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IDAHOMay, June, July 2020Volume 43, No. 1Official peer reviewed publication of Idaho Center for NursingQuarterly publication direct mailed to approximately 26,000 RNs and LPNs in Idaho.These organizations are members of the Idaho Center for Nursing.IDAHO GREENIS GOINGTO MAKE SURE YOU RECEIVE AN ELECTRONIC COPY, PLEASESUBSCRIBE TODAY AT HTTPS://TINYURL.COM/IDGREENDo you love the RN Idaho paper edition?JOIN ANA-IDAHO TODAY!Beginning with our August 2020 issue, a physicaland email copy of RN Idaho will be distributed as partof ANA-Idaho membership services and will be availableonly as an electronic publication to non-members.Several years ago, ANA-Idaho & the Idaho Centerfor Nursing adopted an environmentally friendlyapproach to our events and meetings. We use onlinecommunications for events and programs instead ofpaper, we have reduced the amount of paper used atevents and meetings, and we encourage ride-sharing asa more efficient means of transportation to our events.With this in mind, Idaho Center for Nursing willbe transitioning the distribution of our quarterlynewsletter starting with our August Issue of RN Idaho.Whether you want to go green or just like readingon your tablet, signing up for the online version ofRN Idaho is easy! Instead of receiving a printed copy,you’ll get a copy in your email inbox (and you willget it faster, too). Register your email and sign up toreceive RN Idaho electronically.Sign up for electronic version of RN Idaho - SNOISchool Nurse Organization of Idaho joinsthe Idaho Center for Nursing!current resident orNon-Profit Org.U.S. Postage PaidPrinceton, MNPermit No. 14LIKE US ON LLOW US ON TWITTER@IDAHONURSESINSIDETHIS ISSUEANA IDAHO Presidential ReportCoronavirus Response by the American Nurses Association and ANA-IdahoBrienne Sandow, MSN, RN, NEA-BCPAGE 2TAKE NOTE:LGBTQ Safe Zone Signage Awareness among Nurses in IdahoPAGE 3ADVOCACY IN ACTION:2020 Legislative ConferencePAGE 4Registered Nurse Registered Voter: Federal Legislative UpdateRandall Hudspeth, PhD, APRN-CNP/CNS, FAANPPAGE 4Save the DatesPAGE 5IDAHO BOARD OF NURSING REPORT:Idaho Board of Nursing Update and Response to COVID-19 PandemicRuss Barron, MBAPAGE 5FEATURE:Idaho School District Changes Practice amid Student Vaping CrisisNichole Walters Piekarski, MSN, RNPAGE 6FEATURE:RN Perceptions of Medication Administration and Medication Errors:Results from a Quantitative Nursing Research StudyRenae L. Dougal, PhD, MSN, RN, CLNC, CCRPPAGE 7Healthcare Provider BurnoutAmy Zappia, DNP/FNP StudentPAGE 9AWARDS AND RECOGNITIONS:Terri Lindemann is School Nurse of the Year 2019PAGE 10Daisy Award RecipientsPAGE 10IDAHO CENTER FOR NURSING PARTICIPATING ORGANIZATION UPDATES:NLI and IALN Presidential ReportJoan Agee, DNP, RN, CNOR, FACHEPAGE 10Executive Director ReportRandall Hudspeth, PhD, APRN-CNP/CNS, FAANPPAGE 11NPI Legislative ReportColleen Shackelford, MSN, FNP-C, BSN, RNPAGE 11IDANA Presidential ReportGus Powell, MSN, CRNAPAGE 12PRACTICE MATTERS:Mental Health Specialists in the Emergency Department:Increasing Quality, Decreasing CostsJim Lyons, MSN, RN, CENPAGE 13Teaching Nurses to Care for the CaregiverBonnie J. Schacher, MSN, RNPAGE 13FEATURE:“WHY BSN?” An Interview with Chris SouthardReuben DeKastle, RN BN, MSH, NEA-BC, CNORPAGE 14Spark JoyAmanda Erickson, BSN, RN, RNC-MNNPAGE 14STUDENT FEATURE:Weeding Through the Facts: Marijuana Use and the Developing BrainBecky Gomez, BSN Student and Cara Gallegos, PhD, RNPAGE 15Teen Suicide Trends in the United StatesBrynn Peters, BSN Student and Cara Gallegos, PhD, RNPAGE 16FEATURE:The Color Code - Part III:Color Code can Help Align Work with a Shared PurposeMegan GuidoPAGE 172020 IDAHO LEGISLATURELegislative HighlightsMichael McGrane, RNPAGE 18In MemoriumPAGE 19

