New Paths to Professional Nursing: Using Encouragement to Prepare a Minority Workforce to Enter the Nursing Profession.

The current professional nursing workforce in the United States is predominantly White and female, even though minorities compose 33% of the national population (Travers, Smaldone, & Cohn, 2015). Minority patients are more effectively cared for when their particular cultural milieu is taken into consideration as part of their health care plan (Sullivan, 2004). According to the Agency for Healthcare Research and Quality (AHRQ), health care quality remains suboptimal for diverse populations in the United States because some individuals do not receive quality care or do not believe their values are honored or respected (AHRQ, 2016). Minority professional nurses are necessary to address the racial and ethnic disparities in health care. Robert Wood Johnson Barnabas Health (RWJBH), in collaboration with Rutgers University School of Nursing (RUSON), implemented New Paths to Professional Nursing (NPPN) to increase the number of minority professional nurses in practice at RWJBH. The program provided financial resources as well as infrastructural, group, and personal support for RWJBH minority employees who desired to complete prerequisites to enter RUSON. The academic success of the employees who participated in NPPN was attributed to a unique combination of financial assistance and support and encouragement. The purpose of this article is to describe in detail the development of the program and the effective encouragement strategies that have led to success for NPPN minority student/employees. This article examines, defines, and illustrates particular types of effective encouragement and suggests that this encouragement was the key to success for the NPPN minority students.

"It's a Burden You Carry": Describing Moral Distress in Emergency Nursing.

INTRODUCTION: Moral distress in nursing has been studied in many settings, but there is a paucity of research on moral distress as it manifests in the emergency department. One study suggests a correlation between moral distress and aspects of burnout, and other researchers report that nurses have considered leaving their position or even their profession because of moral distress. Further exploration of these issues may provide insight into their effects on ED patient care and the emergency nursing profession. The purpose of this study was to explore the nature of moral distress as it is experienced and described by emergency nurses. METHODS: A qualitative, exploratory design was employed using semi-structured focus groups for data collection. Using an iterative process, transcripts were analyzed for emerging themes by the research team. Six researchers analyzed the transcripts using a thematic analysis approach. RESULTS: Themes from the data included dysfunctional practice arena, being overwhelmed, and adaptive/maladaptive coping. Participants described, overall, a profound feeling of not being able to provide patient care as they wanted to. DISCUSSION: Causes of moral distress in emergency nurses are environment driven, not incident driven, as is described in other settings, and include a high-acuity, high-demand, technical environment with insufficient resources. Interventions should be targeted to improve environmental factors that contribute to the moral distress of emergency nurses. Future research should focus on the development and validation of an instrument to measure moral distress in this setting.

Exploring the Management of Death: Emergency Nurses' Perceptions of Challenges and Facilitators in the Provision of End-of-Life Care in the Emergency Department.

INTRODUCTION: The importance of end-of-life (EOL) care for dying patients and their families is well described; however, little research has been performed in emergency settings. The purpose of this study was to explore emergency nurses' perceptions of challenges and facilitators in the care of patients at the EOL. METHODS: A mixed-methods design using survey data (N = 1,879) and focus group data (N = 17). Data were collected on questions regarding care of the EOL patient in the emergency department, specifically nurses' perceptions of the care of these patients; educational content needs; barriers to safe and effective care; and the availability of resources. RESULTS: High scores on the quantitative survey showed a high mean level of consistently positive attitudes and beliefs toward caring for dying patients and their families and loved ones (131.26 ± 10.88). Analysis of the focus group transcripts uncovered 9 themes, reflecting concerns around comfort and challenges with EOL care, appropriate training for nurses, and the availability of resources to provide this type of care in the emergency setting. Also noted was dissonance between the nature of emergency care and the nature of EOL care. DISCUSSION: Emergency nurses are comfortable providing EOL care in the emergency setting but note that challenges to providing good care include lack of space, time, and staff. Other challenges involve the mismatch between the goals of emergency care and those of EOL care, as well as the emotional burden of caring for the dying, especially when the appropriate resources are lacking.

Are critical care nurses more likely to leave after a merger?

The relationship between perceptions of a healthy work environment and intent to transfer.