Montana Pulse - February 2021
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<strong>February</strong> <strong>2021</strong> • Vol. 58 • No. 1<br />
THE OFFICIAL PUBLICATION OF THE MONTANA NURSES ASSOCIATION FOUNDATION<br />
Quarterly publication distributed to approximately 13,000 RNs and LPNs in <strong>Montana</strong>.<br />
Executive Director Report<br />
Professional Nurse Commitment<br />
For Nurses, Your License is Your Lifeline<br />
Page 14<br />
<strong>Montana</strong> Vaccinations Update<br />
Page 17<br />
current resident or<br />
Non-Profit Org.<br />
U.S. Postage Paid<br />
Princeton, MN<br />
Permit No. 14<br />
MNA (<strong>Montana</strong> Nurses<br />
Association) is committed<br />
to the nurses and nursing<br />
profession in <strong>Montana</strong> and<br />
will always need the nurses’<br />
commitment to keep it strong<br />
and dynamic, furthermore,<br />
to make decisions that will<br />
safeguard the future of nurses<br />
and their profession. Activism<br />
isn’t for everyone, however,<br />
as nursing professionals we<br />
must invest in our professional<br />
organization to ensure the<br />
infrastructure and advocacy<br />
Vicky Byrd, MSN, RN<br />
Chief Executive<br />
Officer<br />
remain intact to carry our voices in all things that touch<br />
patients and nurses. Below is a quote from the late<br />
Mary Munger, RN, moreover, it will remain visionary and<br />
truthful in relation to professional nurses.<br />
It is one thing to have been educated and licensed<br />
as an R.N., another to be employed as an R.N., but<br />
the mark of a real professional is a love for and<br />
interest in, what is happening to that profession, and<br />
a commitment to help it. Without taking this third step,<br />
without identification as a member of the professional<br />
nursing organization, many nurses are merely draining<br />
the good from the profession without adding their<br />
share to keep it strong and dynamic. What exists<br />
today as professional nursing, good or bad, is here<br />
because other professionals wanted to make it better,<br />
yes, for themselves, but also for future generations.<br />
What happens to nursing in the future is dependent on<br />
action taken by nurses today through their professional<br />
organization. (Munger, M. (n.d.). Membership: A<br />
professional commitment. Letter.)<br />
MNA Mission Statement: The <strong>Montana</strong> Nurses<br />
Association promotes professional nursing practice,<br />
standards and education; represents professional<br />
nurses; and provides nursing leadership in promoting<br />
high quality health care.<br />
MNA, as your advocate, in addition to our mission,<br />
identifies specific functions through governing bylaws.<br />
Here are some highlights of those most relevant today:<br />
• Promote through appropriate means, the<br />
standards of nursing practice, nursing<br />
education, and nursing services;<br />
• Promote adherence to the Code of Ethics for<br />
Nurses established by ANA<br />
• Propose and influence legislation, governmental<br />
programs, and state and national health policy<br />
• Promote and protect the economic and general<br />
welfare of nurses<br />
• Promote and provide for the continuing<br />
professional development of nurses<br />
• Represent nurses and serve as their<br />
spokesperson with professional and community<br />
groups and the public<br />
• Represent nurses in collective bargaining and<br />
provide services to local units<br />
• Maintain communication with members through<br />
official publications<br />
• Assume an active role as a consumer advocate<br />
• Provide for networking among professional<br />
nurses through contact with affiliate members<br />
At the national level, the ANA (American Nurses<br />
Association) has reached an amazing milestone of<br />
130 years in existence, and proudly, the <strong>Montana</strong><br />
Nurses Association has had a relationship with ANA<br />
since their existence in 1912, for 109 of those years!<br />
MNA also incorporated 75 years ago becoming the<br />
non-profit organization, under the laws of the state<br />
of <strong>Montana</strong>, which it is today. Although the MNA has<br />
adapted, grown, and transitioned over these years,<br />
it remains a member driven organization and the<br />
recognized advocate and voice for the professional<br />
nurse in <strong>Montana</strong>, all nurses, whether they choose to<br />
belong to their professional nurse association or not.<br />
Our nurses, and the patients and communities they<br />
serve, remain our number one priority.<br />
“ANA Enterprise joins with the World Health<br />
Organization (WHO) and global colleagues in<br />
extending the Year of the Nurse and Midwife into <strong>2021</strong><br />
because of the impact of the pandemic.<br />
The recognition will build on the increased visibility<br />
of nurses’ contributions from 2020 and ANA’s<br />
expansion of National Nurses Week to Nurses Month<br />
in May.<br />
Now more than ever, we need to support and<br />
recognize nurses for their steadfast commitment to<br />
meeting the needs of patients and their communities<br />
every day. We encourage you to promote nurses’ health<br />
and well-being and honor them in any way you can.”<br />
(https://anayearofthenurse.org/about-year-of-the-nurse/)<br />
Like us on Facebook<br />
Follow us on Twitter<br />
www.mtnurses.org
Page 2 <strong>Montana</strong> Nurses Association <strong>Pulse</strong> <strong>February</strong>, March, April <strong>2021</strong><br />
PUBLISHER INFORMATION<br />
& AD RATES<br />
Circulation 13,000. Provided to every registered<br />
nurse, licensed practical nurse, nursing student and<br />
nurse-related employer in <strong>Montana</strong>. The <strong>Pulse</strong> is<br />
published quarterly each <strong>February</strong>, May, August and<br />
November by Arthur L. Davis Publishing Agency, Inc.<br />
for <strong>Montana</strong> Nurses Association,<br />
20 Old <strong>Montana</strong> State Highway,<br />
<strong>Montana</strong> City, MT 59634, a constituent member of<br />
the American Nurses Association.<br />
For advertising rates and information, please<br />
contact Arthur L. Davis Publishing Agency, Inc.,<br />
517 Washington Street, PO Box 216, Cedar Falls,<br />
Iowa 50613, (800) 626-4081, sales@aldpub.com.<br />
MNA and the Arthur L. Davis Publishing Agency,<br />
Inc. reserve the right to reject any advertisement.<br />
Responsibility for errors in advertising is limited to<br />
corrections in the next issue or refund<br />
of price of advertisement.<br />
Acceptance of advertising does not imply<br />
endorsement or approval by the <strong>Montana</strong> Nurses<br />
Association of products advertised, the advertisers,<br />
or the claims made. Rejection of an advertisement<br />
does not imply a product offered for advertising<br />
is without merit, or that the manufacturer lacks<br />
integrity, or that this association disapproves of<br />
the product or its use. MNA and the Arthur L. Davis<br />
Publishing Agency, Inc. shall not be held liable for<br />
any consequences resulting from purchase or use<br />
of an advertiser’s product. Articles appearing in this<br />
publication express the opinions of the authors; they<br />
do not necessarily reflect views of the staff, board, or<br />
membership of MNA or those of the national or local<br />
associations.<br />
WRITER’S GUIDELINES:<br />
MNA welcomes the submission of articles and<br />
editorials related to nursing or about <strong>Montana</strong> nurses<br />
for publication in The PULSE. Please limit word size<br />
between 500 – 1000 words and provide resources<br />
and references. MNA has the Right to accept, edit or<br />
reject proposed material. Please send articles to:<br />
jennifer@mtnurses.org<br />
If you wish to no longer receive<br />
The <strong>Pulse</strong> please contact Monique:<br />
mheddens@aldpub.com<br />
If your address has changed please<br />
contact <strong>Montana</strong> Board of Nursing<br />
at: www.nurse.mt.gov<br />
PULSE SUBMISSIONS<br />
We are gathering articles that are relevant<br />
and appealing to YOU as a nurse. What<br />
is happening in your world today? Is there<br />
information we can provide that would be<br />
helpful to you? The <strong>Pulse</strong> is YOUR publication,<br />
and we want to present you with content that<br />
pertains to your interests.<br />
Please submit your ideas and<br />
suggestions to Jennifer.<br />
Jennifer@mtnurses.org<br />
Enjoy a user friendly layout and access to more<br />
information, including membership material,<br />
labor resources, Independent Study Library,<br />
a new Career Center for Job Seekers &<br />
Employers, and more downloadable information.<br />
Please visit<br />
MNA’s constantly updated website!<br />
www.mtnurses.org<br />
CONTACT MNA<br />
<strong>Montana</strong> Nurses Association<br />
20 Old <strong>Montana</strong> State Highway, Clancy, MT 59634<br />
Phone (406) 442-6710 • Fax (406) 442-1841<br />
Email: info@mtnurses.org • Website: www.mtnurses.org<br />
Office Hours: 7:30 a.m.-4:00 p.m. Monday through Friday<br />
VOICE OF NURSES IN MONTANA<br />
MNA is a non-profit, membership organization that advocates for nurse<br />
competency, scope of practice, patient safety, continuing education, and<br />
improved healthcare delivery and access. MNA members serve on the<br />
following Councils and other committees to achieve our mission:<br />
• Council on Practice & Government Affairs (CPGA)<br />
• Council on Economic & General Welfare (E&GW)<br />
• Council on Professional Development (CPD)<br />
• Council on Advanced Practice (CAP)<br />
MISSION STATEMENT<br />
The <strong>Montana</strong> Nurses Association promotes professional nursing practice,<br />
standards and education; represents professional nurses; and provides<br />
nursing leadership in promoting high quality health care.<br />
PROFESSIONAL DEVELOPMENT<br />
<strong>Montana</strong> Nurses Association is accredited with distinction as an approver<br />
of nursing continuing professional development by the American Nurses<br />
Credentialing Center’s Commission on Accreditation.<br />
<strong>Montana</strong> Nurses Association is accredited with distinction as a provider<br />
of nursing continuing professional development by the American Nurses<br />
Credentialing Center’s Commission on Accreditation.<br />
MNA Staff<br />
Vicky Byrd, MSN, RN, Chief Executive Officer<br />
Sheila Hogan, BS, Director of Outreach Operations<br />
Kristi Anderson, MN, RN, NPD-BC, CNL Director of Professional<br />
Development<br />
Caroline Baughman, BS, Professional Development Associate<br />
Megan Hamilton, MSN, RN CFRN, NR-P, Nurse Planner & Professional<br />
Development Generalist<br />
Robin Haux, BS, Labor Program Director<br />
Amy Hauschild, BSN, RN, Labor Representative<br />
Leslie Shepherd, BSN, RN, Labor Representative<br />
Laurie Hunton, RN, Labor Representative<br />
Jill Hindoien, BS, Chief Financial Officer<br />
Jennifer Hamilton, Administrative & Marketing Specialist<br />
Position<br />
Board of Directors President<br />
Board of Directors Vice President<br />
Board of Directors Secretary<br />
Board of Directors Treasurer<br />
Board of Directors Member at Large<br />
Board of Directors CPGA<br />
Board of Directors PD<br />
Board of Directors CAP<br />
Board of Directors EGW<br />
MNA Board of Directors<br />
Name<br />
Lorri Bennett, RN<br />
Terry Dutro, MSN, APRN, AGPCNP-BC<br />
Chelsee Baker, BSN, RN<br />
Audrey Dee, RN<br />
Anna Ammons, BSN, RN, PCCN<br />
Tricia Thien, RN, BAN, CGRN<br />
Deborah Lee, BSN, RN-BC, CCRP<br />
Lori Chovanak, DNP, RN, APRN-BC<br />
Brandi Breth, BSN, RN-BC<br />
Council on Practice & Government Affairs (CPGA)<br />
Gwyn Palchak, BSN, RN-BC, ACM Charlotte Skinner, BSN, RN-C<br />
Sally Sluder, DNP, APRN, AGACNP-BC Melissa Anderson, BSN, RN<br />
Paul Lee, CCRN<br />
Council on Professional Development (PD)<br />
Sandy Sacry, MSN, RN<br />
Brenda Donaldson, BA, RN, CAPA<br />
Gwyn Palchak, BSN, RN-BC, ACM Abbie Colussi, BSN, RN<br />
Emily Michalski-Weber, MSN, APRN, Janet Smith, MN, MSHS, RN<br />
PMHNP-BC<br />
Joe Poole, BSN, RN, CHSE<br />
Charlotte Skinner, BSN, RN-C<br />
Council on Advanced Practice (CAP)<br />
Chairperson-CAP<br />
Keven Comer, MN, FNP-BC<br />
Chairperson Elect-CAP<br />
Margaret Hammersla, BSN, MS, PhD,<br />
ANP-BC<br />
Secretary-CAP<br />
Nanci Taylor, APRN<br />
Member at Large-CAP<br />
Terry Dutro, MSN, APRN, AGPCNP-BC<br />
Member at Large-CAP<br />
Deven Robinson, MSN, FNP, PMHNP<br />
Council on Economic & General Welfare (E&GW)<br />
Delayne Stahl, RN, OCN<br />
Adrianne Harrison, RN<br />
Lorie Van Donsel, BSN, RN, PCCN Charlie Julia Buffo, RN<br />
Questions about your nursing license?<br />
Contact <strong>Montana</strong> Board of Nursing at: www.nurse.mt.gov
<strong>February</strong>, March, April <strong>2021</strong> <strong>Montana</strong> Nurses Association <strong>Pulse</strong> Page 3<br />
MNA membership (which includes ANA membership) is your professional nurse<br />
voice and advocacy on your pathways to improve practice, safety, professional<br />
development, legislation, and representation. It is a small investment in your nursing<br />
profession.<br />
****************<br />
As <strong>2021</strong> is a legislative year, here is MNA’s Legislative platform that was<br />
approved by the MNA’s Board of Directors and the memberships House of<br />
Delegates October 2020.<br />
2020-<strong>2021</strong> MNA Government Relations Platform<br />
<strong>Montana</strong> Nurses’ Association (MNA) is the nonprofit professional association<br />
representing the voice of nearly 18,000 Registered Nurses (RNs) in <strong>Montana</strong><br />
including more than 1000 licensed as Advanced Practice Registered Nurses<br />
(APRNs). MNA is the recognized professional organization, which lobbies for<br />
nursing practice issues to protect the practice of professional nurses and also<br />
protect the public in all areas of health care.<br />
MNA is the recognized leader and advocate for the professional nurse in<br />
<strong>Montana</strong>.<br />
1. Improve the quality of nursing practice by:<br />
a. Providing educational opportunities that contribute to improving practice<br />
competency and quality of patient care.<br />
b. Identifying and pursuing funding sources to assist in providing continuing<br />
nursing education.<br />
c. Identifying and pursuing funding sources that support research/projects to<br />
develop evidence based and innovative nursing practice.<br />
d. Promoting national certification of Registered Nurses.<br />
e. Active representation on local, state and national advisory committees/<br />
boards.<br />
f. Supporting the regulatory authority and collaborating with the <strong>Montana</strong> Board<br />
of Nursing (BON) on nursing practice and regulatory issues.<br />
g. Encouraging transparency and promoting communication from the <strong>Montana</strong><br />
Board of Nursing regarding relationship with NCSBN and votes affecting<br />
regulation of registered nurses<br />
h. Providing input into the implementation of NCSBN Nurse Compact Licensure<br />
legislation.<br />
i. Opposing the NCSBN APRN Nurse Compact Licensure legislation.<br />
2. Protect the economic and general welfare of nurses by:<br />
a. Actively engaging in legislation and campaigns that positively contribute to<br />
the economic and general welfare of RNs.<br />
b. Ensuring the right of RNs to engage in collective bargaining in <strong>Montana</strong>.<br />
c. Opposing any “Right to Work” legislation now being referred to as “NO<br />
RIGHTS AT WORK” by MNA.<br />
d. Addressing workplace environment issues including violence against<br />
healthcare workers, safe staffing, infectious disease, and patient safety.<br />
e. Advocating legislation prohibiting mandatory overtime.<br />
3. Improve access to quality, cost effective health care by developing and/or<br />
supporting public policies which:<br />
a. Respond to the needs of the unserved and underserved populations by<br />
promoting access to health care and healthcare coverage.<br />
b. Identify or develop alternative health care delivery systems that are costeffective<br />
and provide quality health care.<br />
c. Mandate third party reimbursements directly to RNs from public and private<br />
payers.<br />
d. Remove barriers (financial, governmental, regulatory, and/or institutional) that<br />
deny access to appropriate/qualified health care providers and approved<br />
medical standard of care treatments.<br />
e. Advocate for legislation that is transparent and bipartisan and support<br />
policies that can achieve evidence based real healthcare reform.<br />
f. Promote community and world health by collaborating with other health<br />
professionals to promote health diplomacy and reduce health disparities.<br />
4. Protect human rights by developing and/or supporting public policies which:<br />
a. Promote access to appropriate health services.<br />
b. Preserve individual rights to privacy.<br />
c. Promote, debate and have consideration of ethical dilemmas in health care<br />
d. Protect nurses and healthcare employees and the public at large from public<br />
health emergencies.<br />
5. Protect the environmental health of individuals and communities through:<br />
a. Acknowledging, supporting and addressing environmental impacts on the<br />
health of <strong>Montana</strong>ns.<br />
b. Actively engaging with national organizational affiliates in addressing<br />
environmental health issues in our nation.<br />
c. Identify the nurse’s primary commitment is to the patient, whether an<br />
individual, family, group, community, or population.<br />
6. Protecting and promoting the future healthcare and nursing practice through:<br />
a. Actively engaging in legislation that supports professional scope of nursing<br />
practice to the full extent of individual education and training.<br />
b. Actively promoting programs and efforts that encourage educational<br />
progression of professional nursing at state and national levels.<br />
c. Representation on boards, committees and advisory groups which influence<br />
the future of the nursing profession and the future of our state and national<br />
healthcare system.<br />
d. Engaging with healthcare partners and associations to work collaboratively to<br />
ensure healthcare as a right for all American populations.<br />
e. Actively support science and evidence based data to drive strong investment<br />
in safe quality public health programs at state and national levels.
