Rhode Island Nurse August 2022

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Volume 11 | No. 4<br />

The Official Publication of the American <strong>Nurse</strong>s Association <strong>Rhode</strong> <strong>Island</strong><br />

Aug., Sept., Oct. <strong>2022</strong><br />

The <strong>Rhode</strong> <strong>Island</strong> <strong>Nurse</strong><br />

Quarterly publication sent to 7,000 Registered <strong>Nurse</strong>s and LPNs in <strong>Rhode</strong> <strong>Island</strong><br />

Message from the President<br />

Inside<br />

Excellence in Nursing Awards<br />

Page 3<br />

I am a Nursing<br />

Conference Junkie<br />

Page 4<br />

Annual Meeting Summary<br />

Page 5<br />

Leigh Hubbard, MS, RN<br />

President, ANA-RI<br />

As fall draws near, I tend<br />

to reflect on the precious,<br />

limited time we have over the<br />

summer months, the official<br />

time of vacations, laughter,<br />

togetherness, 5K runs, cookouts,<br />

and camps. Many of<br />

us count the days until the<br />

weather turns and the tee<br />

shirts come out, when the<br />

school buses disappear, and<br />

the stickiness of melting icecream<br />

and salt and sand are endless.<br />

In this profession, many of us have limited time<br />

to enjoy this weather and these moments with our<br />

people due to the ever-present work of healthcare<br />

that must be done. My hope for all of you is that<br />

you did have slivers of time this season to unplug,<br />

to breathe, to enjoy moments of summer fun,<br />

despite the tasks at hand, namely ongoing (now<br />

baseline) COVID-19 patients, the monkeypox<br />

threat, staffing shortages, gun violence, heat<br />

related trauma and illness, to name a few.<br />

More importantly, I hope that, even during the<br />

work times, you were able to name at least one<br />

great moment each day. Perhaps a colleague<br />

acknowledged what an amazing feat it was to<br />

change the complicated dressing, or a family<br />

member provided you with a sincere thank you.<br />

Perhaps you witnessed a kid skip out of the<br />

hospital when discharged or caught an elderly<br />

couple in a loving embrace. Maybe the wind hit<br />

you in the perfect way as you walked to your car<br />

one morning after a long shift, or you were able<br />

to see the lightbulb go off over your mentee’s<br />

head as they learned the critical ‘why’ behind the<br />

task-oriented ‘what.’ These moments don’t need<br />

the summer heat to be found. They can be found<br />

year-round, every day, if we open our eyes and<br />

hearts to see them and to let the sparkle find its<br />

way into our lives.<br />

It’s understandable why we crave calm, and<br />

we are currently tripping over contact hours<br />

about resilience, mindfulness, and work-life<br />

balance, which is so difficult at times to gain<br />

and maintain. A quick review of our history as<br />

a species reveals, however, that we have never<br />

been in a world where calm and peace is the<br />

baseline. As a species we are born screaming,<br />

and we have always lived in a world with virtually<br />

constant threats. Thousands of years ago, it was<br />

the threat of being eaten, starving, or freezing<br />

to death. The threats have changed, but our<br />

genetically coded response to those threats has<br />

not. Our ability to withstand threat, to be resilient<br />

despite danger and uncertainty, comes from our<br />

ability to feel safe and cared for, and from our<br />

ability to recognize and nurture the humanity<br />

and community that surrounds us. It does not<br />

come from one week off, a 90-minute massage,<br />

or always leaving on time, or even getting eight<br />

hours of sleep every night. It does come from<br />

being certain of our place in the world, of our<br />

acceptance by those that surround us, and it<br />

comes from us providing that to others.<br />

What an easy thing to write or to say. It is<br />

much harder to do when we live and work in<br />

places where people are constantly hearing bad<br />

news, coping with medical nightmares, managing<br />

uncertainty, carrying the weight of oppression or<br />

childhood trauma, navigating addiction or chronic<br />

or acute illness, or unsure of where they will sleep<br />

or what they will eat tomorrow. Still, the ANA Code<br />

of Ethics Provision 1 demands that we …practice<br />

with compassion and respect for the inherent<br />

dignity, worth, and unique attributes of every<br />

person. In other words, we make our fellow<br />

humans feel welcomed, included, and like they are<br />

people worthy of our time and care.<br />

As we enter the fall and the manic holiday<br />

season, I challenge you to make it a habit to<br />

consciously identify at least one instance of<br />

humanity and/or inclusion a day (note examples<br />

above) and tell someone about it. AND I<br />

encourage you to provide the world with an<br />

example of humanity for others to witness. This<br />

could be looking a stranger in the eye, smiling,<br />

and saying hello. It could be acknowledging a<br />

new co-worker who seems to be struggling, or it<br />

could be telling your kid or dear friend that you<br />

accept them unconditionally, no matter what. It<br />

could be giving your leftovers to the person sitting<br />

on the corner or letting the minivan turn left at a<br />

busy intersection. It may be acknowledging how<br />

crappy it is to wait to be seen by the provider or<br />

for an important test result. These moments<br />

matter because they validate all involved as<br />

human beings, living in this time, as being worthy<br />

of this effort. For onlookers, these acts of<br />

humanity provide hope that the world, despite the<br />

ever-present, ever-changing stressors and threats,<br />

isn’t all bad and that in you, their RN (or friend,<br />

neighbor, or family member), they can find safety<br />

and trust.<br />

Each season brings with it a flavor that each<br />

may experience differently, depending on our<br />

history. I urge you to consider what unites us and<br />

to invite others into whatever calm or chaos you<br />

call life. Opportunities to connect may not quiet<br />

the storm but in community we find strength and<br />

support to rise to any challenge.

