Guidelines to support newly qualified professional nurses for effective clinical practice.

BACKGROUND:  Transitioning to a professional role is difficult for newly qualified professional nurses. Given the challenges that these nurses experience during the transition to practice, support is essential for them to become efficient, safe, confident, and competent in their professional roles. OBJECTIVES:  The purpose of this study was to explore the transition experiences of newly qualified professional nurses to develop a preceptorship model. METHOD:  This study employed a qualitative approach to purposively collect data. Concept analyses were conducted applying the steps suggested by Walker and Avant, and the related concepts were classified utilising the survey list of Dickoff, James and Wiedenbach's practice theory. RESULTS:  A preceptorship model for the facilitation of guidance and support in the clinical area for newly qualified professional nurses was developed. The model consists of six components, namely, the clinical environment, the operational manager and preceptor, the newly qualified professional nurse, the preceptorship, the assessment of learning, and the outcome. CONCLUSION:  The study revealed that newly qualified professional nurses face many transition challenges when entering clinical practice. They are thrown far in, experience a reality shock, and are not ready to start performing their professional role. The participants agreed that guidance and support are needed for their independent practice role.Contribution: The preceptorship model for newly qualified professional nurses would be necessary for the transition period within hospitals. This preceptorship model may be implemented by nursing education institutions as part of their curriculum to prepare pre-qualifying students for the professional role.

Using Simulation to Teach Gender-Affirming Care Concepts in Nursing Education.

BACKGROUND: LGBTQIA+ (lesbian, gay, bisexual, trans-gender, queer or questioning, intersex, asexual), and gender-nonconforming (GNC) individuals have limited access to quality care, leading to health disparities. Lack of training and implicit bias are significant contributors to discrimination. Nursing schools must provide opportunities for student interaction with vulnerable populations, and interacting with transgender and GNC individuals during clinical experiences may be challenging. METHOD: Simulated experiences offer opportunities for students to develop clinical competencies. Students participated in a simulation on caring for transgender and GNC populations. Students participated in a prebriefing session, viewed a simulation video, and engaged in a debriefing session. Participants completed a pre- and postsurvey to assess their knowledge and perceived confidence. RESULTS: Students' confidence in providing gender affirming care was improved by the activity. CONCLUSION: Students prioritize providing competent care to vulnerable populations. In-class simulation is an effective method for improving students' clinical competencies in a safe, nonjudgmental setting. [J Nurs Educ. 2024;63(4):241-246.].

Creating Structures to Support Quality Matters Certification Within a School of Nursing.

BACKGROUND: Best practices for online course design aim to improve teaching and learning by emphasizing the relationship between a course's learning outcomes and all other parts of the course, from assessments to technology to student interaction with peers and instructors. The transition and expanded opportunities to online or hybrid learning in nursing education demonstrate the need for quality online learning experiences. METHOD: A university initiative to ensure high quality remote courses focused on expanding Quality Matters (QM) certification of hybrid and online courses, which ensures that a course has been developed according to standards for online learning. RESULTS: Currently, 20 courses within a school of nursing are QM certified with 4 more actively preparing for formal review this academic year. CONCLUSION: This experience can aid schools to develop faculty competencies in evidence-based, online navigation and course design, and systematically improve the online learning experiences for all students. [J Nurs Educ. 2024;63(4):205-211.].

Final-year nursing students' perceptions of humanistic education in nursing: a cross-sectional descriptive study.

BACKGROUND: Humanistic education is an important part of nursing education. Final-year nursing students' perceptions of nursing humanistic education are under-investigated. This study aimed to examined final-year nursing students' perceptions of nursing humanistic education in both school and hospital. METHODS: This was a cross-sectional descriptive study conducted from May to June 2022 among 107 final-year nursing students with a self-designed questionnaire. RESULTS: Final-year nursing students recognized the importance of humanistic education, scoring above 4.0 on a 1-5 scale, while their initiative to enhance humanistic qualities was relatively low. Students' satisfaction with the number of humanities courses offered was only 3.7 ± 0.862. Moreover, 62.6% of students believed there was a need to enhance humanistic environmental development including corridor culture. The "monotonous teaching format" (63.6%) and "teaching methods" (64.5%) have emerged as focal points that students identified as needing attention and improvement. CONCLUSIONS: In the future, nursing humanistic education can be enhanced by increasing the proportion of humanities, improving teaching methods, stimulating students' learning motivation, and strengthening the construction of humanistic environment.

