70-t/O2 SEPTEMBER 2015 Veterans Bridge Course to Licensure Controlled Substance Prescription Monitoring Program see page 18 You want to work with the best minds in medicine You belong here. Operating Room RN Careers You want to enhance your nursing skills, provide exceptional care and work with a forward-thinking organization. You belong at Banner Health. In addition to our award-winning medical centers and continued partnership with the Colleges of Medicine in Tucson and Phoenix, our new Banner University Medical Centers in Phoenix and Tucson build upon our existing award winning hospitals and national reputation for clinical quality. These centers are now infused with the excellence and discovery of academic medicine and research. With innovation and medical excellence, we are changing health care inside and outside of the operating room. Explore opportunities to join our OR nursing team at BannerHealth.com/ORCareers. Work with us on the forefront of medicine using innovative technology including:               Banner Health is the first health Banner Health was the first health Our surgeons use this care system in the western U.S. care provider in Arizona to use technology to perform to use this program to reduce eICU technology to continuously complicated procedures with complications during childbirth. monitor ICU patients. fewer, smaller incisions. Explore all OR RN opportunities – including Trauma, Bariatric, Neurology, Orthopedic, and Gynecologic Surgery – at BannerHealth.com/ORCareers. Banner now operates 28 acute-care facilities in seven western states with more than 45,000 employees. As the largest private employer in Arizona, we pride ourselves on developing the best healthcare professionals in our field and provide advancement internally to promote further career growth. Visit BannerHealth.com/ careers to learn about an array of nursing opportunities in Arizona and other western states. www.BannerHealth.com/careers EOE/AA Banner Health supports a drug-free and tobacco-free work environment. )ROORZ %DQQHU+HDOWK&DUHHUV 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 The Honorable Doug Ducey GOVERNOR Joey Ridenour, RN, MN, FAAN EXECUTIVE DIRECTOR Judy Bontrager, RN, MN ASSOCIATE DIRECTOR/OPERATIONS Pamela Randolph, RN, MS, FRE ASSOCIATE DIRECTOR/EDUCATION & EVIDENCE BASED REGULATION Janeen Dahn, PhD, RN, RNP-C ASSOCIATE DIRECTOR/COMPLAINTS & INVESTIGATIONS Val Smith, Associate Director, MSN, RN, FRE HEARING DEPARTMENT VOL 11 t N O 2 t SEPTEMBER 2015 4 6 8 From the Executive Director Veteran’s Bridge Course to Licensure as a Practical Nurse Staff Directory 18 19 BOARD MEMBERS Randy Quinn, RN, MSN, CRNA PRESIDENT Carolyn Jo McCormies, RN, MSN, FNP-BC VICE PRESIDENT Theresa (Terri) Berrigan, LPN, C-AL SECRETARY Lori A. Gutierrez, BS, RN-C, DON-CLTC, CBN MEMBER M. Shawn Harrell, RN,MS MEMBER Melanie D. Logue, Ph.D., DNP, APRN, CFNP, FAANP MEMBER Jana Machesky, LPN MEMBER Kimberly (Kim) Post, DNP, MBA/HCM, RN, NEA-BC MEMBER Melinda Preston, DNP, APRN, PMHNP-BC MEMBER Brandon E. Dale PUBLIC MEMBER Kathryn L. Busby, JD PUBLIC MEMBER 19 20 Save the Date 2016 CNA Conference Attention: Nurse Practitioners & Certified Nurse Midwives Currently Holding or Intend to Obtain One or More DEA Numbers Controlled Substance Prescription Monitoring Program Application Form arizona EDITION 33 Controlled Substance Prescription Monitoring Program STATE BOARD OF NURSING REGULATORY JOURNAL 22 CNA Disciplinary 24 RN/LPN Disciplinary pcipublishing.com Created by Publishing Concepts, Inc. $AVID "ROWN 0RESIDENT s DBROWN PCIPUBLISHINGCOM For Advertising info contact ,AURA 7EHNER s  EXT  LWEHNER PCIPUBLISHINGCOM ThinkNurse.com arizona STATE BOARD OF NURSING REGULATORY JOURNAL 3 From the Executive Director JOEY RIDENOUR, RN, MN, FAAN The Arizona Board of Nursing (AzBN) supports our military personnel and veterans returning to civilian life and wishes to express our gratitude for the sacrifices that they and their families have made on behalf of our nation. The healthcare skills that men and women acquire in the Armed Forces are valuable and may benefit an individual that decides to pursue a career in nursing. This edition of the Arizona State Board of Regulatory Journal features the nursing leadership of Gateway Community College (GWCC) - Dr. Margi Schultz, Chair and Jeri Lastine, LPN Coordinator. They and other educators accepted the challenge of Arizona House Bill 2076, sponsored by Representative Sunny Borrelli, to translate the service member’s military experiences to the veteran student role for success within the civilian nursing health care world. The overarching goal of the GWCC veteran bridge/pathway program is: “To develop a statewide bridge course/pathway based on the gap analysis for the military veteran educated in the medical field. The ultimate goal of the program was and still is not only to attain the certificate of completion in practical nursing, but to continue on to an associate degree in nursing, a bachelor’s degree in nursing, and beyond.” The following is a summary from Dr. Schultz and Pam Randolph regarding the 50 Bridge Course Students who have competed the course work as of August 2015. The pass rate of the Veteran’s Bridge Course students who have elected to sit for the NCLEX-PN is currently 99%. Two Bridge Course students have successfully completed the RN Maricopa Nursing program at GWCC and additional students are either completing pre-requisites to enter the RN program or are currently in blocks 3 or 4. A total of 50 Veterans have completed the course with 17 to date achieving LPN licensure (cohort 3 has not had time to test). The Gateway educators knowledge of the Operation Iraqi Freedom and New Dawn (OIF) and Operation Enduring Freedom (OEF) veterans was important in developing the a realistic, quality, transitional education program for the veteran students. Over the past two years Gateway has learned what is important for veteran student successful entry, progression, retention, and graduation from the nursing program. Using the National Council of State Boards of Nursing veteran gap analysis and cutting edge educational approaches tailored for the curriculum, as well as coaching; the program has been successful in expediting veteran student progression in the program. Special thanks to Dr. Schultz, Jeri Lastine, GWCC faculty and the AzBN Education Task Force for developing an innovative educational bridge program for veteran students. 4 arizona STATE BOARD OF NURSING REGULATORY JOURNAL ĨƌŽŵůĞŌƚŽƌŝŐŚƚ Jennifer, RN - Telemetry ϮϬϭϱ/^zǁĂƌĚĞĞ* Pharis, RN - Telemetry ϮϬϭϱ/^zǁĂƌĚĞĞ* Amina, RN - ICU/CCU ϮϬϭϱ/^zǁĂƌĚĞĞ* Nurses! We Value Your Experience. We are looking for nurses experienced in OR, ER, NICU, ICU, Cath Lab and Med/Surg to become part of our growing team. On-site interview expenses ZĞůŽĐĂƟŽŶƐƐŝƐƚĂŶĐĞ XWƌŽĨĞƐƐŝŽŶĂůĞǀĞůŽƉŵĞŶƚŝŶĐĞŶƟǀĞƐ ĨŽƌEĂƟŽŶĂůĞƌƟĮĐĂƟŽŶƐ XdƵŝƟŽŶZĞŝŵďƵƌƐĞŵĞŶƚ XŵƉůŽLJĞƌƐƉŽŶƐŽƌĞĚƐ XŚŝůĚĐĂƌĞZĞŝŵďƵƌƐĞŵĞŶƚ XReferral Bonus X X If you want to work where you are valued and honored, Apply Today. sŝƐŝƚƵƐĂƚDD>͘ŽƌŐĂŶĚĂƉƉůLJŽŶůŝŶĞ͘&ŽƌŵŽƌĞŝŶĨŽƌŵĂƟŽŶĐĂůů Ernest Perez, RN, our nurse recruiter at 575-521-2230. ϮϰϱϬ^͘dĞůƐŚŽƌŽƵůĞǀĂƌĚX MMCLC.org X/ŶƚŚĞďĞĂƵƟĨƵůĐŝƚLJŽĨ>ĂƐƌƵĐĞƐ͕EĞǁDĞdžŝĐŽ ΎdŚĞ/^zǁĂƌĚǁĂƐĐƌĞĂƚĞĚƚŽƌĞĐŽŐŶŝnjĞĂŶĚƚŚĂŶŬĞdžƚƌĂŽƌĚŝŶĂƌLJŶƵƌƐĞƐĂĐƌŽƐƐƚŚĞǁŽƌůĚ͘DĞŵŽƌŝĂůDĞĚŝĐĂůĞŶƚĞƌŝƐƉƌŽƵĚƚŽƉĂƌƟĐŝƉĂƚĞ ǁŝƚŚƚŚĞ/^z&ŽƵŶĚĂƟŽŶŝŶƉƌĞƐĞŶƟŶŐƚŚĞ/^zǁĂƌĚĞĂĐŚŵŽŶƚŚƚŽĂŶĞdžĐĞƉƟŽŶĂůŶƵƌƐĞ͘ arizona STATE BOARD OF NURSING REGULATORY JOURNAL 5 VETERAN’S BRIDGE COURSE t o Li cen su re a s a P r a c t ic a l Nur s e By Margi Schultz RN, PhD, CNE, Chair, Gateway Community College Nursing Program Pamela Randolph RN, MS, FRE, Associate Director Education & Evidence Based Regulation Arizona State Board of Nursing Introduction In February 2013, Arizona House Bill 2076 (introduced by Representative Sunny Borrelli) was passed into law, allowing military Veterans with a healthcare designation to obtain licensure as a practical nurse after completion of a bridge course as approved by the Arizona State Board of Nursing (Board). The purpose of the bridge course was to fill any gaps between a healthcare Veteran’s education and experience and completion of a traditional practical nurse program. In May 2013, the Board discussed this opportunity for Veterans and recruited a group of volunteer educators from around the state to partner with military consultants to create a statewide Veteran’s Bridge Course curriculum. The group worked diligently over the summer of 2013 and after presentation to the Board the first pilot course was approved in September, 2013 as a course to be offered at GateWay Community College (GWCC) in Phoenix, AZ. This article presents both the planning and implementation of the course along with the outcomes of the first three cohorts. Background In February 2013, the White House released a report titled, “The Fast Track to Civilian Employment: Streamlining Credentialing and Licensing for Service Members, Veterans and their Spouses.” Based on this document, Representative Borrelli introduced HB 2076 (military applicants; license requirements) to the Arizona legislature. Representative Borrelli was interested in helping military Veterans with a health care designation and military transcripts get jobs as licensed practical nurses. To do that, Veterans needed to meet the educational criteria for practical nurse licensure and the Board needed statutory authority to approve a limited program to address gaps between military education and an approved LPN program. It was fortunate that the National Council of State Boards of Nursing (NCSBN) released a gap analysis 6 arizona STATE BOARD OF NURSING REGULATORY JOURNAL titled, “A Comparison of Selected Military Health Care Occupation Curricula with a Standard Licensed Practical/ Vocational Nurse Curriculum.” This gap analysis became the foundation for creating the curriculum for the Veteran’s Bridge Course. The Task Force The purpose of this task force was: To develop a statewide bridge course/pathway based on the gap analysis for the military veteran educated in the medical field. The ultimate goal of the program was and still is not only to attain the certificate of completion in practical nursing, but to continue on to an associate degree in nursing, a bachelor’s degree in nursing, and beyond. There were many volunteers for this group; ultimately, the group was comprised of RN and LPN educators from rural and urban areas of Arizona and a representative from the Board. Several members had military experience and experience with healthcare designated military personnel (See participant list at the end of this article). The task force considered a variety of sources