Trato digno en la atención de salud a la comunidad LGBTIQA+ / Dignity in treatment in health care to the LGBTIQA+ community

El trato digno, igualitario e inclusivo se ha constituido en un fenómeno de estudio en el contexto de la atención sanitaria, pero su abordaje es aún limitado frente al desconocimiento respecto al tema por parte del equipo de salud hacia las personas de la comunidad de la diversidad sexual, hoy conocida con la sigla que les representa como LGBTIQA+, quienes están inmersos fundamentalmente, en una sociedad heteronormada, donde la formación profesional con enfoque de género y diversidad sexual es aún limitada. El objetivo de la argumentación del escrito es presentar algunas referencias conceptuales, derechos legales, consecuencias para la salud que fundamentan una propuesta para el cambio de las instituciones de salud y de las enfermeras y enfermeros que iluminen el derecho de las personas de esta comunidad a recibir un trato digno.

Dignified, equal and inclusive treatment has become a study phenomenon in the context of health care, but its approach is still limited due to the lack of knowledge on the subject by the health team towards people from the diversity sexual, today known by the acronym that represents them as LGBTIQA+, who are fundamentally immersed in a heteronormative society, where professional training with a gender and sexual diversity approach is still limited. The objective of the argumentation of the writing is to present some conceptual references, legal rights, health consequences that support a proposal for the change of the health institutions and of the nurses that illuminate the right of people in this community to receive a decent deal.

Educación tanatológica en Enfermería / Thanatological education in Nursing

Todo paciente terminal y su entorno pasan por una difícil situación que involucra la muerte, el dolor y la decisión. Para cualquier profesional de la salud es necesario contar con los conocimientos necesarios acerca de los cuidados tanatológicos al paciente o familia, para lograr incrementar el grado de conciencia en lo concerniente a su significado, divulgación y accesibilidad, teniendo en cuenta que es importante la comprensión de dichos cuidados. Los cuidados tanatológicos ante situaciones terminales son la expresión y el cumplimiento de un servicio indispensable en determinadas circunstancias de la vida. El acompañamiento en la última fase de la vida debe ser comprendido con la naturaleza y el conocimiento necesario, por lo que toda escuela que forme recursos en salud debe ofrecer al alumno las herramientas adecuadas para que, a su egreso como profesional de la salud, pueda atender correctamente al paciente en esta fase. La profesión de Enfermería se ha caracterizado por su gran labor humanística, por el ímpetu de aminorar el dolor de todo enfermo, comprendiendo el eje bio-psico-social que rodea a todo paciente y su enfermedad. En el camino asistencial de todo enfermo, el personal de Enfermería juega un rol muy importante al estar en mayor contacto con el paciente, es en este punto donde dos ciencias (Enfermería y Tanatología) se unen para asistir decorosamente a pacientes terminales. Las escuelas formadoras de capital humano en salud deben enfocarse en esta nueva necesidad de la sociedad y crear modelos de atención específicos para pacientes terminales.

Every terminal patient and their environment go through a difficult situation, death, pain and decision. For any health professional, it is necessary to have the necessary knowledge about thanatological care for the individual or family, in order to increase the degree of awareness regarding its meaning, dissemination and accessibility, taking into account that it is important to understand said care. Thanatological care in terminal situations is the expression and fulfillment of an essential service in certain life circumstances. The accompaniment in the last phase of life must be understood with the nature and the necessary knowledge, so that every school that trains health resources must have the correct training so that the health professional who graduates can properly attend to the patient In this phase. The nursing profession has been characterized for many years by its great humanistic work, by the impetus to reduce the pain of every patient, understanding the bio-psycho-social axis that surrounds every patient and their illness. In the care path of every patient, the nursing staff plays a very important role by being in greater contact with the patient, it is at this point where two sciences (nursing and tanology) come together to decently assist terminal patients. Schools that train human capital in health should focus on this new need of society and create specific care models for terminal patients.

Ethics and Well-Being: The Health Professions and the COVID-19 Pandemic.

