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A Foundation for Success: Social Support, Stress, and Resilience, Among Pre-Nursing Students
No full textBackground: To combat the nursing shortage, universities focus on retention of nursing students; however, more than one-third of U.S. nursing programs report less than a 70% graduation rate.1 Nursing students encounter many barriers, and these socially imposed forces can impact academic progress. The Social Determinants of Learning (SDOL™) contains six domains that play a role in achieving learning effectiveness and includes psychosocial factors (stress and resilience) and social support.2 In nursing students, social support is positively associated with resilience3 and negatively associated with stress.4 In pre-nursing students who have not begun formal nursing education training or clinical courses, stress is negatively associated with resilience and persistence.5 Understanding the relationships between social support, stress, and resilience, will provide new insights into pre-nursing student well-being, success, and retention.Purpose: The study\u27s aim was to describe the relationships among perceived social support, stress, and resilience levels in on-campus and online pre-nursing students taking an introduction to nursing course.Methods: This IRB-approved study used a survey-based cross-sectional design with convenience sampling. Pre-nursing students preparing to apply to a large public prelicensure nursing program in the southwestern United States were invited to participate during the fall of 2024.Results: Participants (n=319) were female (88.1%), ethnically diverse (Hispanic 31.0%, Black 22.6%, Asian 22.3%, White 21.3%) an average age of 23.3 years old. Most were first-generation students (52.4%) and worked 17+ hours weekly (48.5%). Relationships among social support, stress, and resilience were statistically significant, and perceived support from friends was negatively associated with stress and positively associated with resilience.Implications: Many academic resources are available to help nursing students succeed, but non-academic resources are lacking. Focusing on two of the SDOL domains in pre-nursing students can inform educators on how to tailor early interventions that concentrate on managing stress, increasing resilience, and increasing social support. Insight into the well-being of nursing students will guide the creation of course-specific content that promotes knowledge and skills to provide a foundation for future nursing student success, promoting retention, and taking those tools into their future nursing careers
Reflect and Respond on the Importance of Caring and Shared Decision Making in Leadership Development
No full textPurpose Statement: There is a gap in the literature related to leadership behaviors with a caring component unique to the nursing profession. Nurses require leaders who support caring, honesty, exemplary professional practice, new knowledge, and approach situations with moral and ethical transparency.
Background Information: Nurse leaders who model the attributes of the authentic nurse leader support a healthy work-life balance and enhance nurse engagement. One of the most important focuses of leadership in healthcare today is shared decision-making. The Authentic Nurse Leadership theoretical framework is based on Jean Watson\u27s Theory of Human Caring. Significance Learning more about the self-perception of authentic nurse leadership and shared decision-making from clinical nurses and nurse managers is necessary in all practice areas. The findings from this baseline study may provide insight for future nursing leadership development.
Methods: A convenience sample of clinical nurses and nurse managers was used for this research study. A self-report electronic survey, (Demographic Questionnaire, Authentic Nurse Leader Questionnaire (ANLQ), and Decisional Involvement Scale (DIS) was distributed to all clinical nurses and nurse managers of NSUH via their work email. The data from the subjective responses were analyzed. Results: A total of 361 clinical nurses and nurse managers completed the electronic survey. Nurses\u27 highest score on the ANLQ was caring. The third-highest average response was shared decision-making. This behavior recognizes the ideas of others and bases decisions with ethical consideration.
Implications for Practice: The findings from this study provide evidence of the strengths and weaknesses in leadership behaviors of nurses. Caring is unique to the nursing profession and essential for patient needs and health care outcomes. Nurses must be self-aware of their values, beliefs, and insights to engage and motivate others. Future nursing leadership development must support work environments as being honest, trustworthy, respectful, communicative, and responsive to the needs of the nursing profession. The findings from the DIS report show a need for improved shared decision-making in all areas and levels of nursing practice. Increasing nursing involvement in decision-making may benefit the well-being of patients, healthcare organizations, and the nursing profession
Reflecting and Responding: The Impact of Arousal and Mood Changes on Functioning in Nurses with PTSD
No full textIntroduction: Posttraumatic Stress Disorder (PTSD) is a mental health condition that impairs daily functioning following exposure to trauma. Recent studies identify nurses are at a particularly high risk of developing PTSD (Fattori et al., 2023; Hernández Bojorge et al., 2024; Negarandeh et al., 2023). While this vulnerability was underscored during the COVID-19 pandemic, prior research indicates that PTSD is a longstanding concern within the profession (Battles, 2007; Czaja et al., 2012). Individuals with PTSD endorse chronic symptoms in five clusters: reexperiencing, avoidance, negative alterations in cognition and mood, and hyperarousal (American Psychiatric Association, 2013). Understanding which PTSD domains are associated with functional impairment may be essential to enhancing treatment efficacy in nurses, This study explores the relationship between PTSD symptom clusters and functional impairment in nurses with probable PTSD.
