Текст книги "The Nurses: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital"

Автор книги: Alexandra Robbins

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Текущая страница: 27 (всего у книги 33 страниц)

For aspiring nurses

Nursing is the fastest-growing occupation in the country, according to the Bureau of Labor Statistics. Between 2014 and 2022, the United States will create 574,000 new jobs for nurses, many of them in the growing sectors of home health services and outpatient centers. The field needs more smart, dedicated workers. “The profession is exciting and fulfilling. This is a tremendously fabulous time for nurses because of the vast opportunities that exist,” said Terri Weaver, dean of the University of Illinois College of Nursing.

This book describes some negative issues in nursing in the hopes that readers will lobby hospitals and lawmakers to fix these problems. But it is crucial to know that despite these issues, nurses love their jobs and will enthusiastically persuade potential recruits to join the field. Please read the nurses’ testimonials at the end of this chapter to learn more about the rewards of the job.

One resource for aspiring nurses is Johnson & Johnson’s Campaign for Nursing’s Future. The campaign, which focuses on recruitment and retention of nurses and nurse educators, aims to “make nurses feel really good about what they do,” said a spokesperson, and raises funds for scholarships, fellowships, and grants. The campaign’s website, Discovernursing.com, offers steps to take to become a nurse, day-in-the-life videos, career development help, and other interactive tools for nursing students and managers.

For additional advice for aspiring nurses, I asked several nursing school deans what they tell their students and new graduates. Here are some of their tips.

Know your options.

Nursing is a practically limitless field. “Choosing nursing as a profession means that you will have career choices for a lifetime without changing professions,” said Joan Shaver, dean of the University of Arizona College of Nursing. “We practice everywhere—hospitals; retail clinics; community centers; home care; urgent care; hospice; in the military, corporations, and government; in the air, on the water, on the road, on the Web; and more.”

Nurses can also work as scientists, engineers, policy makers, lawyers, researchers, professors, administrators, and businesspeople. “As you learn the basics of nursing practice, observe and learn about where nurses work, their opportunities and impact, and what patients need in each. Your preferred forte will emerge,” Shaver said.

In a hospital, shadowing on various floors “gives you a chance to see how the nurses interact with each other and physicians,” said the Oklahoma nurse supervisor. “We have senior nursing students who will work as nurse techs and float to different floors to check them out. There are so many different job opportunities for nurses that it helps to take some time at the beginning and check out different options.”

Kathleen Potempa, dean of the University of Michigan School of Nursing, recommended that all aspiring nurses “consider no less than a baccalaureate program, which is now required for work at many top hospitals and clinics,” she said. “Studies show that baccalaureate-prepared nurses are first in line for jobs, are best prepared for the challenges of the field, and are exposed to a wide range of options for learning and research.”

Nursing involves more than you might have thought.

Students commonly arrive at nursing school expecting to learn about performing certain tasks. “They have the same perception as the public, that nurses ‘do things’ to people. That’s actually only a very small part of what nurses do,” said Bobbie Berkowitz, dean of the Columbia University School of Nursing. “Most of nursing involves thinking critically, understanding the human condition and how people respond to illness and health, being a mediator, helping people understand what’s happening, and minding the environment and the technology. These are skills that are often hidden from the public. We try to help students understand that nursing is more than giving an injection. It’s a lot more complex than that.”

Never stop learning.

For nurses, learning is a lifelong goal, said Mary Kerr, dean of the Frances Payne Bolton School of Nursing at Case Western Reserve University. Linda Norman, dean of the Vanderbilt University School of Nursing, agreed. “Be avid readers of the latest evidence out there related to healthcare delivery in your practice. You don’t stop that reading and learning when you graduate. To be a great nurse, you’ve got to be able to know what is the best evidence for the care that you’re providing,” Norman said.

Be a team player.

“We’ve got to get away from the doctor–nurse game. Today’s world of healthcare is all about teams; nurses work with a lot of other decision makers,” Norman said. “Nurses need to be comfortable in their own professional skin, and we’ve got to be able to appreciate everybody. We have to be able to appreciate the physicians’ position, but they’ve got to be able to appreciate nursing and that the nurse’s role has changed drastically over even the last five years.”

On giving advice . . .

“Never give advice unless it’s asked for and always give it when it is,” said Judith Karshmer, dean of the University of San Francisco School of Nursing and Health Professions. While some nurse faculty members tell students never to give advice to families or patients, Karshmer had a different take. “People take advice from a lot of different sources. When patients or family say, ‘What do you think I should do?’ if they are asking for expertise from a nurse, it is your responsibility to provide that.”

For nurses

Find your A-team.

“The best coping resource is my fellow nurses. We are dragged through the mud together during these tragic events; who better to debrief with? And my boyfriend, who listens to me go on and on, particularly after a really hard shift,” said a New York pediatric ICU nurse. “I think that’s one of the most important things for a nurse. You need to figure out who your A-team is outside of work and allow yourself to rely on them, because you can’t hold this stuff inside your chest forever.”

One popular resource for nurses is the social-networking site allnurses.com, which offers several discussion forums. “It’s a platform for nurses from around the world to come together with like-minded people, share experiences, get support, and ask questions,” said founder and CEO Brian Short. “A lot of nurses come home from working a tough shift (a patient dies, something bad happens). They don’t really have support systems at home that understand what they just went through. On allnurses.com they can jump on and find thousands of people who understand.”

Volunteer.

“The point of the profession is to improve the overall health of society. One way to do that, which I have found particularly satisfying, is volunteering with a health organization,” such as on an interprofessional board, Terri Weaver said. “It’s an indirect but effective way to impact a population of patients. Being involved in such organizations also showcases what nurses can do. Volunteering is a way to influence the perception of lawyers, businessmen, and other leaders, so that they witness the critical thinking and font of knowledge associated with nursing and realize that nursing is more than the stereotype.”