in deriving the curriculum including: existing literature, policy statements from other boards of nursing, military curriculum documents, past analyses by Board staff, military personnel experiences and student group input. Early on, task force members identified priority content gaps in military education as related to LPN scope of practice, The group held several detailed discussions before agreeing on the amount and type of didactic education, clinical experience and simulation that would be needed to prepare the student for PN licensure. Core knowledge, skills, abilities and attitudes were written into the curriculum. Student learning outcomes and the course organization relied heavily on the current GWCC Practical Nurse curriculum. The task force explored the option of “te knowing there could be a wide range of kno program. Long discussions ensued regardin individual student for placement. Schools w placement were contacted and testing rubr the group came to the conclusion it would course to provide review and practice of all knowing some would be more advanced in can be seen from the comments on evaluat to this review and practice; in fact the majo appreciation for the skill labs and simulatio clinical portion of the course. The task force also wanted the course to encourage graduates to enter an RN or othe program. When the draft was nearing its fi branches of the military and Veteran’s orga well as Veteran students who had previousl Practical Nurse program reviewed the draft for the final course outline. Course Design Eligible students included any person wh care training to include but not limited to: Corpsman Program (Navy and Air Force), Medical Technician, Army Health Care Sp refresher course. Based on the gap analysis and the purpo the course as follows: U n `ˆ`>V̈V VÀi`ˆÌà ­£Óä œ U { VÀi`ˆÌà œv >LÉȓՏ>̈œ˜ U /œÌ> œv £Ó VÀi`ˆÌÃÉÎää Vœ The Veteran’s Bridge Course was envisio £{ ÜiiŽÃ ÜˆÌ ˜i>ÀÞ xä¯ œv Ì i `ˆ`>V̈V Vœ of skill stations and testing with a heavy em and low fidelity simulation was incorporate weighted in areas not covered in most milit and long-term care. Acute care experience Final Lab and clinical hours were determi U {ä œÕÀà œ˜} ÌiÀ“ V>ÀiÉ> U Óx œÕÀà «i`ˆ>ÌÀˆV Vˆ˜ˆV> U Óx œÕÀà “>ÌiÀ˜ˆÌÞ Vˆ˜ˆV> U {x œÕÀà >ÌiÀ˜>̈ÛiÉÈ“Õ U {x œÕÀà 6É* >À“ Continued on page 9 arizona STATE BOARD OF NURSING REGULATORY JOURNAL 7 STAFF DIRECTORY EDUCATION SENIOR INVESTIGATORS ADMINISTRATION Ronda Doolen, RN, BSN, MSN Education Program Administrator 602.771.7877 rdoolen@azbn.gov Bonnie Richter, MSW Senior Investigator 602.771.7828 brichter@azbn.gov Joey Ridenour, RN, MN, FAAN Executive Director 602.771.7801 jridenour@azbn.gov Janeen Dahn, PhD, RN, FNP-C Associate Director Complaints & Investigations 602.771.7814 jdahn@azbn.gov Judy Bontrager, RN, MN Associate Director, Operations & Licensing 602.771.7802 jbontrager@azbn.gov Pamela Randolph, RN, MS, FRE Associate Director Education & Evidenced Based Regulation 602.771.7803 prandolph@azbn.gov Valerie Smith, RN, MS, FRE Associate Director Hearings 602.771.7804 vsmith@azbn.gov Dolores Hurtado, Senior Investigator to the Associate Director of Complaints/Investigations - Intake Triage Coordinator 602.771.7845 dhurtado@azbn.gov Susie Flores Administrative Assistant to the Executive Director 602.771.7806 sflores@azbn.gov Becky Melton Administrative Assistant to Associate Director Operations/RN-LPN Exams 602.771.7805 bmelton@azbn.gov Lyn Ledbetter Administrative Assistant 602.771.7856 lledbetter@azbn.gov FISCAL SERVICES Randi Orchard Fiscal Services Manager 602.771.7810 rorchard@azbn.gov David Elson, III Senior Investigator 602.771.7851 delson@azbn.gov HEARINGS Jennifer Ingram Senior Investigator 602.771.7835 jingram@azbn.gov Trina Smith Legal Assistant 602.771.7852 tsmith@azbn.gov Gail Maloney RN & CNA Renewals 602.771.7836 gmaloney@azbn.gov Helen Tay CNA Exam 602.771.7832 htay@azbn.gov Idalyne Eskava RN/LPN Endorsements 602.771.7840 ieskava@azbn.gov Monica Ortiz RN/LPN Endorsements 602.771.7831 mortiz@azbn.gov INVESTIGATIONS Katrina Alberty Senior Investigator 602.771.7817 kalberty@azbn.gov Kristi Hunter, MSN, FNP-C Advanced Practice Nurse Consultant 602.771.7854 khunter@azbn.gov Kirk Olson Senior Investigator 602.771.7824 kolson@azbn.gov Ann Wooley, PhD, MA, BSN, NCC Nurse Practice Consultant 602.771.7833 awooley@azbn.gov Linda Monas Senior Investigator 602.771.7826 lmonas@azbn.gov Cherie Wade, RN, BSN Nurse Practice Consultant 602.771.7819 cwade@azbn.gov Max Barker Senior Investigator 602.771.7812 mbarker@azbn.gov Tamara Greabell, MA, BSN, RN Nurse Practice Consultant 602.771.7862 tgreabell@azbn.gov Michelle Morton Senior Investigator 602.771.7850 mmorton@azbn.gov Brent Sutter Legal Assistant 602.771.7860 bsutter@azbn.gov LEGAL SECRETARIES Esperanza Flores Legal Secretary 602.771.7861 eflores@azbn.gov Kathleen Harrington, RN Nurse Practice Consultant 602.771.7811 kharrington@azbn.gov Cindy Mand, MSN, RN Nurse Practice Consultant 602.771.7815 cmand@azbn.gov Lynette Drafton Senior Investigator 602.772.7827 llohsandt@azbn.gov CANDO Michael Pilder, MSN, PHCNS-BN APHN-BC Nurse Practice Consultant 602.771.7816 mpilder@azbn.gov Gari Carrol Legal Secretary 602.771.7841 gcarrol@azbn.gov Janet (Jan) Kerrigan, RN, BSN Nurse Consultant 602.771.7864 jkerrigan@azbn.gov Ruth Kish, RN, MN Nurse Practice Consultant 602.771.7823 rkish@azbn.gov Richard Carr Legal Secretary 602.771.7852 rcarr@azbn.gov Olga Zuniga Administrative Secretary 602.771.7865 ozuniga@azbn.gov Stephanie Chambers, RN, MN Nurse Practice Consultant 602.771.7818 schambers@azbn.gov INFORMATION TECHNOLOGY Lila Wiemann Administrative Assistant lwiemann@azbn.gov COMPLAINTS-INTAKE Dolores Hurtado, Senior Investigator Complaints-Intake Triage Coordinator 602.771.7845 dhurtado@azbn.gov Lynette Drafton Senior Investigator Applicant Triage 602.771.7827 llohsandt@azbn.gov 8 Daniel Phelan, BS, M Adm Senior Investigator 602.771.7813 dphelan@azbn.gov Donna Frye RN/LPN Renewals/Advance Practice Certifications dfrye@azbn.gov arizona STATE BOARD OF NURSING REGULATORY JOURNAL Adam Henriksen 602.771.7807 ahenriksen@azbn.gov Cory Davitt 602.771.7808 cdavitt@azbn.gov LICENSING Claudia Deines Verifications 602.771.7833 cdeines@azbn.gov Naira Kutnerian Advanced Practice Certifications 602.771.7834 nkutnerian@azbn.gov MAILROOM Karen Johnson 602.771.7876 kjohnson@azbn.gov MONITORING RECEPTIONISTS Nancy Davis 602.771.7872 ndavis@azbn.gov Lisa Harper 602.771.7871 lharper@azbn.gov Susan Kingsland 602.771.7873 skingsland@azbn.gov RECORDS Anne Parlin 602.771.7875 aparlin@azbn.gov Course Content Course content included care of geriatric, adult, pediatric, and childbearing clients. Within these populations of care, areas of didactic and clinical focus included: UÊ ,œiʜvÊÌ iÊ«À>V̈V>Ê˜ÕÀÃiÊVœ>LœÀ>̈˜}ÊÜˆÌ ÊœÌ iÀÊ members of the healthcare team; UÊ œ˜Vi«ÌÃʜvÊ i>Ì Ê«Àœ“œÌˆœ˜Ê>˜`Ê`ˆÃi>ÃiɈ˜iÃÃÊ prevention; UÊ / iÀ>«iṎVÊVœ““Õ˜ˆV>̈œ˜ÊÌiV ˜ˆµÕiÃÆÊ UÊ ÕÌÀˆÌˆœ˜>ÊVœ˜Vi«ÌÃÆÊ UÊ i`ˆV>̈œ˜Ê>`“ˆ˜ˆÃÌÀ>̈œ˜Êˆ˜VÕ`ˆ˜}Ê pharmacokinetics and pharmacodynamics of medications, nursing considerations in medication administration, and dosage calculation; UÊ ˜>̜“ÞÊ>˜`Ê« ÞȜœ}ÞÊ>˜`Ê«>Ì œ« ÞȜœ}ˆVÊ UÊ œVՓi˜Ì>̈œ˜Ê>˜`ÊVœ˜Vi«ÌÃÊÀi>Ìi`Ê̜ʈ˜vœÀ“>̈œ˜Ê technology. UÊ œ˜Vi«ÌÃʜvÊ`ii}>̈œ˜]Ê«ÀˆœÀˆÌˆâ>̈œ˜Ê>˜`Ê management of care for the practical nurse See Figure 1 for Course Competencies and Figure 2 for Course Outline Lessons Learned As with all well-planned good intentions, there are simply times things don’t go as hoped and planned. Several students – especially in the first two cohorts – let us know in no uncertain terms what we were doing incorrectly! The team listened and made revisions along the way. Here are a few “pearls of wisdom” from the GWCC teaching team. UÊ /À>˜ÃVÀˆ«ÌÊ Û>Õ>̈œ˜Ê Ý«iÀ̈Ãi\ÊÊ >V ÊÃV œœÊà œÕ`Ê ensure that they have the necessary expertise to evaluate military transcripts. While these transcripts may seem simple, there are many different courses to review for the “health care designation” part of the criteria. At GWCC, these military courses are then substituted for the first semester of the practical nurse program with the Bridge Course meeting the criteria for the certificate of completion. One student from the second cohort wrote, “passing the course was actually easier than getting into the course.” Unfortunately, that might have had a ring of truth to it for the first few cohorts! UÊ * ÊÃVœ«iʜvÊ«À>V̈Vi\ÊÊ/ iÊÀœiʜvÊÌ iÊ* ʈÃÊ`ˆvviÀi˜ÌÊ than a Registered Nurse (RN). A successful LPN program is not a “watered down” RN program, nor is it the first half of a RN program. LPNs have specific skills and knowledge, which need to be clearly articulated throughout the program of study. We at GWCC were fortunate to have a dedicated LPN faculty and advisor team to facilitate the course and routinely review and update the curriculum based on student evaluations. We were also fortunate that many of these were, themselves, military veterans. UÊ ,i‡Ì ˆ˜ŽÊœ˜ˆ˜i\ÊÊ/ iʜÀˆ}ˆ˜>Ê«Àœ}À>“ÊœvÊÃÌÕ`ÞÊ V>i`ÊvœÀÊ>“œÃÌÊxä¯ÊœvÊÌ iÊ`ˆ`>V̈VÊVœ˜Ìi˜ÌÊ̜ÊLiÊ offered online. While it sounded good to all, students reported a feeling of disconnectedness and lack of structure in the theory portion. Approximately halfway through the first cohort, additional face-toface classes were added including review sessions to assist students in learning the content. In subsequent Continued on page 10 arizona STATE BOARD OF NURSING REGULATORY JOURNAL 9 Vœ œÀÌÃ]ÊÌ iʜ˜ˆ˜iÊ«œÀ̈œ˜ÊœvÊÌ iÊVœ˜Ìi˜ÌÊÜ>ÃÊÀi`ÕVi`Ê̜ÊÓx¯ÊÜ ˆV Ê >ÃÊLii˜ÊÜi‡ÀiViˆÛi`ÊLÞÊÃÌÕ`i˜ÌÃÊ>˜`Êv>VՏÌÞ° UÊ ->ÌÕÀ`>ÞÊ-iÃȜ˜Ã\ÊÊ>LÊ>˜`ÊVˆ˜ˆV>ÊÃiÃȜ˜ÃÊÜiÀiʜÀˆ}ˆ˜>ÞÊÃV i`Տi`ÊvœÀÊ->ÌÕÀ`>ÞÃÊÜˆÌ ÊÌ iÊ>ÃÃՓ«Ìˆœ˜ Ì >ÌÊÌ iÊÃÌÕ`i˜ÌÃÊ would be working Monday through Friday and available on weekends. This was a false assumption because many of the students were in the military reserves which entailed service every other weekend. Again, a quick change was needed and we are now facilitating the majority of lab and clinical sessions on weekdays whenever possible. UÊ 6iÌiÀ>˜ÃÊ i˜ÌiÀ\ÊÊÌʈÃʈ“«œÀÌ>˜ÌÊvœÀÊ>ÊVœi}iÊ̜ÊÀi>ˆâiʓ>˜ÞÊ6iÌiÀ>˜ÊÃÌÕ`i˜ÌÃÊ>ÀiÊ>ÃœÊˆ˜Ìi}À>̈˜}ʈ˜ÌœÊVˆÛˆˆ>˜ÊˆviÊÜ ˆV ÊV>˜Ê be challenging. Some concerns of our students were: finding work while in school, reuniting with family, integrating back into civilian work, and emotional/psychological stressors such as post-traumatic stress disorder. Our Veteran’s Center at GWCC is an important resource for these students. UÊ œÌʍÕÃÌÊvœÀÊ6iÌiÀ>˜Ã\ÊÊ7iÊ`ˆÃVœÛiÀi`ÊÌ >ÌʈvÊÌ iÊVœÕÀÃiÊÜ>ÃÊ" 9ÊvœÀÊ6iÌiÀ>˜Ã]ÊÃÌÕ`i˜ÌÃÊܜՏ`ʘœÌÊLiÊ>LiÊ̜Ê>VViÃÃÊw˜>˜Vˆ>Ê aid (GI benefits, federal financial aid, etc.). Armed with this information and experience in teaching LPN refresher students, we were able to gain Board approval to add LPN refresher students