Montana Pulse - February 2021

February 2021 • Vol. 58 • No. 1 

THE OFFICIAL PUBLICATION OF THE MONTANA NURSES ASSOCIATION FOUNDATION 

Quarterly publication distributed to approximately 13,000 RNs and LPNs in Montana. 

Executive Director Report 

Professional Nurse Commitment 

For Nurses, Your License is Your Lifeline 

Page 14 

Montana Vaccinations Update 

Page 17 

current resident or 

Non-Profit Org. 

U.S. Postage Paid 

Princeton, MN 

Permit No. 14 

MNA (Montana Nurses 

Association) is committed 

to the nurses and nursing 

profession in Montana and 

will always need the nurses’ 

commitment to keep it strong 

and dynamic, furthermore, 

to make decisions that will 

safeguard the future of nurses 

and their profession. Activism 

isn’t for everyone, however, 

as nursing professionals we 

must invest in our professional 

organization to ensure the 

infrastructure and advocacy 

Vicky Byrd, MSN, RN 

Chief Executive 

Officer 

remain intact to carry our voices in all things that touch 

patients and nurses. Below is a quote from the late 

Mary Munger, RN, moreover, it will remain visionary and 

truthful in relation to professional nurses. 

It is one thing to have been educated and licensed 

as an R.N., another to be employed as an R.N., but 

the mark of a real professional is a love for and 

interest in, what is happening to that profession, and 

a commitment to help it. Without taking this third step, 

without identification as a member of the professional 

nursing organization, many nurses are merely draining 

the good from the profession without adding their 

share to keep it strong and dynamic. What exists 

today as professional nursing, good or bad, is here 

because other professionals wanted to make it better, 

yes, for themselves, but also for future generations. 

What happens to nursing in the future is dependent on 

action taken by nurses today through their professional 

organization. (Munger, M. (n.d.). Membership: A 

professional commitment. Letter.) 

MNA Mission Statement: The Montana Nurses 

Association promotes professional nursing practice, 

standards and education; represents professional 

nurses; and provides nursing leadership in promoting 

high quality health care. 

MNA, as your advocate, in addition to our mission, 

identifies specific functions through governing bylaws. 

Here are some highlights of those most relevant today: 

• Promote through appropriate means, the 

standards of nursing practice, nursing 

education, and nursing services; 

• Promote adherence to the Code of Ethics for 

Nurses established by ANA 

• Propose and influence legislation, governmental 

programs, and state and national health policy 

• Promote and protect the economic and general 

welfare of nurses 

• Promote and provide for the continuing 

professional development of nurses 

• Represent nurses and serve as their 

spokesperson with professional and community 

groups and the public 

• Represent nurses in collective bargaining and 

provide services to local units 

• Maintain communication with members through 

official publications 

• Assume an active role as a consumer advocate 

• Provide for networking among professional 

nurses through contact with affiliate members 

At the national level, the ANA (American Nurses 

Association) has reached an amazing milestone of 

130 years in existence, and proudly, the Montana 

Nurses Association has had a relationship with ANA 

since their existence in 1912, for 109 of those years! 

MNA also incorporated 75 years ago becoming the 

non-profit organization, under the laws of the state 

of Montana, which it is today. Although the MNA has 

adapted, grown, and transitioned over these years, 

it remains a member driven organization and the 

recognized advocate and voice for the professional 

nurse in Montana, all nurses, whether they choose to 

belong to their professional nurse association or not. 

Our nurses, and the patients and communities they 

serve, remain our number one priority. 

“ANA Enterprise joins with the World Health 

Organization (WHO) and global colleagues in 

extending the Year of the Nurse and Midwife into 2021 

because of the impact of the pandemic. 

The recognition will build on the increased visibility 

of nurses’ contributions from 2020 and ANA’s 

expansion of National Nurses Week to Nurses Month 

in May. 

Now more than ever, we need to support and 

recognize nurses for their steadfast commitment to 

meeting the needs of patients and their communities 

every day. We encourage you to promote nurses’ health 

and well-being and honor them in any way you can.” 

(https://anayearofthenurse.org/about-year-of-the-nurse/) 

Like us on Facebook 

Follow us on Twitter 

www.mtnurses.org

Page 2 Montana Nurses Association Pulse February, March, April 2021 

PUBLISHER INFORMATION 

& AD RATES 

Circulation 13,000. Provided to every registered 

nurse, licensed practical nurse, nursing student and 

nurse-related employer in Montana. The Pulse is 

published quarterly each February, May, August and 

November by Arthur L. Davis Publishing Agency, Inc. 

for Montana Nurses Association, 

20 Old Montana State Highway, 

Montana City, MT 59634, a constituent member of 

the American Nurses Association. 

For advertising rates and information, please 

contact Arthur L. Davis Publishing Agency, Inc., 

517 Washington Street, PO Box 216, Cedar Falls, 

Iowa 50613, (800) 626-4081, sales@aldpub.com. 

MNA and the Arthur L. Davis Publishing Agency, 

Inc. reserve the right to reject any advertisement. 

Responsibility for errors in advertising is limited to 

corrections in the next issue or refund 

of price of advertisement. 

Acceptance of advertising does not imply 

endorsement or approval by the Montana Nurses 

Association of products advertised, the advertisers, 

or the claims made. Rejection of an advertisement 

does not imply a product offered for advertising 

is without merit, or that the manufacturer lacks 

integrity, or that this association disapproves of 

the product or its use. MNA and the Arthur L. Davis 

Publishing Agency, Inc. shall not be held liable for 

any consequences resulting from purchase or use 

of an advertiser’s product. Articles appearing in this 

publication express the opinions of the authors; they 

do not necessarily reflect views of the staff, board, or 

membership of MNA or those of the national or local 

associations. 

WRITER’S GUIDELINES: 

MNA welcomes the submission of articles and 

editorials related to nursing or about Montana nurses 

for publication in The PULSE. Please limit word size 

between 500 – 1000 words and provide resources 

and references. MNA has the Right to accept, edit or 

reject proposed material. Please send articles to: 

jennifer@mtnurses.org 

If you wish to no longer receive 

The Pulse please contact Monique: 

mheddens@aldpub.com 

If your address has changed please 

contact Montana Board of Nursing 

at: www.nurse.mt.gov 

PULSE SUBMISSIONS 

We are gathering articles that are relevant 

and appealing to YOU as a nurse. What 

is happening in your world today? Is there 

information we can provide that would be 

helpful to you? The Pulse is YOUR publication, 

and we want to present you with content that 

pertains to your interests. 

Please submit your ideas and 

suggestions to Jennifer. 

Jennifer@mtnurses.org 

Enjoy a user friendly layout and access to more 

information, including membership material, 

labor resources, Independent Study Library, 

a new Career Center for Job Seekers & 

Employers, and more downloadable information. 

Please visit 

MNA’s constantly updated website! 

www.mtnurses.org 

CONTACT MNA 

Montana Nurses Association 

20 Old Montana State Highway, Clancy, MT 59634 

Phone (406) 442-6710 • Fax (406) 442-1841 

Email: info@mtnurses.org • Website: www.mtnurses.org 

Office Hours: 7:30 a.m.-4:00 p.m. Monday through Friday 

VOICE OF NURSES IN MONTANA 

MNA is a non-profit, membership organization that advocates for nurse 

competency, scope of practice, patient safety, continuing education, and 

improved healthcare delivery and access. MNA members serve on the 

following Councils and other committees to achieve our mission: 

• Council on Practice & Government Affairs (CPGA) 

• Council on Economic & General Welfare (E&GW) 

• Council on Professional Development (CPD) 

• Council on Advanced Practice (CAP) 

MISSION STATEMENT 

The Montana Nurses Association promotes professional nursing practice, 

standards and education; represents professional nurses; and provides 

nursing leadership in promoting high quality health care. 

PROFESSIONAL DEVELOPMENT 

Montana Nurses Association is accredited with distinction as an approver 

of nursing continuing professional development by the American Nurses 

Credentialing Center’s Commission on Accreditation. 

Montana Nurses Association is accredited with distinction as a provider 

of nursing continuing professional development by the American Nurses 

Credentialing Center’s Commission on Accreditation. 

MNA Staff 

Vicky Byrd, MSN, RN, Chief Executive Officer 

Sheila Hogan, BS, Director of Outreach Operations 

Kristi Anderson, MN, RN, NPD-BC, CNL Director of Professional 

Development 

Caroline Baughman, BS, Professional Development Associate 

Megan Hamilton, MSN, RN CFRN, NR-P, Nurse Planner & Professional 

Development Generalist 

Robin Haux, BS, Labor Program Director 

Amy Hauschild, BSN, RN, Labor Representative 

Leslie Shepherd, BSN, RN, Labor Representative 

Laurie Hunton, RN, Labor Representative 

Jill Hindoien, BS, Chief Financial Officer 

Jennifer Hamilton, Administrative & Marketing Specialist 

Position 

Board of Directors President 

Board of Directors Vice President 

Board of Directors Secretary 

Board of Directors Treasurer 

Board of Directors Member at Large 

Board of Directors CPGA 

Board of Directors PD 

Board of Directors CAP 

Board of Directors EGW 

MNA Board of Directors 

Name 

Lorri Bennett, RN 

Terry Dutro, MSN, APRN, AGPCNP-BC 

Chelsee Baker, BSN, RN 

Audrey Dee, RN 

Anna Ammons, BSN, RN, PCCN 

Tricia Thien, RN, BAN, CGRN 

Deborah Lee, BSN, RN-BC, CCRP 

Lori Chovanak, DNP, RN, APRN-BC 

Brandi Breth, BSN, RN-BC 

Council on Practice & Government Affairs (CPGA) 

Gwyn Palchak, BSN, RN-BC, ACM Charlotte Skinner, BSN, RN-C 

Sally Sluder, DNP, APRN, AGACNP-BC Melissa Anderson, BSN, RN 

Paul Lee, CCRN 

Council on Professional Development (PD) 

Sandy Sacry, MSN, RN 

Brenda Donaldson, BA, RN, CAPA 

Gwyn Palchak, BSN, RN-BC, ACM Abbie Colussi, BSN, RN 

Emily Michalski-Weber, MSN, APRN, Janet Smith, MN, MSHS, RN 

PMHNP-BC 

Joe Poole, BSN, RN, CHSE 

Charlotte Skinner, BSN, RN-C 

Council on Advanced Practice (CAP) 

Chairperson-CAP 

Keven Comer, MN, FNP-BC 

Chairperson Elect-CAP 

Margaret Hammersla, BSN, MS, PhD, 

ANP-BC 

Secretary-CAP 

Nanci Taylor, APRN 

Member at Large-CAP 

Terry Dutro, MSN, APRN, AGPCNP-BC 

Member at Large-CAP 

Deven Robinson, MSN, FNP, PMHNP 

Council on Economic & General Welfare (E&GW) 

Delayne Stahl, RN, OCN 

Adrianne Harrison, RN 

Lorie Van Donsel, BSN, RN, PCCN Charlie Julia Buffo, RN 

Questions about your nursing license? 

Contact Montana Board of Nursing at: www.nurse.mt.gov

February, March, April 2021 Montana Nurses Association Pulse Page 3 

MNA membership (which includes ANA membership) is your professional nurse 

voice and advocacy on your pathways to improve practice, safety, professional 

development, legislation, and representation. It is a small investment in your nursing 

profession. 

**************** 

As 2021 is a legislative year, here is MNA’s Legislative platform that was 

approved by the MNA’s Board of Directors and the memberships House of 

Delegates October 2020. 

2020-2021 MNA Government Relations Platform 

Montana Nurses’ Association (MNA) is the nonprofit professional association 

representing the voice of nearly 18,000 Registered Nurses (RNs) in Montana 

including more than 1000 licensed as Advanced Practice Registered Nurses 

(APRNs). MNA is the recognized professional organization, which lobbies for 

nursing practice issues to protect the practice of professional nurses and also 

protect the public in all areas of health care. 

MNA is the recognized leader and advocate for the professional nurse in 

Montana. 

1. Improve the quality of nursing practice by: 

a. Providing educational opportunities that contribute to improving practice 

competency and quality of patient care. 

b. Identifying and pursuing funding sources to assist in providing continuing 

nursing education. 

c. Identifying and pursuing funding sources that support research/projects to 

develop evidence based and innovative nursing practice. 

d. Promoting national certification of Registered Nurses. 

e. Active representation on local, state and national advisory committees/ 

boards. 

f. Supporting the regulatory authority and collaborating with the Montana Board 

of Nursing (BON) on nursing practice and regulatory issues. 

g. Encouraging transparency and promoting communication from the Montana 

Board of Nursing regarding relationship with NCSBN and votes affecting 

regulation of registered nurses 

h. Providing input into the implementation of NCSBN Nurse Compact Licensure 

legislation. 

i. Opposing the NCSBN APRN Nurse Compact Licensure legislation. 

