arizona vol 9 • No1 JaNuary 2013 state board of nursing RegulatoRy JouRnal Featured Articles SubStance uSe DiSorDer Signs and Symptons Drug DiverSion Cover courtesy of National Council of State Boards of Nursing (NCSBN) Dignity is: unparalleled opportunity Dignity Health is one of the nation’s leading hospital networks. Our Arizona region is comprised of Chandler Regional Medical Center, Mercy Gilbert Medical Center and St. Joseph’s Hospital and Medical Center. Within each of these facilities, we provide numerous opportunities for you to strengthen your skills and move forward in your career as a Nurse. If you’re ready to make the most of your talents, you’re ready to join Dignity Health Arizona. For more information and to apply, visit dignityhealth.org/careers Follow us on Twitter at @dignityhealthaz Chandler Regional Medical Center Mercy Gilbert Medical Center St. Joseph’s Hospital and Medical Center Dignity Health in Arizona is: • One of the “2012 100 Best Arizona Companies,” recognized by AZ Business Magazine and BestCompaniesAZ • One of the “2012 Top 25 Workplaces for Women,” honored by AZ Magazine and BestCompaniesAZ • One of “The Valley’s Healthiest Employers 2011,” recognized by the Phoenix Business Journal Published by ARIzONA STATE BOARD OF NURSING 4747 North 7th Street, Suite 200 Phoenix, Az 85014-3655 Phone: 602.771.7800 Main fax: 602.771.7888 CANDO fax: 602.771.7882 General e-mail: arizona@azbn.gov Website: www.azbn.gov GOVERNOR The Honorable Janice K. Brewer Joey Ridenour, RN, MN, FAAN ExEcutiVE DiREctOR Judy Bontrager, RN, MN AssOciAtE DiREctOR/OpERAtiONs Nikki R. Austin, JD, RN AssOciAtE DiREctOR/iNVEstiGAtiONs & cOmpliANcE Pamela Randolph, RN, MS, FRE AssOciAtE DiREctOR/EDucAtiON & EViDENcE BAsED REGulAtiON vOl 9 • N O 1• JANUARy 2013 4 5 6 From the executive director staff directory substance use disorders: a nursing Regulatory and humanistic Perspective 10 12 boaRd MeMbeRs Randy Quinn, MSN, CRNA pREsiDENt Carolyn Jo McCormies, RN, MSN, FNP-BC VicE pREsiDENt Theresa (Terri) Berrigan, LPN sEcREtARY Leslie Dalton, MSN, RN mEmBER Lori A. Gutierrez, BS, RN-C, RAC-CT, CBN mEmBER M. Shawn Harrell, MS, RN mEmBER Patricia (Pat) Johnson, LPN mEmBER Kimberly (Kim) Post, DNP, MBA/HCM, RN, NEA-BC mEmBER Charleen Snider, BSN, RN mEmBER Kathryn L. Busby, JD puBlic mEmBER 14 16 18 20 e-notify for Rn/lPn signs and symptoms of drug diversion 2013 tenth annual Cna educators Retreat Faculty development a deliberate Process education Program administrator Position open Cna Competency exam Changes arizona EDITION 27 20 nurse Consultant Job opening state board of nursing RegulatoRy JouRnal 23 pcipublishing.com Created by Publishing Concepts, Inc. David Brown, President • dbrown@pcipublishing.com For Advertising info contact Victor Horne • 800.561.4686 ext 114 vhorne@pcipublishing.com ThinkNurse.com 24 25 27 navigating the nurse licensure Compact nuRsys e-notify Cna disciplinary action Rn/lPn disciplinary action arizona STATE BOARD OF NURSING regulatory Journal 3 F ro m th e e xe c u t iv e d ir e c t o r JOEy RIDENOUR, RN, MN, FAAN This edition of the Arizona State Board of Nursing Regulatory Journal is must read “primer” for all nurse leaders, licensed nurses and certified nursing assistants regarding the number one issue that causes licensees and certified persons to be reported to the Board in the past ten years: Substance Use Disorders (SUD). Recent scientific advances, including those supported by the National Institute on Drug Abuse (NIDA), have led to a better understanding of SUD over the past decade, SUD is “now recognized as a chronic relapsing brain disease expressed in the form of compulsive behaviors.”, says NIDA Director Nora D. Volkow, M.D. She further states that “nearly one in 11 Americans over the purpose of the substance use disorder in nursing manual is to provide practical and evidence-based guidelines for evaluating, treating and managing nurses with a substance use disorder. 4 arizona STATE BOARD OF NURSING regulatory Journal the age of 12 is classified with substance abuse or dependence.” The best information and evidence based guidelines addressing SUD for all Nurses is: 1. the downloadable SUD manual from National Council of State Boards of Nursing and 2. articles by Val Smith, RN MS FRE found on pages 6 and 12. For questions or comments regarding SUD, please contact CANDO Nurse Practice Consultant – Jan Kerrigan at 602 771 7864 or Nikki Austin, JD, RN, Associate Director/Investigations at 602 771 7819. https://www.ncsbn.org/2106.htm (Free to Download) Substance Use Disorder in Nursing Manual: A Resource Manual and Guidelines for Alternative and Disciplinary Monitoring Programs An extensive body of scientific evidence shows that approaching addictions as a treatable illness is extremely effective financially and across the broader societal impacts. When treatments for nurses are individually tailored to meet their needs and an appropriate supportive monitoring system is in place, then recovering nurses are not impaired and can practice safely. NCSBN hopes that this manual will be a helpful tool that can be used to implement better practices in helping the healers to heal themselves and at the same time helping to protect the public. staFF diReCtoRy ADMINISTRATION Joey Ridenour, RN, MN, FAAN Executive Director 602.771.7801 jridenour@azbn.gov Judy Bontrager RN, MN Associate Director, Operations & licensing 602.771.7802 jbontrager@azbn.gov Nikki R. Austin, JD, RN Associate Director, Investigations & Compliance 602.771.7819 naustin@azbn.gov Pamela Randolph RN, MS, FRE Associate Director Education & Evidenced Based Regulation 602.771.7803 prandolph@azbn.gov EDUCATION Frannie Breed, RN, BSN Nurse Practice Consultant/CNA Programs 602.771.7857 fbreed@azbn.gov Helen Turner-Epple, BS Administrative Assistant 602.771.7856 hturner@azbn.gov FISCAl SERvICES Randi Orchard Fiscal Services Manager 602.771.7810 rorchard@azbn.gov Norma Salter Accounting Technician 602.771.7809 nsalter@azbn.gov HEARINGS valerie Smith RN, MS, FRE Consultant to Executive Director 602.771.7804 vsmith@azbn.gov Susan Barber, RN, MSN Nurse Practice Consultant 602.771.7851 sbarber@azbn.gov Kirk Olson lead Senior Investigator 602.771.7824 kolson@azbn.gov vicky Driver Administrative Assistant 602.771.7852 vdriver@azbn.gov Dolores Hurtado, Senior Investigator Complaints - Intake Triage Coordinator INvESTIGATIONS Donna Wilson Administrative Assistant -Triage 602.771.7806 dwilson@azbn.gov lila Wiemann Administrative Assistant lwiemann@azbn.gov Becky Melton Administrative Assistant to Associate Director Operations/RN-lPN Exams 602.771.7805 bmelton@azbn.gov CANDO Janet (Jan) Kerrigan, RN, BSN Nurse Consultant - CANDO 602.771.7864 jkerrigan@azbn.gov Olga zuniga Administrative Secretary – CANDO & Monitoring 602.771.7865 ozuniga@azbn.gov COMPlAINTS-INTAKE Dolores Hurtado, Senior Investigator Complaints-Intake Triage Coordinator 602.771.7845 dhurtado@azbn.gov Janeen Dahn, MS, FNP-C Advanced Practice Nurse Consultant 602.771.7814 jdahn@azbn.gov Jeanine Sage, RN, MSN Nurse Practice Consultant 602.771.7815 jsage@azbn.gov Kristi Hunter, MSN, FNP-C Advanced Practice Nurse Consultant 602.771.7854 khunter@azbn.gov Mary Rappoport, RN, MN Nurse Practice Consultant 602.771.7816 mrappoport@azbn.gov Opal Wagner, RN, BSN Nurse Practice Consultant 602.771.7818 owagner@azbn.gov Ruth Kish, RN, MN Nurse Practice Consultant 602.771.7823 rkish@azbn.gov Tamara Greabell, MA, BSN, RN Nurse Practice Consultant 602.771.7813 tgreabell@azbn.gov SENIOR INvESTIGATORS Bonnie Richter Senior Investigator 602.771.7828 brichter@azbn.gov Dirk vandenBerg, Sr. Senior Investigator 602.771.7817 dvandenberg@azbn.gov Monica Ortiz Scanning/verifying 602.771.7831 mortiz@azbn.gov Doug Parlin Senior Investigator 602.771.7822 dparlin@azbn.gov Paula Delphy RN/lPN Endorsements 602.771.7834 pdelphy@azbn.gov linda Monas Senior Investigator 602.771.7826 lmonas@azbn.gov MAIlROOM Ron lester Senior Investigator 602.771.7825 rlester@azbn.gov Jennifer McWilliams legal Assistant 602.771.7835 jmcwilliams@azbn.gov lEGAl SECRETARIES Dorothy lindsey legal Secretary 602.771.7841 dlindsey@azbn.gov llysia Gauntt legal Secretary 602.771.7842 lgauntt@azbn.gov Trina Smith legal Secretary 602.771.7844 tsmith@azbn.gov INFORMATION TECHNOlOGy Adam Henriksen 602.771.7807 ahenriksen@azbn.gov Cory Davitt 602.771.7808 cdavitt@azbn.gov lICENSING Debra Kunkle 602.771.7876 dkunkle@azbn.gov MONITORING Diva Galan, JD Senior Investigator 602.771.7862 dgalan@azbn.gov Cristina Oates legal Assistant 602.771.7861 coates@azbn.gov Brent Sutter legal Secretary Monitoring & CANDO 602.771.7860 bsutter@azbn.gov RECEPTIONISTS Madelyn Emerson 602.771.7871 memerson@azbn.gov Nancy Davis 602.771.7872 ndavis@azbn.gov Susan Kingsland 602.771.7873 skingsland@azbn.gov RECORDS Anne Parlin 602.771.7875 aparlin@azbn.gov Barbara Melberg legal Secretary - CNA Endorsements/CMA Applications 602.771.7840 bmelberg@azbn.gov Donna Frye RN/lPN Renewals 602.771.7833 dfrye@azbn.gov Helen Tay CNA Exam 602.771.7832 htay@azbn.gov lisa Hubbard-Cade Advanced Practice Certifications 602.771.7843 lhubbard@azbn.gov lisa youtsey Administrative Assistant CNA Renewals 602.771.7836 lyoutsey@azbn.gov arizona STATE BOARD OF NURSING regulatory Journal 5 SUBSTANCE USE DISORDERS: A Nursing Regulatory and Humanistic Perspective My first nursing job as a new graduate in the late 1970’s was on a medical surgical unit in a large acute care hospital. Following the advice of my nursing instructors, I identified an experienced nurse to be my “mentor.” “Lydia” was the charge nurse and often picked up additional shifts. Every other weekend, on her days off, Lydia worked for an air ambulance company. On our unit, staff all knew that whatever knowledge and skills we may lack or, as in my situation, still developing, Lydia not only possessed the knowledge and skills but did so at the expert level. In selecting Lydia as my mentor, I knew that when I “grew up” I wanted to be the nurse that Lydia was. Several months into my employment I arrived on duty after a few days off and heard from other coworkers what I thought to be a horrible mistake. Our manager had suspected Lydia of diverting drugs and had been auditing Lydia’s controlled drug removals. After Lydia signed out Demerol and entered a patient’s room, the nurse manager followed. Lydia was found in the patient’s bathroom injecting herself with the Demerol. She was taken to the nurse manager’s office where other persons from administration were waiting and given the option to resign or be terminated. Lydia opted to resign. I remember to this day my shock and disbelief. “They” must have made a mistake. A nurse as capable as Lydia could not be using drugs. To me, at that time in my professional development, Lydia did not “look” like someone who not only used drugs but used patients and the hospital to steal drugs and use those drugs while on duty. My disbelief extended beyond Lydia. I could not fathom that any nurse could or would have a substance use disorder that resulted in them diverting 6 drugs and using while on duty. Within a short period of time we heard that Lydia