President`s Address Under normal circumstances I would be writing

Winter 2014
Volume 24, Issue 4
South Carolina Association of PeriAnesthesia
Nurses
President’s Address
Under normal circumstances I would be writing this letter to you
as my last letter as current SCAPAN president. But, because we did not
have a VP Elect for 2014, I will continue to be the SCAPAN president for
2015. Rebecca Belton was nominated for VP Elect 2015, so she and I
will be working together this year so that she will be prepared to
transition into the Presidency in November 2015. I am excited to have
Rebecca moving into this leadership role as she has exhibited great
interest and abilities for the position of presidency.
As I review this past year I am proud of the conferences that the
Inside this issue
President’s Address .................... 2
Bev Ziegler Award ....................... 3
Central Midland’s and Coastal districts were able to offer to the
2015 Board of Directors .............. 4-10
PeriAnesthesia nurses of South Carolina. The educational content was
ASPAN Development .................. 10
superb and I feel confident that the nurses who attended these conferences
CPAN/CAPA News ....................... 11
returned to their work places providing improved care.
SCAPAN Member Accomplishments
.................................................... 12
The core purpose of SCAPAN, as noted in our organizational bylaws
reads:
BYLAWS OF THE
SOUTH CAROLINA ASSOCIATIONOF
PERIANESTESIA NURSES
ARTICLE II
CORE PURPOSE
Continued on page 2
Save the Date.............................. 13
Editor’s note ............................... 14
Looking Ahead ............................ 14
President’s Address continued
Board of Directors

President:
M. Dianne Jackson, RN,
CAPA
[email protected]

Vice President/ Newsletter:
Rebecca Belton, MSN, RN,
CPAN
[email protected]
Secretary:
Karen DiLorenzo-Thames,
RN
Karen.Thames@ropersaintfranci
s.com
Treasurer:
Marilyn Jefferies, RN
[email protected]






District Director:
Melissa Postell
melissa.postell@ropersaintfrancis.
com
District Director:
Meghan Burgess, BSN,
CPAN
[email protected]
District Director:
Gwendolyn Whitcomb, RN,
BSN, CCRN, CEN, CPAN
[email protected]
District Director:
Rhonda Brugh, RN, BSN,
CAPA
[email protected]
2
Section 2.1 The core purpose
of the South Carolina
Association of PeriAnesthesia
Nurses is to promote
excellence in all aspects of
Perianesthesia Nursing
practice through education,
specialty certification,
nursing research, support for
specialty certification, and
ASPAN Standards in an
environment that is respectful
of others and adaptive to
change.
As members of SCAPAN this
is what you should expect
from the organization you
support financially and with
your involvement. Through
our educational offerings and
round table discussions at the
state and district levels, an
environment is created
whereby perianesthesia
knowledge is shared to assist
in preparing the perianesthesia
nurse for certification.
Your feedback at
conferences and district
meetings guides the decisions
made for the next year’s
conference materials and
topics. The suggestions you
provide are crucial as
SCAPAN leaders meet to plan
next year’s conferences, local
meetings and evaluate the need
for member financial
assistance to attend National
Conference.
I look forward to
serving as SCAPAN’s president
again in 2015!
Dianne Jackson RN,
CAPA, President 2015
Easy Peanut Butter Fudge
Ingredients:
1/2 cup butter
2 1/4 cups brown sugar
1/2 cup milk
3/4 cup peanut butter
1 teaspoon vanilla extract
3 1/2 cups confectioners' sugar
Directions
Melt butter in a medium saucepan over medium heat. Stir in brown
sugar and milk. Bring to a boil and boil for 2 minutes, stirring
frequently. Remove from heat. Stir in peanut butter and vanilla. Pour
over confectioners' sugar in a large mixing bowl. Beat until smooth;
pour into an 8x8 inch dish. Chill until firm and cut into squares.
Gwen Whitcomb Wins Bev Zeigler Award
Each year SCAPAN’s fall
Board of Directors cont.