Violencia en el lugar de trabajo desde la percepción de profesionales de enfermería en un servicio de emergencia pediátrica / Violence in the workplace from the perception of nursing professionals in a pediatric emergency service

Introducción: Los profesionales de la salud tienen un mayor riesgo de sufrir lesiones físicas, sexuales o psicológicas debido a la violencia en el lugar de trabajo ocupando su rol al brindar cuidados de salud hacia el paciente pediátrico en casos de Emergencia. Los incidentes en los que el profesional es abusado, amenazado o agredido en las circunstancias relacionadas con su trabajo implican un desafío explícito o implícito a su seguridad, bienestar o salud. Objetivo: Explorar la percepción de profesionales de enfermería sobre la violencia laboral en el desempeño y ejecución de actividades orientadas al cuidado de salud de Enfermería en la Emergencia Pediátrica. Método: Investigación cualitativa de diseño fenomenológico, el estudio se realizó en profesionales de Enfermería del servicio de Emergencia Pediátrica con una muestra de 32 participantes, distribuidas en 4 grupos focales. Se diseñó una guía de preguntas semiestructuradas sobre los aspectos percibidos en el ámbito del trabajo del profesional que fueron recopiladas mediante archivos de voz y notas de campo, los resultados fueron analizados identificando las fuentes de la violencia en el lugar de trabajo. Resultados: Con la recopilación de datos de los participantes, la investigadora principal analizará la forma en que se presenta la violencia laboral desde la percepción de profesionales de Enfermería determinando los riesgos presentes para brindar recomendaciones y diseñar un plan de acción que ayuda a prevenir la violencia. (AU)

Introduction: Healthcare professional face a higher risk of experiencing physical, sexual, or psychological injuries due to violence in the workplace fulfilling their role in providing health care to a pediatric patient in emergency cases. Incidents where professionals are abused, threatened, or assaulted in circumstances related to their work pose an explicit or implicit challenge to their safety, well-being, or health.Objective: To explore the perception of nursing professionals regarding workplace violence in the performance and execution of healthcare activities in Pediatric Emergency Nursing. Method: Qualitative research with a phenomenological design. The study was conducted among nursing professionals in the Pediatric Emergency Service, with a sample size of 32 participants divided into 4 focus groups. A semi-structured questions were designed to gather perceptions about various aspects of their work, that were collected through voice recordings and field notes. The results were analyzed to identify the sources of violence in the workplace. Results: Through the data collected from the participants, the lead researcher analyzed the manifestation of workplace violence as perceived by nursing professionals. This analysis determined the existing risks and provided recommendations for designing an action plan to prevent violence. (AU)

Retiro no electivo del Catéter Central de Inserción Periférica: estudio transversal / Remoção não eletiva do Cateter Central de Inserção Periférica: estudo transversal / Non-elective removal of Peripherally Inserted Central Catheter: cross-sectional study

Introducción: El catéter central de inserción periférica es un dispositivo intravenoso que se ha vuelto cada vez más necesario por sus numerosos beneficios, especialmente en los niños.Objetivo: Describir la prevalencia y causas de retiros no electivos de Catéteres Centrales de Insertación Periférica insertados en una Unidad de Cuidados Intensivos Pediátricos. Métodos: Se trata de un estudio transversal, con enfoque cuantitativo, realizado en una Unidad de Cuidados Intensivos Pediátricos de un hospital universitario de Natal, Rio Grande do Norte, entre enero de 2017 y diciembre de 2019. Los datos se obtuvieron del libro de registro de catéteres presentes en el sector de estudio. Resultados: Se observó una alta tasa de retiros no electivos de este catéter en los años estudiados: 56,6%, 41,6% y 40% respectivamente, destacándose, en todos los años, la obstrucción como la principal complicación que provocó su retiro, seguida de la rotura y la tracción. Conclusiones: Identificar las principales complicaciones y capacitar al equipo de enfermería en estrategias preventivas son acciones que apuntan a reducir esta prevalencia.

