SDONE Legislation Prac

Present: Tammy Hillstad, Carla Borchardt, Darcy Sherman-Justice, Rosanna Morris, Denise Cundy, Deb Paauw, Carol Kooi, Mary Ryan, Jan Burnette, Connie Teut. Recorder: Terie McLaughlin

Congratulations to Denise Cundy for achieving her Masters’ Degree. She graduated last Friday.

Denise & Tammy mentioned that at the smaller hospitals they are getting the new graduates. It is more difficult to get “seasoned nurses”.

The 2-year mark seems to be where staff begins looking at or for new/different opportunities.

A lot of the young grads want to become Nurse Practioners or Physician Assistants. Why the increase in Nurse Practioners? Upward mobility is more readily available now – on line.

Sioux Valley mentioned that they don’t have the trend to part time as some hospitals do. They offer Full time – 3 – 12 hour shifts. Their units seem more content with not so much interest in the float pool. They look at the job security and staffing incentives.

Managers are more nervous of the increased percentage of staff getting to retirement age.

Question asked of Sioux Valley group regarding status of December grads? The nursing grads must pass their boards before they start in February. It is too much for them to study and go through orientation at the same time. They need to come licensed. They did offer a trial GNR program ( Grad. Nurse Readiness (Recovery)) the second time board takers – 50% passed. Clinical/classroom met 1 time a week (190 hours) discussions on prioritizing, worksheets, problems, scenarios, etc. The instructor has helped to write the boards so she did a lot to get them ready to take the boards. If they fail the boards they are generally kept on as a PCT – if it’s a person they would like to keep in their organization. This GNR was a partnership with Augustana. Not sure if this is going to be offered again, but feel the program was effective….but costly. This year showed the highest rate of failure of future nurses taking the boards.

Clinical Nurse Leader Degree. How do we prepare in creating the new option of Clinical Nurse Leader? See attachment. The program starts this fall with a generalists masters degree program. Augustana and State are the colleges who will offer the certification and exam. Looking for clinical people who understand research, etc. – more global. The hope is that NP CNS will move to a PhD level. SDSU is finalizing stages to offer PhD in Nursing. It is the first college in the state to move that way. Other organizations and colleges are working together towards this type of program. Question asked as to the response from staff following the meeting with Dean Olson & Dr. Nelson? There were several who are interested – depends on the time frame, cost, tuition reimbursement, 1 ay a week? ½ day on Friday and full day on Saturday?? Looking toward getting feedback on what would be most valuable. Where will a masters fit in the overall organization? What is the role going to be? Where do these people see themselves?

ANA update – The Convention was in Minneapolis this year. South Dakota was well represented. The ANA changed its structure to 2 groups. Unionized States and Non-Unionized States. Each has their own offices, budgets & staff. The union states have more members so not that they are separated, non-union feel like they have more of a voice.

The offices are in Silver Spring, MD. There is more efficiency in the services that they provide. They have a bus that goes on a 10 state tour providing Blood Pressure screenings. Very positive campaign – Know Your Numbers, Prevention of musculo/skeletal injuries, education of staff – adapting work environment – need to keep “seasoned” nurses in the workplace. There is a research facility in VA and another in Tampa. They talk on good body mechanics. They use “crash dummies” for their talks. The average nurse lifts something like 15 tons per shift. Teaching needle safety. AJN – 3 yr funded project. Increasing the knowledge of caring of the geriatric patients.

California, Massachusetts & Maine have disassociated themselves with the National ANA. The materials that they send out confuse people. People don’t always read the fine print. Watch for this type of activity….we don’t want unions in our state. We want to keep a positive environment for our nurses. The sole job of these groups is to come into an organization and bring in the union. People have less say than what they had before.

The group ANA is always working on: 1) Nursing Shortage 2)Promoting nursing staffing 3) Giving nurses more of a voice. We don’t need to see mandated ratios, etc. Need to keep an eye on what is happening in our State Capitol. Gov. Rounds has been looking at the Nursing Boards – that is all we are seeing in SD currently.

