Wisconsin Board of Nursing Newsletter

By: Peter Kallio, DNP, CRNA, APNP

   To all the hard-working Nurses of Wisconsin, I continue to salute you for remaining steadfast in these unprecedented times of the pandemic. The Pandemic continues into the new year, but now there is new hope with the introduction of a vaccine. Hopefully, your workplaces have put you in the front of the line to receive yours. You are continuing to be the heroes of this pandemic with the direct care and the support roles that you are providing our Covid patients. We continue to hear the stories of nurses being with patients in their final moments. This is truly a special calling.

   The Board of Nursing has been busy working with DSPS and the Governor to make sure that our own rules around the Nurse Practice act do not create barriers to our nurses and those that want to work here. The board is now working to create language within our rules to allow future boards of nursing to act immediately to adjust rules in a time of emergency. We are trying to be forward thinking and construct language with flexibility with advice of legal counsel and the legislative rules division of DSPS. The goal is to be able to be nimble and responsive if ever in another state of emergency.

   As you will see in this newsletter, some of the faces are changing on the board as they do with expiration of terms. We recently said goodbye to Beth Smith-Houskamp as her term expired in July. She did stay on until a replacement was appointed through November 2020. Beth was a valued member of the board with her unique perspective as a COO and CNO of Gunderson Health System in La Crosse. Personally, I learned from her as to what the expectations are to be a good leader. She is always seeking truth and was relentless in that aim. This may be one of the reasons that the Wisconsin Organization of Nurse Leaders (WONL) recently awarded her the Nurse Executive of the Year award. Congratulations and thank you again for participating on our Board and being the leader that you are.

   As the board moves forward in its duties, we are cognizant of the challenges that face nursing, now and into the future. On the short term, goals include being resilient to rules changes in respect to the pandemic and making sure the LPN renewal cycle runs smoothly. We will be testing the renewal website to ensure the process runs smoothly. For the long term, we are tasked to modernize the rules to reflect current practice. This is an ongoing process, and we encourage all nurse with interest to be part of the process. The Board of Nursing meetings are always open to the public and we value your input. We will continue to push for a social media presence as to disseminate information in an up-to-date fashion. We are also looking at the long-term workforce predictions and how that may reflect care in the future. This is especially true in the rural areas of Wisconsin.

   One duty that the Board of Nursing has is to protect the public in this state. We continue to discipline nurses around the state for everything from diversion and substance abuse to neglect and poor decision making. I encourage all nurses to consider the ramifications of this. If you have a drug or alcohol problem, it is much better to come forward and ask for help rather than getting caught impaired or diverting. This matter is not taken lightly, and one would be surprised as to how often this occurs. The state has a confidential program for those professionals seeking help. Please visit the DSPS website to learn more about the Professional Assistance Procedure:
https://dsps.wi.gov/Pages/SelfService/ProfessionalAssistanceProcedure.aspx

   The nurse licensure compact now has 34 states with more states in the legislative process. For more information you can go the NCSBN Nurse Licensure Compact website:  https://www.ncsbn.org/nurse-licensure-compact.htm

   I am proud to be working for all nurses in Wisconsin during this pandemic. I have been blessed to work with an amazing group of nurses and public members and DSPS staff on this board.  Their passion for our mission comes through in everything they do. I thank the Board and the nurses of Wisconsin for your courage and work ethic as we continue to work through this pandemic. Please stay safe and please care for yourselves as well as your patients.

By: Lisa Pisney, NP

   The 2020 Annual meeting of the NCSBN was held virtually on 8/12/2020. The Wisconsin Board of Nursing was represented by board members Emily Zentz and Lisa Pisney. The meeting included the President’s address by Julia George, MSN, RN, FRE, who is the CEO of the North Carolina Board of Nursing. The CEO also gave an address. There were two committee forums presented; the finance committee and the APRN Compact.

