Precautions for Covid based on evidence and data as we know it today. MNA will continue to adjust our message as new scientific evidence and data emerges.

MNA strongly encourages all Montana citizens to wear facemasks to help limit the spread of the coronavirus. As COVID-19 spreads across the globe and cases continue to

increase in Montana, the chances that you will be exposed and get sick continue to increase. When someone talks, coughs, or sneezes they may release droplets into the air that land on surfaces and can infect others. If someone is ill or is an asymptomatic

THE OFFICIAL PUBLICATION OF THE MONTANA NURSES ASSOCIATION FOUNDATION Quarterly publication distributed to approximately 19,000 RNs and LPNs in Montana.

August 2020 • Vol. 57 • No. 3

www.mtnurses.org

Like us on Facebook Follow us on Twitter

CEO Report

Vicky Byrd,MSN, RN

Excerpts from ANA7 tips nurses should know about

safe patient handlingPage 9

current resident or

Non-Profit Org.U.S. Postage Paid

Princeton, MNPermit No. 14

State Wide Nursing NewsNEGOTIATION: WINNING BY MUTUAL

AGREEMENTPage 10

carrier, a face masks can reduce the number of germs that the wearer releases and can protect other people from becoming infected. Because this virus has its own agenda, and we now see evidence that asymptomatic people can spread the virus (may be contagious 48 to 72 hours before starting to experience any symptoms if at all), MNA kindly asks: “Please wear a mask in all public settings when social distancing cannot be maintained to protect others.” Masks are especially important when you have to be around someone not in your “bubble” of regular contacts and will be spending time in close proximity, such as a car drive.

MNA applauds all businesses requiring masks to be worn, keeping their patrons and employees as safe as possible. What a simple thing we can all to for each other. Those who are selfish and remove their masks after entering any business that requires them

Executive Director Report continued on page 2

Page 2 Montana Nurses Association Pulse August, September, October 2020

CONTACT MNAF & MNAMontana Nurses Association Foundation

and Montana Nurses Association20 Old Montana State Highway, Clancy, MT 59634• Phone (406) 442-6710 • Fax (406) 442-1841

• Email: info@mtnurses.org • Website: www.mtnurses.orgOffice Hours: 7:30 a.m.-4:00 p.m. Monday through Friday

VOICE OF NURSES IN MONTANAMNA 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 – MNAFPreserve the history of nursing in Montana and contribute, support and

empower the professional nurse in Montana.

MISSION STATEMENT – MNAThe Montana Nurses Association promotes professional nursing practice, standards and education; represents professional nurses; and provides

nursing leadership in promoting high quality health care.

PROFESSIONAL DEVELOPMENTMontana 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.

MNAF & MNAStaff:Vicky Byrd, MSN, RN, Chief Executive OfficerPam Dickerson, PhD, RN, NPD-BC, FAAN, Director of Professional DevelopmentKristi Anderson, MN, RN, NPD-BC, CNL Director of Professional DevelopmentCaroline Baughman, BS, Professional Development AssociateRobin Haux, BS, Labor Program DirectorAmy Hauschild, BSN, RN, Labor RepresentativeLeslie Shepherd, BSN, RN, Labor RepresentativeLaurie Hunton, RN, Labor RepresentativeJill Hindoien, BS, Chief Financial OfficerJennifer Hamilton,Administrative & Marketing Specialist

Board of DirectorsExecutive Committee:Board of Directors President Lorri Bennett, RNBoard of Directors Vice President Terry Dutro, MSN, APRN, AGPCNP-BCBoard of Directors Secretary Chelsee Baker, BSN, RN Board of Directors Treasurer Audrey Dee, RNBoard of Directors Member at Large Anna Ammons, BSN, RN, PCCNBoard of Directors CPGA Board of Directors PD Cheryl Richards, Ed.D, RN-BCBoard of Directors CAP Lori Chovanak, DNP, RN, APRN-BCBoard of Directors EGW Brandi Breth, BSN, RN-BC

Council on Practice & Government Affairs (CPGA)Gwyn Palchak, BSN, RN-BC, ACM Lisa Ash, RN, CNORSally Sluder, DNP, APRN, AGACNP-BC Loni Conley, BSN, RN

Council on Professional Development (PD)Sandy Sacry, MSN, RN Megan Hamilton, MSN, RN, CFRN, NRP Gwyn Palchak, BSN, RN-BC, ACM Debby Lee, BSN, RN-BC, CCRP Emily Michalski-Weber, PMHNP-BC Abbie Colussi, RN Brenda Donaldson, BA, RN, CAPA Kim Reynen, BSN, RN Janet Smith, MN, MSHS, RN

Council on Advanced Practice (CAP)Chairperson-CAP Deborah Kern, MSN, FNPChairperson Elect-CAP Keven Comer, MN, FNP-BCSecretary-CAP Nanci Taylor, APRNMember at Large-CAP Terry Dutro, MSN, APRN, AGPCNP-BCMember at Large-CAP Emily Michalski-Weber, MSN, RN-BC

Council on Economic & General Welfare (EGW)Delayne Stahl, RN, OCN Lorie Van Donsel BSN, RN, PCCNAdrianne Harrison, RN

Questions about your nursing license?Contact Montana Board of Nursing at: www.nurse.mt.gov

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

PUBLISHER INFORMATION & AD RATESCirculation 19,000. 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., 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

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

or choose not to wear a mask when social distancing cannot be maintained, you are compromising the safety of others, including your loved ones. Be smart. The longer we adhere to these recommendations, the longer we are able to support our public health and economy by limiting the spread of the disease in Montana.

Wear your Face Covering Correctly• Wash your hands before putting on your face

covering with soap and water for 20 seconds or use hand sanitizer before touching the mask.

• Put it over your nose and mouth and secure it under your chin

• Try to fit it snugly against the sides of your face• Make sure you can breathe easily• Wearing a mask only over your mouth and

exposing your nose does NOT protect anyone and is equivalent to NOT wearing a mask at all.

• Wash your hands again after removing your face covering with soap and water for 20 seconds or use hand sanitizer.

Face Coverings Protect Others• Wear a face covering to help protect others in

case you’re infected but don’t have symptoms• Keep the covering on your face the entire time

you’re in public• Don’t put the covering around your neck or up

on your forehead• Don’t touch the face covering, and, if you do,

wash your hands

Everyday Health Habits• Stay at least six feet away from others, maintain

social distancing• Avoid contact with people who are sick, please

stay home if you are ill• Wash your hands often, with soap and water,

for at least 20 seconds each time• Use hand sanitizer if soap and water are not

available

If we all do this now, we will be able to maintain our progress through planned reopening stages and get back to safely opening schools and working and living as we all hope to.

Executive Director Report continued from page 1

New Licensed Graduates Welcome!Competitive Salary and Pay Based on Experience.

To learn more, please contact:Valerie Moreland - Medical Recruiter

Valerie.Moreland@corecivic.comApply online at jobs.corecivic.com

CoreCivic is a Drug Free Workplace & EOE - M/F/Vets/Disabled.

Announcing Career OpportunitiesYou’ve Been Waiting For!

