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October, November, December 2014Texas Nursing Voice Page 3Letters to the EditorReject Nurse StereotypesDear Editor:I appreciate receiving TNV and read it coverto cover, and I was pleased to see the essayby Dr. Bonnie Carter on the doctor-nurserelationship (Texas Nursing Voice, Vol. 8,No. 3, July, August, September 2014). She hassome positive things to say about the teamworkbetween our disciplines. But ultimately hermessage reinforces the stereotype she claims toreject, that of doctor as lord and nurse as serf.She says, for example, that “nurses have anamazing wealth of knowledge and experience,”but then in the next paragraph goes on to saythat “the doctor may well be the brains, butthe nurse is the heart” of her family medicinepractice. What! How did that get past you?Someone there is editing submissions to theTNV. I hope that someone is a nurse.Nurses and doctors play different roles onthe team, and that is as it should be. It is thedifferences that make a team strong. Respectwill only come to nurses, however, when ourcontribution to the team is acknowledged to beequal in value to that of doctors. The problemwith Dr. Connor’s model is in the greater valueplaced on the doctor’s role. As good as Dr.Carter’s intentions clearly are, she gives herselfaway with statements like this.We have to get past the touchy-feely image ofthe nurse as an “angel in comfy shoes” if we areever to be truly respected as equal contributorsto the team. Yes, we use our hearts–and ourhands and our brains–every day as nurses. So,hopefully, do doctors.I appeal to you to use our newspaper tohighlight the role of nurses as scientists, and deemphasize this idea of our practice being drivenby heart and instinct.Ileen SelfWestworth Village, TXEditor response:We are happy nurses are reading andencourage your feedback. While I might parseDr. Carter’s intended meaning (I think the“brains” she referred to have to do with runningthe practice she owns and, after all, she doessay nurses should “stand shoulder to shoulder”with her), but I get your point. This is a age-oldtension between doctors and nurses and I thinkwe’d all agree it’s getting better, though not asfast as we’d like.P.S.I’m not a nurse, but at TNA I am surroundedby them! They read every issue before they goto print.Nurses are the heart of the hospital. That’s why we’re looking for nurseswho are dedicated and passionate about their work. We’re looking fornurses who can add to our culture of exemplary patient care and personalexcellence. We’re looking for exceptional employees.Northwest is a 475 bed system serving the city of Amarillo and thesurrounding region. We offer the ideal combination of traditional values andthe most advanced technologies in healthcare, plus the conveniences ofbig city living in a friendly, smaller-town atmosphere. From the beauty ofPalo Duro Canyon and great recreational facilities, to our quality educationalsystem, Amarillo is a great place to live and work.Seeking experienced Critical Care RN’s,Med Surg RN’s and Behavioral Health RN’s.We are also seeking RNs for all positions.To apply, please visit: www.nwtexashealthcare.comWhen you’re readyto advance.You are ready for American Public University.Expand your opportunities with a CCNEaccredited RN to BSN program. APUcan help you balance your personal andprofessional life while pursuing arespected degree online — at theuniversity that is the only 3-time EffectivePractice Award winner from theOnline Learning Consortium.Visit: StudyatAPU.com/ALDBESTONLINE PROGRAMSBACHELOR’S2014We want you to make an informed decision about the university that’s right for you.For more about our graduation rates, the median debt of students who completedeach program, and other important information, visit www.apus.edu/disclosure.

