All Virginia nurses are invited to the Nurse Staffing Summit, hosted by the Virginia Nurses Association and Virginia Nurses Foundation on November 22-23, 2024. We’ll be addressing the pressing nursing staffing crisis in Virginia -- and across the country -- that has been top of mind for nurses everywhere. Top healthcare professionals, educators, and healthcare leaders will shape this conference by offering a comprehensive examination of the staffing challenges faced globally, nationally, and within the commonwealth. Participants can expect to take a deep dive into the multifaceted nature of this highly complex issue and gain insights into innovative strategies and actionable solutions that can be implemented across healthcare organizations in Virginia. 

“Our healthcare system faces immense challenges. Cost-cutting decisions, an aging population, increased patient complexity and need, and an aging workforce all contribute to the current nurse staffing crisis that is negatively affecting nurses’ mental health and well-being,” said the American Nurses Association in an official statement. These same challenges negatively impact quality of care, and we must act now to create change in our systems to improve the health of our communities.

VNF's 2024 Silent Auction will Feature Exciting New Finds
Proceeds Benefit Virginia Nurses

Mark your calendars for November 1 when the Virginia Nurses Foundation's 2024 Online Auction will go live! Don't miss out on exclusive getaways and prizes! Supporting nursing has never been easier and it's just in time for the holiday season! Bid on your favorite gifts, vacations and more, all from the comfort of your home. Proceeds will benefit VNF's nurse scholarship and education initiatives. Don't wait to bid as the auction will only take place during November! Simply bookmark the VNF Gala webpage today, then on November 1, head to the webpage and click on the Online Auction graphic to begin!

Support Nursing's Biggest Night! Sponsorships Available for VNF's Annual Gala

Sponsors are indispensable to the success and sustainability of VNA and VNF's mission. Your financial support, credibility, and partnership drive innovation, enhance visibility, and empower communities. With your sponsorship contribution, we can continue to fund critical programs and services, as well as raise awareness of our mission and impact.

As a Gala sponsor, we welcome you to celebrate with VNF and about 500 nurses at our grand celebration of nursing! We will be recognizing a host of Virginia nurses with our Leadership Excellence Awards in addition to Magnet and Pathways recognitions and additional nursing awards. Top sponsoring organizations are highlighted in Virginia Nurses Today (circulation 120,000) and VNA's members-only News Brief. These two publications boast an open rate of greater than 50%! Certain sponsorships are limited to a single organization so don't wait! View the Gala Sponsor Opportunities then reserve your sponsorship today!

We're excited to invite all nurses to our annual virtual Legislative Summit, now in late September! This is a unique opportunity for nursing professionals to engage with policymakers, learn about the latest legislative issues affecting healthcare, and advocate for the nursing profession, all in time for the 2024 election!

** VNA is a NON-partisan organization that focuses on issues, not candidates.**

Event Details:

• Date: Thursday, September 26

• Time: 8 a.m.

• Cost: $29 for prelicensure students, $59 for VNA members, $89 for nonmembers. Group pricing is available for health systems, hospitals and schools of nursing! This content will be on-demand for 6 months through March 31, 2025.

Why Attend?

1. Influence Healthcare Policy: Gain insights into current legislative issues and how they impact nursing and healthcare. Learn how you can be a voice for change and advocate for policies that support nurses and improve patient care.

2. Professional Development: Enhance your knowledge and skills through informative sessions led by experts in healthcare policy. Earn continuing education credits and stay informed about the latest trends and challenges in nursing.

3. Networking Opportunities: Connect with fellow nurses, healthcare leaders, and policymakers. Share experiences, exchange ideas, and build relationships that can help you in your professional journey.

4. Advocacy Training: Participate in workshops that teach effective advocacy strategies. Learn how to communicate with legislators, present your case, and make a lasting impact on healthcare policy.

5. Inspiration and Empowerment: Hear from inspiring speakers who are leading the charge in healthcare reform. Leave the summit feeling empowered to make a difference in your workplace and community.

Highlights of the Summit

• Keynote Speakers: Hear from prominent figures in healthcare and politics on the local, statewide and national front!

• Panel Discussions: Engage in discussions on critical issues such as nurse staffing, patient safety, and healthcare access and get your pressing questions answered.

• Interactive Sessions: Participate in hands-on sessions designed to equip you with advocacy tools and techniques you can use from your couch or at the Capitol.

• Timely Information: Get the inside scoop on healthcare issues that will be addressed during the 2025 General Assembly session and utilize information from the summit to speak with your legislators!

Registration

Join us for this transformative event! Register today!

Erica Carbajal - Updated Thursday, April 25th, 2024

Kentucky Gov. Andy Beshear recently signed a bill into law that shields healthcare providers from being criminally charged for medical errors, making it the first state to do so.

HB 159 ensures that healthcare providers, including nurses, "shall be immune from criminal liability for any harm or damages alleged to arise from an act or omission relating to the provision of health services." It includes exceptions for negligence and intentional harm. 

In 2022, RaDonda Vaught, a former nurse at Nashville, Tenn.-based Vanderbilt University Medical Center, was convicted for a fatal medication error she made while working as a nurse in 2017. Ms. Vaught lost her nursing license and was sentenced to three years of supervised probation. The case garnered national attention and spurred a far-reaching debate surrounding the criminalization and reporting of medical errors and patient safety culture. Read the full article here!

Virginia hopes to follow in Kentucky's footsteps

During the 2024 General Assembly session, Kentucky successfully passed legislation to decriminalize unintentional medical errors made by healthcare providers. The Virginia Nurses Association is collaborating with our healthcare colleagues and patient advocates to move forward with similar legislation in the commonwealth.

