Nurse Reporter Summer 2013 - Wyoming State Board of Nursing
Nurse Reporter Summer 2013 - Wyoming State Board of Nursing
Nurse Reporter Summer 2013 - Wyoming State Board of Nursing
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VOL. 9<strong>Nurse</strong>NUMBER 2 SUMMER<strong>2013</strong>R E P O R T E RWYOMINGEDUCATION
Ally Cordonier, RN
WYOMING<strong>Summer</strong> <strong>2013</strong> VOL. 9 NUMBER 2<strong>Nurse</strong> R“Serving and safeguarding thepeople <strong>of</strong> <strong>Wyoming</strong> through theregulation <strong>of</strong> nursing educationand practice”E P O R T E RPublished by the<strong>Wyoming</strong> <strong>State</strong> <strong>Board</strong> <strong>of</strong> <strong>Nursing</strong>130 Hobbs Ave., Suite BCheyenne, <strong>Wyoming</strong> 82002Phone: 307-777-7601Fax: 307-777-3519Web Address: http://nursing.state.wy.usMission: To serve and safeguard the people <strong>of</strong><strong>Wyoming</strong> through the regulation <strong>of</strong> nursing educationand practice.Vision <strong>State</strong>ment: Acknowledging the dynamicnature <strong>of</strong> healthcare, provides the climate, collaborationand regulatory framework for nurses to practice to thefullest extent <strong>of</strong> their scope.Values: Excellence, Ethics, Education, Safety andCompetence.EDITORSKathleen Laidlaw, RNMarguerite HermanBOARD PRESIDENTCarrie Deselms, MSN, APRN, FNP-BCVICE PRESIDENTMarcie Burr, RN, RD, CCHPSECRETARYLori Johnson, LPNAPRN MEMBERDonna Nurss, MS, APRN, BCRN MEMBERCindy Woods, BSN, RN, BCRN MEMBERTracy Wasserburger, RNC,NNPPUBLIC MEMBERBarbara <strong>Summer</strong>sT A B L E O F C O N T E N T S3 <strong>2013</strong> <strong>Wyoming</strong> <strong>State</strong> <strong>Board</strong> <strong>of</strong> <strong>Nursing</strong> Meetings4 Executive Director’s Message5 Message from the <strong>Board</strong> President6 Reporting Violations <strong>of</strong> the <strong>Wyoming</strong> <strong>Nurse</strong> Practice Act and<strong>Wyoming</strong> <strong>State</strong> <strong>Board</strong> <strong>of</strong> <strong>Nursing</strong> Rules and Regulations:Facility and Licensee Obligations8 New HIPPA Rules10 Medical Malpractice Cases, <strong>Nurse</strong>s are not “Out <strong>of</strong> the Woods”11 <strong>Wyoming</strong> Stakeholders Meet to Discuss <strong>Nurse</strong> Licensure Compact12 <strong>Nurse</strong> Monitoring Program and Incidental Exposure to Alcohol14 Revolutionizing <strong>Nursing</strong> Education in <strong>Wyoming</strong> (ReNEW)16 Recent Cases <strong>of</strong> Interest18 Donate to our ‘Wall <strong>of</strong> Caps’19 <strong>Wyoming</strong> Council for Advanced Practice <strong>Nursing</strong>19 Two board members drive more than 1,100 miles to attend MidyearMeeting20 <strong>Wyoming</strong> Center for <strong>Nursing</strong> and Health Care Partnerships Corner24 What Can a Baccalaureate Degree Do For Me?27 Disciplinary ActionsON THE COVER: Associate degree nursing students from Central <strong>Wyoming</strong> Collegein Riverton auscultate lung sounds in the simulation lab. Students are (left to right):Bridget Carlson Gardner, Lacey Mills, Natalie Hawk.<strong>2013</strong> WYOMING STATE BOARDOF NURSING MEETINGSAll board meetings are held in accordancewith <strong>Wyoming</strong> Public Meetings Statutes andare open to the public. Unless otherwisespecified, all <strong>Board</strong> meetings are at 138 HobbsAve, Cheyenne WY 82002.Please feel free to join us in person orvia teleconference at the regularly scheduledquarterly meeting or interim teleconferencemeetings. Minutes <strong>of</strong> past meetings areavailable on the WSBN Web site under “<strong>Board</strong>Meetings.”Requests for agenda items must besubmitted at least two business weeks priorto the scheduled board meeting. If you havequestions regarding a board meeting or agendaitem, or if you have special needs for access toa board meeting, please contacts our ExecutiveAssistant at 307-777-3425.pcipublishing.comCreated by Publishing Concepts, Inc.David Brown, President • dbrown@pcipublishing.comFor Advertising info contactVictor Horne • 1-800-561-4686 ext. 114vhorne@pcipublishing.comThink<strong>Nurse</strong>.comEDITION 33July 8-11 <strong>Board</strong> MeetingJuly 29 Teleconference, time to be determinedOctober 7-10 <strong>Board</strong> MeetingOctober 28 Teleconference, time to be determinedWYOMING NURSE REPORTER 3
eetingsFrom Cynthia LaBonde, MN, RNExecutive DirectorThe theme <strong>of</strong> this issue <strong>of</strong> WNR is “Education,” so I thoughtI would begin by explaining how the <strong>Wyoming</strong> <strong>State</strong> <strong>Board</strong> <strong>of</strong><strong>Nursing</strong> -- a regulatory agency -- is connected to education.The mission <strong>of</strong> the <strong>Board</strong> <strong>of</strong> <strong>Nursing</strong> is to serve and safeguardthe people <strong>of</strong> <strong>Wyoming</strong> through the regulation <strong>of</strong> nursingeducation and practice. That mission drives everything we do,and Chapter VI <strong>of</strong> our Administrative Rules and Regulationsis devoted to “Standards for <strong>Nursing</strong> Education Programs.”Quoting directly from Rules:“The purpose <strong>of</strong> the board in adopting rules and regulations… is to: (i) Serve as a guide for the development <strong>of</strong> new nursingeducation programs; (ii) Provide criteria for the evaluation andapproval <strong>of</strong> new and established nursing education programs;(iii) Foster the continued improvement <strong>of</strong> established nursingeducation programs; (iv) Ensure that graduates <strong>of</strong> nursingeducation programs are prepared for safe nursing practice; (v)Assure eligibility for admission to the licensure examination fornurses; and (vi) Facilitate interstate endorsement <strong>of</strong> graduates <strong>of</strong>board-approved nursing education programs.”The <strong>Board</strong> initially considers the characteristics <strong>of</strong> theprogram to confirm that it meets minimum expectations <strong>of</strong>providing the educational foundation to prepare future nursesin practice, both in organization and in curriculum. Ideally, thecurriculum includes solid clinical and classroom components toThe mission <strong>of</strong> the <strong>Board</strong> <strong>of</strong> <strong>Nursing</strong>is to serve and safeguard the people <strong>of</strong><strong>Wyoming</strong> through the regulation <strong>of</strong> nursingeducation and practice. That mission driveseverything we do, and Chapter VI <strong>of</strong> ourAdministrative Rules and Regulationsis devoted to “Standards for <strong>Nursing</strong>Education Programs.”provide nursing students with practical exposure and practice ina variety <strong>of</strong> clinical settings. Once a program is approved, the<strong>Board</strong> reevaluates the program every eight years, which includesa site visit. Each program also submits an annual report withdocumentation <strong>of</strong> continued compliance with the standards fornursing education, projected program changes, faculty data formsand current college catalog.The process for <strong>Board</strong> approval <strong>of</strong> a program can be comparedto a recipe. As with any good recipe, there must be ingredientsthat are very familiar and those that provide for more creativity.It is an evolving process not only for the programs but for the<strong>Board</strong> as well. The programs themselves are also developingcreative methods for education, including different types <strong>of</strong>opportunities for clinical experiences and partnerships toaccommodate the needs <strong>of</strong> both the student population and anever evolving nursing environment.The <strong>Board</strong> has received a multitude <strong>of</strong> requests for approvalby online out-<strong>of</strong>-state programs for approval. Technology haschanged the landscape <strong>of</strong> traditional nursing programs. Thepopulation <strong>of</strong> students also demands the accommodationsand conveniences online programs may <strong>of</strong>fer. However, theexpectations for these programs to provide a solid educationalbackground for nurses do not change. In fact, the <strong>Board</strong>’sPractice and Education Committee, which is also assigned torespond to practice and education questions on a continuingbasis, has established an objective that all nursing educationprograms, whether brick-and-mortar or online, will meet thestandards expected <strong>of</strong> programs. In other words, there is processimprovement even with the <strong>Board</strong> to meet the needs <strong>of</strong> nursingeducation.The <strong>Board</strong> is committed both to keep up with the times andto actively effect improvement <strong>of</strong> formal educational programs,both traditional and emerging. This requires attentiveness tothe trends in nursing practice, which are also influenced bytechnology. In addition, this requires the <strong>Board</strong> to hear thechallenges the programs themselves face. After all, we all have acommon goal: to equip nurses to meet competency expectationsand, by doing so, prepare a pr<strong>of</strong>essional workforce that providessafe practice to the people <strong>of</strong> <strong>Wyoming</strong>.4 WYOMING NURSE REPORTER
PRESIDENT’S OPINIONFrom Carrie DeselmsPresident <strong>of</strong> <strong>Wyoming</strong> <strong>State</strong> <strong>Board</strong> <strong>of</strong> <strong>Nursing</strong>Congratulations to the many newnursing graduates who have recentlycompleted their program <strong>of</strong> studies and arepreparing for that final exam, the NCLEX.Each and every one <strong>of</strong> the seven schools<strong>of</strong> nursing located within the <strong>State</strong> <strong>of</strong><strong>Wyoming</strong> has been granted approval bythe <strong>Wyoming</strong> <strong>State</strong> <strong>Board</strong> <strong>of</strong> <strong>Nursing</strong>.All provide excellent education, trainingand clinical experiences for their nursingstudents. <strong>Wyoming</strong> nursing schools areindeed exceptional.Many new nursing graduates talk abouthow they can’t wait to get out in the“real” world <strong>of</strong> nursing and put in PICClines, draw blood, administer medications,work a code, defibrillate V-Tach -- ingeneral many <strong>of</strong> the fast paced technicalactivities <strong>of</strong> being a nurse. Few nursinggraduates ever say they want to teach.They want the Emergency Department orIntensive Care Unit action.Yet every licensed nurse is truly aneducator. It might be explaining to apatient to avoid grapefruit juice withcertain medications, or training a familymember how to do home peritonealdialysis, or preparing a disaster plan for acommunity. <strong>Nurse</strong>s are natural teachers <strong>of</strong>health promotion. We teach and supportour communities through outreach likehealth fairs and immunization clinics.We also teach each other throughpeer review, orientations, precepting andmentoring. The spirit <strong>of</strong> learning andteaching is intrinsic to the pr<strong>of</strong>ession.<strong>Nurse</strong>s have the knowledge, skills andattitudes to be remarkable educators withtheir patients, families, communities andeach other.We welcome our new graduates aspeers into this wonderful pr<strong>of</strong>ession <strong>of</strong>nursing and we hope some will evenconsider teaching nursing as a <strong>Nurse</strong>Educator in their future.WSBN STAFFCHANGESLaura Rowe, JD, our <strong>Nurse</strong> Monitoring ProgramManager and Investigator, has added a new WSBN title:Compliance and Discipline Department Manager. Laurajoined the WSBN staff 18 months ago and had beenInterim Compliance and Discipline Manager for sixmonths. She assumed the permanent position on June 1,<strong>2013</strong>.Lacey Osburn has accepted the job <strong>of</strong> InvestigativeAssistant, effective June 17, <strong>2013</strong>. She comes to WSBNfrom the <strong>Wyoming</strong> Department <strong>of</strong> Transportation,where she has been integrally involved with preparingdocuments for hearings and working with the state’sOffice <strong>of</strong> Administrative Hearings.The <strong>Board</strong>’s position for Practice and EducationConsultant is open until filled.WSBN LICENSESAND CERTIFICATESRENEWED FOR <strong>2013</strong>-14The statistics are compiled on the number <strong>of</strong> nurses andcertified nursing assistants who renewed their licenses andcertificates with the <strong>Wyoming</strong> <strong>State</strong> <strong>Board</strong> <strong>of</strong> <strong>Nursing</strong> by thedeadline Dec. 31, 2012. The next renewal deadline is Dec.31, 2014.The renewal tally:1,925 in October3,199 in November6,442 in DecemberAnother 675 renewals were processed in January andFebruary <strong>of</strong> <strong>2013</strong>. That is a total <strong>of</strong> 12,241 renewals out <strong>of</strong>17,129 licenses and certificates that expired at the end <strong>of</strong> 2012,a rate <strong>of</strong> 71.5 percent.The <strong>Board</strong> also issued 1,647 initial licenses and certificatesby the end <strong>of</strong> February <strong>2013</strong> for a total <strong>of</strong> 13,890.WYOMING NURSE REPORTER 5