Page 2 • <strong>Rhode</strong> <strong>Island</strong> <strong>Nurse</strong> <strong>August</strong>, September, October <strong>2022</strong><br />

Welcome Back<br />

It is with pleasure that RISNA (ANA-RI) renews their relationship with ALD Publishing<br />

to present you with our first quarterly digital newsletter. The newsletter will be<br />

published quarterly and will update you on local and national issues that are of<br />

concern to nurses and the nursing profession.<br />

Please let us know what would be of interest to you in upcoming editions.<br />

Email your suggestions and articles of interest to dpolicastro@risna.org.<br />

The <strong>Rhode</strong><br />

<strong>Island</strong> <strong>Nurse</strong><br />

The American <strong>Nurse</strong>s Association - <strong>Rhode</strong> <strong>Island</strong><br />

(ANA-RI), a constituent member of the American<br />

<strong>Nurse</strong>s Association (ANA), is the authority on<br />

matters concerning the profession of nursing and<br />

nursing practice in the State of <strong>Rhode</strong> <strong>Island</strong>.<br />

Updates from the Executive Director<br />

Executive Director<br />

Donna Policastro, RNP, ED<br />

Donna M. Policastro, RN<br />

Executive Director<br />

After over two years of<br />

isolation and multiple “ZOOM”<br />

meetings; it now seems that<br />

we have returned to some<br />

kind of normalcy. However, we<br />

must still remain vigilant.<br />

So, what has RISNA<br />

(ANA-RI) been up to for<br />

the last two years. Many<br />

members volunteered at<br />

COVID immunization clinics,<br />

volunteered at RIDOH and<br />

staffed our hospitals Covid units and ER’s. Many<br />

nurses took a pause and reprioritized their career<br />

goals and left the profession entirely.<br />

The 2020/21 licensing cycle in RI revealed that<br />

5500 registered nurses did not renew their license.<br />

What will the future look like for nursing care as we<br />

figure out how to replace the nurses that we have lost.<br />

On a positive note, two new baccalaureate<br />

programs have applied to the Board of Nursing<br />

for approval. Providence College will welcome 50<br />

students as will Johnson & Wales University in 2023.<br />

RISNA”s board has been engaged in increasing<br />

networking and education activities for our<br />

members and to attract new members. Please visit<br />

our website at www.risna.org for updates on events.<br />

The board of directors election will occur in late<br />

Fall. Please consider running for a board seat. This<br />

year, we will elect a President, Treasurer, Secretary<br />

and two Directors.<br />

The Legislative session will begin in January 2023.<br />

A Legislative Commission to study the benefits of reentering<br />

the <strong>Nurse</strong> License Compact will commence in<br />

October <strong>2022</strong>. RISNA has a “seat” on the commission<br />

and will provide an update in our next edition.<br />

Until then, enjoy the end of your summer.<br />

Respectfully submitted:<br />

Donna M. Policastro, RN<br />

Executive Director<br />

President<br />

Leigh Hubbard, MS, RN, ONC<br />

Vice-President<br />

Donna McDonald, RN, BSN<br />

Treasurer<br />

Annette Fonteneau, MSN, APRN,<br />

DCNP<br />

Secretary<br />

Julie Ann Greenhalgh<br />

Board of Directors<br />

Joanne Borademos, RN<br />

Jacqueline Insana, MSN, RN,<br />

PMH-BC, NPD-BC<br />

Ara Millette<br />

Sylvia Weber, MSN, RN<br />

Publisher<br />

<strong>Rhode</strong> <strong>Island</strong> <strong>Nurse</strong> is published quarterly every<br />

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

L. Davis Publishing Agency, Inc.<br />

For advertising rates and information, please<br />

contact Arthur L. Davis Publishing Agency,<br />

Inc., PO Box 216, Cedar Falls, Iowa 50613,<br />

(800) 626-4081, sales@aldpub.com. ANA-RI<br />

and the Arthur L. Davis Publishing Agency, Inc.<br />

reserve the right to reject any advertisement.<br />

Responsibility for errors in advertising is limited<br />

to corrections in the next issue or refund of price<br />

of advertisement.<br />

Acceptance of advertising does not imply<br />

endorsement or approval by the ANA-RI of<br />

products advertised, the advertisers, or the<br />

claims made. Rejection of an advertisement<br />

does not imply a product offered for advertising<br />

is without merit, or that the manufacturer lacks<br />

integrity, or that this association disapproves of<br />

the product or its use. ANA-RI and the Arthur<br />

L. Davis Publishing Agency, Inc. shall not be<br />

held liable for any consequences resulting from<br />

purchase or use of an advertiser’s product.<br />

Articles appearing in this publication express the<br />

opinions of the authors; they do not necessarily<br />

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

of ANA-RI or those of the national or local<br />

associations.<br />

American <strong>Nurse</strong>s Association - <strong>Rhode</strong> <strong>Island</strong><br />

1800D Mineral Spring Avenue, PO Box 299<br />

North Providence, <strong>Rhode</strong> <strong>Island</strong> 02904<br />

Tel: 401-331-5644 • Fax: 401-331-5646

<strong>August</strong>, September, October <strong>2022</strong> <strong>Rhode</strong> <strong>Island</strong> <strong>Nurse</strong> • Page 3<br />