Our healthcare system relies on the concept of "Just Culture," that is, an organization-wide mindset and process whereby mistakes do not automatically result in punishment. When an error is made, healthcare facilities rely on clinicians to voluntarily report the error so that a root cause analysis can be performed, and system changes can be implemented to prevent the error from occurring again. If clinicians fear criminal prosecution for an accidental error, they may be less inclined to report it. This would allow system failures to go undetected and uncorrected, ultimately making patients much less safe. To protect patient safety, it is vital that we preserve Just Culture in healthcare. Unfortunately, under current Virginia law, clinicians can be criminally prosecuted for unintentional medical errors.

"Criminalization is an important issue for patients and healthcare clinicians alike, but it's particularly important to nurses. Nurses spend more time with patients than any other healthcare discipline, and ensuring patient safety is a responsibility that we take very seriously. Criminalization of unintentional errors does nothing to improve patient safety; instead, it erodes the just culture we rely on to keep our patients safe in the healthcare setting and creates significant stress for our healthcare workforce," shared VNA Commissioner on Government Relations Dr. Ashley Apple, DNP, RN, FNP-BC.

"The public should be reassured that numerous safeguards exist to ensure that patients receive safe, high-quality care," continued Dr. Apple. "This includes robust academic and clinical preparation of our healthcare workforce, professional oversight and supervision by state regulatory boards, and utilization of evidence-based practices and procedures that support optimal patient outcomes. In the event that a medical error causes harm to a patient, clinicians are subject to revocation of their license to practice, and patients have recourse to hold clinicians accountable and seek compensation for damages through civil litigation."

Dr. Apple underscored that, "Making a mistake that causes harm to a patient is every nurse's worst nightmare, and the fear of criminal prosecution is a tremendous and unnecessary burden on the nation's most trusted profession. The Virginia Nurses Association is proud to lead the way in preserving just culture and protecting the safety of patients in the commonwealth. "

The esteemed Executive Director of the Virginia Board of Nursing, Jay Doulas, MSM, RN, CSAC, FRE, is retiring this September from the role she has held for the past 22 years! Throughout her tenure, she has been an invaluable leader, advocate, and mentor in shaping the landscape of nursing in Virginia.

Ms. Douglas currently serves as President of the NCSBN Board of Directors and has been on the Board of Directors since 2018 and assumed the role of president in 2020. She has been the Executive Director of the Virginia Board of Nursing since 2002. In this position, she oversees the regulation of approximately 230,000 license, certificate and registration holders including registered nurses, licensed practical nurses, advanced practice nurses, massage therapists, nurse aides and medication aides. Additionally, Ms. Douglas has responsibility for oversight of 150 prelicensure nursing education programs.

Ms. Douglas is a registered nurse with a master's degree in management, is certified in Substance Abuse Counseling, and is a Fellow of the National Council of State Boards of Nursing Institute of Regulatory Excellence. She further serves as Commissioner of the Interstate Nurse Licensure Compact.

In recognition of her dedication and service, Ms. Douglas has expressed her wish to forego traditional retirement gifts. Instead, she believes in paying it forward to support the very heart of our profession -- nurses. Therefore, she kindly requests that any gestures of appreciation be directed toward the Virginia Nurses Foundation.

The Virginia Nurses Foundation plays a crucial role in advancing the nursing profession by providing scholarships, top tier professional development, grants, and resources to support nurses' ongoing education and professional development. By contributing to this cause, we not only honor Ms. Douglas' remarkable career and her unwavering commitment to nursing excellence, but also invest in the future of nursing in Virginia.

If you would like to participate in this meaningful gesture, you can make a donation directly to the Virginia Nurses Foundation in Ms. Douglas' honor (https://tinyurl.com/VNFJayDouglas).

In 1999, when I completed my literature review for my dissertation on nurse staffing and patient satisfaction, there were fewer than 20 published studies in the literature that evaluated the impact of nurse staffing on patient outcomes (Ridge, 2001). As a dissertation with a small sample size, my study was relatively underpowered to identify relationships between the study variables. Nurse staff researchers developed methods to combine large patient datasets with hospital staffing data to address key staffing questions and to answer variations of the basic question: "Does staffing matter?"

There were many challenges to studying staffing, but significant progress has been made. Since those early days, a total of 2,167 nurse staffing research papers had been published worldwide as of September 2022 (Morioka et al., 2023). Thirteen of the top 20 authors in the field are from the U.S., and Linda Aiken is at the top of the list, with more than 95 published studies to her credit. Linda Aiken and her associates are at it again, with a recently published study that explores the impact of team nursing models on patient mortality, readmission, length-of-stay, and patient satisfaction (Lasater et al., 2024a). In this article I will provide a summary of the body of nurse staffing research, critique this recent study, and explore some of the policy implications that emerge from the understanding that nurse staffing is a matter of life and death for our patients and for ourselves professionally.

Nurse Staffing Research

Worldwide, most staffing research has focused on nurse and patient outcomes in acute care hospitals. In the U.S., a seminal study by Aiken et al. (2003) clearly identified an indirect relationship between 30-day mortality after common surgical procedures and nursing workload. This early cross-sectional study, using data from Pennsylvania hospitals linked to administrative and survey data, showed that mortality increased by 7 percent for each additional patient added to a nurse's workload. Further, for each 10 percent increase in nurses with BSN degrees, mortality declined by 5-7 percent. As the number of studies increased through the years, systematic reviews were conducted to summarize key findings and conclusions. Statistically significant associations between higher nurse staffing and patient outcomes such as decreased mortality have been identified mostly in acute care but also in critical care settings to a limited extent (Brenan et al., 2013; Dall'Ora et al., 2022; Dall'Ora et al., 2023; Griffiths et al., 2023; Rae et al., 2021). Many of these studies were observational and cross-sectional, which means that with these research designs, associations between the variables can be established, but showing causality between staffing and outcomes may not be justified (Costa & Yakusheva, 2016).

