From The Desk of Dean Shannon
How very little can be done under the spirit of fear.” - Florence Nightingale
Hello Bobcat Nursing friends,
2020 is an extraordinary year for nurses, the nursing profession and nursing education.
- 200th anniversary of the birth of Florence Nightingale: a visionary leader of the nursing profession who resolutely believed in the power of data and the value of science.
- International Year of the Nurse and Midwife: a celebration of the 20 million nurses and 2 million midwives who work for the health of all people worldwide. Nine million additional nurses will be needed internationally by 2030.
- COVID-19: the novel coronavirus has caused the worst pandemic since the 1918 H1N1 flu pandemic with nearly 300,000 deaths worldwide as of mid-May.
The past six months have shown a spotlight on the role of nurses. Stories of nurses promoting and restoring health; welcoming life and easing its passing; protecting public health and saving critically-ill lives; safeguarding vulnerable elders in long term care and ensuring mental health in a time of social isolation. Nurses have been and will remain at the forefront of the healthcare response to the pandemic.
In this newsletter we share stories of Bobcats who are making a difference such as:
- Cindy Farr, CON and CO-OP alum and Missoula County’s COVID-19 Response Incident Commander who epitomizes the importance of public health nursing.
- Peter Buerhaus, CON faculty who is creating the evidence for decision-making around the healthcare workforce during this time of uncertainty.
- Nate Goodwin, CON senior, who is volunteering at a “bubble hospital” in New York City.
- April Woods-Tatarka, CON alum and a leader within Benefis Health System in Great Falls helping to ensure her healthcare system is able to meet the COVID-19 challenge.
- Julie Ruff, CON faculty who, in partnership with the Fort Peck Tribes, Wolf Point School District, and a community advisory board, leads Art for Wellness to use art to help children.
- Hilary Brannen, CON alum and mental health services leader who is adapting mental health care delivery to help clients avoid using the ED when seeking mental health care during COVID.
- Brittany Coburn, CON faculty and nurse practitioner who writes food prescriptions (vouchers) to address food insecurity and nutrition for vulnerable families.
- All CON faculty who quickly pivoted to deliver all lecture, simulation and clinical content using online and virtual strategies, ensuring student and patient safety.
These are unprecedented times. As Florence Nightingale advised, the MSU College of Nursing is approaching it head-on.
Making a Difference in Montana
Cindy Farr is a December 2007 graduate of the MSU College of Nursing Caring for Our Own Program (CO-OP). She is the Health Promotion Division Director at the Missoula City/County Health Department.Cindy has been in the news since the start of the COVID-19 pandemic. She has provided unwavering leadership during the pandemic acting as the Missoula County’s COVID-19 Response Incident Commander. Cindy credits the support of the CO-OP with her success which includes leading Missoula through the COVID-19 crisis.
"The things I learned throughout my nursing education and the skills learned in the CO-OP program set a strong foundation for my career and leadership in public health." - Cindy Farr
Timely Articles During Historic Times
“Historic times call for health care workforce researchers and analysts doing their part to help strengthen the nation’s health care workforce and defeat the COVID-19 pandemic” - Dr. Peter Buerhaus
For over two decades, nursing has been ranked as the most trusted profession in the country. Research shows that one of the reasons behind the public’s trust of nurses is that people perceive that nurses protect them from potentially unsafe environments, such as when they are hospitalized, and when nurses help during disasters. The media’s frequent and positive portrayal of nurses throughout the current COVID-19 pandemic exemplifies and reinforces these positive public perceptions and has elevated the importance of the profession.
In March, College of Nursing professor Peter Buerhaus organized his workforce colleagues to write two publications simultaneously that supported nurses and other professions in fighting the COVID-19 pandemic. The first article, prepared in 24 hours, reported on the age of the nursing and physician workforce, and the geographic areas of the country where older clinicians practice – many, it turns out, are located in or near coronavirus hot spots. The Journal of the American Medical Association reviewed the manuscript and accepted it within 24 hours, an “all-time record”, noted Buerhaus. The article offers ideas on how to decrease older nurses’ and physicians’ exposure to the virus by having them perform less direct clinical care and, instead, engage in other meaningful activities, such as a consultant to younger staff, advising on the use of resources, being readily available for clinical and organizational problem-solving, helping clinicians and managers make tough decisions, talking with families of patients, advising managers and executives, being public spokespersons, and liaising with public and community health organizations
At the same time this article was being prepared, Buerhaus organized and led the directors of the six federally-funded health workforce centers to prepare an article with a different focus— how to rapidly increase the size of the current health care workforce. The article emphasized the need for health care delivery organizations, health profession educators, and government leaders to cut through bureaucratic red tape that prevents the full use of health care professionals, including nurses, nursing students, physicians, dentists, and many others. The article also acknowledged the need to sustain the workforce over the course of the pandemic by unclogging the educational pipeline of nurses and physicians. Written in only three days, and submitted on the fourth, the article was accepted a few weeks later for publication in the New England Journal of Medicine.
