Happy spring Nurses of Georgia! 

It has been a wonderful two years of growth, learning, and exciting change! We are in a time where it is essential that we lend our voices and spring into action! There are many milestones that we have seen together and legislation that has been enacted because of Our diligence. 

However, the work continues. This Nurses' month let's make it count! The power of Nurses is being amplified through advocacy. Being the largest part of the healthcare mix, our voices hold weight. When we speak in unity, and when we allow our passion to be felt, policies change!

It has been my honor to be the chairwoman of the board of directors for the Georgia Nurses Association (GNA) for the past two years. In August, I will pass the torch to the very capable Dr. Joy King. She has been an unwavering support system for me in this role as well as an advocate for the Georgia Nurses Association in many roles. Joy, your hard work does not go unnoticed! I'm so grateful to have gained a nurse sister, friend for life.

I would like to take this time to thank the hard-working board of the GNA. Each of the directors hold their positions very dearly and take them seriously. 

I am grateful to the awesome staff of the GNA. Thank you, Matt Caseman for being the best honorary nurse ever. 

The incomparable relationship that the GNA holds with the Georgia Nurses Foundation makes it even better. To the outgoing president, Wanda Jones. Thank you for being a guiding force and inspiration to many. Wanda has been by my side through it all. It has been a sincere honor to work alongside of you and to have the wealth of knowledge that you have at my fingertips. Thank you, thank you and thank you! 

It is a great pleasure to welcome the new slate of candidates. Best wishes to each of you.

Voting is very important, and it is your civic duty. As a member of this organization, we ask that you consider exercising your right to be informed with each of the candidates and to vote accordingly.

I will continue to serve in the role as an advisor now that I have this experience under my belt. I have used many of my messages to the membership to not only express my gratitude for you all entrusting me in this role, but also for encouragement of self-care. I would be remiss if I did not continue along these lines by reminding you as spring comes into season that it is time to smell the roses. Stop and do those things that bring a smile to your face again.

It is ok to have fun and to do things that bring you happiness. Sometimes that involves going back to things that are primitive. I enjoy coloring because it takes your mind to a new place and it allows it to rest for a little bit. 

At the conference, August 22 through the 24th in Columbus, you will have the opportunity to not only continue your education but also to take part in exploring the beautiful city and all that it has to offer! The downtown area is quite scenic, filled with many restaurants and businesses that you can patronize. Also, there are several upcoming events posted by the GNA and partners that are listed on the website. Please look at the events page and join us as we gather and continue to work on our priorities. 

This 2025 legislative session was extremely fruitful. A huge thank you to GNA Senior Director of Membership & Government Affairs Tim Davis who works tirelessly alongside of our very reputable lobbyists. We have forged many great relationships under the gold dome, and it shows. 

The summer months are a time where many families get together and do fun things. As you gather with your family and plan your downtime, remember that you have earned it and you deserve it! 

There are many legislators who are nurse advocates, and huge supporters who are looking for opportunities to help remedy some of the less desirable situations that we find ourselves in. Become their trusted advisor. There is innovative work being done in the state of Georgia.

Although Georgia is currently ranked number seven in the nursing shortage, GNA is working feverishly to improve the practice environment for nurses. If you have any suggestions on ways that we can attract talent to help curtail this issue, we are here to listen. Nurses, THANK YOU for all that you do. 

Allow me to be one of the first to tell you "happy nurses week" and happy national nurses month. We hope to celebrate with you at GNA Headquarters on May 3! 

Please do not forget to celebrate yourself a little more this month and to recommit to the passion that brought you into our beloved profession! 

Wishes of continued health to you and yours.

With immense gratitude, Erica Mills, PhD, RN, NPD-BC,

President, Georgia Nurses Association

The Georgia Nurses Association (GNA), the state's largest professional association for registered nurses and affiliate of the American Nurses Association (ANA), is excited to host its 2025 Conference and Membership Assembly on August 22nd through the 24th at the Columbus Georgia Convention and Trade Center.

Attendees of this always robust and dynamic conference range from CNOs, Deans and Directors, Bedside Nurses, Faculty, Home Health, APRNs, Students, Retirees, Public Health, and School Nurses, and much more. GNA members are innovative healthcare practitioners and team champions within their respective practices.

Our keynote speakers this year include two nurses doing amazing work on a national scale.

Dr. Katie Boston-Leary, PhD, MBA, MHA, RN, NEA-BC, FADLN, FAONL, is the Senior Vice President of Equity and Engagement at the American Nurses Association addressing DEIAB and workforce challenges within the profession. Katie is an Adjunct Professor at the University of Maryland School of Nursing and the School of Nursing at Case Western Reserve University. Katie leads the National Commission to Address Racism in Nursing and served on the National Academy of Science and Medicine's National Plan to Address Clinician Well-Being supported by the previous U.S. Surgeon General.

Katie authored two chapters in The Sage Encyclopedia of Multicultural Counseling, Social Justice, and Advocacy, the first encyclopedia focused on racism and Diversity, Equity, Inclusion and Belonging. Katie was also featured in the award-winning documentary film, Everybody's Work funded by the Robert Wood Johnson Foundation.

