I AM A ROCK – I AM AN ISLAND

The APA and APA Practice Organization Practice Leadership Conference (PLC):  One knows that spring has arrived in our nation's Capital when the talk of the town becomes the annual cherry blossom festival, perhaps the last snow storm of the year, and the APAPO state leadership conference, which is always the highlight of my APA year.  Renamed this year as PLC, over 400 colleagues enthusiastically attended "Practice, Politics & Policy."  HPA President-Elect Tanya Gamby led the Hawaii delegation, with executive director Ray Folen actively attempting to herd the crew to their various scheduled venues.  Once again, Dan Abrahamson and Susie Lazaroff did an outstanding job and it was particularly nice to have Congressman Tim Murphy (R-PA), who is a psychologist, honored for his outstanding contributions to our nation's mental health and substance abuse programs.

            APA President Tony Puente and President-Elect Jessica Henderson Daniel were ever-present, as was former HPA President Kate Brown now serving as Chair of CAPP.  At PLC we learned that Kate's fellow CAPP member, June Ching, will soon join the National Register Board of Directors.  Personally, I particularly appreciated Tony Puente's efforts to actively engage those early career psychologists and graduate students who were present in shaping the future of their profession.  Sybil Mallonee (1^st Lt., USA) is a graduate student at USUHS: "As a student attending the APA's Practice Leadership Conference for the first time, it was an amazing and exciting experience.  It was amazing seeing so many clinicians from all stages in their career come together to advocate for our field.  It was exciting to have the opportunity to be mentored by so many incredible clinicians who were eager to pass on their knowledge to the upcoming generation of psychologists.  It was also exciting to see such an emphasis on the importance of diversity and on having the sometimes challenging conversations around issues related to diversity.  There were many great speakers throughout the conference, but the one that stands out the most was the diversity panel.  This panel was of psychologists sharing challenging conversations and experiences related to diversity.  In keeping with the theme of the conference as a whole, their stories were inspiring to this future psychologist.  They were honest and challenging, but they also emphasized the importance of not losing your voice and of standing up for what is right."

            Katherine Nordal was most impressive in crystalizing the notion of promoting psychologists by advancing the trade of professional psychology – truly a new message for a number of our colleagues – and by each of us contributing to our Political Action Committee (PAC).  Today, the national psychology PAC ranks 44^th among 129 health professional PACs with dentistry, medicine, optometry, nursing, physical therapy, podiatry, social work, and psychiatry significantly ahead of us.  I would rhetorically ask: What percent of the membership has contributed to HPA's PAC?

            Hawaii psychologists are very fortunate in that our state has long possessed a Congressional delegation which truly appreciates the value of psychological care.  Kathy McNamara describing one of her recent Hill visits: "While in Washington in September for Hill meetings, I had an opportunity to meet with our Senator Mazie Hirono.  She voiced her absolute support of efforts to improve access to quality mental health care.  While I appreciated the Senator's statement of support, I appreciated even more the time she then took to stay in a conversation with me, sharing about her childhood in Japan, with a fond memory of being with her mother and eating persimmons (a reference to our persimmons season in Hawaii!).  Among other personal aspects of her background, she proudly mentioned that her undergraduate major was Psychology, so her interest in psychological services has been long-standing.  What a gracious, competent, and compassionate side of Senator Hirono was evident in this visit."

The Prescribing Psychologist (RxP) Evolution:  At PLC there were a number of interesting informal discussions following up on the success of Bethe Lonning and her colleagues in Iowa in having their RxP legislation enacted into public law.  The Connecticut Psychological Association (CPA) RxP Task Force just completed a survey of 900 licensed psychologists in their state and found that 70 percent supported RxP for properly trained psychologists (Anne Klee and Barbara Bunk).  Robin Henderson noted that RxP is once again alive in Oregon – this time being advocated for by non-psychologists.  Recall that in 2010 their legislation was vetoed by the Governor.  Beth Rom-Rymer is pleased with the progress they are making in Illinois in implementing their law.

