ARIZONA STATE BOARD OF NURSING NEWSLETTER PRESORTED STANDARD MAIL U.S. POSTAGE PAID Grundy Center, IA 50638 Permit No. 18 QUARTERLY CIRCULATION APPROXIMATELY 90,000 TO ALL RNs, LPNs, CNAs AND STUDENT NURSES IN ARIZONA The Official Publication of the Arizona State Board of Nursing Volume 5, No. 4 SECTION I 1651 East Morten Avenue, Suite 210, Phoenix, Arizona 85020-4316 Web site: http://www.azbn.org From the Executive Director by Joey Ridenour, RN MN Special Column on Faculty Recruitment As many of you are aware, the nursing programs in Arizona have responded to the nursing shortage by expanding their student enrollments. Unfortunately the plans will not be realized until faculties are recruited for the vacant positions. To assist in addressing the nursing shortage and subsequent risk to the public, the Arizona Board of Nursing will continue running a special column in each Newsletter for nursing programs to list their faculty needs. Pima Community College is seeking an applicant for Instructional Faculty in Nursing. Primary duties are to teach courses in Nursing with an emphasis in Adult Medical/Surgical nursing to a diverse student population. Please visit our website at www.pima.edu to read more about the college and these positions. The application can be downloaded as a PDF file from www.humres@pimacc.pima.edu. Maricopa Community College District Nursing Program is seeking full time and part time nursing faculty and clinical instructors for the following areas: Adult Medical/Surgical, Pediatrics, Psychiatric/Mental Health and Maternal Child Health nursing. Year-round, day, evening, weekend, bilingual Index: Arizona State Board of Nursing Competency Model ............................3 Annual Reports from Arizona Prelicensure Nursing Education Programs ............................................7 Regulation Rundown ......................11 New Appointment at University of Arizona College of Nursing ............14 Advanced Practice Corner..............19 Certified Nursing Assistant Corner ..20 2005 Lobby & Legislative Day........21 Education Corner ............................22 Approved Nursing Assistant Program List......................................24 RN/LPN Disciplinary Actions ........29 CNA Disciplinary Actions ..............31 and online didactic positions are available. Applications may be submitted for full time positions online: www.dist.maricopa.edu/hrweb/faculty.html or for adjunct faculty and clinical positions online: www.dist.maricopa.edu/hrweb/adjunct.html Arizona Western College, Yuma, Az, is seeking applicants for a full-time Nursing/Computer Lab Coordinator. Bachelor's degree in Nursing; valid Arizona license as a Registered Nurse; minimum 2 years of recent experience as a professional nurse providing direct patient care. Must have demonstrated ability to work in primary health care and clinical practice in performing nursing skills as per textbook reference guidelines, and the ability to manage human and physical resources to meet the needs of students and faculty of the Department of Nursing and Allied Health. Please contact AWC Human Resources at 928-344-7504 or visit our website, http://www.azwestern.edu/hr/jobs.php?jobsID=68. Northern Arizona University, Flagstaff, AZ is seeking applicants for full time tenure track and clinical faculty positions as well as part time clinical positions to teach in the undergraduate and graduate programs in all specialty areas. Applicants with a Masters or Doctoral degree preferred, especially with CNS preparation and/or experience. We are also seeking a 50% time Coordinator of the Learning Laboratory on the Flagstaff campus that could be combined with a 50% time clinical faculty position. Our pre-licensure BSN, RN/BSN, and graduate program tracks are expanding in numbers of students, sites, and numbers of offerings. Therefore, we welcome applicants from areas outside Flagstaff. Please visit the Northern Arizona University nursing web site (www.nau.edu/hp/dept/nurse) for complete information about positions, qualifications, and application instructions or contact Dr. Margaret Conger 928-523-6710. Northland Pioneer College is seeking applicants for a faculty position to teach theory in third and fourth semesters in an integrated curriculum and provide clinical supervision of students in regional health care facilities. Masters degree in Nursing Required. Eligible for Registered Nurse license in AZ. Experience in Medical/Surgical, Maternal/Child and Psychiatric nursing. Two to three years of teaching experience in nursing education and curriculum development preferred. Forward cover letter, resume, copies of transcripts, and five current professional references with addresses and phone numbers to: Attention: Personnel Department, Northland Pioneer College, P.O. Box 610, Holbrook, AZ 86025-0610 Eastern Arizona College, Thatcher, Az, is seeking applicants for a full-time Clinical Nursing Instructor. Bachelor's degree in Nursing; valid Arizona license as a Registered Nurse; minimum 2 years of recent experience as a professional nurse providing direct patient care. This position involves teaching clinical in Safford, Globe, Tucson and Mesa. Applicant must demonstrate ability to teach nursing skills as per textbook reference guidelines and the ability to manage human and physical resources to meet the needs of students and faculty of the Department of Nursing. Please contact EAC Human Resources at 928-428-8915 or visit our website, http://www.eac.edu/Working_at_EAC/detail.asp?ID=115 Central Arizona College seeks a full-time Professor of Nursing. The successful candidate will have a Master's degree in Nursing and Arizona RN license or ability to obtain one. Please visit the web site at www.centralaz.edu to read more about the college and to obtain application instructions. Central Arizona College is also seeking adjunct clinical nursing faculty to teach in the Associate Degree Nursing Program. Applicants must have a minimum of a Bachelor of Science degree in Nursing (BSN); Master’s degree in Nursing preferred; valid Arizona license as a Registered Nurse; minimum 3 years of recent experience as a professional nurse providing direct patient care: previous teaching experience preferred. Please visit the website at www.centralaz.edu to read more about the college and to obtain application instructions. November, December 2004, January 2005 From the President By Alice Gagnaire RN MHSA In August 2004 I had the privilege of representing the Arizona State Board of Nursing at the National Council of State Boards of Nursing (NCSBN) Annual Meeting in Kansas City, Mo. I joined Joey Ridenour, Executive Director of the Board of Nursing, as the second delegate from Arizona. Most nurses know that each state has a board of nursing that helps define the practice of nursing and oversee the nursing profession on an individual state level. But what about at the national level? How do boards of nursing from different states work together to identify and solve issues or address opportunities in nursing regulation? How do we ensure that nurses from across the country are meeting the same standards for licensing? That’s where the NCSBN steps in. Every year, delegates from 60 states and U.S. territories attend the NCSBN annual meeting and help conduct the council’s business. I was very impressed with the professionalism of this dedicated group. I found them to be very forward thinking, and proactive in helping advance nursing regulation. One of the primary tasks of the NCSBN is to oversee the national licensure exam for nurses (NCLEX). This is a highly sophisticated testing mechanism that ensures graduates entering the nursing profession have the same knowledge and skill to safely practice nursing across the country. (On a side note: Congratulations to all Arizona’s nursing schools and new nursing graduates. Arizona had the second highest pass rate on the NCLEX-RN in the country during the second quarter of 2004. Our pass rate was 93.61 percent, second only to the Northern Mariana Islands where one student took the test and passed.) Some of the issues we addressed during this year’s annual meeting of the NCSBN included: • Reducing the barriers to nurses who want to move to a new state through the Nurse Licensure Compact and Model Nursing Practice Act and Model Administrative Rules. • Standardizing how states can evaluate if nurses trained outside the United States meet the educational qualifications to work in the U.S. • Discussing administration of the NCLEX in three foreign countries within the next six months and potentially offering the test in other languages. Delegates also directed the Examination Committee to research this possibility. Another highlight of the week was the award presented to Joey Ridenour. The Board and staff were instrumental in Joey being selected for the most prestigious award given to a member of National Council, the R. Louise McManus Award. Over the past 25 or so years only 8 individuals have been chosen for this award out of a potential pool of over 900 Board/ Staff Members within the 60 Boards of Nursing. This is just an example of the important work being done by the NCSBN. I was proud to represent Arizona and excited about the role I was able to play on behalf of all of Arizona’s nurses in advancing nursing regulation. ARIZONA STATE BOARD OF NURSING NEWSLETTER NOV., DEC . 2004, JAN. 2005 BOARD OF NURSING CONTACT INFORMATION GOVERNOR The Honorable Janet Napolitano BOARD MEMBERS Alice Gagnaire, RN, MSHA President Kathy Malloch, PhD., MBA, RN Vice President Beverly Ogden Public Member Secretary Trista Campbell, RN, BSN Member Theresa Crawley, CRNA, MSHSA Member Karen Hodges Hardy, RN, MSN Member Gregory Y. Harris Public Member Patricia A. Johnson, LPN Member Sharon Molleo, LPN Member MAIN LINE: e-MAIL: (602) 889-5150 arizona@azbn.org MAIN FAX: (602) 889-5155 CANDO FAX: (602) 889-5238 HOME PAGE: http://www.azboardofnursing.org ADDRESS CHANGE AND APPLICATION REQUESTS arizona@azbn.org verify@azbn.org ON-LINE VERIFICATION OF LICENSE/CERTIFICATE STATUS ADMINISTRATION Joey Ridenour RN, MN Judy Bontrager RN, MN Valerie Smith RN, MS 602-889-5200 602-889-5204 602-889-5206 jridenour@azbn.org jbontrager@azbn.org vsmith@azbn.org Lila Wiemann Executive Director Associate Director–Operations & Licensing Associate Director–Nursing Practice/ Complaints & Investigations Administrative Assistant to the Executive Director 602-889-5202 lwiemann@azbn.org ADVANCED PRACTICE Karen Grady MS, RN, FNP, BC Advanced Practice/RN/LPN 602-889-5182 kgrady@azbn.org CHEMICAL DEPENDENCE / CANDO Suanne Smith Nurse Consultant-CANDO Olga Zuniga Administrative Secretary - Monitoring & CANDO 602-889-5156 602-889-5157 ssmith@azbn.org ozuniga@azbn.org EDUCATION Pamela Randolph RN, MS, CPNP 602-889-5209 prandolph@azbn.org Rose Wilcox RN Meredith Fountain Education Consultant/ Educational Programs RN/LPN/CNA Education Programs CNA Administrative Assistant-Education 602-889-5176 602-889-5187 rwilcox@azbn.org mfountain@azbn.org FISCAL SERVICES Diane Serra Norma Salter Business Manager Accounting Technician 602-889-5210 602-889-5211 dserra@azbn.org nsalter@azbn.org HEARINGS Susan Barber RN, MSN Debra Blake Vicky Driver Nurse Practice Consultant-Hearing Department Legal Assistant Adm. Asst./Hearing Department 602-889-5161 602-889-5183 602-889-5162 sbarber@azbn.org dblake@azbn.org vdriver@azbn.org CNA CNA RN/LPN RN/LPN/Southern AZ RN/LPN RN/LPN RN/LPN 602-889-5169 602-889-5174 602-889-5184 602-889-5185 602-889-5179 602-889-5180 602-889-5186 bnelson@azbn.org jsage@azbn.org mrappoport@azbn.org ntwigg@azbn.org pmidkiff@azbn.org srachel@azbn.org smunger@azbn.org RN/LPN CNA CNA CNA RN/LPN (CANDO) CNA 602-889-5170 602-889-5167 602-889-5178 602-889-5171 602-889-5159 602-889-5172 jball@azbn.org jwilliams@azbn.org jbauer@azbn.org kolson@azbn.org lbrown@azbn.org vjohansen@azbn.org Board Minutes/Endorsements Assistant to Associate Director/ Nursing Practice, Complaints & Investigations RN/LPN Investigations CNA Investigations CNA Investigations Administrative Assistant to Associate Director/ Operation & Licensing RN/LPN Investigations Assistant to Associate Director/Nursing Practice, Complaints & Investigations 602-889-5193 602-889-5158 bjones@azbn.org dhurtado@azbn.org 602-889-5175 602-889-5177 602-889-5173 602-889-5205 jthompson@azbn.org dlindsey@azbn.org egarcia@azbn.org mpalmer@azbn.org 602-889-5187 602-889-5208 mfountain@azbn.org tberry@azbn.org INVESTIGATIONS Nurse Practice Consultants Betty Nelson RN, MS Jeanine Sage RN, MSN Mary Rappoport RN, MN Nancy “Nan” Twigg RN, MS Pat Midkiff, RN, MN Sister Rachel Torrez RN, MS Sydney Munger RN, MS Senior Investigators James (Jim) Ball James Williams Jeanne Bauer Kirk Olson Lorraine Brown Vicki Johansen Legal Secretaries Barbara Ritenour Dolores Hurtado Janice Thompson Dorothy Lindsey Esther Garcia Mary Palmer Meredith Fountain Thereasa Berry INFORMATION TECHNOLOGY Cory Davitt Adam Henriksen Network Administrator Webmaster 602-889-5213 602-889-5231 cdavitt@azbn.org ahenriksen@azbn.org LICENSING Becky Aranyos Brent Sutter Beck Loar Diana Lucas Donna Frye Paula Delphy Rhonda Rogers Yvonne Godinez RN/LPN Exam RN/LPN Renewals RN/LPN Renewal RN/LPN Endorsements Advanced Practice – School Nurses CNA Exam/Endorsements CNA-Renewals RN/LPN Endorsements 602-889-5190 602-889-5195 602-889-5207 602-889-5191 602-889-5194 602-889-5189 602-889-5188 602-889-5192 baranyos@azbn.org bsutter@azbn.org bloar@azbn.org dfrye@azbn.org pdelphy@azbn.org rrogers@azbn.org ygodinez@azbn.org MAILROOM Marlane Brosseau Rita Kelly-Sierra Mail Room Mail Room 602-889-5216 602-889-5215 mbrosseau@azbn.org rkelly@azbn.org MONITORING Stephanie Nelson RN, MS Nurse Consultant Monitoring 602-889-5160 snelson@azbn.org RECEPTIONISTS Athena Sanchez Jennifer Butler Susan Kingsland Cristina Oates Receptionist Receptionist Receptionist Receptionist 602-889-5196 602-889-5199 602-889-5197 602-889-5221 asanchez@azbn.org jbutler@azbn.org skingsland@azbn.org coates@azbn.org RECORDS Charlotte Seechoma Records Room 602-889-5217 cseechoma@azbn.org DISCLAIMER CLAUSE The Nursing Newsletter is published quarterly by the Arizona State Board of Nursing. Advertising is not solicited nor endorsed by the Arizona State Board of Nursing. For advertising rates and information, contact Arthur L. Davis Agency, 517 Washington St., P.O. Box 216, Cedar Falls, IA 50613, Ph. 1-800-626-4081. Responsibility for errors in advertising is limited to corrections in the next issue or refund of price of advertisement. Publisher is not responsible for errors in printing of schedule. The State Board of Nursing and the Arthur L. Davis Agency reserve the right to reject advertising. The Arizona State Board of Nursing and the Arthur L. Davis Publishing Agency, Inc. shall not be liable for any consequences resulting from purchase or use of advertisers’ products from the advertisers’ opinions, expressed or reported, or the claims made herein. NOV., DEC . 2004, JAN. 2005 ARIZONA STATE BOARD OF NURSING NEWSLETTER Arizona State Board of Nursing Competency Model INTRODUCTION Background The mission of the Arizona State Board of Nursing is to protect the public health, safety and welfare through the safe and competent practice of nurses and nursing assistants. The Board relies on Advisory Committees composed of practicing nurses to guide them on matters relating to scope of practice, chemical dependency, education, law and rules, and nursing assistants. The Education Advisory Committee is the entity that advises the Board on matters relating to education. The committee is composed of educators and nurses from a variety of programs and geographic regions. In 2003, the Education Advisory Committee became aware of confusion among nurses and the public regarding the competencies of nurses at differing educational levels. The multiple pathways to RN licensure at either an associate, baccalaureate, or in some cases diploma levels add to the confusion of the public, nurses, and prospective nursing students. Additionally, confusion exists regarding the competencies of a nurse with a master’s degree in nursing as compared to a nurse with a master’s degree in another field. This document was developed to clarify nursing roles for the public, nurses, and prospective nursing students regarding nursing ability and function at the differing levels of nursing education. To facilitate the work of the committee a subcommittee was formed to develop a draft document. The mission of the subcommittee was to develop a document that: • Delineates competencies for levels of nursing education from nursing assistant through doctoral level • Focuses on outcomes and builds on previous competencies • Is easily accessible to the public • Is consistent with recognized models of nursing education • Decreases confusion on the part of nurses, prospective nursing students and the public • Is consistent with the administrative rules and statutes of the Arizona State Board of Nursing • Demonstrates the inherent worth and value of all educational levels of nursing The subcommittee reviewed the language and structure of competency models developed by the Kentucky Nursing Education Mobility Task Force (2001), the Oklahoma Board of Nursing, and other related publications to guide the development of this model (see references). The subcommittee adapted the framework developed by the Kentucky Nursing Education Mobility Task Force to delineate nursing practice and education in Arizona. Levels of Education The Arizona State Board of Nursing regulates certified nursing assistants, licensed practical nurses, registered nurses, and advanced practice nurses. The Board