Nursing Student Perceptions of Faculty Advising.

AIM: The aim of the study was to determine student perceptions of faculty advising and the most effective method of faculty advising. BACKGROUND: The nursing faculty advisor is important in facilitating the timely completion of the program. Faculty members have initiated synchronous electronic methods of advising to facilitate advising. METHOD: A descriptive study was conducted with a convenience sample of members of a student nurses' association. The Faculty Advisor Evaluation Questionnaire was used for data collection via online survey. RESULTS: With 106 respondents, results demonstrated high levels of student-perceived effectiveness of the advising session, advocacy/accountability, faculty advisor knowledge, and availability. The majority of nursing students reported that face-to-face advising (58.5 percent, n = 62) was the most helpful method. CONCLUSION: This study is one of the first to examine nursing students' perceptions of faculty advising. As nursing faculty implement online methods of advising, it is important to evaluate the evidence.

Staff Nurses' Perceptions of Their Nurse Managers' Transformational Leadership Behaviors and Their Own Structural Empowerment.

OBJECTIVE: The aim of this study was to investigate staff nurses' perception of their nurse managers' transformational leadership behaviors and their own structural empowerment. BACKGROUND: Transformational leadership behaviors in nurse managers have been linked to increased staff nurse satisfaction and decreased turnover and burnout. Perception of nurse managers' leadership behaviors by staff nurses and the relationship to the staff nurses' structural empowerment is important to advance our understanding of the leadership role of nurse managers. METHODS: A descriptive correlational design was used to examine the relationship between staff nurses' perception of their nurse managers' transformational leadership behaviors and their own structural empowerment. Staff nurses at a conference were offered an opportunity to participate in the study. RESULTS: The transformational leadership behaviors of nurse managers were moderately correlated to staff nurses' structural empowerment. Transactional leadership behaviors were associated with staff nurses' structural empowerment to a lesser degree. CONCLUSION: Nurses who perceived their nurse managers as demonstrating transformational leadership behaviors experienced higher structural empowerment.

Transformational Leadership Practices and Work Engagement Among Nurse Leaders.

OBJECTIVE: The aim of this study was to develop better understanding of the leadership characteristics of clinical nurse leaders. BACKGROUND: Transformational leaders are the essential to support nursing in taking control of patient and family care coordination. One prior study of leadership and work engagement among clinical nurse leaders was identified. METHODS: This descriptive correlational study explored the relationship between transformational leadership practices and work engagement among nurse leaders in the United States. Sample consisted of clinical nursing leaders attending the 2016 Magnet® Conference. RESULTS: A significant positive relationship was identified between leadership practices and work engagement. Differences were noted in areas of select leadership practices and work engagement among nurse leaders based on different levels of education. Nurse leaders underperform in inspiring a shared vision, support for innovation, and taking risks, while also showing relatively weak levels of engagement in areas of vigor and absorption. CONCLUSION: There is a need for additional research to better understand the characteristics of clinical nurse leaders to promote the principles of transformational leadership.

Emotional Intelligence and Transformational Leadership in Nurse Managers.

OBJECTIVE: This study describes the relationship between emotional intelligence (EI) and transformational leadership (TL) in nurse managers (NMs). BACKGROUND: Effective NM leadership is important as they have direct influence over RN performance and patient outcomes. Research has demonstrated that a TL style generates greater commitment from followers than other leadership styles. EI is 1 potential characteristic of TL. METHODS: A descriptive exploratory research study was conducted to correlate EI and TL practices of NMs. RESULTS: EI was significantly positively correlated with TL and outcome measures of extra-effort, effectiveness, and satisfaction and significantly negatively correlated with laissez-faire leadership. A positive relationship was found between TL and NMs with advanced education and administrative certification. CONCLUSION: Nursing administrators should consider EI characteristics when hiring NMs and lead efforts to advance education to align with organization needs for business and strategic essentials necessary for NM effectiveness.

Donepezil and memantine for moderate-to-severe Alzheimer's disease.