District Director:
Kristie Alvey, MSN,
RN, CCRN, CPAN,
BC-ACNS
kristie.alvey@palmettoheal
th.org

District Director:
Jeanie Roberts Baxley,
RN
[email protected]

Region Five Director:
Sarah Cartwright, RN,
BA, CAPA
[email protected]

Coastal District
President:
Donna Hughes, RN
donna.hughes@ropersaintfr
ancis.com

Midlands District
President:
Donnalea Shearer, RN,
CAPA
donnalea.shearer@palmetto
health.org

Piedmont District
President:
Helena Williams RN,
BSN, CPAN
[email protected]

ABPANC
Representative:
Laura Williams
[email protected]
in Kansas City and NC in Las
conference includes the
Vegas with Gwen. She
awarding of the Bev Zeigler
consistently exhibited her
Excellence in Clinical Practice
professionalism and always
Award. This year’s recipient is
willing to share her work and
Major Gwendolyn Whitcomb.
life experiences, when
In her letter of
beneficial to the conversation.
recommendation, SCAPAN
I am proud to be serving with
President Dianne Jackson
her in SCAPAN, proud to be a
writes “She has worked with
PeriAnesthesia nurse with her,
staff, Anesthesia and
and proud to have her serve
leadership to address nursing
our country as Major
documentation concerns in the
Gwendolyn Whitcomb United
Post Anesthesia Care unit.
States Army!”
This action led to a resolution
Congratulations to Major
that satisfied all requirements
Gwendolyn Whitcomb on
and increased staff morale.”
receiving the Bev Zeigler
Gwen has been a member of
Award.
SCAPAN’s leadership since
2012 when she first came to
the fall conference in
Greenville and was elected to
fill a one year term as a district
director. Dianne goes on to
say that “she has been a key
leader in SCAPAN and also in
our local district Central
Midlands. She is always
willing to help when asked,
and often volunteers without
being asked. I personally had
the privilege of attending LDI
3
New Members
Nicole from Irmo
Julie from Easley
Geralyn from Simpsonville
Denise from Columbia
Editor’s Note: This issue is going to be a little bit different.
Rather than articles and general news, this issue is all about us.
Starting with introductions of all the board members and continuing
through the amazing things that SCAPAN nurses have done this
year, readers will get to know more about SCAPAN and see what
our nurses can accomplish in our practice.
Meet the 2015 SCAPAN Board of Directors
Suzanne from Goldsboro
Courtney from Blythewood
Susan from Lexington
Cheryl from Columbia
Lorraine from Ruffin
Jess from Meggett
Corey from Charleston
Susan from Taylors
Nancy from Mount Pleasant
Judy from Columbia
Kara from Eglin
Melissa from Charleston
Lauren from Simpsonville
Suzanne from Columbia
Jennifer from Ward
what a journey it has been! Since
becoming certified in perioperative
nursing, I have had the great
opportunity to be more involved in
I am
our nursing organization by being on
Rhonda H.
the South Carolina board for
Brugh. I live in
PeriAnesthesia nurses.
Columbia,
What a special group of nurses.
South Carolina.
South Carolina peri-op nurses are a
I work at
group we should be very proud of! I
Palmetto
only wish that more of you would
Health Baptist
become involved in the organization
in
you have been certified in. My hope
pre-op area. I have been in nursing
for 2015 is that each of you will
for almost 30 years now. Wow
consider taking a more active role so
how the time has flown by. Health
you too can see what a great
care has certainly changed since I
organization we are and how much
first started. It has been a wonderful
fun it is to be involved.
journey. Since starting nursing, I
I hope each of you had a wonderful
have worked orthopedics followed
Christmas and a safe New Year. I
by PACU, then plastic surgery and
would like to leave you with a
finally peri-op. Every area I have
wonderful family recipe I think you
worked has been an educational
and your family will enjoy.
experience that has made me a
better, more informed nurse. Wow
Rhonda Brugh, District
Director
Vegetable casserole
1 can shoe peg corn
1 can french green beans
1 can cream of celery soup
1/2 cup celery chopped fine
1 cup grated sharp cheddar cheese
1/4 cup chopped green peppers
1/2 cup finely chopped onion
1(8oz) ctn. sour cream
1 pkg. slivered almonds
1/2 stick butter
Drain corn and green beans. Combine all ingredients, except almonds and butter. Salt and pepper to taste. Place in casserole dish and
