Charmaine Branchaud sees the stories of Red Lake Nation students in the data.
Branchaud has been an RN for four and a half decades and began overseeing school clinics across all Red Lake Nation schools in Minnesota in 2021. Her work improving Red Lake School District’s immunization rates began as she sifted through paper records and data, which allowed her to understand student health needs.
“I wanted to see if we had any frequent fliers,” she says, referring to children who often require health care. “It could be a red flag for something else going on in a student’s life.”
Branchaud has been named this year’s Immunization Champion by the Association of Immunization Managers and the Minnesota Department of Health for her work organizing immunization clinics at all Red Lake schools.
The school district had software for tracking immunization records. Still, Branchaud recognized it was underutilized, so with help from the school administrative staff, she started by entering paper records into the school’s electronic database.
Once student health records were fully digitized, Branchaud ensured the school’s database interfaced with the system used by the state for tracking immunizations.
With the pandemic near its height, Branchaud says she turned to raising the district’s immunization rates.
She brainstormed with Red Lake Schools’ superintendent, principals, administrative staff, health technicians, the Red Lake Indian Health Service pediatrics unit, and Red Lake IHS, and together, they worked to organize school-based immunization clinics. An April clinic held at the Red Lake Elementary Complex immunized 38 elementary students, raising the district’s overall rates for kindergartners, first and second grades from 84 percent to 94 percent.
A public health nurse, Hannah Tolman, says the clinics greatly impacted community health. “Making it convenient for parents to get their kids immunized at school … is huge.”
Her work with Red Lake School District is just one of several roles in which she’s worked to improve public health in her community. From Sept. 2022 to June, Branchaud was a member of the Minnesota Department of Health’s Childhood Immunization Workgroup.
Branchaud says that once parents have accurate information, it’s up to them to make an informed decision. “It’s our duty to educate them.”
Nominate a Nurse of the Week! Every Wednesday, DailyNurse.com features a nurse making a difference in the lives of their patients, students, and colleagues. We encourage you to nominate a nurse who has impacted your life as the next Nurse of the Week, and we’ll feature them online and in our weekly newsletter.
Diane Keinanen, a registered nurse of 32 years in Duluth, Minnesota, is a transgender woman who started her transition journey four years ago.
Since then, she’s proudly expressed her identity and life post-transition through motivational photos and videos on her social media on her challenges and moments of joy through bike rides, confessions about her family, and what brings her inspiration today.
Daily Nurse spoke with Diane about her transition journey, what her life looks like as a transgender nurse, and advice she would give to LGBTQ nurses.
Can you describe your nursing journey? What made you decide to enter nursing?
I have worked in general medical and oncology, and for the last 22 years, I have been a vascular access specialist (IV, PICC, Midline placement). My first calling in healthcare was when I was in my teens, and I helped my mother care for my ailing grandmother in our family home. However, in my mid-20s, I formally entered schooling to become a nurse.
What are some of the challenges you face?
There have been challenges in healthcare over these last few years. Being a transgender woman in nursing is not without its unique challenges. Still, I must say that I have received much support from family, friends, the community, and my employer, and I am grateful for this.
On your identity as a transgender woman, what encouraged you to start your transition journey?
Like most people, my life has had its ups and downs. I had felt wrong within myself for many years, going back as far as I can remember. It wasn’t until my early 50s that I finally felt that I could consider transitioning, but the concept of coming out was still so terrifying that I chose suicide instead. Thank God I failed. After I recovered, I knew I had to transition or perish. I decided to change my life into the polar opposite of what it once was and never looked back.
How different does your life look now you’re four years into your transition?
I remember after I first came back to work as Diane. I was so scared. Would I be accepted? I experienced a myriad of emotions.
Has it been easy? No. Have there been challenges? Yes, but through it all, I have become a stronger woman and a more skilled nurse.
How does your nursing career tie into who you are as a transgender woman?