Methods: An interprofessional team of a nurse and two psychologists conducted this study. Data were collected through an online survey of 433 U.S. nurses distributed on social media in 2021. The survey included demographic questions and the Brief Inventory of Psychosocial Functioning (B-IPF), a valid and reliable instrument to assess PTSD–related functional impairment (Kleiman et al., 2020). Hierarchical regression analyses identified factors (work-related, trauma history, and mental health) predicting functional impairment and examined how specific PTSD symptoms affect nurses\u27 day-to-day functioning and workplace performance.
Results: Negative mood alterations (Cluster D) and hyperarousal (Cluster E) were significantly associated with functional impairment in personal and professional life. Higher levels of depression and anxiety correlated with greater impairment. Protective factors included higher education and more years of nursing experience.
Implications for Nursing: Findings highlight the significant impact of mood disturbances and hyperarousal on nurses\u27 functioning and underscore the potential for positive change. By reflecting on nurses’ experiences and responding with effective interventions, we can mitigate PTSD\u27s effects, promote resilience, and improve patient care. Given the ongoing challenges in healthcare settings, including witnessing trauma and additional public health threats, these results are crucial for shaping policies that support nurses\u27 mental health now and in the future
Sigma Peer Chapter Collaboration: Promoting Global Partnerships
No full textIntroduction: International partnerships empower nurses with the capacity to address global health challenges. In August 2022, Phi Mu chapter in Bournemouth, England, UK, and Beta Zeta at-Large chapter in western Massachusetts, US, launched an informal peer chapter collaboration.
Purpose: The purpose is to promote a global partnership among chapter leaders and students and increase membership in Sigma as the preeminent international professional nursing organization positioned to promote global health equity.
Goals: Aligned with Sigma’s 2023-2025 Biennial Call to Action, Represent, the goals of this peer chapter collaboration are to reflect on our shared experiences, respect our diversity and distinct professional nursing heritage, and respond to the nursing practice and education challenges of an evolving global healthcare landscape.
Actions: Collaborative activities to date include two online peer chapter student collaboration events, opportunities for chapter leaders and members to connect at each other’s chapter meetings and programs, and the opportunity to participate in each other’s regional and national conference events.
Results: This peer chapter collaboration has enabled members to enjoy the benefits gained from joint endeavors. Students from the US and UK have come together via networking. Students highly rated the use of breakout rooms to engage with and learn from one another. In addition, Beta-Zeta at-Large members have been actively involved in presenting and leading sessions in the 7th European Regional Sigma Conference in June 2024 and Sigma’s President-Elect delivered the endnote address at the Sigma Region 15 Nursing Symposium held in the US, October 2024. Although scheduling of joint programs to accommodate the five-hour time difference has been challenging, the two chapters continue to share regular chapter meetings, and the partnership continues to thrive.
Implications for Practice: Peer chapter collaboration is recommended as an innovative model to respond to Sigma’s Call to Action strategy, mission, and vision and create international nursing partnerships that support Sigma’s global nursing excellence goals
Developing a Hypothetical GP Practice: Using AI, Human Interaction and Data for Virtual Placements
No full textPurpose: Expanding placement opportunities has become a global strategic priority, driven by the need to address workforce shortages and improve healthcare delivery worldwide. To address this growing demand, innovative solutions for expanding placement capacity are critical, especially as regulatory bodies like NMC now permit the integration of simulation into practice learning (NMC, 2023). Virtual placements offer a cost-effective and sustainable alternative to traditional placements, enhancing student confidence, knowledge retention, and clinical competence (Hill & Mitchell 2024). These align with the broader vision of digitally advanced healthcare systems, reflecting the evolving healthcare landscape and adhering to proficiency standards in line with the Fourth Industrial Revolution (Booth et al. 2021).Methods: An iterative multistep consensus-building process was used to develop the virtual placement for pre-registration nursing students. This process involved the development and implementation of an EHR, designing the student journey, data monitoring architecture and interactive modalities, including AI, 360 simulations, and ‘live’ simulated patients. The virtual placement incorporated engagement with a multidisciplinary team and practice assessors, all within the context of a hypothetical GP practice. The design of this initiative was rooted in simulation pedagogy and incorporates elements of gamification, creating an interactive and engaging learning environment.Results: The results indicated that this initiative effectively prepared students for future practice by enhancing their knowledge and skills in key areas.While many virtual placement initiatives predominantly involve the use of digital and virtual simulation scenarios, this virtual placement model integrated a range of dynamic patient experiences and inter-professional interactions that not only helped students to develop the diverse proficiencies and skills required within community nursing but also provide an experience that addresses technological literacy and prepares students as a modern workforce.Conclusion: The integration of virtual placements marks a significant advancement in preparing students for healthcare\u27s evolving demands. This innovative approach aligns with global healthcare priorities, supporting workforce development and digital transformation while offering a sustainable, scalable solution to traditional placement challenges
Enablers Towards Men\u27s Engagement at Child Welfare Clinics in Ghana