She was identified in August 2019 Health Leaders Media Journal as "One of Five Chief Nursing Officers Changing Healthcare". She also won the ICABA TD Bank 2023 Woman of Impact award and the 2024 Spectrum Circle Award for Innovation in Health. She was recently inducted as a Distinguished Fellow at the Academy of Diversity Leaders in Nursing with the National Black Nurses Association and will be inducted this year as a Fellow with American Organization of Nursing Leadership (AONL).

Lynn Pierce, FNP-C, is a Risk Consultant with AON Affinity. Her background includes working in risk management as a director for an insurance carrier, acute care hospitals and integrated healthcare systems. She has also held leadership positions in quality, HIPAA privacy, environmental and patient safety, case management, corporate compliance, Workers' Compensation, and infection prevention. As a clinician, she practiced in such clinical settings as emergency, surgical, and cardiac critical care, and cardiac and orthopedic rehabilitation services. Lynn is a subject matter expert for developing content, educating healthcare providers, and researching recommendations based on standards of practice. Prior to joining the risk management team at Aon, she worked as a full-time Nurse Practitioner in Georgia, where she lives.

This is your opportunity to not only hear from these two amazing keynote speakers, but a way to come together as nurses in what is sure to be a great couple of days of seeing old friends, building new relationships, learning, and having a good time!

And if that wasn't enough, attendees will enjoy the benefits of discounted rates at over 20 businesses in the area through the Show Your Badge Discount Card Program. From dining, shopping, to activities - an additional perk for joining us in Columbus!

That said, we could not be more excited and hope you join us. Don't delay, take advantage of the Early Bird Rate, which ends April 30th, and sign up today.

Up to 15 contact hours are available to participants who attend the entire conference.

To learn more and register, click here.

Thank you for choosing the number one trusted profession, nursing!

I am deeply honored to have received the Ruth Hartley Mosley Pioneer of Community Advancement Award at the Central Georgia Women of Impact Annual Awards Ceremony on March 8, 2025. This recognition, presented on International Women's Day, not only celebrates individual contributions but also honors the remarkable legacy of Ruth Hartley Mosley---a visionary whose impact continues to shape our communities and serve as a guiding light for current and future leaders in healthcare.

A Life of Purpose and Pioneering Impact

Born in Savannah, Georgia, in 1886, Ruth Hartley Mosley was a trailblazer in every sense of the word. After completing her nursing education in Concord, North Carolina, and clinical training at Provident Hospital in Chicago, she became the first African American nurse appointed head nurse of the "Colored Females Department" at the Georgia State Sanitarium in Milledgeville at just 24 years old. In 1938, she began serving as a nurse with the Health Department and with Bibb County Schools---continuing her lifelong commitment to the care and well-being of others.

Mrs. Mosley was also a midwife and was deeply committed to improving maternal and infant health outcomes within her community. She dedicated herself to educating and mentoring Black midwives across Georgia at a time when access to safe, culturally competent reproductive care was extremely limited for African American families. Her influence helped to expand access to quality maternal care and uplifted an entire generation of midwives.

In addition to breaking barriers in healthcare, Mosley was a successful entrepreneur and community leader. She and her first husband, Richard Hartley, owned and operated a funeral home in Macon. Demonstrating her commitment to excellence and breaking new ground for women in business, she became one of the first women to earn a mortician's license in Georgia. She went on to grow the business substantially. She also invested in real estate, at one point owning over 100 rental properties. But Ruth's success was not merely in personal gain---it was in her unrelenting service to others. She was an active civil rights leader, organizing sit-ins and serving as a key figure in the Macon chapter of the NAACP. She also helped establish the Booker T. Washington Community Center, further cementing her legacy of civic engagement.

Inspiration for Nursing Leaders

Ruth Hartley Mosley's multifaceted career offers profound inspiration for current and aspiring nursing leaders. Her pioneering spirit is evident in her rise to leadership in an era plagued by racial and gender inequality---exemplifying courage, tenacity, and vision. She was deeply committed to education, and upon her death in 1975 at the age of 89, her estate included two major trust funds. One established the Ruth Hartley Mosley Memorial Fund to support students pursuing careers in nursing and other healthcare professions. The other established the Ruth Hartley Mosley Memorial Women's Center, located in her home on Spring Street in Macon, Georgia---a space that continues to serve and empower the community to this day.

Mosley's dedication to community engagement is another cornerstone of her legacy. Her activism reminds us that nurses---and all healthcare professionals---can be powerful agents of change beyond clinical walls, advocating for health equity, social justice, and systemic transformation.

A Heartfelt Thank You

I extend my deepest gratitude to the Ruth Hartley Mosley Center committee for selecting me for this award, with special thanks to Ms. Sylvia McGee for her warmth and generosity. I am also incredibly grateful to Dr. Keisha Callins for presenting the award to me. As the inaugural recipient of the Ruth Hartley Mosley Pioneer of Community Advancement Award, Dr. Callins embodies the legacy of service and leadership this recognition represents. Her unwavering support of the healthcare profession and the patients of Georgia continues to inspire so many. Dr. Callins, an OB/GYN and dedicated community health advocate, exemplifies the same passion for uplifting others that Ruth Hartley Mosley championed throughout her life.

Ruth Hartley Mosley achieved striking success against heavy odds, and her legacy reminds us that true leadership is rooted in compassion, service, and unwavering commitment to the greater good. May her life continue to inspire nurses and healthcare professionals across Georgia and beyond to lead with courage and purpose.

