RESUMO
There is increased national attention to the impact nurses can and should have in advancing health equity. Nurses of color have made important contributions in nursing and other sectors to this end, but their efforts remain invisible. To amplify the contribution of Latino nurses in advancing health equity, we use oral histories and supplemental records to examine the career of Henrietta Villaescusa, RN, FAAN to illuminate her impact across government, health, and nursing sectors in advocating for the health of Latino communities. She was skilled in community activism, political savvy, and developing and leading intersectoral networks to address and identify Hispanic health issues and strategies to address them. Her career serves as an exemplar to the importance of including and supporting diverse nurses in leading health equity efforts.
Assuntos
Equidade em Saúde , Hispânico ou Latino , Humanos , Hispânico ou Latino/estatística & dados numéricos , História do Século XXI , Feminino , História do Século XX , Estados Unidos , Adulto , Papel do Profissional de EnfermagemRESUMO
BACKGROUND: The Robert Wood Johnson Foundation Future of Nursing Scholars program supported nurses to complete PhDs in 3 years. Support mechanisms included mentoring by the program office and school faculty, and leadership development activities. PURPOSE: To describe scholars' perspectives of mentoring received by faculty during the accelerated timeline. METHODS: Of 201 scholars, 157 (78%) completed exit surveys, providing qualitative data on their experiences working with faculty mentors. DISCUSSION: Scholars highlighted strong mentorship (i.e., accessibility, emotional support) as the most important facilitator to program completion. Mentor challenges were identified as the second-most mentioned barrier to success, while the first was the accelerated timeline. CONCLUSION: The scholars' most-reported mentor-provided facilitators to success were availability and emotional support. Among scholars who noted barriers to their success caused by their mentor relationship, the most-reported issue was lack of access to their mentors.
Assuntos
Docentes de Enfermagem , Fundações , Tutoria , Humanos , Docentes de Enfermagem/psicologia , Masculino , Feminino , Educação de Pós-Graduação em Enfermagem , Mentores/psicologia , Mentores/estatística & dados numéricos , Adulto , Pessoa de Meia-Idade , Liderança , Inquéritos e QuestionáriosRESUMO
BACKGROUND: To address the need for faculty scientists, Robert Wood Johnson Foundation (RWJF) provided support for an accelerated PhD program: Future of Nursing Scholars (FNS). PURPOSE: To describe the experience of faculty mentoring PhD students in the RWJF FNS program pursuing a 3-year accelerated PhD degree, including faculty members' support activities for students, time commitment, student productivity in manuscript dissemination, and challenges and opportunities for supporting students. METHODS: Surveys were sent to faculty mentors of FNS to understand mentoring activities, strategies used, and mentee productivity. FINDINGS: Of 93 faculty mentors, they reported most FNS students (n = 61, 65.6%) completed a manuscript format dissertation. FNS students required academic/dissertation mentoring, with frequent emotional support and positive reinforcement. DISCUSSION AND CONCLUSION: Mentors reported providing more frequent mentoring and spent more time mentoring FNS students than with other PhD students. Alignment of the student's research to that of the faculty mentor was identified as valuable.
Assuntos
Tutoria , Estudantes de Enfermagem , Humanos , Mentores , Docentes de Enfermagem/educação , Previsões , Estudantes de Enfermagem/psicologiaRESUMO
BACKGROUND: The Robert Wood Johnson Foundation (RWJF) Future of Nursing Scholars program (FNS) supported 45 nursing schools to create or adapt their PhD curricula to facilitate students completing a PhD degree in 3-years. PURPOSE: This analysis characterized the PhD program curricula of 45 schools. Differences in curricula were examined based on school characteristics. METHODS: Data were collected from five cohorts of school FNS applications. Summaries of curricula are provided and differences in curricula between schools were examined. FINDINGS: Most of the PhD programs (73.3%) were at very high research intensive universities. A median of 60 credit hours were needed to complete a 3-year PhD. Most programs (84.0%) required year-round enrollment, oftentimes inclusive of summers, and placed an emphasis on scholars pursuing additional coursework to meet the 3-year timeline. DISCUSSION: Findings highlight common elements of 3-year PhD curricula that can be utilized to inform the development and educational needs of future nurse scientists.
