The long-term impact of COVID-19 on nursing: An e-panel discussion from the International Network for Child and Family Centred Care.

AIM: To explore the International Network for Child and Family Centred Care (INCFCC) members' experiences and views on the long-term impact of COVID-19 on the nursing workforce. BACKGROUND: On the 11 March 2020, the World Health Organization declared COVID-19 a global pandemic. While some countries adopted a herd immunity approach, others imposed stricter measures to reduce the transmission of the virus. Hospitals in some countries faced an avalanche of extremely sick admissions, whereas others experienced an early surge in cases or were able to control the spread. DESIGN: Discursive paper. METHODS: A web-based survey was e-mailed to 63 INCFCC members from 28 March to 30 April 2022, as an invitation to share their experience concerning the long-term impact of COVID-19 on their role as a nurse educator, clinician or researcher. RESULTS: Sixteen members responded, and the responses were grouped under the themes stress and anxiety, safe staffing and pay, doing things differently, impact on research, impact on teaching and learning, impact on clinical practice, nursing made visible and lessons for the future. CONCLUSION: The INCFCC members provided their views and highlighted the impact on their role in nursing education, administration, research and/or practice. This discussion of international perspectives on the similarities and differences imposed by COVID-19 found that the impact was wide-ranging and prolonged. The overarching theme revealed the resilience of the participating members in the face of COVID-19. RELEVANCE TO CLINICAL PRACTICE: This study highlights the importance of all areas of nursing, be it in academia or in clinical practice, to work together to learn from the present and to plan for the future. Future work should focus on supporting organizational and personal resiliency and effective interventions to support the nursing workforce both during a disaster and in the recovery phase. Nursing workforce resilience in the face of COVID-19.

First Job Workplace Stressors for New Nurse Graduates in Their Own Words: A Secondary Analysis.

AIM: The purpose of this study was to have a better understanding of the experiences of new nurse graduates in their work environment and the perceived stressors during their transition into the role of registered nurse. BACKGROUND: The National Student Nurses' Association conducts an annual survey of all its members who are new graduates in the months following graduation. METHOD: The study used a qualitative design on a sample of 1,456 responses. Participants provided typed-in responses. Responses were sorted and coded using constant comparison method. Three independent judges aggregated interpretations through consensus. RESULTS: The themes that emerged were related to respondents' attempts to find balance and reflected the stress of the environment, expectations on self, and interactions with others that affected them. CONCLUSION: New graduates describe their transitions to the role of new nurse in words that suggest that their workplace environments are extremely stressful.

Psychometric Testing of Family Centered Care (FCC) Instrument: A Mixed Methods Analysis of Pediatric Nurses and Their Workplace Perceptions of FCC.

BACKGROUND/PURPOSE: Family-Centered care (FCC) is a model used in pediatric healthcare delivery wherein planning care for children incorporates the family, but questions remain whether there has been effective FCC implementation in practice. The purpose of this study was to examine the importance of FCC to pediatric nurses and their view of their organizations' support of FCC implementation. METHOD: A survey with FCC descriptor statements was distributed electronically to the Society of Pediatric Nurses. Direct care nurses (N = 132) responded to demographic questions including their education level and organization size, and 26 items rating the importance of elements of FCC in their care (as it applies to themselves) and in their organizations (as it applies to their hospital or organization) using a 5-point Likert scale. Open ended questions supplemented the survey to yield narrative comments to triangulate the findings. RESULTS: The nurses' personal responses and their rating of their organizations were analyzed separately. The Cronbach alphas were 0.867 and 0.938, respectively. Factor analyses revealed the same three factors in the two foci of questions for (a) the nurse's own practice and (b) the organization's support of FCC: Philosophy of FCC, Implementation of FCC and Environment Variations of FCC. A qualitative process of narrative analysis added support to the factors with clarity in thematic triangulation. Additionally, there was a significant difference in the mean scores between nurses' personal responses and the mean scores for their organizations for all three factors (p = .000) and for self-reported FCC by nursing education to validate the utility of the tool. CONCLUSIONS: This instrument quantified the importance of FCC to pediatric nurses and their workplace support of FCC and can be used in future studies to evaluate FCC.

Ethical Dilemmas for Nursing Students and Faculty: In Their Own Voices.

AIM: The aim of this national study was to explore student and faculty personal experiences of ethical dilemmas in nursing education and clinical practice. BACKGROUND: Nurses encounter complex ethical dilemmas in practice that can lead to moral distress when they cannot "do the right thing" because of external constraints. METHOD: A mixed-methods study via online survey was conducted on senior nursing student members and faculty advisors of the National Student Nurses Association. Over 1,600 students and 600 faculty answered a "two-minute survey" with the question: "Please describe an ethical dilemma you have experienced." RESULTS: Descriptive statistics demonstrated a difference in student and faculty reports about the ethics content they received. The qualitative results from constant comparison of open-ended questions also supported differences in themes from student and faculty perspectives. CONCLUSION: This study supports that students and faculty voice their concerns with different ethical dilemmas in their nursing education experiences.