All the proposed RxP legislative bills have referenced graduates taking a nationally recognized exam.  The Psychopharmacology Examination for Psychologists (PEP) exam is in the process of being transferred from the APA Practice Organization to ASPPB, with the original PEP examination remaining available to candidates until March 30, 2017.  This January, ASPPB, which has been intimately involved from the very beginning, issued a broad call for volunteers to assist in developing the new version of the national exam.  "An exam of this nature requires periodic updates to ensure that it continues to assess current knowledge required for competent practice."  With change comes opportunity; perhaps the time has come for APA to embrace pre-doctoral training rather than exclusively focusing upon post-doctoral models.  Beth's vision of a vibrant state with undergraduates, graduate students, and practicing psychologists working towards becoming prescribing psychologists, working in concert with Illinois' largest social service organizations, NAMI, the prison system, Illinois's largest academic and research medical institutions, major medical centers, and smaller community hospitals is coming to fruition.

In reviewing some of the statements made on the floor of the Hawaii State Legislature in opposition to Hawaii's RxP legislation, I could not help but reflect that these are not uncommon views being said in other states.  They present an opportunity for psychologists to do more and particularly to personally meet with their own local elected officials to discuss how rigorous their doctoral training was.  The essence of several of the statements is that those licensed psychologists who are pursuing RxP are "public health hazards" who would affirmatively harm their patients.  "One of the basic concerns we had last year, when the bill was killed, was safety.  We have, I believe, inadequate basic education amongst some of these people who will be prescribing medication.  Many of the people do not have basic science education.  Some of these people come from private universities which have very low entrance requirements."  "I'll be voting no on this measure, because we are playing games with people's health….  And I believe that they are not qualified to do it, and because of that, and in the interest of being cautious, we should, I am voting no on this measure."  One can reasonably agree or disagree on the RxP agenda.  One could also argue that when non-physicians, such as Advanced Practice Registered Nurses (APRNs) and Clinical Pharmacists, are actively engaged in the prescriptive process, more appropriate and more judicious use of medications is the result; that is, an overall higher quality of health care is provided.  "As of today, Hawaii's SB 384 has made it through crossover and is being heard in the House Health Committee this Thursday.  We're still alive!" [Jill Oliveira Gray].

Earlier this year South Dakota became the 22^nd state in the nation, plus the District of Columbia, to have Full Practice Authority for Nurse Practitioners.  In January, the Department of Veterans Affairs (VA), utilizing its federal preemption authority, issued regulations granting Full Practice Authority for APRNs (other than nurse anesthetists) regardless of State or local law restrictions, when the APRN is working within the scope of their VA employment.  This authority includes providing diagnosis and treatment of health or illness states, disease management, health promotion; and prevention of illness and risk behaviors among individuals, families, groups, and communities.  It also expressly authorizes prescribing medication and durable medical equipment.  "And a rock feels no pain.  And an island never cries."  Aloha,

Pat DeLeon, former APA President – HPA – March, 2017

Sent from my iPhone

HPA - Spring column

“I AM A ROCK – I AM AN ISLAND”

            The APA and APA Practice Organization Practice Leadership Conference (PLC):  One knows that spring has arrived in our nation’s Capital when the talk of the town becomes the annual cherry blossom festival, perhaps the last snow storm of the year, and the APAPO state leadership conference, which is always the highlight of my APA year.  Renamed this year as PLC, over 400 colleagues enthusiastically attended “Practice, Politics & Policy.”  HPA President-Elect Tanya Gamby led the Hawaii delegation, with executive director Ray Folen actively attempting to herd the crew to their various scheduled venues.  Once again, Dan Abrahamson and Susie Lazaroff did an outstanding job and it was particularly nice to have Congressman Tim Murphy (R-PA), who is a psychologist, honored for his outstanding contributions to our nation’s mental health and substance abuse programs.

            APA President Tony Puente and President-Elect Jessica Henderson Daniel were ever-present, as was former HPA President Kate Brown now serving as Chair of CAPP.  At PLC we learned that Kate’s fellow CAPP member, June Ching, will soon join the National Register Board of Directors.  Personally, I particularly appreciated Tony Puente’s efforts to actively engage those early career psychologists and graduate students who were present in shaping the future of their profession.  Sybil Mallonee (1^st Lt., USA) is a graduate student at USUHS: “As a student attending the APA’s Practice Leadership Conference for the first time, it was an amazing and exciting experience.  It was amazing seeing so many clinicians from all stages in their career come together to advocate for our field.  It was exciting to have the opportunity to be mentored by so many incredible clinicians who were eager to pass on their knowledge to the upcoming generation of psychologists.  It was also exciting to see such an emphasis on the importance of diversity and on having the sometimes challenging conversations around issues related to diversity.  There were many great speakers throughout the conference, but the one that stands out the most was the diversity panel.  This panel was of psychologists sharing challenging conversations and experiences related to diversity.  In keeping with the theme of the conference as a whole, their stories were inspiring to this future psychologist.  They were honest and challenging, but they also emphasized the importance of not losing your voice and of standing up for what is right.”

