Racism and Nursing Leadership in Massachusetts: A Mixed-Methods Study.

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.

Storytelling and Workplace Bullying as Deterrents to Evidence-Based Innovation in Teaching: Nurse Educators' Lived Experiences.

AIM: The aim of this study was to examine the impact of academic context characteristics, especially bullying, on innovation in nursing education. BACKGROUND: Rapid and extensive changes in health care have prompted recognition of a need for concomitant changes in nurse educators' teaching practices. Nurse educator successes in meeting the demands of change, however, are challenged by constraints characterizing their academic practice settings. METHOD: Narrative analysis structured the study. RESULTS: The findings suggested that nurse educators' shared stories directed pervasive and lasting beliefs that discouraged innovation, fostered uniformity of teaching practice, and urged acts of bullying. CONCLUSION: Reflective teaching practice, open communication, and teaching innovation may be constrained by workplace storytelling and the bullying behaviors it engenders. Recognizing the impact of stories told in nursing education settings might contribute to strengthening the uptake of pedagogical research, supporting leadership for and innovation in nurse educators' evidence-based teaching practices.

African American Nurses' Perspectives on a Leadership Development Program.

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.

Developing Authentic Leadership Voice: Novice Faculty Experience.

AIM: The aim of this study was to determine the perceptions of 14 novice nurse faculty of a 20-month experiential leadership academy on the leadership development. BACKGROUND: Managing the complexities of nursing faculty roles requires significant leadership skills that often are hard won. Evidence suggests that leadership preparation to prepare nursing faculty through guided mentoring can enhance faculty recruitment, satisfaction, and retention. METHOD: Participants completed open-ended questions about their experiences in Sigma Theta Tau International's Nurse Faculty Leadership Academy. RESULTS: Data analysis revealed a meta-theme of "Finding Authentic Leadership Voice." Four subthemes emerged to shape the meta-theme: Identifying Inner Strengths and Areas for Improvement, Increasing Self-Confidence and Self-Awareness, Increasing Focus on Others, and Clarifying Aspirations for a Leadership Future. CONCLUSION: Reflecting on their experiences, participants recognized changes in their leadership roles as they found an authentic voice that helped them persist and thrive amid the complexities of their faculty roles.

Examining 'sticky' storytelling and moral claims as the essence of workplace bullying.

BACKGROUND: Fisher (1985) argued that "there is no genre…that is not an episode in the story of life" (p. 347). As they incorporate moral claims, stories become 'sticky,' even when they are not accurate of fact, shifting listener beliefs, values, and sense of self. PURPOSE: This study examined 'sticky' storytelling and moral claims inherent in workplace bullying. METHOD: Critical hermeneutic method nested within an integrative review served as the research approach, extending findings reported in published research reports and gray literature. FINDINGS: Through polished use of rhetorical style and resource control strategies within tacitly or explicitly supportive workplace contexts, bullies construct convincing but morally disengaged narratives-sticky stories-that violate ethical principles and yield moral ambiguity for their victims as they impede workplace productivity. DISCUSSION: Largely ineffective, policies aimed to stem bullying have done little to date to mitigate bullying's impact. Recognizing the moral storytelling characterizing workplace bullying might strengthen policy for constraining workplace bullying.

The incongruity of workplace bullying victimization and inclusive excellence.