Page 4 Texas Nursing VoiceOctober, November, December 2014Meeting the Demand for RNsIn today’s highly-specialized healthcare,Registered Nurses (RNs) are leading the way inpolicy, patient care, and management. Whilethe role of nurses is evolving to meet ourchanging healthcare needs–requiring additionalpreparation and education–the shortage ofnurses is expected to continue.These two trends, occurring concurrently,offer great challenges for nurses. Together,the Texas Nurses Association (TNA) and theAmerican Nurses Association (ANA) are activelymonitoring developments and helping nurses toprepare now for future career opportunities.Job Growth ExpectedJob growth for registered nurses nationwideis projected to increase faster than any otherprofession–19 percent by 2022 according to theU.S. Bureau of Labor Statistics. Texas is the 2ndgreatest state for RN job growth in the nation. InTexas, the demand is expected to be more than50 percent with 90,000 new RNs needed by2022. This does not take into consideration thejobs opening up as nurses retire and leave theprofession.Today’s nurses are better educated andare pursuing higher education, a trend that isexpected to continue. A 2010 Robert WoodJohnson study states that half the nurses in theU.S. have four-year degrees or higher. The studyrecommends that, by 2020, 80 percent of thenurses will need higher degrees so they candeliver medical care traditionally provided byphysicians.Both TNA and ANA are here to help nursesstay informed, advance their skills and earn CEcontact hours. A few important ways that TNAand ANA are supporting nurses are throughANCC certification, leadership development,online learning and advanced education.Earn ANCC CertificationAPRNs are filling unmet needs for primarycare, especially in rural and underservedareas. The Future of Nursing: Leading Change,Advancing Health, the landmark 2010 Instituteof Medicine (IOM) report called on nurses,especially APRNs, to contribute as essentialpartners in the redesign of the nation’s healthcare system.A subsidiary of ANA, the AmericanNurses Credentialing Center (ANCC) is thecredentialing program to certify and recognizeindividual nurses in specialty practice areas.TNA and ANA members save on ANCC initialcertification and on ANCC certification renewal.TNA is also an ANCC-accredited Provider,which allows the organization to provideactivities that award contact hours.Strengthen Your LeadershipTNA and ANA nurses are leading the way.Through the ANA Leadership Institute, TNAand ANA members can access professionallydeveloped programs that draw on es. These self-paced courses will build,develop, enhance and grow your leadershipimpact.Attend Nursing WebinarsEach month, TNA and ANA members canparticipate in a free webinar and earn 1.0 CNEcontact hours (60 minute contact hour). Eachtimely topic is focused on the most importantissues impacting nursing. Recent webinarshave covered preventing patient falls, buildinga healthy work environment, navigatingmeaningful use, staffing issues and genomics.Save with the Education AllianceTNA and ANA members can continue theireducations with online degree programs–RN toBSN and BSN to MSN to doctoral programs–atmember only discounts. Participating nursingschools include: Capella University Chamberlain College Drexel University Georgetown University School of Nursing &Health StudiesIf you believe in supporting TNA’s efforts toadvance health care and protect nurses, addyour voice and support by becoming a member.Membership dues for joint membership inTNA and ANA are an affordable 15/month or 174/year. Membership includes a free monthlyNavigate Nursing webinar, a subscription to TheAmerican Nurse and American Nurse Today,savings on education programs, networkingopportunities and more.LOOKING FOR A CAREERLET US HELP YOU!WWW.NURSINGALD.COMLegal Issues?Call Joe Flores, JD, NP361.887.8670Attorneyjoeflores@gmail.com24 / 7Family Nurse PractitionerExcellent Benefits Competitive SalaryGreat Location Tuition Reimbursement AvailableFax Resume or CV To (713)554-1096 Attn. HR Serviceswww.pasadenahealthcenter.comANA’s NewPresident Takesthe Helm, LaysOut PrioritiesTNAwelcomesnew ANA PresidentPamela Cipriano,PhD, RN, NEA-BC,FA A N ! C i p r i a n owas elected at theANAMembershipAssembly on June 14to a two-year term.Here is a little moreabout