BACKGROUND: Clinical trials have shown the benefits of cholinesterase inhibitors for the treatment of mild-to-moderate Alzheimer's disease. It is not known whether treatment benefits continue after the progression to moderate-to-severe disease. METHODS: We assigned 295 community-dwelling patients who had been treated with donepezil for at least 3 months and who had moderate or severe Alzheimer's disease (a score of 5 to 13 on the Standardized Mini-Mental State Examination [SMMSE, on which scores range from 0 to 30, with higher scores indicating better cognitive function]) to continue donepezil, discontinue donepezil, discontinue donepezil and start memantine, or continue donepezil and start memantine. Patients received the study treatment for 52 weeks. The coprimary outcomes were scores on the SMMSE and on the Bristol Activities of Daily Living Scale (BADLS, on which scores range from 0 to 60, with higher scores indicating greater impairment). The minimum clinically important differences were 1.4 points on the SMMSE and 3.5 points on the BADLS. RESULTS: Patients assigned to continue donepezil, as compared with those assigned to discontinue donepezil, had a score on the SMMSE that was higher by an average of 1.9 points (95% confidence interval [CI], 1.3 to 2.5) and a score on the BADLS that was lower (indicating less impairment) by 3.0 points (95% CI, 1.8 to 4.3) (P<0.001 for both comparisons). Patients assigned to receive memantine, as compared with those assigned to receive memantine placebo, had a score on the SMMSE that was an average of 1.2 points higher (95% CI, 0.6 to 1.8; P<0.001) and a score on the BADLS that was 1.5 points lower (95% CI, 0.3 to 2.8; P=0.02). The efficacy of donepezil and of memantine did not differ significantly in the presence or absence of the other. There were no significant benefits of the combination of donepezil and memantine over donepezil alone. CONCLUSIONS: In patients with moderate or severe Alzheimer's disease, continued treatment with donepezil was associated with cognitive benefits that exceeded the minimum clinically important difference and with significant functional benefits over the course of 12 months. (Funded by the U.K. Medical Research Council and the U.K. Alzheimer's Society; Current Controlled Trials number, ISRCTN49545035.).

Nursing on empty: compassion fatigue signs, symptoms, and system interventions.

Few healthcare organizations acknowledge, discuss, or provide interventions for assisting with compassion fatigue. Yet, it is an important concept due to its individual, professional, and financial costs. This article defines compassion fatigue, differentiates it from burnout, and offers system interventions for supporting nurses and reducing compassion fatigue.

Structural empowerment of clinical nurse managers.

OBJECTIVE: The purpose of this study was to describe perceptions of structural empowerment of clinical nurse managers (CNMs) in 1 large healthcare system. BACKGROUND: The recruitment and retention of CNMs are crucial to the future of healthcare institutions. Understanding the extent to which CNMs feel supported in the work environment and have access to resources, information, support, and opportunities to learn and develop will be beneficial to organizational effectiveness. METHODS: The sample included 140 CNMs from 1 large healthcare system in the northeastern United States. RESULTS: Consistent with previous research, CNMs in the present study had moderate levels of empowerment. They had lower than expected subscale scores on the resources subscale and acceptable scores on the subscales of support, formal power, and informal power. CONCLUSIONS: In the current changing healthcare environment, it is important to gain more understanding of the role of CNMs who are crucial to quality care and patient and nurse satisfaction. This study provides important baseline information about perceptions of structural empowerment among CNMs. Interventions that can be initiated to enhance the CNM empowerment are presented.

Spiritual dimensions of care: developing an educational package for hospital nurses in the Republic of Ireland.

The nurses' role in providing spiritual care to in-hospital patients is not clearly outlined in the Republic of Ireland (ROI). This and other deficits reveal that there are current gaps in nurses' knowledge and confidence in this area. In response, an educational innovation has been developed and this article reports on its development.

Resilience and professional quality of life among military healthcare providers.

The retention of qualified military healthcare providers is a top priority for Department of Defense (DoD) leaders. The purpose of this study is to examine the relationship between resilience and professional quality of life and to explore differences among providers who had been deployed and those who had never been deployed. Results indicated high resilience scores among all providers, and significant relationships between dimensions of professional quality of life and resilience. There were significant differences in professional quality of life based on deployment. Recommendations for future research are included, particularly as retention is an important issue for the DoD.

Consumer food system participation: a community analysis.

This study examined the prevalence, patterns, and health associations of consumer participation in different stages of the food system using a survey of 663 adults in one U.S. county. Consumer food system participation by stage was 43% in food production, 47% in food processing, 65% in food distribution, 62% in food acquisition, 61% in food preparation, and 100% in food consumption. Consumers participated in an average of 3.7 of these 6 possible stages. Women and unmarried people participated in more stages. Food system participation was associated with few health problems, although people reporting some illnesses had higher food system participation.

Professional values, self-esteem, and ethical confidence of baccalaureate nursing students.

Professional identity and competent ethical behaviors of nursing students are commonly developed through curricular inclusion of professional nursing values education. Despite the enactment of this approach, nursing students continue to express difficulty in managing ethical conflicts encountered in their practice. This descriptive correlational study explores the relationships between professional nursing values, self-esteem, and ethical decision making among senior baccalaureate nursing students. A convenience sample of 47 senior nursing students from the United States were surveyed for their level of internalized professional nursing values (Revised Professional Nursing Values Scale), level of self-esteem (Rosenberg's Self-Esteem Scale), and perceived level of confidence in ethical decision making. A significant positive relationship (p < 0.05) was found between nursing students' professional nursing values and levels of self-esteem. The results of this study can be useful to nursing educators whose efforts are focused on promoting professional identity development and competent ethical behaviors of future nurses.

