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A Concept Analysis of Entrenched Toxic Cultures in Nursing Academia
No full textIntroduction: Toxic cultures in nursing academia are environments characterized by incivility, bullying, and harassment, all concepts well defined in the literature (Beckmann et al., 2013; Clark, 2013; Fry & Schmer, 2021). While some toxic cultures can be addressed with targeted interventions, others are more widespread, established, and difficult to dismantle (Beitz & Beckmann, 2023; Clark & Ritter, 2018; Coates, 2024; Goldberg et al., 2013; Olsen et al., 2020). Specific data are scarce; however, as negative behaviors persist and intensify, we believe the unexplored phenomenon of entrenched toxic culture (ETC) emerges.Purpose: This concept analysis aims to define ETCs in nursing academia by identifying its uses, attributes, antecedents, and consequences, and proposes an operational definition and strategies to address and mitigate its effects. The goal is to foster a healthy, supportive academic setting that enhances the well-being and professional growth of all its members.Theoretical Framework: Guided by Walker and Avant’s (2019) 8-step concept analysis framework, we reviewed literature on ETC using the databases PubMed, CINAHL, ERIC, APA, and PsycINFO. Search terms included toxic culture, toxic work environment, workplace aggression, workplace violence, bullying, incivility, harassment, nursing faculty, and nursing education. Two disciplines’ uses of entrenched and toxic, the military and chemistry respectively, were also reviewed.Findings: The search yielded 193 articles, of which 61 met the inclusion criteria. The concept of ETC implies a deeper, persistent problem ingrained in the institutional fabric. Unlike transient or isolated instances of toxicity, ETCs are systemic, deeply rooted, resistant to change, and pervasive across multiple levels of the nursing academic hierarchy. The effects are profound, harming individuals and disrupting the profession. Consequences include faculty departures, which create a ripple effect, limiting student admissions in nursing programs (AACN, 2024). We offer model, borderline, and contrary cases to further delineate ETC.Conclusion: The concept of ETC in nursing academia has not been well-defined in the literature. Defining ETC is crucial for breaking the silence and addressing pervasive issues that undermine the well-being of nursing faculty. By analyzing existing uses with the Walker and Avant framework, we can better understand ETCs impact on nursing academia and propose strategies for addressing it
[Excerpt from] TRANSforming Nursing Education: Infusing Gender-Sensitive Care into Healthcare
Get PDFTrans and gender-diverse patients face significant barriers to respectful, comprehensive healthcare. Provider ignorance shouldn\u27t be one of them. TRANSforming Nursing Education supplies the context to help readers understand the gaps and missteps in providing healthcare to this marginalized population and explains how we can better treat these patients.
Author Christine Rodriguez tackles tough subjects and tough statistics head on. This no-nonsense guide is packed with inclusive case studies, immersive simulation-based scenarios, checklists, and ready-to-use templates on everything from social transitioning to hormone therapy to surgeries and potential complications, all with thoughtful, reflective questions to guide readers in their understanding of the gender-diverse community. The book answers key questions, like: What is the difference between sex, gender, gender identity, gender expression, and sexual orientation? How can we improve healthcare education and onboarding to better serve trans and gender-diverse patients? What is binary language, and how does it impact trans and gender-diverse people? What barriers in healthcare settings marginalize trans and gender-diverse patients, and how can we be more inclusive and better meet their needs? What types of medical and surgical interventions are available for individuals who wants to affirm their gender identity?https://www.sigmarepository.org/book_excerpts/1076/thumbnail.jp
Radiation: Risk, Exposure and Efficacy of Protective Measures
Get PDFSince x-ray radiography was discovered in 1895, radiology has evolved into a critical component of modern medicine. The rise of minimally invasive surgery (MIS) has increased the need for radiologic imaging to ensure proper instrument placement and anatomical accuracy during procedures. This study evaluates radiation exposure, associated risks, monitoring devices, and the effectiveness of personal protective equipment (PPE) to enhance radiation safety and protective practices in the surgical environment..