Page 2 RN IdahoMay, June, July 2020ANAI PRESIDENTIAL REPORTCoronavirus Response by the AmericanNurses Association and ANA-IdahoBrienne Sandow, MSN, RN, NEA-BCANA-Idaho PresidentThe coronavirus pandemichas challenged all of us inmany ways. We see theplethora of news items andadvice coming from a multitudeof sources; and we have alsoseen some incorrect and falseitems being posted on socialmedia. Nurses and physicianshave been measured andresponsive in issuing publicBrie Sandowcomment, possibly leavingIdaho nurses to wonder what the current positions of thenursing association are. The following is a synopsis ofwhat the nursing associations have promoted in both thenational arena and in Idaho:ANA-Idaho Activities: Supported the public donation and collectionof Personal Protective Equipment, especiallyN95 Respirator Masks, for use by healthcareproviders who lacked access to supplies. ANAIdaho thanks the Idaho Democratic Socialistsof America in Idaho chapter that donated fourcases of N95 respirators. These were distributedto Nurse Practitioners and staff working insmall clinics, to home care nurses and nursesvolunteering in free clinics, all of whom lackedaccess to PPE supplies. Supported the easing of new graduate temporarylicensure and license reactivation by retirednurses to enhance numbers in the availablenursing workforce by the Idaho Board of Nursing.The Idaho BON Executive Director and the ANA-IExecutive Director collaborated to communicatethese changes.Communicated the ANA position and CDCguidance on the use of home-made masks asan adjunct, not a replacement, for approved N95masks.ANA-Idaho answered multiple individual nurses’requests for information about how nurses couldrespond to Idaho’s needs and to seek clarificationon PPE use and infection control measures (136email requests as of March 29). Idaho nurses directly contacted our nationalcongressional representatives to support theCoronavirus Aid, Relief and Economic SecurityAct (CARES). Both Senators Crapo andRisch voted to support the bill. Senator Rischcorresponded directly with ANA-Idaho stating“I really value your effort to get in touch with meto share your thoughts, as many Idahoans do.Please do not hesitate to contact me in the futureon this or other issues.” The House was a voicevote, so we cannot say how RepresentativesSimpson and Fulcher voted because they did notcontact ANA-Idaho, but the measure passed.Supported telehealth expansion efforts in Idahothat included both nurse practitioners and nurses.ANA-Nation Activities: ANA has had a major focus to educate aboutthe demand for and supporting access to PPE,especially N95 respirator masks that are neededby bedside nurses. Established the ANA website specific org/coronavirus Lobbied Congress to increase funding for PPEand increase distribution. Maintained daily updates on legislative andregulatory developments. Published Crisis Standard of Care specific toCOVID-19. ANA started a COVID-19 “Essentials Exchange”webpage whereby state based informationis posted for sharing and as an informationresource. This is available at peRouteDesignKey 976aaa5d-023f-4e45-9d0e4c9924607dca&NavigationKey 02e6fb77-06aa4171-b55a-c232f36e1fc2&ssopc 1The ANA communicates directly with members daily,as well as through its officer and executive directoremail threads. Nurses are the largest number and mostimpacted healthcare workforce in America, and in Idaho,and the nursing association is monitoring COVID-19issues and how they impact the well-being of nurses.NursingALD.comcan point youright to that perfect NURSING JOB!NursingALD.comFree to NursesPrivacyAssuredEasy to UseE-mailedJob LeadsIDAHORN Idaho is published byIdaho Center for Nursing6126 West State St., Suite 306Boise, ID 83703Direct Dial: 208-367-1171Email: rnidaho@idahonurses.orgWebsite: www.idahonurses.nursingnetwork.comRN Idaho is peer reviewed and publishedby the Idaho Center for Nursing. RN Idahois distributed to every Registered Nurse andLicensed Practical Nurse licensed in Idaho,state legislators, employer executives, and Idahoschools of nursing. The total quarterly circulationis over 26,000. RN