RISNA News<br />

Sylvia Weber, RN, MSN, PCNS<br />

Since early childhood I<br />

was always sensitive to my<br />

surroundings and would be<br />

the one who would intervene<br />

when peers would be<br />

aggressive or cruel towards<br />

any living being. This, and<br />

my mothers favorite saying,<br />

“it’s a great life if you don’t<br />

weaken,” was the foundation<br />

for the path I followed and<br />

committed to.<br />

A defining experience occurred when I was six<br />

years old when relatives from Europe, who were<br />

survivors of the Holocaust, came to the United<br />

States and stayed with family until they were able<br />

to create a life here. After I went to bed I would<br />

pretend I was sleeping. I stayed awake because I<br />

wanted to hear them share their experiences. It was<br />

this experience that led me to make a commitment<br />

that as long as I lived I would so something every<br />

day to make this a better world for all, no matter<br />

how small or large it was, a smile, a greeting, a chat,<br />

support, etc. As I followed this path I learned about<br />

many principles/concepts. One is the concept of<br />

innocence, the ability to approach each situation<br />

with “new eyes” while taking into account lessons<br />

previously learned. I also learned that in Western<br />

thought we tend to believe in a beginning and<br />

an end instead of eternity which allows us to be<br />

near sighted rather than look at our impact on all<br />

generations, all of life, present and future.<br />

When the time came for me to explore the<br />

career path I wanted to follow, these and other<br />

experiences, led me to look at professions that<br />

brought compassion, healing and knowledge into<br />

the world to help others. I was drawn to nursing as it<br />

is based on these principles/concepts.<br />

During my career I continued to have<br />

experiences that broadened and expanded my<br />

knowledge of the underlying principles/concepts<br />

that enhanced my life and work. As Dolores<br />

Krieger, RN, PhD said, “think deeply and care<br />

deeply.” This occurred at Pumpkin Hollow Retreat<br />

Center in New York State. It was also there that I<br />

learned a wonderful metaphor that’s an underlying<br />

principle for me, that of the brook: The brook is<br />

always changing and its path is not always smooth.<br />

It comes to rocks and other obstacles to eventually<br />

find a way around or over the obstacle, and it<br />

keeps on flowing.<br />

Equally true is the principle of consciousness.<br />

As James O’Dea stated in an Institute of Noetic<br />

Science publication in the winter of 2008-2009,<br />

“consciousness can be limited and divisive or can<br />

lead to a new humanity, the capacity to heal, to<br />

forgive, to deepen the bonds of friendship and love<br />

and become an integrated whole/oneness.”<br />

My experiences as a nurse also expanded my<br />

view of spirituality. There are many ways people<br />

express their spirituality, organized religion being<br />

one. It includes our relationship with and within the<br />

universe. It’s also our sense of purpose, direction<br />

and why we believe we are here. It’s our feelings<br />

of connectedness with our selves, with others,<br />

with all of life. When we have a clear sense of our<br />

spiritual path, our sense of purpose, and are true<br />

to it, our possibilities are limitless. We understand<br />

that when one door closes, another opens. We<br />

understand that opportunities are not better or<br />

worse, they are different. We understand that we<br />

are more comfortable with the concept of surrender<br />

as not giving up but rather of turning it over from<br />

the physical plane to the spiritual plane while<br />

still doing what’s in our control on the physical<br />

plane. We understand that surrender is letting go<br />

of our attachment to the outcome. It is true that<br />

we may not get what we want and we understand<br />

that we are starting a process of change and of<br />

transformation. The process of our experiences are<br />

as important as the outcome.<br />

As a result, to me, nursing is more than a<br />

profession, it is who we are and how we live and<br />

walk in this world.<br />

have thousands<br />

We<br />

nursing jobs!<br />

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Find your dream job now.

Page 4 • <strong>Rhode</strong> <strong>Island</strong> <strong>Nurse</strong> <strong>August</strong>, September, October <strong>2022</strong><br />

I am a Nursing Conference Junkie<br />

Leigh Hubbard, MS, RN<br />

President, ANA-RI<br />

I remember my Nursing<br />

Research course in my<br />

Bachelor’s program at<br />

UMass Dartmouth. It<br />

was a mandatory course<br />

within the curriculum, but<br />

I remember thinking, this<br />

is silly – I want to care for<br />

people, not do research!<br />

I tucked the info from<br />

that course into a corner<br />

of my brain and got to<br />

work. For the first few years I busied myself with<br />

getting into the practice of nursing, refining my<br />

assessment skills, trying not to do harm, learning<br />

how to be a good colleague, and teaching<br />

those coming on after me. As I became more<br />

comfortable with the basics, I felt a tug toward<br />

improving the systems and workplaces that I<br />

was a part of. I remember thinking, what would<br />

happen if we changed this a bit, or refined this<br />

process, or asked nurses about this scenario?<br />

There was a desire to learn what other similar<br />

institutions were doing – how were they handling<br />

staffing deficits and medication errors? How<br />

were they coping with the unexpected death of<br />

a patient? How were other institutions reducing<br />

post-surgical complications or admission rates?<br />

I began using my institution’s library (Because<br />

back then there was an actual place where<br />

nursing journals were sitting on shelves) and<br />

looking for information. It was in the front and<br />

back of those journals I discovered invitations<br />

to attend conferences. Then I remembered my<br />

research class.<br />

I attended my first conference in Boston in<br />

2008. It was an adolescent health conference,<br />

with a track in sexual health, which was the<br />

area of nursing I was practicing at that time. I<br />

paid a few hundred dollars, requested the time<br />

off of work, and took the train from Providence<br />

to Boston. I heard incredible speakers and met<br />

incredible people. I learned of alternative ways to<br />

ask questions in a way that carried less judgment<br />

and would help put my youthful patients at<br />

ease. I learned about assessment tools I hadn’t<br />

seen before, and I learned of up-and-coming<br />

technology and medications that were going to<br />

be emerging in the near future. It was an injection<br />

East Bay Community Action Program (EBCAP) is seeking experienced<br />

Registered <strong>Nurse</strong>s, <strong>Nurse</strong> Practitioners, and Physician Assistants<br />

to join our agency at various locations. All positions are offering sign-on<br />

bonuses of up to $2,500 for select positions!<br />

We are seeking highly professional and motivated individuals who enjoy<br />

working with clients in a community health setting. Come join our expanding<br />

dynamic multidisciplinary team and provide comprehensive patient care<br />

using a care team model. To learn more about career opportunities,<br />

visit www.ebcap.org/careers or email careers@ebcap.org.<br />

For Full Time Employees Working 30 – 40 hours per week, EBCAP provides<br />

a comprehensive compensation and benefits package that includes heavily<br />

subsidized medical and dental insurance plans (BCBSRI), supplemental<br />

vision insurance, voluntary medical and dependent care flexible spending<br />

accounts, up to 3% company matching 403(b) retirement plan, employer-paid<br />

life insurance & long term disability, generous paid time off that includes<br />

vacation/holidays/personal days/sick time, mileage reimbursement, tuition<br />

reimbursement, opportunities for center-paid training/CEUs, employee<br />

assistance programs, and more!<br />

EBCAP is an equal opportunity/affirmative action employer committed to providing a diverse work environment.<br />