also has jurisdiction over nursing assistant programs, pre-licensure nursing programs, and advanced practice nursing programs. Six levels of education are addressed in the competency model. Since there are no diploma-nursing programs in Arizona, this level of education was not addressed. The subcommit- tee recognized the importance of including the doctoral level in order to inform the public of expectations of nursing care at that level. The levels of education and descriptions of these levels in Arizona are: • Nursing Assistant: A nursing assistant has a minimum of 120 hours of education focused on meeting basic needs of long-term care residents. • Licensed Practical Nurse: A licensed practical nurse generally completes a vocationally oriented program of 6 to 12 months in length at a community college, skill center, or private vocational college. • Associate Degree RN: An associate degree RN completes a two-year nursing program at a community or private college. The program may be preceded by 2-3 semesters of prerequisite courses. • Bachelors of Science Degree RN: A bachelor of science in nursing RN completes a 4-year degree at a university. The first 3-4 semesters of the program consist of prerequisites and general education courses. • Master of Science in Nursing: A master of science in nursing degree consists of 3-5 semesters of full time study including a research thesis or project. There are several tracks available to students such as advanced practice, teaching, or administration. • Doctoral Level (Ph.D, DNSc): A doctoral degree in nursing involves a minimum of 4 semesters of additional study and the completion of an extensive original research project (dissertation). Conceptual Framework The model describes attributes of nurses and nursing assistants from the CNA level through the doctoral level based on educational preparation. The framework is organized into three roles of nursing: • Provider of care: " the nurse uses a systematic process and appropriate resources to assist clients in meeting health needs in an evolving health system." (Kentucky, 2001, p. 13) • Manager of care: "the nurse assures that the right care is given at the right time, in the right setting, and at the right cost to achieve desired outcomes," (Kentucky, 2001 p.14) and • Member of the profession: "the nurse is accountable for a practice reflecting the legal and professional standards governing nursing" (Kentucky, 2001, p. 15). Within each role, nursing functions include: caregiver, communicator, coordinator/collaborator, advocate, and teacher/counselor (Kentucky, 2001). These concepts are defined as follows: • Caregiver: Provides care according to a nursing plan that promotes and maintains optimal health status. • Communicator: Engages in a complex, ongoing, interactive process, which leads to therapeutic and effective relationships with patients and others. • Coordinator/Collaborator: Manages resources and interacts with others to achieve optimal client outcomes. • Advocate: Directs actions so that client welfare prevails. • Teacher/Counselor: Facilitates knowledge acquisition to effect behavioral changes that promote optimal health status. • Scholar: Continually seeks and utilizes information to promote scientifically based nursing practice. Uses The competency model described in this document will serve to guide nurses, prospective nursing students, and the public in distinguishing the functions and abilities of nurses and nursing assistants by educational level. The model demonstrates that all levels of nursing practice/education contribute to the overall health and well being of individuals, families, and groups within the context of safe competent nursing care. This model is not intended to define the legal scope of practice for any level of nursing. As nursing practice evolves, the model will be updated to encompass the increasing complexity of nursing knowledge and changes in health care delivery systems. Introduction by Pamela K. Randolph RN, MS, CPNP Subcommittee Members: Subcommittee members include: • Joyceen Boyle RN, Ph.D., Associate Dean University of Arizona; • Teri Britt, RN, Ph.D, Mayo Hospital; • Linda Riesdorph RN, MS, Director, Mohave Community College Nursing Program; • Margie Schultz, RN, Ph.D., GateWay Community College Practical Nurse Educator, • Noel Smith, RN, BSN, Scottsdale Community College Nurse Assistant Educator, and • Pamela Randolph RN, MS, CPNP, Arizona State Board of Nursing Education Consultant. References: American Nurses Association (1997). Position statement: Education for participation in nursing research. Retrieved December 31, 2003 from www.nursingworld.org/readroom/position/research/rseduccat.htm. State of Arizona (2003). Nurse Practice Act. Retrieved on December 31, 2003 from http://www.azboardofnursing.org. Kentucky Nursing Education Mobility Task Force (2000). Nursing Education in Kentucky. Louisville, KY: Kentucky Mobility Task Force. Nurse Utilization Task Force (2001). Goals for Nursing Practice and Education in Oklahoma. Retrieved December 31, 2003 from http://www.youroklahoma.com/nursing/edgoals.htm. Competency Model cont. on pg. 4 ARIZONA STATE BOARD OF NURSING NEWSLETTER NOV., DEC . 2004, JAN. 2005 Competency Model cont. from pg. 3 Manager of Care INTEGRATED CONCEPTS Caregiver Communicator Coordinator/ Collaborator Advocate Teacher/ Counselor Scholar NURSING ASSISTANT Under the direction of the licensed nurse, follows directions according to the established plan of care. LICENSED PRACTICAL NURSE ASSOCIATE DEGREE Under the direction of the Develops and implements a registered nurse, uses an plan of care using theory and established plan of care to evaluates patient outcomes. meet basic health needs. BACHELORS DEGREE IN NURSING MASTERS DEGREE IN NURSING DOCTORAL LEVEL Develops and implements a plan of care and evaluates patient outcomes using theory, evidence based practice and interdisciplinary resources. Applies specialized knowledge Designs and evaluates sysand expertise to design, coordi- tems of care. nate, implement, and evaluate comprehensive, integrated care. Reports and records data using Establishes and participates appropriate health care terminol- in therapeutic relationships. ogy and demonstrates caring behavior. Uses goal-directed therapeutic communication techniques effectively with individuals and families. Uses goal directed therapeutic communication effectively with individuals, families, communities and special populations. Implements complex communication strategies with individuals, families, communities and special populations. Provides creative leadership to address political, social, and ethical issues in health care. Completes assignments in an Organizes and manages care organized manner while con- for assigned clients while working with families and tributing to team functioning. health team members. Works with the patient and health team members to establish priorities and manage care to achieve desired patient outcomes. Facilitates interdisciplinary services to ensure desired outcomes in individual, families, communities, and special populations. Establishes and evaluates professional networks for the purpose of improving outcomes for individuals, families, communities and special populations. Collaborates with individuals, families, communities, special populations, health systems to communicate research and theoretical concepts that improve outcomes. Recognizes situations that may Identifies and actively Uses knowledge of conimpact patient/family well addresses issues related to sumer rights and responsibilprotection of patients. ities to plan care and interbeing. vene on behalf of patients. Is aware of health policy and its impact on patient care. Uses problem solving strategies in support of patient rights and facilitates policy changes. Disseminates information about health policy and consumer rights and responsibilities. Analyses data and engages in health policy development and evaluation at the institutional and community level. Synthesizes knowledge in nursing and related fields to improve health care policies at the institutional, state, regional, national and global level. Reports client knowledge needs Implements health teaching Develops implements, and and provides basic instruction as for clients with identified evaluates teaching plans for health needs using estab- individuals and families. directed. lished teaching plans. Uses interdisciplinary resources to develop implement and evaluate comprehensive teaching plans to meet the learning needs of individuals, groups and communities. Uses advanced theoretical knowledge to design, coordinate, and evaluate comprehensive teaching programs for individuals, populations and systems. Uses concepts, theories, and strategies from nursing and related disciplines to promote excellence in contemporary nursing education and clinical practice. Achieves and maintains knowl- Participates in formal and Participates in the imple- Critically appraises and uses edge and skills necessary to pro- informal education neces- mentation of evidence- research findings to implement sary to perform nursing care based programs/practice. evidence based practice. vide safe patientcare. consistent with the LPN scope of practice. Commits to the development and dissemination of knowledge for the purpose of improving nursing care. Independently conducts and communicates research that advances nursing knowledge and scholarship to improve nursing care. BACHELORS DEGREE IN NURSING MASTERS DEGREE IN NURSING DOCTORAL LEVEL Organizes care for assigned Prioritizes care for own Manages client care delivery clients and delegates to unli- and delegates/ assigns care clients censed assistive personnel. to peers, L.P.N.s and unlicensed assistive personnel. Coor-dinates human and material resources for clients and families. Assumes an influential role in planning, organizing, and monitoring the effective use of resources within the health care setting. Analyzes and influences system level strategies to optimize resources and promote positive client outcomes. Designs and evaluates organizational strategies and their impact on individuals, families, communities, and special populations. Effectively interacts with Participates in group process Uses appropriate communito promote the provision of cation strategies to effect other health care workers. nursing care. positive outcomes for individuals and groups. Interacts with multi- disciplinary teams to manage the continuum of care for individuals, families, or groups. Implements complex communication strategies to create, modify, evaluate, and enhance health care policy and systems. Effectively disseminates and utilizes relevant researchbased strategies to scientific communities, policy makers and the public. Provider of Care INTEGRATED CONCEPTS Caregiver Communicator Coordinator/ Collaborator Advocate Teacher/ Counselor Scholar NURSING ASSISTANT LICENSED PRACTICAL NURSE ASSOCIATE DEGREE Demonstrates efficient use of Participates with the health Participates in the develop- Participates in the multidiscipli- Directs the health care team in Designs, implements, and evaluates multi-disciplinary management of achieving optimal outcomes. time, equipment, and supplies care team to plan and imple- ment and revision of stan- nary models of management within dards of care. client/organizational evaluative in managing own assignment. ment client care. health care systems. process. Supports client rights and Identifies, reports, and seek Uses appropriate processes Develops, implements and evalreports instances of resolution in discrepancies to support client decisions uates strategies to support client in policies and practices regarding care decisions. care decisions. abuse/neglect. related to individual and family well-being. Challenges assumptions and explores alternative avenues to anticipate and design, and implement changes in health care. Creates and analyses health care models to support rights of individuals, families, groups, and special populations. Reinforces organizational Identifies and responds to Develops, evaluates and policies related to safety and client situations that require modifies teaching plans instruction. based on individual learning health. outcomes for clients and health care personnel. Designs and evaluates instructional programs that meet learning needs in clients, families, groups and health care personnel. Consults and collaborates with multi-disciplinary teams to design, manage, and implement education programs for specific populations. Creates, implements and evaluates evidence-based educational programs to inform administration of best practices, and support optimal care. Updates and refines skills to Demonstrates knowledge of Acquires knowledge to Analyzes the impact of practice current practice trends and assist in modifying the deliv- trends based on evidence and enhance patient care. delivery of care. ery of care. applies the findings to the delivery of health care. Systematically formulates solutions to problems resulting from practice and contributes to the delivery of health care. Creates and synthesizes knowledge of nursing and health care systems to improve health care delivery. NOV., DEC . 2004, JAN. 2005 ARIZONA STATE BOARD OF NURSING NEWSLETTER Member of Profession INTEGRATED CONCEPTS Caregiver Communicator NURSING ASSISTANT LICENSED PRACTICAL NURSE Demonstrates ethical and responsible behavior as a member of the nursing team and consistent with regulation. Makes decisions and takes actions that are consistent with the standard of practical nursing practice, established policies, procedures, and licensing laws. ASSOCIATE DEGREE BACHELORS DEGREE IN NURSING MASTERS DEGREE IN NURSING DOCTORAL LEVEL Makes decisions and takes Assumes a leadership role in the actions that are consistent implementation of professional with the standard of regis- standards in nursing practice. tered nursing practice, established policies, procedures, and licensing laws. Evaluates and contributes to stan- Creates and utilizes databases dards of nursing practice and to evaluate organizational practices consistent with practices. advanced practice licensing regulations. Demonstrates caring behavior Demonstrates ethical/legal Promotes nursing as a pro- Promotes public awareness of behavior consistent with fession. nursing’s contribution to health and projects a positive image. practical nurse standards of care. practice. Explicates advanced nursing Disseminates research to practice roles to the public, other inform and advance the nurshealth care providers, and policy ing profession. makers. Coordinator/ Collaborator Performs within a defined role Interacts with health care Develops collegial relation- Assumes leadership role in pro- Partners with consumers and Initiates and evaluates policy other groups to promote nursing. changes to promote the proand accepts delegation and colleagues to promote legal ships for the purpose of fessional activities. and ethical practice. fession. development of the professupervision. sion. Advocate Recognizes the rights of all indi- Demonstrates awareness of Uses political processes to Demonstrates leadership skills Influences the political environ- Envisions and creates an environment that promotes an viduals and respects differences. political influences on nurs- improve client care and pro- to advocate and influence nurs- ment of the nursing profession. ing and health care. optimal future for nursing. mote nursing. ing practice. Teacher/ Counselor Scholar Explains nurse assistant care to Communicates LPN scope Communicates RN scope of Communicates and differenti- Communicates and promotes Communicates and promotes advanced practice roles in nurs- nursing research, leadership of practice to clients and oth- practice and practice stan- ates levels of nursing practice. clients and others. ing. ers. and clinical excellence. dards to clients and others. Seeks educational opportunities Identifies learning needs and Implements a plan of contin- Fosters professional and person- Plans and implements evidence- Creates a climate that proal growth in self and health care based professional development motes scholarly inquiry and to advance knowledge and establishes a plan for ued professional growth. programs for self and others. increasing knowledge and advances the profession. team members. skills. skills. Medical Treatment of self or others without Orders is not Acceptable Nursing Practice by Sister M. Rachel Torrez RN, MS, Nurse Practice Consultant When did we learn in nursing programs that it was acceptable practice to prescribe and treat co-workers, others, or yourself with medications removed from the stock at a facility without a physicians order because someone was not feeling good, forgot their personal medication, or just because we thought it was the right thing to do? When did we learn in nursing programs that it was acceptable practice to remove intravenous supplies in order to prepare an IV, start the intravenous on a co-worker, or yourself while on duty for any reason without a physicians order? Where does the Nurse Practice Act (NPA) state this is acceptable practice? I would suggest that no nurse has ever been instructed in any nursing program that this is acceptable practice. It is of interest that there are nursing staff who work in a variety of work settings who believe they have the authority to prescribe and treat for himself or herself or a co-worker. The Arizona State Board of Nursing staff is required to investigate any and all allegations suggesting a nurse may be practicing in this manner. The following are some examples of investigations that have been conducted because a nurse was reported to Arizona State Board of Nursing (ASBN) alleging that a nurse was performing in such a manner. • Nurses who gave each other medications because a staff member was nauseated, had a headache, needed an antibiotic (a variety of routes), forgot or ran out of their personal medication, wasn’t feeling well and did not wish to go the ED for treatment. • Removed intravenous supplies and initiated IV therapy on themselves or a co-worker while on duty. • Removed stock medications, narcotic and non-narcotic medications and administered the medications to themselves or a co- workers while on duty. • Removed supplies from the facility in order to treat themselves or a co-worker. • Called in a prescription for medications to a pharmacy or wrote a prescription without a physicians order. A nurse can be disciplined when such a violation occurs. The following are potential Violations of Rules and Statues of the Nurse Practice Act. POTENTIAL VIOLATIONS OF LAW: A.R.S. 32-1663 (D) AS DEFINED IN A.R.S. 32-1601 (16) (d) and (j) 16. "Unprofessional conduct" includes the following whether occurring in this state or elsewhere: (d) Any conduct or practice that is or might be harmful to dangerous to the health of a patient or the public. (j) Violating a rule that is adopted by the Board pursuant to this chapter. POTENTIAL VIOLATIONS OF RULE R4-19-403 For purposes of A.R.S. 32-1601 (16) (d) and (j) a practice that is or might be harmful or dangerous to the health of a patient or the public includes the following: A pattern of failure to maintain minimum standards of acceptable and prevailing nursing practice. Intentionally or negligently causing physical or emotional injury. Removing without authorization, narcotics, drugs, supplies, equipment or medical records from any health care facility, school, institution or other work place location. Practicing in any other manner which gives the Board reasonable cause to believe the health of a patient or the public may be harmed. ARIZONA STATE BOARD OF NURSING NEWSLETTER NOV., DEC . 