The Nursing Voice March 2017 Page 1

Message from the INF President . . . . . . . 2

President’s Message . . . . . . . . . . . . . . . . . .3

Congratulations ISAPN Award Winners . . .3

Bullying in the Workplace: Are You a Participant? . . . . . . . . . . . . . .4

School Nurse Challenge . . . . . . . . . . . . . . .5

Continuing Education Offering . . . . . . 6-7

INF Holds 4th Annual Holiday Fundraiser . . . . . . . . . . . . . . . . . . . . . . .8-9

Tea with Florence Nightingale . . . . . . . . 10

Illinois Department of Financial and Professional Regulation . . . . . . . . . . 11-13

Workplace Safety Survey Series . . . . . . 13

American Nurses Association . . . . . . 14-15

current resident or

Non-Profit Org.U.S. Postage Paid

Princeton, MNPermit No. 14

The Official Publication of the Illinois Nurses FoundationQuarterly publication direct mailed to approximately 183,000 RNs in Illinois.

VOLUME 4 | NUMBER 4 | MARCH 2017

Index

Highlights from the INFAnnual Holiday Fundraiser

pages 8-9

Page 2 March 2017 The Nursing Voice

The NursingVoice

INF Board of DirectorsOfficersMaureen Shekleton, PhD, RN, DPNAP, FAAN . . . . . . . . PresidentAlma Labunski, PhD, MS, RN . . . . . . . . . . . . . . . . .Vice PresidentCathy Neuman, MSN, RN, CNAA . . . . . . . . . Secretary/Treasurer

DirectorsCheryl Anema, PhD, RNMaria Connolly, PhD, CNE, ANEF, FCCMKaren Egenes, EdD, MSN, MA, RNJacqueline Garcia, MSN, APN, NP-BCRhys Gibson, RN, BSNGuadalupe Hernandez, MSN, APN, FNP-BCP . Joan Larsen, RNLinda Olson, PhD, RN, NEA-BCBonnie Salvetti, BSN, RNKathryn Serbin, MS, DNPc, RN

2015-2017 ANA-Illinois Board of DirectorsOfficersDan Fraczkowski, MSN, RN . . . . . . . . . . . . . . . . . . . . . . . PresidentAnn O’Sullivan, MSN, RN, CNE, NE-BC, ANEF . . . . . .Vice PresidentPam Brown, PhD, RN, ANEF . . . . . . . . . . . . . . . . . . . . . . TreasurerKathryn Serbin, MS, DNPc, RN . . . . . . . . . . . . . . . . . . . . Secretary

DirectorsAmanda Buechel, BSN, RNKaren Egenes, EdD, MSN, MA, RNElaine Hardy, PhD, RNCrystal Vasquez, DNP, MS, MBA, RN, NEA-BCBonnie Salvetti, BSN, RN

Editorial CommitteeEditor EmeritusAlma Labunski, PhD, MS, RN

Chief EditorsLisa Anderson-Shaw, DrPH, MA, MSNKaren Mayville, MSN, PhD, RN

MembersCheryl Anema, PhD, RNNancy Brent, RN, MS, JDKathy Long-Martin, BSN, MSN, RNLinda Olson, PhD, RN, NEA-BCLisa Woodward, DNP, RN, CENP

Executive DirectorSusan Y . Swart, MS, RN, CAEANA-Illinois/Illinois Nurses Foundation

Article Submission• SubjecttoeditingbytheINFExecutiveDirector&Editorial

Committee• ElectronicsubmissionsONLYasanattachment(word

document preferred)• Email:syswart@ana-illinois .org• SubjectLine:Nursing VoiceSubmission:Nameofthearticle• Mustincludethenameoftheauthorandatitle.• INF reserves the right to pull or edit any article / news

submission for space and availability and/or deadlines• If requested,notificationwill begiven toauthorsonce the

final draft of the Nursing Voice has been submitted .• INFdoesnotacceptmonetarypaymentforarticles.Article submissions, deadline information and all other inquiries regarding the Nursing Voice please email: syswart@ana-illinois .org

Article Submission Dates(submissionsbyendofthebusinessday)January 15th, April 15th, July 15th, October 15th

Advertising: for advertising rates and information please contact Arthur L . Davis Publishing Agency, Inc ., 517 Washington Street, P.O.Box216,CedarFalls,Iowa50613(800-626-4081),sales@aldpub .com . ANA-Illinois and the Arthur L . Davis Publishing Agency,Inc.reservetherighttorejectanyadvertisement.Responsibility for errors in advertising is limited to corrections in thenextissueorrefundofpriceofadvertisement.

Acceptance of advertising does not imply endorsement or approval by the ANA-Illinois and Illinois Nurses Foundation of products advertised, the advertisers, or the claims made . Rejectionofanadvertisementdoesnotimplyaproductofferedfor advertising is without merit, or that the manufacturer lacks integrity, or that this association disapproves of the product or its use . ANA-Illinois and the Arthur L . Davis Publishing Agency, Inc . shall not be held liable for any consequences resulting from purchase or use of an advertiser’s product . Articles appearing in thispublicationexpresstheopinionsoftheauthors;theydonotnecessarily reflect views of the staff, board, or membership of ANA-Illinois or those of the national or local associations .

Message froM the INf PresIdeNt

Published by:Arthur L. Davis

Publishing Agency, Inc.

www.ana-illinois.org

Dear Illinois Nurse Colleagues,

The word legacy refers to a gift or bequest that one leaves to another . It can be something inherited from a predecessor like an outright gift of money or property . The word often refers to a heritage that might take the form of the work or actions one is known for .

Since I wrote my last column we have experienced a lot ofchange – the only constant in life – some good, some bad! The2016ChicagoCubsbecametheWorldChampions after 108 long years! Their legacyof being the “lovable losers” changed to that of being “fun loving” world champs! As the election cycle grew to a close, we heard a lot about the legacy of the departing administration and how history would view it . According to its creator, Lin-Manuel Miranda, the current Broadway hit, Hamilton, is a show about the characters grappling with their legacy (Interview with Chris Jones, ChicagoTribune,Sunday,9/11/16,Section4,p.2).

So, legacy, what has been given and is left behind, what is in people’s minds, what one is known for, is

important . Why is it important? It is a starting point for future action . In a way, it is a platform for creating change in the future -both positive and negative .

In nursing, the legacy of others got us to where we are today . Nurses who spoke out for patients’ rights, quality care, educational opportunity, a clear, strong code of ethics, a voice in the governance of institutions where care and education occurs left a legacy of being viewed by the public as the most trusted of professions . The most recentGalluppoll (December, 2016) asking thepublic torate the honesty and ethical standards of professions showed nurses receiving the highest public rating for the 15th year in a row .

Here in Illinois we want to continue and build on this legacy of trust and respect! We can do this through philanthropy . Philanthropy is all about legacy . A Foundation exists as a mechanism for philanthropiststo create or support and leave a legacy – one that they believe in and support . A donation to the Illinois Nurses Foundation allows you to support the legacy of trust and respect for nurses and nursing in Illinois . Your donation supports education and leadership development and soon will be supporting research – please consider helping to strengthen nursing’s legacy by donating today at www .illinoisnurses .foundation .

Thank you for all you do for our patients and for nursing!

Maureen ShekletonPhD, RN, DPNAP,

FAAN

PresIdeNt's Message

Through the generous donations of individuals, wecelebratethefollowingnurses:

2014 Memorial donationsPeg Kraft

Karen Egenes’s Brother

2014 In Honor donationsDr . Alma Labunski

Illinois Nurses Foundation Board of Directors

• PediatricPrivateDutyNursing• AdultServices• SeniorServices• VeteranAid&Attendance• ConsumerDirectedServices

Advantage Nursing Services isseeking LPNs & RNs for ourPediatric Private Duty cases

*Nurses applying to work in Illinois must have one year practicing experience as a LPN or RN

Contact our 24 hour Recruitment Line at 1-800-830-2737 for openings

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For Assessments and services contact our 24 hour centralized intake line:

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We have openings in a variety of clinical areas.

Applicants can apply by visitingstanthonys.jobs or call 314-525-1272.

St. Anthony’s Medical Center, 10010 Kennerly Road, St. Louis, MO 63128

The Nursing Voice March 2017 Page 3

PresIdeNt's Message

Greetings! By the time you read this we will be well into the 100th Illinois GeneralAssembly, a new Congress and new President . Huge changes are likely and we need to make sure our voices are heard to advocate for our patients . As you think back to the recent election- did you stay on the sidelines or were you an active participant? Did you get out to vote, canvass for a candidate, or phone bank?

In the new year, it’s time to recommit to becoming active in the political process as a nurse . That can include volunteering to serve on a local school council or running for school board . You can serve on your state legislator’s advisory committees, or participate in professional nursing organizations . If you do not have time, but a few extra dollars tospend, consider donating to the Nurses Political Action Committee (Nurses PAC), to ensure that we electcandidates at the state level who value and support the nursing profession . The ANA-Illinois Nurses PAC supports nurse friendly legislators through campaign contributions . We contribute to candidates in both political parties to advance the legislative agenda to support our patients and the profession .

For the 15th year in a row the Gallup Poll rated nurses as the most trusted profession . We have an opportunity to influence our elected officials because we understand healthcare, and we are trusted . It is never too late to get

involved at the state or local level . Thank you to so many of you who were involved this election season .