to this group. This blending of the two groups worked well as both unique student cohorts come with varying levels of experience and skills. Evaluation The following is a summary of the groups to date. The pass rate of the Veteran’s Bridge Course students who have elected to sit vœÀÊÌ iÊ  8‡* ʈÃÊVÕÀÀi˜ÌÞʙ™¯°ÊÊ/ÜœÊ Àˆ`}iÊ œÕÀÃiÊÃÌÕ`i˜ÌÃÊ >ÛiÊÃÕVViÃÃvՏÞÊVœ“«iÌi`ÊÌ iÊ, Ê>ÀˆVœ«> ÕÀȘ}Ê«Àœ}À>“Ê>ÌÊ 7 Ê>˜`Ê>``ˆÌˆœ˜>ÊÃÌÕ`i˜ÌÃÊ>ÀiÊiˆÌ iÀÊVœ“«ï˜}Ê«Ài‡ÀiµÕˆÃˆÌiÃÊ̜ i˜ÌiÀÊÌ iÊ, Ê«Àœ}À>“ÊœÀÊ>ÀiÊVÕÀÀi˜ÌÞʈ˜ÊLœVŽÃÊÎʜÀÊ{°ÊÊÊ̜Ì>Ê of 50 Veterans have completed the course with 17 to date achieving LPN licensure (cohort 3 has not had time to test). The chart below contains representative course comments of the first cohort and the changes made at GWCC. Cohort Grads Positive Comments Negative comments Changes made Feb-June 2014 20 -Loved the clinical and labs -Faculty made the information easy to understand -Appreciated the option to use what I had learned and feel ready to enter RN program -Clinical in long-term care facility was eye-opening -OB part was awesome -Need more lab time with hands on practice -More simulation, please! -Want more in-person class time; -The online information is not easy to follow and needed more explanation -Getting into the program was a hassle -Decreased hybrid component Adjusted schedule to week-day labs -Added more hands-on practice to lab hours -Added open lab hours for all students -Implemented adaptive testing -Based on faculty evaluation – students were provided extra time learning basics. Continued on page 12 10 arizona STATE BOARD OF NURSING REGULATORY JOURNAL Inspiring Change & Restoring Hope Since 1975 Join Southwest Behavioral & Health Services as we celebrate 40 years of helping people feel better and maximize their potential. If you’re a compassionate, dedicated professional looking to make a positive impact in the lives of individuals, families and communities, consider the following opportunities: Nurse Manager Coconino/Yavapi and Mohave Counties Full-time and Pool RN Opportunities -SHNZ[HɈ7H`ZVUHUK)\SSOLHK*P[` Required to be Registered Nurse, currently licensed in the State of Arizona. Post-degree experience of two years in the area of psychiatric nursing or a Master’s degree in Psychiatric Nursing strongly preferred. Experienced in a community-based psychiatric practice is preferred. Documentation of education, relevant experience and credentials is required. As part of Arizona’s oldest, largest and most highly regarded behavioral health agency, Southwest Behavioral team members LUQV` JVTWL[P[P]L WH` L_JLSSLU[ ILULÄ[Z HUK YL^HYKPUN JHYLLY challenges. Apply today at: http://jobs.sbhservices.org/# or contact Jenel Taylor at (602) 351-6901. Drug screen required. EOE Leadership Integrity Excellence Respect Accountability Compassion Living our values At Maricopa Integrated Health System, our values inspire us to dream big and reach high. We seek experienced RNs for these roles: • Clinical Practice Educator - Pre-Op, OR, PACU, & Endo (Req# 17830) - Adult ED or Critical Care (Req# 18514) • RN I – Oncology (Req# 17898) Come live our values and enjoy competitive wages, generous PTO and the Arizona State Retirement System Plan with a lifelong pension upon retirement. MARICOPA INTEGRATED HEALTH SYSTEM Maricopa County Special Health Care District Apply online at http://Jobs.MIHS.org Online PhD and DNP degrees in Nursing The College of Nursing at the University of New Mexico has outstanding and innovative nursing education programs leading to the Doctor of Philosophy degree in Nursing or Doctor of Nursing Practice degree. PhD in Nursing – for the RN with a Bachelor’s or Master’s degree in nursing who desires to develop skills as a nurse scientist and leader. Graduates are prepared as researchers and leaders to conduct independent and original research that can solve critical problems in health care. Students work closely with internationally esteemed faculty to pursue an individualized plan of study or a concentration in Health Policy. DNP for Nurse Executives – for the RN with a Bachelor’s in Nursing and Master’s in nursing or related field who desires to develop executive organizational leadership skills for practice, teaching, and research, using evidence-based solutions to shape outcomes of health care delivery. The curriculum is taught by real world Nurse Executives and blends the AACN’s DNP 8 Essentials with the 14 Forces of magnetism ® and the RWJ Executive Nurse Fellows principles. Application Deadlines are November 1, 2015 for PhD and January 15, 2016 for DNP. Classes start June 2016. For more information, see http://nursing.unm.edu or call 1-800-690-0934. Students from WICHE member states are eligible for in-state tuition. See http://wiche.edu/wrgp for more information. arizona STATE BOARD OF NURSING REGULATORY JOURNAL 11 2nd Group started 7/2014; completed 12/2014 (16 students) UÊ œœ`ʜ««œÀÌ՘ˆÌÞÊ̜ʏi>À˜ÉÀii>À˜ÊΈÃ UÊ œÛi`ÊÌ iʈ˜ÃÌÀÕV̜ÀÃÊqÊ i«vՏʓ>˜ÞÊ >`ʓˆˆÌ>ÀÞÊ background UÊ ÊVœÕ`Ê«ÕÌʈ˜Ê>ÊV iÃÌÊÌÕLiÊLÕÌÊ`ˆ`˜½Ìʎ˜œÜÊ œÜÊ̜Ê}ˆÛiÊ>ÊLi`Ê bath – who knew! UÊ ̽ÃÊ}Ài>ÌÊ6iÌiÀ>˜ÃÊ>ÀiÊ>LiÊ̜ÊÕÃiÊÜ >ÌÊÌ iÞʏi>À˜i`ÊvÀœ“ÊÀi>Ê life job UÊ -œ“iʓ>ÌiÀˆ>ÊVœÕ`ÊLiÊVœ˜`i˜Ãi` UÊ / iÊ­7 ®Ê«Àœ}À>“ʈÌÃivʈÃÊ>Ê}Ài>Ìʈ`i>ÊvœÀʓˆˆÌ>ÀÞÊ members with training as the military is based on more emergency care and critical care – never learned the basics UÊ œÛi`ÊÌ iÊ" É*i`ÃÊqÊ}Ài>ÌÊ >˜`ǜ˜t UÊ ÊÌ œÕ} ÌÊʎ˜iÜʓ>˜ÞÊÌ ˆ˜}Ã]ÊLÕÌÊÌ ˆÃÊÜ>ÃÊiÞi‡œ«i˜ˆ˜} UÊ ˜ÃÌÀÕV̜ÀÃÊÜiÀiÊ>ÊŽ˜œÜi`}i>LiÊ>˜`ÊÜ>˜Ìi`ÊiÛiÀޜ˜iÊÌœÊ succeed and his desire that the course be offered at community colleges throughout the state. GWCC is making continuous improvements to the course and eager to share the curriculum, forms, and any resources to help other schools offer this option. Conclusion In Arizona a group of educators in conjunction with our Board designed and implemented an effective Bridge Course for Veterans with health care designations to allow them to attain LPN licensure. The outcomes of the course included 50 graduates, positive student evaluations and 9 graduates enrolled in an RN program. With thanks to the excellent GWCC Bridge Course team – Jeri Lastine, MSN, RN, Program Coordinator; Nancy Dunn, MSN, RN (Captain, Navy Reserves); Suzanne Clifford, MSN, RN; Pat Novak, MSN, RN; Adrian Stauffer, MSN, RN; Manny Moneda, RN, (Air Force Reserves, Ret.) 3rd group started 2/2015, completed 6/2015 (16 students) Task Force Members UÊ / iÊLiÃÌÊÌ ˆ˜}Ê>LœÕÌÊÌ ˆÃÊÃi“iÃÌiÀÊ >ÃÊLii˜Êi>À˜ˆ˜}ʘiÜÊ Margi Schultz, GateWay Community College (Chair) tools for being a nurse and the instructors Jeri Lastine, GateWay Community College LPN Program UÊ / iÊÃi“iÃÌiÀÊ >ÃÊ}œ˜iʵՈVŽÞÊ>˜`ÊÊ}œÌÊ̜ÊÀiۈiÜÊ Coordinator information I knew as well as learn new skills Brian Stewart, Pima Community College, Center for Training and UÊ / iÊ" Ê>˜`Ê«i`ˆ>ÌÀˆVʈ˜vœÀ“>̈œ˜ÊÜ>ÃÊ}Ài>ÌÊqÊÃÕ«iÀÊ Development instructor Sharon Caves, Pima Medical Institute, Mesa UÊ œœ`ÊLi˜`ʜvʜ˜ˆ˜iÊ>˜`ʈ˜‡«iÀܘÊqÊÊÜ>ÃÊ>LiÊ̜ʎii«ÊÕ«Ê Debra Colbert, Breckinridge School of Nursing @ ITT Tech and not feel stressed! Bruno Talerico, Southwest Skill Center at Estrella Mountain UÊ / iÊVœÕÀÃiÊÜ>ÃÊÌ iÊLiÃÌ°ÊÊ iˆ˜}Ê>LiÊ̜ÊÕÃiÊÜ >ÌÊÊ`ˆ`ʈ˜ÊÌ iÊ Community College military was great Pam Fuller, President, Chamberlain College of Nursing UÊ / iʈ˜ÃÌÀÕV̜ÀÃÊ>ÀiÊÀi>ÞÊ}œœ`Ê>˜`ÊÌ iÊ«Àœ}À>“ʈÃÊv>Ã̇«>Vi`Ê Marty Mayhew, Pima Community College RN Program but good! Peg Erdman, Northland Pioneer College UÊ ÌʈÃÊ>VViiÀ>Ìi`Ê>˜`Ê`œiؽÌÊëi˜`Ê̜œÊ“ÕV Ê̈“iʜ˜ÊÜ >ÌÊÊ Freya Brewer, Chamberlain College of Nursing already knew David Kutzler, Pima Community College, Center for Training and UÊ / iÊv>VÌÃÊ>ÀiÊVi>ÀÊqÊÌ ˆÃʈÃÊÌ iÊwÀÃÌÊ«Àœ}À>“ʽ“Ê>Ü>ÀiʜvÊ Development that actually takes into account military experience and the Carolyn McCormies, Eastern Arizona College instructors recognize this fact as well. Pamela Randolph (Arizona State Board of Nursing). UÊ / ˆÃʈÃÊÌ iÊLiÃÌÊ«Àœ}À>“ÊÊVœÕ`ʈ“>}ˆ˜i°ÊÊÊÜÊ>««ÀiVˆ>ÌiÊ7Ê Figure 1. Veterans Bridge Course Competencies doing the bridge program and while getting enrolled was a Specific course competencies included: little tough, the class itself has been excellent 1) Next Steps The next cohort is getting ready to start at GWCC and at this writing; the Bridge Course team has spent the summer reviewing evaluations and updating the curriculum. Representative Borrelli recently paid us a visit and expressed his appreciation for the program Discuss the differences between current military healthcare role and practical nursing. 2) Demonstrate therapeutic communication skills and caring behaviors to clients and their families across the lifespan. 3) Demonstrate critical thinking skills and problem-solving to provide holistic nursing care to clients. œ˜Ìˆ˜Õi`ʜ˜Ê«>}iÊ£{ 12 arizona STATE BOARD OF NURSING REGULATORY JOURNAL ding Care er s tstan u O Aw ard Winning Care &!-.Ŀ5 #&5(.,5R5,5&&35 #&5(.,5R5)(5 #&5(.,5 "0#),&5&."5R5 5R5,#.#&5,5R5',!(35R5 I/,!5R5/,!#&5,0#-5R5)'(5;5 ( (.53)/5,5&))%#(!5 ),5'),5&(5#(53)/,5&# 5(551&."5) 5*,) --#)(&5)**),./(#.#-515#(0#.53)/5.)5 )'5.)5."5*&51",5&# 5#-5!,(5(5,,-5ł)/,#-"85 ,(5'),5)/.5)/,5,,5)**),./(#.#-65 #&#.#-5 (5(ŀ.5*%!-5.5www.nahealth.com/careers8 )&&)15/-5)( Our College of Nursing and Health Care Professions has been providing an outstanding health care education for over 30 years. The College prides itself on the ability to create degree programs based on the demand for highly qualified health care professionals. We currently have full-time positions available at our main campus in Phoenix, Arizona. We are also hiring adjunct faculty. Founded in 1949, GCU is a private, Christian university serving nearly 11,000 students on our main campus in Phoenix, Arizona and an online student population of more than 50,000. HOW TO APPLY Please apply online by visiting jobs.gcu.edu Discover D iscover a place place where where iideas, deas, collaboration, collaboration, and and eexperience xperience combine combine to to innovate innovate healthcare. healthcare. Think excellence. Think UNM Hospitals. We currently have opportunities available for: RNs – !(+ $!"!##!" $!" +#! +" !" At UNM Hospitals, excellence is the basis of our every action. It’s evident in the accreditations, recognition and honors that reflect our continued commitment to quality, and in our leadership as the only academic medical center in the state. More importantly, it’s visible in the care each member of our organization provides our patients. For more information about UNM Hospitals and our benefits, visit: ## $")ndly.com/ Visit Facebook.com/ UNMHCareers EOE arizona STATE BOARD OF NURSING REGULATORY JOURNAL 13 {®Ê ,iۈiÜÊÌÞ«iÃ]ÊV>ÃÈwV>̈œ˜Ã]Ê« >À“>VœŽˆ˜ïVÃ]Ê>˜`Ê« >À“>Vœ`ޘ>“ˆVÊ properties of selected drugs. 5) 6) 1. Communication pediatric, adult, and geriatric clients. 