To be a good nurse . . .

“To be a good nurse you have to have ‘tits,’ the female version of cojones,” a Texas advanced practice nurse advised. “It’s not about you, it’s about the patients. What do you need to do to get their needs met? That requires self-confidence and lack of fear of humiliation by MDs (and PAs, who can also be horses’ patoots). You have to be able to tell a physician that their orders aren’t safe, or the patient’s allergic to X, or that they need to come assess the patient.”

Find a comfortable way to share.

“Many times patients wanted to connect more closely to me, but I held back after the first few times I invested emotionally” in patients who died, said a Washington State nursing professor. “It’s hard to be caring and not give up part of yourself. My solution was sharing one or two things (over and over again) that seemed to meet the need of personal investment for the patient without surrendering my whole self. I learned how to use my ‘polite face’ with patients getting bad news, so I don’t show emotion. I teach it now to my students: eye contact, relax face, and breathe. It works when they are angry at you, their illness, pain, or death, and helps the caregiver be the bridge to comfort for the patient.”

Consider becoming a mentor.

Nurses nationwide told me how valuable their mentors and mentees have been to their development as a nurse. A Virginia nurse practitioner said she thinks of her mentors as “second moms.”

Seasoned nurses offered several tips for being a good mentor. “I think the key components of good mentors are (1) patience: allowing a nurse to struggle and not to expect an answer immediately; (2) challenge: teaching a nurse to think out a process, task, or situation by reviewing the pros and cons; and (3) interest: helping a nurse both professionally and personally as she deals with new stresses and responsibilities,” said a clinical nursing instructor in the upper Midwest. “Learning to be a nurse is like learning to be a mom. It’s holistic, complicated and requires desire, knowledge, and a willingness to accept criticism. These are hard for some people, but so very important.”

A Missouri clinical instructor said that mentors should be open to the idea that a mentee might have different needs than a mentor expects, and that those needs might change. “So be adaptable. Have a sense of humor, listen attentively, give the learner a chance to problem-solve or identify the possible options,” she said.

Take “you time.”

Flight attendants remind passengers to secure their own oxygen masks first before helping others. Similarly, nurses should remember to take care of themselves, even if only to take better care of their patients. This can help them to find joy or comfort in even the toughest weeks. “After a bad day, I go home and take twenty minutes all to myself. Sometimes I sit and cry and sometimes I just reflect on the day. After those twenty minutes, I let it go,” an Oklahoma LPN said.

Help coworkers with substance abuse issues.

If you or a coworker have a substance abuse issue, check with your state nursing association for peer assistance, alternative-to-discipline rehabilitation, or diversion programs. For signs of an impaired colleague, and treatment recommendations, see www.aana.com/GettingHelp. For resources searchable by state, visit Webapps.aana.com/Peer/directory.asp. While the AANA’s comprehensive directory is intended for nurse anesthetists—and the Peer Advisors volunteer only for CRNAs and student nurse anesthetists—many of the resources and state assistance programs can help all nurses. The AANA’s pages provide one of the best one-stop shops for nurses seeking help.

The ANA’s Impaired Nurse Resource Center also includes some links to organizations specializing in addiction: Nursingworld.org/MainMenuCategories/WorkplaceSafety/Healthy-Work-Environment/Work-Environment/ImpairedNurse/Impaired-Nurse-Resources.html.

The Massachusetts Nurses Association’s guidebook on interventions advised colleagues to begin this delicate conversation with: “I am not asking you to confirm, deny, or explain the reasons for the observed behaviors. I am here to share concerns and offer possible resources for your consideration.” The guidebook added: “It is important that the nurse understands that his/her options will become limited and their license will be in jeopardy if substance use continues.” Coworkers can then inform the nurse about the availability of family medical leave and direct her/him to a peer assistance program.

Create moments of connection.

Canadian nursing professor Beth Perry studied exemplary oncology nurses to determine how they avoided compassion fatigue. She found that the nurses who created and appreciated “moments of connection” were energized by these occasions: “Those meaningful connections occur in moments often created by shared humor, therapeutic silence, touch, keeping the promise to never abandon—small gestures lovingly given that change the patient’s sense of well-being and have a positive effect on the nurse as well.”

Lobby for staff education on lateral aggression.

When Martha Griffin, director of nursing education and research at Boston Medical Center, taught a group of new nurses how to recognize lateral aggression and what to do about it, every nurse who was bullied confronted her aggressor, and in every case, the bullying stopped. Educating staff about what constitutes lateral aggression both empowers the victims and alerts the bullies to the ways their colleagues might be interpreting their behavior. This awareness and preparation can improve nurse retention rates.

Reach out to colleagues.

In some cases, alleviating hostilities among nurses could be as simple as making an effort to bridge generation or seniority gaps. “Experienced nurses can feel threatened by new nurses and resistant to changes recommended by new nurses. At the same time, new nurses don’t recognize the significance of experience,” said a Midwestern nursing professor. “As a Clinical Nurse Specialist, I was the one to orient new employees, and found that having sharing sessions off-the-clock, whether at coffee, lunch, or after work, decreased this. Unless nurses are allowed to share their understanding of how and why things are being done, the not-understanding becomes anger and disgruntlement. Both sides need to learn how to bring up something new and be willing to work together on change.”

Remember why you love your job.

At Barnes-Jewish Hospital in St. Louis, part of the program to mitigate compassion fatigue includes an exercise in which participants share verbally with each other the reasons they chose their career. Similarly, it might be helpful for other nurses to remind themselves why their field is rewarding. Here are some perspectives on why nursing is wonderful.