On behalf of the Board of Directors we are proud to announce that ANA-Illinois is one of the states that has been selected to participate in the ANA pricing pilot . Through our participation, we will be able to offer an even more affordable membership price . More details will be coming soon . Our long-term goal is to allow every individual an opportunity to experience ANA at oneattractive and extremely affordable membership rate.If you haven’t yet joined us, there is no better time tobelong!

We hope to see you at our upcoming Student Nurse Political Action Day, on Tuesday, March 28th or NurseLobby Day on Wednesday, March 29th in Springfield,Illinois . There are numerous other events we will be hosting throughout the state, so keep an eye on our email communication and social media feeds . Also, if you are a nursing student, I hopeyou can join theStudentNursesAssociation of Illinois who is hosting their leadership workshop on Saturday, March 18th at Illinois WesleyanUniversity – more info is available at www .snaillinois .com . I hope to see you there! As Nurses Week approaches, do not hesitate to reach out if your organization is hosting an event or function that you would like ANA-Illinois to attend, since our calendar is already beginning to fill up .

Thank you for all you do for your patients and the profession .

Sincerely,Dan Fraczkowski MSN, RNPresident- ANA-Illinois@NurseDanF

Dan FraczkowskiMSN, RN

SaVe the DaTefor the Illinois APNA Psychiatric Nurses

Conference! Friday,April7th,2017-theIllinoisChapterofthe

American Psychiatric Nurses Association (APNA)presents the 16th Annual Illinois State Meeting.Event will be held at the beautiful Northwestern Prentice Conference Center right between the Magnificent Mile and Navy Pier in downtown Chicago . The destination is great for a day or bring the family for a weekend get away . The Illinois chapter conference is the biggest state chapter conference in the country and sold out last year in two and a half weeks!

"PsychiatricNursing:meetingtoday'scrisesheadon" is a full-day program with breakfast, lunch, postersandaday'sworthofCNEwitha receptionto follow .

Free parking comes with the conference registration .

The program features Cook County Sherriff Tom Dart on mental health in corrections, as well as two champions of nursing in the General Assembly, Assistant Majority Leader Sara Feigenholtz andSenator Heather Steans will attend . Diana Knaebe, Director of the division of Mental Health for Illinois DHS will also talk about the upcoming majorchanges to behavioral health in the Medicaid system .

OtherprogramswillincludeNaloxonetreatmentof opioid overdose, violence and the brain, veterans treatment and more .

Feeisonly$75non-member,$50APNAmember.Student rates are available at $35, $25 for APNAstudent members . A limited number of psychiatric nursing student scholarship slots are available .

Registration information is available at http://www .apna .org/illinois . If registration is not yet open and you would like to be notified when it does or would like to apply for a student scholarship . Please send an email to illinoisAPNAevents@gmail .com .Ricki Loar, Ph.D., APN-CNP

President, ISAPN

ISAPN is pleased to share with you the winners for The Marie Lindsey Spirit of Advanced Practice Nursing and the ISAPN Member of the Year awards . These awards were presentedatthe2016MidwestConference.

The Marie Lindsey Spirit of Advanced Practice Nursing award is given to a licensed advanced practice nurse in Illinoiswhoexemplifies thecharacteristicsof leadership,commitment, and achievement in advanced practice nursing . The criteria for this award for the outstanding ISAPN member includes: demonstrating excellence inclinical practice and as role model, creatively making a significant contribution to the improvement of care, using current research to enhance quality of care and having a positive effect on both clients’ care and on colleagues’ professional growth . Brittany Sell nominated

the2015winneroftheMarieLindseySpiritofAdvancedPractice Nursing, and this honor was awarded to Reenu Varghese for her dedication to her patients as well as to improvements in care in her community .

The second award presented at the Midwest Conference is the ISAPN Member of the Year Award . This award was developed to recognize an ISAPN member who has worked diligently to achieve the goals set forth by the association, including leadership and visibility . The criteria for this award includes active participation and leadership on the Board of Directors or service on one or more ISAPN committees, APN representation and role modeling, and presenting/follow through with new ideas that advance ISAPN as an organization . Mary Barton and Beth Mathews nominated the 2016 winner of theMember of the Year Award, and Julie Aistars was selected to receive this honor . Ms . Aistars has not only facilitated changes to the ISAPN nominations committee, but has demonstrated excellence in her Oncology CNS role atNorthwest Community Hospital . She not only works with patients with lung cancer, but has been fundraising to provide programming to assist low income people with cancer detection and treatment, and to assist them in their smoking cessation efforts . She recently ran a 500-kilometerrunacrossthestateofTennessee---thatis314milesin10daysorless!

Please joinme in congratulating ReenuVarghese andJulie Aistars our two award winners!

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Page 4 March 2017 The Nursing Voice

Katherine Barclay, RN

Five years into her practice, nurse Susan started a new job fivemonths ago torealize her dream of becoming a kidney transplant nurse . Throughout her nursing career, Susan has enjoyed working alongside her coworkers, and feeling likea valued team member . But she has been struggling these last five months to be accepted by this group of staff members on her transplant unit . She noticed some of hercolleagueslaughingatherexpensewhensheaskedaquestionaboutherwork,and it seemed lately that when she needed help turning her patients, no one was available .

Just last week Susan was unsure about administering a medication due to her patient’s hemodynamics, but when she sought guidance about her concern, the charge nurse informed her that after five months Susan should be able to work independently . Susan gave the medication, which caused the patient to become hypotensive . Susan had to write an incident report as well as receive a reprimand from her manager for this “avoidable mistake ." Every day since then, Susan has felt anxiousbefore startingher shifts,andhashaddiarrheadue toanupset stomach.She stopped asking questions of her colleagues, even though she was unsure how to handle certain situations, praying she made the correct decisions and had not caused harm to her patients . After completing her latest shift, Susan went home and cried herself to sleep, vowing to call her former manager tomorrow and ask for heroldjobback.

Nurse Susan was unable to get rehired with her former employer, so she transferredtothecardiactransplantunit,andwasbeingtrainedbyMolly,a25-yearveteran nurse on the unit . Susan found Molly to be a bit gruff during her training, and Molly watched Susan closely as Susan practiced her newly acquired skill set on their patients . Four weeks into Susan’s training, Molly gave Susan a surprise quiz on anti-rejectionmedication frequently administered to theheart transplantpatientson the unit, but Susan could not answer the medication questions because she had not studied the medication as she should have . Molly instructed Susan on the importance of knowing these lifesaving medications, and informed Susan that she was not to give the patients’ medications until she demonstrated her knowledge of these drugs to Molly .

It is hoped that Susan’s experience does not sound similar to your own but itis very possible that it does. Healthcare professionals are exposed to an increaseinbullying at a startling rate. Clearly et al. (2010)writes that several studieshavedemonstrated that more than 50% of nurses have admitted to being involvedin bullying behavior in the work environment . One wonders how much higher would that number be if it included those nurses who did not admit to being a

bully?Another studybyWalrafen,BrewerandMulvenon (2012) found thatnursesreportedwitnessedhorizontalbullying(nursetonurse)isashighas77%.Thesearealarming, shameful statistics that should bring about needed changes to eradicate bullying in the workplace .

Bullying: What It Is and Is NotAlthough there are many definitions of bullying in the research literature,

DeKeyserGanzetal. (2015)defineitas“repeated,offensive,abusive, intimidating,orinsultingbehaviors;abuseofpower;orunfairsanctionsthatmakerecipientsfeelhumiliated, vulnerable, or threatened, thus creating stress and undermining their self-confidence .” The key word here is repeated . Bullying behavior also includes withholding information, responsibility, or tools needed to do the job effectively,trivial fault finding, and setting unrealistic goals or deadlines (Chapovalov & VanHulle, 2015; Gould, 2016; Granstra, 2015). After reading these two definitions, itis clear that in the first hypothetical, bullying behaviors were displayed by nursing staff . In the second hypothetical, Susan is not being bullied by Molly . Molly is giving Susan needed professional guidance during her training, and constructively criticizingSusanfornotmeetingunitexpectedknowledgeofmedications,toensurepatient safety. Behaviors such as constructive and timely feedback, expression ofdiffering opinions, performance evaluations (in non-bullying situations), normalinstruction or on the job training, personality conflict, or an unintended offense,are not considered bullying, and nurses should be trained to know the difference (Granstra,2015).

Negative Effects of Bullying In the opening scenario, Susan experiences some of the negative effects

bullying had on her: anxiety, nervous stomach and diarrhea before beginning hershift, afraid to ask important questions regarding patient care, and quitting her dreamjob.Theseare justa fewof thenegativeeffectscausedbybullying.Othersinclude, but are not limited to, depression, post-traumatic stress disorder (PTSD),sleep and eating habit disturbances, headaches, low morale and efficiency, high burnout and turnover rate, high absenteeism rate, compromised patient safety, and cardiovascularproblems (DeKeyserGanzetal.,2015;Ekici&Beder,2014;Hoghetal.,2011;WeaverMooreetal.,2013;Srabstein&Leventhal,2010).

The negative effects of bullying reach beyond nursing staff . Healthcare organizations also suffer greatly, not only in their statewide and national standing, but financially as well. Granstra (2015) cites several articles with interestingnumbers about the financial impactof bullying. J.S.Murray (2009) states that thecost of workplace bullying can exceed $4 billion per year. This cost was lookedat more closely by Becher & Visovsky (2012). These authors’ calculated theannual expense to be in the range of $30,000-$100,000 per person, due to highabsenteeism, low work productivity, worker’s compensation, and high turnover rate amongst staff .