According to Buerhaus, “This was a very focused, productive, and satisfying experience. All of my teammates worked at the top of our abilities, united by the common goal of trying to help make a difference.”
Frogner, B., Fraher, E., Spetz, J., Pittman, P., Moore, J., Beck, A., Armstrong, D., Buerhaus, P. (2020). It’s time to modernize health professions scope of practice regulations. The New England Journal of Medicine, 382(7): 591-593. DOI: 10.1056/NEJMp1911077.
Fraher, E., Frogner, B., Spetz, J., Pittman, P., Moore, J., Beck, A., Armstrong, D., Buerhaus, P. (April 8, 2020). Ensuring and sustaining the pandemic workforce. The New England Journal of Medicine, DOI: 10.1056/NEJMp2006376.
Buerhaus, P., Auerbach, D., Staiger, D. Older clinicians and the surge in Novel Coronavirus Disease 2019 (COVID-19). The Journal of the American Medical Association. (Published online March 30, 2020). DOI:10.1001/jama.2020.4978
During an uncertain time, when everyone scrambled to learn about the coronavirus and COVID-19, the College of Nursing was at the forefront of educating students and faculty. Dean Sarah Shannon and Associate Dean Susan Raph created a simulation module to teach students about the virus and how they could protect themselves and patients.
"The COVID-19 Learning Module prepared by the MSU Leadership was simply fabulous. From Assessment to Pharmacology, Epidemiology to Ethics, there was something in this module for every one of our students (and alumni, preceptors and faculty). As a public health nurse, I really enjoyed the content on risk-reduction and communication priorities in a rapidly changing situation. We have now lived and learned through a live-action, evolving case-study. I think the 8-hour module is a potent and timeless synthesis of nursing content with appeal beyond the classroom.” - Dr. Laura Larsson
The goals of the training were to describe the epidemiology of the virus, analyze infection control measures, and discuss the decision-making process in evidence-based practice. Students were guided through self-paced modules that began with videos describing the epidemiological concepts used to estimate the disease burden and the rate of infection for the virus. Students learned about flattening the curve and why social distancing makes a difference in infection rates. The module covered personal protective equipment and use. It also presented information about the ethics of the pandemic – from the potential rationing of ventilators to the morality of ordering takeout. At the end of each lesson, students completed a written assessment which faculty graded.
“We wanted to create a module that would give our faculty a bit of breathing room while educating our students,” remarked Dean Shannon. “I believe they will emerge smarter, more committed, and more passionate about nursing because of the experiences they’re having in these unprecedented times.”
Faculty across the campuses raved about its usefulness and timeliness.
“I was so impressed by the quality of this module,” said Dr. Laura Larsson, College of Nursing Faculty Member. “And I learned a great deal about the pandemic myself!”
“I knew the necessary precautions to keep both myself and others safe from the illness.” - Nathan Gallegos, Bobcat Nursing Student
Making a Difference in Montana
Nate Goodwin, a senior MSU nursing student, answered an ad he saw on Facebook. Two weeks later he found himself in New York City orienting with healthcare professionals from across the country getting ready to help staff a field hospital called the Bubble, which was built on the Columbia University soccer field. The Bubble is a step-down unit and staff working in the Bubble provide care for COVID-19 patients until discharge. Under the supervision of an RN, Nate cared for up to five patients, working 14-hour shifts with a 2-day on and 1-day off schedule, all while completing his nursing classes online. “It has been a steep learning curve but a very cool experience,” said Nate.