Page 4 <strong>Montana</strong> Nurses Association <strong>Pulse</strong> <strong>February</strong>, March, April <strong>2021</strong><br />
The Makeup of MNA<br />
MNA consists of over 2,200 Registered Nurses and<br />
Advanced Practice Registered Nurses across the state of<br />
<strong>Montana</strong>. The state is divided into eight Districts based upon<br />
location. Each District Nurses Association (DNA) is made up<br />
of collective bargaining members (local unit members) and<br />
non-collective bargaining members.<br />
Our Annual Convention and House of Delegates is held<br />
every October. The House of Delegates sessions is where the<br />
yearly business of MNA is completed, i.e. bylaws changes,<br />
resolutions, legislative platform etc. To participate as an<br />
MNA District Delegate, you must be elected. These elections<br />
happen yearly, usually in the spring for each District. If you<br />
have any questions email jennifer@mtnurses.org.<br />
Here is the breakdown of each MNA District:<br />
Jennifer Hamilton<br />
Administrative &<br />
Marketing Specialist<br />
District 1: Mineral County, Missoula County and Ravalli County<br />
Local units in District 1 – Local #15-Community Medical Center<br />
Local #17-Providence St Patrick Hospital<br />
Local #18-Providence St. Patrick Coagulation Clinic<br />
Local #32-Partners in Home Care<br />
Local #33-Fresenius Kidney Care-Missoula<br />
Local #35-Marcus Daly Memorial Hospital<br />
CONGRATULATIONS TO THE FOLLOWING NURSES WHO HAVE<br />
TAKEN ADVANTAGE OF THE SUCCESS PAYS OFFERING BY ANCC<br />
TO MNA MEMBERS!<br />
1. Tiffany Sturdevant, RN-BC – Medical Surgical Nursing<br />
2. Stephanie A. Barrett, BSN, RN-BC – Medical Surgical Nursing<br />
3. Sara Nestor, RN-BC – Medical Surgical Nursing<br />
4. Metta Barnhart, RN-BC – Medical Surgical Nursing<br />
5. Nichole Schmidt, RN-BC – Medical Surgical Nursing<br />
6. Jessica Stevenson, RN-BC – Cardiac-Vascular Nursing<br />
New Member Benefit: MNA now offers certification<br />
through ANCC’s Success Pays ® Program<br />
District 2: Beaverhead County, Deer Lodge County, Granite<br />
County, Powell County and Silver Bow County<br />
Local units in District 2 – Local #1-Community Hospital of Anaconda<br />
Local #3-Rocky Mountain Clinic<br />
Local #5-Saint James Healthcare<br />
Local #7-<strong>Montana</strong> State Hospital<br />
Local #36-<strong>Montana</strong> Chemical Dependency Center<br />
Local #37-Butte Silver Bow Health Department<br />
District 3: Gallatin County, Madison County, Park County<br />
and Sweet Grass County<br />
Local units in District 3 – Local #4-Bozeman Health<br />
Local #6-Fresenius Kidney Care-Bozeman<br />
District 4: Broadwater County, Jefferson County, Lewis & Clark<br />
County and Meagher County<br />
Local units in District 4 – Local #8-<strong>Montana</strong> DPHHS<br />
Local #13-St Peters Hospital<br />
> Reduced fee for MNA Members to obtain initial certification<br />
or recertify<br />
> No cost if you don’t pass the exam; you can also take the<br />
exam a second time at no cost<br />
> Pay only when you pass!<br />
> Identify your specialty practice area<br />
How Success Pays ® Works<br />
> Visit nursingworld.org/our-certifications/ to:<br />
• Make sure you’re eligible to sit for the exam<br />
• Look at the test blueprint and test preparation materials<br />
• Make the decision to move forward<br />
> Visit www.mtnurses.org and click on Success Pays ® option<br />
to the left and sign up for the program!<br />
> MNA will contact you regarding how to get the benefit.<br />
District 5: Big Horn County, Carbon County, Carter County,<br />
Custer County, Fallon County, Golden Valley County, Musselshell<br />
County, Powder River County, Rosebud County, Stillwater County,<br />
Treasure County, Wheatland County and Yellowstone County<br />
Local units in District 5 – Local #2-Billings Clinic<br />
Local #38-Rosebud Health Care Center<br />
Local #44-Holy Rosary Healthcare<br />
District 6: Blaine County, Cascade County, Chouteau County,<br />
Fergus County, Glacier County, Hill County, Judith Basin County,<br />
Liberty County, Pondera County, Teton County and Toole County<br />
Local units in District 6 – Local #11-Cascade City-County Health Department<br />
Local #12 Northern <strong>Montana</strong> Health Care<br />
Local #14 <strong>Montana</strong> Mental Health Nursing Care Center<br />
Local #25 Northern Rockies Medical Center<br />
District 7: Flathead County, Lake County, Lincoln County and<br />
Sanders County<br />
Local units in District 7 – Local #22-Cabinet Peaks Medical Center<br />
Local #27-<strong>Montana</strong> Veterans Home<br />
Local #34-Clark Fork Valley Hospital<br />
District 8: Daniels County, Dawson County, Garfield County,<br />
McCone County, Petroleum County, Phillips County, Prairie County,<br />
Richland County, Roosevelt County, Sheridan County, Valley County,<br />
and Wibaux County<br />
Local units in District 8 – Local #21-Glendive Medical Center<br />
Local #39-Sidney Health Center<br />
If you have any questions regarding your District, please contact Jennifer at<br />
jennfer@mtnurses.org.
<strong>February</strong>, March, April <strong>2021</strong> <strong>Montana</strong> Nurses Association <strong>Pulse</strong> Page 5<br />
Labor Reports and News<br />
Promoting Health and Safety at Work:<br />
Covid-19 Accommodations and Resources<br />
As you continue to work during this pandemic,<br />
providing care for our communities, it’s important you<br />
learn what resources you have available to you. Over<br />
the past year, and with increased COVID-19 cases,<br />
your work environment continues to put you at risk for<br />
exposure. Understanding and learning about resources<br />
available to you is more important than ever.<br />
WORKERS COMPENSATION INSURANCE:<br />
Workers’ compensation insurance (WCI) is a type of<br />
business insurance that provides benefits to nurses<br />
who suffer a work-related injury or illness and it may<br />
help cover costs for medical care and wages for lost<br />
work time. The number one rule to understand is: you<br />
will NOT qualify or possibly receive benefits if you do not<br />
file. You MUST file! If you contact COVID-19 and believe<br />
Robin Haux, BS<br />
Labor Program<br />
Director<br />
you were infected at work, FILE A WORKERS COMPENSATION claim! We<br />
cannot guarantee you will receive benefits, however it is important that you file.<br />
Currently, <strong>Montana</strong> does not have presumption of eligibility related to COVID-19<br />
for frontline healthcare workers, but MNA is working to address this during the<br />
<strong>2021</strong> legislative session.<br />
The first step to filing a claim is to notify your Human Resource Department.<br />
You have 30 days to file and your employer will have six days to respond.<br />
Remember, we cannot guarantee your claim will be accepted, but it is<br />
important you try!<br />
UNEMPLOYMENT INSURANCE: Unemployment insurance (UI) is a<br />
program to pay short-term benefits to eligible workers to help lessen the<br />
negative impact that being out of work has on workers, their families and<br />
the local economy. UI requires week-to-week eligibility and your first week is<br />
called your Waiting Week. To file a claim, visit www.<strong>Montana</strong>Works.gov and<br />
it is important to understand that filing a claim is not the same as requesting<br />
payment. Once your claim is filed, you must request payments weekly to<br />
receive benefits.<br />
You may receive unemployment benefits if:<br />
• You are exposed to COVID-19 and required to quarantine and NOT<br />
provided wages by your employer to cover your 14-day quarantine.<br />
• You are unable to work, or have a reduction in hours, due to health risk<br />
factors or any other COVID-19 related reason.<br />
For questions related to the topics above, please contact your MNA Labor<br />
Representative or the MNA office and our staff will provide answers or direct<br />
you to a person who can. Filing is the first action that must start with YOU for<br />
both resources above. Thank you for all you do!<br />
PLEASE CHECK YOUR MEMBERSHIP STATUS<br />
If you fall into any of the below categories, you could qualify for the<br />
‘Professional Reduced Rate’ $38.65/month. Your rate will not automatically<br />
change. You must let us know.<br />
• You are a new graduate. You must apply within the first six months after<br />
receiving your initial RN licensure and this rate is good for one year.<br />
• You are an RN in a full-time study program working towards a higher<br />
degree. You will need to provide proof of enrollment and you could<br />
receive this rate for up to three years.<br />
• You are an RN 65+ year of age who is licensed and working. You<br />
could receive this rate for the remainder of your employment.<br />
• If you are a retired RN and are no longer working or hold an RN<br />
licensure you could be eligible for the retired rate of $13.07/month.<br />
If you are working in a collective bargaining position and move into a<br />
non-collective bargaining position, please contact the <strong>Montana</strong> Nurses<br />
Association to let us know. Your membership dues will continue to be paid<br />
until YOU authorize them to be discontinued. Please remember, only you<br />
can cancel your membership and membership payments.<br />
To provide MNA with information on your status or to receive<br />
additional information on MNA membership please e-mail Jill Hindoien at<br />
jill@mtnurses.org.
