"Finding My Place in Academia": Understanding the Experiences of Novice Faculty.

BACKGROUND: The current nursing faculty shortage rapidly has expanded the need to hire faculty. New faculty are clinical experts in their own practice; however, many lack formal knowledge about the academic setting, making the transition from practice to academia difficult. METHOD: A qualitative descriptive study was developed to identify how new faculty transition into their academic positions. The sample consisted of 12 clinical nursing faculty participants. RESULTS: A total of 12 themes emerged: awful day as faculty, career plans, compensation, finding my place in academia, great day at clinical, "I wanted to be successful," preparation for the faculty role, struggling, student experiences, support, lack of support, and surprise. Finding ways to recruit and retain qualified faculty is imperative. CONCLUSION: Inadequate support for transitioning to the faculty role may contribute to faculty turnover; developing a strong mentoring program may help retain qualified faculty. [J Nurs Educ. 2023;62(8):433-442.].

How to Write Powerful Letters of Recommendation.

Nurses at all levels may be asked to write a letter of recommendation to support colleagues' and students' career and academic advancement. This article outlines key steps and considerations in the letter-writing process.

Evidence-Based Practice: Implementing Trauma-Informed Care of Children and Adolescents in the Inpatient Psychiatric Setting.

INTRODUCTION: At our inpatient psychiatric hospital, which cares for children and adolescents, internal data of use of seclusions and holds as crisis interventions for immediate behavioral health issues demonstrated that we were using these too often. AIMS: Benchmarking indicated that we were at the 75% in use of these measures, and it became an organizational goal to reduce the use of these strategies in order to reduce the risk of retraumatization to an already traumatized child. METHODS: We used the Iowa Model for Evidence Based Practice-Revised to initiate an evidence-based practice project introducing and hardwiring Trauma Informed Care to the staff and institution. This involved implementing six core strategies specifically designed to reduce the use of crisis interventions. RESULTS: Data obtained at 6 months revealed a 40% reduction in the use of holds and seclusions, and at 12 months, this change was sustained and even improved, reducing the use of these approaches by another 9%. Furthermore, the culture in the institution was changed, and Trauma Informed Care became the norm. CONCLUSIONS: Evidence-based practice is a viable approach to change the culture and improve patient outcomes in inpatient psychiatric care of children and adolescents. Further investigation is warranted to determine the specific patient and staff experiences of being cared for, and caring within, the context of trauma-informed care.

What do novice faculty need to transition successfully to the nurse faculty role? An integrative review.

OBJECTIVES: The objective was to describe and illustrate what is known about the needs of novice nursing faculty as they transition into the faculty role. The worldwide nursing shortage is partly due to the lack of faculty, and one reason for that lack is the reported difficulty of transitioning into the faculty role. METHODS: An integrative review of the literature was conducted. RESULTS: Results demonstrated that new faculty are either intentionally supported in their new environment, with successful development of their skills and career, or they are unintentionally unsupported, which leaves them languishing and reduces intent to stay. CONCLUSIONS: Despite gaps in the literature and a low level of strength of evidence, the review offers implications for managing and maintaining relationships with novice faculty to facilitate their ultimate success. Institutions should aim to have in place identified elements that ensure novice faculty are intentionally supported rather than unintentionally unsupported.

Scholarly Requirements and Support for Nursing Faculty Development and Career Advancement: A Nationwide Delphi Study.

AIM: The aim of the study was to better understand the scholarship requirements and support for nursing faculty as they work to advance their scholarship and careers. BACKGROUND: Nursing faculty are often required to participate in teaching, service, and scholarship. New faculty often struggle with the scholarship component. METHOD: A nationwide Delphi study was conducted, surveying deans and/or associate deans for research at master's and doctoral degree-granting institutions. RESULTS: Scholarly requirements provided for faculty to enable development of scholarship were well defined: having a dedicated leader; funding support; a culture of scholarship; publications, presentations, and grant writing expectations; formal programs; mentors; and support. CONCLUSION: This study provided a beginning understanding of important aspects of faculty support for scholarship and career development. More information is needed to determine if the support structures and activities described reach faculty and enhance career development.

Safe clinical practice in pre-licensure nursing students: A concept analysis.