In terms of policy research, these results are like the vast body of seat belt and helmet studies that have linked the use of these safety devices to reductions in injury and mortality. Associations are found and causality is presumed. I am reminded by an incident in which a physician who was critiquing my staffing dissertation suggested that I would need to conduct a full randomized control trial (RCT) to establish the causal link between staffing and patient satisfaction. He recommended that I randomly assign some patients to higher or lower staffing, and then study the relationship with the outcome. I did not follow his suggestion for obvious reasons. We obviously don't use RCTs to study nurse staffing.

As in the case of helmet and seat belt studies, and other policy research designs, the use of cross-sectional designs is appropriate in fields where RCTs are inappropriate. No one would dare suggest we randomly assign participants in seatbelts or helmets studies. Nor would we do this with actual patients, especially considering the current state of knowledge regarding the harm associated with nurse staffing reductions. Rather, quasi-experimental designs in policy research are used in cases where RCT would be unethical or impractical, such as in nurse staffing studies.

Recent Studies

Before turning attention to the latest study from Lasater, who is part of the Aiken team, it is helpful to look at a previous staffing study published this year by the same team. This cross-sectional study uses data from about 87,936 patients from more than 200 Illinois and Pennsylvania hospitals to evaluate the impact of nurse staffing on mortality pre-and post-pandemic. (Lasater et al., 2024b). Each additional patient in nurse workload pre-pandemic was associated with 20% higher odds of in-hospital mortality, and 15% higher odds in 30-day mortality. Is it reasonable to conclude that RNs make a difference during a hospital stay, as well as after discharge? It's not only the quantity of nurses that makes a difference. They also found significant relationships between higher percentages of BSN-staff, better quality nurse work environments, and ANCC Magnet recognition and lower mortality.

Alternative Models of Nurse Staffing May Be Dangerous in High-Stakes Hospital Care

The latest staffing study from Aiken's team, with Lasater again as the primary author, used a cross-sectional, retrospective design drawing 2019 pre-Covid data from more than 6.5 million patients and almost 70% of U.S. hospitals to examine nurse staffing and mortality (Lasater et al., 2024a). The purpose of the study was to inform healthcare policy and healthcare leaders on action priorities related to hospital nurse staffing challenges. Specifically, the study examined the potential impact of implementing nurse staffing models, such as team nursing, that use a lower RN skill mix. The Medicare claims dataset was linked to data from the American Hospital Association (AHA) Annual Survey and Hospital Compare's Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). Clinically meaningful outcomes, including in-hospital mortality, 30-day mortality, length of stay, 30-day readmissions, and HCAHPS star ratings were analyzed in relation to nursing skill mix, defined as the proportion of RNs. In addition, the study examined projected costs associated with a reduction in RN skill mix. As in most quasi-experimental research, several covariates were included in the analysis to control for potential influences beyond nurse staffing. Hospital characteristics such as bed size, teaching status, and high technology were included. In addition, patient characteristics included age, gender, transfer status, comorbidities, and palliative care status. As in previous Aiken studies, odds ratios (OR) were used to estimate impact of staffing on mortality and readmissions, and incident rate ratios (IRR) were used for hospital length-of-stay.

Key Findings & Conclusions

Several key findings were identified that reinforce and expand on previous nurse staffing literature. Again, lower nurse staffing levels were associated with poorer outcomes.

• A 10-percentage point reduction in RN skill mix was associated with a 7% higher mortality. On a national level, this could result in an annual increase of 11,000 Medicare patient deaths.

• The lower RN Skill mix was associated with higher rates of hospital readmission, prolonged hospital length of stay, and lower patient satisfaction scores.

• Salary expense reductions from lowering RN skill mix would likely not result in overall cost savings to hospitals because increase in expenses due to longer lengths of stay would offset any estimated savings.

• On a policy level, Medicare would risk almost $70 million per year associated with avoidable readmissions, and hospitals could possibly face readmission penalties.

The authors conclude that nurse staffing models with a lower RN skill mix, such as team nursing, would be highly detrimental to patient care and would even result in a negative fiscal impact on hospitals and Medicare. In terms of limitations, this study carries the causal restrictions associated with cross-sectional retrospective designs. However, considering the systematic and reasoned approach in this study, logic dictates that it is reasonable to conclude that the direction of the relationship places nurse staffing before the outcomes in any rational explanation. Perhaps more importantly, another limitation is related to the assumption that nurse staffing is solely about numbers. Due to this study's design, they did not include processes of care regarding how the actual nursing teams were organized, prepared, implemented, or managed. Albeit this would be highly challenging while establishing sufficient sample size. Such processes would be helpful to understand how to best implement lower levels of nurse staffing. Processes could include how well the staff were prepared to delegate and supervise, and the types and levels of clinical support, such as Clinical Nurse Leaders and Clinical Nurse Specialists. Additional limitations relate to the restriction to Medicare patient and financial analysis, and to the omission of the secondary adverse impact of nurse burnout and turnover, and other variables that could muddle the observed relationships.

This study reinforces the 20+-year portfolio of nurse staffing research that supports the conclusion that lower levels of nurse staffing are related to higher patient mortality. It adds to the literature by also including the cost analysis that supports the conclusion that the transition to staffing models with a lower RN skill mix would result in significant patient mortality and a worse bottom line for hospitals. This work sets the stage to answer many other questions related to actual team nursing and its potential impact on patient care and professional nursing.

Future Directions

Ed Freeman, a business ethics professor at UVA who founded and developed the Stakeholder Theory of business ethics, would probably use reductions in nurse staffing as an example of "Fishing with Dynamite". "Fishing with Dynamite" is the title of a 2019 documentary that showcases what happens when companies pursue short-term financial gains without consideration of longer-term impact on stakeholder interests (Wagner, 2019). Business success is about creating synergy between purpose and profit, in a way that adds value to all stakeholders, and not solely by positive gains on a short-term income statement or balance sheet.