Page 6 <strong>Montana</strong> Nurses Association <strong>Pulse</strong> <strong>February</strong>, March, April <strong>2021</strong><br />
Labor Reports and News<br />
What Would A Reasonable Nurse Do?<br />
MNA has been fielding many inquiries from concerned<br />
nurses regarding their professional liability in caring<br />
for patients in less-than-ideal conditions during the<br />
pandemic. From what I understand, patients are being<br />
held or cared for in hallways sometimes. Old outpatient<br />
areas have been converted to inpatient areas simply<br />
using curtains. Due to overwhelming volumes of ICU<br />
patients, they are being housed in other areas of<br />
the facility being cared for by nurses who are not ICU<br />
specialists. Hospitals in outlying areas are needing<br />
to hold on to ventilated critically ill patients due to lack<br />
of capacity at larger facilities, nurses in those smaller<br />
hospitals are not used to caring for such critically ill<br />
patients, home health nurses are challenged as well.<br />
PPE is a struggle in many settings.<br />
Amy Hauschild,<br />
BSN, RN, Labor<br />
Representative<br />
Suffice it to say, most nurses have not been trained to practice in these<br />
conditions. Nurses report great distress in not being able to practice according<br />
to the standards they have been taught or being required to care for more<br />
patients than ratios and unit standards dictate. They are worried about not<br />
being able to give the care they want to, and report being very concerned<br />
about being subject to a lawsuit or worse, action being taken against their<br />
license by the MT Board of Nursing (BON).<br />
In both cases, nurses are expected to practice like a reasonable nurse<br />
would do in similar circumstances. The conditions of the pandemic are the<br />
circumstances of today. There are, however, a couple things nurses can do<br />
to greatly enhance their protection. Use of the Assignment Despite Objection<br />
(ADO) form to document unsafe situations is certainly a great tool that should<br />
be utilized. If you are unfamiliar with the ADO, please ask one of your MNA<br />
Local Unit Representatives or your MNA Staff Representative.<br />
Completing facility occurrence reports is another good way to document<br />
situations out of the ordinary. Please do not forget to ask for help. Many nurses<br />
have said they do not feel comfortable asking for help because everyone is<br />
so busy, and they do not want to be seen as a complainer or a weak team<br />
member. If action were to be taken against a nurse, it is important for them to<br />
be able to show they asked for help. ADOs and occurrence reports are two<br />
ways to do this.<br />
Lastly and the most proactive way for nurses to protect themselves is<br />
through coverage with professional liability insurance. Many years ago, when I<br />
was a newly graduated nurse, the wisdom of the day spoke to not purchasing<br />
liability insurance because plaintiffs would be more likely to include a nurse<br />
if they knew the nurse had insurance (deep pocket syndrome). Some nurses<br />
report feeling comfortable because their employer will cover them with their<br />
facility malpractice insurance. Nurses have found employer coverage is<br />
primarily to protect the interests of the employer, not necessarily the interests<br />
of the nurse. Nurses covered by their own liability insurance report they are<br />
much more comfortable being covered by an entity whose primary concern<br />
is protecting the nurse’s interest. Some nursing liability policies also cover the<br />
nurse with BON investigations.<br />
Polices are very reasonable, often just a little over one-hundred dollars per<br />
year. Nurses Services Organization (NSO) is endorsed by American Nurses<br />
Association and they specialize in nursing malpractice coverage, though there<br />
are other companies out there as well. Help your mind be at ease and check<br />
out malpractice coverage.<br />
Getting Organized<br />
During a Pandemic<br />
COVID-19 is a reality that we are all being forced to<br />
adjust to. Nurses and healthcare workers across the<br />
country are exhausted both physically and mentally<br />
by the toll this virus is taking. This is not something I<br />
need to tell you. You are living it. Nurses and healthcare<br />
workers know the reality of this virus unlike any<br />
other profession. So, how do we as a union keep<br />
our members engaged, informed, and unified when<br />
they are already doing so much? Nurses are already<br />
overworked, so how can we ask them to engage in any<br />
additional activity, no matter how small? There are a<br />
few strategies that I think we can utilize to ensure our<br />
members are getting the information they need while<br />
still respecting the level of effort they are already being<br />
asked to give to care for our communities.<br />
Leslie Shepherd,<br />
BSN, RN, Labor<br />
Representative<br />
Meet them where they are at! This can be both a simple and complex<br />
tactic to ensure necessary information is getting to our members. Whether<br />
it is social media, daily huddles, bulletin boards, or union meetings; make<br />
receiving the information as easy and accessible as possible by utilizing a<br />
“shotgun” approach. Make sure all of the information you need to get out to<br />
your members is shared in as many method’s as possible. Not everyone has<br />
Facebook. Not everyone actually reads their emails. If it’s important information,<br />
blast it out to your members in as many methods as possible and send<br />
reminders!<br />
Make it easy! If you need your members to fill out a survey, get it in front<br />
of their faces. Utilizing the shotgun approach, get it to them in EVERY way<br />
possible, even if that means going to their unit and handing it to them. If you<br />
are sending reminders, put the link in your text message instead of directing<br />
them to an email. Ease for the member is KEY here. Make it as simple as<br />
possible for your members to participate. Hold virtual meetings, make them<br />
short and sweet, and send out minutes to those who cannot attend.<br />
Lastly, extend grace to your members. As you all know, this is a trying time<br />
that we are learning to adapt to as we go. Most people are not at their best<br />
right now. There will be meetings that are not well attended. There will be forms<br />
that are not globally filled out. I believe that people will participate when they<br />
can, as they can. It is our job to extend grace during this unprecedented time<br />
and to make disseminating information, engaging our members, and fostering<br />
unity as simple and easy as possible.<br />
Have a great idea to encourage membership engagement at your Local?<br />
Please share your thoughts with your MNA Labor Representative so we can<br />
share ideas with others!!<br />
Consider a Tax-Deductible Donation to:<br />
<strong>Montana</strong> Nurses Association<br />
Foundation – (MNAF)<br />
➢ Donations to the MNAF foundation are 100%<br />
tax deductible.<br />
➢ MNAF mission statement: “The <strong>Montana</strong><br />
Nurses Association Foundation (MNAF) is<br />
the charitable and philanthropic branch of<br />
the <strong>Montana</strong> Nurses Association (MNA), with<br />
a mission to preserve the history of nursing<br />
in <strong>Montana</strong> and contribute, support and<br />
empower the professional nurse in <strong>Montana</strong>.”<br />
➢ The purposes for which the Corporation is<br />
organized are as follows:<br />
“(a) charitable; (b) educational; (c) to accept<br />
healthcare/nursing research and educational<br />
grants; (d) to provide continuing educational<br />
grants to licensed registered nurses; and (e) to<br />
award scholarships to qualifying persons.”
<strong>February</strong>, March, April <strong>2021</strong> <strong>Montana</strong> Nurses Association <strong>Pulse</strong> Page 7<br />
As we roll into the new year with new leadership across<br />
the state, we as unions are faced with different challenges.<br />
Those challenges still include Covid-19, but also include<br />
some changes that could come legislatively that would<br />
impact nurses and teachers across the state. It should<br />
not be overlooked that right to work legislation would take<br />
away protections for front-line workers that the union has<br />
fought for. Many of these protections come from collective<br />
bargaining tables, such as workplace health and safety,<br />
better pay and benefits, civil rights, gender equality, and the<br />
right to have representation at the table.<br />
The labor movement has always been at the forefront<br />
in protecting working people from workplace injury, illness,<br />
and death. The Occupational Safety and Health Act of 1970<br />
Unions, Protections, and Quality of Life<br />
Lauri Hunton, RN, CCBE<br />
Labor Representative<br />
(OSHA) and the Federal Mine Safety and Health Act of 1977 are two of the key laws<br />
passed to protect workers that the labor movement fought to pass, which give working<br />
people the right to a safe job. While workplace injuries and deaths have declined<br />
drastically, there are still thousands of workers killed or injured each year, and unions will<br />
continue to fight and advocate for safe workplaces.<br />
One of the biggest issues at the bargaining table is the right to bargain fair wages<br />
to allow working people to support their families. Unions work to make sure that the<br />
wealth generating labor of working people is justly rewarded to support the working<br />
person with a broad range of policies, including minimum wage as a living wage, pay<br />
equity for women and minority groups, restoring overtime protections, benefits for health<br />
insurance, retirement, and wage standards.<br />
Labor Reports and News<br />
The Black Lives Matter movement awakened many Americans to the systematic<br />
racism ingrained in America, and it has never been more evident that our society is still<br />
fighting racism and racial biases. The labor movement seeks to protect civil rights of<br />
all workers, which gives the union rights to bargain civil rights into collective bargaining<br />
agreements, thus protecting workers irrespective of race, gender, nationality, religion,<br />
sexual orientation, or gender identity. Unions are here to help defeat the prejudices of<br />
our societies. Segregation, inequality, and oppression harm us all.<br />
Unions have proven to help build a stronger middle class, provide diverse<br />
opportunities for our children, increase economic growth for all, reverse income<br />
inequality, decrease government dependency, and foster happier, healthier<br />
communities. Our union is our voice for safety and change to improve the quality of life<br />
for all that are involved.<br />
Sources<br />
AFL-CIO. (n.d.). What We Care About. Retrieved December 30, 2020, from https://aflcio.org/issues<br />
UWUA. (n.d.). Eight Surprising Ways Unions Benefit Workers & the American Economy. Retrieved<br />
December 30, 2020, from https://union-benefits.uwua.net/<br />
When Your Employer Notifies You of a Meeting...<br />
*Immediately ask your Supervisor/Manager/Director:<br />
• “What is the purpose of the meeting?”<br />
• “Is the meeting investigatory?”<br />
• “Will I be asked questions which may possibly lead to discipline?”<br />
• “Will I be asked questions which require me to defend my conduct?”<br />
If the meeting is investigatory or answers may<br />
lead to discipline:<br />
_ #1 – Respectfully inform your employer you are invoking<br />
your Weingarten Rights & will need to have your Union/Unit<br />
Representative or Nurse Advocate present during questioning.<br />
_ #2 – Quickly arrange for your Union/Unit Representative or<br />
Nurses Advocate to attend the meeting.<br />
Weingarten Rights<br />
If this discussion could in any way lead to my being<br />
disciplined or terminated, or affect my personal<br />
working conditions, I respectfully request that my<br />
Union/Unit Representative or Nurse Advocate be<br />
present at this meeting.<br />
Until my representative arrives, I choose not to<br />
participate in this discussion<br />
Everyone Deserves A Job They Love!!<br />
Let Us Help Today,<br />
Call 406.228.9541<br />
Prairie Travelers is recruiting Traveling<br />
Healthcare Staff in <strong>Montana</strong>,<br />
North & South Dakota<br />
• Registered Nurses (Hospital, ER, ICU, OB and LTC)<br />
• Licensed Practical Nurses<br />
• Certified Medication Aides<br />
• Certified Nurse Aides<br />
• Full-Time and Part-Time<br />
Prairie Traveler’s Commitment<br />
to our Staff<br />
• Excellent Wages • Health Care Benefits<br />
• Travel Reimbursement • Annual Bonus<br />
• Paid Lodging<br />
• Zero Assignment<br />
• Flexible Work Schedules Cancellations<br />
• 24/7 Staff Support • Varied Work Settings<br />
APPLY TODAY 406.228.9541<br />
Prairie Travelers Recruitment Department<br />
130 3rd Street South, Suite 2 • Glasgow, MT 59230<br />
For an application or more information, visit<br />
www.prairietravelers.com
Page 8 <strong>Montana</strong> Nurses Association <strong>Pulse</strong> <strong>February</strong>, March, April <strong>2021</strong><br />
Professional Development Department<br />
Nursing Professional Development Pandemic Resources<br />
Professional development<br />
is defined by the<br />
Association for Nursing<br />
Professional Development<br />
as “the continuous, active<br />
participation in activities that<br />
assist in developing and<br />
maintaining competence,<br />
enhance professional<br />
practice, and support<br />
achievement of professional<br />
goals” (Harper & Maloney, p.<br />
64). The current challenges<br />
of the pandemic highlight<br />
the importance of nursing<br />
Kristi Anderson,<br />
MN, RN, NPD-BC, CNL<br />
Director of Professional<br />
Development<br />
continuing professional<br />
development (NCPD). As<br />
nurses transition to different areas, new knowledge<br />
and skills are necessary in order to practice safe<br />
patient care. It has never been MORE important for<br />
nurses and healthcare professionals to have current,<br />
evidence-based knowledge to guide their practice.<br />
The good news—it is now much easier to<br />
actively participate in virtual nursing professional<br />
development educational activities. National<br />
and specialty organizations have transitioned<br />
many activities to virtual formats in response to<br />
education needs during the pandemic. In addition to<br />
current COVID-19 guidelines, there are a variety of<br />
additional topics related to different aspects of the<br />
pandemic.<br />
Resilience and self-care activities are accessible<br />
from several different organizations to support<br />
nurses with the major challenges such as those<br />
presented by a pandemic. New educational<br />
opportunities on navigating telehealth and managing<br />
chronic conditions assist in supporting patients in<br />
a virtual environment. Educational activities on how<br />
to develop virtual learning while promoting active<br />
learner engagement are also available.<br />
Check out a few of the nursing professional<br />
development activities and resources in response<br />
to the pandemic as we continue to navigate through<br />
this challenging time.<br />
• CNEbyMNA-Resiliency, Wellness, and Self-Care<br />
Resources: https://courses.cnebymna.com/courses<br />
• American Nurses Association-COVID-19 Resource<br />
Center: https://www.nursingworld.org/practicepolicy/work-environment/health-safety/disasterpreparedness/coronavirus/<br />
• Association for Nursing Professional Development-<br />
COVID-19 Resources: https://www.anpd.org/page/<br />
covid-19-resources<br />
• Centers for Disease Control and Prevention-<br />
Telehealth Interventions to Improve Chronic<br />
Disease: https://www.cdc.gov/dhdsp/pubs/<br />
telehealth.htm<br />
• National Academy of Medicine-Taking Action<br />
Against Clinician Burnout: https://nam.edu/<br />
systems-approaches-to-improve-patient-care-bysupporting-clinician-well-being/<br />
Additional Reference:<br />
Harper, M. & Maloney, P. (2016). Nursing professional<br />
development: Scope and standards of practice, 3rd<br />
ed. Chicago: Association for Nursing Professional<br />
Development.<br />
Visit nursingALD.com today!<br />
Search job listings<br />
in all 50 states, and filter by location and credentials.<br />
Browse our online database of articles and content.<br />
Find events for nursing professionals in your area.<br />
Your always-on resource for nursing jobs, research, and events.<br />
Director of Nursing<br />