Introdução: O cateter central de inserção periférica é um dispositivo intravenoso que vem se mostrando cada vez mais necessário diante dos inúmeros benefícios, sobretudo para as crianças. Objetivo: Descrever a prevalência e causas de remoções não eletivas dos Cateteres Centrais de Inserção Periférica inseridos em uma Unidade de Terapia Intensiva Pediátrica. Enfermería GlobalNº 74 Abril 2024Página 317Métodos: Trata-se de um estudo transversal de abordagem quantitativa, realizado em uma Unidade de Terapia Intensiva Pediátrica de um hospital de ensino de Natal, Rio Grande do Norte, entre janeiro de 2017 e dezembro de 2019. Os dados foram obtidos do livro de registro de cateteres presente no setor do estudo. Resultados: Observou-se elevado índice de remoções não eletivas desse cateter nos anos estudados: 56,6%, 41,6% e 40% respectivamente, destacando-se, em todos os anos, a obstrução como a principal complicação que causou a retirada, seguida de ruptura e tração. Conclusões: Identificar as principais complicações e capacitar a equipe de enfermagem sobre estratégias preventivas são ações que visam obter uma redução dessa prevalência. (AU)

Introduction: Peripherally Inserted Central Catheter is an intravenous device that has become increasingly necessary due to its numerous benefits, especially for children.Objective: Describing the prevalence and causes of non-elective removals of Peripherally Inserted Central Catheters inserted in a Pediatric Intensive Care Unit. Methods: This is a cross-sectional study, with a quantitative approach, conducted in a Pediatric Intensive Care Unit of a teaching hospital in Natal, Rio Grande do Norte, between January 2017 and December 2019. Data were obtained from the record book of catheters present in the study sector. Results: A high rate of non-elective removals of this catheter was observed in the studied years: 56.6%, 41.6% and 40%, respectively, highlighting, in all years, obstruction as the main complication that caused removal, followed by rupture and traction.Conclusions: Identifying the main complications and training the nursing team on preventive strategies are actions aimed at reducing this prevalence. (AU)

Trayectorias académicas de estudiantes de la Licenciatura en Enfermería de la Universidad Nacional de Tucumán a través del análisis de indicadores de rendimiento académico / Academic trajectories of nursing students at the National University of Tucumán through the analysis of academic performance indicators

Introducción: En Argentina la formación en enfermería muestra avances, pero aún no mejora el déficit cuantitativo del colectivo, ni la distribución por regiones. El análisis de las trayectorias académicas permite identificar el recorrido realizado por el estudiante en el plan de estudios y planificar instancias remediales para los aspectos que se consideren deficitarios.Objetivo: Analizar las trayectorias académicas de los estudiantes de la Licenciatura en Enfermería de la Universidad Nacional de Tucumán a través del análisis de indicadores de rendimiento académico en el periodo 2015-2019.Métodos: Estudio descriptivo, retrospectivo y cuantitativo. La población estuvo constituida por el total de estudiantes de la carrera Licenciatura en Enfermería en el período 2015-2019.Resultados: El promedio de calificaciones de la carrera es 6,35 de 10 y el promedio de duración real de la misma es de 13,35 años superando los 5 años de duración esperada. Se halló un índice de desaprobación y aplazos en el 57% de las materias del primer ciclo y el 38% del segundo.Conclusión: El rendimiento académico de las/os estudiantes de enfermería disminuyó en las últimas décadas, y esto se visibiliza en el descenso de los promedios de calificaciones y el incremento en la duración real de la carrera. Estos resultados muestran el desacople existente entre las trayectorias académicas de las/os estudiantes de enfermería, en relación con las esperadas por el sistema.(AU)

Introduction: In Argentina, nursing education shows progress, but it still does not improve the quantitative deficit of the group, nor the distribution by regions. The analysis of academic trajectories makes it possible to identify the path taken by the student in the study plan and to plan remedial measures for those aspects considered deficient. Objective: To analyze the academic trajectories of students of the bachelor’s degree in nursing at the National University of Tucumán, through the analysis of academic performance indicators in the period 2015-2019.Methodes: Descriptive, retrospective, and quantitative study. The population was constituted by the total number of students of the bachelor’s degree in nursing in the period 2015-2019.Results: The average GPA of the career is 6.35 out of 10 and the average actual duration of the career is 13.35 years, exceeding the expected duration of 5 years. A failure rate was found in 57% of the subjects of the first cycle and 38% of the second cycle.Conclusions: The academic performance of nursing students has decreased in the last decades, which can be seen in the decrease of the grade point average and the increase of the actual duration of the course. These results show the existing decoupling between the academic trajectories of nursing students in relation to those expected by the system.(AU)

Relationship between skin-to-skin contact during the first hour of life and duration of exclusive breastfeeding.