Scroll through the slideshow below to see a full slate of candidates for all open positions.

I recently observed people in a couple of different (unrelated) situations react ever so quickly to an encounter each had. At the time, I wondered if responding so rapidly was truly in the best interest of all involved, including the individuals reacting. There is not necessarily any right or wrong answer here, but it did get me thinking. I found information on the discipline of "pause" or "selah" in Hebrew. For those who enjoy Biblical references, it is mentioned more than 70 times in the book of Psalms. Selah is the practice of creating space and time to step away from "doing" or "speaking" and allowing yourself to simply "be." Taking a break can help you be more resilient, focused, and even more creative. Challenges may not seem so overwhelming, and decision-making may come forth without as much difficulty. Overall, you may realize your performance is enhanced by practicing the discipline of Selah. On the receiving end, listeners may appreciate the extra time allotted for them to process what is happening or has just occurred.

Imagine a baseball player practicing with a pitching machine. But it is adjusted way beyond the pace the player can handle. No matter the level of expertise, the player will soon become exhausted, overwhelmed, and defeated. Only by pausing, readjusting the machine, and deciding which pitches are best to hit will the player be able to improve his/her game and become an even better player. It's impossible to tackle each and every ball tossed towards the player. It's best to "take a pause."

Again, for the Biblical scholars among us, throughout Psalms, David shares his hopes, dreams, fears, and faith. He often presents himself to God in pain and agony, in great distress. When reading David's words, the reader can also imagine the ebb and flow of the turmoil churning in his soul. At one point, a change occurs in David. Selah! He pauses in the presence of Spirit and gains a new perspective. David finds hope in his situation. See Psalm 32:7 for the scripture reference. We can also find a new way of looking at situations and circumstances by taking time to reflect, meditate, and pause our actions.

Have you ever heard someone proclaim, "I'm glad I did not leave my house when I was intending. I would have been in the middle of a fatal accident on the highway."? Whether it was a pause or something else that required attention, it is later realized as a blessing that the person didn't rush out of the house as scheduled.

So how does one truly practice the discipline of Selah? It can be as simple as scheduling short breaks throughout the day to pause and reflect- nothing lengthy, maybe 10 minutes at most. We can all find that amount of time in a few places in our daily lives. One way that helps me is to take advantage of natural transitions, such as getting in and out of the car as I travel between patients. If you need something more profound, perhaps setting an alarm on your smartphone might be in order. You could take a walk around the building where you work or plan an afternoon tea or coffee break. In my role as the Clinical Nurse Specialist, the charge nurse and I would stop at 4 pm daily to have "high tea." We found it helpful to take this break from the craziness of the unit. Even after just fifteen minutes, we felt refreshed and ready to finish the remainder of our shift. If you stop and think about it, there are many opportunities to practice pausing.

SmartBrief on Leadership published an article by Chris O'Neill in which the author suggests at least four critical times a leader should pause before making a decision. First, in business, take a moment before a major launch or initiative. In my current practice as a hospice nurse, it's important to pause (on your own and then with the loved ones) before making a change from full care to comfort or supportive care. Another opportunity in business is when you believe it's necessary to regain control of a situation. In hospice, this may occur when family choices have not yielded the desired outcome, and it's time to have a reality check so that the patient's wishes are upheld. Thirdly, O'Neill recommends a leader pause prior to updating assumptions, especially when technology or regulations have shifted. In hospice, this may be the point when caregivers are no longer able to care for their loved one but can't accept the realization that long-term care may be the next step. Lastly, to prevent burnout and enhance performance ability, leaders need to take a "time-out" to prevent making costly mistakes. In nursing, burnout is very costly -- to ourselves, our employers, and most importantly, those in our care.

Let me know if you find a way to practice selah in your professional (or personal) life. I would love to hear your stories. Thank you.

Nursing faculty at the Nell Hodgson Woodruff School of Nursing (NHWSON) identified an opportunity to support students while in school and simultaneously support their successful nursing practice. This interest emerged alongside growing awareness of the importance of teaching students to deliver trauma-informed care (Burton,2019). Secondary traumatic stress is a common risk for professionals caring for individuals affected by trauma. While nursing students are being trained to provide care to others, it may be the most opportune time to teach effective tools to manage personal stress and promote personal well-being. This is particularly important, potentially a critical education gap, as we recognize the mental health toll on nursing may be among the highest in healthcare (Davis, 2021).

The Community Resiliency Model (CRM) was first incorporated into the curriculum to be addressed in 2019. The initiative emanated from an ongoing research project focused on providing concrete, evidence-based tools to help practicing nurses manage stress, prevent burnout, and maintain well-being while providing compassionate care (Grabbe, 2020). Faculty recognized that our own well-being as nurses is an investment that needs to begin in school and that the ability to engage in self-care to respond and heal from personal trauma or secondary stress may directly affect a nurse's ability to be available for and provide the best care for patients.

An Innovative Approach to Building Resilience

The Community Resiliency Model is an innovative body-based wellness approach that teaches practical, body-based skills to regulate the nervous system's response to stress. Derived from somatic psychotherapy, CRM offers a unique set of self-care skills that can be adapted for diverse populations and contexts (Miller-Karas, 2023). The six wellness skills of the model help individuals develop sensory-motor awareness and strengths-based communication. Unlike traditional stress management programs that often rely on cognitive strategies alone, CRM emphasizes interoceptive awareness---the ability to recognize and respond to internal bodily sensations related to well-being or distress.