There may come a time when team nursing or other models that use a reduced RN skill mix become necessary due to the unavailability of RNs. However, given the seriousness of the consequences of lowering RN staffing, it would be important to first identify and implement strategies that would at least optimize the full use of currently licensed RNs at their highest level of license, and include adequate training and preparation for applying new models. Retaining RNs in bedside positions should remain a high priority. Health systems must work to improve RN retention in a systematic manner. Also, as identified by the most recent 2022 National Nursing Workforce Survey, only 70% of nurses are employed full time, and less than 90% are employed in nursing (Smiley et al., 2023). If better working conditions are maintained, including proper staffing and workplace civility, then we may be able to increase the availability of FTEs through better use of current RNs. Second, whether through mandated ratios or via effective nurse staffing committees led by front-line staff, the evidence can no longer be ignored, and appropriate staffing standards should be established, adhered to, and continuously monitored and evaluated. On a higher level, shifting away from reimbursement models as called for in the last Future of Nursing Report (NASEM, 2021) is long overdue, and should receive high priority to address the fundamental flaws in current payment systems. These payment systems force health care systems to treat nurse labor as a commodity to be minimized, and not as a value-added resource that is positively leveraged for the sake of patients, organizations, and the health care system in general.

VNA has found great success in holding our Legislative Hours virtually (a COVID-prompted change) and hope you will plan to join us for this year's events! The 9 anticipated Legislative Advocacy Hours will be held for all areas of the commonwealth during this fall. Participating nurses will receive a copy of Nursing's Public Policy Platform, developed each year by the VNA-spearheaded Virginia Legislative Nursing Alliance, and will have the opportunity to hear from and converse with their legislators. Ample time will be planned for Q&A.

Bookmark our online events calendar now to ensure you don't miss the announcement of this year's event dates! This information will also be posted to VNA's Facebook page, www.facebook.com/vanurses.

We couldn't be more excited for a couple days of shaping and celebrating the profession with nurses this fall! VNA and VNF's annual, in-person fall conference and the VNF gala will be held at the Hilton Hotel & Spa in Short Pump, Virginia on November 22 and 23. Just 20 minutes from downtown Richmond, this inviting and lively area is bursting with shops and eateries, perfect for holiday shopping! Read on to learn more about some great points of interest near our events.

The Hilton Hotel & Spa

We'd be remiss if we didn't start with the wonderful getaway location that is our conference hotel this year! As regulars of this Hilton, we can assure you that these amenities are not-to-be-missed and perfect after a long day of professional networking and education!

Just off Interstate 64, the hotel is just a 10-minute walk to the shops of Short Pump Town Center, and within a 20-minute drive of the Lewis Ginter Botanical Garden. Enjoy the hotel's indoor pool, outdoor patio and on-site Aura Spa offering exquisite massages, skin treatments, manicures and pedicures

Short Pump Town Center (Mall)

Short Pump Town Center (left, photo courtesy of Short Pump Town Center) is a beautiful open-air shopping mall within walking distance of our host hotel. The center offers some of the best shopping and dining in the area with the hottest fashion and beauty brands and the tastiest Richmond restaurants.

Some of the most popular eating options include:

• Auntie Anne's
• Baker's Crust Artisan Kitchen
• Casa del Barco
• Cava Grill
• Cheesecake Factory
• Chipotle
• Coldstone Creamery
• Cooper's Hawk Winery
• Firebirds Wood Fired Grill
• Frost a Gelato Shoppe
• Great Steak & Surf City
• Komma Tea
• Maggiano's Little Italy
• Perry's Steakhouse & Grille
• Red Robin
• Starbucks

Recreational Activities

• Draftcade (Bar & Arcade)
• Funny Bone (Eatery, often with live stand-up comedy)
• Red Door Escape Room
• Dave & Buster's (located just a few blocks from Short Pump Town Center)
• Regal Short Pump movie theater (located just a few blocks from Short Pump Town Center)

VNA was delighted to participate as an exhibitor at the HCA Capital Division Nursing Annual Conference held in May in Richmond. This event brought together more than 160 nursing professionals, providing VNA a prime opportunity to connect with current and potential members, including attendees such as Augusta Chapter President Nicole Tucker and Immediate Past Commissioner on Nursing Practice Erin Keister.

Membership Manager MJ Gearles represented VNA and noted the booth was a bustling hub for discussion by providing information on how VNA supports nurses in their professional growth and advocacy efforts. The conference's closing speech was presented by VNA President Dr. Sherri Wilson, who highlighted well-being strategies that empower nurses to thrive as leaders. Dr. Wilson also shared updates about VNA's initiatives to advance nurses' well-being across the commonwealth and our commitment to advancing the nursing profession.

We thank HCA for the opportunity to participate and look forward to engaging more deeply with the nursing community at future events.

VNA Membership Manager MJ Gearles and Augusta Chapter President Nicole Tucker

VNA Membership Manager MJ Gearles and Immediate Past Commissioner on Nursing Practice Erin Keister

VNA President Dr. Sherri Wilson

VNA is pleased to share that we've recently released some new resources for to address crucial issues such as bullying, incivility and workplace violence. These resources are exclusive to VNA members and can be found under the Workforce Issues section of the VNA website on the Incivility & Bullying Resources page. Regardless of your practice setting or position, you will find resources to add to your toolkit and nursing practice!

Resources include:

• Bullying & Incivility Self-Assessment

• Recognizing & Addressing Bullying & Incivility in Healthcare

• Common Bullying Behaviors List

• Bullying & Incivility Infographic

• Implementing Incivility & Anti-Bullying Plans

• Eradicating Bullying & Incivility eCourse

Expert articles by VNA's Workforce Issues Commission, including:

• Words Matter - Using Inclusive Language

• A Just Culture Is a Safe Culture

• Occupational Stress: Definition, Impact, and Strategic Mitigation

• Nonviolent Communication: Imperative for Uncivil Work Environments

• Reporting: A Matter of Ethics

If you're not a VNA member and would like to access this resource page, consider joining VNA and ANA today for just $15 a month! You'll also receive access to VNA's Nursing Advancement Toolkit and Workplace Violence Toolkit as well as a slew of other unique benefits from both VNA and the American Nurses Association.

