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The lmpact of the COVID-19 Pandemic on Registered Nurses
No full textBackground: The Covid –19 pandemic is a new experience with a substantial impact on the health and well-being of nurses caring for the patients diagnosed with the disease. Increased work and family demands have not been studied in these frontline workers. COVID-19 has altered many US nurses’ career plans. Over the past two years, the researchers have spoken with nurses who consistently, and increasingly, report planning to leave the workforce. This study looks at the impact of COVID-19 on the professional and personal lives of nurses.Purpose: To understand the effects of COVID-19 a global pandemic on nurses caring for patients with the disease.Methodology: A descriptive study design using a survey method was used. Qualtrics a known survey tool was used to complete a 20-minute survey which described experience of nurses (n=229) caring for patients with COVID 19. Participants came from a national database of state nurses’ associations.
Results: Of the participants the majority were baccalaureate prepared and affiliated with urban academic centers. 56 % did not have additional training related to caring for patients with COVID-19. The majority of the participants were from the northeast United States which was ground zero early in the pandemic. 76% were fully vaccinated. 45% never had COVID and 55% had COVID in one or more wave. Stress, anxiety, and depression were reported as mental health side effects related to the pandemic. Isolation was reported as a major factor. Nurses reported burnout, worry and fear and mistrust.
Conclusions: Although high vaccination rates were reported nurses were exposed to COVID-19. Nurses reported an impact on their lives and mental health as a result of the pandemic and lack of preparedness and education to handle the pandemic. Nurses reported a desire to leave the profession.
Implications: This study shows the need for education, preparedness plans for future pandemics. Support systems should be in place to care for the emotional, physical and mental health needs of nurses on the frontlines during a public health crisis
Empowering Nurses Through Scope Advancement: Strategies for Professional Growth
No full textNurses globally work within various scopes of practice, from entry-level to advanced roles, and play a vital role in meeting the health needs of individuals and communities across diverse healthcare settings. Nurses can further their education, to advance their scope, such as diploma-prepared Licensed/Registered Practical Nurses (LPNs/RPNs) completing their Bachelor of Nursing (BN) to become Registered Nurses (RN). In Canada, select BN programs use innovative pedagogies to specifically bridge curriculum that recognizes LPN/RPN experience (Chachula et al., 2020). LPN/RPN to BN learners bring rich clinical experience and diversity as they engage in career advancement and professional development (Almost, 2021).
A qualitative descriptive, two-phase research design (Doyle et al., 2019) was utilized across three Canadian universities to explore how successful transition is determined and measured for LPN/RPN to BN learners as they complete their final consolidation practicum (CP). Participants (n=41 learners and n=48 preceptors) completed a 20-minute anonymized digital survey and a virtual 60-minute semi-structured interview about what constitutes successful role transition and the markers of transition. Data were analyzed using Braun and Clarke’s (2021) thematic analysis technique.
Findings revealed that transition is marked by changes in thinking, behaviour, workplace relationships, role perception, and skill competence. Transition is influenced by preceptor, learner, and contextual factors, and strategies can be developed to facilitate it. Within the themes, similarities and differences were noted between learners’ and preceptors’ perspectives. The study findings illuminate how innovative and inclusive programs can empower these learners.
A tailored educational approach to this unique cohort of LPN/RPN to BN learners can facilitate a successful transition to the role of the RN. Furthermore, a successful transition supports the advancement of a diverse body of nurses with rich clinical experience to meet the ever-complex needs of healthcare systems. Enhancing the quality of educational experiences for nurses already in the healthcare system and advancing their scope demonstrates a commitment to retention practices. Findings from this national study reiterate the importance of advancing the scholarship of teaching and learning and may be applicable to other contexts and settings, such as different countries and other scopes of nursing and healthcare professions
Strategies for Managing Interruptions: Improving Task Efficiency and Patient Safety
No full textIntroduction: Worldwide, interruptions to nurses are prevalent during medication administration1,2 and handoff.3 Interruptions decrease task efficiency3,4 and increase risks for errors.1-3 The use of interruption management strategies (intentional behaviors to handle interruptions) may improve the efficiency and safety of interrupted tasks.5
Purpose: To describe the investigation of the Stay SAFE interruption management strategy.
Theoretical Framework: Stay SAFE is based on the memory for goals cognitive science model5 which posits that use of associative cues (retrieval cues) when interrupted can improve task efficiency and decrease errors. Stay SAFE is an acronym for: Stay where you are, S: Stay focused on your current task, A: Associate cues, F: Find a natural break, E: Evaluate the urgency of the interruption.