top with 2/3 box of crumbled cheese-its. Melt butter and pour over
crackers. Top with slivered almonds. Bake at 350 for 1 hour. Enjoy!
4
Meet the 2015 SCAPAN Board of Directors
10 & 12. They keep us busy
with cheerleading practices
Hi, my name is Kristie Alvey. I’ve been a and competitions all over the
southeast. Above all
nurse for 18 years with experience in Medical
Cardiology, CVICU and then I found my niche in though, I place my trust and
the recovery room. I returned to my alma mater at faith in Jesus; recognizing
He will direct my path
East Carolina University (Go Pirates
Arrrgggghhhh!) in 2009 obtaining my MSN in the spiritually, personally and
Clinical Nurse Specialist curriculum. I have found professionally.
my work home to be at Palmetto Health Baptist,
I’m eager to serve
representing the entire PeriOperative Service line. I
my nursing profession and work to improve
have a passion for education and improving
nursing practice at the bedside. I’ve been an active perianesthesia nursing practice throughout the
state. Hope to see you all at our nursing
ASPAN member since 2008 and have served on
the SCAPAN Board of Directors 2010-2012. I’m conferences and chapter meetings to engage in
active discussions about the things that matter most
pleased to be able to serve our SCAPAN state
to you.
chapter again. Please let me know if I can be of
any assistance to you or if you have any ideas on
how to improve our nursing practice. I believe
nursing is more than a job, but a profession that is Kristie Alvey, MSN, RN, CCRN, CPAN, BCACNS
ever evolving; we should be dedicated to our
Clinical Practice Specialist, PeriOperative Services
profession and seek a place at the table where
health care decisions are made.
Kristie Alvey, District Director
On a personal note, I’ve been married for
18 years to my wonderful, adventurous
husband. We have 2 very active daughters who are
Jeanie Roberts Baxley, District Director
Married with two children: Callie (13) and Web(11)
1984 BSN Clemson University
1984-1985 Oncology RN Baptist Hospital Columbia, SC
1985-1992 Telemetry Stepdown Unit Asst. Head Nurse St. Francis
Hospital Charleston SC
1992-2000 Nurse Manager Ambulatory Care Unit St. Francis Hospital
Charleston
2000-2002 Roper St. Francis Peri-op Pool RN Charleston SC
2002- present PACU RN Roper Hospital Charleston SC
5
Meet the 2015 SCAPAN Board of Directors
6.5 years, all of which have been with
Palmetto Health in Columbia, SC. For
my first 2.5 years, I was a surgical
oncology nurse. I then began working
I am a
in PACU at Palmetto Health Baptist in
PACU nurse in
January 2011. During my time in
Charleston, SC at
PACU, I precepted, ran charge, and sat
Roper Hospital. I
on committees within our unit. In
have been a nurse
October of 2013, I was hired as the
for 20 years. I found my home with
staff educator for Outpatient Surgery,
PACU nursing 16 years ago and
PACU and Inpatient Holding room and
continue to enjoy all the challenges
currently hold that position. I am
that come with PACU patient care. I
responsible for the onboarding of new
am currently the Patient Care
nurses, continuing education and
Coordinator for a Main PACU and
mandatory educational requirements. I
Cardiovascular PACU. I have served
also serve on many committees such as
on the Board of SCAPAN as the
Nursing Shared Leadership and sit as
Treasurer for the past 5 years and will
the chair for the Best Practice commitnow transition to another year of
tee. Through this committee we have
service as a Board member.
made many positive changes to impact
In addition to being a nurse, I have
been married now for 11 years. I am a improved patient care in our areas. I
mother to a 9 year old girl and a 1 year have a true love for nursing. The past
four years in Periop have been a
old boy. I am a native to Charleston
and feel fortunate to live close to most blessing. I can’t imagine myself in any
of my family. My interests outside of other department and look forward to
hopefully working with this amazing
work mostly include time with my
family. We enjoy the beach almost
team in the future. On a personal note,
year round as well as many other
I am married to my wonderful husband
outdoor activities.
Logan. I have two beautiful girls,
Calleigh and Eliza. All three of them
are my entire world! I have two dogs
Meghan Burgess, District
(Roxie & Sadie) and a cat (Simba). In
Director