Recently, the Virginia Nurses Foundation (VNF) and the Virginia Nurses Association (VNA) presented the 2024 Future Nurse Leader award to seven outstanding BSN graduates. Recipients were selected by their school's faculty based on their leadership impact, activity in nursing associations, a history of community involvement, and significant contributions to their school's overall excellence. Each winner received a one-year VNA membership, an invitation to participate on one of VNF or VNA's commissions or workgroups, complimentary "Nurses Change Lives" license plates for their car, and a complimentary registration for our fall conference, the Nurse Staffing Summit!

Reach out to Linda McKay to learn more about this awards program.

Sophia Brat, Liberty University

Sophia joined the LU Nursing Student Association (LUSNA) Board as a sophomore and served as secretary and served also as a junior as the Board vice president. She chaired the research committee for the association as well. LUNSA is the largest student chapter in the nation, with more than 200 students on the roster. Sophia has planned and led numerous events for the nursing student body and was often called on by the Administration to be a voice for her peers. Sophia will be taking her first steps in the profession as a PICU nurse at the University of Virginia this summer.

Kayla Weston, Emory & Henry College

Kayla emerged as a leader in her cohort by bridging divides and providing her peers with motivation and organization during the program. She volunteered and helped with events on campus, even when outside of courses. She was an active member of the band on the main campus and effectively balanced her duties as a nursing student.

She mentored students in the cohort below her while on campus and frequently checked in with her assigned mentees. She was a source of positivity and encouragement in all her interactions, even when faced with adversity. In clinical, she upholds the highest standards of ethics and works well with all members of the care team. Kayla has accepted a position in Smyth County Community Hospital's Emergency Department.

Rebecca Chung, Longwood University

Rebecca was a member of the Honor's college. She was involved in several university organizations to include Delta Sigma Theta Sorority President; Cormerier Honors College (Class Treasurer; community outreach position); Student Nurses Association (Fall 2021-2022- Community Outreach and Fall 2022-2023 - VP of Service); Longwood Ambassadors; Geist Chapter of Mortar Board (Oktoberfest Royalty). She also started a campus-wide project entitled "Take What You Need" which offers students the ability to obtain hygiene products free of charge. She participated in numerous community outreach activities. She assisted in running a flu shot clinic on campus several years in a row. She has received several awards including: Nursing Honor Society; McNaulty Scholarship Award; Longwood Emerging Citizen Leader Award; Dean's List; Joan of Arc Award; Citizen Leader Award. Rebecca has also held several externship positions, including at the VCU Children's Hospital. She has accepted a position with VCU Health after graduation and will work on their Mother-Infant Unit. She is passionate about maternal healthcare and is an advocate for Black Maternal Health.

Danielle McChesney, Old Dominion University

Danielle established the Peer Mentoring Committee as president of the Student Nursing Association. Serving as both a mentor and a mentee, she facilitated connections between senior and junior nursing students, providing guidance, encouragement, and sharing valuable insights into navigating the program.

As president of the SNA, she assumed a leadership role not only within the organization but also as a representative of the ODU nursing community. Many looked to her for guidance on community event ideas and execution. She took this responsibility seriously, ensuring that the initiatives aligned with the needs of our members and the broader nursing community. Through tireless dedication, they successfully decreased the nursing student dropout rate and cultivated a sense of camaraderie that alleviated feelings of isolation and overwhelm. Her commitment to mentorship and leadership extends beyond the university campus to bolstering the nursing workforce in the Hampton Roads area and promoting public health. Danielle is working on the Advanced Heart Failure Unit at Norfolk General's Heart Hospital and will begin her Clinical Nurse Specialist MSN degree this fall at ODU.

Cynthia Almendarez, Virginia Commonwealth University

Cynthia worked with junior level students to help them understand patho/pharm. She was a peer tutor this year for the nursing school and was one of the first to sign up for that role. She was a part of the Fellowship of Christian Nurses and has an extremely positive attitude with everything she does. She is bilingual and was often asked to help explain medical procedures and information while attending clinical for those patients and families who were Spanish speaking. She has a passion for making sure others understand. Whether she is working with a patient or an underclassman, she puts a lot of energy and care into her words and actions.

In January 2024, Cynthia embarked on a transformative service-learning trip to the Highlands region of Guatemala with Nursing Students Without Borders, where she actively engaged with indigenous women through the Highland Support Project. Enthusiastically embracing the opportunity to immerse herself in a different culture, she worked closely with local communities, particularly focusing on empowering indigenous women. Her dedication was evident, as she actively sought to understand the challenges faced by these women and collaborated with them to implement sustainable solutions. Her genuine empathy and open-minded approach fostered meaningful connections, breaking down cultural barriers. She is a fluent Spanish speaker and was able to act as an additional translator for the group. Through her involvement, she not only contributed to community development projects but also left a lasting impact by fostering cross-cultural understanding and promoting the importance of collaboration in addressing global health challenges.

The VCU faculty are confident that Cynthia will be an outstanding nurse who provides not only technically excellent patient care, but an empathic approach that is guaranteed to leave a lasting impact on her future patients. She plans on furthering her education after gaining nursing experience and wishes to become a nurse educator. Cynthia currently works at VCU Health.

Candice Bailey, George Washington University

Candice graduated from the GW School of Nursing and was an active advocate at the University's Foggy Bottom Campus, where she also served as secretary of the Student Nursing Association. Candice participated in fundraisers for the SNA and took part in volunteer opportunities. In total, she volunteered more than 100 hours to organizations around DC, college preparation, and older adult organizations.

She has served as a peer tutor for GW School of Nursing every semester. As an aspiring future nurse leader, she has found a career in the cardiovascular step-down unit at Inova Fairfax and will begin work at Inova in October.

