Transatlantic Collaborations: Baccalaureate Nursing Students' Experiences of Participating in a Semester-Long Study Abroad Program.

AIM: The aim of this study was to describe students' experiences during a 15-week semester involving clinical placement in an Irish university. BACKGROUND: Internationalization is promoted and facilitated through study abroad initiatives within nurse education. Collaborations were developed between one university in the United States, an Irish university, and service partners. This study abroad initiative involved planning logistics, curriculum learning opportunities, and negotiating clinical placement in meeting state professional requirements. METHOD: A qualitative descriptive approach was used. Following ethical approval, 19 fourth-year students participated in focus group and individual semistructured interviews. Data analysis followed a thematic approach. RESULTS: Connecting our worlds details a process of acclimatizing, navigating learning, and using person-centered practices, illustrating meaningful learning in a journey of personal and professional development. CONCLUSION: Moving beyond the rhetoric of globalization is critical in future proofing initiatives in developing nursing practitioners while balancing potential safety risks in a post-COVID-19 era.

Navigating Professional and Personal Knowing Through Reflective Storytelling Amidst Covid-19.

The paper offers space for dialogue illustrating reflection as lived, exploring both my personal and professional experiences of grief and loss surrounding the death of my Dad from Covid -19. In my role as a nurse educator, I share understandings of reflection in facilitating learning and person centered practices with students. I illustrate my approach with two stories generating a narrative giving testimony to those who have died and highlighting the ensuing grief for those who have cared for older people during the pandemic. The first reflective story has been shared with students and snapshots of student responses during virtual sessions are incorporated. The second story shifts to a more personal focus reflecting personal knowing. Insights emerge bringing forth personal and professional knowing, about the art and science of holistic nursing. I explore the challenges in separating ourselves from personal knowledge and experience in reflective writing. I invite readers to take time to pause amidst a global healthcare pandemic to consider the potential of reflection to support nurses in recovering from suffering experienced during a pandemic.

Becoming student kind: A nurse educator's reflexive narrative inquiry.

This reflexive narrative inquiry examines reflection as a living learning strategy. My doctoral inquiry aims to illuminate a journey of transformation as a nurse educator within higher education. An innovative self-study, reflexive narrative methodology frames the research. Philosophical influences draw upon auto-ethnography, critical social theory and hermeneutics, guided by six dialogical movements. Nineteen reflections generated the data. Insights emerged through reflection, engagement with literature and guidance within a reflective community. Snapshots from reflective texts form the basis for dialogue presented in this paper. Emerging Insights are expressed as being available becoming student kind in relationship with students as a foundation for developing person centred nursing weaves through the narrative. This dynamic concept is expressed through The Being Available Template interlinking vision, knowing the person and compassion, poise and creating and sustaining a learning environment. Tensions in representing storied findings from innovative methodologies are identified. The contribution of reflection and potential of reflexive narrative for knowledge and practice transformation are shared. Challenges for educators in supporting reflective learning in curriculum in an ever complex landscape of higher education.are considered.

Key stakeholders' perspectives on the development of a national transfer document, for older persons, when transferring between the residential and acute care settings: A qualitative descriptive study.

AIMS AND OBJECTIVES: This study has aimed to examine key stakeholders' perspectives, views and experiences regarding transfer documents, used when an older person is being transferred from a residential to an acute care setting. The objective of the study was to inform, in part, the development of an effective national transfer document. BACKGROUND: For the effective and safe transfer of older persons from residential to acute care settings, it is important to ensure that the transfer document encapsulates relevant, current and person-centred information to ensure a smooth, quality and safe transition. Evidence highlights that, where documentation has lacked vital and relevant information, the older persons experience negative impacts during the transfer process. DESIGN: A qualitative descriptive study was conducted, following the COREQ checklist, to establish participants' perspectives, views and experiences of using transfer documents. METHODS: Focus group interviews (n = 8) were conducted with a convenience sample of key stakeholders (n = 68) in an Irish setting. The data were analysed using content analysis. RESULTS: The findings have highlighted the important aspects for consideration in the development of future transfer documentation. The three broad categories, used to present the data findings, are (a) existing transfer documentation; (b) design framework; and (c) essentials of care. CONCLUSIONS: The transfer document of the future is required to be concise, regularly reviewed and with a user-friendly colour-coded design. Essential and current information, with an emphasis on person centeredness, must be in the first page, with more detailed supporting information in the subsequent sections.

Juggling to survive: Master of Science postgraduate nursing students' experiences of studying far from home.