            Katherine Nordal was most impressive in crystalizing the notion of promoting psychologists by advancing the trade of professional psychology – truly a new message for a number of our colleagues – and by each of us contributing to our Political Action Committee (PAC).  Today, the national psychology PAC ranks 44^th among 129 health professional PACs with dentistry, medicine, optometry, nursing, physical therapy, podiatry, social work, and psychiatry significantly ahead of us.  I would rhetorically ask: What percent of the membership has contributed to HPA’s PAC?

            Hawaii psychologists are very fortunate in that our state has long possessed a Congressional delegation which truly appreciates the value of psychological care.  Kathy McNamara describing one of her recent Hill visits: “While in Washington in September for Hill meetings, I had an opportunity to meet with our Senator Mazie Hirono.  She voiced her absolute support of efforts to improve access to quality mental health care.  While I appreciated the Senator’s statement of support, I appreciated even more the time she then took to stay in a conversation with me, sharing about her childhood in Japan, with a fond memory of being with her mother and eating persimmons (a reference to our persimmons season in Hawaii!).  Among other personal aspects of her background, she proudly mentioned that her undergraduate major was Psychology, so her interest in psychological services has been long-standing.  What a gracious, competent, and compassionate side of Senator Hirono was evident in this visit.”

The Prescribing Psychologist (RxP) Evolution:  At PLC there were a number of interesting informal discussions following up on the success of Bethe Lonning and her colleagues in Iowa in having their RxP legislation enacted into public law.  The Connecticut Psychological Association (CPA) RxP Task Force just completed a survey of 900 licensed psychologists in their state and found that 70 percent supported RxP for properly trained psychologists (Anne Klee and Barbara Bunk).  Robin Henderson noted that RxP is once again alive in Oregon – this time being advocated for by non-psychologists.  Recall that in 2010 their legislation was vetoed by the Governor.  Beth Rom-Rymer is pleased with the progress they are making in Illinois in implementing their law.

All the proposed RxP legislative bills have referenced graduates taking a nationally recognized exam.  The Psychopharmacology Examination for Psychologists (PEP) exam is in the process of being transferred from the APA Practice Organization to ASPPB, with the original PEP examination remaining available to candidates until March 30, 2017.  This January, ASPPB, which has been intimately involved from the very beginning, issued a broad call for volunteers to assist in developing the new version of the national exam.  “An exam of this nature requires periodic updates to ensure that it continues to assess current knowledge required for competent practice.”  With change comes opportunity; perhaps the time has come for APA to embrace pre-doctoral training rather than exclusively focusing upon post-doctoral models.  Beth’s vision of a vibrant state with undergraduates, graduate students, and practicing psychologists working towards becoming prescribing psychologists, working in concert with Illinois’ largest social service organizations, NAMI, the prison system, Illinois’s largest academic and research medical institutions, major medical centers, and smaller community hospitals is coming to fruition.

In reviewing some of the statements made on the floor of the Hawaii State Legislature in opposition to Hawaii’s RxP legislation, I could not help but reflect that these are not uncommon views being said in other states.  They present an opportunity for psychologists to do more and particularly to personally meet with their own local elected officials to discuss how rigorous their doctoral training was.  The essence of several of the statements is that those licensed psychologists who are pursuing RxP are “public health hazards” who would affirmatively harm their patients.  “One of the basic concerns we had last year, when the bill was killed, was safety.  We have, I believe, inadequate basic education amongst some of these people who will be prescribing medication.  Many of the people do not have basic science education.  Some of these people come from private universities which have very low entrance requirements.”  “I’ll be voting no on this measure, because we are playing games with people’s health….  And I believe that they are not qualified to do it, and because of that, and in the interest of being cautious, we should, I am voting no on this measure.”  One can reasonably agree or disagree on the RxP agenda.  One could also argue that when non-physicians, such as Advanced Practice Registered Nurses (APRNs) and Clinical Pharmacists, are actively engaged in the prescriptive process, more appropriate and more judicious use of medications is the result; that is, an overall higher quality of health care is provided.  “As of today, Hawaii’s SB 384 has made it through crossover and is being heard in the House Health Committee this Thursday.  We’re still alive!” [Jill Oliveira Gray].