The COVID-19 pandemic has had a profound impact on health professionals, adding to the moral suffering and burnout that existed prepandemic. The physical, psychological, and moral toll of the pandemic has threatened the well-being and integrity of clinicians. The narrative of self-sacrifice and heroism bolstered people early on but was not sustainable over time. For health professions students, the learning environment changed dramatically, limiting opportunities in direct patient care and raising concerns for meeting training requirements. Learners lost social connections and felt isolated while learning remotely, and they witnessed ethical tensions between patient-centered care and parallel obligations to public health. Worries about transmission of the virus and uncertainty about its management contributed to their moral suffering. Educators adjusted curricula to address the changing ethical landscape. Preparing learners for the realities of their future professional identities requires creation of interprofessional moral communities that provide support and help develop the moral agency and integrity of its members using experiential and relational learning methods. Investing in the well-being and resilience of clinicians, implementing the recommendations of the National Academy of Medicine, and engaging learners and faculty as cocreators of ethical practice have the potential to transform the learning environment. Faculty need to be trained as effective mentors to create safe spaces for exploring challenges and address moral adversity. Ethics education will need to expand to issues related to health systems science, social determinants of health, and public health, and the cultivation of moral sensitivity, character development, professional identity formation, and moral resilience.

Impact of the COVID-19 Pandemic on the Future of Nursing Education.

Nursing is the largest health profession, with nearly 4 million providers practicing across acute, primary, and public health care settings. In response to the pandemic, nursing schools halted on-site course delivery and redesigned programs to attenuate risks to students and faculty. Key challenges faced by schools included financial cutbacks, rapid increases in online learning technology, maintaining student academic progression, disruption to clinical learning opportunities, and meeting accreditation standards, while addressing the stress and loss experienced by faculty, staff, and students. Despite challenges, nursing organizations provided guidance for decision making, new learning resources, and faculty development opportunities. Schools of nursing leveraged their resources to redesign nursing curricula, strengthen partnerships for student clinical experiences, and address needs of the community. Nursing education will look different from its prepandemic profile in the future. Lessons learned during the pandemic point to gaps in nursing education, particularly related to disaster and public health preparedness, health equity, and technology. The American Association of Colleges of Nursing's new Essentials-standards for professional nursing education-were finalized during the pandemic and reflect these lessons. The need for nurse scientists to conduct emergency response research was made evident. The importance of strong academic-practice partnerships was highlighted for rapid communication, flexibility, and responses to dynamic environments. For the future, nursing education and practice must collaborate to ensure that students and practicing nurses are prepared to address emergencies and pandemics, as well as the needs of vulnerable populations.

Competência cultural no cuidado de Enfermagem à pessoa com deficiência: notas sobre a formação do enfermeiro / Cultural competence in nursing care for disabled people: notes on nursing education / Competencia cultural en el cuidado de enfermería de la persona con discapacidad: notas sobre la formación del enfermero

O objetivo do presente estudo foi analisar a formulação de competência cultural para o cuidado de Enfermagem à pessoa com deficiência. Trata-se de um estudo descritivo e documental realizado por meio da análise de projetos pedagógicos de cursos de graduação em Enfermagem. Os dados foram analisados no software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnairese, associado ao referencial teórico Transcultural Interprofessional Practice. A classificação hierárquica descendente originou duas classes, abordando o desenvolvimento da competência cultural para o cuidado de enfermagem individual e coletivo da pessoa com deficiência por meio de evidências científicas nos diferentes ciclos de vida e níveis de atenção, com ênfase na reabilitação e comunicação no processo saúde-doença. A formulação da competência cultural foi abordada de modo amplo e inespecífico, requerendo inclusão nos currículos de disciplinas que abordem a temática.(AU)

This study analyzed the development of cultural competence in nursing care for disabled people. We conducted a descriptive documentary study involving the analysis of education plans for undergraduate degree courses in nursing. The data were analyzed using the software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaire Transcultural in Interprofessional Practice in conjunction with the theoretical frame of reference. The descending hierarchical classification gave rise to two categories: the development of cultural competence in individual and collective nursing care for disabled people using scientific evidence for different life cycles; and levels of care, with emphasis on rehabilitation and communication in the health-disease process. The development of cultural competence was approached in a broad and unspecific manner and should be included in the curriculums of courses that address the topic.(AU)

Analizar la formulación de competencia cultural para el cuidado de enfermería de la persona con discapacidad. Estudio descriptivo, documental realizado por medio del análisis de proyectos pedagógicos de cursos de graduación en enfermería. Datos analizados en el software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires y asociado a la referencia teórica Transcultural Interprofessional Practice. La clasificación jerárquica descendente originó dos clases abordando el desarrollo de competencia cultural para el cuidado de enfermería individual y colectivo de la persona con discapacidad por medio de evidencias científicas en los diferentes ciclos de vida y niveles de atención con énfasis en la rehabilitación y comunicación en el proceso salud-enfermedad. La formulación de competencia cultural se abordó de modo amplio e inespecífico, requiriendo inclusión en los currículos de asignaturas que aborden la temática.(AU)

Evolution of nursing teaching in the use of education technology: a scoping review.