PresidentCipriano and her hopes for the future of ANAand the profession.Prior to becoming ANA president, Ciprianoserved as senior director for health caremanagement consulting at Galloway Advisoryby iVantage. She also has held faculty andhealth system leadership positions at theUniversity of Virginia (UVA) since 2000.Cipriano is known nationally as a strongadvocate for health care quality, and serves ona number of boards and committees for highprofile organizations, including the NationalQuality Forum and the Joint Commission. Shewas the 2010-11 Distinguished Nurse Scholar-inResidence at the Institute of Medicine.A longtime ANA member, Ciprianohas served two terms on the ANA Boardof Directors and was the recipient of theassociation’s 2008 Distinguished MembershipAward. She acted as the inaugural editor-inchief of American Nurse Today, ANA’s officialjournal, from 2006-14, and is currently amember of the Virginia Nurses Association.Vision for the Future of ANAIn a recent conversation with The AmericanNurse, Cipriano shared her vision for ANA byoutlining three priorities for her presidency.First, she will focus on ANA’s “corestrengths,” which include: political advocacy,efforts around safe staffing and healthy workenvironments, and fighting for nurses’ rights tocontrol their profession and practice to the fullextent of their education and licensure.Second, Dr. Cipriano will lead membershipgrowth and retention. “I strongly believe in theold saying, ‘There’s strength in numbers,’” shesaid.The third priority for her first term includespositioning nurses to exert greater influencein the transformation of health care. “It’s veryimportant for ANA to make sure nurses arein prime positions and key decision-makinggroups so our voice is there at every turn,” shesaid.Finally, what does President Cipriano wantmembers around the country to keep inmind? Optimism. “We are making a number ofstrides,” she said. “We’re going to need all ofour members. if we want to truly achieve a newdirection in health care.”To read more about President Cipriano,please visit: www.theamericannurse.org

October, November, December 2014Texas Nursing Voice Page 5Robin Williams Suicide Raises Awarenessby Toni Inglis, MSN, RN, CNS, FAANLet’s imagine we’re all sitting in a roomtogether and someone says, “Raise yourhand if you love Robin Williams.” We wouldprobably all raise our hand. Then, “Raise yourhand if someone in your family or a family youknow struggles with mental illness,” we wouldprobably again all raise our hand—although withmuch more hesitation.The media’s desperate attempt to uncovera cause for his suicide—say, financial orrelationshipproblems—isastonishinglynaive. What caused Williams to end his life isunknowable, no matter how exhaustive theinvestigation. What is knowable, from mediareports, is that Williams wrestled the beast of amood disorder—depression, and the early stagesof Parkinson’s disease. And he was very openabout his struggles with chemical dependency.That’s a very dangerous cocktail.Life is full of tripwires, from the mundane tothe major. If you have a mental illness, whetherbipolar, schizophrenia, major depression,or a variety of other disorders, any of life’scircumstances can trigger an episode. We cannotknow what ignited his brain’s vulnerabilities.That’s his to know.An Aug. 11 New York Times article tells us thatWilliams was the privileged son of a Detroit autoexecutive who grew up chubby and lonesomeplaying by himself with 2,000 toy soldiers in anempty room of a suburban mansion. Oh, to havebeen a soldier in that room!Through his originality and lightningimprovisations, the way he played his roles, hiscomedic routines, we know he was a creativegenius. The feature article of the June AtlanticMonthly, “Secrets of the Creative Brain,” byneuroscientist Nancy Andreasen, sheds lighton why mental illness so often accompaniescreativity.Andreasen’s research shows that creativegeniuses like to teach themselves from an earlyage and are often misfits in the education system(think: Michael Dell, Bill Gates, Steve Jobs, MarkZuckerberg). They have many deep interests;they are highly persistent in the face of rejection;and above all, they excel at making connections.According to research done by Johns Hopkinspsychologist Kay Redfield Jamison and Harvardpsychiatrist