Making a Difference in Montana
Like many other healthcare professionals, April Woods-Tatarka has been immersed in the COVID-19 pandemic. April is the Manager of Quality Improvement, Patient Safety and the Infection Prevention Coordinator for Benefis Health System in Great Falls. She is a Bobcat Nurse alum and current MSN graduate student. “It has been an overwhelming, hectic and sometimes a frightening experience,” said April. “But I am proud of my healthcare system, colleagues across the nation and my University who have led the way during this crisis.” April’s primary goal during the COVID-19 crisis has been patient, staff and community safety. “I let the experts and science guide my path rather than fear,” said April. “My MSU training taught me how to think critically, vet scientific research and work as a team. I am often reminded how fortunate I am to be a Bobcat Nurse. That background prepared me well for my role.”
Making a Difference in Montana
During the COVID-19 pandemic access to mental health services is critical according to Hilary Brannen, Director of Nursing at the Western Montana Mental Health Center (WMMHC). Hilary is a Bobcat Nurse alum and current DNP graduate student. Hilary and her clinic partners wanted to reduce the number of people having to go to the emergency room (ER) for mental health care needs. To accomplish this WMMHC teamed up with Bozeman Health and community partners to create the Behavioral Health Urgent Care Center. This center allows behavioral health needs to be addressed safely and efficiently outside the ER. Hilary said, “The College of Nursing taught me to seek out creative ways to utilize available resources. This collaboration effectively provided a needed resource to those struggling with their mental health or substance abuse concerns. It betters the community.”
The Caring for Our Own Program, a College of Nursing program designed to help American Indian nursing students succeed in nursing, celebrated its 20th anniversary last fall. Adding to the celebration the College of Nursing received a grant renewal from the Indian Health Service for $2.1 million. This grant will be used to support approximately 10 American Indian nursing students per year with funds for tuition, books, and other educational expenses. In return these student then pay back that support by serving in an Indian Health Service facility for two years.
SWITCHING TO VIRTUAL IN SEVEN DAYS
Not surprising spring semester 2020 has been one of the most challenging semesters the College of Nursing (CON) has ever faced in the long history of the Bobcat Nursing Program. Those challenges, however, brought opportunities for growth, collaboration and empathy and tested the CON in ways never expected. What became clear as the semester closed was that the CON had demonstrated the extraordinary ability to quickly react to an unexpected and rare crisis while continuing to deliver high quality nursing education to meet the needs of Montana and the nation.
Back in March of 2020, in a span of a mere week and in response to the COVID-19 pandemic, CON faculty were required to switch both classroom and clinical teaching to the remote or virtual learning environment; something many had never done. At that point in time CON faculty and staff also packed up offices to provide student and institutional support from home for an unknown timeframe. CON faculty quickly adapted to teaching in new formats in response to clinical agency need and for the safety of the nursing students. Yet, consistent with how nurses approach challenges, the plans came together quickly and without complaint.
"In these difficult times, the we remain committed to educating the next generation of Bobcat Nurses!" Sue Raph, Associate Dean for Academic Affairs
One of the most striking accomplishments was the conversion to virtual clinical education. CON faculty seized the opportunity to utilize vSim®, a virtual simulation platform that immerses students in realistic patient interactions. The CON was well positioned to utilize vSim® because by the time all clinical experiences had to go virtual or online all nursing courses had already met 70-80% of course and clinical objectives. Faculty expertly filled the remaining part of the semester by utilizing vSim® scenarios to replace live, in-person hours lost to the COVID-19 pandemic. The virtual clinical environment provided opportunities for students to assess, plan, deliver and evaluate patient care on the computer as well as a means for faculty to evaluate and provide feedback for the students. Professor Karrin Sax, Missoula Campus, noted, “vSim® has helped the students ‘think’ like a nurse!” The platform allows a student to repeat his or her efforts to further solidify patient care learning. An overall evaluation of the utilization of the teaching method is underway to assist the College in planning for a future that may present an unpredictable, live clinical environment.
Art is something that makes you breathe with a different kind of happiness – Anni Albers
Imagine the chatter and excitement of sixty 4th grade students creating art; welcome to the bi-monthly Art for Wellness project. Art for Wellness is the creation of an ongoing partnership with the Fort Peck Tribes, Wolf Point School District, a Community Advisory Board, and College of Nursing faculty member Dr. Julie Ruff. The project consists of health and wellness education lessons aimed at children’s empowerment and resiliency and is capped with an art activity. While the children are creating their masterpieces, healing music or native drumming and song is played. In addition, the kids are provided with a healthy snack, supported by nutrition education. Art supplies are provided and include the title, instructions and an example of the activity. After each Art for Wellness session a meeting is held with the school superintendent, principal, an elder, and the 4th grade teachers and staff. Ideas are shared and the group discusses what was learned, what went well, and concerns. “Through this process, we have been able to identify children who are grieving, children who are disengaged with school, struggling with relationships in school or at home, and children who may need additional support services in the educational setting,” said Ruff. At the end of the school year the children’s artwork is displayed (with permission) in a public building located on the reservation. The community is invited to celebrate the children’s art and accomplishments. Ruff said there are plans for the Art for Wellness project to continue with hope for a spin-off project with a focus on stress in Indigenous children and its effects on lifelong health and well being.