my free time I enjoy Yoga, spending
time with all my family, traveling the
My
world and shopping!!!
name is
Meghan
Burgess. I have
my Bachelor’s
of Science in
Nursing along with my CPAN
certification. I have been a nurse for
Melissa Postell,
District Director
6
Meet the 2015 SCAPAN Board of Directors
qualification and knowledge for
practice in a defined functional or
MAJ Whitcomb was born on 02 August 1975 in clinical area of nursing.
Ware, Massachusetts. She graduated from Ware High
MAJ Whitcomb’s awards
School in May of 1993 and graduated from Central
and
decorations
include Air
Community College, Columbus, Nebraska with her
Associate of Science Degree and Diploma for Practical Medal, the Army Commendation
Nursing in May 1998. MAJ Whitcomb obtained her
Medal with four oak leaf clusters,
Bachelors of Science in Nursing from the University of Army Achievement medal, National Defense Service
Kansas Medical Center, Kansas City, KS. A direct
medal, Afghan Campaign medal with two bronze
commission, she entered the United States Army on 28 service stars, Iraqi Campaign medal with one service
August 2003 and attended the Officer Basic Course at
star, Global War on Terrorism Expeditionary Medal,
Ft Sam Houston, TX.
Global War on Terrorism Service Medal, National
Defense Service Ribbon, Over Seas Ribbon with
MAJ Whitcomb was assigned to Medical
numeral 2, NATO (ISAF) International Security
Company Moncrief Army Community Hospital in June
Assistance Force Ribbon, Basic Aviation Badge and the
2012. She currently holds the position of Clinical Nurse
Combat Medic Badge.
Officer in Charge of the Same Day Surgery / PACU.
MAJ Whitcomb currently holds three national
certifications in Critical and Emergency care, and Post
Anesthesia Care. Certification is a process by which a
nongovernmental agency validates, based upon
predetermined standards, an individual nurse's
Gwendolyn Whitcomb, District Director
Marilyn Jefferies, Treasurer
She has been a nurse for 30+ years with 20 of those years spent working in
Emergency Services and the 1ast 10 years in OPS/PACU. She has a Bachelor of Science
Degree. Marilyn really enjoys working in OPS/ PACU. She also very much enjoys actively
participating in our state and national nursing specialty organization. She is a very willing
worker and eager to help in any way that she can.
7
Meet the 2015 SCAPAN Board of Directors
CPAN and CAPA
CPAN:
Debra Manning
Marilyn Jefferies
Rebecca Belton
Barbara McAlister
CAPA:
Cora Norris
Jennifer Rodgers
Barbara Cobb
Karen DiLorenzo-Thames
Age: only my hair dr esser knows for sur e : )
Hometown: Br istol, PA
Current City: Char leston, SC (last 42 year s)
Relationship – Married to Bob Thames (32 years) ;a grown, married
daughter, Amy ; an awesome grandson and a sweet rescue cat, Bubba
Nursing Education: LPN – Bucks County Tech School 1972; BSN –
MUSC 1981; MSN – MUSC 1981
Military Service: Hospital Cor psman in the 1970’s; Stationed in
Charleston. I was the first female enlisted woman to work in the
PACU at the Charleston Navy Hospital.
Current Employer – Roper Hospital, Charleston, SC (25 years)
Current Position – Clinical Manager, Pre & Postop Services (9 years);
responsible for Pre-Admission Testing, Ambulatory, CV and Main OR
Preops & PACUs and Extended Recovery Unit
Certifications: CPAN; CAPA: CCRN and NE-BC
My motto: “What you per mit is what you pr omote”
Perianesthesia Nursing - I love all aspects of PeriAnesthsia Nursing.
If I have to pick a favorite, it would be Pre-op. I love getting folks
ready, explaining what going to happen, helping them relax and decrease their anxiety and providing necessary teaching. I also love starting IVs! I have been active in SCPAN for many years now, serving at
both the local and state level. I look forward to getting back on the
SCAPAN Board in 2015, serving as secretary.
What I do for fun: I am a workaholic. I have been nursing for 41
years and a lot of it has been in management. My guilty pleasures are a
glass of wine and TV entertainment new shows and “reality” show.
Shark Tank is my latest addiction! Plan to start back on my workout
routine, after the first of the year, so I can keep up with my grandson!
Looking to attend National Conference but can’t
afford the registration fee? SCAPAN is able to
sponsor a group of attendees. If you are
interested email Dianne Jackson at
[email protected] before
