current resident or

Non-Profit Org.U.S. Postage Paid

Princeton, MNPermit No. 14

Members Get a Member . . . . . . . . . . . . . . . . . . . . 2Wisconsin Nurses Association Updates: Welcome New Members . . . . . . . . . . . . . . . . . . . 3 WNA Update on Supporting Nurses during COVID-19 Public Health Emergency . . . . . 4 Call to WNA Membership Assembly . . . . . . . . 5 Nurses Day at the Capitol Recap . . . . . . . . . . . . 6Environmental Health . . . . . . . . . . . . . . . . . . . . . . .7Mutual Interest Groups (MIGs) Updates:

WNA Nurse Practitioner Forum . . . . . . . . . . . . . . .8Wisconsin Faith Community Nurse Coalition . . .9Wisconsin Center for Nursing . . . . . . . . . . . . . . .10Grant Updates . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11Nurses Weathering the Pandemic . . . . . . . . . . . .12Judgment in Nursing . . . . . . . . . . . . . . . . . . . . . . . .13Results of WNA Member COVID Survey . . . . . .14WINPAC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14ANA Updates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

VOLUME 6 NUMBER 3JUNE 2020

The Official Publication of the Nurses Foundation of Wisconsin, in cooperation withthe Wisconsin Nurses Association. Delivered to you courtesy of the WNA membership.

NEWSLETTERALONG NURSE

COLLEAGUETO

A

PASS THIS

GAIN AMEMBER!

MEMBERSHIP APPLICATION ON PAGE 2

WNA Welcome

Pamela Macari Sanberg, MS, RN, NEA-BC President, WI Nurses Association

Perhaps it was divine providence that Nursing was to be celebrated this year with WHO declaring that 2020 would be the International Year of the Nurse and Midwife . Little did we know what was looming in March that would magnify the role of our profession . Social media and news have provided a quick link to pictures, comments, memes, and testimonials of nurses and provides inside information representing the caring profession . An hour does not go by without hearing a well-deserved thank you to the nurses on the front-line .

My plan was to bring you historical information from the life of Florence Nightingale as the celebration of her 200th birthday progressed . Florence Nightingale was one the pioneers in epidemiology as a statistician recognizing the source and models of infections . Her application of the principles and concepts of epidemiology convinced many of the importance of hand washing and clean surroundings for the patient . Pandemics happened in her era; did we ever think that one this vast would occur in our modern age . The realization of the importance of statistics as we watch or listen to experts explain the models of imminent outcomes supports this science .

This experience has made the world smaller and more connected . Nurses across the world feel unified in the nursing process which makes our profession function with the level of expertise

to provide a patient centered plan of care in a wholistic manner . Nursing continues to be a primary educator, advocate and influencer to those we care for .

The Wisconsin Nurses Association (WNA) extends our sincere gratitude to the quality care and services provided by Wisconsin’s registered nurses and other health care providers during this public health emergency .

WNA has been monitoring the impact of the Coronavirus (COVID-19) in our state, country, and the world focusing on the role and practice implications for nurses through the following:

• The Wisconsin Nurses Association (WNA) was invited to be a member of the Health Services State Disaster Medical Advisory Committee (SDMAC) created by Governor Evers to address the COVID-19 Pandemic . WNA is the only association representing nursing on this committee .

• WNA created a WNA COVID Response Work plan Committee which allowed strategies to be developed to assist in advocacy for nurses . My extreme appreciation is extended to all the members of this task force that provided

information and their professional expertise in moving us forward .

• A survey was developed to obtain information from WI nurses related to practice during the pandemic . Outcomes related to this survey can be found on the WNA website .

• WNA applauds and supports the WI Board of Nursing to develop emergency rules that will increase the supply of LPNs, RNs and Advanced Practice Nurses while maintaining public safety . A letter to advocate for changes was sent to both Governor Evers and the Board of Nursing by WNA .

• WNA has a long history of providing opportunities for nursing specialty associations and organizations to meet to increase networking and identify concerns affecting the practice of Nursing . COVID-19 is a virus that is affecting the entire state of WI and all healthcare workers . To ensure cohesive communications and identification of issues, WNA invited associations and organizations to join together to discuss the pandemic with the goal of using

WNA President Letter

Pamela Macari Sanberg

WNA President Letter continued on page 9

Page 2 The Wisconsin Nurse June 2020

8” AdsOPEN

WISCONSIN NURSES ASSOCIATION2019 BOARD OF DIRECTORS

Pamela Macari Sanberg, PresidentElizabeth Markham, Vice President

Tanya Brueggen, Treasurer Megan LeClair-Netzel, SecretaryWendy Crary, Director-at-LargeJulie Olson, Director-at-Large

Laura Tidwell, Director-at-LargeAdey Tewolde, Staff Nurse Representative

Lisa Pisney, APRN Representative

WISCONSIN NURSES ASSOCIATION STAFFGina Dennik-Champion, Executive Director

Megan Leadholm, Associate Director Briona Dunbar, Events and Membership

CoordinatorTeresa Prattke, Education Program Coordinator

NURSES FOUNDATION OF WISCONSINBOARD OF DIRECTORS

SueAnne TeStrake, PresidentPamela Macari Sanberg, Treasurer

Jana Esden, Secretary Alex Hetzer, Director-at-LargeGina Fellenz, Director-at-Large

Isabelle Garibaldi, Director-at-LargeJill Berg, Director-at-Large

Laurie Radojevich, Director-at-LargeLindsey Lucero, Director-at-LargeRorey Pritchard, Director-at-Large

Julie Olson, WNA Board Representative

THE WISCONSIN NURSE EDITORIAL STAFFSueAnne TeStrake, Executive Editor

Gina Dennik-Champion, Deputy Executive EditorBriona Dunbar, Managing Editor

CONTACT INFORMATIONWisconsin Nurses Association/

Nurses Foundation of Wisconsin2820 Walton Commons, Suite 136

Madison, WI 53718 info@wisconsinnurses .org

www .wisconsinnurses .org – @wisconsinnurses

American Nurses Association 8515 Georgia Avenue, Suite 400 Silver Spring, MD 20910-3492

memberinfo@ana .org – www .nursingworld .org

The Wisconsin Nurse is published quarterly every March, June, September, and December by the Arthur L . Davis Publishing Agency, Inc . Subscriber rates are available, 608-221-0383 .

For advertising rates and information, please contact Arthur L . Davis Publishing Agency, Inc ., 517 Washington Street, PO Box 216, Cedar Falls, Iowa 50613 . (800) 626-4081, sales@aldpub .com .

NFW and the Arthur L . Davis Publishing Agency, Inc . reserve the right to reject any advertisement . Responsibility for errors in advertising is limited to corrections in the next issue or refund of price of advertisement .

Acceptance of advertising does not imply endorsement or approval by the Nurses Foundation of Wisconsin of the products advertised, the advertisers or the claims made . Rejection of an advertisement does not imply that a product offered for advertising is without merit, or that the manufacturer lacks integrity, or that this association disapproves of the product or its use . NFW and the Arthur L . Davis Publishing Agency, Inc . shall not be held liable for any consequences resulting from purchase or use of advertisers’ products . Articles appearing in this publication express the opinions of the authors; they do not necessarily reflect views of the staff, board, or membership of WNA, or those of the American Nurses Association .

Membership

JOINTODAY!

JUST BECAUSE YOU RECEIVED THIS NEWSLETTER DOESN’T MEAN YOU’RE A

MEMBER OF WNA.

VISIT WWW.JOINANA.ORG OR COMPLETE THIS APPLICATION.