was hired by another hospital. After all, she was a well regarded nurse but one with a tremendous and deadly secret. While there is much to the story that I do not know, it is likely Lydia was not referred for treatment and likely Lydia was not reported to the Board of Nursing. It was the 1970’s and for many of us, our knowledge of the Board of Nursing was limited to the granting of new graduates like myself our nursing licenses. It is my hope that if that same scenario occurred today with the same people, it would be done so with more confidentiality safeguards in place. Whether she remained employed at the hospital or not, it is my hope that Lydia would be referred for an evaluation for the purposes of obtaining appropriate treatment for a chronic, progressive and potentially fatal disease. Additionally, to assure patient and public safety, Lydia would be encouraged to report and be reported to the Board of Nursing. The Board of Nursing has programs in place that when appropriate, allow the nurse to maintain licensure contingent in part upon abstaining from unauthorized use of alcohol and drugs, compliance with treatment and other recovery requirements. Not only is their compliance with treatment monitored but their nursing practice is supervised and monitored. What is Addiction/Substance Use Dependence? Addiction, also referred to as substance use dependence, is a chronic and complex disease that often includes physical, cognitive, emotional, spiritual, financial and/or legal consequences. Addiction is a disease of the brain. The excessive use of alcohol and other drugs alter the normal function of the brain arizona STATE BOARD OF NURSING regulatory Journal and changes the way the brain responds to issues of self-control, judgment, emotion, motivation, memory and learning. The course of the disease follows a predictable and progressive course and not uncommon, may result in death if left untreated. The disease of addiction is characterized by a maladaptive pattern of substance use manifested by at least 3 of the following: • Persistent desire or unsuccessful attempts to “cut down” or control one’s use • Excessive time spent seeking and/or using alcohol and/or drugs • Reduction of important activities as the substance use becomes more pervasive • Changes in tolerance • Continued use despite adverse consequences or high potential for adverse consequences • Withdrawal While individuals may have initially chosen to misuse substances, the disease of addiction is not intentional. Individuals who struggle with alcohol and/or drug addiction do not set out to destroy themselves, everyone & everything in their path. These disastrous and often deadly consequences are the result of the vicious cycle of a defined medical condition. The National Council on Alcoholism and Drug Dependence (www.ncadd.org) sites the following statistics: • Alcohol is the most commonly used addictive substance in the United States- 17.6 million people, or one in every 12 adults, suffer from alcohol abuse or dependence along with several million more who engage in risky, binge drinking patterns that The pay, the benefits, the bonus, the caring, the opportunity is yours with... Now hiring RN’s You’re invited to join our dynamic registry. Health Temp, Arizona’s largest and most respected agency offers: • Top Wages • Block Assignments • Daily Pay • Local Assignments • Sign On Bonus • Statewide Assignments • Direct Deposit • Priority Contracts • Credit Union • Individual Insurance All RN Areas Available. Call 602-234-1944, 520-577-9088 or 800-486-8367 for additional info. w w w . h e a l t h tarizona e m pSTATE . c BOARD o mOF NURSING regulatory REGULATORY Journal JOURNAL 75 could lead to alcohol problems. Over 1.4 million arrests for DWI each year (less than 1% of 159 million self-reported episodes of alcohol-impaired driving) • Almost half of all traffic fatalities are alcohol-related • Over 86.5% of all alcohol-related deaths are pedestrian accidents, falls, fires, homicides, alcohol overdose, suicides and health-related deaths, e.g., cirrhosis, etc. • One-quarter of all emergency room admissions, one-third of all suicides, and more than half of all homicides and incidents of domestic violence are alcohol-related • Approximately 5 to 6 million Americans have drug problems • Approximately 20 million Americans aged 12 or older used an illegal drug in the past 30 days representing 8% of the population aged 12 years old or older. • There are more deaths and disabilities each year in the United States from substance abuse than from any other cause • Untreated addiction is more expensive than heart disease, diabetes and cancer combined Second to alcohol, the most commonly used and abused drug by the general population is marijuana. Other common drugs of abuse include cocaine, heroin, inhalants, LSD (acid), MDMA (ecstasy), methamphetamine, phencyclidine (PCP), steroids (anabolic), Vicodin, OxyContin and other prescription drugs. • Substance Use Disorders in Nursing Substance use disorders in nursing is not a modern day phenomenon. O. M. Church, in a 1985 Nursing Administration Quarterly article, provided a historical review of substance abuse in nursing literature. Church reviewed the literary character Mrs. Sarah Gamp in Charles Dickens’ novel Martin Chuzzlewit, published in the 1840’s. Mrs. Sarah Gamp, otherwise known as Sairey, is a nurse who “sought work that provided accessibility to alcohol and food at the patient’s expense.” Nightingale reportedly addressed in her writings the need to dismiss nurses for being “dead drunk.” In a 1900 Nursing Ethics book, a nursing author wrote, “Among my saddest experiences are the instances, fortunately very rare, in which I have encoun8 tered members of our own profession who have lost their power of self control and have become victims to the abuse of some powerful drug or alcoholic stimulant with all of it attending evils.” Nurses are no more immune from developing substance use disorders and addiction than the general population. The risk of prescription drug misuse is higher among nurses than the general population. Prescription drug use is defined as drugs available by prescription whether or not the nurse obtains the drug by legitimate prescription or other means. Factors associated with nurses having a higher risk of misuse and abuse of prescription drugs include the easy access of medications/drugs, belief that medications/drugs can and will alleviate unwanted feelings and the belief that with the nurse’s knowledge of pharmacology, they can control their substance use. Although the actual rate of addiction in nurses is unknown with estimates ranging from 6% to 20% of all nurses suffer from a substance use disorder, what is known is that one of the most common complaints received by Boards of Nursing and forms the basis for licensure disciplinary action is substance misuse, abuse or dependence related. Profile of The Nurse With A Substance Use Disorder Despite the prevalence of substance use disorders both within society and within the nursing profession, and despite increased media and attention within the nursing profession, many co-workers, supervisors, employers and others have difficulty recognizing or assisting a nurse colleague with an apparent substance use disorder. This is alarming considering the inherent responsibilities nurses have for patient care and safety and the potential fatal nature of the disease if left untreated. Nurses and other healthcare professionals take great effort to protect their professional reputation, identity and nursing licensure. As with “Lydia,” it is not uncommon that the nurse with a substance use disorder continues to be perceived by colleagues and themselves as high functioning well into the disease. Thus, signs and symptoms of the disease on the job usually indicates a late stage disease process and is characteristic of the inability to control one’s use and the continued use despite potential for negative consequences (compromised patient care, patient arizona STATE BOARD OF NURSING regulatory Journal harm, loss of job, licensure sanctions, ect). Late into their disease, many nurses will continue to rationalize their use and want to believe they can control their substance misuse. Their denial, intense shame and fear of consequences should others learn of their “secret” prevents them from proactively seeking treatment. Managers and co-workers may unintentionally enable the disease to progress by ignoring or excusing poor performance, incomplete work, attendance issues and other symptoms of a substance use disorder. Another way in which the disease is enabled is when an employer recognizing symptoms consistent with a possible substance use disorder opts to allow the nurse to resign or terminates the nurse without addressing the concerns of a possible substance use disorder and/or reporting the nurse to the Board. When this happens, the nurse is allowed to continue with a potentially fatal disease and patient care with the next employer is potentially negatively impacted. Recognizing Workplace Indicators of Substance Use Disorder As the substance use disorder progresses, signs and symptoms of the disease begin to manifest in the workplace. Workplace indicators of a substance use disorder may include and is not limited to the following: Attendance: As the disease progresses,an individual’s world becomes smaller as activities are selected that provide access and opportunity to use. If the substance of abuse is obtained outside of the workplace (alcohol, illegal drugs …) the individual may begin to demonstrate progressive absences from work, difficulty adhering to their work schedule, unusual or implausible reasons for absences. When at work, they may also demonstrate on the job absences (unexplained frequent or prolonged absences from the unit). When the workplace has become a source of supply of the drug (drug diversion) as it did with Lydia, it is not uncommon for the nurse to seek employment opportunities that provide access to the drug. This may be through work setting, patient selection, additional work hours, including overtime and they may have unexplained presence in the workplace during scheduled times off. Interpersonal: Indicators include complaints from co-workers or patients or others; increased isolation from others; unpredictability; changes in mood and/or energy level (alert to appearing sedated); increased conflict with others; legal problems; family or social problems. Job Performance: Indicators include difficulty in organizing and prioritizing duties and responsibilities; difficulty meeting deadlines; deterioration in quality of work; poor judgment; forgetfulness; below standard practice; odor of alcohol on person or breath; inappropriate, inadequate or missing documentation; discrepancies with controlled drugs or the amount removed as compared to co-workers without a corresponding change in the patient condition that would explain the need for additional medications; high volume of controlled drug “waste,” discrepancies in the accounting for controlled medications signed out; unauthorized