Methods: A multi-methods research design was used in this study.6 Prelicensure nursing students from four US schools participated. Data were collected January-October 2024.
Participants completed a pretest and seven posttest simulations across six study visits. After the pretest, participants were taught the Stay SAFE strategy. All simulations included an interruption during medication administration. In the last four simulations, an interruption also occurred during handoff.
Trained data collectors observed and documented participants\u27 behaviors used to manage the interruptions on a researcher-made tool. After each simulation, participants completed a checklist to indicate how they managed the interruption. The observed and self-reported data were compared to validate or correct the findings.
Participants’ perceptions of Stay SAFE were explored via semi-structured interviews. Two researchers independently read the transcribed interviews, coded the data, then collaborated to identify themes.6
Results: Fifty-one students completed all pre/posttests. During the pretest, all engaged or multitasked when interrupted. A majority (93-100%) used Stay SAFE when interrupted during the posttests. Students described Stay SAFE as easy to use, reported using Stay SAFE in hospital settings, and felt that Stay SAFE could improve the efficiency and safety of tasks. Findings were similar across study sites.
Conclusions: Interruptions decrease task efficiency and can lead to errors. Nurses and nursing students require education on how to best manage interruptions. Stay SAFE aims to improve efficiency and mitigate errors, thus it’s use may lead to improved patient care
Should I Consider a Terminal Nursing Degree?
No full textThe purpose is to provide information for nurses who desire continuation of nursing education, learn new skills, and understand differences in core concepts of the Doctor of Philosophy (PhD) and Doctor of Nursing Practice (DNP) terminal nursing degrees.Changing demands of national and global healthcare environment requires a high level of scientific knowledge and practice expertise to assure quality patient outcomes. Some factors building momentum for change in nursing education at an advanced level include: rapid expansion of knowledge underlying practice; increasing complexity of patient care; national concerns of quality of care and patient safety; shortages of nursing personnel which demands higher levels of preparation for leaders to design and assess care; shortages of doctorally-prepared nursing faculty; and increasing educational expectations. In the 2005 report Advancing the Nation\u27s Health Needs: NIH Research Training Programs, it called for nursing to develop a non-research clinical doctorate to prepare expert practitioners. AACN has worked to advance the DNP and is consistent with this call to action.Review of literature for terminal degrees in nursing was conducted through PubMed, Google Scholar, and websites. These focus on PhD and DNP terminal nursing degrees.It’s important the nurse determine which type of terminal degree fits their personal and professional goals. Based on current literature findings, each type of doctoral program has different goals and competencies for students to achieve. The PhD nursing program provides knowledge and skills in theoretical, methodological, and analytical approaches that will enable conducting research to discover and apply knowledge in nursing science and health care. The DNP focuses on developing advanced knowledge, skills, and leadership roles necessary to apply research findings in clinical settings, concentrating on innovative and evidence-based practice. Attending discussion sessions help to identify personal reasons for considering a terminal degree and learn differences between the PhD and DNP. Both require students to submit a scholarly project or dissertation.Examining the types of nursing terminal degrees (PhD vs. DNP) is the first step in determining best fit. Attending discussion sessions can assist nurses in determining a suitable pathway for their personal and professional goals. This may form additional questions and provide answers that help form rationale in selection and next steps
Rethinking Nursing Education: Supporting Neurodiversity in Nursing Classrooms
No full textNeurodiversity is an inclusive term that describes the range of neurological or neurocognitive variation naturally found in the human population (Legault et al., 2021). Neurodivergence has historically been labeled and classified as a disability (Armstrong, 2017). Examples of neurodivergent diagnoses include specific learning disabilities in reading, writing, and math: dyslexia, dysgraphia, dyscalculia; autism; ADHD, or others. Estimated prevalence data suggests that 15-20% of adults are neurodiverse (Doyle, 2020). The Yale Center for Dyslexia reports that 20% of the general population are dyslexic (The Yale Center for Dyslexia and Creativity, 2022). Prevalence estimates of ADHD range from 3-7% (Song et al., 2021).