Miles Community College is a rural, public, two-year<br />
institution and is inviting applications for the Director of<br />
Nursing. Reporting to the Vice President of Academic<br />
Affairs, the Director will be responsible for the overall<br />
leadership and administration of the nursing and allied<br />
health programs. This is an exciting opportunity for a dynamic individual who is<br />
visionary, with demonstrated excellence in teaching, leadership and service.<br />
Salary range is commensurate with education and experience<br />
and offers a great benefits package.<br />
For more information, and full position description please visit our<br />
website at https://www.milescc.edu/Employment/ or email<br />
humanresources@milescc.edu. Application deadline is March 1, <strong>2021</strong>.<br />
Miles Community College is an equal opportunity employer.<br />
Welcome to our new MNA Nurse Planner!<br />
Please help us welcome<br />
Megan Hamilton, MSN, RN<br />
CFRN, NR-P, as our new<br />
nurse planner and professional<br />
development generalist. Megan<br />
will start part time with MNA<br />
in January <strong>2021</strong>. Her primary<br />
responsibilities will include<br />
being a nurse planner for the<br />
MNA accredited provider unit,<br />
coordinating real-time and<br />
virtual professional development<br />
events and activities, and<br />
navigating statewide, regional,<br />
and national relationships<br />
Megan Hamilton,<br />
MSN, RN CFRN,<br />
NR-P<br />
impacting our ability to provide evidence-based quality<br />
continuing professional development activities. Megan<br />
has worked as our “seasonal” nurse planner since April<br />
2020 and has developed a number of activities including<br />
the “Building our Resilience” series available on our<br />
enduring material library (https://courses.cnebymna.com/<br />
courses).<br />
With over 27 years of EMS and nursing experience,<br />
Megan has worked as a nurse in a variety of settings<br />
including urban medium to high-volume Emergency<br />
Departments, rural and wilderness hospital settings, and<br />
ground and air medical transport. She has a passion<br />
for teaching and has worked as a clinical educator in a<br />
variety of areas including outreach, hospital, pre-hospital,<br />
air medical, and academics. Megan obtained her MSN<br />
in Nursing Education in 2015. She is co-founder of the<br />
Survivor’s Network for the Air Medical Community and<br />
has published two research studies exploring critical<br />
incidents in healthcare and air medical transport.<br />
RN – Inpatient Nursing<br />
Full Time or Part Time<br />
Competitive salary, great benefit package,<br />
student loan repayment and relocation expenses available.<br />
Please contact the HR department at (406) 228.3662 for more information.<br />
http://www.fmdh.org<br />
FMDH is an Equal Opportunity/Affirmative Action Employer
<strong>February</strong>, March, April <strong>2021</strong> <strong>Montana</strong> Nurses Association <strong>Pulse</strong> Page 9<br />
Professional<br />
Development<br />
Department<br />
<strong>Montana</strong> Nurses Association<br />
Approved Providers<br />
MNA thanks all of the Approved Provider Units we work with for their<br />
commitment to advancing and promoting quality nursing practice through<br />
continuing nursing education.<br />
Acute Care Education<br />
Vancouver, WA<br />
Alaska Native Tribal Health Consortium<br />
Anchorage, AK<br />
Alaska Nurses Association<br />
Anchorage, AK<br />
Alzheimer’s Resource of Alaska<br />
Anchorage, AK<br />
Bartlett Regional Hospital<br />
Juneau, AK<br />
Benefis Healthcare Systems<br />
Great Falls, MT<br />
Billings Clinic<br />
Billings, MT<br />
Boise State School of Nursing<br />
Boise, ID<br />
Bozeman Health<br />
Bozeman, MT<br />
Cardea Services<br />
Seattle, WA<br />
Caring for Hawai’i Neonates<br />
Honolulu, HI<br />
Central <strong>Montana</strong> Medical Center<br />
Lewistown, MT<br />
Central Peninsula General Hospital<br />
Soldatna, AK<br />
With Distinction<br />
Community Medical Center<br />
Missoula, MT<br />
Confluence Health<br />
East Wenatchee, WA<br />
Evergreen Health<br />
Kirkland, WA<br />
Foundation Health Partners<br />
Fairbanks, AK<br />
Kalispell Regional Healthcare System<br />
Kalispell, MT<br />
With Distinction<br />
Kootenai Health<br />
Coeur d’Alene, ID<br />
Midland Memorial Hospital<br />
Midland, TX<br />
With Distinction<br />
<strong>Montana</strong> Geriatric Education<br />
Center of UM<br />
Missoula, MT<br />
With Distinction<br />
<strong>Montana</strong> Health Network<br />
Miles City, MT<br />
<strong>Montana</strong> VA Health Care System<br />
Helena, MT<br />
With Distinction<br />
Mountain Pacific Quality Health<br />
Helena, MT<br />
North Valley Hospital<br />
Whitefish, MT<br />
Pacific Lutheran University<br />
Tacoma, WA<br />
With Distinction<br />
Planned Parenthood of the Great<br />
Northwest and the Hawaiian Islands<br />
Seattle, WA<br />
Providence Alaska Learning Institute<br />
Anchorage, AK<br />
Providence Healthcare<br />
Spokane, WA<br />
South Dakota Nurses Association<br />
Pierre, SD<br />
South Peninsula Hospital<br />
Homer, AK<br />
With Distinction<br />
St. Luke’s Health System<br />
Boise, ID<br />
St. Peter’s Health<br />
Helena, MT<br />
St. Vincent Healthcare<br />
Billings, MT<br />
UF Health Shands Hospital<br />
Gainesville, FL<br />
Wisconsin Nurses Association<br />
Madison, WI<br />
www.cnebymna.com<br />
Be sure to check out our CNEbyMNA<br />
Website for Continuing Education<br />
opportunities. Sign up for upcoming<br />
events and online learning courses.<br />
It is constantly updated with new<br />
Webinars and Courses for your<br />
continued learning!<br />
*<strong>Montana</strong> Nurses Association<br />
is accredited with distinction as<br />
a provider of continuing nursing<br />
education by the American Nurses<br />
Credentialing Center’s Commission on<br />
Accreditation*<br />
$15.00 $15.00<br />
What is Your<br />
Learning<br />
Environment?<br />
see more<br />
$15.00 $15.00<br />
Transitions of<br />
Care:<br />
Interfacility<br />
Transfers<br />
see more<br />
Performing<br />
a Quick and<br />
Helpful Physical<br />
Assessment<br />
see more<br />
Quick Review of<br />
12-lead ECG<br />
see more
Page 10 <strong>Montana</strong> Nurses Association <strong>Pulse</strong> <strong>February</strong>, March, April <strong>2021</strong><br />
State Wide Nursing News<br />
Challenges in Acquiring New or Experienced<br />
Nursing Leaders & Nursing Administrators<br />
Nowadays, hiring any<br />
nursing administrator (DON)<br />
or nursing leader (RN) brings<br />
a challenge to organizations<br />
trying to maintain a budget<br />
and provide nursing<br />
leadership quality. A newly<br />
hired nursing leader must<br />
perform and have relevant<br />
leadership experience<br />
and a natural ability to<br />
work effectively with other<br />
employees. The following<br />
Carolyn Taylor<br />
Ed.D, MN, RN<br />
considerations encourage<br />
informed hiring practice, help<br />
hire with more awareness of potential legal and policy<br />
concerns, and identify specific leadership qualities.<br />
It can be difficult and important to determine who<br />
and why a particular person should be in a nursing<br />
leader position. It is better to carefully consider all the<br />
ramifications of selecting a nursing leader the first time<br />
than to have to take the time and energy to undo a<br />
poor hiring decision.<br />
Written and followed hiring processes/policies<br />
(in general) with pre-established hiring behavior<br />
and screening expectations will prevent the facility/<br />
organization from future legal questioning about the<br />
hiring process by disgruntled job applicants. Follow<br />
the same written, precise hiring policy process that<br />
shows written guidelines for minimizing biases and<br />
discrimination for EVERY potential employee. These<br />
policies should support the facility/organization’s<br />
philosophical beliefs, including the mission, definition,<br />
purpose, goals, and objectives of the facility/<br />
organization.<br />
Superb written record-keeping concerning each<br />
accepted job applicant is necessary as a part of the<br />
job interview. All job interviews are legally challenged<br />
(verbally, written, or subconsciously) regarding the<br />
hiring process or final hiring decision. The appearance<br />
of interview biases or discrimination is always a<br />
potential problem when determining any nursing<br />
leader! You can trust that somebody will always ask<br />
and question employment processes and decisions!<br />
Sometimes there are negative comments from existing<br />
employees about hiring a specific person(s) to do a<br />
particular job. A hiring committee with a set criteria<br />
plan and policies for making employment decisions<br />
can easily dismiss such comments knowing that<br />
they have determined employment decisions by preestablished<br />
criteria. The criteria and written records<br />
show an obvious effort and concern for the nonexistence<br />
of personal biases or discrimination.<br />
Recognizing a Nursing Leader – A nursing<br />
leader is a registered nurse who assesses, directs,<br />
participates, plans, implements, and evaluates<br />
outcomes toward meeting patient goals. He/she<br />
has the power to stand alone and the courage to<br />
make difficult/tough decisions. It is a nursing leader<br />
Nurses/NPs/PAs/Physicians –<br />
Rural <strong>Montana</strong> Needs YOU<br />
Employer: One Health/Bighorn Valley Health Center<br />
Possible Location: Ashland, Chinook, Glendive,<br />
Hardin, Lewistown, Miles City<br />
Salary: Competitive wages based on experience<br />
and licensure.<br />
Hours: Full-Time/Part-Time<br />
Are you ready for a challenging position? Do you have a strong<br />
desire to work with passionate people whose mission is to improve the<br />
wellbeing of everyone by providing accessible, quality health care for<br />
the whole community? One Health’s locations are looking for RNs,<br />
LPNs, and Providers such as a Nurse Practitioner to join us in delivering a<br />
holistic, patient-centered care model that advances quality outcomes for<br />
individuals and the community.<br />
Check out the careers section on our website for more<br />
information at www.chcfamily.org<br />
who always strives to be the best of all who serve.<br />
This type of person gives his/her “all” for the nursing<br />
team’s success and positive patient outcomes. It is a<br />
person who faces human relationship challenges with<br />
courage and acts civilly and with sensitivity regarding<br />
the personal decisions that improve nursing care. A<br />
nursing leader is often a person with significant and<br />
proven successful life experiences related to problemsolving.<br />
A new or inexperienced nursing leader “shadowing”<br />
an experienced and successful nursing leader might<br />
keep an organization from experiencing, again, past<br />
nursing leadership errors. It is always helpful to first<br />
mutually synchronize nursing thoughts and behavior<br />
patterns that support the philosophy, mission,<br />
purpose, and goals of the facility/organization.<br />
Teaching appropriate choices and understanding<br />
nursing leadership behaviors is important to a new<br />
nursing leader’s success.<br />
Intuitive powers are an added positive dimension<br />
of nursing leadership. It requires listening to the voice<br />
from within when attempting to lead others. Intuition is<br />
helpful and improves with leadership experience and<br />
chronological age.<br />
It is integrity and correct decisive actions that<br />
identify nursing leaders. Hence, the nature versus<br />
nurture question arises: Is a nursing leader naturally<br />
“born to be a leader” (nature concept) or “learns to<br />
be a leader” (nurture concept)? Some data shows<br />
that exceptional nursing leaders show their beginning<br />
natural potential as outstanding nursing leaders in their<br />
early adult years – usually in their early twenties.<br />
Male or Female Leader – Gender choice can<br />
be a dilemma considered by facilities/organizations<br />
for a nursing leaders’ role. Of course, there are<br />
many considerations as it relates to experience and<br />
capability. However, it was an interesting perspective<br />
of Madeleine Albright (American Politician and<br />
diplomat from 1997-2001 – U.S. Secretary of State)<br />
that women are often the best choice! She believes<br />
that women have an increased propensity over men<br />
when it comes to multi-tasking. After all, she says,<br />
women are required to multi-task responsibilities<br />
of home, family, children, dietary intake, and<br />
sometimes jobs. A practice of handling and solving<br />
multiple activities and problems simultaneously<br />
is required of a nursing leader – and experience in<br />
these convoluted activities is the basis of nursing<br />
leadership success. However, this philosophy is<br />
challenged because we know as experienced<br />
nursing leaders that all situations are influenced by<br />
the concept of IT ALL DEPENDS!<br />
Men – they have their unique abilities, too.<br />
Employees sometimes react positively to a known<br />
authority figure, such as a male. Therefore, men<br />
have qualities that form the basis of nursing<br />
leadership success.<br />
Regardless of gender, leadership abilities are<br />
individually unique. Yet, gender, by its very nature,<br />
deserves consideration when employing leaders.<br />
Be sure your written documentation during the<br />
hiring process supports criteria WITHOUT biases<br />
or discrimination – including gender, marital status,<br />
race, and transgender status.<br />
Importance of Personal Skills—Educationally,<br />
nursing leaders are taught the Theory of Leadership<br />
and Critical Thinking. However, we all recognize that<br />
education is not the only facet for consideration.<br />
The ability to work with people with integrity is<br />
also a MUST. The acquisition of personal skills and<br />
education is not always the sole determinant of<br />
acquiring a certain job; sometimes, it seems that the<br />
time and need chooses you.<br />
If you are an educator, teach potential nursing<br />
leaders how to understand employees and<br />
know that every person has different personal<br />
human qualities. Nursing leaders will also have<br />
a background of success, problems, worries,<br />
and “baggage.” We are all human with needs,<br />
desires, personal difficulties, and you name<br />
it – we all share it to some degree! Therefore,<br />
responding appropriately to employees’ needs<br />
(work and personal) must always be in the equation<br />
of becoming a successful nursing leader. A<br />
reciprocating nursing leader response will most<br />
likely be: “I will do what you expect if you will<br />
consider me and my legitimate personal needs<br />
(within reason) as I perform the expected behaviors<br />
of my job description.” The outcome is mutual<br />
respect.<br />
Sometimes, nursing leaders need to learn that<br />
the balance of leadership firmness and leadership<br />
kindness is a balancing act that demands constant<br />
weighing of work and personal behaviors. Therefore,<br />
NURSING LEADERSHIP POWER is related to how a<br />
nursing leader can effectively relate and empathize<br />
with other nursing employees in stressful situations<br />
and how nursing leaders can support each other’s<br />
personal needs while getting the job assignment/<br />
description accomplished. We have to admit that<br />
empathetic kindness in serving all others (including<br />
other nurses) is a major hallmark of the nursing<br />
profession!<br />
Hiring Inside the Facility/Organization to<br />
Administrative Positions – Any hired nursing<br />
leader must perform and have relevant leadership<br />
education and experience. Whether it is wise always<br />
to promote a nursing leader to an administrative<br />
position within the same facility/organization is<br />
questionable.<br />
The promotion of a nursing leader who knows<br />
others’ strengths and limitations sometimes gives a<br />
new nursing administrator an edge on success. The<br />
challenge is to find a nursing leader recognized by<br />
other nursing leaders as knowledgeable about the<br />
processes/policies and can be considered a role<br />
model as a nursing administrator. In other words,<br />
does a nursing leader have what it takes?<br />
The nurse leader’s internal facility/organization’s<br />
elevation of responsibilities to a new and more<br />
demanding nursing administrator position is not<br />
