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The Nurse as an Inspiring Leader of Health: A Framework Rooted in Neurochemical Drivers of Influence
No full textThe healthcare landscape is constantly evolving, demanding nurses navigate increasingly complex and challenging situations. Modern nursing goes beyond providing care and motivation—it now requires inspiration and mentoring to drive meaningful, systemic change promoting health at every level. Inspiration is an essential intrinsic motivator, positioning nurses as leaders uniquely equipped to foster resilience and excellence.Transformational leadership principles, deeply rooted in nursing philosophy, place human caring at the core. By embodying these principles, nurses can inspire change within themselves, their peers, and their organizations. As guardians of public health, nurses are inherently positioned to lead socio-ecological transformations, advance health promotion, and prevent illness and injury.This presentation explores effective nursing leadership and health behavior theories, and introduces a new theory of inspirational leadership, emphasizing the qualities of an effective nurse and an effective leader are inherently intertwined. By embracing their role as inspirational leaders, nurses can shape the future of care, ensuring their impact resonates across individuals, communities, and systems.Inspired by Simon Sinek’s leadership framework and Golden Circle Theory, the model highlights how nurses can transform health outcomes by understanding patient values and leveraging neurochemicals that drive connection, motivation, and resilience. Sinek emphasizes by fostering positive responses, leaders create environments of trust, support, and empowerment. This approach enables us to inspire change, enhance individual and community well-being, and equip patients to take active roles in their health; thus, advancing nursing as a discipline of inspiring leadership in healthcare.It is time to transform our view of nursing from a discipline of care to one of awe-inspiring leadership, with caring at the forefront. We are not only caregivers, but leaders uniquely equipped to enable change and champion health at every level. Through a deep understanding of human neurochemistry, we can elevate patient care and empower individuals and communities to take active roles in their own health. As we embrace our leadership potential, we drive a resilient, equitable healthcare future where well-being is not just tended to, but actively cultivated. This is our charge: to redefine nursing as a force for inspirational leadership in a changing world
Gastrointestinal Simulation: A Learning Strategy for Nursing Students
No full textImplementing high fidelity simulation (HFS) into undergraduate nursing courses allows faculty to evaluate the nursing student’s ability to provide safe care for a client in a realistic, controlled environment. Simulation is a learning strategy that fosters competency-based education (CBE). The CBE model focuses on competency attainment by utilizing learning strategies promoting nursing students’ development of knowledge, skills, attitudes, and behaviors needed to become a proficient novice nurse.
The simulation experience begins with a pre-briefing session where faculty provide information about the client, orient the nursing students to the HFS equipment, and reiterates that HFS is a safe learning environment. The unfolding HFS involves a client admitted with abdominal pain who proceeds to have a gastrointestinal bleed. After getting report, the simulation unfolds with nursing students assuming total nursing care of the client while being observed by faculty in the control room. As nursing students assess the client, they should identify abnormal subjective and objective data, cluster relevant data, and notify the provider of concerning findings. Next, the provider gives the nursing students a set of orders requiring prioritization and implementation. If the provider is not notified or interventions are not prioritized in a timely manner the client’s condition deteriorates. The unfolding nature of our HFS requires nursing students to implement continual assessment and collaboration with the provider, and evaluation of interventions while providing education for the client and family. Interventions for this client include safe medication administration, intravenous fluid regulation, and nasogastric tube insertion. The unfolding HFS is followed by a debriefing session focused on the nursing student’s ability to self-reflect on what happened, what went well, what could be improved, and how this unfolding HFS could be applied to other client scenarios.
Participation in this unfolding HFS promoted nursing students’ competence within the American Association of College of Nursing (AACN) Essentials domain one, Knowledge for Nursing Practice, demonstrates compassionate care, effective communication, prioritization of care, and evaluation of outcomes (AACN, 2021; Lewis et.al., 2022). The nursing student outcomes validate this learning strategy as an exemplar of CBE and the application of knowledge regarding the care of clients with gastrointestinal bleeding
Shift: Master Clinical Decision Making through a Gamified, Interactive Experience
No full textShift, a Serious-Gaming simulation, aims to revolutionize simulation education by providing an immersive, interactive platform that replicates real-world scenarios with detailed attention to INACSL standards for evidence-informed excellence in simulation. Simulation is a fundamental part of nursing education, but the traditional approach may not fully cater to the learning preferences of the future nursing workforce. Traditional educational methods often fail to fully engage tech-savvy cohorts who thrive on interactivity, instant feedback, and multimedia content. The project was designed to enhance knowledge acquisition and promote reflection on critical decision-making in an engrossing tech-infused platform compatible with most devices. The modules are intentionally brief, providing impactful bursts of engaging instruction and immediate feedback. Players engage in various clinical situations that mirror challenges nurses experience during a typical day. Players are challenged in a choose-your-own adventure game, exploring different decision points as they complete their “shift.” This platform immerses learners in the world of professional nursing practice and aids in bridging the transition to practice gap. Players must make pivotal choices in high-pressure environments where time management is essential, fostering a reflective learning process that highlights the consequences of their actions.
