Indiana Bulletin - May 2021

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THE BULLETIN

Volume 47 • Number 3

May, June, July 2021

Brought to you by the Indiana Nurses Foundation (INF) and the Indiana State Nurses Association (ISNA) whose

dues paying members make it possible to advocate for nurses and nursing at the state and federal level.

Quarterly publication direct mailed to approximately 2,300 RNs and electronically via email to 65,000+ RNs licensed in Indiana.

MESSAGE from the PRESIDENT

INSIDE

Emily B. Sego

DNP, RN, NEA-BC

National Nurses Week is May

6th – May 12th. The Indiana

State Nurses Association would

like to thank you for all you

do! Your continued advocacy

for the nursing profession

and persistent fight against

COVID-19 helps bring a renewed

hope across Indiana. We hope

that you take time out to

celebrate National Nurses Week

with your teams and colleagues.

ISNA Announcement – What is New?

The Indiana State Nurses Association Board of

Directors has some exciting news to share! At our

March meeting, the Board of Directors voted to change

the bylaws to include both a President and President-

Elect to serve on the board starting this year.

What does this mean?

Instead of electing a Vice President, members will

now vote for President-Elect that will become the

President after serving as Elect. The President-Elect

will serve the first year in an observatory role which will

allow the officer to learn more about the President role

and obtain historical knowledge prior to taking his or

her seat as President for the following two years. Once

seated, the outgoing President will then mentor the new

President for a one-year term.

When will this begin?

The Board of Directors voted that changes to the

bylaws will go into effect May 7th, 2021.

How does this impact the current election?

The Call for Nominations was originally shared as

a call for the VP and President roles. After further

consideration and concern for delaying a positive

transition for the Board and ISNA, the role was

announced through the ISNAbler, our Nursing Network

website, and on Facebook. The Call for Nominations

deadline was extended by two weeks. Each nominee was

notified of the change and was provided the opportunity

to adjust their intent to run for available positions.

Why is this change important?

This change in the bylaws will allow the Indiana State

Nurses Association ample time to train, educate, and

mentor our future Presidents. In talking with nurses of

various backgrounds across the state about why they do

not apply for Vice President and President positions in

particular, many do not feel they have the proper training,

education, and/or mentorship to be successful. Having

both a President and President-Elect also provides

consistency for times when we have high board turnover

all at one time. When this occurs, you risk losing historical

information and perspectives critical to decision making.

We also believe these changes will promote a larger,

more diverse, candidate pool and will encourage those

who previously would never think of running to consider a

position with the ISNA Board of Directors.

A great way to start your engagement is to join

us for an open board meeting and serve on an ISNA

Committee. Follow the Event Calendar on the website

for more information. If you have been contemplating

running for the ISNA Board, we hope our new cadence

and role will provide growth and learning opportunities

for new and future board officers. I highly encourage

you to consider running for President-Elect or any of the

positions that might interest you in the future. Serving

on a board is a great way to give back to your profession

and a valuable way to learn new skills as a leader.

Stop the Slander: Focus on the Patient

Page 4

Community Health, Connections, and

COVID-19: Coming Full Circle

Page 5

2021 ISNA Policy Conference Goes Remote

Page 8

ISNA’s Bookshelf: Sanditon

Page 9

Year of the Nurse: How to Celebrate

Page 10

Jean Ross: Will 2021 be the Year of the

Nurse at the Statehouse?

Page 17

current resident or

Non-Profit Org.

U.S. Postage Paid

Princeton, MN

Permit No. 14


2

The Bulletin May, June, July 2021

THE BULLETIN

Magnet and Pathway Recognition

ISNA would like to recognize healthcare organizations

that are making a commitment to safeguard clinician’s

well-being and creating a positive practice environment

for our nurses. With 25 Magnet and nine Pathway

designated sites across Indiana, #IndianaNurses are

practicing in a state in which promotes excellence in care

delivery, in addition to safe and healthy environments

in which we are providing care. Please join me in

celebrating newly (within the last 12 months) designated

Magnet and Pathway sites, and those that continue

striving for excellence with Magnet Redesignation.

The Pathway to Excellence Program® – the

premier designation for healthy work environments –

recognizes health care organizations that demonstrate

a commitment to establishing the foundation of

a healthy workplace for staff. Pathway Standards

impact a range of factors that influence bottom-line

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and Kentucky Children’s Hospital, all part of the University of

Kentucky HealthCare system.

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• Tuition benefits • Nursing professional advancement program

• Comprehensive benefits package including

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· BSN to DNP

results, such as employee turnover, job satisfaction

and engagement, productivity and teamwork, nursingsensitive

quality indicators, errors and safety events,

and patient satisfaction.

Congratulations Indiana University

Health Paoli (Redesignation)

The Magnet Recognition Program designates

organizations worldwide where nursing leaders

successfully align their nursing strategic goals to improve

the organization’s patient outcomes. The Magnet

Recognition Program provides a roadmap to nursing

excellence, which benefits the whole of an organization.

To nurses, Magnet Recognition means education and

development through every career stage, which leads

to greater autonomy at the bedside. To patients, it

means the very best care, delivered by nurses who are

supported to be the very best that they can be.

Congratulations Schneck Medical

Center (Redesignation)

Thank you to all of Indiana’s 34 designated sites.

From greater nurse satisfaction to improved patient

outcomes, discover the ways that ANCC’s Magnet and

Pathway programs can help drive your organization to

succeed, and for a detailed list of designated sites,

please visit nursingworld.org/organizational-programs/.

An official publication of the Indiana Nurses Foundation and

the Indiana State Nurses Association, 2915 North High School

Road, Indianapolis, IN 46224-2969. Tel: 317/299-4575. Fax:

317/297-3525. E-mail: info@indiananurses.org. Web site:

www.indiananurses.org

Materials may not be reproduced without written permission from

the Editor. Views stated may not necessarily represent those of the

Indiana Nurses Foundation or the Indiana State Nurses Association.

ISNA Staff

Katherine Feley, DNP, RN, NE-BC, CPPS, CEO

Blayne Miley, JD, Director of Policy and Advocacy

ISNA Board of Directors

Emily Sego, President; Beth Townsend, Vice President; Barbara

Kelly, Treasurer; Angela Mamat, Secretary; Directors: Shalini

Alim, Brian Atwood, Jolynn Kuehr, Susan Waltz and Recent

Graduate Director, Andrea Jacobs

ISNA is a multi-purpose professional association serving

registered nurses since 1903. ISNA is a constituent member of

the American Nurses Association.

ISNA Mission Statement

ISNA works through its members to promote and influence

quality nursing and health care.

ISNA Pillars

ISNA accomplishes its mission through unity, advocacy,

professionalism, and leadership.

Address Change

The INF Bulletin obtains its mailing list from the Indiana Board of

Nursing. Send your address changes to the Indiana Board of Nursing

at Professional Licensing Agency, 402 W. Washington Street, Rm

W072, Indianapolis, IN 46204 or call 317-234-2043.

Bulletin Copy Deadline Dates

All ISNA members are encouraged to submit material for

publication that is of interest to nurses. The material will be

reviewed and may be edited for publication. To submit an article

mail to The Bulletin, 2915 North High School Road, Indianapolis,

IN. 46224-2969 or E-mail to info@indiananurses.org.

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and November. Copy deadline is December 15 for publication in

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the staff, board, or membership of ISNA or those of the national

or local associations.

Courses address current topics including global health,

evidence-based practices and informatics.

Flexible course delivery

Valuable practice experiences


May, June, July 2021 The Bulletin 3

CEO NOTE

4….7…….8……..

Katherine Feley, DNP, RN, NE-BC, CPPS

Chief Executive Officer

Self-care is different

for everyone. The Oxford

Dictionary (2021) defines selfcare

as the practice of taking

an active role in protecting

one’s own well-being and

happiness, in particular during

periods of stress. Self-care

is also a journey and positive

results may not happen

overnight, but a good night’s

rest is always a great start.

I was recently reminded of

a simple favorite, the 4-7-8 breathing technique. For

me, it works like a charm, every time. Whether I am

trying to relax before sleep or clear my mind during the

day, the counting and steadiness brings me back to

my center. Last Bulletin, I asked you to take a pause

with me. This time I am asking that you take a longer

pause;

• Breathe in, counting 4 seconds, through the nose

• Hold the breath for a count of 7

• Exhale through the mouth for 8 seconds

• Repeat

This can be done in various counts like 5-5-5 or

4-4-6. Choose your own count!

ISNA is focused on sharing different ways to

promote self-care in hopes that one or many might

fit your journey. We plan to add programs that engage

our community through socializing in various ways and

introducing health lifestyle habits, all while remaining

focused on professionalism, growth, and advocacy. I

encourage you to join us as a member and to engage

in the ISNA community to build resilience and add

to your self-care toolbelt. Membership dues directly

support new programs and your benefits. Thank you to

our new and long-term members for your support!

Looking back (ICYMI):

✓ We had a great Advocacy Day! Thank you to both

our attendees and speakers that made this such

a fruitful activity. The invigoration of an advocacy

event like ISNA’s Advocacy Day is both enjoyable

and informative. Catch the full review in Blayne’s

write up later in this issue.

✓ Launch of the National Commission to Address

Racism in Nursing led by ANA

✓ 21 Day Kickstart – We just finished our first

ever 21 Day Kickstart with member and author

Joanne Evans in which we learned how to plan

and sustain a plant-based diet. We had fun

while dedicating time and action to improving

our nutrition which led to better sleep, improved

mood, and even weight loss.

✓ Certified Nurses Day and Launch of the Success

Pays- New Member Benefit

✓ An INF Scholarship Awarded to an ISNA

Member to attend AHA’s Accelerating Health

Equity Conference – Congratulations Theresa

Fullenkamp!

✓ More and more additions to RNPerks through

ANA ~ Happy Shopping!

I can’t spill all of the spring jellybeans but we have

new projects launching soon:

• Celebration of Nurses Month – May 2021

• Release the Fourth Edition of the Nursing: Scope

and Standards of Practice

• ANA Membership Assembly and Advocacy Day –

June 2021

• Ride & Raise for National Nurses Month - ISNA

will be joining our local colleagues at Ride

& Raise to donate to the American Nurses

Foundation while we exercise and meditate

May8th-22nd See Page 17 for more info!

• Emphasis on Diversity and Inclusion

• More collaborations!

• More scholarships!