THEWISCONSINNURSE

Notice of Vacancy for

NURSE CLINICIAN 2Sand Ridge Secure Treatment CenterMauston, Wisconsin (Juneau County)

Wisconsin’s Department of Health Services (DHS), Sand Ridge Secure Treatment Center (SRSTC) in Mauston, is seeking candidates for the position of Nurse Clinician 2. There are currently several vacancies available.

To be considered for this position, you will need to create an account and apply online. For instructions please visit the State of Wisconsin website

at www.wisc.jobs and refer to Job Announcement Code 1900880.

EOE

June 2020 The Wisconsin Nurse Page 3

Welcome New WNA Members! 2/4/20 – 5/13/20

Claudia C BartzTina Marie AdamsCatrin Emma AdamsEulona AguilarAndrea AlvarezRenae AndersonHannah ArendtLacy ArrowoodAutumn Rose AvilaLynda J BahdeKeli K BaldwinRosetta Lee BarkeJennifer A BaslerDylan Thomas BastienSierra BatesAngie Marie BauerLeah BaveryKevin Alex BeirneKaren M BewerIndira BhagwandinBritt E BilgrienMarija Bjegovich-WeidmanSarah Elizabeth BlackSara BlasierLanny BlexrudeLaura BodineTricia BoehlkePatricia Sue BollingAlyssa BowenAmanda BowersKristie L BrookeCindy BrosigTerry Ann Brown-BryanGinny BrowningNelle L BurkeHillary Danielle BuschLaura ButchScott CalvertNatasha Campbell-OkrahAngie M CannalteStephanie CaterSarah ChernohorskyRachel ChianakasLinda Shanta ChitharanjanElizabeth I ChristmanTeresa Ann CoonenLisa CoreyHeather Margaret CorkPamela CraryJennifer Lynn Moker CzubakowskiMary DargaCourtney DetersLaura DischlerBrandyn DomnieMary A . DowneyDiane DuffySharon DziengelHeidi E . EckelbergRebecca EichnerErica EickVicky Lynn Elkins-Klink

Ashley R EllenbergerMa Lourdes EscaleraAndrea EsselmanNikki FeketeHeather L FesslerAmber FieldsAnn Louise FleesMary E FordBrenda L ForsterCandida D FrankeMarcey FrankiewiczBrooke FulaDestiny GartlandMonica Lee GaulkeKaren GeibCarisah GerdinPatricia A GiovanniniAsia GomezJennifer Elaine GomezKimberly GonyoAndrea GonzalezShelley GovekSarah Marie GrayBrenna GrotegutCarol Marie GuentnerCrystal Dianne HaegeleCarla HahnLisa Marie HamiltonHeather Mae Curley HankinsJamie HanrahanSheryl K HansenRosemond HarlestonKatie HarrisRose M . HartlaubJennifer W HartlaubMaureen Kittner Haske-PalominoDeborah Lynne HederErica HelgersonMolly A HendricksLauren Marie HenleyKaren HenryJill HerbstTeresa HeslerAmber L HeussCeleste M HilgartEmily HoepfnerBrian Kent HoffmannCynthia S HogeJessica HoppaTheresa Anne HoppeCatherine A HubbardEmily Suzanne HubbsRachel HuberCristal Ibarra-PayanRoanne Rae ImhoffStacie Lee JacobsCrystal L JacobsMichael JaebCamilla JaekelTeresa JanczakAnnette JensenTracy Marie JensenJulie Anne JensenJanelle J Jensen

Nicole JohnsonDarci F JohnsonStephanie JohnsonJulie Ann JohnsonMorgen Rohn JohnsonVerrita JordanAnnick KaboreJamie Ruth KastenTiffany KatherDiane M KelleyJami KelloggMatthew J KempferHossein KhaliliHeather Lynn KhanAnna K KimMolly KleinsteiberMary C KlostermanJennifer KnightAlissa KochaverBobbi Jo KozikShawna KratochwillEmilie K KreilkampCindy KroeningAndrea KrogmanAlyssa Lynn KruegerSherri Ann KuckKristin KuesterAnthony KunzeRebecca KwiesielewiczSherrie Ann LancourJacqueline LangeKristina LangenkampJulia M LaschChristine p LaurentKayla LautenschlagerDawn LawrenceLee Her LeeSoua LeeSarah LeeLeah LejaTheresa M LenaghanTheresa M LenaghanCoral LinbergTheresa M LindbloomJamie L LodesJennifer LohrMartha LuceBranka LugonjaCallie LundVicki L LynchSuzanne MaloneyKimberly ManneyLaurel R MarekBrenda K . MarondeMegan MartinKerrie MastersTeresa P MatthaeusAmanda Marie McAfeeAmanda McCannLeaellyn McCarthyCandi McCauleyConor McChesneyLori McDonaldBridget Kathryn McDonaldMiranda McElligott

Cheryl McGrawAntoinette Renee McLaughlinJamie MeierEileen MercerChristy L MiddletonBobbilynn MiddletonMichelle MikkelsonJelena MilanovicJanette Lynne MillerColleen MillerCarmen MillerKatrina Joanne MillsLiz MixRachel MoorePatricia MooreSamantha MoranAllison Rose MorkKathleen Marie MortlLeah A MydlachSilvana NakasoneLouise NebelBrita NelsonAmy Rose NewmanKalinda Chiree NicholsJolleen Mary NicholsBarbara NienasPatricia OconnorTennille O’ConnorLeah H OlsonKim OlsonDayna OsborneMegan PainterHeather PasterskiBrandy PerineTammery M PerryKyla Peyton-BuziEric PietersTiffany PippTracy Cecilia PlaskeyKayla PoncekMatthew PostLennet RadkeAmalia Mihaela RaileanuErin RaioloEricka Heather RaislegerAlecia RaschkeAlyssa RedingAbby ReierJudith A ReilleyMelany RemitzChristine Restivo-PritzlLaura Lynn RobertsJori Lee RussMerari SalazarCatie SampedroMari SchaeferMichelle ScharineMartha ScheckelLisa ScherrerHilary SchiefferKera SchillAmanda SchmidtCedar Marie SchneiderTammy Ann SchneiderLeah Schneiter

Nathan SchuckCynthia L SchulzCatherine A SchulzDeborah J . SchumacherLydia ScottJennifer SebastianShelly SellLea ShimokawaJennifer Doyle SimonsonLuke SironiSusan Becker SlatterySarah SmetCorey SmithTerry L SoperJulia SteinerAmy StensonMaria StephansPatricia StewartMonique StewartMelissa StockJacob Matthew StodolaAna StoicaMilka StojanovicAnne Catherine StrangeChristin StrongAmy SturinoLuke TankovichAmanda Jean TatreauSally A TomcheckJennifer TopelAmy TornioTida Bayoh TrawallyMarsha H TyackeLindsay Van GheemPatricia Van KampenRebecca Lyn Vanden PlasAmanda VierlingStephanie Hana VineMarcia VoigtMao VueLaura WadzinskiNicole Marie WalmerWendy WardKenlee Marie WasurickShawnna WebberJessie WeberAmy Janel WeberClara WeltrowskiCynthia C WhiteRebecca WicklerKayla WieczorekEmily WilantMary Margaret WilenMandy WilliamsAshley WilsonErica M . WintersCynthia S WolfMelissa May WoodBillie Jan WorzellaLaura V WotachekClarissa WrightKara YanacheckTiffany Ann ZertucheJennifer ZimmerTracy Zook

Wisconsin Nurses Association Updates

Page 4 The Wisconsin Nurse June 2020

On March 20, 2020 the WNA Board of Directors met and approved a plan for responding to the COVID-19 pandemic as it relates to supporting and promoting the nursing workforce . The first step was the development of a WNA COVID-19 Response Committee . The committee included the WNA Board of Directors and the members of the three Councils . The committee continues to meet every Thursday evening . Meeting agendas include review of the work plan and determine next steps and identify volunteers . The plan is organized using WNA’s five programmatic pillars: policy, workforce advocacy, education, practice and leadership . Below is a summary of their progress .