An internal grant funded a pilot study for Shift, which was completed in Spring 2024. This initial iteration focused on Infection Prevention and Control (IPC). Early user results indicate that the product is engaging and effective in increasing awareness of IPC protocols. Adjectives used to describe Shift include “informative,” “needed in the profession,” and “engaging.”
Patient care is more complex than ever, and a new generation of nursing students is entering nursing programs, placing nursing education at a critical juncture. We must explore alternatives to traditional simulation labs, classroom, and clinical instructional approaches to adjust to these changes. Tapping into a Serious Gaming instructional design fosters knowledge growth and bolsters decision-making confidence. Shift offers an innovative, impactful, learner-centered game tailored to modern nursing education needs. More importantly, it can improve the transition to practice, significantly advancing nursing education and patient safety
Transform the Work Environment & Psychological Distress in Nurses: Sustain Health Promotion Behaviors
No full textBackground: The healthcare work environment poses numerous stressors contributing to distress1, and poor health outcomes in nurses4,5. A critical nursing shortage exists, and it is crucial to explore the work environment, leading to distress symptoms. Coping strategies using health promotion behaviors are essential to restore nurses\u27 health3, which has not been explored well.
Purpose: Examine the work environment - workload and the association with psychological distress, sleep disturbance, and health promotion behaviors in nurses, using a structural equation modeling (SEM) approach guided by the job demands-resources framework.
Methods: The Nurse Worklife and Wellness Study data collected between November to March using a cross-sectional survey from nine representative US states (n=1170) was used to test the direct and indirect associations between variables such as workload, health promotion, psychological distress, sleep, and health.
A confirmatory factor analysis was performed, and the factor loadings for the indicators in each variable were analyzed using Mplus. The variables demonstrated evidence of composite reliability and convergent / discriminant validity. Model building was performed using weighted least squares estimation (WLSMV). Model fit was assessed using the chi-square statistic, root mean square error of approximation (RMSEA), comparative fit index, Tucker-Lewis index, and the standardized root mean residual2.
Results: The structural model showed that the job demands from increased workload significantly increased psychological distress (β = 1.47, p\u3c 0.001), increased sleep disturbance (β = 1.22, p\u3c 0.01), and decreased overall health (β = -1.36, p\u3c 0.01). Health promotion behaviors had restorative effects, significantly mediating the relationship between workload and psychological distress, reducing distress (β = -1.01) and sleep disturbance (β = -0.94), and increasing overall health (β = 0.67).
Conclusions: Our findings underscore the importance of improving nurses\u27 work environment by reducing their workload and address nurses distress. It is crucial for nurses to advocate for policies that standardize the structure, distribution, and supervision of their work, and future research should focus on longitudinal studies of the work environment using comprehensive measurement tools. Implementing strategies to encourage health promotion behaviors could help alleviate nurses distress, enhance their well-being, and contribute to workforce stability
Culturally Diverse End-of-Life Simulation and Perceptions in Undergraduate Nursing Students
No full textEnd-of-life (EOL) patient care is a challenging reality that nearly all nurses will face during their careers. Preparing nursing students for these situations can alleviate anxieties related to patient death (Venkatasalu et al., 2015). Simulation-based learning is an effective approach for teaching complex scenarios like EOL care (Cannity et al., 2021), with numerous studies highlighting improved confidence and competence in students who participate in EOL simulations (Gillan et al., 2014; Tamaki et al., 2019; Venkatasalu et al., 2015; Lewis et al., 2016; Jablonski et al., 2020). However, the lack of cross-cultural variations in death and dying highlights the need for culturally competent nurses (Northam et al., 2015).
This project aims to assess whether participation in culturally and spiritually diverse EOL simulations improves undergraduate nursing students\u27 perceived competence in providing culturally inclusive EOL care.
Utilizing Kolb\u27s Experiential Learning Theory (1984), in the spring of 2025, 52 undergraduate juniors at the College of St. Benedict/St. John\u27s University, enrolled in course NRSG 302, will participate and observe a simulated death experience involving three culturally distinct groups in the Central Minnesota area: Catholic Caucasian, Muslim Somali, and Mide Ojibwe. Creating a high-fidelity learning environment is key to providing students with an authentic experience that includes live actors, real culturally and spiritually distinct props, and high-tech geriatric mannequins to simulate the dying process. Pre- and post-simulation surveys will assess students\u27 perceived competence in EOL care using the CARES Perceived Competence Measure 2.0 (AACN, 2021). Preliminary data has already shown improved perceived competence after students completed one EOL simulation in the spring of 2024.