of professionalism, innovation, and inspiration.<br />

As my nursing career evolved, I sought<br />

out conferences and ways to physically<br />

connect with others instead of just reading<br />

a paper and doing a continuing education<br />

quiz. When I met my mentor, the Director of<br />

one of my programs, they shared this tidbit:<br />

“Submit abstracts. You have things that you<br />

are doing that other institutions should know<br />

about. And don’t submit alone – always include<br />

a colleague. We never do anything alone in<br />

nursing.” I thought, no… everyone knows this<br />

stuff. Everyone is doing this. What I’m doing<br />

isn’t special. And also, Writing an abstract is<br />

hard! What if it gets rejected? Ultimately, she<br />

encouraged me to submit a 250 word abstract<br />

about our program’s successful perioperative<br />

transfusion reduction initiative. I logged onto<br />

the website, followed the instructions, wrote<br />

our story, found a few trusted colleagues to<br />

edit and then incorporated their feedback. I hit<br />

the ‘submit’ button and waited two months. I<br />

remember receiving the email informing me that<br />

our abstract was accepted! I was so excited and<br />

also validated in the work we were doing for our<br />

patients – now we would be able to share with<br />

others and potentially positively impact care on a<br />

larger scale!<br />

My institution offered a professional<br />

development benefit, so had I attended, the<br />

conference would have been paid for but the<br />

hotel and flight would have been on me, and I<br />

would have had to take PTO to attend. Because<br />

I had an accepted abstract, however, my<br />

institution was willing to pay for the conference,<br />

hotel, and flight. I was sold. With this<br />

conference I not only got a dose of innovation<br />

and inspiration but I also had the financial<br />

support of my institution. I was tasked with<br />

being an ambassador for our organization and<br />

presenting this great information, but I wasn’t<br />

left to do this on my own. I received help<br />

organizing my presentation, working on timing,<br />

and considering and preparing for questions<br />

the audience may ask. The conference itself<br />

was thrilling, as was presenting to a group of<br />

supportive peers.<br />

I now submit abstracts regularly. Some don’t<br />

get accepted and some do. Some are related to<br />

outcomes and data, and others are related to<br />

nursing collaboration with other disciplines, or<br />

how to manage angry patients, or care for people<br />

who use drugs. More recently I worked with a<br />

systems designer and researcher and submitted<br />

an abstract to the Design Research Society<br />

International conference. It was an entirely<br />

different experience attending a conference<br />

as one of the only healthcare professionals in a<br />

huge room with creatives and designers, many of<br />

whom were designing tech, systems, and policy<br />

for healthcare. I met people who worked for<br />

the United Nations, aiming to reduce antibiotic<br />

resistance in rural India in females with urinary<br />

symptoms, people designing adaptive equipment<br />

Founded in 1971, CODAC is RI’s oldest and largest non-profit, outpatient provider of<br />

treatment for Opioid Use Disorder. With 7 community-based locations, as well as 3<br />

correctional facilities, CODAC is well-positioned to deliver services wherever they are<br />

needed across the state.<br />

CODAC is Hiring for Medication <strong>Nurse</strong>s (LPNs)<br />

We are looking for dedicated nurses who are looking to make a difference in a patient’s<br />

life. Our medication nurses are responsible for dosing patients who are struggling with<br />

opioid addiction, as well as providing support and guidance as they journey to recovery.<br />

We offer a competitive salary, comprehensive benefits and a generous time off package.<br />

Hours are 5am to 2pm, Monday -Friday, and occasional weekends. Flexibility to float<br />

between sites is required. Applicants must have a valid RI Nursing license and be fully<br />

vaccinated against Covid-19.<br />

Check us out at: www.codacinc.org<br />

Interested candidates can contact Jessica Perry at 401-461-5056 or<br />

jperry@codacinc.org<br />

for people who had suffered a stroke, people<br />

designing for wellness and aiming to end stigma<br />

surrounding mental health disorders through a<br />

redesign of algorithms associated with stock<br />

imagery. Fascinating!<br />

I have never been to a conference that I<br />

felt wasn’t worth going to, and the network<br />

of people that I have met have come in handy<br />

long after the closing keynote speaker. From<br />

those relationships, I have hosted nurses from<br />

other hospitals who want to see what we are<br />

doing, and I have visited hospitals and spoken<br />

with nurses who have extended the offer. I’ve<br />

emailed simple questions and received examples<br />

of policies that I’ve used when developing new<br />

programs or researching alternative ways of<br />

doing. I’ve connected my colleagues with my<br />

connections and fostered interstate institutional<br />

collaborations. This, to me, is how great ideas<br />

are spread, when we remove the silo and have<br />

opportunities to connect and learn outside of our<br />

usual four walls.<br />

If you say to yourself, “I don’t have time,<br />

and I don’t have anything to add….,” it’s likely<br />

not true, but that’s okay – just attend. Attend a<br />

regional conference and use that professional<br />

development stipend which is a benefit likely<br />

offered by your employer. Or think about the<br />

things you do, the workarounds or the gaps in<br />

care or practice that you have solved. Talk with<br />

your manager or nurse educator about what it<br />

would take to measure the effects of an action<br />

or to write up the improvement. You may think,<br />

“I don’t know what conference to attend…”<br />

If you subscribe to a journal, seek out their<br />

annual conference or check the ANA website<br />

for upcoming conferences. Google it! Specialty<br />

organizations usually have, at minimum, annual<br />

offerings, but many have local or regional miniconferences<br />

that may be available.<br />

If you think, “I can’t take the time off…” when<br />

planned for (and many of these are scheduled<br />

up to a year in advance), it’s easier to request<br />

the time, and if you let your manager know how<br />

your attendance will improve your practice or the<br />

practice on your unit, then they are likely to work<br />

to support you if possible.<br />

If you are scared to go alone, know that nurses<br />

are pretty good at talking to people and making<br />

others feel welcomed. By getting slightly outside<br />

of your comfort zone, by stretching, you will<br />

grow. Through this personal growth, learning,<br />

and networking, we find common ground,<br />

solutions to problems, and return to our daily<br />

work professionally revitalized. **<br />

Have you been to a conference you found<br />

particularly exciting/valuable?<br />

We would love to hear from you ! Use THIS<br />

LINK and in the Subject: “Conference Junkie”<br />

Happy Conferencing!<br />

Leigh Hubbard’s nursing work includes<br />

Managing a LGBTQ and sexual health clinic,<br />

surgical services, program development<br />

and management, regulatory readiness, and<br />

ambulatory care and management. She has<br />

worked in surgical intensive care, neurosurgery,<br />

oncology, and women’s health. She finds great<br />

joy in smoothing transitions within healthcare<br />

through process improvement and helping to<br />

guide RNs and other healthcare staff members<br />

through unsure, challenging circumstances.<br />

She feels that “professional growth spurts”<br />

abound when a person or team innovate and find<br />

connection.<br />

Leigh Hubbard is also the President of the<br />

American <strong>Nurse</strong>s Association in <strong>Rhode</strong> <strong>Island</strong><br />