Idaho is published quarterlyevery February, May, August, and November.Editor:Sara F. Hawkins, PhD, RN, CPPSEditor Emerita:Barbara McNeil, PhD, RN-BCExecutive Director:Randall Hudspeth, PhD, MBA, MS, APRN-CNP,FAANPEditorial Board:Michelle Anderson, DNP, APRN, FNP-BC, FAANPSandra Evans, MAEd, RNPamela Gehrke, EdD, RNBeverly Kloepfer, MSN, RN, NP-CKaren Neill, PhD, RN, SANE-A, PF-IAFNGus Powell, MSN, CRNAKatie Roberts, MSN, RNLaura J. Tivis, PhD, CCRPRN Idaho welcomes comments, suggestions,and contributions. Articles, editorials and othersubmissions may be sent directly to the IdahoCenter for Nursing office via mail or e-mail.Visit our website for information on submissionguidelines.JOIN ANA IDAHO TODAYWE NEED YOU!Membership application advertising rates and information, pleasecontact Arthur L. Davis Publishing Agency, Inc., 517Washington Street, PO Box 216, Cedar Falls, Iowa50613, (800) 626-4081, IALN andthe Arthur L. Davis Publishing Agency, Inc. reservethe right to reject any advertisement. Responsibilityfor errors in advertising is limited to corrections in thenext issue or refund of price of advertisement.Acceptance of advertising does not implyendorsement or approval by the Idaho Alliance ofLeaders in Nursing or by any professional nursingorganization that is affiliated with the Idaho Centerfor Nursing, of products advertised, the advertisers,or the claims made. Rejection of an advertisementdoes not imply a product offered for advertising iswithout merit, or that the manufacturer lacks integrity,or that these associations disapproved of the productor its use. The affiliated nursing organizations and theArthur L. Davis Publishing Agency, Inc. shall not beheld liable for any consequences resulting frompurchase or use of an advertiser’s product.Articles appearing in this publication expressthe opinions of the authors. They do notnecessarily reflect views of the staff,board or membership of affiliatednursing organizations, or those of thenational or local associations.

May, June, July 2020ANAel c o m eWohaIdRN Idaho Page 3s Newn i ng M& R et u r19 –02,1berDecemIdaho FallsRegina WattersAtholJon HansenBoiseJason BlomquistSamantha BlackburnJessica WilcoxKimberley FitzpatrickKayla LukeVictor OnodjachaEmilie HerbekCaldwellKaren BeanDena Finer-DeanTami DutyCoeur D’AleneDerek AndersenNikki GrahamIrina LopachukEagleJoanna PhillipsWendy GordonFirthGennelle TaylorHarrisonCrystal Butler0202,1hMarcHaydenNicole HouseAmmonJoshua Pixtonem b er sKimberlySamantha HarrisErin GoodfellowKunaDeborah JonesLewistonEarlene ReaganTara BrenBrandon WhitlockMeridianCorrie Jasa-BruderCourtney AubertinMary BodineRieneke GovreauAmanda WoodyMaria RickseckerFaith ChennetteMichael PahangToni SparksNampaKathlean PrindleCarl DaytonOrofinoCurtis HartmanPocatelloLidia Timofeenko PetersenChristy KigginsPost FallsRobert SmothermanBonnie WilsonSandpointElizabeth DotsonJennifer TaylorShoshoneLaura PattenTwin FallsDaniell BauerAmysue Thorlakson-FleenorEdna PetersenBatina PeerWinchesterVallarey DahlMiddletonDevan TroskyMoscowJennifer ThomasTAKE NOTELGBTQ Safe Zone SignageAwareness amongNurses in IdahoSara Hawkins, PhD, RN, CPPSEastern Idaho Regional Medical CenterSafe Zone signage inhealthcare settings supportssexual orientation and rallycompetent care (The JointCommission, 2015).In February, 2020, weinformally surveyed RN Idahoreadership to assess awarenessof LGBTQ Safe Zone signageusage in healthcare facilitiesusing an informal web-basedsurvey. This method waschosen for convenience.ResultsResponse rate to the survey was less than 1% of the potential RN Idahoreadership (10 of 26,000) and represented three counties in Idaho: Ada, Bonneville,and Twin Falls. While the results are not representative of the full demographicand may be a source of bias, a snapshot of how things are at this time in Idaho ispresented. Overall, the results have future research implications and practical utility forhealthcare administrators and policy-makers.