   There was much discussion about the proposed language changes to the APRN compact. Each member representative from their state board of nursing was given a vote in the decision. Most of the discussion centered on the proposed addition of 2080 hours of practice requirement prior to getting a multi-state license under the compact. The compact was brought up for a vote last year, but the Board of Directors decided to withhold the vote due to concerns voiced by the LACE network. This is the network created by the consensus model that represents APRN licensure, accreditation, certification and education stakeholders.

   NCSBN hosted a meeting with LACE participants and in response to their concerns regarding the examination requirement language, the board of directors decided to recommend the language be modified to be consistent with the consensus model.

   After the revised draft was presented at the Midyear meeting in March 2020, a survey of members was sought for feedback on two of the major changes. The first major change was that of the requirement of 2080 hours of practice prior to being eligible for a multistate license.

   The second major change was the allowance of felony convictions to be analyzed on a case-by-case basis. The results showed that 73% of the respondents supported the 2080 hour requirement, but the case-by-case felony conviction analysis was only supported by 48%.

   Once a state signs on to the compact, the compact supersedes all state requirements. Once APRN’s are granted multi-state license, they can practice independently in their home state and all party states. This would broaden the amount of states that would be eligible to participate in the Compact. Currently only 14 states would be eligible to join the compact, but with the proposed changes this would increase to 23 states.

   Many of the states that have newly gained independent practice already have transition to independent practice hours required. Nursing coalitions are finding it necessary to include transition to practice hours in order to gain independent practice in state legislatures.

   Ninety-two percent of all APRN’s will be eligible for independent practice under the compact from day one. Those that opposed this language change mentioned that there is nothing in literature showing that any number of hours leads to better quality care of APRN’s.

   The vote was taken and the addition of the 2080 practice hours was added to the compact language. The exact language of the compact in relation to this reads, “Has practiced for at least 2,080 hours as an APRN in a role and population focus congruent with the applicant’s education and training. For purposes of this section, practice shall not include hours obtained as part of enrollment in an APRN education program.” The review of felony convictions on a case-by-case basis did not pass and the language in the compact states, “has not been convicted or found guilty, or has entered into an agreed disposition, of a felony offense under applicable state, federal or foreign criminal law.”

   This was a very spirited discussion and we now have a new APRN compact. As yet, there is only two states that have joined the compact and they are North Dakota and Delaware.

By: Luann Skarlupka, Public Member

   Among the Wisconsin Board of Nursing's nine members are two seats for public members. Like the RN and LPN members of the Board, the public members are appointed by the Governor for staggered four-year terms and confirmed by the Wisconsin State Senate. 

   The public members shall not, nor any member of the public members' family, have ever worked as a nurse or have financial ties to the nursing profession.

   Just like the nurse members of the Board, the public members are full voting members. They are eligible to become officers of the Board and sit on any of the Board's committees or work groups.

   At the very core of its mission, the Board of Nursing protects the public. To that goal, a public member's perspective from outside the nursing profession is key in evaluating Board matters from a consumer, patient, and taxpayer perspective. While it is likely instinctive for any professional to first evaluate an issue from the vantage point of their occupation, a public member is separate from the occupation and plays a critical role in evaluating matters from an outsider perspective. As issues are presented to the Board for decisions, all Board members including public members look for consistency with precedence on nursing school regulatory matters and on disciplinary issues involving licensees.

   In matters of regarding licensee discipline, public members serve on the screening panel that determines which complaints should be opened for investigation. Public members also serve as case advisors to work with attorneys and investigators to make recommendations to the full board on how individual complaints should be handled. The cases assigned to public members are those not involving nursing standards of practice as the core issue. Standards of practice disciplinary cases are handled by nurse board members.

   Public members have the opportunity to attend National Council of State Boards of Nursing as state delegates to national meetings where they can connect with and learn from other public and nurse members of boards from across the nation.

   Just like nurse members, public members are responsible for protecting the personal details of nurses involved in disciplinary cases, protecting any private details of involved patients in those disciplinary cases, and upholding all laws pertaining to state officials and open meetings.

   The Wisconsin Board of Nursing will have an opening for a new public member in 2021. Anyone interested should contact the Governor's Office to submit an application for consideration.