NURSES’ DAY @ The LEGISLATURE is Feb 6, 7, & 8. Evening (6:30 – 8) Advocacy & orientation. How do you testify before a legislative committee? Committee hearings – Legislature updates, public protection. What is the number of impaired professionals? There is a chili supper with the legislatures that is very well attended. Don’t forget to mark your calendars.

Sioux Valley has a Lift Team. They average 60 lifts per day. There are 2 people per shift and they work from 8:30 am to 9 pm. They do complete lifts, pivoting and help with the first few transfers. They come to all codes (falls)

What is their educational background? They go through core strengthening at the fitness center. Background is that of nurses’ aid work. Currently they are all male. There are guidelines on which lifts should be done first. This is a very busy team. They have guidelines on which lifts should be done first. Lifting is a technique not just based on size. They have purchased different Hooyers, etc.

VI. Future Meetings will be March & June. Connie asked for input. Tammy from Madison offered to have the SDONE meeting at their location. This will be March18, 2004 from 11:30 – 2:00 p.m. Sioux Valley will host the one in June.

Please bring suggestions to the next meeting. Must be at least 1 hour long meeting to be considered for CEUs. CEUs are not needed for licensure but they are for certification. Most would like to see the focus on receiving CEUs for the SDAHO convention. SDONE is one of the groups that haven’t gotten these yet. Darcy will work on this as the application goes to ND. She will work with Vicki Tigner.

Are there any topics of interest for the March meeting? Compliance is always an interest. Safety Goals.

Connie will announce a topic for discussion so that everyone can bring the information to discuss.

There were brief discussions on the following subjects: Med. Reconciliation, prohibited abbreviations – most have been encouraging staff to write it out and NOT abbreviate, Hand washing – monitor 30 people and their hand washing skills. Is this 30 per month/per department?? No artificial nails for direct care givers. Some facilities are going back to white for the registered nurses. No visible tattoos.

SV is hiring FT between 2 units for more flexibility. All hospitals seem to have a lot of commuters.

Terie will be available to work with Tammy/Connie on the meeting plans/agenda for the next meeting in March.

Diane Davis, Darla Gullikson, Marilyn Lofflin, Laurie McKee, Mike Larson, Mary Tow, Lynette Bruening, Denise Muntefering, Lisa VanHeek, Barbara Larson, Linda Pedersen, Cindy Sage, Carol Stewart, Judy Youngbluth, Dianne Larson, Jan Stahnke, Stacey Erickson.

Barbara Larson introduced today’s guest speakers Michael McVay, MD and Ellen McVay, MSW. Together they presented on the Avera Center for Mind-Body-Spirit. They educated the group on the importance of mind-body-spirit integration for personal health care. The discussed the body’s physiological response to acute and chronic stress as well as describing the “relaxation response.” The group participated in an exercise where they closed their eyes and measured their body’s’ temperature response to relaxation. The followed up with a discussion about the importance of Spirituality in health and coping with illness. There were 1.5 CEU’s available today.

District IV extends their appreciation to Barbara Larson and her staff for their time spent coordinating the CEU’s for today’s event.

**The bylaws were reviewed and the eligibility did change. Nurses are not only eligible for membership if they hold leadership positions but are also eligible if they aspire to hold such positions. Carol DeSchepper takes all membership dues and currently evaluates each application for eligibility. If there is a question of eligibility, Carol will consult the board.

**The membership year is the 12 month period beginning each January. New members applying for membership during the 3^rd quarter of the organizational year, shall pay dues prorated at 50% of the annual dues. New members applying for membership during the 4^th quarter of the organization year shall be forgiven dues for that period and dues will be applied to the next full organization year.

**Districts are asked to meet the requirement of 3 meetings per year rather than 4 as was the stated expectation before.

**In regards to elections: The ballot shall be returned to the President and no ballot shall be valid if postmarked later than 14 days before the annual meeting ---it had been 30 days.