Laura C. Rowe, JD, <strong>Nurse</strong> Monitoring Program Manager / InvestigatorReporting Violations <strong>of</strong> the <strong>Wyoming</strong> <strong>Nurse</strong> Practice Act and<strong>Wyoming</strong> <strong>State</strong> <strong>Board</strong> <strong>of</strong> <strong>Nursing</strong> Rules and Regulations:Facility and Licensee ObligationsThe mission <strong>of</strong> the <strong>Wyoming</strong> <strong>State</strong><strong>Board</strong> <strong>of</strong> <strong>Nursing</strong> is to “serve andsafeguard the people <strong>of</strong> <strong>Wyoming</strong> throughregulation <strong>of</strong> nursing education andpractice.” License- and certificate-holdersin <strong>Wyoming</strong> have an important role toplay in this mission.The <strong>Board</strong> carries out its mission inpart by ensuring that licensees continueto adhere to the standards <strong>of</strong> nursingpractice and follow the provisions <strong>of</strong> the<strong>Wyoming</strong> <strong>Nurse</strong> Practice Act (NPA) andthe <strong>Board</strong>’s rules and regulations. The<strong>Board</strong> accomplishes this task primarilythrough investigation <strong>of</strong> complaintsand grievances filed with the <strong>Board</strong>.Complaints allege a licensee or certifiednurse assistant (CNA) is not meeting thestandard <strong>of</strong> nursing or nursing assistantpractice or in some other manner is inviolation <strong>of</strong> the NPA or <strong>Board</strong>s rules.The nursing pr<strong>of</strong>ession is highly selfregulated.Employers, nurses and nursingassistants have obligations to tell the<strong>Board</strong> <strong>of</strong> violations <strong>of</strong> the NPA and<strong>Board</strong>’s rules and regulations. Patientsand citizens with concerns about nursingpractice and care can also file complaintswith the <strong>Board</strong>.Following is a discussion<strong>of</strong> these reporting requirements.Employers <strong>of</strong> nurses and certified nurseassistants have an obligation under theNPA to report to the <strong>Board</strong> those nursesand CNAs who are terminated or resignas a result <strong>of</strong> a violation <strong>of</strong> the NPA.Specifically, the NPA provides:Wyo. Stat. Ann. § 33-21-153Names <strong>of</strong> terminated licensees to board;enforcement by court order; civilcontempt for noncompliance; immunity.(a) Hospitals, nursing homes and otheremployers <strong>of</strong> registered nurses,licensed practical nurses, andadvanced practice registered nursesshall report to the board the names<strong>of</strong> those licensees whose employmenthas been terminated voluntarilyor involuntarily for any reasonsstipulated in W.S. 33-21-146.(b) The board may seek an order from aproper court <strong>of</strong> competent jurisdictionfor a report from any <strong>of</strong> the partiesstipulated in subsection (a) <strong>of</strong> thissection if one is not forthcomingvoluntarily.(c) The board may seek a citation forcivil contempt if a court order for areport is not obeyed by any <strong>of</strong> theparties stipulated in subsection (a) <strong>of</strong>this section.(d) Any institution or person reportingin good faith and without fraud ormalice, information to the boardunder this section, is immune fromcivil action as provided in W.S. 33-21-150.A majority <strong>of</strong> the complaints filedwith the <strong>Board</strong> are those from facilitiesthat have terminated a nurse or CNAfor alleged violations <strong>of</strong> the NPA asrequired under subsection (a). Uponreceipt <strong>of</strong> these complaints <strong>Board</strong> staffevaluates their content to determine ifan investigation is warranted to furtherreview the allegations.It should be noted that not everytermination <strong>of</strong> a nurse or CNA warrantsa complaint or report being filed with the<strong>Board</strong>. For example, a nurse or CNA whois terminated as a result <strong>of</strong> employmentrelatedissues (i.e. numerous absencesand tardiness, failure to follow policieson appropriate dress code, etc.) has notviolated the NPA or the <strong>Board</strong>’s rules andregulations, as these actions do not relateto patient care and safety. When theboard receives complaints <strong>of</strong> this nature,our staff will not open an investigationbut will notify the complainant that theconduct is not a violation <strong>of</strong> the NPA or<strong>Board</strong>’s rules and regulations. <strong>Board</strong> staffwill also provide the licensee with a copy<strong>of</strong> the complaint with notification thatno investigation was opened, resulting indismissal <strong>of</strong> the complaint.<strong>Nurse</strong>s and CNAs also have anobligation to report licensees engagingin unfit or unsafe practice or who areotherwise committing violations <strong>of</strong> theNPA and the <strong>Board</strong>’s rules and regulations.These reporting requirements are asfollows:Chapter 3, Section 2(a) [Standards <strong>of</strong><strong>Nursing</strong> Practice for the RegisteredPr<strong>of</strong>essional <strong>Nurse</strong>] <strong>of</strong> the <strong>Board</strong>’sRules:(i) The registered pr<strong>of</strong>essional nurseshall:(G) Report unfit or incompetent nursingpractice to the recognized legalauthorities [.]Chapter 3, Section 2(a) [Standards<strong>of</strong> <strong>Nursing</strong> Practice for the LicensedPractical <strong>Nurse</strong>] <strong>of</strong> the <strong>Board</strong>’s Rules:(i) The licensed practical nurse shall:(J) Report unfit or incompetentnursing practice to the board. Reportunsafe conditions for practice torecognized legal authorities [.]Chapter 7, Section 7(b) (vi) [Basic<strong>Nursing</strong> Functions, Task, and Skillsthat may be Delegated] for Certified<strong>Nursing</strong> Assistants:(vi) <strong>Nursing</strong> Team Member Skills <strong>of</strong> theCertified <strong>Nursing</strong> Assistant:(J) Reporting unsafe, neglectful or abusivecare [.]In addition, a nurse or CNA can facedisciplinary action for not reporting unsafenursing practice. The NPA provides asfollows:Wyo. Stat. Ann. § 33-21-146.Disciplining licensees and certificateholders; grounds.(a) The board <strong>of</strong> nursing may . . .suspend or revoke the license, certificateor temporary permit <strong>of</strong> any person, or6 WYOMING NURSE REPORTER
to otherwise discipline a licensee orcertificate holder, upon pro<strong>of</strong> that theperson:(viii) Has knowingly and willfullyfailed to report to the board anyviolation <strong>of</strong> this act or <strong>of</strong> board rulesand regulations [.]<strong>Nurse</strong>s and CNAs, as well as theiremployers, play an important role inthe regulation <strong>of</strong> nursing practice. Thecontinuing integrity <strong>of</strong> the nursingpr<strong>of</strong>ession requires that those nursesand CNAs who are engaging in actsinconsistent with the standards <strong>of</strong>nursing practice be reported to the<strong>Board</strong> for investigation and possibleremediation, including additionaltraining, and potential removalfrom nursing practice until they candemonstrate they are able to providesafe and adequate patient care.For more information on thedisciplinary process or complaintprocedures please visit https://nursingonline.state.wy.us/Default.aspxandclick on the “Discipline” tab or e-mailbon-wsbncompliance@wyo.gov.You realized your nursing dream.Now Realize YourPOTENTIAL.Earn your BSN or MSN Online.You’ve come a long way since your first day as an RN. Goeven further with one <strong>of</strong> Jacksonville University’s acclaimednursing programs, <strong>of</strong>fered in a 100% online classroom.• RN to BSN – Now OfferingScholarships!• MSN: Leadership in HealthcareSystems• MSN: Clinical <strong>Nurse</strong> EducatorJacksonvilleU.com/OnlineProgramOr, talk with a specialist:800-571-49348-week classes | 6 sessions per year© 2012 All Rights Reserved. Made Available by University Alliance®The Nation’s Leading Universities Online. SC: 191734ZJ1 | MCID: 13186One <strong>of</strong> America’s Best CollegesU.S. News & World ReportDOCTORALNURSING DEGREESNOW TAKIN G APPLICATION SThe Ph.D. in <strong>Nursing</strong> programwill prepare graduates to conduct<strong>Summer</strong> <strong>2013</strong>independentresearch, collaborateas scholars, and educate forimproving health and healthcare globally. The application isavailable atwww.isu.edu/nursing/phd.shtmlSchool <strong>of</strong> <strong>Nursing</strong>The Doctor <strong>of</strong> <strong>Nursing</strong> Practicedegree program will prepareFall <strong>2013</strong>the graduate forpractice in the Family<strong>Nurse</strong> Practitioner role with anemphasis on innovation andevidence based practice. Theapplication is available atwww.isu.edu/nursing/dnp.shtml.MS and BSN options are also available at ISU School <strong>of</strong> <strong>Nursing</strong>.(208) 282-2132 • www.isu.edu/nursingNow Recruiting!Welcome to <strong>Wyoming</strong> Behavioral Institute, a 90-bed acute carepsychiatric hospital in Casper, <strong>Wyoming</strong>, specializing in thetreatment <strong>of</strong> children, adolescents and adults.Our philosophy is intensity <strong>of</strong> service with a true patient focus.We believe in providing the highest quality treatment servicesavailable for long-term healing and improved quality <strong>of</strong> life.If you have a commitment to service excellence, join our team today!• RNs • LPNsNew Grads Welcome!We <strong>of</strong>fer excellent compensation and full benefits package. Thestate <strong>of</strong> <strong>Wyoming</strong> has no state income tax! Interested applicantsplease visit our website and apply online today!<strong>Wyoming</strong> Behavioral Institute has been accredited by theJoint Commission on the Accreditation <strong>of</strong> HealthcareOrganizations (JCAHO) and is licensed by the <strong>State</strong> <strong>of</strong><strong>Wyoming</strong>’s Department <strong>of</strong> Health.<strong>Wyoming</strong> Behavioral Institute is owned, managed andoperated by a subsidiary <strong>of</strong> Universal Health Services,Inc., one <strong>of</strong> the largest providers <strong>of</strong> high-quality health-care in the nation.www.wbihelp.comWYOMING NURSE REPORTER 7
GOOD TO KNOW...New federal regulations must beimplemented by Sept. 24, <strong>2013</strong>, so thepublic can better protect and control theirpersonal or protected health information.The new regulations also implementtougher privacy and security provisions forcovered entities by lowering the securitybreach notification standard.The Department <strong>of</strong> Health and HumanServices released new regulations underthe Health Insurance Portability andAccountability Act (HIPAA) on Jan. 17,<strong>2013</strong>, to become effective March 26.Many<strong>of</strong> the changes must be implemented onSept. 24.The HIPAA Privacy and Security Ruleshave focused on health care providers,health plans and other entities that processhealth insurance claims. The regulationsexpand many <strong>of</strong> the requirements to businessassociates <strong>of</strong> these entities that receiveprotected health information (PHI), suchas contractors and subcontractors. Some <strong>of</strong>the largest breaches reported to HHS haveinvolved business associates. Penalties areincreased for noncompliance based on thelevel <strong>of</strong> negligence with a maximum penalty<strong>of</strong> $1.5 million per violation. The changesalso strengthen the Health InformationTechnology for Economic and ClinicalHealth (HITECH) Breach Notificationrequirements by clarifying when breaches<strong>of</strong> unsecured health information must bereported to HHS.Although the new regulations donot substantially alter the fundamentalstructure <strong>of</strong> HIPAA compliance, coveredentities and employers will likely need tomake some changes to ensure continuedcompliance.Changes to Security Breach NotificationStandardsThe new regulations establish a lowerstandard for determining whether a coveredentity must notify a patient or health planparticipant <strong>of</strong> a security breach involvingtheir PHI. The old standard requirednotification only if an unauthorized useor disclosure <strong>of</strong> PHI “posed a significantrisk <strong>of</strong> financial, reputational, or otherNew HIPAA Rulesharm” to the subject. Under the newregulations, the covered entity is requiredto notify <strong>of</strong> a security breach following anyunauthorized disclosure <strong>of</strong> unencryptedPHI unless the entity can prove that thereis a “low probability” that the PHI hasbeen compromised based on a four-partrisk assessment. The risk assessment mustconsider:(1) The nature and extent <strong>of</strong> the PHIinvolved, including the types <strong>of</strong>identifiers and the likelihood <strong>of</strong> reidentification;(2) The unauthorized person who usedthe information or to whom thedisclosure was made;(3) Whether the PHI was actuallyacquired or viewed; and(4) The extent to which the risk to thePHI has been disclosed.If the covered entity determines thereis a low probability the PHI has beencompromised, it must document its riskassessment supporting the decision not tonotify patients or participants <strong>of</strong> the breach.Changes to Individual Rights --New Notice <strong>of</strong> Privacy PracticesIndividual rights are expandedin important ways. Patients canask for a copy <strong>of</strong> their electronicmedical record in an electronicform. When individuals pay bycash they can instruct their providernot to share information abouttheir treatment with their healthplan. The new regulations set newlimits on how information is used anddisclosed for marketing and fundraisingpurposes and prohibits the sale <strong>of</strong> anindividuals’ health information withouttheir permission. The new regulations alsostreamline individuals’ ability to authorizethe use <strong>of</strong> their health information forresearch purposes.The new regulations require certainstatements in the Notice <strong>of</strong> PrivacyPractices (“NPP”) regarding uses anddisclosures that require authorization. TheNPP must contain a statement indicatingthat an authorization is required for: (1)most uses and disclosures <strong>of</strong> psychotherapynotes; (2) uses and disclosures <strong>of</strong> PHI formarketing purposes; and (3) disclosuresthat constitute a sale <strong>of</strong> PHI; as well as astatement that other uses and disclosuresnot described in the NPP will be made onlywith authorization from the individual.If a covered entity does not record ormaintain psychotherapy notes, it need notinclude the requisite statement in its NPP.The new regulations require a statement inthe NPP indicating the individual’s newright to restrict certain disclosures <strong>of</strong> PHIto a health plan where the individual paysout <strong>of</strong> pocket in full for the healthcare itemor service. Only healthcare providers arerequired to include such a statement inthe NPP. The new regulations also requirethat covered entities include in their NPPa statement <strong>of</strong> the right <strong>of</strong> an affectedindividual to be notified following a breach<strong>of</strong> unsecured NPP.8 WYOMING NURSE REPORTER