No full textGlobally, male involvement in Maternal, Child and Reproductive Health Care is a concept envisaged to improve children\u27s and women\u27s wellbeing (Angusubalakshmi et al., 2023; Nambile Cumber et al., 2024). Men are encouraged to be involved in prenatal care through to Wellbaby Clinics (WBC), also called Child Welfare Clinics (CWC). Most African countries have aligned to this concept as a strategy (Lusambili et al., 2021) to help attain Sustainable Development Goal 3, Good Health and Wellbeing for All Ages by 2030 due to men’s role as providers and decision makers in family settings. In Ghana, some men are engaged in their children\u27s promotive and preventive health services through advocacy and verbal encouragement. This qualitative study used Constructivist Grounded Theory to explore the enablers of men’s engagement at CWC, which is part of a bigger study that explored the process of involving men at CWC and conceptualised male involvement in the socio-cultural context of Ghana. Purposive sampling was employed to elicit responses from men accessing services at CWC. Data collection and analysis was an iterative process that commenced after ethical clearance was sought. Saturation determined a sample size of 12 men. The findings revealed two categories: intrinsic motivators, referring to men’s involvement due to their innate desires, and extrinsic motivators, focused on external factors which encouraged men’s involvement. The associated sub-categories are intrinsic: paternal bonding, seeking knowledge, and a sense of responsibility towards the child. Extrinsic motivators evolved around men’s past experiences, supporting spouses to reduce stress and preferential treatment provided at the clinic. Generally, men yearned to connect with their children during the early life stages to secure lifelong connections. They felt their participation was a shared responsibility that should be fulfilled towards the child. In the clinics, men appreciated the preferential treatment nurses provided through fast services for couples/men who attend CWC. In conclusion, men perceive themselves as supportive parents in the space of CWC with facilitators to effectively contribute to their child\u27s wellbeing. Nurses and midwives must continue the advocacy for male involvement in child health and wellbeing, strengthen the facilitators and minimise the barriers to male involvement at CWC
Community Engagement within Doctoral Dissertations in Nursing
No full textCommunity engagement is increasingly recognized as a key research approach across disciplines with the goal of promoting health equity (Key et al., 2019), yet the benefits and best practices for incorporating this approach within doctoral dissertations remain understudied. Other health sciences, such as social work, have recorded student and community benefits in conducting community-engaged dissertations (Yan et al., 2021), but there remains a significant gap of considerations for nursing dissertations. This presentation seeks to discuss the benefits, challenges, and pathways of community-engaged dissertations informed by an ongoing doctoral dissertation in nursing focused on sexual health equity. This dissertation engages community members as peer researchers throughout the research process, meeting with an advisory board to develop an interview guide, training members as interviewers, and co-analyzing results for data integration and dissemination.
For future nurse scientists positioning themselves to advance health equity, a community-engaged dissertation can provide opportunities to conduct mutually beneficial research, engage in inter-institutional collaboration, and build capacity for navigating administrative and regulatory structures. Students may gain experience in training community members as peer researchers, with both learning skills relevant to research and dissemination back into communities. While developing relationships with communities to create meaningful engagement can seem daunting in the relatively short time frame of a PhD program, networks within a student’s committee, program, and university may be leveraged for the student to build trust within existing collaborations. Embracing this approach for a dissertation may come with other challenges related to needs for supplemental funds and time to establish formal agreements across institutions. However, these challenges pose unique learning opportunities of project management that many students do not obtain before they transition to independent scientists. Ultimately, a community-engaged approach for a dissertation in nursing draws on the holistic and trustworthy nature of the profession to strive for more contextualized and meaningful research processes and outcomes. Additionally, by promoting the skills vital to advancing health equity in a learning environment, students receive close mentorship and feedback that will help to strengthen the future of nursing science
Women’s Experiences With Traditional Medicine for Treatment of Cervical Cancer: A Qualitative Study
No full textBackground: Over 60% of patients with cancer in sub-Saharan Africa used traditional medicine for cancer treatment (Alegbeleye et al., 2020, Mwaka et al., 2020). The common predictors of traditional medicine use include being a female (Kristoffersen et al., 2022, Aboufaras et al., 2023). However, there is limited empirical information about the experiences of women with traditional medicine usage for the treatment of cervical cancer. The current study explored the experiences of women who used traditional medicine for the treatment of cervical cancer in Accra, Ghana.Methods: An exploratory qualitative research design was used in this study. A semi-structured interview guide was used to interview 12 women to gain insight into their experiences with traditional medicine for cervical cancer treatment. The data collected were analyzed using content analysis in which major themes and subthemes were generated. These findings were supported with verbatim quotes from the participants.Results: Women with signs and symptoms of cervical cancer consulted herbalists first for treatment. The herbalists treated the women based on presenting signs and symptoms without a definitive diagnosis. The main types of traditional medicine the women used include herbal medicine in the form of sap (extracted from herbs, roots, leaves, and flowers) through the process of boiling, insertion of substances (i.e., “balm”, and penicillin ointment) into the vagina, and prayers from pastors as a treatment for cervical cancer. The routes through which the herbal medicine was administered to effect healing of cervical cancer include oral (drinking the sap), skin (bathing with the sap), and vagina orifice (douching and insertion)
Workplace Violence in the ED as a Global Phenomenon: Literature Review
No full textPurpose: This presentation reviews the literature to explore the experience of workplace violence towards healthcare workers from patients/families in the emergency department as a global phenomenon.