Joseph Schildkraut, mood disordersand a strong family history of mental illness tendto occur with creative genius, especially amongwriters and painters.Hugely successful people with crushingpersonal histories: Bertrand Russell, AlbertEinstein, Sylvia Plath, Ernest Hemingway, JamesJoyce, Kurt Vonnegut, Vincent van Gogh, MarkRothko, the list goes on and on. Like Williams,many were as funny and lovable as they weretormented. They often end their own lives.The link between mental illness and thecreative genius that has made our world so muchmore livable and enjoyable is so strong that it hasbeen suggested we withhold treatment. A moresane suggestion was made recently on the PBSNewsHour by Mark Vonnegut, a pediatricianwith schizophrenia andson of Kurt Vonnegut.He suggests that we do abetter job of taking care ofeach other; that among thehomeless veterans we seemay be another Van Gogh.Robin WilliamsThere’smorethanthe abject sadness wefeel with Williams’ death. There’s also hopeand inspiration. Despite his mental illnessand chemical dependency, Williams workednonstop and was known for his reliability anddependability. And, according to the Timesarticle, he displayed none of the traits of troubledactors such as showing up late, forgetting thelines or flaring tempers. His 20 years of sobrietyafter his cocaine habit in the 1980s also isinspiring.We tend to think that suicide is rare. It is notrare. Mental illness is not rare. There is help ntionlifeline.org or afsp.org.Toni Inglis, a retired neonatal intensive carenurse, is a writer/editor with the Seton HealthcareFamily. She writes a monthly opinion column forthe Austin American-Statesman editorial page.Inglis served on the Board of Trustees of AustinTravis County Integral Care (formerly ATC MentalHealth Mental Retardation) for 13 years.

Page 6 Texas Nursing VoiceOctober, November, December 2014Hydrocodone-Combination DrugsReclassified as Schedule IIStarting October 6, hydrocodone-combinationproducts (HCPs) will be classified as restrictedSchedule II drugs, due to action by the U. S. DrugEnforcement Administration (DEA) in August andsupported by the U.S. Department of Healthand Human Services. The reclassification fromSchedule III will directly impact practitioners whoprescribe common HCP drugs, such as Vicodin,for pain management.The rule imposes more rigorous regulatorycontrols and sanctions applicable to Schedule IIsubstances on those who handle HCPs. HCPs aredrugs that contain both hydrocodone, which byitself is a Schedule II drug, and specified amountsof other substances, such as acetaminophen oraspirin.ONLINE convenience,QUALITY educationRN to BSN Online Program No CampusVisits Liberal TransferCreditsMSN Online Program Classes That FitYour Schedule CompetitiveTuitionBSN-LINC: 1-877-656-1483 or bsn-linc.wisconsin.eduMSN-LINC: 1-888-674-8942 or uwgb.edu/nursing/msn5016 South US Hwy 75, Denison, TX903-416-4050To view current job opportunities, please visitwww.texomamedicalcenter.net Written prescriptions are required forSchedule II drugs, except for limited,short-term quantities under emergencycircumstances with no refills. Refills may not be called into the pharmacy. Prescriptions are restricted to three for amaximum of a 90-day supply (in contrast toSchedule III drugs, which allow for up to fiverefills in a six month period). Prescriptions issued before October 6,2014 that are authorized for refills may bedispensed, as long as dispensing occursbefore April 8, 2015.“Almost seven million Americans abusecontrolled-substance prescription medications,including opioid painkillers, resulting in moredeaths from prescription drug overdoses thanauto accidents,” said DEA Administrator MicheleLeonhart, “This action recognizes that theseproducts are some of the most addictive andpotentially dangerous prescription medicationsavailable.”We Offer 18 Online AccreditedCertificate Programs including: Anticoagulation Case ManagementCome join ateam you canbelieve in.Implications of the change include: Clinical Simulation Health Promotionsand Worksite Wellness Heart Failure Neuroscience (Coming Soon) Diabetes Pain Management Health Informatics Wound ManagementSeeking RNs & LPNs for civilian employment to care for themilitary beneficiaries of the Greater Fort Riley area.Federal benefits and retirement are available.PLUS: online degree programs RN-BSN, MSN, DNPEducation in Your Own Time and 84At Texoma Medical Center, we understand that what matters mostto our patients is access to safe and effective care. That’s why eachof us makes a daily commitment to achieving the best possibleoutcome for every patient.D14-111193 ICU RNs - License, BLS & 1 yr exp. required Primary Care LPNs - License, BLS & 1 yr exp. required785-240-JOBS (5627) obs.comLovewhatyou do.Come join our team atHuntsville Memorial HospitalSIGN ON BONUS for experienced RNsRN positions available in most areasNEW Seasonal Program – 13 week commitmentEarn up to 48.00 per hour anda 1,500 Completion Bonus(* 44.00 Base Rate Shift Differentials – if applicable)Touch a life, share your compassion andmake a difference to those in need. Be apart of a team that believes in the principlesof Christian service, clinical excellence andhealthy communities. Come join our ministryand love what you do.** Must Meet All Requirements During 13 Week CommitmentApply at covenanthealth.orgFor more information, please log on to our website atwww.huntsvillememorial.comfor a complete list of open positions and to apply.Protect Your License!If you have received: Letter of Investigation from theTexas Board of Nursing Notice of Peer ReviewExceeding expectations since 1927.Joyce Stamp LillyCall today, delay is not an option!Contact Joyce Stamp Lilly RN JD713-759-6430 orjslilly@nurse-lawyer.comRegistered Nurse and Attorneywww.nurse-lawyer.com

October, November, December 2014Texas Nursing Voice Page 7Look Again at Delegation PracticesOFFERED BY THE AMERICAN NURSES ASSOCIATIONRN toMSNI CAN’TAFFORD AMALPRACTICELAWSUIT. BUTI CAN AFFORDMALPRACTICEINSURANCE.Advancing Your NursingCareer Just GotEasierFor about the cost of a year’s worthof scrubs, you can get a year’s worthof protection from malpracticelawsuits—with malpractice coverageoffered by the American NursesAssociation (ANA).FIVE SETS OF SCRUBS 120 - 200ANNUAL PREMIUM FOR THEMALPRACTICE INSURANCEOFFERED BY THE ANAAs low as 98**Please contact the program administrator for more information,or visit proliability.com for a free quote.YOU MAY QUALIFY FOR ONE OFTHESE FOUR WAYS TO SAVE! Attend four hours of approved loss prevention/loss control/risk management seminarsYou will receive a10% premium creditif you complete orparticipate in one ofthe following!Concordia University Texas is proud to offeronline MSN degree options for all nurses Hold an approved certification Employment at a Magnet Hospital Employment in a unit that has received the Beacon Award for ExcellenceNOT AN ANA MEMBER?Visit www.nursingworld.org for more info!Get the protection you need—without paying more than youneed. To take advantage of special rates for ANA members,visit proliability.com/65691 for an instant quote and to fillout an application. Or call 800-503-9230.Complete Concordia’s RN to MSN degreeprogram or their standalone MSN program.*Benefits for each include: An accelerated program with just four semesters of nursing courses Convenient and flexible online format perfect for working students Improve job opportunities, salary, and nursing skills*Concordia also offers a stand-alone online MSN programfor students already having their baccalaureate degree.*Please contact the program administrator for more information, or visit proliability.com for a free quote.09291465691 Copyright 2014 Mercer LLC. All rights reserved.Underwritten by Liberty Insurance Underwriters Inc.,a member company of Liberty Mutual Insurance. 55 Water Street, New York, NY 10041Administered by: Mercer Consumer, a service of Mercer Health & Benefits Administration LLCIn CA d/b/a Mercer Health & Benefits Insurance Services LLCAR Ins. Lic. #303439 CA Ins. Lic. #0G39709Discover how to becomea leader in nursing atConcordia University Texas!Visit us atonline.concordia.edu/texasnurse(844) 289-2891 Email: online@concordia.edu

Page 8 Texas Nursing VoiceOctober, November, December 2014REGISTER NOW and find out more at texasnurs

Registered Nurse (RN) and the client, leveraging the knowledge the RN has regarding the unique client as the care environment changes and care delivery requires delegation of selected nursing tasks. Understanding what the general term "delegation" means and fully grasping the scope of delegation are two very different things. The