RN OPPORTUNITIESRegistered<strong>Nurse</strong>sSeeking a great work/life balance in a fulfilling environment?Then explore contributing your efforts for a dynamic team in beautiful Sheridan, <strong>Wyoming</strong>.Sheridan Memorial Hospital is recruiting for Registered <strong>Nurse</strong>s in a variety <strong>of</strong> departments.Work with a great team <strong>of</strong> healthcare pr<strong>of</strong>essionals within a growing organization withtremendous opportunity. Ideal candidates are detail oriented, organized, critically thinkingin a fast-paced environment, effective communicators & provide service excellence to all.Positions require <strong>Wyoming</strong> Registered <strong>Nurse</strong> license.Living at the base <strong>of</strong> the Big Horn Mountains <strong>of</strong>fers a beautiful setting with four seasons andunlimited recreational opportunities. Superb fishing, hiking, bicycling, backpacking, boating &hunting are right out the back door. Apply your talents and passion for excellence at SheridanMemorial Hospital, where the role <strong>of</strong> nursing is a highly valued!For more information & to apply, please visitwww.sheridanhospital.org and view Career Opportunities.EOE/AAPJackson Hole, a Great Placeto Live & WorkSt. John’s Medical Center, locatedin beautiful Jackson, <strong>Wyoming</strong> isaccepting applications for Registered<strong>Nurse</strong>s. We <strong>of</strong>fer:• Relocation Assistance• Hospital-based Childcare• Discounted Ski Pass• Competitive Salary/BenefitsFor more information, please visitwww.tetonhospital.orgClick on the “careers” tab to apply.PO Box 428, Jackson, WY 83001EOE/Drug Free Employer<strong>Nurse</strong>sWantedTuition ReimbursementGreat BenefitsSign-on BonusCompetitive WagesRelocation AssistanceFree Housing for 6 monthsContinuous Opportunitiesfor TrainingIn AllSpecialtieswww.ConverseHospital.com • 307-358-2122Memorial Hospital <strong>of</strong> Converse County is an equal opportunity employer.Behavioral Health CareMaking a difference in the lives<strong>of</strong> patients and their familiesNursiNg OppOrtuNities• Student Loan Repayment• Continuing Education• License Fee Reimbursement• Excellent Pay and BenefitsLearn more atprairie-stjohns.comFargo, NDWYOMING NURSE REPORTER 9
By Robert J. Walters, Senior Assistant Attorney General, <strong>State</strong> <strong>of</strong> <strong>Wyoming</strong>In Medical Malpractice Cases, <strong>Nurse</strong>s Are Not“Out <strong>of</strong> the Woods”A six-member state court jury heard 10 days <strong>of</strong> evidence andargument and then took less than four hours to determine thatRiverton OB/GYN Stephen Rotholz did not commit medicalmalpractice in the 2008 delivery <strong>of</strong> a baby who sustained injuriesin the process. (Docket No. 37674 in the Ninth Judicial DistrictCourt Lander <strong>Wyoming</strong>. Brandi Jo Veach and Anthony JamesRodriguez v. Stephen S. Rotholz, M.D.)The Lawsuit Against the PhysicianBrandi Jo Veach and Anthony James Rodriguez filed suit andmade two claims against Dr. Rotholz. One was for negligence byfailure to act within the applicable standard <strong>of</strong> care. The other claimwas lack <strong>of</strong> informed consent. The plaintiffs contended that, afteran induction <strong>of</strong> labor and administration <strong>of</strong> regional anesthesia andafter approximately two hours <strong>of</strong> pushing, Dr. Rotholz performeda vacuum extraction without adequately informing the mother <strong>of</strong>the potential risks <strong>of</strong> vacuum extraction or informing the mother <strong>of</strong>alternate delivery procedures, including a caesarean section.During the delivery, the infant sustained bilateral clavicularfractures and permanent brachial nerve damage to her left arm,so she cannot raise her left arm above her shoulder. The parentssought compensation for their daughter for future lost wages andearning potential as well as pain and suffering.Important Lessons for <strong>Nurse</strong>sNone <strong>of</strong> the nurses involved in this birth was named in thelawsuit, but four nurses were called to testify in this case. <strong>Nurse</strong>sshould always be aware that they can become witnesses who maybe compelled to provide testimony against other members <strong>of</strong> thehealth care team or an employer. Lawsuits create an opportunityfor “discovery” – the process attorneys use to seek out evidencesupporting their clients’ claims or defenses. In the discoveryprocess, information could reveal that a nurse’s acts or omissionsprovide a defense for the physician. If the nurse’s conduct hasindependent significance <strong>of</strong> culpability, he or she could become aparty to the lawsuit.In cases where a nurse has not engaged in acceptable nursepractice, claims have been made by physicians that the nurse’snegligence at least contributed to the negative outcome. If thosetypes <strong>of</strong> claims are made, the focus <strong>of</strong> the physician’s acts oromissions may shift to the nurse. In depositions, medical recordsmay be presented that reveal, for example, a lack <strong>of</strong> appropriatedocumentation. A nurse might be questioned regarding his orher own actions, including communications with the physician,which may not be reflected in the medical records. Claims <strong>of</strong> failureto meet acceptable standards <strong>of</strong> nursing practice may result iftestimony indicates the nurse did not communicate properly withthe physician or did not take actions ordinarily required in thepresenting situation. This may lead to the nurse becoming a partyto the litigation or at the very least testifying as a witness regardinghis or her own deficiencies in nursing practice.It also is possible that information developed in the course <strong>of</strong>a lawsuit results in a complaint to the <strong>Wyoming</strong> <strong>State</strong> <strong>Board</strong> <strong>of</strong><strong>Nursing</strong>, which may evolve into an independent investigationand a sanction that is not tied to the outcome. The focus <strong>of</strong> thatinvestigation would be the nurse’s deviation from acceptablestandards <strong>of</strong> practice. In this situation the nurse would be requiredto provide information or a response related to allegations <strong>of</strong>substandard practice as well as other related misconduct.The significance <strong>of</strong> engaging in proper nursing practice cannotbe over emphasized. There is a risk that what has been done (oromitted) during practice may be closely scrutinized. If the evidencereflects appropriate nurse practice, the nurse is not subjected tocriticism. But if the evidence reflects substandard or unsafepractice, or negligence, the nurse’s pr<strong>of</strong>essional integrity may bequestioned.One important lesson from this Fremont County case is thatmedical records and any testimony that may be elicited from anurse should document the adherence to the standards <strong>of</strong> nursingpractice and patient advocacy. This may not prevent the nursefrom becoming embroiled in litigation, but pro<strong>of</strong> <strong>of</strong> appropriatenursing practice may prevent turning the focus <strong>of</strong> litigation to thenurse or leading to a WSBN complaint.10 WYOMING NURSE REPORTER
Amy Edith Richardson MillerSee story on page 12<strong>Wyoming</strong> StakeholdersMeet to Discuss<strong>Nurse</strong> Licensure CompactRepresentatives <strong>of</strong> the <strong>Wyoming</strong> <strong>State</strong><strong>Board</strong> <strong>of</strong> <strong>Nursing</strong> and other groups with astake in nurse licensure in <strong>Wyoming</strong> arecontinuing to meet to see if they can identifyand resolve issues with the <strong>Nurse</strong> LicensureCompact.Twenty-five representatives <strong>of</strong> stakeholdergroups met for five hours on April 25at the WSBN <strong>of</strong>fice in Cheyenne to startidentifying strengths and weaknesses <strong>of</strong> theNLC. They tentatively plan to meet againin Casper this summer.Currently, 24 states are members <strong>of</strong> theNLC, including all states that surround<strong>Wyoming</strong> except for Montana. NLC Membershipgives LPNs and RNs licensed in one<strong>of</strong> the states the privilege <strong>of</strong> practicing in all<strong>of</strong> the member states. Hospitals and otherfacilities that employ nurses want <strong>Wyoming</strong>to join the compact, which they say wouldmake hiring easier and faster. Joining thecompact would require action by the <strong>Wyoming</strong>Legislature.Potential advantages <strong>of</strong> NLC for licensednurses include the ease <strong>of</strong> movingamong member states for temporary workwithout the cost and trouble <strong>of</strong> applyingfor licenses in each state. <strong>Wyoming</strong> HospitalAssociation Director Dan Perdue saidhospitals would benefit from a larger pool <strong>of</strong>potential employees, which might lessen relianceon traveler nurses. Other advantagescited at the meeting included ease <strong>of</strong> followingpatients after hospital discharge andpractice via telemedicine.A major disadvantage identified at themeeting was the importance <strong>of</strong> criminalbackground checks for nurses and the factthat some compact states, including Coloradoand Nebraska, don’t do those checksas part <strong>of</strong> licensure. Another disadvantagediscussed at the meeting was the expectedloss <strong>of</strong> licensure fees to the WSBN <strong>of</strong> about10 percent <strong>of</strong> its $2.1 million biennial revenue,which would have to be made upsomehow. These two issues are expected tobe explored further at future meetings.Perdue recalled that a previous legislativeeffort to join the NLC in 2007 failed,with opposition from the WSBN, and hospitalsare reluctant to try again without supportfrom WSBN and other stakeholders.The <strong>Nurse</strong> Practice Act and the <strong>Board</strong>’sRules and Regulations provide for 90-daytemporary permits, while applications for<strong>Wyoming</strong> licensure are processed, for nurseswith licenses from other states in goodstanding.The meeting facilitator was MargueriteHerman, former WSBN consumer member.Stakeholders who attended the April 25meeting were:• WSBN President Carrie Deselmsand Vice President Marci Burr• WSBN Executive Director CynthiaLaBonde• Maxine Hernandez, WSBN LicensingSpecialist• Jessica Frint, Assistant AttorneyGeneral for WSBN• Bob Walters, Senior Assistant AttorneyGeneral for WSBN• Mary Burman, Pr<strong>of</strong>essor and Dean<strong>of</strong> Fay Whitney School <strong>of</strong> <strong>Nursing</strong>,University <strong>of</strong> <strong>Wyoming</strong>• Laramie County Community College- Jennifer Anderson, ProgramDirector, <strong>Nursing</strong>, Health Sciences& Wellness, and nursing programfaculty Paula Belknap• Vickie Winney, CNA instructor,Eastern <strong>Wyoming</strong> College• <strong>Wyoming</strong> Hospital AssociationPresident Dan Purdue and VicePresident Neil Hilton• Phyllis Sherard, Executive Director<strong>of</strong> Population Health at CheyenneRegional Medical Center• <strong>Wyoming</strong> Aging Division SeniorServices – Community ServicesRepresentatives Jeanne Schenenmanand Rebecca McDaniel• Toni Decklever, representing the<strong>Wyoming</strong> <strong>Nurse</strong>s Association• Anne Raga, Director <strong>of</strong> <strong>Nursing</strong> atCampbell County Memorial HospitalRead more about the NLC at www.ncsbn.org/nlc.htmReachRecruitRetainWYOMING WVOL. 5The ImpairedW <strong>Nurse</strong>VOL. 9 NUMBER 2 SUMMER<strong>2013</strong>EDUCATIONR E P O R T E R<strong>Nurse</strong>YOMINGThe <strong>Wyoming</strong><strong>Board</strong> <strong>of</strong> <strong>Nursing</strong>JOURNALR E P O R T E RThe First Licensed<strong>Nurse</strong> in <strong>Wyoming</strong>Mailed to every nurse in <strong>Wyoming</strong>to reserve advertising spacecontact Victor Hornevhorne@pcipublishing.com1-800-561-4686 ext. 114Our nursing journals aremailed directly to over 1.5 millionnurses, healthcare pr<strong>of</strong>essionalsand educators nationwide.ArizonaArkansasThe District<strong>of</strong> ColumbiaIndianaKentuckyMississippiMontanaNebraskaNevadaNew MexicoThink<strong>Nurse</strong>.comNorth CarolinaNorth DakotaOhioOregonSouth CarolinaSouth DakotaStu<strong>Nurse</strong>/NationwideTennesseeWashingtonWest Virginia<strong>Wyoming</strong>WYOMING NURSE REPORTER 11
By: Laura C. Rowe, J.D.<strong>Nurse</strong> Monitoring Program Manager / InvestigatorNURSE MONITORING PROGRAM andINCIDENTAL EXPOSURE TO ALCOHOL<strong>Nurse</strong>s and nurse aides who haveconditional licenses or certificates in<strong>Wyoming</strong> are able to continue practicingas part <strong>of</strong> the <strong>Nurse</strong> Monitoring Program.An essential requirement <strong>of</strong> the program isavoiding alcohol.The <strong>Wyoming</strong> <strong>State</strong> <strong>Board</strong> <strong>of</strong> <strong>Nursing</strong>operates the <strong>Nurse</strong> Monitoring Program(NPM) to provide the framework andguidelines necessary to promote safe andcompetent nursing practice for those witha conditional license or certificate. Manyparticipants in the NMP are being monitoredfor substance use disorders (SUDs) and arerequired to undergo random drug screens ona monthly basis. These drug screens test for alarge number <strong>of</strong> amphetamines, barbiturates,benzodiazepines, opiates and alcohol.SUD participants in the NMP must avoidingesting and using products containingalcohol, even if their substance <strong>of</strong> choicewas not alcohol. The NMP and those in theProgram use the Talbott Recovery Campus’sMedication Guide for a Safe Recovery asa reference tool on what products to avoidthat contain alcohol and the different types<strong>of</strong> alcohol-free products that are availablefor use. Many types <strong>of</strong> everyday productscontain alcohol, such as: (1) personal hygieneproducts (hand sanitizers, perfumes, colognes,mouth wash); (2) foods (vanilla extract, soysauce, some meals prepared with alcohol);(3) household items (cleaning products, paintthinner, wood stain, insect repellant, roomdeodorizers, some detergents); and (4) manyover-the-counter medicines (cough syrup,antihistamines). The Medication Guideis very helpful in identifying many <strong>of</strong> thosecommon products that contain alcohol andlisting alternative products with no alcoholcontent.Those in the NMP are directed to reviewthe Medication Guide and avoid ingestion <strong>of</strong>or exposure to products containing alcohol.When an NMP participant tests positivefor alcohol the participant is notified and isrequired to provide a personal statement asto what may have caused the positive result.The lab results are then provided to a MedicalReview Officer (MRO) to determine whetheror not the amount <strong>of</strong> alcohol detected isdue to the ingestion <strong>of</strong> a large amount(indicating a possible relapse) or whether itis the result <strong>of</strong> incidental exposure to alcohol.This determination is made by reviewing theethylglucuronide (EtG) and ethylsulfate (EtS)levels in the urinalysis specimen.If, after review <strong>of</strong> the lab and conversationwith the licensee, the MRO determines thepositive result to be at levels indicative <strong>of</strong>incidental exposure to alcohol and not amore serious relapse, the licensee will not beconsidered to be non-compliant. However,the licensee will be given an informal letteradvising him or her <strong>of</strong> the need to avoidexposure to products containing alcohol (byreference to the Medication Guide) and ifsubsequent similar positive results occur, otheraction (including further discipline) may betaken.It is important for those in the NMPto closely adhere to the requirementsand conditions <strong>of</strong> their <strong>Board</strong> orders andmonitoring contracts, including avoidingexposure to alcohol. However, the NMPdoes provide for a small margin <strong>of</strong> leeway inthe event <strong>of</strong> incidental exposure to alcoholgiven its existence in so many commonly usedproducts.For more information on the NMP pleasevisit https://nursing-online.state.wy.us/ andclick on the “<strong>Nurse</strong> Monitoring Program” tabor e-mail bon-wsbnnursemonitoring@wyo.gov.References1. See Talbott Recovery Campus.Medication Guide For A SafeRecovery. Atlanta, GA: Revision 1.0– April 2008. Print, internet. (https://www.talbottcampus.com/index.php/medication-guide/). This link isavailable through the NMP webpageat https://nursing-online.state.wy.us/Default.aspx?page=38.2. See footnote 1.3. See footnote 1. The lists <strong>of</strong> substancesin the Medication Guide which doand do not contain alcohol are notexhaustive.12 WYOMING NURSE REPORTER
