Professionalism in pre-licensure nursing education: Core values, didactic coursework and clinical training.

AIM: To discuss professionalism for pre-licensure nursing students and identify recommendations for inclusion in core values, didactic coursework and clinical training. BACKGROUND: Professionalism is part of the nursing identity that encompasses integrity and honesty. This concept has been difficult to translate into formal education in nursing programs and clinical practice. DESIGN: A discursive paper. DATA SOURCES: A search of national literature without date restrictions in PubMed, CINAHL, Google Scholar and frameworks for nursing education. We explored principles of professionalism in nursing education and practice. DISCUSSION: Evidence-based literature supports the integration of core values of altruism, autonomy, human dignity, integrity, honesty and social justice into didactic curricula, and clinical training. Principles of professionalism can be incorporated intentionally in nursing education to maintain patient safety and trust. CONCLUSION: The principles of professionalism, related to core values of the nursing profession, are abundantly described in the literature. However, these principles represent core values that have not been formally conceptualized. With the changing landscape of healthcare, there is a need for deliberate, measurable integration of professionalism into pre-licensure education. PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public involvement in the design or drafting of this discursive paper.

Addressing systemic racism and intergenerational transmission of anxiety using Bowenian family therapy with African American populations: A Discursive paper.

AIM: To examine the intergenerational impact of systemic racism on mental health, depicting the evolution and patterns of anxiety symptoms and the application of the Bowenian family therapy to understand the interrelatedness and long-standing impact of intergenerational trauma in African American families. This article highlights interventions that increase awareness of and promotes physical and mental health for African American populations. DESIGN: Discursive Paper. METHOD: Searching literature published between 2012 and 2022 in PubMed, SCOPUS, EBSCO Host and Google Scholar, we explored factors associated with systemic racism and generational anxiety. DISCUSSION: Evidence-based literature supports the application of the Bowenian family therapy theoretical framework to understand the intergenerational impact of systemic racism and to address the transmission of anxiety symptoms in African American  populations. CONCLUSION: Culturally appropriate interventions are needed to decrease anxiety symptoms in an attempt to heal intergenerational trauma and to improve family dynamics in African American populations. IMPACT TO NURSING PRACTICE: Nurses play an integral role in providing holistic quality patient-centred care for African American populations who have experienced racial trauma. It is critical for nurses to implement culturally responsive and racially informed care with patients that focuses on self-awareness, health promotion, prevention and healing in efforts to address racial trauma. Application of Bowenian family therapy can aid in the reduction of both intergenerational transmission of racial trauma and generational anxiety. NO PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public involvement in the design or drafting of this discursive paper. The authors reviewed the literature to develop a discussion.

Factors influencing intrapartum health outcomes among Black birthing persons: A discursive paper.

AIM: To examine factors that influence intrapartum health outcomes among Black childbearing persons, including cisgender women, transmasculine and gender-diverse birthing persons. BACKGROUND: Black childbearing persons are three to four times (243%) more likely to die while giving birth than any other racial/ethnic group. Black birthing persons are not just dying from complications but also from inequitable care from healthcare providers compared to their white counterparts. DESIGN: Discursive paper. METHOD: Searching national literature published between 2010 and 2021 in PubMed, CINAHL, Embase and SCOPUS, we explored factors associated with poor intrapartum health outcomes among Black childbearing persons. DISCUSSION: Several studies have ruled out social determinants of health as sufficient causative factors for poor intrapartum health outcomes among Black birthing persons. Recent research has shown that discrimination by race heavily influences whether a birthing person dies while childbearing. CONCLUSIONS: There is a historical context for obstetric medicine that includes harmful stereotypes, implicit bias and racism, all having a negative impact on intrapartum health outcomes. The existing health disparity among this population is endemic and requires close attention. IMPACT ON NURSING PRACTICE: Nurses and other healthcare professionals must understand their role in establishing unbiased care that promotes respect for diversity, equity and inclusion. NO PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public involvement in the design or drafting of this discursive paper.