ISNA along with our professional partners The

Indiana Center for Nursing, Indiana Organization of

Nursing Leaders, Indiana Student Nurse Association,

and Indiana League for Nursing and the Education

Council of Indiana Nursing Deans and Directors

invite you join us for a 12 week text initiative to

promote well-being and resiliency. Opt-in by texting

RNconnectIN to 60298 to receive resources and

activities by nurses, for nurses. Refresh, de-stress, and

revive! Membership is not required to participate. Msg

& Data rates may apply.

You are not too late, too early, but just in time.

Being a member of your professional organization

is more than just a resume builder. It is becoming a

friend and an ally in a community of fellow nurses. It

is a way to show pride in the power of nursing and a

perfect way to support YOU in becoming the best

nurse you can be!

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4

The Bulletin May, June, July 2021

MESSAGE from the INF PRESIDENT

Jo May

President Indiana Nurses Foundation

It is hard to believe we are

well into 2021 with all this new

year has to offer. In the last

publication, I discussed that

the INF Board was focused

on reviewing our mission

and growth strategy for the

foundation. We want to be a

foundation that stands out as

supporting Indiana nurses and

the nursing profession. One

good thing that came out of

social distancing in 2020 was the need for INF to look for

new opportunities to grow funds as our historic fundraising

luncheon was not a possibility. This new vision launched

much discussion and many new opportunities for the

foundation’s future.

One of the first gaps we focused on was the listing

of INF in a charity navigator so people looking for

organizations to support can find us. Sadly, it is a fear

of donors that some organizations take advantage of

generosity. People who are looking to help often use a

charity navigator to make sure their contribution is being

used for work they want to support and that funds are

being managed wisely with little to no administrative fees.

INF has started the application to be listed as a nonprofit

foundation with Candid. Candid was established

when Foundation Center and GuideStar joined forces in

2019. On their website they say, “Every year, millions of

nonprofits spend trillions of dollars around the world. We

ONLINE convenience,

QUALITY education

We offer over 30 continuing education

programs for health professionals

From anticoagulation therapy to wound

management. Designated contact hours

for pharmacology for APRNs! Learn your

way with live, independent study, online

interactive, and hybrid programs.

Education in Your Own Time and Place

http://www.usi.edu/health/center-for-healthprofessions-lifelong-learning/certificate-programs/

877-874-4584

In support of improving patient care, the University of

Southern Indiana Center for Health Professions Lifelong

Learning is jointly accredited by the Accreditation

Council for Continuing Medical Education (ACCME), the

Accreditation Council for Pharmacy Education (ACPE),

and the American Nurses Credentialing Center (ANCC), to

provide continuing education for the healthcare team.

find out where that money comes from, where it goes,

and why it matters. Through research, collaboration,

and training, we connect nonprofits, foundations, and

individuals to the resources they need to do good.” INF is

very excited to be part of this list so we can be found by

people who want to support Indiana nurses through giving.

In our outreach to learn more from other state nursing

foundations, we talked to a few who offer awards to

nurses in the way of financial support in a time of need.

Layoffs or decreased hours from the COIVD event stood

out to the INF board as an opportunity to help Indiana

nurses and this could eventually grow into a new focus of

the foundation. We are currently in discussion of how this

would expand the INF mission statement but are excited

about the possibility of this growth. If you would like to give

input on this topic please feel free to reach out to me by

email, at jomay.3181@gmail.com we would love to hear

your thoughts.

As we know, March was the month to honor

certified nurses and the INF board wanted to take

advantage of ISNA’s new participation in ANCC’s

Success Pays Program by offering some ANCC

certification scholarships over the year. Please look for

more information on the ISNA/INF website for these

opportunities. We know certified nurses find more joy in

their work and their patient outcomes are benefited by

this increased skill set and knowledge.

In closing, we would again like to offer an open

invitation to attend an INF Board meeting, if interested,

please email me and I will be happy to send you

information on our next meeting. We would also welcome

any ideas you have for the foundation, especially as we

review our mission and vision.

Hiring Nurses in NWI

Approved NHSC Sites • FQHC Designations

Student Loan Repayment • Full Benefits

Work/Life Balance

To Apply, visit:

www.regionalmentalhealth.org

Stop the Slander:

Focus on the Patient

Angela Thompson DNP, RN, FNP-C, BC-ADM,

CDCES, FAANP

President of the Coalition of Advanced

Practice Registered Nurses

Over the last few

years there has been an

increasing trend among

physician groups to defame

non-physician healthcare

providers on social media,

news outlets, and other

platforms. It is unfortunate

that during the pandemic,

when Hoosiers desperately

need healthcare providers to

come together, the Indiana

State Medical Association

under a newly formed organization called the Indiana

Physician Coalition, has used their resources to

breed distrust and advocate for protectionist policies

that reduce availability of care. The division has the

potential to negatively impact many individuals seeking

care during the pandemic and serves to increase

mistrust and skepticism in the quality and safety of

care provided by non-physician healthcare providers.

Indiana is facing many challenges in securing

access to affordable, quality healthcare. During

this time, it is critically important that healthcare

professions make it a high priority to evaluate ways

that enhance, not further restrict, patients’ access to

healthcare. Actions to marginalize other healthcare

professions do not achieve this objective and ultimately

fail the patients who should be the main focus.

It is for this reason that the Indiana Coalition for

Patient-Centered Care (ICPCC) was developed. The

ICPCC is comprised of a diverse group of healthcare

professionals with the mission to increase access to

high-quality, cost-effective, patient-centered care with

particular focus on reducing healthcare disparities. The

ICPCC has representatives from many organizations

including the Coalition of Advanced Practice

Registered Nurses of Indiana, Indiana Center for

Nursing, Indiana Nursing League, Indiana Organization

of Nurse Leaders, Indiana State Nursing Organization,

Indiana Association of Nursing Students, Association

of Certified Nurse Midwifes, Central Indiana

Organization of Clinical Nurse Specialists, Indiana

Association of Nurse Anesthetists, Indiana Optometric

Association, and Indiana Pharmacists Association.

The ICPCC understands that the realities of today’s

healthcare environment are such that providers share

overlapping knowledge and skills within separate

disciplines. The ICPCC supports patient autonomy and

choice and will fight for the right of every Hoosier to

choose the health care provider of their choice. We

believe that all healthcare providers need to practice

at the top of their license, education and training to

ensure patients have access to individualized care and

patient-centered care. It is only through this version of

interdependent healthcare that a patient is truly at the

center of their care.

By working together through collaborative and

interprofessional care, the ICPCC aims to ensure

patients and communities understand the importance

of access to diverse healthcare teams to improve

overall health outcomes in Indiana.

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Health & Rehabilitation Center


May, June, July 2021 The Bulletin 5

Community Health, Connections, and COVID-19:

Coming Full Circle

Heather Anderson MSN, RN CNE

Teressa L. “Terri” Moore MSN, RN

Nursing students, faculty, and alumni from Indiana

State University (ISU) shared a unique opportunity to

work together during the COVID-19 vaccination efforts at

point of distribution (POD) sites set up by the Vigo County

Emergency Management Agency (EMA) and Vigo County

Health Department (VCHD) as part of the State of Indiana

and National COVID-19 response.

These vaccination efforts are far removed from one

year ago when the COVID-19 pandemic forced colleges

and universities across the country to suspend inperson

learning and transition to online learning. Many

hospitals and clinics were forced to reallocate their

staffing and redirect resources to other areas due to the

rapid spread of the COVID-19 virus resulting in the loss

of many of the clinical educational sites. Ultimately,

this loss was compounded by colleges and universities,

including Indiana State University, when nursing clinicals

were suspended until further notice. Nurse educators

were tasked with finding alternatives for replacement

experiences for these losses. Uncertainty became the new

reality for both students and faculty.

This uncertainty has been replaced with newfound

purpose and confidence through service at the vaccine

clinics. The National Council of State Boards of Nursing

(NCSBN) COVID-19 Policy Brief points to a shortage of

nurses in rural and urban areas to administer vaccines and encourages nursing

education program partnerships such as ISU School of Nursing, Vigo County

EMA, and VCDH partnership. Additionally, the NCSBN supports student nurse

participation under the supervision of faculty or other appropriate licensed

practitioners.

The authors provided student education including a review of Centers for

Disease Control and Prevention (CDC) COVID-19 protocol and safe practices, along

with manufacturer information and guidelines on proper storage, handling, and

injection techniques by both Moderna and Pfizer-BioNTech prior to their service

at the clinic. VCDH nurses Jane Keyes, Andrea Craft, Twyla Spidel, and Chelsea

Willis, all ISU nursing alumni, educated ISU nursing students regarding vaccine

clinic protocol including preparation of and proper vaccine handling, patient

screening, and documentation. Students were cross trained as educators, greeters,

runners, screeners, scribes, and vaccinators.

Student feedback from their experiences at the vaccine clinic include being part of

history, making a difference, feeling like part of a team, working side by side with other

schools of nursing, being accepted and respected by professionals and volunteers for

their participation, gaining real world experience during a pandemic, learning to make

due with limited resources, and learning the importance of public health. Hojnicki points

out, “What book or PowerPoint slide could teach the students what they take away from

this experience?” Keyes added, “The students who were able to participate in the public

health response to the COVID-19 pandemic are going to be more seasoned nurses.”

ISU Nursing student Maddie Sermershiem reflected on the experience, “There

is a feeling of unity when you walk through the door, you feel like you accomplish so

much.” The authors noted, “Partnerships like this enabled the students to have practical,

hands-on experiences they would not normally be exposed to in a traditional classroom or

clinical setting. The students will leave with lifelong memories they carry throughout their

nursing careers and beyond.”

The authors are both employed at Indiana State University School of Nursing as fulltime

instructors and teach Baccalaureate Degree Senior level Community Health Nursing

students. Both authors are active ISNA members and serve on the ISNA-PAC.

References

National Council of State Boards of Nursing. 12/15/2020. Policy Brief: COVID-19 Vaccine

Administration. https://www.ncsbn.org/COVID19VaccineAdministrationPolicyBrief.pdf

WE DON’T JUST

TREAT SYMPTOMS.

We take care of the entire person.

If you’re a nurse practitioner

interested in psychiatric or primary care,

contact us!

ISU Nursing Students at Clinic

Keyes said the past year she has seen COVID come full circle from identifying

the problem tracing outbreaks to now participating in the solution alongside ISU

nursing students and faculty at the vaccine clinic. The setting for the clinic was a

former Sears automotive garage and tire shop which had been empty for several

years.