2. Protect the economic and general welfare of nurses by: 

a. Actively engaging in legislation and campaigns that positively contribute to 

the economic and general welfare of RNs. 

b. Ensuring the right of RNs to engage in collective bargaining in Montana. 

c. Opposing any “Right to Work” legislation now being referred to as “NO 

RIGHTS AT WORK” by MNA. 

d. Addressing workplace environment issues including violence against 

healthcare workers, safe staffing, infectious disease, and patient safety. 

e. Advocating legislation prohibiting mandatory overtime. 

3. Improve access to quality, cost effective health care by developing and/or 

supporting public policies which: 

a. Respond to the needs of the unserved and underserved populations by 

promoting access to health care and healthcare coverage. 

b. Identify or develop alternative health care delivery systems that are costeffective 

and provide quality health care. 

c. Mandate third party reimbursements directly to RNs from public and private 

payers. 

d. Remove barriers (financial, governmental, regulatory, and/or institutional) that 

deny access to appropriate/qualified health care providers and approved 

medical standard of care treatments. 

e. Advocate for legislation that is transparent and bipartisan and support 

policies that can achieve evidence based real healthcare reform. 

f. Promote community and world health by collaborating with other health 

professionals to promote health diplomacy and reduce health disparities. 

4. Protect human rights by developing and/or supporting public policies which: 

a. Promote access to appropriate health services. 

b. Preserve individual rights to privacy. 

c. Promote, debate and have consideration of ethical dilemmas in health care 

d. Protect nurses and healthcare employees and the public at large from public 

health emergencies. 

5. Protect the environmental health of individuals and communities through: 

a. Acknowledging, supporting and addressing environmental impacts on the 

health of Montanans. 

b. Actively engaging with national organizational affiliates in addressing 

environmental health issues in our nation. 

c. Identify the nurse’s primary commitment is to the patient, whether an 

individual, family, group, community, or population. 

6. Protecting and promoting the future healthcare and nursing practice through: 

a. Actively engaging in legislation that supports professional scope of nursing 

practice to the full extent of individual education and training. 

b. Actively promoting programs and efforts that encourage educational 

progression of professional nursing at state and national levels. 

c. Representation on boards, committees and advisory groups which influence 

the future of the nursing profession and the future of our state and national 

healthcare system. 

d. Engaging with healthcare partners and associations to work collaboratively to 

ensure healthcare as a right for all American populations. 

e. Actively support science and evidence based data to drive strong investment 

in safe quality public health programs at state and national levels.


The Makeup of MNA 

MNA consists of over 2,200 Registered Nurses and 

Advanced Practice Registered Nurses across the state of 

Montana. The state is divided into eight Districts based upon 

location. Each District Nurses Association (DNA) is made up 

of collective bargaining members (local unit members) and 

non-collective bargaining members. 

Our Annual Convention and House of Delegates is held 

every October. The House of Delegates sessions is where the 

yearly business of MNA is completed, i.e. bylaws changes, 

resolutions, legislative platform etc. To participate as an 

MNA District Delegate, you must be elected. These elections 

happen yearly, usually in the spring for each District. If you 

have any questions email jennifer@mtnurses.org. 

Here is the breakdown of each MNA District: 

Jennifer Hamilton 

Administrative & 

Marketing Specialist 

District 1: Mineral County, Missoula County and Ravalli County 

Local units in District 1 – Local #15-Community Medical Center 

Local #17-Providence St Patrick Hospital 

Local #18-Providence St. Patrick Coagulation Clinic 

Local #32-Partners in Home Care 

Local #33-Fresenius Kidney Care-Missoula 

Local #35-Marcus Daly Memorial Hospital 

CONGRATULATIONS TO THE FOLLOWING NURSES WHO HAVE 

TAKEN ADVANTAGE OF THE SUCCESS PAYS OFFERING BY ANCC 

TO MNA MEMBERS! 

1. Tiffany Sturdevant, RN-BC – Medical Surgical Nursing 

2. Stephanie A. Barrett, BSN, RN-BC – Medical Surgical Nursing 

3. Sara Nestor, RN-BC – Medical Surgical Nursing 

4. Metta Barnhart, RN-BC – Medical Surgical Nursing 

5. Nichole Schmidt, RN-BC – Medical Surgical Nursing 

6. Jessica Stevenson, RN-BC – Cardiac-Vascular Nursing 

New Member Benefit: MNA now offers certification 

through ANCC’s Success Pays ® Program 

District 2: Beaverhead County, Deer Lodge County, Granite 

County, Powell County and Silver Bow County 

Local units in District 2 – Local #1-Community Hospital of Anaconda 

Local #3-Rocky Mountain Clinic 

Local #5-Saint James Healthcare 

Local #7-Montana State Hospital 

Local #36-Montana Chemical Dependency Center 

Local #37-Butte Silver Bow Health Department 

District 3: Gallatin County, Madison County, Park County 

and Sweet Grass County 

Local units in District 3 – Local #4-Bozeman Health 

Local #6-Fresenius Kidney Care-Bozeman 

District 4: Broadwater County, Jefferson County, Lewis & Clark 

County and Meagher County 

Local units in District 4 – Local #8-Montana DPHHS 

Local #13-St Peters Hospital 

> Reduced fee for MNA Members to obtain initial certification 

or recertify 

> No cost if you don’t pass the exam; you can also take the 

exam a second time at no cost 

> Pay only when you pass! 

> Identify your specialty practice area 

How Success Pays ® Works 

> Visit nursingworld.org/our-certifications/ to: 

• Make sure you’re eligible to sit for the exam 

• Look at the test blueprint and test preparation materials 

• Make the decision to move forward 

> Visit www.mtnurses.org and click on Success Pays ® option 

to the left and sign up for the program! 

> MNA will contact you regarding how to get the benefit. 

District 5: Big Horn County, Carbon County, Carter County, 

Custer County, Fallon County, Golden Valley County, Musselshell 

County, Powder River County, Rosebud County, Stillwater County, 

Treasure County, Wheatland County and Yellowstone County 

Local units in District 5 – Local #2-Billings Clinic 

Local #38-Rosebud Health Care Center 

Local #44-Holy Rosary Healthcare 

District 6: Blaine County, Cascade County, Chouteau County, 

Fergus County, Glacier County, Hill County, Judith Basin County, 

Liberty County, Pondera County, Teton County and Toole County 

Local units in District 6 – Local #11-Cascade City-County Health Department 

Local #12 Northern Montana Health Care 

Local #14 Montana Mental Health Nursing Care Center 

Local #25 Northern Rockies Medical Center 

District 7: Flathead County, Lake County, Lincoln County and 

Sanders County 

Local units in District 7 – Local #22-Cabinet Peaks Medical Center 

Local #27-Montana Veterans Home 

Local #34-Clark Fork Valley Hospital 

District 8: Daniels County, Dawson County, Garfield County, 

McCone County, Petroleum County, Phillips County, Prairie County, 

Richland County, Roosevelt County, Sheridan County, Valley County, 

and Wibaux County 

Local units in District 8 – Local #21-Glendive Medical Center 

Local #39-Sidney Health Center 

If you have any questions regarding your District, please contact Jennifer at 

jennfer@mtnurses.org.


Labor Reports and News 

Promoting Health and Safety at Work: 

Covid-19 Accommodations and Resources 

As you continue to work during this pandemic, 

providing care for our communities, it’s important you 

learn what resources you have available to you. Over 

the past year, and with increased COVID-19 cases, 

your work environment continues to put you at risk for 

exposure. Understanding and learning about resources 

available to you is more important than ever. 

WORKERS COMPENSATION INSURANCE: 

Workers’ compensation insurance (WCI) is a type of 

business insurance that provides benefits to nurses 

who suffer a work-related injury or illness and it may 

help cover costs for medical care and wages for lost 

work time. The number one rule to understand is: you 

will NOT qualify or possibly receive benefits if you do not 

file. You MUST file! If you contact COVID-19 and believe 

Robin Haux, BS 

Labor Program 

Director 

you were infected at work, FILE A WORKERS COMPENSATION claim! We 

cannot guarantee you will receive benefits, however it is important that you file. 

Currently, Montana does not have presumption of eligibility related to COVID-19 

for frontline healthcare workers, but MNA is working to address this during the 

2021 legislative session. 

The first step to filing a claim is to notify your Human Resource Department. 

You have 30 days to file and your employer will have six days to respond. 

Remember, we cannot guarantee your claim will be accepted, but it is 

important you try! 

UNEMPLOYMENT INSURANCE: Unemployment insurance (UI) is a 

program to pay short-term benefits to eligible workers to help lessen the 

negative impact that being out of work has on workers, their families and 

the local economy. UI requires week-to-week eligibility and your first week is 

called your Waiting Week. To file a claim, visit www.MontanaWorks.gov and 

it is important to understand that filing a claim is not the same as requesting 

payment. Once your claim is filed, you must request payments weekly to 

receive benefits. 

You may receive unemployment benefits if: 

• You are exposed to COVID-19 and required to quarantine and NOT 

provided wages by your employer to cover your 14-day quarantine. 

• You are unable to work, or have a reduction in hours, due to health risk 

factors or any other COVID-19 related reason. 

For questions related to the topics above, please contact your MNA Labor 

Representative or the MNA office and our staff will provide answers or direct 

you to a person who can. Filing is the first action that must start with YOU for 

both resources above. Thank you for all you do! 

PLEASE CHECK YOUR MEMBERSHIP STATUS 

If you fall into any of the below categories, you could qualify for the 

‘Professional Reduced Rate’ $38.65/month. Your rate will not automatically 

change. You must let us know. 

• You are a new graduate. You must apply within the first six months after 

receiving your initial RN licensure and this rate is good for one year. 

• You are an RN in a full-time study program working towards a higher 

degree. You will need to provide proof of enrollment and you could 

receive this rate for up to three years. 

• You are an RN 65+ year of age who is licensed and working. You 

could receive this rate for the remainder of your employment. 

• If you are a retired RN and are no longer working or hold an RN 

licensure you could be eligible for the retired rate of $13.07/month. 

If you are working in a collective bargaining position and move into a 

non-collective bargaining position, please contact the Montana Nurses 

Association to let us know. Your membership dues will continue to be paid 

until YOU authorize them to be discontinued. Please remember, only you 

can cancel your membership and membership payments. 

To provide MNA with information on your status or to receive 

additional information on MNA membership please e-mail Jill Hindoien at 

jill@mtnurses.org.



What Would A Reasonable Nurse Do? 

MNA has been fielding many inquiries from concerned 

nurses regarding their professional liability in caring 

for patients in less-than-ideal conditions during the 

pandemic. From what I understand, patients are being 

held or cared for in hallways sometimes. Old outpatient 

areas have been converted to inpatient areas simply 

using curtains. Due to overwhelming volumes of ICU 

patients, they are being housed in other areas of 

the facility being cared for by nurses who are not ICU 

specialists. Hospitals in outlying areas are needing 

to hold on to ventilated critically ill patients due to lack 

of capacity at larger facilities, nurses in those smaller 

hospitals are not used to caring for such critically ill 

patients, home health nurses are challenged as well. 

PPE is a struggle in many settings. 

Amy Hauschild, 

BSN, RN, Labor 

Representative 

Suffice it to say, most nurses have not been trained to practice in these 

conditions. Nurses report great distress in not being able to practice according 

to the standards they have been taught or being required to care for more 

patients than ratios and unit standards dictate. They are worried about not 

being able to give the care they want to, and report being very concerned 

about being subject to a lawsuit or worse, action being taken against their 

license by the MT Board of Nursing (BON). 

In both cases, nurses are expected to practice like a reasonable nurse 

would do in similar circumstances. The conditions of the pandemic are the 

circumstances of today. There are, however, a couple things nurses can do 

to greatly enhance their protection. Use of the Assignment Despite Objection 

(ADO) form to document unsafe situations is certainly a great tool that should 

be utilized. If you are unfamiliar with the ADO, please ask one of your MNA 

Local Unit Representatives or your MNA Staff Representative. 