Every Child is an Artist - Piscasso
Bobcat Nurse Faculty Making an Impact in their Communities
BOZEMAN - Drs. Jennifer Sofie and Ann Galloway helped develop the Bozeman Health House Calls Program, part of geriatric services within Bozeman Health Internal Medicine. The geriatric team (MDs and NPs) provides services in the clinic, nursing homes and via the house calls program. Sofie and Galloway conduct NP home visits to frail, elderly patients who have difficulty leaving home for medical care. The goal is to allow patients to remain living at home, prevent hospital admissions and/or readmissions, and decrease emergency department visits.
BILLINGS - Ms. Jeanne Conner provides primary care services to individuals and families working in agriculture. The Montana Migrant & Seasonal Farmworkers Council provides health services including primary care, dental hygiene, and behavioral health working closely with families to promote health and positive development, and to manage chronic health problems across the lifespan. The Council is headquartered in Billings, MT but provides summer outreach to Hardin, Shepherd, Harlowton, and other rural areas of Montana.
GREAT FALLS - Dr. Paul Krogue, through Planned Parenthood Cascade County Detention Center, provides care for local, state, and federal inmates. He is part of team that manages mental health and chronic health care problems, as well as a variety of acute conditions and injuries for approximately 300 inmates. The Cascade County Detention Center employs several Bobcat Nurses and is a clinical site for MSU nursing graduate students.
KALISPELL - Ms. Brittany Coburn works with a support organization called Farm Hands - Nourish the Flathead. The mission of Farm Hands Nourish is to build a strong community food system that fosters socially just ways of accessing food. Coburn prescribes for the Food Rx program writing prescriptions (vouchers) for clients that need dietary intervention. Food Rx can be exchanged at local markets and farmers markets for fresh fruits and vegetables.
MISSOULA - Dr. Dorothy “Dale” Mayer provides faculty mentorship for an interprofessional team of health professional students who identify patients that are high utilizers of health care services (“hot spots”). As an interprofessional team, students collaborate to identify ways to improve the quality and efficiency of care for these complex patients while saving the health system money.
Congratulations to Drs. Alice Running and Sandra Benavides-Vaello on completing their Integrative Nursing Fellows!
Drs. Alice Running and Sandra Benavides-Vaello completed an intensive 1-year fellowship in Integrative Nursing at the University of Arizona, College of Nursing. This program trains nurse educators and researchers to lead students, clinicians, and systems in whole-person, patient-centered care models that utilize the full range of therapeutic interventions. Key elements of the program include developing expertise in integrative and wellness approaches, improving health outcomes, expanding knowledge of national standards in integrative nursing core competencies, and meeting global demand for cost-effective, safe, and responsive health interventions. Dr. Running completed 200-hour Yoga Teacher Training and a Heart Math for Health Care Providers program; Dr. Benavides-Vaello completed Level 2 (Chuden, and currently in Level 3, Okuden) Japanese Reiki Training and Mindful Meditation to meet the expertise in integrative and wellness approaches to health requirement. Both aim to expand their health outcomes research to include these modalities. Congratulations on this achievement!
Recognized for Excellence
The College is proud to announce that Jennifer Sofie received the American Association of Nurse Practitioners 2020 State Award for Excellence. The award is given annually to one dedicated nurse practitioner in each state who demonstrates excellence in her or his area of practice. Sofie is Montana’s awardee!
61 MSU Nursing Students Graduate Early
Extraordinary, dedicated, and inspiring are just a few of the words used to describe this group of students. In March the College of Nursing offered students an early graduation option to enable them to enter the workforce as soon as possible to help address the need for health care workers during the COVID-19 pandemic. Sixty-one seniors worked hard to complete all course requirements by April 20, 2020 to finish three weeks early.