removal of controlled substances or other medications of abuse; missing medications; selecting patients or assignments that provide them with access to drugs; altered provider orders for controlled substances, prescription fraud… In another section of this journal is listed some common indicators of drug diversion from the workplace. What Not To Do Do not ignore your observations and intuitive concerns. Often by the time a colleague begins to consider the possibility that a nurse has a substance use disorder, there is merit to the concerns. Do not allow the nurse who is demonstrating active signs and symptoms of impairment to continue to provide patient care or make decisions impacting patient care until further expert assessment can be completed and evidence of ability to safely perform. Do not allow the nurse to resign or be terminated without addressing identified concerns, providing resources for further evaluation and treatment and without notifying or causing the Board to be notified. Do not encourage the nurse to hide information from the Board. At times, and perhaps well meaning friends, colleagues, and others advising the nurse in how or what to share with the Board or assigned investigative staff, have encouraged the nurse to not disclose their substance abuse history or substance use disorder with the Board. Not disclosing can put patients at risk and can have deadly consequences for the nurse. It is a barrier to the nurse obtaining appropriate intervention and treatment. Addiction is a chronic progressive disease that may and often does result in death if left untreated. What To Do One of the first steps is having the knowledge and understanding that nurses are not immune from developing a substance use disorder. It is an equal opportunity disease that is often misunderstood by those with or impacted by the disease, including employers and co-workers. Nurses with an active substance use disorder have potential to not only harm patients but also cause harm or death to themselves. Be aware and observant for indicators of substance abuse. Colleagues who work closely with a nurse struggling with a substance use disorder often recognize that something is wrong before the supervisor who may not have as frequent encounters. If you are a colleague, do not assume the supervisor is aware. Share your concerns with the supervisor. Understand that simply asking the nurse whether or not they have a substance use disorder will not likely result in an admission. The barriers for those with a substance use disorder being truthful results from their intense shame and fear. You must be prepared to present objective information and ask questions until you understand what did or did not happen. Do not accept implausible answers. Anytime that there is reasonable concern that a nurse, for whatever reason, is currently unable to safely practice, they should immediately be removed from patient care until further assessment can be completed. If employer policies permit, and there is reasonable suspicion that the nurse may be under the influence of a substance, a drug test should be obtained and the panel of drugs tested should include the drug(s) that are of suspect. A nurse with a suspected substance use disorder should be referred for further evaluation for possible treatment and a report submitted to the Board for further review and investigation by the Board to determine safeness to practice. If the nurse acknowledges substance abuse, they may be eligible for the Board’s nonpublic and non-disciplinary monitoring program for nurses with substance abuse disorders, CANDO. Information about CANDO can be found on the Board’s website at www.azbn.gov. Although the Board’s mission is patient protection, patient protection can often be accomplished by nurses who have a recent or active substance use disorder entering into CANDO or entering into a Consent Agreement with the Board that mandates treatment, abstaining from unauthorized substance use, practice limitations and practice supervision. Summary As nurses, we have shared responsibilities for patient safety and when we recognize that one of our colleagues may be struggling with a substance use disorder, we have a responsibility to do the right thing and bring it to the attention of someone who can intervene in behalf of both the patients and the nurse. While there is much to still learn about substance use disorders, the evidence shows that a combination of treatment, involvement in 12-step meetings and licensure/practice monitoring requirements established by healthcare regulatory boards can have positive impact on facilitating remission of the disease and returning nurses, when appropriate, to patient care and/or practice. I often think back to my first known experience with a colleague who had an apparent substance use disorder. I hope somehow, someway she was able to seek and obtain appropriate treatment. I share the story of Lydia when providing education to nursing and healthcare employers as we need to see this disease with eyes wide open. To be effective in identifying and appropriately responding to colleagues with possible substance use disorders we need to shed our stereotype view of what a person with an addiction looks or acts like and timely respond with compassion, understanding and firmness. It is not if, but rather, when you suspect a nurse has a substance abuse disorder, dare to do the right thing and make your concerns known to those who have the ability to intervene in behalf of the nurse and patients. Written by Valerie Smith, MS, RN, FRE, Consultant to the Executive Director, Arizona State Board of Nursing Val has over 25 years experience with substance use disorders in nursing. She has been active both within the state and nationally in assisting others with developing guidelines and policies for recognition, intervention and regulatory management of nurses with substance use disorders. arizona STATE BOARD OF NURSING regulatory Journal 9 e-Notify for RN/LPN By JUDy BONTRAGER, RN, MS AssOciAtE DiREctOR OpERAtiONs/licENsiNG are made to a nurse’s record, including changes to license status, license expirations, license renewal, and public disciplinary action/resolutions and alerts. This means that if a nurse’s license is about to expire, the system will send a notification to the employer about the expiration date. Employers can also immediately learn about new disciplinary actions issued by a BON for their employed nurse, including receiving access to available public discipline documents. Benefits The information in e-Notify is pulled directly from Nursys, the only national database for licensure verification, discipline and practice privileges for registered nurses (RNs) and licensed practical/vocational nurses (LPN/LVNs). Nursys data is compiled from information directly inputted from BONs (in participating jurisdictions; visit nursys.com for current participation list). The system provides real-time automatic notification of status and discipline changes delivered directly to institutions. Cost Every year, boards of nursing (BONs) across the U.S. contact thousands of their nurses to remind them to renew their nursing license. Some BONs send emails; others send postcards and letters. It is then the responsibility of the nurse to renew their license. Left out of this equation, however, are the employers who rely on nurses to have current licenses to practice. Previously, the only way for employers to know if a nurse’s license was about to expire was to look it up, one nurse at a time. And when it came to learning about discipline status, employers were left out of the loop again, having to seek this information on their own. Not anymore Institutions that employ nurses can now have the ability to receive automatic licensure and discipline notifications about their nurses quickly, easily and securely with NCSBN’s new Nursys e-Notify system. Launch Dec, 2012, e-Notify is an innovative nurse licensure notification system that automatically provides employers licensure and publicly available discipline information of nurses in their employ; that information will automatically be sent to them. The e-Notify system alerts subscribers when changes 10 arizona STATE BOARD OF NURSING regulatory Journal All institutions are given 100 credits free of charge. This means that the first 100 nurses enrolled into the system are free. After that, each nurse is $1 per nurse, per year. A facility that employs 25 nurses would pay nothing to utilize e-Notify; a facility with 150 nurses only pay $50 With e-notify, any institution that employs a nurse can utilize this system to track licensure and discipline information for little or not charge. e-notify is an innovative tool that provides vital information to employers, saving them money and staff time. per year. A unique feature of e-notify is the ability for institutions to turn a nurse’s notification setting on or off, choosing whether or not to receive notifications about a specific nurse’s licensure or discipline status. Only nurses who have their notifications turned on are charged against one of the employer’s 100 free credits. Customizable Features It’s entirely up to the institution to determine how often they want to receive notifications about their nurses. They have the option of receiving email notifications daily, weekly or monthly. For licensure renewal notification, institutions can choose to receive alerts 30, 60 or 90 days prior to a nurse’s license expiring. Ease of Use Institutions can enroll nurses into e-Notify easily either as an individual or through bulk uploads; all that is needed is the nurse’s license number, license type and the state that issued their license. This information is used to locate the nurse directly from the Nursys RN OPPORTUNITIES database. Once nurses are enrolled, institutions can access their nurse list and download the data at anytime. Another unique feature of e-Notify is its search functionality. Rather than searching for a nurse by his or her name, e-Notify only allows institutions to search by licensure number. This way if a nurse changes their name with the BON, that information will automatically be updated in e-Notify, decreasing the likelihood of multiple entries being entered into the system for the same person. When enrolling a nurse in e-Notify, institutions also have the option of including the nurse’s email address and/or cell phone number, Institutions can send automatic e-mails reminders, as well as text messages, to a nurse securely. With e-Notify, any institution that employs a nurse can utilize this system to track licensure and discipline information for little or not charge. e-Notify is an innovative tool that provides vital information to employers, saving them money and staff time. To subscribe to Nursys e-Notify go to nursys.com A ri zona - Metro P hoeni x A rea You want to change lives – including your own. Jackson Hole, a Great Place to Live & Work St. John’s Medical Center, located in beautiful Jackson, Wyoming is accepting applications for Registered Nurses. 