**District Chair terms were established at 2 year terms. District IV will open in October of 2005.

Dianna Vanderwoude will be the legislative representative for SDONE in the coming year.

Open discussion was held on recent survey activity in District IV. As promised the surveys are unannounced in acute care as they have always been in LTC. Dates and times were a focus as well as open record review. Discussion was held on the order Diet as Tolerated or Advance as Tolerated. Evidently there is some concern with the survey teams about ordering more specific diets.

Attendees were able to share news about their facilities and network with their colleagues.

March 11, 2005 – “Legislative Update” by Deb Fischer-Clemens in Mitchell (confirmed)

June 10, 2005 – “Hardwiring for Excellence” by Marilyn Lofflin and Barbara Larson in Yankton (tentative)

November 2005 date not decided with a suggestion for education being a representative from the new Bariatric Center at Avera Queen of Peace.

Managers Meeting: Past meeting minutes were read and approved. Facility reports were shared.

Overview of Program: Personality (self-awareness) Profile was done by the members present. The book this profile was taken from – How to Work with People: Understanding Team Dynamics, Item #4032.

Old Business: Kim Beck – Chairperson, called the meeting to order. Note cards were distributed for members to invite colleagues who are not members of SDONE to a meeting and to help increase District II membership. When we receive the brochures being printed by SDONE, all District II hospital and nursing home DONs will receive one. E-mail has been working well for sending agendas and minutes to current members.

New Business: Discussion was held about having some meetings using the Polycom system. It was decided to continue having meetings on the 2^nd Thursday of every other month.

SDONE District III Meeting - Friday, June 11, 2004
Pioneer Memorial Hospital & Health Services, Viborg, SD

Kay Santema called the meeting to order. Thank you to Viborg for hosting this meeting!

The assessment was completed in the Fall of 2003. Carla Borchardt reviewed the data with the group. Some of the top issues facing nursing leaders are recruitment, retention, and leadership development.

The following suggestions were given for upcoming District meetings:
-          Updates from Board of Nursing
-          Updates from Center for Nursing Workforce
-          Updates on Medicare legislation and other pertinent legislation
-          Communicate educational opportunities that are available.
-          Other issues – long term acute care
To obtain CEUs for these discussions, the presentation must be a minimum of 50 minutes, and would need to be announced in advance. Will need further discussion. Darcy Sherman Justice is willing to assist in obtaining CEUs.

Diana Berkland distributed the National Quality Forum Report. This report was commissioned by the federal government to measure effectiveness of nursing in healthcare outcomes. It will be publicly reported at some point in the future. Have not clearly defined all numerators and denominators; 15 for acute care, some for chronic care. Nurse satisfaction tool – similar to one for Magnet. Not copyrighted so can use.

Barb Pridie, Project Director for SD Center for Nursing Workforce, was a guest speaker. Barb shared that SD’s shortage is much better than other states nationwide. By 2010 – 2015, the national shortage will be significant. Aging of nursing is a big concern – not enough young nurses replacing those who will be retiring. Schools can’t handle all those who are interested due to faculty shortage – 33,000 couldn’t get into schools because of shortage of faculty. Significant aging of current faculty is also a concern. Service and academia have met together to work out an expectation. We have an opportunity to hang on to our profession by keeping control of education and developing plans to maintain integrity of the profession – if we don’t, someone else will. Texas A & M has identified modules to work on “articulation.”

Clinical Leadership – applied for three grants. Looking for six states to participate. Look at developing partnership for precepting clinical leadership.

MSN opportunities could be available with remote teaching modules and creative options for senior nurses who may be partially retired. May need to address “agism” in nursing and nursing education. Get people with other Master’s degree to assist with nursing education.

Diana Berkland gave an update of the program for the annual meeting which will be held in September. Working on finalizing a speaker (Richard Henley) that spoke for AONE. He is the Executive Vice President/COO/CFO of Health Quest in Poughkeepsie, NY. His topic is How the Nurse Executive Can Impact the Bottom Line.

