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Horse therapy teaches nursing students the value of presence

Four students with a horse


Four students with a horse
Students practice precise communication in haltering horses at senior instructor Jayne Beebe’s Spirit of Hope equine center. 

By Addy Hatch, WSU College of Nursing

Horses have a lot to teach nurses, says Jayne Beebe, a senior instructor at the WSU College of Nursing in Yakima.

Some patients are nonverbal, for example, or can’t communicate with health care providers because of a language barrier. Some patients are a little scary. And horses, like patients, react to a person’s body language and can sense when someone isn’t “truly with them,” Beebe said.

Beebe knows horses very well. She grew up riding, and started an equine center in Yakima where using 21 rescued and donated horses she offers therapeutic riding for chemically dependent youth, foster children, and veterans. Now she incorporates equine therapy into an elective class offered to WSU College of Nursing students and to other health care students in the Yakima Valley.

In one exercise, for example, students link arms and follow one person’s instructions in how to halter a horse, which teaches them about the need for precise communications.

In another, a student starts off leading one horse that represents a patient, then Beebe gives the student a second horse representing a worry about something they forgot to do. A third horse represents what the student is thinking about for dinner, and so on, until eventually the horse representing the patient is just part of a string.

“They did not have to take the horse, I just offered them the horse,” Beebe said. “That’s where they need to stop and think, ‘What’s for dinner is not important right now, I just need to be taking care of this patient.’”

The elective class Beebe offers is called “Presencing,” and includes components on spirituality and mindfulness. Beebe recently presented her research on building emotional self-awareness using horses at the Sigma conference in Indianapolis.

Jayne Beebe standing with two Belgian Draft horses.
Senior instructor Jayne Beebe with Joe and Bubbles, both Belgian Draft horses.

One student who took the elective class in the spring said of the experience, “This class should be implemented into the nursing program. We learned a lot of valuable information – presencing, therapeutic touch, nonverbal communication, etc. I believe all nurses should learn this at some point in their nursing education; all of the elements of this class can help a patient in their most vulnerable times.”

Working with horses “can be so powerful,” Beebe said. “I see how many times students are wrapped up in their heads, and they’re not really present with their patients, the team they’re working with, or the families.”

Dr. Dawn Garzon Maaks to be featured on SiriusXM show

Portrait of Dawn Garzon
Portrait of Dawn Garzon
Dr. Dawn Garzon Maaks of the WSU College of Nursing in Vancouver.

Dr. Dawn Garzon Maaks, clinical professor and associate director of the WSU College of Nursing Vancouver, will be a guest on SiriusXM’s Doctor Radio on Thursday to discuss the role of nurse practitioners in health care.

Dr. Garzon Maaks has more than two decades’ experience as a primary care pediatric nurse practitioner, and she’s certified as a pediatric primary care mental health specialist. She provides primary care and behavioral health care for underserved populations in her clinical practice. She’s also the president-elect of the National Association of Pediatric Nurse Practitioners, and will become president of the organization in July 2018.

Doctor Radio, on SiriusXM Channel 110, is a 24/7 national radio channel featuring live, call-in shows hosted by health care providers from New York University Langone Health, and broadcast from a studio in the lobby of the Manhattan-based academic medical center.

Dr. Garzon Maaks will take part in “The Nurse Practitioner” show, a bi-monthly special that highlights the role of nurse practitioners in health care. She’ll discuss the roles NPs fill, NP education, and diabetes awareness.

To listen: Thursday, Nov. 16, 1-1:30 p.m. (PDT)

Subscribers:  Sirius or XM Channel 110; the show will be posted to about 48 hours after it airs.

Non-subscribers: Sign up for a 30-day free online pass at and listen online.


Give to Nursing – November 2017

Why Give?

You can help support innovative nursing education at the Washington State University College of Nursing by giving to the Dean’s Excellence Fund.


The WSU College of Nursing was named a Center of Excellence in Nursing Education this fall. Your year-end gift to the Dean’s Excellence Fund will help the College continue to elevate the practice and science of nursing in 2018 and beyond.

The fund is used at the Dean’s discretion for the College’s most urgent needs, which could include hiring and retaining expert faculty or supporting advancements in nursing science.