By: Janice (Thompson) Edelstein, Registered Nurse Member

   Originally from Milwaukee, Janice Edelstein earned a BSN from the University of Wisconsin-Milwaukee. Following graduation, she worked in surgery, critical care, and as a charge nurse on a med-surgical unit. Transitioning to an academic role in rural Oklahoma, she continued her education with a MSN from the University of Oklahoma-Health Science Center and later with an M.Ed. and Ed.D. from the University of Arkansas-Fayetteville.  Janice has taught at the ADN, BSN, and at the MSN level in nursing in Oklahoma and in Wisconsin.  Throughout the years, she has developed her skills in curriculum development, accreditation work, teaching online as well as face to face instruction. She has been a Nurse Educator since 1981 and retired from full time teaching in May 2020. Currently, she lives in Omro (near Oshkosh).

   Having a strong background in community/public health nursing practice and health care policy, Janice has been involved in various areas of clinical practice including homecare/hospice, correctional health, and school nursing. In the past, she has served as a member of the Board of Health for Winnebago County and an Executive Board member for Lutheran Homes of Oshkosh (currently Miravida Living). She is a Red Cross Health Services Nurse and has served on local, State, and national disasters for over 15 years.

   Janice Edelstein has been a speaker at local, state, and national nursing conferences over the years. She has been published in the areas of ethics, health literacy, and older adult care. She has also worked with refugees and immigrants in assisting with English proficiency skills with a focus on health care needs. Janice is a member of the Wisconsin Public Health Association and is recognized as a Fellow with the National League for Nursing, Academy of Excellence in Nursing Education.

   At a time of tremendous change in health care, the role of the nurse, and the advanced practice nurse continues to evolve. Ms. Edelstein is enthusiastic in seeking out information as an advocate for nursing practice and nursing education. She will serve as the Board Education Liaison, a position that works with Department staff in review of Nursing Schools, for the Board of Nursing. Janice states “It is a great and challenging time to be a nurse in Wisconsin.”

By: Christian Saldivar, Public Member

   Christian Saldivar, BA Political Science is currently a middle school teacher at Lad Lake Synergy South School. He worked as a therapeutic activities aide at Eastside Health and Rehab on Milwaukee's east side from 2008-2011. He has more than ten years’ experience in behavioral and mental health services for both children and adults. He worked as a crisis stabilizer for Milwaukee's Wraparound Program for several years working with students and families on developing coping mechanisms around the areas of mental and behavioral health.

   Christian has returned to all the schools he attended as a youth. He worked as a teacher, administrator and staff member at all of these institutions. He cites his passion for public service, criminal justice reform and mental health as motivating agents for his continued openness to growth and learning in whatever he puts his time into. When he is not teaching, running for office or working on his master’s in public administration, Christian enjoys playing sports and spending quality time with his family.

By: Barbara Nichols, WCN Executive Director

   The Wisconsin Center for Nursing (WCN) is focused on ensuring that the current nursing workforce is prepared to meet the needs of Wisconsin’s populations. WCN’s workforce data has documented that RNs and LPNs are prepared for disasters but not public health pandemics such as Covid-19. Currently the Covid-19 pandemic has magnified the negative health consequences experienced by disparate and vulnerable populations: greater health risks, poor health outcomes and higher death rates. Additionally, WCNs 2019-2020 workforce data shows that 93.4% of RNs and 87.7% of LPNs in Wisconsin are white, therefore, potentially limiting authentic knowledge of the afore mentioned increased challenges and determinants of health that place patients of color and the elderly at higher risk. In response to these facts, WCN has developed and implemented a priority online training program to provide relevant, high quality education for nurses about the disparities, social determinants of health, and equity concerns experienced by Wisconsin’s most vulnerable populations.

This 6-hour online program has two segments:

• Segment 1: Identifies vulnerable populations as an essential part of community preparedness (3.0 hours).
• Segment 2: Identifies the nurses’ role in responding to Public Health Emergencies in your community (3.0 hours).

The course is open to individual RNs, LPNs Health Systems, and Long-Term Care Organizations.

For more information go to: https://wicenterfornursing.org/.