2004, JAN. 2005 Annual Reports from Arizona Prelicensure Nursing Education Programs INTRODUCTION The Mission of the Arizona State Board of Nursing is to protect the public health, safety and welfare through the safe and competent practice of nurses and nursing assistants. The Annual Reports from Nursing Education Programs The Arizona State Board of Nursing (Board) annually requests a report from all Arizona pre-licensure nursing education programs. The report includes student admission, graduation, and other information. Additionally the program administrator is requested to sign an attestation of compliance with Board education rules (A.A.C. Chapter 4, Title 19, Article 2) or self-report rule violations. The annual reports cover a calendar year. For the 2003 annual reports, in addition to graduation and admission data, programs were asked about unfilled placements and number of applicants that met qualifications but were not admitted to the semester for which they applied. The number of RN to BSN and master degree recipients was also requested. In the 2002 annual report, the number of students who dropped back or dropped out was requested. This was not requested in 2003, but data on the whether a graduate completed on time, was advanced placement, or took longer than the specified length of the program was included. The number of full time equivalent faculty and unfilled faculty placements was also requested. Definition of Terms In order that the data can be understood, the following terms are operationally defined: Total Enrollment: All students enrolled in a pre-licensure nursing program Total Admissions: Students admitted in the first semester of a nursing program, regardless of whether it was fall, spring, or summer Advanced Placement Admissions: A student, usually an LPN, admitted to a semester, other than the first, of an RN program Capacity: Student placements available in a nursing program Graduates from original cohort: Students who graduated with their admission class Repeated or dropped back: Students took longer time to complete nursing program because they either repeated a course or dropped out for a period. Assumptions/Explanatory remarks The following assumptions and explanations must be understood in interpreting the data: • Practical nurse (PN) data only applies to traditional PN programs, not multiple exit programs unless indicated in the explanatory comments • The number of students "qualified but not admitted" to a program may be overestimated because some students, particularly in the metropolitan areas of the state, apply to multiple program and, due to varying requirements, a student may qualify for one program, but not qualify for another. • Number of unfilled placements is probably overestimated as some programs only considered a student admitted if they attended class the first 45 days of class, therefore these unfilled placements were actually offered to a student and would not be available to another student. In reality, there were very few programs with unfilled placements at the start of the semester. DATA AND ANALYSIS Two programs self-reported rule violations involving hiring an unqualified adjunct clinical faculty. Both programs currently are compliant with rules and did not require Board action. ATTRITION In 2002, 72 % of students admitted continued in a nursing program until graduation without stopping, repeating or failing. Sixteen percent of those admitted were lost to the program because they either failed out or dropped out and 12% fell behind but continued. These data were not requested in 2003, so it is not known if this is a typical attrition rate. 12% Continue 16% Drop out Overall enrollments in RN programs increased 6.23% in 2002 and 12.68% in 2003 for an overall 2-year increase of 17.8% or 577 students in two years. Practical Nursing Program Enrollment There was also an increase in practical nurse program enrollment. While the percentage increase is dramatic, the increase represents fewer students than the increase in RN programs. Practical nursing programs more than doubled enrollment from 2001 to 2003 and increased by 86% from 2002 to 2003 for an overall 2-year increase of 220 students. This is mainly due to the opening of a new practical nursing program at Estrella Mountain Community College and increases in enrollment at GateWay Fast Track Program and Pima Community College Center for Training and Development. PN PROGRAM ENROLLMENT 400 Fall Back 72% 350 300 ENROLLMENT The following figure shows enrollment in all nursing programs (RN/PN) increased each year since 2001. Enrollment increased by 7.55% between 2001 and 2002 and by 19.25% between 2002 and 2003. Overall enrollment increased by 26.28% in two years. This represents an additional 797 nursing students. TOTAL PROGRAM ENROLLMENT 250 2001 200 2002 150 2003 100 50 0 2001 2002 2003 4000 3000 2000 1000 0 2001 2001 2002 2003 2002 2003 2820 PROGRESS TO GOAL OF SENATE BILL 1260 In the 2002 legislative session, Senate Bill 1260 entitled "An Act Providing for the Development of the Caregiver and Resource Expansion Program within the Arizona Board of Regents and Community College Districts" was passed. Senate Bill 1260 charged the educational community in Arizona develop a five year plan to double the capacity of Arizona RN nursing programs by 2007. If one examines over- 3033 3617 Registered Nurse Program Enrollment There was a modest increase in enrollments in RN programs between 2001 and 2003. RN PROGRAM ENROLLMENT p pp q were not admitted to the semester for which they applied. The number of RN to BSN and master degree recipients was also requested. In the 2002 annual report, the number of students who dropped back or dropped out was requested. This was not requested in 2003, but data on the whether a graduate completed on time, was advanced placement, or took longer than the specified length of the program was included. The number of full time equivalent faculty and unfilled faculty placements was also requested. Definition of Terms In order that the data can be understood, the following terms are operationally defined: Total Enrollment: All students enrolled in a pre-licensure nursing program Total Admissions: Students admitted in the first semester of a nursing program, regardless of whether it was fall, spring, or summer Advanced Placement Admissions: A student, usually an LPN, admitted to a semester, other than the first, of an RN program Capacity: Student placements available in a nursing program Graduates from original cohort: Students who graduated with their admission class Repeated or dropped back: Students took longer time to complete nursing program because they either repeated a course or dropped out for a period. Assumptions/Explanatory remarks The following assumptions and explanations must be understood in interpreting the data: • Practical nurse (PN) data only applies to traditional PN programs, not multiple exit programs unless indicated in the explanatory comments • The number of students “qualified but not admitted” to a program may be overestimated because some students, particularly in the metropolitan areas of the state, apply to multiple program and, due to varying requirements, a student may qualify for one program, but not qualify for another. 2007 Goal 32% Baseline 50% 2003 Increase 18% NOV., DEC . 2004, JAN. 2005 ARIZONA STATE BOARD OF NURSING NEWSLETTER RN PROGRAM ADMISSIONS all enrollments as an indicator of capacity, the 2002 capacity was 2230 RN students. From 2002 to 2003 RN enrollments increased by 411 students, representing 18% of the total needed to double enrollment. Programs need to enroll an additional 1,819 students by 2007 to reach the goal of doubling enrollment/capacity. PROGRAM ADMISSIONS AND CAPACITY Admissions to the first semester of a nursing program increased slightly from 2001 to 2002 as did capacity. Admissions rose more dramatically in 2003 by 35.79%. Unfilled placements represented approximately 3-4% of capacity over the last 2 years. Registered nursing programs that reported admitting under capacity in 2003 include: Grand Canyon University (7), Maricopa Community College District Nursing Program (15), Mohave CC (1), and Northern Arizona University (30). Northern Arizona University’s (NAU) high number of unfilled placements was due to insufficient qualified applicants for their distance program that serves Native American students exclusively. Thirteen qualified applicants were denied admission to NAUs Flagstaff program. Some programs did not report admitting students to capacity because, even though the placement was offered and accepted, the student did not attend the first day of class. Practical nursing programs admitting under capacity in 2003 are GateWay (6), and Pima Community College Center for Training and Development (29). Maricopa Skill Center admitted 20 students over capacity. These admission data do not include advanced placement admissions (LPN’s enrolling in the 3rd semester of an RN program). ARIZONA NURSING PROGRAM ADMISSIONS/CAPACITY 4000 2000 0 2001 2002 2003 Admission 1614 1652 2083 Capacity 1773 1701 2160 Registered Nurse Program Admissions Registered nursing program admissions to the first semester of a nursing program were totaled and then broken down by type of program. Total RN admissions remained stable between 2001 and 2002. Associate Programs increased admissions by 13% from 2002 to 2003 and 17% from 20012003; baccalaureate programs increased by 8% from 20022003 and 5% from 2001 to 2003. Baccalaureate programs reported a slight decrease of 11 students from 2001 to 2002. QUALIFIED/NOT 2000 0 2001 2002 2003 Total 1413 1437 1608 A.D.N. 1030 1065 1206 BSN 383 372 402 Practical Nursing Program Admissions A dramatic increase in practical nursing program admissions was seen in 2003. Practical nursing programs actually report more admissions than currently enrolled students. This can be explained by a shorter curriculum that allows a student to graduate in as little as 6 months. Therefore, some students were admitted and graduated before October 15 of the same year, the date on which enrollment was measured. Increases, while dramatic in percentage, actually represent an additional 274 students. By contrast RN program admissions increased by 195 students, but a less dramatic effect is seen due to the larger number of RN students. PN PROGRAM ADMISSIONS 600 400 200 2001 2002 2003 201 215 475 ADMISSIONS VS. CAPACITY The number of students admitted in 2003 compared with the number of qualified applicants that were denied admission. Overall, 971 qualified applicants were not admitted in the semester for which they applied. Some of those that were denied admission in one program may have been admitted to another program or to an PN program. For example, on interview, approximately 80% of the students in one PN program stated the reason for attending was that they did not gain admittance to the RN program in the area. Also, due to differing admission standards, a student may qualify for admission in one program and not qualify for admission in another program. ALLPROGRAMS CAPACITY – ADMITS – QUALIFIED/NOTADMITTED 2003 RN Programs For RN programs, there were 756 qualified applicants who were not admitted to the semester for which they applied. Programs with the largest number of qualified applicants that were not admitted were MCCDNP (321), ASU (117), 2160 CAPACITY 0 500 1000 1500 2000 University of Arizona (82), Cochise College (56), and Coconino Community College (30). RN CAPACITY – ADMITS – QUALIFIED/NOTADMITTED 2003 QUALIFIED/NOT ADMITTED 756 1608 ADMITS 1670 CAPACITY 0 LPN 2083 ADMITS 1000 0 971 ADMITTED 500 1000 1500 2000 PN Programs There were 215 qualified practical nurse applicants who were not admitted to the semester or session for which they applied. Programs with large numbers of qualified applicants who were not admitted include GateWay Fast Track (125) and Maricopa Skill Center (90). While GateWay Fast Track reported turning away qualified students, they also reported that they admitted under capacity by 6 students. Pima Community College Center for Training and Development also reported 29 vacant placements. Maricopa Skill Center reported admitting 20 students over their stated capacity. PN CAPACITY /QUALIFIED/NOTADMITTED 2003 PN CAPACITY/QUALIFIED/NOT ADMITTED 2003 215 Not Admitted 475 Admitted 490 Capacity 0 100 200 300 400 500 ARIZONA STATE BOARD OF NURSING NEWSLETTER PROGRAM GRADUATES Total Graduates Graduates for all types of programs increased between 2002 and 2003 by 151 persons. Most of this increase is accounted for by the increase in practical nursing program graduates of 158 students. TOTAL GRADUATES IN ALL PROGRAMS 1400 1398 1247 1126 1200 1119 1000 800 Total 600 RN 400 200 0 PN 279 121 2002 2003 TOTAL GRADUATESIN ALL PROGRAMS RN Programs There was a slight decrease in RN graduates between 2002 and 2003. Associate degree graduates increased by 7 and BSN graduates decreased by 14. Graduates of RN programs are projected to increase in 2004 to reflect increased enrollments. BSN graduates comprise 27% of the total graduates in 2003 and 28% in 2002. 1200 1126 RN 800 1119 RN 0 The programs were also requested to submit information on admissions to RN to BSN or RN to MSN completion programs. It is difficult to compare numbers for the total because University of Phoenix was not surveyed in 2002. Grand Canyon University and Arizona State University significantly increased admissions while Northern Arizona University remained steady. University of Arizona decreased admissions. University of Arizona only offers a RN-to-Masters program. 140 100 ASU 80 GCU 60 NAU U of P U of A 2002 305 BSN 2002 2003 CHARACTERISTICS OF RN GRADUATES Of RN graduates, 79% finished in the optimal allotted time for their program. 13% of the graduates took extra time to finish the program and 8% were advanced placement students, mostly LPN students finishing an RN program. These numbers are nearly the same as 2002, where 80% of graduates finished with their cohort, 11% dropped back and finished, and 9% were advanced placement. 2003 Graduates Graduates of RN to BSN programs appeared to increase in 2003 as compared to 2002. However, a significant proportion of BSN graduates are from the University of Phoenix, which was not surveyed in 2002. A total of 317 nurses graduated from RN to BSN programs 2003. These data may be more meaningful when compared in 2004. 80 60 8% DROPPED BACK 40 ADVANCED PLACEMENT 9% 79% 30 2002 20 11% GRADUATE COHORT 2002 80% 10 DROPPED BACK 0 ADVANCED PLACEMENT 9 NCLEX® RN EXAM In comparing takers and passers of the National Council Licensure Examination for Registered Nurses (NCLEX-RN), there were 7% fewer takers in 2003 than in 2002, but only 1% fewer first time passers. This represents a 40% decrease in the number of first time failures. The overall pass rate for NCLEX RN was 85.7% in 2002 and 91% in 2003. Seventy-four fewer persons took the exam in 2003. In comparing exam statistics with program statistics, it must be remembered that students graduating in December do not take NCLEX until the following year, therefore the number of graduates in a year may be considerably more than the number of NCLEX takers. There are very few graduates who do not take the NCLEX exam. 1100 1050 1000 All takers 950 Passers 900 850 800 2002 ASU GCU NAU U of A U of P 50 GRADUATE COHORT 13% 2002 250 200 PN 150 AD 100 BSN 50 Full PartUnfilled Time Time SUMMARY The systematic and routine collection of nursing program data will assist the Board, nurses, and the public in understanding nursing education and enrollments and in setting realistic goals. In Arizona, nursing program enrollment and admissions increased in both 2002 and 2003. While an immediate increase in practical nurse graduates was experienced, it will take 2 years before a subsequent increase in registered nurse graduates is seen due to the length of the program. Bachelor of Science in Nursing graduates comprise less than 30% of new graduates. This is below the national average of 34% (NCSBN). The low proportion of baccalaureate prepared graduates may contribute to the reported shortage of nursing program faculty. In 2003 a large number of qualified students were either denied or placed on a waiting list. Pamela Randolph RN, MS, CPNP Education Consultant Arizona State Board Of Nursing REFERENCES National Council of State Boards of Nursing. 