Page 4 RN IdahoMay, June, July 2020LEGISLATIVE CORNERAnnual NLI & ANA-ILegislative ConferenceADVOCACY IN ACTIONRegistered Nurse-RegisteredVoter: Federal Legislative UpdateRandall Hudspeth, PhD, MBA, APRN, Executive DirectorOn February 20, 2020, nurses gathered at the Idaho State Capitol and met withGovernor Brad Little and multiple other state legislators to discuss various bills andexchange questions and answers. Legislators were interested to know about the billsupporting graduate education at Lewis Clark State College (LCSC) and about the billcalling for an exemption from prosecution for mental health patients who abuse or injurenurses. Among other activities, the Idaho Board of Nursing presented a large banner insupport of “2020 The Year of the Nurse and Midwife” for signatures.Governor Brad Little (R) Idaho isseen signing the Year of theNurse banner.Governor Brad Little at Nurse’s Dayat the CapitolDuring the afternoon, 186 nurses attended the Legislative Conference sponsored byANA-Idaho and Nurse Leaders of Idaho. Presentations focused on current legislation,the status of Medicaid Expansion that nurses supported, and other HOT TOPICS suchas: Marijuana, opioids, 2020 census, and honoring choices for living wills, POA forHealthcare and workplace violence.Participants at the 2020Legislative ConferenceOur “Registered Nurse-Registered Voter” campaign hasmade us more aware of how our elected representativesare actually voting on issues that nurses care about. Eventhough nurses have met with our elected representatives,or more commonly their staff members, when nurses visitWashington D.C., they often leave those meetings feelinggood about the message that was delivered, but theresulting vote and support from our elected legislator is notwhat the nurses wanted.There are many bills introduced in Congress thatthe Legislative Committees of the professional nursingorganizations in Idaho monitor. Updates on legislativeRandall Hudspethactions for the Idaho Legislature and the Federal House andSenate are reported by these committees to their members. Collectively, the nursingprofession in Idaho is focused on bills that impact the general health of Idahoans andthe access to care experienced by Idahoans, especially in rural communities. Weare monitoring three current bills and we are advocating for their passage becausethey support access to care and remove barriers for Idaho citizens and for nursingpractice.Today, there are eleven Idaho communities that only have nurse practitioners whotreat patients. Idaho ranks 50th of states in the number of primary care physiciansper 100,000 population (Gamble, 2019). Approximately 1,050 physicians and 1,910NPs identify themselves as primary care providers in Idaho. Thus, almost two-thirdsof all primary care is provided by nurse practitioners.The barriers that passage of these bills will remove helps patients and can alsosave costs. For example, an elderly patient in a rural community who sees a NPmust be referred from the NP to a physician for home health care or long termcare placement because only physicians are approved to order these services.The physician can then bill for a new patient visit and for the evaluation and orderscompleted. Then the physician can refer the patient back to the NP to continue careonce the patient is admitted to the service. Often times patients experience travel toanother community and prolonged wait times to be seen. If the NP could providethe service, which they are certainly educated for and capable to do, then time,inconvenience and cost could be saved. Idahoans deserve this care. We need toask our representatives and senators to support these bills, and nurses can trackthe bill’s progress at: is a summary of the Bill Number/Description/Action/Co-sponsor/Engagementby Idaho Delegation Representatives:1. HR 808 – ACCESS TO DIABETIC SHOESPurpose: To amend the documentation requirement under the Medicareprogram that is a barrier for NPs and PAs to document for coverage of certainshoes for individuals with diabetes.Action: Introduced Jan 28, 2019, but no further action. There are 91 cosponsors including Idaho Rep Mike Simpson. (Thank you Rep.Simpson) Rep Fulcher has been asked to co-sponsor.2. HR728 & S1399 – TITLE VIII NURSING WORKFORCE REAUTHORIZATIONACT OF 2019.Purpose: This bill expands and reauthorizes through FY2024 specifiednursing workforce development programs. Specifically, the bill reauthorizes(1) loan