and the Strategic Design Fellow at RISD Center<br />

for Complexity. She is a founding member of<br />

Mainstay RI, a small think tank dedicated to<br />

opioid overdose care redesign. She is an active<br />

member of Grace Episcopal Church in Downtown<br />

Providence, where she sings soprano in the choir<br />

with her two children.

<strong>August</strong>, September, October <strong>2022</strong> <strong>Rhode</strong> <strong>Island</strong> <strong>Nurse</strong> • Page 5<br />

ANA-RI Annual Meeting Summary

Page 6 • <strong>Rhode</strong> <strong>Island</strong> <strong>Nurse</strong> <strong>August</strong>, September, October <strong>2022</strong><br />

GOVERNANCE Column<br />

Inspiring Words from RISNA Governance Chair,<br />

Joanne Borodemos, RN<br />

Nursing Politics 101: Public Opinion is On Our Side<br />

Current Professional Nursing Issues are more<br />

complex than just “staffing ratios” and we need<br />

local Legislative and policy solutions immediately to<br />

correct them. Our role as a patient advocate and our<br />

ethical code demand that public policy formulation<br />

is part of our work. <strong>Nurse</strong>s must produce and lobby<br />

for these laws and policies as the role of nursing has<br />

been compromised in every setting and our patients<br />

need us. No knight in shining armor is coming to<br />

save us from the evil profiteers.<br />

“Health Care Delivery systems are held together,<br />

and enabled to function by the nurses”<br />

– Lewis Thomas<br />

“America’s <strong>Nurse</strong>s are the beating heart of our<br />

medical system “ – Barack Obama<br />

“<strong>Nurse</strong>s are ranked the most trusted profession 20<br />

years in a row” – Gallup poll<br />

Once upon a time, nurses simply went wherever<br />

we were needed without interference – the<br />

battlefield, the homes, the schools, the factories.<br />

The hospitals were staffed exclusively by nurses and<br />

physicians. We were highly regarded, respected and<br />

appreciated. The need for nursing care, comfort and<br />

support, teaching, and patient advocacy has not<br />

waivered. Our social contract with our patients and<br />

communities still stands!!<br />

What has changed, is that somehow the<br />

corporate world we live in now has had the<br />

audacity to move nurses to the “cost side” of<br />

the equation and corporate CEOs and insurance<br />

companies have an incentive to cut back on nursing<br />

services everywhere to save money for them, even<br />

though there would be no revenues for hospitals<br />

at all without us. At the same time they hold us<br />

hostage to corporate priorities based on surveys<br />

and consumerism and more aggravation. They<br />

constantly interfere with our responsibilities, but we<br />

do our job in spite of them. We know this cannot go<br />

on.<br />

<strong>Nurse</strong>s, for example, once served an important<br />

role in physician offices. The nurse triaged patient<br />

phone calls and concerns. The nurse was a second<br />

pair of eyes and ears, did the much needed patient<br />

teaching, provided support and comfort to the<br />

patient and families, made follow-up phone calls<br />

to check on the patient, provided referral to other<br />

services when needed, and as always watched<br />

and advocated for the patients. Everyone working<br />

in the physician office now is there for billing<br />

purposes. They will schedule you the “first available”<br />

appointment in two months or send you to the ER to<br />

sit and wait for seven hours or three days…<br />

Healthcare has become chaotic, fragmented,<br />

inadequate and increasingly unsafe, and people<br />

are dying because of these unchecked changes<br />

imposed on nurses and healthcare. It is a miracle<br />

that some survive this obstacle course.<br />

No longer protected or empowered by Common<br />

Law and tradition, we require legislation now to<br />

codify and protect the role of nurses in healthcare.<br />

The law must guarantee our independence,<br />

authority, autonomy and self-direction as a<br />

profession. We must be able to practice at our full<br />

potential.<br />

Our political voice in our state must become<br />

louder. We must increase our solidarity and our<br />

visibility or nothing will change. RISNA represents<br />

all nurses in our state. Unions cannot address all the<br />

complexities of our profession, and not all nurses<br />

belong to a union. We are in the process of writing<br />

critical legislation for the next session of the general<br />

assembly.<br />

We also have our own RISNA Political Action<br />

Committee for local politics. Let’s fire it up! The PAC<br />

can donate to local political candidates who support<br />

nurses. We can also use the PAC as our collective<br />

voice to issue opinions and speak out publicly,<br />

endorse candidates and support causes that nurses<br />

believe in, or oppose those we strongly do not<br />

support. We can have a powerful voice because the<br />

people trust us and need us to take care of them.<br />

Public opinion is behind us.<br />

Ideally we encourage membership to ANA-RI, if<br />

you cannot do that, please at least join our RISNA<br />

PAC. A donation of 10 dollars or more to the PAC<br />

will also connect you to the RISNA PAC newsletter<br />

which will focus on state candidates, issues and<br />

legislation pertaining to Nursing and Healthcare<br />

in our state. We will also update you on our critical<br />

upcoming legislative projects regarding nurse<br />

practice through this newsletter.<br />

I would love to speak to any RI <strong>Nurse</strong>s who have<br />

ideas, questions or would like to be more involved.<br />

Please email JoanneBorodmos@gmail.com so we<br />

can connect. Nursing is a team sport!<br />

Please consider joining your professional association<br />

and donating to our PAC; just go to www.risna.org!<br />

<strong>2022</strong> ANA Membership Assembly<br />

Thundermist Health Center is a federally qualified<br />

community health center in <strong>Rhode</strong> <strong>Island</strong>. The health center<br />