This project is significant as it will provide insights into the effectiveness of EOL simulations in improving students\u27 confidence and competence in EOL care. The results may support the integration of culturally diverse EOL simulations into nursing curricula to better prepare future nurses for diverse patient care scenarios. Further, the study could fill a gap in the current literature by providing data on cultural competence in EOL simulations, and it offers a foundation for future research and curriculum development that ensures nursing students are well-equipped to handle culturally diverse EOL situations
Building Research Capacity: Challenges and Lessons of an Undergraduate Nursing Research Program
No full textBackground: The future of nursing scholarship relies on developing research capacity throughout the professional education trajectory. Nurse educators find motivating undergraduate nursing students to engage in the research process a challenge.1 Understanding of the nursing research process and its link to optimal clinical practice is not well understood by undergraduate nursing students.2 Global health challenges and issues impacting nursing education, such as faculty retirements and decreasing numbers of nurses pursuing research-focused doctoral degrees, necessitate introducing nursing students to the research process early, creatively, and consistently throughout their educational journey.3
Purpose: Describe the challenges and lessons learned in developing a mentored undergraduate nursing research fellowship program to build future nursing science and scholarship capacity.
Results: The Essig Mentorship Program was designed to promote undergraduate student nursing research interest and skill development, with the added benefit of faculty mentorship skill-building. Changes to the program schedule from only summer term to fall and spring terms and research topic and methods expansion have increased the applicant numbers. Challenges of program timing, student academic commitments, availability of research faculty to mentor students, faculty-perceived lack of personal mentorship skill, and the understanding of the research-practice link required a reimaging and refocusing of the program. Lessons learned from addressing these challenges continue to increase the diversity and number of applicants and have provided early career researchers with the opportunity to be mentored by senior research faculty in preparation for future mentor roles.
Conclusions: Continued development of an undergraduate nursing research experiential learning opportunity by addressing today’s challenges provides the opportunity to increase student research skills and improve faculty mentorship ability. These undergraduate programs provide a critical and innovative avenue for educating nurses to contribute to the body of scholarship needed to meet global health challenges
A Hospital Based Residency Program for Newly Arrived Internationally Educated Nurses to the USA
No full textPurpose: The purpose of this abstract and research is to establish the efficacy of a hospital-based nurse residency program for newly arrived internationally educated nurses to the United States.
Background: Healthcare institutions are recruiting Internationally educated nurses (IEN) to fill gaps in staffing (Spetz et al., 2013). Internationally educated nurses are coming from an entirely different country and healthcare system and are then placed into foreign clinical settings amongst a foreign culture and having to find their place within the culture at the same time (Rosenkoetter et al., 2017). Literature delineates that an approach to support IENs is needed to ease transition into US healthcare as well as ensure a streamlined recruitment and retention process exists (Ghazal et al., 2020; Primeau et al., 2014). Little research has explored or examined the transition to practice programs for internationally educated nurses worldwide.
Method: The residency program is held over seven months. The first month is weekly four-hour sessions, followed by one four-hour session monthly for six months. To measure transition experience the Casey-Fink graduate nurse experience survey will be used (Casey-Fink, 2023). This includes the following outcome variables: practice confidence in clinical skills, role confidence, care prioritization, support, role satisfaction, stress, burnout, resilience and organizational commitment. Nurse retention after 1 year will be measured as an outcome variable.
Study Procedures: A quantitative quasi-experimental single-group time-series design will be used for this research. This design establishes a baseline through pre-tests and can establish causation without using a control group (Gliner et al., 2016). This research has two variables, transition experience and retention, so approximately 60 participants will be needed.
Results: There are currently 21 IENs to date, with 13 successfully completing the program. The anticipated findings are that this residency program will help to promote an increase in self-perceived practice confidence in working in a new country, an increased feeling of hospital support, decreased stress and burnout, increased resilience thus promoting nurse satisfaction and ultimately retention and organizational commitment of these IENs. The findings from this research will help to establish an evidence-based program for institutions to implement when onboarding IENs to the US healthcare system
Creating A Standardized Intraoperative Handoff Report
No full textPurpose: Effective communication during nurse-to-nurse relief is vital for patient safety, especially in complex surgeries. In the Operating Room (OR), inconsistencies in handoffs arise due to lack of structure, information gaps and time constraints. This project evaluates the impact of implementing a structured SWITCH (Surgical Procedure, Wet, Instruments, Tissue, Counts, and Have Questions) protocol for nurse-to-nurse handoff reports during breaks and permanent relief, aiming to improve continuity of care, reduce errors, and enhance patient safety.