“I absolutely love what I do. When patients and families come into the hospital, they are at the very least concerned, and at the most extremely frightened. There is nothing more satisfying than sitting down with a patient and discussing their diagnosis and what they can expect from their hospital stay. You can see them relax; they are so thankful that you simply took the time to sit and listen to them. I also love helping patients recover from surgery because you can directly see how your care helps them make a full recovery.”

–a Minnesota travel nurse

“Helping someone fills up that part of me that makes me able to give some more. I love figuring out what the matter is, that collaborative effort to make a nursing diagnosis and plan. I like that I have never been unemployed. I will always have the dignity of work that is fulfilling.”

–a Washington State nursing instructor

“There is not a day at work where a life is not changed by something I do, whether it’s a decision on how to staff the floor, answering another nurse’s question so she can understand what to do, or helping to settle a family issue.”

–an Oklahoma clinical supervisor

“Nursing is that challenge which can make you a better person than you could have imagined being. It is a continuous education requiring curiosity, flexibility, ingenuity, resourcefulness, faith, compassion, and humor.”

–a Missouri clinical nursing instructor

“I think nursing is the only occupation that is ridiculously crazy, challenging, and sometimes out of control, while at the same time the most rewarding, fulfilling, and inspirational occupation. It amazes me how many people’s lives I have been able to touch in a meaningful way.”

–a Maryland oncology nurse

“I love working in an environment where I can see the effects of my work in real time—instant gratification! I never leave feeling like I wasted my time at work. I like the mental puzzle of trying to figure out what’s going on, but I also really appreciate the physical aspect of working with my hands. I learn something new every day; no day is ‘just another day at the office.’ ”

–a California nurse practitioner

“I strive never to let my patients die alone. If family can’t come, I do my best to stay and be their final companion in life. We are aware of the enormity of this journey. Our job is to help them not be afraid, feel alone, in pain, or anxious. I think nurses do this job well. There is joy in nursing, too: to see a patient’s pain or infection disappear; a patient and their family’s joy as they walk several feet for the first time. How can you not love nursing?”

–a Washington State cardiac nurse

“There are very few jobs that each day some or most of the things you do for your clients make their day better. You always make a difference.”

–a Missouri public health nurse

“My favorite times in nursing are when I’ve been able to help the spirit of the patient, from letting a kid cover me in Silly String to rocking a baby who was taken from her birth parents for maltreatment. It’s the moments where I feel a connection between souls that I love the most. I also love to share my knowledge. When I teach a family something and I see the lightbulb of realization click on, that’s a very rewarding feeling.”

–an Arizona pediatric oncology nurse

“As a nurse, you wake up every morning and say to yourself, ‘Today I’m going to do the work of my life.’ Behind every great doctor is an even greater nurse.”

–an Ohio outpatient nurse

“I have never had a boring day as a nurse. Mostly I feel privileged to be involved in the lives of others and to work with them toward a better future. I have practiced for thirty-nine years, and I still have so much joy and energy every time I go to work. That’s truly the sign of being in the right profession! We’re like a secret club because we’re privileged to share intimate life stories with our patients, and this level of awareness makes us a bit wiser about the true nature of people. There isn’t much that surprises us about the human body, and we feel free with each other to discuss topics that are clearly off limits in other social groups. Our shared tragedies and losses help us deal with our own grief and sadness. I would say we are a hardy group.”

–a Michigan nurse practitioner

“I love some of the stories I get to take home with me. It’s also pretty cool to see some of the amazing things that medicine can now do. I’ve seen people brought back from the dead (Code Blue that ends well). Once, I got to have my hands inside a man’s face, literally, like opening a real-life anatomy textbook. Where else do you get to do things like that?”

–an ICU nurse in Canada

“We are strong and opinionated. [Our unit has] worked together for so many years that we are like sisters. We finish each other’s sentences, watch each other’s children, and vacation together. We have a strong bond and love for each other. We spend more time with each other than most of our family members. We have nearly zero turnover. We are very close and comfort each other often.”

–an Indiana NICU nurse

“I love my job, and I hope people find comfort in knowing there are still people out there who love what they do.”

–a New York acute care nurse

Wall of Heroes

This book is also dedicated to the selfless, hardworking nurses, past and present, whose stories would be enough to fill many more books. The inspirational nurses listed here were nominated by fellow nurses, who pay the highest compliments to their coworkers, mentors, relatives, or instructors. All of them deserve our heartfelt thanks.

