February 2014 Vol. 15 Issue 1 RURAL NURSE CONNECTION Official Newsletter of the RNO Board Membership Executive Director Angeline Bushy President Pamela S. Fahs President Elect Elizabeth Merwin Secretary Martha Scheckel (interim) Treasurer Nancy Blume Member at Large Martha Scheckel Member at Large Sheila Montgomery (interim) Member at Large Meega Wells Committee Chairs: Bylaws Communications Co-Chairs Online Journal Pamela S. Fahs Newsletter Sandra Nadelson Website Sheila Montgomery Education Catherine Belden Membership Nicole Rouhana Office Manager Karla Jordan Contact: Web address: Email: RURAL NURSING IS MY SPECIALTY www.rno.org membership@rno.org Journal of Rural Nursing and Health Care: http://rnojournal.binghamton.edu/index.php/rno Newsletter Content: President s Update Page 1 Internet Resources Page 2 Conference Information Page 2 RNO Honored Nurse Award Page 3 Candidate Information Page 3 RNO Journal Abstracts Page 6 Ballot Page 10 President s Update By Pam Stewart Fahs, RN, DSN I have been in nursing over 35 years and throughout my career I have heard Change is inevitable. Change is inevitable and sometimes that change is difficult. Change is happening in our country in the delivery of health care. The road has been rocky to date but there are signs the Affordable Care Act may survive. Although not perfect, this change has the potential to bring health care to a large number of people who have been previously uninsured. Access to affordable health care is a goal professional nursing has long supported. One concern is what happens to rural health care facilities and the roles of nurses in rural communities in the future. As with any change I expect there will be some positive and some negative effects associated with the change. The public puts a good deal of trust into nurses. The December 2013 Gallup Poll again ranked nurses as the most trusted profession. This ranking was based on the public s perception of the honesty and ethical PRESIDENT S standards of MESSAGE various professions. As nurses and as an organization, we need to work to assure the best care possible for our rural populations, throughout the inevitable change we see in health care. In my opinion, putting the individuals, families and communities, we care for high on our priority list is another reason nurses have the public trust. Change is inevitable and sometimes sad. We were saddened to hear of the death of Bette Ide, RN, PhD. Bette has been involved in the RNO for many years and held many of the leadership positions in this organization. She was honored as RNO Rural Nurse in 2010. (Continued on page 2)
President s Update (continued) At the time of her death she was Past President and Chair of the Bylaws committee. She will be missed by this organization and many whose lives she touched as a nurse, educator and researcher. Change is inevitable but can also be hopeful producing growth and rejuvenation. RNO members are being asked to vote for incoming Board of Directors positions and new members will be coming on board in the Spring of 2014. I will be stepping down as President and Elizabeth Merwin President Elect will become the new President. I look forward to seeing the direction the organization takes in her capable hands. RNO has been part of my professional life for several years and I will remain active in the organization as Editor of the Online Journal of Rural Nursing and Health Care. I want to thank Karla Jordan, Office Manager and Angeline Bushy, RNO Executive Director as well as our current Board of Directors, Elizabeth Merwin, President-elect; Martha Scheckel, Interim Secretary; Nancy Blume, Treasurer; Sheila Montgomery and Meega Wells, Members at Large; and Committee chairs, Catherine Belden, Sandie Nadelson, Sheila Montgomery, and Nicole Rouhana for their support and enthusiasm for rural nursing and this organization. Upcoming Conference The 2014 International Rural Health and Rural Nursing Research Conference s agenda has now been set. Key speakers will include: Mary Wakefield, Susan Wilburn, Larry Gamm, Judith Kulig, and Clarann Weinert. More information about the conference agenda and the keynote speakers can be found at: http://eu.montana.edu/rural/health/default.ht m Conference registration is currently open at http://eu.montana.edu/rural/health/registratio n.htm Internet Resources for Rural Nurses By Sandie Nadelson, RN, PhD Need information about other rural health related conferences, webinars, networking, or careers? Rural nurses and other health care practitioners can find information about these and other related topics at the NRHA (National Rural Health Association) website: http://www.ruralhealthweb.org/ Looking for grants to fund your nursing research? Whether your work is related to general health, social and civic issues, science, psychology, or the environment, you will likely find a link to a foundation or organization which could help pay for your scholarly work. Over 100 different sources of funding can be found at: http://oedb.org/library/features/100_places_to_fin d_funding_your_research 2