serves three communities with locations in Woonsocket,<br />

West Warwick, and South County. Thundermist has been<br />

improving the health of patients and communities for more<br />

than 50 years.<br />

We are accepting applications for the following<br />

nursing positions:<br />

• <strong>Nurse</strong> Manager<br />

• Registered <strong>Nurse</strong><br />

• <strong>Nurse</strong> Care Manager<br />

Learn more about these positions at https://us62e2.<br />

dayforcehcm.com/CandidatePortal/en-US/THUNDERMIST<br />

Thundermist is dedicated to the goal of building and maintaining a<br />

diverse and inclusive workforce committed to caring for patients in a<br />

manner that is respectful of cultural difference.<br />

Donna McDonald, Vice President of ANA-RI<br />

with Senator Jack Reed (D)

<strong>August</strong>, September, October <strong>2022</strong> <strong>Rhode</strong> <strong>Island</strong> <strong>Nurse</strong> • Page 7<br />

Opening<br />

This is a journey.<br />

Throughout our history, the American <strong>Nurse</strong>s<br />

Association (ANA) has sought to lead nursing<br />

into the future. Through acts of omission, when<br />

we failed to act, and commission, when ANA’s<br />

actions negatively impacted nurses of color, we<br />

have caused harm and perpetuated systemic<br />

racism. This statement serves as a starting<br />

point for a journey during which we seek to<br />

acknowledge past actions that continue to impact<br />

the profession today and as a starting point of a<br />

new journey toward the future.<br />

ANA begins this journey in conjunction with the<br />

efforts undertaken by the National Commission<br />

to Address Racism in Nursing (the Commission).<br />

This statement focuses on ANA’s own actions,<br />

while the Commission seeks to address racism<br />

in nursing within the broader profession.<br />

We recognize that as a leader, ANA holds<br />

accountabilities at both the organizational and the<br />

broader professional level. Through both efforts,<br />

we are striving for a more inclusive, diverse, and<br />

equitable professional organization and a nursing<br />

profession that meets the needs of all people.<br />

Our intention with this statement is to publicly<br />

identify and acknowledge our past actions<br />

while addressing the harms that continue today.<br />

The section on ANA Reckoning is not meant<br />

to be a complete listing of all ANA actions that<br />

have caused harm. Historical exclusions of<br />

and transgressions against Black nurses will<br />

be discussed in this document. This harm has<br />

undoubtedly extended to all nurses of color. In<br />

addition, there is much debate about labels and<br />

terms to identify racialized minorities. We have<br />

chosen to use the term “nurses of color” to reflect<br />

all nurses representing race and ethnic groups. It<br />

is our intention to be fully inclusive in the use of<br />

this language.<br />

In the end, it is our actions that will truly reflect<br />

the sincerity of this apology and serve as the<br />

underpinning for forgiveness. For it is forgiveness<br />

that we seek — forgiveness from nurses of color,<br />

the nursing profession and the communities that<br />

have been harmed by our actions. We fervently<br />

hope that this statement, its subsequent work<br />

and the efforts of the Commission will contribute<br />

to healing — individual healing for nurses,<br />

reconciliation with the ethnic-minority nurse<br />

associations and healing of the profession.<br />

ANA wants this statement to reflect genuine<br />

reconciliation and acknowledgment and hopes<br />

that it is a step toward forgiveness. Ultimately, we<br />

seek to contribute to the healing of nursing.<br />

ANA Reckoning<br />

There is much that can be said about ANA’s<br />

history and failure to include and represent<br />

the views and needs of nurses of color. The<br />

examples below are not to be considered as a<br />

complete reckoning of ANA’s past, but they are<br />

representative of times and actions when ANA<br />

failed.<br />

To begin, we must acknowledge that from<br />

1916 until 1964, ANA purposefully, systemically<br />

and systematically excluded Black nurses.<br />

ANA’s predecessor organization, the <strong>Nurse</strong>s’<br />

Associated Alumnae of the United States and<br />

Canada, was open to alumnae associations of<br />

schools of nursing, including Black hospitals and<br />

nurse training schools (Hine, 1989). The <strong>Nurse</strong>s’<br />

Associated Alumnae became the American<br />

<strong>Nurse</strong>s Association, and in 1916, the membership<br />

rules shifted away from an alumnae-based<br />

membership to that of a state- and districtbased<br />

membership. This resulted in Black nurses<br />

being denied membership in some state nurses<br />

associations. Despite significant advocacy and<br />

pressure from the National Association of Colored<br />

Graduate <strong>Nurse</strong>s (NACGN), this discrimination<br />

persisted. In 1946, the ANA House of Delegates<br />

voted to adopt a statement that urged the<br />

“removal, as rapidly as possible, of barriers that<br />

prevent the full employment and professional<br />

development of nurses belonging to minority<br />

racial groups” (Carnegie, 1991, p. 76). And in<br />

1948, the ANA House of Delegates established<br />

ANA’s Racial Reckoning Statement<br />

an “Individual Membership Category” that was<br />

open to all nurses who were not accepted through<br />

a state or district association. However, it was<br />