The aim of this paper is to provide a concept analysis for safe clinical practice for pre-licensure nursing students. Safe clinical practice is crucial to creating a safe environment. Defining the concept of safe clinical practice is important. Walker and Avant's concept analysis approach was used. Cumulative index to Nursing and Allied Health, Business Source Elite, Education Resources Information Center, and PsycINFO were searched for literature on safe clinical practice. The key words "student," "safety," "performance," and "unsafe student" were used. From a review of the literature, defining attributes, antecedents, and consequences of safe clinical practice were established and a definition of the concept emerged. The defining attributes identified are knowledge, skills, individual accountability, and professionalism. Students demonstrating appropriate knowledge levels and good technique with skills contribute to safe clinical practice. Taking accountability for one's actions and being professional also are important attributes to maintaining a safe clinical environment and ensuring safe clinical practice. Safe clinical practice in a patient-student situation occurs when pre-licensure nursing students who have been adequately prepared and practicing within a safe environment demonstrate knowledge of the clinical situation and its risks; communicate with faculty and staff members professionally; and develop appropriate relationships.

The Expressions of Hope in the Face of Complex Surgery: Experiences of Patients and Their Loved Ones.

BACKGROUND: Lung volume reduction surgery (LVRS), a reduction in damaged lung tissue in end-stage chronic obstructive pulmonary disease, is a breakthrough surgical procedure requiring months of rigorous screening, testing, and conditioning. Engaging in this process is prolonged and challenging with no research found exploring patients and loved ones' experiences through this demanding process. OBJECTIVE: The purpose was to examine the experience of LVRS for patients and loved ones as they encounter the complex preparation required prior to, during, and throughout the extended convalescence following surgery. METHODS: A mixed-methods approach was used, combining health outcomes with interview data. Participants and loved ones were purposefully selected, invited, and consented during the perioperative phase of LVRS. Quantitative data were obtained via chart review, while qualitative data were gathered through a 2-stage interview process, preoperatively and postoperatively. Qualitative data were analyzed using naturalistic inquiry approaches. RESULTS: Patients and loved ones described difficulties of living with illness during the preoperative phase, and expressed relief and joy for an improved quality of life afterward. The overarching theme uncovered was hope. Preoperatively, hope was coupled with anxiety about the upcoming surgery and potential outcomes, whereas the hope expressed after surgery focused on the future, in particular, a shared future. Statistically significant differences were found in the quality of life measures. CONCLUSION: For both patients and loved ones, LVRS is filled with hope for a more expansive future. Although that future is unclear prior to surgery, clarification and a new normal signals hope for a shared future following LVRS.

Faculty Support for a Culture of Scholarship of Discovery: A Literature Review.

BACKGROUND: A review of the literature was completed answering the question: "What is known about the barriers to, and support of, the scholarship of discovery that faculty members in nursing and related health sciences (i.e., medical, dental, and pharmacy) whose time is used in both the academic setting and clinical setting encounter as they develop programs of research, engage in grant writing, and pursue scientific publication?" METHODS: Using a systematic approach, a total of 29 articles were included in this review. RESULTS: Four major themes were identified: (1) Organizational expectations (2) administrative support (3) mentorship and (4) barriers to scholarship in nursing and related health sciences faculty. Organizational expectations and administrative support were critical in developing and maintaining a culture of scholarship, various mentorship models improved faculty scholarship skills and productivity, while multiple barriers were found to inhibit faculty development and scholarly productivity. CONCLUSION: The implementation of organizational, administrative, and faculty activities and interventions can promote a culture of scholarship. Further research is needed to determine which interventions are most helpful in developing health science faculty scholarship.

Innovation During Orientation: How Does Rhetoric Drive New Graduate Nurse Performance?

Modern health care demands knowledge, swift action, and critical thinking from nurses. New and experienced registered nurses are better able to provide excellent care when they are supported by documents that drive consistent nursing action. The process of developing these documents is critically important. Technical writers can improve the adoption of carefully designed forms that help newly licensed registered nurses develop a foundation in critical thinking as they move through orientation.

Methodology Update: Delphi Studies.

BACKGROUND: The Delphi method is a research approach that is beneficial when wanting to solve real-world problems, and expert opinions are needed. OBJECTIVES: The purpose of this study was to describe the Delphi method as a qualitative research approach and provide a case study example of a study using the Delphi method to demonstrate the advantages and challenges of this methodological approach. METHODS: A literature search was conducted to understand the Delphi method and examine its use in nursing. RESULTS: The literature search revealed what the Delphi method was and how it could be used. To better help explain the method, a case study from the literature is presented. DISCUSSION: Using the Delphi method in nursing research is becoming easier. With emerging technology, communication with geographically diverse experts may be easily and affordably achieved. With updated software, results can be interpreted almost immediately, and additional rounds of the Delphi occur in a timely manner, increasing participation and decreasing attrition rates. The Delphi method is a viable option for nurse researchers looking for expert opinion.

"I Am Surprised at the Change in Me": What Is It Like for Nurses to Be in the Process of Completing a Baccalaureate Degree in Nursing?