Perceptions of empowerment among ED nurses.

BACKGROUND: Nurses' perceptions of empowerment have been linked to a number of variables in the hospital workplace, including job satisfaction, autonomy, and work effectiveness. Yet there have been no previous studies of perceptions of empowerment specifically among emergency department (ED) nurses. METHODS: Registered nurses (RNs) employed in the EDs of 6 hospitals in a major health care system in the eastern United States were surveyed regarding their perceptions of empowerment. Of the 240 RNs eligible to participate, there were 167 usable surveys. RESULTS: There was a moderate level of empowerment among the RNs who participated, consistent with the level of empowerment reported in several other studies of staff nurses and nurses in other positions. DISCUSSION: The moderate level of empowerment in this sample may be attributed to the many opportunities for RN involvement in the hospitals within this health care system. Nurse leaders can initiate programs focused on enhancing RN perceptions of empowerment. In addition, there is a need for further research among RNs with different specialty preparation.

Enhancing Nurse Roles in Community Health (ENRICH): The Impact of a Primary Care-Based Undergraduate Nursing Fellowship.

BACKGROUND: Low numbers of new graduate nurses entering careers in primary care settings are insufficient to meet the demand of the current nursing shortage. The Enhancing Nurse Roles in Community Health (ENRICH) Fellowship is aimed at increasing undergraduate nursing students' exposure to population health concepts by providing opportunities to practice in primary care settings. PURPOSE: The purpose of this study was to implement and evaluate an undergraduate nursing fellowship program to enhance competency development in the primary care setting. METHODS: Fellows received targeted exposure to population health content and immersive primary care experiences through participation in 150 dedicated clinical hours in primary clinics, coupled with up to 250 hours of dedicated curriculum. RESULTS: Students who participated in the ENRICH Fellowship showed increased knowledge, improved perception of skills performance, and changed attitudes about population health and primary care nursing. CONCLUSION: Participation in a population health-based fellowship that includes targeted curricular content and primary care-based clinical experiences during an undergraduate nursing program improves knowledge, attitudes, and competency-based skills related to primary care and population health.

"Ditch the white coats": What LGBTQ+ patients prefer in their primary care provider.

BACKGROUND: Health disparities in lesbian, gay, bisexual, transgender, queer and other sexual and gender minority (LGBTQ+) individuals are well documented, and there is a dearth of primary care providers (PCPs) with the knowledge, skills, and attitudes to sensitively care for this diverse population. PURPOSE: The purpose of this research study was to ask LGBTQ+ patients what qualities they prefer in their PCP. The findings will be used to better prepare nurse practitioners (NPs) to care for this diverse community and inform the training of future NPs to provide patient-centered care to LGBTQ+ individuals. METHODOLOGY: In this qualitative descriptive study, four focus groups were conducted remotely between December 2020 and January 2021 with self-identified LGBTQ+ patients of an LGBTQ+ health center in the northeast. Thematic analysis of the data elicited codes, categories, and themes. Strategies were implemented to promote trustworthiness of the results. RESULTS: Twenty-eight participants shared the qualities they value in their PCP. Analysis revealed four themes: "Ditch the white coats"; "Meet me where I am"; "The relationship is key"; and "Be knowledgeable about and comfortable with LGBTQ+ people and their health care needs." CONCLUSIONS: The focus groups elucidated important information on caring for the LGTBQ+ communities and insights into what NPs must do to provide patient-centered care to this diverse population. IMPLICATIONS: These findings can improve practice through a better understanding of LGBTQ+ patients' perspectives. Additionally, this study demonstrates the feasibility of directly asking our patients what they want in their health care provider.

Genetics researchers' and IRB professionals' attitudes toward genetic research review: a comparative analysis.

PURPOSE: Genetic research involving human participants can pose challenging questions related to ethical and regulatory standards for research oversight. However, few empirical studies describe how genetic researchers and institutional review board (IRB) professionals conceptualize ethical issues in genetic research or where common ground might exist. METHODS: Parallel online surveys collected information from human genetic researchers (n = 351) and IRB professionals (n = 208) regarding their views about human participant oversight for genetic protocols. RESULTS: A range of opinions were observed within groups on most issues. In both groups, a minority thought it likely that people would be harmed by participation in genetic research or identified from coded genetic data. A majority of both groups agreed that reconsent should be required for four of the six scenarios presented. Statistically significant differences were observed between groups on some issues, with more genetic researcher respondents trusting the confidentiality of coded data, fewer expecting harms from reidentification, and fewer considering reconsent necessary in certain scenarios. CONCLUSION: The range of views observed within and between IRB and genetic researcher groups highlights the complexity and unsettled nature of many ethical issues in genome research. Our findings also identify areas where researcher and IRB views diverge and areas of common ground.