Breanna Roach, University of Virginia

Breanna has been her class president for the past three years. She and another student kick started the school RN organization. She has served on countless panels to recruit others to nursing and has been a School of Nursing student ambassador. Breanna has found a career at VCU, working on the Cellular Immunotherapies and Transplant Inpatient Unit.

During May, the Georgetown University School of Nursing hosted a webinar titled, Equity & Well-being: The Delivery of Health Care. The event featured a conversation between Georgetown Distinguished University Professor and past director of the National Institute of Allergy and Infectious Diseases (NIAID) Dr. Anthony Fauci, and School of Nursing Dean Dr. Roberta Waite. The two healthcare experts reflected on how health inequities impact the delivery of care with a special focus on significant health events such as the COVID-19 pandemic. They also explored workforce disruptions and well-being of health care workers during such exceptional times. Watch the webinar on-demand here!

The Virginia Nurses Foundation is thrilled to announce the results of its annual scholarship program for prelicensure nursing students throughout the commonwealth. As in previous years, VNF will be awarding one $1,000 scholarship to a deserving student in each VNA chapter and in 2024, the three largest chapters---Central VA, Northern VA, and Hampton Roads---will be offering an additional $1,000 scholarship each, resulting in a total of two scholarships in each of these areas. Additionally, some chapters have generously chosen to award extra funds to scholarship winners to assist with the purchase of textbooks.

This year, the program received a remarkable 68 submissions, setting a new record! In collaboration with VNA's chapters, VNF has awarded an impressive $18,250 in scholarships to support these students' academic pursuits.

The Virginia Nurses Foundation and Virginia Nurses Association are grateful for the immense efforts of all the nursing students, chapter leaders, and this year's scholarship review committee member. Their collective contributions have made this opportunity a reality for deserving individuals pursuing their nursing education.

As the current scholarship cycle concludes, we encourage aspiring pre-licensure nursing students to keep an eye out for the opening of the 2025 VNA/VNF Scholarship Application in January. Please help us spread the word!

This spring, the VNA's Hampton Roads Chapter held a social event to honor nurses in partnership with the Chrysler Museum of Art and 'Every Brilliant Thing: On Tour'. Celebrating mental health month and museum month, this partnership recognized nursing as an art and science as we continue to support and highlight how mental illness can affect all of us -- patients, providers, families, and our society at large. 'Every Brilliant Thing: On Tour', performed a powerful story from the perspective of a single performer. An immersive storytelling experience performed in the round that blends comedy, improv, and audience interaction to tell the story of someone growing up in the shadow of their mother's struggle with suicidal depression while learning to grapple with their own journey. 'Every Brilliant Thing' provides a life-affirming jolt of humanism, reminding us that hope comes from the miracles of life's minutiae. The performance and audience participation were amazing and such a powerful experience. The Hampton Roads Chapter extends a warm appreciation to Michael Berlucchi, manager at The Chrysler Museum of Art, and Stacey Shelnut-Hendrick, the Deputy Director for Public Engagement and Learning for this partnership. 

First Cannabis Nursing Scope and Standards of Practice Released

In June, the American Nurses Association released their first guidelines on Cannabis Nursing Scope and Standards of Practice. ANA officially recognized cannabis nursing as a specialty nursing practice last September. As past president of the American Cannabis Nurses Association (ACNA), VNA Treasurer Llewellyn Smith, MSN RN-BC, CNEcl, Clin IV (at left) initiated and chaired the credentialing committee of ACNA members. This committee was responsible for creating cannabis nursing scope and standards by following ANA's recognition program for specialty nursing practice processes.

"I am honored to be a leading author of the document and I appreciate the committee's contributions and tenacious dedication to its success during uncertain times," shared Smith.

Congratulations, Llewellyn!

Reduced Transition to Practice Period for NPs Signed into Law

On June 17, VNA Commissioner on Government Relations Dr. Ashley Apple, DNP, RN, FNP-BC joined Virginia Council of Nurse Practitioners President Alysia Pack and Past President Olivia Newby as Governor Glenn Youngkin signed HB 971 into law. This bill reduces the transition to practice period for nurse practitioners from five years to three. Passage of this legislation was a remarkable win for nursing in Virginia, paving the way for increased access to care and easing the current provider shortage.

"Nurse Practitioners provide high-quality care and autonomous practice expands Virginia's ability to meet the needs of patients, particularly those in rural and underserved areas. I'm proud of our work on this bill, and it was an honor to join VCNP and Governor Youngkin to celebrate its success!" Dr. Apple shared.

This victory was made possible by the pictured representatives (at left), VNA and VCNP's lobbyists, bill patron Delegate Kathy Tran and enthusiastic support from nurse advocates across the commonwealth! Thank you!

Kudos to Immediate Past VNA President Dr. Linda Shepherd, DPN, MBA, RN, NEA-BC (at left) for her contributions to The DNP Project: A Step-by-Step Project for Success, published earlier this year!

The workbook helps translate your knowledge into action with activities designed to jump-start and propel you through your DNP Project!

This acclaimed workbook delivers an organized, systematic roadmap for the development, implementation, evaluation, and completion of the DNP Project. Designed by two nurse educators motivated by their own frustrating DNP experiences to help the next generation of students, it consists of a collection of lessons guiding readers, step-by-step, through the entire DNP Project process. Anchored in a real-world context with more than 100 learning activities, the resource promotes active learning and delivers practical tips and advice for every stage of the project

Congratulations, Linda!

Congratulations to Bon Secours Memorial Regional Medical Center, Chief Nursing Officer Dr. Emily Mapes, Magnet Director Abby Pennington, and the entire nursing team for being re-designated as a Magnet® facility.

The Magnet Recognition Program designates organizations worldwide in which nursing leaders successfully align their nursing strategic goals to improve the organization's patient outcomes.

We want to hear from you! Share your news with us so that we can share it in our next issue of Virginia Nurses Today! Simply email to lmckay@virginianurses.com and be sure to include any quality photos in JPG or PNG format.