2003 NCLEX Quarterly Reports. Available from Arizona State Board of Nursing, 1651 E. Morten, STE 212, Phoenix AZ, 85020. RN to BSN/MS Grads 70 2003 FACULTY 300 0 RN to BSN/MS Admissions 0 319 BSN Faculty At the time of data measurement, there were 775 Full-time equivalent (FTE) nursing faculty employed and 42 FTE faculty positions unfilled for a total number of 817.18 FTE available faculty positions. This represents a 5% vacancy rate in faculty positions. There are more vacancies in BSN programs, probably due to the increased educational requirements for teaching in a BSN program and plans to expand several BSN programs with subsequent faculty positions to be filled. Associate degree nursing programs employ twice the number of part-time faculty as baccalaureate, due to their increased number, increased enrollment, and the subsequent need for more clinical faculty to maintain the Board mandated student-to-faculty ratio of 10 to 1 during patient care experiences. 350 20 400 200 RN to BSN Admissions 40 814 ADN 807 ADN 600 NCLEX® PN EXAM In 2003, there was an overall increase of 50% in both takers and passers of the 700 NCLEX PN exam. This not only reflects the 600 increase in admissions to Graduates 500 PN programs, but a sub400 All takers stantial increase in num300 ber of takers from multiPassers ple-exit RN programs. 200 There was an overall 100 increase of 158 PN pro0 gram graduates. 2002 120 RN GRADUATES 1000 NOV., DEC . 2004, JAN. 2005 2003 NOV., DEC . 2004, JAN. 2005 ARIZONA STATE BOARD OF NURSING NEWSLETTER Regulation Rundown by Pamela Randolph RN, MS, CPNP Current Rule Activity R4-19-403 UNPROFESSIONAL CONDUCT AND ARTICLE 5. ADVANCED PRACTICE NURSING An open public workshop was held on September 2, 2004. Changes were recommended in the rules consistent with community feedback and courtesy review by the staff at the Governor’s Regulatory Review Council. The latest version of the rulemaking is on the website (www.azbn.org) and is expected to be filed for publication with the Secretary of State this fall. Please address all comments to Pamela Randolph by e-mail at prandolph@azbn.org, by fax 602-889-5155, or regular mail at the Arizona State Board of Nursing, 1651 E. Morten, Suite 210, Phoenix, AZ 85020. Summary of Changes: • Incorporating standard criteria for recognizing a specialty in advanced practice; • Modifying and updating criteria for approval of NP and CNS programs; • Requiring national certification in the category and specialty of NP or CNS practice, with some exceptions as noted below; • Temporary provisions that allow nurses using the CNS title, who are not eligible for national certification, to obtain Board certification by demonstrating mastery of core competencies and successful CNS practice. These provisions will expire in a year; • Restricting the use of the titles "Nurse Practitioner" and "Clinical Nurse Specialist" to those that are certified by the Board; • Reorganizing and updating prescribing and dispensing rules and adding unprofessional practitioner prescribing practices currently in Article 4 (R4-19-403); • Amending other unprofessional conduct rules in R419-403 to include boundary violations, providing false information to the Board in an investigation, falsifying health or other institutional records for any reason, use of force with a client, making a false employment application, and assisting an unlicensed person in the unlawful practice of registered or practical nursing; and • New rules that provide: * Temporary certification for CNS and NP; * Expiration and renewal of new nurse practitioner and clinical nurse specialist certificates; * Delegation guidelines for nurse practitioners who delegate tasks to medical assistants, as authorized by the nurse practice act; and * Clarification of the scope of practice of registered nurse anesthetists. Article 2. Arizona Practical and Professional Nursing Programs. The Notice of Proposed Rulemaking was filed with the Secretary of State. An oral proceeding on the proposed rulemaking is scheduled for October 15, 2004 at 9 a.m. in the Board offices. A copy of the rulemaking is available on the web www.azbn.org Highlights of Proposed Changes: • Allow a post secondary institution that is either regionally or nationally accredited by an accrediting agency recognized by the U.S. Department of Education to conduct a nursing program; • Measurable criteria added for classroom specifications in a nursing program; • A nursing program must develop policies to ensure students, faculty and preceptors are safe to deliver patient care; • Clinical supervision criteria added; • Programs must provide accurate information to students including cost of the program, length of the program, and transferability of credit; • All programs must offer clinical instruction in the major areas of nursing practice for the level of the program; • Standards for refresher programs were revised to allow more flexibility; • New rules for out-of-state and distance programs were added Article 8. Certified Nursing Assistants The Nursing Assistant Advisory Committee has reviewed the draft rules. The Education Committee and Law and Rules Committee will next review the rulemaking. It will be discussed at the CNA Educators Retreat on January 14, 2005. A draft of the rule is currently posted on the web for comment. Highlights of Proposed Changes: • Increased clarification of expectations for nursing assistant programs including minimum number of didactic hours, clinical hours, and minimum curriculum • Allowing an LPN to supervise a clinical group in a C.N.A. program; • Lists equipment necessary for a C.N.A. program to simulate patient care in a laboratory setting; • Allows the Board to grant one-year initial approval to a new program without a site visit; • Allows the Board to grant re-approval to a program with a telephone visit every other renewal cycle; • Requires a C.N.A. program to graduate and certify at least one student in each renewal cycle; • If approval is rescinded or revoked, the entity cannot reapply for 2 years; • Increased options for endorsement C.N.A.s to qualify for certification if their program was less than 120 hours; • Increased specificity in standards of conduct for Certified Nursing Assistants including boundary violations, dual relationships, and falsification of patient records or employment applications. Future Rule Activity Article 4. Regulation. Unprofessional Conduct will be amended with Article 5 and a copy of amendments is available with Article 5 on the website. The rest of the Article will be opened for revision in 2005. Article 1. Definitions and Time-Frames. The Board will amend these rules to be consistent with other rulemaking changes over the past 2 years in 2005. The person to contact at the Board regarding rules is: Pamela Randolph Nurse Practice Consultant 1651 E. Morten Suite 210 Phoenix, AZ 85020 602-889-5209 e-mail: prandolph@azbn.org Nurse Imposter Alert, May, 2004 - September, 2004 The following individuals have either applied for a nursing position or have been employed as a nurse in Arizona without evidence of a valid nursing license. Sandra Miller aka: Thompson, Nurse Imposter, Revoked LPN. A cease and desist letter was issued September 13, 2004 after the Board received information that Ms. Miller had represented herself as a nurse to healthcare professionals and other members of the public. Although Miller was previously licensed, her Arizona license was revoked in May 1997. Marlene Muller, LPN Imposter. A cease and desist letter was issued on June 14, 2004, after it was reported that Muller had represented herself to patients and others as a "nurse"; presented an forged LPN license and had business cards reflecting the credentials of “LPN”. Muller is not licensed nor has she completed a nursing education program. Cindy Parish-Tamayo, Nurse/CNA Imposter. A cease and desist letter was issued April 21, 2004, after the Board of Nursing received information that Parish-Tamayo represented herself as a Certified Nursing Assistant and as a Registered Nurse and presented business cards stating that she was a CNA. Parish-Tamayo is neither licensed nor certified in Arizona. Richard Puczko, RN Imposter. A cease and desist letter was issued on October 6, 2004, after the Board received information that Puczko had represented of himself to the public as an RN. Puczko applied for and secured employment as a staff RN stating that he had recently graduated from nursing school. Puczko was in fact a respiratory therapist student and had not attended nursing school or obtained licensure to practice nursing. Ketura Rathbun, Nurse Imposter, RN Denial. A cease and desist letter was issued July 21, 2004, after the Board received information that Rathburn accepted a travel assignment and had been working as a Registered Nurse in Arizona utilizing an Idaho multi-state license. Rathburn had previously submitted an Arizona application for licensure as a Registered Nurse and in December 2000, and was denied licensure. Based upon this prior denial, Rathburn was not authorized to practice nursing in the State of Arizona under the license or privilege of any other state including a compact state. Cheri Ritter, RN Imposter. A cease and desist letter was issued April 22, 2004, after the Board received information that Ms. Ritter had been employed as a nurse in Arizona since October 2000. Ritter does not hold a license to practice nursing in Arizona. Neda Rodriguez, Nurse Imposter. A cease and desist letter was issued April 21, 2004, after the Board received information that Rodriguez represented herself as a nurse in order to obtain employment for a night Nurse Supervisor position. Michael Ryan, RN Imposter, Revoked RN. Ryan's nursing license was revoked November 3, 2003. A cease and desist letter was issued May 12, 2004, after the Board received information that Ryan had continued to represent himself as a professional nurse by maintaining employment and accepting nursing shifts. In addition to the above, the Board issued Cease and Desist letters to the following 8 individuals working as a “CNA” without valid certification: Yvonne Barret Veronica Botello Dee Dee Hicks. Juanita Ibarra June Simon Molly Simon Joseph Tinelli. Antionette Welch A complete list of imposters can be found by visiting our website at www.azbn.gov. For questions regarding imposters or to report an imposter, please contact Valerie Smith, RN, MS, Associate Director at vsmith@azbn.org (602-889-5206) or Thereasa Berry, Assistant to Associate Director/Investigations at tberry@azbn.org (602-8895208) University of Arizona College of Nursing Appoints New Professor & Associate Dean for Research: Carolyn Murdaugh, RN, PhD "It gives me great pleasure to welcome this highly esteemed scientist, educator, and scholar to the University of Arizona College of Nursing. Dr. Carolyn Murdaugh will provide outstanding leadership for the future directions of the College's research mission," said Marjorie A. Isenberg, DNSC, RN, FAAN, Dean of the College of Nursing. Dr. Murdaugh comes to the UA from the University of South Carolina College of Nursing, where she had served as Associate Murdaugh Dean for Research since 1996. She also directed the College's Center for Health Promotion and Risk Reduction in Special Populations. Prior to this she worked at the National Institute of Nursing Research at the National Institutes of Health, where she was senior scientist and chief of the Laboratory for the Study of Human Responses to Health and Illness. She also has held adjunct professorships at the University of Hawaii and Johns Hopkins University in Baltimore. At the UA, Dr. Murdaugh's role will be to support the research efforts of College of Nursing faculty. She said the College's research traditionally has focused on three strengths: injury mechanisms and biobehavioral responses; health-care systems; and vulnerable populations, such as the elderly and those living in border or rural areas. ARIZONA STATE BOARD OF NURSING NEWSLETTER NOV., DEC . 2004, JAN. 2005 ARIZONA STATE BOARD OF NURSING NEWSLETTER QUARTERLY CIRCULATION APPROXIMATELY 90,000 TO ALL RNs, LPNs, CNAs AND STUDENT NURSES IN ARIZONA SECTION 2 Volume 5, No. 4 November, December 2004, January 2005 CNA EDUCATORS RETREAT 2005 Phoenix Mountain Preserve Reception Center Friday, January 14, 2005 Schedule: 9:15 - 9:50 a.m. Registration and Continental Breakfast 9:50 - 10:00 a.m. Welcome and Opening Remarks 10:00 – 11:00 a.m. Building Effective Relationships Through Mentoring Presented by: Sheila Sorrentino Ph.D., RN 11:00 - 12:00 a.m. Motivating CNAs to Care Presented by: Jan Dougherty MS, RN 12:00 - 1:00 p.m. Buffet Lunch 1:00 – 2:00 p.m. Effective Teaching Methods Presented by: Elizabeth Gilbert, RNC, MS, cFNP 2:00 – 2:45 p.m. Legal Issues: Understanding Criminal Background Presented by: Dan Christl, JD, Asst. Attorney General 2:45 – 3:00 p.m. Break 3:00 – 3:45 p.m. Board Issues: Statute & Rule Update Presented by: Joey Ridenour, MS, RN, Exec. Director, AZBN Pamela Randolph, MS, RN, Education 3:45 – 4:15 p.m. Dialogue with Testing service Presented by: Testing Service 4:15 – 4:30 p.m. Evaluation Keynote Speaker: Sheila Sorrentino, PhD, RN: Dr. Sorrentino is currently a curriculum and health care consultant focusing on career ladder nursing programs and effective delegation and partnering with assistive personnel. She has taught at all levels of nursing from CNA to baccalaureate and higher degree. A Mosby author since 1982, Dr. Sorrentino has written several textbooks for nursing assistants and other assistive personnel. She was awarded the 1992 International Medical Films Award for her work on skills videos and the Alumni Achievement Award from Lewis University for outstanding leadership and dedication in nursing education. She was a consultant for Mosby’s Nursing Assistant Skills Videos and Mosby’s Nursing Skills Videos (selected for the 2003 AJN Book of the Year Award for Electronic Media). Her presentations at national conferences focus on delegation and other issues related to assistive personnel. Registration Form CNA EDUCATORS RETREAT January 14, 2005 Fees include continental breakfast and lunch: Before December 15th December 15th or later Walk-in (as space permits) $50 per person $75 per person $100 per person Submit one form for each person attending: Name:______________________________________________ Educational Institution:_________________________________ Position:_____________________________________________ Address:_____________________________________________ Phone:____________ Fax: ___________ E-mail: _____________ Amount Enclosed:______________________________________ Please pay by check or money order. Make checks payable to Arizona State Board of Nursing and mail to: Arizona State Board of Nursing Attn: Meredith Fountain, Education 1651 E. Morten, Suite 210 Phoenix, AZ 85020-4613 Refunds: Money will be refunded only in the event the conference is cancelled. Mountain Preserve Reception Center 1431 East Dunlap Phoenix, Arizona 85068 (602) 943-2656 Directions from I-17: Exit I-17 on Northern East on Northern to 12th Street North (left) on 12th Street Right on Dunlap NOV., DEC . 