Message from the Dean – November 2017

Dean Joyce Griffin-Sobel


Dean Joyce Griffin-Sobel

Message from Dean
Joyce Griffin-Sobel


As I write this, Veterans Day is approaching. How welcome it is to read this issue of Focus, which highlights the faculty and students who have served their country. My own years in the Navy included some of the best experiences of my career. I went on active duty from the reserves to begin a nursing research program for the Navy Nurse Corps. I worked closely with nurses stationed all over the globe and was a first-hand witness to their professionalism and dedication. Because the Navy (and all the services) fully supports lifelong education, most of the nurses had earned masters degrees and were eager to engage in research. It was an exciting time as I facilitated research studies on aircraft carriers (noise), bases (fitness assessment) and hospitals (orthopedic pain, workload, infections). It would be such a benefit to nursing science if that enthusiasm and commitment existed in our civilian health care system.

However, let us keep the health care needs of veterans uppermost in our minds as we think about Veterans Day. Many of our veterans have significant health problems due to toxic exposures, psychological trauma and battlefield or occupational injuries. I encourage you to look at a campaign organized by the American Academy of Nursing called “Have you ever served in the military?” ( This initiative exists to improve the health of veterans, and encourages us – indeed all health care providers – to ask about a patient’s military background and document it in their record. From the website, you can obtain a pocket card that explains the most common health problems a veteran may have, what additional questions one should ask, and research and policy briefs for further information.

Policy and social interventions are so important for this population. Women veterans, for example, have the highest incidence of homelessness. Think of how that impacts children. From the streets around us, we can see the toll that veterans have paid, and we must be involved in advocacy and interventions to help. Thanking them for their service is not enough.

Special screening of “Defining Hope” documentary

“Defining Hope” follows eight patients with life-threatening illness, and the nurses who guide them in making critical decisions along the way. Nurses who attend will receive 1.25 free contact hours for watching the film and completing an evaluation. Brought to Spokane for a one-night screening by the Washington State Nurses Association and the WSU College of Nursing. Order tickets in advance at or buy them at the box office.

WSU College of Nursing expanding online offerings to better serve all nurses

Dr. Wendy Buenzli of the WSU College of Nursing talked about continuing education during an event with WSU Extension in Island County; here she's shown on a monitor used to link up the Spokane campus with the office on Whidbey Island.
Dr. Wendy Buenzli of the WSU College of Nursing talked about continuing education during an event with WSU Extension in Island County; here she's shown on a monitor used to link up the Spokane campus with the office on Whidbey Island.
Dr. Wendy Buenzli, of the WSU College of Nursing, is shown on a monitor as she takes part in an event with WSU Extension in Island County, Washington in October 2017.

Nurses in Washington need 45 hours of continuing education every three years to maintain their licenses, but that’s not easy to achieve for nurses working in rural or remote locations.

That’s why the Washington State University College of Nursing is working with WSU’s Academic Outreach & Innovation group and WSU Extension to make continuing education more accessible to nurses everywhere.

Using a mix of online course work and traditional classes that are offered through interactive video technology, the College of Nursing “sees a real possibility to expand our reach and better serve the nursing profession,” said Wendy Buenzli, Ph.D., Director of Professional Development at the college.

The College of Nursing, for example, is in the early stages of a partnership with Kootenai Health in Coeur d’Alene, Idaho, to offer online continuing education for nurse leaders there. A pediatric outreach program piloted in Grand Coulee, Washington in conjunction with Sacred Heart Children’s Hospital could be moved mostly online. And the College of Nursing’s RN refresher program, required by the state of Washington for nurses who have let their license lapse, has been reworked and moved online in a project headed by Vicky Sattler, Ph.D., clinical coordinator of that program.

Most recently, Buenzli joined a group on Whidbey Island via interactive video to celebrate the opening of a relocated WSU Extension office that could offer new possibilities for continuing education there.

Tim Lawrence, Island County director of WSU Extension, said the nurses who staff Whidbey Island’s two hospitals and many medical clinics don’t have good options for fulfilling their continuing education credits. “Generally they have to leave the island” for continuing education classes, he said.

Now, the College of Nursing could link to the Whidbey Island Extension office to offer continuing education that requires some in-person participation, or can offer online-only courses to nurses there, Buenzli said.

Buenzli said the College of Nursing has worked closely with the university’s Academic Outreach & Innovation group, which includes WSU Global Campus, to retool its continuing education program.