Background: Attention to workplace violence (WPV) in emergency departments (ED) by patients or families toward healthcare workers in the US has been increasing (Carey & Hendricks, 2023; Doehring et al., 2024; McLaughlin & Khemthong, 2024). Since EDs are a point of entry to care, WPV can be exacerbated due to the fast-paced and unpredictable environment (McLaughlin & Khemthong, 2024). Patients are commonly admitted experiencing pain, substance use issues, and mental health crises which may trigger verbal or physical abuse (Carey & Hendricks, 2023). Other ED stressors like high volume of patients, understaffing, and long wait times can contribute to WPV from patients and families (Carey & Hendricks, 2023; McLaughlin & Khemthong, 2024). In some ED environments WPV has become normalized and is not reported consistently in the belief that there are no solutions (Buterakos et al., 2020).
Method: CINAHL, PubMed, and Google Scholar were used to search for articles published between 2018 and 2024 to answer the research question, “Do other countries experience WPV towards healthcare workers in the ED similar to the US?” Search terms included workplace violence; emergency department/room; violence and nurses. Twelve articles were chosen representing projects completed in Australia, Brazil, China, Denmark, France, Italy, India, Iran, Jordan, Korea, Portugal, and Turkey.
Findings: The experiences of physical and verbal WPV related to patients/families toward healthcare workers in the ED, including nurses, revealed similarities. As individuals this included physical injury (or fear of it), psychological and emotional stress, and the impact of this on their personal lives. Women reported this more than men, and racial/ethnic attacks were also experienced. As professionals, WPV influenced factors such as intent to leave, mistrust that employers will not take action to protect them, and increased incivility among peers related to displaced frustration. The reflection that WPV was an expected part of working in the ED was also reported.
Conclusion: As the entry point for people in crisis, the experience of violence in the ED by healthcare workers is a global phenomenon. While it is an occupational risk, continuous action must be taken to ensure the safety and well-being of healthcare workers
Palliative Ventilator Withdrawal Algorithm: A Feasibility Quality Improvement (QI) Project
No full textManaging respiratory distress during end-of-life (EOL) ventilator withdrawal poses significant challenges, particularly without structured algorithms or validated, reliable tools. This quality improvement (QI) project addressed these challenges by implementing Campbell’s ventilator withdrawal algorithm and the Respiratory Distress Observation Scale (RDOS), a validated, reliable tool for objective dyspnea assessment. This project sought to enhance care quality by evaluating process feasibility while addressing implementation barriers.
Dyspnea is a complex, subjective symptom frequently encountered during EOL ventilator withdrawal. Campbell’s algorithm provides a structured, individualized approach emphasizing prevention, early intervention, reassessment, and treatment while considering patient-specific factors such as illness severity and level of consciousness. Its algorithmic approach to medication titration, extubation planning, and survival discussions provides individualized care. The RDOS complements this by using objective dyspnea assessment in non-communicative patients.
Conducted over 5 months in an intensive care unit (ICU), this QI project involved a multidisciplinary team of nurses, respiratory therapists, physicians, and advanced practice providers. Participation was voluntary, with education provided via webinars requiring an 80% passing grade to ensure fidelity. The project had 3 phases: observing usual EOL care, conducting educational sessions, and implementing the algorithm and RDOS. Tools such as checklists supported adherence, with fidelity monitored throughout.
Barriers included time constraints, staff workload, knowledge gaps, skepticism regarding sedation adequacy, concerns about euthanasia, and resource limitations. Strategies to mitigate these included “just-in-time” training, computerized order sets, and targeted education addressing knowledge gaps. However, ethical apprehensions and reluctance to relinquish autonomy occurred among some staff.The project underscores the potential of ventilator withdrawal algorithms in reducing dyspnea and improving the quality of EOL care. However, addressing educational, logistical, and ethical challenges remains crucial for successful implementation. Future efforts should focus on identifying and addressing the root causes of these barriers to improve feasibility and acceptance in clinical practice