Vigo County EMA Director Dorene Hojnicki, D.O. pointed out, “Things happen,

power outages, tornados, however, to come together as a community with limited

resources and flip an abandoned commercial garage to a fully functional vaccine

clinic is doing something.” Students were able to be a part of clinic’s transition. To

date, ISU students and faculty have provided nearly 600 hours of service towards

over 15,000 vaccinations provided by the mass vaccination efforts.

Text ASPIRE

to 89743

Or call us at

(317) 587-0500


6

The Bulletin May, June, July 2021

POLICY PRIMER

Blayne Miley, JD

bmiley@indiananurses.org

The 2021 Indiana General Assembly session

concluded in late April. The legislature will return in

mid-to-late May to determine this year’s interim study

committee topics. Topics assigned to interim study

committees will receive a public hearing in late summer

or fall. The legislature also will reconvene again this year

regarding redistricting.

This session, ISNA advocated on a variety of bills to

support nurses. Any bill language involving “veterinary

nurse” was stopped in its tracks. Provider neutrality was

advanced by replacing “physician” with more appropriate

and inclusive language in SB 82. Terminology related to

multiple nursing roles was amended to improve accuracy.

Here is a rundown of health care related legislation from

the 2021 session. Some of these bills are still in the final

stages of the legislative process as we go to press, so

they may pass into law in a different form or not at all.

More details on all of them can be found on the Indiana

General Assembly website: iga.in.gov.

COVID-19 & Immunizations

SB 1 COVID lawsuit immunity

Persons and businesses are immune from civil liability

for damages resulting from exposing others to COVID,

unless the plaintiff establishes by clear and convincing

evidence gross negligence or willful misconduct. The

immunity also applies to manufacturers and suppliers of

COVID personal protective equipment.

SB 5 Appeal of local health enforcement actions

Allows any entity (businesses, schools, churches, etc.)

subject to an enforcement action related to a declared

emergency by a local health department to appeal their

case to the local legislative body. Whether to stay the

enforcement, pending appeal is up to the discretion of the

local legislative body. Requires local orders that are more

stringent than statewide executive orders to be approved

by the local legislative body.

SB 202 Nursing home visitation

Requires nursing homes to allow visitation in specified

circumstances, even during a public health emergency.

Gives the health department oversight over denials of

visitation.

SB 292 COVID reporting

Requires the Department of Health to compile data

from health facilities and residential care facilities on

COVID cases and deaths, and to publish the data on their

website. The introduced bill also created a scholarship for

minority students pursuing a degree in health care, but

that component was removed by amendment.

HB 1002 Health care provider immunity

Protects health care providers from licensure

discipline regarding conduct during a declared state

public health emergency unless the conduct (1)

constitutes gross negligence or willful misconduct, or (2)

constitutes actions that are outside the skills, education,

and training of the health care provider, unless the health

care provider’s actions are undertaken in good faith and

in response to a lack of resources caused by a declared

state public health emergency. Sets forth specific

standards that make it more difficult to sue people/

entities related to COVID exposure.

HB 1079 Allow dentists to administer immunizations

Allows dentists with specified training to administer

immunizations. Also updates regulations on dentist

payment claims.

Nursing Practice & Education

SB 7 Forensic nurses education requirements

Requires forensic nurses to complete a biennial training

program administered by the Indiana SANE Training

Project or approved by the Board of Nursing. A certificate

of completion must be sent to the Board of Nursing. Any

forensic nurse working as of 6/30/21, is not required to

complete the training until 6/30/23.

SB 204 Advance directives

Allows advance directives to cover any aspect of a

patient’s health care. Allows advance directives to be

witnessed and notarized remotely. Allows APRNs and PAs

to fulfill the same duties as physicians with respect to outof-hospital

DNRs.

HB 1549 Education matters

Extends the expanded eligibility for nurse faculty from

2021 to 2023. This allows nurses pursuing graduate

education to serve as nurse faculty.

Health Care Provider Operations

SB 3 Telehealth overhaul

Changes use of telemedicine in Indiana Code to

telehealth. Prohibits any originating site or distant site

requirements under Medicaid. Provides that Medicaid

patients waive confidentiality for any information provided

during a telehealth visit that is heard by another individual

in the vicinity of the patient. Expands providers able to

participate in telehealth from prescribers to a broad list of

providers that includes all nurses.

SB 59 Occupational therapy services

Allows occupational therapists to treat patients without

a referral for 42 days. After 42 days, they must have a

referral from a listed healthcare provider, including an

APRN.

SB 82 Behavioral health referrals

Establishes requirements for a behavioral health

professional (social worker, marriage and family therapist,

mental health counselor, or clinical addiction counselor)

to perform a mental health diagnosis. If a behavioral

health professional performs a mental health diagnosis

and determines the patient has not seen a physician or

APRN in the last 12 months or has a physical condition

that requires medical attention, then the behavioral

health professional shall recommend that the patient see

a physician or APRN.

SB 240 Female genital mutilation

Creates a criminal felony for female genital mutilation.

There is an exception if the act is for medical purposes to

protect the patient. Establishes a duty to report anytime

a child is suspected to be the victim of female genital

mutilation. Any licensed health professional that performs

female genital mutilation shall have their license revoked.

SB 242 Attendant care services & lift equipment

Adds the use of lift equipment to attendant care

services. Requires a personal services agency that utilizes


May, June, July 2021 The Bulletin 7

lift services to have liability insurance covering them.

Requires employees to be trained on lift equipment that

is used.

SB 325 Hospital price disclosures

Increases the number of services a hospital must post

price information for.

HB 1032 Newborn drop boxes

Expands the allowable locations for newborn drop

boxes to include any facility staffed 24/7 by EMS or

certain fire stations.

HB 1040 Student cardiac arrest

Revises the protocols for monitoring and responding to

student cardiac arrest events. In the list of professionals

that can clear a student for return to activity, the original

version used “registered nurse practitioner,” but this was

amended to advanced practice registered nurse.

HB 1109 INSPECT reporting

Controlled substance prescribers only have to report

actual dispensations every 24 hours, instead of having to

report every 24 hours even if there were no dispensations.

HB 1225 Opioid treatment program prior authorization

Requires opioid treatment programs to obtain prior

authorization from the Department of Mental Health and

Addiction for patients receiving more than 14 days supply

of opioid treatment medication.

HB 1392 Military spouse licensure

When military spouses apply for a provisional license,

they do not have to submit a criminal history background

check. Instead the board they are applying to has to

verify whether they have a disqualifying criminal history.

HB 1405 Patient records & insurer regulations

Requires a health care provider to provide health

records to a patient within 30 days of the request.

Violations subject to a fine of up to $5,000. Makes

changes to insurer regulations.

HB 1421 Insurer and hospital/provider agreements

Modifies the permissible arrangements of contracts

between insurers and hospitals/providers.

HB 1454 Non-emergency transportation orders/

reimbursement

Prohibits certain limitations on Medicaid

reimbursement for non-emergency advanced life support

or basic life support transportation. Requires hospitals to

have protocols for nonemergency transportation based

on physician orders that can be certified by other health

professionals.

HB 1468 Suicide prevention and pharmacist scope of

practice

Gives the Department of Mental Health and Addiction

control over state government suicide prevention and

crises programs. Expands pharmacists scope of practice

regarding telemedicine, prescribing, supervision, and

substitution. Allows APRNs and PAs to make referrals to

pharmacists.

HB 1577 More abortion requirements

Adds mental health providers to the list of professions

that can opt out of providing services related to an

abortion. Sets forth additional requirements for abortions

and facilities that perform them. These include requiring

a physician to dispense any abortion inducing drug and

requiring the drug to be consumed in the physician’s

presence. Prohibits the use of telemedicine to provide a

prescription that results in an abortion.

EARN

1 CE

Public Health

SB 10 Maternal mortality review committee

Expands the cases that can be reviewed by the

statewide maternal mortality committee from those

deaths of women while pregnant or within one year of

pregnancy, regardless of cause. Adds mental health

providers to the entities that must provide records to the

committee.

HB 1001 State budget

Provides the two year budget for the state. Includes a

small increase to the cigarette tax.

HB 1007 State health grant program

Establishes the prevention and addressing of health

issues and challenges grant program to be administered

by the department of health. As amended by the Senate

Appropriations Committee, these grants must address at

least one of the following: (1) paths to quality training; (2)

loan forgiveness; (3) psychiatric residencies; (4) mental

health issues in schools; (5) lead exposure; (6) obesity;

(7) diabetes; (8) hypertension; (9) cancer screening; (10)

acute hepatitis C; or (11) other critical health issues for a

specific region, county, sex, or ethnicity that ranks in the

bottom quintile for that specific health issue metric.

HB 1177 State plan on dementia

Instructs the Department of Health to develop a

statewide strategic plan on dementia through an advisory

council. Specifies the members of the council.

HB 1203 Department of Health reorganization

Extends the syringe exchange program through 2026.

Changes the department’s name from Indiana State

Department of Health to Indiana Department of Health.

Removes certain powers of the executive board. Allows

physicians employed by the department to practice

individually, outside their department responsibilities,

without the department being liable.

HB 1340 HIV terminology

Updates statutory terminology related to HIV.

HB 1402 All payer claims database

Establishes a statewide database of healthcare

cost and quality data. Creates an advisory board with

specified membership that does not include a dedicated

spot for nurses.

Time to start thinking about 2022

Even though the 2021 session just recently

concluded, it is already time to plan for 2022. Over the

summer is a great time to develop rapport with your

individual legislators! Additionally, ISNA welcomes any

suggestions for your ideas about how Indiana health

care policy can be improved; email me at bmiley@

indiananurses.org.


8

The Bulletin May, June, July 2021

2021 ISNA POLICY CONFERENCE GOES REMOTE

By Blayne Miley, ISNA Director of Policy & Advocacy

In late January, ISNA hosted our annual policy conference. This year’s event

was different, in that it was completely online. While we missed seeing everyone

in person, it provided more convenience for statewide attendees and out-of-state

presenters. We were fortunate to have the following lineup of great speakers:

• Dr. Kristina Box - Indiana State Health Commissioner

• Rep. Cindy Ledbetter - member of the Indiana General Assembly and nurse

practitioner

• Brian Tabor - CEO of the Indiana Hospital Association

• Janet Haebler - ANA Senior Associate Director of Policy & State Government

Affairs

• Jean Ross - winner of the 2020 ISNA Policy Award

• Rebecca Eberhart - ISNA lobbyist and registered nurse

• Dr. Sharron Crowder - IU School of Nursing Faculty and RWJF Health Policy

Fellow

Attendees learned about the Health Department’s 2021 plans to combat

COVID-19 and infant mortality. They heard from a first-time legislator about her

experiences advocating for APRNs and patient choice. They heard about the

healthcare related bills introduced in the 2021 Indiana General Assembly session

from the perspectives of both the Indiana Hospital Association and the lobbyist

for ISNA. They had the opportunity to dialogue with experienced policy advocates

sharing their wealth of experiences and inspirations. All of this while earning

continuing nurse education contact hours. Also, a big thank you to ISNA Past

President Jennifer Embree, who ran the technical side of the event.

