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I hope you all had great Holidays, from Halloween through New Year's. Me? I think about the holidays in two ways: a) I was grateful for the time devoted to my family and that I have a family, but b) then I keep reading and hearing about the attacks on Falluja, Mosul, and other places in Iraq, and about our telling Iran to stop their nuclear development or else, and that North Korea was discussed at some international meetings as being the most likely to need intervention next. So I am grateful to have had Thanksgiving and the Christmas holidays with my entire family, yet also felt guilty because so many people (Iraqis, Americans, British, and many others) are coping with war, may have lost their children/spouses/ siblings/parents, or are dealing with emotionally and physically maimed young people who've returned from there. Yes, I know there are many in the military who return unscathed, but there are also many who will be forever scarred. I have two sons, 26 & 22. I don't want them sent half-way around the world to protect SUV-driver's cheap gasoline.

I drive a hybrid vehicle, getting an average of 44 mph for the last four years. I pay extra for the utilities at the office and at home to support wind energy. My family has conserved water since we dug three dry wells on our property in 1977. I recycle cans and cardboard and white paper. If you look at what I wear, most of my clothes are 4-6 years old. At the office, the thermostat is set at 55 degrees at night and weekends; it is kept at 68 degrees and I wear a sweater when I am in the office. I work with all the lights off most of the time. I think I do my part to delay the time when the world runs out of oil. But I won't support the U.S. gaining control of whatever is left of the oil reserves by supplying my sons as cannon fodder.

I grieve for the military men and women lost, injured, damaged and maimed, and their families . . . they are facing a lifetime of change and grief themselves. I'm appalled that Congress would agree to the administration's request for cuts in the VA budget, instead of increasing it to provide health care to reservists, active military and their families, who are being injured and maimed right now. I don't even know what to say about the incidence of PTSD in these young people . . . the trauma caused by what they were ordered to do, the things they've seen, and the results of their culture repressing it all will be affecting them, probably for the rest of their lives. My sister sent me a link to a website you might want to see: http:// laramiecrocker.com/cargo.html.

I'm appalled that Congress has again increased the debt ceiling ... every child born today will have $27,000 debt to pay off JUST for what we are spending now . . . without stopping the tax cuts implemented two or three years ago. You know how much that tax cut gave me? I received a $3.42 paycheck raise. Keep the $82.08, Mr. President!

I don't want ANY more men and women to die on foreign soil. None.

Looking at the big picture, like the evolution of the universe, maybe all the bills and taxes and changes in environmental laws isn't such a big deal . . . but I actually think it is. Because the Department of Labor removed overtime protections for 6,000,000 workers, many of whom are registered nurses, we are cutting the standard of living for all those workers and their families. The incidence of asthma and asthma deaths is rising, the effects of increasing mercury levels in the air and water and soil is doing untold damage to the central nervous systems of our children. We are negatively impacting the lives of our future by saddling them with lower IQ's, poorer standards of living-including poorer health care delivery. [The above 5 paragraphs are the personal rants of Carrie, and do not reflect the philosophy of NMNA.]

We are facing a situation in 15 short years of needing twice as many registered nurses as we need right now. The NMNA and many other groups have been working on the issue for three and a half years now. The NMNA lobbyist has been responsible for obtaining $2,000,000.00 each year for the past two years to be divvied up to the various community colleges and state universities for expansion of their nursing programs. Some have chosen to use the money to expand their faculty, some to pay their faculty better so they would stay in their positions, some to tutor their students so more will graduate, and some to purchase and implement computer and other testing programs to help the students learn. Because of that the number of students enrolled in nursing programs over the past three years has increased by more than 75%. It is too early to tell how many nursing students will graduate and successfully pass the NCLEX examinations. The NM Center for Nursing Excellence has worked with NMNA closely to encourage these expansions of the nursing programs, and they have been able to also encourage a number of schools to look at their local hospitals for various projects to share expert nurses as faculty, to secure increased funding for classroom expansion, or to develop programs that encourage young people to think about health care careers after graduation from high school. We must do more.

Almost every nursing program in New Mexico is denying admission to as many qualified applicants as they admit, because of lack of space and lack of faculty. Many of the programs outside of the Santa Fe/Albuquerque area have great difficulty finding and keeping MSN educated faculty because of low salaries. The issue isn't that they don't want to pay good salaries, but those nursing faculties are paid about the same as everyone else who teaches. But nursing salaries in hospitals are often $10,000 more a year for a new graduate than what the schools can pay their faculty. And if the nursing faculty has an MSN and is a nurse practitioner, he or she can earn as much as $20,000-$30,000 more a year working as an NP. Why do we underrate the worth of teachers (pre-school to post-doctoral) so much? What can we do? Well, our lobbyist is going to the legislature this month to try to get the State of NM to allocate $2 million a year for the next two years to help the schools continue to expand. One of our colleagues in the consortium of health care groups is speaking to the NM Dept. of Labor about faculty salaries. We are also introducing a bill to provide $10,000 to 50 faculty members for ten months of graduate education for nursing faculty to complete their BSN, MSN, or PhD. The recipients would have to serve three years in NM nursing programs or pay the loan back with interest. I see it as the start of an exciting program that may really help us deal with the looming nursing crisis.