2. Conflict Resolution Perform data collection techniques for childbearing, pediatric, adult, and 3. Delegation Implement the established plan of care for childbearing, pediatric, adult, and geriatric clients. n®Ê ««ÞÊ>˜>̜“ÞÊ>˜`Ê« ÞȜœ}Þ]Ê>˜`Ê«>Ì œ« ÞȜœ}ˆVÊVœ˜Vi«ÌÃÊ̜ÊÌ iÊ care of clients with selected health alterations across the lifespan. 9) B. Collaboration within the Health Care Team Apply principles of safe medication administration for childbearing, geriatric clients. 7) Practical Nurse {°ÊÊ,œiʈ˜Ê*>̈i˜ÌÊ `ÕV>̈œ˜Ê>˜`Ê ˆÃV >À}iÊ*>˜˜ˆ˜} C. Scope of Practice 1. Standards of Practice for the Practical Nurse 2. State Nurse Practice Act 3. Agency Specific Guidelines Apply integrated nutritional concepts that support health promotion D. Legal and Ethical Considerations in Patient Care and disease prevention to clients across the lifespan. E. Licensure Process 10) Identify developmental stages and transitions for adult, child-bearing, pediatric, and geriatric clients. 11) Demonstrate safe techniques and competent care in providing interventions for clients receiving intravenous therapy. 1. National Council Licensure Examination 2. State Board of Nursing F. Transition into Employment Sector 1. Professional appearance 12) Calculate medication dosages safely and accurately. 2. Professional communication 13) Practice within the regulatory, legal and ethical frameworks of practical 3. Resumes nursing. £{®Ê {°ÊʘÌiÀۈiÜÊΈÃ i“œ˜ÃÌÀ>ÌiÊÃ>viÊ«iÀvœÀ“>˜ViʜvÊÃiiVÌi`ÊVˆ˜ˆV>ÊΈÃÉ«ÀœVi`ÕÀið 15) Communicate significant client findings and events to the registered nurse and other members of the healthcare team. III. Holism A. Religious and Spiritual Considerations 16) Demonstrate culturally sensitive care. B. Cultural Considerations 17) Describe the role of the practical nurse in the management of a group of C. Developmental Life Span Considerations clients under the direction of a registered nurse using time management, interpersonal communication, delegation and organizational skills. £n®Ê ««ÞÊii“i˜ÌÃʜvÊÌiV ˜œœ}ÞÊ>˜`ʈ˜vœÀ“>̈œ˜Ê“>˜>}i“i˜ÌÊÌœÊ document and report client findings and conditions. 1. Stages of Growth and Development for Pediatric/Adult/ Geriatric and Childbearing Patients D. Health Promotion and Disease Prevention for Pediatric/Adult/ Geriatric and Childbearing Patients 19) Demonstrate safe and competent care in providing nursing interventions for clients across the lifespan. 20) Identify various healthcare roles that are part of the healthcare team IV. Safe Nursing Practice A. Nursing Care of Adult/Geriatric/Pediatric Patients with Select and differentiate the LPN role as defined by the Arizona State Board of Alterations in Health, Anatomy/Physiology/Pathophysiology, Nursing. Applicable Laboratory and Diagnostic Examinations, Medical Management, Nursing Process, Pharmacokinetics and Figure 2. Veteran’s Bridge Course Outline I. Critical Thinking Pharmacodynamics of Applicable Medication Classifications 1. A. Nursing Process B. Data Collection Disorders of the Cardiovascular and Peripheral Vascular System 2. Disorders of the Respiratory System 1. Components of a Health History 3. Disorders of the Gastrointestinal System 2. Full vs. Focused Assessment {°Ê ˆÃœÀ`iÀÃʜvÊÌ iÊ ˜`œVÀˆ˜iÊ-ÞÃÌi“ C. Planning 5. D. Implementation 6. Disorders of the Integumentary System E. Evaluation 7. Disorders of the Hematologic and Lymphatic System F. Documentation n°Ê ˆÃœÀ`iÀÃʜvÊÌ iÊ,i«Àœ`ÕV̈ÛiÊ-ÞÃÌi“ 9. Disorders of the Musculoskeletal System 1. Electronic Medical Record G. Caring for the Pediatric/Adult/Geriatric and Childbearing Patient 1. Therapeutic Communication Disorders of the Immune System 10. Disorders of the Genitourinary System 11. Disorders of the Neurologic System 12. Fluid/Electrolyte and Acid/Base Imbalances II. Role Development A. Role transition from Veteran healthcare worker to the role of the 14 arizona STATE BOARD OF NURSING REGULATORY JOURNAL 13. Cancer £{°Ê i˜Ì>Êi>Ì Ê ˆÃœÀ`iÀà Continued on page 16 a. Behavior Management b. Crisis Intervention 15. Surgical Patient c. Documentation 2. Blood Collection 3. Principles of IV Therapy a. Preoperative a. Routine Care and Maintenance b. Intraoperative b. Catheter Site Care c. Postoperative c. Flushing with Saline or Heparinized Saline B. Nursing care of the Antepartum Patient and Family d. Client Evaluation C. Nursing Care of the Intrapartum Patient and Family D. Nursing Care of the Postpartum Patient and Family e. Equipment {°Ê E. Nursing Care of the Neonate œ“«ˆV>̈œ˜ÃÉ`ÛiÀÃiÊ,i>V̈œ˜Ã a. Local b. Mechanical V. Selected Clinical Skills/Therapeutic Procedures A. Assisting with Activities of Daily Living 1. Feeding 2. Dressing 3. Bathing {°Ê *œÃˆÌˆœ˜ˆ˜} 5. Ambulating and Transferring Patients 6. Toileting 7. Grooming c. Systemic 5. 6. b. Peripheral Midline 7. and Medications b. Premixed/Admixture Medications C. Internal and External Disaster Planning 9. D. Handling Hazardous and Infectious Materials œÃ>}iÊ >VՏ>̈œ˜ÃÉ,i}Տ>̈˜}Ê,>Ìià Administration of Select Intravenous Solutions a. Un-medicated Solutions E. Ergonomic Principles H. Wound Care Pharmacokinetics/Pharmacodynamics for Select IV Fluids a. Hypo-/Iso-/Hypertonic Solutions n°Ê G. Admission/Transfer/Discharge Procedures Discontinuation of Peripheral IV Catheters a. Peripheral-Short B. Vital Signs F. Use of Restraint and Safety Devices Insertion of Peripheral-Short IV Catheters b. Premixed/Admixed Medications 10. Care and Maintenance of Central Line U. Clinical Skills/Therapeutic Procedures for the Child-Bearing Client/Family/Neonate I. Heat/Cold Therapy 1. Data Collection J. Oxygen Therapy 2. Use of Isolette/Warmer K. Urinary Catheter V. Clinical Skills/Therapeutic Procedures for the Pediatric Client L. Ostomy 1. Data Collection M. Nasogastric/Feeding Tube 2. Medication Administration N. Chest Tube O. Care of the Patient Receiving a Blood Transfusion P. Tracheostomy Q. Electrocardiogram/Cardiac Monitoring R. Wound Care S. Medication Administration 1. Medication Orders 2. Drug Preparations 3. Dosage Calculations {°Ê *Ài«>À>̈œ˜ÊœvÊi`ˆV>̈œ˜Ã 5. Medication Administration Methods 6. Documentation T. Intravenous Infusion Therapy/Venipuncture 1. Scope of the Practical Nurse a. Arizona State Board of Nursing b. Legal Implications arizona STATE BOARD OF NURSING REGULATORY JOURNAL 15 By Janeen Dahn, PhD, FNP-C Associate Director of Complaints and Investigations Arizona State Board of Nursing Controlled Substance Prescription Monitoring Program The street value of hydrocodone, oxycodone, oxymorphone, and methadone range from $5.00 to $20.00 a pill. A patient receiving a bottle of 90 tablets of oxycodone 30mg, and a bottle of 30 tablets of hydrocodone 5mg, can earn over $1,600 dollars a month (Street Rx, n.d.). Opioids are the most widely misused or abused drugs of controlled medication prescriptions and are involved in most prescription related overdoses (National Institute on Drug Abuse Q R]Ê Óä£{®°Ê Ê / iÊ «ÕLˆVÊ ˆÃÊ «>Vi`Ê >ÌÊ ÀˆÃŽÊ when reckless prescribers indiscriminately prescribe controlled substances to a person with a substance use disorder (SUD), to those patients who divert their prescription drugs to others; or prescribe without safe guards in place to deter abuse and diversion. Today’s physicians, nurse practitioners, physician assistants, nurses, and pharmacists will either contribute to the problem, or become a part of the solution. that overstimulate dopamine, which can influence changes in the brain’s limbic (reward) system and contribute to abuse and addiction in some patients. In the United -Ì>ÌiÃ]Ê >««ÀœÝˆ“>ÌiÞÊ {{Ê «iœ«iÊ `ˆiÊ i>V Ê day from overdoses involving prescription painkillers, more people than those who die from heroin and cocaine combined (Centers for Disease Control and Prevention [CDC], 2015). Prescription overdose deaths often Why Do We Care? involve benzodiazepines which, when used Many people erroneously believe that with opioids, increase the risk of respiratory prescription drugs are safer than illicit drugs. depression and ultimately death. Effective use According to the National Institute on Drug of evidence-based guidelines can assist health Abuse, from 2001 to 2013, there was a 2.5care providers in safe prescribing practices and fold increase in the total number of deaths effective treatment. Utilizing the Controlled from prescription drugs (National Institute Substance Prescription Monitoring Program œ˜Ê ÀÕ}Ê LÕÃiÊ Q R]Ê Óä£x®°Ê Ê ˜Ê Óään]Ê (CSPMP) has become an integral piece in the accidental or unintentional deaths from standard of care to prescribe safely and reduce prescription drugs exceeded motor vehicle the risk of prescription drug misuse and abuse. accidents as the leading cause of injury-related death in the United States (Rhyee, 2015), and in 2013, nearly two million Americans Standard of Practice ˜ÊÓää{ÊÌ iÊÀˆâœ˜>Ê-Ì>ÌiÊ œ>À`ʜvÊ ÕÀȘ}Ê abused prescription painkillers (CDC, 2015). A large percentage of drug overdoses stem Advanced Practice Advisory Committee from prescription opioids. The most common introduced an Advisory Opinion on The prescription drugs involved in overdose Use of Controlled Substances for the Treatment deaths include hydrocodone, oxycodone, of Chronic Pain. This Advisory Opinion was oxymorphone, and methadone. Opioid subsequently updated in 2009 and 2012, medications have psychoactive properties and is intended to assist nurse practitioners 16 arizona STATE BOARD OF NURSING REGULATORY JOURNAL in responsible prescribing of controlled substances in the treatment of patients with chronic pain (Arizona State Board of Nursing Q< R]Ê Óä£Ó®°Ê Ê ˜Ê Óä£{]Ê Ì iÊ Àˆâœ˜>Ê Department of Health Services released prescribing guidelines for treating acute and chronic non-terminal pain, intended to clarify practice guidelines and reduce the frequency of inappropriate prescribing of controlled substances in the treatment of pain. Both documents refer to the CSPMP as a necessary tool in responsible prescribing of controlled substances. Who Uses the CSPMP? The CSPMP is a computerized database tracking system designed to track prescribing, dispensing, and consumption of scheduled drugs. In 2007, the database was originally developed for law enforcement to identify patterns of misuse, diversion, or excessive prescribing. The database has since expanded to allow access to prescribers, pharmacists, patients, regulatory boards, and the Arizona Health Care Cost Containment System, to utilize as an efficient and cost effective resource to identify those patients who abuse or misuse controlled substances (Community Partnership of Southern Arizona [CPSA], 2013). Access to CSPMP Prescribers may request access to the CSPMP through the Arizona Board of Pharmacy website at https://pharmacypmp. az.gov. The