Most importantly, patient care and safety is compromised in hostile work environments. A nurse victim (also known as a target) of a bullying colleague(s)is afraid to ask for help, is likely to make patient care errors, and is more likely to call in sickor leave their jobentirely, thus creatinga shortageof staffon theunit(WeaverMoore,etal.2013).

The Code of Ethics for Nurses With Interpretive Statements: Are You in Violation? The Code of Ethics for Nurses With Interpretive Statements (2015) is the ethical

benchmarktowhichnursesareheldaccountableto.The2015revisionoftheCodeof Ethics for Nurses and its Interpretive Statements provide guidance when nurse bullying occurs in the workplace. Although direction exists throughout the Code,Provision6isoneoftheProvisionstocarefullyexamine.

Provision 6 states that “The nurse, through individual and collective effort, establishes, maintains, and improves the ethical environment of the work setting and conditions of employment that are conducive to safe, quality health care.”

Interpretative statement 1 requires all those in the nursing profession, including nurse managers and executives, to cultivate and maintain high moral characterof respect, patienceand compassion,not just forourpatients, but foreachother(Lachman,etal.2015).Ifyou,asanurse,arenotpracticingtheseattributes,youarenot fulfilling your ethical obligations in the workplace and with your fellow nurse colleagues .

Interpretive statement 2 of Provision 6maintains that “Nurses in all rolesmustcreate a culture of excellence and maintain practice environments that supportnurses and others in the fulfillment of their ethical obligations” (Lachman, et al2015).One wonders if those nurses who reported witnessing horizontal bullying at 77% rate remained as a silent bystander? Undoubtedly, this Statement requires one to act as a deterent to bullying. Therefore, if you have witnessed, or witness bullying behavior in your workplace, you must intervene . Interventions could include, confrontation of the bullying colleague, using positive peer pressure to show solidarity of zero tolerance for bullying, or calling security if the hostile act escalates . However, always remember to maintain your own safety when confronting a bully .

Interpretative statement 3 stresses, “The workplace must be a morally good environment to ensure safe, quality patient care and professional satisfaction for nurses and to minimize and address moral distress, strain, and dissonance ." (Lachman,etal2015).Tominimize does not mean to ignore disparaging workplace issues . Nurses are held responsible to work together respectfully and supportively as a team, to keep moral distress, strain, and dissonance at the lowest level possible, while openly and collectively addressing and resolving the negative impact oftheirexistence.

Nursing Administration and Health Care Institution’s Role Nurse managers and nurse executives play a key role in identifying and

eradicating bullying conduct within their respective units and institutions and to valuetheirteammembersandfosterhealthyinteractions(Chapovalov&VanHulle2015). Nurse Executives must also empower nurses to appropriately intervene if

Bullying in the Workplace:are You a Participant?

The Nursing Voice March 2017 Page 5they witness a hostile interaction . Through this support nurses can be helped to intervene confidently and fulfill their ethical and moral obligations .

Nurse executives also need to support thedevelopment of institutional policies that allow nursing staff to intervene in bullying behavior without fear of retaliation by fellow staff members and/or by nursing administration .

Health care organizations must also be proactive in recognizing the increasing occurrence of workplace bullying . Workplace bullying awareness campaigns and mandatory training strategies can be created and implemented, not only with nurses, but with all healthcare institution employees in order to change a corporate culture that supports bullying to one of cooperation, respect and support among and for all staff.(Srabstein&Leventhal2010).

Conclusion Bullying behavior is at an alarmingly high rate

in nursing . It is furtively eroding the interpersonal relationships of those who practice nursing . More than 50% of nurses have admitted to participatingin bullying behavior (Granstra, 2015) but sadly, thispercentage would likely be higher if more nurses chose to confess their culpability . Without a doubt, all nurses, regardless of their position, are morally and ethically obligated to address, and stop, workplace bullying .

One way in which to address, and stop, bullying, is to take the time to evaluate your relationships with your nurse colleagues . Are you a nurse who conducts her/himself with patience, compassion, and respect towards patients, families, and peers? Or do you somehow set out to squash the morale and confidence of a colleague, or crush a new coworker’s dream of becominganexpertinyourspecialtyofpractice?

If you truly care, you will be honest in your self-assessment . If you find that you have conducted yourself in violation of the Code of Ethics for Nurse With Interpretive Statements, and your unprofessional behavior is contributing to the erosion of the nursing profession’s ethical obligations toward fellow workers and others in the workplace, there is still hope . Chapovalov & Van Hulle (2015) state, “Bullying is abehavior, and behavior is a choice ." Only you can change your own attitude and conduct . The question is:WillYou?

References American Nurses Association (2015). Code for NursesWith

InterpretiveStatements.SilverSpring,MD:author.Becher, J., & Visovsky, C. (2012). Horizontal violence in

nursing [Journal] . MEDSURG Nursing, 21(4),210-213,232.Chapovalov, O., & Van Hulle, H. (2015, Fall/Winter).

Workplacebullying innursing-Part1:Preventionthroughawareness [Journal] . OOHNA Journal,20-24.

Clearly,M.,Hunt,G.E.,&Horsfall, J. (2010). Identifyingandaddressing bullying in nursing [Journal] . Issues in Mental Health Nursing, 31(5),331-335

DeKeyser Ganz, F ., Levy, H ., Khalaila, R ., Arad, D ., Bennaroch, K., Kolpak, O., ... Raanan, O. (2015). Bullying and itsprevention among intensive care nurses [Journal] . Journal of Nursing Scholarship, 47(6), 505-511. Retrieved fromdoi.org/10.1111/jnu.12167

Ekici, D., & Beder, A. (2014, June/August). The effects ofworkplace bullying on physicians and nurses [Journal] . Australian Journal of Advanced Nursing, 31(4),24-33.

Gould, T. (2016). Watch out for these 8 workplace bullypersonality types . Retrieved from https://www.hrmorning.com/8-workplace-bully-personality-types/

Granstra, K. (2015, July/August). Nurse against nurse:Horizontal bullying in the nursing profession [Journal] . Journal of Healthcare Management, 60(4),249-257.

Hogh,A.,Hoel,H.,&Carneiro,I.G.(2011,March6).Bullyingand employee turnover among healthcare workers:A three-wave prospective study [Journal] . Journal of Nursing Management, 19, 742-751. http://dx.doi.org/10.1111/j.1365-2834.2011.01264.x

Lachman, V. D., O’Connor Swanson, E., & Winland-Brown,J. (2015, September-October). The new ’Code of Ethicsfor Nurses with Interpretive Statements’ (2015):Practical clinical application, part II [Journal] . MEDSURG NURSING, 24(5), 363-368. Retrieved from https://www.nursingworld .org/MainMenuCategories/Ethicsstandards/Codeofethicsfornurses/The-New-Code-of-Ethics-for-Nurses-PartII .pdf

Murray, J. S. (2009). Workplace bullying in nursing: Aproblem that can’t be ignored [Journal] . MEDSURG Nursing, 18(5),273-274.

Srabstein, J. C., & Leventhal, B. L. (2010). Prevention ofbullying-related morbidity and mortality: A call forpublic health policies. Retrieved from doi:10.2471/BLT.10.0077123

Walrafen, N., Brewer, M. K., & Mulvenon, C. (2012). CNEseries. Sadly caught up in the moment: An explorationof horizontal violence [Journal]. Nursing Economic$: The Journal for Health Care Leaders, 30(1),6-12,49.

WeaverMoore, L., Leahy, C., Sublett, C., & Lanig, H. (2013,May-June) . Understanding nurse-to-nurse relationships and their impact on work environments [Journal] . MEDSURG Nursing, 22(3),172-179.

School Nurse ChallengeMary Beirne LLM, BN, RN-BC, NCSN

New York

As the healthcare industry transitions from fee-for-service to value-based reimbursement models, there will be winners and losers . As school nurses, our challenge is to find our place in the winners group!

What do winners look like in this new era?In this new era of accountable care and value-based

reimbursement models, winners are paid for good, measurable outcomes . Ultimately, this is an issue of funding . If we, as school nurses, contribute to enhanced outcomes - and there is a large body of school nursing research to demonstrate that we do - then our programs should be appropriately reimbursed in order for these good outcomes to be sustainable over time. This is a win-win-win proposal: the individual student and his/herfamily benefits; the student’s Patient-Centered MedicalHome(PCMH)benefits,andthegovernmentand/orthirdparty payer benefits . On a broader societal level we all benefit .

Present Funding Models for School Nursing Services:School nurse positions are currently funded at the

local level and come from funds primarily designated for education, not health care . The decision-makers in the education system are educators, not health care providers . In other words, in terms of outcomes, educators are focused on educational outcomes, not health outcomes . The perception - and perhaps the reality - is that they have less ‘skin in the game’ of health outcomes than health care providers . We all know that many school nurse positions have been eliminated over the past few years, arguably because our value has not been fully appreciated by the educational system .

Our Present Opportunity:There is no doubt that state/governmental agencies,

health care providers and parents are already very aware of our value as registered nurses to the healthcare system ingeneralandtotheactualhealthoutcomesexperiencedby individual students! We are a wonderful resource, and, typically, our professional services come at no cost to the health systems and providers which stand to benefit financially from our professional services in this new era of health care reimbursement .

Our Value to State/Governmental Agencies:• We engage in vitally important population health

activitiesforourrespectiveDepartmentsofHealth:we generate immunization surveys and track and follow-up on outstanding immunizations . For most if not all of us, these vitally important population health-level activities are unfunded mandates .