How is Family Centered Care Perceived by Healthcare Providers from Different Countries? An International Comparison Study.

UNLABELLED: Family-centered care (FCC) is a healthcare delivery model in which planning care for a child incorporates the entire family. The purpose of this study was to describe and compare how healthcare providers from three countries with varied cultural and healthcare systems perceive the concept FCC by measuring attitudes, and to psychometrically identify a measure that would reflect "family-centeredness." DESIGN AND METHODS: The Working with Families questionnaire, translated when appropriate, was used to capture participants' perceptions of caring for hospitalized children and their parents from pediatric healthcare providers in the United States, Australia and Turkey (n=476). RESULTS: The results indicated significantly more positive attitudes reported for working with children than parents for all countries and individual score differences across countries: the U.S. and Turkey child scores were significantly higher than Australia, whereas the U.S. and Australia parent scores were both significantly higher than Turkey. CONCLUSIONS: Perceptions of working with families were different for nurses from the three countries that call for a clearer understanding about perceptions in relation to delivery systems. Further analyses revealed FCS scores to be significantly different between nurses and physicians and significantly correlated with age, number of children and education. PRACTICE IMPLICATIONS: The results of this study add to our understanding of influences on practice from different countries and healthcare systems. The FCS score may be useful to determine baseline beliefs and ascertain effectiveness of interventions designed to improve FCC implementation.

The relationship of obesity and weight gain to childhood teasing.

This article examines the relationship between weight gain and childhood teasing in children. Anthropometric data and self-reported teasing experiences were collected on a sample of second and third graders at a local elementary school in a disadvantaged suburban community. The study model uses bio-ecological development theory in which child development is understood in context: the child's physical characteristics influence the social environment, which interact and influence the behaviors that result in physical development and characteristics such as weight gain. Results suggest that teasing influences BMI change and that the relationship is more complex than simply stating that obese children are teased.

Predictors of mental illness stigma and attitudes among college students: using vignettes from a campus common reading program.

Research has demonstrated that stigmatizing mentally ill individuals is prevalent and often results in lack of adherence to or avoidance of treatment. The present study sought to examine attitudes of college students regarding mental illness as part of a campus-wide "common readings" program. The book selected was a non-fiction account of a young girl with mental illness and the program was developed to initiate dialogue about young people with mental problems. Faculty from multiple disciplines collaborated on the project. A sample of 309 students completed a web-based survey after reading a vignette about an adolescent girl with mental illness. The vignette description was based on a character in the book selected in the program. The instruments measured attribution of stigma, social distance, and familiarity with people who have mental illness. Results demonstrated that younger students and those who are less familiar with mental illness were more likely to stigmatize and maintain social distance from those who are mentally ill. Awareness of the study findings can assist health professionals and mental health workers to identify interventions that can decrease stigma. Psychiatric mental health nurses are well positioned to lead the education effort aimed at reducing stigmatizing attitudes among the public.

Nursing Student Loan Debt: A Secondary Analysis of the National Student Nurses' Association Annual Survey of New Graduates.

The purpose of this study is to describe nursing student loan debt and financial choices from a secondary analysis of the National Student Nurses Association Annual New Graduate Survey. The findings in the secondary analysis show loan debt incurred by nursing students comparable to loan debt reported recently for all new college graduates in general. However, comparing types of programs and types of schools yielded clear variations. More than one-third of new graduates who reported having loans to repay were unemployed; more than one-quarter of those who worked part-time and one-quarter of those who worked full-time to finance their education were unemployed; and almost one-third of students whose parents had paid for their education were unemployed. New graduates from for-profit schools were more likely to report they had accumulated high debt to pay for school than all new graduates combined. Nursing students enter the job market with substantial financial debt that may impact their future. Educators and policymakers need to address these growing concerns to sustain a healthy supply of nurses.

Toward developing consensus on family-centred care: An international descriptive study and discussion.

Nurses around the world have described family-centred care (FCC) in various ways. With limited evidence regarding its implementation and with dissent among professionals regarding outcomes that are amorphously defined across age groups, systems and global settings, a group of children's nursing experts from around the world collaborated to seek clarification of the terms, deconstruct the elements in the model and describe empirically a consensus of values toward operationally defining FCC. A modified Delphi method was used drawing on expert opinions of participants from eight countries to develop a contemporary and internationally agreed list of 27 statements (descriptors of FCC) that could form the foundation for a measure for future empirical psychometric study of FCC across settings and countries. Results indicated that even among FCC experts, understandings of FCC differ and that this may account for some of the confusion and conceptual disagreement. Recommendations were identified to underpin the development of a clearer vision of FCC.

Testing a bedside personal computer Clinical Care Classification System for nursing students using Microsoft Access.