Earlier this year South Dakota became the 22^nd state in the nation, plus the District of Columbia, to have Full Practice Authority for Nurse Practitioners.  In January, the Department of Veterans Affairs (VA), utilizing its federal preemption authority, issued regulations granting Full Practice Authority for APRNs (other than nurse anesthetists) regardless of State or local law restrictions, when the APRN is working within the scope of their VA employment.  This authority includes providing diagnosis and treatment of health or illness states, disease management, health promotion; and prevention of illness and risk behaviors among individuals, families, groups, and communities.  It also expressly authorizes prescribing medication and durable medical equipment.  “And a rock feels no pain.  And an island never cries.”  Aloha,

Pat DeLeon, former APA President – HPA – March, 2017

 

Division 55 spring column

“COME ON AND HEAR!  COME ON AND HEAR!”

            The 34^th Annual APA and Practice Leadership Conference (PLC):  As always, the APA and Practice Organization’s State Leadership Conference (SLC), this year renamed the Practice Leadership Conference (PLC), was an outstanding success.  Dan Abrahamson and Susie Lazaroff were truly visionary in crafting the agenda for “Practice, Politics & Policy.”  Former Administration and Hill operatives provided an insightful glimpse into the new Trump Administration and what psychology’s practitioners might well face over the next four years.  One could feel a growing sense of urgency among those present for getting personally involved in shaping the future of our nation’s health care environment and especially for ensuring that psychology remains recognized as a bona fide autonomous health care profession.  Having worked on the U.S. Senate staff for over 38 years, I particularly appreciated Katherine Nordal’s challenge to advance the trade of professional psychology – a conceptually different approach than many have heard before.  She also noted that the psychology PAC currently ranks 44^th among 129 health professional PACs with dentistry, medicine, optometry, nursing, physical therapy, podiatry, social work, and psychiatry significantly ahead of us.

            APA President Tony Puente and President-Elect Jessica Henderson Daniel were constantly mingling among the 400+ attendees at PLC, urging colleagues to appreciate that the future of their profession lies in their own hands.  Once again, the number of first-time attendees was most impressive.  Our national leadership was especially attentive to the early career psychologists and graduate students who were present.  Division 55 should be proud that under the leadership of Presidents Neal Morris and now Sean Evers, USUHS graduate students Joanna Sells and Omni Cassidy have been actively engaged in shaping our Division’s annual convention programming.  As Dan Abrahamson reflected afterwards: “If we can’t support the future of our profession, we are done for….”

Sybil Mallonee (1^st Lt., USA) is a graduate student at USUHS: “As a student attending the APA’s Practice Leadership Conference for the first time, it was an amazing and exciting experience.  It was amazing seeing so many clinicians from all stages in their career come together to advocate for our field.  It was exciting to have the opportunity to be mentored by so many incredible clinicians who were eager to pass on their knowledge to the upcoming generation of psychologists.  It was also exciting to see such an emphasis on the importance of diversity and on having the sometimes challenging conversations around issues related to diversity.  There were many great speakers throughout the conference, but the one that stands out the most was the diversity panel.  This panel was of psychologists sharing challenging conversations and experiences related to diversity.  In keeping with the theme of the conference as a whole, their stories were inspiring to this future psychologist.  They were honest and challenging, but they also emphasized the importance of not losing your voice and of standing up for what is right.”

