May, 2014 Volume 23 Number 2 Nevada RNFORMATION

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May, 2014 Volume 23 Number 2www.nvnurses.orgNevada RNFORMATIONTHE OFFICIAL PUBLICATION OF THE NEVADA NURSES ASSOCIATIONThe Nevada Nurses Association is a constituent member of the American Nurses AssociationFree to All Registered Nurses, Licensed Practical Nurses, & Nursing Students in Nevada: Quarterly Circulation 32,000Glaring Disparities in HealthcareA call for nursing advocacy and leadership. Page 10Lateral Violence in HealthcareEnvironmentsTechniques and tools for dealing with this epidemic.Page 14Ethnic Disparitiesin HealthHappyNursesWeekNurses Day Mixer in Las VegasMay 6, 5-7 p.m., Cprato@aol.com for detailsSex Trafficking and the GameReno, May 30, 2-5 p.m.www.nvnurses.org for detailsNNA State ConventionNovember 16-18, 2014, Tropicana Las Vegas,3801 Las Vegas Boulevard South,Las Vegas, NV 89109Nurses Day at the LegislatureFebruary 25, 2015. Registration opens in AugustFor more information, visit www.nvnurses.orgPresort StandardUS PostagePAIDcurrent resident orPermit #14Princeton, MN55371How do you assess andmeet the unique needsof each of Nevada’sethnic groups?

Page 2 nevada RNformationMay, June, July 2014NNA Mission StatementThe Nevada Nurses Association promotes professional nursing practicethrough continuing education, community service, nursing leadership, andlegislative activities to advocate for improved health and high quality healthcare for citizens of Nevada.NNA State Board of DirectorsScott Lamprecht, DNP, MSN, RN, scott@cmcnevada.org . . . . . . . . . PresidentElizabeth Fildes, EdD, RN, CNE, CARN-AP, drfildes@aol.com . . . Vice-PresidentNicola Aaker, MSN, MPH, RN, CNOR, PHCNS-BC, naaker@aol.com . SecretaryPat Alfonso, RN, BSN, MN, APN, patriciahalfonso@hotmail.com . . . TreasurerHeidi Johnston, MSN, RN, CNE, heidi.johnston@gbcnv.edu . . Director at LargeMary Brann, DNP, MSN, RN, mary.brann@tun.touro.edu . . . Director at LargeSusan Growe, MSN/Ed, RN, OCN, susan.growe@nsc.edu. . . Director at LargeJean Lyon, PhD, RN, Jeanclyon@cs.com. . . . . . . . . . . . . . President, District 1Dave Tyrell, BSN, RN, Dave.Tyrell@umcsn.com . . . . . . . . President, District 3Teresa Serratt, PhD. RN, tserratt@unr.edu . . . . . Northern Legislative Co-ChairKatherine Cylke, DNP, RN, mcylke@cox.net. . . . . Southern Legislative Co-ChairWe salute allnurses duringNational NursesWeek andappreciate theirdedicated serviceEditorial BoardActing Editor: Kathy Ryan, MSN, RN-BC   nvnursesassn@mvqn.netMargaret Curley, RN, BSNJohn Buehler Garcia, RN, BSNEliza J. Fountain, RN, BSNWallace J. Henkelman, Ed.D, MSN, RNMary Baker Mackenzie, MSN, RNJohn Malek, PhD, MSN, FNP-CBetty Razor, RN, BSN, CWOCNDenise Rowe, MSN, RN, FNP-CDebra Toney, PhD, RNChristy Apple Johnson, RNAre you interested in submitting an article for publicationin RNFormation? Please send it in a Word document to usat nvnursesassn@mvqn.net. Our Editorial Board will reviewthe article and notify you whether it has been accepted forpublication. Articles for our next edition are due by March 1, 2014.If you wish to contact the author of an article published inRNFormation, please email us and we will be happy to forwardyour comments.www.nvnurses.orgPublished by:Arthur L. DavisPublishing Agency, Inc.CORRECTIONIn our February 2014 issue, the contact web address forACTIONN (Acting in Community Together in OrganizingNorthern Nevada) should be www.actionn.org/Earn 90K, Plus Health and Dental, 401K/Profit SharingAmerican Medflight is Nevada’s largest and most experienced twin engine fixed wing air ambulancecompany and is seeking a Registered Nurse with 3 years Critical care ICU or ER experience. Must haveACLS, PALS and Trauma Certificates. Flight Experience is preferred, but not required. We will Train.Possession of a Nevada EMS-RN license is required prior to performing duties in our aircraft. AmericanMedflight is an employee owned company (ESOP).Please send resume to srule@americanmedflight.com or mail to:American