Completing facility occurrence reports is another good way to document 

situations out of the ordinary. Please do not forget to ask for help. Many nurses 

have said they do not feel comfortable asking for help because everyone is 

so busy, and they do not want to be seen as a complainer or a weak team 

member. If action were to be taken against a nurse, it is important for them to 

be able to show they asked for help. ADOs and occurrence reports are two 

ways to do this. 

Lastly and the most proactive way for nurses to protect themselves is 

through coverage with professional liability insurance. Many years ago, when I 

was a newly graduated nurse, the wisdom of the day spoke to not purchasing 

liability insurance because plaintiffs would be more likely to include a nurse 

if they knew the nurse had insurance (deep pocket syndrome). Some nurses 

report feeling comfortable because their employer will cover them with their 

facility malpractice insurance. Nurses have found employer coverage is 

primarily to protect the interests of the employer, not necessarily the interests 

of the nurse. Nurses covered by their own liability insurance report they are 

much more comfortable being covered by an entity whose primary concern 

is protecting the nurse’s interest. Some nursing liability policies also cover the 

nurse with BON investigations. 

Polices are very reasonable, often just a little over one-hundred dollars per 

year. Nurses Services Organization (NSO) is endorsed by American Nurses 

Association and they specialize in nursing malpractice coverage, though there 

are other companies out there as well. Help your mind be at ease and check 

out malpractice coverage. 

Getting Organized 

During a Pandemic 

COVID-19 is a reality that we are all being forced to 

adjust to. Nurses and healthcare workers across the 

country are exhausted both physically and mentally 

by the toll this virus is taking. This is not something I 

need to tell you. You are living it. Nurses and healthcare 

workers know the reality of this virus unlike any 

other profession. So, how do we as a union keep 

our members engaged, informed, and unified when 

they are already doing so much? Nurses are already 

overworked, so how can we ask them to engage in any 

additional activity, no matter how small? There are a 

few strategies that I think we can utilize to ensure our 

members are getting the information they need while 

still respecting the level of effort they are already being 

asked to give to care for our communities. 

Leslie Shepherd, 

BSN, RN, Labor 

Representative 

Meet them where they are at! This can be both a simple and complex 

tactic to ensure necessary information is getting to our members. Whether 

it is social media, daily huddles, bulletin boards, or union meetings; make 

receiving the information as easy and accessible as possible by utilizing a 

“shotgun” approach. Make sure all of the information you need to get out to 

your members is shared in as many method’s as possible. Not everyone has 

Facebook. Not everyone actually reads their emails. If it’s important information, 

blast it out to your members in as many methods as possible and send 

reminders! 

Make it easy! If you need your members to fill out a survey, get it in front 

of their faces. Utilizing the shotgun approach, get it to them in EVERY way 

possible, even if that means going to their unit and handing it to them. If you 

are sending reminders, put the link in your text message instead of directing 

them to an email. Ease for the member is KEY here. Make it as simple as 

possible for your members to participate. Hold virtual meetings, make them 

short and sweet, and send out minutes to those who cannot attend. 

Lastly, extend grace to your members. As you all know, this is a trying time 

that we are learning to adapt to as we go. Most people are not at their best 

right now. There will be meetings that are not well attended. There will be forms 

that are not globally filled out. I believe that people will participate when they 

can, as they can. It is our job to extend grace during this unprecedented time 

and to make disseminating information, engaging our members, and fostering 

unity as simple and easy as possible. 

Have a great idea to encourage membership engagement at your Local? 

Please share your thoughts with your MNA Labor Representative so we can 

share ideas with others!! 

Consider a Tax-Deductible Donation to: 


Foundation – (MNAF) 

➢ Donations to the MNAF foundation are 100% 

tax deductible. 

➢ MNAF mission statement: “The Montana 

Nurses Association Foundation (MNAF) is 

the charitable and philanthropic branch of 

the Montana Nurses Association (MNA), with 

a mission to preserve the history of nursing 

in Montana and contribute, support and 

empower the professional nurse in Montana.” 

➢ The purposes for which the Corporation is 

organized are as follows: 

“(a) charitable; (b) educational; (c) to accept 

healthcare/nursing research and educational 

grants; (d) to provide continuing educational 

grants to licensed registered nurses; and (e) to 

award scholarships to qualifying persons.”


As we roll into the new year with new leadership across 

the state, we as unions are faced with different challenges. 

Those challenges still include Covid-19, but also include 

some changes that could come legislatively that would 

impact nurses and teachers across the state. It should 

not be overlooked that right to work legislation would take 

away protections for front-line workers that the union has 

fought for. Many of these protections come from collective 

bargaining tables, such as workplace health and safety, 

better pay and benefits, civil rights, gender equality, and the 

right to have representation at the table. 

The labor movement has always been at the forefront 

in protecting working people from workplace injury, illness, 

and death. The Occupational Safety and Health Act of 1970 

Unions, Protections, and Quality of Life 

Lauri Hunton, RN, CCBE 

Labor Representative 

(OSHA) and the Federal Mine Safety and Health Act of 1977 are two of the key laws 

passed to protect workers that the labor movement fought to pass, which give working 

people the right to a safe job. While workplace injuries and deaths have declined 

drastically, there are still thousands of workers killed or injured each year, and unions will 

continue to fight and advocate for safe workplaces. 

One of the biggest issues at the bargaining table is the right to bargain fair wages 

to allow working people to support their families. Unions work to make sure that the 

wealth generating labor of working people is justly rewarded to support the working 

person with a broad range of policies, including minimum wage as a living wage, pay 

equity for women and minority groups, restoring overtime protections, benefits for health 

insurance, retirement, and wage standards. 


The Black Lives Matter movement awakened many Americans to the systematic 

racism ingrained in America, and it has never been more evident that our society is still 

fighting racism and racial biases. The labor movement seeks to protect civil rights of 

all workers, which gives the union rights to bargain civil rights into collective bargaining 

agreements, thus protecting workers irrespective of race, gender, nationality, religion, 

sexual orientation, or gender identity. Unions are here to help defeat the prejudices of 

our societies. Segregation, inequality, and oppression harm us all. 

Unions have proven to help build a stronger middle class, provide diverse 

opportunities for our children, increase economic growth for all, reverse income 

inequality, decrease government dependency, and foster happier, healthier 

communities. Our union is our voice for safety and change to improve the quality of life 

for all that are involved. 

Sources 

AFL-CIO. (n.d.). What We Care About. Retrieved December 30, 2020, from https://aflcio.org/issues 

UWUA. (n.d.). Eight Surprising Ways Unions Benefit Workers & the American Economy. Retrieved 

December 30, 2020, from https://union-benefits.uwua.net/ 

When Your Employer Notifies You of a Meeting... 

*Immediately ask your Supervisor/Manager/Director: 

• “What is the purpose of the meeting?” 

• “Is the meeting investigatory?” 

• “Will I be asked questions which may possibly lead to discipline?” 

• “Will I be asked questions which require me to defend my conduct?” 

If the meeting is investigatory or answers may 

lead to discipline: 

_ #1 – Respectfully inform your employer you are invoking 

your Weingarten Rights & will need to have your Union/Unit 

Representative or Nurse Advocate present during questioning. 

_ #2 – Quickly arrange for your Union/Unit Representative or 

Nurses Advocate to attend the meeting. 

Weingarten Rights 

If this discussion could in any way lead to my being 

disciplined or terminated, or affect my personal 

working conditions, I respectfully request that my 

Union/Unit Representative or Nurse Advocate be 

present at this meeting. 

Until my representative arrives, I choose not to 

participate in this discussion 

Everyone Deserves A Job They Love!! 

Let Us Help Today, 

Call 406.228.9541 

Prairie Travelers is recruiting Traveling 

Healthcare Staff in Montana, 

North & South Dakota 

• Registered Nurses (Hospital, ER, ICU, OB and LTC) 

• Licensed Practical Nurses 

• Certified Medication Aides 

• Certified Nurse Aides 

• Full-Time and Part-Time 

Prairie Traveler’s Commitment 

to our Staff 

• Excellent Wages • Health Care Benefits 

• Travel Reimbursement • Annual Bonus 

• Paid Lodging 

• Zero Assignment 

• Flexible Work Schedules Cancellations 

• 24/7 Staff Support • Varied Work Settings 

APPLY TODAY 406.228.9541 

Prairie Travelers Recruitment Department 

130 3rd Street South, Suite 2 • Glasgow, MT 59230 

For an application or more information, visit 

www.prairietravelers.com


Professional Development Department 

Nursing Professional Development Pandemic Resources 

Professional development 

is defined by the 

Association for Nursing 

Professional Development 

as “the continuous, active 

participation in activities that 

assist in developing and 

maintaining competence, 

enhance professional 

practice, and support 

achievement of professional 

goals” (Harper & Maloney, p. 

64). The current challenges 

of the pandemic highlight 

the importance of nursing 

Kristi Anderson, 

MN, RN, NPD-BC, CNL 

Director of Professional 

Development 

continuing professional 

development (NCPD). As 

nurses transition to different areas, new knowledge 

and skills are necessary in order to practice safe 

patient care. It has never been MORE important for 

nurses and healthcare professionals to have current, 

evidence-based knowledge to guide their practice. 

The good news—it is now much easier to 

actively participate in virtual nursing professional 

development educational activities. National 

and specialty organizations have transitioned 

many activities to virtual formats in response to 

education needs during the pandemic. In addition to 

current COVID-19 guidelines, there are a variety of 

additional topics related to different aspects of the 

pandemic. 

Resilience and self-care activities are accessible 

from several different organizations to support 

nurses with the major challenges such as those 

presented by a pandemic. New educational 

opportunities on navigating telehealth and managing 

chronic conditions assist in supporting patients in 

a virtual environment. Educational activities on how 

to develop virtual learning while promoting active 

learner engagement are also available. 

Check out a few of the nursing professional 

development activities and resources in response 

to the pandemic as we continue to navigate through 

this challenging time. 

• CNEbyMNA-Resiliency, Wellness, and Self-Care 

Resources: https://courses.cnebymna.com/courses 

• American Nurses Association-COVID-19 Resource 

Center: https://www.nursingworld.org/practicepolicy/work-environment/health-safety/disasterpreparedness/coronavirus/ 

• Association for Nursing Professional Development- 

COVID-19 Resources: https://www.anpd.org/page/ 

covid-19-resources 

• Centers for Disease Control and Prevention- 

Telehealth Interventions to Improve Chronic 

Disease: https://www.cdc.gov/dhdsp/pubs/ 

telehealth.htm 

• National Academy of Medicine-Taking Action 

Against Clinician Burnout: https://nam.edu/ 

systems-approaches-to-improve-patient-care-bysupporting-clinician-well-being/ 

Additional Reference: 

Harper, M. & Maloney, P. (2016). Nursing professional 

development: Scope and standards of practice, 3rd 

ed. Chicago: Association for Nursing Professional 

Development. 

Visit nursingALD.com today! 

Search job listings 

in all 50 states, and filter by location and credentials. 

Browse our online database of articles and content. 

Find events for nursing professionals in your area. 

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

Director of Nursing 

Miles Community College is a rural, public, two-year 

institution and is inviting applications for the Director of 

Nursing. Reporting to the Vice President of Academic 

Affairs, the Director will be responsible for the overall 

leadership and administration of the nursing and allied 

health programs. This is an exciting opportunity for a dynamic individual who is 

visionary, with demonstrated excellence in teaching, leadership and service. 

Salary range is commensurate with education and experience 

and offers a great benefits package. 

For more information, and full position description please visit our 

website at https://www.milescc.edu/Employment/ or email 

humanresources@milescc.edu. Application deadline is March 1, 2021. 

Miles Community College is an equal opportunity employer. 

Welcome to our new MNA Nurse Planner! 

Please help us welcome 

Megan Hamilton, MSN, RN 

CFRN, NR-P, as our new 

nurse planner and professional 

development generalist. Megan 

will start part time with MNA 

in January 2021. Her primary 

responsibilities will include 

being a nurse planner for the 

MNA accredited provider unit, 

coordinating real-time and 

virtual professional development 

events and activities, and 

navigating statewide, regional, 

and national relationships 

Megan Hamilton, 

MSN, RN CFRN, 

NR-P 

impacting our ability to provide evidence-based quality 

continuing professional development activities. Megan 

has worked as our “seasonal” nurse planner since April 

2020 and has developed a number of activities including 

the “Building our Resilience” series available on our 

enduring material library (https://courses.cnebymna.com/ 

courses). 