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Banner Health has key Nursing needs in the following areas: L&D • Med/Surg • Oncology • OR • ICU • ED • OB • RN Managers For more information, please visit www.tetonhospital.org Click on the “careers” tab to apply. www.BannerHealth.com/careers 1-866-377-5627 PO Box 428, Jackson, WY 83001 EOE/Drug Free Employer EOE/AA Banner Health supports a drug-free and tobacco-free work environment. Connect with Banner Health Careers: arizona STATE BOARD OF NURSING regulatory Journal 11 Signs and Symptoms of DRug DiveRSioN By vAlERIE SMITH, RN, MS, FRE, cONsultANt tO thE ExEcutiVE DiREctOR When a nurse misappropriates drugs from the workplace and patients it is symptomatic of the disease of addiction. Drug diversion is indicative of compulsion to use, loss of control, and continued substance use (intense and intrusive craving) despite potential for negative consequences. Diversion of drugs is not uncommon in nurses and other healthcare professionals with an active substance use dependence disorder. In hospitals and similar settings, drug diversion is commonly identified following a “discrepancy” or a routine controlled drug audit. Listed below are common patterns associated with a nurse who is diverting drugs: • • • • • • • • • • • • • • 12 Higher volume of controlled drug removals than other nurses working similar hours and with similar patient assignments Intervals between removed doses are less than expected or ordered for the patient Amount removed exceeds the provider’s ordered dose despite the correct dose being available Patients pain needs assessed and managed are often different on shift before and/or following May have a higher incidence of medication “waste” May fail to account for “wastage” May fail to obtain a witness for “wastage” May fail to adhere to established waste policies and procedures for accounting for controlled drugs Controlled drugs and/or corresponding controlled drug record “lost” or missing May select patient assignments that provide access to the controlled drug(s) or patients who can not accurately communicate to others whether or not they needed or received medications May have multiple removals of control drugs that don’t make clinical sense Documentation of removed controlled drugs may be inadequate or nonexistent May remove controlled drugs at times the nurse is not assigned to unit May sign-out controlled drugs to patients not arizona STATE BOARD OF NURSING regulatory Journal • • • • • • • • • • • • • • assigned to the nurse or no longer on unit Inconsistencies between patient’s signed-out by the nurse report of pain & medication May seek additional or increased provider orders for controlled drugs Pattern to medication removals that is inconsistent with clinical status May sign-out under coworkers password May sign-out medications to counter withdrawal symptoms May obtain access to patient’s discharge prescription and may alter the prescription to fill for self use May claim or have received personal prescriptions for drugs that are also being obtained by diversion In homecare settings, in addition to some of the above indicators, listed below are common patterns associated with a nurse who is diverting drugs: May seek early refills of a patient’s controlled drugs without clinical need May call-in a “prescription” to the pharmacy using false credentials or identity May obtain controlled drugs from the patient’s pharmacy without request and/or need from the patient Controlled drugs, partial or all, missing from the patient’s home after the nurse has been to the home May “visit” the patient on off hours and without clinical need or necessity May obtain access to patient’s written prescriptions and alter the prescription for self use. It is important to remember that diversion of drugs is evidence of the progression of a serious and potentially fatal substance use disorder. To protect patients from unsafe practice, timely intervention and removal of the nurse from practice pending further evaluation and determination of safeness to practice is important. Timely and appropriate intervention may also prevent further compromise to the health and safety of the nurse with a substance use disorder. the Opportunities. the culture. the People. the locations! Northern Arizona Healthcare invites experienced RNs to a stimulating and informative event. Meet with staff and leadership to learn about our opportunities, facilities and services. Expand your knowledge by attending our free seminars featuring timely topics for today’s professional nurse, like emergency/trauma, cardiovascular, surgery and Evidence-Based Practice. Education: Free CEUs offered Interviews: Hiring managers will be there to conduct immediate interviews Prizes: Registered attendees will be entered into drawing for 2 iPads, Grand Canyon and Verde Valley wine country vacation packages Black Canyon Conference Center 9440 N. 25th Avenue Phoenix, AZ Tuesday, February 26, 2013 Registration – 8:00 a.m. First presentation – 9:00 a.m. Event concludes – 5:00 p.m. To register for the seminars, please visit services.nahealth.com/Learning F l a g s ta F F M e d i c a l c e n t e r • V e r d e Va l l e Y M e d i c a l c e n t e r c O t t O n W O O d & s e d O n a c a M P U s e s JOIN THE STRONGEST TEAM IN SOUTHERN ARIZONA. At The University of Arizona Medical Center, our nurses are an integral part of a team of professionals dedicated to advancing health and wellness through education, research and patient care. Put the strength of Academic Medicine behind your career. Opportunities are available for RNs, Nurse Leaders and Advanced Practice RNs at two exceptional campuses. • University Campus – Southern Arizona’s only Level I Trauma Center & Magnet hospital. • South Campus – one of Tucson’s finest centers for comprehensive healthcare with a new state-of-the art Behavioral Health Pavilion Magnet Recognition University Campus To learn more and apply, visit www.UAhealth.com. EEO/Affirmative Action Employers arizona STATE BOARD OF NURSING regulatory Journal 13 Registration Full Name____________________________ 2 0 1 3 Te n t h A n n u a l CNA Educators Retreat Building a Quality CNA Program One Block At a Time Title_________________________________ Faculty Name_________________________ Address_____________________________ City_________________________________ State____________ Zip_________________ Telephone #__________________________ Email Address________________________ Registration Fees □ General - $90 Due on or before 12/14/12 □ Late- $95 After 12/14/12 □ On-site- $100 Space permitted □ Thumbdrive- $20 While available January 11, 2013 7:30 am—3:45 pm Black Canyon Conference Center 9440 North 25th Avenue Phoenix, Arizona 85021 14 arizona STATE BOARD OF NURSING regulatory Journal Registration fees include meals and conference materials. Purchase Orders WILL NOT be accepted in lieu of payment. Submit Completed Registration Form and Check or Money Order Payable to AZBN to Arizona State Board of Nursing 4747 North 7th Street, Suite 200, Phoenix, Arizona 85014-3653 arizona STATE BOARD OF NURSING regulatory Journal 15 Don’t delay. Register today. Come attend this retreat to prepare, be informed on current issues and rules regarding the CNA program. Learn how to build a quality CNA program, one block at a time. Conference Agenda 11:15 am 12:00 pm 10:30 am 11:15 am 10:00 am 10:30 am 9:15am 10:00 am 8:30 am 9:15 am 8:00 am 8:30 pm 7:30 am 8:00 am 2:00 pm 2:45 pm Getting the Permit: CNA Exam Update Janine Hinton, PhD, RN, MN by Beatrice Kastenbaum, RN, MSN, CNE & Filling the Gaps: Teaching Method (Clinical Skills) By Debra Hagler, PhD, RN, ACNS- Building a Framework: Teaching Method (Didactic) Break & Vendors by Debra McGinty, RN, PhD. Curriculum Development Establishing a Foundation: Vicky Castillo, RN, BS by Teresa Whitney & Closing Remarks Evaluations & by Opal Wagner, RN, BNS Passing Inspection: Preparing for AZBN Site Visits Break & Vendors by LeighAnn Remmert, BSN, RN, MS Building Structural Integrity: Test Banks & Test Security by Janina C. Johnson, MSN, RN Nailing it Down: Clinical Supervision & Assessment Lunch & Vendors “This activity has been submitted to the Arizona Nurses' Association for approval to award contact hours. The Arizona Nurses Association is accredited as an approver of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.” 3:45 pm 3:50 pm 3:00 pm 3:45 pm 2:45 pm 3:00 pm 1:00 pm 2:00 pm Knowing the Rules: Board Updates by Pamela Randolph, RN, MS 12:00 pm 1:00 pm Registration & Networking FacuLty DeveLoPmeNt a Deliberate Process BY DEBRA mcGiNtY, RN, phD Education program Administrator 2010-2012 My position at the board required me to visit nursing programs for a variety of reasons, from verifying information within applications for approval to conducting investigations. the very best programs are amazing. during one recent visit, after observing students in a clinical simulation exercise, they told me they were “grateful to fail” when they didn’t quite reach the mark. the students said the program had high standards and they had to work very hard to meet faculty’s expectations. they explained that when they failed, they knew the faculty’s assessment was fair because the safety and health of patients were at risk if they continued to perform below standard. they thought themselves blessed to have faculty who were frequently available, easily accessible and always approachable. students knew that the faculty had thoughtfully assessed their level of performance and would provide additional learning opportunities and sufficient support until they attained mastery. Nursing programs with positive outcomes are staffed with faculty who are dedicated and committed to the success of their students. Supportive faculty are most often supported by deans and directors who share in their pursuit of excellence. A conspicuous culture of learning proliferates in which faculty seek opportunities to acquire new knowledge and skills to achieve successful student outcomes. These programs evidence a deliberate process of faculty development as illustrated by the following scenario: The Dean at Watson College hired Ms. Brown in October 2012 to teach health assessment and fundamentals to baccalaureate students. Ms. Brown has 8 years experience in home health and long term care and no prior teaching experience. The Dean paired Ms Brown with an experienced and highly successful faculty mentor to assist her to learn program policies and teaching practices and to foster role development. Ms. Brown will co-teach with her mentor until the semester ends in December. In January 2013 she will teach these same courses independently but with consistent support from her mentor. Ms. Brown will complete a professional needs assessment to identify professional goals 16 and will be encouraged to participate in faculty development workshops that address instructional methods, assessment of student learning, and advances in nursing science. Ms. Brown appreciates the Dean’s evident support as she consistently responds with sensitivity, encouragement and recognition of achievement. Ms. Brown soon