Crossroads Correctional FacilityShelby, Montana

Now Hiring:RN, LPN &

Mental Health Coordinator

August, September, October 2020 Montana Nurses Association Pulse Page 3

Be Informed: Healthcare Continues to Endure Attacks.Vicky Byrd, MSN, RN

CEO, Montana Nurses Association

Montana nurses know the Affordable Care Act (ACA) is not perfect, however, a repeal at any level is not supported by the nurses or the patients they serve. Montana nurses know certain aspects of the current ACA help to provide much needed healthcare for Montana patients. How do we keep what works (preexisting condition coverage, essential health benefits — for example) and adjust or fix what isn’t working without compromising our public’s health? Republican Attorneys General (AGs) are pushing forward with a lawsuit (aiming to be heard this fall) to dismantle the ACA, even despite experiencing our current pandemic due to coronavirus.

Montana Nurses Association (MNA) voices strong opposition to any lawsuit or attempt that would threaten health care affordability, access, and delivery for our Montana residents. MNA will continue to advocate for a healthcare system that ensures access to quality and fair care with a standard package of essential health care services that are covered for all citizens.

Eliminating the ACA’s individual mandate will lead to millions of fewer Americans having health insurance and for Montanans, upwards of 112,000 of our citizens, including children, are at risk of losing their health coverage. The resulting domino effect will be negative health outcomes, higher costs,

fewer individuals with access to critical primary care, ceasing coverage for dependents until 26 years of age, preexisting condition coverage, and preventive services would no longer be covered. This is irresponsible and further proves that health care is being handled like a political game to be won at any cost, and the cost is our patients’ lives. This is unacceptable.

Before the Affordable Care Act, insurance companies routinely denied people coverage because of a pre-existing conditions or canceled coverage when a person got sick. Today, a little over 400,000 Montanans have pre-existing conditions (almost half our population). Taking away health insurance would further exacerbate existing health problems.

Additionally, any attempts at invalidating the ACA also threatens to take away coverage from Montanans receiving care under the Medicaid expansion; it erodes protections for individuals with pre-existing conditions; jeopardizes the 10 Essential Health Benefits requirements; slashes federal funding for healthcare services; defunds the Prevention and Public Health fund; leaves Montana hospitals with $356 million more in uncompensated care; allows insurance companies to raise premiums based on illness or gender; all of which are critically important especially during this global pandemic.

Education and the ramifications if successful, of the Republican AG healthcare lawsuit (that proudly does not include MT AG, Tim Fox), needs to be shared so nurses and their patients can make informed decisions at the ballot box. MNA believes there is not one Montana citizen who would not experience the negative impacts if this lawsuit continues.

We hire people, not resumes. But we also expect excellence,

which is why we require:

Where History and Healing come together

Awe Kualawaache Care Center

HIRING LPNs & RNs

To learn more or to download an application visit: akcc2.org

Awe Kualawaache Care Center located across from the Big Horn Battlefield. We offer not only a career

but culture and caring.

Awe Kualawaache Care Center | 10131 South Heritage LaneCrow Agency, MT 59022 | 406-638-9111

• 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.

Page 4 Montana Nurses Association Pulse August, September, October 2020

MNA continues to support our nurses, healthcare workers, communities, and patients throughout this ongoing Covid-19 pandemic. The health and well-being of our members, their loved ones, and our communities will be top priority.

The MNA board of directors, with thoughtfulness and realistic expectations related to the Covid Virus crisis we are all battling, have unanimously moved to CANCEL the 2020 MNA Convention, however, will continue the business of the association by hosting, on Friday, October 9th, 2020 a virtual meeting of the House of Delegates (HOD). This date could be subject to change and if so, will be communicated to the districts when the delegates are vetted and district elections begin after June 1, 2020. This 2020 MNA meeting of the HOD will be from 9-11am and cover essential business items and elections to move the association forward while remaining compliant and dedicated to our elective process.

This will allow our MNA members the ability to run for open positions that are slated for this 2020 year and keep us on track related to terms of office, moreover, keep us compliant with labor law.

*ATTENTION: MNA CONVENTION 2020 UPDATE*

Be an Active Voice in your State Professional Nurse AssociationVicky Byrd, MSN, RN

CEO, Montana Nurses Association

Montana Nurses Association (MNA) is the recognized leader and advocate for the professional nurse in Montana and comprised of Registered Nurses including Advanced Practice Registered Nurses. MNA is a non-profit, member driven organization that has been in

existence for over 112 years. MNA is the preeminent voice of the professional nurse in Montana at the local, state, and national level. MNA represents and advocates for nurses in relation to nurse competency, scope of practice, patient safety, workplace violence, professional development/continuing education, safe staffing, and improved healthcare delivery and access, just to name a few.

MNA staff and member leaders do all this through the professional association with governing councils and committees. All registered and advance practice registered nurses can (and should) belong to MNA as it is first and foremost the professional association for these nurses, moreover, MNA also enjoys an additional recognition of advocacy through collective bargaining

The draft agenda would be comprised of:1. Committee reports2. Financial review3. Legislative platform4. Resolutions5. Bylaw changes

a. SECTION 1. Amendments with NoticeThe Committee on Bylaws shall receive proposed amendments at least ninety (90) days prior to an annual meeting of the HOD

b. SECTION 2. Amendments without NoticeThese bylaws may be amended without prior notice at an annual or special meeting of the HOD by ninety-five (95) percent of the delegates present

6. Nominations

We can accomplish this by zoom or whatever digital platform that will accommodate voting delegates, along with the board members, to participate together and carry out the business of the association during this challenging time in our lives. There will be no registration fee for delegates to participate, saving the districts money. The vetting of MNA delegates per district will still happen on

June 1 and those MNA delegates will be nominated and elected following the same process we have done in the past. The obligation for those elected delegates will now be with the knowledge that their critical role in this process will be to attend a 90-minute virtual meeting of the HOD. The MNA elections will proceed as it has in the past with Election America and the ballot going out to the entire membership.

Any member can submit legislative platform changes, resolutions, or significant bylaw changes for HOD to address to Jennifer@mtnurses.org. To view MNA’s legislative platform and bylaws go to our website www.mtnurses.org.

Important Communication for Continuing Education

While we won’t have continuing education sessions at the time of our virtual meeting of the HOD, many web-based educational materials are available for you on MNA’s web site: www.cnebymna.com. Several new and innovative materials are currently in development and will be posted throughout the year to support your professional development needs.

We are looking for

passionate and

caring nurses to

join our team.

RN – Inpatient NursingFull 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

(if applicable to your situation). It is a professional commitment to our nursing profession as policy, practice, and work environments are ever changing. Legislation and other advocacy situations are currently supported by those registered nurse members paying membership dues who have committed to their state professional association. It is ok to pay dues and allow others to advocate for you. Your MNA membership (which includes an ANA membership for all members and an AANP membership for APRNs), allows MNA to grow infrastructure and resources to invest in appropriate personnel (professional development, labor, lobbyists, legal, health policy) for all nurses in Montana. MNA additionally invests resources back into the nurse members, financing their attendance to local, state, and national conferences.