3 2 1

Completed Progressing No progress

Policy Goal Activity Progress

Federal - Payment Protection Payment (PPP) Legislation

Allows APRNs to practice without physician collaboration . Increases access to telehealth services . Reauthorizes Title VIII Nursing Workforce Development Programs . Authorizes NPs and CNS’ to certify home health care for their patients .

3

Federal - PPP Requesting inclusion of hazard pay in each of the bills . Include not-for-profits organizations like WNA to be eligible for PPP .

1

State Requested Board of Nursing and Governor Evers to support the care of patients by supporting nursing administrative code waivers .--Interstate Reciprocity .--Timely graduation of nursing students – Simulation and virtual learning . --Graduate Nurse License until NCLEX available . -- Expedited license renewal for retired nurses . --Suspend APNP collaboration agreement with physician . -- Liability Insurance for Nurses .

3

State WNA is the only nurse member on Governor and DHS Secretary State Disaster Medical Advisory Committee . --Developed guidance draft of allocation of ventilators during shortage . --Developed guidance drafts related to transfer of COVID-related patients to Long Term Care . --Develop guidance drafts related to testing, location of nursing home residents to prevent the spread of COVID .

2

State Sent a letter to the Governor supporting his decision to extend the safer-at-home Executive Order as a means of protecting nurses and the public . Filed an amicus brief with other organizations supporting the authority of the Secretary of DHS to extend order .

3

State Identified nurses willing to share their stories with the Governor about caring for COVID patients .

3

Workforce Advocacy Goals

Activity Progress

WNA Member Survey

WNA’s COVID Member Survey subcommittee developed, analyzed and reported to the membership the results of the survey and next steps .

3

Nurse Resilience

WNA is promoting self-care and nurse resiliency resources and tools . Webinar provided May 27, 2020 .

2

Statement on supporting nurses in the workplace

WNA’s Supporting Nurses in the Workplace subcommittee is developing a position statement on ways employers can support their nursing workforce .

2

Volunteer and Employment

Promoted volunteer opportunities through the Wisconsin Emergency Assistance Volunteer Registry (WEAVR) Promoted employment opportunities as a COVID-19 contact tracker . Resource for nurses furloughed laid off .

3

WNA Update on Supporting Wisconsin Nurses during the COVID-19 Public Health Emergency

Wisconsin Nurses Association Updates

June 2020 The Wisconsin Nurse Page 5

Wisconsin Nurses Association Updates

The WNA Membership Assembly and Annual Meeting is scheduled for Friday January 15, 2021 . This is the official call for:

• Nominations for WNA Board and Council positions• Proposed changes to WNA Bylaws• Dialogue Forum Topics

ElectionsThe elections will be for the following positions:

Vice PresidentRole: Serve as an officer of the WNA Board of Directors . Is the chair of

Coordinating Cabinet, and assume all duties of the President in the president's absence .

SecretaryRole: The Secretary serves as an officer on the WNA Board of Directors

and is official recorder of all WNA Board meetings and meetings of the membership .

Staff Nurse Representative PositionRole: The individual Board Member serves as a director-at-large of the WNA

Board of Directors and provides a perspective of the staff nurse .

Director-at-Large Position (2 seats are open)Role: The individual Board Member serves as a director of the WNA Board

of Directors .

WNA Councils The WNA Councils are the identified structural units of WNA . Their

collective role is to advance WNA’s goals and strategic plan, which in turn support the professional image and practice of Wisconsin’s RNs .

There are three Councils: There are three vacancies per council .• Nursing Practice and Quality, Research, and Education (Tri-Council)• Public Policy • Workforce Advocacy

WNA Nominations CommitteeWNA’s Nominating Committee is responsible for preparing the annual slate

of candidates for WNA elections .You can find more information about the positions on WNA’s website

under the membership tab .The members of 2020 WNA Nominating Committee are Lea Acord, Jessica

Dale, Pat Keller, Pat Borgman, Carolyn Krause and Kathy Rozema

Changes to WNA Bylaws The Bylaws are a legal document that outlines how WNA as an association

is governed . The WNA Bylaws direct many of our activities such as membership rights and requirements, role and responsibility of the Board of Directors, frequency of meetings, and voting procedures . The WNA Bylaws Committee receives and reviews proposals and has the authority to introduce proposed changes to the WNA membership for a vote .

Call for Dialogue Forum Topics WNA’s Dialogue Forum provides a formal process for members to respond

to and improve a topic that has relevance to WNA members, the nursing profession and/or the public . Dialogue Forum topics can be submitted by one or a group of WNA members . The Dialogue Forum process consists of no more than three different topics that are introduced and discussed . A summary of the discussions and any recommendations are recorded and reviewed by WNA’s Professional Policy Committee . The Professional Policy Committee submits a report with recommendations for the WNA membership to approve during the WNA Annual Meeting . You can find the process on WNA’s website under “About WNA .”

Call to WNA Membership Assembly and Annual Meeting 2021

Updates and networking

Launched on WNA’s networking platform, Wisconsin Nurses Connect, providing latest information on COVID and a Healthy Nurse group . Come join us!

3

Personal Protective Equipment

Shared concerns about the shortage of PPE and worked on the development of state and CDC guidance on use during a shortage . Responded to multiple media calls regarding PPE shortage .

3

Testing Supplies Shared concerns about the lack of COVID testing materials with the media and support targeting the supply of tests available for LTC .

3

Education Goals Activity Progress

Nursing Education Programs

Supporting the increase of simulation and virtual learning so nursing students can continue to progress in their educational program .

3

COVID Member Survey

The WNA COVID Member Survey identified the areas of educational needs . WNA COVID education subcommittee is identifying educational offerings and methods for delivery, webinar, articles, podcasts . Webinars: Overview of medications to treat COVID Webinar: Nurse Resiliency Webinar: Results of WNA COVID Member Survey Webinar: Innovations in Nursing Practice for homeless populations Podcast: Reducing the incidence of COVID among populations experiencing health disparities and inequities . Webinar/podcast: Telehealth the new normal implications for nurses .

2

Nursing Practice Goals

Activity Progress

Best-practices on use of PPE

Provided links from CDC and DHS on protection practices .

3

COVID numbers

Monitoring and reporting information on COVID cases in the state including health care worker data . Monitoring and reporting information related to COVID test results .

3

WNA Member Survey

Identified the areas of practice concerns and needs . Plan to identify and implement strategies .

2

COVID Health Disparities Subcommittee

The COVID Health Disparities Subcommittee is meeting to identify strategies for offering support to those at-risk populations with identified health disparities .

2

Leadership Goal Activity Progress

WNA Board and Councils COVID Response Committee

The Committee continues to focus on the work plan .

Nursing Organizational Affiliate

WNA invited leaders of Wisconsin’s Nursing Associations to identify issues related to COVID . The WNA COVID-19 Nursing Organizational Affiliate was developed . Meetings are held weekly, members provide updates, has approved a charter, and created a listing of COVID related resources that support nurse resiliency . Recruitment continues .

3

Rapid Response/ Member Town Halls

Identifying topics that are of interest of members that can be discussed .

1

Partnership with the Wisconsin Medical Society

Weekly meetings are occurring between WMS and WNA representatives . Identifying areas where collaboration can occur .

2

Voice of nursing in the media

WNA has responded to media .