Curriculum Integration Across Programs and Beyond

CRM training was integrated into nursing students' curriculum at multiple levels. For prelicensure students (BSN and MN programs), CRM skills were introduced during first-year professionalism classes. This early integration establishes self-care as a foundational professional competency. Students are encouraged to be "CRM guides", meaning the skills they learn can be immediately shared with others in the form of emotional regulation, peer support, and trauma-responsive communication. For post-licensure programs (MSN and DNP), in addition to being preventative and taught as self-care, CRM serves as a complementary approach to motivational interviewing and other advanced communication strategies that are part of graduate program outcomes. CRM vocabulary provides a shared language for the nurses. Creating this common knowledge across the school promotes a culture of openness and normalizing attention to mental health that transfers into the workplace. To promote sustainability, interested students and faculty were trained to teach the model through the Trauma Resource Institute. This embedded expert approach has increased capacity to share the model within the school and beyond. In response to the increased demand for resilience training, Drs. Grabbe and Duva established CRMGeorgia, a non-profit that partners with organizations such as the Georgia Nurses' Association and Resilient Georgia, and the Department of Juvenile Justice to deliver CRM training throughout the state.

Research and Practical Outcomes

The faculty team is also actively conducting research to evaluate the effectiveness of this educational approach for promoting well-being in healthcare workers as well. Their published work includes a randomized controlled trial with healthcare workers before and during COVID-19 (Duva et al., 2022; Grabbe 2020) and studies with nursing students and professionals (Grabbe et al., 2022). This research carefully examined various aspects of educational delivery, including appropriate training dosage, optimal delivery modes, and skill acquisition and retention among participants. Results from these studies involving several hundred nurses and healthcare workers demonstrate that just 1-3 hours of learning this model can produce significant benefits:

• Decreased symptoms of secondary traumatic stress

• Increased well-being

• Enhanced perceptions of teamwork in practice

• Improved resilience and reduced stress, anxiety, and depression

Nurse participants consistently report the value of these skills in their practice. As one nurse shared: "I ground myself before I enter the patient's room, and I know this helps me be present for the visiting family and calm." Another noted, "I can notice now when I am getting upset, but before I act on it."

There are also multiple examples of recent nursing graduates who are additionally trained to teach CRM, incorporating this model into their practice. A nurse practitioner graduate began teaching the nurses in her clinic skills, such as conversational resourcing, to improve their communication with patients during difficult moments. Another nurse practitioner reported back that skills such as "grounding" and "resourcing" helped improve uptake of the COVID-19 vaccine as patients were calmed themselves before receiving the shot. Another impressive use of CRM in practice is by Jordan Murphy, who leads "CRM for Georgia's Children" as part of a first-line wellness intervention within the Bridges to Therapy framework to provide interim behavioral health care in the state (Freeman, 2023).

Implications:

The integration of resilience training into nursing curricula represents a paradigm shift that acknowledges self-care as an essential component of professional nursing practice, not an optional add-on. This initiative demonstrates how faculty scholarship can transform nursing education while simultaneously addressing critical needs in the profession, preparing graduates with both clinical expertise and concrete skills for sustainable practice.

These early benefits leave little doubt that the nursing education community will benefit from evidence-based approaches to integrate resilience training into curricula, as this is an opportunity for pedagogy to simultaneously address educational and professional needs.

Introduction

This HRSA grant-funded project consisted of providing COVID-19 vaccines and education to the residents of the Clayton County community. A county-level approach to fighting COVID-19 involves tailoring strategies and interventions to the specific needs, resources, and circumstances of a particular geographical area. The specific goals of the project were to: a) create a county-wide COVID-19 vaccine administration coalition entitled Clayton Calling the Shots: Get Out the VAX (CCTS) by August 31st, 2021, and b) increase Clayton County's COVID-19's fully vaccine rates from the current CDC recorded rate of 7.9 % as of May 30th, 2021, to at least the Georgia COVID state average on June 30th, 2022. Successes of the project will be discussed.

Methods

This project involved community outreach to address the low COVID-19 vaccination rates in Clayton County, GA. The need of the proposed target population was identified using the CDC COVID vaccination rates for Clayton County as of May 30th, 2021 https://covid.cdc.gov/covid-data-tracker/#county-view and the CDC Social Vulnerability Index (SVI) . The CDC posted the COVID-19 vaccination rate for Clayton County on May 30th, 2021, was 7.9%, https://svi.cdc.gov/map.html. This vaccination rate was compared to the overall state fully vaccinated rate in Georgia of 31% reported by the CDC as of May 28th, 2021, and found to be alarmingly low. In addition, Clayton County has an SVI of .91, which means that Clayton citizens are at risk during public health emergencies due to factors like socioeconomic status, household composition, minority status or housing type, and transportation issues.

While creating vaccine clinics and opportunities for COVID vaccinations and as a part of community outreach, the CCTS grant team collaborated with many entities that assisted with conducting the grant activities. The primary creative partnerships were formed initially included Clayton State University (CSU), Clayton County Health District (CCHD), Clayton County Fire and Emergency Services (CCFD), Clayton County Public School System (CCPS), faith-based organizations, and Clayton County Senior Services (CCSS). Several unexpected partnerships were also formed. 