discovers arizona STATE BOARD OF NURSING regulatory Journal that students positively respond to her instruction, exceed her expectations, and are successful in completing her course. Mentorships for new faculty can ensure that they understand curriculum objectives, develop effective classroom activities, and implement fair and valid methods for evaluation of student performance. A process of reflective Collaboration Now Offering EducationInnovation Stewardship Respect RN TO BSN PROGRAM Accountability Job #: TMR-728 Integrity Title: AZ Regulatory Journal Victor Horne 800-561-4686 X114 (877) 606-5328 Compassion Rundate: September 2012 Publication: AZ State Board of Nursing Regulatory Journal ERTISING, INC. Excellence Leadership ACCSC Accredited • Fully Credentialed Faculty Flexibility To Attend On-Campus & Online Innovative Curriculum Designed By Academic Leaders Access To Campus-Based Student Services And Advising Size: 5.125”x 4.875” 3350 N. Country Club Rd. 520-881-4550 Tucson, AZ 85716 Fax 520-881-4696 www.fortiscollege.edu 555 North 18th Street, Suite 110 Phoenix, AZ 85006 Located on the grounds of St. Luke’s Hospital Financial Aid available for those who Qualify ACCSC Accredited • Approved for VA Benefits For consumer information visit www.fortis.edu Living our values Choose Well. Choose TMC. You’ve put in the hours to become an experienced nurse, now join a team that appreciates you. Tucson Medical Center is Southern Arizona’s community-owned hospital. We’re currently looking for EXPERIENCED NURSES Join an environment that is fun, challenging and rewarding. Check out all of our available positions at jobs.tmcaz.com 5301 E. Grant Rd. • Tucson, AZ 85712 (800) 526-5353 ext. 42775 At Maricopa Integrated Health System, in Phoenix, AZ, our values inspire us to dream big and reach high. And we’re delivering some of the most sophisticated care in the country, while making a genuine difference in the lives of our patients and each other. That’s the power of a nursing environment driven by values like respect, leadership, and education. Besides that, we have the largest teaching hospital in AZ, the 2nd largest burn center in the nation, a level 1 Trauma Center and a 24/7 Level 1 Pediatric Trauma Unit. Please join us. We offer • Competitive wages • Lifelong pension upon retirement • Generous PTO + 10 holidays/year EOE Tobacco-Free Workplace Learn more and apply at When you choose a place to work... Choose Well www.mihs.org arizona STATE BOARD OF NURSING regulatory Journal 17 self-assessment can assist new faculty to identify factors or actions that limit their instructional effectiveness and need improvement. By providing mentors, allocating resources for continuing education, and acknowledging the trials and triumphs of being a nurse educator, the program administrators foster successful transitions into the faculty role. Ms. Brown’s early sense of competence and effectiveness is more likely to result in a positive teaching experience for her, a positive learning environment for her students and a long, satisfying career at Watson College. Unfortunately, another all too common scenario in nursing education often results from the massive shortage of nursing faculty. The following fictitious case study describes the problem: Faculty member Ms. Green was recently hired by the Henderson School of Nursing that offers an Associate Degree. She received her assignment to teach NUR 142 Nursing II, a course that builds on basic foundational skills and introduces students to nursing in acute medicalsurgical settings. Ms. Green worked in ambulatory care settings for 17 years and has no experience in teaching. She was given class/clinical schedule, two text books, a syllabus, three unit exams and a final by the Dean. The concentrated course is 6 weeks in length and starts in two weeks. When bad things happen to good programs, deans and directors do their best to assign the most qualified candidate available to instructional positions sometimes with little notice. However in this scenario, students are less likely to acquire a valued experience education Program administrator Position open 18 due to the learning curve of the new faculty. The faculty member must grasp the structure of course objectives and create a teaching plan with meaningful activities that will encourage and challenge students while teaching course content in an area outside her expertise. Further compromising the teachinglearning situation is the short a period of time available to adequately prepare for a course of critical importance. There will also be little time for students to assimilate, process, and apply their newly acquired knowledge. Their performance in clinical settings to assess and recognize contextual responses to care may be affected. If a student experiences a setback in learning or doesn’t keep up with the pace, there is little time for review or remediation to get back on track. The abbreviated duration of the course combined with her inexperience in instruction will challenge Green’s abilities to adequately engage and evaluate students’ learning. Green is particularly vulnerable to burnout if the difficult realities of her situation begin to erode her capacity for caring and personal satisfaction with her teaching position. Certainly once Green has taught this course initially, she will be better prepared in the future. She may be able to persevere and overcome these difficulties and with time develop a sense of salience of the content within the curriculum. There is plentiful evidence in nursing education to support the implementation of mentorships and benefits of professional development for nursing faculty. The recruitment and retention of nursing faculty is a critical issue currently. Nursing programs that are struggling to attract and retain faculty and students can learn a great deal by examining the practices of nursing programs that have become “destination institutions” for nursing faculty rather than short “flight connection” stops. Related Reading: 1. Dunham-Taylor, J., Lynn, C. W., Moore, P., McDaniel, S., & Walker, J. K. (2008). What goes around comes around: Improving faculty retention through more effective mentoring. Journal of Professional Nursing, 24(5), 337-346. http://dx.doi.org/10.1016/j. profnurs.2007.10.013 1. Krause-Parello, C. A., Sarcone, A., Samms, K., & Boyd, Z. N. (2012). Developing a center for nursing research: An influence on nursing education and research through mentorship. Nurse Education in Practice. In press, corrected proof available online 6 September 2012. http://dx.doi.org/10.1016/j. nepr.2012.08.004 1. Heinrich, K. T., & Oberleitner, M. G. (2012). How a faculty group’s peer mentoring of each other’s scholarship can enhance retention and recruitment. Journal of Professional Nursing, 28(1), 5-12. http://dx.doi.org/10.1016/j. profnurs.2011.06.002 1. Sawatzky, J. V., & Enn, C. L. (2009). A mentoring needs assessment: validating mentorship in nursing education. Journal of Professional Nursing, 25(3), 145150. http://dx.doi.org/10.1016/j. profnurs.2009.01.003 There is an opening at the Arizona State Board of Nursing for a 32 hour per week Education Program Administrator. The position will involve conducting surveys and providing education and consultation to LPN, RN, refresher and advanced practice nursing programs. Requirements include a master’s degree in nursing and significant experience as a full-time faculty member or director in a pre-licensure nursing program. The successful candidate will have exceptional written and oral communication skills, curriculum development and evaluation experience, classroom teaching expertise and effective time management. The position requires frequent travel within the state including overnight stays in rural areas. For more information, please contact Pamela Randolph RN, MS, Associate Director of Education and Evidence-based Regulation at 602-771-7803 or prandolph@azbn.gov. This position is eligible for state benefits. arizona STATE BOARD OF NURSING regulatory Journal You realized your nursing dream. What Magnet® means to us... Now Realize Your POTENTIAL. Earn your BSN or MSN Online. You’ve come a long way since your first day as an RN. Go even further with one of Jacksonville University’s acclaimed nursing programs, offered in a 100% online classroom. • RN to BSN – Now Offering Scholarships! • MSN: Clinical Nurse Educator Situated in the beautiful White Mountains, there are 4 seasons to enjoy outdoor recreational activities. The White Mountain area is a friendly, rural community with affordable housing, excellent schools, and an exceptional quality of life. JacksonvilleU.com/Nurses Or, talk with a specialist: 800-571-4934 8-week classes | 6 sessions per year ... Magnet means having the support to do what’s best for the patient, best for each other, and best for our careers! Located in beautiful Scottsdale, AZ, non-profit Scottsdale Healthcare is a leader in medical innovation, talent and technology with three state-of-the art facilities and a genuine commitment to nursing. RN Cath Lab RN Med Surg RN Emergency Department RN Float RN Labor & Delivery / Nursery Summit Healthcare Regional Medical Center offers a modern, professional environment for you to grow and thrive. • MSN: Leadership in Healthcare Systems Nursing Careers at Arizona’s 1st and only Magnet Hospital System IMMEDIATE RN OPENINGS FOR: © 2012 All Rights Reserved. Made Available by University Alliance® The Nation’s Leading Universities Online. SC: 191734ZJ1 | MCID: 13184 One of America’s Best Colleges U.S. News & World Report Our nursing opportunities give you the perfect way to work with the patient populations you love. You’ve chosen your field of expertise. Let us give you the autonomy and support to care for your patients. We currently have opportunities for: Registered Nurses • ICU • NICU • CVICU • PICU We invite you to join us and become part of the first multihospital health system in Arizona to attain elite Magnet recognition. Z Tucson / Oro Valley, A Travel Nurse Program: g. Loudly. Opportunity is knockin jobs.shc.org Learn more at: Text RNJobs to 447363 [HireMe] for exclusive employment messages Imagine a challenging and fullling career opportunity in paradise. Northwest Medical Center and Oro Valley are looking for registered nurses for 13-week assignments in Tucson. That means 70-degree winter temperatures, hiking, biking and natural beauty complementing a job working for supportive, state-of-the art medical facilities. Better yet, there’s opportunity for full-time employment at the end of your contract. Visit www.tucsontravelnurses.com for complete details and to apply. EOE/AA/M/F/D/V An Equal Opportunity Employer. arizona STATE BOARD OF NURSING regulatory Journal 19 cna corner By PAMElA K. RANDOlPH, RN, MS, ASSOCIATE DIRECTOR EDUCATION/EvIDENCE BASED REGUlATION nurSe conSultant Job oPening The Arizona State Board of Nursing is currently accepting applications for a full-time Nurse Practice Consultant to conduct investigations of licensees and applicants for licensure for whom a complaint has been received. The position requires knowledge