Years ago, I wondered, “How would transitioning affect my medical career?” I’m now four years in, and I can say this with the utmost confidence— being a registered nurse who my coworkers accepted, and my patients as my true self has made my career more rewarding than I ever thought possible. It is a true gift.
I saw on your Instagram that you do shop work and spend time in nature. Do you do these hobbies to destress from your day job as a nurse?
Yes! I greatly enjoy nature hikes and riding my bicycle around Twin Ports in Duluth. I also enjoy creating stained glass art and woodworking and have for many years.
What advice would you give to LGBTQ nurses who struggle to fully express their identity in life?
Removing the mask I wore for many years was the most terrifying yet liberating act ever. Forest Gump said, “Life is like a box of chocolates.” I say life is a merry-go-round, and if we only get one ride, then why not make it the best possible? That is what I am doing today.
Nurse of the Week Elizabeth Anh-Trinh Stulac, RN/BSN is an established nurse leader working toward a Ph.D., but she remembers where she came from. So, earlier this month she went back home to Elk River, Minnesota to share a message with graduating seniors at tiny Ivan Sand High School, the alternative learning center she graduated from herself in 2008.
“It is not a secret that when you go to an ALC school, sometimes people view you as being a bad kid, an outcast, or not smart enough to make it in a traditional high school. I am here to tell you: That is false.”
Stulac, who later graduated from college Summa Cum laude and in the top 15 percent of her class, is studying for a doctorate in transcultural nursing while working as a charge nurse in the Mayo Clinic’s COVID-19 intensive care unit. Her older sister, now a nurse practitioner, was a high school dropout who eventually earned her GED. Thus, Elizabeth Anh-Trinh Stulac knows just how grave an error it can be to make assumptions about someone’s capabilities.
When the latest Ivan Sand grads gathered on June 7 for their graduation ceremony, she urged them to believe in themselves and get in touch with their own leadership skills.
First, the alumna told them, don’t buy into stereotypes of Alternative Learning Center students! “Here I was at the Mayo Clinic, the No. 1 ranked hospital in the world, and they were telling me the strengths that I brought to their organization.” The RN, who is also Mayo’s Rapid Response Team Nurse and chairs two committees (in her spare time), flatly informed the 2022 class: “It is not a secret that when you go to an ALC school, sometimes people view you as being a bad kid, an outcast, or not smart enough to make it in a traditional high school. I am here to tell you: That is false.”
The 2008 Ivan Sand grad can speak from experience: “Through the many leaders that I have worked with throughout the years, I have come to realize that one of the greatest predictors of success is your perception of yourself. I am here to tell you all today, as you graduate from Ivan Sand Community School that you are not an outcast, you are not a bad kid, and you are not the many things society has made you believe about yourself. But in fact, you are a class of potential leaders.”
After stressing the importance of assessing yourself on your own terms and not those imposed on you by others, the RN told the class of future leaders to write down their short-term and long-term goals,” and determine what they need to do to achieve them. Then, with a hat tip toward the Mayo onboarding process, Stulac added, “I would also recommend identifying your own personality type, and the strengths that each of you carries individually.”
And never assume defeat. Her sister, Stulac says, “is one of the smartest people I know.” ALC students learn early that “Life is messy.” After all, “Not all of you come from traditional families. Many of you are working to help support your families. Opportunities are not given equally to each person. But the feeling that you get when you achieve your goals, having overcome those barriers, is worth the hard work and worth the bad days — because you will have many bad days. Success does not come free; you must work hard for it.”
With her NP sister’s example in mind, as she concluded Stulac reminded them, “Your success is not only your own but the people who look up to you. I know that some of the greatest leaders are here among us tonight, and I am so excited for you and the impact that you will make on the world that we live in, and what you will achieve!”
A good message for all graduates to live by. Fort the full story on the graduation ceremony, see here.