always successful! Furthermore, taking on a new<br />
role with new expected administrative relationships<br />
with the same employees is often very difficult.<br />
It causes a necessary change in the degree and<br />
kind of employee fraternization (usually a need for<br />
curtailment of employee fraternization). Effects of job<br />
promotion within a facility/organization recognize the<br />
need for any newly assigned and promoted nursing<br />
leader to an administrative position to withstand<br />
internal turmoil from disheartened employees who<br />
did not get a promotion—and accept it gracefully.<br />
It requires the advanced nursing leader to a nursing<br />
administrative position to change old relationships<br />
into new and unfamiliar behaviors. Some nonpromoted<br />
employees often think someone else
<strong>February</strong>, March, April <strong>2021</strong> <strong>Montana</strong> Nurses Association <strong>Pulse</strong> Page 11<br />
State Wide Nursing News<br />
(often themselves) within the facility/organization should have been the one<br />
promoted to an elevated position. Internal stress occurs, and alliances are<br />
blurred.<br />
One significant detriment is the possibility that the promoted nursing leader<br />
has formed past employee relationships and exhibited behaviors as a nursing<br />
leader that has exposed possible personal areas prone to staff manipulation<br />
or coercion. Going from an employee cohort with overtly friendly employee<br />
behaviors to a more responsible and accountable nursing administrator’s role<br />
with new job expectations is very different from past employee behaviors. It can<br />
be somewhat threatening and daunting (and even confusing).<br />
It is always tempting by a facility/organization to “reward” a nursing leader<br />
for longevity or compliance with a new administrative promotion. Too often,<br />
this “reward” is detrimental to both the employee and the facility/organization.<br />
This person has often learned well to be a follower and not a true nursing<br />
administrative leader.<br />
Some facilities/organizations do not consider the many ramifications of<br />
making such an administrative advancement. Often the hired person is a likable<br />
person within the facility/organization but not necessarily a qualified person for<br />
a specific administrative job. A nursing administrator role should cause careful,<br />
extensive, and time-consuming scrutiny. There is a policy in some facilities/<br />
organizations where nursing leadership employees are the most likely promoted<br />
due to compliance and longevity. The term is often stated as a policy, “We<br />
always hire from within!”<br />
Be aware of work-related friendships and family relationship ties for the<br />
nursing leader for whom administrative advancement is considered. Excessive<br />
employee friendships and apparent nepotism within the facility/organization are<br />
not usually the most outstanding traits for most administrative positions.<br />
Hiring Outside the Facility/Organization to Administrative Positions —<br />
Consider hiring an experienced, advanced academically educated, or a<br />
proven successful nursing leader who is not currently employed by the facility/<br />
organization. The successful pursuance or attainment of advanced higher<br />
education by any nursing leader shows tenacity and forbearance. Experience<br />
and proven abilities are often a “gold mine.” Yes, the recruitment of outside<br />
expertise might cost more and should cost more. This person might have a<br />
varied applicable positive experience in human relationships and getting a job<br />
done. The creative and critical thinking abilities might be a positive surprise with<br />
excellent new ideas beyond your imagination.<br />
Absolutely – Consider hiring an excellent nursing administrator from another<br />
source than the existing facility/organization. Sometimes, no person in the<br />
facility/organization will meet the job’s rigorous requirements. When hiring from<br />
outside the facility/organization, there is less chance of a social entanglement<br />
with current staff and emotional employee ties. Objectivity is increased.<br />
Manipulative employee behaviors are less likely to occur when employee<br />
familial and close friendship ties are absent.<br />
Use your intuition when hiring. Is this person secure in nursing administrative<br />
leader skills, fair, trustworthy, and philosophically congruent with the philosophy<br />
and goal(s) of the facility/organization? Does this person have a healthy ego that<br />
will allow/permit personal criticism? Is the essence of the appropriate use of<br />
personal power evident? Determine, if you can, if the potential administrative<br />
employee is a true leader and not a follower! Determine a way of scoring your<br />
impression(s) or knowledge of each prospective employee applicant according<br />
to the following.<br />
Leader<br />
Exhibits calm amid the chaos<br />
Directs activities with goals in mind<br />
Supports and rewards<br />
positive behaviors<br />
Directs and makes decisions with<br />
concern for consequences<br />
Is responsible for outcomes<br />
Practices, knows, & determines<br />
policy direction<br />
Understands and utilizes<br />
legal knowledge<br />
Problem-solving skills follow a<br />
pattern for calculated outcomes<br />
Calm and ability to direct<br />
during a crisis<br />
Listens to and hears<br />
communication implications<br />
Seeks respect and recognized integrity<br />
Follower<br />
Exhibits nervousness amid the chaos<br />
Performs activities only as directed<br />
Accepts rewards often<br />
with skepticism<br />
Performs as requested with no obvious<br />
concern for ultimate consequences<br />
Limited responsibility for outcomes<br />
Depends on leaders<br />
to give direction<br />
(Read more at leadershippoweronline.com)<br />
Depends on the leader to<br />
make a legal judgment<br />
Problem-solving occurs on a limited scale<br />
without great concern for overall outcomes<br />
Dependent on the direction<br />
during a crisis<br />
Listens to words and<br />
performs accordingly<br />
Only tries to be liked by others<br />
Registered Nurse to…. Paramedic???<br />
By Jeremy Johnson<br />
Director of Marketing, Platinum Educational Group<br />
You may be thinking “Isn’t that title backwards”? While it is true that many<br />
paramedic’s progress towards a nursing degree, there are, however, many benefits<br />
for nurses to obtain a EMT or Paramedic degree as well. This article will discuss<br />
several reasons for RN’s to adopt EMS training to their résumé.<br />
First, let’s all get on the same page. Even though these two fields are in the<br />
healthcare industry together, they are vastly different and extremely important<br />
pieces to the overall “patient care puzzle.” While nursing deals with long term<br />
patient care under the supervision of a doctor in a hospital setting, EMT/Paramedic<br />
training focuses on initial patient assessment and emergency response. Topics<br />
covered in EMT training may include:<br />
*Treatment for Trauma Emergencies<br />
*Airway Management and Maneuvers<br />
*Spinal Immobilization using KED Board and Longboard<br />
*Splinting Procedures<br />
*Traction Splinting<br />
*Treatment for Medical Emergencies *Pediatric Emergencies<br />
*Geriatric Emergencies<br />
*Ambulance Operations<br />
So, why would RN’s want to become EMT/Paramedic certified?<br />
Employment Opportunities<br />
Becoming versed in both fields can assist in expansion of employment<br />
opportunity. Companies in the private sector, and organizations in the public<br />
domain, desire highly educated people with a well-rounded scope of all around<br />
medical care knowledge. RN’s with EMS training and background can find<br />
professional specialties that include:<br />
• Flight Nurse<br />
• Intensive Care Nurse<br />
• Emergency Room Nurse<br />
• EMS Instructor or Program Director<br />
• Local EMS Provider<br />
The Exhilaration/Adrenalin Rush Influence<br />
Some nurses are drawn to the hectic and often unpredictable world of trauma<br />
and emergency. It may be in their nature to take control of an emergency situation<br />
or play an intricate part of a quick moving crisis. Some may have witnessed<br />
paramedics/EMT’s rush into the hospital and provide the details of the patient<br />
event and present the case facts. Others were probably drawn into that “rush”<br />
without witnessing a scene like that at all. Regardless, those situations typically<br />
arise in an ER trauma unit or in the “field.” An on-the-scene ambulance work<br />
environment can provide that lifestyle and may be a better fit than in a slower<br />
paced hospital setting for some.<br />
The Autonomy Factor<br />
Some nurses may not like the strict rules and regulations that can apply to<br />
nursing. Restrictive guidelines, hospital protocol, and close supervision by a<br />
doctor(s) can all contribute to a feeling of not being a “major role player” at all.<br />
Even though paramedicine also has rules and guidelines, it may have a different<br />
“feel” when you are a first responder and it is YOUR actions and decisions that<br />
controls a scene. It can provide a sense of freedom from external control or<br />
influence, as well as, an impression of independence.<br />
How Long are the RN to EMS Courses?<br />
Course length differs by program but typically last 1-2 weeks (average 54 Hrs.)<br />
for RN-to-EMT bridge courses; while RN-to Paramedic bridge courses varies from<br />
a couple of months to up to one year.<br />
Summary<br />
The benefits of converting from RN to EMS can vary and may not apply to you.<br />
In our experience, there has been “tension” between nurses and paramedics/<br />
EMT’s historically. However, the more each learns from the other will help overall<br />
knowledge of patient treatment and care.<br />
National RN to EMT Bridge Training Institutes<br />
Nebraska – Creighton University (Pre-Hospital Care (EMT) for Nurses)<br />
(https://ems.creighton.edu/training-certification/pre-hospital-care-emt-nurses-0)<br />
Wisconsin – Lakeshore Technical College (RN to EMT)<br />
(http://gotoltc.edu/academics/certificates/nurse-to-emt/index.html)<br />
Ohio – Columbus State Community College (RN-to-Paramedic)<br />
(http://www.cscc.edu/academics/departments/ems-fire/faq.shtml#rntoparamedic)<br />
Virginia – Southwest Virginia Community College (RN-to-Paramedic)<br />
(http://sw.edu/catalogs/programs-of-study/career-studies/rn-to-paramedic/)<br />
Nevada – JTM Training Group (RN-to-EMT)<br />
(http://jtmtraining.com/ems_certs_rfrs/registered-nurse-to-emt/)<br />
Michigan – Munson Community Health Center EMS Education (RN-to-EMT and<br />
RN-to-Paramedic)<br />
(https://www.munsonhealthcare.org/clinical-education/ems-education/emseducation)
Page 12 <strong>Montana</strong> Nurses Association <strong>Pulse</strong> <strong>February</strong>, March, April <strong>2021</strong><br />
APRN Corner<br />
Happy New Year. If you are like me, you are optimistic that<br />
<strong>2021</strong> is going to be a better year than 2020—we have all been<br />
working in this crazy COVID world and with the vaccines<br />
beginning to be given there seems to be a light at the end of<br />
the tunnel.<br />
As hard as many of you have been caring for patients and<br />
fellow co-workers, please take care of yourselves. There are<br />
many different strategies for self-care, and nurses are the<br />
best at helping others, but often do not spend that energy on<br />
themselves. Remember these key strategies.<br />
• Stress Relief: We each have many stressors in our lives,<br />
acknowledging the stressors and addressing them<br />
is key. Activities that help combat stress can be as<br />
simple as breathing and sitting in a quiet place for a few<br />
Keven Comer<br />
MN, APRN, FNP-BC<br />
minutes and clearing your busy brain. Listening to peaceful music, soaking in a hot<br />
tub, or just laughing.<br />
• Nutrition: Never underestimate the power of a good diet. Foods can boost the<br />
immune system and our moods can be affected by skipping meals and overeating.<br />
• Physical Activity: Exercise may have been different in these pandemic times –<br />
crazy work hours. A walk around the block, stretching, yoga.<br />
• Kindness: Kindness and thoughtfulness go a long way in helping others. It does<br />
not have to be a large gesture to make you feel good inside.<br />
• Sleep: Making sure you get adequate sleep is essential for “rebooting” your<br />
system. Make sure your bedroom is cool, dark, and quiet, and you like to go there.<br />
Have a bedtime routine. A practice called FREEDOM WRITING can help clear your<br />
mind for a good night’s sleep. FREEDOM WRITING: Take three blank sheets of<br />
paper, front and back and set your phone for seven minutes. Write on the paper<br />
anything that comes to your mind in that seven minutes, if you only use three<br />
sheets in that time or finish the six pages in three minutes, you stop—then you rip<br />
the paper up and throw it away. No keeping the notes, no re-reading. It is really<br />
important to rip and throw away. This has good evidence to really help your brain<br />
relax and sleep.<br />
• Connection: Keeping social connection has been hard with social distancing and<br />
limiting group activities. Face timing, talking on the phone and even dropping a<br />
note or letter can really help you and others feel connected.<br />
Don’t forget to mark your calendar for March 5th-6th for the annual APRN<br />
Pharmacology Conference. We will be held virtually via ZOOM until we are confident in<br />
the safety to meet in large groups. We have a great platform and excellent speakers.<br />
Please go to https://cnebymna.com/aprn/ for more information and to register for the<br />
conference. Hope to see you there. Be sure to reach out with any APRN questions or<br />
concerns. keven.comer@gmail.com.<br />
*NEW MEMBER BENEFIT FOR APRN’s*<br />
If you are an APRN, membership to <strong>Montana</strong> Nurses Association (MNA) includes<br />
three professional memberships for one low membership rate.<br />
o MNA – <strong>Montana</strong> Nurses Association<br />
o ANA – American Nurses Association<br />
o AANP – American Association of Nurse Practitioners<br />
If you are currently an MNA member who is also an APRN, please e-mail Jill at jill@<br />
mtnurses.org so she can sign you up for your AANP membership or if you have any<br />
questions.<br />
NursingALD.com can point you<br />
right to that perfect NURSING JOB!<br />
NursingALD.com<br />
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APRN PHARMACOLOGY<br />
CONFERENCE <strong>2021</strong><br />
Save the Date<br />
MARCH 5TH & 6TH, <strong>2021</strong><br />
<strong>Montana</strong> Nurses Association’s<br />
<strong>2021</strong> APRN Pharmacology Conference<br />
All presentations held virtually<br />
Friday, March 5th <strong>2021</strong>—Full Day Saturday, March 6th <strong>2021</strong>—Morning<br />
Topics & Speakers—FULL AGENDA AVAILABLE SOON<br />
• Keynote: Shaping the health care<br />
landscape: Nursing’s role in improving<br />
health care policy<br />
o Tay Kopanos, DNP, APRN, FNP-BC, Vice<br />
President of State Government Affairs-American<br />
Association of Nurse Practitioners<br />
• Not Diabetes, but Live-abetes! Adapting to<br />
Diabetes Care<br />
o Steven Elrod, PharmD, BCACP<br />
• <strong>Montana</strong> COVID-19 Vaccine Update<br />
o MT Department of Health & Human Services &<br />
Keven Comer, MN, FNP-BC<br />
<br />
• Medical Management of Coronary Artery<br />
Disease in <strong>2021</strong><br />
o Laurie A. Soine PhD, ARNP<br />
• <strong>Montana</strong> Legislative Updates<br />
o Vicky Byrd, MSN, RN - Chief Executive Officer<br />
of <strong>Montana</strong> Nurses Association<br />
<br />
• Alcohol Use Disorders--Foods that Reduce<br />
Cravings and Addictive Behaviors<br />
o John Honsky, APRN & Heidi Moretti, MS, RD<br />
• First Line Antidepressants in Primary Care<br />
o Stacey Pascoe, PharmD<br />
• Art for Wellness-Promoting Well-being in<br />
Indian Reservation Dwelling Preadolescent<br />
Children<br />
o Julie Alexander-Ruff, EdD, MSN, BS, BSN, RN,<br />
CPNP-PC<br />
• Updates on Managing Parkinson’s Disease<br />
o Ann Galloway, PhD, FNP-C<br />
• The use of Cephalosporins in Penicillin<br />
Allergic Patients: A Clinicians guide to<br />
appropriate antibiotic selection<br />
o Daniel Lee, PharmD, BCPS<br />
• Hepatitis C Update<br />
o Paula Cox-North, PhD, ARNP<br />
<br />
• Deprescribing Program-Polypharmacy in<br />
the Geriatric Population<br />
o Jennifer Sofie, DNP, FNP, ANP<br />
• And more!