With over 27 years of EMS and nursing experience, 

Megan has worked as a nurse in a variety of settings 

including urban medium to high-volume Emergency 

Departments, rural and wilderness hospital settings, and 

ground and air medical transport. She has a passion 

for teaching and has worked as a clinical educator in a 

variety of areas including outreach, hospital, pre-hospital, 

air medical, and academics. Megan obtained her MSN 

in Nursing Education in 2015. She is co-founder of the 

Survivor’s Network for the Air Medical Community and 

has published two research studies exploring critical 

incidents in healthcare and air medical transport. 

RN – Inpatient Nursing 

Full Time or Part Time 

Competitive salary, great benefit package, 

student loan repayment and relocation expenses available. 

Please contact the HR department at (406) 228.3662 for more information. 

http://www.fmdh.org 

FMDH is an Equal Opportunity/Affirmative Action Employer


Professional 

Development 

Department 


Approved Providers 

MNA thanks all of the Approved Provider Units we work with for their 

commitment to advancing and promoting quality nursing practice through 

continuing nursing education. 

Acute Care Education 

Vancouver, WA 

Alaska Native Tribal Health Consortium 

Anchorage, AK 

Alaska Nurses Association 

Anchorage, AK 

Alzheimer’s Resource of Alaska 

Anchorage, AK 

Bartlett Regional Hospital 

Juneau, AK 

Benefis Healthcare Systems 

Great Falls, MT 

Billings Clinic 

Billings, MT 

Boise State School of Nursing 

Boise, ID 

Bozeman Health 

Bozeman, MT 

Cardea Services 

Seattle, WA 

Caring for Hawai’i Neonates 

Honolulu, HI 

Central Montana Medical Center 

Lewistown, MT 

Central Peninsula General Hospital 

Soldatna, AK 

With Distinction 

Community Medical Center 

Missoula, MT 

Confluence Health 

East Wenatchee, WA 

Evergreen Health 

Kirkland, WA 

Foundation Health Partners 

Fairbanks, AK 

Kalispell Regional Healthcare System 

Kalispell, MT 


Kootenai Health 

Coeur d’Alene, ID 

Midland Memorial Hospital 

Midland, TX 


Montana Geriatric Education 

Center of UM 

Missoula, MT 


Montana Health Network 

Miles City, MT 

Montana VA Health Care System 

Helena, MT 


Mountain Pacific Quality Health 

Helena, MT 

North Valley Hospital 

Whitefish, MT 

Pacific Lutheran University 

Tacoma, WA 


Planned Parenthood of the Great 

Northwest and the Hawaiian Islands 

Seattle, WA 

Providence Alaska Learning Institute 

Anchorage, AK 

Providence Healthcare 

Spokane, WA 

South Dakota Nurses Association 

Pierre, SD 

South Peninsula Hospital 

Homer, AK 


St. Luke’s Health System 

Boise, ID 

St. Peter’s Health 

Helena, MT 

St. Vincent Healthcare 

Billings, MT 

UF Health Shands Hospital 

Gainesville, FL 

Wisconsin Nurses Association 

Madison, WI 

www.cnebymna.com 

Be sure to check out our CNEbyMNA 

Website for Continuing Education 

opportunities. Sign up for upcoming 

events and online learning courses. 

It is constantly updated with new 

Webinars and Courses for your 

continued learning! 

*Montana Nurses Association 

is accredited with distinction as 

a provider of continuing nursing 

education by the American Nurses 

Credentialing Center’s Commission on 

Accreditation* 

$15.00 $15.00 

What is Your 

Learning 

Environment? 

see more 

$15.00 $15.00 

Transitions of 

Care: 

Interfacility 

Transfers 

see more 

Performing 

a Quick and 

Helpful Physical 

Assessment 

see more 

Quick Review of 

12-lead ECG 

see more


State Wide Nursing News 

Challenges in Acquiring New or Experienced 

Nursing Leaders & Nursing Administrators 

Nowadays, hiring any 

nursing administrator (DON) 

or nursing leader (RN) brings 

a challenge to organizations 

trying to maintain a budget 

and provide nursing 

leadership quality. A newly 

hired nursing leader must 

perform and have relevant 

leadership experience 

and a natural ability to 

work effectively with other 

employees. The following 

Carolyn Taylor 

Ed.D, MN, RN 

considerations encourage 

informed hiring practice, help 

hire with more awareness of potential legal and policy 

concerns, and identify specific leadership qualities. 

It can be difficult and important to determine who 

and why a particular person should be in a nursing 

leader position. It is better to carefully consider all the 

ramifications of selecting a nursing leader the first time 

than to have to take the time and energy to undo a 

poor hiring decision. 

Written and followed hiring processes/policies 

(in general) with pre-established hiring behavior 

and screening expectations will prevent the facility/ 

organization from future legal questioning about the 

hiring process by disgruntled job applicants. Follow 

the same written, precise hiring policy process that 

shows written guidelines for minimizing biases and 

discrimination for EVERY potential employee. These 

policies should support the facility/organization’s 

philosophical beliefs, including the mission, definition, 

purpose, goals, and objectives of the facility/ 

organization. 

Superb written record-keeping concerning each 

accepted job applicant is necessary as a part of the 

job interview. All job interviews are legally challenged 

(verbally, written, or subconsciously) regarding the 

hiring process or final hiring decision. The appearance 

of interview biases or discrimination is always a 

potential problem when determining any nursing 

leader! You can trust that somebody will always ask 

and question employment processes and decisions! 

Sometimes there are negative comments from existing 

employees about hiring a specific person(s) to do a 

particular job. A hiring committee with a set criteria 

plan and policies for making employment decisions 

can easily dismiss such comments knowing that 

they have determined employment decisions by preestablished 

criteria. The criteria and written records 

show an obvious effort and concern for the nonexistence 

of personal biases or discrimination. 

Recognizing a Nursing Leader – A nursing 

leader is a registered nurse who assesses, directs, 

participates, plans, implements, and evaluates 

outcomes toward meeting patient goals. He/she 

has the power to stand alone and the courage to 

make difficult/tough decisions. It is a nursing leader 

Nurses/NPs/PAs/Physicians – 

Rural Montana Needs YOU 

Employer: One Health/Bighorn Valley Health Center 

Possible Location: Ashland, Chinook, Glendive, 

Hardin, Lewistown, Miles City 

Salary: Competitive wages based on experience 

and licensure. 

Hours: Full-Time/Part-Time 

Are you ready for a challenging position? Do you have a strong 

desire to work with passionate people whose mission is to improve the 

wellbeing of everyone by providing accessible, quality health care for 

the whole community? One Health’s locations are looking for RNs, 

LPNs, and Providers such as a Nurse Practitioner to join us in delivering a 

holistic, patient-centered care model that advances quality outcomes for 

individuals and the community. 

Check out the careers section on our website for more 

information at www.chcfamily.org 

who always strives to be the best of all who serve. 

This type of person gives his/her “all” for the nursing 

team’s success and positive patient outcomes. It is a 

person who faces human relationship challenges with 

courage and acts civilly and with sensitivity regarding 

the personal decisions that improve nursing care. A 

nursing leader is often a person with significant and 

proven successful life experiences related to problemsolving. 

A new or inexperienced nursing leader “shadowing” 

an experienced and successful nursing leader might 

keep an organization from experiencing, again, past 

nursing leadership errors. It is always helpful to first 

mutually synchronize nursing thoughts and behavior 

patterns that support the philosophy, mission, 

purpose, and goals of the facility/organization. 

Teaching appropriate choices and understanding 

nursing leadership behaviors is important to a new 

nursing leader’s success. 

Intuitive powers are an added positive dimension 

of nursing leadership. It requires listening to the voice 

from within when attempting to lead others. Intuition is 

helpful and improves with leadership experience and 

chronological age. 

It is integrity and correct decisive actions that 

identify nursing leaders. Hence, the nature versus 

nurture question arises: Is a nursing leader naturally 

“born to be a leader” (nature concept) or “learns to 

be a leader” (nurture concept)? Some data shows 

that exceptional nursing leaders show their beginning 

natural potential as outstanding nursing leaders in their 

early adult years – usually in their early twenties. 

Male or Female Leader – Gender choice can 

be a dilemma considered by facilities/organizations 

for a nursing leaders’ role. Of course, there are 

many considerations as it relates to experience and 

capability. However, it was an interesting perspective 

of Madeleine Albright (American Politician and 

diplomat from 1997-2001 – U.S. Secretary of State) 

that women are often the best choice! She believes 

that women have an increased propensity over men 

when it comes to multi-tasking. After all, she says, 

women are required to multi-task responsibilities 

of home, family, children, dietary intake, and 

sometimes jobs. A practice of handling and solving 

multiple activities and problems simultaneously 

is required of a nursing leader – and experience in 

these convoluted activities is the basis of nursing 

leadership success. However, this philosophy is 

challenged because we know as experienced 

nursing leaders that all situations are influenced by 

the concept of IT ALL DEPENDS! 

Men – they have their unique abilities, too. 

Employees sometimes react positively to a known 

authority figure, such as a male. Therefore, men 

have qualities that form the basis of nursing 

leadership success. 

Regardless of gender, leadership abilities are 

individually unique. Yet, gender, by its very nature, 

deserves consideration when employing leaders. 

Be sure your written documentation during the 

hiring process supports criteria WITHOUT biases 

or discrimination – including gender, marital status, 

race, and transgender status. 

Importance of Personal Skills—Educationally, 

nursing leaders are taught the Theory of Leadership 

and Critical Thinking. However, we all recognize that 

education is not the only facet for consideration. 

The ability to work with people with integrity is 

also a MUST. The acquisition of personal skills and 

education is not always the sole determinant of 

acquiring a certain job; sometimes, it seems that the 

time and need chooses you. 

If you are an educator, teach potential nursing 

leaders how to understand employees and 

know that every person has different personal 

human qualities. Nursing leaders will also have 

a background of success, problems, worries, 

and “baggage.” We are all human with needs, 

desires, personal difficulties, and you name 

it – we all share it to some degree! Therefore, 

responding appropriately to employees’ needs 

(work and personal) must always be in the equation 

of becoming a successful nursing leader. A 

reciprocating nursing leader response will most 

likely be: “I will do what you expect if you will 

consider me and my legitimate personal needs 

(within reason) as I perform the expected behaviors 

of my job description.” The outcome is mutual 

respect. 

Sometimes, nursing leaders need to learn that 

the balance of leadership firmness and leadership 

kindness is a balancing act that demands constant 

weighing of work and personal behaviors. Therefore, 

NURSING LEADERSHIP POWER is related to how a 

nursing leader can effectively relate and empathize 

with other nursing employees in stressful situations 

and how nursing leaders can support each other’s 

personal needs while getting the job assignment/ 

description accomplished. We have to admit that 

empathetic kindness in serving all others (including 

other nurses) is a major hallmark of the nursing 

profession! 

Hiring Inside the Facility/Organization to 

Administrative Positions – Any hired nursing 

leader must perform and have relevant leadership 

education and experience. Whether it is wise always 

to promote a nursing leader to an administrative 

position within the same facility/organization is 

questionable. 

The promotion of a nursing leader who knows 

others’ strengths and limitations sometimes gives a 

new nursing administrator an edge on success. The 

challenge is to find a nursing leader recognized by 

other nursing leaders as knowledgeable about the 

processes/policies and can be considered a role 

model as a nursing administrator. In other words, 

does a nursing leader have what it takes? 

The nurse leader’s internal facility/organization’s 

elevation of responsibilities to a new and more 

demanding nursing administrator position is not 

always successful! Furthermore, taking on a new 

role with new expected administrative relationships 

with the same employees is often very difficult. 

It causes a necessary change in the degree and 

kind of employee fraternization (usually a need for 

curtailment of employee fraternization). Effects of job 

promotion within a facility/organization recognize the 

need for any newly assigned and promoted nursing 

leader to an administrative position to withstand 

internal turmoil from disheartened employees who 

did not get a promotion—and accept it gracefully. 

It requires the advanced nursing leader to a nursing 

administrative position to change old relationships 

into new and unfamiliar behaviors. Some nonpromoted 

employees often think someone else


State Wide Nursing News 

(often themselves) within the facility/organization should have been the one 

promoted to an elevated position. Internal stress occurs, and alliances are 

blurred. 

One significant detriment is the possibility that the promoted nursing leader 

has formed past employee relationships and exhibited behaviors as a nursing 

leader that has exposed possible personal areas prone to staff manipulation 

or coercion. Going from an employee cohort with overtly friendly employee 

behaviors to a more responsible and accountable nursing administrator’s role 

with new job expectations is very different from past employee behaviors. It can 

be somewhat threatening and daunting (and even confusing). 