The Board of Nursing will be introducing changes to the Nursing Practice Act again this year. Some of it is reorganizing sections of the act dealing with Medication Aides in ICF-MR (Intermediate Care Facilities for the Mentally Retarded) and DD-Waiver (Developmentally Disabled-Waiver Medicaid group homes), and pilot projects, and the Hemodialysis Technician programs. Instead of having a different section for the Medication Aides for each type, they will have generic language covering all Medication Aides and the various types will be dealt with in the rules. By the way, apparently the Med.Aide pilot programs in the nursing homes and public schools went quite well and will probably be expanded to those that want them in the future.

The Board of Nursing is increasing fees caps for various groups, including LPN and RN licensure or renewals, but at the present the Board doesn't intend to increase the fees themselves. They just want to have the ability to raise them when they think they need to. They are also implementing an extra fee for advanced practice nurses when they renew their licenses, because they will have to look at 20 extra hours of continuing nursing education (15 in pharmacology) when they are audited, and make certain that the certification submitted is up to date or that the advanced practice nurse falls into the category of one who can be "grandfathered" without certification. The extra fee will be $50.00 plus the $93.00 for licensure every two years.

While talking about fee increases, membership in ANA/NMNA/District associations is increasing by $6.00 a year, because ANA convinced the House of Delegates that they needed dues increases every three years based on the cost of living. The change was called an "automatic dues escalator." There is a new chart of membership costs in the back of this issue.

NMNA is again sponsoring the Health Care Employees Protection Act, a bill to provide whistleblower protection to all nurses, doctors, nurses' aides, techs, PTs, OTs, or anyone else who witnesses maltreatment, unsafe care, or fraud. This bill was passed by the House and Senate during the Johnson administration, but vetoed by the Governor. IVo years ago, it got through the House, but the Senate was so backed up with bills that it was only heard in one committee, so never voted on by the whole Senate. Third time's charm!

We are supporting a bill sponsored by NM Health Resources, a non-profit recruiting company, to remove gross receipts and/or income taxes from state-sponsored loan programs, which have in the past come as huge shocks and burdens to those attending school on these programs.

The NM Pharmaceutical Association (the equivalent of NMNA for pharmacists) is sponsoring a bill for the Board of Pharmacy that would expand the ability of pharmacists to prescribe. Those in the prescribing programs now are allowed to prescribe immunizations or emergency contraception. This would expand the pharmacists' ability to prescribe OTC or prescription medications to help with tobacco cessation and includes a fee to be paid by health insurance programs for the required counseling. Anything that will expand our ability to impact tobacco use is fine with us.

I have served on the Medicaid Advisory Committee for about eighteen months now. Sadly, last year, because of the state budget, we had to set limits on some of the benefits available to Medicaid recipients. We are already working on the 2006 budget, which starts next July, and we may have to cut between $20 million and $120 million from the program. Every thing we look at to cut is heart-wrenching, because of the damage it may do to some uninsured, under-insured, or marginalized group. How do you choose whether to cut eyeglasses, hearing aids, or dental care from adults? Whether to cut physical, occupational or speech therapy from adults? Cut subsidized health care from families making less than $26,000 a year? When the average home in Santa Fe is now selling for more than $150,000 a year and so many people are already working one or two jobs to keep themselves and their families clothed, fed and sheltered, to cut these programs just seems too cruel.

NMNA will be hosting the annual legislative workshop for nursing students on February 4th and llth at the Santa Fe Community College and the State Capitol. Buses will be taking the students from SFCC to the Capitol and then back.

We are going to need lots of help this legislative session, both volunteers and financial. We will post the legislature's bills on our website www.nmna.org under Legislative Watch (on the left hand side) as they are introduced. If you wish to be on the legislative alert list, which means you are willing to call or Email your legislator regarding our issues, please Email NMNA: nmnurses@hotmail.com and give me your name, Email or phone, and where you live (there may be some reluctant legislators we want to target for extra attention during the session).

Having a full-time lobbyist is pretty expensive. Linda Siegle talks to any school of nursing or specialty group that requests her time; she provides strategic planning guidance to the NMNA/ NM Nurses Foundation Boards, and at our request carries bills that we feel are critical to the future of nursing and patient protection in New Mexico. If you are grateful for all that Linda and NMNA do for you, a) ask your specialty group to send a lobbying contribution, b) if you don't belong to a specialty group send your own contribution to: NMNA, P.O. Box 29658, Santa Fe, NM 87592-9658. Because it is for lobbying, it is not tax-deductible.

Finally, we will be hosting the annual Nurses Day at the Capitol on March 8, 2005. We'd like each specialty group in NM to commit to sending three or four representatives to the State Capitol that day, with information for the public, and some service for the legislators, such as random blood glucose tests, information on recognizing strokes, heart attacks, information on knowing cholesterol numbers, blood pressures, healthy diets, importance of exercise, skills to reduce stress, importance of adequate sleep, anything you can think of. In the past, the turn-out of legislators has been limited, so this year we want to provide a lunch for them downstairs in their lounges, while providing these services to them. The cost of a table upstairs to educate the public about your specialty or your school of nursing is $100.00 to cover the cost of renting tables and chairs. The cost of providing the lunch and services will be $3000.00 divided by the number of specialty groups involved. The more, the merrier! secure the opportunity to truly reach the legislators and talk about your specialty and your issues!

Copyright New Mexico Nurses Association Jan-Mar 2005
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