Quoting one of our most beloved nurse’s, Mary Munger, RN, reaffirming: 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. (Munger, M. (n.d.). Membership: A professional commitment. Letter.)

MNA 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 the nursing profession. Activism isn’t for everyone but as nursing professionals we must invest in our professional organization to ensure the infrastructure remains intact to carry our voices in all things that touch patients and nurses

CONFIDENTIALCARING HELP for NURSES in DISTRESS

Call 406-245-4300www.montanaprofessionalassistance.com

libertymedicalcenter.org

Hiring LPNs and RNs!

Contact Bev Halter, Director of Human Resources at 406-759-6514.

Hiring LPNs and RNs!

Competitive wages and

benefits packages!

August, September, October 2020 Montana Nurses Association Pulse Page 5

Labor Reports and News

COVID-19 has brought changes to all of our lives. Changes in our families, changes for our children, changes in our jobs, and possible changes we have yet to face. Each of us have modified our everyday lives as we live with this pandemic. MNA and the MNA Labor Department have worked to make adjustments on how we communicate, represent, participate, support, and bargain with our members. Creating new pathways for face to face communications and a virtual method to allow our representation to continue was paramount as the MNA staff also modified their lives to include working from home and travel restrictions.

MNA virtual meeting capabilities have been expanded to allow seamless scheduling for the labor staff and the members they serve. To date, we have used many different virtual platforms to provide virtual “face to face” representation for labor management/PCC meetings, general representation meetings, local

unit meetings, contract negotiations, mediations, and even arbitrations. The ability for our labor representatives to provide dutiful representation and assistance to our nurses has actually been enhanced with this, new to us, process of utilizing a virtual option. Our facilities across the state have also accepted this virtual option as an acceptable, reliable, and efficient method for meetings and other needed communications. As COVID-19 cases continue to rise, our reliance on these virtual methods will also rise, contributing to the safety of our staff, members, and the public.

Currently, MNA is using ZOOM and it is simple to use! We are happy to assist anyone with a quick instructional session. The MNA Professional Development department has also increased the use of virtual educational opportunities. As your professional state association, advocating for nurses as a whole, we are seeing improved efficiencies and communications that will stay with us into the future.

Personally, I would love to hear any comments on how virtual dependency during this coronavirus pandemic has affected your professional life and/or if you have ideas on improvements. Feel free to email me at robin@mtnurses.org and please wear a mask, wash your hands frequently, maintain social distance, and most importantly, stay safe!

Our Virtual Nurse Union World

Robin Haux, BSLabor Program

Director

Since the onset of the COVID-19 pandemic, many questions have come forward regarding nurses classified as “high-risk” seeking work accommodations. We all know (and can’t get away from the fact) that these are unprecedented times for our country. The information we regularly receive from governmental agencies, media, our employers, and our local leaders has been changing based on the facts of the day.

Currently, the Center for Disease Control (CDC) lists “older adults” and “people with underlying medical conditions” as those who are at increased risk for severe illness related to COVID-19. Both of those terms are intentionally vague. As the CDC continues to collect more data, their definitions and recommendations are adjusted to reflect that data.

What we know now is that as we age, our risks for developing severe illness related to COVID-19 increases exponentially. We also know (based on the June 25th update from the CDC) that individuals, regardless of age, with any of the following conditions are at an increased risk of severe illness: i

• Chronic Kidney Disease• COPD• Organ Transplant (immunocompromised)• Obesity• Serious heart conditions• Sickle cell disease• Type 2 diabetes mellitus

This is not an exhaustive list. There are other conditions that the CDC says might cause an individual to be at increased risk for severe illness from COVID-19. So what happens if you have one or more of these conditions? You are a nurse. You come into close contact with people, possibly very sick people, on a regular basis. What concerns do you have? What concerns do your healthcare providers have? How do you protect yourself?

The answer to this question is vague and complicated and has required some research into CDC recommendations, the U.S. Equal Employment Opportunity Commission (EEOC), the Americans with Disabilities Act (ADA), and an organization I hadn’t heard of called the Job Accommodation Network (JAN). The EEOC and the JAN have been working to address some of these concerns. Basically, what I have found to be repeated on most websites that I have looked at is that if an employee has an underlying impairment and could be considered at-risk for developing complications if exposed to the coronavirus, the employer must treat the request as an accommodation request under the ADA and determine if the accommodation is reasonable.

So far, with my experiences, nurses who have needed accommodations due to their “at risk status” have received accommodations from their employer. Whether it is provided in a telework format or the nurse is provided with N95 masks for increased protection from exposure, employers have shown their willingness to work with the needs of their nurses. My suggestion for anyone who is dealing with this, is to have an open communication with your facility’s Human Resources professional and with your healthcare provider. Documentation of the need for any accommodation may be required and is an appropriate request by your employer. Open dialogue with your facility’s Human Resources professional will help to determine if and how the facility can provide the necessary accommodations to keep you safe.

I am by no means an ADA or COVID-19 reasonable accommodation expert. Feel free to reach out to your Labor Representative with questions or concerns you have. Talk with your health care provider. Talk with HR. Do your research. Advocate for your safety!

Helpful Resources: • https://www.cdc.gov/coronavirus/2019-ncov/

need-extra-precautions/people-at-increased-risk.html

• https://askjan.org/topics/COVID-19.cfm• https://www.eeoc.gov/coronavirus• https://www.eeoc.gov/wysk/what-you-should-

know-about-covid-19-and-ada-rehabilitation-act-and-other-eeo-laws

i https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fneed-extra-precautions%2Fgroups-at-higher-risk.html

ii https://www.eeoc.gov/wysk/what-you-should-know-about-covid-19-and-ada-rehabilitation-act-and-other-eeo-laws

iii https://askjan.org/topics/COVID-19.cfm

Seeking Accommodations

Leslie Shepherd, BSN, RN, Labor Representative

OPPORTUNITIES & ADVENTURESIN MONTANA & WYOMING

Seeking enthusiastic RNs; Outpatient, Inpatient, Emergency Department, OB/GYN, Surgical, Public Health, Administrative, Supervisory l APRNs l Physicians who are

looking for a rewarding career with Indian Health Service!

Competitive Salaries, Loan Repayment, $ Incentives, and other GREAT Benefits

Contact: Susan Swanz P: 406-247-7126 l Susan.Swanz@ihs.gov

Mid-level provider: PA or NP licensed within the State of Montana. Family Medicine to include emergencies, chronic illness, family planning and other duties. No call, standard work week or portion of. Flexible scheduling if needed. Pay DOE, includes insurance, CME. Open until filled.

Nursing staff: RN/LPN to cover open shifts on FT, PT or per diem basis. Regular staff enjoy excellent benefits and flexible schedules. Per Diem staff have multiple options based on needs and availability. Pay DOE. Accepting applications continuously. Submit application: http://prco.mt.gov/Portals/207/Documents/EmploymentFormRevised.pdf?ver=2018-05-10-161140-587 to Nancy.trent@powderriverhealth.org or mail to Powder River Health, Po Box 719, Broadus Montana 59317. E.O.E. Contact Nancy Trent at 406-436-2646 with questions.