When they hear “ding, dong!” at their door, many of Nicole Bock’s patients are old enough that they might expect to see a cosmetic salesperson or vacuum huckster cooling her heels on their doorstep, but having a Nurse make house calls sounds like a blast from an even more distant past.
In fact, while “working from home” is the norm for many now, Nurse of the Week Nicole Bock, RN does her work from other people’s homes as an essential nurse.
“I go around and see patients in their home and help them with any nursing needs they have,” says the RN case manager – and Daisy Award winner.
“You kind of get to see them on their turf a little bit instead of in the hospital,” Bock says. Teaching others about their medications, taking care of wounds, and lab draws are just some of the tasks the eight-year nurse is counted on to complete.
Bock might not have become a roving photojournalist as originally planned, but she is certainly a hit as a Roving Nurse. She pivoted to a nursing career after her four-year degree in photojournalism produced few opportunities… and a lot of patients are very grateful for her career pivot.
On getting a Daisy: “I was beyond shocked!”
Patient Nancy D. Loehr says Bock “makes me feel comfortable and I feel I can ask her anything.”
Elevating people’s health is Bock’s goal. Elite at taking care of clients, she was nonetheless surprised when honored with The DAISY Award for extraordinary nurses: “I was beyond shocked. I had no idea. Beyond shocked,” she says. “Very honored and I love that they felt that I was worthy of this.”
Going above and beyond for those she cares for and for her teammates is why she’s getting well-deserved recognition. Simply put, “I like helping people,” Bock says.
“She’s very special to us”
Linda Stokes says Bock’s care for her husband Otis, who is fighting cancer, is keeping her family safe and putting them at ease.
“She’s very special to us. Good Samaritan was just good to us period,” Linda says. “It’s hard when you don’t know or understand anything about medicine. To have someone who comes in and doesn’t talk down to you explains to you simply what you can do but clearly cares about what she’s doing.”
That effort prompted Linda and Otis to type up a letter of gratitude.
“Nicole said whatever you need is what we will do when we come into your home. Period. Everyone who came in on this team walked in and said I want you to know I’ve been vaccinated. I’ve been boosted,” Linda says.
A humble team player, Bock says the kind words mean a lot.
“It makes it all worth it just knowing that people appreciate it and I’m making a difference,” Bock says.
Our Nurse of the Week only received honorary credentials at best, but in the end, even a very hostile medical community had to acknowledge that Sister Elizabeth Kenny’s polio treatments helped thousands of children in the 1940s recover from the disease without being immobilized and imprisoned in braces and casts.
Born in 1880 in a New South Wales village in Australia, Elizabeth Kenny found her career path the way many nurses do today – as a girl, she found herself a patient and became fascinated with the science and practice of healing. When she broke her forearm after falling off a horse, the teenager developed a hunger for learning about human bones and anatomy. She found a mentor in the physician who treated her and, as David Anthony Forrest, PhD, RN, ANEF, FAAN relates in Nursing’s Greatest Leaders, “He had a wonderful library that contained a skeleton. She played with the skeleton for hours and learned how to trace muscle from origin to insertion.”
As she reached adulthood Kenny shadowed various nurses and doctors, then began to work as a “bush nurse” in Queensland, delivering babies and treating injured laborers, sick adults, and children. Bush nursing was a bit like being a traveling FNP, but young Elizabeth never attended a school, she reached her patients via horseback rather than plane, and instead of money she only accepted barter as payment. Kenny went on to work as a nurse on troop ships in World War I, and when they promoted her to “Sister” she adopted the title for the remainder of her career.
A treatment nearly as dreadful as the disease
In 1911 Sister Kenny encountered her first poliomyelitis epidemic. Polio had been endemic for most of known history when epidemics of the devastating intestinal infection began to break out in the 20th century. There was no cure and the Salk vaccine was not developed until 1955, and the fearsomeness of polio was exacerbated by the unpredictability with which the disease could strike. Before the vaccine, parents around the world faced each summer with dread: a fun family outing could turn on a dime and become a tragedy. It happened in 1921 to a then-39-year-old Franklin Delano Roosevelt during a vacation, and in the US 35,000 children and adults were afflicted every year during the 1940s.