Marion Acker, LPN, Mississippi • Deborah Ackerman, RN, BSN, Arizona • Suzanne Adams, RN, ASN, Utah • Kristen Albert, RN, Kansas • Cindy Alexander, RN, Kansas • Jodean Allen, LPN, Arkansas • Rebecca Almeida, BSN, Massachusetts • Christine Amidon, BSN, RN, NCSN, Indiana • Daynabelle Anderson, BSN, California • Jada Anderson, LPN, Indiana • Myrtle M. Anderson, RN, Washington • Judy Andrews, RN, CCRN, Maine • Laura Ardizonne, CRNA, DNP, DCC, New York • Howard Armour, CRNA, MS, Pennsylvania • Patricia Armstrong, ADN, Connecticut • Sylvia Arroyo, RN, MSN, Florida • Patricia Prentce Austin, retired USAF Major, BSN, MSN, North Carolina • Joyce Backus, RN, Kansas • Shayla Badgett, ASN, Florida • Becki Brown Baker, RN, BSN, MSN, Tennessee • Shayla Bakke-Caravia, RN, BSN, California • Amy Bales, RN, Indiana • Lee G. Balos, CRNA, Georgia • Virginia Rose Bamford-Perkins, RN, MSN, Maine • Alysia V. Barber, RN, BSN, Maryland • Jamacia Barker, LPN, Mississippi • Jenifer Barney, RN, Kansas • Brian J. Bauhs, CRNA, MSN, New York • Theodora Belz, RN, New Jersey • Wendy Beaudoin, BSN, MSN, NP, Canada • Sharon Beautz, RN, BSN, Maryland • Nancy Beckman, CRNA, RNC, MS, Michigan • Donald Bell, CRNA, MS, MSNA, Tennessee • Kim Bell, RN, New Jersey • Sheryl Bellinger, RN, BSN, MEd, Colorado • Patricia Benner, RN, PhD, California • Connie C. Bennett, LPN, Florida • Estella Bennett, LPN, Ohio • Robert J. Berger, CRNA, ARNP-A, MSNA, LTC, USAR, Iowa • Beth Bergeron, RN, New Hampshire • Anita Bertrand, CRNA, MS, Texas • Joy Biard, RN, Kansas • Antoinette “Peg” Black, RN, Wisconsin • Lisa Blackwelder, BSN, MSN, FNP, Texas • Jamie Blalock, APRN, FNP-C, Georgia • Diane Blanchfield, RN, MS, North Carolina • Gloria Jean Blenkhorn, LPN, Maine • Jo Ann Blevins, RN, Kansas • Eileen Bole, RN, Kansas • Tammy Fitch Borger, RN, BSN, Virginia • Pam Bormann, RN, New Hampshire • Loretta (Ann) Bostic, DNP, CRNA, West Virginia • Blair Bowers, BSN, Georgia • Catherine Boyts, RN, Kansas • Dr. Beverly Bradley, RN, PhD, California • Olympia Branch, LPN, Mississippi • Shirley A. Braun, RN, BSN, Florida • Cathy Bray, RN, Indiana • Jeanne Brennan, RN, Pennsylvania • Maria Brilhante MSN, FNP, MSRN, New Jersey • Hazel Brown-Johnson, Brigadier General, RN, BSN, MSN, PhD, Washington, DC • Marie Brophy, RN, BSN, MSN, Arizona • Laura L. Brown, RN, BSN, Ohio • Sharon Brown, RN, Washington State • Katina Brownridge, RN, Mississippi • Jack Brueggemann, CRNA, Kentucky • Jo Buddrius, RN, MSN, New Mexico • Paula Bunde, RN, Kansas • Kelly Bunker-Taylor, RN, Maine • Charmon Burch, LPN, Alabama • Dana Burch, RN, New Jersey • Tashikkea Burns, RN, Alabama • Elizabeth Burridge, RN, Massachusetts • Kelly Bushnell, RN, BSN, Florida • Elizabeth Butler, RN, ACLS, NRP, Texas • Melody Anne Butler, RN, BSN, New York • Delores Byington, LPN, Oregon • Sally Caltrider, MSN, RN, Vermont • Lauren Calzonetti, RN, New Jersey • Pat Campanella, RN, BSN, California • Angela Sanders Campbell, RN, BSN, Mississippi • Tia Campbell, MSN, RN, NCSN, FNASN, Virginia • Annathea Canning, RN, Canada • Guy Caraffa, CRNA, Arizona • Agnes Carr, RN, Washington, DC • April Carter, RN, Mississippi • Frances Charles, RN, West Virginia • Julie Chase, RN, New York • Carl A. Cheramie, CRNA, MHS, Louisiana • Tony Chipas, CRNA, PhD, South Carolina • Diane Christoffer, ADN, Arizona • Tricia Christoffer, ASN, Virginia • Angela P. Clark, PhD, RN, CNS, FAAN, Texas • Gary Clark, CRNA, EdD, Missouri • Kristy Clendenin, RN, Texas • Keeshia Clouds, CRNP, Alabama • Peter Cockram, CRNA, Michigan • Ferne M. Cohen, CRNA, New Jersey • Marie Coker, CRNA, MS, Michigan • Hermine Endelkofer Colasanti, RN, Colorado • Robert J. Colcord, CRNA, MHS, Indiana • Margaret M. Cole, APRN, Connecticut • Ann Coller, RN, BSN, Indiana • Stacy Colson, RN, Indiana • Cindy Connellan, RN, Kansas • Noreen Conway, RN, Ohio • Angela Cook, RN, England • Renee Cooper, RN, Mississippi • Leigh Copsey, RN, New Hampshire • Robert N. Corbeille, CRNA, New Hampshire • Betsy Corrigan, MSN, RN, Maine • Judith Coward, RN, BSN, Utah • Lynda Lee Huse Crayon, RN, BSN, Florida • James Cuddeford, CRNA, Nebraska • Cynthia