It is always tempting by a facility/organization to “reward” a nursing leader 

for longevity or compliance with a new administrative promotion. Too often, 

this “reward” is detrimental to both the employee and the facility/organization. 

This person has often learned well to be a follower and not a true nursing 

administrative leader. 

Some facilities/organizations do not consider the many ramifications of 

making such an administrative advancement. Often the hired person is a likable 

person within the facility/organization but not necessarily a qualified person for 

a specific administrative job. A nursing administrator role should cause careful, 

extensive, and time-consuming scrutiny. There is a policy in some facilities/ 

organizations where nursing leadership employees are the most likely promoted 

due to compliance and longevity. The term is often stated as a policy, “We 

always hire from within!” 

Be aware of work-related friendships and family relationship ties for the 

nursing leader for whom administrative advancement is considered. Excessive 

employee friendships and apparent nepotism within the facility/organization are 

not usually the most outstanding traits for most administrative positions. 

Hiring Outside the Facility/Organization to Administrative Positions — 

Consider hiring an experienced, advanced academically educated, or a 

proven successful nursing leader who is not currently employed by the facility/ 

organization. The successful pursuance or attainment of advanced higher 

education by any nursing leader shows tenacity and forbearance. Experience 

and proven abilities are often a “gold mine.” Yes, the recruitment of outside 

expertise might cost more and should cost more. This person might have a 

varied applicable positive experience in human relationships and getting a job 

done. The creative and critical thinking abilities might be a positive surprise with 

excellent new ideas beyond your imagination. 

Absolutely – Consider hiring an excellent nursing administrator from another 

source than the existing facility/organization. Sometimes, no person in the 

facility/organization will meet the job’s rigorous requirements. When hiring from 

outside the facility/organization, there is less chance of a social entanglement 

with current staff and emotional employee ties. Objectivity is increased. 

Manipulative employee behaviors are less likely to occur when employee 

familial and close friendship ties are absent. 

Use your intuition when hiring. Is this person secure in nursing administrative 

leader skills, fair, trustworthy, and philosophically congruent with the philosophy 

and goal(s) of the facility/organization? Does this person have a healthy ego that 

will allow/permit personal criticism? Is the essence of the appropriate use of 

personal power evident? Determine, if you can, if the potential administrative 

employee is a true leader and not a follower! Determine a way of scoring your 

impression(s) or knowledge of each prospective employee applicant according 

to the following. 

Leader 

Exhibits calm amid the chaos 

Directs activities with goals in mind 

Supports and rewards 

positive behaviors 

Directs and makes decisions with 

concern for consequences 

Is responsible for outcomes 

Practices, knows, & determines 

policy direction 

Understands and utilizes 

legal knowledge 

Problem-solving skills follow a 

pattern for calculated outcomes 

Calm and ability to direct 

during a crisis 

Listens to and hears 

communication implications 

Seeks respect and recognized integrity 

Follower 

Exhibits nervousness amid the chaos 

Performs activities only as directed 

Accepts rewards often 

with skepticism 

Performs as requested with no obvious 

concern for ultimate consequences 

Limited responsibility for outcomes 

Depends on leaders 

to give direction 

(Read more at leadershippoweronline.com) 

Depends on the leader to 

make a legal judgment 

Problem-solving occurs on a limited scale 

without great concern for overall outcomes 

Dependent on the direction 

during a crisis 

Listens to words and 

performs accordingly 

Only tries to be liked by others 

Registered Nurse to…. Paramedic??? 

By Jeremy Johnson 

Director of Marketing, Platinum Educational Group 

You may be thinking “Isn’t that title backwards”? While it is true that many 

paramedic’s progress towards a nursing degree, there are, however, many benefits 

for nurses to obtain a EMT or Paramedic degree as well. This article will discuss 

several reasons for RN’s to adopt EMS training to their résumé. 

First, let’s all get on the same page. Even though these two fields are in the 

healthcare industry together, they are vastly different and extremely important 

pieces to the overall “patient care puzzle.” While nursing deals with long term 

patient care under the supervision of a doctor in a hospital setting, EMT/Paramedic 

training focuses on initial patient assessment and emergency response. Topics 

covered in EMT training may include: 

*Treatment for Trauma Emergencies 

*Airway Management and Maneuvers 

*Spinal Immobilization using KED Board and Longboard 

*Splinting Procedures 

*Traction Splinting 

*Treatment for Medical Emergencies *Pediatric Emergencies 

*Geriatric Emergencies 

*Ambulance Operations 

So, why would RN’s want to become EMT/Paramedic certified? 

Employment Opportunities 

Becoming versed in both fields can assist in expansion of employment 

opportunity. Companies in the private sector, and organizations in the public 

domain, desire highly educated people with a well-rounded scope of all around 

medical care knowledge. RN’s with EMS training and background can find 

professional specialties that include: 

• Flight Nurse 

• Intensive Care Nurse 

• Emergency Room Nurse 

• EMS Instructor or Program Director 

• Local EMS Provider 

The Exhilaration/Adrenalin Rush Influence 

Some nurses are drawn to the hectic and often unpredictable world of trauma 

and emergency. It may be in their nature to take control of an emergency situation 

or play an intricate part of a quick moving crisis. Some may have witnessed 

paramedics/EMT’s rush into the hospital and provide the details of the patient 

event and present the case facts. Others were probably drawn into that “rush” 

without witnessing a scene like that at all. Regardless, those situations typically 

arise in an ER trauma unit or in the “field.” An on-the-scene ambulance work 

environment can provide that lifestyle and may be a better fit than in a slower 

paced hospital setting for some. 

The Autonomy Factor 

Some nurses may not like the strict rules and regulations that can apply to 

nursing. Restrictive guidelines, hospital protocol, and close supervision by a 

doctor(s) can all contribute to a feeling of not being a “major role player” at all. 

Even though paramedicine also has rules and guidelines, it may have a different 

“feel” when you are a first responder and it is YOUR actions and decisions that 

controls a scene. It can provide a sense of freedom from external control or 

influence, as well as, an impression of independence. 

How Long are the RN to EMS Courses? 

Course length differs by program but typically last 1-2 weeks (average 54 Hrs.) 

for RN-to-EMT bridge courses; while RN-to Paramedic bridge courses varies from 

a couple of months to up to one year. 

Summary 

The benefits of converting from RN to EMS can vary and may not apply to you. 

In our experience, there has been “tension” between nurses and paramedics/ 

EMT’s historically. However, the more each learns from the other will help overall 

knowledge of patient treatment and care. 

National RN to EMT Bridge Training Institutes 

Nebraska – Creighton University (Pre-Hospital Care (EMT) for Nurses) 

(https://ems.creighton.edu/training-certification/pre-hospital-care-emt-nurses-0) 

Wisconsin – Lakeshore Technical College (RN to EMT) 

(http://gotoltc.edu/academics/certificates/nurse-to-emt/index.html) 

Ohio – Columbus State Community College (RN-to-Paramedic) 

(http://www.cscc.edu/academics/departments/ems-fire/faq.shtml#rntoparamedic) 

Virginia – Southwest Virginia Community College (RN-to-Paramedic) 

(http://sw.edu/catalogs/programs-of-study/career-studies/rn-to-paramedic/) 

Nevada – JTM Training Group (RN-to-EMT) 

(http://jtmtraining.com/ems_certs_rfrs/registered-nurse-to-emt/) 

Michigan – Munson Community Health Center EMS Education (RN-to-EMT and 

RN-to-Paramedic) 

(https://www.munsonhealthcare.org/clinical-education/ems-education/emseducation)


APRN Corner 

Happy New Year. If you are like me, you are optimistic that 

2021 is going to be a better year than 2020—we have all been 

working in this crazy COVID world and with the vaccines 

beginning to be given there seems to be a light at the end of 

the tunnel. 

As hard as many of you have been caring for patients and 

fellow co-workers, please take care of yourselves. There are 

many different strategies for self-care, and nurses are the 

best at helping others, but often do not spend that energy on 

themselves. Remember these key strategies. 

• Stress Relief: We each have many stressors in our lives, 

acknowledging the stressors and addressing them 

is key. Activities that help combat stress can be as 

simple as breathing and sitting in a quiet place for a few 

Keven Comer 

MN, APRN, FNP-BC 

minutes and clearing your busy brain. Listening to peaceful music, soaking in a hot 

tub, or just laughing. 

• Nutrition: Never underestimate the power of a good diet. Foods can boost the 

immune system and our moods can be affected by skipping meals and overeating. 

• Physical Activity: Exercise may have been different in these pandemic times – 

crazy work hours. A walk around the block, stretching, yoga. 

• Kindness: Kindness and thoughtfulness go a long way in helping others. It does 

not have to be a large gesture to make you feel good inside. 

• Sleep: Making sure you get adequate sleep is essential for “rebooting” your 

system. Make sure your bedroom is cool, dark, and quiet, and you like to go there. 

Have a bedtime routine. A practice called FREEDOM WRITING can help clear your 

mind for a good night’s sleep. FREEDOM WRITING: Take three blank sheets of 

paper, front and back and set your phone for seven minutes. Write on the paper 

anything that comes to your mind in that seven minutes, if you only use three 

sheets in that time or finish the six pages in three minutes, you stop—then you rip 

the paper up and throw it away. No keeping the notes, no re-reading. It is really 

important to rip and throw away. This has good evidence to really help your brain 

relax and sleep. 

• Connection: Keeping social connection has been hard with social distancing and 

limiting group activities. Face timing, talking on the phone and even dropping a 

note or letter can really help you and others feel connected. 

Don’t forget to mark your calendar for March 5th-6th for the annual APRN 

Pharmacology Conference. We will be held virtually via ZOOM until we are confident in 

the safety to meet in large groups. We have a great platform and excellent speakers. 

Please go to https://cnebymna.com/aprn/ for more information and to register for the 

conference. Hope to see you there. Be sure to reach out with any APRN questions or 

concerns. keven.comer@gmail.com. 

*NEW MEMBER BENEFIT FOR APRN’s* 

If you are an APRN, membership to Montana Nurses Association (MNA) includes 

three professional memberships for one low membership rate. 

o MNA – Montana Nurses Association 

o ANA – American Nurses Association 

o AANP – American Association of Nurse Practitioners 

If you are currently an MNA member who is also an APRN, please e-mail Jill at jill@ 

mtnurses.org so she can sign you up for your AANP membership or if you have any 

questions. 

NursingALD.com can point you 

right to that perfect NURSING JOB! 

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APRN PHARMACOLOGY 

CONFERENCE 2021 

Save the Date 

MARCH 5TH & 6TH, 2021 

Montana Nurses Association’s 

2021 APRN Pharmacology Conference 

All presentations held virtually 

Friday, March 5th 2021—Full Day Saturday, March 6th 2021—Morning 

Topics & Speakers—FULL AGENDA AVAILABLE SOON 

• Keynote: Shaping the health care 

landscape: Nursing’s role in improving 

health care policy 

o Tay Kopanos, DNP, APRN, FNP-BC, Vice 

President of State Government Affairs-American 

Association of Nurse Practitioners 

• Not Diabetes, but Live-abetes! Adapting to 

Diabetes Care 

o Steven Elrod, PharmD, BCACP 

• Montana COVID-19 Vaccine Update 

o MT Department of Health & Human Services & 

Keven Comer, MN, FNP-BC 

 

• Medical Management of Coronary Artery 

Disease in 2021 

o Laurie A. Soine PhD, ARNP 

• Montana Legislative Updates 

o Vicky Byrd, MSN, RN - Chief Executive Officer 

of Montana Nurses Association 

 

• Alcohol Use Disorders--Foods that Reduce 

Cravings and Addictive Behaviors 

o John Honsky, APRN & Heidi Moretti, MS, RD 

• First Line Antidepressants in Primary Care 

o Stacey Pascoe, PharmD 

• Art for Wellness-Promoting Well-being in 

Indian Reservation Dwelling Preadolescent 

Children 

o Julie Alexander-Ruff, EdD, MSN, BS, BSN, RN, 

CPNP-PC 

• Updates on Managing Parkinson’s Disease 

o Ann Galloway, PhD, FNP-C 

• The use of Cephalosporins in Penicillin 

Allergic Patients: A Clinicians guide to 

appropriate antibiotic selection 

o Daniel Lee, PharmD, BCPS 

• Hepatitis C Update 

o Paula Cox-North, PhD, ARNP 

 

• Deprescribing Program-Polypharmacy in 

the Geriatric Population 

o Jennifer Sofie, DNP, FNP, ANP 

• And more!