Worland, Wheatland & Torrington, <strong>Wyoming</strong>You want to changehealth care withoutchanging your address.You belong here.You don’t have to go far to take health care – and your career – to another level. At Banner Health,you can contribute to world-class patient care right here in <strong>Wyoming</strong>.When you join Banner Health, you’ll be part <strong>of</strong> a nationally-respected, award-winning health careinnovator with more than 20 hospitals in seven western states. In fact, Truven Health Analyticsnamed Banner Health one <strong>of</strong> the top five large health systems in the U.S., based on superiorclinical outcomes, quality, patient care and efficiency. With such an organization behind you,you’ll have an exciting future ahead <strong>of</strong> you.We have exceptional opportunities for Experienced RNs and RN Leaders at our three<strong>Wyoming</strong> hospitals:• Washakie Medical Center, Worland• Platte County Medical Center, Wheatland• Community Hospital, TorringtonVisit our website at www.BannerHealth.com/careersfor more information and to apply.www.BannerHealth.com/careersEOE/AA Banner Health supports a drug-freeand tobacco-free work environment.Connect withBanner Health Careers:WYOMING NURSE REPORTER 13
Mary E. Burman, Dean and Pr<strong>of</strong>essor, Fay W. Whitney School <strong>of</strong> <strong>Nursing</strong> University <strong>of</strong> <strong>Wyoming</strong>Revolutionizing <strong>Nursing</strong> Educationin <strong>Wyoming</strong> (ReNEW)What is ReNEW?ReNEW (Revolutionizing <strong>Nursing</strong>Education in <strong>Wyoming</strong>) seeks to enhancethe quality <strong>of</strong> nursing and health carein <strong>Wyoming</strong> by revolutionizing nursingeducation by developing:Shared, competency-based statewidecurriculum where students can earnan associate’s degree (AD) and thencontinue seamlessly to a BSN degree (orhigher) starting at any <strong>of</strong> the communitycolleges and continuing to the University<strong>of</strong> <strong>Wyoming</strong>. The courses/clinicalexperiences needed to complete the BSNthrough the university will be availablethrough distance delivery.Shared leadership through educationand practice partnerships to:• Co-create the nursing curriculum• Optimize the use <strong>of</strong> clinical facilitiesand faculty throughout the state <strong>of</strong><strong>Wyoming</strong>• Share educational and clinicalresourcesA clinical education model focusingon enhancing clinical judgment, skilldevelopment and pr<strong>of</strong>essional nursingpractice.ReNEW was formally launched in2010 after a statewide nursing educationsummit, where a groundswell <strong>of</strong> supportfrom nurses and nurse educators wasevident. Subsequently, this has becomea key initiative <strong>of</strong> the <strong>Wyoming</strong> Centerfor <strong>Nursing</strong> and Health Care Partnerships(WCNHCP), the state’s nursingworkforce center and Action Coalition.Why a statewide curriculum?The initiative is closely aligned withrecommendations from the Institute <strong>of</strong>Medicine (IOM) in its report on TheFuture <strong>of</strong> <strong>Nursing</strong>. The IOM recommendsthat “nurses should achieve higher levels<strong>of</strong> education and training through animproved education system that promotesseamless academic progression.” Thereport recommends that the proportion<strong>of</strong> nurses with a baccalaureate degree(or higher) be increased to 80 percentby 2020. Moreover, ReNEW is criticalto <strong>Wyoming</strong>’s efforts to diversify thenursing workforce by serving as an accesspoint for nontraditional students throughthe collaboration with the communitycolleges.ReNEW is based upon similarstatewide efforts in Oregon and Hawaii. InOregon, the shared curriculum involves13 campuses, including eight communitycolleges and the five campuses <strong>of</strong> theOregon Health & Sciences University(OSHU; Tanner, Gubrud-Howe & Shores,2008). Initial outcome studies indicatethat in the first three graduating classes,30% <strong>of</strong> community college graduatesinvolved in OCNE have continuedon for the BSN at OHSU (Munkvold,Tanner & Herinckx, 2012). While thisis significantly lower than projected, it isconsiderably higher than recent nationaltrends, which suggest that less than 10%<strong>of</strong> AD graduates continue on for thebaccalaureate degree (Munkvold et al.).Hawaii’s <strong>State</strong>wide <strong>Nursing</strong> Consortiuminvolves the University <strong>of</strong> Hawaii andRENEW aims torevolutionize nursing in<strong>Wyoming</strong>, and nurses andothers around the stateare excited about thepotential <strong>of</strong> this initiativeto transform nursing andhealth in <strong>Wyoming</strong>. Theinitiative brings together avariety <strong>of</strong> individuals andorganizations that weresomewhat disconnected inthe past to work together tocreate a vision <strong>of</strong> nursingeducation. The challengesare significant!four community colleges. Similar toOregon, the Hawaii model focuses on afour-year, competency-based programthat culminates in a baccalaureate degreein nursing, although students can chooseto leave after the associate degree (Lewis,2010). The first community college14 WYOMING NURSE REPORTER
graduates will be eligible to transfer tothe University <strong>of</strong> Hawaii in Fall 2012, sooutcome data are not yet available.Why is ReNEW important for<strong>Wyoming</strong>?In order to realize our vision, we needto create seamless processes for studentsto continue to the BSN in highernumbers and much sooner following ADgraduation using a model that fits withour rural nature. <strong>Nursing</strong> education in<strong>Wyoming</strong> is challenged by our sparsepopulation, with much <strong>of</strong> the state beingrural and/or frontier. The state’s hospitalsand other clinical facilities are small (<strong>of</strong>28 hospitals in <strong>Wyoming</strong>, 16 are criticalaccess hospitals). <strong>Nursing</strong> education In<strong>Wyoming</strong> is also unique, with only onebaccalaureate program in nursing at thesole 4-year public institution (UW) and6 community colleges <strong>of</strong>fering associatedegrees in nursing. Approximately 70%<strong>of</strong> nurses have an associate degree, and30% have a baccalaureate or higher. Inaddition, the number <strong>of</strong> new nurses withADs is significantly higher than thosewith BSNs. In 2011, there were 78 BSNgraduates and 290 AD graduates from<strong>Wyoming</strong> programs. Moreover, analysis <strong>of</strong>5 years <strong>of</strong> data on graduates <strong>of</strong> AD programsin <strong>Wyoming</strong> who have continued on toUW for the BSN reveals that on averageit is 5 years from graduation from an ADprogram to starting the BSN at UW, whichis somewhat lower than national average<strong>of</strong> 7.5 years. Only about 10% <strong>of</strong> graduatesare continuing on to the BSN in <strong>Wyoming</strong>(at least through the RN-BSN completionprogram at UW).However, the demand for baccalaureateeducation is increasing fairly dramaticallyin <strong>Wyoming</strong>. The number <strong>of</strong> students andgraduates <strong>of</strong> the UW RN-BSN completionprogram have grown significantly between2007 and 2011, increasing from 104students and 42 graduates in 2007 to 334students and 73 graduates in 2011, almosta 100% increase in graduates in 5 years(See Figure).What is the current status <strong>of</strong>ReNEW?ReNEW has received three years<strong>of</strong> funding in collaboration with the<strong>Wyoming</strong> Community Foundation tosupport RENEW through the RobertWood Johnson Foundation PartnersInvesting in <strong>Nursing</strong>’s Future program.This supports committee work, e.g., travel,teleconferences, etc., staff support person,and an annual statewide nursing educationsummit. All six community college nursingprograms and the Fay W. Whitney School<strong>of</strong> <strong>Nursing</strong> at UW have all formally agreedto participate in RENEW. The RENEWSteering Committee has been meeting forseveral years to develop support for theproject and outline a process. Dr. ChristineTanner, from Oregon Consortium for<strong>Nursing</strong> Education and the OregonHealth & Sciences University, is servingas a consultant on the project. The fourReNEW Committees were organizedin Fall 2011 and are working on theirrespective charges. Annual statewidenursing education summits have beenheld bringing together educators, nurses,administrators and employers to developRENEW.How is ReNEW supported?Funding for ReNEW comes fromgrants and donations. Health carefacilities, educational institutions, privatefoundations, and individual donors areproviding financial support, with a number<strong>of</strong> other organizations supporting theproject through contributions <strong>of</strong> volunteertime and energy. Volunteers from acrossthe state are participating in committeesto develop a common curriculum, enhancepr<strong>of</strong>essional development <strong>of</strong> nurses andnurse educators, coordinate classroomeducation with clinical experiences,and facilitate seamless transition fromcommunity colleges to UW.SummaryRENEW aims to revolutionize nursingin <strong>Wyoming</strong>, and nurses and others aroundthe state are excited about the potential<strong>of</strong> this initiative to transform nursingand health in <strong>Wyoming</strong>. The initiativebrings together a variety <strong>of</strong> individualsand organizations that were somewhatdisconnected in the past to work togetherto create a vision <strong>of</strong> nursing education.The challenges are significant! But webelieve the shared vision, commitmentand the extensive expertise and experience<strong>of</strong> those involved will help lead to asuccessful outcome.WYOMING NURSE REPORTER 15
Robert J Walters Senior Assistant Attorney General, <strong>State</strong> <strong>of</strong> <strong>Wyoming</strong>Recent Cases <strong>of</strong> InterestBarnes v. Greater Baltimore MedicalCenter, Inc., 63 A.3d 620 (Md.App.<strong>2013</strong>)Plaintiff brought medical malpracticeaction against a hospital and emergencymedicine physician for alleged failure toprevent a stroke.Plaintiff saw his primary care physicianbecause he was experiencing weakness in hisright hand grip, numbness and tingling inhis right arm. The physician was concernedthe plaintiff was having a transient ischemicattack (mini-stroke) or was in the beginningphases <strong>of</strong> a stroke, so he sent the plaintiff to thehospital immediately with a note that said hewas to have a “stroke work up.” The plaintiffinitially saw the “quick look nurse,” who readthe physician’s note and indicated plaintiff’scondition was a priority number one, which“represents a potentially life threateningsituation and should be automatically routedto the main emergency department.” Plaintiffwas sent to the triage nurse, who changed thepriority from one to four and changed theword “side” to “hand” so it said “numb righthand.” The triage nurse testified she did notsee the physician’s note. Plaintiff saw theemergency medicine physician on duty in theurgent care center, who ordered a wrist x-rayand diagnosed carpel tunnel syndromePlaintiff later returned to the hospitaland received a partial stroke work up (IV,blood tests, CAT scan <strong>of</strong> the brain and anelectrocardiogram). The emergency roomphysician concluded that plaintiff should beadmitted for more evaluation by the attendingphysician. However, plaintiff decided to returnhome. The next day, plaintiff’s wife took himback to the hospital. He had suffered a stroke.At trial, an expert witness for the plaintifftestified the triage nurse breached the standard<strong>of</strong> care when she ignored the physician’s noteand downgraded his priority. The hospitalcontended the plaintiff did not prove thetriage nurse’s negligence contributed to hisinjury.The jury returned a verdict for theplaintiff. Then the judge granted a defensemotion for a judgment notwithstanding theverdict (JNOV). The plaintiff appealed andthe Court <strong>of</strong> Appeals sent the case back fora new trial to decide whether he would havebeen admitted to the hospital and receivedappropriate tests if the emergency roomphysician and the triage nurse had compliedwith the standard <strong>of</strong> care.COMMENT: This case illustrates thepossibility that nursing care can becomescrutinized even if other health carepr<strong>of</strong>essionals subsequently provide care andtreatment. The issue in this case is whetherthe nurse’s negligence contributed to thepatient’s not receiving a full stroke workup,which might have prevented the stroke. Theinitial visit to the emergency room, and theER physician’s actions did not become anintervening event. The nurse was not a partyto the litigation.Erroneous directed verdict for cardiacunit nurse considered harmless, as jurydetermines other nurses named in lawsuitmet standard <strong>of</strong> care.Wilson v. Munson Medical Center, <strong>2013</strong>WL 1830864, (Mich.App. <strong>2013</strong>)Plaintiff’s wife, Cindy Wilson, 32, wastransported to the emergency room on March27, 2005, after experiencing excruciatingchest pain that radiated into her back.Several tests failed to explain the pain. Ms.Wilson was provided pain medication andadmitted to the hospital for further testing.Her pain periodically strengthened andlessened and appeared to shift throughout hermid-section over the next 24 hours. She wasprovided medications for the pain and nauseathat occasionally accompanied the pain. Thenext day, Ms. Wilson’s heart rate droppeddrastically and she died. An autopsy revealedthe cause <strong>of</strong> death as an aortic dissection withassociated rupture <strong>of</strong> the ascending aorta.Plaintiff initiated an action for medicalmalpractice and wrongful death based uponfailure to diagnose and treat his deceased wife’saortic dissection. In addition to claims againstthe physician, Plaintiff alleged that the nurseswho treated his wife were negligent becausethey failed to report changes in her conditionto doctors so that they could reassess her.The trial court granted a motion for directedverdict in favor <strong>of</strong> one <strong>of</strong> the four cardiac unitnurses -- <strong>Nurse</strong> Sanders -- because Ms. Wilsonhad no chest pain during Sanders’ shift.The jury found no negligence by the threenurses remaining in the lawsuit. The nursesnoted varying instances <strong>of</strong> pain, in varyingbody areas, at varying levels, and they alladministered pain medications. The jurydetermined they met the standard <strong>of</strong> care.The Court <strong>of</strong> Appeals concluded that adirected verdict for Sanders was incorrect butthe jury also found no negligence on the part<strong>of</strong> any other nurse for failing to report Ms.Wilson’s pain to a doctor or request that shebe reassessed. So there was no indication thejury would have found Sanders negligent. Theerror was considered harmless.COMMENT: This case illustrates theimportance <strong>of</strong> solid documentation to reflectappropriate care. Although there was experttestimony indicating the nurses should have16 WYOMING NURSE REPORTER