            Psychology Proudly Serving the Nation:  Cynthia Belar, Interim APA CEO, recently reported to the Council of Representatives: “Dr. Heather O’Beirne Kelly is now APA’s first Director of Veterans and Military Health Policy.  Dr. Kelly has served as a Senior Legislative & Federal Affairs Officer for the past 19 years in APA’s Science Directorate, where she has led our association efforts to address military and veteran issues and to promote the role of psychology in tackling those issues.  In her new role Dr. Kelly will join Practice’s government relations office, headed by Doug Walter, J.D., and she will work across directorates to ensure that the range of military and veteran issues are addressed.  One out of every six Americans is either a military service member, veteran, or family member of someone serving or having served in the U.S. armed forces.  APA has a long history of attending to the health and well-being of these populations, and the VA is the largest single employer of psychologists.  We believe that in this new role, Dr. Kelly will enhance our advocacy and work to better serve our service members, veterans, and the psychologists who care for them.”  As many of us aware, Heather has been working closely with the Division to expand psychology’s RxP capabilities throughout the federal system, including within the VA.

            On Veterans’ Day 2016, a long-time friend, Kris Ludwigsen shared her reflections with her local congregation on her personal service in the USAF.  “Today I would like to focus on the women who’ve volunteered to serve in the military.  I am a veteran of Desert Storm and my father was torpedoed in the Navy in WWII.  A Scottish ancestor, Daniel McClure, fought in the American Revolution at the battle of Ft. Vincennes, and 200 years later I went on active duty in the USAF.  We all survived the dangers of our tours of duty in the Army, Navy, and Air Force.

“Women of verve formed a militia of ‘minutemen,’ or stepped up as spies for the American Revolution.  In the Civil War they disguised themselves as men to fight with their husbands.  While Rosie went to work building battleships and bombers to backfill positions vacated by men, in WWII the WASPs flew hundreds of missions over some 64,000 miles; yet they were only granted veterans’ status in 1977.  In the wake of the WACs (1943) and the WAVES (1944) came the Army nurses tending the wounded in Viet Nam and the women of the National Guard who were deployed to grunt work and combat in Iraq and Afghanistan.

            “Why would a woman choose to join the military?  Some volunteer out of a desire to serve their country or family tradition, the same as a man.  Some join for adventure or travel, to be exposed to a broader view of the world.  Some join for financial independence and a structure that makes it possible to leave home or support children on their own.  Some sign up for training and educational opportunities.  For me it was the professional experience.  Teaching in a university and rubbing elbows with part-time instructors who were active duty psychologists at Wright-Patterson AFB, I wanted the immersion clinical experience the Air Force provided.

            “The military is a microcosm of society that includes physicians and nurses, social workers and psychologists, dentists and dieticians, attorneys and chaplains – as well as missile launchers and those fighting on the front lines.  It is a milieu with valuable lessons to teach.  The military is about learning responsibility and reliability, resourcefulness, leadership and teamwork with pride in an esprit de corps.  It is about courage under fire, proving yourself as an adult without the support of family, and about submerging your ego to the mission, to the common objective.

            “As the first military psychologist at an 18-bed hospital, I had an advantage in that no one really knew what a psychologist did.  So I was able to create my own job description that included meeting with the squadron commander or first sergeant to explain the dynamics that had resulted in the member’s problem behavior, often the precursor to discharge.  After assessment and treatment my goal was to integrate the member back into the squadron to salvage his or her Air Force career.  When a stream of young women from Dugway Army Proving Ground was admitted, I decided to investigate the cause, and drove out to the desert once a month to run an enlisted women’s morale group.  In such isolated surroundings, these women were being harassed by their male counterparts, resulting in acute stress disorder symptoms that precluded functioning on the job; and I worked with the company commander who had them transferred out of a hostile work environment. 

            “The transition back to civilian life is not easy; war time separations foster family problems difficult to repair.  Many Vets have suffered the toxic effects of Agent Orange or symptoms of post-traumatic stress disorder as I found working with retirees who’d served in Viet Nam, and with a nurse-friend who endured SCUD missile attacks in Desert Storm.  We must do more to help support Vets whose special needs originate from having given their all, for Service Beyond Self.  I went in as a Captain and retired as a Lieutenant Colonel line officer some 25 years later.  The Air Force was the most creative and exciting period of my 35-year career as a psychologist.  As a ‘lone ranger’ I learned that if I didn’t do it, it wasn’t going to get done.  I had to establish priorities for treatment and I had to grasp what it was like to be in the shoes of the diverse members of this military community.  In my time I met a number of men and women who earned my respect as true public servants, dedicated to the highest aims.  Remembering our Vets and those who continue to serve us in the military is our duty and professional responsibility.”

