Exposing Undergraduate Nursing Students to Older Adults: A Qualitative Analysis.

ABSTRACT: Care of the older adult can be complex and influenced by ageism. The purpose of this pilot study was to expose nursing students to older adults earlier in the undergraduate curriculum. This study examined the experiences of student participation in caring for older adults. Qualitative analysis of student logs was conducted. Themes that emerged included age-related changes, environmental considerations, psychosocial needs and changes, consideration of gerontology as a career choice, and existing bias. Early experiences are vital in the curriculum and provide enhanced engagement in gerontology.

An uncertain time: Clinical nurses' first impressions during the COVID-19 pandemic.

The COVID-19 pandemic overwhelmed the US healthcare system and healthcare providers. Nurses, who comprise one of the most affected groups because they are the largest group of healthcare providers, were in a unique position to speak about their perspectives. As a result of the COVID-19 pandemic, nurses have experienced ongoing physical and psychological challenges while displaying strength and perseverance during uncertain times. In this study, we explored the perceptions and experiences of nurses in clinical practice caring for patients diagnosed with COVID-19 during the pandemic. Researchers conducted a qualitative descriptive study with 20 clinical nurses most of whom were enrolled in a graduate program while working in healthcare settings. Semi-structured interviews conducted through Zoom occurred between August 2020 and December 2020. Thematic analysis was used to analyze the transcripts. Five themes emerged: navigating uncertainty, managing death and loss, acknowledging emotional responses, learning opportunities, and facing community undercurrents. Lack of clinical practice guidelines, and inconsistent access to personal protective equipment when providing care to patients with COVID-19 caused emotional strain for nurses and highlighted future learning opportunities. Providing support to dying patients was devastating to nurses. Concern about community misunderstandings of the pandemic created challenges. Evolving teamwork provided invaluable support to study participants. Nurses shared essential information for revising and creating clinical practice guidelines. Nursing interventions and strategies were used to produce humane and positive patient outcomes and provide a foundation for nurse-driven care in possible future pandemics.

The experience of baccalaureate clinical nursing faculty transitioning to emergency remote clinical teaching during the COVID-19 pandemic: Lessons for the future.

BACKGROUND: Experiential clinical learning in undergraduate nursing education allows for fusion of nursing knowledge with practice to ensure the development of competent graduate nurses. The global COVID-19 pandemic necessitated an abrupt transition from in-person clinical educational experiences to emergency remote clinical teaching. OBJECTIVES: The purpose of this study was to describe the experiences of baccalaureate nursing clinical faculty who transitioned from in-person clinical to emergency remote clinical teaching during the COVID-19 pandemic in spring 2020. DESIGN: A qualitative descriptive design was used. SETTING: The study took place in the United States. PARTICIPANTS: Nineteen baccalaureate nursing clinical faculty participated in the study. METHODS: Participants engaged in semi-structured, in-depth, online interviews. RESULTS: Five themes emerged from the data: transition, collaboration and support, the joy of teaching, authentic professional experience, and the overarching primary theme, stress of the moment. CONCLUSIONS: The transition to emergency remote clinical teaching during the COVID-19 pandemic caused stress and anxiety. However, there were important lessons learned about how to best support students and faculty while providing a robust online learning experience. Understanding the experiences of clinical nursing faculty during this abrupt transition can support recommendations for best practices in the future.

Original Research: Nurses' Experiences of Caring for Patients and Families During the COVID-19 Pandemic: Communication Challenges.

OBJECTIVE: The purpose of this study was to gain a better understanding of the perceptions and experiences of nurses caring for patients and families under the COVID-19 pandemic's socially restrictive practices and policies. BACKGROUND: The COVID-19 global pandemic has affected the delivery of health care to patients and their families, with many aspects altered because of the need for social distancing, social isolation, and visitation restriction policies. These policies have created communication challenges for interdisciplinary health care teams, patients, and families. As frontline caregivers, nurses have felt strongly the impact of these challenges. METHODS: A qualitative descriptive study was conducted among 17 RNs who were caring for patients during the COVID-19 pandemic and were recruited via social media posts on Facebook, Twitter, and LinkedIn. Watson's theory of human caring served as the conceptual framework for the study. RESULTS: Several themes emerged regarding nurses' experiences of communication with patients and families. These include communication challenges and barriers, prioritization, integration of group communication, nurse self-reflection, and acceptance of gratitude. CONCLUSIONS: The study findings underscore the importance of nurses' communication with patients and families under the pandemic's restricted conditions. They demonstrate the value of nurses' ability to innovate in fostering all parties' participation in the plan of care, and highlight the comfort nurses provide to patients who are isolated from loved ones. Strategies that fostered communication were identified, as were areas for further research.

Nurse practitioners' experiences of polypharmacy in community-dwelling older adults.

BACKGROUND: Numerous studies have defined polypharmacy and its impact on health. The literature is also rich in studies documenting the benefits of care provided by nurse practitioners (NPs). A gap in research exists at the intersection of the value of NPs in caring for older adults and their management of polypharmacy. PURPOSE: Coinciding with growth in America's older adult population and the need for adequate care, the purpose of this study was to explore the experiences of NPs caring for community-dwelling older adults experiencing polypharmacy. METHODOLOGICAL ORIENTATION: A qualitative descriptive study was conducted. Interviews were conducted, and data were analyzed for themes. SAMPLE: This study was conducted using a purposive sampling of NPs who care for older adults (n = 15). CONCLUSIONS: Four themes emerged: defining polypharmacy, communicating and collaborating, clinical judgement of NPs in relation to polypharmacy, and medication issues of older adults. The themes depict the complexity of medication management in older adults and the important role of NPs in providing care to older adults. IMPLICATIONS FOR PRACTICE: The significance of the study findings to future practice includes improving communication and collaboration between prescribing health care providers, better identification and management of polypharmacy, and improving the health care delivered to older adults. Safe and effective prescribing for older adults requires that NPs consider the unique needs of each older adult while using technology to support collaboration and decision making.

An Integrative Review of Methods of Measurement of Polypharmacy.

BACKGROUND AND PURPOSE: The purpose of this integrative review is to synthesize research on the measurement of polypharmacy. METHODS: A comprehensive search of the literature databases Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PubMed was conducted using a combination of terms/keywords to search existing studies to explore measures used to address polypharmacy. RESULTS: Several methods of measuring the existence of polypharmacy have been used in research. In addition to screening tools, the number of medications taken was used as an indicator of polypharmacy. CONCLUSIONS: Multiple methods of the measurement of polypharmacy have been used throughout the literature. Most methods related to the intended study objectives and population. The most frequently reported measure of screening was the Beers Criteria.