Compelling Voices of Diversity, Equity, and Inclusion in Prelicensure Nursing Students: Application of the Cultural Humility Framework.

BACKGROUND: Diversity, equity, and inclusion are increasingly recognized as core values for guiding nursing education, practice, and research. The conceptual framework of cultural humility has been adapted in a variety of health care settings, fostering a culture of diversity, equity, and inclusion through openness, supportive interaction, self-awareness, self-reflection, and critique. PROBLEM: Nurse educators have the opportunity, but may find it challenging, to teach students about the changing landscape of health care and the populations we serve. APPROACH: This article describes the integration of the cultural humility framework into nursing curricula to teach principles of diversity, equity, and inclusivity. We provide a practical example of a diversity panel, with student and panelist reflections, exploring the intersectionality of experiences in health care and integration of personal accounts and perspectives. CONCLUSION: Dialogue about diversity, equity, and inclusion is essential for preparing future nurses to deliver culturally competent care and promote health equity.

Heterogeneity of Cardiovascular Disease Risk Factors Among Asian Immigrants: Insights From the 2010 to 2018 National Health Interview Survey.

Background The Asian population is the fastest-growing immigrant population in the United States. Prior studies have examined the Asian immigrant population as a homogenous group. We hypothesized that there will be heterogeneity in cardiovascular disease risk factors among Asian immigrant subgroups (Indian subcontinent, Southeast Asia, Asia) compared with the non-Hispanic White population. Methods and Results A cross-sectional analysis of the 2010 to 2018 National Health Interview Survey was conducted among 508 941 adults who were born in Asian regions or were non-Hispanic White and born in the United States. Generalized linear models with Poisson distribution were fitted to compare the prevalence of self-reported hypertension, overweight/obesity, diabetes mellitus, high cholesterol, physical inactivity, and current smoking among Asian immigrants compared with White adults, adjusting for known confounders. We included 33 973 Asian immigrants from Southeast Asia (45%), Asia (29%), the Indian subcontinent (26%), and 474 968 White adults. Compared with non-Hispanic White adults, Indian subcontinent immigrants had the highest prevalence of overweight/obesity (prevalence ratio, 1.22; 95% CI, 1.19-1.25); Southeast Asian immigrants had the highest prevalence of high cholesterol (prevalence ratio, 1.16; 95% CI, 1.10-1.23); Indian subcontinent (prevalence ratio, 1.69; 95% CI, 1.49-1.93) and Southeast Asian (prevalence ratio, 1.38; 95% CI, 1.26-1.52) immigrants had a higher prevalence of diabetes. All Asian immigrant subgroups were more likely to be physically inactive and less likely to smoke than White adults. Conclusions We observed significant heterogeneity in cardiovascular disease risk factors among Asian immigrants and a varied prevalence of risk factors compared with non-Hispanic White adults. Providers caring for Asian immigrants should provide tailored and culturally informed care to improve the cardiovascular health of this diverse group.

Establishing a Dedicated Difficult Vascular Access Team in the Emergency Department: A Needs Assessment.

Peripheral vascular access is one of the most common procedures performed in emergency departments across the United States. Successful venipuncture is critical in providing timely diagnosis and treatments for patients. The aim of this article is to describe a needs assessment performed in a level-one academic emergency department to establish the need for a dedicated team for patients with difficult vascular access. Results from this assessment suggest that difficult vascular access represents tangible threats to patient safety and increased use of resources.

Increasing the Number of Certified Registered Nurses in an Emergency Department: A Cohort Program Implementation.

Nationally, hospital emergency departments are met with challenges because of increasing patient demands, overcrowding, and the need to protect patient safety. It is imperative that frontline emergency department nurses are prepared to meet the complex needs of diverse patient populations by having appropriate continuing education, training, and institutional resources. Professional certification is associated with improved patient safety, higher organizational performance scores, professional growth, and credibility among nurses. The purpose of this article is to describe the process and outcome of a nursing professional development-practitioner-led intervention to promote professional certification among nurses in an urban adult emergency department while reducing overall cost of institutional support for certification preparation.