Key activities of the grant included vaccine administration, vaccine education, and community outreach. Vaccine administration occurred throughout the county at a local hospital clinic provided by a local facility, elementary, middle, and high schools, CSU, and community events. Collaborating with a local university was favorable to the grant as most of the vaccines were administered by the grant team along with student nurses. Regarding vaccine education, most outlets included social media platforms, a personally created website, various Clayton County Schools locations, CSU, and various community sites. Vaccines administered were tracked and entered into the Georgia Registry of Immunizations and Transactions Services (GRITS). Each vaccine administered was accompanied by a $50 gift card to Walmart®.

Results

At the conclusion of the project, the following were considered successes of the project:

Vaccine administration. The grant team strategized on how to market and promote the benefits of the COVID-19 vaccine in a sensitive and non-intimidating way. Building rapport with community members and working at a local clinic and other sites proved successful as the vaccination rate for Clayton County increased from 7.9% in 2021 to 46% in May 2023. As a result of the grant team's vaccine administration efforts, a total of 3,347 vaccinations were administered.

Vaccine education. The grant team was not only successful in providing education online and in-person, but through various team members, was able to engage over 70,000 individuals during the 2-year grant period.

Community outreach. The grant team utilized a coalition of entities to provide information and allow access to vaccine administration. The aim was to help prevent the spread of the virus and mitigate its impact on the community. High school vaccine navigators were able to participate. In total, 11 Student Public Health Educators recorded 57,330 interactions with schoolmates in seven high schools and community members.

Discussion

At the beginning of the pandemic, there was much consternation and uncertainty. Finding ways to combat COVID-19 was multilayered, with counties playing a significant role in prevention efforts. HRSA grant funding allowed for the dissemination of accurate information, enforcement of health measures, and, most importantly for this project, vaccine campaigns.

Conclusion

The COVID-19 pandemic brought unprecedented challenges to communities around the world. Addressing the COVID-19 pandemic required a coordinated effort at the individual, community, and national levels. County-level interventions played an integral role in increasing access to vaccines, increasing knowledge of the virus transmission, and decreasing rates of infection. Fighting COVID-19 at the county level has been a critical aspect of the global response to the pandemic.

Nurses Service Organization (NSO), in collaboration with CNA, has published our 4th Edition of the NSO/CNA Nurse Liability Claim Report. It includes statistical data and case scenarios from CNA claim files, as well as risk management recommendations designed to help nurses reduce their malpractice exposures and improve patient safety.

You may access the complete report and additional Risk Control Spotlights at: www.nso.com/nurseclaimreport.

This Nurse Spotlight focuses the analysis and risk recommendations regarding one of the most significant topics in the report and for nursing professionals: Healthcare Documentation.

Nursing Allegations Related to Healthcare Documentation

While documenting care represents a critical component of nursing processes and standards, the electronic health record [EHR] has posed a level of complexity for nurses who are often challenged with why, how, what, and where to document in a patient’s EHR.

Documentation deficiencies are contributing factors to many nurse professional liability claims, as well as license protection matters. However, in the 4th Edition of the NSO/CNA Nurse Liability Claim Report, failure to document or falsifying documentation closed claims, as an allegation of professional liability, increased in distribution and severity when compared to the 2011 closed claim report and the 2015 closed claim report. Below is an example of a professional liability claim asserted against a nurse due to the failure to document:

Nurse Legal Case Study: Absence of documentation in violation of nursing standard of care

The patient was admitted to a rehabilitation facility after undergoing a right hip arthroplasty. Due to the patient’s other co-morbidities, her rehabilitation and recovery were slow and difficult. The patient’s health continued to deteriorate during her admission until her death four months following admission. After the death of the patient, the family (plaintiffs) filed a complaint with the Department of Health (DOH) regarding the patient’s care at the facility.

The DOH investigated the complaint and cited 13 violations in the nursing standard of care. In particular, the DOH was critical of the absence of documentation related to care plans for the Foley catheter, the patient’s weight loss (from 93 to 77 pounds over four months), and neither shower nor self-care was documented for a timespan of more than five weeks. The insured registered nurse (RN) was the facility’s wound care nurse, and the DOH’s investigation found several violations of the nursing standard of care specific to the RN’s lack of documentation. First, the DON found a lack of documentation regarding a nursing incision wound for a period of approximately three weeks. The RN told the DOH surveyor that daily assessments were performed during that time, but since the wound care orders were to leave the right hip incision wound open to air, no treatment was performed, so the RN did not document anything. The patient also had a left heel pressure injury that was not healing, and the RN agreed that this non-healing injury had not been appropriately assessed or documented. Moreover, the director of nursing informed the DOH surveyor that the RN was required to perform weekly assessments on all patients in the facility. However, none were noted in the patient’s healthcare information records during a three-month period.

After seeing the DOH report, the family sued the facility and sued the insured RN separately. Knowing the challenges of the missing documentation and the negative DOH report, mediation was proposed with the plaintiffs. The total incurred amount to defend and settle this case on behalf of the insured RN was greater than $270,000.