PURPOSE: Bullying occurs frequently-and with significant negative outcomes-in workplace settings. Once established, bullying endures in the workplace, requiring the interaction of a bully perpetrator and an intended target who takes on the role of victim. Not every target becomes a victim, however. The purpose of this study is to investigate the processes by which targets, intended objects of bullies' affronts, become victims, those individuals who experience ongoing emotional injury in response to bullies' affronts, and to clarify how bullying victimization impedes inclusive excellence in the workplace. DESIGN: The design for this study was pragmatic utility, an inductive research approach grounded in assumptions of hermeneutics. METHODS: The pragmatic utility process involved the investigators' synthesis of descriptions from a broad, interdisciplinary published literature. Integrating knowledge from their previous research and practice experiences with the pragmatic utility process, they derived qualitative features of victims' experiences, differentiating target from victim in bullying encounters. FINDINGS: For those targets who ultimately are victimized, response to bullies' affronts extends far beyond the immediate present. Redolence of personal, lived experience revives bygone vulnerabilities, and naïve communication and relationship expectations reinforce a long-standing, impoverished sense. That sense couples with workplace dynamics to augment a context of exclusion. CONCLUSION: Findings suggest that, as Heidegger contended, we are our histories. Personal history demonstrates a significance influence on the manifestation of bullying victimization, acting to distance them from their workplace peers and to impede inclusive excellence.

Unacknowledged threats proffered "in a manner of speaking": recognizing workplace bullying as shaming.

PURPOSE: The purpose of this study was to examine workplace bullying victims' perceptions of what they heard their bully counterparts say through their use of prosody. DESIGN: From a sampling frame of 89 manuscripts referenced in the authors' previous studies, we identified a subset (n = 10) that included quotes regarding bullying victims' perceptions of communication experiences with their bully perpetrators. METHODS: We used hermeneutics and a recursive metasynthesis to interpret quotes embedded in the manuscripts chosen for this study. FINDINGS: Two-thirds of language is expressed nonverbally through prosody or "manner of speaking"-rhythm, stress, intonation, and vocabulary choice. We found that as bullies communicated with their intended victims over time, they used prosody across subtle, linked communications, or boldly and openly in public venues, to establish a context-embedded, one-way communication process of "doublespeak." CONCLUSIONS: Bullies' confusing prosodic communication processes served to recontexualize victims' situations and, through mechanisms largely unacknowledged by the victims, to subtly demean their personhood, and to shame them and render them voiceless. CLINICAL RELEVANCE: This study directs formal attention to the language of workplace bullying. Further study might strengthen opportunities to effectively address and curtail the long-term personal, professional, and organizational injuries deriving from workplace bullying.

Toward A Fuller Definition for the Science of Nursing Education Through Hermeneutical Analysis.

BACKGROUND: Authors writing about the science of nursing education have tended to focus extensionally, describing and analyzing the significance and benefits of nurse educators' unique, individual teaching endeavors, rather than clarifying their perceptions of the intensional core essence of the science itself. As a result, communal thinking about the science of nursing education and its implications for student learning are constrained. Methods: Hermeneutical analysis of published reports and narratives supported identification of a provisional, intensionally oriented definition of the science guiding nurse educators' disciplinary practice. RESULTS: The emerging definition was "study of nurse educators' mindful implementation of effective and meaningful learning opportunities to enculturate graduates for practice excellence guided by nursing's disciplinary knowledge." CONCLUSION: A working, intensional definition of the science of nursing education emphasizes qualities central to nurse educators' practice, ultimately contributing to preparing graduates for professional nursing practice. [J Nurs Educ. 2024;63(2):72-78.].

Mental Health Rather than Mental Disorders as a Predictor of Immediate Postoperative Recovery Following Elective Lumbar Fusion: Using the PROMIS-10 Global Mental Health T-Score.

STUDY DESIGN: Retrospective comparative cohort. OBJECTIVE: Investigate how a patient's mental health, as measured using the PROMIS-10 Global Mental Health T-Score (MHT), influences their in-hospital recovery following elective one to two level lumbar fusion. SUMMARY OF BACKGROUND DATA: The intersection of mental and physical health among candidates for lumbar fusion has increased. While there is strong evidence to suggest mental disorders can influence a patient's postoperative recovery, there is a paucity of information detailing the association between unrecognized low mental health and surgical outcomes. The MHT may provide a more nuanced insight to a patient's preoperative mental health status. METHODS: 637 patients that underwent one or two level elective lumbar fusion between April 2020 and June 2023 were analyzed for this study. Patients were stratified by their MHT (Above Average [AA] >50, control 40-50, Below Average [BA] <40) regardless of mental illness diagnosis. Outcome measures including: pain scores both during activity and at rest, opioid consumption during the in-hospital stay, and ambulation distance were compared among groups using both univariate and multivariate models to control for confounders. RESULTS: The majority of patients reported average (41.4%) to above average (35.3%) mental health. After controlling for confounders, findings suggested that patients in the BA group reported higher pain, consumed more opioids, and had shorter ambulation distances than patients in the AA group (P=0.004, P-0.008, and P=0.020 respectively). Patients in the AA group were 84% less likely to be discharged to a facility compared to the BA group (P=0.001). CONCLUSION: The MHT was an independent predictor of immediate postsurgical recovery, while a mental disorder diagnosis was not. A preoperative MHT<40, may represent and additional risk factor that has not previously been identified in patients undergoing elective lumbar fusion.