Assuntos
Educação de Pós-Graduação em Enfermagem , Humanos , Currículo , Instituições Acadêmicas , Previsões , UniversidadesRESUMO
BACKGROUND: The Future of Nursing Scholars program prepared a cadre of PhD prepared nurses for long-term careers advancing science and discovery, strengthening nursing education, and leading transformational change in health care. PURPOSE: The purpose of this manuscript was to describe the program's impact on Scholars' outcomes, nursing schools, and perceived impact on nursing science. METHODS: An independent program evaluation was conducted, including interviewing representatives from schools and reviewing Scholars' Curriculum Vitae. FINDINGS: Two hundred one scholars were supported across 45 institutions. To date, 181 scholars graduated within 3.1 years, on average. Most graduates reported holding appointments in academic institutions. School representatives believed the program supported rapid entry into the field, longer research trajectories, and will improve the nursing faculty pipeline. DISCUSSION: The program achieved its goal of developing cohorts of PhD prepared nurses poised for long-term careers. It provided "proof of concept" on high-quality accelerated PhD education for students well matched with mentors, and elevated the national conversation on PhD education.
Assuntos
Educação de Pós-Graduação em Enfermagem , Instituições Acadêmicas , Humanos , Avaliação de Programas e Projetos de Saúde , Estudantes , Docentes de Enfermagem/educação , PrevisõesRESUMO
BACKGROUND: Robert Wood Johnson Foundation Future of Nursing Scholars program used multi-pronged approach to support nurses completing accelerated PhD programs. PURPOSE: The purpose of this manuscript was to describe scholars' experiences completing PhDs, their dissertation characteristics, program leadership development sessions, scholar perceptions of program components. METHODS: Of 201 scholars, 157 (78%) completed quantitative exit surveys, providing: satisfaction with doctoral programs and FNS curricula, types of dissertation data used, dissertation formats. Interviews held with five scholars to capture representative themes. FINDINGS: Scholars utilized primary and secondary data for dissertations; 53% primarily used secondary data. The majority (68%) used manuscript dissertation formats. Approximately 64% completely agreed program curricula helped prepare them for professional transitions, to work collaboratively, lead confidently. Proportion of FNS graduates (42%) pursuing postdoctoral positions exceeded national trends. DISCUSSION: Despite stresses posed by accelerated PhD programs, scholars are well-situated to advance nursing science. Findings suggest secondary data analyses work well for accelerated programs. Scholar program experiences were positive.
Assuntos
Educação de Pós-Graduação em Enfermagem , Pesquisa em Enfermagem , Estudantes de Enfermagem , Feminino , Humanos , Currículo , Educação de Pós-Graduação em Enfermagem/organização & administração , Previsões , Fundações , Liderança , Pesquisa em Avaliação de Enfermagem , Pesquisa em Enfermagem/educação , Estudantes de Enfermagem/psicologia , Estudantes de Enfermagem/estatística & dados numéricos , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Following the 2010 report, "The Future of Nursing: Leading Change, Advancing Health," Robert Wood Johnson Foundation created the Future of Nursing Scholars program to increase the number of PhD-prepared nurses who could assume leadership roles earlier in their careers by shortening the PhD education trajectory and developing leadership skills. PURPOSE: The purpose of this paper is to describe the state of the field at program launch, the program development, and operations. METHODS: A descriptive narrative was used, which relied on literature review focused on nursing PhD program completion and presentation of FNS program objectives and findings. FINDINGS: Nurses from 46 schools pursued their PhDs as Future of Nursing Scholars. As of May 1, 2022, 181 scholars graduated with 20 scholars still enrolled. Preliminary results suggest accelerate PhD programs featuring intensive mentoring and financial support can produce well-prepared nurse researchers ready for postdoctoral positions and leadership roles. DISCUSSION: Program attributes including financial support and leadership development initiatives may be replicated.
Assuntos
Educação de Pós-Graduação em Enfermagem , Tutoria , Humanos , Fundações , Docentes de Enfermagem/educação , Desenvolvimento de Programas , Currículo , LiderançaRESUMO
BACKGROUND: The Robert Wood Johnson Foundation launched the Future of Nursing Scholars program to support nurses to complete PhDs in 3 years in schools across the United States. PURPOSE: To explore why scholars participated in the program and to articulate challenges and facilitators to successful completion of their doctoral degrees. METHOD: Thirty-one scholars representing 18 different schools participated in focus groups at a convening in January 2022. FINDINGS: Scholars identified that funding and planned length of degree completion were important factors in their choosing the accelerated program. Mentorship, networking, and support were identified as facilitators to program completion with the tight timeline of three years noted as a challenge. DISCUSSION: Accelerated students require adequate resources including access to data, mentoring, and financing to overcome challenges presented by accelerated PhD training programs. Cohort models provide support and clarity of expectations for both students and mentors is critical.