The Virginia Nurses Foundation in collaboration with the Virginia Nurses Association is focused on growing nursing leaders in the commonwealth and preparing them to lead change within their organizations and our communities. The Nurse Leadership Academy (NLA) is one of several professional development opportunities created to support this goal. The program was designed for Virginia nurses by Virginia nurse leaders and kicked off in 2022. NLA is a 10-month program for new and aspiring nurse leaders concentrated on developing foundational leadership knowledge and then applying this knowledge to implement change management projects. Participants engage in seven virtual sessions to learn more about effective leadership styles, developing organizational culture, facilitating high reliability environments, influencing change through strategic action, and managing healthcare finances. Throughout the program, they develop a project proposal with their organization and then implement and lead this quality improvement effort. The 2024 cohort will graduate 23 fellows focused on making a positive impact within their organizations and community on November 21, 2024!

The Nurse Leadership Academy is effecting change by preparing more nurses to lead teams focused on improving our communities' care. This year the Virginia Department of Health (VDH) awarded 15 full scholarships to support nurse leaders in completing NLA. These scholarship recipients are leading quality improvement projects focused on enhancing the care of patients experiencing stroke, diabetes, and hypertension. VDH supported projects encompass an array of impactful strategies such as stroke awareness community education events, the development of healthcare simulation scenarios to improve stroke care, standardizing neurological stroke assessment bedside reporting, stroke screening and education within black churches, and processes to improve the safety of transfer to home after stroke. Our other NLA fellows are exploring change projects related to creating environments safe for patients at risk for suicide, enhancing charge nurse education, providing heat related health services, and developing collaborative partnerships to support TB reporting in the community. We are excited about the impact that each of the NLA fellows is creating through their projects, and we want to share their work with you!

The 2024 Nurse Leadership Academy fellows will present their leadership projects at the VNA & VNF Nurse Staffing Summit, November 22-23, 2024, at the Hilton Short Pump Hotel & Spa. Fellows will share via a rapid-fire podium series and an on-demand bonus series that will be provided to all Nurse Staffing Summit participants! Register today so you can learn more about the impact of our 2024 Nurse Leadership Academy!

If you are interested in participating in the 2026 Nurse Leadership Academy cohort or know someone who would benefit, visit our Nurse Leadership Academy webpage to learn more and get on the waitlist!

Developed collaboratively by the Virginia Nurses Association and the Virginia Hospital & Healthcare Association, the Nurse Staffing Committee Model Has Been Endorsed by the VNA and Virginia Hospital & Healthcare Association Boards of Directors as a Method to Empower Nurses as Partners in Developing Staffing Strategies

Frontline nurses play a key role in providing direct patient care across clinical settings and are often the 'eyes and ears' at health care facilities, giving nurses unique insight on patient needs and workload challenges.

In recognition of that, the Virginia Nurses Association (VNA) and the Virginia Hospital & Healthcare Association (VHHA) spent the past year developing strategies to elevate the voice of frontline nurses so that their valuable perspectives and ideas are shared with hospital leaders. The result of that work is the creation of a framework and principles for establishing Nurse Staffing Committee models in Virginia hospitals. The Committee framework provides a structured template for this work while also allowing flexibility for individual hospitals to customize plans appropriate for their unique needs.

The Nurse Staffing Committee framework has been developed to facilitate enhanced collaboration between hospital leaders and bedside nurses on the development of innovative staffing solutions to address healthcare team workload and drive quality and safety improvements within existing system constraints. The model can be customized to function within existing organizational structures at hospitals with unique features and can work alongside existing programs to ensure meaningful engagement by nurses.

"Both VNA and VHHA strongly support a nurse staffing committee model to promote collaboration, enhance clinical care, and address workforce challenges," said VNA CEO Janet Wall. "We're extremely pleased with the outcomes of this joint effort and are eager to continue our work with VHHA and other stakeholders throughout the commonwealth to ensure that nursing's voice is heard. I'm confident that, as a community of healthcare professionals, we can improve patient outcomes, provide for healthier workplaces, and grow our future nursing workforce."

The VHHA Board of Directors has unanimously voted to adopt the proposed Nurse Staffing Committee framework and implement committees in their facilities. These formal actions affirm the importance of hospital leaders partnering with nurses on issues related to staffing and care delivery. The Nurse Staffing Committee framework provides a structured template for this work while also allowing flexibility for individual hospitals to customize plans appropriate for their unique needs.

"As the largest and most trusted healthcare profession, the voice of nursing at all levels is critical in developing sustainable and innovative solutions for staffing," said VNA President Dr. Sherri Wilson, DNP, MPA, RN, CDP®, FAAN. "The evidence clearly indicates that the well-being, health, and safety of nurses and their patients are inextricably linked. I am enthusiastic about this partnership and eagerly anticipate collaborating to disseminate the results of our efforts." Future staffing shortages are projected across a variety of clinical roles including physicians, nursing, behavioral health care, and more. Specialized training and education, which can take years to complete, is required to fill these technical and specialized roles, which makes it even more challenging to address health care workforce challenges. The U.S. Bureau of Labor Statistics (BLS) forecasts that registered nurse employment is expected "to grow 6 percent from 2022 to 2032, faster than the average for all occupations" with an average of 193,100 registered nurse openings each year across the U.S. to replace nurses who leave the profession due to retirement or other factors. BLS further predicts rising demands for health care services due to an aging population that may have higher utilization of medical services. Registered nurse employment in the U.S. was 3.17 million in 2022 and is expected to grow to 3.45 million in 2032. In Virginia, more than 8,900 hospital jobs across various clinical roles are open, including more than 3,300 nursing jobs.

"As we contend with ongoing workforce challenges, including persistent nursing shortages, and devise responsive strategies, it is imperative that the voice and perspective of frontline nurses are part of these important discussions and contributors to the solutions," said Eric Deaton, Ballad Health Chief Operating Officer and Executive Vice President and Immediate Past Chair of the VHHA Board of Directors. "The Nurse Staffing Committee framework provides a template that can be employed to strengthen communication and feedback pathways between frontline nurses, nursing leaders, and hospital administrators. Having these important conversations and working collaboratively on solutions is more important than ever as the health care community continues to grapple with workforce shortages."