of nursing standards of care and the Nurse Practice Act. Knowledge related to addiction, alcoholism, substance use disorders, and chemical dependence OR knowledge related to assisted living facilities, skilled nursing facilities, and long term acute care as well as experience in interviewing and report writing is desired. Successful candidates will have substantial nursing experience, a BSN, an active and good standing RN license, excellent written and oral communication skills, effective time management skills, and analytical abilities. Master’s Degree in Nursing or a related field preferred. For more information or to submit a resume for consideration, please contact Nikki Austin, JD, RN, Associate Director of Investigations/Compliance at 602771-7819 or naustin@azbn.gov. 20 cna coMPetency eXaM cHangeS The annual review of the CNA Manual Skills and Written Tests and testing procedures was conducted on September 27, 2012, at the meeting of the ad hoc Test Advisory Panel (TAP) at the Arizona Board of Nursing. Background: The ad hoc Test Advisory Panel (TAP) is made up of volunteer CNA instructors. Attendees at the CNA Retreat are asked if they would like to serve on this panel and selection is made based upon past attendance, past or potential contributions to the process and representation of rural/ urban areas and program types. Most volunteers are offered at least one opportunity to participate on a TAP. The changes proposed by the TAP were approved by the Board on November 9, 2012 and will be effective February 1, 2013. Changes Effective February 1, 2013 Testing Processes/Evaluation • To emphasize safety yet retain the efficiency of the test on items such as bedpan and occupied bed making, the candidates will be able to use the test observer (TO) to ensure against resident falls if they need to leave the immediate bedside. • One evaluation question will be changed to ask which current testing practices help lessen anxiety. • All sites will be required to have a wheelchair with removable footrests • Test sites will be asked to remove or cover posters or displays that may cue students on skill performance. • All test sites will be asked to sign an agreement that they will not videotape testing events. • Test confirmation and candidate handbook changes will be made to better inform candidates of ID requirements and wait times. • Testing candidates with proof of arizona STATE BOARD OF NURSING regulatory Journal • allergy to hand sanitizer will be allowed to bring their own inert substance to simulate hand sanitizer. D and S will provide data on skill test time to see if there is a relationship between time to complete skills and passing. Written Exam • TAP members reviewed 163 new test items and retained 111 for use on AZ candidates—total items 1216. • There was one minor change to the written exam plan: an item was added to the category of “Safety” and deleted from “Basic Nursing Skills.” This increases the items in “Safety” from 6 to 7 and decreases the items in “Basic Nursing Skills” from 10 to 9. The total number of items on written test remains at 75. • D and S will explore writing more items on essential skills that are not tested in the manual skills exam, such as weighing, peri-care male, and catheter care. Manual Skills Exam • Mouthcare Comatose Patient: Delete “Rinses and dries equipment and returns to storage.” Rationale: a “toothette” is used which can be discarded in the trash, no other equipment is needed—currently candidates would fail if they did not use equipment • Pericare Female: Add “Maintains respectful, courteous interpersonal interactions and all times.” Rationale: Consistent with other skills and resident rights. • Pericare Female: Specify that 3 strokes (each stroke a separate step) must be used to clean and rinse outer and middle perineal area and must clean and rinse the rectal area from front to back all Navajo Technical College P.O. Box 849, Crownpoint, NM 87313-0849 ASSOCIATE DEGREE NURSING PROGRAM Invitation to apply for the following positions: • Director of Nursing Programs/Nursing Department Chair • Nursing Program Instructor Excellent benefit package. MSN, nursing education experience required. View full job descriptions at http://www.navajotech.edu/index.php/human-resources Contact Human Resources at 505-786-4109 ArizonA Home CAre is the fastest growing home health agency in Arizona We have field positions and an office position available. We are looking for the following RNs to meet our increasing patient census: • Welcome to your new life. experienced infusion rn (FT) Earn $100 a visit with $200 minimum guaranteed per night. 4-evenings (3pm - 11pm) and every other weekend Infusion experience required PoSiTionS AVAiLABLe in oUr GenerAL Home CAre DiViSion: • • Registered Nurses You’ve put years of hard work, education and training into establishing a great career for yourself. Your compassion and commitment to quality care have placed you among the best in the profession. Now it’s time to enjoy the incomparable rewards of a career with Yavapai Regional Medical Center in Prescott, Arizona. The acuity and advanced technology are just what you’re used to. But living here is far beyond the expected. We have an opening for these Registered Nurse positions: • Cardiac Cath Lab • Clinical Coordinator Med/Surg • Med/Surg/Tele • Clinical Coordinator Med/Tele • CVICU/ICU/PCU • Surgical Services • L&D/OB/Neonatal • Emergency Department • PACU To take the first step, visit us online at: www.mycareeratyrmc.org. • • Part time (3 week day commitment) and full time centrally located RN Part time Sat/Sun Weekend Warrior; must be able to drive Valley wide; earn great $ Full time M-F SWAT all Valley RN; company car program applies Part time (3 week day commitment) and Full time centrally located RN Please apply today at: www.azhomecare.com If you are a qualified candidate for any of these positions, please apply online or e-mail resumes to VIPCareerNetwork@yrmc.org. For further information, contact our recruiter at 877-976-9762. EOE Two great hospitals. One caring spirit. arizona STATE BOARD OF NURSING regulatory Journal 21 • • • • • 22 with a clean portion of the wash cloth. Rationale: consistent with textbook instructions and principles of personal hygiene Range of Motion: All range of motion tasks will have as key step, “places resident supine (leg)” or “places resident on back (arm).” Rationale: ROM cannot be effectively done in other positions Ambulation with Walker and Ambulation with Weight Belt: Add step “places resident (in wheelchair) in easy reach of call light” and remove “places call light within reach of resident.” Rationale: removes “trickiness” from this item which calls for the student to place the call light near the resident, yet the call light does not reach the resident in the wheel chair without unplugging. Some students are able to critically think and move the resident to the call light, others are very nervous and do not think to do this resulting in missing the step or providing an inoperable call light. Anti-embolic Hose: Add key step that stocking must be properly placed without restriction. Rationale: Some candidates are placing the heel and toe of the stocking in the wrong position resulting in constriction and potential harm to patients by cutting off circulation. Blood Pressure: Change step to “inflates BP cuff to no more than 30 mmHg above loss of pulse.” The test observer (TO) will be given a narrow range to count as correct. Rationale: step was misleading by instructing candidates to inflate no more than 30 mmHg above loss of pulse—may be scored as correct by a TO if inflated less than 10 mmHg above even if the candidate was unable to detect the systolic BP. Bed Bath-Face, Arm, Hand and Underarm: Change test scenario to instruct students to wash the whole face and the one side (R or L) arm, hand and underarm. Rationale: current instructions just state wash one side of the body and some students are confused as to whether to wash half or whole face (both are correct). Revising • • • • • • this instruction will eliminate confusion on the part of candidates and be more consistent with teaching in programs. Change title of “Transferring a Weight bearing Non-ambulatory Resident from Bed to Wheelchair (and wheelchair to bed) Using a Gait Belt” to “PIVOT Transfer a Weight- bearing ….” Rationale: decrease confusion and lets candidate know the type of transfer better—candidates have been asking the actor to ambulate thereby failing the skill. Positioning Resident on Side: Specify in the instructions and candidate handbook that resident does not need to be under the covers for the positioning. Rationale: allows candidate to better visualize position of resident and ensure correct alignment. Positioning Resident on Side: Add a step that the resident must be positioned on the correct side. Rationale: the TO specifies L or R side but occasionally the candidate places on the wrong side—without this step, the candidate would pass. Positioning Resident on Side and Making an Occupied: Better clarify the separate steps in the Candidate Bulletin based on whether the candidate uses the TO for fall prevention or not. Rationale: To better prepare students and decrease confusion for both scenarios. For any skill involving a wheelchair: Include in candidate instructions of the scenario that the physician has ordered “no footrests” on the wheelchair. TO will remove footrests from wheelchair before testing. All sites will be required to have wheelchairs with removable foot rests. Rationale: Much time is lost manipulating footrests that may be unfamiliar to candidates. Many nursing home residents have orders for no footrests so they can self propel with feet. Denture Care: Add “rinses cup” after step #4—and that denture cream does not need to be labeled “non-abrasive.” Rationale: currently the item is “places dentures arizona STATE BOARD OF NURSING regulatory Journal • in rinsed cup” which measures 2 behaviors—placing the dentures in the cup and rinsing the cup—separating these increases the reliability and validity of the test—denture cream by definition is non-abrasive. Bedpan and Output/Bed Bath/ Perineal Care: moving step of lowering bed in candidate handbook to prior to equipment being cleaned so patient is not left with bed in high position—candidate also has the option to ask the T.O. to monitor the patient for safety. Rationale: consistent with safety standards although doing this would necessitate removing gloves and washing hands prior to lowering the bed and then re-donning gloves to take care of equipment. Instructors may want to encourage students to use the TO as a safety person to prevent falls. TAP Panel Members 2012 Delores Brindle, CareGiver Training Institute Mary Edwards, Hospice of the Valley Teresa Hagen-Hale, Cochise College @ Sierra Vista Campus Stacy Hatton, Rio Rico High School Marie Rozell, East Valley Institute of Technology (EVIT) Shirley Soden, Cactus Wren Training Program, LLC. Jacqueline Cushard, Paradise Valley Community College Linda Niemeyer, Central Arizona College Karen A. Hansen, Northland