program is free. Registration requires contact information, Drug Enforcement Agency (DEA) and state license and or certification numbers. Once registration is confirmed, a short training tutorial is required. Upon completion of the tutorial, submit log-on information, username and password. Legal Ramifications Arizona Revised Statute 36-2606 requires each medical practitioner who is licensed under Title 32, and who possesses a DEA license, to register with the CSPMP; each DEA license number should have a corresponding CSPMP registration number. Practitioners may only obtain a CSPMP profile on an individual with whom there is a patient-provider relationship. If authorized to request information from this repository, practitioners must also ensure confidentiality and the security of the data. All aspects of the report are considered confidential, which include data collection, storage, transmission of requests, and dissemination of reports. Morphine Equivalency Dosing (MED) The Morphine Equivalency Dosing number is provided on the CSPMP when opioids are reported on the CSPMP. The Morphine Equivalency Dosing (MED) number was developed by the Center for Disease Control, and is a conversion chart designed to equate different opiates and strengths into a standard morphine equivalent value. Each active opioid prescription (those that the patient is currently taking based on how the prescription is written) will have a MED value on the conversion chart, and then combined into one daily MED value. It is important to note that the MED value is a snapshot of the day that the report is run and may have up to a two-week lag time for prescriptions not yet entered. A team of specialists identified a threshold of 100 or greater, to stimulate prescribers to “Press Pause” before prescribing the opiate (Arizona State Board of Pharmacy, 2015). If the MED value is greater than 100, it does not mean the prescriber should not prescribe the opioid. The MED value is intended to trigger the prescriber to pause and take into account a number of clinical considerations. Red Flags Analyze the CSPMP The CSPMP contains an individual’s controlled substance prescription profile during a specified time period. This list includes schedule II-IV controlled substances prescribed by a prescriber. Information on a CSPMP report contains the date a prescription was written and the date it was filled. An important distinction to make is that the “fill” date on the CSPMP report is the date the pharmacist or dispenser filled the prescription, which is not necessarily the same date that the patient received the prescription. Other information contained on the report includes the prescriber name and DEA number, prescription number, medication name, quantity of the drug, the number of days intended for the prescription to be used, pharmacy name, and whether the prescription was new or a refill. Every 19 minutes someone in the United States dies from prescription drug overdose (Partnership for Drug-Free Kids, 2015). When viewing a patient’s CSPMP profile, some potential signs of prescription drug diversion include early refills, filling prescriptions at a pharmacy an unusual distance from the clinic, and receiving the same medications from multiple providers. The CSPMP may reveal a pattern of obtaining controlled substances with early refills that reveal the patient may have, or is developing, a psychological dependence on a drug. Review of the CSPMP may also provide the prescriber an opportunity for an early intervention that may prevent future abuse and misuse. “What a patient received over the last 6-12 months is more important than what they ÀiViˆÛi`ʏ>ÃÌÊÜiiŽ»Ê­ *-]ÊÓä£Î]Ê«>À>°Ên®° The CSPMP report may reveal groups of specific drugs that should raise a red flag for concern. Some abusers of prescriptions drugs will combine other controlled substances to intensify the desired effect. Common combinations include an opiate, benzodiazepine and a muscle relaxant, also known as a drug “cocktail.” Hydrocodone, alprazolam, and carisoprodol are commonly referred to as the “Trio or Trinity.” When hydrocodone is replaced with oxycodone, the cocktail is known as “Holy Trinity” (Arizona State Board of Pharmacy, n.d.). Other red flags include, claiming lost or stolen prescriptions, requesting early refills, or requesting drugs with a high street value. When reviewing the CSPMP, examine the report for multiple prescribers, cash payments, or patients using multiple addresses or similar birthdates. OxyContin OxyContin is designed to slowly release oxycodone over 12-hours, but abusers discovered that chewing an OxyContin tablet, crushing the tablet and snorting the powder, or dissolving the powder to create a solution and injecting it, produces an instant high Vœ“«>À>LiÊÌœÊ iÀœˆ˜Ê­/ iÊ iÜÊ9œÀŽÊ/ˆ“iÃ]Ê 2011). The makers of oxycodone reformulated OxyContin to turn into a gel when crushed. Since the reformulation of OxyContin in 2010, the demand for OxyContin has dropped, but Opana, another time-release drug, has surged in demand and been associated with increasing overdose deaths. Oxycodone 30mg is the highest dose available for oxycodone and is one of the most sought after prescription drugs for abuse. What Do Regulators Look For? If a complaint is filed with a regulatory agency, such as the Board of Nursing, the Board may request a CSPMP profile for the prescriber to review prescribing patterns, such as the same drug and identical dose regardless of patient type, large volumes of drugs, drug cocktail combinations, family members receiving same drug, and prescribing early refills. The Board may request patient medical records and compare the record to the CSPMP report to arizona STATE BOARD OF NURSING REGULATORY JOURNAL 17 determine if the prescription is consistent with diagnostic evidence, if urine drug screens are consistent with prescriptions, and if unexpected findings are documented in the medical records and if there is evidence that the prescriber consulted the CSPMP before prescribing the controlled substance. Pharmacists Federal regulations indicate, “A Pharmacist has a corresponding responsibility to that of the prescriber to ensure that a prescription is being filled is one for a legitimate medical purpose.” Because of this, pharmacists may also check a patient’s CSPMP and contact the prescriber if there is a question about the legitimacy of the prescription. If a pharmacist, or any licensed clinician, believes a medication is being prescribed for other than “legitimate medical purposes” they must report the conduct to the respective licensing Board. Limitations – Just a Tool The CSPMP has its limitations. First and foremost, prescribers must understand that the CSPMP is just a tool, and providers should review additional information, when available, to validate unexpected findings on the CSPMP report. Prescribers should use the CSPMP as a means to review prescriptions with their patients and receive their feedback to clarify any concerning findings. Contributors Limitations of the CSPMP include contributors to the database. Prescriptions that are filled in bordering states may not be reported on the state CSPMP database searched by the provider, and delays in providing information to the CSPMP may result in a CSPMP report to appear lacking of recent prescriptions filled. The law requires that all dispensing providers enter the information in the system within one week of dispensing the controlled substance, and the pharmacy board has another week to enter the information into the CSPMP database, creating a potential two-week lag in reporting a controlled substance prescription. A further consideration is that not all facilities are required to report to database. Federal healthcare facilities (e.g. Department of Veterans Affairs [VA], Department of Defense, 18 and Indian Health Service) are not required, and do not generally report to state CSPMPs, though more VA systems are now contributing. Additionally, methadone clinics are also not required to report to state agencies. Human Error Human error should be considered when reviewing the CSPMP report, as a human being must enter the information into the system and sometimes the wrong drug, wrong dose, or wrong provider is entered in error. An illegible prescriber name, handwritten on a prescription, may result in the pharmacist incorrectly identifying a prescriber in the system. The column on the CSPMP identified, as “Date filled” is the date the medication was dispensed into the bottle, not the date the patient picked up the prescription. Summary The public is harmed when reckless prescribers indiscriminately prescribe controlled substances to a person with a substance use disorder (SUD), to those patients who divert their prescription drugs to others; or prescribe without safe guards in place to deter abuse and diversion. The Arizona State Board of * >À“>VÞÊ ­˜°`°Ê ۈ`iœ®Ê Ài«œÀÌi`Ê Ì >ÌÊ Çä¯Ê œvÊ Americans are taking one prescription drug >˜`Ê xä¯Ê œvÊ Ì iÊ «œ«Õ>̈œ˜Ê Ì>ŽiÊ >ÌÊ i>ÃÌÊ Ìܜ°ÊÊ America’s prevalent drug problem is not only with drug dealers and drug lords; it is also in our medicine cabinet. The mother of a young woman who died of an overdose said to me, “It was no secret that my daughter was a drug addict; why would anyone hand a drug addict, a prescription for an addictive drug?” The State Board of Pharmacy provides access for prescribers to register for the CSPMP and obtain prescription profiles on patients before they write a prescription for a controlled substance. The CSPMP is a necessary tool in responsible and safe prescribing of controlled substances. References Arizona State Board of Nursing. (2012). Advisory Opinion: The use of controlled substances for the treatment of chronic pain. Retrieved from https://www.azbn.gov/Documents/advisory_opinion/ "¯Óä œ˜ÌÀœi`¯Óä-ÕLÃÌ>˜ViïÓävœÀ¯Óä arizona STATE BOARD OF NURSING REGULATORY JOURNAL Ì i/Ài>̓i˜Ì¯Óäœv¯Óä Àœ˜ˆV¯Óä*>ˆ˜°«`v Arizona State Board of Pharmacy. (2015). Controlled Substances Prescription Monitoring Program. Retrieved from https://pharmacypmp. >â°}œÛÉÈÌiÃÉ`iv>ՏÌÉwiÃÉ ¯Óä Ý«>˜>̈œ˜°«`v Arizona State Board of Pharmacy. (n.d.). Red flags video. Retrieved from https://onedrive.live. Vœ“ɶˆ`r Î{n x™  ȯӣ£ÓxEVˆ`r Î{n x™  ÈE}ÀœÕ«räE«>À`r Î{n x ™  ȯӣ£ä{E>ÕÌ ŽiÞr¯Ó£xÃ/£,äâx£Þ }6äEœr"˜i1« Centers for Disease Control and Prevention. (2011). Prescription painkillers overdoses in the US. Retrieved from http://www.cdc.gov/vitalsigns/ painkilleroverdoses/ Centers for Disease Control and Prevention. (2015). Understanding the epidemic. When the prescription becomes the problem. Retrieved from http://www.cdc.gov/drugoverdose/epidemic/index. html Community Partnership of Southern Arizona. (2013). Controlled substances prescription monitoring program. Retrieved from http://www. cpsaarizona.org/providers/Pages/ControlledSubstances-Prescription-Monitoring-Program.aspx >̈œ˜>Ê ˜Ã̈ÌÕÌiÊ œ˜Ê ÀÕ}Ê LÕÃi°Ê ­Óä£{®°Ê Drug facts: Prescription and over-the-counter medications. Retrieved from http://www.drugabuse. gov/publications/drugfacts/prescription-overcounter-medications National Institute on Drug Abuse. (2015). Overdose death rates. Retrieved from http://www. drugabuse.gov/related-topics/trends-statistics/ overdose-death-rates Partnership for Drug-Free Kids. (2015). Prescription drug abuse results in one death every 19 minutes in U.S. Retrieved from http://www. drugfree.org/join-together/prescription-drug-abuseresults-in-one-death-every-19-minutes-in-u-s/ Rhyee, S. H. (2015). General approach to drug poisoning in adults. In S. J. Traub (Ed.), UpToDate. Retrieved from http://www.uptodate. com.contentproxy.phoenix.edu/contents/generalapproach-to-drug-poisoning-in-adults?source=mac ˆ˜ii>À˜ˆ˜}EÃi>ÀV r«ÀiÃVÀˆ«Ìˆœ˜³`ÀÕ}³œÛiÀ`œÃ iEÃiiVÌi`/ˆÌir£H£xäEÃiV̈œ˜,>˜Žr£E>˜V œÀ =H19#H1 Street Rx. (n.d.). Did you get a good deal? Retrieved from http://streetrx.com/ / iÊ iÜÊ 9œÀŽÊ /ˆ“iÃ°Ê ­Ó䣣®°Ê ÀÕ}Ê ˆÃÊ >À`iÀÊ to abuse but users persevere. Retrieved from http:// www.nytimes.com/2011/06/16/health/16oxy. html?