Other possibilities for speakers include:
-          Gloria Damgaard from the Board of Nursing regarding discipline, justice, and Regulation.
-          Darcy Sherman Justice from Avera McKennan regarding mentorship.
-          Jo Voss, Ph.D. from Rapid City – research regarding music therapy in open heart patients.
-          Eric Doucette – LTC – nurse sensitive outcomes or falls. SDAHO sponsored.
-          Sandy Young and Dr. LuAnn Eidsness from Sioux Valley regarding palliative care.
Will need help the day of the meeting. Will host a new member breakfast.

We were asked to work with them on a fundraiser. The decision was made at the SDONE Board meeting to not participate.

The following positions are open:
-          Secretary
-          Bylaws
-          Program and Public Relations
All names must be submitted to Rita Haxton by June 15

These items must be submitted to Carol DeSchepper, Treasurer; postmarked no later than August 5.

Unanimous vote to elect Connie Teut from Avera McKennan as the new Chair. She will start in September, and will be a member of the SDONE Board. Robin Thompson and Darcy Sherman Justice agreed to support Connie with minutes and program. Thank you to Kay Santema for the leadership she has provided to the District!!

- Sharing Our Wisdom Conference – Thursday, September 9, from 8:00 a.m
5:00 p.m., Avera McKennan, Orthopedic Institute Auditorium. Speaker is Tim Porter O’Grady.

- SDONE Board Meeting – Wednesday, September 22, from 10:00-11:45 a.m., SF Sheraton.

- SDONE Annual Meeting – Thursday, September 23, from 2:30-3:30 p.m., SF
Sheraton. During SDAHO Convention.

    Thursday, October 14 – Opening Reception 6-8 p.m.
Friday, October 15 – Meeting All Day
          Barb Pridie
          Pam Thompson – AONE President
          Liz – MONE
          Elaine Cohen – University of Colorado
          Panel with JoEllen, Pam and Elaine
          3 voices from the past – Native American traditions
          $20 bus trip to Deadwood
    Saturday, October 16 – Meeting in morning -- Adjourn @ 12:00 noon

Darcy Sherman Justice thanked all for the $200 donation for the speaker for the SDNA Convention keynote event on October 3 from 7-8 p.m. The speaker will be Mark Ackermann, Senior VP and Chief Corporate Officer of Saint Vincent Catholic Medical Centers of NY. He will be speaking on the response to the attack on the World Trade Center on September 11, 2001 and preparedness for the next event. SDONE members can attend the keynote free of charge.

The entire SDNA Convention runs October 3-5 at the Sheraton. On October 5, SDONE can have a poster booth at no charge. Vendor display.

Next Meeting - The next meeting will be held in conjunction with the SDAHO Convention in September.

Attendees: Kim Beck-Britton, Jacalyn Eberhart - Eureka, Carie Kappes-Eureka, Dawn Hinckley-Gettysburg

Managers Meeting: Discussed pharmacy policies and problems; what kinds of medexes are in use; the use of med cards. Discussion was also held about mandatory in-services and how they are conducted in each facility.

Overview of Program: Steve Aamot, RPh of Avera St. Luke’s gave an informal presentation of what he looks for in documentation of nursing and physician notes when doing medication reviews at SNFs.

Board Report: The Board is putting together a letter to send to potential new members for all districts. Notecards and brochures will also be printed for all districts to distribute to potential new members. SDONE Leadership award applications are available. See enclosures. A $1500 scholarship is available for members of SDONE for tuition expenses.

Old Business: Kim Beck – Chairperson, called the meeting to order. March 16 meeting minutes were approved with no changes. Visit www.sdone.org to read the current newsletter.