• Manyofusprovidebiometricscreeningdatatoourrespective Departments of Health . This is another mandate which - for most of us - is unfunded .

• WearetheeyesandearsofourlocalDepartmentsof Health . We may be the first to recognize and report a communicable disease outbreak to the DOH .

Our Value to Students’ PCMH:• This new interest in care management among

health care providers arises from the transition from fee-for-service to value-based care . Providers and hospitals are now being paid for actual outcomes, rather than for isolated episodes of care . So, their focus has shifted from an isolated office visit, to healthmaintenance and 24/7/365 chroniccondition management, so that costly ER visits and hospital admissions can be avoided for ambulatory care sensitive conditions, such as asthma .

• School nurses have always engaged in caremanagement; indeed, we are experts in caremanagement . A school nurse with a good asthma action plan will keep a child in the school and out of the ER, ultimately saving money for the PCMH which is rewarded for keeping their ‘covered lives’ out of the ER .

Our Value to Students and Families:The families of students with chronic health conditions

know our value, and are frequently our staunchest supporters when school nurse positions are threatened with downsizing .

Our Challenge:Our challenge is to get a seat at the table, and to have

our contribution to students’ health outcomes recognized and appropriately funded .

SAVETHEDATE

March 29, 2017 Nurse Lobby DayJoinusforthe2ndAnnualNurse Lobby Day . Nurses

from around the state will jointogethertoadvocatefor

our patients and advance our profession as we wrap up our

efforts on the Sunset of the Nurse Practice Act .

REGISTRATION athttp://conta.cc/2h7fOS9

March 28, 2017Student Nurse

Political Action DayJoin us for our 19th annual

event!1000sofstudentsfromacross the state will converge

on Springfield to learn about the importance of advocacy .

REGISTRATION athttp://conta.cc/2hRSzc9

Page 6 March 2017 The Nursing Voice

coNtINuINg educatIoN offerINg

Suzanne P. Carroll, RN

IntroductionThe rising rates of obesity have become a national

healthpriority,withseveralobjectivesofHealthyPeople2020 aimed at increasing physical activity, preventionof childhood obesity, and aiding in the management of existing obesity. Knowing that over one-third of adultsin the United States is considered overweight or obese, as well as the growing rates of childhood obesity, the FoodandDrugAdministration(FDA)developedahealthpolicy that is now requiring chain restaurants and retail food establishments to post the nutritional information, as well as caloric value, of their menu items . This paper will aim to explain the health policy developed by theFDA and its relevance to health care, discuss issues and arguments against the implementation of the policy, and outline supportive evidence for this public health change .

Health Policy Explained As a part of theAffordableCareAct (ACA), the FDA

issueda final ruleonmenu-labeling inDecember2014,which is tobefully implementedbyDecember1,2016.This ruling is definitely a shift in health policy for the FDA, as it now includes fast-food restaurants, beverages, grocery store salad bars, and chain restaurants (Goldman, 2015). The first-time menu labeling wasaddressed/regulated by the FDA was in 1993, and itwas last updated in 2003 when the acknowledgementof trans fats on nutrition label was mandated (Foodlabeling, 2014). Many reasons exist as to the need forupdating these guidelines . Cardiac disease, cancer and stroke are the leading causes of death in the United States today, while additional chronic diseases such as diabetes and obesity are becoming more prevalent . Diets high in trans-fats, sodium, cholesterol, and sugar can add to the development of these diseases, as it has been revealed that poor diet can contribute to morbidity and mortality of an individual (Food labeling, 2014).Encouraging individuals to maintain healthy lifestyles and make educated and appropriate decisions regarding their diet is one of the main goals of this health policy .

This health policy requires all chain restaurants, drive-through restaurants, vending machines, take out and made-to-order restaurants, coffee shops, alcoholic beverages, and convenience stores display nutritional information, caloric value, and recommended daily caloric intake in a clear and visibleway (Food labeling,

2014).Restaurantsthatareexcludedincludethosewhoare not part of a chain that has 20 ormore locations.Providing this nutritional information will cost the restaurants money, but the FDA estimates that this policywillresultinanywherefrom3.7-10.4billiondollarsofbenefitsoverthenexttwentyyears,(Goldman,2015).

Relevance to Health Care As previously stated, more than one of every three

adults is considered either overweight or obese, and childhood obesity is also on the rise . Much like many other chronic diseases, the best way to manage these increasing rates is with prevention and education of the patient . Education has always been an integral part of the job for nurses,mid-level practitioners, andphysicians alike . Promotion of a balanced, healthy diet alongwith exercise and increasing activity areways tohelp prevent the development of obesity . However, with the information that over half of a consumers’ annual food dollars are spent on food that are not made at home, it can be suggested that chain restaurants are locations in which individuals are spending their money (Food labeling, 2014). Targeting individuals who aredining outside the home with education regarding their food choices is one way to promote healthier eating and prevention of obesity .

Impact of Menu Labeling and Supportive Evidence Alargestudyofover2,000participantsrevealedthat

one fourth of adults, adolescents, and children all under-estimate the caloric values of their fast food meals by nearly500calories(Blocketal.,2013).This informationshows that individuals do not correctly estimate the caloric value of their fast-food meals, which is a critical point and can easily add to the obesity epidemic . Would the knowledge of the caloric value of their meal options change the order? One could assume if an individual sees that their order is over half the daily recommended caloric intake, that this would make someone double-think about their choice, and possibly choose a healthier option . A study through Yale University evaluated this question, with 303 participants. Overall, the resultsshowed that consumers who had menus, which showed the caloric values of the meal options overall consumed less calories and orders healthier options than those who were not aware of the caloric value, with an average of 250 less calories consumed by the calorie-awaregroup(Roberto,Larsen,Agnew,Baik&Brownell,2010).

A cross-sectional study was done in Philadelphia in 2011 of 648 consumers at seven different restaurants,two with menu-labeling and the other five did not . When comparing the orders of the two different consumers, it was found that those that dined that the restaurant with menu-labeling overall consumed 400lesscalories,370mglesssodium,and10glesssaturatedfat (Auchincloss, Mallya, Leonberg, Ricchezza, Glanz& Schwartz, 2011). Additionally, consumers reportedpositive feeling regarding having the nutritional information available regarding the menu items .

In King County, Washington, a group of 50restaurants from 10 different chains includingMcDonalds, Starbucks, Subway, Taco Time, Taco del Mar, Burger King, Quizo’s, Jack in the Box, and Tully’s,participated in a study to evaluate the effect that menu labelinghason customers.With7325customersparticipating, the major measurement outcome wasthe number of calories purchased . It was noted that during the first 4-6 months of the implementation ofthe menu labeling, there was not a significant difference frombaselineordering(Kreiger,Chan,Sealens,Ta,Solet& Fleming, 2013). However, after 18-months after theinitial implementation of menu labeling, there was a decrease the in mean number of calories from both food chains and coffee chains (Kreiger et al., 2013).Importantly, there was a drastic increase of label-awareness among the customer base, from 18.8% to61.7%, though only one third of customers reportedusing themenu labels (Kreiger et al., 2013). This studydemonstrates that there is a definite change in the mean amount of calories after implementation of menu labeling, but that it takes time for the consumer to become aware of the labeling and change their order to healthier options .

The results of these studies show that consumers are not accurately estimating their caloric intake when dining in restaurants; and if theywere educatedregarding the caloric value of their meal options, they would choose healthier, lower-calorie, meals . These studies are suggestive that implementing the health policy of menu labeling could largely benefit the overall population .

Arguments Against PolicyThe successful implementation of a health policy is

never done without significant push back . There is an argument that menu labeling places a large financial burden on the restaurants, which would then impact

exploration of Health Policy: The FDa’s Requirement for Caloric Labeling at Food establishments

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The Nursing Voice March 2017 Page 7

coNtINuINg educatIoN offerINg the consumers’ prices (Armstrong, 2009). Additionally,the restaurant industry is claiming that these additional mandated costs would easily put small restaurant chains out of business (Armstrong, 2009). However, itshouldbenotedthat themajorityof restaurantchainsalready assess and evaluate the nutritional values of their menu items, so adding calorie or nutritional labeling would not pose as much of a cost to the company as the argument is implying . Opponents of this health policy state that proper menu labeling is not possible due to the ever-changing daily specials, and while this is a good argument, many specialty items or daily specials are exempt from the policy (Armstrong,2009).

There is some research that challenges and opposes the value of menu labeling in restaurants . In a systemic review of seven studies, published in the International Journal of Behavioral Nutrition and Physical Activity, did not find supportive evidence that menu labeling is effective in assisting consumers to purchase healthier option at restaurants (Swartz, Braxton& Viera, 2011).Only two of the seven studies reviewed had statistically significant evidence that menu labeling impacts calorie consumption, but overall there was not strong support that menu labeling had any effect on a consumer (Swartz, Braxton & Viera, 2011). This directly putsinto question the reason for making menu labeling a national health policy, and of course the opposition to the health policy uses this information in order to argue against the implementation of the policy .

Health Politics Preemption is the main legal argument targeted by

the opposition when it comes to the implementation of thehealthpolicy (Armstrong,2009).Preemption is thenotion that a greater and more powerful government creates laws or policies that prevents certain actions by a lower level of government . Many public health care laws are affected by the preemption doctrine in the Constitution . In this case, the federal law of requiring chain restaurants to provide nutritional labeling on their menus would supersede the state and local laws that currently exist. However, state and local governmentsare allowed to create additional policies that fall outside the preemptive rule or apply to restaurants that are not covered by the federal law .