Cunningham, RN, BSN, Arizona • Lynn Curran, CRNA, Rhode Island • Deborah Currie, RN, Canada • Olive Cyrus, DNSc, MS, North Carolina • Leslie Dalaly, RN, BA, BSN, California • Karen A. Daley RN, PhD, MPH, FAAN, Massachusetts • Jessica Damon, RN, New Hampshire • Judi Dansizen, MSN, APRN, CNS, Illinois • Dr. Patricia D’Antonio, PhD, RN, FAAN, Pennsylvania • Kim Dare, RN, Kansas • Kristine Dascoulias, RN, New Hampshire • Julie Davidson, RN, Kansas • Susan Davis, RN, Tennessee • Leonardo De La Garza, BSN, Texas • Darla Denny, RN, Kansas • Mary Devlin, CRNA, BA, Pennsylvania • Janet Dewan, CRNA, PhD, Massachusetts • Monika Dewar, MSN, RN, Texas • Cindy DeWaters, RN, BSN, MSN, CCRN, Arizona • Judy Diaz, RN, Washington, DC • Saundra C. Dicicco, RN, BSN, Florida • Sheila Dickens, RN, West Virginia • Kathy Dietrich, RN, Illinois • Gail Dixon, RN, Florida • Brenda Dixon-Smith, RN, BSN, MSN, PhD, retired Army major, Oregon • Kristine Djuric, BSN, RN, Massachusetts • Saundra Dockins, CRNA, BA, Kentucky • Evelyn Dogbey, BSN, MSN, PhD, Pennsylvania • Andrea Dossey, RN, NNP, Texas • Anna Michelle Dozier, BSN, Florida • Jamie Dozier, RN, BSN, Florida • Joan Dozier, RN, Florida • Suzanne Dozier, MSN, Kentucky • Terri Dresch, RN, Colorado • Marissa Drummond, RN, BSN, California • Faith Dugger, RN, Mississippi • Nan Duncan, RN, Oregon • Belinda Dundon, BSN, MSN, NP, Canada • Dawnah Durkee, RN, Kansas • Patricia Edgecomb, LPN, Maine • John (Jack) Edmondson, CRNA, MS, Tennessee • Scott Elder, CRNA, Idaho • Karen Eldridge, BS, RN, Maine • Tina Elwood, RN, Kansas • Alice Peterson Erspamer, RN, Illinois • Cindy Evans, RN, ADN, Michigan • Sandra Fails, ASN, Oklahoma • Rebecca P. Fairly, CRNA, Mississippi • Theresa Faivre, MSN, RN, Illinois • Lucille M. Fennell, RN, US Army Captain, Montana • Mary Ferenz, RN, New Jersey • Phyllis Mary Sinclair Ferguson, RN, Louisiana • Lauren Fink, BSN, RN, California • Jane Firth, RN, BSN, MSN, North Carolina • Jennifer Fitzgerald, RN, Vermont • Jeni Fitzpatrick, RN, BSN, Oregon • April Fitzsimmons, RN, New Hampshire • Dave Fletcher, CRNA, MA, California • Kelly Fletcher, RN, New Mexico • Jen Flippin, RN, BSN, North Carolina • Karen Florey, RNC-LRN, Texas • Linda S. Foley, CRNA, Florida • Dr. Loretta Ford, EdD, PNP, FAAN, Professor Emeritus, Florida • Barbara “Foof” Forfar, RN, New Jersey • Gail Foster, BSN, California • Janine Fowler, RN, Kansas • Carol Fox, RN, BSN, New York • Bucky (Buck) M. Frost, CRNA, Alaska • Kim Funk, RN, Indiana • Lisa Ann Gallup, MS, BSN, RN, New York • Cheryl K. Gamble, CRNA, MSN, Delaware • John F. Garde, MS, CRNA, FAAN, Illinois • Melissa Gaunce, RN, Ohio • Malgosia Glanda, RN, ADN, Massachusetts • Timothy P. Glidden, CRNA, MS, Nebraska • Stacey Goddard, MSN, Maryland • Brittney Golden, RN, Alabama • Lois Gombar, RN, Illinois • Ronna Gore, RN, Mississippi • Ellen Graham, RN, Massachusetts • Dr. Carol Green, RN, BSN, MN, PhD, Kansas • Susan Gregory, RN, ADN, Massachusetts • Aline Grischkan, BScN, Canada • Linda K. Groah, RN, MSN, FAAN • Liz Guiterrez, RN, Texas • Heather Gulish, RN, MSN, NP, Michigan • Shirna Gullo, DNP, RN, MSN, BSN, Alabama • Jewel Gummer, RN, BSN, Oregon • Allison Hagen, RN, New Jersey • Cherith Hager, RN, ADN, Colorado • Joel Hague, BSN, Pennsylvania • Gary Hahn, CRNA, BSN, Virginia • Jehannah Hakim, RN, BSN, California • Dr. Bethany Hall-Long, PhD, RN, MSN, BSN, Delaware • Donna Hallas, PhD, PNP-BC, CPNP, PMHS, FAANP, New York • Heather Hamza, CRNA, MS, California • John Hanlon Jr., CRNA, DNP, ARNP, New Hampshire • Tiki Hansen, BSN, RN, Maine • Kelly Harmon, RN, Indiana • Ivan Hart, DNP, FNP-C, Kansas • Adrienne Hartgerink, CRNA, DNP, Virginia • Felicia J. Haskins, BSN, MSN, Delaware • Ellen Haynes, RN, Florida • Katherine “Licia” Hedian, RN, NP, CNM, DO, West Virginia • Kay Heley, RN, Kansas • Kim Miller Hendrix, RN, Indiana • Karen Henken, RN, BSN, MSN, Pennsylvania • DeShaunda Henly, RN, BSN, MSN, Florida • Ursula Shriver Henry, RN, South Carolina • Jan Herren, RN, Arkansas • Amy Hicks, MSN, CNS, North Carolina • Sharon Hindman, RN, Florida • Carla Kaye Hobbs, CRNA, APRN, Kentucky • Mallory