Call for Nomination for the 2014 Anna Mae Ericksen RNO Award Award Criteria for the Purpose of Recognize Outstanding Performance of Rural Nurses: The Anna Mae Ericksen RNO Award The Rural Nurse Organization (RNO) is an international organization formed for the purposes of recognizing, promoting and maintaining the specialty of Rural Nursing practice. As such, the RNO wishes to recognize leadership in the specialty of Rural Nursing and the provision of health care in rural populations. This leadership may have been exhibited in one or more of multiple roles, not limited to practitioner, educator, or researcher. The recipient of this award will have provided a voice for rural nursing in nursing or health care agencies, professional organizations, academia, community and/or government. Typically, the winner of this award will have influenced rural nursing beyond the local level with work that is recognized as supportive of the specialty of rural nursing and / or health care for rural populations. The award winner s work will be recognized as having long lasting influence in rural nursing and health care. This award may be based on recognition of a single achievement or a trajectory of work in the area of rural nursing. Nominations should include a letter of nomination specifying the leadership accomplishments in Rural Nursing by the individual being nominated as well as a CV, resume or biosketch of the individual. Nominations are due by March 15, 2014 and should be sent to Angeline Bushy at Angeline.Bushy@ucf.edu 2014 RNO Board & Officer Nominees Please review the candidates statement of willingness and ability to serve in an elected position on the Executive Board of the RNO. Candidate for President Elect: Sheila Ray Montgomery, MSN, RN Critical Care Nurse, The University of Alabama Birmingham Hospital Adjunct Faculty and Current Doctoral student University of Alabama, Capstone College of Nursing I am willing to run for the President Elect position posted on the RNO website. Shelia Ray Montgomery Biographical Sketch Sheila Ray Montgomery is an international presenter and award-winning nurse. She received her Bachelor of Science in Nursing degree at Jacksonville State University and is working on her dissertation at the University of Alabama, Capstone College of Nursing, in Tuscaloosa, Alabama. She received the Clinical Nurse Excellence Award at UAB Hospital (2008); the Best in Research, National Healthcare Quality Week Award (2010); Financial Excellence Award (2011), Helen Henry Excellence of Care Award (2013), and Adjunct Faculty of the Year from UAB School of Nursing (2013). She has also presented her work both nationally and internationally. Ms. Montgomery has presented on topics such as leadership, success, nursing environments and nursing ethics. Having experience with chronic and acute patients, Ms. Montgomery brings a flavor of clinical inquiry combined with understandings of innovations of research into her work and presentations. Montgomery serves as a 3
critical-care nurse at UAB Hospital and as adjunct faculty at the UAB School of Nursing. Sheila Ray Montgomery has special interest in rural health and rural populations and finished her Masters in Nursing with a special focus on rural case management. She has served the present Board of Directors of RNO as Interim Member at Large. Ms. Montgomery is also presently serving as the website committee chair. Candidate for Secretary: Martha Scheckel, PhD, RN Associate Professor Undergraduate Director Michigan State University, College of Nursing I am interested in running for the Secretary s office within the Rural Nurse Organization. I have been serving as Member-at-Large since being elected to that position in the spring 2013. I have also been serving as Interim Secretary since the fall of 2013. I have enjoyed being part of the RNO Board and look forward to continuing to serve on it. Martha Scheckel Biographical Sketch I am currently serving as an Associate Professor and Undergraduate Programs Director in the College of Nursing at Michigan State University in East Lansing, Michigan. Prior to this appointment, I served as an Associate Professor in the Department of Nursing at Winona State University in Winona, Minnesota. I am interested in serving on the Rural Nursing Organization Board of Directors in the Secretary position. I have a great interest in rural nursing practice. After being raised on a dairy farm in southwestern Iowa, I pursued a nursing career by first obtaining practical and associate degrees in nursing at Marshalltown Community College in Marshalltown, Iowa. Following my basic nursing education, I practiced nursing in oncology/hematology, home care and hospice, and school nursing. My home care and hospice experience occurred in rural Wisconsin where I gained a great appreciation and understanding for the meaning of rural life in relation to health and health care. During the years I worked in nursing practice, I received my baccalaureate, masters, and doctoral degrees in nursing. My research has involved using qualitative research to understand the experiences of students and teachers in nursing