_r=0 Attention: Nurse Practitioners & Certified Nurse Midwives Currently Holding or Intend to Obtain One or More DEA Numbers The Controlled Substances Prescription Monitoring Program (CSPMP) is a statutory program developed to promote the public health and welfare by detecting diversion, abuse and misuse of prescription medications classified as controlled substances under the Arizona Uniform Controlled Substances Act. Arizona Revised Statutes (A.R.S) § 36-2606, effective December 31, 2015, requires every Arizona medical practitioner, including Nurse Practitioners & Nurse Midwives who intend to obtain a Drug Enforcement Administration (DEA) number or who hold one or more DEA registration number to also hold a Controlled Substances Prescription Monitoring Program (CSPMP) registration issued by the Arizona State Board of Pharmacy. There is NO fee to the practitioner for this registration. Please complete Application for Registration Access to the Arizona CSPMP Program found on page 20 and return to the Arizona Board of Nursing no later than October 1, 2015. Please contact Ì iÊ œ>À`ʜvÊ ÕÀȘ}Ê>ÌÊÈäÓÊÇÇ£‡ÇnääʜÀÊ email Judy Bontrager at jbontrager@azbn. gov should you need additional information about this new law. Additional information regarding the CSPMP may be accessed from the Arizona Board of Pharmacy at https:// pharmacypmp.az.gov/    6DYHWKH'DWH 2016 Thirteenth Annual CNA Conference CNA EDUCATION: PASSIONATE, PROFESSIONAL & PRACTICAL January 8, 2016 Black Canyon Conference Center 9440 North 25th Avenue Phoenix, Arizona 85021  Registration Opening Soon Questions? Contact Lyn Ledbetter, LLedbetter@azbn.gov arizona STATE BOARD OF NURSING REGULATORY JOURNAL 19 ARIZONA STATE BOARD OF NURSING Application for Registration Access to the Arizona Controlled Substances Prescription Monitoring Program (CSPMP) FOR OFFICE USE ONLY PRINT CLEARLY USING CAPITAL LETTERS  NP License Type  CNM Certificate Number(s) / / Expiration Date SECURITY QUESTIONS: *DEA Number Mother's Maiden Name / Expiration Date of DEA / NPI Number Your birth City: 1. DEMOGRAPHICS Legal First Name Middle Name Legal Last Name Last 4 Digits of SSN / Date of Birth / 2. PRACTICE ADDRESS Street Address Line 1 Street Address Line 2 City State Work Phone Zip Code - County - Fax - 3. Complete If Mailing Address is NOT the same as PRACTICE ADDRESS Street Address Line 1 Street Address Line 2 City State Zip Code County 4. Practitioner's - Work or Personal E-mail Address *If a Practitioner has multiple DEA numbers, you MUST complete one form for each DEA number Submit Completed form(s) to: Arizona State Board of Nursing 4747 N. 7th Street, Suite 200 Phoenix, AZ 85014-3655 20 arizona STATE BOARD OF NURSING REGULATORY JOURNAL - UPPER IOWA UNIVERSITY – Mesa Center RN-BSN PROGRAM 3 Courses that fit your busy lifestyle – online, hybrid and face-to-face options 3 Year-round schedule with 8-week classes 3 Full time or part time 3 Small class size 3 Complete the RN-BSN major in one year Nationally accredited by Commission on Collegiate Nursing Education (CCNE) YOUR DEGREE. ll YOUR WAY. o r n E 1361 S. Alma School Road, Mesa, AZ ! y a d to 480-834-4620 uiu.edu/mesa-nursing Save the environment. Start keeping kids in science class. 77% of Littles reported doing better in school because of their Big. One-to-one mentoring works. Even big change starts with something little. Support kids in your community at BigBrothersBigSisters.org. Start Something™ Donate money or time at BigBrothersBigSisters.org arizona STATE BOARD OF NURSING REGULATORY JOURNAL 21 CNA DISCIPLINARY ACTION *Not reported in previous Journal CONTINUED FEBRUARY - MARCH - APRIL - MAY - JUNE - JULY 2015 EFFECTIVE DATE NAME CERTIFICATE DISCIPLINE 7/7/2015 Alcott, Corraina L. CNA Applicant Certificate Denied 6/23/2015 Amos, Vanessa A. CNA1000022898 Revoked 7/24/2015 Anderson, Christiane K. CNA1000037809 Voluntary Surrender 6/12/2015 Arbizu, Corrina M. CNA1000046840 Civil Penalty 6/24/2015 Arustamov, Marsha CNA1000034425 Decree of Censure 6/24/2015 Aubert, Melanie K. CNA999949223 Revoked 6/24/2015 Balmorez, Rebecca L. CNA1000021104 Decree of Censure 5/8/2015 Bopray, Ciara J. CNA Applicant Certificate Denied 4/20/2015 Burnette, De Adriann S. CNA1000046334 Civil Penalty 6/25/2015 Bryant, April R. CNA Applicant Certificate Denied 7/10/2015 Bryd, Lakilllie P. CAN Applicant Certificate Denied 5/1/2015 Capshaw, Jeramee W. CNA1000047048 Decree of Censure 5/7/2015 Carpenter, William M. CNA Applicant Certificate Denied 7/29/2015 Clah, Lorraine R. CNA492013353 Suspension 5/12/2015 Clark, Kylee M. CNA Applicant Certificate Denied 5/7/2015 Curley, Melanie D. CNA Applicant Certificate Denied 4/30/2015 Davis, Harry CNA1000042617 Suspension 6/15/2015 Davis , Harry CNA1000042617 Revoked 4/20/2015 Del Frate, Michelle CNA1000046304 Civil Penalty 2/2/2015 Douglas, Christeina Y. CNA1000045528 Decree of Censure 5/8/2015 Drenth, Jacqueline M. CNA Applicant Certificate Denied 6/19/2015 Dufault, Lori L. CNA827875057 Voluntary Surrender 4/17/2015 Felix, Ronaldo D. CNA1000046332 Decree of Censure 5/20/2015 Fletcher, Monica F. CNA1000011538 Voluntary Surrender 5/5/2015 Forsythe, Tanya M. CNA1000006774 Revoked 5/7/2015 Freddy, Victoria L. CNA Applicant Certificate Denied 6/16/2015 Garza, Norma L. CNA999950449 Decree of Censure 5/7/2015 Gilbert, Sherry L. CNA1000016262 Decree of Censure 7/24/2015 Gillmore-Anderson, Jacob A. CNA 1000047577 Suspension 7/24/2015 Gonzales, Rebecca R. CNA1000032746 Decree of Censure 5/5/2015 Greco, Stephen R. CNA Applicant Certificate Denied 5/20/2015 Hansen, Anisa A. CNA1000032434 Voluntary Surrender 6/24/2015 Haro, Alex CNA1000023763 Revoked 6/25/2015 Hill, Schuante M. CNA Applicant Certificate Denied 5/5/2015 James, Sherry A. CNA1000006859 Revoked 4/30/2015 Jervis, Joel R. CNA223402733 Voluntary Surrender 6/24/2015 Korting, Shawn M. CNA1000019371 Revoked 4/17/2015 Leon, Stanley R. CNA1000046305 Decree of Censure 6/25/2015 Leos, Jaime D. CNA Applicant Certificate Denied 3/23/2015 Lidster, Steven M. CNA Applicant Certificate Denied 6/24/2015 Lucarelli, Magdalena F. CNA1000012479 Revoked 22 arizona STATE BOARD OF NURSING REGULATORY JOURNAL *Not reported in previous Journal CNA DISCIPLINARY ACTION FEBRUARY - MARCH - APRIL - MAY - JUNE - JULY 2015 EFFECTIVE DATE NAME CERTIFICATE DISCIPLINE 6/4/2015 Martin, Kelly M. CNA1000028309 Voluntary Surrender 6/4/2015 Mason, Ashley M. CNA1000010010 Voluntary Surrender 5/12/2015 Mcclure, Mckayla M. CNA Applicant Certificate Denied 5/22/2015 McLin, Jerisha J. CNA Applicant Certificate Denied 5/7/2015 Mitchell, Robert L. CNA994812033 Suspension 5/5/2015 Mitchell, Sabrina C. CNA Applicant Certificate Denied 7/7/2015 Morales, Maria I. CNA Applicant Certificate Denied 4/20/2015 Moore, Beverly A. CNA1000037209 Decree of Censure 5/5/2015 Natsyn, Alisha CNA Applicant Certificate Denied 5/5/2015 Newport, Emily R. CNA Applicant Certificate Denied 5/13/2015 Nez, Veloria CNA1000026879 Decree of Censure 6/25/2015 Olivarria, Yesenia CNA Applicant Certificate Denied 6/25/2015 Paswinski, Christopher M. CNA Applicant Certificate Denied 6/12/2015 Peterson, Brandy M. CNA Applicant Certificate Denied 5/8/2015 Pressey, Sasha M. CNA Applicant Certificate Denied 6/24/2015 Prinsloo, Patricia D. CNA1000018379 Decree of Censure 7/10/2015 Ramon, Angel W. CNA Applicant Certificate Denied 6/25/2015 Reece, Karri L. CNA Applicant Certificate Denied 5/6/2015 Rizzi, Nicole R. CNA1000033121 Revoked 7/24/2015 Rubio, Laura B. CNA Applicant Certificate Denied 5/6/2015 Salman, Nyenonbai R. CNA314658974 Revoked 3/19/2015 Samano, Lizeth CNA999991985 Renewal Denied 5/15/2015 Sanchez, Griselda M. CNA1000004470 Civil Penalty 6/24/2015 Sanchez, Sara P. CNA999990277 Revoked 7/14/2015 Sandford, Michael P. CNA465555713 Renewal Denied 5/5/2015 Scott, Jeremi M. CNA Applicant Certificate Denied 5/29/2015 Shore-Fritz, Alexander S. CNA1000045975 Revoked 2/2/2015 Sindayigaya, Victor CNA1000014230 Voluntary Surrender 4/29/2015 Slim, Timothy L. CNA999952167 Stayed Revocation 6/30/2015 Sow, Fatmata CNA1000030730 Civil Penalty 4/27/2015 Stevens, Deann J. CNA1000046373 Stayed Revocation 5/26/2015 Stevens, Deann J. CNA1000046373 Voluntary Surrender 7/8/2015 Stoll, Kellie L. CNA1000011261 Stayed Revocation 7/31/2015 Stoll, Kellie L. CNA1000011261 Voluntary Surrender 6/17/2015 Thomas, Devin J. CNA1000047225 Stayed Revocation 6/23/2015 Tong, Heather M. CNA Applicant Certificate Denied 4/30/2015 Torres Campos, Ediberto CNA1000032169 Voluntary Surrender 6/3/2015 Villa, Cecilia R. CNA Applicant Certificate Denied 5/7/2015 Wagaman, Wendy M. CNA Applicant Certificate Denied 6/8/2015 Wilcox, John J. CNA1000046773 Stayed Suspension 6/23/2015 Woldeab, Yinabi W. CNA1000020663 Revoked arizona STATE BOARD OF NURSING REGULATORY JOURNAL 23 RN/LPN DISCIPLINARY ACTION *Not reported in previous Journal CONTINUED FEBRUARY - MARCH - APRIL - MAY - JUNE - JULY 2015 EFFECTIVE DATE NAME LICENSE DISCIPLINE 7/1/2015 Abdi, Meredith J. RN147896 Summary Suspension 3/30/2015 Ali, Zaibunnisa RN172505 Voluntary Surrender 2/5/2015 Anderson, Gail E. RN173803 Revocation 7/24/2015 Anderson, Christiane K. LP Exam License Denied 4/15/2015 Andrews, Michael S. LP049344 Revocation 5/11/2015 Arnett, Kate L. RN174454/LP047517 Probation 3/11/2015 Baker, Esther L. RN Endorsement License Denied 3/18/2015 Beard, Shonna J. RN144522 Probation 