In treating children afflicted by a deadly disease with no known cure, her lack of classical medical training prompted her to base her treatments on empirical evidence. When she had treated soldiers with meningitis during the war, Kenny had learned that patients responded well to a combination of exercise, moist heat, and massage or manipulation. Could this also help in treating polio victims? Doctors were often horrified by her refusal to immobilize young patients who they believed should be immobilized ion braces, corsets, and casts, but Sister Kenny insisted that her methods not only were less harmful, they were usually more effective as well and her patients seemed more likely to recover the use of their limbs. While standard practice at the time was to confine patients – child or adult – in plaster casts for as long as 10 months, at which point some of the more advanced doctors recommended some light physical therapy.
As medical historian Bruce Becker, MD states, “The then-orthodox treatment of prolonged encasement in plaster was almost as bad as the disease.” Sister Kenny, however, feeling a nurse’s empathy for her charges, recognized this at the time without needing the benefit of hindsight. Arlene Wynbeek Keeling, Ph.D., R.N., F.A.A.N recounts in her History of Professional Nursing in the United States:
“Kenny maintained that patients’ affected muscles and limbs should be wrapped in hot packs and exercised—not immobilized, as was the customary medical treatment. Kenny’s method was most successful on early cases before deformities and paralysis occurred.
The treatment was done in three stages. In the first stage, hot moist packs were applied to the patients’ muscles; this helped to relax both the muscle and the pain. Next, gentle manipulation of the affected limb and muscles was performed. As treatments continued, the patients were allowed to move their own limbs with assistance until they were able to independently do so.”
The “screwball” vs the “dodos”
The medical communities in her home country and in the US were naturally hostile to the very idea that the patients of an uneducated nurse might be more likely than their own to recover and have a better quality of life during treatment and afterward. After all, as the Minneapolis Star Tribune once put it, “Most experts at the time thought polio killed nerve cells and yanked muscles out of place, requiring immobilizing casts and splints. Kenny insisted the muscles were merely tight so “your splints and casts are illogical; throw them out.” When she arrived in the US in 1940 to treat kids during the relentless summer polio epidemics, doctors in New York City and Chicago simply referred to her as a “screwball.”
The former bush nurse was never shy about returning fire, though, and it was not unusual for Kenny to tell experts that they were “dodos” for dismissing her methods without a hearing. Minneapolis truly embraced the persistent Sister, though, and she and her daughter treated patients at the Mayo Clinic and the Minneapolis General Hospital. By 1941, doctors started to abandon their “dodo” views. The National Foundation for Infantile Paralysis (NFIP) issued a report and Harvard orthopedist Frank Ober, an erstwhile skeptic, wrote in JAMA, “when her ideas are applied, splinting is not necessary. Sister Kenny’s treatment is superb nursing and common sense.” In 1942, she opened a 65-bed facility in Minneapolis, the Elizabeth Kenny Institute, and her work helped place the city on the map for implementing much-needed advances in polio treatment.
Sister Kenny’s determination and sheer force of character, her refusal to be intimidated – and the fact that their children not only seemed more likely to survive but even thrived after her treatments – certainly won over the American public. Today’s nurses – who are rightly proud of being America’s most trusted profession – might be pleased to know that in Gallup’s “most trusted women” polls the self-taught bush nurse ranked second only to Eleanor Roosevelt throughout the 1940s. Sister Kenny owned that #2 spot for nearly a decade and made #1 in 1952 just before she died.
Resources on Sister Kenny
If you are interested in the history of nursing, Sister Kenny is one of the most colorful nurses ever to make a mark. Her significance and popularity in the US were such that Hollywood made a film about her in 1946 starring Rosalind Russell and new accounts of her life, battles, and work continue to appear in both the US and Australia.