Jean Ross, presenting at the 2021 ISNA Policy Conference

Slide from Janet Haebler’s presentation

The goal of this event is to inform nurses about current health policy topics,

as well as to provide the tools and inspiration to be an effective health policy

advocate. I believe we succeeded in those goals this year. We are extremely grateful

for the wisdom and knowledge shared by our presenters. However, do not just take

my word for it, here is a comment we received from an ISNA Member and first-time

attendee: “Thanks for a terrific event yesterday! This was the first ISNA advocacy

day event I have attended, but I can tell you it won’t be the last. The speakers were

so amazing and inspiring! I am so glad that I set aside time to attend. Thanks,”

Karen Snyder, BSN, RN, CLSSBB, PMP.

I hope that you will be able to join us at our future events!


May, June, July 2021 The Bulletin 9

ISNA’s Bookshelf

Sanditon

Jolynn Kuehr DNP, RN, NPD-BC, NE-BC

What is the book you are reviewing this month?

I opted to review a fictional novel entitled Sanditon by

Jane Austen. This novel is the last work of Jane Austen.

She completed only the first eleven chapters of the novel,

beginning the work in January of 1817 and ending her work

on the novel on March 18, 1817, due to her failing health

at the time. Austen died July 18, 1817 with the novel

unfinished. Since her death, several other authors have

attempted to publish endings for the novel.

Sanditon is the story of the creation of a fictional seaside

resort on the south coast of England during the Regency

period (1817). The story revolves around the Parker Brothersthree

very different brothers working together to make the resort fashionable with the

latest trends such as sea-bathing, terraced apartments, and ballroom dancing. The

heroine, Charlotte Heywood, is a country girl who is brought to the town by the eldest

Parker brother, Tom, and his wife, Mary, in appreciation for the care they were provided

by her family after their carriage overturned near her family’s farm. Charlotte is warned

by her father about the different morals and values of people who frequent seaside

resorts. As the chapters unfold, various colorful characters are introduced to the reader,

many of whom display some questionable behaviors for the time period. It is a shame

the original story was never finished in the true Austen style of a romantic happy ending

for the heroine, and a social commentary on some of the behaviors described of the

town’s inhabitants.

Why review a fiction book that does not appear to have any connection to nursing or

health care?

For me, this story provided a much-needed escape from the difficult COVID 19

pandemic over the past year. Reading fiction is my self-care. Jane Austen has always

been my favorite author, and I’ve read many of her works, such as Pride and Prejudice

and Emma previously (often more than once). However, I had never read Sanditon. While

I love the romance and happy endings Austen provides in her novels, I also love her

description of society in England during the Regency period, especially as it relates to

women. Austen’s heroines are often shockingly independent within a society that is

dominated by men. Austen also weaves poor health into her stories. There is, usually, at

least one character in poor health, and it is fun to see the health care of that time period

provided to that character.

My interest in Sanditon actually began with a viewing of a Masterpiece production

based upon the novel that aired on public television in early 2020. The story was

continued beyond the original 11 chapters by Andrew Davies, a British writer wellknown

for television period pieces based upon famous works of English literature. The

production consisted of eight episodes, ending with a

“cliff hanger” romantic conundrum for heroine Charlotte

and the middle Parker brother, Sidney. As the pandemic

was bearing down on all of us, I joined several online

Sanditon “fandoms” and began participating in weekly

“Twitter Fests” to discuss the story and compare

the novel with the television production. Some of the

discussions even included the cast and crew from the Sanditon by Jane Austen

production, as many of them were in lockdown and

enjoyed interacting through social media. (In fact, we even crashed Twitter during one of

our weekly discussions!)

What does a novel like Sanditon offer to the nurses of Indiana?

One of the themes ISNA promoted to the nurses of Indiana during the pandemic was

the need for self-care. The pandemic put nurses at risk in so many ways, from exposure

to COVID 19 to increased anxiety levels related to professional and personal stressors.

Isn’t it interesting that a novel written in 1817 had self-care at its focus? The creation

of the sea-side resort at Sanditon was focused upon creating a place where individuals

could come to focus upon their personal health. The story explores practices such as

sea-bathing, exercise, and ingesting donkey milk, as methods by which personal health

could be restored after periods of both physical and mental illness. Similarly, we are

also focusing on practices such as exercise, meditation, and massage that can improve

our self-care and restore many of us to a healthier disposition. As we read about 1817

version of self-care the novel describes, we are allowed a period of escape to a time

quite different from our own with characters we can come to love.

Because of this story and my involvement with its fandoms, I now have friends all

over the globe who share my interest in Jane Austen and Sanditon. I even correspond

with two pen pals via old-fashioned letter-writing, whom I met through one of my online

fandoms. We continue to chat via social media and hope to meet each other in person

once the pandemic dissipates.

As nurses, we know the importance of self-care for our physical, mental, and

emotional health. If you enjoy reading, consider taking a journey with a fictional novel to

escape the daily stressors of life. Especially at this time, when physical travel is difficult

at best, a fictional novel may provide you a means of escape that enables you to grow in

knowledge of new times and places and relationships that you never thought possible.

What’s next on your reading list?

I’m one of those people who has a pile of various books waiting on me at all times.

My next book is going to be in the non-fiction realm with White Fragility: Why it’s So

Hard for White People to Talk About Racism. I will be participating in a book club

discussion about this book with work colleagues. However, I also intend to continue with

a fictional book, too – The Survivors by Jane Harper.

---

Jolynn Kuehr DNP, RN, NPD-BC, NE-BC is currently a senior education specialist with

Community Health Network and Director at-large for ISNA. She is part of the Core RN/

LPN Orientation team and oversees the network’s new graduate nurse residency program,

as well as the network’s nursing competency program. Jolynn has been a nurse for over

35 years and has worked in both critical care and long term acute care environments, as

well as nursing education. Her passion is nursing professional development and finds

fulfillment in guiding nurses along their chosen career-path.

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10

The Bulletin May, June, July 2021

HOW TO CELEBRATE

Suggestions for Celebrating

& Elevating Nursing

Nurses, this is your time. Never in history has the

world been so focused on the profession of nursing.

You have proven to be compassionate, innovative,

and resilient in the face of the biggest public health

crisis of this century. ANA Enterprise joins with the

World Health Organization and global colleagues

in extending the Year of the Nurse and Midwife

into 2021 because of the impact of the pandemic.

Recognizing the challenges ahead, it’s important to

look for opportunities to inspire, infuse leadership,

and foster innovation in the months ahead. Below are

suggestions for how you can continue to excel, lead,

and innovate throughout the coming year as the

nation’s most trusted working professionals.

EXCEL

Nurses, you did the extraordinary in 2020. Make 2021 the year to reflect

on your accomplishments, build upon lessons learned, and infuse self-care

strategies and practices into your life.

Self-care is essential. The American Nurses Foundation created the

Well-Being Initiative to support your mental health and resilience

because it’s you, nurses who are really feeling the impact of the

COVID-19 pandemic. There’s a host of online resources and tools

dedicated to helping nurses cope with a variety of issues like lack of

sleep, grief, and finances. You will also find familial support, webinars,

and mood-boosting podcasts.

Connect with a mentor. During these uncertain times when you may be

isolated from loved ones and facing difficult working conditions, having

a mentor who can advise you and offer other helpful advice could be

a pivotal step in successfully managing during this challenging time.

ANA also offers its members a Mentorship Program. Enrollment for the

Class of 2021-2022 Mentorship Program will open during the summer

of 2021.

Utilize the resources. Visit ANA’s COVID-19 Resource Center to find

other helpful tools and information to stay agile and resilient during

these challenging times. Register for the free webinar, What’s Happening

in Nurse Staffing? To learn how to use the revised principles of nurse

staffing in day-to-day nursing practice to help alleviate the burden on

nurses and our overwhelmed hospitals. Share the revised nurse staffing

principles with your team and determine an action plan for 2021.

Knowledge is power. Nurses, you are on the frontlines responding to

the COVID-19 pandemic, caring for infected patients, and educating

the public about prevention and vaccination. Therefore, as the nation’s

most trusted working professionals, it’s vital you stay current on the

latest COVID-19 case statistics, COVID-19 vaccines and distribution, and

ensure you receive consistent information from your employers in order to

continue to educate your community. The American Nurses Credentialing

Center (ANCC) Certification Program offers a variety of courses and

webinars which allow to you demonstrate your specialized knowledge and

continuing competence. Nurses should also reference ANA’s COVID-19

vaccine resources to reference helpful tools and information.

LEAD

Nurses—as the nation’s largest group of health care professionals and the

most trusted profession—you serve a critical role within America’s health care

infrastructure. Never has this been truer than during the COVID-19 pandemic.

We encourage you recognize your inherent leadership skills and to apply them in

your health care role and setting.

Inspire the next generation. This is a critical time in the nursing

profession, which has seen a dramatic increase in the need for nurses.

In order to combat nursing shortages, we need more people to pursue

nursing as a career. And we need to ensure we continue building a

diverse nursing workforce, to foster greater equity and inclusion in

health care. Connect with elementary and middle schools, career fairs,

community centers, and youth clubs to talk about your path to nursing

and inspire future nurses.


May, June, July 2021 The Bulletin 11

Exercise leadership skills. Make this the year

you learn more about how you can become

an advocate or serve on a board of directors.

Start by visiting Nurses on Boards for more

resources and updates on nationwide board

opportunities. If you are already contributing

to advocacy or board leadership, inspire

others to serve on boards by sharing your

“bedside to boardroom” story. And visit

ANA’s webpage on Legislative and Regulatory

Advocacy to learn how you can get involved.

Impact political change. Visit RNAction to

learn how you can ensure nurses’ voices are

heard by politicians. If you want to engage

more in political advocacy, participate in

your state or constituent nurses association’s

Legislative Day and ANA’s Hill Day in June.

These annual events provide the opportunity

for you to share your perspective as a nursing

professional and gain elected officials support

for crucial legislation.

