Development and implementation of a novel peer mentoring program for undergraduate nursing students.

OBJECTIVES: Given the dynamic and high-stress environment of nursing education today, the need arose for the development and implementation of a novel peer mentoring program to support undergraduate nursing students. Peer mentoring refers to a network of support in which a more skilled or experienced person serves as a role model for a less skilled person for professional development and personal growth. Peer mentoring provides a support system that encourages self-confidence and increases self-worth for both the mentee and the mentor. The undergraduate student peer mentoring program in a large, Southeastern United States, university-based, 4-year school of nursing was created in response to a desire for more support conveyed by upper-level nursing students. METHODS: A model was developed whereby each incoming nursing student (Semester 1) would be paired with a senior nursing student (Semesters 3, 4, or 5). This mentoring dyad was then assigned to a faculty mentor who ensured that the mentoring relationship was functioning in accordance with established guidelines and provided support to both the student mentee and the student mentor. RESULTS: The first cohort was comprised of 20 mentoring dyads. Subsequent cohorts have ranged from 20 to 45 mentoring dyads. To date, over 300 nursing students have participated in the undergraduate peer mentoring program. Based on feedback from student evaluation surveys, both mentors and mentees appreciate and find value in the program. Approximately 93% of student mentors indicated that they would have appreciated such a program when they were first semester nursing students. CONCLUSION: Some of the challenges of navigating nursing programs are not related to lack of academic aptitude. Rather, other challenges, including lack of social support and soft skills needed to successfully complete the first and second semesters of nursing school. These are critical challenges that a peer mentor could help to meet.

Healthcare worker resilience during the COVID-19 pandemic: An integrative review.

AIM: The purpose of this review was to examine resilience among healthcare workers during the coronavirus-disease-2019 (COVID-19) pandemic. BACKGROUND: The COVID-19 pandemic has caused an unprecedented strain on healthcare workers internationally. Rising infection rates, inadequate personal protective equipment, and the lack of availability of hospital beds has resulted in further deterioration of the already-fragile mental health of healthcare workers. Resilient workers have lower rates of burnout and improved patient outcomes. EVALUATION: PubMed and the Cumulative Index to Nursing and Allied Health Literature databases were searched using the terms resilience, nurse and COVID-19 to identify studies on resilience during the COVID-19 pandemic. Results were organized by outcome measures for comparison. KEY ISSUES: Resilience scores among frontline healthcare workers worldwide during the COVID-19 pandemic in the studies reviewed were overall found to be in the moderate range. Data from the United States showed a decrease in nurse resilience, whereas participants from China had increased resilience compared with pre-pandemic levels. CONCLUSIONS: Building resilience in nurses and other healthcare workers can serve as a protective factor against negative outcomes related to the job, including burnout, anxiety and depression, and can improve patient outcomes. IMPLICATIONS FOR NURSING MANAGEMENT: Strategies for building resilience in healthcare workers are discussed.

Life-Span Lessons: The Importance of Age-Related Knowledge for Aging Into Any Career.

Demand to meet the needs of a rapidly aging population is high. Students outside of gerontology programs, however, remain resistant to enrolling in aging coursework, which are often electives within or outside their degree programs. A life-span development course, however, is likely to be a requirement in many disciplines. In a multigenerational workforce spanning five generations and with intergenerational conflict making media headlines, students must understand how to navigate age-diverse climates. We advocate that a course in life-span development can serve as both a recruitment tool for driving interest in aging-related careers and an access point for preparing students to enter a sometimes contentious, multigenerational workforce. We illustrate how knowledge of developmental influences across the lifespan may lead to a better understanding of individual similarities and differences in developmental experiences, fostering intergenerational cohesion throughout one's career.

Health-Related Quality of Life Among Survivors of Cancer in Adolescence: An Integrative Literature Review.

PROBLEM: Adolescence is a critical developmental period, but little research is available on the quality of life for individuals ages 10-19, especially those who have faced a life-threatening illness. This integrative review examines factors related to quality of life among survivors of a childhood cancer that occurred during adolescence. ELIGIBILITY CRITERIA: The Garrard Matrix Method guided this review of studies that were conducted from 1990 to 2017. Studies were eligible if participants were diagnosed with cancer during adolescence, the studies followed survivorship from cancer diagnosis to treatment completion, and health-related quality of life measures were taken. SAMPLE: Fifteen articles met the inclusion criteria. RESULTS: Most survivors of a childhood cancer that occurred during adolescence reported physical and psychological health-related quality of life scores similar to, or higher than, healthy controls. Risk factors for poorer quality of life were type of cancer, type of treatment, late effects, and time since diagnosis. Factors for better quality of life were older age, positive feelings such as happiness and optimism, social support, and coping strategies. Most studies used the Short Form-36 and the PedsQL Generic Core Scales to measure quality of life. CONCLUSIONS: Protective factors such as social support and subjective feelings positively affected quality of life. IMPLICATIONS: In order to promote the best patient outcomes, relevant protective factors that improve quality of life should be incorporated in long-term care plans for survivors of a childhood cancer that occurred during adolescence.