BACKGROUND: Exclusive breastfeeding (BF) has the greatest potential impact on child mortality of any preventive intervention. Skin-to-skin contact (SSC) during the first hour of life is beneficial for initiating BF; however, routine separation of mother and infant is still common. This work aimed to demonstrate that SSC during the first hour of life is associated with a greater frequency and duration of exclusive BF. METHODS: This is an observational case-control study. We reviewed the medical records of patients born between 2016 and 2022 classified as cases or controls based on the history of SSC in the first hour of life. Statistical analysis was performed using SPSS version 28. RESULTS: We included 362 medical records, of which 200 (55.2%) had SSC and were considered cases; the 162 (44.8%) who did not have SSC were considered controls. Those who received SSC were more likely to receive exclusive BF at 3 (163 [81.5%] vs. 94 [58%], p < 0.001) and 6 months of age (147 [73.5%] vs. 83 [51.2%], p < 0.001). CONCLUSIONS: Patients who received SSC in the first hour of life were more likely to receive exclusive BF at 3 and 6 months of age. Promoting and respecting this practice is essential to increase the possibility of a newborn to be exclusively breastfed for the first 6 months of life.

INTRODUCCIÓN: La lactancia materna exclusiva (LME) es la intervención preventiva con mayor impacto en mortalidad infantil. El contacto piel con piel (CPP) durante la primera hora de vida es un periodo crítico para establecer la lactancia; sin embargo, la separación rutinaria del recién nacido de su madre es frecuente. El objetivo de este trabajo fue demostrar que el CPP durante la primera hora se asocia con mayor frecuencia y duración de LME. MÉTODOS: Se llevó a cabo un estudio observacional de casos y controles. Se revisaron expedientes de pacientes de nuestra consulta pediátrica que nacieron entre 2016 y 2022. Se clasificaron como casos y controles de acuerdo con el antecedente de haber recibido CPP durante la primera hora de vida. Se realizó el análisis estadístico en SPSS version 28. RESULTADOS: Se incluyeron 362 expedientes, de los cuales 200 (55.2%) recibieron CPP en la primera hora de vida y fueron considerados casos; los 162 (44.8%) que no lo hicieron fueron considerados controles. Aquellos que recibieron CPP tuvieron con mayor frecuencia LME a los 3 (163 [81.5%] vs. 94 [58%], p < 0.001) y 6 meses de edad (147 [73.5%] vs. 83 [51.2%], p < 0.001). CONCLUSIONES: La frecuencia con la cual los pacientes lograron tener lactancia materna exclusiva a los 3 y 6 meses es mayor en aquellos en los que se respeta el CPP en la primera hora de vida. Promover y respetar esta práctica es fundamental para incrementar las probabilidades de que los lactantes reciban LME durante sus primeros 6 meses de vida.

Social Responsibility and Commitment to Children; Pediatric Nurses' Experiences With Redeployment During the First Wave of COVID-19: A Qualitative Study.

COVID-19 represented a challenge for health care worldwide and led to new tasks and a rethinking of resource use. It was necessary to establish capacity within hospitals and to reassign critical resources between hospitals. This study aimed to explore pediatric nurses' experiences of redeployment, new tasks, and use of specialized competencies during the first wave of COVID-19. An exploratory design, involving qualitative individual interviews with 12 pediatric nurses was used. The analysis resulted in 3 main themes. Firstly, a feeling of social responsibility focused on how pediatric nurses felt committed to use their competencies during the crisis, whether they remained on the pediatric ward or were redeployed. Secondly, fewer children to counterbalance the shortage of pediatric nurses showed how redeployment was offset by fewer pediatric patients. Thirdly, adapting pediatric nursing competencies to new tasks described how the nurses adapted their skills to new tasks either in pediatric or adult wards. The results revealed that pediatric nurses had a social and ethical commitment to society in a crisis. They agreed to be redeployed and take on new tasks but were still concerned about the health and well-being of the children and their families, which led to a sense of ambivalence. They questioned whether their skills were being used appropriately in redeployment to adult wards. Fewer pediatric patients mitigated the workload of the remaining nurses. There is a risk of neglecting the needs of hospitalized children and their families during a pandemic. There was concern that "voluntary coercion" was a counterproductive strategy for reassignment.

Perceived self-efficacy to teach comprehensive abortion care among nursing and midwifery faculty in higher learning institutions in Rwanda: A mixed method study.