<strong>February</strong>, March, April <strong>2021</strong> <strong>Montana</strong> Nurses Association <strong>Pulse</strong> Page 13<br />
ANA Excerpts<br />
At the Great Falls Clinic we believe our<br />
employees are our greatest asset, and we<br />
are actively seeking LPNs and CMAs to join<br />
our dedicated healthcare team.<br />
• Competitive salary and benefits<br />
• Vacation/sick leave package that promotes<br />
health-work life balance<br />
• Retention and moving bonus<br />
If you'd like to balance working in a busy, forwardthinking<br />
organization, contact Joey Richman at<br />
406-454-7325 or joey.richman@gfclinic.com.<br />
Great Falls Clinic Hospital<br />
3010 15th Ave South<br />
Great Falls MT 59405<br />
www.gfclinic.com<br />
185 Crestline Ave., Kalispell, MT<br />
ILCORP.ORG/CAREERS<br />
OR 406-752-9144<br />
Now hiring for all nursing positions and more!<br />
INTERVIEW & START IMMEDIATELY!<br />
WE OFFER: Sign On Bonuses | Employee Scholarships<br />
Full Benefit Packages | Competitive Wages | Flexible Schedule<br />
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BE PART<br />
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Critical Access Hospital, Longterm<br />
Care Facility and Rural Health Clinic.<br />
166 <strong>Montana</strong> Ave. East | Big Sandy, MT 59520<br />
(406) 378-2188 | www.bsmc.org
Page 14 <strong>Montana</strong> Nurses Association <strong>Pulse</strong> <strong>February</strong>, March, April <strong>2021</strong><br />
For Nurses, Your License is Your Lifeline<br />
The field of nursing is fast and diverse. For many<br />
nurses, especially those of you who are members of the<br />
<strong>Montana</strong> Nurses Association, have big responsibilities,<br />
including:<br />
• Confirm medical history and symptoms<br />
• Monitor vital signs<br />
• Administer medicine<br />
• Coordinate overall care with the entire health<br />
care team<br />
• Provide detailed care for individual patients<br />
• Employers for misconduct<br />
• Patients or their family because they disagreed<br />
with you<br />
• Anybody else you come in contact with at work.<br />
Most of you are on your feet all day or all night to<br />
perform a job that is physically demanding, emotionally<br />
taxing, and mentally draining. Much of the tasks<br />
you perform are one’s not just anyone is capable of<br />
performing, and that is why a license is required by<br />
the <strong>Montana</strong> Board of Nursing. After proving yourself<br />
academically and ethically the state issues you a<br />
license.<br />
Many people would consider nursing a good<br />
noble career, especially in terms of pay, benefits, and<br />
community appreciation. But what happens when<br />
somebody files a complaint about you or threatens<br />
to jeopardize your license? Without your license, you<br />
cannot perform a nursing job. Without your job taking<br />
care of others, how will you earn enough to take<br />
care of yourself, and your family? Your license is your<br />
lifeline.<br />
Whether their complaint has merit or not the mere<br />
filing of an allegation brings forth a process that can<br />
be daunting and have long-term implications for your<br />
career. This process can be very time consuming<br />
and costly if you try defending yourself. It will require<br />
you preparing a statement, gathering records,<br />
and testifying. It then takes times for the board to<br />
investigate.<br />
Unfamiliar Territory: The Complaint.<br />
If someone files a complaint about you, your license<br />
is at risk. Even if there is no merit to their complaint.<br />
Complaints can be filed by:<br />
• Co-workers who do not like you, personally or<br />
disagree with you, professionally<br />
<strong>Montana</strong> Healthcare Mutual Aid System (MHMAS) is the Emergency<br />
System for the Advance Registration of Volunteer Health Professionals for<br />
the state of <strong>Montana</strong>. MHMAS is a secure, web-based online registration<br />
system used to register, verify, and credential volunteer health care<br />
professionals before a major disaster or public health emergency occurs.<br />
MHMAS is a secure, web-based online registration system used to<br />
register all levels of medical professionals to be needed to respond to<br />
a medical and/or public health emergency.<br />
But there are ways you can minimize all of this.<br />
Hire an Expert and Respond with Confidence<br />
If someone files a complaint against your license,<br />
it’s imperative you find an attorney quickly. Even if<br />
you’ve done nothing wrong. This will save you both<br />
time and money. Consider it an investment. A licensing<br />
law specialist will protect you so that you can continue<br />
working and doing what you do best. No need to<br />
figure out specific licensing laws and administrative<br />
rules that may apply. By hiring a licensing attorney,<br />
it will give you peace of mind that you will come out<br />
ahead on the other side.<br />
Silverman Law Office, PLLC ~Helena, MT~ (406) 449-4829<br />
Once you register you are under no obligation to respond to a request,<br />
you decide when and where you would like to respond. MHMAS does<br />
ask for personal information (e.g., SSN, DOB) this is needed so we<br />
can conduct a background check once a request is made for medical<br />
professionals.<br />
If you would like to register, please follow the link below.<br />
Register Here @ https://mhmas.org/<br />
Mountainview Medical Center<br />
is Searching for You!<br />
Full-time RN (Hosp/ER)<br />
Full-time RN/Quality Coord<br />
Competitive Pay & Benefits<br />
Live in the last best place<br />
White Sulphur Springs, MT<br />
Contact<br />
KARI JO KIFF, DON<br />
406-547-3323, Ext. 144
<strong>February</strong>, March, April <strong>2021</strong> <strong>Montana</strong> Nurses Association <strong>Pulse</strong> Page 15<br />
Three Risk Areas Nurses Face in the Time of COVID-19<br />
Georgia Reiner, MS/Senior Risk Specialist,<br />
Nurses Service Organization,<br />
Healthcare Division, Aon Affinity<br />
Reprinted from West Virginia Nurse<br />
October, November, December 2020 Issue<br />
The spread of the coronavirus (COVID-19)<br />
reinforces the dedication and selflessness of nursing<br />
professionals. This is a scary and uncertain time for<br />
everyone, especially nurses on the frontlines working<br />
tirelessly to help curb the spread of the COVID-19 and<br />
balance an influx in patients.<br />
As nursing professionals tirelessly work to provide<br />
the best care possible to their patients during a difficult<br />
time, they need to know the steps to take to mitigate<br />
the risks that can impact their license, career, and<br />
reputation.<br />
Three risk areas nurses need to have on their radar<br />
include:<br />
1) Using Social Media Best Practices<br />
Nurses are held to a higher standard than others<br />
because of their role as caretakers and because they<br />
have intimate access to patients’ private information.<br />
Their social media presence should reflect this<br />
heightened responsibility, especially in this uncertain<br />
time. They must consider patients’ right to privacy and<br />
act professionally before posting.<br />
As the media and social media are consumed<br />
by COVID-19 news, nurses may want to join in<br />
and share their thoughts or may be tempted to air<br />
their grievances. Online comments or comments<br />
to members of the media by a nurse regarding<br />
employers or co-workers, even if posted from home<br />
during nonwork hours, may violate their employer’s<br />
social media or media relations policies. Violations<br />
of employer policies may lead to employment<br />
consequences for the nurse, including termination.<br />
Nurses may want to think twice before posting or<br />
otherwise giving the appearance they are speaking<br />
on behalf of their employer unless authorized to do so,<br />
and must follow all applicable employer policies.<br />
Quit Your Way<br />
with the <strong>Montana</strong><br />
Tobacco Quit Line<br />
The <strong>Montana</strong> Tobacco Quit Line now offers free<br />
coaching via chat, text (under age 25) and phone,<br />
increased incentives for pregnant women, and has<br />
resumed offering Chantix!<br />
• FREE Chantix Starting January 1, <strong>2021</strong> (While<br />
Supplies Last): The Quit Line will resume<br />
offering free Chantix on January 1, <strong>2021</strong> to<br />
<strong>Montana</strong>ns who enroll and complete their first<br />
coaching call. While supplies last, participants<br />
will be eligible to receive up to three months of<br />
Chantix with a doctor’s prescription.<br />
• NEW Online Chat: In addition to phone coaching,<br />
the Quit Line now offers coaching via online chat<br />
for all <strong>Montana</strong>ns at QuitNow<strong>Montana</strong>.com. Those<br />
who enroll in online coaching are eligible for free<br />
NRT, free Chantix and reduced-cost Bupropion.<br />
• NEW Young Adult Program: The Quit Line<br />
now offers coaching via text messaging to<br />
those between 18-24 years of age. To access<br />
the texting feature, young adults can text “start<br />
my quit” to 36072. The <strong>Montana</strong> Tobacco Quit<br />
Line continues to offer My Life, My Quit to those<br />
under the age of 18.<br />
• Quit Now <strong>Montana</strong> Pregnancy Program<br />
Increased Rewards: The Quit Now <strong>Montana</strong><br />
Pregnancy Program offers pregnant callers<br />
nine free coaching sessions with a dedicated<br />
female coach, as well as $20 for each completed<br />
coaching call while pregnant and $30 for each<br />
completed coaching call post-partum.<br />
• American Indian Commercial Tobacco Quit<br />
Line Updated Features: The American Indian<br />
Commercial Tobacco Quit Line has a new,<br />
easier-to-remember phone number, 1-855-5AI-<br />
QUIT, and a brand new website.<br />
2) Preventing Medication Errors<br />
Nurses must continue to work to catch their own<br />
potential medication errors, as well as the errors<br />
of other healthcare providers in the medication<br />
administration chain. Research has found that the<br />
majority of medication errors result from human<br />
factors, including inadequate communication, biased<br />
reasoning, reduced memory, and insufficient training<br />
and inexperience (Benner et al., 2002; Brady et al.,<br />
2009; Choo et al., 2010; Saintsing et al., 2011; TJC,<br />
2012). Nurses also identify distractions and fatigue as<br />
contributing to medication errors — which are factors<br />
that the COVID-19 crisis can exacerbate (Choo et al.).<br />
Since the beginning of April 2020, the Institute<br />
for Safe Medication Practices (ISMP) has received<br />
reports of COVID-19-related medication errors (ISMP,<br />
2020). One error involved a redeployed OR nurse who<br />
administered the wrong type of inhaler after failing to<br />
engage unfamiliar barcode medication administration<br />
technology (ISMP). Other missed dose errors have<br />
been reported due to communication failures between<br />
nurses and respiratory therapists (ISMP).<br />
To prevent medication errors and other adverse<br />
outcomes, nurses pulled to an unfamiliar unit should<br />
be oriented to the patient population, technologies,<br />
processes, and medications typically used on the<br />
newly assigned unit (ISMP, 2020). Nurses should also<br />
employ communication techniques such as a doublecheck/“check<br />
back” to verify they understand all<br />
verbal orders and instructions (AHRQ, 2020).<br />
3) Preparing to accept unfamiliar assignments<br />
Nurses are at the forefront of this public health<br />
crisis — treating, educating, and preventing the spread<br />
of COVID-19. As the pandemic continues to evolve,<br />
nurses may be given patient assignments outside<br />
of their accustomed practice areas and locations.<br />
No circumstances change nurses’ obligation to<br />
practice ethically, but nurses should be aware of their<br />
employers’ protocols for protecting nurses operating in<br />
extreme conditions and scarcities, and to ensure that<br />
the public receives the most adequate treatment and<br />
care possible in the situation.<br />
With so much still unknown about the<br />
coronavirus, it’s also important for nurses to be<br />
aware of the steps they can take if they do not<br />
feel equipped to handle an assignment. When the<br />
assignment is within a nurse’s scope of practice<br />
but not within their realm of experience or training,<br />
Parenting<strong>Montana</strong>.org [parentingmontana.org] is an<br />
online resource that offers tools to <strong>Montana</strong> parents<br />
and those in a parenting role to help them raise<br />
healthy, successful children. The tools grow social<br />
and emotional skills by addressing common parenting<br />
challenges like confidence, chores, routines, and<br />
homework.<br />
Stress management, self-motivation,<br />
communication, teamwork, problem-solving, and<br />
ethical responsibility are social and emotional skills.<br />
Social and emotional skills are essential for people’s<br />
success in school, work, and relationships. These skills<br />
saying “no” could lead to dismissal. In these<br />
scenarios, nurses need to share their concerns with<br />
their supervisor. Nurses should describe the task or<br />
assignment they don’t feel equipped to handle, the<br />
reason for their feelings, and the training they would<br />
need to be more confident and better prepared.<br />
Speaking up can lead to positive outcomes for<br />
nurses and patients.<br />
These are trying times for health care workers.<br />
Being aware of potential risks helps nurses take steps<br />
to protect themselves as they care for others.<br />
References<br />
Agency for Healthcare Research and Quality [AHRQ]. (2020,<br />
January: last review). Pocket Guide: TeamSTEPPS®.<br />
Team strategies & tools to enhance performance<br />
and patient safety content. https://www.ahrq.gov/<br />
teamstepps/instructor/essentials/pocketguide.<br />
html#checkback<br />
Benner, P., Sheets, V., Uris, P., Malloch K., Schwed K.,<br />
& Jamison, D. (2002). Individual, practice, and<br />
system causes of errors in nursing: A taxonomy.<br />
Journal of Nursing Administration, 32, 509-523. doi:<br />
10.1097/00005110-200210000-00006<br />
Brady, A.-M., Malone, A.-M., & Fleming, S. (2009). A<br />
literature review of the individual and systems factors<br />
that contribute to medication errors in nursing practice.<br />
Journal of Nursing Management, 17, 679-697. doi:<br />
10.1111/j.1365-2834.2009.00995.x<br />
Choo, J., Hutchinson, A., & Bucknall, T. (2010). Nurses’ role<br />
in medication safety. Journal of Nursing Management,<br />
18, 853-861. doi.org/10.1111/j.1365-2834.2010.01164.x<br />
Institute for Safe Medication Practices (ISMP). (2020, May<br />
14). COVID-19-related medication errors. https://www.<br />
ismp.org/resources/covid-19-related-medication-errors.<br />
Saintsing, D., Gibson, L. M., & Pennington, A. W. (2011).<br />
The novice nurse and clinical decision-making: How to<br />
avoid errors. Journal of Nursing Management, 19, 354-<br />
359. doi.10.1111/j.1365-2834.2011.01248.x<br />
The Joint Commission [TJC]. (2013). Sentinel event data:<br />
Root causes by event type, 2004 – June 2013. https://<br />
www.medleague.com/wp-content/uploads/2013/11/<br />
Root_Causes_by_Event_Type_2004-2Q2013.pdf<br />
This risk management information was provided<br />
by Nurses Service Organization (NSO), the nation’s<br />
largest provider of nurses’ professional liability<br />
insurance coverage for over 550,000 nurses since 1976.<br />
Reproduction without permission of the publisher is<br />
prohibited. For questions, send an e-mail to service@<br />
nso.com or call 1-800-247-1500. www.nso.com. The<br />
author may be reached at Georgia.Reiner@aon.com.<br />
are associated with better behavior, lower emotional<br />
stress, and positive wellbeing.<br />
Parenting<strong>Montana</strong>.org emphasizes that<br />
parents and those in a parenting role have a<br />
significant influence on their children and can<br />
create environments to help their children develop<br />
social and emotional skills in everyday life.<br />
Parenting<strong>Montana</strong>.org provides ways for parents and<br />
those in a parenting role to teach and practice the<br />
skills with their children.<br />
Learn more at Parenting<strong>Montana</strong>.org.