2004, JAN. 2005 ARIZONA STATE BOARD OF NURSING NEWSLETTER Arizona Nursing Exam Pass Rate Hightest In U.S. by Arizona State Board of Nursing PRESS RELEASE 8/19/04 PHOENIX: The statewide first-time passing rate on the national licensure exam for registered nurses (NCLEXRN®) for the second quarter, 2004 was the highest in the United States excluding the territories. At 93.61%, the pass rate for Arizona nursing programs graduates represents 425 (out of 454) graduates of Arizona community college and university nursing programs who passed the exam on the first attempt. This was only exceeded by Northern Mariana Islands, where one candidate took and passed the exam resulting in a 100% pass rate. The national passing rate for the same period was 88.45%. Kathy Malloch Ph.D. RN, Vice President of the Arizona State Board of Nursing and Chairperson of the Education Committee, expressed support and congratulations to all the nursing programs in Arizona for this remarkable achievement. Just two years ago, the Board was concerned over low NCLEX pass rates posted by Arizona nursing programs and held a statewide meeting to discuss the issue with program representatives. At that meeting, the programs were asked to identify factors leading to success or failure on the exam and present a plan to improve scores. Following the meeting, based on the information shared, several programs instituted measures designed to improve a graduate’s success on the exam. Steps taken by the programs include requiring program applicants to pass tests of competency in reading and math, requiring high scores on national predictor exams, and instituting high standards for entrance and progression within the nursing program. Additionally, the Board indicated that all nursing programs should strive for a 90% pass rate on the NCLEX examination. The NCLEX-RN competency examination test is required for nursing licensure in all states. The exam is computer adapted and based on a job analysis of entrylevel registered nurses. The passing standard is assessed every three years. Board of Nursing Education Consultant, Pamela Randolph stated, "the high pass rates of Arizona programs are even more significant because the passing standard for the exam was raised on April first of this year." Because of the trends seen in the past when the passing standard was raised, the Board expected the passing rate to decrease. The Board does not grant licensure to applicants who do not take and pass the NCLEX examination. Individual programs that posted very high passing rates include: Arizona Western College 96%, Central Arizona College 100%, The Maricopa District Community College Nursing Program 99%, Mohave Community College 100%, Northern Arizona University 100%, Northland Pioneer College 100%, and Yavapai College 98%. Board President, Alice Gagnaire RN, MHSA stated, "These test scores are a real testament to the quality of nursing programs offered in the state of Arizona. With the national and state nursing shortage, having nurses successfully pass the exam the first time around is vital to patient care. We will be able to place more nurses into the healthcare facilities to care for the patients. Congratulations to the nursing programs for all their hard work and accomplishments. Congratulations to all the new nurses." Advanced Practice Corner by Karen Grady, MS, RN, FNP, BC Advanced Practice Consultant Nurse Practitioners: Who Are They And What Do They Do? For answers to your questions about nurse practitioners, including their certification requirements and scope of practice, visit our website, www.azbn.org, under Resources/Advisory Opinions, and review the advisory opinion, Nurse Practitioner Description of Roles and Functions. This advisory opinion describes the multiple roles and functions of nurse practitioners, and for easy reference, cites the relevant statutes and rules from the Nurse Practice Act that pertain to nurse practitioner certification requirements and scope of practice. The cited statutes and rules can also be viewed in their entirety under Resources/Nurse Practice Act. Nurse practitioners provide the services described in the above advisory opinion within the scope of practice of their education, training, and specialty area of certification. The specialty area of certification is based upon their educational program preparation in that specialty area. The specialty area of certification describes the population (e.g., pediatric, adult, family, psychiatric, etc.) of patients that are within the nurse practitioner’s scope of practice. Nurse practitioners consult with or refer to physicians and other health care providers in situations that are outside the limits of the nurse practitioner’s knowledge, expertise, and/or specialty area. A common misconception is that Nurse Practitioners and Physician’s Assistants are essentially identical providers. Although both are licensed health care providers and may provide similar services, there are significant differences: • All Nurse Practitioners in Arizona are licensed professional nurses who have completed a nurse practitioner program approved or recognized by the Board. If entering practice after January 2001, they are required to hold a graduate degree in nursing or a health related area. If entering practice after July 1, 2004, they are also required to hold national certification. Nurse Practitioners are regulated by the Board of Nursing and practice under the authority of their professional nursing license and advanced practice certification in a specialty area. Nurse practitioners collaborate with one or more physicians on an as-needed basis. They do not require direct or on-site supervision by a physician. Nurse practitioners authorized by the Board may prescribe and dispense medications, including Class II-V controlled substances if they also hold a DEA registration. Nurse practitioners may work in independent practice. • Physician’s Assistants in Arizona do not require any underlying health care licensure. Physician’s Assistants must attend and complete an approved course of training and pass a certifying examination. Physician’s Assistants are licensed and regulated by the Arizona Medical Board and must practice under the supervision of a physician. A notification of supervision must be filed with the Medical Board. The tasks that Physician’s Assistants perform must be delegated to them from their supervising physician, including the prescribing and dispensing of medications. There are restrictions on their ability to prescribe Class II and III controlled substances. Death Certificates The Board’s on-line educational program for nurse practitioners who wish to sign death certificates became available on our website on September 1, 2004. For those without computer access, hard copies are available on request. Nurse practitioners must complete the program before they can sign a death certificate. Once the nurse practitioner has completed the program, they are eligible to sign death certificates. No additional certification is required. Temporary Advanced Practice Certification On September 23, 2004, the Board approved a policy to allow Temporary Advanced Practice Certification for new graduate applicants (nurse practitioners and clinical nurse specialists) who have met all other requirements for Board certification and who are waiting to take the National Certification Examination. If the new graduate has met all other certification requirements and can submit evidence of eligibility to sit for the national examination, a temporary certificate can be issued. The applicant must also provide written authorization to the national certifying body to release their exam results directly to the Board (i.e., pass/fail notification). The temporary certificate expires in 3 months or upon failure of the examination. The temporary certificate does not include P&D privileges. To apply, submit a temporary certification application plus the $25 fee to Donna Frye, along with proof of eligibility to sit for the exam. If you need additional information about the application process, contact Donna Frye, Licensing Technician, at dfrye@azbn.org. Advanced Practice Committee The advisory opinion, The Use of Controlled Substances for the Treatment of Chronic Pain, was presented to the Board and approved on September 24, 2004. The full text of the advisory opinion is published separately in this newsletter and is available on our website menu under Resources-Advisory Opinions-Controlled Substances for Treatment of Chronic Pain. The guidelines were developed to assist nurse practitioners in the responsible use of controlled substances in the treatment of patients with chronic pain. The next meeting of the Advanced Practice Committee is tentatively scheduled to be held on November 12, 2004. If you have any questions about advanced practice or the committee, contact Karen Grady at kgrady@azbn.org. Testing Schedule for Experior November 11-12, 2004 Yuma December 6, 2004 Flagstaff ARIZONA STATE BOARD OF NURSING NEWSLETTER NOV., DEC . 2004, JAN. 2005 Certified Nursing Assistant Corner by By Patricia A. Staten RN, MS & Pamela Randolph RN, MS; Nurse Practice Consultants Resident Rights What is the difference between Resident’s Rights and Patient’s Rights? It may be useful to first examine the definitions of patient and resident. A patient is "one who suffers, one under medical care, one who is sick with, or being treated for, an illness or injury". A resident is "one who makes his home or dwell in a particular place". Patients are usually transient and do not dwell in a particular place. A patient does not "live" in the health care setting, whereas, a resident does. In many cases, it is the resident’s only home. When visiting a long-term care facility, one may observe the residents dressed in their own clothing, strolling the hall, playing with facility pets, and keeping their own furniture, artwork, and bedspreads in their rooms. Hospitals and outpatient clinics have standard furniture, institutionalized artwork, and patients typically wear hospital-issued clothing. The Federal Nursing Home Reform Act or OBRA ’87 created a set of national minimum standards of care and rights for people living in certified facilities. The Federal Nursing Home Reform Act became law because of growing public concern with the poor quality of care in some nursing homes and the concerted advocacy of consumers, provider associations, and health care professionals. Nursing home residents are guaranteed certain rights under federal and most state laws. Long-term care facilities are required to advise residents of these rights, and to encourage and assist residents in exercising their rights throughout their stay in a facility. The nursing home must list and give all new residents a copy of these rights. These rights include: • Financial: The right to be informed in writing about services and fees before entering a long term cares facility. The right to manage the resident’s own money or to choose someone else to do this; • Information: The right to access all records, be informed of their health condition; • Refuse treatment: The right to refuse the care provided; • Privacy and confidentiality: The right not to be unnecessarily exposed; visit with others in private areas; send and receive mail and phone calls; medical information is not released without the consent of the resident; • Personal Choice: The right to choose a physician and take part in planning treatment, choose activities, plan schedules and care—when to sleep, what to wear, and what to eat; • Disputes and Grievances: The right to voice concerns, questions, and complaints about treatment or care; • Work: The resident does not work for care, care items, or other items or privileges. A resident may work if they choose to; • Participation in Family and Group Activities: The right to take part in resident and family groups and events; • Care and Security of Personal Belongings: The right to keep and use personal items; the facility must protect the personal belongings of the resident; • Freedom from Abuse, Mistreatment, and Neglect: The right to be free from verbal, sexual, physical, or mental abuse and involuntary seclusion; • Freedom from Restraint: The right to have body movements unrestricted by either physical or chemical means; • Quality of Life: Residents must be cared for in a manner that promotes dignity, self-esteem, and physical, psychological, and mental well-being. Activities that offer personal choice and a home-like environment must be provided. Meticulous protection of a resident’s rights by RNs, LPNs, and CNAs working in residential facilities will enhance the resident’s quality of life and promote a therapeutic environment. It is also a component of the professional conduct expected of licensed health care professionals working with residential clients. Reference: Sorrentino, S. (2004). Textbook for Nursing Assistants. St. Louis, MO: Mosby. Frequent Errors in the Manual Skills Test Experior Rater, Doris Donithon has reported applicants often fail the manual skills test by mistakes such as these: • Many candidates have difficulty telling the right side from the left side of the body (i.e. ROM on the wrong extremity or positioning the resident on the wrong side) • When placing the resident on the bedpan, candidates often place the pan backwards under the resident (placing the handle of the fracture pan under the spine) or fail to give the resident an opportunity to clean themselves up after using the bedpan. • If the bed is elevated, it must be lowered before the candidate exits the room. • When making an occupied bed, the top linen goes over the resident, not under. • Attention should be paid to the type of soap being used during pericare, bed bath or catheter care. (Regular or rinseless.) Attention to these matters in the CNA training program should enhance the student’s opportunities for success on the manual skills exam. Nursing Assistant Advisory Committee The Committee met on June 4th and September 10th to continue reviewing the proposed changes to Article 8: Certified Nursing Assistants. The committee assisted in the planning of the CNA Educator’s Retreat on January 14th, 2004. The committee also examined common violations of the Nurse Practice Act for CNAs and recommended that the Board adopt a proposed rule that requires a CNA program to inform students of certification requirements. The most common violation is criminal conduct and the most common discipline is denial or revocation of the certificate. The committee will meet again on December 3, 2004 and set the calendar for 2005. If you wish to attend a meeting, please contact the Board to confirm meeting dates and times. CNA Program Curriculum Project A diligent group of nursing assistant educators continues to meet to write a common CNA curriculum based on Board minimum competencies. The group is expected to release a draft of the work by the end of the year. It is hoped that the common curriculum will assist educators in teaching CNA content. Persons contributing to the project include: Diane Ayle, Emelia Lewis, Regina Cottrell, Katie Windsor, Jan Gibson, and Mary Edwards. The Board is grateful for the dedication and commitment of this group. If you would like to assist in this project, please contact Pamela Randolph at prandolph@azbn.org. Medication Technician Update The steering group for the pilot study on the use of medication technicians in long-term care has divided into three working groups: Financial, Research, and Curriculum. Preliminary drafts of the scope of work for the research study, protocols for delegating medications, and curriculum guidelines were reviewed on September 14, 2004. The next steps are to continue to refine protocols and curriculum guidelines, develop curriculum, secure funding and develop criteria for choosing pilot facilities. For additional information on this project, contact Pamela Randolph at 602-889-5209 (prandolph@azbn.org) or Joey Ridenour at 602-889-5200 (jridenour@azbn.org). NOV., DEC . 2004, JAN. 2005 ARIZONA STATE BOARD OF NURSING NEWSLETTER Arizona Nurses Association 2005 Lobby Day & Legislative Day by Gayle Armstrong, RN, BSN, Special Projects Coordinator Save the dates of Friday, February 18, 2005 for Nurses Legislative Day, and Thursday, March 10, 2005 for Nurses Lobby Day. Attendance at one or both of these events allows attendees to meet key political players in the profession and state. Attendees will also learn how to influence the political scene and how the political scene influences the practice of nursing. Highlights of Lobby Day include observation of the Arizona Senate and House Health Committees, followed by a legislative healthcare briefing by AzNA’s lobbyist, Rory Hays, JD. Learn about keys to effective lobbying from AzNA’s Executive Director, Marla Weston, RN, MS. After lunch, attendees may meet with legislators, followed by a debriefing of those visits, with Rory and Marla. Legislative Day will begin with the keynote speaker, Jana Bommersbach, one of Arizona’s acclaimed journalists, who will speak on "Political Advocacy in Action". Judy Lersch, Chair of AzNA’s Political Action Committee, will provide information on Arizona’s current political climate. If missed at Lobby Day, Rory Hays will give a legislative healthcare briefing. Following lunch, you can join either the novice nurse track or the experienced nurse track. The day will close with important information related to taking control and making changes in the controversial and always changing political arena. Arizona Nurses Association Registration Form for Nurses Legislative Day and Nurse Lobby Day Name ______________________________ Credentials__________________ W-Phone __________________ H-Phone____________________________ E-mail ______________________________________ Arizona Legislative District __________________(check www.vote-smart.org for this info.) Address ____________________________________City___________________________ Zip___________ Please mark appropriate program(s) Nurses Legislative Day ____ Member ____ Non-Member ____ Entry Level Student $ 80 $100 $ 45 Nurses Lobby Day ____ Member $65 ____ Non-Member $95 *Late Fee ____ Add $25 if Legislative Day rec’d after Feb. 4, or Lobby Day rec’d after Feb. 24. Registration is limited to RNs and space is limited Total Enclosed $___________(Make check payable to AzNA) ______________________________________ __________ Credit Card # Exp.date ____________________________________ Signature Questions? 480.831.0404 www.aznurse.org debby@aznurse.org Fax: 480.839.4780 AzNA, 1850 E. Southern Ave., Ste. 1, Tempe, AZ 85282 Licensed Nurses Hearthstone of Mesa is looking for experienced Sub-Acute Nurses to join our Team. We have FT, PT and Pool positions available for RNs (Evenings and Night Shift) if you have experience in working with Orthopedic, CVA, Cardiac and Medically complex rehab patients. Call for an appointment 480-985-6992. We are located at 215 S. Power Road, Suite 1251 ARIZONA STATE BOARD OF NURSING NEWSLETTER NOV., DEC . 