            The Future of Advanced Practice Nursing:  The Robert Wood Johnson Foundation (RWJ) has released its report Charting Nursing’s Future highlighting the progress our 350,000 APRN colleagues have made in obtaining full practice authority.  Twenty-two states and the District of Columbia allow APRNs to practice to the full extent of their education and training.  Final VA regulations, citing federal preemption authority, authorize its 5,825 APRNs (excluding nurse anesthetists) to follow national practice guidelines covering basic prescriptive authority, admissions; and eliminate previous physician supervision requirements, notwithstanding more restrictive state or local laws.  “It’s the best band in the land!”  Aloha,

Pat DeLeon, former APA President – Division 55 – March, 2017

 

COME ON AND HEAR! COME ON AND HEAR!

The 34^th Annual APA and Practice Leadership Conference (PLC):  As always, the APA and Practice Organization's State Leadership Conference (SLC), this year renamed the Practice Leadership Conference (PLC), was an outstanding success.  Dan Abrahamson and Susie Lazaroff were truly visionary in crafting the agenda for "Practice, Politics & Policy."  Former Administration and Hill operatives provided an insightful glimpse into the new Trump Administration and what psychology's practitioners might well face over the next four years.  One could feel a growing sense of urgency among those present for getting personally involved in shaping the future of our nation's health care environment and especially for ensuring that psychology remains recognized as a bona fide autonomous health care profession.  Having worked on the U.S. Senate staff for over 38 years, I particularly appreciated Katherine Nordal's challenge to advance the trade of professional psychology – a conceptually different approach than many have heard before.  She also noted that the psychology PAC currently ranks 44^th among 129 health professional PACs with dentistry, medicine, optometry, nursing, physical therapy, podiatry, social work, and psychiatry significantly ahead of us.

            APA President Tony Puente and President-Elect Jessica Henderson Daniel were constantly mingling among the 400+ attendees at PLC, urging colleagues to appreciate that the future of their profession lies in their own hands.  Once again, the number of first-time attendees was most impressive.  Our national leadership was especially attentive to the early career psychologists and graduate students who were present.  Division 55 should be proud that under the leadership of Presidents Neal Morris and now Sean Evers, USUHS graduate students Joanna Sells and Omni Cassidy have been actively engaged in shaping our Division's annual convention programming.  As Dan Abrahamson reflected afterwards: "If we can't support the future of our profession, we are done for…."

Sybil Mallonee (1^st Lt., USA) is a graduate student at USUHS: "As a student attending the APA's Practice Leadership Conference for the first time, it was an amazing and exciting experience.  It was amazing seeing so many clinicians from all stages in their career come together to advocate for our field.  It was exciting to have the opportunity to be mentored by so many incredible clinicians who were eager to pass on their knowledge to the upcoming generation of psychologists.  It was also exciting to see such an emphasis on the importance of diversity and on having the sometimes challenging conversations around issues related to diversity.  There were many great speakers throughout the conference, but the one that stands out the most was the diversity panel.  This panel was of psychologists sharing challenging conversations and experiences related to diversity.  In keeping with the theme of the conference as a whole, their stories were inspiring to this future psychologist.  They were honest and challenging, but they also emphasized the importance of not losing your voice and of standing up for what is right."

            Psychology Proudly Serving the Nation:  Cynthia Belar, Interim APA CEO, recently reported to the Council of Representatives: "Dr. Heather O'Beirne Kelly is now APA's first Director of Veterans and Military Health Policy.  Dr. Kelly has served as a Senior Legislative & Federal Affairs Officer for the past 19 years in APA's Science Directorate, where she has led our association efforts to address military and veteran issues and to promote the role of psychology in tackling those issues.  In her new role Dr. Kelly will join Practice's government relations office, headed by Doug Walter, J.D., and she will work across directorates to ensure that the range of military and veteran issues are addressed.  One out of every six Americans is either a military service member, veteran, or family member of someone serving or having served in the U.S. armed forces.  APA has a long history of attending to the health and well-being of these populations, and the VA is the largest single employer of psychologists.  We believe that in this new role, Dr. Kelly will enhance our advocacy and work to better serve our service members, veterans, and the psychologists who care for them."  As many of us aware, Heather has been working closely with the Division to expand psychology's RxP capabilities throughout the federal system, including within the VA. 

