New registered nurse and registered psychiatric nurse graduates' transition-to-practice amid the pandemic: An art-based grounded theory study.

BACKGROUND: According to the Transition Shock theory, new Registered Nurses face formidable obstacles within their first year of practice. However, little is known about the experience of new Registered Psychiatric Nurses entering the workforce. OBJECTIVES: The aim was to explore how new graduates from nursing and psychiatric nursing experience their transition into the workplace that included identifying mediating factors that assist or challenge these entry-level professionals within their transition. DESIGN: Constructivist grounded theory methodology developed by Charmaz was utilized to explore the first-year transition period using art-based methods. PARTICIPANTS AND SETTING: A total of 13 new graduates practicing as Registered Nurses and Registered Psychiatric Nurse in a western Canadian province were recruited to participate in the study. Three art-based workshops occurred at four, eight, and 12-months starting in the fall of 2020 through the Spring of 2021 during the novel coronavirus pandemic with subsequent member checks in the Spring of 2022. METHODS: A total of 38 interview and focus group data were collected. Art-based activities included sand tray and figurine object exercises, collaging, reflective and thematic writing, as well as group concept mapping. Through co-creation of knowledge using Charmaz's methodology, participants selected the major themes throughout their first year of transition with guided researcher facilitation. Data were analyzed using the constant comparative method of analysis for each workshop drawing on the art creations, discussion, and narrative reflective writing pieces generated by participants. RESULTS: Participants were in a basic psychosocial process of growing personal and professional self. Through co-construction of knowledge with the participants, three substantive interconnected categories were identified: (1) Being thrown into the fire; (2) Adjusting and adapting to the team environment; and (3) Nurturing self and others. CONCLUSIONS: The findings revealed many recommendations for employers hiring new graduates and nursing education programs preparing graduates for the practice arena.

Perceptions and experiences of psychological trauma in nursing and psychiatric nursing students: A small scale qualitative case study.

Entry-level health care professionals are socialized to accept the norms and values associated with institutions in which violence and suffering is considered an anticipated and even routine and normalized part of frontline care. The objective of the study was to illuminate the subjective experience of psychological trauma in graduates from a baccalaureate nursing and psychiatric nursing program using the McGill Illness Narrative Interview, an ethnographic interview guide. Participants included graduates from each program in a western Canadian province who reflected back on their experiences of trauma as students and newly-graduated nurses within their first year of practice as a regulated health professional. Results: Six key themes were identified. Witnessing sudden change in patient or client status and unexpected death; Emotional labour; Faculty incivility; Sabotage, bullying and verbal abuse from the health care team; Exposure to physical violence and sexual inappropriateness; and Mobilizing supports. All exposures were linked to the participants' definition of psychological trauma. Conclusions: The study findings highlight the power dynamic, abuses, and vulnerability between students, faculty, and their clinical counterparts without adequate recourse. There is a need to foster emotional intelligence, self-efficacy, and resilience when potentially traumatic and stressful experiences occur with student nurse and early-career nursing populations.

Professional quality of life, stress, and trauma in nursing students: Before and during the novel coronavirus pandemic.

OBJECTIVE: The aim of the study was to assess the levels of stress, burnout, primary and secondary trauma, and self-efficacy before and during the novel coronavirus pandemic in a sample of baccalaureate nursing and psychiatric nursing students, a population which has seldom been studied regarding these factors. METHOD: The study used a nonexperimental, cross-sectional methodology at 2 time-points. Nursing and psychiatric nursing students enrolled at 1 western Canadian university were invited to participate in an online, anonymous survey in 2020 prior to the pandemic and in 2021 during Canada's third-wave. Survey measures included the Professional Quality of Life Scale (includes Compassion Satisfaction, Burnout, and Secondary Traumatic Stress), the Perceived Stress Scale, the Life Events Checklist to assess the amount of prior traumatic experiences, and the Core Self-Evaluations Scale. RESULTS: Statistically higher significant differences in prior traumatic experiences measured by the Life Events Checklist were found in the midpandemic cohort in comparison to the prepandemic 2020 student cohort (t(159) = -2.32, p < .05, 95% CI [-2.23, -.18]). Strong correlated relationships were found in many of the study variables (ranging from r = .301 to -.745, p ≤ .001). CONCLUSION: This preliminary study is the first to reveal that students in the nursing field experienced more traumatic events during the pandemic than before. The findings imply that access to greater support for experiences of trauma may be needed to support undergraduate students entering the health care arena amid the novel coronavirus pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A comprehensive review of compassion fatigue in pre-licensure health students: antecedents, attributes, and consequences.