While these statistics are not specific to nursing, they give a sense of the prevalence of neurodiversity within the population. Neurodiverse students may struggle to access the curriculum as it is presented for the neurotypical learner. Students struggle for various reasons, including academic, personal, social, and demographic factors (Arbour et al., 2023). Some students struggle due to more than one issue at the same time (Al-Tameemi et al., 2023). A renewed awareness of healthcare disparities for disabled individuals (National Institutes of Health, 2023) supports a call and commitment to disability inclusion among health professions. To support diversifying the nursing workforce, the Future of Nursing 2020-2030 recognizes the importance of cultivating an inclusive educational environment, including supporting neurodiverse students (National Academy of Medicine, 2021). Neurodiverse nursing students become neurodiverse clinicians (Frawley et al., 2024) at greater risk for burnout than their peers (Syharat et al., 2023).
Nursing faculty are challenged to support and educate all of their students, including those who are often underserved in traditional learning environments. For this reason, and in support of the neurodiverse student population, this presentation will explore integrating inclusive strategies, including Universal Design for Learning (UDL) (Levey, 2018), Transparency in Learning and Teaching (TILT) assignments for course review and revision (Winkelmes, 2023), and trauma-informed pedagogy (Arbour et al., 2023). Through this work, nursing programs can create more equitable learning experiences. Faculty development and curriculum revision are essential to support neurodiversity and student success in nursing education
Innovative Leadership Strategies for Maintaining Educational Standards During Unscheduled Downtime
No full textUnscheduled downtime caused by pandemics, natural disasters, or technological failures, poses significant challenges to maintaining educational continuity and standards in academic institutions. This abstract describes innovative leadership strategies for ensuring that educational standards are upheld during such disruptions.
Key strategies include adopting flexible, technology-driven solutions such as virtual learning platforms and remote simulation tools to ensure uninterrupted teaching and assessment (Schachenhofer, Hirsch, & Gronalt, 2023). Leaders can promote the rapid development and implementation of adaptive curricula designed for online delivery, while ensuring that learning objectives remain aligned with accreditation requirements. Enhancing communication with students and faculty through digital platforms fosters transparency and provides ongoing support during transitions (Fouad, 2021; Wang, 2024)
Another approach involves leveraging collaborative leadership to engage educators and staff in identifying immediate challenges and co-developing creative solutions (bin Roslan, bin Abd Hamid, & Al-Hafiz, 2024). The Department of Education (2024) provides professional development opportunities for faculty on the effective use of virtual tools and innovative teaching strategies that can improve educational outcomes even during periods of disruption.
In conclusion, by embracing technology, fostering collaboration, and offering targeted support, educational leaders can maintain high standards and ensure academic continuity during unscheduled downtime, preparing institutions to be resilient and adaptable in the face of unforeseen challenges
Overcoming Toxic Positivity: Leadership Strategies for Promoting Healthy Nursing Work Environments
No full textIn the post-COVID-19 landscape, many nurses report feeling abandoned (5), undervalued (6), and inadequately supported (2,3). As such, it is incumbent for organizational leaders to take action to support nursing staff and implement strategies that foster healthy work environments and promote nurses’ well-being. A potentially overlooked contributing factor is toxic positivity. While this phenomenon appears to be present in nursing, it remains underexplored. The purpose of this presentation is: (a) to provide an overview of the concept of toxic positivity, (b) to explore its potential impacts on patient care outcomes, and (c) to discuss strategies nurse leaders can employ to move away from toxic positivity and create supportive, healthy work environments.A concept analysis of toxic positivity using Schatzman’s dimensional analysis method was conducted, revealing a multi-dimensional concept applicable across various settings, including the nursing workforce. Toxic positivity, defined as a process in which givers—either intentionally or unintentionally—deny or disregard another person’s negative emotions or experiences through misplaced positivity (7), may contribute to burnout, diminished well-being, job dissatisfaction, and retention challenges. The salient dimension of toxic positivity is Emotional Suppression, which, when compounded by other relevant dimensions and sub-dimensions, may lead to psychological distress and decreased well-being among recipients. These negative outcomes can, in turn, affect patient care quality and outcomes (4), making toxic positivity a significant concern for nursing leaders. Given the identified consequences, nurse leaders should develop a heightened awareness of the presence of toxic positivity within their organizations.The findings from this concept analysis align with long-standing issues in the nursing workforce. Nurse leaders should focus on identifying toxic positivity, learning how to avoid it, and educating staff on healthy coping strategies. Instead of promoting dismissive positivity, leaders should adopt trauma-informed care practices, provide adequate resources, foster open communication channels, and actively address nurse burnout (1). These leadership strategies, coupled with system-level interventions, can help create and sustain work environments that shift the focus from harmful emotional suppression to healthy acknowledgment and meaningful support for the nursing workforce