Trajectories of Suicide Ideation and Attempts from Early Adolescence to Mid-Adulthood: Associations with Race/Ethnicity.

Prior research has demonstrated that behavioral, demographic, and mental health characteristics are associated with suicide, particularly among youth and young adults. Although recent research has begun to explore developmental trajectories of suicide-related outcomes, few studies to date have extended beyond late adolescence. Understanding different trajectories of suicide-related thoughts and behaviors from adolescence through mid-adulthood has the potential to refine developmental perspectives on suicide risk and to inform prevention efforts. Using National Longitudinal Study of Adolescent to Adult Health data (n = 9421 respondents with data at all four waves), this study analyzed suicide-related outcomes across ages 12-31 years. Growth mixture modeling (GMM) was used to estimate trajectory classes for past-year suicide ideation and attempts, followed by multinomial logistic regression to explore the association between race/ethnicity and class membership. In weighted descriptive analyses, the sample was 50.0% female; it was 15.5% African American, 2.1% Asian/Pacific Islander, 12.0% Hispanic, 0.9% other, and 65.9% White. GMM results revealed three trajectory classes for ideation: sustained higher risk, sustained lower risk, and adolescent-limited risk. Two trajectory classes emerged for attempts: declining higher risk and sustained lower risk. For ideation, African Americans were less likely than Whites to be in either the sustained higher risk or the adolescent-limited risk trajectory. For attempts, African Americans had significantly lower odds than Whites and Asians/Pacific Islanders had nearly four times the odds of Whites of being in the sustained higher risk trajectory, though the latter was only marginally significant. The finding of associations between race/ethnicity and distinct patterns of suicide-related behavioral development from early adolescence into mid-adulthood suggests new directions for developmental research and provides evidence to inform future suicide prevention efforts.

Are Emergency Departments in the United States Following Recommendations by the Emergency Severity Index to Promote Quality Triage and Reliability?

INTRODUCTION: The purpose of this study was to explore and describe (1) the extent to which emergency departments in the United States are promoting the quality of triage and the reliability of triage systems according to recommendations in the Emergency Severity Index (ESI) Handbook and (2) if relationships existed between triage structure (policies) and process (procedures) in emergency departments that promote accuracy of triage decisions. METHODS: Donabedian's Structure, Process, Outcome model guided this descriptive, correlational study. Nurses were recruited from all geographic regions in the United States, and the ED TRiAGE Structure and Process Survey was developed to collect data. Χ2 tests of independence, Fisher's exact tests, and Kendall's τ were used to assess relationships of structure and process. RESULTS: The majority of emergency departments did not meet at least the minimum recommendations of the ESI triage system. Significant positive relationships were found when an emergency department had structure (policy) to guide process (procedures). Differences were reported in the type, amount, and focus of the policies and procedures. DISCUSSION: Donabedian's model emphasizes that good structure and process are antecedents of good outcomes. This study serves as a foundation on which to examine the consistency of emergency departments meeting the ESI guidelines that promote triage accuracy and maintaining the reliability of evidence-based triage acuity systems.

Schools as Sites for Recruiting Participants and Implementing Research.

Schools can be a valuable resource for recruitment of participants for research involving children, adolescents, and parents. Awareness of the benefits and challenges of working with schools can assist researchers in developing effective school partnerships. This article discusses the advantages of conducting research within the school system as well as the challenges that may also arise. Such challenges include developing key contacts, building relationships, logistical arrangements, and facilitating trust in the research topic and team. Suggestions for strategies to forge successful collaborative relationships with schools are provided.

Communication and Bonding Between African-American Middle School Girls and Their Maternal Figures.

The objective of this study was to explore the associations between bonding, communication, and maternal monitoring of daughters' behaviors among a sample of African-Americans girls and their maternal figures. The relationship between the frequency of church attendance and the mother-daughter relationship was also explored. A correlational analysis was conducted on 101 African-American adolescents and their maternalfigures recruitedfrom middle schools. Girls completed the Maternal Bonding, Mother-Adolescent Communication, and Maternal Monitoring scales while maternalfigures completed the parent versions of the Mother-Adolescent Communication and Monitoring Scales. The findings revealed that maternal monitoring, as perceived by girls and mothers, is related to increased communication between mothers and daughters. Greater church attendance was related to greater perceived maternal bonding for girls. We recommend that nurses use strategies to enhance communication between girls and their maternalfigures and to increase maternal monitoring of daughters' behavior to reduce health risk behaviors among African-American girls.

How Patients and Nurses Experience an Open Versus an Enclosed Nursing Station on an Inpatient Psychiatric Unit.

The inpatient environment is a critical space for nurses and patients in psychiatric settings. In this article, we describe nurses' and patients' perceptions of the inpatient environment both before the removal of a Plexiglas enclosure around a nurses' station and after its removal. Nurses had mixed feelings about the enclosure, reporting that it provided for confidentiality and a concentrated work space but also acknowledged the challenge of the barrier for communication with their patients. Patients unanimously preferred the nurses' station without the barrier, reporting increased feelings of freedom, safety, and connection with the nurses after its removal. It is important to consider the implications of environmental decisions in inpatient settings in order to promote a healthy workplace and healing environment for all community members.