Page 6 Montana Nurses Association Pulse August, September, October 2020

Labor Reports and News

Updates from Montana AFL-CIO 64th Annual COPE

ConventionMontana AFL-CIO held its 64th annual Committee

on Political Education COPE Convention June 25-26 virtually, via Zoom. It was well attended and given the format; it was wildly successful! It looks like we are all getting used to using more and more virtual formats these days.

The COPE Committee, Constitution and Resolutions Committee and the Credentials Committee met during various times on Thursday June 25th. The COPE Committee submitted its report to the delegates on Friday June 16.

On Friday June 26th, the convention began with opening remarks made by Randy Tocci, President, Montana AFL-CIO and Al Ekblad, Executive Secretary Montana AFL-CIO.

Liz Shuler, Secretary/Treasurer, National AFL-CIO then addressed the convention. Her over-reaching theme was “we are stronger together,” which is not an uncommon union theme. Though in these uncertain times with the global COVID-19 pandemic, subsequent economic challenges followed by racial and social justice issues coming into the forefront in the USA, that message cannot be overstated. Secretary/Treasurer Shuler recalled the many times when fighting for civil and worker rights have been entwined.

Shuler reminded us, we cannot speak about civil rights in Montana without mentioning Jeanette Rankin, the first woman in the country to be elected to the U.S. House of Representatives. Rankin, a republican suffragist, represented Montana from 1917-1919 and 1941-1943. Rankin introduced a proposal to congress which eventually became known as the 19th Constitutional Amendment which granted women across America the right to vote. As a woman with three generations rooted in Montana, I am proud to reflect upon that fact. Please remind your children, grandchildren, and great-grandchildren about their rich Montana history about important voting rights!

This year, as with every year, we are permitted to vote to choose our elected representatives, both local and national, it is exceedingly important to exercise our right to vote as many fought to ensure. PLEASE VOTE IN 2020!

Additional remarks were received by candidates running for state and national positions, including Mike Cooney, Candidate for Montana Governor.

A complete list of Montana AFL-CIO endorsed candidates may be found at http://mtpeoplesvoice.com/2020/06/26/montana-afl-cio-announces-candidate-endorsements-for-2020-election-cycle/

Amy Hauschild, BSN, RN, Labor Representative

Lauri Hunton, RN, RNCLabor Representative

Hi, I’m Lauri Hunton RN, RNC. I live in Missoula and have been a nurse for 27 years. I have done so many things in my nursing career and had so many opportunities, that will be an asset to this position, representing nurses across the state of Montana. I am married and have 3 grown children and 3 grandchildren with another one the way. I’m a native Montanan and am super excited to advocate for nurses across Montana.

Welcome New Labor Representative!

Everyone Deserves A Job They Love!!Let Us Help Today, Call 406.228.9541

Prairie Traveler’s Commitmentto 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 406.228.9541Prairie Travelers Recruitment Department

130 3rd Street South, Suite 2 • Glasgow, MT 59230For an application or more information, visit

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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

August, September, October 2020 Montana Nurses Association Pulse Page 7

Pam Dickerson, PhD, RN, NPD-BC, FAAN

So, convention was cancelled for 2020. You were looking forward to opportunities to participate in continuing education sessions there. What to do now?

We know that life has been very disrupted for you over the past several months. People are combining work, parenting, home schooling, virus protection, and multiple other challenges into their daily lives. To help you keep up with important information, earn contact hours, and develop your professional portfolio, there are multiple and growing resources on the MNA professional development web site, www.cnebymna.com.

Here are some of the ways we’ve improved the system to help you:

• Structure allowing for more broken-up, “bite-sized” learning as your schedule allows

• Course work you can start, take a break from, and resume as needed—even your video will pick up right where you left off after you pause it!

• Integrated payments and bundling for coursework that makes purchasing access a cinch

• Certificates generated and delivered directly to your email inbox, instead of being stored online

Here are some of the activities currently available (as of July 1):• Developing your professional portfolio• Physical assessment• Inter-facility transfers• 12-lead ECG• Creativity and innovation in decision making• Leading with influence• Developing critical thinking and clinical judgment skills• Dealing with moral distress and ethical dilemmas

Here are some of the activities we’re developing for you:• Self-care – multiple modules related to burnout, nutrition• Medication safety• Communication • Other medical and trauma related topics

Visit www.cnebymna.com soon to set up your account and get started on a new learning adventure! If you have questions or suggestions that would help us improve the site, your learning experience, or the types of courses available, please let us know!

Professional Development Department

Pam A. Dickerson, PhD, RN, NPD-BC, FAAN Director of Professional

Development

Welcome to MNA’s new Director of Professional

Development! The MNA staff team is pleased to welcome Kristi

Anderson, MN, RN, NPD-BC, CNL, who will be transitioning to the role of Director of Professional Development. Kristi will start full time with MNA on July 6. Her responsibilities will include accountability for the operation of the ANCC-accredited approver and provider units to support professional development and quality of nursing practice.

Kristi comes to us from her most recent position as Continuing Education Coordinator, Primary Nurse Planner at Kalispell Regional Healthcare Services in Kalispell, MT, where she has been involved in their approved provider unit for the last seven years. Prior to that role, she worked in a variety of clinical settings in inpatient and outpatient areas. She has a bachelor of science in nursing and a master’s degree in nursing from Montana State University in Bozeman, MT. Kristi is a Nursing Professional Development Specialist and also holds certification as a Clinical Nurse Leader.

Pam and Caroline will be working closely with Kristi during the next several months to facilitate a smooth transition prior to Pam’s retirement toward the end of the year. Succession planning is critical to the effective operation of MNA’s accredited provider and approver units. A comprehensive orientation process will prepare Kristi for fully assuming her new role at the beginning of 2021.

Educational Resources for your Professional Development

Kristi AndersonMN, RN, NPD-BC, CNLDirector of Professional

Development

Page 8 Montana Nurses Association Pulse August, September, October 2020

Professional Development DepartmentMontana Nurses Association

Approved Providers

Acute Care EducationVancouver, WA

Kootenai HealthCoeur d’Alene, ID With Distinction

Alaska Native Tribal Health Consortium Anchorage, AK

Montana Geriatric Education Center of UMMissoula, MT With Distinction

Alaska Nurses AssociationAnchorage, AK

Montana Health NetworkMiles City, MT

Alzheimer’s Resource of AlaskaAnchorage, AK

Montana VA Health Care SystemHelena, MT With Distinction

Bartlett Regional HospitalJuneau, AK With Distinction

Mountain Pacific Quality HealthHelena, MT

Benefis Healthcare SystemsGreat Falls, MT

North Valley Hospital Whitefish, MT With Distinction

Billings ClinicBillings, MT

Pacific Lutheran UniversityTacoma, WA

Boise State School of NursingBoise, ID

Planned Parenthood of the Great Northwest and the Hawaiian IslandsSeattle, WA

Bozeman HealthBozeman, MT

Providence Alaska Learning Institute Anchorage, AK

Cardea ServicesSeattle, WA

Providence HealthcareSpokane, WA

Caring for Hawai’i NeonatesHonolulu, HI

Providence St. Patrick HospitalMissoula, MT With Distinction

Central Peninsula General Hospital Soldatna, AK With Distinction

South Dakota Nurses Association Pierre, SD

Community Medical Center Missoula, MT

South Peninsula Hospital Homer, AK With Distinction

Confluence Health East Wenatchee, WA

St. Alphonsus Health SystemBoise, ID

Evergreen HealthKirkland, WA

St. Luke’s Health System Boise, ID

Foundation Health PartnersFairbanks, AK

St. Peter’s Health Helena, MT

Kadlec Regional Medical CenterRichland, WA

St. Vincent Healthcare Billings, MT

Kalispell Regional Healthcare System Kalispell, MT With Distinction

UF Health Shands Hospital Gainesville, FL

Wisconsin Nurses Association Madison, WI With Distinction

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.