An overview of the DSM-5: changes, controversy, and implications for psychiatric nursing.

Scheduled for publication in May 2013, the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), will guide clinical diagnoses, treatment plans, medication choices and protocols, insurance reimbursements, and research agendas throughout the United States. It will also serve as a reference manual for clinicians around the world. This primary diagnostic source used by psychiatric and mental health providers is undergoing significant change in organization and content relative to the previous edition. This article provides a general overview of what to expect in the DSM-5, highlighting major aspects of the revision. Included is a list of the proposed diagnostic categories and an overview of some of the debate and discussion accompanying the changes. Implications for psychiatric nurses and psychiatric nursing are presented.

Examining the factor structure of the Pain Catastrophizing Scale (PCS) as a measure of victim response to the psychological pain of subtle workplace bullying.

BACKGROUND AND PURPOSE: Literature addressing victim-bully dynamics suggests that subtle bullying is prevalent in health care, both in practice and educational settings. The complex dynamics of workplace bullying complicate its assessment. The purpose was to investigate the factor structure of the Pain Catastrophizing Scale (PCS) for modeling victim responses to subtle workplace bullying. METHODS: Nursing faculty members from multiple Midwestern universities (N = 116) completed the PCS online. RESULTS: The 3-factor PCS structure (i.e., Rumination, Helplessness, Magnification) developed to describe victim response to chronic physical pain was useful in describing victim response to the chronic psychological pain of bullying via confirmatory factor analysis (CFA). CONCLUSIONS: With minor modifications, the PCS represented the construct of victim response to bullying's psychological pain.

Ramifications of the COVID-19 Pandemic on Nursing Students' Transition to Practice.

As the COVID-19 pandemic altered the course of nursing education worldwide, it disrupted efforts to transition nursing students to professional practice. The investigators examined clinical nursing faculty members' assessment of senior students' practice strengths and challenges compared to graduates of prior years. Findings demonstrated COVID-19's wide-ranging impacts on nursing students' transition to practice and offered suggestions about the implications for nursing professional development practitioners.

COVID-19-Mediated Strengths and Challenges for 2021 Nursing Graduates: Implications for Nurse Leaders and Educators.

The purpose of this hospital-based quality improvement project was to ascertain 18 clinical instructors' perceptions regarding senior nursing students' strengths and challenges in the time of COVID-19. Constant comparative method yielded 4 themes suggesting 2021 diversity in senior nursing students' clinical strengths and challenges, as well COVID-19's implications for students' professional identity development and transition to professional practice. Findings also suggested significant implications for nurses in professional development roles.

Psychological type and explanatory style of nursing students and clinical faculty.

Health care providers' collaboration and effective teamwork are essential to patient safety and quality care. Part of an ongoing project, this study focused on nursing faculty-student communication characteristics, specifically examining psychological type (Myers-Briggs Type Indicator) and explanatory style (Attributional Style Questionnaire) of participating first-year baccalaureate nursing students (n = 286) and clinical nursing faculty (n = 59) from both 2-year and 4-year nursing programs. Modal student psychological type was ESFJ, and modal faculty psychological type was ISTJ. The two groups demonstrated significant differences in information processing styles and in making decisions and judgments. Students demonstrated slightly more optimistic outlooks than did faculty. Psychological type and level of optimism did not appear to correlate. Data from this study provide an initial framework on which to base research to examine quality of teamwork among health care providers and, consequently, the quality of patient care.