Hoffman, RN, BSN, Michigan • Denise Honn, RN, Kansas • Mary Hopkins, RN, New Jersey • Diane Horner, RN, BSN, Indiana • Anne Hoskins, RN, Kansas • Debbie Houser, LPN, Mississippi • Anne Howland, RN, New Hampshire • Vickie Huff, RN, Mississippi • Cathy Hughes, RN, Wisconsin • Mel Hungerford, RN, BSN, Georgia • Debra Hunsucker, RN, BSN, Virginia • Denise Indermuehle, RN, California • Renee Irving, RN, California • US Air Force Captain Dayla Jackson, RN, BSN, USAF, North Carolina • Falane S. Jackson, RN, BSN, Florida • Gena Jackson, RN, Mississippi • Josie Jackson, RN, Arkansas • Kristi Jackson, RN, Mississippi • Nicole Jackson, RN, New Hampshire • Richard G. Jaco, CRNA, California • Candice Janek, RN, Texas • Shirley Jensen, RN, Massachusetts • Brynn Jerles, RN, BS, MS, Indiana • Frances Jimenez, RN, MA, Colorado • Dr. Lucille Joel, RN, PhD, FAAN, New Jersey • Julie Johnson, RN, Kansas • Kathleen H. Johnson, DNP, MN, NCSN, Washington • Margie Johnson, RN, Mississippi • Marie Audrey Johnson, RN, Illinois • Julie Johnston, RN, Kansas • Nancy Johnston, RN, BSN, Florida • Bernice Jones, MN, Professor Emeritus, Oregon • Iberis Jones, RN, Virginia • June Jones, RN, Michigan • Roxanne Jones, RN, Kansas • Rubynelle Jordan, RN, BSN, Maryland • Lindsey Kabrud, LPN, Minnesota • Lauren Kaiser, RN, New Jersey • Kaci Karas, RN, Texas • Sarah Wilcox Katz, RN, BSN, Nevada • Sally Keating, RN, Kansas • Cindy Keilman, RN, New Jersey • Sharon Kendall, CRNA, South Carolina • Maia Kern, RN, New York • Kimberly Kerr, RN, BSN, MSN, Ohio • Maryann Kerr, BSN, RN, MSN, Indiana • Marsha King, BSN, RN, MSN, DNP, Indiana • Tim Kinnetz, RN, PS, Iowa • Melissa Phipps Kirby, RN, ADN, Virginia • Bonnie Kirtley, RN, Tennessee • MaryAlice Klaus, RN, New Jersey • Jamie Knight, RN, Kansas • Jennifer Kobylski, RN, BSN, Virginia • Robin M. Koeppel, MSN, RNC, CPNP, California • Mary-Beth Koslap-Petraco, DNP, PNP-BC, CPNP, New York • Martha Kral, CRNA, BSN, Georgia • Jaclyn Krostek, BSN, RN, Pennsylvania • Virginia Krostek, BSN, RN, New Jersey • Nikia Krouse, RN, New Jersey • Charity Kumpf, LPN, Indiana • Teresa Labrador, RN, Kansas • Kathy Lamb, RN, BSN, Pennsylvania • Dawn Landers, RN, New Hampshire • Elizabeth Lane, BSN, RN, Maine • Sharon Lane, ADN, Arizona • Patricia Lang, LPN, Minnesota • Rebecca Lang, BSN, RN, Indiana • Missy Lathem, RN, Mississippi • Sue Leach¸ RN, BSN, MSN, North Carolina • Heidi Leonard, RN, MHS, CDE, Canada • Joanne Lesiewicz, RN, New York • Fran Lewis, RN, PhD, Washington • Carol Goldenstein Lillie, RN, BSN, California • Ambur Lindstrom-Mette, DNP, FNP, RN, Arizona • Delores Linnenkamp, RN, Maryland • Rita Marie Linnenkamp, RN, Maryland • Rosemarie Linnenkamp, RN, Maryland • Nelda Welch Lively, RN, BSN, MHA, Texas • Glenda Lochridge, RN, Arkansas • Marilyn Logan, RN, Kansas • Ruth E. Long, CRNA, North Carolina • Daniel Longo, CRNA, BS, Michigan • Katie Loper, RN, Mississippi • Lianne Lopez, RN, BSN, MSN, California • Carry Lovelace, RN, MSN, BSN, Oklahoma • Danilo Lovinaria, CRNA, DNP, MS, MBA, Minnesota • Barbara Ballo Lowinger, RN, BSN, North Carolina • Joni Mee Lowsley, RN, Kansas • Chrystal A. Lucas, RN, BSN, MSN, Pennsylvania • Victoria Luther, RN, BSN, Indiana • Cissy Lux, BSN, NP, Texas • Daisy Moore Lydy, RN, BSN, MSN, Oregon • Claire MacDonald, RN, New Hampshire • Kathleen M. Madej, CRNA, Alaska • Uriah Magill, CRNA, MSN, North Carolina • Tak Yue Mai, RN, BSN, Florida • Marti Major, BSN, Illinois • MaryJane Maloney, RN, New Jersey • Carolina Marles, RN, New Hampshire • Kim Martin, RN, Kansas • Kimberly Martin, LPN, Georgia • Luis Martínez, RN, MSN, Puerto Rico • Wilhelmina Maslanek, BSN, MSN, Pennsylvania • Sandy Mason, RN, New Hampshire • Tommie Mathieu, CRNA, MS, Connecticut • Joy Mattsson-Boze, RN, BSN, MBA, Texas • Susan Matwiejczyk, RN, BSN, Michigan • Suzanne Maynard, CRNA, MSN, Alaska • Frank Maziarski, CRNA, MS, Washington • Elizabeth McDaniel, ADN, Ohio • Ryan W. McDonald, CRNA, MSN, Washington • John P. McDonough, CRNA, EdD, Florida • Michelle Royal McDowell, DNP, RN, CPNP, Arizona • Charlene McKean, LPN, Indiana • Kristy McKindley, RN, California • Judy