1. Stockwell, Serena

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Workplace violence.

Figure. A woman is e... - Click to enlarge in new window A woman is escorted to safety by plainclothes police officers near the Bronx-Lebanon Hospital in New York City after a gunman opened fire there. Photo (C) Associated Press.

* An update from the Joint Commission. Sounding the alarm about violence in health care settings, the Joint Commission rereleased its 2010 Sentinel Event Alert about the steadily increasing-but still likely underreported-rates of violent crimes in medical institutions, with new resources for preparation and prevention.


* Arrest of Utah nurse for doing her job. In a widely reported case, a nurse in Salt Lake City was arrested for protecting the rights of an unconscious patient. As shown in a police body-camera video, Alex Wubbels, the charge nurse on duty at the University of Utah Hospital, was shoved against a wall and arrested after refusing to allow a sample of the patient's blood to be drawn without a warrant. Wubbels was subsequently released and reached a $500,000 settlement, the police officer was fired, and his supervisor was demoted. Newly written policies for how officers should interact with hospital staff were drafted soon afterward by the Valley Police Alliance in cooperation with the Utah Nurses Association. Wubbels said she will donate a portion of her settlement money for the purchase of more body cameras for police and to the American Nurses Association's #EndNurseAbuse campaign.



Advanced practice registered nurse (APRN) practice authority.


* More states approve independent practice for APRNs. NPs in 22 states and the District of Columbia now have full practice authority, meaning they can independently order and interpret diagnostic tests, prescribe medication, and manage treatment. This authority follows the model recommended by the Institute of Medicine (IOM) and the National Council of State Boards of Nursing. NPs in the other states have reduced or restricted authority in at least one element of practice.


* VA expands APRN practice authority. Three of the four types of APRNs-certified NPs, clinical nurse specialists, and certified nurse midwives-can now practice without physician supervision in all Department of Veterans Affairs medical centers. The final rule, which went into effect last January, excluded certified registered nurse anesthetists (CRNAs). Several nursing organizations continue to recommend full practice authority for CRNAs to ensure timely care for veterans.



Progress on Nurse Licensure Compact. Twenty-six states have enacted enhanced Nurse Licensure Compact (eNLC) legislation, which allows nurses to practice in eNLC states without needing separate licenses for each state. Current holders of single state licenses in participating states must meet 11 conditions ( to qualify for an eNLC license. Other states are in the process of enacting the legislation. Nurses may begin practicing under eNLC licensing as of January 19.


Future of Nursing goals.


* Bachelor of science in nursing (BSN) degrees. The percentage of nurses with BSNs continues to increase, but will likely fall short of the 80% goal for 2020 set by the IOM. The most recent data (Journal of Nursing Scholarship, 2017) show that the proportion of BSN nurses in acute care units increased from 44% in 2004 to 57% in 2013. If current trends continue, by 2020 the proportion of BSN nurses will be 64%, with 22% of units reaching the 80% goal.


* Men in nursing. The percentage of male nurses has increased from 8.8% in 2004-2005 to 13.6% in 2014-2015 (Nursing Outlook, 2017).



Nurse named acting surgeon general. Rear Admiral Sylvia Trent-Adams was appointed in April, the first nonphysician to hold the position (2002-2006 surgeon general Richard Carmona is a physician as well as a nurse). She returned to her previous job of deputy surgeon general when Jerome Adams (no relation) became surgeon general on September 5, 2017.-Serena Stockwell