Challenges faced by new nurses during the COVID-19 pandemic.

INTRODUCTION: COVID-19 can be considered a unique and complex form of trauma with potentially devastating consequences for nurses in general and new nurses specifically. Few studies have been published that explain how relatively new nurses were prepared for COVID-19 in terms of knowledge and skill and how these nurses fared physically and emotionally. DESIGN: A qualitative descriptive design utilizing purposive sampling to recruit a diverse group of nurses who were within 2 years post-graduation from nursing school. METHODS: In-depth interviews of 29 nurses were conducted using a semi-structured interview guide to elicit data, which was coded and analyzed using thematic analysis. RESULTS: Six main themes and multiple subthemes were identified in the data. The main themes were: "We were not prepared," "I was just thrown in," "Avoiding infection," "It was so sad," "We did the best we could," and "I learned so much." CONCLUSION: The nurses who participated in this study expressed fear, weariness, exhaustion, isolation, and distress, observations echoed by studies from other countries. Retention of new nurses in acute care settings has always been a concern. In the recent Current Population Survey, a 4% reduction in nurses under 35 years of age has been reported, imperiling the retention of an effective workforce for decades to come. CLINICAL RELEVANCE: A recent report suggests that a larger than expected number of young nurses have left the profession in the wake of the pandemic. Staff shortages threaten the ability of the remaining nurses to do their jobs. This is the time to listen to the needs of new nurses to retain them in the profession and to avoid an even greater shortage in the near future.

Survey of Nursing Faculty Preparation for Teaching About Autism Spectrum Disorders.

The prevalence of autism spectrum disorders (ASDs) has increased significantly in children and adults. Nursing faculty's ability to teach students about best practices in their care across the lifespan is important. This study explored nurse educators' perceived knowledge of, and levels of comfort in, their abilities to teach nursing students about nursing care of people with ASD. Strategies are proposed to incorporate competencies for care of people with ASD into nursing curricula.

Mammogram Use and Self-Efficacy in an Urban Minority Population.

OBJECTIVES: (1) To compare a sample of low-income African American and Hispanic women in general and mammogram specific self-efficacy and other factors potentially associated with screening to identify any differences related to ethnicity and in the use of mammogram screening; and (2) to examine the association of general self-efficacy and mammography specific self-efficacy and mammogram screening in these two ethnically different groups of women. DESIGN AND SAMPLE: Cross-sectional. A convenience sample of 139 women. MEASURES: General and mammogram specific self-efficacy, having ever had a mammogram, acculturation, and demographics. RESULTS: Mammogram specific self-efficacy was significantly associated with having had a mammogram (p < .001), as was insurance status (p = .027). Using logistic regression, older women (OR: 1.3) and those with insurance (OR: 4.8) were more likely to have been screened. When mammogram specific self-efficacy was added to the model, overlap between this construct and insurance prevented insurance from reaching significance. CONCLUSIONS: An association between insurance status and mammogram specific self-efficacy was found. It is likely that mammogram specific self-efficacy will vary with mammogram adherence and insurance status, rather than predict screening. General self-efficacy, higher in screened women, may be an effective mediator through which to develop interventions to increase preventive health-seeking behaviors.

Focusing on maternal health beyond breastfeeding and depression during the first year postpartum.

Nursing experts reviewed publications between 2003 and 2013 to identify practices for the care of women during the recovery year after childbirth. They focused on maternal transition, role and function, and psychosocial support. Findings indicated that clarification of the psychosocial meanings of childbirth and motherhood and family support systems that strengthen or hinder optimal wellness and functioning are needed. In addition, evidence is required to promote healthy transitions during this transition year.

Nursing faculty preparedness for clinical teaching.