Page 6 The Wisconsin Nurse June 2020

Wisconsin Nurses Association Updates

June 2020 The Wisconsin Nurse Page 7

By Kathryn Lammers PhD PHN RN

Decades ago, partial stories about the birth defects and early death of the Dupont Teflon employees in Parkersburg, West Virginia, were described minimally . Now you can learn this extensive factual pollution story via the movie Dark Waters and many other sources . The movie helps us to emotionally connect to the profound deception that the chemicals were safe . The community was finally studied for the widespread nature of the health problems to not only employees but also their families, neighbors, and farmers . The 2020 Wisconsin Environmental Health Network conference provided several speakers on the science of the PFAS pollution and the highly dangerous community example in Marinette, Wisconsin, due to firefighting chemicals in their water . Our state departments of health and natural resources have additional reliable sources .

Former Mayor of Marinette, Doug Oitzinger, described the dramatic community group, Stop Poisoning Our Waters, also called S .O .H2O . The group promoted powerful investigations and actions to prevent further pollution by fire retardants . One of the outward signs was large white foam on the Peshtigo River . The barriers included bringing many non-science participants along with their understanding and creating doable steps of action . The work reminds us once again that local groups can make a difference .

Wisconsin Department of Healthhttps://www .dhs .wisconsin .gov/chemical/pfas .htm

Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are a group of man-made chemicals that have been used since the 1950s . Although some of these substances have been phased out of production, such as those through the PFOA stewardship program, they may still be found in everyday consumer products, such as some grease-resistant paper, nonstick cookware, stain resistant fabrics, cleaning products, and other personal care products like shampoo and nail polish .

There are many abbreviations used to describe PFAS . The table below helps to clarify the most common PFAS abbreviations and pronunciations .

Abbreviation Pronunciation Chemical Name

PFAS p-fas (like fast without the ‘t’)

Per- and polyfluoroalkyl substances

PFOS p-fos (like foster) Perfluorooctane sulfonic acid

PFOA (aka C8) p-foe-uh Perfluorooctanoic acid

The acronym PFC has been used to describe perfluorinated compounds in the past . This acronym is no longer used to describe perfluoroalkyl and polyfluoroalkyl substances because it is used to describe perfluorocarbons, which are an entirely different family of chemicals .

Health Effects

Scientists are still learning about the health effects that various PFAS can have on the body . The more widely used substances, like PFOS, PFOA, perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA), have been studied more than other PFAS .

A large number of studies in people have examined possible relationships between levels of PFAS in blood and harmful health effects in people . However, most of these studies analyzed only a small number of chemicals, and not all PFAS have the same health effects . This research suggests that high levels of certain PFAS may:

• Increase cholesterol levels .

• Decrease how well the body responds to vaccines .

• Increase the risk of thyroid disease .

• Decrease fertility in women .

• Increase the risk of serious conditions like high blood pressure or pre-eclampsia in pregnant women .

• Lower infant birth weights; however, the decrease in birth weight is small and may not affect the infant’s health .

Chemical Pollutants called PFASThe animal studies have found that PFOA and PFOS can cause damage to

the liver and the immune system, birth defects, delayed development, and newborn deaths in lab animals .

Currently, several federal agencies are in the process of evaluating human health risks of PFAS . For instance, the CDC Agency for Toxic Substances and Disease Registry (ATSDR) recently released a draft review summarizing many of the studies on the toxicity of 14 different PFAS compounds . the Environmental Protection Agency (EPA) is taking several actions to address PFAS, including drafting risk assessments for some PFAS as well .

Most people in the U .S . have PFAS in their blood, similar to the low levels observed in blood for other industrial compound classes like flame retardants and plasticizers . While you can do a blood test to determine the amount of PFAS in your body, there is not enough research to determine the level at which we would expect to see health problems . ATSDR has more information on blood testing .

StandardsThese substances have been used in non-stick cookware, water-

repellent clothing, stain resistant fabrics and carpets, some cosmetics, some firefighting foams, and products that resist grease, water, and oil .

Over half of our contact with PFAS are estimated to come from food. The main ways people come into contact with PFAS are:

• Eating food that was packaged in material that contains PFAS .

• Eating fish caught from water contaminated by PFAS (PFOS, in particular) .

• Drinking contaminated water .

• Accidentally swallowing contaminated soil or dust .

People may also come into contact with PFAS by using some consumer products, such as non-stick cookware, stain resistant carpeting, and water repellant clothing .

It’s not practical to completely reduce our exposure to these chemicals as they are so common and present in our environment, but we can take simple actions to limit our contact with them . Drink safe water, follow fish consumption advice, and rinse off after touching water that contains PFAS . Even though recent federal efforts to remove PFAS have reduced the likelihood of exposure, some products still contain them .

Wisconsin Department of Natural Resourceshttps://dnr .wi .gov/topic/Contaminants/PFAS .html

Perfluoroalkyl and polyfluoroalkyl substances (PFAS) do not occur naturally and are widespread in the environment . They are found in people, wildlife and fish all over the world . Some PFAS can stay in peoples' bodies a long time and do not break down easily in the environment .

The U .S . EPA has established cumulative-lifetime health advisories for PFOA and PFOS, which are two PFAS that have been most widely produced and studied, at 70 parts per trillion (ppt) . At the request of the DNR, the Wisconsin Department of Health Services (DHS) reviewed scientific literature and recommended groundwater enforcement standards of 20 ppt for PFOA and PFOS individually and combined .

Public input opportunitiesThe DNR will continue to seek public input on PFAS investigation,

contamination and cleanup issues . Public meetings are being held for PFAS contamination in the Marinette and Peshtigo area .

Gov . Evers' Executive Order #40 directed the DNR to create the PFAS Coordinating Council, now known as the Wisconsin PFAS Action Council (WisPAC), in partnership with other state agencies . WisPac will develop and coordinate statewide initiatives to address the growing public health and environmental concerns regarding PFAS . Meetings are open to the public .

The DNR has convened a PFAS Technical Advisory Group to discuss PFAS-related concerns . The group does not have an appointed membership; any interested party may attend .

Final commentsI am proud to see the state respond with action-oriented methods

to decrease pollution . Often nurses attend these meetings and are welcome due to their science background . Acting locally or regionally are often a great way to start your journey to make a difference . We want to proactively prevent poor health outcomes . Thank you for your efforts .

Environmental Health

Page 8 The Wisconsin Nurse June 2020

By Dr. Tina Bettin DNP, MSN, RN, FNP-BC, APNP, FAANP

Benefits of Covid-19? Some of you may think there are no benefits, just hassles-lots of COVID emails; persistently changing schedules; working in different facilities or different roles; and scientific information that changes on a daily basis, just to mention a few . Some of you may think of benefits like the discounts at various locations; gas for less than a dollar; refunds from auto insurance policies, to mention a few . But, for NPs there has been significant benefits which impact our ability to practice .

On March 27, 2020, Governor Tony Evers issued Executive Order #16 . As part of the Executive Order, Wisconsin Administrative Code N8 .10(2) and (7) were suspended . This code specifically relates to collaboration of APNPs with physicians and dentists . By suspending these Administrative Codes, Wisconsin became a full practice authority (FPA) State for three of the four clinical roles . The roles covered are nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists . Certified nurse midwives are not covered as this role has collaboration written into State Statute 441, which was not suspended . Realize this is only temporary during the state of emergency, but it is a step in the right direction . Wisconsin was one of five States where practice agreements were completely suspended and these five States then joined the permanent 22 FPA States . Fifteen States had waivers of selected parts of

the practice agreements and seven States had no changes . Hopefully, this will help propel permanent changes to the Administrative Code to allow increased patient access to timely and quality care . Once the State of Emergency is lifted, Executive Order #16 is effective for 60 more days .