BACKGROUND: The percentage of nurses with a baccalaureate degree in nursing (BSN) affects patient morbidity and mortality, so health care organizations are encouraging staff nurses to finish their BSN degree. However, there is little data related to what it is like for RNs to return to school. METHOD: In this qualitative, descriptive study, 16 RN-to-BSN students were interviewed using naturalistic inquiry processes to gain an understanding of what it is like for students in the midst of an RN-to-BSN program. RESULTS: Students encountered financial and work-life barriers to seeking BSN completion yet found it to be worth the effort. Indeed, they are "surprised at the change in" themselves. CONCLUSION: Support that could benefit RN-to-BSN students is detailed, including from employers (e.g., flexible scheduling), faculty (e.g., rapid feedback and grading), and students themselves (e.g., understand personal time constraints). More research is needed to determine the priorities of support that facilitates RN-to-BSN students. J Contin Educ Nurs. 2018;49(7):307-314.

What Is It Like to Experience Improved Care Coordination Through a Community Outreach Program? A Qualitative, Descriptive Study.

Community-based programs deploying community health workers (CHWs) who collaborate with other entities are beginning to emerge as the US health system evolves. Although these programs have used various evaluation criteria to determine program success, little research has been completed to examine the experiences of program participants as they receive these services. The purpose of this qualitative descriptive study was to describe what it was like to experience the benefit of improved care coordination through a community-based program featuring CHWs, in collaboration with community-based interprofessional providers. Knowing the help I needed emerged as the overarching theme.

"I do the best I can:" Personal care preferences of patients of size.

AIM: Obesity is a common co-morbidity of hospitalized patients, and nurses sometimes have great difficulty meeting the skin care needs of patients of size. The purpose of this qualitative study was to identify successful self-care strategies patients of size used to care for themselves at home, in order to replicate these successes in the hospital. BACKGROUND: When patients who are obese are hospitalized they are vulnerable to complications, including skin integrity problems. These can be made worse for the patient if s/he cannot engage in their usual self-care hygiene practices. By uncovering self-developed solutions to hygienic care at home, nurses could incorporate these into their individualized plan of care. METHODS: This qualitative descriptive study used an appreciative inquiry approach, to discover what works well, in order to replicate these actions. A skilled qualitative nurse researcher used a semi-structured interview process to uncover the personal care preferences of patients whose admission body mass index (BMI) was >50. A step-wise approach was used for data reduction, and triangulation of researchers added to the study's trustworthiness. RESULTS: Fourteen patients of size were interviewed. Nine categories emerged from the data, all of which fit under the overarching theme: "I do the best I can." Multiple ideas for quality care, delivered while preserving patient dignity, were identified. Implications for nursing practice are included. CONCLUSION: Patients of size have developed creative and useful approaches to managing skin health that could be used in the hospital when patients are unable to manage their self-care alone.

Influencing Commitment to BSN Completion: A Pilot Project Using Motivational Interviewing.

The 2010 Institute of Medicine's Future of Nursing report posed recommendations to increase numbers of nurses with baccalaureate degrees or greater to 80%. This project engaged associate degree nurses in motivational interviewing focusing on finding and removing barriers to baccalaureate matriculation and completion. Results indicated a statistically significant influence on attitudes and return-to-school decision making and identified a qualitative theme: "I know more now… I could be a better nurse."

"To See With My Own Eyes": Experiences of Family Visits During Phase 1 Recovery.

PURPOSE: Long separations are a characteristic of the day of surgery, keeping patients and their family members waiting and apart. At a time of high vulnerability, these separations can cause anxiety and worry. The purpose of this study was to identify the outcomes and experiences of patients and family members who engaged in a 5- to 10-minute supervised family visit during phase I postanesthesia recovery. DESIGN: This was a descriptive, single-group, mixed-methods study. METHODS: Quantitative data, gathered on the day of surgery, was obtained from patients (vital signs, state anxiety scores) and their designated family members (state anxiety scores); satisfaction with the visit was also measured. An optional second, qualitative phase included a semi-structured interview examining the remembered experiences of patients and family members. FINDING: A statistically significant drop in state anxiety was discovered after the visit, and satisfaction with the visit was exceedingly high. Qualitatively, patients and family members described their overwhelming relief to be able "to see with my own eyes" how well each was doing. CONCLUSIONS: This study supports that family visits in the postanesthesia care unit are safe and profoundly important as an independent nursing intervention. Recommendations include implementation of family visits during postanesthesia care unit recovery for all patients and family members who desire them.