The <strong>Wyoming</strong> Simulation Center is an education center designedto develop and reinforce clinical skills as well as build new skillsto help keep pace with changes in the health care field.We <strong>of</strong>fer training for all, using:• Mock-hospital six-bed patient ward with nursing station• Functioning medication room with Pyxis• Pediatric room• Two high-fidelity rooms (video/audio wired)• 24-seat classroom environmentHUNGERKEEPSUP ONCURRENTEVENTS,TOO.245 Broadway, Suite 107Sheridan, WY 82801Phone: 307-674-1470Fax: 307-675-1954wyosimcenter@sheridan.eduCheck us out on the web:www.sheridan.edu/site/wyomingsimulationcenterExcellence in Patient Care Achieved through Excellence in Education1 IN 6AMERICANSSTRUGGLESWITH HUNGER.Opportunities come with options.If you’re a committed nurse looking for a rewarding career, <strong>Wyoming</strong>Medical Center may be the place for you. Over 50 specialties andabundant outdoor opportunities await you in <strong>Wyoming</strong>!To apply & view all <strong>of</strong> our current openings, visit <strong>Wyoming</strong>MedicalCenter.org.Contact: Sammie Stephens, R.N. - Recruiter1233 E. 2nd St., Casper, WY 82601(307) 577-2669 • sstephens@wyomingmedicalcenter.orgRelocation Assistance is AvailableEqual Opportunity EmployerTOGETHERWE’REHunger is closer than youthink. Reach out to yourlocal food bank for waysto do your part.Visit FeedingAmerica.org today.Casper, <strong>Wyoming</strong>WYOMING NURSE REPORTER 17
done more, their care and treatment did notfall below the applicable standard <strong>of</strong> care.The nurses were parties to the litigation.Standard <strong>of</strong> Care complaints should beproven with appropriate expert opinionsLuscombe v. Missouri <strong>State</strong> Bd. <strong>of</strong><strong>Nursing</strong>, --- S.W.3d ----, WL 68899 (Mo.App. W.D. <strong>2013</strong>)Mary Luscombe (ML) appealed theAdministrative Hearing Commission’sdecision that found cause for disciplining herand cause for revocation <strong>of</strong> her license by theMissouri <strong>State</strong> <strong>Board</strong> <strong>of</strong> <strong>Nursing</strong>.ML worked as an RN in the neonatalintensive care unit at Columbia RegionalHospital, which required that all NICUpatients have continuous cardiacmonitoring. A cardiac monitor couldbe temporarily suspended, but only withconstant observation by a nurse. On May 29,2005, during a 12-hour shift, ML repeatedlysuspended a patient’s cardiac monitor, turnedthe screen so that she could see it and walkedaway from the patient’s bedside. She wasfired.Subsequently, ML worked as a health careprovider for Integrity Home Care, whichprovides services to Medicaid recipients.When she resigned after two years,documentation for her home visits showedshe charged for visits when the clientsweren’t at home.The hospital and Integrity filedcomplaints with the Missouri <strong>State</strong> <strong>Board</strong> <strong>of</strong><strong>Nursing</strong>. Following investigation, the <strong>Board</strong>filed a complaint seeking discipline <strong>of</strong> herlicense with the Commission related to ML’srepeated suspension <strong>of</strong> the cardiac alarms inthe NICU and her failure to turn in true andaccurate nurse visit reports.The Commission found ML’s suspension<strong>of</strong> a patient’s cardiac monitor constitutedgross negligence. The Commission als<strong>of</strong>ound that ML falsified documents andobtained a fee by fraud. The <strong>Board</strong> held ahearing and revoked ML’s nursing license.ML asked for judicial review, and the courtaffirmed decisions by both the Commissionand <strong>Board</strong>. She appealed further on the point<strong>of</strong> whether the Commission needed experttestimony to apply pr<strong>of</strong>essional standards.The Court <strong>of</strong> Appeals held that thestandard <strong>of</strong> care applicable to pr<strong>of</strong>essionalconduct cannot be established by a hospital’srules and regulations. Mere violation<strong>of</strong> a hospital rule or regulation does notestablish a violation <strong>of</strong> the standard <strong>of</strong>care without expert testimony, the courtheld. Accordingly, the court held that theCommission erroneously found ML to begrossly negligent. However, expert testimonywas not necessary for the Commission toestablish a standard <strong>of</strong> care for the recordkeepingcomplaint.The case was remanded to the <strong>Board</strong> <strong>of</strong><strong>Nursing</strong> for reconsideration <strong>of</strong> the sanctionto be imposed on ML’s nursing license basedsolely on the Integrity finding.COMMENT: This case illustrates theimportance <strong>of</strong> having expert testimonyin standard <strong>of</strong> care cases. In this case, theground for discipline related to the complaintinvolving suspension <strong>of</strong> the cardiac monitoris removed from further consideration bythe <strong>Board</strong>. The <strong>Board</strong> could only imposedisciplinary sanctions for the fraudulent andsubstandard documentation issue.Donate to our ‘Wall <strong>of</strong> Caps’What have you done with that nursing cap?Halloween costume accessory for the kids?Bookmark in a nursing text book? Or is it sittingon your closet shelf in a clear protective hat boxall zipped-up with no place to go?License application photos from the<strong>Wyoming</strong> <strong>State</strong> <strong>Board</strong> <strong>of</strong> <strong>Nursing</strong> archives madeus think about all those wonderful nursing caps.We’d like to celebrate them – and the nurseswho proudly wore them -- in all their diversitywith a “Wall <strong>of</strong> Caps” at our new <strong>Board</strong> <strong>of</strong>fice.If you can spare it, please send your nursingcap to: <strong>Wyoming</strong> <strong>State</strong> <strong>Board</strong> <strong>of</strong> <strong>Nursing</strong>- CAPS130 Hobbs Ave Suite B Cheyenne, WY 8200218 WYOMING NURSE REPORTER
<strong>Wyoming</strong> Council for Advanced Practice <strong>Nursing</strong>A nationally renowned advocate for nursepractitioners is a featured presenter at theAnnual Pharmacology Conference <strong>of</strong> the<strong>Wyoming</strong> Council for Advanced Practice<strong>Nursing</strong> (WCAPN) in Cheyenne Oct. 17-18.Wendy Wright, MS, RN,APRN, FNP,FAANP, will conduct a skill-building sessionon Oct. 17 on “Eye Examinations in PrimaryCare” and will present for other topics thatday, as part <strong>of</strong> two full days <strong>of</strong> sessions forAPRNs in <strong>Wyoming</strong>. Wright is a highlyrespectedpractitioner and author and haspresented at more than 300 conferences in41 states.WCAPN is a non-pr<strong>of</strong>it organizationgoverned by a board and dedicated topromoting pr<strong>of</strong>essional growth <strong>of</strong> AdvancedPractice <strong>Nurse</strong>s throughout <strong>Wyoming</strong>.The council’s Pharmacology Conferenceis scheduled this fall at the Holiday Inn inCheyenne.Wright works full-time at the practiceshe founded, Wright & Associates FamilyHealthcare, in Amherst, N.H. She is theauthor <strong>of</strong> the “Physical Assessment andHealth Advisory Cue Card Series” and hasproduced a number <strong>of</strong> videos and audiotapes.She is the past president <strong>of</strong> the <strong>Nurse</strong>Practitioner Associates for ContinuingEducation and is Senior Lecturer for FitzgeraldHealth Education Associates. In 2005, shewas chosen as a Fellow by the AmericanAssociation <strong>of</strong> <strong>Nurse</strong> Practitioners.The WCAPN conference agenda includesa “Joint Injection” workshop on the firstmorning, Thursday, and five other sessionson Friday:• Contraceptive Update by EstherGilman-Kehrer, DNP, CNM,Assistant Lecturer, Fay W. WhitneySchool <strong>of</strong> <strong>Nursing</strong>• Geriatric Pharmacology by AnnGreen, PhD, GNP• Obesity Medications by Jessie Burch,PharmD, UW Clinical Asst. Pr<strong>of</strong>essor<strong>of</strong> Pharmacy• New Medication Update by LaurenBiehle, PharmD, UW Clinical Asst.Pr<strong>of</strong>essor <strong>of</strong> Pharmacy• Obesity Related DermatologicConditions and Treatment by SandraSurbrugg, M.D., Cheyenne SkinClinic• Treatment <strong>of</strong> Thyroid Disorders byJaime Hornecker, PharmD, UWClinical Assoc. Pr<strong>of</strong>essor <strong>of</strong> Pharmacy.The meeting includes the annual luncheonon Thursday hosted by the Fay W. WhitneyWendy Wright, featured presenter at theAnnual Pharmacology Conference <strong>of</strong> the<strong>Wyoming</strong> Council for Advanced Practice<strong>Nursing</strong> in Cheyenne Oct. 17-18.School <strong>of</strong> <strong>Nursing</strong>, University <strong>of</strong> <strong>Wyoming</strong>,which will provide an update on the School<strong>of</strong> <strong>Nursing</strong> and honor clinical preceptors.The annual WCAPN general membershipmeeting will be held during lunch on Friday.Conference registration is expected toopen July 1. Find conference and registrationinformation online at www.wcapn.org.Two board members drive more than 1,100 miles toattend Midyear Meeting<strong>Wyoming</strong> <strong>State</strong> <strong>Board</strong> <strong>of</strong> <strong>Nursing</strong> members Marcie Burr, RN, RD,CCHP, and Lori Johnson, LPN, were celebrated for their spirit <strong>of</strong>adventure as they traveled to the Midyear Meeting <strong>of</strong> the NationalCouncil <strong>of</strong> <strong>State</strong> <strong>Board</strong>s <strong>of</strong> <strong>Nursing</strong>. In San Jose, Calif. By car.They were supposed to travel by plane to the meeting March 11-13, but winter storms forced cancellation <strong>of</strong> flights for two days. Sothey packed up Burr’s car and set out for an adventure in the form <strong>of</strong>an old fashioned road trip. “We love adventure and were always gamefor a road trip, so we made a quick decision that we could get theredriving in less than half the time, so away we went,” Burr said in anarticle in the NCSBN’s “Council Connector” publication.” Eighteenhours and 1,117 miles later, they arrived in San Jose with smiles ontheir faces and memories to last a lifetime.“We saw the great Salt Lake, Donner Pass and Bear Lake, theGolden Gate and Bay Bridges, Henry Cowell Redwood Park, and weeven ran down to Santa Cruz for a walk on the pier. On the wayhome, we stopped at Pier 39 and Alcatraz. I work in corrections, so <strong>of</strong>course I had to see Alcatraz,” Burr said. Burr and Johnson bunked forthe night in the small town <strong>of</strong> Puckerbrush, Nev., population: 28. “Inever knew Nevada had so many unique names and that Californiahad such wonderful sites!” Johnson said.Johnson and Burr said they didn’t want to miss the networkingopportunities <strong>of</strong> the Midyear Meeting. “I want to make a differencein nursing and being able to network with NCSBN staff and otherboards o nursing is fantastic,” Johnson explained. Burr agreed, addingthat she wanted to hear how other boards <strong>of</strong> nursing are dealing withapplication reviews and disciplinary decisions. “I met several peoplewho are seeing the same types <strong>of</strong> things coming to their attention,”she explained.“Our road trip gave us an opportunity to get to know each otherand understand why we chose to be part <strong>of</strong> the <strong>Wyoming</strong> <strong>Board</strong> <strong>of</strong><strong>Nursing</strong>,” Johnson told the Council Connector. That, and “we dolove a spontaneous adventure!WYOMING NURSE REPORTER 19