Recruitment and retention of African American and Hispanic girls and women in research.

Recruiting women and girls into research studies, especially minority women, continues to be a major challenge that impacts health policy and delivery systems. This article discusses various strategies to recruit and retain African American and Hispanic girls and women in studies. Strategies for successful recruitment focus on trust, familiarity and visibility, racial and ethnic similarities, environmental context, and convenience. Retention strategies include issues of transportation, language, literacy, cultural appropriateness, safety, flexibility, incentives, communication, and veracity. All strategies assist in meeting the challenge of engaging minority women in research to decrease health disparities.

Consumers' perceptions of transitions from assertive community treatment to less intensive services.

When first conceptualized, it was thought that individuals with severe mental illness who needed assertive community treatment (ACT) would need ACT for life. Today, ACT-for-life is contrary to recovery-based principles, and teams routinely transition consumers to less intensive services. However, there is little qualitative information about the experiences of consumers who transition from ACT. To address this gap in our knowledge, we conducted semi-structured interviews with 11 consumers who had transitioned from ACT to case management services. Consumers expressed feelings of loss and frustration about transitioning from ACT to case management services. Findings underscore the importance of facilitating open dialogue about transitions with consumers, managing consumers' expectations of post-transition services, and facilitating consumer independence prior to transition. ACT teams should be deliberate about preparing consumers for transitions from ACT. More research is needed about facilitating successful transitions from ACT.

Enclosed versus open nursing stations in adult acute care psychiatric settings: does the design affect the therapeutic milieu?

Specific efforts by hospital accreditation organizations encourage renovation of nursing stations, so nurses can better see, attend, and care for their patients. The purpose of this study was to examine the effect of nursing station design on the therapeutic milieu in an adult acute care psychiatric unit. A repeated cross-sectional, pretest-posttest design was used. Data were collected from a convenience sample of 81 patients and 25 nursing staff members who completed the Ward Atmosphere Scale. Pretest data were collected when the unit had an enclosed nursing station, and posttest data were collected after renovations to the unit created an open nursing station. No statistically significant differences were found in patient or staff perceptions of the therapeutic milieu. No increase in aggression toward staff was found, given patients' ease of access to the nursing station. More research is needed about the impact of unit design in acute care psychiatric settings.

The Role of Resilience in Ethnic Minority Adolescent Navigation of Ecological Adversity.

Adverse childhood experiences and health disparities profoundly affect the health of ethnic minority adolescents and influence their overall well-being. In light of current health disparities and civil unrest, this secondary analysis sought to better understand resilience among ethnic minority adolescents living in rural eastern North Carolina (NC). Using Ungar's (2013) Theory of Resilience and Seven Tensions, the two tensions that depicted the most adversity for these adolescents were social justice and power and control. Racism and discrimination were identified as prevalent risk factors. Four tensions in the model, cultural adherence, identity, cohesion, and access to material resources, were linked to protective factors and represented ethnocultural pride. Findings suggest that rural-dwelling African American and Latinx adolescents share concerns related to racial adversity but navigate their ecological experiences in unique ways.

Feasibility and initial efficacy testing of an HIV prevention intervention for Black adolescent girls.

HIV is disproportionately prevalent among Blacks. Black women most often contract HIV from having risky sex, and adolescence is a time when risky sex behaviors peak. This study tested the feasibility and initial efficacy of an intervention designed to help Black adolescent girls avoid risky sex behaviors. The intervention included group education for girls followed by a service learning opportunity in which the girls practiced the assertiveness and communication skills they had learned in the education sessions, and individual education for the girls’ mothers. The intervention was guided by a risk and protective factors framework and by the goal of promoting racial/ethnic pride in the girls. We determined that the intervention was feasible. Schools allowed recruitment of potential participants and the use of their facilities for meeting with the girls. We encountered little participant dropout from the study, and the intervention was highly regarded by the girls who participated and their mothers. We found improvements in aspects of the girls’ relationships with their mothers, their sexual assertiveness, and their self-efficacy to use condoms.

Integrative Literature Review on Psychological Distress and Coping Strategies Among Survivors of Adolescent Cancer.

PROBLEM IDENTIFICATION: Cancer survivors, particularly those diagnosed in adolescence, are faced with physical, mental, and emotional stressors associated with the disease and its treatment. These stressors add to the demand placed on survivors' already taxed coping skills. This article reviews the literature on psychological distress experienced by survivors diagnosed with cancer during adolescence and the coping strategies they employed. LITERATURE SEARCH: Three electronic databases (CINAHL®, PsycINFO®, PubMed®) were searched, and 19 studies were selected. Garrard's matrix method guided this integrative review. DATA EVALUATION: Gough's weight of evidence framework was used to evaluate each study. SYNTHESIS: Analysis revealed important findings about the types of coping strategies used by adolescents during and after cancer treatment and the impact of each on levels of psychological distress. IMPLICATIONS FOR PRACTICE: Healthcare providers, who regularly assess for negative thoughts and unmet needs among survivors, may identify symptoms of psychological distress, intervene early, and facilitate better outcomes for their patients. Patient-centered interventions aimed at coping with psychological distress are most helpful.