Raise your voice with the media. Share your

perspective about the value of nursing and

nursing leadership amidst the challenges

of this pandemic and the need to continue

to invest in and elevate nursing. Reach out

to a reporter in your city who covers health

issues to recommend they do a story about

the “Year of the Nurse” or submit an editorial

to your local newspaper, commenting on

recent coverage of COVID-19 that would have

benefited from the perspective of a nurse.

Look for opportunities to self-identify as

a nurse. Introduce yourself to patients,

colleagues, and members of the community as

Nurse [Last Name]. Include your RN credential

on business cards, checks, credit cards, emails

signatures, and more. Take every opportunity

to educate others about nursing and show

pride in your profession.

Get social. Share a week of posts on your life

as a nurse. Give your social media followers

a glimpse into all you do with highlights

about your activities, colleagues, and nursing

moments where you make a difference.

#YON2021.

Inspire colleagues. Words of encouragement

and random acts of kindness can make all

the difference in a person’s day, especially

a nurse. Share inspirational messages or

a handwritten “words from a nurse” letter

to give the support, encouragement, and

motivation we all appreciate and occasionally

need to brighten the day.

Celebrate the power of great nursing. Honor

a nurse mentor, celebrate a nurse colleague,

or thank a special caregiver, nurse friend,

or family member with a contribution to the

American Nurses Foundation in their name.

Your donation will support innovations to

make care more patient-centered, financial

aid to students in need, and programs that

help nurses lead to better health.

INNOVATE

Nurses are natural problem solvers and innovators.

Innovations occur at all levels of health care and

nurses can and should be at the forefront, just like

Florence Nightingale, the first nurse innovator.

Consider participating in some of ANA’s interactive

opportunities to share your voice and learn how

nurses are leading innovation—you just might

become inspired to create the next big innovation!

Initiate an innovation. Nearly 70 hospitals

and health systems across the U.S. are

recognized for their innovation programs. If

your organization has an innovation program,

are there opportunities for you and your nurse

colleagues to support the program? If your

organization does not have an innovation

program, how can you start a nursing

innovation program that improves workflow,

efficiency, and patient care? Listen to the

ANA and Johnson & Johnson podcast SEE

YOU NOW to learn about what other nurses

are doing in this space and to get inspired. If

you do have an innovation you would like to

share, consider applying for the next cycle of

The ANA Innovation Awards.

Join or host a hackathon. Champion nurse-led

innovation by participating in or organizing a

platform that encourages nurses to bring their

ideas to life. Live-action events such as pitch

competitions or hack-a-thons are fun ways to

learn about innovation, design thinking, and

even failure. Check for corporate sponsored

events, local nursing schools, or state nurses

or business associations.

Share your experience. Are you a nurse

innovator or aspiring visionary who wants to

help build a culture of innovation? Consider

sharing your ideas, thoughts, and advice in a

blog post or writing an article for a nursing,

health care industry, or nursing school

publication.

Launch your idea. Do you have a nursingled

innovation you want to see through from

concept to reality? Consider launching your

idea at NursePitch TM a live, interactive event

for nurses to compete for a chance to turn

their innovation dreams into reality. There

is no time like now to start planning for the

2021 competition.


12

The Bulletin May, June, July 2021

IANS –

Connecting Students

Throughout Indiana

My name is Katie Gauker,

and I am the President of the

Indiana Association of Nursing

Students (IANS). IANS is an

organization consisting of

nursing students throughout

the state that aims to provide

educational, innovative, and

developmental events for our

members. We serve as the

Indiana chapter for the National

Student Nurse’s Association

(NSNA). The Board of Directors plans an annual

convention at different Schools of Nursing in Indiana.

This past January we hosted our first virtual convention

with great success. It showed us that we can be flexible

and adapt to anything that is thrown our way. At the

convention, students can network, hear from nationallyknown

speakers and vendors, and learn about different

opportunities.

Students are a valuable resource in every healthcare

setting. We hope to connect students to future employers,

educational opportunities, and professional development

opportunities. If you are interested in working with

students, need volunteers for an event, or would like

to possibly become a speaker or vendor at our annual

convention, please reach out to me at presidentians@

gmail.com. I look forward to speaking with you!

For more information on IANS, please visit http://

indianastudentnurses.org/what-we-do/ians-annualconvention.


May, June, July 2021 The Bulletin 13

This Is the Time for Nursing Research

Jessica Peterson, PhD, RN,

NODNA Director of Research

Reprinted with permission from Louisiana State Nurses

Association Pelican News July 2020 issue

Many nurses’ eyes glaze over when thinking of

research. Perhaps they are remembering a class in school

emphasizing knowledge of endless terminology and

statistics that seemed so removed from daily practice. This

aversion can carry over to evidence-based practice (EBP),

which most nurses would likely define as applying research

in practice. However, research is only part of the EBP

story, and there hasn’t been a better time to start changing

nurses’ minds about EBP and nursing research.

EBP is about applying research in practice; however,

it’s also about integrating research with one’s own clinical

expertise, and with patient preferences and values when

making health care decisions (Polit & Beck, 2017). Taylor

et al. (2016) make the distinction between defining EBP

as “implementation of interventions that are based on

evidence,” a traditional definition, and defining EBP as

“a way of practicing that is supported by evidence.” The

difference, though subtle, reflects the difference between

an attitude of EBP as a one-time intervention with a start

and an end, to an attitude of “this is how I practice”

(Taylor et al., 2016). An example may help clarify the

difference. In my practice as an orthopedic nurse caring

for patients following hip and knee replacements, one of

my goals was to control pain so patients could ambulate

as quickly as possible. Research showed the importance

of movement in this population (Guerra et al., 2015).

However, some patients did not want to take opioids for

pain management, fearing the addictive effects. Integrating

patient preferences into my practice meant that I needed

to use my clinical judgment to work with my patients to

find options that respected their preferences and allowed

us to meet the treatment goals of early mobilization. I was

by no means unique. Nurses do this every day. There are

many examples of care standards based on research, such

as using sterile technique for central line dressing changes,

turning immobile patients every two hours, and hand

hygiene before and after patient contact. Nurses take these

standards and individualize their care to each patient. This

is how evidence is integrated into daily care and leads me

to say: EBP is “the way we practice.”

The COVID-19 pandemic has presented many

challenges to nurses, not the least is that there is lack

of evidence to guide practice. However, we can learn

from research conducted during or following previous

pandemics. From these we have seen reflected the

moral dilemma that health care workers’ face when

balancing their dedication and professional commitment

to patient care with the fear of exposing themselves and

their loved ones to a virulent pathogen (Ehrenstein et al.,

2006; Fernandez et al., 2020; Maben & Bridges, 2020).

Research has provided evidence of the importance of

support strategies for those working during crises, such

as self-care and peer, team, and leader support (Maben

& Bridges). Many of these practices can be and are

implemented in work settings to support nurses and health

care workers. As time progresses, it will also be critical

that we monitor for potential long-term effects that have

been found following previous crises (Maben & Bridges;

Wu et al., 2009).

Beyond learning from and applying previous research

to practice, there is a need for more nursing studies.

Because COVID-19 is a new virus, there has been little

conclusive research regarding treatment and nursing

care. As a new infection, there were so many questions

in the beginning, such as: what are the presenting

symptoms? How is it spread? What risk factors lead to

some to severe illness? While we are starting to get

answers to some of these questions, there is still much

that is unknown. This presents many opportunities

for nurses. Certainly, there is an enormous amount

of research being conducted on the effectiveness of

different medications for treatments for COVID-19.

There are news stories almost daily about research

for a vaccine. Nurses are likely collaborating with other

health care disciplines and scientists involved in these

studies and trials. But there are many questions related

specifically to nursing care as well. What are nursing best

practices in caring for patients with COVID-19? How do

we best support patients and their families? How can

nurses across all areas of practice (e.g. community and

public health, long-term care, acute care) best care for

patients from prevention of Covid-19 to recovery?

I typed “COVID-19” into the PubMed search engine in

early March, shortly after the first case in Louisiana was

confirmed. If memory serves correctly, there were 700+

Visit nursingALD.com today!

citations at that time. In early June, I found over 18,000

citations when running the same search. I, for one, am

looking forward to learning from the contributions of my

fellow nurses who are adding to this body of evidence.

References

Ehrenstein, B. P., Hanses, F., & Salzberger, B. (2006). Influenza

pandemic and professional duty: family or patients first? A

survey of hospital employees. BMC Public Health, 6, 311.

https://doi.org/ doi:10.1186/1471-2458-6-311

Fernandez, R., Lord, H., Halcomb, E., Moxham, L., Middleton,

R., …Ellwood, L. (2020). Implications of Covid-19: A

systematic review of nurses’ experiences working in acute

care hospital settings during a respiratory pandemic.

International Journal of Nursing Studies, online ahead of

print. https://doi.org/10.1016/j.ijnurstu.2020.103637

Guerra, M. L., Singh, P. J., & Taylor, N. F. (2015). Early

mobilization of patients who have had a hip or knee joint

replacement reduces length of stay in hospital: A systematic

review. Clinical Rehabilitation, 29(9), 844-854. https://doi.

org/ 10.1177/0269215514558641

Maben, J. & Bridges, J. (2020). Covid-19: Supporting nurses’

psychological and mental health. Journal of Clinical Nursing,

online ahead of print. https://doi.org/10.1111/jocn.15307

Polit, D. F. & Beck, C. T. (2017). Nursing Research. Generating

and Assessing Evidence for Nursing Practice 10th Ed.

Philadelphia: Wolters Kluwer.

Taylor, M. V., Priefer, B. A. & Alt-White, A. C. (2016). Evidencebased

practice: Embracing integration. Nursing Outlook, 64,

575-582. https://doi.org/10.1016/j.outlook.2016.04.004

Wu, P., Fang, Y., Guan, Z., Fan, B., Kong, J., Yao, Z., …

Hoven, C. W. (2009). The psychological impact of the

SARS epidemic on hospital employees in China: Exposure,

risk, perception, and altruistic acceptance of risk. The

Canadian Journal of Psychiatry, 54(5), 302-311. https://doi.

org/10.1177/070674370905400504

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14

The Bulletin May, June, July 2021

It’s More Than the Paycheck: Nine Questions to Ask about Benefits

Denise Hancock, PhD, RN, LCCE

Reprinted with permission from

Louisiana Pelican News October 2020

After a handful of conversations with novice and

experienced nurses, I realized that while we have

many job opportunities, we don’t always have personal

finance knowledge to compare and choose between

jobs. Before you accept a job offer, you need to know

the full impact that wages and benefits will have on

your financial life. Benefits are a very important part

of your total compensation, whether you are single or

have a family.