ANA Excerpts 

At the Great Falls Clinic we believe our 

employees are our greatest asset, and we 

are actively seeking LPNs and CMAs to join 

our dedicated healthcare team. 

• Competitive salary and benefits 

• Vacation/sick leave package that promotes 

health-work life balance 

• Retention and moving bonus 

If you'd like to balance working in a busy, forwardthinking 

organization, contact Joey Richman at 

406-454-7325 or joey.richman@gfclinic.com. 

Great Falls Clinic Hospital 

3010 15th Ave South 

Great Falls MT 59405 

www.gfclinic.com 

185 Crestline Ave., Kalispell, MT 

ILCORP.ORG/CAREERS 

OR 406-752-9144 

Now hiring for all nursing positions and more! 

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166 Montana Ave. East | Big Sandy, MT 59520 

(406) 378-2188 | www.bsmc.org


For Nurses, Your License is Your Lifeline 

The field of nursing is fast and diverse. For many 

nurses, especially those of you who are members of the 

Montana Nurses Association, have big responsibilities, 

including: 

• Confirm medical history and symptoms 

• Monitor vital signs 

• Administer medicine 

• Coordinate overall care with the entire health 

care team 

• Provide detailed care for individual patients 

• Employers for misconduct 

• Patients or their family because they disagreed 

with you 

• Anybody else you come in contact with at work. 

Most of you are on your feet all day or all night to 

perform a job that is physically demanding, emotionally 

taxing, and mentally draining. Much of the tasks 

you perform are one’s not just anyone is capable of 

performing, and that is why a license is required by 

the Montana Board of Nursing. After proving yourself 

academically and ethically the state issues you a 

license. 

Many people would consider nursing a good 

noble career, especially in terms of pay, benefits, and 

community appreciation. But what happens when 

somebody files a complaint about you or threatens 

to jeopardize your license? Without your license, you 

cannot perform a nursing job. Without your job taking 

care of others, how will you earn enough to take 

care of yourself, and your family? Your license is your 

lifeline. 

Whether their complaint has merit or not the mere 

filing of an allegation brings forth a process that can 

be daunting and have long-term implications for your 

career. This process can be very time consuming 

and costly if you try defending yourself. It will require 

you preparing a statement, gathering records, 

and testifying. It then takes times for the board to 

investigate. 

Unfamiliar Territory: The Complaint. 

If someone files a complaint about you, your license 

is at risk. Even if there is no merit to their complaint. 

Complaints can be filed by: 

• Co-workers who do not like you, personally or 

disagree with you, professionally 

Montana Healthcare Mutual Aid System (MHMAS) is the Emergency 

System for the Advance Registration of Volunteer Health Professionals for 

the state of Montana. MHMAS is a secure, web-based online registration 

system used to register, verify, and credential volunteer health care 

professionals before a major disaster or public health emergency occurs. 

MHMAS is a secure, web-based online registration system used to 

register all levels of medical professionals to be needed to respond to 

a medical and/or public health emergency. 

But there are ways you can minimize all of this. 

Hire an Expert and Respond with Confidence 

If someone files a complaint against your license, 

it’s imperative you find an attorney quickly. Even if 

you’ve done nothing wrong. This will save you both 

time and money. Consider it an investment. A licensing 

law specialist will protect you so that you can continue 

working and doing what you do best. No need to 

figure out specific licensing laws and administrative 

rules that may apply. By hiring a licensing attorney, 

it will give you peace of mind that you will come out 

ahead on the other side. 

Silverman Law Office, PLLC ~Helena, MT~ (406) 449-4829 

Once you register you are under no obligation to respond to a request, 

you decide when and where you would like to respond. MHMAS does 

ask for personal information (e.g., SSN, DOB) this is needed so we 

can conduct a background check once a request is made for medical 

professionals. 

If you would like to register, please follow the link below. 

Register Here @ https://mhmas.org/ 

Mountainview Medical Center 

is Searching for You! 

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Full-time RN/Quality Coord 

Competitive Pay & Benefits 

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Contact 

KARI JO KIFF, DON 

406-547-3323, Ext. 144


Three Risk Areas Nurses Face in the Time of COVID-19 

Georgia Reiner, MS/Senior Risk Specialist, 

Nurses Service Organization, 

Healthcare Division, Aon Affinity 

Reprinted from West Virginia Nurse 

October, November, December 2020 Issue 

The spread of the coronavirus (COVID-19) 

reinforces the dedication and selflessness of nursing 

professionals. This is a scary and uncertain time for 

everyone, especially nurses on the frontlines working 

tirelessly to help curb the spread of the COVID-19 and 

balance an influx in patients. 

As nursing professionals tirelessly work to provide 

the best care possible to their patients during a difficult 

time, they need to know the steps to take to mitigate 

the risks that can impact their license, career, and 

reputation. 

Three risk areas nurses need to have on their radar 

include: 

1) Using Social Media Best Practices 

Nurses are held to a higher standard than others 

because of their role as caretakers and because they 

have intimate access to patients’ private information. 

Their social media presence should reflect this 

heightened responsibility, especially in this uncertain 

time. They must consider patients’ right to privacy and 

act professionally before posting. 

As the media and social media are consumed 

by COVID-19 news, nurses may want to join in 

and share their thoughts or may be tempted to air 

their grievances. Online comments or comments 

to members of the media by a nurse regarding 

employers or co-workers, even if posted from home 

during nonwork hours, may violate their employer’s 

social media or media relations policies. Violations 

of employer policies may lead to employment 

consequences for the nurse, including termination. 

Nurses may want to think twice before posting or 

otherwise giving the appearance they are speaking 

on behalf of their employer unless authorized to do so, 

and must follow all applicable employer policies. 

Quit Your Way 

with the Montana 

Tobacco Quit Line 

The Montana Tobacco Quit Line now offers free 

coaching via chat, text (under age 25) and phone, 

increased incentives for pregnant women, and has 

resumed offering Chantix! 

• FREE Chantix Starting January 1, 2021 (While 

Supplies Last): The Quit Line will resume 

offering free Chantix on January 1, 2021 to 

Montanans who enroll and complete their first 

coaching call. While supplies last, participants 

will be eligible to receive up to three months of 

Chantix with a doctor’s prescription. 

• NEW Online Chat: In addition to phone coaching, 

the Quit Line now offers coaching via online chat 

for all Montanans at QuitNowMontana.com. Those 

who enroll in online coaching are eligible for free 

NRT, free Chantix and reduced-cost Bupropion. 

• NEW Young Adult Program: The Quit Line 

now offers coaching via text messaging to 

those between 18-24 years of age. To access 

the texting feature, young adults can text “start 

my quit” to 36072. The Montana Tobacco Quit 

Line continues to offer My Life, My Quit to those 

under the age of 18. 

• Quit Now Montana Pregnancy Program 

Increased Rewards: The Quit Now Montana 

Pregnancy Program offers pregnant callers 

nine free coaching sessions with a dedicated 

female coach, as well as $20 for each completed 

coaching call while pregnant and $30 for each 

completed coaching call post-partum. 

• American Indian Commercial Tobacco Quit 

Line Updated Features: The American Indian 

Commercial Tobacco Quit Line has a new, 

easier-to-remember phone number, 1-855-5AI- 

QUIT, and a brand new website. 

2) Preventing Medication Errors 

Nurses must continue to work to catch their own 

potential medication errors, as well as the errors 

of other healthcare providers in the medication 

administration chain. Research has found that the 

majority of medication errors result from human 

factors, including inadequate communication, biased 

reasoning, reduced memory, and insufficient training 

and inexperience (Benner et al., 2002; Brady et al., 

2009; Choo et al., 2010; Saintsing et al., 2011; TJC, 

2012). Nurses also identify distractions and fatigue as 

contributing to medication errors — which are factors 

that the COVID-19 crisis can exacerbate (Choo et al.). 

Since the beginning of April 2020, the Institute 

for Safe Medication Practices (ISMP) has received 

reports of COVID-19-related medication errors (ISMP, 

2020). One error involved a redeployed OR nurse who 

administered the wrong type of inhaler after failing to 

engage unfamiliar barcode medication administration 

technology (ISMP). Other missed dose errors have 

been reported due to communication failures between 

nurses and respiratory therapists (ISMP). 

To prevent medication errors and other adverse 

outcomes, nurses pulled to an unfamiliar unit should 

be oriented to the patient population, technologies, 

processes, and medications typically used on the 

newly assigned unit (ISMP, 2020). Nurses should also 

employ communication techniques such as a doublecheck/“check 

back” to verify they understand all 

verbal orders and instructions (AHRQ, 2020). 

3) Preparing to accept unfamiliar assignments 

Nurses are at the forefront of this public health 

crisis — treating, educating, and preventing the spread 

of COVID-19. As the pandemic continues to evolve, 

nurses may be given patient assignments outside 

of their accustomed practice areas and locations. 

No circumstances change nurses’ obligation to 

practice ethically, but nurses should be aware of their 

employers’ protocols for protecting nurses operating in 

extreme conditions and scarcities, and to ensure that 

the public receives the most adequate treatment and 

care possible in the situation. 

With so much still unknown about the 

coronavirus, it’s also important for nurses to be 

aware of the steps they can take if they do not 

feel equipped to handle an assignment. When the 

assignment is within a nurse’s scope of practice 

but not within their realm of experience or training, 

ParentingMontana.org [parentingmontana.org] is an 

online resource that offers tools to Montana parents 

and those in a parenting role to help them raise 

healthy, successful children. The tools grow social 

and emotional skills by addressing common parenting 

challenges like confidence, chores, routines, and 

homework. 

Stress management, self-motivation, 

communication, teamwork, problem-solving, and 

ethical responsibility are social and emotional skills. 

Social and emotional skills are essential for people’s 

success in school, work, and relationships. These skills 

saying “no” could lead to dismissal. In these 

scenarios, nurses need to share their concerns with 

their supervisor. Nurses should describe the task or 

assignment they don’t feel equipped to handle, the 

reason for their feelings, and the training they would 

need to be more confident and better prepared. 

Speaking up can lead to positive outcomes for 

nurses and patients. 

These are trying times for health care workers. 

Being aware of potential risks helps nurses take steps 

to protect themselves as they care for others. 

References 

Agency for Healthcare Research and Quality [AHRQ]. (2020, 

January: last review). Pocket Guide: TeamSTEPPS®. 

Team strategies & tools to enhance performance 

and patient safety content. https://www.ahrq.gov/ 

teamstepps/instructor/essentials/pocketguide. 

html#checkback 

Benner, P., Sheets, V., Uris, P., Malloch K., Schwed K., 

& Jamison, D. (2002). Individual, practice, and 

system causes of errors in nursing: A taxonomy. 

Journal of Nursing Administration, 32, 509-523. doi: 

10.1097/00005110-200210000-00006 

Brady, A.-M., Malone, A.-M., & Fleming, S. (2009). A 

literature review of the individual and systems factors 

that contribute to medication errors in nursing practice. 

Journal of Nursing Management, 17, 679-697. doi: 

10.1111/j.1365-2834.2009.00995.x 

Choo, J., Hutchinson, A., & Bucknall, T. (2010). Nurses’ role 

in medication safety. Journal of Nursing Management, 

18, 853-861. doi.org/10.1111/j.1365-2834.2010.01164.x 

Institute for Safe Medication Practices (ISMP). (2020, May 

14). COVID-19-related medication errors. https://www. 

ismp.org/resources/covid-19-related-medication-errors. 

Saintsing, D., Gibson, L. M., & Pennington, A. W. (2011). 

The novice nurse and clinical decision-making: How to 

avoid errors. Journal of Nursing Management, 19, 354- 

359. doi.10.1111/j.1365-2834.2011.01248.x 

The Joint Commission [TJC]. (2013). Sentinel event data: 

Root causes by event type, 2004 – June 2013. https:// 

www.medleague.com/wp-content/uploads/2013/11/ 

Root_Causes_by_Event_Type_2004-2Q2013.pdf 

This risk management information was provided 

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

largest provider of nurses’ professional liability 

insurance coverage for over 550,000 nurses since 1976. 

Reproduction without permission of the publisher is 

prohibited. For questions, send an e-mail to service@ 

nso.com or call 1-800-247-1500. www.nso.com. The 

author may be reached at Georgia.Reiner@aon.com. 

are associated with better behavior, lower emotional 

stress, and positive wellbeing. 

ParentingMontana.org emphasizes that 

parents and those in a parenting role have a 

significant influence on their children and can 

create environments to help their children develop 

social and emotional skills in everyday life. 