2004, JAN. 2005 • Education Corner • Pamela Randolph RN, MS, CPNP PACNE/AZBN CONFERENCE: Creating Educational Excellence-Changes and Challenges The Practical and Associate Degree Council of Nurse Educators and the Arizona State Board of Nursing co-sponsored a conference on November 5, entitled, "Creating Educational Excellence: Changes and Challenges". At this conference, I spoke on the topic of faculty professionalism. Here is a summary of the talk. Nursing faculty members have a responsibility not only to identify and appropriately intervene to promote professional behaviors in students, but to model professional behaviors themselves. Professional behavior is demonstrated by a faculty member’s attentiveness to the needs of students, patients, and facility staff. The instructor will intervene in situations that pose a risk of patient harm to promote good and prevent injury. Because of the potential for patient harm that nursing practice entails, these teachers recognize their public fiduciary duty to ensure that students deliver safe nursing care. They have confidence in their assessment of student performance and their ability to motivate, explain, coach, and structure learning to help a student succeed. They counsel students who are not proficient, and will fail students that truly, despite all efforts, do not meet course competencies. They not only expect critical thinking from their students, but exhibit it themselves as they guide students in formulating nursing diagnoses, posing alternatives to problems, and evaluating strategies that did or more importantly, did not, achieve the expected goal. They will also critically examine a struggling student’s learning style, proficiency, and educational need and formulate an educational plan. Professional faculty members maintain faculty-student boundaries and do not establish personal relationships with students, accept gifts from students, or develop friendships or intimate relationships with students. They exhibit friendliness and compassion by offering genuine praise, encouragement, and attentive listening. They have the courage to tackle the tough issues: the impaired student, the student with poor hygiene, the student suspected of cheating. They have high standards for their own behavior. They do not violate copyright laws and readily admit when they make a mistake. They report errors and potential errors at the clinical site. They do not function as a student’s personal counselor, physician, or therapist but recognize and refer when a student needs these services. The basis of professional behavior lies in the instructor’s own values such as altruism, accountability, excellence, duty, service, honor, integrity and respect for others. How can you tell if a faculty member is truly professional? You can tell by the amount of learning and growth in their students. Faculty members that adhere most strictly to codes of professionalism are not always the most beloved, but they are the most influential. Question of the Quarter Can a new graduate practice as an LPN or RN and utilize the title "graduate nurse" with verification that they have passed the appropriate licensure exam before the license is issued? The answer is no. Practicing nursing without a license is a violation of the nurse practice act and against the law. There are three requirements for licensure: completing an approved nursing program, passing the licensure exam, and completing an application process that includes passing a criminal background check. The Board will not issue a license until all standards are met in each category. Before an Arizona exam applicant is authorized to take NCLEX®, the Board ensures that the educational program of the applicant meets Board standards. The criminal background check ensures that the applicant’s past behavior does not indicate a threat to the health, safety, or welfare of the public. A potential reason for a delay in licensure, although rare, is that the Board received a complaint/self report on an applicant, which needs to be resolved before issuing a license. 2004-2006 Education Committee Members The following individuals have been appointed by the Board to serve on the Education Committee for a 2-year term. Committee Chair: Kathy Malloch, Ph.D., RN, ASBN Vice- President Continuing Members: Linda Riesdorph—Mohave Community College Marty Mayhew—Pima Community College Mary Killeen—Arizona State University Sue MacDonald—Cochise College Judith Sellers—Northern Arizona University Teri Britt—Mayo Clinic Sue Hanauer—J.C. Lincoln Health Network Joyceen Boyle—University of Arizona New Members: Barbara Nubile—Yavapai College Paula Calcaterra—Central AZ College Cheryl Roat—Grand Canyon University Ela-Joy Lehrman—University of Phoenix Cathy Lucius—Maricopa Community College District Nursing Program Kathleen Ellis—SouthWest Skill Center/Estrella Mountain Community College Sherrie Beardsley—Banner Health System Sue Roe—Performance Dimensions LLC Board Actions on Education Matters July 21-23, 2004 • Approved Clinical Nurse Specialist Program at Grand Canyon University • Granted Estrella Mountain Community College’s request to increase the length of the program • Directed Board staff to conduct a focus site visit of Estrella Mountain Community College/SouthWest Skill Center in October 2004 and that the program submit documentation of faculty changes and impact on students within 10 days of a change in faculty. • Granted request from Arizona Western College to award LPN certificate after 3 semesters of the nursing program • Accepted report from Arizona Western College that deficiency in clerical help was remedied and continued approval of the program • Granted 3-year approval to the Mohave Community College Nursing Program • Accepted report from Education Committee advising against requiring NCLEX before graduation from a nursing program • Adopted Competency Model for Certified Nursing Assistants, LPN’s, RN’s and Advanced Practice Nurses • Offered a consent agreement for one-year probation to Northland Pioneer Nursing Program • Approved the Notice of Proposed Rulemaking Article 2—Arizona Professional and Practical Nursing Programs September 22-24, 2004 • Granted provisional approval to the associate degree multiple exit nursing program at International Institute of the Americas • Granted proposal approval to Apollo College to establish a nursing program • Denied application for credential evaluation service from Foreign Credential Services of America • Dismissed complaint/self report Cochise College nursing program Education Committee Future Meeting Dates The Education Committee will meet on the following dates in 2004-05. Meetings start at the time indicated and conclude when business is finished. All meetings are held at the Arizona State Board of Nursing offices at 1651 E. Morten, Ste. 210, Phoenix, AZ. Agendas for each meeting are posted in advance at the Board offices. Dates and times are subject to change up to 24 hours before the meeting. Contact Pamela Randolph at 602889-5209 (prandolph@azbn.org) or Meredith Fountain at 602-889-5187 (mfountain@azbn.org) to obtain further information regarding the meetings. October 22, 2004 at 9:30 a.m. February 11, 2005 at 9:30 a.m. December 3, 2004 at 9:00 a.m. April 8, 2005 at 9:30 a.m. June 3, 2005 at 9:30 a.m. NOV., DEC . 2004, JAN. 2005 ARIZONA STATE BOARD OF NURSING NEWSLETTER Arizona State Board of Nursing Nursing Assistant Programs Current Approved Program List - September 24, 2004 Facility Apache Junction Health Care Center Beatitudes Campus of Care Beverly Health Care of Chandler dba Chandler Health Care Center Capri Care Center Casa Del Mar Nursing & Rehabilitation Center, Sunbridge Christian Care Nursing Center Chula Vista Nursing Home Citadel Care Center Copper Mountain Inn Desert Cove Nursing Center Desert Life Rehabilitation and Care Center Devon Gables Health Care Center East Mesa Care Center, Sunbridge Evergreen Sun City Evergreen Valley Health & Rehab Center Gardens Rehab & Care Center, The Gila River Indian Care Center Good Shepherd Retirement Community Handmaker's Jewish Services for the Aging Havasu Nursing Center Heather Glen Care Center Infinia @ Camp Verde Infinia at Flagstaff Infinia@Safford Care Center Kachina Point Healthcare & Rehab Kivel Campus of Care La Canada Care Center La Colina Health Care Lake Hills Inn Life Care Center at South Mountain Life Care Center of North Glendale Life Care Center of Tucson Lingenfelter Center Apache Junction Phoenix Chandler (480) (602) (480) 983-0700 995-2611 899-6717 Phoenix Scottsdale (602) (480) 944-1574 994-1333 Phoenix Mesa Mesa Globe Chandler Tucson Tucson Mesa Sun City Mesa Kingman Laveen Peoria Tucson Lake Havasu Glendale Camp Verde Flagstaff Safford Sedona Phoenix Tucson Tucson Lake Havasu City Phoenix Glendale Tucson Kingman (602) (480) (480) (928) (480) (520) (520) (480) (623) (480) (928) (520) (623) (520) (928) (623) (928) (928) (928) (928) (602) (520) (520) (928) (602) (602) (520) (928) 861-3241 832-3903 832-5555 425-5721 899-0641 297-8311 296-6181 832-8333 933-0022 832-5160 718-0718 430-3813 875-0119 881-2323 453-1500 842-4025 567-5253 779-6931 428-4910 284-1000 956-3110 797-1191 294-0005 505-5552 243-2780 843-8433 575-0900 718-4852 Mi Casa Nursing Center Mountain View Care Center Mountain View Manor Northern Cochise Nursing Home Payson Care Center Peaks, The Plaza Del Rio Care Center Prescott Samaritan Village Prescott Valley Samaritan Center Quiburi Mission Ridgecrest Health Care SilverRidge Village Southern Arizona Veteran's Administration Medical Center Sun Grove Village Care Center Sunbridge Catalina Health Care Center Valley Health Care Villa Campana Health Care Center Independent Academy for Caregiving - Chapter Classroom - American Red Cross Academy for Caregiving @ Humanities & Science Academy for Caregiving: East Valley American Red Cross American Red Cross Academy for Caregiving Banker's NA Program at Desert Highlands Caring Connection, The Direct Care Giver Association Dynamic Registry Nursing Assistant Program Fred G. Acosta Job Corps Mesa Tucson Prescott Willcox Payson Flagstaff Peoria Prescott Prescott Valley Benson Phoenix Bullhead City Tucson (480) (520) (928) (520) (928) (928) (623) (928) (928) (520) (602) (928) (520) 981-0687 797-2600 778-4837 384-3541 474-6896 774-7160 933-7722 778-2450 775-0045 586-2372 482-6671 763-1404 792-1450 Peoria Tucson Tucson Tucson (623) (520) (520) (520) 566-0642 795-9574 296-2306 731-8500 Phoenix (602) 347-6501 Phoenix (602) 347-6501 Phoenix, (602) 347-6501 Phoenix (602) 336-6674 Kingman Amado Tucson Glendale (928) (520) (520) (623) 716-3035 398-2090 325-4870 435-9000 Tucson (520) 792-3015 ARIZONA STATE BOARD OF NURSING NEWSLETTER Horizon Health Care Inst @ Wickenburg Regional Med Center - Wickenburg AZ Horizon Health Care Inst. @ Las Fuentes - Care Center,Prescott Horizon Health Care Institute Horizon Health Care Institute @ Holy Cross - Nogales Horizona Health Care Inst. @ Infinia of Douglas Medical Services Company Phoenix Shanti Group Referral for Senior Adult Assistance Saunders Asso. @ Chinle Nursing Home SEVEN Healthcare Academy Tuba City Regional Health Care NA Program Yuma Private Industry Council - Palm View Rehab & Care Center Yuma Private Industry Council @ Life Care Center Yuma Private Industry Council at La Mesa Rehabilitation and Care Center Yuma Private Industry Council at Yuma Nursing Center School Arizona Western College AWC Nursing Assistant at La Paz Buckeye Union High School CNA Training Program Cactus High School CNA Program Catalina High Magnet School Centennial High School Central Arizona College - Signal Peak Campus Central Arizona College @ Casa Grand UHS and Casa Verde Central Arizona College @ Casa Grande Center Central Arizona College @ Santa Cruz High School Central Arizona College Aravaipa Campus Central Arizona College Superstition Mtn Campus Cochise College Douglas Cochise College@Benson High School Cochise College-Sierra Vista Coconino Community College Coconino Community College/Page Coconino High School College America CNA Program Dysart High School Dysart HS @ Southwest Skill Center East Valley Institute of Technology Eastern Arizona College - Thatcher Emmanuel Nursing Assistant Training Program Ethel Bauer School of Nursing Flagstaff High School Gateway CC - EVIT Gateway Community College Gila County Community College Dist. - Globe Gila County Community College Dist. - Rim Country Glendale Community College Globe High School Independence H.S. Lamson College Maricopa Skill Center Mesa Community College Mesa Community College/Boswell Mesa Community College /Precision HS Dual Excellent Metro Tech Miami High School Sierra Vista (520) 559-4020 Sierra Vista (520) 559-4020 Sierra Vista Sierra Vista (520) (520) 559-4020 559-4020 Sierra Vista (520) 559-4020 Scottsdale Phoenix Mesa Chinle Tempe Tuba City Yuma (480) (602) (480) (920) (480) (928) (928) 860-9552 279-0008 835-7679 739-4653 557-9115 283-2501 783-8831 Yuma (928) 344-0425 Yuma (928) 344-8541 Yuma (928) 726-6700 Yuma Parker Buckeye (928) 344-7554 (623) 386-4423 Glendale (623) 412-5000 Tucson Peoria Apache Junction (520) (623) (480) 232-8404 412-4445 288-4017 Apache Junction (480) 288-4017 Apache Junction (480) 288-4017 Apache Junction (480) 288-4017 Apache Junction Apache Junction (480) (480) 288-4017 288-4017 Douglas Douglas Sierra Vista Flagstaff PAGE Flagstaff Flagstaff (520) (520) (520) (928) (928) (928) (928) 364-7943 417-4016 364-7943 527-1222 645-3987 522-6140 526-0763 El Mirage Avondale Mesa Thatcher Phoenix (623) (623) (480) (928) (602) 932-2700 535-2772 461-4094 428-8389 674-8888 Phoenix Flagstaff Phoenix Phoenix Globe (623) (928) (602) (602) (928) 849-8208 773-8135 286-8529 392-5025 425-8481 Payson (928) 468-8039 Glendale Globe Glendale Scottsdale Phoenix Mesa Sun City Phoenix (623) (602) (623) (480) (602) (480) (623) (602) 845-3264 425-3211 435-6100 898-7000 238-4300 461-7106 974-7837 453-3661 Phoenix Miami (602) (928) 271-2600 425-3271 NOV., DEC . 2004, JAN. 2005 Mingus Union High School Mohave Community College @ Kingman Mohave Community College- Bullhead City Mohave Community College-Colorado City Mohave Community College-LHC Mohave High in Partnership w/Mohave Community College Northland Pioneer College Northland Pioneer College - Hopi Center Northland Pioneer College - Nat 101 Video, Northland Pioneer College - Springerville High School Northland Pioneer College - Wht Mtn Campus/ShowLow Northland Pioneer College - Winslow Little Colorado Campus Northland Pioneer College -Springerville WMRMC Northland Pioneer College -Wht Mtn Campus HS Northwest Education Ctr Page High School Paradise Valley Community College Paradise Valley High School fka Paradise Valley Unified School District Phoenix College Phoenix Job Corps Center Pima Community College (CTD)/Desert Vista Pima Community College CTD @ Tucson Medical Center Pima Community College@Manor Care Pima Community College@Villa Campana Pima Community College-West Campus - NRA 101 Pima Community College-West-NRS104 Pima CTD@Acosta Job Corps Pima Medical Institute/Mesa Saguaro High School San Carlos High School Scottsdale Community College Southwest Skill Center @ Estrella Mtn. CC Sunnyside High School Thunderbird - Greenway CNA Program Nursing Assistant Program Thunderbird High School Glendale District Tucson College Yavapai College@Verde Valley Campus Yavapai Community College-Prescott Cottonwood Lake Havasu City Bullhead City Lake Havasu Lake Havasu City Bullhead City (928) (928) (928) (928) (928) (928) 634-7531 505-3378 505-3378 505-3378 505-3378 763-0288 Holbrook Holbrook Holbrook Holbrook (928) (928) (928) (928) 532-6133 532-6133 532-6133 352-6133 Holbrook (928) 532-6133 Holbrook (928) 532-6133 Holbrook (928) 532-6133 Holbrook (928) 532-6133 Glendale Page Phoenix Phoenix (623) (928) (602) (602) 845-4066 608-4138 787-7288 867-5554 Phoenix Phoenix Tucson (602) (602) (520) 285-7133 254-5921 295-5113 Tucson (520) 206-5113 Tucson Tucson Tucson (520) (520) (520) 206-5140 206-5140 206-6661 Tucson Tucson Mesa Scottsdale San Carlos Scottsdale Avondale Tucson Glendale (520) (520) (480) (480) (928) (480) (623) (520) (602) 206-6661 206-5176 898-9898 443-7200 475-2378 423-6000 932-2700 545-5466 588-5775 Phoenix (623) 915-8900 Tucson Prescott Prescott (520) (928) (928) 296-3261 776-2247 778-2450 NOTE: COLLEGE AND/OR VOCATIONAL-BASED PROGRAMS MAY OFER THE NURSING ASSISTANT TRAINING PROGRAM AT MORE THAN ONE CAMPUS LOCATION. NOV., DEC . 