repayment and scholarships for nurses; (2) loans for nursing facultydevelopment; (3) advanced education nursing grants; (4) grants for increasingnursing workforce diversity; and (5) nurse education, practice, quality, andretention grants. In 2018 Idaho received 501,877 from this funding.Action: Passed the House Oct 28, but not supported by Reps Simpsonor Fulcher. Currently in Senate without action. Neither IdahoSenators Crapo nor Risch are co-sponsors.3. HR 2150 – HOME HEALTH CARE PLANNING IMPROVEMENT ACT OF 2019Purpose: This bill allows Medicare payment for home health services orderedby an APRN or PA. Currently, coverage is provided only for services orderedby a physician.Action: Introduced in the House. There are 138 co-sponsors, (42 Republican,96 Democrat), including Liz Cheney from Wyoming. Neither Reps Simpsonnor Fulcher are co-sponsors.Nurses should monitor these federal bills and communicate with our Idahodelegation in Washington or at their local Idaho offices. Both Senator Risch andRepresentative Simpson face re-election in 2020.ReferencesGamble, M, (2019). Primary care physician supply in all 50 states. Becker’s Hospital in-all-50-states-ranked.html

May, June, July 2020RN Idaho Page 5IDAHO BOARD OF NURSING REPORTIdaho Board of Nursing Update andResponse to COVID-19 PandemicRuss Barron, MBAExecutive DirectorTheIdahoBoardofNursing (IBN) experienceda relatively quiet legislativeseason because of the workcompleted over the past sixmonths to eliminate outdatedand unnecessary rules, whichwas a major focus of GovernorLittle’s first year. Governor Littlealso placed a moratorium onany new rules for the currentRuss Barronyear. The IBN continuedworking with Idaho’s nursing education programs andthe professional associations to meet updated standardsand to monitor the nursing workforce data.The impact of the coronavirus changed the IBN’sroutine business. Governor Little asked each stateagency, and especially healthcare regulatory boards, toevaluate any barriers to maintaining a sufficient workforceto meet the healthcare needs of Idahoans and to put inplace mitigation strategies to overcome those barriers.To accomplish this, IBN staff met with educators andrepresentatives of the Idaho Center for Nursing to worktogether to implement an impact plan. On March 18 aformal notification was sent to all nursing schools andagencies where nurses work. Some changes have beensince that time and all current information is includedbelow, and is also available on the Idaho Board ofNursing’s new and improved website at: are six ways the Idaho Board of Nursing istrying to ensure adequate nursing personnel, whileensuring public safety, during the Novel Coronavirus(Covid-19) pandemic.1. Nurse Apprentice Authorization: IdahoRule authorizes the Idaho NurseApprentice Program. As a Nurse Apprentice,nursing students may perform functions asunlicensed assistive personnel through the nursedelegation model. As part of this temporaryprogram and in compliance with the delegationmodel, a nurse apprentice is authorized toperform specific nursing functions within thelimits of their nursing education and up to theknowledge and skills that they have successfullyobtained as verified by their nursing programwith direct supervision from a licensed registerednurse. Each organization may structure thenurse apprentice role to best fit their organizationas long as it does not exceed the above-listedscope for a Nurse Apprentice. This may includemaintaining the role at an unlicensed assistivepersonnel level.A. Historically, healthcare organizations thatwere interested in becoming a NurseApprentice site were required to submit anannual application with a fee. However, theIdaho Board of Nursing is temporarily waivingthese requirements.B. Nursing students interested in becominga Temporary Nurse Apprentice who havesuccessfully completed a basic nursingfundamentals course and are in goodacademic standing in the nursing programare eligible to apply through the Idaho Boardof Nursing. There is no fee for this application.C. The Idaho Board of Nursing will ensure thatall requirements for each nursing student aremet through confirmation from the applicableNursing Program Authority and will issue aletter authorizing the nursing student to workas a Nurse Apprentice.2. New Graduate Temporary License: IdahoRule authorizes the New GraduateTemporary License Program. A New Graduate3.4.5.6.Temporary License allows senior nursing