Registered nurse job satisfaction and satisfaction with the professional practice model.

AIMS: This paper describes the initial assessment of job satisfaction and satisfaction with the professional practice environment of registered nurses working on units where a professional practice model was implemented and the relationship between these two variables. BACKGROUND: The nursing shortage has been linked to overall job satisfaction and specifically to nurses' satisfaction with the professional practice environment. Initiatives to increase retention and recruitment and decrease turnover have been linked to work satisfaction among nurses. METHODS: A descriptive, cross-sectional design was used with participants (N = 101) from four patient care units; this represented a 55% response rate. RESULTS: The nurses were moderately satisfied with the professional practice environment but had overall low job satisfaction. There was a significant negative relationship between overall work satisfaction and satisfaction with the professional practice environment (P < 0.0001). CONCLUSIONS: The introduction of the professional practice model may have raised awareness of the components of job satisfaction that were not being met. Thus, the nurses may have become more knowledgeable about the potential needs in these areas. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers and leaders must recognize that job satisfaction consists of many dimensions, and each of these dimensions is important to nurse retention. Implementation of a professional practice model may heighten awareness of the missing components within a practice environment and lead to decreased overall satisfaction. A broader understanding of characteristics associated with increased satisfaction may aid in development of organizational change necessary to retain and attract nurses.

Structural empowerment and anticipated turnover among behavioural health nurses.

AIM: The aim of this pilot study was to examine the relationship between structural empowerment and anticipated turnover among behavioural health nurses. BACKGROUND: There have been several studies relating structural empowerment to a range of organizational characteristics and personal attributes of nurses themselves. There are also previous studies linking the key variables in the present study, but no previous research of behavioural health nurses was available. METHODS: A quantitative design was used for this cross-sectional pilot study. All registered nurses (RN) working on inpatient units in the study facility were invited to participate (n = 97). An anonymous survey was sent to all potential participants. RESULTS: The response rate was 53% (n = 50). The majority of participants perceived themselves as moderately empowered. There was a significant negative correlation between empowerment and anticipated turnover. CONCLUSION: The results of this pilot study among behavioural health nurses are similar to the results among nurses working in other clinical areas. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should be cognizant of the factors that enhance nurses' perceptions of empowerment, particularly related to issues of retention and anticipated turnover among behavioural health nurses.

Perceptions of structural empowerment: differences between nationally certified perinatal nurses and perinatal nurses who are not nationally certified.

BACKGROUND: Although there has been previous research linking perceptions of empowerment to specialty certification among critical care nurses, no research in this area has been conducted among nationally certified perinatal nurses. METHODS: A comparative quantitative survey design was used. Participants included 80 perinatal registered nurses from one community hospital in New York. RESULTS: Registered nurses who were nationally certified in a perinatal specialty had higher total empowerment scores and higher scores on five of the six subscales. CONCLUSION: This study supports the results of previous studies focused on differences in empowerment among nationally certified nurses and nurses without national certification. Because much of the preparation for certification is done within continuing education, nurse leaders must be cognizant of the value of certification and must develop and implement programs to support certification in the workplace.

Corrigendum to The Professional Quality of Life and Work Engagement of Nurse Leaders [Nurse Leader 19 (2021) 95-100].

[This corrects the article DOI: 10.1016/j.mnl.2020.08.001.].

Incorporating climate change into Doctor of Nursing Practice curricula.

Climate change is a global crisis with major impacts on planetary health and quality of life. Nurses are well positioned to recognize the major health consequences of climate change on health. Therefore, highlighting nurses' active engagement in mitigating climate change impact and resilience efforts is essential. However, there is little evidence of climate change content in nursing curricula. Climate change/planetary health content could be integrated into existing Doctor of Nursing Practice programs so that graduates, as influential leaders, are equipped to meet the challenges ahead. The domains, competencies and sub-competencies outlined in the Essentials: Core competencies for professional nursing education (American Association of Colleges of Nursing (AACN), 2021) are proposed as a curricular scaffold to integrate climate change content in DNP curricula. Climate change content matched to the AACN domains and competencies could be included in many existing DNP courses. Climate change would become a consistent concept throughout all DNP curricular programs rather than a specified course addressing climate change. The curricular structure presented would provide a foundation for enhancing DNP students' knowledge, attitudes and skills related to climate change. These students and future graduates would be well prepared to introduce changes in practices and policies at the local, national, and global levels.