Said Kelly Newell, director of outreach and program development at Academic Outreach & Innovation, “I think the potential is huge, honestly. I do a lot of market research on what occupations are growing and in need of continuing education, and nursing is always at the top. This partnership is timely – it broadens the reach of what is already happening at the WSU College of Nursing.”

Janet Katz inducted as a Fellow in the American Academy of Nursing

Dr. Janet Katz is inducted as a Fellow in the American Academy of Nursing on Oct. 7, 2017.
Dr. Janet Katz is inducted as a Fellow in the American Academy of Nursing on Oct. 7, 2017.
Dr. Janet Katz, right, is inducted as a Fellow in the American Academy of Nursing on Oct. 7, 2017.

Dr. Janet Katz, professor at the Washington State University College of Nursing, on Saturday was inducted as a Fellow of the American Academy of Nursing at the organization’s annual meeting in Washington D.C.

The academy’s more than 2,500 fellows worldwide are nurse leaders in education, management, practice, policy, and research. Fellows are selected for their significant contributions to nursing and health care, and the impact of their career on health policies and population health and well-being.

Dr. Katz was the only inductee this year from Eastern Washington, and one of just three from the state.

Her work has focused on diversifying the nursing workforce. Dr. Katz is currently principle investigator on a federal grant to increase the number of disadvantaged, Native American and Hispanic students from rural areas who choose health sciences for their careers. She is also principle investigator for a project focusing on preventing substance abuse and suicide among young members of the Spokane Tribe of Indians. In addition, she coordinates nursing programs for the annual Na-ha-shnee Native American Health Sciences Institute held annually at WSU Spokane, and teaches community health at the WSU College of Nursing.

Study: 12-hour night shift can affect a nurse’s performance


Working a 12-hour night shift affects a nurse’s performance more than working a 12-hour day shift does, according to a recent study by Marian Wilson, Ph.D., an assistant professor at the WSU College of Nursing.

Most hospitals in the United States operate on 12-hour nursing shifts now, because they’re easier for administrators to manage and nurses like them, research has shown.

But Wilson’s study, which will appear in the journal “Accident Analysis and Prevention,” shows declines in alertness and performance during a 12-hour night shift that could have implications for both patient and nurse safety.

Strategies to address the discrepancy between day-shift and night-shift performance could include sanctioned napping in the workplace, or a return to 8-hour shifts at night, the paper concludes.

Wilson’s co-investigators on the study were Hans Van Dongen, Ph.D., director of the Sleep and Performance Research Center at the WSU Elson S. Floyd College of Medicine, and Regan Permito, research assistant at the Sleep and Performance Research lab, plus registered nurses Ashley English, Sandra Albritton and Carlana Coogle, of Kootenai Health in Coeur d’Alene. Kootenai Health also supported the research with a grant and their staff donated time to assist with data collection.

The study tracked 22 nurses at Kootenai Health, 11 on the day shift and 11 on the night shift. The nurses took a brief test before, during, and after their shifts to measure behavioral alertness and sleepiness using validated tools. In addition, they wore activity trackers on their wrists to measure sleep duration and kept sleep diaries.

Dr. Marian Wilson
Dr. Marian Wilson

The dayshift nurses’ performance was relatively good and stable across their 12-hour shift. But the performance of nurses working the night shift gradually degraded as their shift wore on, the study found. Both groups slept about the same number of hours per day – 7.1 – and both had roughly the same workload.

“Because 12-hour shifts are becoming the popular norm for nurses, it is critical that organizations consider the potential risks to patients, particularly with regard to night shift employees,” the study concluded. The study also has implications for nurse safety, with nurses whose performance has declined driving home after a night shift, it said.

Added Wilson, “The bottom line – night shift nurses are fighting their natural biological drive for sleep and need more help in maintaining performance and alertness during 12-hour night shifts.”

“Performance and sleepiness in nurses working 12-h day shifts or night shifts in a community hospital” –  Accident Analysis and Prevention. Marian Wilson, Regan Permito, Ashley English, Sandra Albritton, Carlana Coogle, Hans P.A. Van Dongen.

Julie Postma of the College of Nursing honored for public health work

Portrait of Julie Postma
Portrait of Julie Postma, who specializes in environmental health and asthma
Dr. Julie Postma

Julie Postma, associate professor at the WSU College of Nursing, will be honored with the Public Health Leadership Award by the Washington State Public Health Association at the organization’s annual meeting this month.