studentsto work as new graduate nurses with directsupervision from a licensed registered nurse whilethey prepare to take the NCLEX.A. Historically, senior nursing students arenot eligible for this program until they havegraduated. Effective immediately, the IdahoBoard of Nursing is temporarily allowingsenior nursing students to work with a NewGraduate Temporary License immediately ifthey are scheduled to graduate this semester.B. Senior students interested in receivinga Graduate Temporary License who arescheduled to graduate this semester and arein good academic standing in the nursingprogram are eligible to apply through theIdaho Board of Nursing. There is no fee forthis application.C. The Idaho Board of Nursing will ensure thatall requirements for each senior nursingstudent are met through confirmation fromthe applicable Nursing Program Authorityand will issue a letter authorizing the seniornursing student’s New Graduate ense:IdahoRule23. authorizes the reinstatement of inactivelicenses. The Idaho Board of Nursing hasalso developed a Temporary Reactivationof Nursing License Application which allowsan inactive Idaho licensed nurse who had aprevious unencumbered license in Idaho as aLPN, RN, and/or APRN to apply for temporaryreactivation of their license. There is no fee forthis application. Nursing Administrators mustverify active licensure through foreach nurse that is utilizing this option.Temporary Permission to Practice forNon-Compact State LPNs and RNs, andCompact State LPNs and RNs with SingleState Licenses: Idaho Rule requirements for licensure byendorsement. LPNs and RNs in a NonCompact State, or in a Compact State withonly a single state license, the Idaho Boardof Nursing is temporarily granting the sameprivilege to practice in Idaho as CompactState nurses with a multi-state license. A RNor LPN with an active, unencumbered licensein any state does not need to apply for anIdaho license to work or practice telehealthin Idaho. This privilege to practice is onlyavailable during Idaho’s Emergency Declaration.Nursing Administrators must verify active,unencumbered licensure through Nursys.comand provide a list of individuals employed tothe Idaho Board of Nursing at the end of everymonth that are utilizing this option.Nurse Licensure Compact: Idaho is amember of the Nurse Licensure Compact.A LPN or RN with an active unencumberedmultistate license in another compact statemay practice nursing in Idaho. NursingAdministrators must verify these nurses haveactive, unencumbered licenses.Nursing Faculty: The Idaho Board ofNursing has encouraged nursing educators toparticipate in helping on the frontlines in theircommunities as the immediate need for nursesmay rise throughout the state.In addition to the temporarily revised applicationslisted above, the Idaho Board of Nursing is continuingto process routine Initial Exam, Endorsement, andReinstatement licensure applications with the upmostspeed while still ensuring accuracy, quality, and safety.SAVETHE DATESNational Nurse Recognition Dates2020 Year of the Nurse and MidwifeNurses MonthMay, 2020Nurses WeekMay 6 through May 122020 Idaho Nurse Recognition DinnerNovember 9, 2020, Riverside Hotel, Boise, IDAmerican Nurses Association ofIdahoANA Delegate AssemblyJune 19-20, Washington DCAnnual Conference with LEAP 2020November 9-10, Riverside Hotel, Boise, IDNurse Leaders of IdahoLEAP 2020November 9-10, Riverside Hotel, Boise, IDNurse Practitioners of IdahoAANP National ConferenceJune 23-28, New Orleans, L A2020 Fall ConferenceFriday & Saturday, October 16-17, Boise, IDSchool Nurses Organization ofIdahoSNOI Conference 2020June 9-10, Vallivue Campus, Caldwell, IDNASN 52nd annual conferenceJune 30-July 3, Las Vegas, NVIdaho Board of NursingQuarterly MeetingsJuly 30-31, Boise, IDNovember 5-6, Boise, IDAPRN Committee MeetingJune 19, Boise, IDOctober 9, Boise, IDIdaho Hospital AssociationConventionOctober 5-7, Sun Valley, IDProgram for Recovering NursesAddiction Intervention and RecoveryServices for Nursing ProfessionalsDo you know a nurse or a colleague who needs help fordrugs/alcohol or mental health problems?Please contact us for assistance. This program is analternative to disciplinary action offered by the BON.For immediate assistance, please call us at