Also, on March 27, 2020, President Donald Trump signed Coronavirus Aid, Relief and Economic Security (CARES) Act into law . The CARES Act increases Medicare beneficiaries’ access to home health care services and provides needed funding for personal protective equipment (PPE) for nurse practitioners (NPs) and other health care providers . For over eleven years, there has been Federal legislation for NPs to order/certify home health care for Medicare patients . The CARES Act gave NPs, CNS, and PAs the ability to certify and recertify home health care . Once the CARES Act was signed, CMS actually had six months to enact this law . To the benefit of our patients, CMS waived this six-month period and implemented it immediately . WOW, what a win!

Additionally, telehealth options have been opened up . On March 6, 2020, the Coronavirus Preparedness and Response Supplemental Appropriations Act, as signed into law by President Trump which includes a provision allowing the Secretary of the Department of Health and Human Services to waive certain Medicare telehealth payment requirements during the Public Health Emergency (PHE) . Prior to the pandemic, Medicare and Medicaid beneficiaries were not able to use

Rainbow Through the Clouds: The Benefits of COVID-19?????telehealth options unless they fit very specific criteria . Previously, beneficiaries covered by telehealth needed to be in a rural area and in a medical facility—the site where the services were received is known as the “eligible originating site .” Unfortunately, the beneficiary’s home is generally not an eligible originating site . With the 1135 waiver, which is valid during the pandemic, it will now allow telehealth services to be provided in all settings – including at a patient’s home . So, the options for telehealth have opened up, but the equipment for telehealth can be expensive and take time to install . Within waiver 1135, in section (b), it allows the Secretary of HHS to authorize the use of telephones that have audio and video for providing telehealth services of Medicare beneficiaries . Additionally, the HHS Office for Civil Rights (OCR) waived the penalties for HIPAA violations against health care providers serving patients through everyday communications technologies, such as FaceTime or Skype during the pandemic . This was also effective immediately .

These are some of the larger changes that have occurred . As the pandemic continues, there are additional changes that continue to occur . Please try to keep up to date on the changes as many can impact your ability to practice in a positive fashion .

As we make some gains be sure to take advantage of the opportunities and remember that once the genie is out of the bottle it is very difficult to put the genie back in . Let’s keep wishing as there is a pot of gold at the end of the rainbow .

June 2020 The Wisconsin Nurse Page 9

Mary Lynne Knighten, DNP, RN, NEA-BCAdjunct Faculty and Lead FCN Foundations

Educator, Azusa Pacific University, Azusa CAHealth Ministry Director, St. Dominic Catholic

Church, Eagle Rock, CAChair, Practice Committee for Faith Community

Nurses International

A newly published specialty nursing book, Faith Community Nursing: An International Specialty Practice Changing the Understanding of Health is now supporting faith community nurses across the nation and internationally . Ann Solari-Twadell, RN, PhD, MPA, FAAN and Deborah J . Ziebarth, PhD, MSN, RN-BC have outdone themselves with this book . Published authors, tenured academic leaders, experts in the field of Faith Community Nursing and Health Ministry, and passionate about the specialty

Book ReviewFaith Community Nursing: An International Specialty Practice

MIG UpdatesWFCNC is a mutual interest group of the Wisconsin Nurses Association

practice, Dr . Solari-Twadell is Associate Professor and Director, Global Experiences and International Studies at Loyola University Chicago’s Niehoff School of Nursing and Dr . Ziebarth is Program Chair for the BSN and LPN Nursing Programs at Herzing University – Brookfield .

Faith Community Nursing: An International Specialty Practice Changing the Understanding of Health amplifies previous publications about health ministry and faith community nursing . It focuses on relevant and timely issues in this specialty nursing practice where nurses provide intentional care of the spirit, disease prevention, and health promotion in the context of one’s faith tradition . Additionally it offers specific chapters that apply to lay health ministers, clergy, physicians, hospitals, and health systems .

Written by experts in the field, there are twenty-five chapters that cover the historical perspective, theoretical underpinnings, practice basics, specialty scope and standards, transitional care, working with interdisciplinary teams, legal and ethical aspects . The book also includes the current state of research in the faith community, health system, public health, and national/international health arenas .

The book is laid out in an organized and easy to access manner, each chapter having a crisp and informative abstract, easily readable text, thoughtful exercises for critical thinking, and many useful tools in the appendices . The book is available in print and eBook format, with the ability to purchase individual digital chapters . This is truly a practical resource for specialty faith community nursing practice, and a great textbook to be used in faith community nursing education programs .

effective communication that results in working together, sharing information, and collaborating to identify solutions to issues that face the nursing profession, regardless of specialty .

• The Nursing Affiliates group will develop resources that will enhance the personal safety, health, and mental ability to create resiliency in the lives of Registered Nurses that are practicing during the Pandemic as well as decrease the potential effects of PTSD .

More information on WNA’s COVID Response Plan is included in this issue of the paper .

WNA President Letter continued from page 1 In addition, we launched WI Nurses Connect which allows a social platform for members to communicate . If you have not responded to your invitation from me, please do so that you are included in the benefits of resources and information .

WNA will continue to monitor and share the latest information to ensure that nurses have access to the latest COVID-related evidence-based practices, quality, education, and policy recommendations . Information can be found on the WNA website .

Nurses will be there to provide care to the population of Wisconsin . WNA will be there to provide care for Wisconsin nurses .

Page 10 The Wisconsin Nurse June 2020

Authors: Linda Young, Gail Hanson Brenner, Jan Adams

The Wisconsin Center for Nursing (WCN) regularly conducts a statewide survey of nursing program administrators . This survey, the Wisconsin Nursing Education and Nurse Faculty Survey, provides a source of data for assessing Wisconsin nurse education programs, faculty and students . Nursing program administrators share information related to program types offered by their institution, program capacity, enrollment numbers, student and faculty demographics, and vacancy rates, as well as other variables – information that can be especially useful when tracked over time . This report, in conjunction with the other reports published by the WCN, provides the State with the ability to discern trends which impact forecasting models for the nursing workforce .

The most recent survey was conducted in the fall of 2018 to collect information for the prior academic year . In conducting the online survey, thirty-nine program administrators were contacted . Thirty-seven surveys were returned . A team under the direction of Dean Linda Young, PhD, RN, CNE, CFLE from UW-Eau Claire College of Nursing and Health Sciences reviewed the data and completed the analysis . Their findings were published in the Wisconsin Nursing Education and Nurse Faculty: 2018-2019 Survey Results Report by the Wisconsin Center for Nursing in April, 2020 . https://wicenterfornursing .org/education/wcn-education-surveys/

This article discusses some of the report’s key findings that are particularly important given the attention in recent years to a potential nurse and nurse educator workforce shortage .

KEY FINDINGSTable 1.

Program Trends Number of Programs

Number of Students Enrolled

Number of New Graduates

2014-15 2017-18 2014-15 2017-18 2014-15 2017-18

LPN 2 4 185 298 58 136

ADN 15 15 3,238 2,968 1,458 1,134

Pre-Licensure BSN

23 22 5,052 5,924 1,621 1,834

Pre-Licensure MSN

3 3 209 325 60 93

RN-BSN 15 15 1,460 1,109 490 476

Clinical Track MSN

8 8 1,178 495 256 249

Non-Clinical Track MSN

8 10 165 159 52 20

DNP 8 9 528 541 123 148

PHD 3 3 142 123 24 26

Table 1 provides a snapshot of Wisconsin nursing programs using data from Wisconsin Nursing Education and Nurse Faculty: 2018-2019 Survey report . The number of LPN programs, as well as number of students enrolled, and graduating have increased . ADN enrollments and graduate numbers have decreased . The number of baccalaureate degree (BSN) graduates has increased by nearly 200 . However, the total number of pre-licensure graduates continue to hover around 3000, which remains relatively constant and may not meet future demand for RNs .