Special Thanks to Megan Hamilton

Megan Hamilton, MSN, RN, CFRN, NR-P, has been working with MNA since the beginning of April in the role of “seasonal employee” working with the Professional Development Department as a nurse planner. She has been instrumental in planning for our fall Seamless Care for Veterans conference as well as developing many resource materials for your own educational access on our web site – www.cnebymna.com. Megan also serves as chair of the MNA Council on Professional Development and a nurse peer reviewer for our accredited approver unit.

July 6th, 2020An open letter to the American public,Since the beginning of the COVID-19 pandemic, we have urged the American people

to protect themselves, their neighbors and their loved ones amidst the worst global health crisis in generations. After months of physical distancing and staying at home, infections and deaths began to decline.

But in the weeks since states began reopening, some of the steps that were critical to the progress we made were too quickly abandoned. And we are now watching in real-time as a dramatic uptick in COVID-19 cases is erasing our hard-won gains. Hospitals in some states are at or nearing their ICU capacity. Shortages of personal protective equipment and testing supplies continue to pose a dire threat to health care workers and patients alike. And last week, Dr. Anthony Fauci told Congress that the U.S could see 100,000 new coronavirus cases each day if we do not take more precautions.

This is why as physicians, nurses, hospital and health system leaders, researchers and public health experts, we are urging the American public to take the simple steps we know will help stop the spread of the virus: wearing a face mask, maintaining physical distancing, and washing hands. We are not powerless in this public health crisis, and we can defeat it in the same way we defeated previous threats to public health—by allowing science and evidence to shape our decisions and inform our actions.

The toll of this pandemic is already staggering, and it will take many more months, perhaps years, to truly understand its impact on our country and our way of life. But what is certain – and what the science and evidence are telling us – is that COVID-19 is not behind us and we must resist confusing re-opening with returning to normalcy. Doing so will escalate this crisis and result in more suffering and death.

To those of you who are doing your part in helping turn the tide of this pandemic – thank you. Your actions are critical to stopping the spread of COVID-19. Moving forward, we must all remain vigilant and continue taking steps to mitigate the spread of the virus to protect each other and our loved ones. There is only one way we will get through this – together.

Your continued partners in health, American Hospital AssociationAmerican Medical AssociationAmerican Nurses Association

AMA, AHA, ANA Issue Open Letter Urging Public to Wear a Mask to Stop COVID-19 Spread

www.cnebymna.comBe 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*

see more

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Performing a Quick and Helpful Physical Assessment

What is Your Learning Environment?

Transitions of Care:Interfacility Transfers

Quick Review of 12-lead ECG

Visit nursingALD.com today!Search job listings

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

Browse our online databaseof articles and content.

Find eventsfor nursing professionals in your area.

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

August, September, October 2020 Montana Nurses Association Pulse Page 9

Excerpts from ANA

By Sarah Lundwall Swenson, MS, APRN, ACNPC-AG, PCCN

NURSING is a demanding job, but it shouldn’t demand injury to the nurse, especially when injury can be prevented. Far too many nurses suffer musculoskeletal injuries (such as back and shoulder muscle strain or vertebral disc herniation) as a result of routine work duties, despite many strategies available to reduce these injuries. Nurses typically experience injuries caused by overexertion, excessive physical effort, or repetitive motion. According to the U.S. Bureau of Labor Statistics and Samaei and colleagues, as many as three quarters of nurses have experienced back injury and pain from working with patients, and most of those injuries were recent (occurring in the previous year). This rate of musculo – skeletal injury is among the highest of all industries and professions in the United States.

7 tips nurses should know about safe patient handling

• Don’t lift patients by yourself.• Keep in mind that repetitive strain can seriously injure your back.• Remember that body mechanics can’t protect your back during lifts. • Your safety and well-being are in the best interests of your patients and employer.• Using mechanical lifts requires sufficient time and adequate space.• Know where lifts are and how to use them. • Report an injury as soon as possible.

American Nurse Journal; May 2020, Volume 15, Number 5; Pages 68-70

Excerpted From

Quick patient handling tips

By Jennifer Chicca, MS, RN, CNE, CNE-cl

What is qualitative research? Defining qualitative research can be challenging. In fact, some authors suggest that providing a simple definition is contrary to the method’s philosophy. Qualitative research approaches a phenomenon, such as a clinical problem, from a place of unknowing and attempts to understand its many facets. This makes qualitative research particularly useful when little is known about a phenomenon because the research helps identify key concepts and constructs. Qualitative research sets the foundation for future quantitative or qualitative research. Qualitative research also can stand alone without quantitative research.

Although qualitative research is diverse, certain chracteristics–holism, subjectivity, intersubjectivity, and situated contexts–guide its methodology. This type of research stresses the importance of studying each individual as a holistic system (holism) influenced by surroundings (situated contexts); each person develops his or her own subjective world (subjectivity) that’s influenced by interactions with others (intersubjectivity) and surroundings (situated contexts). Think of it this way: Each person experiences and interprets the world differently based on many factors, including his or her history and interactions. The truth is a composite of reailities.

Excerpted FromIntroduction to qualitative nursing research

Most qualitative research designs share the following characteristics.

Research design characteristics

Characteristic Example

Emergent • Flexible • Adaptable • Changes to reflect

realities and viewpoints, which may not be known at the outset

Holistic

Intensely involved researcher

Merging data collection strategies

American Nurse Journal; June 2020, Volume 15, Number 6; Pages 28-32

Description

• Considers the whole A researcher completing a histori cal research study analyzes arti facts, journals, interviews, docu ments, photographs, and records to understand a past event

A researcher completing a ground ed theory study changes the inter view questionnaire, based on pre liminary findings, to include more focused questions to help saturate theoretical categories

• Detailed study A researcher completing an ethno graphic inquiry spends time (sometimes years) interviewing, observing, and perhaps even par ticipating in the studied culture

• Many strategies are used to capture holism

A researcher completing a case study analyzes interviews, observa-tions, documents, and records to understand the identified case

Page 10 Montana Nurses Association Pulse August, September, October 2020

State Wide Nursing News

GOALS1. Establish the knowledge

and appreciation of everyday negotiation happenings.