BACKGROUND: Globally, government and higher education institutions are expected to increase international student numbers. Programme development, marketing international collaboration and management has been the focus of strategy roll out. AIMS: This study aimed to explore international student experiences while undertaking Master of Science postgraduate education far from home. METHODS: A qualitative descriptive design was used. Following ethical approval, 11 students studying on a Master of Science Nursing postgraduate programme in one health education institute in Ireland volunteered to participate. Students were of Asian origin and mixed gender and the average age was 27. Data were collected using face-to-face semi-structured interviews and data analysis followed Burnard's thematic framework. RESULTS: The data provide evidence of the complexities and challenges experienced when studying on a Master of Science postgraduate nursing programme. Students described a process of juggling to survive and succeed. Three overarching categories emerged: differing realities, working through, and learning new ways. CONCLUSIONS: This study adds to international debate regarding structures and processes supporting international nurse education. In meeting ethnic and culturally-diverse student learning needs, consideration of learning and teaching approaches is warranted. For globalisation in nurse education to prosper, investment needs to move from focusing on recruitment towards structures and processes to nurture intercultural learning.

Potential and challenges for learning during acute medical/surgical placement for intellectual disability, mental health and midwifery students.

In Ireland nursing and midwifery degree programmes involve four pathways to registration. Three of which, intellectual disability and mental health nursing and midwifery require students to undertake acute medical/surgical placements offering learning opportunities caring for patients with complex needs in settings beyond their core discipline. This paper focuses on findings from a descriptive qualitative study exploring intellectual disability and mental health nursing and midwifery students experiences of such placements. Data analysis identified three themes: Getting ready, Navigating the way and Getting through. Feelings of stress and uncertainty are described by participants when moving from familiarity within a chosen discipline to an unfamiliar environment. Findings have influenced specific placement structures with local health service partners. While our study focuses on an Irish context, findings have relevance for student education in other jurisdictions. Enhancing preparation and support for students undertaking unfamiliar placements needs to be a constant endeavour. Such foundations will foster valuable experiences where students can feel part of a team, gain confidence, enhance skills and transfer meaningful learning to their core practice discipline. Further research is needed to explore the views of preceptors, ward managers and Clinical Placement Coordinators.

Realising the dream of becoming a nurse: Underrepresented BSc nursing students experiences.

BACKGROUND: This paper describes the experiences of underrepresented BSc nursing students in realising the dream of becoming a nurse in one university. In the past ten years, pre-registration nurse education has become established within higher education in Ireland. This development includes promoting access and inclusion of students from traditionally underrepresented groups in higher education. A third of nursing students currently access places on programmes through routes specifically designed for underrepresented groups. METHODS: A qualitative descriptive study design provided an opportunity for student voices to be heard. Ethical approval was sought and granted. Eleven students were interviewed nearing completion of a four year BSc Nursing programme. Data analysis followed a thematic approach, in generating themes. FINDINGS: Three themes emerged from the data: taking the first steps; finding a way and getting through. Findings highlight participants' challenges in balancing study, clinical practice and family life in achieving and realising their dream of becoming a nurse. CONCLUSION: This study illustrates the nature and complexities of participants' experiences throughout the BSc Nursing programmes towards becoming university graduates, eligible for registration as a nurse. Students from underrepresented groups bring rich and diverse life experiences in preparation for and becoming caring practitioners. It highlights the individuality within participants' experiences and draws attention to the value of personalised support for students. An opportunity to encourage the development of emotional intelligence needs to be fostered within nurse education programmes. Creating positive learning environments is critical to supporting student understanding of compassionate patient centred care. Findings have relevance for global curriculum design and structures to support individual student centred engagement. Further research is required to consider how best to support students from underrepresented groups.

Exploring nurses' use of the WHO safety checklist in the perioperative setting.

AIM: To explore nurses' use of the World Health Organization safety checklist in the perioperative setting. BACKGROUND: Promoting quality and safety in health care has received worldwide attention. The World Health Organization surgical safety checklist (2009) is promoted for reducing postoperative morbidity and mortality. The checklist has been introduced in Irish perioperative settings. METHOD(S): A descriptive, qualitative approach was utilised. A purposeful sample of ten nurses participated in individual, semi-structured interviews. RESULTS: Participants were committed to promoting safety in navigating challenges in introducing, complying and accepting the value of the World Health Organization surgical safety checklist in concordance with best practice. Participants moved from task completion to embracing the checklist as an effective surgical safety checking tool. Challenges were identified around roles and responsibilities in overseeing the completion of the checklist. CONCLUSION(S): The management of processes is critical when implementing any safety initiative. This paper highlights the complexity and challenges in implementing the World Health Organization surgical safety checklist, contributing to global discussions around translating policy into practice. IMPLICATIONS FOR NURSING MANAGEMENT: The effective implementation of a checklist requires a coordinated management approach in collaboration with team members. These approaches will support learning experiences contributing to a shared understanding of the change being implemented by all team members.

Developing an educational dvd on the use of hand massage in the care of people with dementia: An innovation.