February 15th. Space is limited so don’t delay. In
addition some of the districts may also be able
offer financial assistance for those wanting to
attend.
8
Meet the 2015 SCAPAN Board of Directors
Rebecca Belton, VP/President Elect
I’m Rebecca Belton and I have been
working in PACU at St. Francis in downtown
Greenville, SC for the last five years. Before that I
spent eight years working in the emergency
department in both SC and NC. I was introduced
to ASPAN in October of 2011 when I became the
newsletter editor for SCAPAN. Since then I have
been elected as a district director and now VP.
This past year has been a whirlwind for me as I
was married in February, joined Sigma Theta Tau
in March, finished my MSN coursework in June,
marched in October and then the elections in
November as well as passing the CPAN
certification exam. As it stands I am still in
bedside nursing
at St. Francis but
I’m hoping to
transition into an
education or
computer
support role
soon. I don’t
have any
children but I do have a ginger boy kitty named
Aslan and two goldfish name Rollin and
Cinnamon. My free time is spent with my husband
Tim, writing fiction, and studying martial arts.
This recipe is titled “Dorin’s Coffee Cake” in honor of Doran who was a volunteer in Preop at Roper
for many years. She would always bake it for us at Christmas time. You will not believe how moist
and delicious it is. The key is to make sure you beat the cake mixture the full 8 minutes. Enjoy!
DORIN’S COFFEE CAKE
Cake mixture
Sugar mixture
1 pkg yellow cake mix
½ cup sugar
1 small pkg of vanilla instant pudding
½ cup brown sugar
4 eggs
2 tbsp cinnamon
¾ cup oil
½ cup chopped pecans
¾ cup water
1 tsp vanilla
1 tsp imitation butter flavor extract
Icing
1 cup powdered sugar
3 tbsp milk (cream is better)
1 tsp vanilla
1 tsp imitation butter flavor extract
Combine the Cake Mixture ingredients and mix well for 8 minutes; In a separate bowl, mix together
next Sugar Mixture ingredients and put aside; Put 1/3 amount of sugar mixture in greased & floured
bundt pan; Put a thin layer (1/3 amt) of cake mixture on top of sugar mixture; Put 1/3 amount of
sugar mixture on top of cake mixture; Put rest of cake mixture on top of sugar mixture; Top with
remaining sugar mixture; Swirl mixture with knife to get marbleized effect; Bake at 325 for 50-70
minutes; Combine Icing ingredients and drizzle over slightly cooled cake.
Submitted by Karen DiLorenzo-Thames
9
Meet the 2015 SCAPAN Board of Directors
Dianne Jackson, President
Since I was a young girl I had dreamed of being a
nurse. That dream came true after graduating from Indiana University with an Associate degree in 1975! I have
loved every minute of my 39 years of nursing experience.
Twenty of those years have been spent with pediatric
patients, some medical/surgical nursing, CCU, hospital
nursing supervisor, nurse manager, nurse educator, and
most recently approximately 15 years in perianesthesia
nursing. I am currently completing my BSN online with USC Upstate. I enjoy
learning and will consider graduate school at the completion of the BSN
studies next summer.
My high school sweetheart and I have been married for 40 years. We have two
young adult children, no grandchildren yet. We stay very busy with two
Weimeraners and one Pomeranian! I enjoy being outdoors, and running along
the Columbia canal is a favorite pastime of mine.
I have been involved in SCAPAN leadership since the Fall Conference of 2009. I began as Membership and Marketing director and have since
filled the positions of Central Midland’s President and now SCAPAN President. I am honored to serve the SCAPAN members. I look forward to the
changes in our nursing profession and desire to be a integral part of those
changes!
ASPAN Development
ASPAN Development encourages giving from individuals and organizations
to advance the practice of perianesthesia nursing. ASPAN uses such gifts for
programs that focus on scholarships and awards, professional education, national advocacy, and
evidence-based research. When you support
ASPAN, you help bring about many good things. Your contribution:
Demonstrates that our constituents care
Supports nurses in perianesthesia practice
Helps optimize patient care
Encourages philanthropy among other prospective donors
Ensures ASPAN programs continue at the lowest possible costs
Contributions can be made on your membership application/renewal form,