Pioneer College Don Johnson, Coconino Community College - Flagstaff Diane Christoffer, The Gardens Rehab & Care Center Patricia Hickey, Life Care Center of Sierra Vista D and S Diversified Staff Paul Dorrance Teresa Whitney Vicky Castillo Board Staff: Pamela Randolph Opal Wagner Navigating the Nurse Licensure compact Two algorithms; licensure and endorsement process that will assist RN’s and LPN’s in understanding if the new declared primary state of residence is part of the Nurse Licensure Compact. For more information, please watch to video The Nurse Licensure Compact Explained on our homepage at HYPERLINK “http://www.azbn.gov” www.azbn.gov NAVIGATING THE NURSE LICENSURE COMPACT : LICENSURE BY ENDORSEMENT LICENSURE BY ENDORSEMENT Declaring a New Primary State of Residence (PSOR) / Obtaining a License when Moving from One State to Another Is your new primary state of residence part of the Nurse Licensure Compact? YES No Apply for a RN or LPN license in your new primary state of residence. Apply for licensure in that state. You may continue to practice for up to 30 days from the time you establish residency, on your privilege to practice from your former home state / PSOR. You may not practice in a noncompact state until you have a temporary permit or permanent license. You can only hold one multi-state RN or LPN license but may hold multiple non-compact state licenses. You may hold multiple licenses from non compact states. Your former license will be inactivated upon receipt of new home state license. Your new multi-state license grants a privilege to practice in all NLC states contingent upon remaining a resident of the issuing state. Each single-state license is valid for practice only in the state of issuance. Page 1 NAVIGATING THE NURSE LICENSURE COMPACT: INITIAL LICENSURE BY EXAMINATION FOR NEW GRADUATES INITIAL LICENSURE BY EXAMINATION FOR NEW GRADUATES Determine your primary state of residence (PSOR): Answer the following questions, 1) In which state do you hold a drivers license? 2) In which state are you registered to vote? 3) In which state do you file your federal income tax? Multi-State License Apply for initial licensure by examination in your primary state of residence (PSOR). YES Is your primary state a member of the NLC? NO Single-State License You may apply for an initial license by examination in any one state of choice. Follow the eight steps of the NCLEX 1. Apply for licensure with ONE board of nursing (BON). 2. Register and pay $200 with Pearson VUE (see candidate bulletin). 3. Receive receipt of registration from Pearson VUE. 4. Receive eligibility from the BON. 5. Receive an authorization to test (ATT) via letter or email from Pearson VUE. 6. Schedule an exam with Pearson VUE via the internet or phone. 7. Arrive for exam, present ATT letter and ID (see candidate bulletin). 8. Receive results from the BON. Your new multi-state license grants a privilege to practice in all NLC states contingent upon remaining a resident of the issuing state. Each single-state license is valid for practice only in the state of issuance. Page 1 arizona STATE BOARD OF NURSING regulatory Journal 23 An InnovAtIve nURSe notIfIcAtIon SyStem The National Council of State Boards of An database for verification of nurse licensure, InnovAtIve discipline and practice privileges for registered nurses (Rns) and licensed practical/vocational nURSe nurses (LPn/vns).* It is comprised of data notIfIcAtIon obtained directly from the licensure systems of U.S. boards of nursing (Bons) through SyStem Nursing’s Nursys® is the only national frequent, secured updates. InfoRmAtIon And chAngeS tRAcked Nursys e-Notify will alert subscribers when the following changes are made to a nurse’s record: License status License expirations License renewal Disciplinary action Disciplinary action resolved cUStomIzABLe notIfIcAtIon You choose how often you receive emails, when and how often you receive nurse licensure status change updates, and when to run your reports. You can even choose to enter nurse contact information so that you can send licensure renewal reminders to them via email or text directly from the system. 24 arizona STATE BOARD OF NURSING regulatory Journal Why nURSyS e-notIfy? Nursys is the only national database for verification of nurse licensure, discipline and practice privileges for RNs and LPN/VNs.* Nursys e-Notify provides real-time automatic notification of status and discipline changes delivered directly to you. Nursys e-Notify economically provides you with vital information saving you money and staff time. Learn more and subscribe to Nursys e-Notify by visiting nursys.com. For more information contact nursysenotify@ncsbn.org. continued >>> UnIQUe PRodUct Nursys e-Notify is an innovative nurse licensure notification system where you receive real-time email notifications about nurses in your employ. The system provides licensure and publicly available discipline data directly to you automatically as the data is entered into the Nursys database without you needing to proactively seek this information! economIcAL The first 100 nurses in your facility that are registered with Nursys e-Notify are free of charge. After that, each nurse is $1 per year. If you employ 99 nurses you will pay nothing; if you have 200 nurses, your cost per year will be $100. eASy, QUIck And effIcIent Entering your nurses into Nursys e-Notify is fast and easy. Search the Nursys database for nurses to add to your list, bulk upload your entire nursing staff list and/or connect to and upload directly from your system. You manage the addition, deletion or deactivation of nurses with just a few easy clicks. Once you enter your nurses into the Nursys e-Notify system you will receive notification about changes in licensure status as soon as they are made by a board of nursing. If a nurse’s license is about to expire, the system will alert you and then you can choose to use the system option to send the nurse a reminder. You will also immediately find out if there has been new disciplinary action or a publicly available nurse alert issued by a board of nursing for your employed nurse. *Not reported in previous Journal cna DiSciPlinary action JUNE, JUly, AUGUST & SEPTEMBER 2012 eFFeCtive date naMe CeRtiFiCate disCiPline 7/18/2012 Anderson, Ashley N. CNA1000019626 Voluntary Surrender 9/20/2012 Anderson, Raven N. CNA1000026182 Stayed Suspension 9/12/2012 Auer, Katherine J. CNA Applicant Denial of Initial Certificate 7/17/2012 Baez, Christina R. CNA Applicant Denial of Initial Certificate 9/7/2012 Banuelos, Jorge L. CNA1000008931 Revocation 8/10/2012 Barron, Ubaldo A. CNA1000013725 Voluntary Surrender 8/15/2012 Berg, Kristin L. CNA1000034087 Voluntary Surrender 8/1/2012 Berger, Theresa M. CNA1000034536 Decree of Censure 7/20/2012 Blackgoat, Dorothy A. CNA999998551 Stayed Revocation 9/7/2012 Butcher, Shawn E. CNA913727103 Revocation 8/1/2012 Carmical, Kathy J. CNA1000034695 Decree of Censure 7/6/2012 Castro, Conrad S. CNA1000022142 Revocation 7/6/2012 Claunch, Shaylin B. CNA Applicant Denial of Initial Certificate 6/8/2012 Coelho, Jenna M. CNA Applicant Denial of Initial Certificate 6/14/2012 Cook, April A. CNA386348627 Voluntary Surrender 9/20/2012 Cowan, Emily R. CNA1000004128 Voluntary Surrender 6/26/2012 Cunningham, Ashley R. CNA1000015358 Decree of Censure 9/4/2012 Davis, Kristin S. CNA Applicant Denial of Initial Certificate 7/6/2012 Davis, Margo L. CNA338975593 Denial of Certificate Renewal 7/1/2012 Delvalle, Natalie R. CNA1000009645 Stayed Revocation 9/4/2012 Doten, Steven A. CNA Applicant Denial of Initial Certificate 9/7/2012 Eldredge, Emma A. CNA999950782 Revocation 7/6/2012 Espinosa, Michael P. CNA999950102 Revocation 7/6/2012 Felix, Esperanza CNA128361103 Revocation 9/18/2012 Foster, William H. CNA Applicant Civil Penalty 6/12/2012 Franklin, Laura L. CNA1000016252 Decree of Censure 7/6/2012 Furr, Jason P. CNA1000014283 Revocation continued >>> arizona STATE BOARD OF NURSING regulatory Journal 25 cna DiSciPlinary action *Not reported in previous Journal continueD JUNE, JUly, AUGUST & SEPTEMBER 2012 eFFeCtive date naMe CeRtiFiCate disCiPline 9/4/2012 Garcia, Maria C. CNA Applicant Denial of Initial Certificate 8/28/2012 Garcia, Noemi CNA1000017917 Stayed Revocation 8/27/2012 Gomes, Beverly J. CNA Applicant Denial of Initial Certificate 8/21/2012 Hall, Harrison L. CNA1000034887 Decree of Censure 7/3/2012 Hawley, Alba L. CNA999992827 Voluntary Surrender 9/17/2012 Hernandez, Adrianna J. CNA Applicant Denial of Initial Certificate 8/28/2012 Hooper, Pamela J. CNA Applicant Denial of Initial Certificate 7/20/2012 Howe, Dorthina CNA Applicant Denial of Initial Certificate 9/4/2012 Johnson, Danielle R. CNA Applicant Denial of Initial Certificate 8/13/2012 Juarez, Teresa D. CNA1000034753 Civil Penalty 7/17/2012 Keeling, Tyler C. CNA Applicant Denial of Initial Certificate 7/6/2012 Koch, Jacqueline R. CNA1000000669 Revocation 9/7/2012 Lawrence, Juan B. CNA987615103 Revocation 9/7/2012 Luna, Jessica L. CNA1000003999 Revocation 7/17/2012 Lupe, Kristy M. CNA Applicant Denial of Initial Certificate 7/6/2012 Marciniak, Heather M. CNA1000017156 Revocation 9/19/2012 Martino, Ashley R. CNA Applicant Denial of Initial Certificate 9/5/2012 Mata, Maria D. CNA Applicant Denial of Initial Certificate 7/6/2012 Mcelroy, Alba D. CNA999989078 Revocation 7/17/2012 Mcgee, Janet M. CNA Applicant Denial of Initial Certificate 7/17/2012 Moore, Gail Y. CNA Applicant Denial of Initial Certificate 7/17/2012 Moreno, Erica N. CNA Applicant Denial of Initial Certificate 9/10/2012 Moyes, Aleecia M. CNA Applicant Denial of Initial Certificate 7/6/2012 Murrin, Kirk D. CNA1000022446 Revocation 9/7/2012 Nash, Natasha L. CNA1000018447 Revocation 9/6/2012 Njai, Malick M. CNA750763441 Civil Penalty 7/6/2012 Oller, Diana M. CNA1000022440 Revocation 7/13/2012 Oporta, Ileana E. CNA Applicant Denial of Initial Certificate 6/22/2012 Ortega, David G. CNA Applicant Denial of Initial Certificate 9/12/2012 Ortega, Maria CNA Applicant Denial of Initial Certificate 9/7/2012 Parkersmith, Pamela CNA401631103 Revocation 7/6/2012 Piper, Linda A. CNA999989635 Revocation 9/7/2012 Pitman, Vichitra CNA473111619 Decree of Censure 7/6/2012 Pizano, Tina M. CNA1000005305 Revocation 9/6/2012 Quinn, William F. CNA Applicant Denial of Initial Certificate 9/10/2012 Renninger, Anne R. CNA293279649 Voluntary Surrender 7/13/2012 Rexius, Kiley M. CNA Applicant Denial of Initial Certificate 6/5/2012 Reyes, Jessica J. CNA999997496 Revocation 9/4/2012 Richey, John E. CNA Applicant Denial of Initial Certificate 9/3/2012 Ricks Jr, Ronald D. CNA Applicant Denial of Initial Certificate 8/8/2012 Robison, Terrie A. CNA1000035050 Civil Penalty 8/8/2012 Rodriguez Fugger, Elizabeth M. CNA1000019884 Decree of Censure 7/6/2012 Sampson, Richard L. CNA1000008560 Revocation 9/7/2012 Scholz, Heather M. CNA1000009400 Revocation 9/7/2012 Shestko, John A. CNA625785803 Revocation 6/28/2012 Silas, Geneva CNA012678353 Voluntary Surrender 8/13/2012 Smith, Jeanne-Jo CNA1000034754 Decree of Censure 9/17/2012 Smith, Serena CNA Applicant Denial of Initial Certificate 9/7/2012 Sohl, Dena