs in primary care will expand<br />

educational opportunities. In the short term,<br />

the DNP-prepared APRNs can mentor the MSNprepared<br />

APRNs within the system. Equally<br />

important is the opportunity for enhanced<br />

preceptor education for nursing students in<br />

primary care (Dunbar-Jacob et al., 2013).<br />

Indeed, the preparation of the DNP will influence<br />

the perception of health care systems regarding the<br />

added value of DNP education. If graduates of such<br />

programs bring an increased depth of knowledge<br />

and skill to the clinical arena, the DNP will likely<br />

flourish. If graduates bring little more than what<br />

is offered by master’s-level education, the DNP will<br />

not be an attractive addition to the clinical arena.<br />

Thus, the quality of the preparation of the DNP will<br />

influence the adoption of the DNP practitioner and<br />

administrator by health care systems (Dunbar-<br />

Jacob et al., 2013).<br />

Conclusion<br />

Challenges in building DNP programs include the<br />

identification of qualified faculty for each specialty,<br />

qualified capstone advisors, and qualified clinical<br />

preceptors. A further challenge is the simultaneous<br />

education of master’s cohorts and DNP cohorts.<br />

The challenges by requiring faculty to obtain a<br />

doctoral degree, developing critical academic–<br />

service partnerships in mentoring students for<br />

practicum and capstone projects, and discontinuing<br />

MSN advanced practice specialty programs while<br />

focusing on the BSN-to-DNP and MSN-to-DNP<br />

programs. High-quality DNP academics and<br />

DNP clinicians are crucial to help meet these<br />

challenges. Each educational program must assess<br />

its challenges and strategies for addressing those<br />

challenges. How we proceed will determine the<br />

impact of our programs on the future of the health<br />

care system (Dunbar-Jacob, Nativio, & Khalil,<br />

2013).<br />

In academia, both the PhD and DNP prepared<br />

nurses can work together to ensure quality<br />

education for our nursing students. Both need<br />

an educational foundation to be learned to be<br />

successful educators. The distinction of the PhD<br />

concentrating on teaching theory and research to<br />

assist nursing to maintain its scientific foundation<br />

and the DNP concentrating on the clinical skills<br />

and acting as preceptor/clinical educator at any<br />

level of nursing appear to be the ideal partnership<br />

to develop. Both nurses can assist academia and<br />

the clinical arena in staying current and developing<br />

innovative care measures to provide quality care<br />

to clients. When looking at the definitions noted<br />

at the beginning of this work, this collaboration in<br />

teaching nurses fits what was noted.¬

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