Being present: Examining the efficacy of an Internet Mantram Program on RN-delivered patient-centered care.

BACKGROUND: The COVID-19 pandemic highlighted nurses' compassionate presence during stressful conditions. Strategies to reduce workplace stress are needed. PURPOSE: The purpose of this study was to evaluate a stress reduction strategy, an Internet-based Mantram Repetition Program (MRP), for nurses caring for hospitalized Veterans. METHODS: A one group pre-/post-test design was used to assess change in nurses' perceived outcomes after participating in the MRP. A post-test-only design was used to assess hospitalized Veterans' perceptions of nursing presence and satisfaction with care. Qualitative interviews were used to supplement quantitative data. FINDINGS: Patients perceived high levels of presence and satisfaction with care. Post MRP, nurses perceived increased mindfulness, compassion satisfaction, spiritual well-being, and nursing presence. Increased mindfulness was associated with greater compassion satisfaction and less burnout. DISCUSSION: For nurses working on the front lines of patient care, the potential for experiencing stress and burnout is a reality. Participating in a MRP could lessen these effects and facilitate nursing presence.

Validation of the Presence of Nursing Scale Using Data Triangulation.

BACKGROUND: Nursing presence has been developed as a distinct concept with identifiable behaviors but remains only partially defined as a quantifiable construct. OBJECTIVES: This study asked if the Presence of Nursing Scale (PONS) is a reliable and valid instrument to measure nursing presence from the patient's perspective. METHODS: A convenience sample of 75 adult acute care inpatients were verbally administered the 25-item PONS considering the registered nurse taking care of them on the day of data collection. Open-ended questions elicited the patients' explanations of their ratings. They also rated their overall satisfaction with the nursing care provided by the subject nurse using a 5-point scale. RESULTS: The mean PONS score was 104.5 (SD = 17.26) on the 25-125 scale. Instrument reliability reported as a Cronbach's alpha coefficient of .95 was .94 in this study. Instrument validity was tested correlating PONS scores to the satisfaction rating. The Spearman's rho correlation was large and statistically significant, r (73) = .708. The higher the PONS score, the more satisfied the patient was with care from that nurse. Nineteen narratives selected from the lower quartile PONS scores (PONS < 99) and 11 from the upper quartile (PONS > 116) were thematically analyzed. Lower PONS scores corresponded with themes of patients being objectified as the work of the nurse without a respectful and caring nurse-patient relationship. Higher PONS scores coincided with patients' perceptions of enhanced nurse-patient rapport, feelings of better coping, and decreased anxiety. DISCUSSION: These results demonstrate reliability and validity of the PONS and add to the body of evidence about nurse behaviors exhibited in the nurse-patient relationship, which influence patients' feelings of being cared for and satisfied with nursing care. These findings may be useful in the development of educational materials aimed at the advancement of nursing presence competency.

Patient Trust of the Muslim Nurse.

OBJECTIVE: This quantitative study examined patients' trust of a nurse who represents the Muslim faith by wearing the hijab. BACKGROUND: Presumptions about nurse trustworthiness based on religious affiliation may impede the effectiveness of the nurse-patient relationship and diminish the ability of nursing care to promote patient's feelings of well-being. METHODS: Hospitalized participants were randomly given a picture of a nurse either wearing the hijab or not. They completed a survey to measure their level of trust considering the nurse in the picture. RESULTS: No difference was found in trust of the nurse between groups or in trust analyzed for between-group characteristics. In the hijab picture group, the older the patient, the lower the trust of the nurse. CONCLUSIONS: The results may reflect the general trust of nurses as an ethical and honest professional group. A high level of general trust may transcend stereotypes toward a Muslim nurse.

Descriptive Analysis of Newly Hired Academic Nurse Educator Onboarding Practices.

BACKGROUND: Prelicensure nursing programs often hire clinical experts who are novice educators to teach integration of nursing clinical judgment within the context of patient care experiences. PURPOSE: To describe practices of schools of nursing to onboard, orient, and mentor newly hired faculty. METHODS: Faculty (n = 174) and leaders (n = 51) replied to an online survey. RESULTS: The majority (81.63%) of leaders hire novice nurse educators; 58.14% require a minimum bachelor of science in nursing degree; 54.72% have an orientation plan consisting of a mean of 13.86 hours, which was mostly asynchronous learning. Of the 77.08% of leaders with an onboarding plan, 84.13% assign a preceptor; 51.35% of them are compensated. CONCLUSIONS: Most schools of nursing hire experienced clinical nurses who are novice nurse educators, without organizational structures to support acquisition of teaching expertise. Academic institutions are called on to support clinical nurse educator professional development. Evidence is needed to design effective and fiscally pragmatic onboarding programs based on the certified nurse educator competencies.

Restrictions on Nursing Students' Electronic Health Information Access.

BACKGROUND: Restrictions on students' use of electronic health information have been anecdotally reported as a threat to clinical learning, development of informatics competency, and adherence to personal health information privacy laws. However, evidence on which informatics education and policy strategies can be designed is lacking. PURPOSE: This study describes the scope of nursing students' access to and use of electronic health information systems as reported by clinical instructors. METHODS: Clinical faculty (n = 193) in prelicensure programs from 25 states completed the online survey. RESULTS: Students are often restricted in retrieving patient health information, charting assessment data and delivered care, and using medication administration systems. Students alternatively use faculty or staff nurses' system security access. CONCLUSIONS: Results suggest the need for critical review of nursing curriculum related to informatics competency and clinical site health records access policies.

Confronting depression and suicide in physicians: a consensus statement.

OBJECTIVE: To encourage treatment of depression and prevention of suicide in physicians by calling for a shift in professional attitudes and institutional policies to support physicians seeking help. PARTICIPANTS: An American Foundation for Suicide Prevention planning group invited 15 experts on the subject to evaluate the state of knowledge about physician depression and suicide and barriers to treatment. The group assembled for a workshop held October 6-7, 2002, in Philadelphia, Pa. EVIDENCE: The planning group worked with each participant on a preworkshop literature review in an assigned area. Abstracts of presentations and key publications were distributed to participants before the workshop. After workshop presentations, participants were assigned to 1 of 2 breakout groups: (1) physicians in their role as patients and (2) medical institutions and professional organizations. The groups identified areas that required further research, barriers to treatment, and recommendations for reform. CONSENSUS PROCESS: This consensus statement emerged from a plenary session during which each work group presented its recommendations. The consensus statement was circulated to and approved by all participants. CONCLUSIONS: The culture of medicine accords low priority to physician mental health despite evidence of untreated mood disorders and an increased burden of suicide. Barriers to physicians' seeking help are often punitive, including discrimination in medical licensing, hospital privileges, and professional advancement. This consensus statement recommends transforming professional attitudes and changing institutional policies to encourage physicians to seek help. As barriers are removed and physicians confront depression and suicidality in their peers, they are more likely to recognize and treat these conditions in patients, including colleagues and medical students.