ABSTRACT
BACKGROUND: Nursing in the United States has evolved within the same historical context that has reproduced and spread racism worldwide. Nurse administrators are integral to the quality of nurses' practice and play a key role in eliminating racial injustice in places of work. PURPOSE: Using a feminist and critical race feminist framework, this study examined Massachusetts nurses' experiences of racism in their places of work, focusing on nurse administrators' influence on the nonadministrator (staff nurse) experience of racism experiences before and after George Floyd's death. METHODS: An investigator-developed, electronic survey was sent to Massachusetts professional nursing organizations for distribution to their members in 2021. Two hundred nineteen nurse respondents completed Likert-scale and open-ended branching logic survey questions to yield the quantitative and qualitative data analyzed for this mixed-methods study. FINDINGS: Nurse administrators were: 1) more likely than staff nurses to state that policies and meetings to address racism and diversity, equity, and inclusion had taken place before and after George Floyd's murder; and 2) less likely than staff nurses to directly experience racism at the hands of a colleague or a superior. Nurse administrators influence staff nurses' experiences of racism.
Subject(s)
Nurse Administrators , Nursing Care , Racism , Humans , United States , Leadership , MassachusettsABSTRACT
United States demographics are changing, but that change is yet to be recognized in the makeup of the nursing workforce. The underrepresentation of minorities in nursing is a longstanding problem, resulting in missed opportunities for culturally sensitive care that can foster optimal patient care outcomes. This report describes qualitative analysis of leadership opportunities emerging from a collaborative leadership development program between an urban baccalaureate nursing program and a large healthcare system in the northeast United States. The investigative team used qualitative methods to analyze the experiences of 19 participating African American (AA) RN graduates. Findings demonstrated that, for program participants, active engagement in personal and professional nursing leadership activities was enhanced. The academic-practice leadership program was an effective tool for enculturating AA nurses into the practice environment and into eventual leadership in nursing and healthcare.
Subject(s)
Black or African American/statistics & numerical data , Leadership , Nursing Staff/psychology , Program Development , Staff Development , Adult , Black or African American/psychology , Clinical Competence , Cultural Diversity , Delivery of Health Care , Education, Nursing, Baccalaureate , Female , Focus Groups , Humans , Male , Mentors , New EnglandABSTRACT
BACKGROUND: Capacity challenges at quaternary hospitals cause delays or denials in patient transfers from community hospitals that can compromise quality and safety. Repatriation is an innovative approach to increase capacity at the quaternary hospital by transferring a patient back to their originating community hospital after the quaternary portion of their care is completed. METHODS: A repatriation program was implemented at a large quaternary care teaching hospital over a one-year period (2020 to 2021). The authors characterized the rate of successful repatriation and associated patient characteristics, determined the impact on quaternary hospital capacity in terms of bed days saved, and estimated the resultant number of backfilled admissions that could be accommodated. The research team also monitored the rate of readmissions for repatriations back to the quaternary hospital. RESULTS: Overall, 215 repatriations were attempted, and 103 (47.5%) were successful. The most common diagnoses were sepsis (13, 12.6%), stroke (12, 11.7%), intracranial bleed (10, 9.7%), gastrointestinal perforation/obstruction (9, 8.7%), and trauma (9, 8.7%). The median length of stay at the quaternary hospital was 13 days (interquartile range [IQR] 7-20) and 12 days (IQR 4-26) at the community hospital. There were 2,842 bed days saved at the quaternary hospital, with a backfill opportunity of 431 admissions. The readmission rate to the quaternary hospital was 1.9%. CONCLUSION: By dynamically matching patient need with hospital capability at different phases of the patient's care, Repatriation can save bed days at the quaternary hospital, creating capacity to improve access for patients needing timely transfer. The low observed readmission rate suggests that repatriation is safe.
Subject(s)
Hospitals, Community , Stroke , Humans , Hospitalization , Patient Transfer , Patient Readmission , Length of StayABSTRACT
The main objective of this work was to carry out the external morphology characterization of 60-days gestation Myocastor coypus (coypu) fetuses since this stage could be considered a crucial point in the prenatal development in this species. Fourteen fetuses out of three litter were analised. Gestational sacs weighing 3.81 ± 0.27 g showed an elliptical shape with the larger axis along the direction of the uterus. The average weight of fetuses was 1.13 ± 0.19 g, the head-to-tail lenght was 1.99 ± 0.87 cm, the cephalic lenght was 1.01 ± 0.37 cm, and the biparietal diameter was 0.63 ± 0.06 cm. Specimens showed differentiation in corporeal, limbs and tail regions; also showed interdigital membranes, well defined optical vesicles and lateral ear lobe sprouts. Comparative analysis of coypu fetuses and equivalent stages of other mammal species will allow to establish similitudes and differences that would permit to mark particularities in the ontogeny of Myocastor coypus.
El objetivo de este trabajo fue efectuar la caracterización de la morfología externa de fetos de 60 días de gestación en Myocastor coypus (coipo), ya que éstos pueden ser considerados como un punto de inflexión en el desarrollo prenatal de la especie. Se analizaron 14 fetos provenientes de tres camadas. Los sacos gestacionales, cuyo peso fue de 3.81 ± 0.27 g, mostraron forma elíptica, con su diámetro mayor orientado en paralelo con la dirección de los hemiúteros. El peso medio de los fetos fue de 1.13 ± 0.19 grs, con una longitud céfalo-caudal de 1.99 ± 0.87 cm, longitud cefálica de 1.01 ± 0.37 cm y un diámetro biparietal de 0.63 ± 0.06 cm. Los especímenes mostraron diferenciación de regiones corporales, extremidades y cola, membranas interdigitales en los miembros posteriores, vesículas ópticas bien definidas y esbozos de pabellones auriculares en posición lateral. El análisis comparativo de los fetos de coipo con estadios equivalentes de otros mamíferos, permitió determinar similitudes y también diferencias que indicarían particularidades de la especie.