education. During the past four years, I have conducted studies about rural residents experiences of receiving patient education. The first study was about rural residents experiences of receiving patient education in rural hospitals. My current study is about rural residents experiences of patient education following cardiac surgery. I am completing data collection for this study by interviewing patients at the time of hospital discharge and six weeks post-operatively in their rural homes. Due to my growing interest in rural research, I would be pleased to accept the Secretary position for the Rural Nursing Organization. Candidates for Members-at-Large: Adrianne J. Lane, B.S., M.S., EdD Professor University of Cincinnati, College of Nursing I am excited to offer my name as a candidate for Member-at-Large for the RNO. I have been a member for a number of years. Although I work in Cincinnati, Ohio, I live in rural Indiana. My professional service and research have focused breaking down barriers to address health needs in rural, underserved populations. I am open to 4
running as a candidate for other positions or even for committee work. I look forward to hearing from you. Have a wonderful holiday season. Adrianne J. Lane Biographical Sketch I earned my BSN from Indiana University, my MSN from the University of Kentucky, and my EdD. in educational administration from the University of Cincinnati. From 1993-2013 I was certified in Medical-Surgical Nursing by ANCC and from 2008-2013 I was certified as a Certified Nurse Educator by NLN. I am a Full Professor of Nursing at the University of Cincinnati College of Nursing and have been a faculty member at UC since 1992. I also am the director of Trinity Health Clinic, a nurse-managed clinic for underinsured adults in southeastern Indiana, serving several rural counties. In 2004 I co-founded and served as president of the Southeastern Indiana Cancer Health Network, Inc. which provided breast health education and screening to underserved, rural women. I have received numerous grants from the Greater Cincinnati Affiliate of the Susan G. Komen Foundation, the Indiana Breast Cancer Awareness Trust, the Avon Foundation Breast Care Fund, and various regional foundations to support breast health programs in rural Indiana. I have numerous presentations and publications related to breast cancer screening in rural, underserved women. In the fall of 2005 I co-authored the article, Characteristics of Rural Women who Participated in a Free Breast Health Program, which was published in the RNO journal, Online Journal of Rural Nursing and Health Care. Gary Laustsen, PhD, FNP-BC, FAANP, FAAN Associate Professor Oregon Health & Science University, School of Nursing, Le Grande Campus I wish to state my interest in running for a position as a Member-at-Large for the Board of Directors of the Rural Nurse Organization. Gary Laustsen Biographical Sketch I am a tenured Associate Professor at Oregon Health & Science University where I teach undergraduate and graduate courses, work as a Family Nurse Practitioner in rural northeastern Oregon, and Direct the DNP Rural Health Track Program. I have 22 years of experience as a nurse educator and 16 years as a Family Nurse Practitioner. I recently completed a research project that surveyed the clinical skills utilized by Oregon primary care nurse practitioners. This study helped shape and inform the content of two rural DNP courses focused on basic rural healthcare and the care of the urgent/emergent patients in rural primary care. I have worked as an FNP in clinics for the underserved, Emergency Departments, rural primary care clinics, and university health centers. My professional goal is to pursue quality nurse education and practice. I currently specialize in rural aspects of advanced practice nursing education, practice, and research. I have served on a number of university committees and task forces related to my expertise in rural nursing. I have also presented my rural-focused research at the International Rural Nursing and Health Conference (2011), National Organization of Nurse Practitioner Faculties annual conferences (2011 & 2012), and the Sigma Theta Tau International 42nd Biennial Convention (2013). In 2013, I was honored to be inducted as a Fellow into the American Association of Nurse Practitioners (June) and as a Fellow in the American Academy of Nursing (October). 5