Assessing Family-Like Dynamics in the Workplace as Possible Precursors of Workplace Bullying: Psychometric Analysis of a Modified Instrument.

BACKGROUND AND PURPOSE: Family-like dynamics in workplaces may serve as antecedents to workplace bullying. This study addressed the psychometric properties of an instrument modified to assess family-like dynamics in the workplace. DESIGN: The investigators used categorical principal components analysis (CATPCA) to investigate the psychometric properties of an instrument modified to measure coworker perceptions of family-like dynamics in the workplace. METHODS: Primarily White (95%) study participants (N = 273) completed a brief, demographic form and the modified Family Relationships Index (FRI) of the Family Assessment Scale (FES) (Moos & Moos, 1981, 1986). Demographic data were analyzed using descriptive statistics and perceptions of family-like dynamics in the workplace were analyzed using CATPCA. RESULTS: The modified FRI served as a reasonable model for capturing coworker perceptions of family-like dynamics in the workplace. CONCLUSIONS: Further research is indicated to determine the overall utility of the modified FRI and to ascertain whether family-like dynamics actually are precursors to workplace bullying victimization.

Nurse Author: Who Me? Yes, You!

BACKGROUND AND PURPOSE: Potential nurse authors may find writing a challenge, including managing the publication process from getting started through submission to revision of the work and its acceptance. This special article presents strategies to help inexperienced writers develop and hone skills for journal publication. POTENTIAL PUBLICATION STRATEGIES: Tips discussed here that may lead to manuscript acceptance include selecting a topic of interest, using motivational self-talk approaches and structuring time to write, choosing coauthors, targeting a journal for submission, writing strong sentences in active voice, developing a structured abstract, using correct citation and reference formats, understanding reviews and resubmitting the manuscript, and keeping momentum to produce continued writing results. Practical writing hints are also suggested for inexperienced writers. RELEVANCE AND CONCLUSION: These strategies can help guide nurse writers in planning, navigating the system, and finding success as a published author.

First-year nursing students' accounts of reasons for student depression.

This study used content analysis and hermeneutics to examine 53 first-year nursing students' surmised reasons for their own or their peers' experiences of feeling down or depressed. Study data were confidential e-mail responses (n = 53) to the question, "If you or another student you know has been feeling down or depressed, can you describe a reason?" Content analysis reflected respondents' sense of their own relatedness to the experience; a general sense of awareness of the occurrence of feeling down or depressed among students; suggested reasons, from general to specific, for those experiences among students; and sense of ownership, from self to others to individuals unspecified, as they described the experience of feeling down or depressed among first-year college students. Hermeneutic analysis revealed seven themes characterizing student experiences of feeling down or depressed. The authors address the context of depression frequently associated with college student life.

Toward a qualified yes: personal characteristics of postbaccalaureate nursing students and implementation of the clinical nurse leader role.

Anecdotal and research data suggest that psychological type and explanatory style influence individuals' day-to-day functioning. The assessment of these characteristics among postbaccalaureate students will support faculty in planning for students' educational programs and guide them as they provide support for the expansive role functions of, among others, the graduates of the newly proposed clinical nurse leader program. This article is a report of one study included in a longitudinal project examining the influence of psychological type and explanatory style on students' academic success. The questions addressed in this article are as follows: "How do psychological type and explanatory style differ between entering baccalaureate students and entering postbaccalaureate students?" and "How do experiences of depression and fatigue differ between these two groups of novice nursing students?" Findings suggest that postbaccalaureate students, although similar in psychological type to baccalaureate students, are significantly less depressed, less fatigued, and less positive in explanatory style than traditional baccalaureate students, indicating a potential need for support in addressing the demands of the roles that they will encounter as nurses.