6/23/2015 Benally, Lori J. RN143454/LP041067 Probation 2/10/2015 Benefield, Amber L. RN150409 Decree of Censure 2/26/2015 Benton, Cory M. RN164598 Voluntary Surrender 6/26/2015 Binion, Suzanne L. LP023541 Voluntary Surrender 5/15/2015 Bishop, Nicole A. RN143834 Revocation 5/15/2015 Bishop, Melissa R. RN142926 Stayed Revocation with Suspension 3/25/2015 Blanchette, Joni J. TRN087611 Revocation 3/27/2015 Bowditch, Allison D. RN146622/LP042169 Summary Suspension 5/5/2015 Bradshaw, Mary E. RN075560 Revocation 7/8/2015 Brewer, Irene R. RN163347/LP045843 Stayed Revocation with Suspension 3/27/2015 Brinkley, Sandra D. RN093547/LP027013 Stayed Revocation with Probation 2/25/2015 Brotski, Caree L. RN115819/LP035956 Decree of Censure 5/29/2015 Buckwald, Linda D. RN039062 Decree of Censure 3/18/2015 Burnham, Elizabeth RN088688 Voluntary Surrender 2/27/2015 Cairns, Tabitha L. LP042752/CNA1000010060 Decree of Censure 3/20/2015 Caldwell, Deena L. RN099838/LP030577 Stayed Revocation with Probation 2/4/2015 Campbell, Renae J. RN190504 Decree of Censure 5/5/2015 Campos, Eduardo RN192052 Probation 7/1/2015 Caraffa, Guy RN063537/CRNA0671 Summary Suspension 7/1/2015 Carnago, Patricia J. LP048733 Decree of Censure 7/30/2015 Ciudadano, George Neil Jr D. RN138631 Voluntary Surrender 4/30/2015 Coleman, Shelly L. LP030104 Probation 3/27/2015 Coleman, Samuel L. RN135736 Summary Suspension 3/13/2015 Cox, Doris J. LP Endorsement License Denied 6/24/2015 Crites, Heather M. RN164487 Revocation 6/24/2015 Daly, Anastasia L. RN109974/LP034045 Revocation 6/22/2015 Davis, Violet R. LP042979 Decree of Censure 6/18/2015 Day, Lacie E. RN149427/LP034584 Probation 5/13/2015 Deluca, Ashley B. RN124490 Probation 7/14/2015 Dietrich, Rebekah C. RN139564 Revocation 3/23/2015 Dietrich, Rebekah C. RN139564 Stayed Revocation with Suspension 3/11/2015 Digioacchino, Karyn LP034753 Revocation 3/10/2015 Dillon, Jason D. RN191760 Civil Penalty 6/19/2015 Dufault, Lori L. LP045258 Voluntary Surrender 4/20/2015 Duncan, Cynthia A. LP038310 Decree of Censure 6/23/2015 Dustin, Sherry L. LP033541 Voluntary Surrender 3/31/2015 Easley, Wendy J. RN132821 Voluntary Surrender 5/5/2015 Estigoy, Darwin R. RN135022 Voluntary Surrender 7/20/2015 Etheridge, Amy E. RN179511 Voluntary Surrender 3/2/2015 Eubanks, Julainna L. RN173299 Decree of Censure 7/8/2015 Fields, Daniel D. RN160912 Probation 24 arizona STATE BOARD OF NURSING REGULATORY JOURNAL RN/LPN DISCIPLINARY ACTION *Not reported in previous Journal CONTINUED FEBRUARY - MARCH - APRIL - MAY - JUNE - JULY 2015 7/2/2015 Fogarty, Maureen A. RN Endorsement License Denied 3/11/2015 Gallagher, Kara M. RN143287/LP038637 Revocation 2/12/2015 Gamerdinger, Kandi K. RN089868/AP7651 Decree of Censure with Civil Penalty 5/15/2015 Gamus, Marina S. RN142492 Summary Suspension 7/8/2015 Gates, Diane M. RN Endorsement License Denied 3/13/2015 Gerstenlauer, Bonnie J. RN167834 Revocation 4/3/2015 Gibbs Lori A. RN189353 Stayed Revocation with Probation 5/4/2015 Gonzales, Cynthia W. RN083444 Probation 5/5/2015 Goodman, Marla J. RN111391 Revocation 3/14/2015 Gorman, Cora LP Endorsement License Denied 5/27/2015 Gough, Valarie LP Exam Stayed Suspension with Probation 3/11/2015 Gramlich, Lou A. RN151045 Revocation 4/27/2015 Green, Terry D. RN165308 Decree of Censure 5/22/2015 Hall, Shelby L. RN162934 Voluntary Surrender 3/13/2015 Hall, Harrison L. LP048818/CNA1000034887 Revocation 5/15/2015 Hamm, Cynthia A. RN/CRNA Endorsement License/Certificate Denied 3/10/2015 Harker, Shantelle A. RN170787 Probation 5/7/2015 Harrier, Donna J. LP Endorsement License Denied 2/20/2015 Hartley, Kelly S. RN117695 Decree of Censure 3/30/2015 Haydon, Lovella P. RN157947 Revocation 7/24/2015 Henson, Danielle L. RN178347 Stayed Revocation with Suspension 2/11/2015 Hohm, Abram J. RN166423 Stayed Revocation with Suspension 3/30/2015 Hohm, Abram J. RN166423 Voluntary Surrender 6/4/2015 Holley, Denise L. LP037612 Voluntary Surrender 5/20/2015 Holzman, Diane H. RN173093 Voluntary Surrender 4/8/2015 Hopper, Mary J. RN091230 Voluntary Surrender 3/6/2015 Jackson, Lorrie M. LP026634 Revocation 3/19/2015 Jenkins, Crystal L. RN094482/LP030488 Probation 5/15/2015 Johnson, Michelle L. RN089083 Stayed Revocation with Suspension 5/4/2018 Johnson, Brenda D. RN152698 Decree of Censure 4/30/2015 Johnston. Codi V. RN191944 Probation 5/28/2015 Jonas, Shanlyn E. RN155864 Probation 7/13/2015 Jones, Donna J. RN193677 Probation 7/8/2015 Joyner, Taryn E. RN159659 Voluntary Surrender 5/5/2015 Kidder, Amanda B. LP045758 Revocation 7/1/2015 King, Karen M. RN106795/AP2526 Summary Suspension 5/5/2015 Knisely, Susan C. RN168669 Revocation 3/9/2015 Kremleva, Yekaterina LP050832 Probation 5/20/2015 Lebarron, Jeanette A. LP047151 Decree of Censure 3/31/2015 Leitner, Patricia K. RN055957/LP018885 Stayed Suspension with Probation 2/5/2015 Lewis, Aubrey R. RN177821 Revocation 6/23/2015 Lilly, Adrian W. RN154892 Revocation 7/8/2015 Luxem, Dana P. RN135853 Voluntary Surrender 3/6/2015 Lynd, Stephen J. RN172725 Decree of Censure 4/17/2015 Mack, Norman N. RN146159/LP018901 Voluntary Surrender 3/11/2015 Martin, Colby D. LP042452 Revocation 6/24/2015 Maxwell, Sonda M. LP014125 Revocation 5/7/2015 Mbonefor, Geraldine RN Exam License Denied 7/1/2015 McAvoy Jr., James A. RN124750/AP3968 Summary Suspension 6/22/2015 McBride, Holly R. LP039250 Decree of Censure 6/18/2015 McKechnie, Heather D. RN174951 Voluntary Surrender arizona STATE BOARD OF NURSING REGULATORY JOURNAL 25 RN/LPN DISCIPLINARY ACTION *Not reported in previous Journal CONTINUED FEBRUARY - MARCH - APRIL - MAY - JUNE - JULY 2015 4/9/2015 McMurdy, Rachel L. RN145311/CNA1000002391 Voluntary Surrender 5/5/2015 Miller, Christine M. RN141959 Revocation 3/27/2015 Minch, Alice J. RN079946/LP026129 Probation 2/5/2015 Miranda, Angelica M. RN171572 Revocation 5/7/2015 Mitchell, Robert L. RN094677/CNA994812033 Suspension 3/11/2015 Morehead-ruff, Latoya N. LP042480 Revocation 3/9/2015 Moreno, Robert L. LP026650 Reissuance Denied 5/7/2015 Nelson, James M. RN Endorsement License Denied 7/20/2015 Nunez, Nancy F. RN070035/LP018724 Voluntary Surrender 3/11/2015 Oliver, Courtney R. RN138477 Revocation 5/5/2015 Onwiler, Kriste M. RN157061 Revocation 3/26/2015 Paradis, Ashly O. RN178655 Voluntary Surrender 7/16/2015 Parham, Jeanne M. RN123105 Voluntary Surrender 7/9/2015 Patterson, Andrew J. Compact, TN RN160122 Revocation of Nurse Multi-State Licensure Privilege 7/8/2015 Pavloski, Sherry A. RN138184 Voluntary Surrender 7/1/2015 Peaches, Geniece M. RN162537 Summary Suspension 3/2/2015 Petruce-garcia, Cheryl A. LP035680 Decree of Censure 6/24/2015 Pew, Jessica R. RN Endorsement License Denied 5/11/2015 Pickens, Sharon L. RN044133 Voluntary Surrender 5/5/2015 Pieramici, Melissa C. RN143264/CNA1000002485 Revocation 4/17/2015 Pierce, Nancy A. RN119372/AP2192 Decree of Censure 3/20/2015 Pillar, Celeste A. RN103453 Voluntary Surrender 5/5/2015 Player, Paul D. RN139906 Voluntary Surrender 3/9/2015 Porter, Rachael A. RN160001 Stayed Suspension with Probation 7/24/2015 Provost, John J. RN137623 AP Exam Probation Denied 2/6/2015 Randall, Vernon D. RN080075 Voluntary Surrender 4/15/2015 Randall, Brandon J. RN157107 Voluntary Surrender 3/23/2015 Ray, Kerry W. RN080080/LP026193 Decree of Censure with Civil Penalty 7/7/2015 Rees, Angharad RN028366 Probation 7/24/2015 Reichle, Lynn L. RN168901/AP4106 Summary Suspension 6/15/2015 Rice, Rhodora C. RN106055 Voluntary Surrender 6/25/2015 Robrecht, Pamela J. RN173214 Voluntary Surrender 5/5/2015 Sabin, Christina A. RN157329/LP044401 Decree of Censure 2/6/2015 Schnorr, Amie L. RN123257 Revocation 5/22/2015 Sears, Diane F. RN059305 Probation 3/3/2015 Shelburne, Juanita M. LP050848 Probation Reissuance Denied 5/29/2015 Shimp, Mona L. LP041393 3/5/2015 Shotwell, Kearsten E. RN164486/CNA1000017809 Stayed Revocation with Suspension 6/17/2015 Shupe, Michael J. RN041528 Probation 2/6/2015 Sicora, Angela R. RN113837 Voluntary Surrender 3/16/2015 Siegel, Carole D. RN031440 Civil Penalty 2/18/2015 Siragusa, Frank A. LP033390/CNA060357784 Voluntary Surrender 1/28/2015* Skrabak, Jonathan P. CRNA Endorsement Certificate Denied 3/20/2015 Slade, Tamara C. RN163348 Revocation 5/22/2015 Smith, Ronnie LP048950 Voluntary Surrender 6/4/2015 Smithers Sadie F. RN160367 Voluntary Surrender 3/27/2015 Snyder, Kevin B. RN141652 Civil Penalty 6/23/2015 Solomon, William T. RN091795 Voluntary Surrender 4/22/2015 Stearns Gerald M. RN129549 Reissuance with Probation 7/15/2015 Stewart, Sharon R. RN064488 Civil Penalty 2/11/2015 Terns, Melissa B. RN147930 Stayed Revocation with Suspension 26 arizona STATE BOARD OF NURSING REGULATORY JOURNAL *Not reported in previous Journal RN/LPN DISCIPLINARY ACTION FEBRUARY - MARCH - APRIL - MAY - JUNE - JULY 2015 6/17/2015 Thompson, Conscience D. LP041380 Reissuance with Stayed Revocation Probation 7/8/2015 Thompson, Conscience D. LP041380 Voluntary Surrender 5/7/2015 Thompson, Teri A. LP Endorsement License Denied 5/14/2015 Torvik, Nancy A. LP037900/CNA504571500 Voluntary Surrender 5/12/2015 Trofort, Lionelle Compact, VA RN0001196367 Voluntary Surrender of Nurse Multi-State Licensure Privilege 6/15/2015 Tyler, Rebecca J. RN073975 Voluntary Surrender Reissuance Denied 3/20/2015 Wenham, Christa A. LP030510 4/15/2015 West, Jessica L. LP049575 Voluntary Surrender 5/15/2015 Willeford, Christina M. RN133982 Revocation 6/25/2015 Williams, Kristen S. LP030773 Revocation 5/6/2015 Winegeart, Jessie L. RN160895 Revocation 6/1/2015 Wister, Kirsten E. RN097845/AP3956/AP2534 Decree of Censure with Civil Penalty 3/6/2015 Wolf, Diane L. RN141231 Voluntary Surrender 7/24/2015 Wright, Richard A. RN157879 Suspension 7/16/2015 Yeaman, Howard P. RN193789 Probation A Life-Changing Career It only takes a day to change your life. Career Open House !&9:7)&>:,:89 9-B &294 52 &>41.3.(B&89&>41;) ):(&9.43*39*7B-4*3.=%  !#"4)&>&9mayocareers.com/aznursing >&99*3).3,4:7&7**75*34:8*>4:<.11,*9942**9842*4+4:79*&22*2'*78&3))*5&792*391*&)*78<-.1* 1*&73.3,247*&'4:9&>41.3.(&3)&;&.1&'1*(&7**7455479:3.9.*8.3:78.3,$*11).8(:884:7(:19:7*4:989&3).3, '*3*A98 &3) 9-* 2&3> 49-*7 7*&8438 <*;* '**3 7*(4,3.?*) '> FORTUNE 2&,&?.3* &8 43* 4+ 9-* 945  @*89 425&3.*894$47047C&3)7&30*)3:2'*743*.3247*85*(.&19.*89-&3&3>49-*7-485.9&1.39-*3&9.43+47   '>U.S. News and World Report. 49&'1*94&99*3)$*.3;.9*>4:94*=5147*&;&.1&'1*(&7**7455479:3.9.*8&9mayoclinic.org/jobs 433*(9<.9-:8 *9-*A78994-*&7&'4:93*</4'8&3)(&7**77*1&9*)3*<8+742&>41.3.( D &>44:3)&9.43+47*).(&1):(&9.43&3) *8*&7(-4894++*7 57**2514>2*39)7:,8(7**3.3,.87*6:.7*)&>41.3.(.8&3*6:&1455479:3.9>*):(&947&3)*2514>*7.3(1:).3,;*9*7&38&3)5*78438<.9-).8&'.1.9.