Employers offer a variety of benefits to employees.

Some are valuable to you and others are not. In my

experience, the top three benefits for most nurses are

health insurance, disability insurance and retirement

plans. These are the benefits that can have the biggest

impact on your short and long term financial situation.

I will briefly describe the purpose and features of each

of these three benefits. I will include nine essential

questions to ask when you’re making an employment

decision.

# 1 Health Insurance

Unless you are covered by someone else’s health

insurance plan, you must have health insurance.

Health insurance is essential in our world for you to

obtain medical care for illness or injury. Many people

would say this is the most important employee benefit

and there is a growing number of healthcare providers

who will not even see patients without insurance

coverage. Most employers will offer at least one choice

for comprehensive health care coverage, some offer

more than one choice. The cost and benefits of health

insurance plans can vary widely. Do your homework

and make sure you understand how the health

insurance plan works and what the costs are.

• What type(s) of health insurance plan do you

offer? If you don’t understand the description,

ask questions until you do.

• What is the monthly premium for my employee

health insurance?

• What is my annual deductible? The deductible

is the amount you would have to pay out of your

own funds before the health insurance coverage

would begin.

• Who else can be covered on my health insurance

policy? What is the premium cost for each

person I add? If you have dependents, there are

usually options for a spouse and children. Some

employers will cover domestic partners.

• If you have existing health care issues, you may

want to ask more detailed questions about the

cost of co-pays, prescription drug policies, and

specific coverage issues. The details can add up

to big costs if you or your family members have a

chronic health condition.

# 2 Disability Insurance

Nursing is often hard physical work. If you get sick

or injured, you need disability insurance to maintain

your income so you can survive. While worker’s

compensation can help with on-the-job injuries, it does

not help you with other types of illnesses and injuries.

Disability insurance is critical, especially if you are

single or the primary wage earner in a household.

There are two major types, short-term and long-term

disability insurance.

Short term disability (STD) is a benefit that pays

a percentage of your salary for a specified amount of

time if you are ill or injured, and cannot perform your

job duties. A typical amount would be 40-60% of your

pay. Coverage may start anywhere from 1-14 days after

you have a health condition, and last from 60 days to

a year.

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If your condition lasts longer than the STD benefit

covers, then you need a long-term disability (LTD) plan

to kick in. LTD benefits can help you stay above the

poverty level if you become disabled and can’t work.

The amount of income that a LTD policy will provide,

and for how long, depends on the individual policy.

Some last only two years, while others may provide a

lifetime assurance.

• Do you provide short-term disability insurance

coverage? If yes, tell me the monthly premium

and key features of the policy.

• Do you provide long-term disability insurance

coverage? If yes, tell me the monthly premium

and key features of the policy.

By key features, you want to know two things about

each policy. How much would the dollar benefit be, as

a percentage of your pay, if you are disabled? When

would coverage begin and end? You want policies that

offer the highest percentage of pay for the longest

period of time.

# 3 Retirement Plan

Someday you will want to quit working. While it is

possible for a nurse to save for retirement without an

employer’s retirement plan, a good plan can make a

big difference for you. There are two basic types of

employer retirement plans, defined benefit and defined

contribution.

A defined benefit plan is also known as a pension

plan. This is a plan where the employer promises

to pay you a fixed amount of money at some time

in the future based on your years of employment

service to the company. The plan is funded by

the employer, investments are managed by the

employer and the future payment is guaranteed by

the employer. These plans are rare now, but were

common before 1990 and a few still exist. It’s a

great benefit if you plan to work at the same place

for a long period of time.

A defined contribution plan is usually called a

401(k) or 403(b) plan. This is the most common

type of retirement plan today. The plan is primarily

funded by you, the employee, and you receive

tax benefits on the money you contribute. You

participate in the management of funds in the plan

by choosing from a menu of investment options.

No future payments are guaranteed, the amount

of money in the plan depends on how investments

perform over time. If you leave the company, you

can take all or some of the plan’s balance with

you by rolling it to another retirement plan or an

individual retirement account.

Many employers, but not all, will contribute to a

401(k) or 403(b) plan. The most popular way for

employers to contribute is with a matching formula. A

few also give fixed contributions or contributions that

vary with company profits. Here are two examples of

employer contributions.

• Employer A matches 25% on the first 4% of pay

that you save. This means for every $1 you save,

your employer also puts $.25 into your plan, up

to 4% of your pay. If you save 4%, you get 1%

more from Employer A, for a total of 5% of your

salary.

• Employer B gives a fixed contribution of 3% to all

employees, plus a matching contribution of 50%

on 6% of pay that you save. If you save 4% of

your pay, you get 6% more from Employer C for a

total of 10% of your salary.

The numbers sound small, but over 10, 20 or 30

years, the difference in your retirement plan balance

can be huge.

Another important thing to know about a retirement

plan is the vesting schedule. Vesting is a term that

essentially means “ownership.” While you always own

the funds that you saved and put into your plan, you

may not own the employer’s contribution. If you leave

the employer before you are vested, you forfeit any

contributions that were made for you (and the earnings

on those contributions). Vesting schedules come in

three basic types:

Immediate vesting: Employees with this type of

vesting plan gain 100% ownership of the employer’s

matching money as soon as it is deposited. If you

leave any time, all the money in the account is yours

to take.

Cliff vesting: Cliff vesting plans transfer 100%

ownership to the employee in one big chunk after a

specific period of service (for example, one year). You

have no right to any of the employer’s contributions

if you leave before that period expires. Federal law

requires that cliff vesting schedules in a 401(k) or

403(b) plan to be three years or less. However, there

are some state retirement plans out there with vesting

schedules as long as 10 years.

Graded vesting: Graded vesting gives employees

gradually increasing ownership of matching

contributions as their length of service increases,

resulting in 100% ownership. For example, here is how

a five year graded schedule might look.

After Year 1 – You are 20% vested

After Year 2 – You are 40% vested

After Year 3 – You are 60% vested

After Year 4 – You are 80% vested

After Year 5 – You are 100% vested

In the five year graded vesting example, if you leave

the employer before five years are up, you only own the

percentage of the employer’s matching contributions

in which you are vested. If you leave the company

after your 2nd anniversary, you would only get 40% of

the funds that the company contributed to your plan.

The rest is forfeited, and returned to the company.

Federal law sets a six-year maximum on graded vesting

schedules in retirement plans. State retirement plans

may have different rules.

• What type of retirement plan(s) do you offer?

• How does the company contribute to my

retirement plan?

• What is the vesting schedule on employer

contributions to the plan?

I hope this broadens your understanding of

employee benefits. Health insurance and disability

insurance are ways to manage your risk of getting

sick or injured. When you can’t work, you can’t make

money. Retirement plans can help you to save for

retirement and, as a bonus, decrease your annual tax

burden while you work. If your employer doesn’t offer

these benefits, you can acquire them yourself, but is

more challenging and more expensive to manage as an

individual.

In summary, here are the nine questions about

employee benefits every nurse should ask before

accepting a job offer.

• What type(s) of health insurance plan do you

offer?

• What is the monthly premium for my employee

health insurance?

• What is my annual deductible?

• Who else can be covered on my health insurance

policy? What is the premium cost for each person

I add?

• Do you provide short-term disability insurance

coverage? If yes, tell me the monthly premium

and key features of the policy.

• Do you provide long-term disability insurance

coverage? If yes, tell me the monthly premium

and key features of the policy.

• What type of retirement plan(s) do you offer?

• How does the company contribute to my

retirement plan?

• What is the vesting schedule on employer

contributions to the plan?

These nine questions are a starting point, and

there may be other benefit questions that apply to

your personal situation. Benefits are an important part

of your compensation and can have a massive effect

over time on your personal finances. If you need help

in choosing benefit options, don’t be afraid to ask for

it. A personal financial advisor can help you make the

best choices for your personal and family needs. You

can find a fee-based advisor by asking friends and

family, or through professional websites like https://

www.napfa.org/.

You are worth every dollar.

Dr. Hancock is a second-career nurse. She earned

a Bachelor of Science in Economics from Oklahoma

State University in 1991 and worked in financial

services for 12 years. She was formerly a registered

investment advisor and studied employee benefits

through a certification program offered by the Wharton

School of the University of Pennsylvania. After making

a decision to change career paths, Dr. Hancock

completed her BSN at Oklahoma City University

(2006), MSN from University of Oklahoma (2008) and

PhD in Nursing Education and Administration from

William Carey University (2015). She currently serves

on the LSNA Board of Directors as Treasurer.


May, June, July 2021 The Bulletin 15

Managing Moral Distress

Cynthia Saver, MS, RN

The COVID-19 pandemic has added to the

burden of nurses’ daily work in many areas,

including forcing them into situations where they

feel moral distress. Failure to manage this distress

appropriately can affect nurses’ wellbeing and cause

them to leave the profession. But applying strategies

to help prevent moral destress or resolving moral

distress in a positive way can benefit both nurses

and organizations by promoting optimal patient care

and reducing staff turnover and the risk of litigation

from clinical errors.

What is moral distress?

According to the American Association of Critical-

Care Nurses (AACN) tool “Recognize & Address

Moral Distress”, moral distress occurs when someone

Moral distress strategy:

The 4 Rs

Cynda Hylton Rushton and Kathleen Turner

created a tool nurses can use to sort through

situations that can cause moral distress—the 4Rs.

• Recognize. The first step is to recognize

the situation for what it is. To do so, be

aware of the complexities related to the

patient, the patient’s family, and the care

team, including what each party wants to

happen and emotions that may affect their

perspectives.

• Release. Consider what you can change and

what you can’t. Let go of past experiences

that aren’t helpful in the current situation.

• Reconsider. You may need to reframe an

issue or view it in a new way. Be open to

fresh approaches and ensure everyone

understands each other’s perspectives.

• Restart. At this point, you may find you are

asking new questions or have new ideas

about how the situation can be moved

forward in a positive way.

Sources: Hilton L. 4Rs strategy offers a fresh

perspective to confront ethical challenges. Nurse.

com. 2020. www.nurse.com/blog/2020/09/15/4-rsstrategy-offers-a-fresh-perspective-to-confront-ethicalchallenges;

Rushton CH, Turner K. Suspending

our agenda: considering what will serve when

confronting ethical challenges. AACN Adv Crit Care.

2020;31(1):98-105.

“knows the right thing to do, but constraints, conflicts,

dilemmas, or uncertainty make it nearly impossible to

pursue the right course of action.” Moral distress differs

from burnout, which refers to physical, mental, and

emotional exhaustion caused by workplace stress, and

it differs from compassion fatigue, which is physical,

mental, and emotional weariness related to caring for

those in significant pain or emotional distress.