Assuntos
Educação de Pós-Graduação em Enfermagem , Tutoria , Humanos , Estados Unidos , Avaliação de Programas e Projetos de Saúde , Grupos Focais , Mentores , Docentes de Enfermagem/educaçãoRESUMO
A nimble and flexible regulatory response regarding the nursing workforce is essential to a fully integrated public health approach to national crises and pandemics. The COVID-19 pandemic has drawn many comparisons to the 1918 Flu Pandemic. Some of them are well-reasoned and grounded in evidence. Other are not. This study provides a historically contextualized analysis of how the 1918 flu pandemic helped shape Pennsylvania nursing's current regulatory apparatus. We conclude that the state-based solutions that nursing registration represents are inadequate to deal with pandemics and crises with national, if not global, reach. We need to move immediately toward the national COMPACT system, while mindful of how regulatory processes and procedures can reinforce structural inequities.
Assuntos
Licenciamento em Enfermagem , Recursos Humanos de Enfermagem/normas , Pandemias/história , COVID-19 , História do Século XX , História do Século XXI , Humanos , Licenciamento em Enfermagem/história , Licenciamento em Enfermagem/normas , Pennsylvania , Estados UnidosRESUMO
In his classic article, Charles Rosenberg brilliantly sets up epidemics as social phenomena of three interrelated stages-progressive revelation, develop ment of an explanatory framework to manage randomness, and negotiation of public response. This framework, although written almost thirty years ago, still resonates. Even as we have experienced different kinds of infectious epidemics over the last century (Ebola, AIDS), his stages still help us understand how society constructs the meaning of epidemics and manages policies, structures, and postepidemic explanations. Whether Rosenberg's three stages actually help frame the meaning of an epidemic for individual patients and professional care providers, for whom the epidemic is local and personal, is the subject of this essay, with an emphasis on the following question: What is the meaning of an epidemic from a nursing perspective?
Assuntos
Síndrome da Imunodeficiência Adquirida/epidemiologia , COVID-19/epidemiologia , Epidemias/prevenção & controle , Doença pelo Vírus Ebola/epidemiologia , Enfermagem , Saúde Pública , Síndrome da Imunodeficiência Adquirida/história , Epidemias/história , Doença pelo Vírus Ebola/história , História do Século XX , História do Século XXI , HumanosRESUMO
AIM: To show the development of an emerging nursing profession through the eyes of Louisa May Alcott and Hospital Sketches. BACKGROUND: In Hospital Sketches, Louisa May Alcott recounts her experiences when she worked as a nurse of injured soldiers during the American Civil War, in an autobiographically and masked-referential way, which allows her to negotiate between transgression and convention. Unlike other reviews, in this paper the relevance of nursing remains highlighted. DESIGN: Discussion paper. DATA SOURCES: Existing literature in databases, history books and our own reading of facts. IMPLICATIONS FOR NURSING: Illuminating overlooked meanings hidden in nurses' personal sources enables to approach their contribution to history, improve their visibility and project the future of nursing. Nursing care, whether domestic or professional, was and remains a catalyst for change. CONCLUSION: Through Alcott's words, we understand the transition of nursing care as a gradual extension of the middle-class woman's domestic role and a progressive definition of nurses' identity. In particular, we highlight how certain professional nursing nuances which appear in the text are compatible with the gradual extension of the boundaries of women's domesticity. Furthermore, Alcott's use of literary devices reveals the delicate balance between women's domestic role and some new nursing professional features, which anticipates nursing professionalization.