*8 arizona STATE BOARD OF NURSING REGULATORY JOURNAL 27 Advertorial You want to love where you work. You belong here. Banner Health is a nationally-recognized, award-winning health system that is helping to define and drive exciting change in the health care field. That’s opening up great career opportunities throughout a network of more than two dozen hospitals in seven western states. If you’d like to know what it’s like to work at Banner Health, we invite you to hear directly from CNO Cathy Townsend. Please tell us a little bit about Banner Health. Banner Health is a not-for-profit organization with facilities throughout seven western states. We employ 44,000 people and are comprised of 28 medical centers – two of which are academic – and a multitude of clinics. That may seem large, but once you start working here, it feels like a family. Our mission is to make a difference in people’s lives through excellent patient care. We value people above all, excellence and results. We integrate health management, advanced technology, high quality care and a seamless patient experience into our strategic initiatives so that we can achieve the best outcomes for our customers. It really is a company that creates opportunities for people who enjoy change and want to create the future of health care. What makes Banner a great place to work? If you enjoy diverse opportunities, an intellectually stimulating environment in which change is constant and a place where people are valued above all, then you will enjoy working for Banner Health. Our company achieves excellence by never settling or accepting mediocrity in the care that is offered to our customers. We do this by approaching each and every interaction with patients and each other with the three E’s – Energy, Excitement and Enthusiasm. What can a new nurse expect when joining Banner Health? Lots of opportunities to participate in an innovative health care team! Banner Health is an organization that prides itself on delivering excellent patient care that is based on a truly collaborative clinical consensus model with decisions made by nurses, physicians and many health care professionals. The care that is delivered to our customers is based on a franchise model and evidence based practice. As a result of this model a new nurse will be exposed to multiple opportunities to positively impact patient care through shared leadership, research studies, Magnet projects and input into new clinical practices. What are some of the advantages to having a nursing career at Banner Health? A nurse within Banner Health can work at small, medium or large health care facilities, academic, rural, or urban settings throughout seven states. Banner Health values nurses by assisting them with a Clinical Expert Registered Nurse (CE:RN) program, tuition assistance, academic affiliations, scholarship opportunities and a multitude of work schedules and life style choices. There are numerous opportunities for advancement in whatever area a nurse finds fulfilling, from working as a bedside professional or an advanced practice nurse, to a myriad of leadership positions. Nurses are also encouraged to assist with the professional nursing congress where they focus on crucial clinical projects and decision making for the organization. What do you most enjoy about working for Banner Health? It’s the people! I have worked at Banner Health for over ten years and have loved the various opportunities that I have had as a health care professional. Working at four different medical centers within Banner Health has allowed for many interactions, not only with nurses, but every type of health care professional. They are collaborative and genuinely want to work as a team to create the best for associates and patients. Some of my favorite projects have been creating unique opportunities for new grads and helping to design a new hospital. You never know what project is around the corner and with the diversification of my position I really believe that I have the best job within the best health care organization. EEO/AA/Diversity/Vets. We support a tobacco-free and drug-free workplace. 28 arizona STATE BOARD OF NURSING REGULATORY JOURNAL Learn more at BannerHealth.com/careers Follow Banner Health Careers: Summit Healthcare Regional Medical Center Trusted to Deliver Exceptional, Compassionate care close to home  Join a team that supports you ± professionally and personally We are currently seeking top-notch healthcare professionals to join our team across the State of Arizona. We offer generous compensation and benefits! Come to Arizona’s cool, beautiful White Mountains where the quality of life soars as high as the tall pines! Sign on bonus / Relocation Assistance / Excellent Benefits / 403(b) Retirement / Tuition Reimbursement RN opportunities in: f Emergency Dept. f Med Surg f Surgery f ICU f Float f Labor & Delivery / Post Partum f Home Health f RN - Wound Care f RN - Cath Lab To learn more about our Career opportunities visit www.summithealthcare.net or call to speak with the Nurse Recruiter, Healthcare Opportunities Include: Nurse Practitioner Registered Nurse Licensed Practical Nurse Stevie Burnside at 928-537-6367 email sburnside@summithealthcare.net For more information, please visit jobs.correctcaresolutions.com or contact Shawn Harding at SHarding@correctcaresolutions.com CCS is an EOE/Minorities/Females/Vet/Disability Employer Show Low Arizona has four beautiful, mild seasons — a perfect place for outdoor adventures year-round! Summit Healthcare Regional Medical Center 2200 E. Show Low Lake Rd. • Show Low, AZ 85901 arizona STATE BOARD OF NURSING REGULATORY JOURNAL 29 Nurse Network The “NEW” Classifieds (1.5” wide x 1” high) Reach every nurse in Arizona for as little as $290. RESERVE YOUR SPACE NOW! Contact Laura Wehner 1-800-561-4686 ext. 117 November 4 & 5 Phoenix, AZ Evidence-based for nurses; 16 CE's; Certification is on the ANCC magnet recognition list. Call Prepared Childbirth Educators, Inc. at 888-344-9972 or visit www.childbirtheducation.org Board Complaint? YOUR NEW CAREER AWAITS Northern Arizona VA Healthcare System seeks nursing professionals with focus in specialty areas. Contact Katrina Lewis Clinical Recruiter (928) 445-4860 ext. 6578 Katrina.Lewis2@va.gov www.prescott.va.gov ASSISTED LIVING HOME FOR LEASE in Upscale Community Surprise, AZ Licensed: 8 (602)410-7654 lwehner@pcipublishing.com Childbirth Educator Course and/or Exam RNs LPNs CNAs OWN YOUR OWN BUSINESS Do Not Fight It Alone! Your livelihood and career are at stake MD,JD JD Steve Perlmutter, MD Attorney and Physician (602) 346-1212 346-1212 (480) Consult an attorney who is also a physician Call for a complimentary consultation www.boardcomplaint.com steve@boardcomplaint.com EXPERIENCED NURSE –ATTORNEY NURSE ADVOCATE Teressa M. Sanzio, RN, JD Get the representation you deserve when you need it most. FREE Phone Consultation 602-993-3215 Tsanziolaw@gmail.com DHA Student Seeks Assistance With NursingResearch ‡ Critical Care Nurses (CCRN) ‡ In practice 5 years or more ‡ 30-60 minute interview to share perceptions and experiences regarding end-of-life care to ICU patients Contact Debra Fuller, MSN, RN, CCRN Student/Researcher 623-936-8440 bohdi@email.phoenix.edu " I CHOSE " TMC. When you choose a place to work… CHOOSE WELL. NOW SEEKING: ED, ICU, PCCU, FLOAT POOL, GEN VASC, NEURO AND OR NURSES · Increased per diem pay, based on experience · Premium pay rates for ED, ICU and OR nurses · Flexible schedules available, including eight hour shifts, weekends only, part time and per diem. Signing Bonuses up to $7,500 Signing Bonus of $10,000 for Night RNs! 5301 East Grant Road Tucson, Arizona 85712 EOE Tobacco-free workplace Check out all available positions at tmcaz.com/NursingJobs 30 arizona arizona STATE BOARD OF NURSING REGULATORY JOURNAL STATE BOARD OF NURSING REGULATORY JOURNAL YOUR OWN CUSTOMIZED HOSPITAL PATIENT GUIDE SAINT LUKE’S PATIENT INFORMATION & VISITOR GUIDE PATIEN T INFOR MATIO N & VISITO R GUIDE Saint Luke’s Hospital No Cost To You. Fiscal restraints and budget line item cancellations have hospitals cutting back in all areas. Here’s help. Our Patient Guides are an excellent perceived patient benefit saving your hospital time and money while informing and educating patients about your facility and their care. Best of all, there’s no effect on your bottom line, we produce them at absolutely no cost to you. Your full-color, glossy, Patient Guide is completely customized for your hospital. You also get an easy-to-use ePub version to send to patients with email-also at no cost. Inform and educate your patients quickly and efficiently. Your professional staff can now spend less time answering routine questions. Your hospital needs one and you can get it free. For complete, no obligation, information on how we can provide your Hospital Patient Guide, call or email today. Gary Reynolds 1-800-561-4686 ext.115 or greynolds@pcipublishing.com Love your job? Would you like to? A new job is a big change, and we want you to have a better life here — working at a place where your profession is an extension of your life. We stand proudly on our 100+ year foundation of improving the health of the patients, members and communities we serve. Join us in carrying on our tradition of excellence. To apply for positions in New Mexico, please visit www.phs.org/careers. AA/EOE/VET/DISABLED. PHS is committed to ensuring a drug-free workplace. 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 JoinUs WHAT MAGNET MEANS TO US… …it’s a feeling of pride and accomplishment WKDWDOOğYH+RQRU+HDOWKPHGLFDOFHQWHUV KDYHHDUQHG0DJQHWŖUHFRJQLWLRQ ĽLWłVWKHYRLFHZHKDYHZLWKVKDUHGJRYHUQDQFH our Unit-Based Patient Care Councils truly DOORZXVWRGULYHRXUSUDFWLFH LWłVKDYLQJWKHVXSSRUWWRGRZKDWłVEHVWIRU WKHSDWLHQWEHVWIRUHDFKRWKHUDQGEHVW for our careers! Nursing excellence is central to everything we do and everything we are. We are fortunate to have nurses in top OHDGHUVKLSUROHVDQGSURXGWKDWDOOğYHRIRXU hospitals have earned Magnet recognition. Learn more and explore opportunities at: HonorHealth formed after the merger RI6FRWWVGDOH+HDOWKFDUHDQG-RKQ &/LQFROQ+HDOWK1HWZRUN%DVHGLQ 6FRWWVGDOH$UL]RQDZHDUHDQRQSURğW ORFDOKHDOWKFDUHRUJDQL]DWLRQNQRZQ IRUFRPPXQLW\VHUYLFHDQGRXWVWDQGLQJ PHGLFDOTXDOLW\ With PHGLFDOFHQWHUV including /HYHO,7UDXPD&HQWHUVDQRXWSDWLHQW emergency center, an inpatient UHKDELOLWDWLRQKRVSLWDOKRPHKHDOWK VHUYLFHVDQG3K\VLFLDQRIILFHV WKURXJKRXWWKHJUHDW3KRHQL[DUHDZH KDYHDPD]LQJFDUHHURSSRUWXQLWLHVIRU VNLOOHG51V ō &ULWLFDO&DUH ō (PHUJHQF\ Services ō +RPH+HDOWK ō 0HG6XUJ ō 25 ō 3HGLDWULFV ō 7HOHPHWU\ At HonorHealth\RXłOOKDYHH[WUHPHO\ FRPSHWLWLYHFRPSHQVDWLRQDQGEHQHğWV SOXVVXSSRUWLYHFRZRUNHUVDOOZKLOH HQMR\LQJWKHIDEXORXV$UL]RQDOLIHVW\OH -RLQ8V www.HonorHealthJobs.com