The First Amendment of Protection of Commercial Speech is another argument that the restaurant industry uses to oppose the policy . The argument is that this health policy of menu labeling forces certain messages regarding their foods (Armstrong,2009). Supportersof thepolicy state that the law thatpromotes commercial speech of factual information regarding the product being sold and the government should have interest in providing customers with nutritional information on the food being sold (Armstrong,2009).

Implications for Nursing and Clinical Practice The health policy of menu labeling makes a large

impact on health care, and a primary care provider’s practice . As stated in the supportive evidence for the

health policy, customers who were aware of the menu labeling more likely purchased a lower-calorie meal option . Education of the public and patients regarding the menu labeling, and how to read nutritional labels, can now be easily incorporated into an annual physical examorgivenasbedsideteachingtothepatientbeforedischarge from the hospital . Increasing awareness of the recommended daily caloric intake will also apply when promoting patients to choose the healthier options from a menu .

This health policy is relevant to the ANA Code of Ethicsinprovisions3and8.Provision3isthatthenursepromotes, advocates for, and strives for the health, safetyandrightsof thepatient;provision8statesthatthe nurse collaborates without healthcare professionals and the public in promoting community, national, and international efforts to meet health needs (American Nurses Association (ANA), 2001). By implementingthis health policy to display menu labeling at chain restaurants, there is direct promotion of health by allowing the consumer to recognize food options, caloric intake, and hopefully choose lower-calorie options . Nurses should be in support of this policy as it helps educate the public regarding the recommended daily caloric intake whilst also alerting the individual to the caloric value of each meal they order off a menu . Giving the ability to choose lower-calorie, and healthier, options off the menu should help those who are trying to lose weight, but also ignite a change in those who did not realize they were ordering the least-healthy menu item . One would hope that this policy will overall make a positive impact on the overall health of Americans .

Suggestions for Enhancement of PolicyThe health policy reviewed here is the most updated

version of the policy. In July 2015, there were twoproposed changes to the health policy made by the FDA . The first was that there would be a required declaration of the daily value for added sugars, and the second proposal was to change the footnote on the nutrition facts label to increase understanding of the conceptof“dailyvalue”(Proposedchanges,2015).Bothof these proposals seem to appropriate to enhance the customer understanding and literacy of the menu label and nutritional facts .

Conclusion This paper aimed to review the health policy

regarding menu labeling, its relevance to health care, discuss the arguments for and against the implementation of this policy, the politics surrounding the policy, and the implications for clinical practice . Clinicians should support the successful execution ofthis health policy as it would promote education to consumers regarding their eating habits at restaurants and provide them with clear, healthier options to order . Increasing education to the population would help the obesity epidemic in this country, and help add to the success of healthy living for future generations .

References available upon request.

CE Offering1.0ContactHoursThisofferingexpiresin2years:April 1, 2019

LearnerOutcome:After reading the article, the nurse will be able

aimed to discuss health policy regarding menu labeling, its relevance to health care, the arguments for and against the implementation of this policy, and the implications for clinical practice .

HOW TO EARNCONTINUING EDUCATION CREDITThis course is 1.0 Contact Hours

1 . Read the Continuing Education Article2. Go to https://ilnursesfoundation.wufoo.com/

forms/mar-2017self-study/ to complete the test and evaluation . This link is also available on the INF website www .illinoisnurses .foundation under programs .

3. Submitpaymentonline.4. After the test is graded, theCE certificatewill

be emailed to you .

HARD COPY TEST MAY BE DOWNLOADED via the INF website www .illinoisnurses .foundation under programs

DEADLINETEST AND EVALUATION MUST BE COMPLETED BY APRIL 1, 2019Complete online payment of processing fee as follows:

ANA-Illinoismembers-$7.50Nonmembers-$15.00

ACHIEVEMENTToearn1.0contacthoursofcontinuingeducation,

youmustachieveascoreof80%.If you do not pass the test, you may take it again

at no additional charge .Certificates indicating successful completion of

this offering will be emailed to you .The planners and faculty have declared no conflict

of interest .

ACCREDITATIONThis continuing nursing education activity was

approved by the Northeast Multi-State Division (NE-MSD), an accredited approver by the AmericanNurses Credentialing Center’s Commission on Accreditation .

CE quiz, evaluation, and payment are available online at https://ilnursesfoundation.wufoo.com/forms/mar-2017self-study/ or via the INF website www .illinoisnurses .foundation under programs .

Page 8 March 2017 The Nursing Voice

INF Holds 4th Annual Holiday FundraiserOn December 3rd, 2016 INF held its annual Holiday

Fundraising Gala . It was a great night for the Foundation and all those in attendance at the Sheraton in Lisle . This year we had several organizations purchase entire tables for their supporters, members, association, friends or family . This proved to be a great way for groups to get together over the holidays without all the planning and support a great cause at the same time . In fact, many did their Holiday shopping at the Gala . The event was a great successwithnearly$10,000raisedfortheINF!

Again this year the Foundation invited guests to support2veteranshealth initiatives -A Safe Haven and Canine Companions for Independence.

Since 1994,A Safe Haven has offered three types of Veteran housing based on individual need, assessment and eligibility, including transitional housing, per diem housing and permanent affordable housing .

Veterans have access to the appropriate level of housing which may include full wrap-around services;supportive housing and employment services; toindependent permanent affordable housing .

Canine Companions for Independence has provided many assistance dogs to US war veterans across the country .

Canine Companions was the first assistance dog organization to be accredited by Assistance Dogs International, and has provided assistance dogs to over 5000peoplewithdisabilities.

Based on the assessment and eligibility, a Veteran can start at the transitional housing stage and work their way progressively through our housing programs . They can

also start at the per diem program level or go directly to independent permanent affordable housing .

Guests were encouraged to purchase ornaments for the “giving tree” and through the generosity of all in attendanceover$500.00wasraised.

Theeveningwas filledwithraffle ticketbuying (therewereover100items)SilentAuctionbiddingandaspecialTravel Voucher Giveaway . The winner of the giveaway will enjoy$2500.00 towardagetawayofhischoosing!Whata way to support the Foundation! Thank you to everyone who purchased tickets .

Everyone enjoyed a plated 4-course dinner, cash bar,and some great live music by The Danhattans. Guests danced to familiar tunes from Frank Sinatra, Eric Clapton, Miles Davis, Allman Bros, Ray Charles, Neville Bros ., and Springsteen .

INF hopes that this event continues to expand andthat this becomes the MUST ATTEND event for nurses and those that support nursing . Just remember, when the invitationisreleasedforthenextevent,bookyourticketsearly. A special thank-you goes to each of our majorsponsor – ANA-Illinois, and our many donors . Thank-you also go to the many volunteers it took to make this a success event . Thank you for your support and dedication to INF!

The Nursing Voice March 2017 Page 9

INF Holds 4th Annual Holiday FundraiserThank you to our generous

sponsors and donors!PLATINUM SPONSORANA-Illinois

DIAMOND SPONSORSArthur L . Davis PublishingTexasRoadhouse-Dyer

TABLE SPONSORSANA-IllinoisChamberlain College of NursingISAPNMarcella Niehoff School of NursingOlivet Nazarene UniversityThe Council of Catholic Nurses of the Archdiocese of Chicago

GOLD SPONSORSCheryl AnemaMaureen Shekleton

SILVER SPONSORSLaurie AnemaMaria ConnollyMary Ann TuftRuthann SandersSpace Golf - Orland Park

BRONZE SPONSORSAlpha Eta Chapter Inc .Art&Company-OrlandParkCathy NeumanEdible ArrangementsForest Preserve National GrandLuxCaféHooters - Dyer, INJoanne Buckley

Karen EgenesLynwood BowlMary BartonP . Joan LarsenPam DiVito ThomasSilver Lakes GolfSmits Funeral HomeStepping Stone Financial - So Holland Susanna GonzalezTasting DeVineVicki KeoughWild Fire

GENERAL DONORSAurelio’s Pizzeria - So Holland, IL Carraba’s - HighlandCoopers HawkJohn Kamp CPAKathy SerbinLinda OlsonLinda RobertsLinea Salon Made in Italy Massage EnvyMindys - MokenaPat WienskiPS FlowersRed LobsterSchultz Insurance - Lansing The Pit Ribhouse - Hickory Hills Theo’s Steakhouse - Dyer Trio’s RestaurantWalts FoodsWhich Wich - Dyer

GivingTree_Tags16.indd 1 11/30/16 3:18 PM

Page 10 March 2017 The Nursing Voice

Nurses want to provide quality carefor their patients.

The Nurses Political Action Committee (Nurses- PAC) makes sure Springfield gives them the resources to do that.

Help the Nurses-PAC, help YOU!

So. . . . . . . if you think nurses need more visibility. . . . . . . . . if you think nurses united can speak more

effectively in the political arena. . . . . . . . . if you think involvement in the political

process is every citizen’s responsibility.

Become a Nurses-PAC contributor TODAY!

❑ I wish to make my contribution via personal check (Make check payable to Nurses-PAC).

❑ I wish to make a monthly contribution to Nurses-PAC via my checking account. By signing this form, I authorize the charge of the specified amount payable to Nurses-PAC be withdrawn from my account on or after the 15th of each month. (PLEASE INCLUDE A VOIDED CHECK WITH FORM)

❑ I wish to make my monthly Nurses-PAC contribution via credit card. By signing this form, I authorize the charge of the specified contribution to Nurses-PAC on or after the 15th of each month.