McMullen, RN, BSN, Kansas • Amy McNaught, RN, BSN, Maine • Chris McPherson, RN, Kansas • Florence McQuillen, CRNA, Minnesota • Michelle Meader, RN, New Hampshire • Ozella Meaders, RN, BSN, Oregon • Jane Meadows, RN, ADN, Tennessee • Melissa Mellace, RN, New Jersey • Bozena Michalzcuk, RN, New Hampshire • Judith Michoma, RN, BSN, Minnesota • Eileen Milano, RN, New Jersey • Lindsey Minchella, MSN, RN, NCSN, FNASN, Indiana • Sharon Mingo, BSN, Pennsylvania • Dr. Rosalie Mirenda, RN, BSN, MSN, PhD, Pennsylvania • Peggy Moellers, RN, Kansas • Joyce A. Moore, RN, MSN, Ohio • Donna Morris, RN, Kansas • Jamesia Morris, LPN, Mississippi • Marilyn Mortimer, RN, Kansas • Tom Muller, CRNA, Arizona • Idalia Munoz, RN, BSN, MHA, MSN, California • Helen Shea Murphy, RN, MSN, Massachusetts • Charlene Myers-Reid, RN, ADN, Pennsylvania • Angie Nachman, RN, BSN, Texas • Anne H. Napier, EdD, RN, MSN, CNS, Maine • Patricia Nerad, RN, BA, BSN, MHA, California • Nancy Nicolay, RN, Kansas • Phillip Noel, CRNA, BSN, Virginia • Jennifer Noll, RN, Kansas • Mary Norgren, RN, NCSN, Colorado • Paula Nuchols, LPN, Indiana • Lyna Nyamwaya, RN, BSN, Minnesota • Mary Ann Ogonowski, RN, MSN, LDAC, Maine • Karen O’Hara, BSN, RN, Pennsylvania • Nancy O’Hara, LPN, Pennsylvania • Maggie Olsen, CRNA, Georgia • Carrie Olson, RN, BSN, California • Victoria Ombuna, RN, BSN, Minnesota • Grace Oppong, RN, Canada • Victor J. Oskvarek, CRNA, Illinois • Mary Koster Pabst, RN, PhD, retired US Army Nurse Corps Lieutenant, Illinois • Nancy Pankratz, RN, BSN, Canada • Gina Pardo, RN, New York • Dolores B. Pasierb, CRNA, Oklahoma • Stephanie Patschull, RN, California • Janet Peluso, RN, Georgia • Warren L. Penrod, retired USAF Master Sergeant, BSN, MSN, FNP, Indiana • Sherry Perkins, RN, Maryland • Bridget Petrillo, CRNA, APRN, California • Maria (Hutchinson) Petty, BSN, MSN, CRNP, Massachusetts • Mary Broady Petty, RN, BSN, Indiana • Bethanne Pezzuti, RN, New Jersey • Nina Pham, RN, Texas • Gayle Phillips, RN, BSN, Oregon • Pat Polise, RN, Kansas • Graciela Phlatts, RN, New York • Helene Pietrangelo, RN, New Jersey • Pamela Pol, RN, BSN, New Jersey • Jeff Pope, CRNA, Colorado • Patricia Powell, LPN, Mississippi • Leisa Prasser, RN, Indiana • Patrick Price, CRNA, PhD, Minnesota • Venza Mae Price, RN, New York • Stacey Propper, MSN, RN, Maryland • Patricia Pruden, RN, Egypt • Janet Puglisi, RN, BSN, Colorado • Kathie Purcell, RN, New Mexico • Ernest A. Quier, CRNA, California • Diana Quinlan, CRNA, MA, Florida • Kimberly Radig, BSN, RN, Arizona • Cristina Ramirez, RN, Texas • Greg Ramplemann, CRNA, Ohio • Amber Ramsdell, MSN, RN, Texas • Christa Ramsey, RN, New Hampshire • Cyndy Rape, MSN, RN, ACNS-BC, North Carolina • Carlos “Rusty” Ratliff, CRNA, BSNA, Minnesota • Charles Raynor, retired US Army captain, RN, MSN, Texas • Myra Reddish-Randall, RN, MSN, Connecticut • Stephanie Requilman, RN, BSN, California • Siri Richter, MSN, APRN, NP, Arkansas • Amy Riggen, BSN, RN, Indiana • Marilyn Ritenour, RN, BSN, Oregon • Brenda Rivera, RN, Florida • Sophy Rivera, RN, Florida • Keene Roadman, RN, MSN, Illinois • Teresa Robinson, RN, Pennsylvania • Deborah Harrison Robertson, MSN, FNP, Missouri • Bernadette Higgins Roche, CRNA, EdD, Illinois • Sarah Roder, RN, BSN, Texas • Don Roesler, CRNA, MS, South Dakota • Teggie Rogers, RN, Indiana • Patrick D. Roseland, CRNA, South Dakota • Heather Ross, RN, Mississippi • Sarah Rowekamp, LPN, Ohio • Tiffany Rowland, RN, Florida • Rita Rupp, RN, MA, Kansas • Heidi Sabado, RN, BSN, Washington, DC • Raheemah Saleh, BSN, RN, California • Anna Frances Sanders, LPN, Mississippi • Bridget Sanders, RN, Arkansas • Mutiat Sanni, RN, MSN, New Jersey • Natasha Sauceda, LVN, Texas • Aaronique Savage, RN, New Jersey • Akbar Sayed, RN, BSN, Maryland • Andrea Schlembach, RN, MSN, APN, New Jersey • Laura Schneider-Look, CRNA, Maine • Paul Schneider, RN, MSN, CRNA, Maine • Mary Schmitt, BSN, MSN, APRN, New Hampshire • Georgia Schnitkey, RN, ADN, Ohio • Amanda Kaye Schoenrock, Minnesota • Rose Schrempp, RN, Kansas • Heidi Schutte, RN, Kansas • Julie Scott, RN, Kansas • Melissa Sealey, RN, New Mexico • Heidi