INTRODUCTION: Comprehensive abortion care is an emerging intervention being integrated into nursing and midwifery curricula. Yet, no studies have been conducted in Rwanda to determine whether faculty perceive themselves as capable of teaching comprehensive abortion care. This study aims to evaluate the perceived self-efficacy to teach comprehensive abortion care among nursing and midwifery faculty in higher learning institutions in Rwanda. MATERIALS AND METHODS: The University of Rwanda College of Medicine and Health Sciences Institutional Review Board approved this study (UR-CMHS-IRB No 335/CMHSIRB/2022). In quantitative, a self-administered questionnaire was administered to 98 study participants. Data were entered into Statistical Package for the Social Sciences (SPSS) version 26 and analyzed using Chi-square test with a p-value of 0.05 set as the significance level. In the qualitative part, an interview guide was developed based on quantitative data to understand comprehensive abortion care teaching fully. Data were collected from four focus group discussions with eight participants in each group, entered in Dedoose, and analyzed thematically. RESULTS: Among the 98 study participants who were invited to participate in this study, only 85 filled out the questionnaires. This translates into 86.7% of the response rate. More than half 58.8% had adequate self-efficacy in teaching comprehensive abortion care. A Chi-square test has revealed that being a male, being a midwife, and having more years of working experience in nursing education were significantly associated with self-efficacy in teaching comprehensive abortion care (p value <0.05). In the qualitative phase, 32 study participants participated in four focus group discussions and four themes were identified: a) variability in confidence levels to teach comprehensive abortion care; b) readiness about teaching comprehensive abortion care; c) facilitators of teaching comprehensive abortion care; and d) contextual challenges to teach comprehensive abortion care. CONCLUSIONS: The findings revealed that faculty's self-efficacy in teaching comprehensive abortion care was not adequate. Personal and religious beliefs and institutional barriers were also reported to hinder self-efficacy in teaching comprehensive abortion care. Therefore, intensive comprehensive abortion care training for nursing and midwifery faculty in higher learning institutions should be provided, including values clarification and attitude transformation training for attitudes and beliefs. It is also critical for higher learning institutions to develop strategies for overcoming the challenges faculty face when teaching comprehensive abortion care.

The effects of using a flipped classroom pedagogy in nursing anesthesia education: a program evaluation.

BACKGROUND: The flipped classroom (FC) pedagogy improves undergraduate student proficiency and satisfaction. However, its effectiveness has not been demonstrated in nursing anesthesia education. OBJECTIVES: Pre- and post-FC tests and course evaluations were retrospectively compared to determine if FC was an effective pedagogy for a nursing anesthesia program (NAP). METHODS: The design of the study was a retrospective program evaluation. Two groups were compared with 59 students in the pre-FC group taught via traditional lecture and 61 students in the post-FC group taught with FC. Answers to the same 167 test questions were compared using an independent t-test and five course evaluation questions were statistically compared using NPAR1WAY procedure with the Wilcoxon option to determine if significant differences existed between the two nursing anesthesia student cohorts. RESULTS: The post-FC students exhibited a significant 4 % increase in test scores and expressed increased satisfaction compared to their pre-FC counterparts. CONCLUSIONS: This retrospective program evaluation showed that student proficiency and satisfaction improved between the groups after changing to the FC pedagogy. However, research is needed to determine the true value of using FC in nursing anesthesia education. IMPLICATIONS FOR AN INTERNATIONAL AUDIENCE: The flipped classroom model can be beneficial in graduate nursing education with our ever-changing student population.

Online degree programmes in nurse education-Students' perceptions and academic performance: An integrative review.

OBJECTIVES: The aim of this integrative review is to identify, describe, and synthesise evidence regarding students' perceptions of online degree programmes in nurse education, their academic performance, and the factors associated with their academic performance. DESIGN: Integrative review. DATA SOURCES: Four databases, CINAHL, ERIC (Ebsco), PubMed/MEDLINE, and Web of Science were searched. The reference lists of included studies were reviewed to identify other relevant studies. REVIEW METHODS: Whittemore and Knafl's method was used as a guideline for the integrative review. Peer-reviewed studies describing students' perceptions of-or academic performance in-online degree programmes in nurse education were included in the review without time limitations. The quality of the selected article was assessed using the Mixed Method Appraisal Tool. RESULTS: Nursing students' perceptions of online degree programmes were categorised into enabling career development, content delivered online, and community belonging. Factors related to student's academic performance were associated with individual students and the characteristics of online learning environments. Factors associated with students' academic performance were individual self-direction, formal communication skills, and working and educational backgrounds. Factors associated with academic performance in an online learning environment were categorised into regular feedback and methods for learning. CONCLUSIONS: Online degree programmes in nurse education contribute to developing pedagogy through a satisfactory work-life balance, students' experiences of community and support, pleasant digital content, and various teaching methods by faculties. The study findings of this review have implications for educators to develop and adopt strategies for advancing digital environments with the pedagogy that supports community building to meet the needs of individual students.