OBJECTIVE: To identify and map the technological tools of information and communication to support the teaching learning process in Nursing teaching courses. METHODS: This is a scoping review whose search was carried out in seven databases and in grey literature. After an initial analysis of the selection, 88 texts were read integrally, and 29 made up the final sample. RESULTS: Virtual learning environment and object, simulation, hypermedia, and software or cellphone applications were the tools the nursing professors used the most. Studies highlight that the application of technology was important in the teaching-learning process, since it encouraged teaching based on safe care, motivating and developing abilities/competences, supported on significant, effective, flexible, and autonomous learning. CONCLUSION: The contribution of the technology for nursing formation stands out, but it should be highlighted that its employment must be critical, reflective, based on pedagogical theories and developed by trained professors.

Academic-Service Partnerships: Increasing the Advanced Nurse Workforce.

BACKGROUND: Clinical education placement for advanced practice registered nurse (APRN) students is challenging for most graduate schools of nursing. This study describes the experiences of hospitals that formed academic-service partnerships to facilitate clinical education placement for APRN students. METHOD: Hospital staff, schools of nursing administration and clinical faculty staff, clinical preceptors, and APRN students participated in the focus group and interview sessions during the evaluation of the Graduate Nurse Education demonstration project. RESULTS: Content analysis resulted in seven themes: APRN Student Enrollment, Clinical Placements/Process, Clinical Education Sites, Clinical Preceptors, Communication and Collaboration, Sustainability, and Funding Process. CONCLUSION: Future partnerships between hospitals, schools of nursing, and clinical education sites should consider collaborating in multiple regions to increase enrollment and clinical education placement opportunities for APRN students. [J Nurs Educ. 2021;60(4):190-195.].

Advancing Evidence-Based Practice Through Implementation Science: Critical Contributions of Doctor of Nursing Practice- and Doctor of Philosophy-Prepared Nurses.

PURPOSE: Describe the evolution of implementation science and the roles and potential collaborations of doctorally prepared nurses to advance implementation science in practice settings. METHODS: Review of academic preparation and areas of expertise for doctorally prepared nurses as it relates to implementation science and evidence-based practice (EBP). FINDINGS: There have been substantial gains in the number of academic programs in healthcare that include content on EBP, resulting in healthcare teams that are motivated to align practices with best evidence. Unfortunately, many EBP initiatives stall during early stages of implementation, resulting in fragmented practices and persistent gaps between evidence and practice. Implementation science aims to bridge this gap and provides a structured, science-based approach to implementation. Few healthcare teams are familiar with implementation science, and many do not incorporate knowledge from the field when implementing EBPs. Doctorally prepared nurses are in a unique position to serve as leaders in EBP implementation due to the breadth and depth of academic preparation and their pivotal roles across practice settings. CONCLUSIONS: Collaboratively aligning existing strengths of PhD and DNP prepared nurses with knowledge of implementation science can advance implementation of EBP across practice settings to effectively incorporate and sustain meaningful change to improve outcomes. LINKING EVIDENCE TO ACTION SECTION: Doctorally prepared nurses are in a unique position to advance and apply the science of implementation in practice settings. Nurse scientists can generate evidence on effective strategies and outcomes among healthcare teams to successfully integrate evidence based practices into routine care. Nurse leaders and educators can apply these findings and use an implementation science approach when leading clinical teams in evidence-based practice changes.

The future of nurse education? Studying at the Open University in Scotland.

This article describes nurse education with the Open University in Scotland (OUiS). Although there are problems with nurse recruitment and retention across the UK, in Scotland the landscape is somewhat different, with greater support for students required in remote and rural areas. Despite these challenges, the OUiS continues to recruit to the commissioned numbers of places. OUiS nursing students are primarily health care support workers who are a key group within the health and social care workforce but historically have faced many challenges in developing clear career pathways into nursing. At the heart of the OU is the fundamental recognition of distance online pedagogy, complemented by work-based learning support by employers. Partnership working between the OU, employers and education commissioners is crucial to its success.

Simulation and student learning: will NMC policy lead to lasting change?