In the 2011 closed claim report, 0.2 percent ($31,250) of all closed claims were related to inadequate or inappropriate documentation as the primary allegation. This data increased slightly to 0.5 percent ($139,920) in the 2015 closed claim report. Respectively, in the 2020 closed claim report, documentation allegations represent 2.0 percent ($238,761) of all closed claims.

License Protection Allegations Related to Documentation Errors and Omissions

A license protection matter and a professional liability claim reflect a number of differences. First, a license protection matter only involves the cost of providing legal representation to defend the nurse before a regulatory agency or State Board of Nursing (SBON). On the other hand, professional liability claims include an indemnity or settlement payment. Second, license protection matters asserted against a nurse’s license to practice may or may not involve allegations related to patient treatment and care. The Nurse Spotlight: Defending Your License provides an overview of the role of the State Board of Nursing in the legal/regulatory system, describes the disciplinary process, and imparts helpful recommendations on defending yourself if you were to receive a complaint summons.

A nurse’s license is one’s livelihood, and its protection is paramount. A nurse’s practice and behavior is expected to be safe, competent, ethical, and in compliance with applicable laws and rules. However, when a complaint is filed, nurses must be equipped with the resources to adequately defend themselves. Being unprepared may represent the difference between a nurse retaining or losing the license to practice, a suspension, or fine.

The False Claims Act

While documentation deficiencies may result in a professional liability claim and/or a license protections matter, nurses also may be subject to federal and state sanctions for knowingly falsifying healthcare documentation under the federal False Claims Act (FCA). The FCA imposes liability on any person who submits a claim to the federal government that they know (or should have known) is false. An example may be a healthcare provider who submits a bill to Medicare for medical services they know they have not provided. The False Claims Act also imposes liability on an individual who may knowingly submit a false record in order to obtain payment from the government. For additional information on fraud and abuse laws, please see the Office of Inspector General’s provider education materials on Fraud & Abuse Laws.

Healthcare Documentation: Minimizing Risks, Maximizing Benefits

NSO/CNA is often asked about documentation risks and recommendations to minimize those risks. Nurses are certainly aware that there are patient healthcare documenting fundamentals. The healthcare information record is a legal document that is an essential tool to:

• Document the services provided regarding the patient’s illness or injury, response to treatment, and caregiver decisions;
• Communicate documented information about the patient’s plan of care and outcomes to the health care team
• Communicate information to other nursing professionals and healthcare providers;
• Support the appropriate information for billing coding; and
• Serve as the organization’s business and legal

Because complete, accurate and legible healthcare records constitute an essential risk management measure, nurses should maintain proper documentation practices and follow facility policies and procedures governing appropriate and comprehensive records documentation. The facility’s healthcare record documentation policies and procedures should address, at a minimum:

• Correcting documentation errors
• Delineating appropriate use of the copy and paste function in the electronic healthcare record;
• Documenting practices during electronic system failures or outages (“down-time”);
• Maintaining patient confidentiality;
• Releasing patient healthcare information records and auditing practices; and
• Procedures for late or delayed

Risk Management Recommendations: Documentation

Maintaining a consistent, professional patient healthcare information record is integral to providing quality patient care, ensuring consistent communication among all professionals caring for the patient, documenting patient care outcomes and response and establishing the basis for an effective defense in the event of litigation. The following guidelines can help reduce risk:

Documentation – Clinical Content

• Document nursing actions in accordance with facility requirements and patient needs, capturing the following information as clinically indicated:
  • results of each nursing assessment
  • pertinent nursing observations
  • patient complaints or concerns
  • significant changes in the patient’s condition
  • any change in the patient’s care plan
  • relevant monitoring findings, treatment or episode of care, as well as the patient’s response to that care
  • facts relating to any patient accident or incident, including evidence of any injury, all parties notified, nursing care provided, and patient’s condition after care is rendered
  • Laboratory and diagnostic test results, especially those that are abnormal and require provider notification and/or intervention
  • referral and consultation requests and results
  • telephone, face-to-face, and electronic contacts with other members of the healthcare team, including the content of discussions and agreed-upon follow-up.
• Document discussions with the patient about medical issues that require additional explanation by any healthcare practitioners and provider(s).
• Record medications administered, including injections, ointments, and infusions, as well as a description of the patient’s response as Also record self-administered medications.

Recent developments have given us an opportunity to reevaluate how we look at the world in terms of who and what and where and when and how, particularly in nursing practice administrative decisions. As we well know, nurses come in all sizes, shapes, colors, walks of life, cultures religions. Etcetera. It would behoove us to respect and recognize all of these various shapes and sizes that represent those who provide care for the global population. Ultimately, as we have learned in nursing school, we all look the same under our skin, we all look the same in our environments, we all look the same in our cultures, and we all look the same globally, figuratively, and in some cases, physically. 

In healthcare and otherwise, there is not one of us that can describe another without their skin color, without their culture, without their disability, without their outward appearance by making an inept assumptive guess as to who they might be as a result of the conditioning from our lived experiences. The challenge in healthcare is actually the reality about life and living and those who are among us that argue this point, which are actually all of us. We have found and will find in healthcare that once a person is on the table for surgery, their insides look the same regardless no matter how they appear on the outside. We have learned in terms of the Nursing Process that therapeutic communication is the way to go, regardless to whom we are responding and without exception to what this person may have had as a personal description of who or what they may be.