The number of DNP programs increased by one and both enrollment and graduate numbers have increased . Although the number of PhD programs is unchanged, the number of students enrolled has decreased . Since PhD prepared faculty are essential to baccalaureate and graduate programs in nursing, it is important to foster the development of strategies to reverse this trend .

Table 2.

Program Trends for Nurse Educator Programs 2014-15 2017-18

Number of Programs 7 4

Students Admitted 45 37

Student Enrolled 124 89

New Graduates 41 20

New Nursing Education and Nurse Faculty Survey Report Released

Table 2 focuses on the development of academic nurse educators who create the curriculum and scholarship components, plus classroom and clinical environments essential to the development of professional nurses . Unfortunately, the trend is worrisome with a drop in the number of programs, students admitted, enrolled and graduated since 2014-15 .

Table 3.

Filled Nurse Educators Positions 2014-15 2017-18

Full-Time 644 808

Full-Time Adjunct 155 *

Part-Time or Adjunct 610 448

Total 1,409 1,256

Although the total number of full-time nurse educator positions is up slightly, Table 3 denotes that the total number of positions is down by over 150 . Program administrators cited the lack of qualified applicants and low salaries as the primary factors limiting their ability to hire staff .

Table 4.

Anticipated Faculty Retirements Within the Next Five Years

Full-Time 168

Part-Time Adjunct 62

Total 230

Institutions are facing a looming wave of retirements, 230 within the next five years as seen in Table 5 . Survey results also showed that 399 (54 .7%) of full-time faculty are 51 years and older . It is anticipated that within the next fifteen years nearly half of the nurse educator workforce could retire .

Table 5.

Percent of Clinical Hours Replaced with Simulation Experiences

37 programs reporting

0% 14

10% 17

15-25% 5

40% 1

Table 5 shows that most nursing schools now substitute some simulation for direct clinical hours . However, 17 program administrators stated that amount was 10% or less . Due to the COVID-19 emergency and the suspension of Wisconsin Administrative Rule (Wis . Admin . Code § N . l .08(5m)(b)) which limits utilization of simulation for nurse training to 50% percent of clinical hours, schools may move to a higher percentage and deploy new models of simulation education to practice their clinical and decision-making skills and prepare nurses for practice .

Student DemographicsThe type of students enrolled in Wisconsin nursing programs remains

relatively unchanged, white and female . However, survey data revealed that there is greater diversity within the LPN, ADN, and DNP programs and an uptick (3 .2%) in the number of men in baccalaureate programs over the prior survey .

ConclusionThe Wisconsin Nursing Education and Nurse Faculty Survey coupled

with other nursing workforce data generated by the WCN provides valuable information for stakeholders to make informed decisions related to education, industry and the healthcare of Wisconsin citizens .

The next survey will be released fall of 2020 and the findings will be published summer of 2021 by UW-Eau Claire College of Nursing and Health Sciences in partnership with the WCN .

Source: Young, L . K ., Alasagheirin, M ., Aschenbrenner, A ., Marcyjanik, D ., Hanson Brenner, G .,

Sohn, K ., & Adams J . L . (2020) . Wisconsin nursing education and nurse faculty: 2018-2019 survey report . Milwaukee, WI: Wisconsin Center for Nursing, Inc .

Wisconsin Center for Nursing

June 2020 The Wisconsin Nurse Page 11

Grant Updates

Visit nursingALD.com today!

Search job listingsin all 50 states, and filter by location and credentials.

Browse our online databaseof articles and content.

Find eventsfor nursing professionals in your area.

Your always-on resource for nursing jobs, research, and events.

Page 12 The Wisconsin Nurse June 2020

Peggy Weber RN MSN

How proud I am to see our nursing profession in action during this time of Pandemic . Stories on the news are highlighting and validating all the health care workers’ efforts and giving them the praise, they so well deserve .

The Covid 19 virus has created an unanticipated storm for all humanity, and nurses play a major role in helping us heal as individuals, communities and countries . The trauma the virus is creating is unbelievable, yet nurses are there to relieve as much suffering as possible and, most importantly, to save lives . Time and time again nurses demonstrate they will never give up on patients, even while putting their own lives in danger every day .

Each shift is full of new clinical challenges . Thankfully, nurses are critical thinkers . They have no time for drama or politics when caring for their patients . Nurses’ work is priceless and of course is deserving of hazard pay . This important work is accomplished through teamwork, always essential both physically and emotionally with all the uncertainty in each shift . Nurses have always supported and helped each other through critical times .

Their support of their patients fulfils more than just medical needs . Being a patient at this time is very frightening, too . Unable to have family or friends at their bedside, they totally rely on their nurse for everything .

But how do patients get the human support they need when they look at their nurses and see only a pair of eyes peering through a tangle of protective gear? They long for understanding and connection through knowing smiles, gentle skin-to-skin touch . But smiles are harder to see behind those masks, yet come out through the caring eyes of their nurses . Your eye contact is the human connection your patient needs right now . It is a life force for them! You’ve heard the expression that the eyes are the window to your soul - your spirit . Never has this been so important . Patients are watching you very carefully, looking for signs of clarity, understanding and hope . You are helping them understand how they are doing, advocating for their needs and helping them communicate, all while trying to keep yourself safe . Patients may see your fear, sadness, frustration and anger . These are all normal feelings at this time .

Nurses Weathering the PandemicYour active listening is essential at this time, too .

Patients’ concerns, fears and needs have got to be heard, acknowledged, and they need reassurance . Sometimes their fears are projected as anger . Help them work through this by asking what their greatest fear is . Your willingness to listen and your care for their concerns can go far in helping patients—and even coworkers—get through this difficult and scary experience .

The psychological impact of this virus is significant . The longer this virus goes on the greater the mental distress on everyone . How to survive in a time of uncertainty can be overwhelming for everyone .

Most of my 45-year nursing career involved supporting patients, family and staff through critical incidents of some sort, often resulting in a need to address sadness, the dying process, death and grief . These years of nursing have taught me a lot that pertains to the challenges we now face . Primarily, I know people are resilient and their attitudes dealing with what life has handed them makes all the difference . Staff can give and get support from each other! Time for staff debriefing is essential . You need to decompress with those who understand what you are experiencing . Remember that stress has physical, emotional and spiritual reactions deep inside of us .

We all have survived other storms in our lives . Reflecting back on yours, what helped you make it through those crises? We all have developed coping skills to draw upon and these can serve you well as you work through the tempest we now face . Now might be a good time to think about and implement some essential strategies .

• Beware of all of your feelings, as they are natural reactions to this virus! It’s so much like a roller-coaster ride inside both your head and gut . These feelings are responses to all the changes, losses and grief you are experiencing . You are not going crazy although you may feel like it . Acknowledge your feelings, name them and share them with a trusted friend . That’s all that is usually needed to help you feel better . So, ask your colleagues how they are feeling . This emotional support goes both ways .