Medflight; PO Box 10166, Reno, NV 89510.BECOME AHEALTHCAREPARTNER TODAY.Congratulations to our teammates Patti Berry, Jamie Simmons and Judith Stephens.These nurses were recently honored during the 2013 March of Dimes: Nurse of theYear event. HealthCare Partners Medical Group, one of the largest physician groupsand affiliate networks in Southern Nevada, is seeking quality health care providers tojoin our team who offer top-of-the-line care in order to meet the growing medical needsof the community.For more information, visit us online at hcpnv.com. Winner, Managed CareJamie Simmons, LPNWinner, 2013 Distinguished Nurse of the YearPatti Berry, RN, BS, CPUR, CMCN, CCMRunner-up, Managed CareJudith Stephen, RN

May, June, July 2014Nevada RNformation Page 3In this issuefocus510Ethnic Disparities in CervicalCancer11Health Disparities in ProstateCancer5Diversity in Nursing Educationarticles18Diabetes in Children12 Ethical Knowledge1313How Can Nurses Stay Fit?14Lateral Violence in HealthcareEnvironments6Nevada Action Coalition19Nevada Nurses Association DistrictOne - Scholarship Opportunities8Radon - A Real Health Risk forNevadans: Protecting Yourself andYour Family16Strategies for Teaching EvidenceBased Practice in BaccalaureateNursing Education: A ConstructivistModelregular features15Avoid Malpractice and Protect YourLicense: Retaliatory and FraudulentComplaints7Check it Out!4Message from President ScottLamprecht14“Perhaps when cultural assessment is combined with genetic assessment, thiscould be the beginning of culturally holistic care.” NNA President, Dr. Scott Lamprecht

Page 4 nevada RNformationMay, June, July 2014the president’s cornerCulturally Holistic CareScott Lamprecht, DNP, RN, APNPresident, Nevada Nurses AssociationCultural Competence. These are two words that are essential to nursingand modern healthcare. Nursing recognizes culturally competent careas being care that integrates a patient’s values, beliefs, and traditions.Culture is with us everywhere we are and in everything we do, and shapesour behaviors. Given these aspects, understanding the impact of cultureon the individual is essential to providing high quality care. Althoughculture influences our behaviors, it is also important to remember geneticdifferences. People with Mediterranean ancestry have higher incidencesof Thalassemia or Familial Mediterranean Fever. Individuals from EasternEurope tend to have potentially higher cholesterol levels. Certain typesof skin cancers have a higher prevalence in some skin colors and a lowerincidence in others. African Americans have a higher incidence of kidneydisease and lower glomerular filtration rates due to differences in geneticmakeup. Culturally competent care needs to not only recognize andrespect beliefs and values, but be mindful of differences that can lead todisease prevention/earlymanagement. The earliera condition is detected thesooner intervention canbegin. Perhaps when culturalassessment is combined withgenetic assessment, thiscould be the beginning ofculturally holistic care.If you would like to contact NNA or President Lamprecht, pleasecall 775-747-2333 or email nvnursesassn@mvqn.net.People to People Ambassador ProgramsLooking to mix personal and professionaleducation with travel? There are uniqueopportunities waiting for you in People to PeopleAmbassador Programs. The programs, offeredon seven continents, are the result of PresidentDwight Eisenhower’s belief “that peaceful relationsbetween nations require mutual respect betweenindividuals.” This mutual respect may be achieved,in part, through personal interactions thatfacilitate cultural understanding and promotepeace.The programs offer travel itineraries forprofessionals in business, education, law,medicine, and science and technology, and mayinclude cultural activities, educational seminars,and humanitarian projects. This year, mentalhealth practitioners, nurse executives, and nursingprofessionals can travel to Costa Rica or Cuba toshare knowledge and experience.The programs’ website includes detailed travelitineraries, a discussion of health and safetyconcerns, and suggestions for funding travel.For more information, please visit: http://citizens.peopletopeople.comUNIVERSITY OF NEVADA, RENOOrvis School of Nursingwww.unr.edu/nursingB.S. in NursingRN to BSNM.S. in NursingFamily Nurse PractitionerNurse EducatorClinical Nurse LeaderAdult Gerontology Acute Care Nurse Practitioner(Opening Fall 2014)DNP (Doctor of Nursing Practice)*University of Nevada, RenoStatewide Worldwide*The DNP program is a collaborative program with UNLV. Students admitted through UNR for this programhave their DNP degree conferred by UNR.

May, June, July 2014Nevada RNformation Page 5Diversity in Nursing EducationW. Henkelman, EdD, MSN, RNNevada Career InstituteAn important aspect of addressing diversity in our patient populationsinvolves encouraging diversity among the members of our profession.Currently, the U.S. nursing workforce includes the following minorityrepresentations: 5.8% Asian/Pacific Islander, 5.4% Black/African American,3.6% Hispanic/Latino, and 0.3% American Indian/Alaskan Native. Thiscompares to a total population representation of 4.8% Asian/Pacific Islander,12.2% Black/African American, 15.4% Hispanic/Latino, 0.8% AmericanIndian/Alaskan Native (AACN, 2010). All groups except Asian/Pacific Islandersare therefore significantly under-represented in the nursing profession. Mencomprise 6.6% of the nursing profession while 49% of our total population ismale.Nursing schools are the obvious place to address the problem. Accordingto the American Association of Colleges of Nursing (AACN), students ingeneric BSN programs were 8.8% Asian/Pacific Islander, 10.3% Black/AfricanAmerican, 7.0% Hispanic/Latino, 0.5% American Indian/Alaskan Native(AACN, 2012). Healthy People 2010 goals included increasing the numberof degrees awarded in all of the health professions to 13% Black/AfricanAmerican, 12% Hispanic/Latino, and 1% American Indian/Alaskan Native.Minority GroupTotalCurrentPopulation NursesBSNStudentsAsian/Pacific Islander4.8%5.8%8.8%Black/ African American Indian/Alaskan Native0.8%0.3%0.5%Men49%6.6%10.8%Current enrollment data show only modest gains, with minoritiesstill under-represented. Some of the reasons cited by AACN for thedisparities include role stereotypes, economic barriers, gender biases,misunderstanding the practice of nursing, and increased opportunities inother professions. These factors must be addressed by schools of nursing.Rosenberg and O’Rourke (2011) proposed a set of questions and initiativesto help schools of nursing improve performance regarding diversity. Theydescribed a pyramid, with the base being attracting and retaining diversestudents, the middle level being the provision of financial support, and thetop being public relations strategies to attract minority students. To addressthe base, Rosenberg and O’Rourke (2011) suggest the discussion of thesequestions by school leaders:Financial support is already supplied by most schools of nursing, but mayneed to be adjusted to provide more support for minority students. Publicrelations initiatives recommended by AACN (2001) include presenting apositive image of nursing including representation of men and minorities inbrochures and advertisements. They also recommend taking the message tostudents in the communities in which they live, and connecting with potentialstudents at the middle and high school levels.Retention of minority student once enrolled or about to be enrolled ina nursing program can be enhanced through nursing school preparationcourses including such topics as study skills, critical thinking, and nursingmath. Once enrolled, mentorships throughout the nursing program arerecommended, focusing on the minority students.ReferencesAmerica Association of Colleges of Nursing. (2001). Effective strategies forincreasing diversity in nursing programs. Retrieved from ulletin/effective-strategiesAmerican Association of Colleges of Nursing. (2010). Annual report. Retrieved fromhttp://www. aacn.nche.edu/Media/pdf/AnnualReport10.pdfAmerican Association of Colleges of Nursing. (2012). Race/ethnicity of studentsenrolled in generic (entry-level) Baccalaureate, master’s, and doctoral(research-based) programs in nursing, 2002-2011. Retrieved from thnicity-TableRosenberg, L. & O’Rourke, M. E. (2011). The diversity pyramid: An organizationalmodel to structure diversity recruitment and retention in nursing programs.Journal of Nursing Education, 50(10). 