Page 16 <strong>Montana</strong> Nurses Association <strong>Pulse</strong> <strong>February</strong>, March, April <strong>2021</strong><br />
Procedures for Objecting Non-Members to File With MNA<br />
Objections as to the Expenditures of Dues for Purposes<br />
Not Germane to Collective Bargaining Process<br />
This notice is for all employees working under a <strong>Montana</strong> Nurses’<br />
Association collective-bargaining agreement that contains a union security<br />
clause. A union security clause requires, as a condition of employment, that<br />
an employee pay MNA membership dues and fees. MNA membership is a<br />
valuable asset for working nurses.<br />
Federal and state labor laws grant employers and union the right to enter into<br />
agreements requiring workers to join and maintain their membership in a union<br />
as a condition of employment. This right is consistent with the democratic<br />
principle of majority rule and it ensures that everyone who benefits from a<br />
union’s representation shares the union’s financial support.<br />
Over the years, the courts and administrative agencies that enforce the labor<br />
laws have limited the enforcement of union security clauses. Specifically, the<br />
U.S. Supreme Court has held that individuals covered by a collective-bargaining<br />
agreement containing a union security clause may not be required to join the<br />
union and may only be required to pay that percentage of full union dues and<br />
fees that are germane to the collective bargaining process. In other words,<br />
workers can be required to financially support a union but they cannot be<br />
required join the union and they can only be required to pay that percentage of<br />
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the union’s customary dues and fees that is germane to the union’s role as the<br />
collective-bargaining representative.<br />
MNA spends the vast majority of its funds on activities related to the<br />
representation of its members. These expenditures are considered to be<br />
germane to the collective-bargaining process and must be paid for by all<br />
individuals working under MNA contracts containing union security clause<br />
language. MNA also has spent funds on activities such organizing new<br />
bargaining units and legislative lobbying. MNA believes that money spent on<br />
these activities advances one of our fundamental purposes – nurses helping<br />
nurses to better their lives. However, the U.S. Supreme Court does not<br />
consider these activities to be germane to the collective-bargaining process.<br />
Employees employed under a contract containing a union security clause<br />
who choose not be join MNA or who resign their membership from MNA lose<br />
benefits, rights and privileges to which they would have been or were entitled to<br />
as MNA members. For example, these employees lose the right to vote on the<br />
acceptance of agreements negotiated with their employer, the right to vote on<br />
any dues increase, and the right to run and vote in the election of MNA officers.<br />
They lose the right to attend, speak and vote at any MNA meeting.<br />
In short, non-members elect to give up important rights, benefits and<br />
privileges. Moreover, it is illegal for an employer to compensate such workers<br />
in any way for the loss of these valuable rights. However, non-member are<br />
still members of the collective-bargaining unit in which they work, they are<br />
entitled to the benefits of the collective-bargaining agreement covering their<br />
employment and MNA and its officers and employees will provide them with the<br />
representation required by the law.<br />
Individuals employed under a union security clause maintain the right<br />
to object to being a member of MNA and may resign their membership at<br />
any time. However, those who either object to ever being a member or who<br />
were once members and then later resign must pay MNA an amount equal<br />
to the percentage of dues paid by members of MNA which are germane to<br />
collective bargaining process. That percentage includes the expenditures<br />
necessarily or reasonably incurred for the purpose of performing the duties<br />
of an exclusive representative of the employees in dealing with the employer<br />
or labor-management issues including not only the direct costs of negotiating<br />
and administering collective-bargaining contracts and of settling grievances<br />
and disputes, but also the expenses of activities or undertakings normally or<br />
reasonably employed to implement or effectuate the duties of MNA as the<br />
exclusive representative of the employees in a bargaining unit. The percentage<br />
of nonchargeable expenses for MNA which will be effective for the months of<br />
January <strong>2021</strong> through December <strong>2021</strong> is based on the experience from the<br />
2019 calendar year. In other words, those who are covered by a collectivebargaining<br />
agreement containing a union security clause and who elect not<br />
be members and who elect to pay the reduced fee must pay the fair share<br />
percentage of the dues assessed members of MNA employed in the same<br />
bargaining unit.<br />
In addition to other avenues of relief available under the law, a non-member<br />
may challenge MNA’s classification or calculation of expenditures used by MNA<br />
to determine the percentage of chargeable expenses germane to the collectivebargaining<br />
process before a neutral arbitrator appointed by the American<br />
Arbitration Association pursuant to its Rules for Impartial Determination of<br />
Union Fees. Any objection a non-member makes may be coordinated or<br />
consolidated with other objections from other non-members before a single<br />
arbitrator.<br />
In such a challenge, MNA has to justify its calculations and determinations.<br />
All hearings will be conducted in Helena or Clancy, <strong>Montana</strong>. The arbitrator’s<br />
fees and expenses will be paid by MNA. However, an objector will have to pay<br />
for his or her own expenses and the fees, costs and expenses of his or her<br />
witnesses and attorneys.<br />
Once a written objection is received from an individual, MNA will adhere<br />
to the rules established by the courts and by the administrative agencies<br />
that enforce the labor laws as to the handling of the objector’s fees until the<br />
arbitrator has issued his or her ruling. Generally, the objector must pay the<br />
fees as determined by MNA’s calculations. Those fees will be placed in a<br />
separate interest bearing account. If the arbitrator’s decision increases the<br />
percentage of non-chargeable expenditures, the appropriate portion of the<br />
fees will be refunded to the objector, plus interest earned. All reduced service<br />
fee payers will then pay the adjusted amount as determined by the arbitrator.<br />
If the arbitrator’s decision approves the MNA’s calculation, no adjustment will<br />
be made in the amount of the fee and the total fees paid and placed in the<br />
separate interest-bearing account will be released to MNA.<br />
Individuals who choose to file objections to MNA’s fee calculations must<br />
file the objection in writing addressed to MNA, 20 Old <strong>Montana</strong> State Hwy,<br />
Clancy, <strong>Montana</strong> 59634. The written objection must include the objectors<br />
name, address, phone number, social security number, employer and work<br />
location. In order for MNA to understand the nature of the objector’s challenge,<br />
the objector is urged to also include a brief statement concerning the nature of<br />
the objection, including the objector’s opinion as to the appropriate percentage<br />
for non-chargeable expenses. This requirement to file a letter of objection and<br />
request for a hearing is an annual requirement. Objection will not be presumed.<br />
Agency fee payers who do not file a timely notice of objection shall be deemed<br />
to have waived any right to a hearing to challenge the estimated percentage of<br />
reduction of that year’s agency fee.
<strong>February</strong>, March, April <strong>2021</strong> <strong>Montana</strong> Nurses Association <strong>Pulse</strong> Page 17<br />
<strong>Montana</strong> Vaccinations Update: More than 33,000 healthcare<br />
personnel in <strong>Montana</strong> have received their first dose<br />
<strong>Montana</strong> has begun implementing the state’s<br />
COVID-19 vaccination distribution plan beginning with<br />
Phase 1a. Progress is being made daily.<br />
<strong>Montana</strong>’s Updated Vaccine Recommendations<br />
On January 5, 2020, Governor Gianforte<br />
announced at a press conference the updated<br />
COVID-19 Vaccine Allocation Recommendations. The<br />
Governor has prioritized protecting <strong>Montana</strong>’s most<br />
vulnerable, putting our seniors and those with severe<br />
underlying medical conditions next in line for the<br />
vaccine in Phase 1b.<br />
Vaccine distribution is occurring in phases<br />
beginning with Phase 1a, which focuses on health<br />
care workers as well as staff and residents of long<br />
term care facilities. Phase 1a also includes healthcare<br />
workers with direct patient contact, such as dentists,<br />
orthodontists, physical therapists, optometrists, home<br />
health workers and others that fit the criteria.<br />
As of January 8, <strong>2021</strong>, more than 33,000 doses<br />
have been administered to <strong>Montana</strong> health care<br />
personnel since it first became available the week<br />
of December 14. This includes frontline healthcare<br />
workers all across <strong>Montana</strong>.<br />
Deanna Hastings, MN, RN, CNL<br />
MSU Nursing Faculty and PhD Student<br />
University of Arizona<br />
The politically charged events in today’s current<br />
climate, along with the climbing costs of healthcare<br />
illuminates the need for ethical and reliable research.<br />
This need has created opportunities for nurse<br />
scientists to bring their collective knowledge forth to<br />
help inform decisions, decrease costs, and improve<br />
patient outcomes with integrity. Furthermore, nurses<br />
are in a unique position to contribute as they have a<br />
holistic perspective on utilization of evidence in clinical<br />
decision making, and the ability to not just accept<br />
things for what they are.<br />
Nurse Scientists<br />
Nurse scientists are PhD prepared nurses who<br />
are trained to help “bridge the gap between practice<br />
and research” (Brant, 2015, p. 298). They bring their<br />
clinical experience and knowledge to collectively<br />
evaluate research, current practices, and patient safety<br />
to influence policy and procedures. Nurse scientists<br />
identify research questions, design and conduct<br />
scientific studies, collect and analyze data, and<br />
report their findings. Nurse scientists act as mentors,<br />
cheerleaders, and educators, and lead research<br />
activities, to solve clinical problems. Nurse scientists<br />
often partner with scientists in other fields, such as<br />
pharmacy, nutrition, medicine, and engineering, to<br />
better address complex questions and problems. In<br />
filling these roles nurse scientists help contribute to the<br />
healthcare field by disseminating trustworthy research<br />
findings, supporting evidence-based practices at the<br />
bedside, and collaboratively contributing to policy.<br />
These contributions in turn assist with decreasing<br />
healthcare costs, improvement of patient outcomes,<br />
and consumer education and decision making.<br />
The current pandemic has shown how political<br />
influences and public perceptions impact research<br />
practice and implementation of interventions, along<br />
with demonstrating the importance of conducting<br />
honest and trustworthy studies. Due to the unknowns<br />
of the COVID-19 virus along with the negatively<br />
charged Presidential Election, there has been a<br />
creation of skepticism and/or distrust of scientific<br />
rationale from the public’s perception. Gone are<br />
the days that one trusts and believes in something<br />
because they are told to. Unfortunately, the desire<br />
to alter results or financially contribute to research<br />
to fabricate data to fit personal agendas, has also<br />
contributed to a distrust in science. Now, more than<br />
ever, the public wants to see the evidence to support<br />
The updated recommendations for Phase 1b<br />
includes those age 70 years and older, American<br />
Indians and other people of color who may be at<br />
elevated risk for COVID-19 complications, and persons<br />
aged 16-69 with high risk medical conditions. See<br />
the link above for the full list of qualifying medical<br />
conditions.<br />
Phase 1c includes frontline essential workers,<br />
persons aged 60 years and older, individuals living in<br />
congregate care and correctional facilities, persons<br />
aged 16-59 with medical conditions not included in<br />
Phase 1b that may have elevated risk of COVID-19<br />
complications.<br />
Phase 2 is the final phase for all remaining<br />
<strong>Montana</strong>ns aged 16 or older.<br />
Vaccine Allocation Update<br />
So far, more than 52,000 vaccine doses have been<br />
shipped to the state and we are slated to receive<br />
another 41,000 doses in the coming weeks.<br />
These numbers are updated regularly on the<br />
DPHHS website, and soon a dashboard will be<br />
launched with expanded vaccine allocation data. Stay<br />
tuned!<br />
The Role of Nurse Scientists<br />
in Uncertain Times<br />
the claims being made. If there was ever a time<br />
for honest, accurate, trustworthy, and transparent<br />
research in order to rebuild trust within an important<br />
field, it is now. According to a recent Gallup Poll,<br />
nurses were ranked for the 15th year in a row with the<br />
highest honesty and ethical standards above all other<br />
healthcare professionals, by the US public (Norman,<br />
2016).<br />
Nurse scientists recognize their responsibilities<br />
and contributions to the research field. These<br />
responsibilities include: “understanding misconduct,<br />
falsification, fabrication, and plagiarism” (Ulrich, et al.,<br />
2015, p. 171). They also include following ethical and<br />
professional codes of conduct with integrity while<br />
maintaining patient confidentiality. In summary, nurse<br />
scientists have an integral role in implementing and<br />
disseminating research findings into practice. They can<br />
holistically contribute to the collaborative approach to<br />
influencing policy, procedures, and research practices<br />
in order to improve patient safety and outcomes,<br />
education, and healthcare costs.<br />
References<br />
Brant, J.M. (2015). Bridging the research-to-practice gap:<br />
The role of the nurse scientist. Seminars in Oncology<br />
Nursing, 31(4), 298-305. http://dx.doi.org/10.1016/j.<br />
sonen.2015.08.006<br />
Norman, J. (2016). Americans rate healthcare providers<br />
high on honesty, ethics. Social and Policy<br />
