Community Resilience After Hurricanes: Can Neuman's Systems Theory Guide Public Health Nursing?

Objective: Examination of community resilience after Hurricane Harvey and -applicability of Neuman's systems model to the role of public health nurses in applying primary, secondary, and tertiary prevention strategies to communities susceptible to natural disasters. Design: Descriptive, exploratory study. Sample: A convenience sample (N = 1,470). Measurements: Hurricane Harvey Survey. Results: Respondents from seven counties in southeast Texas report previously experiencing a hurricane (80%) with no weather-related flooding (79%), adequate preparation (54%), failure to comprehend the potential severity of Hurricane Harvey (62%), damage to their homes (45%), and a 68% loss of personal belongings. Anxiety, frustration, disbelief, determination, and hopefulness were rated highest after the storm. Residents received updates from family and friends, social media, and online news reports regarding rising water, even though, in many cases, a mandatory evacuation was not officially announced. Only 35% of respondents reported being aware of resources available, possibly due to flooding or inaccessibility of typical resources (e.g., hospitals, shelters). Communicating through social networks (social media, family, and friends) provided avenues for arranging evacuations and assistance. Respondents report giving assistance to others and receiving assistance from family, friends, and their faith community. The majority of respondents reported that the community provided adequate services during the hurricane (59%), and they plan to stay in southeast Texas (70%). Conclusions: Southeast Texas residents demonstrated individual and community resilience which may be further supported with primary, secondary, and tertiary nursing interventions as illustrated by Neuman's systems model. The rise in positive emotional response traits demonstrates positive coping, which is consistent with resilience. Effective and timely communication through social networks provides an additional line of resistance to protect and promote the resilience of the community. The lack of medical resources indicates a break in the normal line of defense and an area for potential improvement with the utilization of mobile medical units to provide healthcare for areas not easily accessible during a disaster. Public health nurses are strategically positioned in the international community to lead prevention and recovery efforts by applying theory-based community interventions.

Virtual versus traditional learning during COVID-19: quantitative comparison of outcomes for two articulating ADN cohorts.

Aim: The study compared outcomes between articulating nursing student cohorts virtual learning during COVID-19 and traditional learning prior to COVID-19. Background: Clinical reasoning is vital to developing clinical nursing judgment. During the COVID-19 pandemic, nursing schools replaced traditional classroom and in-hospital clinical with virtual classroom and clinical learning. Design: A quantitative retrospective cohort study compared outcomes of the nursing students virtual learning during COVID-19 (n = 18) with traditional learning methods before COVID-19 (n = 14) at one college in Texas. Method: Outcomes of the study were measured using a standardized Health Education Systems Inc. (HESI®) specialty exam, HESI® end of program (Exit) exam, and HESI® clinical judgment subscales. Independent-samples t-tests and Chi square were conducted to compare outcomes from virtual and traditional learning. Results: No statistically significant difference was observed between the traditional group (M = 752.93, SD = 148.88) and virtual learning group (M = 761.72, SD = 152.11); t(30) = -0.16, p = 0.87 was identified on the HESI® Maternal pediatric Specialty exam. No statistically significant differences were observed on the HESI® Exit exam or clinical judgment subscales; no relationship between the type of learning and NCLEX-RN® pass rates. Conclusion: The study findings are encouraging, yet limited, warranting further investigation of virtual learning.

Increasing student involvement in research: a collaborative approach between faculty and students.

Baccalaureate nursing curriculum generally include a research or evidence-based practice course, but students may have little opportunity for specific application of the research process during their nursing education. Using Modeling and Role-modeling as a theoretical framework, a scholarly collaboration between faculty and student was developed to promote a unique and engaging undergraduate research endeavor. Faculty researchers developed an exploratory community-based research study to survey the local population about the immediate and lingering physical, financial, psychological, and emotional effects of Hurricane Harvey on the community. The project allowed students to gain invaluable knowledge about the research process, time management techniques, application of theory to the practice setting, community health assessment, collaboration among team members, and achieve student learning outcomes. Student participation in this research project provided necessary collaboration and leadership experiences that will benefit students during school and in their professional practice.

Deliberate practice and self-recorded demonstration of skill proficiency: One baccalaureate nursing school's response to the COVID-19 pandemic.

AIM: The purpose of this study was to determine whether using self-video recording of the skill competency assessment would promote deliberate practice of nursing skills, clinical skill proficiency, limit virtual high stakes testing anxiety and facilitate progression of first semester baccalaureate nursing students during the global COVID-19 pandemic. DESIGN: A cross-sectional study was conducted during the Spring 2020 semester using self-reported student data from an end of course survey. METHODS: A 16 item instructor-designed survey of student's perceptions of critical thinking, preparation, availability of materials, practice, video recording skill demonstrations, self-reported levels of anxiety related to the virtual testing environment and type of skill assessment exam was provided to all first semester baccalaureate nursing students enrolled in the basic nursing skills course. RESULTS: Approximately half of the cohort (N = 33) voluntarily responded to the instructor designed survey. The greatest relationship was observed between 'adequate information for each version' of the test and 'adequate time to prepare' (rho (32) = 0.729 p = 0.000). Although 54.6% (n = 18) of the respondents believed performing the demonstration in the home environment caused them to 'think harder' about the tasks, 78.8% (n = 26) reported feeling less anxiety than while performing previous demonstrations in the lab. A Wilcoxon test examined the results of the anxiety for demonstration on campus and anxiety for demonstration at home and a significant difference was found (p = 0.000, 95% CI) indicating anxiety levels were significantly less when demonstrating in the home environment. A moderate positive correlation was identified between opportunity to repeat with less stress at home (rho (32) = 0.61, p = 0.000), while moderate negative correlations were found between opportunity to repeat and anxiety levels related to recording (rho (32) = -0.60, p = 0.000), opportunity to repeat and anxiety related to demonstration at home (rho (32) = -0.53, p = 0.002) and concern about recording and opportunity to repeat (rho (32) = -0.49, p = 0.004). CONCLUSIONS: Student success using remote assessment strategies during the Spring 2020 semester was similar to the success rate using traditional skill assessment methods in Fall 2019. Although the need for prompt feedback was identified as an area of improvement to promote deliberate practice, student video recording of skill proficiency was a viable solution for comprehensive remote assessment during the COVID-19 pandemic and campus closure. Although further study is recommended, findings have international implications for virtual teaching and learning in nursing education.