Causes of moral distress

Various situations, usually related to values

conflicts, trigger moral distress. Examples of these

situations include continuing what the nurse feels is

unnecessary treatment for a patient or witnessing

inadequate pain relief because a provider fails to

order adequate medication.

Many external factors can constrain or stop

nurses from acting in the way they wish, thus

contributing to moral distress. According to the

AACN tool, unit-level factors include inadequate

staffing, ineffective communication, working with

incompetent colleague(s), bullying, and lack of a

healthy work environment. Organization factors

include inadequate staffing, lack of resources,

pressures to decrease costs, hospital policies,

hierarchy of power, ineffective communication, and

financial limitations. If not addressed, these factors

can lead to the disturbing effects of moral distress.

Effects of moral distress

Moral distress affects both individuals and

organizations. In individuals, it can produce

symptoms that are emotional (frustration, anger,

anxiety, guilt, sadness powerlessness, withdrawal),

physical (muscle aches, headaches, heart

palpitations, neck pain, diarrhea, vomiting), and

psychological (depression, emotional exhaustion,

loss of self-worth, nightmares, reduced job

satisfaction, depersonalization of patients) in nature.

Repeated episodes of moral distress that aren’t

resolved can accumulate as “moral residue,” with

nurses ultimately experiencing burnout and leaving

their jobs—or even their careers.

Job attrition causes organizations to incur

turnover costs. More importantly, unresolved moral

distress can negatively impact the quality of patient

care, potentially leading to adverse patient events.

This not only affects an organization’s reputation in

the community, but it could result in greater liability

exposure from errors.

Taking action

What should you do if you are experiencing moral

distress?

Identify the source. The source may be a patient

care issue, a policy problem (such as how family

member meetings related to end-of-life issues are

Moral resilience

Developing resilience can help nurses cope

with moral distress more effectively. Strategies

include:

• Developing self-awareness (for example,

examine positive and negative assumptions

that may be guiding your behavior to see if

they are accurate).

• Learning to self-regulate to disrupt negative

patterns of thinking and behaving. Methods

to help with this include mindfulness-based

stress reduction, meditation, and movement

practices such as yoga and tai chi.

• Wisely discerning ethical challenges and

principled actions. This requires you to

understand your values and analyze ethical

dilemmas.

• Nurturing the willingness to take courageous

action. Keep in mind that when speaking up,

state your concerns clearly and calmly.

• Discovering meaning amid adversity. It may

help to keep a journal and to reaffirm your

values.

• Preserving one’s integrity, as well as the

integrity of the team, and others. Remember

that you can seek support from others, for

instance, by talking with trusted colleagues

or leaders.

Source: Rushton CH. Moral resilience: a capacity for

navigating moral distress in critical care. AACN Adv

Crit Care 2016;27(1):111-119; Rushton CH. Building

moral resilience to neutralize moral distress. Am Nurse

Today. 2016;11(10).

held), a lack of collaboration among team members,

or something else.

Conduct a self-assessment. Self-assessment

begins with determining the severity of the distress.

The Moral Distress Thermometer, developed by

Wocial and Weaver, is used for research, but also

can be helpful for clinicians. The thermometer asks

you to rate your distress on a scale from 1 to 10

and includes descriptions (mild, uncomfortable,

distressing, intense, and worst possible) to help with

the process. The results will give you a sense of how

urgently you need to act, and you can use the tool

to track changes in your distress over time.

Managing Moral Distress continued on page 16


16

The Bulletin May, June, July 2021

Managing Moral Distress continued from page 15

The second component of self-assessment is

determining your readiness to act. The “4A’s to

Rise Above Moral Distress,” published by AACN,

suggests asking yourself these questions:

• How important is it to you to try to change the

situation?

• How important would it be to your colleagues/

unit to have the situation changed?

• How important would a change be to the

patients/families on your unit?

• How strongly do you feel about trying to

change the situation?

• How confident are you in your ability to make

changes occur?

• How determined are you to work toward making

this change?

The AACN publication contains a rating scale,

but you also can simply reflect on whether you feel

you are ready to act. Listing the risks and benefits

of taking action may be helpful in making your

decision.

Keep in mind that in some cases the law will

compel you to take action. For example, your

state likely has laws requiring you to report child

or elder abuse. Failure to do so leaves you open

to legal liability. You’ll also need to consider if the

standard of care is being violated. In these cases,

failure to speak up can make you the target of a

state licensing board complaint, or a target in any

a lawsuit related to patient harm that occurs as a

result.

Develop a plan. Once you decide to take

action, consider when you will act, who will be

involved, and what resources are available to you.

For example, you may want to gather facts and

share your concerns with a trusted colleague to

ensure you have a sound plan. Your plan should

include self-care, as this will be a stressful time.

Resources to help you in assessing the situation and

developing a plan include the ANA Code of Ethics

with Interpretive Statements, your state board

of nursing (when a practice issue is involved), the

ethics consulting service in your hospital, and your

organization’s employee assistance program.

Make the case. Share your concerns with the

appropriate person(s). Present the facts in a calm,

respectful way. Consider timing and location—

unless the situation is urgent, you’ll want to bring up

the issue privately. Following the chain of command

is important, particularly if your concerns aren’t

being acknowledged. For example, if a physician

isn’t listening to your concerns about lack of

sufficient pain medication, you’ll want to involve

your immediate supervisor. If your supervisor does

not take action, move up to the next level. In the

case of non-clinical issues related to an individual

team member, you may need to speak to a human

resources representative.

Document. Document your conversations, including

whom you spoke with, the information conveyed, and

the response. If related to a patient situation, record

the information in the patient’s health record. If you

are dealing with a problem with a team member or

organizational policy, you should keep a personal

record, so you can trace the steps you took.

Prevention

Nurses, units, and organizations play a role

in preventing moral distress and addressing it

effectively should it occur. Nurses can enhance their

moral resilience (see Moral distress strategy: The

4 Rs) and participate in professional development

activities such as continuing education programs on

ethics.

The AACN tool identifies strategies for units and

organizations. Units can identify ethics champions

for peer support, create a committee to address

common areas that cause distress, and establish a

mentoring program for new staff.

Organizations can provide resources to support

staff (for example, an ethics consulting service),

provide education on topics such as debriefing,

adopt zero-tolerance policies for all forms of

violence, and offer programs that improve staff wellbeing.

Ultimately, the goal should be to create a

healthy work environment.

AACN has identified six standards for a healthy

work environment: skilled communication, true

collaboration, effective decision-making, meaningful

recognition, appropriate staffing, and authentic

leadership. A healthy work environment improves

nurses’ psychological health, job satisfaction, and

job retention; it also results in reduced patient

errors and patient mortality.

A partnership

Ideally, nurses and leaders should work together

to establish a health work environment that supports

nurses in many ways, including providing adequate

staffing and a mechanism for dealing with ethical

dilemmas, so moral distress is reduced. Nurses and

leaders should also partner to ensure that those

experiencing moral distress have the resources

needed to address the situation.

RESOURCES

AACN. Recognize and address moral distress. 2020.

www.aacn.org/clinical-resources/moral-distress.

American Association of Critical-Care Nurses Ethics

Work Group. The 4 A’s to Rise Above Moral Distress.

Aliso Viejo, CA: American Association of Critical-Care

Nurses; 2004.

American Nurses Association. Code of Ethics with

Interpretive Statements. 2015. www.nursingworld.

org/practice-policy/nursing-excellence/ethics/code-ofethics-for-nurses/coe-view-only.

Hilton L. 4Rs strategy offers a fresh perspective to

confront ethical challenges. Nurse.com. 2020. www.

nurse.com/blog/2020/09/15/4-rs-strategy-offers-afresh-perspective-to-confront-ethical-challenges.

Rushton CH. Cultivating moral resilience. Am J Nurs.

2017;117(2 Suppl 1):S11-S15.

Rushton CH. Moral resilience: a capacity for navigating

moral distress in critical care. AACN Adv Crit Care.

2016;27(1):111-119.

Rushton CH. Building moral resilience to neutralize moral

distress. Am Nurse Today. 2016;11(10).

Rushton CH, Turner K. Suspending our agenda:

considering what will serve when confronting ethical

challenges. AACN Adv Crit Care. 2020;31(1):98-105.

Ulrich B, Barden C, Cassidy L, Varn-Davis N. Critical care

nurse work

environments 2018: findings and implications. Crit Care

Nurse. 2019;39(2):67-84.

University of Kentucky Moral Distress Project. 2020.

http://moraldistressproject.med.uky.edu.

Wocial LD, Weaver MT. Development and psychometric

testing of a new tool for detecting moral distress:

the Moral Distress Thermometer. J Adv Nurs.

2013;69(1):167-74.

Cynthia Saver is president of CLS Development,

Inc.,

in Columbia, Md.

Disclaimer: The information offered within this article

reflects general principles only and does not constitute

legal advice by Nurses Service Organization (NSO)

or establish appropriate or acceptable standards of

professional conduct. Readers should consult with an

attorney if they have specific concerns. Neither Affinity

Insurance Services, Inc. nor NSO assumes any liability

for how this information is applied in practice or for the

accuracy of this information.

This risk management information was provided by

Nurses Service Organization (NSO), the nation’s largest

provider of nurses’ professional liability insurance coverage

for over 550,000 nurses since 1976. The individual

professional liability insurance policy administered through

NSO is underwritten by American Casualty Company of

Reading, Pennsylvania, a CNA company. Reproduction

without permission of the publisher is prohibited. For

questions, send an e-mail to service@nso.com or call

1-800-247-1500. www.nso.com.


May, June, July 2021 The Bulletin 17

Jean Ross: Will 2021 be the Year of the Nurse at the Statehouse?

Reprinted with permission from

Indianapolis Business Journal

Did you know 2020 was

supposed to be the Year of the

Nurse? Globally, the nursing

profession was celebrating the

200th anniversary of the birth

of Florence Nightingale.

While 2020 left little time

to celebrate, it was a year

we all deeply understood

the need to have enough

nurses. Before 2020, nurses

in Indiana had been trying

to alert policymakers about the shortages at their

hospitals, nursing homes and home care agencies.

After looking at legislation for 2021, I am

discouraged we might waste another year not

addressing the nursing shortage in Indiana. Cost,

access and poor health outcomes will continue to

be the symptoms discussed, and addressing the

nursing shortage will not be seen as a probable

diagnosis.