Compassion fatigue has been documented in the nursing and allied health literature as an emerging issue for health professionals. Little is known regarding the experience of compassion fatigue in undergraduate, pre-licensure students entering health care professions. This study used Walker and Avant's concept analysis methodology to explain antecedents, attributes, and consequences of compassion fatigue in undergraduate, pre-licensure students. Exploration of the published literature from January 1992-April 2020 occurred using systematic review criteria based on the Joanna Briggs Institute. Findings revealed three antecedents that included: Coping Ability; Self-Efficacy; and Clinical and Occupational Hazards. Three defining attributes of compassion fatigue included: Psychological Stress; Witnessing Negative Experiences of Others; and Depression. Consequences included: Decreased Well-Being; and Program Withdrawal and Intention-to-Leave. The results offer new perspectives and opportunities for research in pre-licensure health studies undergraduate students expected to uphold the values of their professional program prior to entry into the workforce.

Professional Quality of Life Factors and Relationships in Nursing and Psychiatric Nursing Students: An Exploratory Study.

INTRODUCTION: Professional quality of life (ProQOL) that encompasses compassion satisfaction (CS) and compassion fatigue (CF) comprised of burnout (BO) and secondary traumatic stress (STS) has been raised as a world-wide issue for the nursing profession. Limited attention has been paid to the vulnerabilities of nursing students to ProQOL and the associated mechanisms. PURPOSE: Determine what factors are predictive of ProQOL in a population of undergraduate nursing and psychiatric nursing students. Methods: A cross-sectional survey was conducted comprised demographic questions and four validated measures: the Professional Quality of Life Scale (version 5), Core Self-Evaluations Scale, Perceived Stress Scale, and Life Events Checklist (version 5). RESULTS: Students in long-term care-palliative care rotations reported significantly higher levels of BO in comparison to other care areas. Regression analysis revealed students with low self-efficacy and high perceived stress were predictive of BO. Students with increased exposures to prior traumatizing life events were predictive of STS. Students with high levels of self-efficacy and less intent-to-leave were predictive of having CS. CONCLUSION: Findings assist educators, clinicians, and policy makers in understanding at-risk clinical settings and predictors of ProQOL in pre-licensure students. Curricular recommendations that include mindfulness, coping and crisis peer-debriefing, and emotional intelligence are discussed.

The Effectiveness of Tobacco Dependence Education in Health Professional Students' Practice: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

The objective of this study was to perform a systematic review to examine the effectiveness of tobacco dependence education versus usual or no tobacco dependence education on entry-level health professional student practice and client smoking cessation. Sixteen published databases, seven grey literature databases/websites, publishers' websites, books, and pertinent reference lists were searched. Studies from 16 health professional programs yielded 28 RCTs with data on 4343 healthcare students and 3122 patients. Two researchers independently assessed articles and abstracted data about student knowledge, self-efficacy, performance of tobacco cessation interventions, and patient smoking cessation. All forms of tobacco were included. We did not find separate interventions for different kinds of tobacco such as pipes or flavoured tobacco. We computed effect sizes using a random-effects model and applied meta-analytic procedures to 13 RCTs that provided data for meta-analysis. Students' counseling skills increased significantly following the 5As model (SMD = 1.03; 95% CI 0.07, 1.98; p < 0.00001, I2 94%; p = 0.04) or motivational interviewing approach (SMD = 0.90, 95% CI 0.59, 1.21; p = 0.68, I2 0%; p < 0.00001). With tobacco dependence counseling, 78 more patients per 1000 (than control) reported quitting at 6 months (OR 2.02; 95% CI 1.49, 2.74, I² = 0%, p = 0.76; p < 0.00001), although the strength of evidence was moderate or low. Student tobacco cessation counseling improved guided by the above models, active learning strategies, and practice with standardized patients.

It's Complicated: Improving Undergraduate Nursing Students' Understanding Family and Care of LGBTQ Older Adults.

Research has identified the need for improved cultural competence of health care providers regarding the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community's needs. This article articulates the teaching approach and methodology of an unfolding LGBTQ family case study for undergraduate nursing students. This method provided a forum for exploration of personal biases and gender-affirming techniques, and addressed the challenges of aging for a transgender woman and family within the context of societal stigma and discrimination. Students gained knowledge concerning shifts in family structures and understanding of the nurses' role encouraging inclusiveness and equitable access in health care settings, advocating for vulnerable populations, and addressing specific health concerns for transgender older adults. Student responses demonstrated increased knowledge of family diversity, and critical thought regarding the intersectionality of discrimination and aging. The findings revealed the case study methodology facilitated student understanding of the unique health and social issues for LGBTQ older adults within a family context.