Page 6 RN IdahoMay, June, July 2020FEATUREIdaho School District Changes Practice amidStudent Vaping CrisisNichole Walters Piekarski, MSN, RNCoeur d’Alene Public SchoolsCoeur d'Alene Public Schools, the largest schooldistrict in North Idaho, first identified vaping as aproblem during the 2014-15 school year. The highschools responded locally until the prevalence of vapingincreased to become the driving force for an interagencymeeting called by Superintendent Dr. Steven Cook tocollaborate and implement standardized changes inpractice across the District, applying to nearly 3,500 highschool students.School administrators initially responded to studentvaping by educating themselves. The devices wereconfiscated, students suffered in-school consequencesand parents were notified. In 2016, schools began usingonline tobacco cessation curriculum as a consequence.School staff were formally educated on vaping andprovided training to identify the discrete and quicklyevolving devices. Teachers discussed the negativeeffects of vaping and shared articles with students.School nurses engaged in classroom discussionsand individual student counseling sessions for vapingcessation, prevention and education.In 2018, the prevalence of vaping increased and dabpens appeared. High schools increased the visibility ofadministration and staff in strategic areas of the schoolsand permanently opened hallway doors to restroomsto deter vaping inside. Vice Principals and SchoolResource Officers attended parent meetings to discussstudent vaping concerns. Parents were trained on themany types of vaping devices available and seen locally.School Health Services reached out to communitypartners to ask for help.In years past, public health tobacco cessation dollarssupported classroom education to prevent tobaccouse. But “those funds have since greatly decreasedand have very specific criteria” (L. Harder, personalcommunication, Feb. 21, 2019). Superintendent Cookcalled an interagency meeting with law enforcement.School nurses, principals, city police and sheriff’sdeputies met to adopt a zero-tolerance policy. As aresult, students were educated, administration and staffwere visible, and students received three-day in-schoolsuspension for use or possession of a vaping device.School resource officers averaged 82 citations perhigh school in the 2018-19 school year. The next year,Campus Safety Officers, a new role in Coeur d’AlenePublic Schools, regularly spot-checked restrooms,hallways, locker rooms, and campus surroundings. Thenumber of student citations went down.Middle schools in Coeur d’Alene saw student vapingproblems emerge in the 2017-18 school year. The staffand administration adopted similar practices as thehigh schools by increasing the visibility of teachers andadministrators, propping open the outer restroom doorsand educating parents. The dangers of vaping wereadded to student health curricula. Students receivedtwo-day in-school suspension for use or possession of avaping device at the middle schools.In November 2019, the school district’s Director ofSchool Health Services reviewed and revised five Districtpolicies regarding the prohibition of vaporizer smokingdevices by students, employees and visitors to campus.Vaporizer smoking devices are prohibited at all schoolevents, on and off campus. An interdisciplinary teamof District leadership, principals, a school nurse and aresource officer presented the District problem of vaping,change in practice, and change in policy and procedureto the School Board on Nov. 4, 2019. The interdisciplinaryteam asked the school board to take action byadvocating for a legislative ban on flavored electroniccigarettes and vaping products and by advocating forcommunity partners to provide educational opportunitiesfor parents and patrons. The interdisciplinary teamalso asked for the school board to provide increasedstudent supervision in the schools by adding a CampusSafety Officer to each middle school, as the highschool administrators felt the Campus Security Officer’spresence and oversight was the single most importantfactor to deter student vaping at school.Author NoteNichole Walters Piekarski, MSN, RN, Director ofSchool Health Services, Coeur d’Alene Public Schools.The author has no known potential conflict of interest,whether financial or other, a

Page 2 RN Idaho May, June, July 2020 RN Idaho is published by Idaho Center for Nursing 6126 West State St., Suite 306 Boise, ID 83703 Direct Dial: 208-367-1171 Email: Website: RN Idaho is peer reviewed and published by the Idaho Center for Nursing. RN Idaho

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