Dexmedetomidine as an Epidural Adjuvant in the Obstetric Setting
Get PDFLiterature evaluating the use of lipophilic opioid adjuvants (commonly fentanyl, remifentanil, or sufentanil) compared to dexmedetomidine regularly demonstrates comparable and adequate labor analgesic effects. There is also evidence evaluating overall anesthetic consumption during labor when using various epidural adjuvants, which can be used as a proxy to determine the adequacy of pain control. On multiple counts, dexmedetomidine demonstrated significantly less local anesthetic requirements compared to opioid use. Additionally, opioid use is readily understood to increase the risk of pruritis, nausea, and vomiting. In contrast, dexmedetomidine is frequently shown to have a decreased frequency of nausea and vomiting, along with minimal complaints of pruritis. Other potential benefits of dexmedetomidine include anxiolysis, increased frequency and amplitude of contractions, and decreased duration of the first and second stages of labor. These results indicate that dexmedetomidine is a safe and effective alternative to opioids within the obstetric setting and should be considered a valid adjuvant option during epidural administration
Maintaining Airway Patency in Patients with Obstructive Sleep Apnea
Get PDFObstructive sleep apnea (OSA) consists of intermittent or recurrent episodes of upper airway obstruction during sleep. Obstructions can also occur when receiving sedation for endoscopic procedures. Up to 54% of patients experience severe hypoxemia secondary to sedation-related upper airway obstruction, with incidences being worsened by OSA and obesity. Newly created devices, such as nasal continuous positive airway pressure (CPAP) devices, utilize positive pressure to keep the patient’s airway patent and prevent complications during endoscopies. Although these devices are not routinely used during gastrointestinal endoscopic procedures, they can be utilized in patients with OSA to help prevent airway obstructions during sedation
Ondansetron for Propofol Injection Pain
Get PDFPropofol injection pain can be the most distressing part of a patient’s peri-operative experience. The current standard of practice is to use intravenous (IV) lidocaine to blunt the pain on injection caused by propofol; however, this does not guarantee a comfortable, satisfactory induction for the patient..
Improving Patient Experience During Bone Marrow Biopsy/Aspiration (BMBA)
Get PDFBone marrow biopsies (BMBA) are frequent, distressing occurrences for hematological cancer patients. Literature suggests that a variety of interventions may decrease pain or anxiety.
Room décor changes
Music and visual imagery as environmental changes (EC)
Guided meditation
Virtual reality (VR) distraction therapy
Lidocaine is the routine option for pain relief, but it is not effective at completely anesthetizing the marrow cavity.
Nonpharmacologic interventions need to be explored
Reducing Caregiver Accommodations in Pediatric Eating Disorders Through Psychoeducation
Get PDFChildhood eating disorders (ED) are complex conditions, involving both medical and psychological factors. Caregivers, including parents, grandparents, and legal guardians, play crucial roles in managing ED behaviors beyond the clinical setting. The psychological effects of caring for a person with an ED have been shown to be more significant than caregivers of patients with schizophrenia and depression (Martin et al., 2015). Negative emotions often lead to caregivers providing accommodations for their child’s eating disorder. Accommodations are behaviors or decisions meant to reduce stress or conflict but ultimately promote ED behaviors or dysfunction. Caregiver accommodations have been identified as a barriers to treatment. To promote ED recovery in child and adolescent patients, it is important that caregivers understand how these accommodations may negatively impact their child’s treatment
Novice Adjunct Nursing Faculty as Partners in Education: Perspectives on Teaching
Get PDFThe purpose of this basic qualitative study was to investigate how the novice adjunct nursing faculty, with 0 to 3 years\u27 experience, described their preparation to teach nursing. The expert clinician\u27s transition from clinical practice to academia induces much trepidation about the modicum of preparation for the complexed, specialized educator role
Exploring Analgesic Admixtures in a Bier Block Technique
Get PDFThis case posed the question, “In patients undergoing non-vascular procedures of the upper extremity, with an expected duration of less than two hours, do local anesthetics with adjuncts provide superior intraoperative and postoperative analgesia when used in a Bier block compared to the use of local anesthetics alone?