Emeritus Professor Alan Glasper, from the University of Southampton, discusses a new initiative from the Nursing and Midwifery Council to increase clinical learning through simulation during the COVID-19 pandemic.

Global Health Education Amidst COVID-19: Disruptions and Opportunities.

This viewpoint examines the impact of COVID-19 travel bans and remote education on the global health education of students from high-income countries (HIC) and low- and middle-income countries (LMIC) and explores potential opportunities for strengthening global health education based upon more dispersed and equitable practices. Global health is unique in the opportunities it can offer to students during the pandemic if programs can manage and learn from the pandemic's many challenges. Global health educators can: shift to sustainable remote engagement and mobilize resources globally to facilitate this; collaborate with partners to support the efforts to deal with the current pandemic and to prepare for its next phases; partner in new ways with health care professional students and faculty from other countries; collaborate in research with partners in studies of pandemic related health disparities in any country; and document and examine the impact of the pandemic on health care workers and students in different global contexts. These strategies can help work around pandemic travel restrictions, overcome the limitations of existing inequitable models of engagement, and better position global health education and face future challenges while providing the needed support to LMIC partners to participate more equally.

COVID-19 experience in mainland China: Nursing lessons for the United States of America.

COVID-19 emerged in Wuhan, China, and began its worldwide journey. As the severity of the virus became known, the Chinese National Government mobilized resources, and their centralized management was critical to the containment of the epidemic. Healthcare agencies and providers were overwhelmed with patients, many of whom were critically ill and died. Nurses adapted to the work using personal protective equipment, but its initial scarcity contributed to stressful working conditions. Nurses in the United States can take several lessons from the experiences of their Chinese nurse colleagues, including the benefit of centralized management of the epidemic, the need for specialized treatment facilities, and the importance of a national stockpile of critical equipment and supplies. A fully funded United States Department of Health and Human Services Office of Pandemics and Emerging Threats is necessary. A nursing department within the office and a national mobilization plan to send nurses to support local efforts during a pandemic or other threat are likewise essential. Continuous training for nurses, especially caring for patients with infectious diseases in intensive care units, stress management, and how to comfort the dying, are also useful lessons.

COVID-19 pandemic effects on nursing education: looking through the lens of a developing country.

BACKGROUND: COVID-19 pandemic has impacted the way things are done in walks of life including nursing education in both developing and developed countries. Nursing schools all over the world as well as in developing countries responded to the pandemic following the guidelines of the World Health Organisation and different countries specific guidelines regarding the pandemic. AIM: This reflective piece aims to describe the effect of COVID-19 on nursing education in developing countries. RESULT: Face-to-face teaching and learning were converted to virtual remote learning and clinical experiences suspended to protect the students from the pandemic. Specific but broader responses to the pandemic in the Caribbean and other developing countries have been shaped by financial, political and other contextual factors, especially the level of information technology infrastructure development, and the attendant inequities in access to such technology between the rural and urban areas. Internet accessibility, affordability and reliability in certain areas seem to negatively affect the delivery of nursing education during the COVID-19 lockdown. CONCLUSION AND IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY: The impact of COVID-19 on nursing education in the Caribbean and other parts of the world has shown that if adequate measures are put in place by the way of disaster preparedness and preplanned mitigation strategies, future crises like COVID-19 will have less impact on nursing education. Therefore, health policymakers and nursing regulatory bodies in the developing countries should put policies in place that will help in responding, coping and recovering quickly from future occurrences.

White dominance in nursing education: A target for anti-racist efforts.

Literature on racism, anti-racism, whiteness, nursing education and nurse educators was reviewed and analysed for the development of race consciousness and application of anti-racist pedagogy. The literature describes an oppressive educational climate for non-white identifying people, a curriculum that does not attend to the social construction of difference, and a nursing culture that is not consciously situated in a broader sociopolitical context. A particular focus on studies of nurse educators demonstrates a stark need for personal and professional development towards effectively delivering anti-racist pedagogy and a deconstruction of white normativity and dominance amongst white faculty. The protection and reproduction of white privilege is identified through the scholarship itself through a lack of racial analysis, an externalization of the root of oppression and non-specific study measures and outcomes. The persistence and pervasiveness of white dominance in nursing and the lack of anti-racist competence in white educators, particularly, merits a shift in anti-racist efforts away from short-term skill acquisition initiatives towards the deconstruction of socialized white supremacy and enactments of white privilege in nurse educators themselves.