No more "fumbling alone": effect of a nurse-led academic advising service in a Magnet(®) hospital.

BACKGROUND: A nurse-led, hospital-based academic advising service (AAS) was developed at a large Magnet(®) hospital. The AAS aided nurses and aspiring nurses as they considered advancing education. This research project was developed to evaluate the AAS. METHODS: This qualitative study used a web-based survey to gather information from those who had accessed the service; there were 80 participants. Satisfaction was determined quantitatively, and qualitative data analysis was completed with naturalistic inquiry approaches and standards of rigor. RESULTS: A total of 347 codes were isolated from the data and collapsed into nine categories. One comment, "I did not have to fumble through this alone," suggested the idea of coaching within a context of football as the overarching metaphor. Quantitative results indicated that advises were satisfied, with 61 of 80 respondents taking specific action after the session. CONCLUSION: Nurses and aspiring nurses found academic advising at work helpful, and the AAS facilitated a return to formal education for some of the participants.

Translational research: a concept analysis.

UNLABELLED: BACKGROUND/CONCEPTUAL FRAMEWORK: Little is known about which approaches facilitate adoption and sustainment of evidence-based practice change in the highly complex care environments that constitute clinical practice today. The purpose of this article was to complete a concept analysis of translational research using a modified Walker and Avant approach. DESIGN/DATA COLLECTION: Using a rigorous and thorough review of the recent health care literature generated by a deep electronic search from 2004-2011, 85 appropriate documents were retrieved. Close reading of the articles by three coresearchers yielded an analysis of the emerging concept of translational research. DATA ANALYSIS: Using the iterative process described by Walker and Avant, a tentative definition of the concept of translational research, along with antecedents and consequences were identified. Implications for health care professionals in education, practice, and research are offered. Further research is needed to determine the adequacy of the definition, to identify empirical referents, and to guide theory development. RESULTS: The study resulted in a theoretical definition of the concept of translational research, along with identification of antecedents and consequences and a description of an ideal or model case to illustrate the definition. IMPLICATIONS/CONCLUSIONS: Implications for practice and education include the importance of focusing on translational research approaches that may reduce the research-practice gap in health care, thereby improving patient care delivery. Research is needed to determine the usefulness of the definition in health care clinical practice.

Evaluating the impact of a nurse residency program for newly graduated registered nurses.

Nurse residency programs are designed to support graduate nurses as they assume the professional role. Evaluation of these programs has been inconsistent. The purpose of this descriptive research study was to evaluate a year-long nurse residency program using a nonexperimental, repeated measures design with qualitative questions. Results showed statistically significant differences in new nurse confidence, skills, and abilities at 12 months. Nursing turnover was one third of the national average. The metatheme that emerged from the data was "I see that I am not the only one."

Weathering the storm: nurses' satisfaction with a mobile admission nurse service.

AIM: To evaluate nurses' satisfaction with, and perceptions of, a practice innovation introducing a Mobile Admission Nurse service. BACKGROUND: Staff nurses identified that the admission process, while crucial to initiating safe and appropriate acute care, can be disruptive and interfere with care in progress. A pilot project implementing the role of a Mobile Admission Nurse was introduced to address this need. METHOD: A self-developed web-based survey was administered to a convenience sample of 104 RNs who had used the services during the pilot project. RESULTS: Staff nurses (n = 78) reported a chaotic, demanding work environment within which the admission process disrupts the flow of care. The Mobile Admission Nurse helped them in 'weathering the storm', which was the overarching theme that emerged during data analysis. CONCLUSIONS: Having an admission nurse complete the admission process steadied workflow processes for nurses. Improved patient safety and increased staff and family satisfaction were also reported. The strongly positive feedback led to expansion of the service. IMPLICATIONS FOR NURSING MANAGEMENT: Proactively redesigning work processes, using a structured theoretical model such as the (Plan-Do-Study-Act) PDSA approach, may improve outcomes in a chaotic practice environment.

Reflecting on research: sharpening nurses' focus through engaged learning.

BACKGROUND: The Bedside Scientist Institute is a basic research course provided for nurses using an engaged, interactive learning environment. This qualitative study evaluated the course outcomes. METHODS: A large Magnet®-designated teaching hospital provided the setting for both the education and the study. Coding categories and themes were identified from 16 interviews; a focus group confirmed the study findings. RESULTS: Culture change was facilitated by enlarging the perceptual field, reflecting on research evidence and the practice-research interface, and focusing on a new vision for evidence-based practice. Half of the nurses who participated returned to formal education. CONCLUSION: Participating in the Bedside Scientist Institute was transformative. The course opened participants' minds to question traditional practice, developing champions for research.