New Business: It was decided to move the SDONE meeting day to the 2^nd Thursday of every other month. Sharing Wisdom Conference will be held in Sioux Falls on September 9. Last year’s conference was very well attended and had great information. This district will now start e-mailing the meeting minutes and agenda to those who have e-addresses. Those who do not have e-mail will continue to receive the mailing.

Next meeting: July 8, 2004 **Note new day** at Avera St. Luke’s Nursing Conference Room
Education Program: TBA

SDONE District III Meeting - Friday, March 12, 2004

1100-1400 - Avera Health Office – Board Room

- Difficult to communicate within the organization to SDONE members – needs faster turnaround for action. Decisions had to be made by the Board because of need for position statement on a bill.

- Other areas – mental health, long term care, and lay midwifery licensure request – not passed, but keeps coming back to the Legislature – recognition of need to address long term.

- Deb identified a need to find a way to communicate more effectively. Idea: web based chat room.

Kay Santema reviewed and welcomed new members who have joined District III in the last year.

Deb Soholt and Linda Bunkers were the two executive officers who attended the meeting. They found it to be high quality education and a great opportunity to learn from other staff. Topics included globalization, impact of world decisions on healthcare, and impact of trade agreements. Other highlights were as follows:

- Core measures identified by State Boards – the State of SD is lifted up as a standard in five of the six measures. For example, discipline was spoken on by Gloria Damgaard at the December Executive Board of Nursing meeting.

- Discussion on Visascreen – a national initiative to provide a formal program for foreign nurses. Many border states already have laws and regulations they are happy with and do not feel a need for another national process.

- Advance practice nursing agreements and licensure processes with the medical boards. First state passed multi-state licensure for APNs.

- Some discussion regarding the availability of nurses for terrorism being part of the State Board of Nursing responsibility.

Organizational updates were shared. Darcy Sherman Justice shared that Toby Long is the new Executive Director for SDNA. Darcy also shared that on April 3, SDNA is offering nursing exploration badges for SD Girl Scouts. Also, during the SDNA Convention October 3-5, 2004, the keynote speaker will be Mark Ackermann, Senior VP and Chief Corporate Officer of Saint Vincent Catholic Medical Centers of New York. One of the hospitals in his system was the first to care for victims of 9/11.

- Sharing Our Wisdom Conference – September 16, 2004. This date is tentative because of the SDAHO Convention and the desire to have Tim Porter O’Grady as speaker for Sharing Our Wisdom.

New leaders in the organization being mentored into the organization. Kay Santema will talk with Diana Berkland about prior programs.

Kay Santema distributed this report in Diana Berkland’s absence. Discussion was deferred to the next meeting.

The next meeting will be held June 11, 2004 from 1100-1400 at Pioneer Memorial Hospital in Viborg. Thank you to Sharon Akland and Jan Weber for offering to host this meeting.

Sharon Hauck, St. Michaels Hospital; Jan Johnson, Avera Sacred Heart Hospital; Denise Munteferring, Avera St. Benedict Hospital; Ruth Pakeiser, Mount Marty College; Barbara Larson, Avera Sacred Heart; Lynette Bruening, Avera Sacred Heart; Maxine Willman, Avera Sacred Heart; Michael Kusek, Avera Sacred Heart; Mary Tow, Avera Sacred Heart; Becky Nissila, Landmann-Jungeman Memorial Hospital; Carol Stewart, St. Michaels Hospital; Stacey Erickson, Platte Care Center/Avera Health; Julie Ramey, Avera Sacred Heart; Ellen Becker, Avera Sacred Heart; Cindy Sage, Avera Yankton Care Center; Laurie Pospisil, Winner Regional Healthcare Center – LTC; Amy Juracek, Avera Gregory Healthcare Center; Terri Lewis, Weskota Manor/Avera Health; Mike Larson, Avera Sacred Heart Hospital; Elsie Ptacek, Winner Regional Healthcare Center – LTC; Dianne Larson, Wagner Community Memorial Hospital; Judy Youngbluth, Douglas County Memorial Hospital; Bernadette Nelson, South Dakota Foundation for Medical Care.