2. Increase understanding as to the meaning of the negotiation process.

3. Know how to involve others in an effective negotiation process effectively.

4. Recognize the active role of negotiation in caring for patients and administrating nursing staff.

5. Utilize hard and soft skills in the process of negotiation.

KEYWORDS FOR APPLICATION1. Negotiation2. Positional Bargaining3. Hard Skills4. Soft Skills

Have you ever said “YES” to someone or something and then wondered why you “gave in?” Sometimes a person wants something so badly; the only way to satisfy the situation is to say, “YES!” Sometimes the human effort to find a mutual ground of understanding is so difficult and intellectually challenging that we find ourselves mumbling under our breath.

Where did we go wrong? Did the word “negotiation” ever enter into our thoughts? Now (and forever), our first thought as professionals should be: Oh goody, an opportunity to negotiate! Almost everything we do in life with other people involves a negotiation process, or we end in conflict. So, let us learn the skill of negotiation!!

First—what is the definition of “negotiation?” It is when two or more parties reach a compromise. It is through conversation, agreement, and mutual respect. In nursing, the dialogue between patient/client and nurse becomes mutually beneficial. The outcome for the patient is improved health. The outcome for the nurse is the satisfaction that nursing skill and knowledge contributed to the improvement of a patient’s health. That mutual winning has an intended positive outcome for both parties—or shall we say a mutually negotiated outcome.

A job description has stated expectations of behavior. The nursing administrator negotiates with the nursing staff employee to perform tasks and actions to attain, retain, and receive compensation for job performance. In organizational endeavors, positive negotiation skills can avoid conflict and improve work relationships.

RESPONDING TO BASIC HUMAN NEEDSInvolving others in the negotiating process is

essential. It is not to be, “You Win!” or “You Lose!” It requires a respect of the emotion around the talk and making the passion legitimate. Feelings are often more than talk. Allow the other person(s) in the negotiation process to explain their grievance. Listen carefully and acknowledge what is said. Listen quietly without a response or reaction to emotional outbursts. Encourage the completion of verbal frustrations to prevent the festering of future negative feelings.

Learn personal symbolic ways to resolve an emotional impact. Try such individual gestures as presenting a small gift, eating together, sharing familial experiences, or an apology with a future commitment to improvement. A simple apology may be the least costly and most important human investment you can make.

Work on building relationships. A pound of prevention is worth a pound of cure (so they

say). By building positive relationships, there is a tendency to decrease the need for a negotiation process. If negotiation is needed, knowing someone well makes the negotiation easier. Trust between two people can become the basis for diffusing disagreements. The positive relationship with others decreases defensiveness, and negative reactions are less likely to interfere with agreements.

POSITIONAL BARGAINING SKILLSPositional bargaining, in this instance, is when

each party asserts what they absolutely will or will not do. However, other “softer” assertions of positional bargaining might be possible.

Negotiation Skill of Positional Bargaining includes:

1. Taking a position related to your needs or expectations.

2. Providing the anchor of what you want or need in uncertain terms by saying exactly what you want or need.

3. Listening carefully to the other person’s option(s).

4. Being prepared to alter your position appropriately to meet the need.

The fact is that the more extreme your stated position to meet your needs or expectations and the smaller (fewer) your concessions to meet the other person’s options, the more time and effort it will take to discover if an agreement is possible. Undisciplined arguing to arrive at a mutual agreement can be damaging to a lasting and workable relationship. The more people involved in determining a bilateral positional bargaining/negotiation, the more serious and difficult it is to negotiate. If a final decision must include a higher authority, it becomes more difficult to have a constant and lasting negotiation if the higher authority/power is not at the negotiation table.

Every negotiator has two interests—substance and relationship. Maintaining a positive relationship often results in the acquisition of the desired substance. Learning to “work” the soft and hard skills of negotiation will allow for more successful negotiations.

Dealing with people and their needs is a skill. The perception of a problem is often a problem with a person’s thinking (thought process)—and your thinking might be different than their thinking! Differences requiring negotiation exist because there are differences in thinking and ideology.

Negotiation can be known as a “hard negotiation” or a “soft negotiation.” It is often best to use negotiation skills somewhere in the middle of being soft (maintaining relationships) and a hard negotiation strategy (always having it your way).

Consider these negotiation behaviors of hard versus soft negotiation skills:

Hard Skills: Soft Skills:

Insist on your position Insist on an agreement

Make threats Make offers

Distrust others Trust others

Dig into your position Change your position easily

Mislead as to your bottom line Disclose your bottom line

Be process-oriented Be people-oriented

Apply pressure Yield to pressure

Focus on your position Focus on mutual interest

Refuse options Consider options

As professional nurses, we use these concepts daily and know how personal relationships affect outcomes. If nurses think “negotiation” when working effectively with patients and professional cohorts, nurses are more likely to select the middle road behaviors between hard and soft skills to obtain mutually beneficial outcomes.

NOTHING NEW - JUST A REMINDER OF EXPECTED PROFESSIONAL ABILITY

You, as a professional nurse, already knew this information—didn’t you!? It is nothing new. However, we continue to hone our understanding of negotiation skills as well as appreciate the alternative view. The capability to effectively negotiate is the hallmark of the professional nurse.

CRITICAL THINKING QUESTIONS1. What is the last situation in which you “gave

in” without negotiation? How could you have carried on a conversation that would have included “middle of the road negotiation skills?”

2. What skills do you plan to use next time a person challenges you regarding your decision?

3. How do you use your relationship skills to help prevent the need for negotiation?

4. What is your concept of “winning a negotiation?”

RECOMMENDED READINGGETTING TO YES (Negotiating Agreement Without

Giving In) by Roger Fisher and William Ury

NEGOTIATION: WINNING BY MUTUAL AGREEMENT

Carolyn TaylorEd.D, MN, RN

August, September, October 2020 Montana Nurses Association Pulse Page 11

Greg Holzman, MD, MPH, State of Montana Medical Officer

Maggie Cook-Shimanek, MD, MPH

COVID-19 remains a topic of substantial interest and concern for Montana medical and public health communities. As of mid-June, Montana’s COVID-19 case rates were the lowest in the continental U.S. and disease prevention remains the State’s top priority in an effort to retain that status. Robust testing efforts are underway in Montana. The State is conducting sentinel surveillance among those living in high-risk settings such as nursing homes, assisted living facilities, and correctional facilities, among others. Rapid, effective contact tracing, a cornerstone of infectious disease prevention, can quickly identify exposed contacts of those infected with COVID-19 resulting in timely quarantine or isolation, thereby preventing disease spread.

The medical community should strive to provide excellent examples of how to mitigate risk. It is important that patients understand their risk of acquiring COVID-19. Certain populations are more vulnerable to severe infection. People 65 years or older and those living in a nursing home or long-term care facility are at greater risk for severe illness. Patients may have medical conditions that confer higher risk, including those with chronic lung disease such as moderate to severe asthma, or serious heart conditions. Patients who are immunocompromised, have diabetes or liver disease and those who are undergoing dialysis because of chronic kidney disease are also at increased risk compared to the general population.