555-560. Retrieved from ewfile?accountid 159003NURSINGLEADERSHIPPOSITIONS AVAILABLE WITH UTAH STATE UNIVERSITYWhat do we mean by diversity?Is there culture within my institution that promotes diversity?Has my school set diversity goals?What strategies and policies do we need to meet our goals?UTAH STATE UNIVERSITY IS SEEKING APPLICANTSFOR THE FOLLOWING POSITIONS: Director of Nursing Program and Assistant Department Head- Provide exemplary vision and leadership for statewide nursing programs and thedevelopment of new BSN programs. Program Coordinator at USU-Blanding CampusFor more information about these positions please visit jobs.usu.edu.

Page 6 nevada RNformationMay, June, July 2014nevada action coalitionLinda Yi, RNC, MPACoordinator State Implementation ProgramGood news! Last month Dr. Debra Toney, Chair of the Nevada ActionCoalition, discussed that the Action Coalition had applied for at Robert WoodJohnson Foundation State Implementation Program (SIP) grant to increasenurse residency programs throughout the state for new nurses and forregistered nurses returning to the workforce after a significant absence frompractice and to increase the number of BSN prepared nurses in the state by2020. The press release that follows outlines the good news that Nevada is agrant recipient!Nevada Receives Grant from Robert Wood Johnson Foundation toHelp Lead Efforts to Transform Health Care through NursingLas Vegas, NV – The Robert Wood Johnson Foundation (RWJF)announced that the Nevada Action Coalition will be part of a 4.5 millioninitiative, the Future of Nursing State Implementation Program. The programis helping states prepare the nursing profession to Address our nation’s mostpressing health care challenges—access, quality, and cost. RWJF announcedten states that are joining the program this month; it launched with 20states in February.The Most HigHly AwArded Nurses Care forpaTienTs aT The Best HospitAl in Las Vegas.Debra Collins, BSNChair–Nevada Alliance for Nursing Excellence(NANE)The State Implementation Program bolsters efforts already underway in50 states and the District of Columbia – the Future of Nursing: Campaign forAction – to improve health and health care through nursing. A joint initiativeof AARP and RWJF, the Campaign is working to implement the Instituteof Medicine’s (IOM) evidence-based recommendations on the future ofnursing. It provides a vehicle for nurses at all levels to lead system changeto improve care for patients and families through collaboration with business,consumer, and other health professional organizations.“We are confident that this grant will help spur progress in Nevada, whichalready is doing notable work to transform nursing practice, education, andleadership,” said Susan B. Hassmiller, PhD, RN, FAAN, RWJF senior adviserfor nursing and director of the Future of Nursing: Campaign for Action. “TheFoundation is committed to helping states build a more highly educated,diverse nursing workforce so that everyone in America can live a healthierlife, supported by a system in which nurses are essential partners inproviding care and promoting health.”The State Implementation Program is providing two-year grants ofup to 150,000 to a total of 30 state-based Action Coalitions that havedeveloped or made substantial progress toward implementing the IOMrecommendations. Nevada’s grant application was submitted by the NevadaSystem of Higher Education on behalf of the Nevada Action Coalition. Dr.Marcia Turner, vice chancellor of Health Sciences for the Nevada System ofHigher Education (NSHE), will act as the grant’s principal investigator.