Nursing faculty who teach in clinical settings face complex situations requiring evidence-based educational and evaluative strategies, yet many have had limited preparation for these tasks. A convenience sample of 74 nursing faculty participated in a survey about clinical teaching in prelicensure nursing programs. Most faculty developed teaching skills through conferences (57%), orientation at their educational institution (53%), or exposure in graduate school (38%). Thirty-one percent reported having no preparation for clinical teaching. Faculty felt least prepared to manage students with learning, physical, or emotional disabilities and incivility. Twenty-six percent had no preparation for evaluating students in the clinical setting, and only 17% had worked with a faculty mentor. Few evidence-based teaching strategies were used by the faculty. These findings indicate gaps exist in the preparation of clinical faculty. Graduate education, comprehensive orientation programs, and continuing professional development may help to ensure faculty are effective in managing and evaluating student learning.

Using a pedagogical approach to integrate evidence-based teaching in an undergraduate women's health course.

BACKGROUND: Evidence-based practice (EBP) is promoted as a foundation for nursing practice. However, the 2005 U.S. survey of nurses revealed that they do not have requisite skills for EBP. PURPOSE AND GOALS: To evaluate a pedagogical approach aimed at (1) fostering undergraduate nursing students EBP competencies, and (2) identifying gaps in the literature to direct future women's health research. METHODS: A secondary analysis of data abstracted from required EBP clinical journals for an undergraduate women's health course in which students (n = 198) were asked to find evidence to answer their clinical questions. Content analysis was used to identify main themes of the topics of inquiry. RESULTS: Students identified 1,808 clinical questions and 30.3% (n = 547) of these could not be answered or supported by evidence in the literature. CONCLUSIONS: This assignment was an important teaching and assessment tool for EBP. Questions reflected critical thinking and quest for in-depth knowledge to support nursing practice. Some students lacked skills in searching databases and a significant number of knowledge gaps were identified that can direct women's health research.

Fostering a smooth transition to the faculty role.

Both new and experienced nursing faculty across the United States are struggling to meet the individual needs of an increasingly diverse and growing population of nursing students, while simultaneously attempting to balance the research, scholarship, and stewardship requirements of their institutions. Faculty development is part of the professional career journey, and involves mentorship, guidance, and more formal educational experiences. One university's faculty development program is described and addresses the role of mentors and administrators in the faculty development process, the recognized need for continued development and partnering opportunities, and outcome data from two cohorts of new nursing faculty.

Application of the Kessner and Kotelchuck prenatal care adequacy indices in a preterm birth population.

OBJECTIVES: Healthy People 2010 goals to eliminate racial and ethnic health disparities that persist in the utilization of prenatal care (PNC) highlight the importance of measuring PNC as a variable in maternal and infant health outcomes research. These disparities are significantly correlated to adverse infant outcomes in preterm birth (PTB), a leading cause of infant mortality and life-long morbidity. Currently the most extensively used PNC adequacy indices (Kessner and Kotelchuck) were developed to measure outcomes in populations consisting mostly of full-term births. It is unclear whether these PNC adequacy indices are reliable when pregnancy is truncated due to PTB (<37 weeks). This paper compares and demonstrates how they can be applied in a specific PTB cohort. DESIGN AND SAMPLE: This secondary analysis of a nested case-control study compares Kessner and Kotelchuck adequacy scores of 367 mothers of PTB infants. RESULTS: There were significant differences in the rating of PNC inadequacy ( p<.001) depending on the PNC adequacy index used. CONCLUSION: Critical evaluation is warranted before using these PNC adequacy indices in future public health nursing and PTB research.

The benefits of a leadership program and executive coaching for new nursing academic administrators: one college's experience.

Despite attention given to the nursing shortage and now the nursing faculty shortage, what is perhaps less visible but equally critical are the pending retirements of most of the current cadre of academic nursing administrators in the next decade. With only 2.1% of current deans, directors, and department chairs in 2006 aged 45 years or younger, there may be a pending crisis in leadership development and succession planning in our nursing schools and colleges. This article describes an innovative leadership development program for largely new nursing academic administrators, which combined a formal campus-based leadership symposia and executive coaching. This article is particularly useful and practical in that actual case studies are described (albeit modified slightly to protect the identity of the individual administrator), providing a real-life narrative that rarely makes its way into the nursing academic administration literature. The executive coaching focus is very sparsely used in nursing academia, and this college's success using this professional development strategy is likely to become a template for other institutions to follow.