Patients with poorly controlled underlying medical conditions are at even higher risk for severe disease. Now is an opportune time to optimize a patient’s chronic disease management by continuing medications and staying up to date on vaccination status. Counsel patients to avoid delays in seeking emergency medical care for serious symptoms. In this time of stress and uncertainty all patients, but particularly those with mental health conditions, may be vulnerable and would benefit from increased psychosocial support. Montana-specific Crisis Mental Health and Substance Use Disorder resources are available to providers to share with patients during COVID-19. Reinforce to patients that it is extremely important to stay home if they feel at all sick. As medical providers, we too need to follow this guidance. Reinforce with your patients that if a public health professional recommends quarantine or isolation due to COVID-19 exposure, they should follow those recommendations.

Remember that people may spread the virus before they even show symptoms. We often do

not know the underlying health conditions of our friends, colleagues, and neighbors. Right now, we need to live as if we might have the virus and the people around us might have the virus. Businesses are working to mitigate risk for their employees and customers. Educate patients, their families and community members that the intent of wearing a face covering in public is to protect others. Let's make wearing a face covering the norm in Montana, so when visitors come to our State, they know this is the norm around here and they should follow suit.

We need to learn how to minimize our risk as we continue to live our lives with COVID-19

COVID-19 in Montanain the community. We are all in this together. It is not simply an issue of supporting health or the economy. We need good health to have a prosperous economy, too. It is only if we all work together that we can keep Montana healthy – mentally, physically, and economically.

CDC COVID Data Tracker https://www.cdc.gov/covid-data-tracker/index.html#cases

DPHHS COVID-19 Resources for Individuals, Families, and Providers https://dphhs.mt.gov/amdd/covid19

DPHHS Coronavirus Disease 2019 (COVID-19) https://d p h h s . m t .g o v /p u b l i c h e a l t h /c d e p i /d i s e a s e s /coronavirusmt/demographics

NursingALD.com can point you right to that perfect NURSING JOB!

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Page 12 Montana Nurses Association Pulse August, September, October 2020

By Kristina Kenning MSN RN, Nursing Instructor at Helena College

My job as a nursing instructor at Helena College is the most rewarding and intellectually stimulating position I have ever held, but it is not simple. It is a constant juggling act of clinical schedules, simulation times, and exam writing. However, our work as instructors became infinitely more complex with the advent of Covid-19. Suddenly, we were not just worried about how to give students well-rounded and meaningful clinical experiences, rather we were worried about how to give them any clinical experiences at all. Reflecting back on the spring semester of 2020 and how we tackled the situation, I began to realize there are lessons we can learn from this difficult event.

Covid-19 Arrives in Montana On March 12, 2020, we discovered we would not

be returning to campus after spring break. Suddenly instructors and students had to assume the task of learning how to transition from in-person classes to a fully online platform. Yet the most pressing issue for our nursing program was how to plan for clinical time. The National League for Nursing [NLN] issued a statement which proposed that healthcare institutions should partner with nursing schools as a way to “augment and support nursing services in health care facilities” (NLN, 2020). However, most of the hospitals in Montana weren’t facing the same critical nursing shortages like harder-hit states such as New York. Understandably, local facilities stopped allowing students as a way to limit person to person contact and conserve PPE. In addition, there was an ethical concern regarding knowingly sending students into potentially virus-impacted

clinical sites. And so by the end of March, most in-person clinicals were completely removed from the equation. In its place, virtual clinical platforms were implemented as a way to substitute for lost time.

These virtual clinicals are internet based platforms and similar to a high tech video game. A student is given a simulated patient that can be assessed, given medications and even given treatments. While this was a drastic alteration of our usual modus operandi, we were not alone in this change. In fact, 41 out of 50 states reported Covid-19 related changes or recommendations to their States Boards of Nursing regulations to allow for increased flexibility for nursing programs (National Council of State Boards of Nursing, 2020). After six weeks of at-home learning, our students successfully completed their course work. Now, as we turn our gaze forward to the next semester and semesters beyond that, it is important that we remember these past few months without the stain of negativity, but rather as a challenge from which we can learn and grow.

Lesson One: Advantages of TechnologyOne of the first lessons I took away from this

event is the true advantages of technology. Covid-19 forced me to set aside my original teaching plans and forge a path for a different reality. First was the acceptance of virtual simulation as the new normal. We as a faculty had considered using these products for several years, but now out of necessity we quickly adopted a new online virtual clinical system. After a bit of trial and error, we found a rhythm. One of the biggest surprises of this decision was that both the students and the instructors enjoyed these simulated clinicals! They tested students’ medication knowledge, as well as their

Teaching Nursing in a Pandemic: Lessons Learned During the Spring Semester of 2020

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.

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/

prioritization and therapeutic communication skills. They also allowed students to work with acutely sick “patients” that they would rarely encounter even in non-emergent times. As a result of this experience, we plan to keep some form of virtual simulation so students can continue to benefit from these resources.

Lesson Two: Flexibility and UnderstandingIn addition to embracing technology, this

pandemic has also taught me the importance of flexibility and understanding. At Helena College, many of our students are non-traditional and have young families, jobs, and other responsibilities. During this time, these students were not just going through the rigors of nursing school, but were also learning to be “elementary school teachers” for their now at-home kids. Being flexible and understanding during these times was crucial for the success of these students. This also meant allowing students more freedom for creativity. For example, how can you create a video demonstration of yourself completing a medication pass assignment if you are self-isolating alone? One student’s solution – training their dog to answer yes or no questions!

Lesson Three: The Human ConnectionFinally, one of the most powerful lessons

learned through this crisis is the significance of the human connection. We are nurses because we care for patients. The human connection between a nurse and their patient is the cornerstone of our profession. For many of our students, it was a relationship that drew them to nursing in the first place. And so while technology allows us to replicate a human relationship, it can never replace it. In future semesters, we plan to work closely with our local facilities to find creative ways to give our students the opportunity to work safely with real patients.

But it’s not just the nurse-patient relationship that was lost during this crisis, it was also the connection between students and their peers. At the start of my newly-online class, I created a chatroom as a way for students to ask course-related questions and post discussion topics. However, after a few weeks, these chat rooms morphed into something beautiful. They became a support network of students lifting each other up and encouraging each other through these rough times. Watching this transformation has altered my vision of my role as an instructor. Not only can I help these students learn and grow in the profession of nursing, but I can also help to facilitate their growth as kind, caring and supportive individuals.

ConclusionThe pandemic of 2020 brought forward many

unforeseen obstacles and, as distressing as it may be, I believe that it is unlikely that we will ever return to our pre-Covid normal. This event is forever woven into the fabric of our history, and much of that history is still in the making. However, with these challenges comes the opportunity for growth and learning. Reflecting back on the spring semester of 2020, I realize that we can change the lens through which we view this event. After all, I always tell my students to find the lesson learned in every scenario. I accept that Covid-19 is an unfortunate part of our current reality, but moving forward, I can take these lessons and carry on the mission of improving the instruction of our futures nurses.