The intelligent human being would know that diversity uses a broad brush that paints across global spectrums and unimaginable vastness in differences. As the world and society have moved into a climate filled with adjectives to describe human beings, we as nurses know that all human beings’ lives are precious and that we are responsible for maintaining all human beings' welfare to the best of our abilities. There are no codes, no rules, no regulations, no protocols, no policies that hold our profession to treat people according to the title, commonality, nomenclature, or any societal description that they have been audaciously assigned.

It is for this reason that I am calling out DEI as a debacle. Don't get me wrong, there is always a place for diversity, equity, and inclusion; however, these three alphabets do very little to protect, assist, provide, or save a human life. History has shown that there are so many disenfranchised people in our society, which is why we have these 3 alphabets representing 3 words as opposed to calling it out as discriminatory practices. For some reason, we have accepted the three words that represent DEI. Let's be clear: Diversity, Equity and inclusion most often assist those who make up a myriad of our societal populations, although it is projected upon us to believe DEI is a specific code word for racial partiality. Before you go run and remove DEI from your organizations’ landscape in nursing, do the research, period. After all, nursing is evidence-based practice where research provides facts, not fiction. Just saying! 

Financial planning can seem overwhelming at first, but it's an essential step to achieving financial security and building wealth. Here are some strategies for beginners to help get you started:

1. **Set Clear Financial Goals**

•  **Short-term goals**: (e.g., saving for a vacation or paying off credit card debt within the next year).
•  **Long-term goals**: (e.g., buying a home, saving for retirement, or funding a child's education).
• Make sure these goals are specific, measurable, and achievable (SMART goals).

2. **Create a Budget**

• Track your income and expenses to understand where your money is going.
• Use the **50/30/20 rule**:
• 50% of your income should go toward necessities (rent, groceries, utilities).
• 30% for discretionary spending (entertainment, dining out).
• 20% should go to savings or paying off debt.
• Use tools like **Mint**, **YNAB (You Need A Budget)**, or even spreadsheets to help monitor and manage your spending.

3. **Build an Emergency Fund**

• Aim for 3 to 6 months' worth of living expenses in a liquid, easily accessible account.
• Start small, like saving $500 to $1,000, and then work up to a larger amount.

4. **Pay Off High-Interest Debt**

• High-interest debt, like credit card debt, can quickly snowball. Focus on paying this off as soon as possible.
• Consider using the **debt snowball method** (paying off smaller debts first) or the **debt avalanche method** (focusing on higher-interest debts first).

5. **Save for Retirement**

• **Start early**, even with small contributions. The power of compound interest means that early contributions can grow significantly over time.
• Contribute to retirement accounts such as a **401(k)** (especially if your employer offers a match) or an **IRA** (Individual Retirement Account).
• If your employer offers a retirement match, aim to contribute at least enough to get the full match.

6. **Invest for the Future**

• Once your emergency fund and debt are under control, consider starting to invest in the stock market, bonds, or mutual funds.
• Low-cost index funds or ETFs (exchange-traded funds) are popular choices for beginners because of their diversification and low fees.
• Use tax-advantaged accounts like **Roth IRAs** or **401(k)s** to reduce the taxes on your investments.
• Start small if you need to --- even $50 a month can grow significantly over time.

7. **Understand and Manage Your Credit**

• Your credit score impacts your ability to borrow money at favorable interest rates.
• Regularly check your credit score and report and address any errors.
• Keep credit card balances low (aim to use less than 30% of your credit limit) and make payments on time.

8. **Insurance Protection**

• Ensure you have the right insurance in place, such as health insurance, auto insurance, life insurance (if you have dependents), and disability insurance.
• Evaluate your needs and make sure you have enough coverage but aren't overpaying for unnecessary extras.

9. **Plan for Taxes**

• Understand how your income is taxed and explore strategies to minimize your tax burden (e.g., contributing to tax-deferred retirement accounts, tax-loss harvesting).
• Set aside a portion of your income if you are self-employed or have additional tax responsibilities.

10. **Keep Learning and Adjusting**

• Financial planning is a continuous process. Keep educating yourself and adapt your strategies as your financial situation and goals evolve.
• Books, blogs, podcasts, and financial advisors are all great resources for learning more.

Bonus Tip: **Automate Your Finances**

• Automate savings, debt payments, and investments. This helps ensure that you prioritize these important areas without thinking about it.
• Set up automatic transfers into savings accounts, retirement accounts, or paying bills on time to avoid missed payments.

---

Starting with these basic strategies can set you up for long-term financial success. It's important to be patient, as progress might be slow at first, but with consistency, you'll see positive results!

Valerie Edwards offers securities and advisory services through Mutual of Omaha Investor Service, Inc. Member FINRA/SPIC.

Valerie.Edwards@mutualofomaha.com

Governor Brian Kemp has publicly recognized May 12 as Georgia Nurse Honor Guard Day in the state of Georgia. This formally recognizes the dedication and service of the Georgia Nurse Honor Guard in honoring nurses for their lifelong commitment to healthcare. This official Commendation underscores the state's deep appreciation for nurses' invaluable contributions and the Nurse Honor Guard's role in preserving their legacy.