Assuntos
Livros , Enfermagem Militar/história , Enfermagem Militar/organização & administração , Papel do Profissional de Enfermagem/história , Profissionalismo/história , Guerra Civil Norte-Americana , Feminino , História da Enfermagem , História do Século XIX , HumanosRESUMO
The use of legally required supervision occurs across health professionals who provide similar services. Legally required supervision has the potential to disrupt the production of high-quality, cost-efficient, accessible health services across disciplines. This paper examines the effects of nurse practitioner collaborative practice agreements and similar models of health professional regulation, defined as legally required supervision, on the cost and delivery of health services. A policy analysis examines empirical, policy, and law literature between two health professionals providing a similar service. Analysis includes literature on dental hygienists, dentists, certified registered nurse anesthetists, midwives, nurse practitioners, physicians, and pharmacists. A framework for legally required supervision across health professionals is presented. Antecedents of legally required supervision include occupational licensure, reimbursement policy, and institutional policy. Legally required supervision inhibits provider entry to practice and the production of health services by supervised providers. The cost of care increases under legally required supervision. Costs are measured by wages for providers and the price of services for patients. This paper and proposed framework summarize the antecedents and consequences of legally required supervision. Discipline-specific antecedents and provider characteristics must be considered when calculating the full effect of legally required supervision on the delivery and cost of health services.
Assuntos
Pessoal de Saúde/legislação & jurisprudência , Profissionais de Enfermagem/legislação & jurisprudência , Regulamentação Governamental , Pessoal de Saúde/organização & administração , Humanos , Profissionais de Enfermagem/organização & administração , Organização e Administração , Formulação de Políticas , Estados UnidosRESUMO
BACKGROUND: Current regulatory impediments prohibit advanced practice registered nurses from practicing to their full capacity. PURPOSE: To examine the process of successful removal of scope of practice barriers in Pennsylvania under the Rx4PA legislation introduced in 2007. METHOD: We used qualitative research techniques, including purposeful sampling of participants. Twelve stakeholder informed interviews were conducted between October 2013 and May 2014. Participants were closely involved with the development of the Rx4PA legislation. Thematic content analysis was performed to analyze our interviews. DISCUSSION: Interviews identified overarching themes, including the importance of leveraging years of grass roots advocacy, identifying political allies, and recognizing mutually beneficial compromises. CONCLUSIONS: The combination of timing, careful political maneuvering, and compromise were key to scope of practice reform in Pennsylvania and may be useful strategies for other states seeking similar practice changes.
Assuntos
Prática Avançada de Enfermagem/legislação & jurisprudência , Prática Avançada de Enfermagem/normas , Profissionais de Enfermagem/legislação & jurisprudência , Profissionais de Enfermagem/normas , Papel do Profissional de Enfermagem , Humanos , PennsylvaniaRESUMO
Objective To historicize the changes in training human resources in nursing in Brazil during the period from 1942 to 1961 based on the presence of 35 American nurses assigned to work in cooperation with Special Public Health Service. Method The sources used for the study were reports written by American nurses who described their impressions, suggestions, and the activities they carried out in the country. These were analyzed based on the discourse analysis of Michel Foucault. Results The period mentioned was marked by an American presence in nursing projects developed by the Special Public Health Service. The discourses indicated that the period was marked by many changes in Brazilian nursing, particularly with respect to attracting and training human resources for the profession. Conclusion The results indicate that the American nurses, through what they said and their influence, were central to the consolidation of a new paradigm in the training of nursing professionals in Brazil.
RESUMO
As the demand for health care consistently rises and many individuals, even within developed countries, lack access to primary care services, a better understanding of how primary care is defined, the main causes of the primary care shortage both within the United States and across the globe, and key solutions to these issues are paramount. Upon review of the US and international primary care literature, the authors first briefly discuss the fluidity of how primary care is defined and how it is applied in nations with differing levels of health care infrastructure. The main causes of the deficit both domestically and globally are then examined. Finally, upon careful review of the research produced within the past seven years, this article suggests strategies that maximize the primary care workforce: the effective use of technology, task shifting, interprofessional teams, and more consistent primary care data to build workforce strategies.
Assuntos
Saúde Global , Mão de Obra em Saúde/organização & administração , Mão de Obra em Saúde/estatística & dados numéricos , Enfermagem de Atenção Primária , Política de Saúde , Humanos , Relações Interprofissionais , Papel do Profissional de Enfermagem , Equipe de Assistência ao Paciente , Estados UnidosRESUMO
Historians of nursing can inform and provide perspective and context to the discipline and to policy makers. This article provides several examples of the interplay of history and health policy debates across time and place. From issues of the nursing workforce to discussions about the skill level needed to safely care for patients and the issues of practice boundaries, history provides evidence for shaping our understanding of and engagement with health policy. History offers a way to understand the present and think about the future. It illustrates a critical perspective for both action and advocacy.