❑ I wish to make my annual lump sum Nurses-PAC contribution via a credit or debit card. By signing this form, I authorize ANA-Illinois to charge the specified contribution to Nurses-PAC via a ONE TIME credit/debit card charge.

❑ Mastercard ❑ VISA

________________________ ___________ ________ Credit card number Expires CVV Signature: _____________________________________

Date: _________________________________________

Printed Name: __________________________________

E-Mail: _______________________________________

Address: ______________________________________

City, State, Zip Code: ____________________________

Preferred Phone Number: _________________________

Please mail completed form & check to:ANA-IllinoisAtten: Nurses-PACPO Box 636Manteno, Illinois 60950

Tea with Florence Nightingale

On Saturday, May 13 from 11:00 AM to 1:00 PM,Hektoen Nurses and Humanities and the Irish American Heritage Center are partnering to present the first ever Tea with Florence Nightingale.

Whatcouldbemore fittingduring the2017NursesWeek than to have tea with Florence Nightingale, “The Lady with the Lamp,” on the occasion of her 197th birthday? Participate in a rare opportunity to explore her influence on nursing today andthe continuing relevance of her work .

The character of Florence Nightingale will be brought to life by well-known Chicago actress Megan Wells (http://meganwells .com/Progams_Products .html) . Ms . Wells has appeared as many famous women from history including Eleanor Roosevelt and Helen of Troy .

She has vast experience in theater and storytelling.Ms . Wells is developing the character of Florence Nightingale in collaboration with the members of the Nurses and Humanities advisory committee under the leadership of Sandra Gaynor PhD, RN and Mary Ann McDermott PhD, RN .

The Hektoen Nurses have sponsored programs to expose nurses to arts and humanities activities acrossthe Chicago area since 2010. The goal is to exposehealthcare workers, nurses in particular, to the use of arts and culture to manage the stress of modern caregiving .

TeawithFlorenceNightingaleisSaturday,May13at11am-1pm will be held at the Irish American Heritage Center locatedat4626NorthKnoxAvenue,Chicago. Itis part of the ongoing Saturday Morning Tea Series at the Center, featuring performances on notable women in history and literature .

Ticketsare$25foradults&$8.00forchildrenunder12.You may reserve your tickets online at Irish American

Heritage Center http://irish-american.org/orbyPhone:773-282-7035ext.10XX

Bring your nursing, healthcare interested colleagues, and children to this event . Join

in the celebration of the life and work of the world’s most famous nurse, Florence Nightingale .

For more information: HektoenNurses and the Humanities on Facebook https://www.facebook.com/NursesandHumanities/ or Sandra Gaynorat773-774-9276.

The National Association of Hispanic Nurses – Illinois Chapter (NAHN-IL)celebrated their Annual Scholarship Award Recognition ceremony during Hispanic Heritage Month . This annual event was held at the National Museum of Puerto Rican Arts and Culture on October 20, 2016; the primary sponsorswereAT&TandResurrectionUniversity–Illinois.Thisyeartheyawarded$12,000inscholarships.

The event was chaired by NAHN-IL President Susana Gonzalez, MHA, MSN, CNML, RN and President-Elect Elizabeth Florez, PhD, RN . The awards were distributed by Senator Omar Aquino who also presented opening remarks on the value of nursing along with the need for culturally sensitive health care providers . Scholarship recipients:

Carols Becerra, Cassandra Cisneros, Brenda Pacheco, Maribelia Martinez, Victoria Monterrubio, Quennia Montoya, Diana Ortega, Karen Salasblancas, and Isis Nisivaco (Resurrection University Scholarship recipient).

The NAHN-IL, a professional, voluntary and non-profit healthcare organization, is dedicated to enriching the lives of

Hispanic nurses through the promotion of academic attainment, professional advancement, cultural awareness, and active participation in the Hispanic community .

NAHN-IL Board members: President, Susana. Gonzalez; Treasurer, Nancy Garcia; Illinois State Senator, Omar Aquino; President-Elect, Elizabeth. Florez; and Secretary-Elect, Irene Mendez.

NaHN-IL Update

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JOB QUALIFICATIONS: Education/Training/Experience: REQUIRED: * Graduate of an RN School of Nursing

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The Nursing Voice March 2017 Page 11

Illinois Department of Financial and Professional Regulation

The Illinois Department of Financial and Professional Regulation (IDFPR) Board of Nursing (BON) collectsinformation on an annual basis from all Illinois pre-licensure nursing education programs . Disclosure of this annual mandatory report is required to maintain BON pre-licensure nursing education program approval, which is required for a nursing student to be eligible to take the nursinglicenseexamination.Therefore,theresponserateforthisannualsurveyis100%.

The Rules for the Administration of the Illinois Nurse Practice Act, Sections 1300.230 (LPN) Approvalof Programs, b) Continued Program Approval and 1300.340 (RN) Approval of Programs, b) ContinuedProgram Approval states: “Nursing education programs shall submit annual evaluation reports to the Division on forms provided by the Division. These reports shall contain information regarding curriculum, faculty and students and other information deemed appropriate by the Division.” Completion of this annual BON survey form is necessary to accomplish the statutory purpose as outlined in 225 ILCS 65/5-1, et al. For a current copyof the IDFPR Nurse Practice Act, go to http://www.idfpr.com/profs/nursing .asp .

The BON survey is conducted with the intent to capture data on the demographics of both nursing students and faculty; faculty education levels andemployment status; and enrollment and graduationfigures for pre-licensure nursing education programs . The data collected is based on fiscal year, with a fiscal year-end date of June 30. This retrospective survey includesdefinitions of terms, request for three years of faculty and student data, verification of school name, address, chief administrator and minor curriculum revisions . All surveys are required to be signed by the dean or director

of the nursing education program prior to acceptance by the Illinois Board of Nursing . Surveys may be returned to IDFPR by United States mail or by e-mail . A comprehensive record of the questions contained intheannualsurveyisprovidedinAppendixA.

After review of other state board of nursing surveys and past Illinois Board of Nursing annual surveys, the survey process and its content was standardized, beginning in 2008. Thestandardizations include definitions, time of year data is collected, collection based on fiscal year (similar to other state agencies) and onlyrequesting three years of data. In 2011, IDFPRbegan the inclusion process of National Forum of State Nursing Workforce Centers Minimum Dataset for Education (http://nursingworkforcecenters.org/) items, with all items included by 2012. Thisstandardization occurred under the direction of Michele Bromberg, MSN, RN (IDFPR NursingCoordinator) with the assistance of Linda B . Roberts, MSN,RN(IllinoisCenterforNursingManager).

This report provides an analysis of trends in Illinois pre-licensure nursing education, in regards to both faculty and students, from the years 2011-2015 (unlessotherwise noted) . A special thanks to Stephanie Gedzyk-Nieman, MSN, RNC-MNN, Lewis University DNP student on data analysis and compiling these reports . Additional copies of this report may be found on the Illinois Center for Nursing website, http://nursing.illinois.gov/ResearchData .asp .

Nurses are the largest group of healthcare providers in both acute-care and community settings in Illinois . An adequate, well-prepared and diverse nursing workforce depends upon academically rigorous education programs

and adequate resources to prepare the next generationof high quality professional nurses .

Programs: There are 146 pre-licensure programsin Illinois-113 for RNs and 33 for LPNs; in 2011, therewere 142. This growth aligns with the Illinois Board of Higher Education’s (IBHE) Report of the Higher Education Commission on the Future of the Workforce’s goal to have 60% of the adult population in Illinois obtaining a high-qualitypost-secondarycredentialordegreeby2025.ThereportalsoconcurswiththeInstituteofMedicine’s(IOM)(2011) recommendation to increase the proportion ofnurseswithaBSNto80%by2020.

The number of graduates from all Illinois programs combined saw a steady increase until 2013, afterwhich

about the annual Board of Nursing Survey andProgram evaluation Report

IDFPR continued on page 12

Includes both full-time and part-time students; LPN Ladder program students are included in the ADN

Program calculations.

Page 12 March 2017 The Nursing Voice

Illinois Department of Financial and Professional Regulation

the number of graduates began to decline; however, the number of graduates in2015was still 9.1%greater than in 2011.Until 2014,AssociateDegreeNursing (ADN)programsproduced the largestpercentageof graduates in Illinois.However,by2015,BSN programs produced the largest percentage of graduates in Illinois (39%). Thenumberofgraduates fromBSNAcceleratedprogramsgrewfrom2%to6%ofallpre-licensuregraduatesinIllinoiswhileMSNEntryprograms’graduatesgrewfrom3%to4%of all pre-licensure graduates in Illinois .

Illinois’ nursing schools are the critical supplier of the nursing workforce and these educational programs prepare excellent nurses. To enter practice, nursing studentsmust not only successfully graduate with their nursing degree, but they must also pass their respectiveNationalCouncil LicensureExamination (NCLEX®)prior toobtaininganursinglicense.Thefirst-timepassrateforIllinoisstudentstakingtheNCLEX-RN®examhasmetorexceededthenationaltotalpassrateannuallywhilethefirst-timepassratefor Illinois students taking theNCLEX-PN®exam tobecome LicensedPracticalNurses(LPNs)hasexceededthenationaltotalpassrateannually.

Students: In order to plan for both future nursing workforce and healthcare needs in Illinois,itisimportanttoexplorethedemographicsofthenursingstudentpopulationinaddition to program enrollment figures .