A technology-driven nursing faculty resource center.

With the overwhelming need to recruit and retain more nursing faculty, providing faculty development is imperative. The authors discuss the design, implementation, and evaluation of a virtual Nursing Faculty Resource Center, allowing easy replication in other nursing institutions.

Tailoring peripartum nursing care for women of advanced maternal age.

Births to women of advanced maternal age have increased dramatically over the last decade in both the United States. The majority of women who deliver their first baby after age 35 are healthy and experience positive birth outcomes. According to current research, primigravidas over 35 tend to be educated consumers. Their physical and psychosocial needs differ from those of the mother in her 20s, due to advanced age and factors related to difficulty conceiving and life circumstances. This paper presents (a) an overview of the possible risks to outcomes of childbearing for women over the age of 35; (b) a discussion of how women of advanced maternal age may differ from younger women related to developmental stage, stress or anxiety or both, decision making, and support systems; and (c) an exploration of tailoring nursing care strategies during the peripartum period specifically for this age cohort.

The importance of providing smoking relapse counseling during the postpartum hospitalization.

OBJECTIVES: To determine during the postpartum period (a) the most feasible time for addressing smoking relapse, (b) the reasons women relapse, (c) differences in relapse rates in women who receive a counseling intervention in the immediate postpartum period compared to those who do not, and (d) differences in self-reporting of tobacco use compared to cotinine analysis. DESIGN: Randomized clinical trial. SETTING: Medical center in the Northeast United States and two prenatal care sites. PARTICIPANTS: A nonprobability convenience sample of 62 pregnant women. INTERVENTION: A brief counseling session using empowerment techniques, motivational interviewing, identification of stressors and individual coping strategies, and educational materials. MAIN OUTCOMES MEASURE: Relapse to smoking measured by cotinine analysis and descriptive data collected during the antepartum, intrapartum, and postpartum periods. RESULTS: Fifty-two percent of women relapsed to smoking by the 2nd week postdelivery, identifying rest and relaxation and depression as main factors for relapsing. Chi-square analysis showed no significant difference between the two groups regarding the intervention provided. There was a 39% discrepancy rate between self-reporting of tobacco use and cotinine analysis during pregnancy and a 27% discrepancy rate after delivery. CONCLUSIONS: Because of the high occurrence of relapse in the first 2 weeks after delivery, it is imperative that nurses provide interventions to women before their postpartum hospital discharge to prevent smoking relapse. Nurses should also address smoking behaviors each trimester because women stopped smoking at different time intervals and self-reported data were unreliable.

Use of upright positioning with epidural analgesia: findings from an observational study.

PURPOSE: To present research findings and related nursing implications from an observational study designed to evaluate the use of upright positioning during second stage labor with patients who had received low-dose epidural analgesia. STUDY DESIGN AND METHODS: This descriptive study evaluated outcomes from a sample of 74 healthy women having their first childbirth. They had all received epidural analgesia during the first and second stages of labor. Data were also collected by nurses on the use of birthing beds, and the extent of physical and emotional support the women needed while following the upright positioning study protocol. RESULTS: All women were able to maintain upright positions throughout the second stage of labor following epidural analgesia administration. No adverse neonatal outcomes or maternal problems (such as excessive vaginal bleeding) were documented. CLINICAL IMPLICATIONS: Although women were capable of assuming upright positions during second stage, the study results indicated that constant physical and emotional support was necessary for most women. Future research on methods to prepare women for multiple position options after administration of low-dose epidural analgesia should be undertaken. In addition, nurses should evaluate the benefits of upright positioning in terms of facilitating progress of labor.