2004, JAN. 2005 ARIZONA STATE BOARD OF NURSING NEWSLETTER Advisory Opinion: The Use of Controlled Substances for the Treatment of Chronic Pain APPROVED: September 24, 2004 ORIGINATING COMMITTEE: ADVANCED PRACTICE COMMITTEE STATEMENT OF SCOPE A nurse practitioner may prescribe controlled substances for the treatment of chronic pain within the nurse practitioner’s scope of practice for their specialty area. RATIONALE These guidelines are intended to assist nurse practitioners in the responsible use of controlled substances in the treatment of patients with chronic pain. Nurse practitioners who prescribe controlled substances for treatment of patients with chronic pain should use sound clinical judgment, utilizing the following outlined guidelines of responsible professional practice: I. GUIDELINES FOR THE USE OF CONTROLLED SUBSTANCES FOR THE TREATMENT OF CHRONIC PAIN The Arizona State Board of Nursing ("Board") urges nurse practitioners to view effective pain management as a high priority in all patients, including children and the elderly. Pain should be assessed and treated promptly, effectively and for as long as pain persists. The medical management of pain should be based on up-to-date knowledge about pain, pain assessment and pain treatment. Pain treatment may involve the use of several drug and non-drug treatment modalities, often in combination. For some types of pain the use of drugs is appropriate and should be pursued; for other types, the use of drugs is better deemphasized in favor of other therapeutic modalities. Nurse practitioners should have sufficient knowledge or consultation to make such judgments for their patients. Drugs, in particular the opioid analgesics, are considered the cornerstone of treatment for pain associated with trauma, surgery, medical procedures and cancer. Nurse practitioners are referred to available clinical practice guidelines for the management of these types of pain. The prescribing of opioid analgesics for other patients with chronic non-cancer pain also may be beneficial, especially when efforts to remove the cause of pain or to treat it with other modalities have been unsuccessful. For the purposes of these guidelines, chronic pain is defined as: A pain state which is persistent and in which the cause of the pain cannot be removed or otherwise treated. Chronic pain may be associated with a long-term incurable or intractable medical condition or disease. In the generally accepted course of medical practice, no relief or cure of the cause of the pain is possible or none has been found after reasonable efforts including, but not limited to, evaluation by the attending practitioner, physician or surgeon and one or more practitioners, physicians or surgeons specializing in the treatment of the area, system or organs of the body perceived as the source of the pain. II. GUIDELINES FOR PATIENT CARE WHEN PRESCRIBING CONTROLLED SUBSTANCES FOR CHRONIC PAIN A) Evaluation of the Patient Pain assessment should occur during initial evaluation, after each new report of pain, at appropriate intervals after each pharmacological intervention, and at regular intervals during treatment. Unless a patient is terminally ill and death is imminent (in which case the diagnosis is usually evident and diagnostic evaluations may be of little value and discomforting to the patient), the evaluation should include: 1. A medical history and physical examination, which should be conducted and documented in the medical record. The evaluation should include the nature and intensity of the pain, current and past treatments for pain, underlying or coexisting diseases or conditions, the effect of the pain on physical and psychological function, and history of substance abuse. The evaluation should also document the presence of one or more recognized medical indications for the use of a controlled substance. The patient’s medical history should be corroborated by reviewing the patient’s medical records and/or speaking with the patient’s former health care providers. 2. Psycho-social assessment, which may include but is not limited to: a. The patient's understanding of the medical diagnosis, expectations about pain relief and pain management methods, concerns regarding the use of controlled substances, and coping mechanisms for pain; b. Changes in mood which have occurred secondary to pain (i.e., anxiety, depression); and c. The meaning of pain to the patient and his/her family. 3. Periodic urine drug screen testing for commonly abused street drugs as well as prescription pain drugs that are known abused or diverted drugs. Such screening will help identify drug abusers and drug diverters. B) Treatment Plan A treatment plan should be developed for the management of chronic pain and state objectives by which therapeutic success can be evaluated, including: 1. Improvement in pain intensity; 2. Improvement in physical function and/or psychosocial function, e.g., ability to work, need of health care resources, activities of daily living, and quality of social life; 3. Proposed diagnostic evaluations such as blood tests, radiologic exams such as CAT and bone scans, MRI and neurophysiologic exams, and psychological evaluations as indicated; 4. Potential exclusion criteria for opioid management, may include a history of chemical dependency, major psychiatric disorder, chaotic social situation, or a planned pregnancy; and 5. Exploration of other treatment modalities and/or rehabilitation programs as indicted. C) Informed Consent The nurse practitioner should discuss the risks and benefits of the use of controlled substances with the patient, persons designated by the patient, or with the patient’s designated surrogate or guardian if the patient is incompetent. The patient should be counseled on the importance of regular visits, taking medications as prescribed, and the impact of recreational drug use. The nurse practitioner and the patient should enter into a pain treatment agreement that specifically states the patient’s required compliance with the treatment plan and what the consequences of non-compliance, misuse and abuse will be. It is particularly important that patients understand that they will be discontinued from the prescribed controlled substances in a safe manner and referred for appropriate treatment should it be revealed that they are abusing or diverting drugs. D) Ongoing Assessment The assessment and treatment of chronic pain mandates continuing evaluation, and if necessary, modification and/or discontinuation of opioid therapy. The nurse practitioner should monitor patient compliance in medication usage and related treatment plans. If clinical improvement does not occur, the nurse practitioner should consider the appropriateness of continued opioid therapy, and consider a trial of alternative pharmacologic and nonpharmacologic modalities. E) Consultation The nurse practitioner should refer the patient as necessary for additional evaluation to achieve treatment objectives. Nurse practitioners should recognize patients requiring individual attention, in particular, patients whose living situations pose a risk for misuse or diversion of controlled substances. The management of pain in patients with a history of substance abuse or with a comorbid psychiatric disorder may require extra care, monitoring, documentation, and consultation with or referral to an expert in the management of such patients. F) Documentation Documentation should include, as applicable: 1. The medical history and physical examination; 2. Diagnostic, therapeutic, and laboratory results; 3. Evaluations and consultations; 4. Treatment objectives; 5. Discussion of risks and benefits; 6. Treatments; 7. Medications (including date, type, dosage, and quantity prescribed); 8. Instructions and agreements; and 9. Periodic assessment of treatments and patient response. Records should remain current and be maintained in an accessible manner and readily available for review. G. Counting and Destroying Medication The nurse practitioner may desire to see and count a patient’s medication to determine if the patient is taking the medication as prescribed. The patient should display and count the medication in front of the nurse practitioner. Under no circumstance should the nurse practitioner touch a patient’s controlled substances. If the medication must be destroyed, it should be destroyed in accordance with federal guidelines. The nurse practitioner should document this fact in the patient record. H. Post-Dated Prescriptions Post-dated prescriptions are illegal in the State of Arizona. Therefore, nurse practitioners may not issue postdated prescriptions. I. Referral of Patients with Active Substance Abuse Problems Patients discovered to have an active substance abuse problem should be referred to either a detoxification and rehabilitation program or to an appropriate maintenance program for substance abusers. III. COMPLIANCE WITH LAWS AND REGULATIONS A) Prescribing Controlled Substances To prescribe controlled substances, nurse practitioners must comply with all applicable laws, including the following: 1. Possess a valid current RN license and certification as an RNP with prescribing and dispensing authority in the State of Arizona; 2. Possess a valid and current controlled substances Drug Enforcement Administration registration for the schedules being prescribed; and 3. Comply with A.A.C. R4-19-507. B) Dispensing Controlled Substances To dispense controlled substances, nurse practitioners must comply with all applicable laws, including the following: 1. Possess a valid current RN license and certification as an RNP with prescribing and dispensing authority in the State of Arizona; 2. Possess a valid and current controlled substances Drug Enforcement Administration registration for the schedules being dispensed; 3. Comply with A.A.C. R4-19-507 and R4-19-508; and 4. Comply with 22 CFR 1306.07(a) if controlled substances are dispensed for detoxification. REFERENCES Arizona Board of Medical Examiners Substantive Policy Statement #7, Guidelines for the Use of Controlled Substances for the Treatment of Chronic Pain (SPS #7), Revised October, 2003 Model Guidelines for the Use of Constrolled Substances for the Treatment of Pain, Federation of State Medical Boards of the United States, May 1998 The Use of Opiods for the Treatment of Chronic Pain: A Consensus Statement from the American Academy of Pain Medicine and American Pain Society, 1996 Promoting Pain Relief and Preventing Abuse of Pain Medications: A Critical Balancing Act (A Joint Statement From 21 Health Organizations and the Drug Enforcement Administration, (heck year) RESOURCES Prescription Pain Medications: Frequently Asked Questions and Answers for Health Care Professionals, and Law Enforcement Personnel, U.S. Department of Justice Drug Enforcement Administration, In partnership with: Last Acts Partnership, Pain and Policy Studies Group, University of Wisconsin, 2004 ARIZONA STATE BOARD OF NURSING NEWSLETTER NOV., DEC . 2004, JAN. 2005 RN/LPN DISCIPLINARY ACTION July - August - September 2004 DATE * Not reported in previous Newsletter NAME LICENSE DISCIPLINE VIOLATIONS 5/19/2004* 6/16/2004* Adams, Glenn S. Alvarez, Catherine A. LP Exam Applicant LP034070 6/29/2004* 7/16/2004 7/22/2004 Antrim, Diana M. Avery, Linda S. Babalola, Joseph O. LP038791/CNA99995672 RN118956 RN Endorsement Applicant 7/12/2004 7/12/2004 7/22/2004 7/1/2004 Baccelli, Angela F. Bailey, Kathy A. Baldwinn, Brian H. Benninger, Kimberly A. RN108094 RN044281 RN092706 RN115729 6/23/2004* 7/21/2004 5/19/2004* 7/13/2004 Bixby, Joni J. Brock, Heather A. Brock, Jerry L. Brown, Carroline RN087611 RN094826 RN Endorsement Applicant RN090127 8/19/2004 Brown, Shellee E. RN129452/LP039947 7/16/2004 Budnick, August J. RN083231 6/11/2004* 7/21/2004 5/10/2004* Carter, Jennifer R. Chadderdon, David W. Cheatham, Douglas L. RN120243 RN Endorsement Applicant RN026404/CRNA0263 7/21/2004 3/24/2004* 8/20/2004 8/12/2004 Colby-Nielsen, Judith M. Conley, Temar R. Constantine, Denise R. Craig, Eileen E. RN044665 LP Endorsement Applicant RN066106 RN073699/LP020980 7/7/2004 Currier, Dorothy RN046736 8/19/2004 Dallman, Susan M. LP Endorsement Applicant 6/15/2004* 8/17/2004 7/1/2004 5/21/2004* Dassay, Jo M. Davis, Mechelle L. Dooley, Heidi B. Enick, Pamela G. RN080875 RN119724/LP036795 RN100963 LP Endorsement Applicant 8/10/2004 Esquilin, Mittie A. RN082179 8/18/2004 Falk, Dawn M. RN093939 6/4/2004* Farnell, Elizabeth RN082173 6/14/2004* Favor, Cathy R. LP036229 3/24/2004* 7/21/2004 Fazzino, Salvatore Fernandez, Julie M. RN Endorsement Applicant RN047484 9/15/2004 8/13/2004 6/13/2004* 6/25/2004* 7/21/2004 7/1/2004 5/19/2004* 8/1/2004 7/1/2004 7/1/2004 Fernandez, Julie M. Finney, Linda H. Garner, Sandra R. German, Timothy R. Gidley, Jaime S. Gorow, Jeff A. Griffin, Susan M. Grochowski, Jacqueline Hubner, Carol J. Hull, Karen H. RN047484 RN106212 RN097360 RN080898 RN094970 RN046900 LP Endorsement Applicant RN040221 RN088320 LP005334 5/21/2004* 5/20/2004* Jewett, Ronald A. Johnson, Carla D. LP Endorsement Applicant RN070949 3/24/2004* Jones, Lisa A. RN Endorsement Applicant 7/22/2004 6/21/2004* Kennedy, Lezlie A. Kim, Hyesook LP037615 LP030890/CNA819361613 8/25/2004 Kindelspire, Kathleen M. RN104452 Misdemeanor, Failure to cooperate. Unsafe Practice, Failure to Supervise, Inappropriate Delegation Drug Abuse, Drug Use on Duty, Drug Related Decree of Censure Practicing Beyond Scope, Misconduct-Theft Decree of Censure Failure to Maintain Minimal Standards, Unsafe Practice, License Denied Failure to Intervene Drug Abuse, Drug Diversion, Violating Board Order Revocation/Non-Voluntary Documentation Errors Decree of Censure Misconduct-Verbal Abuse Decree of Censure Drug Diversion, Failure to Comply with Requirements of Revocation/Non-Voluntary Impaired Nurse Program Drug Use on Duty Voluntary Surrender Failure to Assess, Failure to Intervene, Medication Errors Probation Criminal Conviction-Misdemeanor, Failure to cooperate License Denied Failure to Maintain Minimal Standards, Misconduct-Mental Probation Abuse Criminal Conviction-Misdemeanor, Misconduct-Theft – Probation Client, Drug Abuse Stayed Revocation w/Suspension Drug Diversion, Failure to Comply with Requirements of Impaired Nurse Program Drug Abuse, Violating Board Order Suspension APPLICATION WITHDRAWN Misdemeanor, Alcohol Abuse Criminal Conviction-Misdemeanor, Alcohol Abuse, Failure Suspension to Comply with Requirements of Impaired Nurse Program Documentation Errors, Drug Related; Fraud, Deceit Probation Criminal Conviction-Misdemeanor License Denied Action in Another Jurisdiction Decree of Censure Drug Diversion, Failure to Comply with Requirements of Voluntary Surrender Impaired Nurse Program, Drug Related Failure to Comply with Requirements of Impaired Nurse Voluntary Surrender Program, Drug Related Misconduct-False Documentation, Drug Diversion, Action in Stayed Suspension w/Probation Another Jurisdiction Stayed Revocation w/Suspension Drug Abuse, Alcohol Abuse, Violating Board Failure to Assess Decree of Censure Violating Board Order Revocation/Non-Voluntary Failure to Maintain Minimal Standards, False License Denied Documentation, Action in Another Jurisdiction Drug Abuse, Failure to Comply with Requirements of Voluntary Surrender Impaired Nurse Program Fraud, Deceit-Obtaining License, Action in Another Decree of Censure Jurisdiction Unsafe Practice, Drug Abuse, Failure to Comply with Suspension Requirements of Impaired Nurse Program Failure to Maintain Minimal Standards, Practicing Beyond Decree of Censure Scope, Unprofessional Conduct Misdemeanor, Criminal Conviction, Sexual Abuse License Denied Documentation Errors, Drug Abuse, Positive Urine Drug Stayed Suspension w/Probation Screen Violating Board Order Suspension Drug Abuse, Violating Board Order Revocation/Non-Voluntary Incompetent Practice Decree of Censure Positive urine drug screen, Violating Board Order Revocation/Non-Voluntary Criminal Conviction-Misdemeanor Decree of Censure Wastage Errors, Documentation Errors, Drug Related Probation Felony, Theft – Employer, Failed to respond to Board License Denied Medication Errors Decree of Censure Drug Related-Positive urine drug screen, Violating Board Order Revocation/Non-Voluntary Failure to Maintain Minimal Standards, Documentation Decree of Censure Errors Drug Diversion, Action in Another Jurisdiction License Denied Criminal Conviction-Misdemeanor, Alcohol Abuse, Drug Suspension Related Criminal Conviction-Felony, Fraud, Deceit-Obtaining License Denied License Theft – Employer Decree of Censure Failure to Maintain Minimal Standards, Unsafe Practice, Decree of Censure Failure to Follow Orders Drug Abuse, Violating Board Order Revocation/Non-Voluntary License Denied Decree of Censure RN/LPN Disciplinary Action cont. on pg. 30 NOV., DEC . 