<strong>Wyoming</strong> Center for <strong>Nursing</strong> andHealth Care Partnerships CornerMary E. Burman, Project Director, WCNHCP Advisory <strong>Board</strong>Toni Decklever, <strong>Nurse</strong>, WCNHCPMatt Sholty, Office Associate, WCNHCPClinical education in nursing: We wouldlike to hear from you!In the previous issue <strong>of</strong> WNR, wetalked about the <strong>State</strong> ImplementationProgram (SIP) grant that we received fromthe Robert Wood Johnson Foundation.This SIP project is designed to transformclinical education in <strong>Wyoming</strong> and thussupport the implementation <strong>of</strong> thestatewide, shared competency-based nursingcurriculum developed through the ReNEW(Revolutionizing <strong>Nursing</strong> Education in<strong>Wyoming</strong>) Initiative. (See article on ReNEWon page 14.) For ReNEW to be successful, wemust develop and enhance clinical educationcapacity throughout the state. Consequently,the overall goal <strong>of</strong> the SIP project is todevelop a clinical education alliance for the<strong>State</strong> <strong>of</strong> <strong>Wyoming</strong> that will:• Develop a streamlined clinicalplacement process that optimizesthe number and use <strong>of</strong> a variety <strong>of</strong>clinical placements around the state,and• Significantly increase the number <strong>of</strong>clinical educators through a preceptordevelopment program.More efficient use <strong>of</strong> clinical facilities is akey strategy to enhance educational capacityin nursing. However, we know very littleabout the use <strong>of</strong> clinical facilities in clinicaleducation and the process used to placestudents in these facilities. An unpublishedstudy by Cleary, McBride, McClure andReinhard looked at health care organizations,including hospitals, nursing homes, andpublic health departments. The study foundoverreliance on hospitals and underuse <strong>of</strong>some clinical units/organizations. In addition,it found the effective use <strong>of</strong> placement systemsfor nursing students. Other states/regions haveadopted computerized clinical placementsystems to make the placement process moretransparent and efficient. Anecdotally, weknow that both educational institutions andclinical facilities spend a lot <strong>of</strong> time gettingstudents ready for their clinical rotationsthrough activities that include HIPAAorientation, background checks and/or drug/alcohol screening, ensuring that studentsCentral <strong>Wyoming</strong> College Associate pr<strong>of</strong>essor Debbie McClure, RN,BSN,FNP,instructing student Sarah Gantenbein about intravenous catheter insertion prior to ablood transfusion on simulation lab (mannequin) patient.have necessary vaccinations and so on.We would like to hear from you whetheryou are a staff nurse, educator or administrator.• What are the challenges associatedwith getting students ready forclinical experiences?• Are there things that go smoothly inthat process?• Are there ways that we couldstreamline this process?• Could we do a better job <strong>of</strong> not overrelying on some institutions whileunder using others?<strong>State</strong>s also are exploring a variety <strong>of</strong> newclinical models that involve nurses in new and/or expanded educational roles as preceptors.Some states have developed <strong>Nurse</strong> PreceptorAcademies, which are designed to providepreceptors with the tools they need to workwith nursing students and/or new graduatenurses. In Colorado, a 40-hour workshopwas developed for Clinical Scholars, who arereleased from their usual clinical assignmentto work as a clinical faculty member withnursing students. Zahmer found that onlinedeliveredpreceptor development <strong>of</strong>feringsincreased preceptor knowledge and weresatisfactorily received by participants. Wealso know that while nurses enjoy beinginvolved and engaged in the education <strong>of</strong>students, they want to be recognized for theirefforts. Furthermore, it isn’t always easy beinga preceptor and the preparation and readiness<strong>of</strong> students is key to the preceptor experience.Again, we would like to hear from you,especially if you are a staff nurse.• What is your involvement in clinicaleducation? What role would you liketo play in clinical education?• What things help students learn inclinical experiences? What thingsare barriers to student learning inclinical education?• Do you feel prepared to be involvedin clinical education?• What kind <strong>of</strong> recognition would youlike to have for your participation inclinical education.Our goal in ReNEW is to enhance thequality <strong>of</strong> nursing and health care in <strong>Wyoming</strong>20 WYOMING NURSE REPORTER
y revolutionizing nursing education. In orderto be successful we need to involve nurses,nurse educators and nurse administrators. Weare serious that we’d really like to hear fromyou! Please feel free to send us your thoughts,concerns, and ideas to msholty@uwyo.edu.The WCNHCP is the nursing workforcecenter and Action Coalition for the <strong>State</strong><strong>of</strong> <strong>Wyoming</strong>. The mission <strong>of</strong> the center isto strengthen the nursing workforce throughon-going collaboration, communication,and consensus building to meet the healthneeds <strong>of</strong> the people <strong>of</strong> <strong>Wyoming</strong>. For furtherinformation, please visit the WCNHCP’swebpage at wynursing.org.References1. Cleary, B. L., McBride, A. B., McClure, M.L., & Reinhard, S., C. (2009). Expandingthe capacity <strong>of</strong> nursing education. HealthAffairs, 28, W634-W635.2. Burns, P., Williams, S. H., Ard, N.,Enright, C., Poster, E. & Ransom, S.A. (2011). Academic partnerships toincrease nursing education capacity:Centralized faculty resources and clinicalplacement centers. Journal <strong>of</strong> Pr<strong>of</strong>essional<strong>Nursing</strong>, 27, e14-e19.3. Horton, C. D., Hertach, M., DePaoli,S. & Bower, M. (2012). Enhancing theeffectiveness <strong>of</strong> nurse preceptors. Journalfor <strong>Nurse</strong>s in Staff Development, 28(4),E1-E7.4. Kowalski, K., & Homer, M. D. & Houser,J. (2011). Evaluation <strong>of</strong> a model forpreparing staff nurses to teach clinicalgroups <strong>of</strong> nursing students. Journal <strong>of</strong>Continuing Education in <strong>Nursing</strong>, 42,233-240.5. Zahner, S. J. (2006). Partnerships forlearning population-based public healthnursing: Web-delivered continuingeducation for public health nursepreceptors. Public Health <strong>Nursing</strong>, 23,547-554.6. Raines, D. A. (2012). <strong>Nurse</strong> preceptors’views <strong>of</strong> precepting undergraduatestudents. <strong>Nursing</strong> Education Perspectives,33(2), 76-79.YOURFUTUREAWAITSBSN • MS • DNPPreparinginnovative nurseleadersFay W. WhitneySCHOOL OF NURSINGOn the Peak <strong>of</strong> Excellence!www.uwyo.edu/nursingExceptional Work Life Balance!West Park Hospital has openings for experienced RNs:Visit www.WestParkHospital.orgto view opportunitiesWe <strong>of</strong>fer a competitive salary, generousbenefits, and moving allowance.If you are looking for an opportunity toprovide exceptional patient care in anurturing environment while enjoying afulfilling work/life balance, explore a careerat West Park Hospital. Our facility is state-<strong>of</strong>the-artand our leadership is committed toensuring a positive healthcare experience.SIGN ONBONUSAVAILABLE707 Sheridan Ave. – Cody WY 82414(307) 527-5701 – (800) 654-9447West Park Hospital District is committed to providing a workplace free from alcohol and controlled substances inorder to ensure a safe, healthy, and work-efficient environment for employees, patients and visitors. Successfulcandidates will be required to complete a post-<strong>of</strong>fer drug screen. EOEWYOMING NURSE REPORTER 21
By Whitney Edinger, BRAND studentBRAND Student Learns Skills, Passion from <strong>Nurse</strong>sAs I begin to look towards my career, unsure<strong>of</strong> what specialty I will find myself in, the lessonsthe BRAND program taught me outside <strong>of</strong> theclassroom have changed me forever -- the love<strong>of</strong> nursing, the compassion for others and thededication to always be improving, for yourself andyour career.Instructor Rachel Thomas, right, with BRAND studentsWhitney Edinger, middle, and Rachel Porterfield, left.<strong>Nursing</strong> students are familiar with the advice regarding their futurecareers: “The right job, the right hospital, the right specialty… etc.will find you,” or, “You will be right where you are supposed to be.”Looking back over the past few years, I would say that also appliesto my placement in the BRAND program at the Fay W. WhitneySchool <strong>of</strong> <strong>Nursing</strong> at the University <strong>of</strong> <strong>Wyoming</strong>.I wasn’t fortunate enough to be one <strong>of</strong> those people who haveknown since childhood they wanted to be a nurse. Not until mysenior year <strong>of</strong> college, studying microbiology, did I realize that while Iloved learning about diseases, viruses and bacteria, I was much moreinterested in understanding how to care for people who are suffering.I knew then that not only did I want to become a nurse, but also Iwanted to immerse myself in the nursing pr<strong>of</strong>ession.After much research, I discovered that an accelerated baccalaureateprogram would give me the opportunity to do just that. What I foundto be truly unique to the BRAND program was the small number <strong>of</strong>students in each cohort and the individual attention I would receivefrom instructors who are experts in their respective fields. While Iunderstood that finishing two years worth <strong>of</strong> incredibly challengingcourses in just 15 months would be very difficult, I learned quicklyI would have the support <strong>of</strong> those instructors, and I would be ableto establish close friendships with my classmates. I applied forprograms across four states, all <strong>of</strong> which <strong>of</strong>fered incredible learningopportunities.However, what really interested me about the BRAND programat the University <strong>of</strong> <strong>Wyoming</strong> was how many opportunities wouldbe given to me to learn from skilled and passionate nurses, workingin a wide variety <strong>of</strong> settings. Traveling all over the state for clinicalrotations is a challenging adventure, especially while trying to balancea rigorous course load and tough <strong>Wyoming</strong> winters! However, therewards <strong>of</strong> the experiences have made the traveling worth it.Ever since I began researching careers in nursing, I have heardthat nurses do so many things and work with a wide range <strong>of</strong> patientpopulations. The clinical experiences I have had with the BRANDprogram certainly prove that statement. In just a short year, I havebeen able to see an amazing team come together to fight for a patient’slife and cry over a patient’s death. I have been able to witness childrenbeing born and disabled adults receiving tremendously thoughtfulcare. I have been able to witness a difficult surgery and teen mothersfight for better lives for their children.Although each <strong>of</strong> my experiences has changed me, the mostvaluable experience I have gained was from working with nurses, whowere eager to impart the passion they have for their chosen field.As I begin to look towards my career, unsure <strong>of</strong> what specialty I willfind myself in, the lessons the BRAND program taught me outside <strong>of</strong>the classroom have changed me forever -- the love <strong>of</strong> nursing, thecompassion for others and the dedication to always be improving, foryourself and your career.I am so grateful for finding where I was “supposed to be” for thispast year. I can say with assurance that no matter where I end uppracticing, I will do so with confidence in my training and knowledgebase from the University <strong>of</strong> <strong>Wyoming</strong> and in my newfound love forthe pr<strong>of</strong>ession.22 WYOMING NURSE REPORTER
e d u c a t i o n / e m p l o y m e n tnationwideApril 2009Free Subscription toStu<strong>Nurse</strong> magazine!e d u c a t i o n / e m p l o y m e n tSEPTEMBER 2009E D I T I O N 1 3OPPORTUNITIES IN HEALTH LAWFOR NURSING DEGREE HOLDERSWEST EDITIONE D I T I O N 1 2nationwideMAKE YOUR EDUCATIONALJOURNEY SMARTThe Art and Science <strong>of</strong> CraftsTREATMENT OF PHYSICALAND COGNITIVE DISABILITIESReaching every nursing student/school in AmericaThinking Outside the Box:BINING CARINGCHNOLOGYReaching every nursing student/school in Americaw w w . S t u N u r s e . c o m 1Do you know someone who is a student nurse, orsomeone considering a nursing career? Then let themknow about the Stu<strong>Nurse</strong> magazine. A subscriptionto the Stu<strong>Nurse</strong> digital magazine is FREE and can bereserved by visiting www.Stu<strong>Nurse</strong>.com and clicking onthe Subscribe button at the upper right corner.Educators…let your students knowthey can subscribe free <strong>of</strong> charge!CLAIM YOUR MEDICALCAREER INWYOMINGIf you are aRegistered <strong>Nurse</strong>with at least one year<strong>of</strong> inpatient experience,you’ll flourish in <strong>Wyoming</strong>’spremier healthcare system,Cheyenne RegionalMedical Center.Competitive salary • Studer partnership • Educational assistanceExpanding medical facilities • Long-term/short-term disabilityHealth, dental and vision benefits • On-site pr<strong>of</strong>essional developmentCall for more information:Brad Wiegel • (307) 633-7767 • crmcwy.orgWYOMING NURSE REPORTER 23
What Can a Baccalaureate Degree Do For Me?Kathleen Laidlaw, RN, BSNAssistant Editor <strong>Wyoming</strong> <strong>Nurse</strong> <strong>Reporter</strong>The trend in nursing is toward finishinga four-year degree program, but many nursesare asking, “What can a baccalaureate degreedo for me? Good question.I started my RN career with an Associate<strong>of</strong> Science Degree in <strong>Nursing</strong> (ASN).Throughout my career I have had the opportunityto work shoulder-to-shoulder withADN and Diploma nurses and have foundthem to be the some <strong>of</strong> the most clinicallycompetent, passionate, caring and devotedpr<strong>of</strong>essionals I have encountered. Today, associateand diploma-prepared nurses representhalf <strong>of</strong> the nearly 3 million RNs in theUnited <strong>State</strong>s. But that is changing.In 2010 the Institute <strong>of</strong> Medicine inpartnership with the Robert Wood JohnsonFoundation (RWJF) released a report “TheFuture <strong>of</strong> <strong>Nursing</strong>.” Included in the reportwere eight recommendations for transformingthe nursing pr<strong>of</strong>ession to meet the needs<strong>of</strong> the growing number <strong>of</strong> aging and chronicallyill people, and the increasing complexity<strong>of</strong> both health care needs and health caredelivery. One recommendation from the“Future <strong>of</strong> <strong>Nursing</strong>” is to increase the number<strong>of</strong> baccalaureate prepared nurses (BSN)from 50 percent to 80 percent by the year2020. People wonder, “With so many successfulADNs and diploma RNs, why promoteincreasing the number <strong>of</strong> BSN nurses?”Perhaps you subscribe to the notion, “Moreeducation will not make me a better nurse.”Obtaining a baccalaureate degree mostlikely will not increase your ability to startan IV, sink an NG or change a dressing. A“BSN” behind your name is not likely toincrease your common sense, your nursingintuition or your dedication to your patientsand pr<strong>of</strong>ession. But a baccalaureate degreecan teach you principles <strong>of</strong> leadership thatmay give you the skills and confidence to collaboratewith providers and team members toresolve patient issues.A BSN may help you understand the importance<strong>of</strong> evidence-based practice and leadyou to information that will assist in makinghealth care decisions and providing the bestcare to your client and community.A BSN can broaden your knowledge base,increase your understanding <strong>of</strong> health care,throw open the doors <strong>of</strong> opportunity and –yes-- even make you a better nurse.Ten reasons for getting a baccalaureatedegree:• An abundance <strong>of</strong> online RN-BSNand RN-MSN bridging programs thathave made attaining the BSN achievablewherever you live (Check intothe programs available at the University<strong>of</strong> <strong>Wyoming</strong>.)• Availability <strong>of</strong> scholarships or tuitionreimbursement programs from youremployer to assist with tuition• New and innovative teaching strategiesthat help to develop essentialnursing skills• Updated nursing knowledge andpractice• Increased confidence• Acquisition <strong>of</strong> new skills• Increased career possibilities• Renewed outlook on your nursing career(and a sense <strong>of</strong> accomplishment)• Easier advancement into another degreeor advanced practice nursing• Networking opportunities with othernurses and development <strong>of</strong> pr<strong>of</strong>essionalcontacts and friendships<strong>Board</strong> News<strong>Board</strong> President Carrie Deselms, MSN, APRN, FNP-BC Second term exp: 2/28/2015Vice President Marcie Burr, RN, RD, CCHP Second Term exp: 2/28/2016Secretary Lori Johnson, LPN First Term exp: 2/28/2014APRN Member Donna Nurss, MS, APRN, BC First Term exp: 2/28/2015RN Member Cindy Woods, BSN, RN, BC Second term exp: 2/28/2016RN Member Tracy Wasserburger, RNC,NNP Second term exp: 2/28/2014Public Member Barbara <strong>Summer</strong>s First term exp: 2/28/2016New Public Member Joins WSBNBarbara <strong>Summer</strong>s is the new consumermember <strong>of</strong> the <strong>Wyoming</strong> <strong>State</strong> <strong>Board</strong> <strong>of</strong><strong>Nursing</strong>, appointed by Gov. Matt Meadto represent the public. <strong>Summer</strong>s’ threeyear-termwill expire Feb. 28, 2016.<strong>Summer</strong>s lives in Casper and hasworked for 33 years with the <strong>State</strong> <strong>of</strong><strong>Wyoming</strong> in various capacities at theBoys and Girls schools, Department<strong>of</strong> Family Services and Department <strong>of</strong>Workforce Services. She received herBachelor <strong>of</strong> Arts degree from Colorado<strong>State</strong> University.<strong>Summer</strong>s’ experience as social worker,counselor and public relations will be anasset to the <strong>Board</strong>. WSBN welcomes her.24 WYOMING NURSE REPORTER