not until 1964 that a final district in Louisiana<br />

dropped its discriminatory rule for membership<br />

(Carnegie, 1991). This timeline reflects the failure<br />

of ANA leaders to aggressively pursue changes<br />

in its discriminatory membership rules and allow<br />

for full membership regardless of race. While<br />

membership within ANA was hard fought by<br />

NACGN, the full inclusion of Black nurses within<br />

ANA leadership and decision-making remains<br />

unrealized and elusive for all nurses of color.<br />

One representative incident from 1939 involved<br />

Estelle Massey Riddle Osborne, president of<br />

NACGN from 1934-1939. In 1939, President<br />

Osborne was invited by ANA President Julia C.<br />

Stimson to meet with ANA’s Advisory Council<br />

to discuss the status of Black nurses in the<br />

profession. The site of the meeting was the St.<br />

Charles Hotel in New Orleans, where Black guests<br />

were required to use the service entrance and<br />

freight elevator. President Osborne called on<br />

ANA and President Stimson to adamantly protest<br />

this discrimination. Instead of protesting the<br />

discriminatory policy, President Stimson offered<br />

to enter the hotel with President Osborne through<br />

the service entrance. In the end, President<br />

Osborne decided against attending and ANA<br />

failed to step into a space of advocacy and<br />

support (Hine, 1989).<br />

President Osborne was the first Black nurse to<br />

earn a master’s degree in the U.S. and became the<br />

first Black nurse elected to the ANA board in 1948.<br />

However, after her four- year term, there were no<br />

Black nurses elected to the board again until 1970<br />

(Carnegie, 1991). This lack of representation on the<br />

policy level for 22 years concerned many Black<br />

nurses, and when it was brought up at ANA’s 1972<br />

convention, it was communicated that the only<br />

obligation of ANA from the dissolution of NACGN<br />

was the awarding of the Mary Mahoney Award.<br />

In 1965, ANA approved a position paper on<br />

nursing education that recommended the minimum<br />

preparation for “beginning professional nursing<br />

practice should be a baccalaureate degree” (ANA,<br />

1976). The stated rationale for this change was<br />

the increasing complexity of nursing activities and<br />

patient care. One result of ANA taking this position<br />

was the disenfranchisement of institutions and<br />

schools of nursing that were available to students<br />

of color and the exclusion of nurses who graduated<br />

from those programs. ANA sought to advance<br />

the educational level of nurses without ensuring<br />

that all nurses would have the same access to<br />

the education necessary to achieve the desired<br />

educational level for entry into the profession.<br />

There continues to be a need to examine how<br />

this policy advances nursing today and to<br />

examine strategies for ensuring that educational<br />

opportunities are equally available to all students,<br />

especially students of color.<br />

In 1970, Dr. Lauranne Sams organized a meeting<br />

with 200 Black nurses for the primary purpose of<br />

organizing a Black nurse association. The group<br />

reported the following concerns (Carnegie, 1991):<br />

1. Concern over the absence of Black nurses in<br />

leadership positions at ANA.<br />

2. Limited opportunities for Black nurses to<br />

support and shape ANA policies.<br />

3. Persistent tokenism.<br />

4. Limited recognition of Black nurses’<br />

contributions to the profession.<br />

5. Lack of significant increases in the number of<br />

Black registered nurses.<br />

6. No recognition of achievement with awards<br />

(other than the Mary Mahoney Award).<br />

7. Limited appointments of Black nurses to<br />

committees and commissions.<br />

In 1973, in her first address to the newly<br />

created National Black <strong>Nurse</strong>s Association<br />

(NBNA), Dr. Sams considered the question of why<br />

a Black <strong>Nurse</strong>s Association was needed:<br />

“No, I am speaking about all the past deficits<br />

and discriminatory practice which have<br />

continuously disgraced and limited the full<br />

potential, the development, the selfhood,<br />

and the self determination of Black folk. I am<br />

speaking about today, Here and Now.”<br />

In telling the history of the formation of the<br />

NBNA, the article From Invisibility to Blackness:<br />

The Story of the National Black <strong>Nurse</strong>s’<br />

Association by Gloria R. Smith notes that there<br />

was a desire on the part of the <strong>Nurse</strong>s’ Associated<br />

Alumnae of the United States and Canada and<br />

ANA for Black nurses to be members, but these<br />

professional associations granted them few<br />

privileges “other than paying dues” (1975, p. 225).<br />

Although by 1964 there were no tangible rules<br />

preventing membership for nurses of color, it<br />

was evident that exclusionary practices and a<br />

failure to represent all nurses remained. Similar<br />

to the concerns raised by Black nurses, in 1974,<br />

led by Dr. Ildaura Murillo- <strong>Rhode</strong>, a group of 12<br />

Hispanic nurses who were also members of ANA<br />

came together to consider establishing a Hispanic<br />

<strong>Nurse</strong>s Caucus within ANA because “ANA was not<br />

being responsive to the needs of Hispanic nurses”<br />

(National Association of Hispanic <strong>Nurse</strong>s, <strong>2022</strong>).<br />