Relevance: The SWITCH handoff model ensures all relevant surgical information is clearly communicated, reducing the risk of incomplete or unclear handoffs that can compromise patient care. By implementing a structured handoff report, communication improves, incomplete information is minimized, patient complications and errors are reduced, OR nurses experience improved situational awareness and increased satisfaction with handoff reports (1,2,3,4).
Methods: This evidence-based practice project uses the IOWA model as the framework, with a new report template reflecting the SWITCH model. Staff education included a live presentation on project expectations, followed by weekly education reinforcement, socializing the new template, and visual cues at workstations. Outcomes were evaluated through pre-and post-surveys that assess staff perceptions and experiences, as well as audits of the SWITCH handoff templates.
Results: The pre-survey (n=48) indicated that 91% of nurses believed that a standardized handoff report would improve patient safety, with 56% of nurses being “very satisfied” with their non-standardized handoff reports. In contrast, the post- survey (n=23) revealed 82% were “very satisfied” with the practice change of the SWITCH model. Additionally, 86% of participants confirmed that the SWITCH model improved patient safety and that they would continue using it. All audited SWITCH handoff reports were 100% logically and concisely completed, confirming full adherence to the required handoff report standards.
Conclusion: The SWITCH handoff report model effectively standardizes and structures communication, which is critical for improving communication and ensuring patient safety. This model aligns with the conference theme by representing a commitment to structured communication, reflecting on current practices, respecting patient safety and responding with actionable improvements in the operating room
Critically Thinking Through a Multiple-Patient Simulation: Applying Real World Principles
No full textBackground Simulating multiple-patient care scenarios enables nursing students to put prioritization and time-management into practice prior to working as registered nurses in the healthcare environment. This project aimed to implement and evaluate a multi-patient simulation.Method Senior nursing students enrolled in leadership and management experience a multi-patient simulation in which learners are assigned various roles to support four diverse patients. Students exercise autonomy in problem solving as the patient situations unfold around them. Students navigate admissions, transfers, discharges, patient noncompliance, medical complications, and complex family dynamics. After participation, students completed an evaluation of the experience.Results After approval from the Institutional Review Board (IRB), qualitative and quantitative data from the post-simulation evaluation will be analyzed. Quantitative questions on the evaluation are derived from the Healthcare Simulation Standards of Best PracticeÒ (INACSL Standards Committee, 2021). Qualitative analysis will focus on delegation, prioritization, and collaborative practice themes. Conclusions will be drawn from the analysis and improvement strategies will be explored
The Nurse Practitioner’s Role in Managing Care of Clients with Sepsis/Septic Shock
No full textSepsis is a secondary infection that causes a dysregulated physiological systemic response, which may lead to shock with multiple organ dysfunction syndrome (MODS). Approximately 350,000 adults who develop sepsis die during their hospitalization or after discharge. Most adult clients who develop septic shock have complex comorbidities that complicate the management of care which impairs quality of life after treatment; and increases mortality. The burden of care falls on the client as well as their family. Not only do nurse practitioners (NPs) serve a significant role in managing care for clients; they educate the community on sepsis awareness and primary prevention. During the acute phase of sepsis, NPs use diagnostic studies and screening tools to identify cause of sepsis. This may include reviewing inflammatory markers, culture data, imaging, systemic inflammatory response syndrome (SIRS) criteria, sequential organ failure assessment (SOFA) Score, etc. Using evidence-based standards of care, NPs manage clients with septic shock in the emergency departments (ED) and intensive care units (ICUs). In these acute care settings, they participate in the decision making, assess static hemodynamics, perform point of care assessments using bedside ultrasounds, etc. Lastly, NPs manage clients post-sepsis once discharged from the ICU and/or hospital. Often this follow-up is not as robust as the care provided in the acute phase. NPs must collaborate with multidisciplinary teams to assist with discharge planning, transitional care, home health, physical therapy, occupational therapy, medication reconciliation, psychosocial health, etc. Consultation from specialists (ex. cardiologist, nephrologist, pulmonologist, etc.) may be needed to assist with newly acquired organ dysfunction secondary to septic shock. Mortality remains high during the recovery phase and up to two years post-septic shock. NPs assist with decreasing mortality and improving client outcomes by participating in post-ICU follow-up care. Some NPs lead post-sepsis clinics to assess and evaluate the clients and family individualized needs. In summary NPs contribute to the care of clients with septic shock during each phase of treatment and recovery. Their contributions are vital and help to improve the overall health of clients with septic shock