New! Nurse Leaders Forum to provide the stage for the robust dialogue

The Nurse Leaders Forum, a new broad-based group being spearheaded by VNA and including nurse leaders from academia, state government, and all practice settings is expected to hold its inaugural meeting in the next few months. Participants will discuss critical challenges facing nursing and healthcare, strategize about sustainable solutions such as the Nurse Staffing Committees framework encouraged by both VNA and VHHA, hear from relevant speakers, and share best practices.

The second dialogue forum focused on recommendations for action to ensure that all healthcare providers, including RNs, are adequately prepared to provide the highest level of care to military veterans receiving community care outside the Veterans Health Administration.

The third dialogue forum concerned an upcoming revision of the Code of Ethics for Nurses with Interpretive Statements, with delegates providing feedback on the proposed changes for the 2025 version. The proposed revisions are open for public comment through July 31, 2024.

Confronting major issues

In her address, ANA President Jennifer Mensik Kennedy, PhD, MBA, RN, NEA-BC, FAAN, emphasized that the persistent nurse staffing crisis has "far-reaching consequences for both nurses and patients ... when nurses are overburdened, the quality of care and patient safety significantly decline."

She stressed the combined efforts of ANA and its C/SNAs to achieve safe staffing levels. "Together, we can address this critical issue, ensuring safe staffing levels for nurses and equitable, high-quality care for all patients. Let us continue our collective efforts to make a meaningful difference in healthcare," she said.

Mensik Kennedy also called out the "intolerable" level of workplace violence that nurses experience and the toll gun violence takes on nurses and the communities they serve. She highlighted ANA's efforts to combat workplace violence nationally and on the state level, such as urging the Occupational Safety and Health Administration to develop and enforce specific standards for employers to protect healthcare professionals and convening a national workplace violence prevention committee to develop a public health strategy and provide resources for nurses.

Mensik Kennedy noted steps the organization has taken itself and in collaboration with other nursing organizations to confront racism in nursing and advance diversity, equity, inclusion and access. This work---including awarding a total of $200,000 to 10 organizations with evidence-based initiatives to dismantle systemic racism and contributing $100,000 in grants specifically to support C/SNA projects in this space---is ongoing. "Through these actions, we strive to examine and overcome the systemic racism in the workplace that harms all of us, but especially nurses of color," she noted. "I also want to thank the C/SNAs for your parallel efforts to combat racism in your communities."

Looking ahead: imagining ANA in 2040
ANA Interim CEO Angela Beddoe described the need for ANA not only to advance its current operational and strategic priorities but also to consider how "our decisions affect us 10 minutes from now, 10 months from now and 10 years from now." 

With the future in mind, she described an initiative ANA is undertaking to meet nursing's needs in 2040. This project, "Integrating Excellence: Imagining ANA in 2040," will involve taking "a good look at the environment we're in today and what we anticipate the landscape will look like in 2040 and how we continue to serve the nursing profession with best-in-class practices, innovation, engagement, education, anticipating emerging markets, research, advocacy, nursing programs, financial vitality...just to name a few," she explained. "We need to reach for the stars and see where we go and grow."

Nurses' mental health and licensure, improved care for veterans, and ethics key issues at ANA Membership Assembly

The ANA Membership Assembly also acted to support nurses struggling with mental health issues and licensure and to increase access to quality healthcare for veterans.

Aiming high

In her report to the Assembly, ANA Enterprise CNO Debbie Hatmaker, PhD, RN, FAAN, thanked members for coming together to demonstrate "the power of nurses."

"It is this body --- representing nearly every corner of the nation---that sets the priorities for nursing," said Hatmaker. "You are activists, change-makers, experts, leaders, educators, and more."

In support of ANA's commitment to confront racism in nursing, Hatmaker reported on the formation of the Racial Reckoning Think Tank in partnership with ethnic minority nursing associations. "We are approaching this work intentionally, ensuring that the right voices and lived experiences are represented," she said. "We expect the outcomes from the Think Tank to offer meaningful recommendations to advance an anti-racist profession."

Hatmaker provided a report to the Assembly on progress made on last year's dialogue forum recommendations on the topics of virtual nursing, preventing gun violence, and documentation burden. For example, ANA is developing a national policy that addresses standardization of virtual nursing.

ANA is also advocating for legislation to address gun safety and access and increase funding for research on gun violence and mental health services. During the meeting, the organization released a statement applauding the Surgeon General's declaration of gun violence as public health crisis.

Compassion and support

Assembly participants agreed that change is needed to eliminate discriminatory policies against nurses with substance misuse and mental health issues and foster a culture of support and compassion. Nurses who struggle with addiction are often reluctant to seek help because they fear loss of license and employment opportunities. Several attendees described losing colleagues to suicide due to feelings of hopelessness. The Assembly voted to accelerate changes to mental health reporting requirements and normalize the process for nurses to seek help for workplace-related stresses.

• In support of increased access to care for the U.S. veteran population, the Assembly voted to consider VA Community Care as a supplement to care delivery by the Veterans Health Administration, and to work to improve nursing knowledge relating to the unique health care needs of the veteran population.

• In addition to its policy actions, the Membership Assembly also approved a scheduled dues escalation starting in 2025.

• Attendees also provided input to the Professional Policy Committee recommendations involving a draft revision of the Code of Ethics for Nurses with Interpretive Statements. The revision, due for publication in January 2025, is open for public comments through July 31, 2024.

Emerging issues

The Assembly did not approve a motion recommending that the ANA Board of Directors endorse a candidate in the 2024 U.S. presidential election.

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Please reach out to VNA Communications Manager Elle Buck here with any questions, comments or feedback on the articles included in Virginia Nurses Today.