            On Veterans' Day 2016, a long-time friend, Kris Ludwigsen shared her reflections with her local congregation on her personal service in the USAF.  "Today I would like to focus on the women who've volunteered to serve in the military.  I am a veteran of Desert Storm and my father was torpedoed in the Navy in WWII.  A Scottish ancestor, Daniel McClure, fought in the American Revolution at the battle of Ft. Vincennes, and 200 years later I went on active duty in the USAF.  We all survived the dangers of our tours of duty in the Army, Navy, and Air Force.

"Women of verve formed a militia of 'minutemen,' or stepped up as spies for the American Revolution.  In the Civil War they disguised themselves as men to fight with their husbands.  While Rosie went to work building battleships and bombers to backfill positions vacated by men, in WWII the WASPs flew hundreds of missions over some 64,000 miles; yet they were only granted veterans' status in 1977.  In the wake of the WACs (1943) and the WAVES (1944) came the Army nurses tending the wounded in Viet Nam and the women of the National Guard who were deployed to grunt work and combat in Iraq and Afghanistan.

            "Why would a woman choose to join the military?  Some volunteer out of a desire to serve their country or family tradition, the same as a man.  Some join for adventure or travel, to be exposed to a broader view of the world.  Some join for financial independence and a structure that makes it possible to leave home or support children on their own.  Some sign up for training and educational opportunities.  For me it was the professional experience.  Teaching in a university and rubbing elbows with part-time instructors who were active duty psychologists at Wright-Patterson AFB, I wanted the immersion clinical experience the Air Force provided.

            "The military is a microcosm of society that includes physicians and nurses, social workers and psychologists, dentists and dieticians, attorneys and chaplains – as well as missile launchers and those fighting on the front lines.  It is a milieu with valuable lessons to teach.  The military is about learning responsibility and reliability, resourcefulness, leadership and teamwork with pride in an esprit de corps.  It is about courage under fire, proving yourself as an adult without the support of family, and about submerging your ego to the mission, to the common objective.

            "As the first military psychologist at an 18-bed hospital, I had an advantage in that no one really knew what a psychologist did.  So I was able to create my own job description that included meeting with the squadron commander or first sergeant to explain the dynamics that had resulted in the member's problem behavior, often the precursor to discharge.  After assessment and treatment my goal was to integrate the member back into the squadron to salvage his or her Air Force career.  When a stream of young women from Dugway Army Proving Ground was admitted, I decided to investigate the cause, and drove out to the desert once a month to run an enlisted women's morale group.  In such isolated surroundings, these women were being harassed by their male counterparts, resulting in acute stress disorder symptoms that precluded functioning on the job; and I worked with the company commander who had them transferred out of a hostile work environment.  

            "The transition back to civilian life is not easy; war time separations foster family problems difficult to repair.  Many Vets have suffered the toxic effects of Agent Orange or symptoms of post-traumatic stress disorder as I found working with retirees who'd served in Viet Nam, and with a nurse-friend who endured SCUD missile attacks in Desert Storm.  We must do more to help support Vets whose special needs originate from having given their all, for Service Beyond Self.  I went in as a Captain and retired as a Lieutenant Colonel line officer some 25 years later.  The Air Force was the most creative and exciting period of my 35-year career as a psychologist.  As a 'lone ranger' I learned that if I didn't do it, it wasn't going to get done.  I had to establish priorities for treatment and I had to grasp what it was like to be in the shoes of the diverse members of this military community.  In my time I met a number of men and women who earned my respect as true public servants, dedicated to the highest aims.  Remembering our Vets and those who continue to serve us in the military is our duty and professional responsibility."

            The Future of Advanced Practice Nursing:  The Robert Wood Johnson Foundation (RWJ) has released its report Charting Nursing's Future highlighting the progress our 350,000 APRN colleagues have made in obtaining full practice authority.  Twenty-two states and the District of Columbia allow APRNs to practice to the full extent of their education and training.  Final VA regulations, citing federal preemption authority, authorize its 5,825 APRNs (excluding nurse anesthetists) to follow national practice guidelines covering basic prescriptive authority, admissions; and eliminate previous physician supervision requirements, notwithstanding more restrictive state or local laws.  "It's the best band in the land!"  Aloha,

Pat DeLeon, former APA President – Division 55 – March, 2017

 

Sent from my iPhone