through the Hail, Honor, Salute! program, or by contacting Doug Hanisch,
Marketing and Communications Manager at: [email protected] or toll-free:
877.737.9696, x. 15.
10
News to Share from ABPANC
ABPANC Announces New Early Bird Discount Pricing for CPAN® and
CAPA® Exams
Register early and save money with new Early Bird Discounts. Registering
early also give you more time to study and makes you better prepared to pass
the exam.
The Spring Exam Registration Window is January 12 – March 9.
The Early Bird Discount Registration Deadline is February 22.
Register now and take the exam any time between April 6 and May 30,
2015.
Visit www.cpancapa.org for valuable resources and study tools:
Certification Handbook
Study Reference List
Webinar – Test Taking Strategies
NEW Webinar – Conquering Test Anxiety and Fear of Failure
12-week Study Plan
Study Tips
Practice Exams
Mind Mapping Study Guide
Test Blueprints
Certification Coach
ASPAN Member
Early Bird Fee: $299
Regular Fee: $314
Non-Member
Early Bird Fee: $404
Regular Fee: $424
11
Recognition Corner
We have a wonderful
problem this issue. We have
so many things to recognize
that I’m going to dedicate
an entire page to our
members and their
accomplishments.
If you have obtained a
degree, award, or
certification other than the
CPAN/CAPA please let us
know so we can recognize
you. This includes
inductions to an honor
society, recognition in your
organization’s internal
newsletters etc.
Rebecca Belton, Editor
SCAPAN Member Recognition
Barbara Cobb who wor ks in the
Pediatric Heart Cath Prep and
Recovery at MUSC, achieved her
Clinical Ladder level 3, CAPA
certification and was able to obtain
a grant from MUSC’s volunteer
services to implement a music
intervention program in the PACU.
Susan Nethercutt RN who wor ks
with Tuomey Healthcare, achieved
her CPAN certification.
Suzanne Steele MSN, RN, CPAN
graduated with her MSN.
Debra Manning achieved CPAN
certification.
Nancy Farley BSN, RN, CPAN,
received her BSN from USC
Beaufort in May.
Rebecca Belton, MSN, RN, CPAN
received her MSN from University
of Phoenix, achieved CPAN
certification and joined Sigma
Theta Tau.
Susan Della Rocca BSN, RN-BC,
CPAN, CNIII completed BSN in
2014, became board certified in Pan
Management, finalist for the Pinnacle award, received the 2014 high
performance award at Carolina’s
Medical Center Pineville , and the
Star in the Southern Sky, and finally
received Clinical Nurse III on their
Clinical Ladder
12
Annette Brancati, RN, CPAN was
reelected ABPANC secretary/
Treasurer through 2016.
Congratulations to everyone listed
and to everyone in SCAPAN who
received an accomplishment that
isn’t listed here.
SCAPAN
2015 Spring Conference
March 14, 2015
8:00 a.m. – 4:30 p.m.
Lexington Medical Center
Lexington, S.C.
13
SCAPAN MISSION
STATEMENT
The core purpose of the
South Carolina Association
of PeriAnesthesia Nurses is
to promote excellence in all
aspects of PeriAnesthesia
Nursing practice through
education, specialty certification, nursing research,
support for specialty certification, and ASPAN Standards in an environment that
is respectful of others and
adaptive to change.
Letters to the Editor by Rebecca Belton
SCAPAN wants to hear from you. YOU are the back bone of our
component and the board would like to know what interests or concerns
you. If you have questions about practices, ASPAN standards or even
just an opinion on an article we ran. Perhaps you’re feeling ambitious
or you need an article for your clinical ladder or school, let us know
and we’ll do our best to get you published. Maybe you have Grandma’s
famous recipe and you want to share it with the rest of the organization,
please send it in. We can also use pictures from our conferences
(please keep it PG) and if you want to remain anonymous, we can do
that too.
Looking Ahead
January 12th– March 9th: Registr ation Window for CPAN/CAPA
Testing
February 7-8th: CPAN/CAPA Review Cour se, Bon Secour s St. Fr ancis Charleston, SC
February 15th: Deadline to request assistance for National
Conference Fees. Deadline to return Survey Monkey responses (Piedmont
District)
February 22nd: Ear ly Bir d Discount Deadline
for CPAN/CAPA Testing
March 7th: Spr ing Conference, Columbia SC
April 6th-May 30th: Testing Window for
CPAN/CAPA Exams
April 26-30th: ASPAN National Conference in
San Antonio, TX
© 2015 South Carolina Association of PeriAnesthesia Nurses