ParentingMontana.org provides ways for parents and 

those in a parenting role to teach and practice the 

skills with their children. 

Learn more at ParentingMontana.org.


Procedures for Objecting Non-Members to File With MNA 

Objections as to the Expenditures of Dues for Purposes 

Not Germane to Collective Bargaining Process 

This notice is for all employees working under a Montana Nurses’ 

Association collective-bargaining agreement that contains a union security 

clause. A union security clause requires, as a condition of employment, that 

an employee pay MNA membership dues and fees. MNA membership is a 

valuable asset for working nurses. 

Federal and state labor laws grant employers and union the right to enter into 

agreements requiring workers to join and maintain their membership in a union 

as a condition of employment. This right is consistent with the democratic 

principle of majority rule and it ensures that everyone who benefits from a 

union’s representation shares the union’s financial support. 

Over the years, the courts and administrative agencies that enforce the labor 

laws have limited the enforcement of union security clauses. Specifically, the 

U.S. Supreme Court has held that individuals covered by a collective-bargaining 

agreement containing a union security clause may not be required to join the 

union and may only be required to pay that percentage of full union dues and 

fees that are germane to the collective bargaining process. In other words, 

workers can be required to financially support a union but they cannot be 

required join the union and they can only be required to pay that percentage of 

Awe Kualawaache 

Care Center 

Where History and Healing come together 

HIRING LPNs & RNs 

Sign on Bonus! 

Awe Kualawaache Care Center located across from 

the Big Horn Battlefield. We offer not only a career 

but culture and caring. 

We hire people, not resumes. 

But we also expect excellence, 

which is why we require: 

• Graduate of an accredited school of nursing, required 

• Bachelor of Science in Nursing (BSN), preferred 

• Current/valid R.N.or L.P.N. license from the state licensing 

board, required 

• Current BLS endorsed by the American Heart Association or 

ACLS certification, required 

• Minimum of one (1) year of related experience. 

To learn more or to download an 

application visit: akcc2.org 

Awe Kualawaache Care Center | 10131 South Heritage Lane 

Crow Agency, MT 59022 | 406-638-9111 

the union’s customary dues and fees that is germane to the union’s role as the 

collective-bargaining representative. 

MNA spends the vast majority of its funds on activities related to the 

representation of its members. These expenditures are considered to be 

germane to the collective-bargaining process and must be paid for by all 

individuals working under MNA contracts containing union security clause 

language. MNA also has spent funds on activities such organizing new 

bargaining units and legislative lobbying. MNA believes that money spent on 

these activities advances one of our fundamental purposes – nurses helping 

nurses to better their lives. However, the U.S. Supreme Court does not 

consider these activities to be germane to the collective-bargaining process. 

Employees employed under a contract containing a union security clause 

who choose not be join MNA or who resign their membership from MNA lose 

benefits, rights and privileges to which they would have been or were entitled to 

as MNA members. For example, these employees lose the right to vote on the 

acceptance of agreements negotiated with their employer, the right to vote on 

any dues increase, and the right to run and vote in the election of MNA officers. 

They lose the right to attend, speak and vote at any MNA meeting. 

In short, non-members elect to give up important rights, benefits and 

privileges. Moreover, it is illegal for an employer to compensate such workers 

in any way for the loss of these valuable rights. However, non-member are 

still members of the collective-bargaining unit in which they work, they are 

entitled to the benefits of the collective-bargaining agreement covering their 

employment and MNA and its officers and employees will provide them with the 

representation required by the law. 

Individuals employed under a union security clause maintain the right 

to object to being a member of MNA and may resign their membership at 

any time. However, those who either object to ever being a member or who 

were once members and then later resign must pay MNA an amount equal 

to the percentage of dues paid by members of MNA which are germane to 

collective bargaining process. That percentage includes the expenditures 

necessarily or reasonably incurred for the purpose of performing the duties 

of an exclusive representative of the employees in dealing with the employer 

or labor-management issues including not only the direct costs of negotiating 

and administering collective-bargaining contracts and of settling grievances 

and disputes, but also the expenses of activities or undertakings normally or 

reasonably employed to implement or effectuate the duties of MNA as the 

exclusive representative of the employees in a bargaining unit. The percentage 

of nonchargeable expenses for MNA which will be effective for the months of 

January 2021 through December 2021 is based on the experience from the 

2019 calendar year. In other words, those who are covered by a collectivebargaining 

agreement containing a union security clause and who elect not 

be members and who elect to pay the reduced fee must pay the fair share 

percentage of the dues assessed members of MNA employed in the same 

bargaining unit. 

In addition to other avenues of relief available under the law, a non-member 

may challenge MNA’s classification or calculation of expenditures used by MNA 

to determine the percentage of chargeable expenses germane to the collectivebargaining 

process before a neutral arbitrator appointed by the American 

Arbitration Association pursuant to its Rules for Impartial Determination of 

Union Fees. Any objection a non-member makes may be coordinated or 

consolidated with other objections from other non-members before a single 

arbitrator. 

In such a challenge, MNA has to justify its calculations and determinations. 

All hearings will be conducted in Helena or Clancy, Montana. The arbitrator’s 

fees and expenses will be paid by MNA. However, an objector will have to pay 

for his or her own expenses and the fees, costs and expenses of his or her 

witnesses and attorneys. 

Once a written objection is received from an individual, MNA will adhere 

to the rules established by the courts and by the administrative agencies 

that enforce the labor laws as to the handling of the objector’s fees until the 

arbitrator has issued his or her ruling. Generally, the objector must pay the 

fees as determined by MNA’s calculations. Those fees will be placed in a 

separate interest bearing account. If the arbitrator’s decision increases the 

percentage of non-chargeable expenditures, the appropriate portion of the 

fees will be refunded to the objector, plus interest earned. All reduced service 

fee payers will then pay the adjusted amount as determined by the arbitrator. 

If the arbitrator’s decision approves the MNA’s calculation, no adjustment will 

be made in the amount of the fee and the total fees paid and placed in the 

separate interest-bearing account will be released to MNA. 

Individuals who choose to file objections to MNA’s fee calculations must 

file the objection in writing addressed to MNA, 20 Old Montana State Hwy, 

Clancy, Montana 59634. The written objection must include the objectors 

name, address, phone number, social security number, employer and work 

location. In order for MNA to understand the nature of the objector’s challenge, 

the objector is urged to also include a brief statement concerning the nature of 

the objection, including the objector’s opinion as to the appropriate percentage 

for non-chargeable expenses. This requirement to file a letter of objection and 

request for a hearing is an annual requirement. Objection will not be presumed. 

Agency fee payers who do not file a timely notice of objection shall be deemed 

to have waived any right to a hearing to challenge the estimated percentage of 

reduction of that year’s agency fee.


Montana Vaccinations Update: More than 33,000 healthcare 

personnel in Montana have received their first dose 

Montana has begun implementing the state’s 

COVID-19 vaccination distribution plan beginning with 

Phase 1a. Progress is being made daily. 

Montana’s Updated Vaccine Recommendations 

On January 5, 2020, Governor Gianforte 

announced at a press conference the updated 

COVID-19 Vaccine Allocation Recommendations. The 

Governor has prioritized protecting Montana’s most 

vulnerable, putting our seniors and those with severe 

underlying medical conditions next in line for the 

vaccine in Phase 1b. 

Vaccine distribution is occurring in phases 

beginning with Phase 1a, which focuses on health 

care workers as well as staff and residents of long 

term care facilities. Phase 1a also includes healthcare 

workers with direct patient contact, such as dentists, 

orthodontists, physical therapists, optometrists, home 

health workers and others that fit the criteria. 

As of January 8, 2021, more than 33,000 doses 

have been administered to Montana health care 

personnel since it first became available the week 

of December 14. This includes frontline healthcare 

workers all across Montana. 

Deanna Hastings, MN, RN, CNL 

MSU Nursing Faculty and PhD Student 

University of Arizona 

The politically charged events in today’s current 

climate, along with the climbing costs of healthcare 

illuminates the need for ethical and reliable research. 

This need has created opportunities for nurse 

scientists to bring their collective knowledge forth to 

help inform decisions, decrease costs, and improve 

patient outcomes with integrity. Furthermore, nurses 

are in a unique position to contribute as they have a 

holistic perspective on utilization of evidence in clinical 

decision making, and the ability to not just accept 

things for what they are. 

Nurse Scientists 

Nurse scientists are PhD prepared nurses who 

are trained to help “bridge the gap between practice 

and research” (Brant, 2015, p. 298). They bring their 

clinical experience and knowledge to collectively 

evaluate research, current practices, and patient safety 

to influence policy and procedures. Nurse scientists 

identify research questions, design and conduct 

scientific studies, collect and analyze data, and 

report their findings. Nurse scientists act as mentors, 

cheerleaders, and educators, and lead research 

activities, to solve clinical problems. Nurse scientists 

often partner with scientists in other fields, such as 

pharmacy, nutrition, medicine, and engineering, to 

better address complex questions and problems. In 

filling these roles nurse scientists help contribute to the 

healthcare field by disseminating trustworthy research 

findings, supporting evidence-based practices at the 

bedside, and collaboratively contributing to policy. 

These contributions in turn assist with decreasing 

healthcare costs, improvement of patient outcomes, 

and consumer education and decision making. 

The current pandemic has shown how political 

influences and public perceptions impact research 

practice and implementation of interventions, along 

with demonstrating the importance of conducting 

honest and trustworthy studies. Due to the unknowns 

of the COVID-19 virus along with the negatively 

charged Presidential Election, there has been a 

creation of skepticism and/or distrust of scientific 

rationale from the public’s perception. Gone are 

the days that one trusts and believes in something 

because they are told to. Unfortunately, the desire 

to alter results or financially contribute to research 

to fabricate data to fit personal agendas, has also 

contributed to a distrust in science. Now, more than 

ever, the public wants to see the evidence to support 

The updated recommendations for Phase 1b 

includes those age 70 years and older, American 

Indians and other people of color who may be at 

elevated risk for COVID-19 complications, and persons 

aged 16-69 with high risk medical conditions. See 

the link above for the full list of qualifying medical 

conditions. 

Phase 1c includes frontline essential workers, 

persons aged 60 years and older, individuals living in 

congregate care and correctional facilities, persons 

aged 16-59 with medical conditions not included in 

Phase 1b that may have elevated risk of COVID-19 

complications. 

Phase 2 is the final phase for all remaining 

Montanans aged 16 or older. 

Vaccine Allocation Update 

So far, more than 52,000 vaccine doses have been 

shipped to the state and we are slated to receive 

another 41,000 doses in the coming weeks. 

These numbers are updated regularly on the 

DPHHS website, and soon a dashboard will be 

launched with expanded vaccine allocation data. Stay 

tuned! 

The Role of Nurse Scientists 

in Uncertain Times 

the claims being made. If there was ever a time 

for honest, accurate, trustworthy, and transparent 

research in order to rebuild trust within an important 

field, it is now. According to a recent Gallup Poll, 

nurses were ranked for the 15th year in a row with the 

highest honesty and ethical standards above all other 

healthcare professionals, by the US public (Norman, 

2016). 

Nurse scientists recognize their responsibilities 

and contributions to the research field. These 

responsibilities include: “understanding misconduct, 

falsification, fabrication, and plagiarism” (Ulrich, et al., 

2015, p. 171). They also include following ethical and 

professional codes of conduct with integrity while 

maintaining patient confidentiality. In summary, nurse 

scientists have an integral role in implementing and 

disseminating research findings into practice. They can 

holistically contribute to the collaborative approach to 

influencing policy, procedures, and research practices 

in order to improve patient safety and outcomes, 

education, and healthcare costs. 

References 

Brant, J.M. (2015). Bridging the research-to-practice gap: 

The role of the nurse scientist. Seminars in Oncology 

Nursing, 31(4), 298-305. http://dx.doi.org/10.1016/j. 

sonen.2015.08.006 

Norman, J. (2016). Americans rate healthcare providers 

high on honesty, ethics. Social and Policy 

Issues. https://www.google.com/url?q=https:// 

news.gallup.com/poll/200057/americans-ratehealthcare-providers-high-honesty-ethics. 

aspx?g_source%3DSocial%2520Issues%26g_ 

medium%3Dlead%26g_campaign%3Dtiles&sa=D 

&ust=1610432848158000&usg=AOvVaw22t0_77- 

s4jXnAabnmtZJ6 

Ulrich, C.M., Wallen, G.R., Cui, N., Chittams, J., Sweet, M., 

& Plemmons, D. (2015). Establishing good collaborative 

research practices in the responsible conduct of 

research in nursing science. Nursing Outlook, 63(2), 

171-180. http://dx.doi.org/10.1016/j.outlook.2014.10.007 

NEED EXTRA INCOME? 