“We are pleased that NSHE has this opportunity to partner with theNevada Action Coalition to promote nursing education throughout our state,”said Dan Klaich, chancellor of NSHE. “Working with our colleagues at theDepartment of Employment, Training and Rehabilitation, the Governor’sOffice of Economic Development, and myriad nursing leaders and otherhealth care stakeholders, I am confident we will better prepare Nevada’snurses for success in a changing workforce environment.”States must obtain matching funds to receive the grant. The Departmentof Employment, Training and Rehabilitation (DETR) provided 75,000 inmatching funds to enable Nevada to receive this 150,000 grant. “DETRis delighted by the news that Nevada is a RWJF grant recipient, and weare proud to partner with the NSHE in furthering the work of the NevadaAction Coalition. This is a perfect example of Governor Sandoval’s mission tostrategically leverage funding to promote workforce development in criticalareas such as nursing,” said Frank Woodbeck, director of DETR.The Nevada Action Coalition also gratefully accepted a 10,000 donationfrom the Nevada Hospital Association. Bill Welch, President & CEO of theNevada Hospital Association, said, “The Nevada Hospital Association isdelighted to support this effort which will prepare the next generation ofnurses to meet greater demands and challenges under the new models ofcare delivery and help ensure patients get the care they need, when andwhere they need it.”In addition to Nevada, grants were announced in Alabama, Alaska,Arkansas, Illinois, Minnesota, Ohio, South Carolina, Vermont, and Virginia.The 20 states that received grants in February are: Colorado, Connecticut,Florida, Georgia, Iowa, Idaho, Kansas, Louisiana, Maryland, Michigan,Missouri, Mississippi, Nebraska, New Jersey, Pennsylvania, Rhode Island,Tennessee, Utah, Wisconsin, and Wyoming.“The diverse leadership of our Action Coalition and our focus onmeaningful outcomes that improve care were key factors in Nevada beingselected,” said Debra Gulley-Collins, chair of the Nevada Alliance for NursingExcellence (NANE) and one of the lead organizations for the Action Coalition.“We are part of a powerful movement that is improving health care for allAmericans. The Nevada Action Coalition is grateful to RWJF for this support,which will strengthen our work immeasurably.”Dr. Debra Toney, chair of the Nevada Action Coalition ExecutiveCommittee, noted that the Coalition plans to focus on increasing theNevada Action Coalition continued on page 7

May, June, July 2014Nevada RNformation Page 7Nevada Action Coalition continued from page 6proportion of nurses with baccalaureate degreesto 80 percent by 2020 and implementing a nurseresidency program throughout the state for newgraduates and for registered nurse returning topractice after a significant absence.The Center to Champion Nursing in America(CCNA), an initiative of AARP, the AARPFoundation, and the Robert Wood JohnsonFoundation, serves as the national program officefor the Future of Nursing State ImplementationProgram.“This new program will help Action Coalitionsget the strategic and technical support requiredto advance their goals,” said Susan Reinhard,PhD, RN, FAAN, senior vice president of the AARPPublic Policy Institute and chief strategist at CCNA.“Our hope is that with this support, Nevada will beeven more effective in improving health outcomesfor patients, families and communities.”About the Future of Nursing: Campaignfor ActionThe Nevada Action Coalition is part of theFuture of Nursing: Campaign for Action, a jointinitiative of AARP and the Robert Wood JohnsonFoundation (RWJF), worki

Orvis School of Nursing University of Nevada, Reno Statewide Worldwide UnIVERSITY OF nEVADA, REnO *The DNP program is a collaborative program with UNLV. Students admitted through UNR for this program have their DNP degree conferred by UNR. May, June, July 2014 Nevada RNformation Page 5