Seizys, RN, New Mexico • Anne M. Shannon, LPN, Florida • Karen Sharp, RN, BSN, Illinois • Farhan Shaukat, RN, BSN, Virginia • Jay Shelton, RN, Kansas • Marjorie Shelton, RN, Tennessee • Lisa Sheppard, RN, MSN, IBCLC, Ohio • Jan Sherman, RN, NNP-BC, PhD, Missouri • Shirley Sherman, LPN, Minnesota • Laura Shirey, RN, Arkansas • Danielle Shockley, RN, Kansas • Brian Short, ADN, RN, Minnesota • Jessie Shumpert Jr., LPN, New Mexico • Paul Silbernagel, CRNA, North Dakota • Latricia L. Simmons, RN, BSN, Florida • Leah Singletary, RN, BSN, Georgia • Evangeline Smith, LPN, Alabama • Gwen Smith, RN, MSN, Virginia • Melinda Smith, RN, BSN, Georgia • Patrick Smith, RN, BSN, MSN, Washington • Valerie Joy Smith, RN, MSN, BSN, California • Betsy Snook, RN, MEd, BSN, Pennsylvania • Tracy Snow, RN, Indiana • Alice Sollenberger, FNP, Colorado • Brent Sommer, CRNA, BS, California • Tammi Sontag, LPN, Florida • Grace Sotomayor, DNP, CNO, North Carolina • Brenda Splawn, RN, MSN, NP, Georgia • Danny Stanton, CRNA, BSN, Maryland • Rebecca Stanton, RN, BSN, Maryland • Ann Steffney, RN, MSN, New Jersey • John (Jack) T. Stem, CRNA, Ohio • Roxie Stempel, LPN, Arizona • Janet R. Stewart, CRNA, ARNP, Washington • Judy Stilwell, MSN, EdDc, Arizona • Jennifer Stinson, RN, Texas • Gregory S. Stocks, RN, EJD, Maryland • Alison Stone, RN, Arkansas • Linda Stone, CRNA, MSN, North Carolina • Arlene Stonelake, RN, Pennsylvania • Jeffrey R. Story, CRNA, MSN, Mississippi • Kellye Stroman, RN, South Dakota • Shelbe Sundeen, RN, Oregon • Jessica Switzman, CRNA, MS, Maryland • Thomas Szczygiel, CRNA, MSN, Pennsylvania • Melissa Tanner, RN, Mississippi • Betty Tate, RN, BSN, Maryland • Doris Taylor, RN, Texas • Robert Teasdale, RN, retired US Navy Lieutenant, New Jersey • Lorraine Thayer, RN, MSN, APN, New Jersey • Stacey Thein, RN, Kansas • Sharon Thomas, ADN, Texas • Michele Thompson, RN, Indiana • Vilma Thompson, RN, New York • Megan Tinling, RN, BSN, Oregon • Patty Toland, RN, Texas • Carol Torpey, RN, MSN, Washington • Jan Tracy, RN, PhD, New Jersey • Carla Trout, RN, Nebraska • Cheryl Truzzi, RN, BSN, Washington • Sandra K. Tunajek, CRNA, DNP, North Carolina • Lemonia Tzimou-Vlisnaki, RN, BSN, Greece • Chad A. Utterson, CRNA, Colorado • Lawrence C. Van Atta, CRNA, Utah • Chris Vanderwal, RN, BSN, Iowa • Christine Varner, RN, New Jersey • Susan Varner, RN, Kansas • Amy Velez, RN, New York • Cassandra Villa-Lugo, RN, ADN, Texas • Rebecca Villanueva, RN, ADN, Texas • Amber Vinson, RN, Texas • Elizabeth Visintine, CRNA, Texas • Kristine Vosters, RN, BSN, Wisconsin • Barbara Waldron, BSN, CRNA, Georgia • Elizabeth A. Walls, RN, MSN, MBA, CNA, Pennsylvania • Cherri Ward, RN, BSN, Texas • Maureen B. Kelly Ward, CRNA, Pennsylvania • Angela Warner, RN, New Jersey • Bobbi Watson, RN, ADN, Illinois • Estelle Watts, MSN, RN, NCSN, Mississippi • Mary Watts, BSN, RN, Tennessee • Laura Way, RN, Kansas • Pam Webb, RN, BSN, Indiana • Ron Wegner, CRNA, ARNP, Florida • Amber Welch, RN, Florida • Barbee Whisnant-Burgess, RN, MSN, North Carolina • Marina Whitcomb, LPN, Vermont • Kelly White, RN, Indiana • Sheri White, RN, ADN, Washington • Robert R. Whitmore, CRNA, MS, Kansas • Anita Whittington, RN, Mississippi • Terry Wicks, CRNA, MHS, North Carolina • Lynne Widlund, RN, BSN, Oregon • Nikki Wiggins, RN, BSN, Oregon • Alicia Wilburn, RN, Mississippi • Bradley Wilburn, RN, Mississippi • Jennifer Wildung, RN, Kansas • Ernie Wildman, RN, Kansas • Diana J. Wilkie, PhD, RN, FAAN, Illinois • Luanne Williams, MSN, RN, Florida • Eleanor Sigurdson Wilson, RN, Maryland • Patty Wilson, RN, Kansas • Karen Witt, RN, MSN, Wisconsin • Christopher C. Woods, RN, BSN, Louisiana • Josephine Wong, RN, PhD, Canada • E. Laura Wright, CRNA, PhD, Alabama • Eliot Wright, RN, New Jersey • Sandi Wright, ADN, Virginia • Dixie Wyckoff-Raney, RN, BSN, CPAN, CAPA, Washington • Tracey Yazvac, RN, ADN, South Carolina • Barbara Yow, RN, MEd, NCSN, Virginia • Nancy Zeliff, RN, New Jersey • Sandra Sue Zenz, RN, Illinois • Barbara Zimmerman, RN, Pennsylvania • Gloria Zak, RN, North Dakota • Arthur J. Zwerling, CRNA, DNP, DAAPM, MSN, MS, Pennsylvania