The meeting was called to order and the minutes from the last meeting were approved. Introductions were completed.

Bernadette Nelson, South Dakota Foundation for Medical Care; Laurie Pospisil and Elsie Ptacek, Winner Regional Healthcare Center – LTC presented this morning education piece. They spoke not only to the current collaborative taking place in South Dakota’s LTC facilities but also of the national project Winner Regional has been a participating in. Winner Regional – LTC is working at a national level on pressure ulcer reduction. They shared where they were how far they have come and lessons learned along the way. They have offered any assistance to other LTC facilities that have questions or concerns about the national collaborative. They shared several of the tools they have been using and opened at the end for discussion. For more details and a copy of the PowerPoint you may contact Laurie Pospisil at Winner Regional Healthcare Center – LTC.

Bernadette Nelson concluded the education session with an overview of Quality Issues. She spoke to the role of SDFMC in the current LTC initiatives and discussed the upcoming initiatives and quality measures for Home Health and Hospitals. She gave an overview of some of her favorite problem solving techniques and key features of a QI system.

Tentative meeting dates were reviewed and Carol will communicate those to the board. We will try for the first Friday of the month in the month chosen. Educational speakers may require flexibility. It was discussed that some districts meet 4 or 5 times yearly and members today indicate that 3 meetings plus attending the convention was meeting their needs.

The Membership Needs Assessment conducted by SDONE was reviewed. 25 members responded. 14 of those are active in their district and 16 indicate that the meetings benefit their leadership skills. Barriers to participation included time, timely notification, distance, short staffing, date conflicts and good topics. The following are the top ranking additional services that would be seen as benefits: leadership development, networking, and education programs with contact hours, use of teleconferencing, connecting with state and national nursing issues, legislative updates, and orientation to SDONE.

This group held discussion on these items and decided to offer an educational session with CEU’s at our October gathering. This group also felt that the orientation to SDONE for new nurse leaders was important.

The following are the top issues facing nurse leaders today: Recruitment and retention, workforce shortages, financial limitations, leadership development (wearing many hats), staff satisfaction, patient safety.

This group concurred that those issues do face us and are a challenging part of our role as nurse leaders.

Comments included encouraging the rural nurse to not only become active in her district but also at the board level. Also discussed memberships old and current. Carol Stewart did compare the lists prior to this meeting and sent invitations to those members who have not yet renewed their membership.

SDONE will be hosting the AONE District 6 & 8 conference in Rapid City on October 14 & 15, 2004. Members are encouraged to attend.

Sharing of Wisdom Conference will be held September 9, 2004 in Sioux Falls. Several members attending today have heard the featured speaker and recommend him very highly.

Mentorship for new members was discussed at the board level. It has been suggested to have a mentorship workshop at the SDAHO fall convention to kick off the concept with new members. It was also suggested to have a list of mentors for different topics, areas of expertise that new members could contact to ask questions.

Members agreed to reimburse Winner Regional Healthcare Staff travel time for being our presenters today. They decline reimbursement for the presentation but will use the funds to make a purchase related to pressure reduction in the nursing home. $50.00 will be sent to their facility.

The next meeting is set for June 4, 2004 at Avera Queen of Peace. Phil Authier will be asked to speak.

At the time of this printing Phil Authier has accepted the invitation to speak but has been unable to commit to June 4. As soon as he is able to commit to a day that will be communicated to members.

Managers Meeting: Discussed the “Prohibited abbreviations” list noted in an e-mail from Carol DeScheppar. Needs Assessment results discussed. It was decided that the new pamphlets would be sent along with note cards to potential new members for our district. HIPE week activities and Stroke Awareness Month activities were discussed. Kim shared the minutes of the Board Report.

Old Business: Kim Beck – Chairperson, called the meeting to order. January 9 meeting minutes were approved with no changes. Visit www.sdone.org to read the current newsletter.