Issues. https://www.google.com/url?q=https://<br />
news.gallup.com/poll/200057/americans-ratehealthcare-providers-high-honesty-ethics.<br />
aspx?g_source%3DSocial%2520Issues%26g_<br />
medium%3Dlead%26g_campaign%3Dtiles&sa=D<br />
&ust=1610432848158000&usg=AOvVaw22t0_77-<br />
s4jXnAabnmtZJ6<br />
Ulrich, C.M., Wallen, G.R., Cui, N., Chittams, J., Sweet, M.,<br />
& Plemmons, D. (2015). Establishing good collaborative<br />
research practices in the responsible conduct of<br />
research in nursing science. Nursing Outlook, 63(2),<br />
171-180. http://dx.doi.org/10.1016/j.outlook.2014.10.007<br />
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Apply online at: www.montanahealthnetwork.com<br />
or contact David Perry, RN - Staff Coordinator/Director of Nursing Services<br />
406-852-6361 or 406-228-8044 | contact@montanahealthnetwork.com<br />
In addition, vaccine distribution to long term care<br />
facilities (including nursing homes and assisted<br />
living facilities) has begun. Efforts to vaccinate staff<br />
and residents in these facilities began on 12/28 and<br />
vaccination efforts have been initiated in approximately<br />
54 facilities.<br />
The Department of Public Health and Human<br />
Services (DPHHS) is working with local county and<br />
Tribal health departments, pharmacies, hospitals,<br />
and community health centers across <strong>Montana</strong> to<br />
distribute the vaccine. To date, DPHHS has enrolled<br />
approximately 200 providers who, as part of that<br />
enrollment, are trained on how to store, handle and<br />
administer the vaccine. As more vaccine becomes<br />
available, these providers will have the ability to receive<br />
and administer the vaccine.<br />
Communications<br />
DPHHS is planning to expand its website and<br />
launch a public service announcement campaign for<br />
the public to learn more about the vaccine, as well as<br />
when and where they can get it. DPHHS will produce<br />
TV, radio, and print media products.<br />
Additional Resources<br />
• DPHHS has launched a vaccine-specific<br />
website with an FAQ. DPHHS will continue to<br />
add more info as it becomes available. https://<br />
dphhs.mt.gov/publichealth/cdepi/diseases/<br />
coronavirusvaccine<br />
• The COVID-19 information phone line and email<br />
continue to be a resource for <strong>Montana</strong>ns with<br />
questions. The phone line is 1-888-333-0461<br />
and email is covid19info@mt.gov.<br />
Contact: Jon Ebelt, Public Information Officer<br />
406-444-0936/jebelt@mt.gov.<br />
Great Falls College MSU is seeking a part-time Nursing Faculty<br />
member to join the team for our Nursing Programs (ASN and PN).<br />
BSN required, MSN preferred, State of <strong>Montana</strong> RN licensure, and<br />
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Learn more about our<br />
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To Apply Online, please visit:<br />
jobs.gfcmsu.edu<br />
Disabled/AA/EEO/Vet Preference Employer
Page 18 <strong>Montana</strong> Nurses Association <strong>Pulse</strong> <strong>February</strong>, March, April <strong>2021</strong><br />
<strong>Montana</strong> Provider Orders for Life-Sustaining Treatment<br />
(POLST) Update<br />
Amanda Lucas, DNP, APRN-CNS, ACHPN &<br />
Kathryn Borgenicht, M.D., FACP, CHMD<br />
In the era of modern medicine, opportunities<br />
to sustain life through cutting edge technology<br />
and medicines abound. However, for a growing<br />
population of frail, chronically or seriously ill<br />
individuals, such heroic life-supportive measures<br />
may not be medically beneficial or desired by<br />
the patient or medical surrogate. The Provider<br />
Orders for Life-Sustaining Treatment (POLST) is<br />
a medical order intended to define an individual’s<br />
preferences around cardiopulmonary resuscitation,<br />
levels of care like intubation or hospitalization, and<br />
the use of artificial nutrition. When a medical crisis<br />
occurs and the patient cannot convey medical<br />
preferences, the POLST is an actionable and<br />
portable medical order that directs healthcare<br />
personnel across care settings. The POLST may<br />
exist in different forms or under varying names in<br />
other states, but the concept is nearing 30 years in<br />
<strong>Montana</strong> practice, as it derived from the Comfort<br />
One movement that began in the 1990s. In 2019,<br />
a statewide Palliative Care Alliance reviewed the<br />
latest literature and compared the <strong>Montana</strong> POLST<br />
to recommendations from the National POLST<br />
Paradigm. The resulting September 2019 revision of<br />
the <strong>Montana</strong> POLST was endorsed by the Board of<br />
Medical Examiners.<br />
Here are a few key points we ask you to<br />
remember and convey to other members of the<br />
healthcare team. Additional information and a<br />
downloadable <strong>Montana</strong> POLST may be obtained at<br />
the <strong>Montana</strong> Department of Labor & Industry, Board<br />
of Medical Examiners website www.polst.mt.gov.<br />
Beneficial videos, stories and patient advance care<br />
planning resources are available at the National<br />
POLST Paradigm at www.polst.org.<br />
1. What was changed on the most recent<br />
POLST revision and are older documents<br />
still valid? Yes, older documents remain valid<br />
until care changes necessitate a new POLST.<br />
The new POLST wording was changed to stress<br />
commonly misunderstood areas. These include:<br />
o Section A: Cardiopulmonary Resuscitation<br />
(CPR)- is for the person who has NO pulse<br />
and is NOT breathing. Selecting NO CPR<br />
in this section indicates allow natural death.<br />
For patients who are in respiratory or cardiac<br />
distress, but still possess a pulse and are<br />
breathing, Section B directs care.<br />
o Section B: Medical Interventions – Is<br />
now ordered differently beginning with Full<br />
Treatment, to include CPR, intubation,<br />
vasopressors, defibrillation and cardioversion.<br />
For those who WOULD desire to return to the<br />
hospital for care, but do not want intubation<br />
and generally would like to avoid invasive<br />
or ICU level care, Selective Treatments<br />
is the recommended option. Patients who<br />
do not desire to return to the hospital and<br />
who only desire comfort care, such as pain<br />
relief, oxygen and symptom management,<br />
then Comfort-focused Treatment is the<br />
recommended care.<br />
o Section C: Artificially Administered<br />
Nutrition - Now includes the option for no<br />
decision has been made, along with shortterm,<br />
long-term and no artificial nutrition by<br />
tube options.<br />
Competitive wages and<br />
benefits packages!<br />
Contact Bev Halter, Director of<br />
Human Resources at 406-759-6514.<br />
libertymedicalcenter.org<br />
Hiring LPNs, RNs<br />
and<br />
Director of Nursing<br />
2. If you have another advance directive form,<br />
do you also need a POLST? Are these<br />
two documents different? YES, advance<br />
directives and POLST are very different but<br />
complimentary. Advance directive forms often<br />
include a Living Will and Medical Power of<br />
Attorney, also known as a Healthcare Power of<br />
Attorney, and are encouraged to be completed<br />
by the patient in advance of a healthcare crisis.<br />
Evidence supports the use of patient guides<br />
that combine the two advance directives<br />
such as those found at Prepare for Your Care<br />
(www.prepareforyourcare.org), which has a<br />
<strong>Montana</strong> specific advance directive. Other<br />
commonly seen documents include the<br />
<strong>Montana</strong> My Choices Advance Directive<br />
( https://dojmt.gov/consumer/end-of-liferegistry/),<br />
and purchased documents like the Five<br />
Wishes (https://fivewishes.org/). When patients<br />
become seriously ill or frail, and have discussed<br />
preferences regarding life-sustaining treatments<br />
with their healthcare team, then the POLST is<br />
a recommended addition to traditional health<br />
advance directives. As described above, the<br />
POLST is an actionable, medical order for the<br />
healthcare team used in a crisis when the patient<br />
lacks decision making capacity. Unlike advance<br />
directives that require the patient to convey his<br />
own wishes about end of life and surrogate<br />
decision maker, then sign with two witnesses, the<br />
POLST may be completed on the patient’s behalf<br />
by a legal medical surrogate when the patient<br />
lacks decision making ability. For information on<br />
<strong>Montana</strong>’s definitions of proxy decision makers<br />
you may reference <strong>Montana</strong> Annotated Code 50-<br />
5-1301.<br />
3. What should happen when there is a<br />
disagreement between the patient’s POLST<br />
wishes and the wishes of surrogates or<br />
other family members? A patient, who has<br />
medical decision-making capacity, may change<br />
the POLST at any time, as further detailed in<br />
#6. When disagreements between documented<br />
POLST wishes and surrogate or family members<br />
occur, this should prompt discussion between<br />
those in disagreement and the healthcare team,<br />
with the focus remaining on patient-centered<br />
care. Careful discussion should include the<br />
patient’s ethical right to autonomy, the healthcare<br />
team’s assessment of treatment burdens and<br />
benefits, along with the family’s perspective,<br />
all of which must be documented thoroughly.<br />
To improve your skills in communication and<br />
conflict resolution, you could access the following<br />
websites: Prepareforyourcare.org, vitaltalk.org<br />
and ariadneslabs.org.<br />
4. Is a POLST form mandatory? The POLST is<br />
completely voluntary. Although facilities have<br />
state or national requirements for assessing<br />
resuscitation status, the completion of the POLST<br />
is voluntary and requires the patient to possess<br />
medical decision-making capacity in order to<br />
complete the form. If the patient is unable to<br />
consent for the POLST, a surrogate may sign the<br />
document on the patient’s behalf. For information<br />
on <strong>Montana</strong>’s definitions of proxy decision<br />
makers you may reference <strong>Montana</strong> Annotated<br />
Code 50-5-1301.<br />
5. Who signs the POLST? The POLST requires<br />
the patient’s signature, or as detailed in #2<br />
the signature of the medical surrogate when<br />
the patient lacks medical decision making.<br />
Because the document is a medical order, the<br />
approved medical providers who must also<br />
sign the document includes <strong>Montana</strong> licensed<br />
physicians, physician assistants (PAs) or advance<br />
practice registered nurses (APRNs). Licensed<br />
APRNs most commonly participating in POLST<br />
completion are nurse practitioners and clinical<br />
nurse specialists, but other APRNs of certified<br />
registered nurse anesthetist or certified nurse<br />
midwife are not excluded. There is a location on<br />
the POLST to document which other healthcare<br />
team members assists in the document review<br />
and completion. This role requires knowledge<br />
and skill in review of POLST components, and<br />
end of life discussion, but is not prescribed at the<br />
state level. It is strongly encouraged that those<br />
who engage in POLST conversations, or other<br />
ACP discussions and document completion,<br />
do undergo training to ensure quality and skill<br />
competency.<br />
6. What should happen when the patient’s<br />
POLST wishes change? If a prior POLST exists,<br />
the document should be obtained, “VOID” written<br />
across the front and when able signed by the<br />
provider, patient or medical surrogate. A new<br />
POLST should be completed, by all parties and<br />
dated, with copies distributed to involved parties<br />
and the original remaining with the patient.<br />
7. Where are POLST documents kept? The<br />
original POLST, which is on terra green paper,<br />
should remain with the patient regardless of<br />
the setting where care is being provided. When<br />
the patient is at home, the POLST should be<br />
kept on the refrigerator or easily accessible<br />
location, in a green envelope with POLST written<br />
across the front. State POLST envelopes are<br />
available through the <strong>Montana</strong> EMS and Trauma<br />
Systems, a division of MT DPHHS, by e-mailing<br />
emsinfo@mt.gov. If a patient is within a medical<br />
facility, organizational policy may require the<br />
POLST to remain on the medical record while<br />
the patient is receiving care within that institution.<br />
A POLST copy should also be shared with the<br />
patient’s primary care provider, frequently used<br />
healthcare facility, family member.<br />
8. Does the POLST work in other states? Each<br />
state has differing regulations, forms and even<br />
titles for the POLST. The patient should take the<br />
<strong>Montana</strong> POLST and other advance directives<br />
forms when travelling, but if spending extended<br />
time in other states may want to also complete<br />
that state’s documents.<br />
9. Is a copy of the POLST valid? Yes, in the absence<br />
of the terra green original, a copy is sufficient as long<br />
as it is the most recently dated and valid document.<br />
HIPAA regulations allow original and copies to be<br />
shared with other healthcare team members as part<br />
of continuity of care.<br />
10. If POLST questions arise, who should<br />
we contact? If questions remain after consulting<br />
the resources available at www.polst.mt.gov, you<br />
may contact either Dr. Kathryn Borgenicht at<br />
kborgenicht@gmail.com or Amanda Lucas, DNP,<br />
APRN-CNS at amandalucas@benefis.org.<br />
COVID-19 Conversation Resources:<br />
In this time in healthcare, conversations about<br />
medical care preferences and completion of<br />
POLST orders have never been timelier. As we face<br />
the unique challenges provided by of COVID-19,<br />
clinician resources for ACP conversations have<br />
been developed. Evidence-based resources below<br />
include conversation acronyms, guidance on<br />
wording and many include exemplar videos aimed<br />
to promote clinician confidence and skills. Consider<br />
reviewing one or more of the following:<br />
- Vital Talk – COVID Ready Communication<br />
Playbook available at https://www.vitaltalk.org/<br />
guides/covid-19-communication-skills/<br />
- Ariadne Labs – Serious Illness Care Program<br />
COVID-19 Response Toolkit available at https://<br />
covid19.ariadnelabs.org/serious-illness-careprogram-covid-19-response-toolkit/<br />
- Center for the Advancement of Palliative Care<br />
(CAPC) COVID-19 Response Resources Hub,<br />
Communication available at https://www.capc.<br />
org/covid-19/communication/<br />
- Prepare for Your Care COVID-19 Resources<br />
available at www.prepareforyourcare.org/<br />
covid-19
<strong>February</strong>, March, April <strong>2021</strong> <strong>Montana</strong> Nurses Association <strong>Pulse</strong> Page 19<br />
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