• Consider that most feelings experienced right now are remarkably similar to grief reactions . All the changes and all the (non-death) losses from the changes lead us to emotionally deal with grief . At first, we had some denial, shock,

and disbelief about the virus, and we still don’t want to believe it . When people are still in the denial stage about the effects of the virus, this causes them to avoid confronting the reality of it . Uncertainty is a loaded feeling because it creates a lot of anxiety and fear . No one knows for sure when life will return to the new normal . Who will get this virus next? Can we ever make plans again? Then there’s Anger . It’s real and healthy . If we didn’t care we wouldn’t be so angry about this virus and its impact on life . Anger’s energy motivates us into action . “I’m angry because___________” needs to be expressed, or the heavy negative energy of anger will make us more tense and sick . Old Dr . Fraud said if anger was not dealt with it would lead to depression . Well, look at all the sadness today . Fear is usually behind or hidden in anger . Our fears and anxieties are real and need to be expressed . Like uncertainties there are so many unknowns today . “This is not fair” is what I am hearing from my grandchildren . But we all know that sometimes life is not fair .

• Practice self-care . It has never been more important than now . Trying to balance work, family, children and home is depleting you . You are getting pressure from all areas of your life . This is a storm which will end, but now you need to protect yourself as best you can . Prioritize, simplify, lower your expectations so you do not become more frustrated . Let go of your “shoulds .” If you have to do it and its important, do it . If it’s not important, let it go . You can only control so much . And you have only so much energy to survive on . I worry that all this stress will cause burnout and compassion fatigue . Don’t let them sneak up on you . Use your recourses at work, and don’t be afraid or embarrassed to ask for help . You must express your needs, de-stress and give yourself much kindness, compassion and patience .

Nursing is a fabulous career but it is tough work! Caring comes at a price, so you must care for yourself first and keep your life in balance . These are complex times and you will weather this storm if you do not abandon your needs . That way, you will have the strength and courage to present your best self to those who need you the most: your patients .

P .S . I’m feeling guilty for being retired .

June 2020 The Wisconsin Nurse Page 13

By Dr. Mary Ellen Wurzbach

When I graduated from nursing school in 1970 my primary concern was that I did not know sufficient psycho-motor skills to practice . I was graduating in the first class from one of the first BSN Programs in the country and the belief back then was that nurses who graduated from a Diploma Program had more psycho-motor skills and were more adequately prepared to practice . Before I graduated I went to see our Dean and told her that I was not ready to graduate . She patiently listened, patted me on the head and ushered me to the door, telling me I would do just fine .

After graduation I went to work on a surgical floor . After three months on the floor I was made a charge nurse (Assistant Head Nurse), a role in which I continued for two years . I was practicing in a hospital that had its own Diploma Program nearing its end and my colleagues convinced me that what BSN graduates had that others might not was a theoretical base to build upon . This, as they conveyed to me, was evidenced by my promotion to charge nurse after only three months .

Many years later, as a faculty member at the University of Wisconsin-Oshkosh, I came to a conclusion - that what the theoretical base did was provide grounding in good judgment . As I taught, I wanted my students to leave my classes able to read, write and speak but, even more so, to have good judgment .

I thought long and hard about how to instill judgment skills and decided at some point that there were aspects of judgment which could be taught, although indirectly . More than any other aspect I came to recognize and appreciate the importance of assessment - physical, psychological and psychosocial .

Too often I saw practitioners make a decision with little or no information, based on assumptions, experiential prejudices or in some cases not taking the time to complete an assessment .

Thus, even before I taught, I decided to pursue a Master’s degree which emphasized both clinical and administrative assessment . I found and believed that accurate assessment was the most important skill leading to appropriate judgment, care plans and interventions . Evaluating the results of a judgment was also essential in revising care plans and interventions and, again, judging the efficacy and appropriateness of what was done .

I spent years teaching all forms of assessment skills, including home assessment, physical assessment, organizational assessment, community assessment and mental health assessment . I concluded that too often poor judgment was based on a limited or nonexistent assessment . The practitioner in question just did not have sufficient information to even make a judgment and certainly not a sound judgment .

Frequently in the health care system I see a lack of health and physical assessment . In my Master’s Program a review of systems and the health assessment interview were integral parts of the assessment process . Physical assessment as an APNP was emphasized .

Judgment in NursingSometimes assessment requires patience and time the practitioner

believes he or she does not have . However, not taking the time often leads to judgments based on assumption, and suppositions about past behavior, which are always suspect . There is an old philosophical argument that says that just because the sun rose this morning doesn’t necessarily mean it will again tomorrow . Jumping to conclusions, committing logical fallacies, performing little or no assessment, and having preconceived ideas all hamper sound judgment . Frequently, however, these obstacles to good judgment are personality characteristics or heuristics and biases which are innate to all of us . But decision-makers can be taught to collect more information and do a more thorough and comprehensive assessment .

This sounds daunting, but it may be as simple as returning a phone call or withholding judgment until more information is available . A noted decision theorist tells decision makers that they should always consider that they just might be wrong . His solution to the problem of false conclusions is to delay a decision, on the assumption that one might be mistaken .

The difference I have found between the students who I perceive to have “good” judgment and those who don’t is a questioning attitude and time spent making a decision . Students I have taught who have good judgment take the time to gather the necessary information to make a sound decision . They don’t assume they “know” or that the patient can’t help or convey to them what in the patient’s frame of reference might be the best course of action . Above all, they question themselves . Too often, perceived time constraints, premature conclusions and a lack of questioning lead to less than optimal choices .

In all the years I taught I never failed a student but if a student did not receive the highest grade it was usually that they didn’t exert sufficient effort to receive it . I graded on effort and outcome . If either were not sufficient the student received a lower grade . Invariably, the effort which justified the higher grade, because the outcome was better, was that of a complete assessment . Sometimes an assessment is quite complicated but many times quite simple .

Sound decisions in health care have such a profound impact that to do anything less is providing suboptimal care and may have a very deleterious effect on the health of the patient . Maybe judgment cannot be taught directly, but students can be taught to do a continuous assessment, can be taught not to assume and can be taught that even something as simple as delaying or questioning one’s own perspective may save a life or prevent irresolvable consequences . Taking the time to assess is essential to good judgment .

Are you an experienced

NURSE LEADER?

Aznurse.org/CEOSearch

Be the new CEO of Arizona Nurses Association

Page 14 The Wisconsin Nurse June 2020

The purpose of WINPAC is to endorse candidates for the Wisconsin Legislature based upon the principles of the WNA Public Policy Agenda .

WINPAC encourages nurses to become active and effective in shaping public policy through the electoral process . WINPAC raises funds to educate nurses about political action . The Board of Trustees evaluates, endorses, and contributes to candidates for the State Legislature in Wisconsin who have clearly demonstrated responsible awareness of nurses' needs .

WINPAC is looking for contributions to support our endorsement efforts . With a contribution of $25 .00 or more you will receive “Registered Nurse Voter” button .

WINPAC Endorsements

As our community is feeling the effects of the COVID-19 virus outbreak, it is a time when nurses and frontline health providers are tasked the greatest . Yet, as in any crisis, nurses continue to step up and provide the leadership and expertise that we need to get through these difficult times . It is during these times, that we often look to government to make honest and rational decisions (nurses call these “evidence-based” decisions) that can help us manage and mitigate the effects of the COVID-19 pandemic .

Never before have the stakes been higher . That is why it is critical to have nursing represented in our state legislature! This fall, WINPAC has made early endorsements for the following Wisconsin Registered Nurse and Advanced Practice Nurses who are running for the State Assembly:

Gae Magnafici – Assembly District 28, DresserRachel Cabral-Guevara - Assembly District 55, AppletonEmily Siegrist - Assembly District 24, River HillsWINPAC is proud to early endorse these three candidates and asks for

your help in getting them elected . Learn more about how to support them and WINPAC’s efforts by going to the WINPAC webpage: https://www .wisconsinnurses .org/about-wna/affiliates/winpac/

The Wisconsin Nurses Association formed the WNA COVID-19 subcommittee in March 2020 in response to the rapidly changing environment of the COVID-19 pandemic . The subcommittee, composed of nine members, was charged to identify WNA members’ knowledge and needs in response to COVID-19, identify issues, disseminate findings, and inform practice and policy . The subcommittee developed, piloted and ultimately disseminated a survey to 3,000 WNA members between April 1 and April 17, 2020 . Survey questions included 12 quantitative questions regarding nursing role, preparedness to care for COVID-19 patients, concerns, and educational needs . Two additional open-ended questions were used to solicit additional feedback and information .