The development and challenges of public health nursing education in China from 1912 to 1949: A historical study.

OBJECTIVE: To examine the development and challenges of public health nursing education in China during the period of the Republic of China (1912-1949). METHODS: This study utilized a historical research design that combined a social framework and a policy framework to explore the early history of public health nursing education in China. Historical data were collected from periodicals, newspapers, archives, books and other sources. RESULTS: Public health was integrated into the nursing school curriculum for the first time during the period of the Republic of China, and health facilities and nursing schools conducted early explorations of public health nurse training. However, public health nursing education faced difficulties in terms of the curriculum, personnel training, and the localization of education. CONCLUSIONS: The achievements and difficulties associated with public health nursing education in China during the period of the Republic of China provide a historical reference for the integration of public health into current basic nursing education and the compatibility between the training of public health nurses and practical needs. Comparative studies of early public health nursing education across countries are expected to offer a better understanding of current public health nursing education.

The effect of interactive learning method on nursing students' learning of movement requirement: A randomized controlled study.

BACKGROUND: Interactive learning is one of the active learning methods used to develop students' knowledge and skills. OBJECTIVES: This study was conducted to determine the effect of the interactive learning method with questions prepared according to Bloom's taxonomy on nursing students' learning of the need for movement. DESIGN: It is a randomized controlled study conducted in May 2023. PARTICIPANTS: This study was conducted with 134 first-year nursing students taking the Fundamentals of Nursing course. The students were randomly divided into control (n = 67) and experimental (n = 67). METHOD: The data was collected by using a form delineating descriptive characteristics, a test assessing the necessity of movement knowledge, an analysis of a specific case study, and an assessment form for gathering student opinions on interactive learning. The queries within the data collection form were tailored to align with Bloom's taxonomy. Following the theoretical instruction, each student participated in the mobility needs knowledge test and case analysis (pre-test). The instructional session for the control group involved conventional lecture-style teaching supplemented with a question-and-answer format, while the experimental group received instruction through an interactive learning approach. One week subsequent to this, all students retook the mobility needs knowledge test and case analysis (post-test). Subsequently, feedback regarding the interactive learning method was solicited from the students. RESULTS: The knowledge test revealed a statistically significant difference, with the control group exhibiting a higher median comprehension score in the post-test compared to the experimental group (p < 0.05). Regarding the case analysis, statistical analysis demonstrated that the experimental group surpassed the control group in median scores for comprehension, synthesis, and total scores, with a significant difference (p < 0.05). Additionally, most students expressed favorable opinions toward the interactive learning approach. CONCLUSIONS: It is recommended that studies on interactive learning be repeated in different subjects in nursing education. CLINICALTRIALS: gov ID:NCT05868278.

Enhancing nursing education for Indigenous students: Indigenous nursing students' insights and strategies.

BACKGROUND: Indigenous nursing students contended with far-reaching challenges during the pandemic that significantly altered their experiences of nursing education. These experiences are poorly understood by nursing educators and strategies for Indigenous nursing student success rarely involve the insights of current Indigenous nursing students. AIM: The aim of this article is to offer Indigenous-student derived recommendations regarding strategies for improving their experiences and success within nursing education during the pandemic and beyond. DESIGN AND METHODS: This qualitative study employed an Indigenous methodology including land-based learning, ceremony, and sharing circles. PARTICIPANTS AND SETTING: Indigenous nursing students (n = 17) from a Western Canadian school of nursing participated in one of three sharing circles. RESULTS: Indigenous nursing students recommended institutional and program adaptations along with increases to cultural safety for enhancing their experience in nursing education. Institutional and program strategies included: decreasing course loads and class sizes; an Indigenous-specific cohort; a transition program after course failure; increasing academic supports such as additional clinical skills and academic writing practice. Recommendations for increasing cultural safety included: mandatory and recurrent cultural safety training for faculty, staff and students; differential learning and evaluation strategies; and increased inclusion of Indigenous ceremonies and practices. CONCLUSION: The findings of this study provide insights that can help guide curriculum development, pedagogical approaches, and policy development to improve nursing education for Indigenous students.