The world's population is ageing and while the vast majority of older people live independently, a significant number will develop dementia. Communication and interpersonal skills are essential in developing relationships. People with dementia may have complex health needs and may have limited language capacity and therefore the use of presence and touch and more specifically hand massage gains greater significance for their wellbeing. This paper describes the process of developing an educational dvd on the use of hand massage in the care of people with dementia which is easily accessible via the web. A description of the design and project management including post production editing is provided. A number of outcomes are identified including: dvd launch, development of local and national interest, facilitation of workshops and the securing of funding for research. The educational dvd is a resource for learning for health care professionals and members of the public. The initiative offers a way of using technology to support individuals, nurses, carers and families living with dementia. This project demonstrates collaboration and connection between practice, education and technology and highlights the importance of the cyclical nature of theory and practice in responding to health care needs of a community.

Conversations through barriers of language and interpretation.

Ireland has become a multicultural society in just over a decade, with non-Irish nationals comprising 12% of the population. The challenge for nurses working in the Irish healthcare system is to provide culturally appropriate care to this diverse population. This paper reports on a qualitative descriptive study exploring nurses' experiences of communicating with people from diverse cultures, and focuses on language barriers and the use of interpreters. The findings indicate that communicating with people who do not share the same first language is challenging, in particular the participants (nurses) were concerned about their ability to make a comprehensive assessment that ultimately forms the basis for quality care provision. The use of interpreters can inform the assessment process, but there are challenges in accessing and utilising these services. Further continuing education is required to promote culturally appropriate care. There is a need for increased discussion between nurses and interpreters to maximise communication with patients.

The effect of contact precautions on healthcare worker activity in acute care hospitals.

BACKGROUND AND OBJECTIVE: Contact precautions are a cornerstone of infection prevention but have also been associated with less healthcare worker (HCW) contact and adverse events. We studied how contact precautions modified HCW behavior in 4 acute care facilities. DESIGN: Prospective cohort study. PARTICIPANTS AND SETTING: Four acute care facilities in the United States performing active surveillance for methicillin-resistant Staphylococcus aureus. METHODS: Trained observers performed "secret shopper" monitoring of HCW activities during routine care, using a standardized collection tool and fixed 1-hour observation periods. RESULTS: A total of 7,743 HCW visits were observed over 1,989 hours. Patients on contact precautions had 36.4% fewer hourly HCW visits than patients not on contact precautions (2.78 vs 4.37 visits per hour; [Formula: see text]) as well as 17.7% less direct patient contact time with HCWs (13.98 vs 16.98 minutes per hour; [Formula: see text]). Patients on contact precautions tended to have fewer visitors (23.6% fewer; [Formula: see text]). HCWs were more likely to perform hand hygiene on exiting the room of a patient on contact precautions (63.2% vs 47.4% in rooms of patients not on contact precautions; [Formula: see text]). CONCLUSION: Contact precautions were found to be associated with activities likely to reduce transmission of resistant pathogens, such as fewer visits and better hand hygiene at exit, while exposing patients on contact precautions to less HCW contact, less visitor contact, and potentially other unintended outcomes.

Creating a spiritual tapestry: nurses' experiences of delivering spiritual care to patients in an Irish hospice.

This study aims to describe nurses' experiences of delivering spiritual support in a palliative care setting in the Republic of Ireland. The authors conducted semi-structured interviews with 22 nurses working in the area of specialist palliative care. A content analysis of the transcriptions revealed five sub-themes: understanding spirituality; the art of nursing in spiritual care; education and learning; the challenge of spiritual caring; and the dimensions of time. The resulting creation of a spiritual tapestry provided an overall theme. Nurses in this study were spiritually self-aware and placed a high value on the spiritual element of their caring role. Nurses described their individual understanding of spirituality and discussed how they recognized and addressed a patient's spiritual needs. Time was described as essential to the provision of spiritual support and appeared to be a significant resource challenge to the provision of spiritual care. The challenges of assessing spiritual needs and measuring outcomes of care were also reported. Participants in this study described the creation of a spiritual tapestry that 'weaves' together care and compassion with skills and knowledge in their nursing practice.

Introducing guided group reflective practice in an Irish palliative care unit.

This paper describes the processes involved over one year in introducing, facilitating and evaluating a project of guided reflective practice for a group of eight palliative care nurses in Milford Care Centre, Republic of Ireland. While literature has tended to concentrate on critical discussion relating to reflection, less attention has been directed towards the organisation and facilitation of reflective processes in practice. In addressing this deficit, a detailed account of the collaborative processes and challenges involved in this project are presented. Group evaluation of the project is discussed under the following themes: understanding the process of reflective practice; the value of keeping a reflective diary; guided group reflection and moving forward. The introduction of guided reflection for palliative care nurses has afforded both the facilitators and the participants an opportunity to meet away from the clinical environment, and to work together, finding fresh insights to inform practice. The valuing and promotion of reflective processes by an organisation arguably provides a fundamental strategy to support nurses in a quality palliative care setting.