The small town of Bemidji, Minnesota, may seem like it’s a world away from the scenes playing out every day in Ukraine. But at a Sanford Health walk-in clinic in Bemidji, one nurse knows firsthand that a war a continent away can be felt across an ocean.
Olha Finnelly is an LPN Ambulatory from Ukraine, and her family still lives in the city of Dnipro, about 250 miles southeast of Kyiv, the country’s capital. When the invasion of her home country started in late February, her life turned upside-down.
“I was just crying every day at work. I couldn’t believe that it was happening,” said Finnelly. “I never could imagine that the big brother, Russia, would just attack and start bombing and killing people. It’s not a war that’s happening somewhere in a foreign territory. It’s happening right by our homes.”
“We had to help”
Finnelly’s clinic co-workers noticed that their friend was in distress, and they asked her often about her family.
“She would make mention that she would talk to them from time to time, and then the sirens would go off in the background, and she’d have to get off of the phone and just wait until the next time that she was able to talk to them,” said Erin Petrowske, RN and Bemidji clinic supervisor.
Kim Schulz, a medical laboratory scientist at Sanford Bemidji, said they all knew Finnelly was from Ukraine.
“We’d ask ‘How’s your family?’ One day all of a sudden she wasn’t functioning so well. Very teary-eyed. She was trying to get them out (of Ukraine). When we all heard that, we had to help,” Schulz said. “So we did whatever we could to help her get the funds and anything else she needed.”
Getting out of Ukraine
As the war continued, Finnelly’s father and brother-in-law decided to stay in Ukraine and help in any way they could. But her mother, sister and 3-year-old niece prepared to leave their homes.
“They decided to take a train to go to Lviv, which is the biggest city on the Western part of Ukraine, closer to Poland,” said Finnelly.
They traveled 22 hours by train, sharing a room that was designed to sleep four at a time, with 16 people.
“They didn’t have any luggage with them,” Finnelly said. “The only belongings that they had were backpacks. They brought underpants for the little one. Some snacks, because you are not sure if you are able to get some food. And my sister was able to get her laptop because she is trying to keep her job working online.”
When that was done, they took a small bus to the Polish border, eventually making it to Krakow. Luckily for the family, they had been planning on visiting Olha in the near future, so they already had approved U.S. travel visas from before the war began. Finnelly booked them plane tickets to Minneapolis. The cost: roughly $3,000, all raised by her co-workers. After five days of travel, Finnelly’s family arrived in the United States.
“We were all on pins and needles waiting for the final word from her that everybody was safe,” said Petrowske. “And then when we saw that picture of her and her mom and her sister and her niece, and just the look of relief in her eyes, it was so amazing.”
“Everyone jumped in and tried to help her. And we helped. We got the women out,” said Schulz.
Together again
“Right now I’m smiling because yes, I understand how stressful it still is in Ukraine — and it’s little bit selfish — but the most important three people in my life, they’re right here around the table,” said Finnelly.
Finnelly’s mother Liana Taradaiko, her sister Ksusha Zarubina, and her niece, Masha Zarubina, have been in Bemidji for a few weeks now. Taradaiko cooks food for the family, and has made pierogi for the staff at the Bemidji clinic. Zarubina works each day starting around 3 a.m. to keep her job and stay on Ukrainian time. And Masha? Well, Masha plays with Play-Doh, paints at the dining room table, and dances like a 3-year-old, wearing some of the clothes that have also been donated by Finnelly’s co-workers.
“In our Ukrainian language, we have this saying. ‘Tell me who is your friend, and I can tell you who you are.’ So I’m just so happy with my colleagues. (The) Sanford family in Bemidji … we are really like real family over here,” said Finnelly.
A war is being fought in Ukraine, but in one living room in Bemidji, Minnesota, USA, a family is smiling, happy to be together again.