Apply online at: www.montanahealthnetwork.com 

or contact David Perry, RN - Staff Coordinator/Director of Nursing Services 

406-852-6361 or 406-228-8044 | contact@montanahealthnetwork.com 

In addition, vaccine distribution to long term care 

facilities (including nursing homes and assisted 

living facilities) has begun. Efforts to vaccinate staff 

and residents in these facilities began on 12/28 and 

vaccination efforts have been initiated in approximately 

54 facilities. 

The Department of Public Health and Human 

Services (DPHHS) is working with local county and 

Tribal health departments, pharmacies, hospitals, 

and community health centers across Montana to 

distribute the vaccine. To date, DPHHS has enrolled 

approximately 200 providers who, as part of that 

enrollment, are trained on how to store, handle and 

administer the vaccine. As more vaccine becomes 

available, these providers will have the ability to receive 

and administer the vaccine. 

Communications 

DPHHS is planning to expand its website and 

launch a public service announcement campaign for 

the public to learn more about the vaccine, as well as 

when and where they can get it. DPHHS will produce 

TV, radio, and print media products. 

Additional Resources 

• DPHHS has launched a vaccine-specific 

website with an FAQ. DPHHS will continue to 

add more info as it becomes available. https:// 

dphhs.mt.gov/publichealth/cdepi/diseases/ 

coronavirusvaccine 

• The COVID-19 information phone line and email 

continue to be a resource for Montanans with 

questions. The phone line is 1-888-333-0461 

and email is covid19info@mt.gov. 

Contact: Jon Ebelt, Public Information Officer 

406-444-0936/jebelt@mt.gov. 

Great Falls College MSU is seeking a part-time Nursing Faculty 

member to join the team for our Nursing Programs (ASN and PN). 

BSN required, MSN preferred, State of Montana RN licensure, and 

two years of experience required. 

Excellent benefits package • Summers and Holidays off 

Learn more about our 

Nursing Programs at: 

gfcmsu.edu/webs/nursing/ 

To Apply Online, please visit: 

jobs.gfcmsu.edu 

Disabled/AA/EEO/Vet Preference Employer


Montana Provider Orders for Life-Sustaining Treatment 

(POLST) Update 

Amanda Lucas, DNP, APRN-CNS, ACHPN & 

Kathryn Borgenicht, M.D., FACP, CHMD 

In the era of modern medicine, opportunities 

to sustain life through cutting edge technology 

and medicines abound. However, for a growing 

population of frail, chronically or seriously ill 

individuals, such heroic life-supportive measures 

may not be medically beneficial or desired by 

the patient or medical surrogate. The Provider 

Orders for Life-Sustaining Treatment (POLST) is 

a medical order intended to define an individual’s 

preferences around cardiopulmonary resuscitation, 

levels of care like intubation or hospitalization, and 

the use of artificial nutrition. When a medical crisis 

occurs and the patient cannot convey medical 

preferences, the POLST is an actionable and 

portable medical order that directs healthcare 

personnel across care settings. The POLST may 

exist in different forms or under varying names in 

other states, but the concept is nearing 30 years in 

Montana practice, as it derived from the Comfort 

One movement that began in the 1990s. In 2019, 

a statewide Palliative Care Alliance reviewed the 

latest literature and compared the Montana POLST 

to recommendations from the National POLST 

Paradigm. The resulting September 2019 revision of 

the Montana POLST was endorsed by the Board of 

Medical Examiners. 

Here are a few key points we ask you to 

remember and convey to other members of the 

healthcare team. Additional information and a 

downloadable Montana POLST may be obtained at 

the Montana Department of Labor & Industry, Board 

of Medical Examiners website www.polst.mt.gov. 

Beneficial videos, stories and patient advance care 

planning resources are available at the National 

POLST Paradigm at www.polst.org. 

1. What was changed on the most recent 

POLST revision and are older documents 

still valid? Yes, older documents remain valid 

until care changes necessitate a new POLST. 

The new POLST wording was changed to stress 

commonly misunderstood areas. These include: 

o Section A: Cardiopulmonary Resuscitation 

(CPR)- is for the person who has NO pulse 

and is NOT breathing. Selecting NO CPR 

in this section indicates allow natural death. 

For patients who are in respiratory or cardiac 

distress, but still possess a pulse and are 

breathing, Section B directs care. 

o Section B: Medical Interventions – Is 

now ordered differently beginning with Full 

Treatment, to include CPR, intubation, 

vasopressors, defibrillation and cardioversion. 

For those who WOULD desire to return to the 

hospital for care, but do not want intubation 

and generally would like to avoid invasive 

or ICU level care, Selective Treatments 

is the recommended option. Patients who 

do not desire to return to the hospital and 

who only desire comfort care, such as pain 

relief, oxygen and symptom management, 

then Comfort-focused Treatment is the 

recommended care. 

o Section C: Artificially Administered 

Nutrition - Now includes the option for no 

decision has been made, along with shortterm, 

long-term and no artificial nutrition by 

tube options. 

Competitive wages and 

benefits packages! 

Contact Bev Halter, Director of 

Human Resources at 406-759-6514. 

libertymedicalcenter.org 

Hiring LPNs, RNs 

and 

Director of Nursing 

2. If you have another advance directive form, 

do you also need a POLST? Are these 

two documents different? YES, advance 

directives and POLST are very different but 

complimentary. Advance directive forms often 

include a Living Will and Medical Power of 

Attorney, also known as a Healthcare Power of 

Attorney, and are encouraged to be completed 

by the patient in advance of a healthcare crisis. 

Evidence supports the use of patient guides 

that combine the two advance directives 

such as those found at Prepare for Your Care 

(www.prepareforyourcare.org), which has a 

Montana specific advance directive. Other 

commonly seen documents include the 

Montana My Choices Advance Directive 

( https://dojmt.gov/consumer/end-of-liferegistry/), 

and purchased documents like the Five 

Wishes (https://fivewishes.org/). When patients 

become seriously ill or frail, and have discussed 

preferences regarding life-sustaining treatments 

with their healthcare team, then the POLST is 

a recommended addition to traditional health 

advance directives. As described above, the 

POLST is an actionable, medical order for the 

healthcare team used in a crisis when the patient 

lacks decision making capacity. Unlike advance 

directives that require the patient to convey his 

own wishes about end of life and surrogate 

decision maker, then sign with two witnesses, the 

POLST may be completed on the patient’s behalf 

by a legal medical surrogate when the patient 

lacks decision making ability. For information on 

Montana’s definitions of proxy decision makers 

you may reference Montana Annotated Code 50- 

5-1301. 

3. What should happen when there is a 

disagreement between the patient’s POLST 

wishes and the wishes of surrogates or 

other family members? A patient, who has 

medical decision-making capacity, may change 

the POLST at any time, as further detailed in 

#6. When disagreements between documented 

POLST wishes and surrogate or family members 

occur, this should prompt discussion between 

those in disagreement and the healthcare team, 

with the focus remaining on patient-centered 

care. Careful discussion should include the 

patient’s ethical right to autonomy, the healthcare 

team’s assessment of treatment burdens and 

benefits, along with the family’s perspective, 

all of which must be documented thoroughly. 

To improve your skills in communication and 

conflict resolution, you could access the following 

websites: Prepareforyourcare.org, vitaltalk.org 

and ariadneslabs.org. 

4. Is a POLST form mandatory? The POLST is 

completely voluntary. Although facilities have 

state or national requirements for assessing 

resuscitation status, the completion of the POLST 

is voluntary and requires the patient to possess 

medical decision-making capacity in order to 

complete the form. If the patient is unable to 

consent for the POLST, a surrogate may sign the 

document on the patient’s behalf. For information 

on Montana’s definitions of proxy decision 

makers you may reference Montana Annotated 

Code 50-5-1301. 

5. Who signs the POLST? The POLST requires 

the patient’s signature, or as detailed in #2 

the signature of the medical surrogate when 

the patient lacks medical decision making. 

Because the document is a medical order, the 

approved medical providers who must also 

sign the document includes Montana licensed 

physicians, physician assistants (PAs) or advance 

practice registered nurses (APRNs). Licensed 

APRNs most commonly participating in POLST 

completion are nurse practitioners and clinical 

nurse specialists, but other APRNs of certified 

registered nurse anesthetist or certified nurse 

midwife are not excluded. There is a location on 

the POLST to document which other healthcare 

team members assists in the document review 

and completion. This role requires knowledge 

and skill in review of POLST components, and 

end of life discussion, but is not prescribed at the 

state level. It is strongly encouraged that those 

who engage in POLST conversations, or other 

ACP discussions and document completion, 

do undergo training to ensure quality and skill 

competency. 

6. What should happen when the patient’s 

POLST wishes change? If a prior POLST exists, 

the document should be obtained, “VOID” written 

across the front and when able signed by the 

provider, patient or medical surrogate. A new 

POLST should be completed, by all parties and 

dated, with copies distributed to involved parties 

and the original remaining with the patient. 

7. Where are POLST documents kept? The 

original POLST, which is on terra green paper, 

should remain with the patient regardless of 

the setting where care is being provided. When 

the patient is at home, the POLST should be 

kept on the refrigerator or easily accessible 

location, in a green envelope with POLST written 

across the front. State POLST envelopes are 

available through the Montana EMS and Trauma 

Systems, a division of MT DPHHS, by e-mailing 

emsinfo@mt.gov. If a patient is within a medical 

facility, organizational policy may require the 

POLST to remain on the medical record while 

the patient is receiving care within that institution. 

A POLST copy should also be shared with the 

patient’s primary care provider, frequently used 

healthcare facility, family member. 

8. Does the POLST work in other states? Each 

state has differing regulations, forms and even 

titles for the POLST. The patient should take the 

Montana POLST and other advance directives 

forms when travelling, but if spending extended 

time in other states may want to also complete 

that state’s documents. 

9. Is a copy of the POLST valid? Yes, in the absence 

of the terra green original, a copy is sufficient as long 

as it is the most recently dated and valid document. 

HIPAA regulations allow original and copies to be 

shared with other healthcare team members as part 

of continuity of care. 

10. If POLST questions arise, who should 

we contact? If questions remain after consulting 

the resources available at www.polst.mt.gov, you 

may contact either Dr. Kathryn Borgenicht at 

kborgenicht@gmail.com or Amanda Lucas, DNP, 

APRN-CNS at amandalucas@benefis.org. 

COVID-19 Conversation Resources: 

In this time in healthcare, conversations about 

medical care preferences and completion of 

POLST orders have never been timelier. As we face 

the unique challenges provided by of COVID-19, 

clinician resources for ACP conversations have 

been developed. Evidence-based resources below 

include conversation acronyms, guidance on 

wording and many include exemplar videos aimed 

to promote clinician confidence and skills. Consider 

reviewing one or more of the following: 

- Vital Talk – COVID Ready Communication 

Playbook available at https://www.vitaltalk.org/ 

guides/covid-19-communication-skills/ 

- Ariadne Labs – Serious Illness Care Program 

COVID-19 Response Toolkit available at https:// 

covid19.ariadnelabs.org/serious-illness-careprogram-covid-19-response-toolkit/ 

- Center for the Advancement of Palliative Care 

(CAPC) COVID-19 Response Resources Hub, 

Communication available at https://www.capc. 

org/covid-19/communication/ 

- Prepare for Your Care COVID-19 Resources 

available at www.prepareforyourcare.org/ 

covid-19


MEMBERSHIP 

MATTERS! 

Montana Nurses Association would like to 

invite you to join us today! 

BENEFITS INCLUDE: 

• EMPOWERING RNs TO USE THEIR 

VOICES IN THE WORKPLACE 

• IMPROVING PATIENT CARE 

• HAVING INPUT REGARDING 

WAGES & BENEFITS 

• CONTINUING EDUCATION OPPORTUNITIES 

• LEGISLATIVE REPRESENTATION 

Call or email today 

jill@mtnurses.org 

(406) 442-6710 

Applications also available on 

our website. 

mtnurses.org 

Has your contact 

information changed? 

New name? New address? 

New phone number? 

New email address? 

To update your contact information, 

please email or call 

Montana Nurses Association: 

jill@mtnurses.org or 406-442-6710

Montana Pulse - February 2021

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