L. CNA999993487 Decree of Censure 7/6/2012 Soto, Jessica M. CNA1000006869 Revocation 6/11/2012 Stevens, Suzanne C. CNA1000021011 Voluntary Surrender 26 arizona STATE BOARD OF NURSING regulatory Journal cna DiSciPlinary action *Not reported in previous Journal continueD JUNE, JUly, AUGUST & SEPTEMBER 2012 eFFeCtive date naMe CeRtiFiCate disCiPline 8/20/2012 Stuart, Shanna L. CNA1000030764 Civil Penalty 7/19/2012 Sutton, Cristin L. CNA1000034174 Decree of Censure 7/6/2012 Taylor, Heather J. CNA1000023673 Revocation 9/21/2012 Taylor, Natalie N. CNA1000035333 Stayed Revocation with Suspension 8/15/2012 Tucker-Villa, Cheryl A. CNA109030103 Voluntary Surrender 7/6/2012 Turquoise, Caroline CNA1000013078 Revocation 9/7/2012 Van Dyke, Alice K. CNA999947768 Revocation 6/12/2012 Vierra, Ellen M. CNA453815083 Decree of Censure 7/17/2012 Walker, Sharonda N. CNA Applicant Denial of Initial Certificate 6/2/2012 Wearne, Haiden CNA1000025034 Decree of Censure 8/30/2012 Wils, Lynn D. CNA1000011636 Decree of Censure 9/7/2012 Woods, Sheila A. CNA108741669 Revocation 9/21/2012 Zamarripa, Erica M. CNA1000027527 Civil Penalty 9/12/2012 Zambonini, Shann M. CNA Applicant Denial of Initial Certificate *Not reported in previous Journal rn/lPn DiSciPlinary action JUNE, JUly, AUGUST & SEPTEMBER 2012 eFFeCtive date naMe liCense disCiPline 8/13/2012 Althoff, Christine M. RN033121/CNA216801360 Voluntary Surrender 8/8/2012 Andersen, Lisa M. RN175566 Civil Penalty 7/13/2012 Arrington, Melissa M. RN115663 Revocation 7/6/2012 Berg, Deborah A. LP041858 Decree of Censure 6/26/2012 Beyerlein, Ellen J. RN122412 Voluntary Surrender 9/18/2012 Bosseler, Jill D. RN065435 Probation 7/30/2012 Bostic, Juny Y. RN Endorsement Applicant Denial of Initial License 7/11/2012 Branum, Robert W. RN137052 Probation 6/18/2012 Braveman, Marc B. RN151443 Decree of Censure 7/6/2012 Burke, Stacy J. RN101708 Revocation 7/6/2012 Burns, Michelle B. RN078233 Revocation 7/18/2012 Capotosti, Elizabeth D. RN113576/AP3574 Stayed Revocation with Suspension; Voluntary 9/7/2012 Carlton, Tommy L. RN127562 Revocation 8/16/2012 Chebbi, Souhaiel RN157575 Stayed Suspension/Probation 7/6/2012 Cherry, Cynthia A. RN147125 Revocation 7/6/2011 Christensen, Vanessa L. RN128064/LP037896 Revocation 8/23/2012 Christian, Casey J. RN129051/LP035864/CNA700728313 Suspension 9/21/2012 Christianson, Laura J. RN076329 Revocation 7/6/2012 Clarke, Vicki L. RN128844 Revocation 7/18/2012 Connerton, Amy R. RN087578 Voluntary Surrender 7/10/2012 Coons, Connie M. RN090703/LP030068 Voluntary Surrender 7/16/2012 Cooper, Gina C. RN128425 Suspension 8/20/2012 Coursey, Victoria A. RN112915 Voluntary Surrender 8/29/2012 Davis, Kayren L. RN125761 Decree of Censure 7/6/2012 Delate, Marylee RN152204 Revocation 7/6/2012 Do Carmo, Kathryn L. LP037548 Revocation 7/6/2012 Dowdy, Brenda J. LP037329 Revocation 9/21/2012 Drew, Elizabeth T. RN117517 Civil Penalty Surrender of Advanced Practice Certificate continued >>> arizona STATE BOARD OF NURSING regulatory Journal 27 rn/lPn DiSciPlinary action JUNE, JUly, AUGUST & SEPTEMBER 2012 *Not reported in previous Journal continueD eFFeCtive date naMe liCense disCiPline 7/20/2012 Eades, Robert A. TRN165958 Denial of Initial License 6/29/2012 Engelbretson, Nicole L. RN Exam Applicant Denial of Initial License 7/6/2012 Etzel-Elaqad, Jennifer L. RN154226 Revocation 7/13/2012 Faraci, April D. LP046426 Revocation 6/4/2012 Farnworth, Lindsay A. RN174382 Probation 7/26/2012 Fawley, Kimberly A. RN159187 Civil Penalty 7/6/2012 Gabbard, Linda E. RN078051 Revocation 8/3/2012 Garris, Dwiana G. RN064416 Voluntary Surrender 7/6/2012 Gentile, Phil J. RN097452 Revocation 6/22/2012 George, Jennifer L. RN153283 Probation 6/17/2012 Golden, Kristin M. RN164181 Probation 9/21/2012 Goley, Melissa M. TRN176897 Stayed Revocation with Probation 7/30/2012 Gorsuch, Jasmine E. LP045725/CNA1000011542 Decree of Censure 6/4/2012 Hair, Edward L. TRN164228 Denial of Initial License 9/7/2012 Hamilton, Courtney C. RN154763/LP043840/CNA1000011676 Revocation 7/6/2012 Haney, Robin R. RN110519 Revocation 9/7/2012 Harms, Debra J. LP040621 Revocation 8/31/2012 Harrelson, Vicki L. LP014894 Voluntary Surrender 9/19/2012 Harris, Danny N. RN137186 Voluntary Surrender 6/22/2012 Hatcher, Delmar M. LP043281 Voluntary Surrender 7/31/2012 Hayes, Aaron J. RN165398 Probation 6/7/2012 Hernandez, Jerilynn LP040769/CNA1000001146 Decree of Censure 7/6/2012 Hickman, Sharon R. LP042726 Suspension 6/20/2012 Horn, Tiffany A. RN150360 Stayed Suspension with Probation 7/6/2012 Hua, Chyi Jen RN114042/LP033131/CNA573348499 Revocation 9/18/2012 Ivery, Susan RN133137 Voluntary Surrender 7/25/2012 Jadlocki, Erin E. RN120586 Voluntary Surrender 7/31/2012 Karaszewski, Kathleen A. RN059186/AP3583 Suspension 6/26/2012 Kibler, Ramona M. RN062310 Voluntary Surrender 8/14/2012 King, Brandon L. RN175638 Suspension 8/15/2012 Knerr, Gail D. RN070222 Voluntary Surrender 7/18/2012 Kropczynski, Raymond M. RN169604 Stayed Suspension with Probation 8/6/2012 Lamis, Elizabeth A. RN095229 Decree of Censure 7/6/2012 Landa, Stephanie L. RN090090 Revocation 8/14/2012 Langevin, Debra A. LP031383 Voluntary Surrender 7/6/2012 Laskowski, Judith A. RN128606 Voluntary Surrender 6/1/2012 Leary, Phyllis A. RN090326 Revocation 9/10/2012 Leonard, Linda L. RN149056 Voluntary Surrender 7/6/2012 Leonardo, Nancy S. RN056074/LP018360 Revocation 6/20/2012 Long, Roxanne L. RN090529/LP029040 Voluntary Surrender 9/20/2012 Lopshire, Jennifer A. RN098560 Suspension 6/30/2012 Mackey, Marlise A. LP025149/CNA718121803 Decree of Censure 6/18/2012 Maley, Robert L. LP042750 Probation 7/24/2012 Marson, Theresa J. RN151909 Probation 7/6/2012 Mcconnell, Sherry M. RN139247 Revocation 7/13/2012 Mccullough, Amy J. RN049271 Voluntary Surrender 7/6/2012 Mclain, Sarah RN113175 Stayed Suspension with Probation 8/14/2012 Mcmacken, Rhonda R. RN037938 Voluntary Surrender 6/21/2012 Mcquinn, Ashley N. RN155036 Probation 7/20/2012 Mercer, Meegan A. LP024604 Voluntary Surrender 8/15/2012 Milacek, Cindy N. RN069702 Voluntary Surrender continued >>> 28 arizona STATE BOARD OF NURSING regulatory Journal *Not reported in previous Journal rn/lPn DiSciPlinary action JUNE, JUly, AUGUST & SEPTEMBER 2012 eFFeCtive date naMe liCense disCiPline 7/6/2012 Mills, Barbara A. RN106182/LP032661 Revocation 7/3/2012 Mills, Katherine S. RN078388/LP024218/CNA652660103 Voluntary Surrender 7/2/2012 Mineweaser, Kevin L. RN164538 Probation 7/13/2012 Mitchell, Jennifer A. LP045304 Revocation 9/7/2012 Moeser, Cynthia H. RN070302/LP022965 Revocation 8/6/2012 Moody, Kimberly A. RN152388/LP043199 Probation 7/6/2012 Moore, Rita RN063898/LP021121 Revocation 9/7/2012 Morrill, Carole B. RN043092 Revocation 7/6/2012 Mulhare, Kimberly R. RN119228 Revocation 7/6/2012 Myrick, Margo F. LP016807 Revocation 8/23/2012 Neal, William R. RN097393 Revocation 9/20/2012 Nieblas, Madalene RN119362/LP036960 Civil Penalty 7/6/2012 Noble, Cindy C. RN090524/LP029109/CNA246878163 Revocation 9/28/2012 Ogrady, John J. RN135233 Voluntary Surrender 7/6/2012 Oladiran, Tajudeen O. LP000032877/CNA545045414 Revocation 9/20/2012 Olson, Rebecca RN098724 Stayed Revocation with Probation 7/6/2012 Olstein, Cynthia K. RN030305 Revocation 8/22/2012 Opfel, Ned J. RN152503 Civil Penalty 6/11/2012 Osebold, Celine G. RN113017 Decree of Censure 6/12/2012 Peterson, Astra V. LP045242 Probation 9/7/2012 Phillips, Leslyann K. RN142246 Revocation 8/3/2012 Porter, Rachael A. RN160001 Probation 7/6/2012 Prawdzic-Witoslawski, Bozena A. RN111477/LP034041 Revocation 7/12/2012 Purtill, Mary T. RN Exam Applicant Denial of Initial License 7/5/2012 Radcliffe, Leslie C. RN121673/CNA999987590 Voluntary Surrender 7/6/2012 Rider, Jennifer D. LP037135 Revocation 9/19/2012 Robertson, Inyanga RN Endorsement Applicant Denial of Initial License 7/5/2012 Russell, Sally A. RN057561 Voluntary Surrender 9/7/2012 Sanabria, Cathy E. RN094273 Revocation 8/29/2012 Scarce, Sandra S. RN114468 Voluntary Surrender 7/3/2012 Schneider, Brandi L. RN146151 Voluntary Surrender 8/31/2012 Sikes, Suzanne H. RN145485 Voluntary Surrender 7/6/2012 Smith, Linda D. RN079924 Revocation 9/7/2012 Smith, Lisa A. LP020978 Revocation 9/7/2012 Smith, Rhoda C. LP010557 Revocation 6/5/2012 Somerlik, Miloslava LP031393/CNA024621433 Revocation 9/25/2012 Songer, Denise J. RN107519 Voluntary Surrender 6/26/2012 Soto, Adrian LP046950 Probation 8/17/2012 Thompson, Connie M. RN080799 Voluntary Surrender 7/20/2012 Tolentino, Tracy A. LP036193/CNA138706441 Probation 9/7/2012 Tuck, Debora L. RN086567 Revocation 9/14/2012 Turner, Audrey L. RN143271 Voluntary Surrender 7/6/2012 Vincent, Sheema T. RN160863 Revocation 9/20/2012 Vucetic, Anne C. RN155243 Stayed Revocation with Suspension 7/20/2012 Weinstein, Pamela A. RN147720 Revocation 9/7/2012 Welch, Anne M. LP040399/CNA1000001150 Revocation 9/20/2012 Welch, Heidi L. LP040399 Stayed Revocation with Probation 9/7/2012 Willison, Keri R. RN125492 Revocation 9/19/2012 Withey, Carrie A. RN164112 Voluntary Surrender 6/20/2012 Woodrum, Diana M. LP046578 Civil Penalty 6/4/2012 Wright, Sandra L. RN056130 Decree of Censure 6/26/2012 Zerbel, Ashley M. RN158213/LP044459/CNA1000007430 Revocation arizona STATE BOARD OF NURSING regulatory Journal 29 Nurse Network NURSING BOARD COMPLAINT? The “NEW” Classifieds (1.5” wide x 1” high) Reach every nurse in Arizona for as little as $290. Kelly J. 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We also offer an excellent compensation and benefits package, including health, dental, vision, life insurance, 401K and a generous vacation plan. For further details regarding job opportunities or to apply, visit our website www.havasuregional.com. We support a drug-free environment. EOE For All Graduate Programs, contact: Jill Racicot jill.racicot@unlv.edu (702) 895-5920 arizona STATE BOARD OF NURSING regulatory Journal 31 ARIzONA STATE BOARD OF NURSING 4747 North 7th Street, Suite 200 Phoenix, Az 85014-3655 PRESORTED STANDARD U.S. POSTAGE PAID LITTLE ROCK, AR PERMIT NO. 1884 RN EMPLOYMENT • Immediate Openings! Registered Nurse ... Due To Our Success and Expansion, We’re Looking For You to Join Our Team of Friendly, Compassionate, Home Health Professionals. We offer: Sign-On Bonus Attractive Per Diem Visit Compensation 401k Plan Health Care Benefits Home Health allows you as RN an opportunity to do more one-on-one care than most clinical settings. Our registered nurses realize a higher level of professional satisfaction and a schedule that allows for more personal autonomy and freedom. Annual earnings are quite competitive and can be considerably higher than normal shift work for motivated RNs. At Sunlife we provide a team-oriented environment that gives great support, flexibility and recognition. Applicants must have a devotion to providing quality nursing care, enjoy their independence, be self-motivated and desire a rewarding career! CALL 520.888.1311 TODAY for additional information or fax your resume to 520.577.2160 NURSING... A relationship unlike any other. Administrative Office 627 N. 6th Avenue Tucson, AZ 85705 520.888.1311 S U N L I F E H O M E H E A L T H . C O M Sunlife RN Employment fullE.indd 1 11/26/11 10:17:00 AM