Over the period of this report, enrollment in pre-licensure nursing programs has increased almost 19% with approximately 23,000 students enrolled in a pre-licensure nursing program in 2015. The largest growth in enrollment has been inthe University setting among bachelor’s degree (including accelerated programs)and master’s degree programs. Associate degree (ADN) programs’ enrollmentexperienced a downward trend after a large growth period in 2012; however,this is a modest decline (-2.4%) considering the closure of four ADN programs by2015.

The pre-licensure nursing student body in Illinois essentially emulates that of the general population in Illinois, except for having slightly less Hispanic and non-Hispanic/Black than the Illinois population (United States Census Bureau, 2015).Although still predominately Caucasian, the percentage of pre-licensure nursing studentsinIllinoisbelongingtoaracialorethnicminorityhasgrown2.6%since2012.The largest minority group among all pre-licensure programs in Illinois is non-Hispanic Black,except fortheMSNEntryprogramwherethe largestgroup isAsian (11.4% in2015)andtheBSNprogramwherethelargestgroupisHispanic(12.3%in2015).

Compared to 2014 national data reported by NLN (2014b), there were morenon-Hispanic/Black, Hispanic and Asian/Native Hawaiian/other Pacific Islander pre-

licensure students in Illinois than the national average . Male student enrollment in pre-licensure nursing programs in Illinois has remained essentially the same at 12.9%, which is slightly less than the 2014 nationalaverageof15%(NLN,2014e).

Faculty: A critical resource affecting the ability of schools of nursing to educate the future nurses needed for Illinois is having readily available, highly-educated faculty .

The age distribution among pre-licensure nursing faculty has essentially remained unchanged since 2011and the largest age group among faculty continues to be 41-50 years old. In 2015, 18.6% of pre-licensure nursingfaculty were 61 years or older, up from 14.6% in 2011.The percentage of full-time pre-licensure faculty in Illinois aged61orolderisalsohigherthannationalrates(IL-22%;US-20%) (NLN, 2016a). Faculty aged 61 years or olderare eligible for retirement and if this occurs, without the

ability or a plan to replace them, program capacities and student admissions could be negativelyimpacted(IOM,2011).

Diversity among Illinois nursing faculty has slightly increased, with the percentage of pre-licensure nursing faculty belonging to a racial or ethnic minority increasing 1.3%since2012.73%offacultyisnon-Hispanic/White,a5%decreasefrom2012.Thelargest minority group represented among all pre-licensure nursing faculty remains non-Hispanic/Black (12% in 2015). The ethnic diversity of Illinois’ pre-licensurefaculty essentially emulates that of national figures . The only difference was among the number of Hispanic full-time pre-licensure faculty, whichwas 1% in Illinois but3.7%nationally (NLN, 2016a). Thepercent ofmale pre-licensurenursing faculty hasincreasedby1.3%,to6.0%in2015,yetmalefacultystillremaintheminority.Ofallofthe programs in Illinois, LPN program faculty are the most diverse and BSN program facultyexperiencedthelargestgrowthindiversity.

A key component in meeting nursing workforce supply is Illinois’ ability to produce new nurses through the pre-licensure nursing education system . To evaluate this system,it is importanttoexaminethetype,demandandoutcomesoftheprogramsprovided, in addition to student and faculty characteristics, which was the intent of this report . A copy of the full report is available on the IDFPR/Illinois Center for Nursingwebsite:http://nursing.illinois.gov/ResearchData.asp .

IDFPR continued from page 11

Includes both full-time and part-time students; LPN Ladder program students are included in the ADN program percentages.

The Nursing Voice March 2017 Page 13

The Commission is led by the Illinois Board of Higher Education and is comprised of legislators, presidents of institutions, and representatives of business and industry . The Illinois Center for Nursing website contains links to Illinois pre- and post-licensure nursing programs, including online options for education advancement . The State of Illinois Department of Professional Regulation does not regulate or give approval for post-licensure nursing education programs .

Illinois Department of Financial and Professional Regulation

New from IDFPR – Online ResourcesThe Illinois Department of Financial and Professional

Regulation website http://idfpr.com is regularly updated to provide Illinois licensed professionals with useful resources . From our home page, a variety of licensing user guides and additional tools can be found by clicking “Online Resources .”

Print a copy of your license or store a copy on your smartphone or tablet:

The tab “eLicense Search” allows “Licensed Professionals” (the middle option) the opportunity toprint a free copy of their license . Licensees only need to provide their individual license number and date of birth or last four digits of your social security number .

For licensees wishing to store an electronic license pocket card on their smartphone or tablet, please visit:www .idfpr .com/GetMyLicense . Electronic pocket cards may be saved as a PDF file or by taking a screenshot and storing as a photo .

To Change your Address:A change of address, including email address or

change of phone number can be accomplished online . https://www.idfpr.com/applications/LicenseReprint/ . A change of name cannot be completed via online process, supporting documents must be submitted to Licensing in Springfield, IL .

If you have questions, is there someone to talk to? Yes, assistance is available Monday through Friday by contacting the IDFPR call center at: 1-800-560-6420; orbyemailat:FPR .LMU@illinois .gov .

Many Illinois universities offer online nursing courses that lead to a degree . The Illinois Center for Nursing Website http://nursing.illinois.gov/education.asp highlightsonlinenursingeducation.Forexample,threeofthe four RN-baccalaureate completion programs at public universities offer either the majority or a significantportion of the courses leading to a BSNc online . Many graduate nursing education programs also make a significant portion of their classes available online .

Online education is tied to a goal of the Commission on the Future of the Illinois Workforce http://www.ibhe .state .il .us/WorkforceCommission/default .htm .

Where Can I go for Online Nursing education in Illinois?

Nursing is an aging profession causing a shortage and increasing the demand for nurses . In addition, the demand for quality healthcare and patient-acuity levels are increasing exponentially.Nurses’ experience, education, and professionalenvironment affect each of us in various ways . As the profession focuses on meeting patient needs and providing quality care in a multitude of specialized areas, we are also facing increased interpersonal violence as well as increased exposures to occupational hazards. It comes as nosurprise that workplace safety is a widely-discussed topic in nursing . Although each of our stories is unique, there are identified common experiencesthat need to be addressed to improve workplace safety .

Thus, the strategic plan of the ANA-Illinois called foranExpertPanelonWorkplaceSafety.Thispanel,comprised of members with rich and varied nursing backgrounds, has been charged with the task of assessing Illinois nurses’ perception of workplace safety . They have worked as a team to create a comprehensive survey, which will provide data for the State of Illinois, and a foundation for improving

THaNk YOU!

Workplace Safety Survey Series:Part One Introduction

and enhancing workplace safety . This survey series supports nurses and their patients in Illinois .

A new survey topic and link will be published in the Voice each quarter . The survey will be open to all nurses . We are asking for your help in making this survey a success by taking part in it, so please take a few minutes to complete it online and share the link with other Illinois nurses .

We appreciate your support in helping ANA-Illinois study and improve nurses’ workplaces .

Thank you for doing your part in improving the workplace for Illinois nurses!

Submitted by the Expert Panel on Workplace Safety

TimbolinHolmesMSN,APN,CNP(chair)Lauren Martin RNCarolyn Ruud MSN, RNPam Brown PhD, RN, ANEFJessica Gerdes MS, RN, NCSN

https://www.surveymonkey.com/r/WORKPLACESAFETYPART2

Piotrowski, PauletteSmith, Ann

Cody, WilliamShekleton, Maureen

Miller, MarkHannon, REllingsen, T

Dalicandro, MOlson, Linda

Egenes, Karen

Connolly, MLabunski, AOlson, Linda

Serbin, KathrynLarsen,P . Joan

Kamp, JTuft, Mary Ann Salvetti, Bonnie

Langer, S

Lecturer/Assistant Professor – NursingFull-time, 9 month positions to begin August 2017.

Summary: The School of Nursing and Health Professions has vacancies for three (3) Lecturers/Assistant Professors. Two (2) positions in adult or maternal/child, and one (1) position in mental health.

Responsibilities: Clinical and didactic teaching, recruitment and advising of students; participation on committees; university/regional service; scholarship.

Qualifications: Masters of Science in Nursing. Minimum of three years of clinical experience in adult health, maternal/child, or mental health as a registered nurse. Eligible for RN licensure in Kentucky. Preferred doctorate in nursing or related field; preferred teaching experience at the collegiate level; preferred experience in gerontology.

Application Deadline: April 10, 2017

To apply please visit: http://www.murraystatejobs.com/postings/6317

Women and minorities are encouraged to apply. Murray State University is an equal education and employment opportunity, M/F/D, AA employer.

The INF Board of Directors wishes to thank our 2016 donors.

Page 14 March 2017 The Nursing Voice

aMerIcaN Nurses assocIatIoN aMerIcaN Nurses assocIatIoN

2017: YEAR OF THE HEALTHY NURSEBalance your life for a healthier you .