The award conferred by the statewide organization recognizes a person who’s demonstrated sustained leadership in public health advocacy, research, education, or equity and social justice.

Postma teaches population health courses in the WSU College of Nursing graduate program and serves as clinical faculty in the Puget Sound region for the college’s undergraduate program. Her research and expertise focus on environmental health, especially asthma.

“The impact of Dr. Postma’s work to reduce the burden of asthma through asthma management is truly impressive,” wrote Janet Primomo of the University of Washington Tacoma, one of two people who nominated Postma for the award.

Patricia Butterfield, associate dean of research at the WSU Elson S. Floyd College of Medicine, wrote of Postma, “She effectively works alongside parents who are new to this country and may not speak English, public health professionals, clinicians and asthma researchers.”

Among Postma’s many activities, she led a successful three-year community engagement project to increase parent participation in the Puget Sound Asthma Coalition. She convened both a parent advisory group and a research advisory network, and has served as chair of the asthma coalition’s research and evaluation subcommittee since 2014.

Wrote Primomo, “She has demonstrated expertise in a range of public health issues, worked with many collaboratives and partnerships throughout the state, and applied her outstanding research and advocacy skills to address health inequalities and improve health.”

Cleveland police department to test simulator developed by College of Nursing professor

Portrait of Lois James
Portrait of Lois James
Lois James stands in front of a screen showing one of the simulations featured in CBTSim.

Two hundred patrol officers in the Cleveland police department will undergo training to recognize their subconscious biases using a simulator developed by an assistant professor in the WSU College of Nursing.

The large-scale training is part of a $750,000 research grant awarded to Lois James, Ph.D., by the National Institute of Justice, the research and development agency of the U.S. Department of Justice.

Lois James and her colleague Stephen James, Ph.D., assistant research professor in the WSU Elson S. Floyd College of Medicine, developed Counter Bias Training Simulation (CBTSim), a portable simulator that presents officers with realistic scenarios in which they are required to make shoot-or-don’t-shoot decisions. The scenarios are based on 30 years of data on police use of force, and repeatedly expose officers to simulations where the suspect’s characteristics, such as age, gender or race, aren’t predictably related to the outcome.

No comparative evidence yet

Such training is a response to national concerns about bias in police decision-making that arose following the 2014 shooting of Michael Brown in Ferguson, Mo.

Implicit-bias training has become common in law enforcement agencies nationwide. So far, however, there has been no evidence on whether simulation-based training, traditional classroom lectures, or a combination of the two is most effective in changing police behavior.

“Rigorous, randomized controlled trials such as the one proposed are desperately required to inform policy and practice at the national level,” Lois James wrote in her grant application to the National Institute of Justice.

Four participant groups

James’ study will randomly assign 400 patrol officers with the Cleveland police department to one of four groups:

  • One will receive classroom training in implicit bias.
  • Another group will be trained using the CBTSim simulator.
  • A third group will be trained using both methods.
  • A fourth control group won’t receive any additional training.

Results will be measured by scoring body-camera footage, the number of citizen complaints received, police surveys and focus groups, and surveys of people arrested to see whether they felt they were treated fairly. The goal is to identify best practices for reducing unconscious or subconscious bias, leading to improved police decision-making and enhanced citizen trust.

Police welcome study

The research study is supported by both the Cleveland Division of Police and Ohio Peace Officer Training Commission.

The three-year research project will begin on Jan. 1, with police training beginning in the spring of 2019. James is principal investigator, with co-investigators Stephen James and Elizabeth Dotson, M.S., research assistant, WSU Sleep and Performance Research Center. Also on the research team are Renee Mitchell, Ph.D., of the Sacramento Police Department, who’s an evidence-based policing consultant, and Mary Davis, executive director of the Ohio Peace Officer Training Commission.

Davis said in a letter of support for the project that the research is “of critical importance to the future of implicit bias training.” And Calvin Williams, chief of the Cleveland police department, wrote, “We understand the commitment required to participate, and are excited to play a pioneering role in the evaluation of implicit bias training for improving police decision-making, promoting public perceptions of police legitimacy, and enhancing the outcomes of police-citizen interactions.”