Ultimately, this core group and their organizing<br />

efforts led to the establishment of the National<br />

Association of Hispanic <strong>Nurse</strong>s (NAHN). Today,<br />

“NAHN members advocate, educate, volunteer,<br />

seek partnerships, and conduct programming<br />

in the Latino community to improve outcomes,<br />

elevate literacy, heighten education, and influence<br />

policy. We also work collaboratively with others<br />

to improve health equity and to create a future in<br />

which everyone regardless of race or ethnicity has<br />

opportunities to be healthy.”<br />

ANA recognizes that issues of racism persist<br />

today and continue to harm nurses of color.<br />

Findings from the Commission’s 2021 national<br />

survey on racism in nursing (n = 5,600) noted<br />

that racist acts are principally perpetrated by<br />

colleagues and those in positions of power. Over<br />

half of nurses surveyed (63%) said they had<br />

personally experienced an act of racism in the<br />

workplace with the transgressors being either<br />

a peer (66%) or a manager or supervisor (60%).<br />

Fifty-six percent of respondents also noted that<br />

racism in the workplace has negatively impacted<br />

their professional well-being. During listening<br />

sessions with nurses of color convened by<br />

ANA and the Commission, persistent themes of<br />

stereotyping, prejudice, discrimination, exclusion,<br />

oppression, tokenism, inequity, and insistence<br />

on conformity and assimilation were found<br />

(National Commission, 2021). The impact of these<br />

experiences is demoralization, exhaustion, spirit<br />

murder (murder of the soul), invisible workload,<br />

silence, invisibility and self-doubt.<br />

“The power in nursing is primarily held by middleage<br />

to old-age white women who have just<br />

recently begun to consider racism in nursing care.<br />

There are racist principles that have been carried<br />

down through history and never challenged.”<br />

(Anonymous Quote, National Commission to<br />

Address Racism in Nursing, 2021)<br />

Seeking Forgiveness<br />

As leaders of ANA, we apologize for the<br />

named and the unaccounted-for harms. Our past<br />

actions have caused irreparable physiological,<br />

psychological and socioeconomic harm, not only<br />

to nurses of color but to all patients, families and<br />

communities that depend on ANA as the national<br />

leader of the nursing profession. We failed to live<br />

up to the professional values established through<br />

the Code of Ethics for <strong>Nurse</strong>s (ANA, 2015) and<br />

our social contract that guides the relationship<br />

between the nursing profession and society<br />

and their reciprocal expectations (ANA, 2010).<br />

In addition, as ANA sought to “professionalize”<br />

nursing, we failed to support a robust education<br />

approach that included the appropriate<br />

preparation to care for ALL our patients,<br />

especially patients of color.<br />

More specifically, we apologize to all nurses<br />

of color. Not only is the profession richer for your<br />

Racial Reckoning Statement continued on page 8

Page 8 • <strong>Rhode</strong> <strong>Island</strong> <strong>Nurse</strong> <strong>August</strong>, September, October <strong>2022</strong><br />

Racial Reckoning Statement continued from page 7<br />

having persisted, but the people you cared for<br />

and continue to care for today have been better<br />

served. ANA failed to uphold your work and<br />

support you as you advanced in nursing and<br />

worked to improve the profession. Having failed<br />

you, ANA also failed in supporting and caring<br />

for communities of color and other marginalized<br />

people.<br />

We apologize to the ethnic-minority nurse<br />

associations that have ably represented the<br />

needs of their nurses and communities. Early<br />

in the profession’s history, there was a stated<br />

desire for one association to meet the needs of all<br />

nurses. ANA only represented the needs of some<br />

nurses and some patients. <strong>Nurse</strong> leaders of color<br />

stepped into the breach. ANA’s failure to lead<br />

resulted in a fragmentation of the profession that<br />

contributed to a fragmentation in nursing care for<br />

minoritized communities.<br />

Moving Forward<br />

As important as it is to reconcile ANA’s history,<br />

our path points toward the future and actions<br />

that should be taken as a means of holding ANA<br />

accountable, continuing reconciliation to repair<br />

the breach and becoming a restored association.<br />

Each of the actions below will lead to additional<br />

actions and efforts as ANA continues the journey.<br />

Therefore, the ANA Board of Directors will:<br />

• Continue to reckon with and apologize for<br />

past harms that are made known to ANA.<br />

• Engage in direct reconciliation with each of<br />

the ethnic-minority nurse associations.<br />

• Develop and implement a diversity, equity<br />

and inclusion impact analysis that is<br />

considered in all policies and positions of the<br />

association.<br />

• Initiate an oral history project dedicated to<br />

amplifying the contributions by nurses of<br />

color to ANA and the nursing professions.<br />

Therefore, the American <strong>Nurse</strong>s Association<br />

will:<br />

• Continue to serve as a partner in and<br />

support the National Commission to<br />

Address Racism in Nursing as it strives<br />

to create antiracist practices and<br />

environments.<br />

• Advocate for and follow established<br />

guidance on the reporting of race and<br />

ethnicity in professional journals and<br />

publications.<br />

• Advocate for appropriate representation and<br />

inclusion in textbooks and other educational<br />

material.<br />

• Actively engage in a program of diversity,<br />

equity and inclusion within the association.<br />

• Provide transparency into the race and<br />

ethnic makeup of the ANA Board of<br />

Directors, leadership and staff.<br />

• Deliberately work to build diversity within<br />

ANA’s volunteer and governance structure.<br />

Conclusion<br />

We, as ANA, are on a journey — a journey of<br />

reckoning and reconciliation, forgiveness, and<br />

healing. This journey will take some time, but it<br />

is one that ANA is fully committed to. We invite<br />

others to join us as ANA seeks to strengthen<br />

who we are as a professional association and<br />

the broader nursing profession through inclusion,<br />

diversity and equity as we strive for antiracist<br />

nursing practices and environments.<br />

“As nurses we need to unlearn much of what<br />

we thought we knew about racism — and get<br />

comfortable being uncomfortable about our<br />

profession and our own way of being — need<br />

to see nursing through a new lens and be<br />

open to what we might see versus stating that<br />

racism does not exist.”<br />

(Anonymous Quote, National Commission to<br />

Address Racism in Nursing, 2021)<br />

References<br />

American <strong>Nurse</strong>s Association. (2015). Code of ethics<br />

for nurses with interpretive statements. American<br />

<strong>Nurse</strong>s Association.<br />

American <strong>Nurse</strong>s Association. (2010). Nursing’s social<br />

policy statement: The essence of the profession.<br />

American <strong>Nurse</strong>s Association.<br />

American <strong>Nurse</strong>s Association. (1976). One strong<br />

voice: The story of the American <strong>Nurse</strong>s<br />

Association. American <strong>Nurse</strong>s Association.<br />

Carnegie, M.E. (1991). The path we tread: Blacks in<br />

nursing, 1854-1990. National League for Nursing<br />

Press.<br />

Hine, D.C. (1989). Black women in white: Racial<br />

conflict and cooperation in the nursing<br />

profession 1890–1950. Indiana University Press.<br />

National Association of Hispanic <strong>Nurse</strong>s. (2021).<br />

History. https://www.nahnnet.org/history.<br />

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

(2021). Defining Racism. final-defining-racismjune-2021.pdf<br />

(nursingworld.org).<br />

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

(2021). Summary Report: Listening Sessions<br />

on Racism in Nursing. final-racism-in-nursinglistening-session-report-june-2021.pdf<br />

(nursingworld.org).<br />

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

(<strong>2022</strong>). Survey Shows Substantial Racism in<br />

Nursing. (nursingworld.org).<br />

Sams, L. (1973, September). Presidential Address.<br />

National Black <strong>Nurse</strong>s Association. Cleveland;<br />

Ohio.<br />

Smith, G.R. (1975). From invisibility to blackness: The<br />

story of the National Black <strong>Nurse</strong>s Association.<br />

Nursing Outlook, 23(4), 225-229.

<strong>August</strong>, September, October <strong>2022</strong> <strong>Rhode</strong> <strong>Island</strong> <strong>Nurse</strong> • Page 9

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