Practical Nurses' Lived Experience of Returning to School.

The lived experience of licensed practical nurses (LPNs) pursuing Bachelor of Nursing (BN) education is not commonly studied in Canada. The aim was to understand the transition experience of LPNs who bridged into a BN program. Max van Manen's phenomenological methodology was used through use of a semistructured interview guide to explore the lived experience of LPNs who pursued baccalaureate nursing education. Five themes were found: seeking advancement; stepping back into the student role; juggling work, school, and family; struggling to be understood; and seeing things differently. In summary, LPN-to-BN students have a well-developed sense of identity as nurses. These students can benefit from a specifically designed, stand-alone bridge course to situate them within a BN program that leads to successful fulfillment of entry-to-practice competencies for RN licensure.

Comparison of Nursing Student and Instructor Preferences for Block and Nonblock Clinical Models.

Clinical experiences are the hallmark of prelicensure nursing programs and assist students with applying nursing theory into practice. The literature is limited with respect to nursing student and instructor preferences for type of clinical model to facilitate student learning. This article explores these perceptions in the nursing programs of 5 universities located in 4 Western Canadian provinces. Findings support the use of both nonblock and block clinical models throughout nursing education programs.

Nursing Student Preference for Block Versus Nonblock Clinical Models.

BACKGROUND: Clinical experiences are essential in undergraduate nursing student education to develop professionalism and integrate theory into practice. However, little evidence is available to guide curricular planners in determining the appropriate and effective use of different clinical models in nursing education. METHOD: Nursing students and four schools of nursing in two western Canadian provinces participated in this descriptive exploratory study examining student preference for clinical models. Thematic analysis of qualitative data addressed two research questions: What type of clinical model is preferred by nursing students? and How does clinical structure influence nursing students' perceived learning? RESULTS: Nonblock clinical practice is preferred by students with respect to a balanced lifestyle, concurrent integration of theory and practice, and critical reflection, whereas the block model is preferred for assimilation, consolidation, and socialization. CONCLUSION: Integration of both clinical models is recommended within undergraduate nursing curricula, as each model can facilitate student learning. [J Nurs Educ. 2017;56(3):152-157.].

Effectiveness of tobacco intervention education in health professional students' practice: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE: The objective of this review is to examine the effectiveness of entry-level education on smoking cessation or prevention and tobacco-dependence interventions on health professional student practice in promoting client health and on client smoking cessation behaviors.The specific review question to be addressed: what is the effect of entry-level tobacco dependence education on: (1) health professional students' knowledge and skills and self-efficacy, (2) performance of tobacco prevention and cessation interventions, and (3) client smoking cessation behaviors?

Letting go: How newly graduated registered nurses in Western Canada decide to exit the nursing profession.

BACKGROUND: The Canadian Nurses Association (CNA) estimates a nursing shortage in Canada will rise to 60,000 registered nurses by 2022. Further compounding this crisis is the approximate 14-61% of new nursing graduates who will change nursing roles or exit the profession. AIM: To explore the factors and basic psychosocial process involved in the decisions of newly graduated registered nurses in Western Canada who permanently exit the nursing profession within five years. DESIGN: Data was collected through unstructured and semi-structured interviews using the Glaserian grounded theory method. FINDINGS: Participants were found to be in a process of letting go of nursing that commenced as students and continued as they entered practice as registered nurses. Four major themes were identified. 1) Navigating constraints of the healthcare system and workplace: participants encountered difficulties adjusting to shiftwork and workload. 2) Negotiating social relationships, hierarchies, and troublesome behaviors; specifically hierarchal and horizontal violence. 3) Facing fears, traumas and challenges. 4) Weighing competing rewards and tensions which resulted in leaving the nursing profession. CONCLUSION: Students and subsequently new nursing graduates require a variety of supports to establish a nursing identity and remain in the profession. These supports include a manageable workload; meaningful orientation; interprofessional teamwork; and engagement within transformational and authentic leadership constructs. New nurses require a sense of being welcomed, valued, respected and accepted into the workplace environment, as well as constructive feedback, emotional support and debriefing to face workplace challenges.