In total, 514 members responded to the survey representing 44 Wisconsin counties . 61 .1% of respondents (n=314) work in direct patient care . The majority of nurses who completed the survey reported either working with COVID-19 patients or COVID-19 rule out patients (50 .63%), or believe they will in time (24 .37%) . Respondents reported that, while there are ongoing needs, most nurses feel knowledgeable and prepared to face COVID-19 . Approximately 60% agreed that their infection control training had prepared them for COVID-19 (45 .57% - agree, 14 .41% - strongly agree), and that they had enough knowledge about COVID-19 to deliver safe patient care (12 .06% - strongly agree, 47 .03% - agree) . However, only 40% felt that their workplace was equipped to handle COVID-19 cases (8 .9% strongly agree and 31 .7% agree) . A mere 29% (6 .9% strongly agree and 22% agree) felt that their workplace was able to provide adequate and appropriate personal protective equipment (PPE) to safely perform nursing duties, with 22% of respondent strongly disagreeing .

In an effort to target relevant and desired resources, WNA asked respondents to prioritize their concerns . PPE and Safety of Family and Community were most frequently listed as the top two priorities, followed by personal safety, and caring for patient under investigation . Two open-ended questions regarding additional needs and comments were examined . The final questions revealed two primary themes: need for evidence-based best practice updates and mental health support for nurses . Nurses expressed their concerns about how to best educate not only themselves, but their family and communities as well . The need for support and mental health outlets was clear, and is a priority for WNA moving forward .

In response to the survey, WNA is working on many different tools and recourses to best support members and non-members across the state . WNA is developing educational materials that reflect the desires of the members (survey update, ethics), as well as identifying resiliency strategies for nurses . WNA continues to monitor the status of PPE across the state, and update best practice recommendations particularly related to PPE, COVID-19 transmission and testing . Additionally, WNA is forming a COVID Organizational Affiliate Group which consists of other Wisconsin nursing associations . Finally, WNA continues to respond to changing guidelines, including ventilator allocation and transfers to long term care facilities .

WNA is proud of the nurses across the state who are battling the COVID-19 pandemic and is working to support them . All nurses are encouraged to reach out, share thoughts and concerns .

Results of WNA Member COVID Survey

June 2020 The Wisconsin Nurse Page 15

ANA Updates

Your future starts now, so make the Year of the Nurse your year to inspire, grow, and celebrate! Throughout the year, we encourage you to seek opportunities and engage in activities to promote nursing excellence, infuse leadership, and foster innovation . Below are suggestions for how you can excel, lead, and innovate .

EXCELGo beyond the ordinary in 2020 and make

this the year you focus on your professional and personal development .

• Find a mentor . Is there a colleague, nurse friend, or former instructor who has useful insights to share or inspires you to be your best? Having a mentor who can help you navigate your career and offer advice could be the motivation you need to excel and advance your nursing career . ANA also offers its members a Mentorship Program . Enrollment for 2020-2021 will open in the summer .

• Take your nursing to the next level. Do you want to build your leadership ability or improve your nursing practice? Webinars and online courses can help enhance your knowledge and give you the skills you need to succeed . Sign up for the free webinars Ten Steps to Becoming a Successful Nursing Manager or What’s Happening in Nurse Staffing?

• Knowledge is power. Make 2020 your year for professional development . Whether you are looking to achieve your first certification, explore new ones, or renew a certification, The American Nurses Credentialing Center Certification Program lets you demonstrate your specialized knowledge and continuing competence .

• Make self-care a priority. Join the Healthy Nurse Health Nation Grand Challenge, an initiative to connect and engage nurses, employers, and organizations around improving health in five areas: physical activity, nutrition, rest, quality of life, and safety . If you’re looking for an inspiring way to focus on your well-being in 2020, join the monthly challenges .

• Give back to your community. Help promote the value of nursing by supporting a special health screening event in your community or volunteering at a health clinic . Consider joining a local organization that supports something you are passionate about and could benefit from your insight as a health care professional .

LEADAs a nurse you inspire, influence, and innovate

— all leadership qualities . In this Year of the Nurse, commit to elevating your voice to show the influence you have as the backbone of health care .

• Inspire the next generation. Your outreach this year is critical to engaging with the next generation of nurses and increasing workforce diversity . Visit elementary and middle schools, career fairs, community centers, and youth clubs to talk about your path to nursing and inspire future nurses .

• Exercise leadership skills. Make this the year you learn more about how you can serve on a board of directors . Start by visiting Nurses on Boards for resources and updates on nationwide board opportunities . If you are

already contributing to board leadership, inspire others to serve on boards by sharing your “bedside to boardroom” story .

• Impact political change. In this critical election year, make a commitment to engage in political advocacy . Visit RNAction to learn how you can ensure nurses’ voices are heard by politicians . Learn more about candidates, priority issues, voter registration, and ways to volunteer on campaigns . Share what you learn with your friends, family, and colleagues . 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 with your local media . Reach out to a reporter in your city who covers health issues to recommend they do a story about the “Year of the Nurse,” submit an editorial to your local newspaper, or send a letter to the editor commenting on recent coverage that would have benefited from the nursing perspective .

• Elevate your profession. 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 . When making work-related posts, be attentive ANA’s Social Networking Principles . #YON2020 .

• Inspire colleagues. Words of encouragement and random acts of kindness can make all the difference in a person’s day, especially for nurses . 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 our 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 achieve better health .

INNOVATENurses 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 .

• Initiate an innovation program. 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 it? If your organization does not have an innovation program, how can you start one that improves workflow, efficiency, and patient care?

• 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 hackathons are fun ways to learn about innovation, design thinking, and even failure . Check for corporate-sponsored events, or competitions at local nursing schools or your state nurses association .

• 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 nursing-led innovation you want to see through from concept to reality? Consider launching your idea at NursePitch™, 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 .

Suggestions for Celebrating and Elevating Nursing throughout the Year

RN OpportunitiesLooking for a career change?We have just the opening for you!• Critical Care Unit

• Emergency Services

• Med/Surg

Apply online at hfmhealth.org/careers!

Join our award winning, patient centered, and community minded organization!

Human Resources2300 Western Ave · PO Box 1450Manitowoc, WI 54221-1450Phone (920) 320-4029recruiter@hfmhealth.org

Equal Opportunity/Affirmative Action Employer

Openings available

throughout Wisconsin

BENEFITS

CLINICAL MANAGERS, REGISTERED NURSES, & PATIENT CARE TECHNICIANSCome Explore a Nursing Career in Kidney Care!

w Paid Training for Non-Dialysis Nurses or Technicians w Tuition Reimbursement w Clinical Advancement Programs w Sundays Off

w Very Competitive Pay w Best in Class Benefit Package including: medical, vision, dental, 401k, etc...

If interested, please contact one of our representatives below or visit jobs.fmcna.com/Wisconsin-Jobs

An Equal Opportunity Employer.

Ebony Moore 856-667-7537 | Ebony.Moore@fmc-na.com

Kim Davie 256-770-7754 | Kim.Davie@fmc-na.com

JOIN WNA TODAY!

SEE PAGE 2