Jennifer Mallow, PhD, WVCTSI Scholar Assistant Professor West Virginia University, School of Nursing I am interest in running for the position of Member-at-Large on the Board of Directors of the Rural Nurse Organization. I am a member of the RNO. Jennifer Mallow Biographical Sketch The focus of Dr. Mallow s research is the care of uninsured individuals with Chronic Illness. As a clinician, Dr. Mallow has provided care, promoted health and managed disease for rural uninsured individuals since 2002. As a leader at her clinical practice site, she instituted Diabetes Group Medical Visits for uninsured individuals. Through this work, she has successfully lead interdisciplinary teams to achieve successful and measurable outcomes. As a postdoctoral investigator, Dr. Mallow has received the West Virginia Clinical and Translational Science Institute Scholar award. She has recently completed a research project that identified barriers to attendance at health care visits of poor uninsured individuals living in rural areas at a Free Clinic through Electronic Medical Record mining. Her current project centers on developing a healthcare delivery model that includes mhealth technologies in order to improve rural health disparities and access to affordable health care. In addition to the Rural Nurse Organization, she is a member of the following professional organizations: Southern Nursing Research Society WV State Liaison, Sigma Theta Tau, Alpha Rho Chapter Counselor, American Nurses Association/West Virginia Nurses Association Member, Council for the Advancement of Nursing Science Member. Judith Pare, MSN, RN Graduate Program Director & Director of External Partnerships Nursing and Health Professions South New Hampshire University In my current position as Graduate Program Director/Nursing & Health Professions I have had the privilege to work with several of our nursing colleagues who work in rural and critical access hospitals and I value the uniqueness of their practice and their contributions to our profession. I am currently the lead researcher of a qualitative study examining the lived experiences of nurses working in a critical access hospital. Below is my brief biographical sketch for your review Judith Pare Biographical Sketch Judith Pare is a Master s prepared nurse educator and a current PhD candidate in the field of education at Capella University. Judith has over 33-years experience in clinical nursing and nursing education. Currently, Judith holds the position of Graduate Program Director/Nursing & Health Professions at Southern New Hampshire University. In the past she has held a variety of teaching positions in academic settings and as a national lecturer and published author on issues related to Alzheimer s Disease and Related Disorders. Journal Abstracts Abstracts from Online Journal of Rural Nursing and Health Care, 2013, (2) Live health assessment in a virtual class: Eliminating educational burdens for rural distance learners JoAnn Klaassen, RN, MN, JD 1 Carol Schmer, RN, PhD 2 Anita Skarbek, RN, PhD(c) 3 6
1 Associate Clinical Professor, School of Nursing and Health Studies, University of Missouri Kansas City, klaassenj@umkc.edu 2 Assistant Clinical Professor, School of Nursing and Health Studies, University of Missouri Kansas City, schmerc@umkc.edu 3 Assistant Clinical Professor, School of Nursing and Health Studies, University of Missouri Kansas City, skarbeka@umkc.edu Abstract Online nursing education presents challenges for educators. Demonstrating and testing skills acquisition in a nontraditional face to face format is difficult. The Learning Exchange Reverse Demonstration (LERD) Model provides a mechanism that allows students in an online setting to demonstrate skills acquisition with real time faculty feedback, increased student satisfaction, and measureable learned outcomes. A sample consisting of online rural RN- BSN students who utilized the LERD Model was compared to a traditional face to face RN-BSN sample. Both groups were completing the same Health Assessment course. Questionnaires distributed to both groups after completion of the Health Assessment course indicated that the rural students were very satisfied with the LERD Model experience, had less travel and time off work expenses, and achievement of learning outcomes was equal to or greater than those in the traditional face to face format. Although initial expenses are required for the LERD Model, once instituted this model offers a viable alternative to the traditional face to face format that in today s world of online learning is not always possible or practical. This method could allow rural students the opportunity to continue their nursing education while remaining in their communities, thus insuring needed health care will continue in rural areas. http://rnojournal.binghamton.edu/index.p hp/rno/index Pages 6 22 Older Rural Women Moving Up and Moving on in Cardiac Rehabilitation Elizabeth N Austin, PhD, MA, RN, CNE, CEN 1 1Assistant Professor at Department of Nursing, Towson University; Graduate Program Director, Integrated Homeland Security Management, eaustin@towson.edu Abstract Purpose: Cardiac disease often strikes without warning. Its sudden nature interrupts the lives of individuals and families. Recovery from cardiac events may take months or even years. Cardiac rehabilitation (CR) is an essential step in the recovery process. CR improves physical fitness and provides education for the reduction of risk factors for future cardiac events. Women are known to be under-referred to cardiac rehabilitation. Women are also underrepresented in CR research, are less likely to attend CR than men, and may have worse outcomes than men. Little is known about the experiences of older rural women in CR. The purpose of this study was to describe and interpret