Social Capital in the Workplace for New Graduate Nurses: Maximizing Recruitment and Retention
No full textBackground: Given the widespread nursing shortages, prioritizing nurse recruitment and retention efforts is essential. Understanding the impact of new graduates\u27 initial experiences on their decision to accept and remain in their roles is essential for educators, recruiters, and healthcare system administrators to gain valuable insights. Purpose: This study aimed to examine a national sample of new graduate nurses’ first job experiences through the lens of social capital. Theoretical Framework: Social capital (Bourdieu, 1986; Coleman, 1988; Putnam, 1994) asserts that social relationships create valuable networks that serve as resources to their members, extending reciprocal benefits for individuals and the organization, building trust, and fostering engagement. Social relationships in the workplace build human capital, an individual’s knowledge, skills, and experiences (Pil & Leana, 2009; Smylie & Hart, 1999). Method: Quantitative secondary analysis of the National Student Nurses’ Association membership survey data and qualitative content analysis of open-ended responses. Data were collected from October 2023 through January 2024, capturing graduates (n = 1,597) from the 2022-2023 academic year. Results: Significant relationships were found between variables related to the presence/absence of social capital and having a happy and healthy working environment. Significant differences in group means were identified in the length of time new nurses intended to stay in their positions. Main factors influencing nurses\u27 decisions to accept a job were ranked. Conclusion: Enhancing structural, relational, and cognitive aspects of social capital in the workplace can contribute to a positive, healthy, and happy work environment. New graduates who were supported and working in a happy and healthy environment were more likely to remain in their positions longer. A well-structured nursing residency program could help improve retention rates. Nursing Implication: Understanding the impact of social capital on the recruitment and retention of nurses is essential for developing effective strategies to combat the nursing shortage and foster a positive work environment. Identifying factors contributing to a healthy workplace is crucial for prioritizing initiatives and allocating resources to ensure that nurses receive adequate support and feel prepared. Encouraging social interactions and relationships creates valuable networks to support the transition to practice
Combining Organizational Assessment and Evidence-Based Strategies to Address Incivility in Nursing
No full textThe workplace environment in healthcare is complex and negatively influenced by an increasing pattern of incivility. Recent reports of the increasing prevalence of incivility and related disruptive behaviors within nursing academic and clinical settings are alarming. Incivility threatens the sense of belonging needed to support and nurture the development of nursing students in the profession, and significantly impacts the work performance of front-line healthcare workers, contributing to medical errors and poor patient outcomes (Patel et al., 2022). Nurses and nursing students must be well equipped to effectively address incivility in the workplace and promote the collaboration necessary to optimize patient safety (Clark, 2019).Multiple evidence-based strategies are available to improve communication and teamwork skills to address incivility and improve safety and quality of care. These include (a) cognitive rehearsal (Griffin & Clarke, 2014; Patel et al., 2022), which supports being well-prepared, speaking confidently, and using respectful expressions to address incivility and empower nurses to break the silence of incivility and oppression; and (b) Team Strategies and Tools to Enhance Performance and Patient Safety (Team-STEPPS), a proven evidence-based teamwork system to improve communication, teamwork skills, and the patient safety culture among healthcare providers, as well as patient outcomes (Mohsen et al., 2021).
The purpose of this study was to assess the work environment and identify strengths, needs and areas of concern within a single organization using the Clark Healthy Workplace Inventory. The results revealed an organization’s culture that fostered consistent implementation of good team communication horizontally and vertically across the healthcare organization is warranted to help tackle incivility in the academic and clinical settings.
Relevant to nursing education and practice, nurses and nursing students must be well equipped to effectively address incivility in the workplace and promote the collaboration necessary to optimize patient safety (Clark, 2019). Despite the challenges posed by increased incivility in the healthcare workplace, assessment and multidisciplinary strategies can help reduce incivility and bullying. It is imperative that leadership across healthcare organizations and systems collaborate to eradicate horizontal and vertical violence in the healthcare workplace
Healthy Work Environments: Introduction to the Standards
No full textCreating a healthy work environment (HWE) is now more important than ever. Substantial evidence exists demonstrating the impact of HWEs on nurse/healthcare team, patient, and organizational outcomes. This session focuses on the importance of HWEs and highlights ways to operationalize AACN’s six HWE standards to better achieve and sustain them. An interactive exercise will be offered for practical application of the standards