The last attempt at working with representatives

made this very clear.

In 2018, Senate Bill 28, the Nurse Faculty Loan

Repayment Program, attempted to divert funds from

nursing licenses to encourage more nursing faculty.

This legislation never saw a hearing. Instead, the

bill was amended into House Bill 2001 to simply

suspend nurse faculty qualification requirements.

Thankfully, it failed, and we did not lower the quality

of an educated nurse in 2018.

For our lawmakers who are not familiar with the

nursing workforce, here are the key talking points.

According to the Indiana Center for Nursing, Indiana

has 29 accredited bachelor’s degree programs. While

a nursing degree has a two- and four-year track,

patient outcomes improve and health care costs

decrease with a higher percentage of bachelor’sprepared

nurses.

You cannot rebuild a quality nursing workforce

overnight. Supporting four-year programs is key. To

get more nurses, you must increase enrollment and

programs. To increase enrollment, your universities

need more faculty.

The shortage of faculty is made worse by the

fact that the nursing workforce is aging alongside

the rest of the United States. This is the reason we

need policies to motivate individuals today to fill

these faculty positions. Once faculty positions are

growing, then we can focus on attracting individuals

to the nursing profession and getting them to stay in

the profession. Most nursing faculty members are in

their 50s and 60s, while the average age of a nurse

in Indiana is 44.8.

Some might see these ages and think retirement

is years away. However, you need to understand the

physical and emotional demands of nursing. This

leads me to my final point.

Nurses working today in patient-care roles are

experiencing increased levels of stress and burnout

because of insufficient staffing. Of course, the

pandemic has made this worse.

When hospitals were boasting of opening old

wings of their hospital and tents in the parking lot

to prepare for COVID patients, nurses were asking,

“Who will take care of these patients safely?”

There was an assumption that Indiana had a

readily available nursing workforce. The reality is,

Indiana has been experiencing a nursing shortage

for some time, and the problem only worsens every

year that our policymakers choose to ignore it and not

pass legislation to set us on a better course.

To access electronic copies of

The Bulletin, please visit

http://www.NursingALD.com/

publications

NursingALD.com

can point you right to that perfect

NURSING JOB!

NursingALD.com

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18

The Bulletin May, June, July 2021

ISNA WELCOMES our NEW and REINSTATED MEMBERS

Elizabeth A. Weaver

Tammy Berber

Monica G. Herning

Amanda Gordon

Amanda Lee Bonilla

Sean A Kruse

Charlene Whitfield

Christina Marie Cavinder

Kelly Freeman

Mary Beth Schaefer

Sarah Agee

Nadine M Prather

Yamsse Jackson

Tracy Springsteen

Diana L Vogeler

Sabrina McKinney

Kassie Cruse

Paula Annette Morrow

Lisa Lee

Diane Hountz

Decoma Cavender

Kandace Desadier

Julie Renee’ Ruschhaupt

Roslyn Marie Davila

Amy E Todd

Alethia Donald

Cheryl Lynn Kirkpatrick

Augusta Nobel

Stephanie J Golden

Jodi Boling

Karri Dee Thomas

Kelly Bireley

Kendra Lamb Brimhall

Lisa Schutz

Jeanna Lisman

Tonya Renee Wetmore

Audra L Pierce

Erika Rice

Chandra Marlin

Saleh Abuqwider

Heather Green

Amorette Jackson Vorkpor

Erin Wyatt

Kristi Fleenor

Kathryn White

Vanessa Street

Beth Anne Koleszar

Carrie Gresham

Tristan Schaefer

Jadezia Johnson

Kristin Hines

Kevin Bryant

Starr Bacon

Connie Fella

Margaret Pannell

Casie Coffin

Jaleigh Asbell

Samantha Theresa Schultz

Vickie Sweet

Amanda Jourdan

Gretta R Townsend

Corinna M Mayer

Linda S Gonzalez

Kaleigh Hoffman

Malia Chaney

Felicia Noel Manning

Terica Monay Yates

Britt Colleen Watson

Leah R Kelly

Stacy L Smith

Rachel Ingle

Tammy Mae Cripe

Ghazala Shahid

Shawn Michelle Kroft

Sara Lacy Gambs

Ana Rodriguez-Sandoval

Michelle Dawn Fleener

Deanna R. Jones

Julie Lavender

Jennifer Baute

Sarah Enlow

Jean Barnhill

Kaylyn Cooke

Suphayada Tammawoharl

Caylie Cappelli

Tiffany Glover

Heather Marie Schilling

Nikiyia Y Lozada

Stephenie Weaver

Annie Janson

April Burnside

Judy Hollingsworth

Allyra Cardenas

Alexa Brooke Crawford

Jami Lynn Crisman

Bryson Robuck

Shelley Edler

Heather Wood

Keelie Baker

Kayleigh Appleton

Daniel Selter

Karlie Henderson

Barbara Derose

Staci Schroeder

Joy Ann Hall

Rebekah Scott

Crystal Marie Sanders

Gayle C Snowbrick Bower

Anne Searles

Stacy Spencer

Caroline Pilewicz

Tyris Devontae Ford

Korinne Pinkstaff

Heather Dawn

Harshbarger

Melissa Johnson

Mateland Keith

Aduragbemi John

Ogundipe

Helen Nichole (Nikki)

Farmer

Bethany Eifrid

Jennifer Leeanna Barber

Joan Elizabeth Carr

Deanna Squires

Celeste R Phillips

Shannon Brennan

Anna Z Kreuser

Currently hiring faculty in Kentucky for

all specialty areas.

We change the life of one to care for the

lives of many

Student Success, Institutional Excellence, Relationships, Stewardship

Galen College is currently hiring expert educators and committed

professionals in all areas of expertise whose guidance and experience

contribute to the success of thousands of students entering the

nursing field every year.

Must have MSN, DNP or PhD degree

Rachel Ann Isom

Elizabeth Mickschl

Lillian Mwamba

Allison Gardner

Michelle Lane

Shawntae Brewer

Hema Hemlata Mehta

Jennifer Andrews

Angelique Smith

Larissa Leigh Davids

Megan Hamm

Grace Amalachukwu

Madueke

Chelsea Eads

Louise Catherine

Amberger

Susan Victoria Felts

Lori Ann Summers

Jael Otieno

Gretchen Hogan

Lauren Whitney Abebe

Randi Lasky

Gertrude Bahambula

Lusende

Susan D. Schmitt

Alireza Pourabedini

Terri Buroker

Elizabeth Yvonne Streich

Destiny Hefling

Kristina Nicole Troutman

Angela Lasley

Crystal Hackler

Julijana Obetkovska

Robin Danielle Hedge

Carrie Blanche Rose

Jenifer Lynn Fortner

Brigitte Nastally

Brandon Ford Goodman

Shelly Shields

Debra Nelson

Lorna Lee Marcus

Lynette Rayman

Tarra L Putnam

Leslie Gasser

Faryal Miakhel

Kimberly Smith

Janice Wellington

Crystal Lynn Deno

Amy Daniels

Danealle Baldwin

Andrea P Johnson

Amy Jackson

Amanda Sue Trowbridge

Kim Rene’ Finke

Ashleigh Yvonne Peterson

Hannah Duncan

Lex Ann Kaiser

Radmila Bostock

Sarah Croner

Erika Salgado-Mejia

Alex James Luzadder

Star Swan Meyer

Angela Bauer

Jennifer K Maingi

Tori E Selznick

Jun Wang

Michael Ryan Edwards

Janet Ultreras

Michelle Hedrick

Melinda Linville

Lori McBride

Audra Bair

Jennifer M Schura

Melissa Rouse

Nachel Rhoades

Yvonne M Kieffer

Ruth Ellen Wiley

Marjorie E Wiseman

Elizabeth L Hale

Teresa Lynn Gee

Anjanette Zielinski

Matilde S Upano

Pam Cooper

Patricia A Damron-

Robinson

Louisville Campus

https://rb.gy/ztpdpi


May, June, July 2021 The Bulletin 19

MEMBERSHIP

GET YOUR PROFESSIONAL TOOLKIT

ü LICENSE – BOARD OF NURSING

ü MEMBERSHIP – INDIANA STATE NURSES ASSOCIATION (ISNA)

ISNA IS CARING

FOR YOU WHILE YOU PRACTICE

www.indiananurses.org

Sandra Harston

Martha A Michel

Helen E Sandford

Nicole Nadene Johnson

Jennifer Ann Nielsen

Tai Lynn Morrell

Cheryl London

Mandy Lynn Dees

Gretchen Blevins

Marian Gilhooly

Melissa Michele

Bartoszewicz

Rebecca Jane Ellis

Megan Creech

Sharlotte Ann Brown

Kristin Gale Miller

Elizabeth Esther Swank

Wingerter

Karen Alicia Shaffer

Rita Anne Halac

Megan Shea Isley

Marcia Rooks

Channah Chava Klor

Angela Louise Johnson

Laura L. Marovich

Elizabeth Walton

Patricia D. DeNeal

Elizabeth A. Weaver

Loretta Elnora Lewis

Kendra Rottet

Beverly Shamloo

Sarah Agee

Kristen Council

Maureen Burger

Diane Hountz

Lizelle Hill

Megan Alexis Goldsberry

Amy Vyain

Jenny Simon

Amanda R Leffler

Julie Forster

Ma Carmel Breidigan

Kathy M Strasser

Danielle Emenhiser

Patricia Irene Cox

Rebecca Bustin

Natasha Monique

Johnson

Janette Richardson

Amanda Tucker

Vanessa Street

Monica Mae Hardy

Sara E Haniford

Kimberly Nealon

Crystal Crowdus

Ashley Holmes

Kristie Ross

Stacy Lee Westmoreland

Sarah Hartley

Melanie Lutz

Dawn McWhirter

Martha L Shirley

Carol Elizabeth Bonham

Marilyn L Milligan

Cynthia L. Bone-Heithoff

Janis Lynne Watts

Juana Maria Ambriz De

Williams

Sharlotte Ann Brown

Charisse Lynette Prall

Diane Carr-Lynn

Heather D Roberts

Augusta Nobel

Become someone's HERO today

and join our team of

NURSING HEROES at

HARRISBURG MEDICAL CENTER!

Looking for RN positions for:

• Surgery

• Behavioral Health*

• SCU/PCU*

• Med/Surg*

• ER*

*offering Sign on Bonus

To see a complete list of all the nursing opportunities go to

recruitingsite.com/

csbsites/harrisburg/Careers.asp

*** resume not required and you can apply through our website today!

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