In recognition of the impact that increased nurse health, safety, and wellness has on patient outcomes, quality of care, and overall nurse satisfaction and quality oflife,AmericanNursesAssociation(ANA)hasdesignated2017asthe“Year of the Healthy Nurse” with the tagline of “Balance your life for a healthier you .” Each month will highlight various health, safety, and wellness topics important not only to nurses, but to their co-workers, families, patients, and the communities in which they live, work, and play . Nurses struggle with multiple health, safety, and wellness challenges. ANA’s 2016 Health RiskAppraisal shows alarming trends for registered nurses (RNs)andnursingstudents:

• AnaverageBMIof27.6(overweight)

• 12% have nodded off while driving in the pastmonth

• Only 16% eat the recommended daily amount offruits and vegetables

• Less than half perform the recommended quantity andtimeofmuscle-strengtheningexercises (ICG&ANA,2016)

RNs continue to rate workplace stress as a hazardous occupational riskwellabove thenationalaverage (ICG&ANA,2016).Yetnurses’verycalling,professionalism,andstrong sense of ethics demand that they become better role models, advocates, and educators .

2017 brings a focus on the Year of the HealthyNurse, and will include the launch of the Healthy Nurse, Healthy NationTM Grand Challenge (HNHN GC) and thecontinuation of #FitNurseFriday . ANA’s HNHN GC is a sweeping social movement to increase the health of the United States’ 3.6 million RNs, thereby impacting andimproving the health of the nation . HNHN GC focuses on five fundamental indicators of wellness: rest, nutrition,activity, quality of life, and safety . These five wellness indicators are incorporated into ANA’s Year of the Healthy Nurse topics to ensure RNs receive cohesive messaging andassistanceon their journey toward theirbesthealthever!

Visit www.nursingworld.org/2017-Year-of-Healthy-Nurse today for more information!

Reference:Insight ConsultingGroup (ICG)&AmericanNursesAssociation

(ANA), (2016). Health risk appraisal exploratory dataanalysis:November30,2016.(PowerPointslides).

YeaR OF THe HeaLTHY NURSe CaLeNDaR

MONTH TOPIC

January •WorksiteWellness

February •CardiovascularHealth

March •Nutrition

April •CombattingStress

May •Women’sHealth•NationalFitnessandSportsMonth

June•Men’sHealth•CancerAwareness•SkinHealth

July •HealthySleep

August •Happiness

September •Recovery•Work-LifeBalance

October•InfectionControl•Immunizations•MoralResilience/MoralDistress

November •MentalHealth•Wellness

December •HealthyEating/HealthyHolidays

SILVER SPRING, MD – The American Nurses Association (ANA) is steadfast in its commitment toimprove the health of people across the country . We look forwardtosharingthevaluableexpertiseofnurseswiththe new Administration and Congress .

“As President Trump looks to improve America’s health care system we are ready to work with his administration to advance health care that is accessible, affordable, equitable, integrated and innovative,” said Pamela F . Cipriano, PhD, RN, NEA-BC, FAAN, president of ANA .

“This new Administration also has an opportunity to unite the country around a shared vision that puts protecting and promoting quality health care for all Americans above partisan politics,” said Cipriano . “ANA

aNa Ready to Work with New administration to Improve Health for all

stands ready to offer support and assistance to make this opportunity a reality .”

In addition to the presidential race, many advocates of health care and nursing priorities were elected to the U.S. Congress. In total, 83 percent of the 52 candidatesendorsedbyANA’sPoliticalActionCommittee(PAC)wontheir election and will serve in the 115th Congress .

Nurses are the largest single group of health care professionals, and the nursing profession has been voted as the most trusted profession for 15 years straight . ANA will continue to leverage this trust to advocate for access to quality, affordable health care, optimal nurse staffing and other policies that remove barriers to health care for the broader community .

For more information, visit NursingWorld .org .

Family Health Network & Community Care Alliance of Illinois

is now seeking Nurse Care Coordinators to join our team

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HAPPY NATIONAL NURSES WEEK

May 6-12, 2017

The Nursing Voice March 2017 Page 15

aMerIcaN Nurses assocIatIoN aMerIcaN Nurses assocIatIoN

Nurses Lead in Fighting Opioid CrisisFrom the American Nurse Today Journal

November 2016, Vol. 11 No. 11Authors: Janet Haebler, MSN, RN, and Tim Casey

Nowhere in the nation are we immune to the ravages of the opioid epidemic . The crisis has struck our cities, suburbs, and rural communities . Across party lines, lawmakers at the state and federal levels are searching for solutions. Registered nurses (RNs) are uniquelypositioned to help tackle this public health crisis, and ANA has been busy educating legislators about how .

As the most trusted direct-care providers on the frontlines of the epidemic, RNs help patients understand pain treatment options and play a key role in the prevention of opioid overuse and dependence . ANA has sought to advance nursing’s role in fighting the opioid crisis by addressing barriers and expanding access totreatment, as described below .

Expand access to medication-assisted treatmentMedication-assisted treatment (MAT), combinedwith

counseling, serves as one of the most effective forms of treatment for opioid use disorders . For millions of opioid addicts who are uninsured, homeless, or recently incarcerated, however, getting on – and staying on – medication is a struggle . To improve access to treatment, ANA has advocated for MAT prescribing authority for nurses, as well as expanded private insurance coverageand Medicaid health benefits .

Expand access to overdose reversal drugUnfortunately, addiction to opioids, including heroin,

is difficult to treat . Not everyone recovers . Among those

who do, most relapse at least once before sustained recovery . With that in mind, ANA has advocated strongly for theexpansionofnaloxoneaccess.Naloxone isa life-saving medication that rapidly blocks the effects of opioids when signs and symptoms of a prescription opioid or heroin overdose first appear . Some states have looked forways to expand access to naloxonewhile protectinghealth professionals from criminal, civil, and professional liability(GoodSamaritanOverdoseImmunityLaw).

Increase use of physician drug monitoring programsPhysician drug monitoring programs (PDMPs) are

integral to reducing inappropriate prescribing and abuse of prescription medications . PDMPs are state-run electronic databases that can provide a prescriber or pharmacist with information regarding a patient’s prescription history, thereby allowing them to identify patients who potentially are knowingly or unknowingly misusing medications . ANA supports efforts to increase utilization of PDMPs . The Department of Health and Human Services is working toward the goal of doubling the number of healthcare providers registered with their PDMPinthenext2years.

Culture changeANA recognizes that we must also look beyond

legislative and regulatory solutions to address the opioid epidemic . As educators and patient advocates, nurses embrace a holistic approach to addressing pain, including nonopioid therapy alternatives, such as rehabilitative therapy, regional anesthetic interventions, surgery, psychological therapies, and complementary and alternative medicine .

ANA believes nurses can lead culture change around pain management and opioid prescribing . To that end, we are working closely with the White House to promote and educate nurses on the new Centers for Disease Control and Prevention guidelines for opioid prescribing, which aim to improve clinical decision making and reduce inappropriate prescribing . Additionally, ANA continues to support innovative industry partners who are stepping up to promote valuable medication take-back programs, as well as those conducting research to improve abuse-deterrent formulas for prescription medications .

In recent years, ANA and its state affiliates have advocated successfully for many of these changes—and more . At the federal level, ANA argued strongly for MAT prescribing authority, increased access to the overdose-reversal drug naloxone, and expanded treatmentoptions for those living in areas most affected by the opioid crisis . Passage of the Comprehensive Addiction and Recovery Act (CARA) in Congress this summermarked an important victory in the battle against substance abuse disorders .

While CARA and the laws enacted in the states represent enormous progress in addressing this epidemic, we must now work to ensure the necessary funding is appropriated . Only then will we truly begin to expandaccesstocriticaltreatmentservicesandturnthetide on this devastating public health crisis .

For ANA resources on the opioid epidemic, visit • n u r s i n g w o r l d . o r g / M a i n M e n u C a t e g o r i e s /

WorkplaceSafety/Healthy-Work-Environment/Opioid-Epidemic

• (http://nursingworld.org/MainMenuCategories/WorkplaceSafety/Healthy-Work-Environment/Opioid-Epidemic) .

Janet Haebler and Tim Casey are senior associate directors in Government Affairs at ANA.

THe HeaLTHY NURSe, HeaLTHY NaTIONTM GRaND CHaLLeNGe

In2017,theANAEnterprisewilllaunchtheHealthyNurse,HealthyNationTM Grand Challenge, a national movement designed to transform the health of the nation by improving the health of the nation’s 3.6 million registered nurses.

The Grand Challenge will:• Broadly connect and engage individual nurses, employers of nurses, state nurses

organizations, and specialty nurse associations to take action within five domains:physical activity, rest, nutrition, quality of life, and safety

• Provide a web platform to inspire action, cultivate friendly competition, provide content and resources to users, gather data and serve to connect registered nurses with each other, with employers and organizations

In a number of significant indicators, nurses are less healthy than the average American . Nurses are likely to be overweight, have higher levels of stress, and get less than the recommended hours of sleep. Because health care delivery requires 24/7 support, thedemands of shift work challenges the health of nurses . In addition, hazards such as workplace violence andmusculoskeletal injuries are contributing factors to poorer health. According totheBureauof Labor Statistics, registered nurses have the fourth-highest rate of injuries andillnesses that result in days away from work when compared with all other occupations .

As the largest group of health care workers, nurses are critical to America’s healthcare system . Nurses protect, promote, and optimize the health of their patients by preventing illness andinjury,facilitatinghealing,andalleviatingsuffering.Theirwell-beingisfundamentaltothehealthofournation.Nursesshouldbeviewedasexemplarsofhealth,andserveasrolemodelsfor their patients, colleagues, families, and communities .

\’Grand ‘Chal·lenge\: bold, socially beneficial goals that successfully address a systemic and embedded problem through collaboration

and joint leadership

The domains of Healthy Nurse, Healthy NationTMwillincludetheareasof:

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Page 16 March 2017 The Nursing Voice