"This Commendation is a powerful acknowledgment of the impact nurses have on our communities," said Jennifer Heyer, Coordinator of the Georgia Nurse Honor Guard. "We are honored that Governor Kemp has recognized our mission to celebrate the lives and legacies of nurses who have dedicated themselves to the service of others."

The official Commendation designates May 12, the birthday of Florence Nightingale, as an annual day of recognition for the Georgia Nurse Honor Guard and its vital role in honoring the profession's legacy. The Commendation highlights the organization's volunteer efforts at memorials, funerals, and special ceremonies, ensuring that nurses are remembered with dignity and admiration.

As Georgia joins in recognizing Georgia Nurse Honor Guard Day, the public is encouraged to reflect on the profound contributions of nurses and support initiatives that honor their legacy. We encourage nurses across the state to take part in recognizing this important day by raising awareness of our mission, supporting local chapters, and celebrating the invaluable contributions of nurses, past and present.

For more information about the Georgia Nurse Honor Guard and how to get involved, visit https://georgianursehonorguard.com/ or contact Jennifer Heyer at SWGAnurse@outlook.com

Introduction

Women are the backbone of Georgia's families, communities, and workforce. They are mothers, caregivers, essential workers, and entrepreneurs. Yet, despite their vital contributions, many are locked out of the very systems designed to protect their health and well-being. Every day, thousands of women across Georgia go without health insurance---not by choice, but because of outdated and unjust health care policies.

The Coverage Crisis

Nearly one in five women aged 18 to 44 in Georgia is uninsured (Alker, Osorio, & Cuello, 2022). Unless they are pregnant or diagnosed with breast or cervical cancer, many women do not qualify for Medicaid. The state's limited alternative, the Pathways to Coverage program, imposes strict work and reporting requirements that many women, especially caregivers, students, and those with chronic conditions, cannot meet. As a result, women remain uninsured and untreated (Chan, 2024).

Stories from the Gap

Through the Cover Georgia Coalition's "Close the Gap" campaign, women from across the state have shared their stories. Their names have been changed to protect privacy, but their realities are quite real.

• Taylor, a mother of three in Rome, lost coverage when her husband became too sick to work. When his income disappeared, so did the family's Medicaid. Although Taylor now works full-time and earns just below the income threshold, she still does not meet certain Medicaid requirements. Without insurance, her husband can't get the heart surgery he needs, and the family struggles to cover both medical bills and basic needs like food.

• Karla, a college student in Villa Rica, has applied for Pathways coverage twice and has been denied with no clear explanation. She suffers from severe eczema but can't afford a doctor's visit. After repeated denials and dead-end phone calls, she's lost faith in the system and doesn't know where else to turn.

• Samantha, from Douglasville, cares for her granddaughter while managing cancer and other chronic illnesses. She earns just over $6,300 a year---too much for Medicaid, too little for Marketplace subsidies. A generous oncologist offers discounted treatment for her cancer, but she has no access to care for her other serious conditions.

These are just a few of the countless Georgia women forced to choose between medical care and daily survival. Their stories are heartbreaking but preventable.

The Gaps in Georgia's Medicaid

Georgia's Medicaid program currently serves many vulnerable populations---pregnant women, children, seniors, and people with disabilities. But the eligibility rules are so restrictive that many working women with low incomes and caregivers fall through the cracks. Pregnancy Medicaid ends 12 months postpartum. Women's Health Medicaid only applies to those with breast or cervical cancer. And Pathways to Coverage requires burdensome work reporting that doesn't reflect the realities of caregiving, chronic illness, or part-time labor (Chan, 2024).

A Proven Solution: Medicaid Expansion

There is a clear and proven solution: expand Medicaid. Doing so would extend coverage to more than 434,000 uninsured Georgians, including tens of thousands of women (Georgia Health Initiative, 2024). In 40 other states, Medicaid expansion has led to improved health outcomes, economic stability, and fewer hospital closures (Callison et al., 2021).

Medicaid expansion would:

• Provide coverage across all stages of a woman's life, not just during pregnancy.

• Allowing earlier treatment for chronic conditions like diabetes and hypertension.

• Enable caregivers to access care while continuing to support their families.

• Remove unnecessary work-reporting rules that block people from life-saving coverage.

States that expanded Medicaid have also saved millions in uncompensated care costs and improved the financial health of hospitals (Ammula & Guth, 2023).

The Role of Nurses in Advocacy

Nurses are on the front lines of Georgia's health care system. They care for uninsured patients, manage preventable complications, and witness firsthand how coverage gaps harm health outcomes. As trusted voices in every community, nurses are uniquely positioned to advocate for Medicaid expansion and health equity.

Take Action

If you're ready to make a difference, CoverGA.org is your one-stop resource for action. There, nurses and health advocates can:

• Join the Cover Georgia Coalition to advocate for change

• Contact their state legislators about Medicaid expansion

• Share personal stories that highlight the real impact of Georgia's coverage gap

Visit CoverGA.org to get involved and help close the gap.

Conclusion

Georgia's failure to expand Medicaid is not just a political decision, it's a public health crisis. Women across the state are living with untreated illnesses, financial hardship, and preventable suffering. Medicaid expansion is a solution backed by evidence, supported by data, and driven by stories like Taylor's, Karla's, and Samantha's. 

As nurses, health workers, and advocates, your collective power is crucial in bridging this gap and ensuring health and dignity for every woman in Georgia.