2004, JAN. 2005 ARIZONA STATE BOARD OF NURSING NEWSLETTER RN/LPN Disciplinary Action cont. from pg. 29 RN/LPN DISCIPLINARY ACTION July - August - September 2004 DATE NAME LICENSE DISCIPLINE 7/21/2004 8/13/2004 6/10/2004* 7/22/2004 7/1/2004 8/4/2004 Knoettgen, Sheri K. Kovalcik, Shannon M. Lancaster, Carolyn J. Lee, Laura S. Lester, Linda E. Lungwitz, Theresa A. LP037292 RN111951 RN092645 LP030473 RN115200 RN086077 Stayed Revocation w/Probation Probation Completed Decree of Censure Decree of Censure Revocation/Non-Voluntary Decree of Censure 6/17/2004* 6/25/2004* 8/2/2004 6/18/2004* 7/1/2004 Macias, Valery F. Mack, Norman N. Maloney, Caroline R. Maloney, Cynthia Maloney, Jeffrey R. RN120155 LP018901 RN119251 LP030744 RN095109 Decree of Censure with Fine Probation Completed Decree of Censure with Fine Decree of Censure Revocation/Non-Voluntary 5/21/2004* 5/19/2004* Marinello, Karen K. Marvin, Arthur K. LP Endorsement Applicant RN Endorsement Applicant License Denied License Denied 7/1/2004 9/14/2004 Meisse, Linda A. Mullen, Priscilla LP037981 LP034798 Decree of Censure with Fine Voluntary Surrender 7/21/2004 7/16/2004 Newman, Jennifer L. Nwosu, Jude N. RN115285 RN114528 Probation Completed Voluntary Surrender 8/19/2004 6/18/2004* O'Brien, Robert W. Ortiz, Henry G. RN125649 LP022420 Probation Voluntary Surrender 6/16/2004* 8/30/2004 8/22/2004 8/3/2004 Pate, Kelsie D. Peltz, Andrea S. Perry, Cynthia L. Pranke, Kristi A. RN128151 RN057428 LP035799 RN071157 Probation Stayed Suspension w/Probation Decree of Censure Stayed Revocation w/Suspension 6/17/2004* 7/1/2004 1/22/2004* 7/1/2004 7/22/2004 3/24/2004* Prats, Gail G. Remmers, Janice L. Ritten, Therese F. Roberge, Judith M. Rodgers, Dianne E. Sarhan, Mark RN072526 LP029569/CNA164112103 LP Endorsement Applicant RN059282/AP0466 RN120630 RN Endorsement Applicant Stayed Revocation w/Probation Revocation/Non-Voluntary License Denied Voluntary Surrender Decree of Censure License Denied 6/23/2004* 7/1/2004 Schmidt, Connie K. Schreck, Sheryl V. LP006672 LP011748 Decree of Censure Revocation/Non-Voluntary 7/21/2004 8/20/2004 7/6/2004 6/25/2004* Simpson, Barry A. Soulik, Bareana St. James, Katherine T. Tiede, Benjamin B. RN063242 LP032393 RN041790 RN093484 Probation Probation Voluntary Surrender Probation 8/10/2004 1/22/2004* 3/4/2004* Tiede, Benjamin B. Tiedemann, Laine C. Tucker, Randye R. RN093484 RN Endorsement Applicant RN Endorsement Applicant Voluntary Surrender License Denied License Denied 8/10/2004 3/24/2004* Valandry, Kelly D. Vissert-Hooft, Virginia A. RN058286 RN Endorsement Applicant Voluntary Surrender License Denied 6/10/2004* 7/21/2004 Wartz, Kaye E. Weaver, Rose M. RN128123 RN093868 Decree of Censure Probation 5/19/2004* 7/7/2004 7/22/2004 Williams, Stacey Wormell, Karen L. Wright, Kenneth T. LP Endorsement Applicant RN087133 LP037077 License Denied Decree of Censure Probation 7/1/2004 Wright, Mary G. LP000033006 Revocation/Non-Voluntary 7/1/2004 Yarbrough, John D. RN119167 Revocation/Non-Voluntary 4/20/2004* Young, Leslie D. LP026109 Stayed Revocation w/Probation * Not reported in previous Newsletter VIOLATIONS Documentation Errors, Drug Abuse, Violating Board Order Positive urine drug screen Practicing Beyond Scope Documentation Errors, Drug Related, Violating Board Order Failure to Maintain Minimal Standards, Documentation Errors Medication Errors, False Documentation Practicing without License Documentation Errors Drug Diversion, Failure to Comply with Requirements of Impaired Nurse Program Drug Abuse, Alcohol Abuse, Action in Another Jurisdiction Criminal Conviction-Misdemeanor, Alcohol Related Physical Abuse Drug Abuse, Failure to Comply with Requirements of Impaired Nurse Program Incompetent Practice, Unsafe Practice, Documentation Errors Criminal Conviction-Misdemeanor, Alcohol Abuse Criminal Conviction-Misdemeanor, Misconduct-Verbal Abuse Misdemeanor- Alcohol Related, Alcohol Abuse Drug Abuse, Drug Use on Duty, Drug Diversion Documentation Errors, Practicing Beyond Scope Drug Diversion, Failure to Comply with Requirements of Impaired Nurse Program Alcohol Abuse, Violating Board Order Violating Board Order Fraud, Deceit-Obtaining License Alcohol Abuse Practicing Beyond Scope Criminal Conviction-Felony-Against Person, Sexual Misconduct Failure to Supervise, Documentation Errors Theft – Employer, Failure to Comply with Requirements of Impaired Nurse Program, Drug Related-Other Documentation Errors Drug Related Positive Urine Drug Screen Alcohol Abuse Alcohol Abuse Action in Another Jurisdiction, Practicing without License Criminal Conviction-Felony, Failure to Maintain Minimal Standards Drug Abuse Criminal Conviction-Felony, Criminal Conviction-Drug Related Fraud, Deceit, Practicing without a license Failure to Intervene, Medication Errors, Misconduct-False Documentation Misdemeanor, Fraud, Deceit, Failure to cooperate Failure to Follow Orders, Failure to Assess Criminal Conviction-Misdemeanor, Boundaries, Sexual Misconduct Documentation Errors, Drug Related, Failure to cooperate Failure to Comply with Requirements of Impaired Nurse Program Drug Abuse, Drug Diversion, Failure to Comply with Requirements of Impaired Nurse Program ARIZONA STATE BOARD OF NURSING NEWSLETTER NOV., DEC . 2004, JAN. 2005 CNA DISCIPLINARY ACTION July - August - September 2004 DATE * Not reported in previous Newsletter NAME LICENSE DISCIPLINE VIOLATIONS 8/30/2004 7/1/2004 4/19/2004* 7/21/2004 7/23/2004 7/21/2004 6/13/2004* Bahe, Carol L. Bailey, Michelle K. Bankhead, Lola R. Barlow, Lilly Barnes, John J. Begay, Alberta Bell, Shawn D. CNA1000002879 CNA999952235 CNA284814070 CNA189458353 CNA Applicant CNA999947883 CNA100000222 Suspension Revocation/Non-voluntary Civil Penalty Suspension Cleared Certificate Denied Stayed Suspension Cleared Civil Penalty Criminal Conviction-Misdemeanor; Alcohol Abuse Criminal Conviction-Misdemeanor; Drug Related Criminal Conviction-Misdemeanor; Failure to Cooperate 4/5/2004* 7/28/2004 9/7/2004 9/7/2004 Bennett, Shaunna M. Bennett, Shaunna M. Blair, David W. Bostwick, Georgia I. CNA1000001640 CNA1000001640 CNA723074333 CNA724917406 Civil Penalty Suspension Revocation/Non-voluntary Revocation/Non-voluntary 9/7/2004 7/1/2004 9/7/2004 6/23/2004* Buchanan, Robin E. Byrd, John W. Cammiso, Joseph M. Campbell, Hallie C. CNA724553039 CNA591777640 CNA208641179 CNA Applicant Revocation/Non-voluntary Revocation/Non-voluntary Revocation/Non-voluntary Civil Penalty Criminal Conviction-Misdemeanor Violating Board Order Adjudication; Violating Board Order Criminal Conviction-Misdemeanor; Violating Board Order; Failure to Cooperate Misconduct; Drug Related Violating Board Order Alcohol Abuse; Failure to Cooperate Criminal Conviction-Misdemeanor; Drug Related 9/7/2004 7/23/2004 Carbone, Mary Lou Carmichael, Genevieve M. CNA638866803 CNA Applicant Revocation/Non-voluntary Certificate Denied 5/20/2004* Chavez, Victoria J. CNA999949017 Certificate Denied 5/20/2004* 5/20/2004* 9/7/2004 Chesshir, Sarah J. Clarke, Willie Clements, Jacquelin D. CNA Applicant CNA Applicant CNA186855990 Certificate Denied Certificate Denied Revocation/Non-voluntary 4/5/2004* Cody, Roseita A CNA1000001364 Civil Penalty Drug Related; Violating Board Order Criminal Conviction-Misdemeanor; Unprofessional Conduct; Failure to Cooperate Criminal Conviction-Misdemeanor; Alcohol Abuse; Failure to Cooperate Failure to Cooperate Criminal Conviction; Fraud/Deceit; Failure to Cooperate Criminal Conviction-Misdemeanor; Obtaining Certificate by Fraud; Failure to Cooperate Criminal Conviction-Against Person, Against Property 5/25/2004* Cooke, Sarah K. CNA1000001990 Civil Penalty Criminal Conviction-Misdemeanor, Against Person 9/7/2004 9/13/2004 7/1/2004 Copas, Glenda A. Coris, Tara D. Crater, Augusta D. CNA 097331803 CNA1000001591 CNA827889003 Revocation/Non-voluntary Suspension Civil Penalty False Documentation; Theft - Client; Fraud/Deceit Violating Board Order Criminal Conviction-Misdemeanor, Against Person 7/1/2004 Dahl, Amy S. CNA725615773 Revocation/Non-voluntary 7/1/2004 Daniels, Arthur CNA529472710 Revocation/Non-voluntary 7/28/2004 7/1/2004 Davis, Shauniece D. Demara, Toni M. CNA477987713 CNA335617441 Suspension Revocation/Non-voluntary 3/31/2004* Duarte, Jessica L. CNA1000001300 Civil Penalty Criminal Conviction-Felony; Criminal Conviction-Against Property Physical Abuse; Verbal Abuse; Sexual Misconduct; Obtaining Certificate by Fraud Violating Board Order Criminal Conviction-Misdemeanor; Obtaining Certificate by Fraud; Violating Board Order Criminal Conviction-Misdemeanor, Drug Related 4/12/2004* 9/7/2004 Egbo, Bartholomew T. Evans, Carla CNA999999045 CNA999947005 Civil Penalty Revocation/Non-voluntary 1/22/2004* 3/24/2004* Ford, Shelly D. Fowler, Darlene M. CNA Applicant CNA Applicant Certificate Denied Certificate Denied 3/24/2004* Frazier, Shaylynn L. CNA Applicant Certificate Denied 5/20/2004* 7/6/2004 4/7/2004* 9/7/2004 Garcia, Arturo V. Garcia, Graciela V. Goe, Sally Y. Grajeda, Lupe CNA Applicant CNA Applicant CNA999948720 CNA808426803 Certificate Denied Stayed Suspension Stayed Suspension Revocation/Non-voluntary 5/3/2004* 1/21/2004* Greenberg, Alvin A. Gresham, Tamara S. CNA137969903 CNA Applicant Stayed Suspension Certificate Denied Failure to Follow Orders; Misconduct; Boundaries Drug Abuse; Drug Related Failure to Maintain Minimal Standards; Verbal Abuse Criminal Conviction-Misdemeanor; Leaving Duty Station; Violating Board Order Criminal Conviction-Misdemeanor; Alcohol Abuse Criminal Conviction-Misdemeanor, Against Person 8/9/2004 Gustad, Leif N. CNA1000002676 Civil Penalty Criminal Conviction-Against Person; Failure to Cooperate 9/7/2004 5/19/2004* 5/20/2004* Guzman, Naomi C. Hall, Kelley M. Hall, Vincent L. CNA706065103 CNA999991876 CNA Applicant Revocation/Non-voluntary Civil Penalty Certificate Denied Drug Related; Failure to Cooperate Physical Abuse; Failure to Cooperate Criminal Conviction-Against Person; Failure to Cooperate Criminal Conviction-Misdemeanor; Failure to Cooperate Criminal Conviction-Misdemeanor, Against Person Verbal Abuse Criminal Conviction-Misdemeanor; Drug Related; Failure to Cooperate Failure to Cooperate; Fraud/Deceit Criminal Conviction-Felony; Obtaining Certificate by Fraud; Practicing without certificate Criminal Conviction-Felony; Obtaining Certificate by Fraud CNA Disciplinary Action cont. on pg. 32 NOV., DEC . 2004, JAN. 2005 ARIZONA STATE BOARD OF NURSING NEWSLETTER CNA Disciplinary Action cont. from pg. 31 CNA DISCIPLINARY ACTION July - August - September 2004 DATE * Not reported in previous Newsletter NAME LICENSE DISCIPLINE VIOLATIONS 6/24/2004* 9/7/2004 9/7/2004 Hamlin, John R. Hand, Danya C. Harter, Susan M. CNA99999054 CNA999995245 CNA006679783 stayed suspension Revocation/Non-voluntary Revocation/Non-voluntary 9/7/2004 7/1/2004 Haske, Julie Heinssen, Wendy K. CNA532142803 CNA838938803 Revocation/Non-voluntary Revocation/Non-voluntary 7/29/2004 9/7/2004 4/1/2004* 9/7/2004 Heng, Jane E. Hill, Beverly Holyfield, Shawna M. Hunt, Crystal CNA250832842 CNA002341346 CNA10000001363 CNA058341034 Stayed Revocation Revocation/Non-voluntary Civil Penalty Revocation/Non-voluntary 5/20/2004* Ingoldsby, Arthur L. CNA Applicant Certificate Denied 7/21/2004 8/4/2004 Jennings, Missy Johnson, Brian D. CNA066129110 CNA999946984 Stayed Suspension Cleared Civil Penalty 3/26/2004* Johnson, Sherry D. CNA Applicant Certificate Denied 9/7/2004 6/3/2004* 7/8/2004 Jones, Eric W. Jones, Theresa M Joseph, Sharon P. CNA531182803 CNA Applicant CNA593027803 Revocation/Non-voluntary Civil Penalty Suspension 5/28/2004* 6/1/2004* 7/1/2004* Kearns, Michael D. Kolasinski, Joldie K. Krause, John A. CNA Applicant CNA131718641 CNA999990142 Civil Penalty Civil Penalty Revocation/Non-voluntary Practicing Beyond Scope; Unprofessional Conduct; False Documentation Criminal Conviction - Against Person, Alcohol Related, Failure to Cooperate; Practicing without certificate; Drug Abuse; Alcohol Abuse Criminal Conviction-Drug Related Violating Board Order, Criminal Conviction Misdemeanor, Alcohol Abuse. Criminal Conviction-Against Person; Theft Related Unsafe Practice Leaving Duty Station; Physical Abuse; Violating Board Order 7/21/2004 Labrie, Jill M. CNA982903726 Stayed Revocation Drug Abuse; Drug Related; Violating Board Order 5/26/2004* 5/21/2004* 7/1/2004 Latham, Jacquelyn S. Lewis, Jennifer A. Leyva, Megan M. CNA1000001941 CNA1000001901 CNA375218999 Civil Penalty Civil Penalty Revocation/Non-voluntary Misconduct - Drug Related Criminal Conviction-Misdemeanor; Theft Related Criminal Conviction-Misdemeanor; Violating Board Order 5/20/2004* Lively, Regina D. CNA Applicant Certificate Denied Criminal Conviction-Misdemeanor; Theft - Employer; Failure to Cooperate 4/27/2004* 7/1/2004 5/22/2004* Mackey, Annette G. Martinez, Christina S. Matheny, Taiana L. CNA1000001596 CNA230461103 CNA1000001929 Revocation/Non-voluntary Revocation/Non-voluntary Civil Penalty 5/20/2004* McAlpin, Matthew A. CNA Applicant Certificate Denied Drug Abuse; Violating Board Order Theft - Client; Misconduct Criminal Conviction-Misdemeanor; Alcohol Abuse Criminal Conviction; Obtaining Certificate by Fraud 4/22/2004* 9/7/2004 McDaniel, Diane I. Mendivil, Jorge A. CNA050513489 CNA999991565 Civil Penalty Revocation/Non-voluntary 9/7/2004 6/14/2004* 8/9/2004 8/10/2004 4/7/2004* Messina, Jessica F. Miranda, Rose M. Miranda, Rose M. Molina, Benjamin H. Morales Beltran, Raymond E. CNA999992172 CNA999950297 CNA999950297 CNA999992519 CNA1000001369 Revocation/Non-voluntary stayed suspension Suspension Suspension Civil Penalty 7/28/2004 4/21/2004* Morales, Annette Morales, Annette CNA848220353 CNA848220353 Suspension Civil Penalty Failure to Maintain Minimal Standards; Physical Abuse Criminal Conviction-Felony; Obtaining Certificate by Fraud Misconduct, Unsafe Practice, Failure to Follow Orders Drug Abuse Violating Board Order Violating Board Order Misconduct; Failure to Maintain Minimal Standards; Failure to Follow Orders; Practicing without certificate; Violating Board Order Misconduct; Practicing without certificate; Failure to Cooperate 5/13/2004* 4/11/2004* 8/4/2004 7/1/2004 Navas, Rafael O. Nelson, Stefanie D. Olcan, Natalija Oles, Lavon M. CNA999991982 CNA999994078 CNA999995612 CNA999991991 Voluntary Surrender Civil Penalty Civil Penalty Revocation/Non-voluntary Fraud/Deceit Physical Abuse Drug Related Failure to Follow Orders; Neglect; Verbal Abuse 9/7/2004 9/7/2004 Pablo, Jennifer Parker, Timothy A. CNA827837103 CNA718058173 Revocation/Non-voluntary Revocation/Non-voluntary Drug Related; Violating Board Order Misconduct; Sexual Misconduct; Violating Board Order 9/7/2004 8/10/2004 Parra, Anna Perez, Roberta CNA321567803 CNA 567363103 Revocation/Non-voluntary Voluntary Surrender 4/2/2004* Peterson, Tina M. CNA Applicant Civil Penalty Misconduct - Financial Exploitation Criminal Conviction-Misdemeanor; Obtaining Certificate by Fraud, Alcohol Abuse Criminal Conviction-Misdemeanor; Failure to Cooperate Drug Abuse Violating Board Order, Drug Related Criminal Conviction-Felony; Fraud/Deceit; Theft - Client Physical Abuse; Failure to Cooperate Criminal Conviction-Drug Related; Theft - Client; Misconduct Drug Related Misconduct; Unprofessional Conduct Criminal Conviction-Against Person; Misconduct Practicing Beyond Scope; Obtaining Certificate by Fraud; Violating Board Order Criminal Conviction-Against Property; Unprofessional Conduct; Failure to Cooperate CNA Disciplinary Action cont. on pg. 33 ARIZONA STATE BOARD OF NURSING NEWSLETTER NOV., DEC . 2004, JAN. 2005 CNA Disciplinary Action cont. from pg. 32 CNA DISCIPLINARY ACTION July - August - September 2004 DATE * Not reported in previous Newsletter NAME LICENSE DISCIPLINE VIOLATIONS 5/20/2004* Poolaw, Ramona C. CNA Applicant Certificate Denied Criminal Conviction-Drug Related; Failure to Cooperate 7/1/2004 8/13/2004 7/11/2004 Pulbratek, Shawna R. Qendraj, Doreida Quihuis, Teresa A. CNA999991886 CNA1000002830 CNA1000002374 Civil Penalty Civil Penalty Civil Penalty Criminal Conviction Misdemeanor; Misconduct Criminal Conviction-Drug Related; Failure to Cooperate 4/6/2004* Reaves, Bonnie R. CNA999994111 Stayed Suspension Failure to Maintain Minimal Standards; Incompetent Practice 5/20/2004* 8/12/2004 9/7/2004 Robles, Donato V. Rodriguez, Carolyn F. Romo, Nubia L. CNA Applicant CNA530015803 CNA999999257 Civil Penalty Revocation/Non-voluntary Revocation/Non-voluntary Drug Related Violating Board Order Criminal Conviction-Felony; Drug Related, Failure to Cooperate 9/7/2004 5/20/2004* Ruffin, Gary Russell, Charles E. CNA999950121 CNA Applicant Revocation/Non-voluntary Certificate Denied 3/26/2004* Salazar, Gabriel A. CNA Applicant Certificate Denied 6/21/2004* 9/7/2004 SantaMaria, Rene Scholl, Darla J. CNA999992125 CNA999947699 Revocation/Court Ordered Revocation/Non-voluntary Criminal Conviction-Felony; Drug Abuse Criminal Conviction-Against Person; Obtaining Certificate by Fraud; Fraud/Deceit Criminal Conviction-Misdemeanor; Criminal ConvictionAgainst Person; Alcohol Abuse; Failure to Cooperate; Criminal Conviction-Felony; Fraud/Deceit; Theft - Client Criminal Conviction-Misdemeanor; Alcohol Abuse 3/26/2004* See, Veronica L. CNA Applicant Certificate Denied 6/10/2004* Sharma, Sonia CNA Applicant Civil Penalty 7/21/2004 9/7/2004 Shotwell, Cecelia Skaggs, Tammy M. CNA999991649 CNA999950886 Stayed Suspension Cleared Revocation/Non-voluntary 7/1/2004 9/7/2004 Smith, Leticia R. Smith, Rebecca A. CNA999952933 CNA999947214 Revocation/Non-voluntary Revocation/Non-voluntary Criminal Conviction-Against Property; Incompetent Practice; Obtaining Certificate by Fraud Criminal Conviction-Felony Drug Abuse; Drug Related; Failure to Cooperate 9/7/2004 7/21/2004 1/12/2004* Sorensen, Fred B. Southwood, Patricia Spangler, Pamela J. CNA460053463 CNA999948360 CNA Applicant Revocation/Non-voluntary Civil Penalty Civil Penalty Drug Related, Drug Abuse Misconduct Criminal Conviction-Misdemeanor - Against Property 7/21/2004 3/24/2004* Stanton, Sheila Stewart, Allison L. CNA999992874 CNA Applicant Suspension Cleared Certificate Renewal Denied 5/27/2004* 4/1/2004* 5/20/2004* Stone, Virginia A. Thompson, Connie D. Tilley, Anthony CNA1000002003 CNA Applicant CNA Applicant Civil Penalty Civil Penalty Certificate Denied 7/1/2004 3/26/2004* 9/7/2004 9/7/2004 7/1/2004 4/22/2004* Tillman, Loretta S. Tillman, Lynette D. Turner, Betty J. Vesbach, Michele A. Villalpando, Sheila M. Wainwright, Betty A. CNA941123103 CNA Applicant CNA022575103 CNA999950451 CNA051731103 CNA1000001549 Revocation/Non-voluntary Certificate Denied Revocation/Non-voluntary Revocation/Non-voluntary Revocation/Non-voluntary Stayed Suspension Criminal Conviction-Felony, Drug Abuse Obtaining Certificate by Fraud; Failure to Cooperate Misconduct; Failure to Cooperate Criminal Conviction; Obtaining Certificate by Fraud; Failure to Cooperate Criminal Conviction-Felony Misconduct - Theft Related; Failure to Cooperate Neglect; Misconduct; Fraud/Deceit Drug Abuse; Failure to Cooperate Criminal Conviction-Felony Criminal Conviction-Misdemeanor; Drug Abuse; Alcohol Abuse 9/7/2004 5/19/2004* 8/10/2004 4/30/2004* 5/31/2004* 5/25/2004* 9/7/2004 Waitley, Timothy S. Wallace, Alvin B. Wallace, Alvin B. Welch, Tiffany R. Whitman, Kassandra J. Worman, Shannon L. Zaragoza, Ysenia M CNA999994750 CNA073704353 CNA073704353 CNA486065803 CNA999999202/RN Applicant CNA156208009 CNA999995466 Revocation/Non-voluntary Stayed Suspension Suspension Civil Penalty Decree of Censure Civil Penalty Revocation/Non-voluntary Physical Abuse; Fraud/Deceit; Failure to Cooperate Criminal Conviction-Misdemeanor Violating Board Order Failure to Maintain Minimal Standards; Leaving Duty Station Drug Abuse Criminal Conviction-Misdemeanor; Fraud/Deceit Drug Related; Failure to Cooperate Criminal Conviction-Misdemeanor; Unprofessional Conduct; Failure to Cooperate Misconduct; Unprofessional Conduct