Great <strong>Nurse</strong>s Welcome Here!Located in Missoula, Montana,Community Medical Center is a majormedical hub between Minneapolisand Seattle. Home to the University<strong>of</strong> Montana, Missoula is a progressivecommunity <strong>of</strong>fering a variety <strong>of</strong> culturaland entertainment options. It isconsistently rated as one <strong>of</strong> the toptowns for outdoor recreation in the U.S.by Outside Magazine.At our 151-bed facility, we are committedto providing our patients with the highestquality, family-friendly care available.CMC goes “live” with EMR!Community Medical Center provides anoutstanding and leading edge environment for itsemployees and patients. We recently implementedCerner© EMR to centralize data and providereal-time access to patient health information. Theconsistent delivery <strong>of</strong> quality, customer serviceoriented health care is matched only by ourcommitment to great nursing. We are seekingoutstanding nurses to join our team!To view our employment opportunities,please visit our website atwww.communitymed.orgCMC is an Equal Opportunity Employer2827 Fort Missoula Road • Missoula, MT 59804 • (406) 728-4100 • www.communitymed.orgWYOMING NURSE REPORTER 25
Achieve your goal <strong>of</strong> helping others when you start yourcareer with Altru Health System in Grand Forks, ND.Altru, a progressive, non-pr<strong>of</strong>it, integrated health system<strong>of</strong>fers a comprehensive benefits package to all <strong>of</strong> its fulland part-time employees. Altru is now hiring for:» <strong>Nurse</strong> Practitioner » Physician Assistant» Registered <strong>Nurse</strong> » Licensed Practical <strong>Nurse</strong>» Clinic Office <strong>Nurse</strong>For a complete listing and toapply online, visit altru.org/careersEOECompassionate,Respectful, ThoroughYou can see it in everything we do.Improving Health, Enriching Lifealtru.org/careersAltruHEALTH SYSTEMGet Your BSN in <strong>Nursing</strong>On-line and at Home from MSU-Northern•MSU-Northern <strong>of</strong>fers the only online RN to BSNCompletion Program in Montana•Allows students to stay at home and take coursesover the internet•Allows for fulfillment <strong>of</strong> clinical hours at homecommunities•Prepares students for leadership in health care•Perfect for place-bound students•Fully accredited by the National Leaguefor <strong>Nursing</strong> Accrediting Commission(NLNAC)1-800-662-6132 ext 3749loneil@msun.eduwww.msun.edu®Licensing <strong>Board</strong>or EmploymentProblems?Contact AngelaDougherty,former SeniorAssistant AttorneyGeneral andProsecutingAttorney forthe <strong>Wyoming</strong> <strong>State</strong><strong>Board</strong> <strong>of</strong> <strong>Nursing</strong>.Dougherty Law OfficeAngela C. DoughertyAttorney and Counselor at Law(307) 432-4006www.angeladoughertylaw.comlawacd@gmail.com1623 Central AvenueP.O. Box 254 • Cheyenne, WY 82003Licensed in <strong>Wyoming</strong> and ColoradoThe <strong>Wyoming</strong> <strong>State</strong> Bar does not certify any lawyer as a specialistor expert. Anyone considering a lawyer should independentlyinvestigate the lawyer’s credentials and ability, and not rely uponadvertisements or self-proclaimed expertise.Congratulations!<strong>2013</strong> Class <strong>of</strong>Faith Community <strong>Nurse</strong>s:Amanda B.Carolyn D.Nicole K.Kate M.Amy P.Carole S.Nancy W.Faith Community <strong>Nurse</strong>snurture the body, mind andspirit through health education,early intervention and diseaseprevention.<strong>Wyoming</strong> Health Council307-632-3640ahubbard@wyhc.org • www.wyhc.orgSponsored by a community benefit grantfrom Cheyenne Regional Medical Center.26 WYOMING NURSE REPORTER
Please be advised that several licensees may have the same name and the only positive verification is by license number. Every discipline case isconsidered separately by the <strong>Board</strong> and multiple factors can affect the final disposition. The facts listed here are for summary information only.The <strong>Board</strong> is not bound by previous decisions and no single case establishes <strong>Board</strong> Policy.DISCIPLINARY ACTIONSGrounds for discipline for all licensees or certificateholders are listed in <strong>Wyoming</strong> Statutes Annotated § 33-21-146, as well as located in the Administrative Rules andRegulations as follows: Advanced Practice Registered <strong>Nurse</strong>sat Chapter 4, pages 4-7 through 4-8; Registered Pr<strong>of</strong>essional<strong>Nurse</strong>s and Licensed Practical <strong>Nurse</strong>s at Chapter 3, pages3-13 through 3-15 and Certified <strong>Nursing</strong> Assistants atChapter 7, pages 7-16 and 7 17 (July 2010).Finalized <strong>Board</strong> Orders are accessible under the“Discipline” tab at our Website: http://nursing.state.wy.us.Grounds for Discipline include: (i) engaging in anyact inconsistent with uniform and reasonable standards<strong>of</strong> practice, including but not limited to: (A) Fraudand deceit; (B) Performance <strong>of</strong> unsafe client care; (C)Misappropriation or misuse <strong>of</strong> property; (D) Abandonment;(E) Abuse, including emotional, physical or sexual abuse;(F) Neglect, including substandard care; (G) Violation<strong>of</strong> privacy or confidentiality in any form, written, verbalor technological; (H) Drug diversion-self/others; (I) Sale,unauthorized use, or manufacturing <strong>of</strong> controlled/illicitdrugs; (J) Criminal conviction; (K) Unpr<strong>of</strong>essional conduct;(L) Boundary violations, including sexual boundaries; (M)Failure to comply with reasonable requests from the boardincluding, but not limited to: (i) Responses to complaints;(ii) Responses to formal pleadings such as notice <strong>of</strong> hearingand/or petition and complaint; (III) Responses to requestsregarding application and/or renewal information; (IV)Written response to request for explanation for failure todisclose required information; (V) Failure to appear atproperly noticed hearings; (N) Impairment; (i) Lack <strong>of</strong>nursing competence; (II) Mental illness; (III) Physical illnessincluding, but not limited to, deterioration through theaging process or loss <strong>of</strong> motor skills; or (IV) Chemical oralcohol impairment/abuse; and (ii) Failure to conform to thestandards <strong>of</strong> prevailing nursing practice, in which case actualinjury need not be established. NOTE: Please refer to theAdministrative Rules and Regulations as applicable to level<strong>of</strong> nurse licensure or nursing assistant certification.MALGORZATA BURNSCNA 21594REVOCATIONMalgorzata Burns, CNA, had an OrderGranting Petitioner’s Motion for DefaultJudgment and Order <strong>of</strong> Revocation enteredagainst her and approved by the <strong>Board</strong> onApril 29, <strong>2013</strong>, as a result <strong>of</strong> alleged violations<strong>of</strong> the <strong>Nurse</strong> Practice Act and <strong>Board</strong>’s Rules.A complaint was initiated alleging Ms. Burnshad repeatedly misappropriated the property<strong>of</strong> a vulnerable person while working as aCertified <strong>Nursing</strong> Assistant.DARCI JOHNSONCNA 21877REVOCATIONDarci Johnson, CNA, had an Order GrantingPetitioner’s Motion for Default Judgment andOrder <strong>of</strong> Revocation entered against her andapproved by the <strong>Board</strong> on April 29, <strong>2013</strong>,as a result <strong>of</strong> alleged violations <strong>of</strong> the <strong>Nurse</strong>Practice Act and <strong>Board</strong>’s Rules. A complaintwas initiated alleging unpr<strong>of</strong>essional conduct,unfitness/incompetency due to use <strong>of</strong>drugs and other mind altering chemical/performance <strong>of</strong> unsafe nursing practice andfailure to conform to standards <strong>of</strong> prevailingnurse practice.KARA SMITHCNA 18036REVOCATIONKara Smith, CNA, had an Order GrantingPetitioner’s Motion for Default Judgmentand Order <strong>of</strong> Revocation entered against herand approved by the <strong>Board</strong> on April 29, <strong>2013</strong>,as a result <strong>of</strong> alleged violations <strong>of</strong> the <strong>Nurse</strong>Practice Act and <strong>Board</strong>’s Rules. On January29, 2012 the <strong>Board</strong> received a complaint thatMs. Smith had tested positive for cocaine.KAREN McMILLANRN 16710VOLUNTARY SURRENDERKaren McMillan, RN, entered into aSettlement Agreement as well as an Agreementand Order for Voluntary Surrender, approvedby the <strong>Board</strong> on April 9, <strong>2013</strong>, as a result<strong>of</strong> alleged violations <strong>of</strong> the <strong>Nurse</strong> PracticeAct and <strong>Board</strong>’s Rules, and specifically forworking as a nurse while impaired. Ms.McMillan requested to voluntarily surrenderher license.BRENDA ALLENRN 22633SUSPENSIONBrenda Allen, RN, entered into a SettlementAgreement, Stipulation and Order forSuspended License, approved by the <strong>Board</strong> onApril 9, <strong>2013</strong>, as a result <strong>of</strong> alleged violations<strong>of</strong> the <strong>Nurse</strong> Practice Act and <strong>Board</strong>’s Rules,including chemical dependency and drugdiversion. A substance abuse evaluationdiagnosed a substance use disorder andrecommended suspension from the practice <strong>of</strong>nursing for a minimum two year period. Ms.Allen will be eligible for reinstatement uponcompletion <strong>of</strong> treatment recommendationsand a demonstrated minimum two yearperiod <strong>of</strong> sobriety. Ms. Allen will continueto be pr<strong>of</strong>essionally monitored by the <strong>Nurse</strong>Monitoring Program.SCOTT BEZOLDLPN 7111SUSPENSIONScott Bezold, LPN, entered into a SettlementAgreement, Stipulation and Order forSuspended License, approved by the <strong>Board</strong> onApril 9, <strong>2013</strong>, as a result <strong>of</strong> alleged violations<strong>of</strong> the <strong>Nurse</strong> Practice Act and <strong>Board</strong>’s Rules,including discipline in another jurisdiction.Mr. Bezold was suspended in North Dakotafor practice <strong>of</strong> nursing without sufficientknowledge, skills, or nursing judgment, andperformance <strong>of</strong> nursing interventions in amanner inconsistent with acceptable nursingpractice standards, as well psychologicalissues presenting concerns regarding unsafepractice. Mr. Bezold will be required tocooperate in further investigation, includingsubmitting to psychological evaluations andtreatment, pr<strong>of</strong>essional monitoring as well ascompletion <strong>of</strong> indicated training.JENNIFER EVANSRN 17161CONDITIONAL LICENSEJennifer Evans, RN, entered into aSettlement Agreement, Stipulation andOrder for Conditional License, approvedby the <strong>Board</strong> on April 29, <strong>2013</strong>, as a result<strong>of</strong> alleged violations <strong>of</strong> the <strong>Nurse</strong> PracticeAct and <strong>Board</strong>’s Rules, including fraud anddeceit, chemical dependency, and failureto conform to the standards <strong>of</strong> prevailingnursing practice and violation <strong>of</strong> a previous<strong>Board</strong> order. Ms. Evans previously wasthe subject <strong>of</strong> a conditional license thatshe violated by administering controlledsubstances in violation <strong>of</strong> the <strong>Board</strong>’s orderand forged the name <strong>of</strong> another nurse relatedto controlled substances, as well as improperdocumentation. Ms. Evans will not beWYOMING NURSE REPORTER 27