the experiences of older women who lived in rural communities and attended CR. Sample: A purposive sample of 10 women (ages 60-83) was recruited from three CR centers in Pennsylvania and New York. All women were residents of rural communities and had been discharged from CR. Method: Participants were enrolled in a phenomenological study to identify the meaning of CR for older rural women. Interviews were audio-recorded, transcribed, and analyzed using van Manen s methodology. Findings: Three themes emerged from the study: (a) companionship, (b) hospitality, and (c) accomplishment. Conclusions: The women described CR as a program offering companionship in an atmosphere of hospitality to assist women in accomplishing their personal goals. The study has implications for nursing practice, 7
education, policy, and theory development in rural nursing. http://rnojournal.binghamton.edu/index.p hp/rno/index Pages 23 55 Telehealth Technologies for Heart Failure Disease Management in Rural Areas: An Integrative Research Review Barbara Ann Graves, PhD, RN 1 Cassandra D. Ford, PhD, RN 2 Kathryn Davis Mooney, RN 3 1 Associate Professor of Nursing, Capstone College of Nursing, University of Alabama, agraves@ua.edu 2 Assistant Professor of Nursing, Capstone College of Nursing, University of Alabama, ford039@ua.edu 3 Registered Nurse, ksdmooney@gmail.com Abstract Purpose: The purpose of this integrative research review (IRR) is to present evidence of the use and effectiveness of telehealth technologies for improving health outcomes in heart failure (HF) disease management in general as well as the use and effectiveness specific to rural populations. Background: HF is the most common chronic disease cause of hospitalization in the U.S. with subsequent high admission rates and cost. Because many rural areas are designated as medically underserved, disease management for patients with HF living in rural areas is challenging and in need of innovative management strategies. Telehealth technologies have capabilities to provide frequent surveillance and improve outcomes in a variety of health conditions. Methods: An IRR methodology was used to present evidence of the use and effectiveness of telehealth technologies in the provision of disease management to HF patients in both the general and rural populations. Findings: Results showed five broad themes of effectiveness: improved knowledge, improved self-care behaviors, improved health outcomes, cost reduction and patient satisfaction. Telehealth technologies have proven effective in the management of HF patients by detecting changes in health status earlier, decreasing the rates of hospital readmission and emergency department visits, decreasing costs, and improving self-care behaviors and quality of care. Conclusion: Evidence from clinical trials supports the use of telehealth in disease management in general as well as future development of strategies for management of HF in rural populations. http://rnojournal.binghamton.edu/index.p hp/rno/index Pages 56 83. Perceived Health Status of Farm/Ranch Women Shirley Cudney, MA, RN 1 Clarann Weinert, SC, PhD, RN, FAAN 2 Nicole Todorovich, FNP-BC 3 1 Associate Professor (Retired), College of Nursing, Montana State University, scudney@montana.edu 2 Professor Emerita, College of Nursing, Montana State University, cweinert@montana.edu 3 St. Peters Medical Group, Interventional Pain Management. Helena, MT, thetodors@hotmail.com Abstract Purposes: To (a) describe the self-reported perceptions of health among a group of farm/ranch women with chronic illness, and (b) examine the women s impressions of the impact of farm/ranch living on their health. Sample and Methods: A secondary analysis was done with data generated from a paper/pencil survey of 21 farm/ranch women with chronic illnesses who participated in the Women to Women (WTW) computer-based support and health education project at Montana State University during the past decade. Questions were related to perceived 8
general health status, health as it relates to chronic illness, and health problems associated with farm/ranch living and work. Findings: Farm/ranch women perceived their health positively. In addition to their chronic illnesses, some had illnesses or injuries related to living and or working on a farm/ranch, though few attributed their health problems to the farm/ranch life style. Conclusions: Rural healthcare providers need to be aware of the challenges faced by farm/ranch women with chronic illness such as: isolation, healthcare access, healthcare costs, fatigue, pain, and feelings of anger and guilt. In response, they must provide preventive counsel for the health risks, e.g., injuries, skin conditions, hearing impairment, respiratory disease, which may be associated with living and working on a farm/ranch. http://rnojournal.binghamton.edu/index.p hp/rno/index Pages 84-109 9
2014 RNO Official Ballot President Elect: Vote for one (1) Sheila Ray Montgomery Secretary Vote for one (1) Martha Scheckel Member-at-Large position # 2 Vote for one (1) Adrianne J. Lane Gary Laustsen Jennifer Mallow Judith Pare