ReferencesNational Council of State Boards of Nursing. (2020, June

22). Changes in Education Requirements for Nursing Programs During Covid-19. Retrieved from NCSBN.org: https://www.ncsbn.org/Education-Requirement-Changes_COVID-19.pdf

National League for Nursing. (2020, March 26). U.S. Nursing Supports Practice/Academic Partnerships During COVID-19 Crisis. Retrieved from nln.org: http://www.nln.org/newsroom/news-releases/news-release/2020/03/26/u.s.-nursing-supports-practice-academic-partnerships-during-covid-19-crisis

August, September, October 2020 Montana Nurses Association Pulse Page 13

This month I attended my very first Black Lives Matter Rally in Missoula. I was completely unaware of what to expect, a portion of me went out of curiosity and a portion out of wanting to become anti-racist but not knowing how. The speakers and message of that rally hit me hard, “it’s not enough to not be racist, we must be anti-racist.”

I remember years ago encountering my first black patient. I experienced a quiet panic as I reached the nursing assessment of checking capillary refill and thought “how will I know if it’s less than three seconds?” I was completely unprepared for how to care for patients with dark skin tones. This might seem trivial to most, however upon reflection I see the system that lead to my quiet panic.

I attended nursing school a decade ago in Montana. I had never encountered a Black patient during clinicals, never practiced on a black SIM doll or a black CPR mannequin. My entire nursing experience was white skin oriented some indigenous influence. Sure the text books had rash or skin condition photos of all skin colors, and we were taught what health conditions were more prevalent by race, but we were not taught how to adequately give care from a place of acknowledging the systems of oppression black and people of color have grown up in.

Going back further, I remember only two black students in my high school. I come from an extremely conservative and white centric family. Diversity, social injustice, and anti-racism where never taught to me during my school years or in my family of origin.

Today, I consider myself lucky to work alongside a handful of black colleagues. However, I must confess I never acknowledged their skin color or race difficulties until this spring. I took for granted their existence and did not acknowledge the struggles of their race. I work in a Human Resource oriented setting now, where I have always been an advocate against systemic wage and labor disparity. My confession is I want to do more. Now that I am learning more about this issue and now that I am choosing to break free of my limited upbringing.

Collectively, as a nursing community, we need to advocate for race equivalency in nursing education programs, especially in rural areas. We must advocate against gun violence since it is primarily directed at people of color. We must open conversations and become actively anti-racist caregivers.

Loni Conley, RNCandidate,

Montana State Legislature

Confessions of a White Nurse

New Member Benefit: MNA now offers certification through ANCC’s Success Pays® Program

> 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.

CONGRATULATIONS TO THE FOLLOWING NURSES WHO HAVE TAKEN ADVANTAGE OF THE SUCCESS PAYS OFFERING BY ANCC TO MNA MEMBERS!

1. Shannon Murray RN-BC; certified in Medical Surgical Nursing

APRN PHARMACOLOGY CONFERENCE 2021

Save the DateMARCH 5TH & 6TH, 2021

APRN Corner

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.

Keven ComerMN, APRN, FNP-BC

Page 14 Montana Nurses Association Pulse August, September, October 2020

2020 MNA Open Positions-Positions to start 1/1/21

~Any member wishing to run for an open position MUST complete a Consent to Serve by October 9th and email it to jennifer@mtnurses.org and include your PERSONAL email address~

General Ballot• Treasurer – One (1) will be elected for a two-year term-Jan 2021 –

Dec 2022• Director at Large – One (1) will be elected for a two-year term-Jan

2021 – Dec 2022• Council on Professional Development – Representative to the

Board – One (1) will be elected for a two-year term-Jan 2021 – Dec 2022

• Council on Professional Development – Five (5) will be elected for a two-year term Jan 2021 – Dec 2022

• Council on Practice and Government Affairs – Representative to the Board – One (1) will be elected for a one-year term (due to vacancy)-Jan 2021 – Dec 2021

• Council on Practice and Government Affairs – Three (3) will be elected for a two-year term (with alternates)-Jan 2021 – Dec 2022

• Nominations Committee – Three (3) will be elected for a one-year term (with alternates) Jan 2021 – Dec 2021

• Elections Committee – Three (3) will be elected for a one-year term (with alternates) Jan 2021 – Dec 2021

• ANA Membership Assembly Representative – Two (2) will be elected for a two-year term (with alternates) Jan 2021 – Dec 2022

Council on Advanced Practice Ballot• Chairperson Elect – One (1) will be elected for a one year term

(Jan 2021 – Dec 2021) to be followed by a two (2) year term as Chair Person (Jan 2022 – Dec 2023) for a total of three years.

• Member at Large – One (1) will be elected for a two-year term-Jan 2021 – Dec 2022

Collective Bargaining Ballot• Council on Economic & General Welfare – Representative to

the Board – One (1) will be elected for a two-year term-Jan 2021 – Dec 2022

• Council on Economic & General Welfare – Two (2) will be elected for a two-year term (with alternates)-Jan 2021 – Dec 2022

• AFL-CIO Convention Delegates – Four (4) will be elected for a one-year term (with alternates) Jan 2021 – Dec 2021

Montana Nurses Association Position Open

Title: Nurse Planner Anticipated start date January 4, 2021

Qualifications: Active, unrestricted nursing license and a member of MNA; Bachelor’s degree in nursing required or graduate degree with either graduate or undergraduate degree in nursing required; Familiar with ANCC continuing nursing professional development accreditation criteria and processes with certification in nursing professional development preferred – required within 2 years of hire; Proficient in Microsoft Word, Excel, and PowerPoint and knowledgeable of web-based learning platforms and management of web site, social media, and other web-based resources.

Responsibilities include:• Serve as nurse planner for MNA accredited provider unit

§ Plan, implement, and evaluate educational activities in adherence to ANCC accreditation program criteria

§ Maintain activity files, NARS records, and learner participation data

§ Manage development of online learning content• Serve as event coordinator and community liaison• Facilitate face-to-face, webinar, or enduring material as appropriate• Participate in staff support for the Professional Development Council• Participate in special projects that support mission of MNA to promote

professional growth of members and other nurses in Montana

Submit Resume or CV to kristi@mtnurses.org by September 15, 2020. Competitive pay and excellent benefits.

The Montana Nurses Association is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to age, gender, race, ethnicity, sexual orientation, disability, national origin, political affiliation, or religious belief.

MNA Open Positions

If you’d like to balance working in a busy, forward-thinking organization while playing in a recreational paradise, contact Joey Richman at 406-454-7325 or joey.richman@gfclinic.com.

Thrive where you live. Grow your career—while hiking, skiing, fishing and living the good life in Montana. The Great Falls Clinic is a progressive, physician-led healthcare organizations—and we think living a good life is just as important as building a career. Our comprehensive care facilities are headquartered in and around Great Falls, Montana—an exceptionally safe, affordable town surrounded by three mountain ranges.

Great Falls Clinic Hospital | 3010 15th Ave South Great Falls MT 59405 | www.gfclinic.com

The Great Falls Clinic Hospital is seeking experienced Utilization Review, Critical Care, PACU, Cath Lab & OR Circulating Registered Nurses for our

growing service lines.

• 12 hour shifts; with call rotation

• Competitive salary and benefits

• Vacation/sick leave package that promotes health-work life balance

• Retention and moving bonus

August, September, October 2020 Montana Nurses Association Pulse Page 15

MEMBERSHIPMATTERS!

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 todayjill@mtnurses.org

(406) 442-6710

Applications also available onour 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

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