permitted to practice in any clinical setting without prior approval<strong>of</strong> the Disciplinary Committee for at least one year. Ms. Evans willbe required to continue in treatment and pr<strong>of</strong>essional monitoring bythe <strong>Nurse</strong> Monitoring Program (NMP), and have a worksite monitorwhen she obtains a nursing position, subject to additional limitationsand restrictions.TAMMY GOLLYHORNLPN 6133CONDITIONAL LICENSETammy Gollyhorn, LPN, entered into a Settlement Agreement,Stipulation and Order for Suspension and Conditional Licenseapproved by the <strong>Board</strong> on March 6, <strong>2013</strong>, as a result <strong>of</strong> allegedviolations <strong>of</strong> the <strong>Nurse</strong> Practice Act and <strong>Board</strong>’s Rules. Ms. Gollyhornwas the subject <strong>of</strong> a disciplinary order from the Colorado <strong>Board</strong> <strong>of</strong><strong>Nursing</strong>, in which she was placed on a probation status and requiredto have a worksite monitor for a period <strong>of</strong> two (2) years wherevershe practices nursing, subject to reporting requirements, as well asadditional education requirements. Ms. Gollyhorn will be subject tosuch requirements as a condition to nurse employment in the <strong>State</strong> <strong>of</strong><strong>Wyoming</strong>.JOSEPH IVERSONRN 27673CONDITIONAL LICENSEJoseph Iverson, RN, entered into a Settlement Agreement, Stipulationand Order for Conditional License, approved by the <strong>Board</strong> on March6, <strong>2013</strong>, as a result <strong>of</strong> alleged violations <strong>of</strong> the <strong>Nurse</strong> Practice Act and<strong>Board</strong>’s Rules, including criminal conviction, drug diversion, chemicaldependency, and failure to conform to the standards <strong>of</strong> prevailingnursing practice. Mr. Iverson’s license to practice previously wassummarily suspended at which time he entered treatment and wasmonitored by the <strong>Nurse</strong> Monitoring Program (NMP). Mr. Iversonwill be authorized to practice with certain restrictions and otherconditions, including continued treatment as recommended andmonitoring by the NMP, with requirements for a worksite monitorand further annual evaluations.WENDY SAMSONCNA 22733CONDITIONAL CERTIFICATEWendy Samson (aka Wendy Sorensen), entered into a SettlementAgreement, Stipulation and Order for Conditional Certificate,approved by the <strong>Board</strong> on April 9, <strong>2013</strong>, as a result <strong>of</strong> allegedviolations <strong>of</strong> the <strong>Nurse</strong> Practice Act and <strong>Board</strong>’s Rules, includingcriminal conviction, chemical dependency and failure to conformto the standards <strong>of</strong> prevailing nursing practice. Ms. Samson wasconvicted <strong>of</strong> her third DUI and participated in court orderedtreatment and random drug tests. Ms. Samson will continue withtreatment recommendations, as well as to be monitored by the <strong>Nurse</strong>Monitoring Program (NMP), and have a worksite monitor when sheobtains a nursing assistant position, subject to additional conditions.LORI TANNERRN 31671CONDITIONAL LICENSELori Tanner, applicant for a license as a Registered Pr<strong>of</strong>essional<strong>Nurse</strong>, entered into a Settlement Agreement, Stipulation and Orderfor Conditional License, approved by the <strong>Board</strong> on March 6, <strong>2013</strong>,as a result <strong>of</strong> disclosure <strong>of</strong> discipline in another jurisdiction by apr<strong>of</strong>essional licensing board and substance abuse, constitutingviolations <strong>of</strong> the <strong>Nurse</strong> Practice Act and <strong>Board</strong>’s Rules. Ms. Tannerparticipated in treatment, has met treatment goals and participates inaftercare. Ms. Tanner will continue with treatment recommendations,and will have practice restrictions and conditions, as well as to bemonitored by the <strong>Nurse</strong> Monitoring Program.AMBERLEE ALBRIGHTCNA 24593LETTER OF REPRIMANDAmberlee Albright, CNA, entered into a Settlement Agreement,Stipulation and Order for Letter <strong>of</strong> Reprimand, approved by the<strong>Board</strong> on March 6, <strong>2013</strong>, as a result <strong>of</strong> alleged violations <strong>of</strong> the <strong>Nurse</strong>Practice Act. Ms. Albright engaged in the unlicensed practice <strong>of</strong> anursing assistant after her temporary permit expired. Ms. Albright’sapplication for certification as a Certified <strong>Nursing</strong> Assistant wasapproved subject to the reprimand <strong>of</strong> her certificate.STEPHNIE CONNALLYCNA 16293LETTER OF REPRIMANDStephnie Connally, CNA, entered into a Settlement Agreement,Stipulation and Order for Reprimand <strong>of</strong> her Certified <strong>Nursing</strong>Assistant Certificate, approved by the <strong>Board</strong> on April 29, <strong>2013</strong>, asa result <strong>of</strong> alleged violations <strong>of</strong> the <strong>Nurse</strong> Practice Act and <strong>Board</strong>’sRules. Ms. Connally engaged in unlicensed nursing assistant practiceby practicing without a <strong>Wyoming</strong> certificate after it had expired andfailed to timely renew her certificate.GWEN GALERN 23402LETTER OF REPRIMANDGwen Gale, RN, entered into a Settlement Agreement, Stipulation andOrder for Reprimand <strong>of</strong> her Registered Pr<strong>of</strong>essional <strong>Nurse</strong> License,approved by the <strong>Board</strong> on April 29, <strong>2013</strong>, as a result <strong>of</strong> allegedviolations <strong>of</strong> the <strong>Nurse</strong> Practice Act and <strong>Board</strong>’s Rules. Ms. Galeengaged in the unlicensed practice <strong>of</strong> nursing, by practicing withouta <strong>Wyoming</strong> license following expiration and failure to timely renew.28 WYOMING NURSE REPORTER
DIANA GUMMRN 22394LETTER OF REPRIMANDDiana Gumm, RN, entered into a Settlement Agreement, Stipulationand Order for Letter <strong>of</strong> Reprimand, approved by the <strong>Board</strong> on April29, <strong>2013</strong>, as a result <strong>of</strong> alleged violations <strong>of</strong> the <strong>Nurse</strong> Practice Actand <strong>Board</strong>’s Rules, including violation <strong>of</strong> a previous <strong>Board</strong> order.Ms. Gumm previously was the subject <strong>of</strong> a conditional license thatshe violated by failing to report attendance at 12-step meetings andto submit to an updated substance abuse evaluation. Ms. Gummwill be required to continue pr<strong>of</strong>essional monitoring by the <strong>Nurse</strong>Monitoring Program (NMP) and undergo additional training.MARILYN HESCORN 8612LETTER OF REPRIMANDMarilyn Hesco, RN, entered into a Settlement Agreement, Stipulationand Order for Reprimand <strong>of</strong> her Registered Pr<strong>of</strong>essional <strong>Nurse</strong>License, approved by the <strong>Board</strong> on April 29, <strong>2013</strong>, as a result <strong>of</strong> allegedviolations <strong>of</strong> the <strong>Nurse</strong> Practice Act and <strong>Board</strong>’s Rules. Ms. Hescoengaged in the unlicensed practice <strong>of</strong> nursing, by practicing withouta <strong>Wyoming</strong> license after it had expired and failed to timely renew herlicense.BRENDA HOBBSLPN 7526LETTER OF REPRIMANDBrenda Hobbs, LPN, entered into a Settlement Agreement, Stipulationand Order for Letter <strong>of</strong> Reprimand <strong>of</strong> her Licensed Practical <strong>Nurse</strong>License, approved by the <strong>Board</strong> on April 9, <strong>2013</strong>, as a result <strong>of</strong> allegedviolations <strong>of</strong> the <strong>Nurse</strong> Practice Act and <strong>Board</strong>’s Rules. Ms. Hobbscommitted medication errors and administered medication without aphysician’s order constituting a failure to conform to the standards <strong>of</strong>prevailing nursing practice and a violation <strong>of</strong> the <strong>Board</strong>’s Rules. Ms.Hobbs also will be required to undertake particular remedial training.MARGARET IBETORN 28728LETTER OF REPRIMANDMargaret Ibeto, RN, entered into a Settlement Agreement, Stipulationand Order for Letter <strong>of</strong> Reprimand <strong>of</strong> her Registered Pr<strong>of</strong>essional<strong>Nurse</strong> License, approved by the <strong>Board</strong> on March 6, <strong>2013</strong>, as a result<strong>of</strong> alleged violations <strong>of</strong> the <strong>Nurse</strong> Practice Act and <strong>Board</strong>’s Rules. Ms.Ibeto allegedly forced medications to a patient refusing medicationdespite the patient suffering from mental deterioration, which, ifproven, would constitute unsafe practice and/or failure to conform toacceptable nurse practice standards. Ms. Ibeto also will be required toundertake particular remedial training.PATRICIA MALLIOTLPN 5332LETTER OF REPRIMANDPatricia Malliot, LPN, entered into a Settlement Agreement, Stipulationand Order for Letter <strong>of</strong> Reprimand <strong>of</strong> her Licensed Practical <strong>Nurse</strong>License, approved by the <strong>Board</strong> on April 9, <strong>2013</strong>, as a result <strong>of</strong> allegedviolations <strong>of</strong> the <strong>Nurse</strong> Practice Act and <strong>Board</strong>’s Rules. Ms. Malliotcommitted fraud and deceit, medication errors and failed to properlywaste controlled substances as well as falsification <strong>of</strong> or appropriatedocumentation <strong>of</strong> medical records constituting a failure to conformto the standards <strong>of</strong> prevailing nursing practice and a violation <strong>of</strong>the <strong>Board</strong>’s Rules. Ms. Malliot also will be required to undertakeparticular remedial training.STEPHEN SALAPATARN 30915LETTER OF REPRIMANDStephen Salapata, RN, entered into a Settlement Agreement,Stipulation and Order for Letter <strong>of</strong> Reprimand <strong>of</strong> his RegisteredPr<strong>of</strong>essional <strong>Nurse</strong> License, approved by the <strong>Board</strong> on April 29, <strong>2013</strong>,as a result <strong>of</strong> alleged violations <strong>of</strong> the <strong>Nurse</strong> Practice Act and <strong>Board</strong>’sRules. Mr. Salapata administered IV fluids without a physician’s orderto a person outside <strong>of</strong> a clinical setting, which constitutes failure toconform to acceptable nurse practice standards. Mr. Salapata also willbe required to undertake particular remedial training.OTHER BOARD ACTIONSTANIE HEITZRN 31197APPLICANT DENIALMs. Heitz requested that her RN license be reinstated without furtherconditions or restrictions. The <strong>Board</strong> denied her request on April 10,<strong>2013</strong> and wants Ms. Heitz to complete her original 2012 ConditionalRN Licensee Order before reinstating.JENNIFER EVANSRN 17161REINSTATEMENTOn April 29, <strong>2013</strong>, WSBN entered a Findings <strong>of</strong> Fact, Conclusion <strong>of</strong>Law, and Order <strong>of</strong> Reinstatement <strong>of</strong> Jennifer Evans, RN, <strong>Wyoming</strong>Registered Pr<strong>of</strong>essional <strong>Nurse</strong> License No. 17161 subject toConditions: Order Approving Settlement Agreement and Stipulationfor Modified Conditional License.VAN HARMONRN 19984REINSTATEMENTOn April 29, <strong>2013</strong>, WSBN entered a Findings <strong>of</strong> Fact, Conclusion<strong>of</strong> Law, and Order <strong>of</strong> Reinstatement <strong>of</strong> Van Harmon, RN, <strong>Wyoming</strong>Registered Pr<strong>of</strong>essional <strong>Nurse</strong> License No. 19984. Mr. Harmoncompleted all requirements imposed by a 2010 Conditional RNLicense Order and his license was reinstated without furtherconditions or restrictions.WYOMING NURSE REPORTER 29
The <strong>Wyoming</strong> <strong>State</strong> <strong>Board</strong> <strong>of</strong> <strong>Nursing</strong>Congratulates all <strong>Nurse</strong>s forNATIONAL NURSESWEEK!The theme <strong>of</strong> National <strong>Nurse</strong>s Weekthis year was delivering quality andinnovation in patient care.The WSBN recognizes and celebrateseverything nurses do to deliver highqualitypatient care, to conduct research,to develop innovations that improve thequality <strong>of</strong> care, to provide primary care,to teach, to serve in the military, to runhealth organizations – and more.(National <strong>Nurse</strong>s Week was May6-13 this year. It encompasses theMay 12, 1820, birthday <strong>of</strong> FlorenceNightingale, OM, RRC, who was anEnglish social reformer and founder <strong>of</strong>modern nursing. )LIMITEDAVAILABILITYCALL TODAY<strong>Nurse</strong> NetworkEconomical ClassifiedsCopy to ComeReach 11,000 nurses in <strong>Wyoming</strong> for as little as $325.Thrive in Alaska!- New hospital now open! -ER & OB <strong>Nursing</strong> Opportunitiesin natural Northwest Alaska!NORTON SOUND HEALTH CORPORATIONRhonda Schneider(877) 538-3142 or rmschneider@nshcorp.orgVisit www.nortonsoundhealth.orgCOME HOME TOMONTANAYOUR NEW CAREER AWAITS.COMMUNITY MEDICAL CENTERMISSOULA, MONTANAApply online atwww.communitymed.org.Inquiries: Deborah Trandtran@communitymed.orgor (406) 327-4244Defending <strong>Wyoming</strong> <strong>Nurse</strong>s for Over 20 YearsObtain the best representationto protect your interests!KATHLEEN B. DIXON, RN, JDATTORNEY AT LAWDixon & Dixon, LLP104 S. Wolcott Street, Suite 600Casper, <strong>Wyoming</strong> 82601Phone: 307/234-7321E-mail: KDIXON@TRIBCSP.COMThe <strong>Wyoming</strong> <strong>State</strong> Bar does not certify any lawyer as aspecialist or expert. Anyone considering a lawyer shouldindependently investigate the lawyer’s credentials and ability,and not rely upon advertisements or self-proclaimed expertise.Thrive as a Legal <strong>Nurse</strong> Consultant!LNCs are in demand and can earn $80 to $150 perhour analyzing medical cases for attorneys.Legal <strong>Nurse</strong> Consulting, Inc.'s dynamic, self-pacedLNC training program prepares you for ASLNCcertification - from the privacy <strong>of</strong> your own home!Put your clinical experience to work in theexciting legal arena... take that first step today.Call 888-888-4560 oradmin@lnccenter.comVisit www.LNCcenter.com<strong>Nursing</strong> ProgramAdministratorsRecruit <strong>Nursing</strong>Faculty HereVictor Horne(800) 561-4686 ext. 11430 WYOMING NURSE REPORTER
Kindred Healthcare, Inc., a top-150 private employer in the United <strong>State</strong>s,is a healthcare services company based in Louisville, Kentucky withapproximately 77,800 employees in 46 states. Ranked as one <strong>of</strong> Fortunemagazine’s Most Admired Healthcare Companies for four years in a row,Kindred’s mission is to promote healing, provide hope, preserve dignity andproduce value for each patient, resident, family member, customer,employee and shareholder we serve.We are currently seekingRNs, LPNs & CNAsfor the following facilities:Kindred Transitional Care and Rehabilitation – CheyenneCheyenne, WYKindred Transitional Care and Rehabilitation – South CentralRawlins, WYKindred Transitional Care and Rehabilitation – Wind RiverRiverton, WYRN/LPN Requirements: graduation from an accredited school<strong>of</strong> nursing, current WY RN/LPN license and CPR certification.CNA Requirements: Valid state certification as a CNA. Sixmonths experience in a long-term care environment preferred.Apply online at kindred.comand call Matthew Marakis at: (801) 302-0089Drug-free/EOEWYOMING NURSE REPORTER 31
WYOMING STATE BOARD OF NURSING1810 Pioneer Ave.Cheyenne, <strong>Wyoming</strong> 82002Presorted StandardU.S. POSTAGE PAIDLittle Rock, ARPermit No. 1884Lookingfor yourperfect match?Quality <strong>of</strong> care, work and life ● Market-leading compensation ●Expanded benefits ● Relocation package ● Career advancementPatient focused resources ● Vibrant communityFind your perfect match atccmh.net/careersEqual Opportunity Employer I Human Resources I P.O. Box 3011 I Gillette, WY 82717 I 800.208.2043 I 307.688.1504
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