This study tested a personal computer-based version of the Sabacare Clinical Care Classification System on students' performance of charting patient care plans. The application was designed as an inexpensive alternative to teach electronic charting for use on any laptop or personal computer with Windows and Microsoft Access. The data-based system was tested in a randomized trial with the control group using a type-in text-based-only system also mounted on a laptop at the bedside in the laboratory. Student care plans were more complete using the data-based system over the type-in text version. Students were more positive but not necessarily more efficient with the data-based system. The results demonstrate that the application is effective for improving student nursing care charting using the nursing process and capturing patient care information with a language that is standardized and ready for integration with other patient electronic health record data. It can be implemented on a bedside stand in the clinical laboratory or used to aggregate care planning over a student's clinical experience.

Advancing the Development of the Guidelines for the Nursing of Children, Adolescents, and Families: 2014 Revision: Process, Development, and Dissemination.

This article details the process used to develop the revision of the original Guidelines that resulted in the development of the 2014 Health Care Quality and Outcomes Guidelines for Nursing of Children, Adolescents, and Families. Members of the 2014 Guidelines Revision Task Force conducted an extensive process of revision, which included the input and approval of 16 pediatric and child health nursing and affiliated organizational endorsements. The revised Guidelines were presented to and endorsed by the American Academy of Nursing Board. These Guidelines are designed for use by pediatric and child health nurses who work in a range of health care and community-based settings. The Guidelines are proposed to be used as a framework for nurse-directed services and intervention development and testing, as a model for undergraduate and graduate pediatric and child health nursing program curriculum development, and as the theoretical basis for nursing investigations on the care of children, adolescents, and families.

Exploratory study on end-of-life issues: barriers to palliative care and advance directives.

BACKGROUND: In the United States, as in most developed countries, death is rarely unexpected. It usually occurs in older persons with chronic progressive illnesses that often are complicated by infections or exacerbations. Many patients with terminal illnesses choose palliative care to relieve symptoms, improve the quality of their lives, and strive for a peaceful death. Professionals who serve dying patients need to recognize the importance of advance directives as part of a patient's decision to forgo curative treatment for palliative care. OBJECTIVES: SOLACE (Supporters of Life-Affirming Care at End of Life) is a coalition of interdisciplinary professionals in the northern Virginia community dedicated to improving end-of-life care. The objectives of the SOLACE survey were to identify and describe: 1) professionals' perceptions about barriers related to hospice and palliative care, 2) professionals' opinions about barriers related to dying at home, 3) professionals' perceptions about barriers related to advance directives, and 4) relationships between professionals and their perceived barriers to advance directives and hospice and palliative care. METHODS: From several consultations with hospice experts, a survey questionnaire was developed to solicit responses from professionals on palliative care, dying at home, and advance directives. Measures that assessed obstacles to palliative care were modified from previous studies to yield composite barrier scores. From a sample of a variety of participants at a national conference on palliative care (n = 200), 101 subjects returned questionnaires (51 percent) yielding 100 usable completed forms from attendees who demonstrated an interest in palliative care and, in some cases, a high level of personal or professional experience. Survey results were analyzed on respondents' perceptions concerning barriers related to advance directives and the delivery of palliative care. RESULTS: Of the 13 obstacle statements, results show that respondents rated the top three barriers as 1) physician reluctance to make referrals (mean = 4.23), 2) physician lack of familiarity with availability and suitability of hospice (mean = 3.93), and 3) association of hospice with death (mean = 3.93). There was a statistically significant difference in scores for respondents from hospitals and respondents from hospices on their assessment of barriers for the association of hospice with death (t = -2.09, p < .05) and the lack of information about the severity of or irreversibility of the patients illness (t = -2.78, p < .01).

Development and testing of a CD-ROM based tutorial for nursing students: getting ready for HIPAA.

The purpose of this study was to develop and test a CD-ROM tutorial for nursing students to educate them on how the rules and regulations of the Health Insurance Portability and Accountability Act (HIPAA) affect them as they engage in patient care activities in hospitals. The project was completed in two parts, the first of which was production of a stand-alone, audio lecture, image and text self-instruction on CD-ROM to distribute to students as they began their clinical experience. The second part compared the effectiveness of learning the HIPAA content via CD-ROM to a text-directed, self study method. Students were pretested and randomly assigned to one of the types of instruction based on their seminar group assignment. One group received the CD-ROM, Getting Started with HIPAA, along with a journal article on HIPAA, while the other (control) group received only the journal article. All students were instructed to prepare for a test on their understanding about HIPAA by the end of the clinical rotation. The test was analyzed, and items clarified to yield a reliable Web-based examination with 20 questions, 18 of which were used in the analysis. The students' scores were analyzed before and after the instruction, and the methods of instruction were compared. The study findings demonstrated significant differences between experimental-group and control-group students' performance on a knowledge test of HIPAA, as well as overall satisfaction with learning the material by CD-ROM among students who used it. The tutorial is now available for all students, and the Web-based examination provides automatic scoring to a preestablished competence level.