Returning enlisted veterans-upward (to) professional nursing: not all innovative ideas succeed.

Military licensed vocational nurses (LVNs) provide nursing care for the ill, injured, convalescent, or disabled persons. Those who have deployed both for humanitarian and wartime situations have a tremendous experiential base in stabilization of life-threatening frontline injuries and critical care intense facilities. An educational program was created called Returning Enlisted Veterans-Upward (to) Professional Nursing for retired/discharged U.S. Army LVNs to acknowledge their special military education and experiences. This educational model represented one step in the right direction to increase men and minorities in the professional nursing workforce, yet the program had to be dissolved. "Lessons learned" are presented so others might consider a similar project.

Partnering to maximize simulation-based learning: nursing regional interdisciplinary simulation centers.

The Upper Rio Grande Texas Schools of Nursing Regional Partnership, which is composed of the University of Texas at El Paso School of Nursing, Texas Tech University Health Science Center School of Nursing at El Paso, and the El Paso Community College School of Nursing, received American Recovery and Reinvestment Act funding under the Texas Tech University Health Science Center's umbrella to establish four Nursing Regional Interdisciplinary Simulation Centers (NRISC) in 2009. The NRISC were established as a partnership between the schools of nursing and four El Paso, TX, hospitals: Del Sol Medical Center, Sierra Medical Center, University Medical Center of El Paso, and Las Palmas Medical Center. This unique and innovative partnership had the following outcomes: (a) increased capacity to produce more nurses and (b) increased synergy among all the partners in relation to the use of simulation-based learning.

Preparing underemployed Latino U.S. nurses through the Mexico NCLEX-RN Success Program.

The critical nursing shortage in U.S. communities along the United States-Mexico border is compounded by the need for nurses who are linguistically and culturally concordant with the growing number of Latinos in these communities. The innovative 16-week Mexico NCLEX-RN Success Program responds to this need by helping underemployed Latino nurses, who were educated in Mexico and live in the United States, adapt linguistically and culturally to multiple-choice testing. Ten of the program students have taken the NCLEX-RN with a 50% pass rate, which is twice as high as the internationally educated candidate passing average. This demonstrates potential for the program to build the human capacity of U.S. communities along the United States-Mexico border by infusing linguistically and culturally concordant nurses into the workforce and materializing the dream of underemployed Latino nurses to implement their hard-earned and urgently needed nursing skills. Lessons learned from the program are discussed.

A case study of the Scaffolding Clinical Practicum Model: is it culturally competent for Hispanic nursing students?

The Institute of Medicine, Office of Minority Health, and the Health Resources and Services Administration have called for culturally competent teaching methods to promote the success of Hispanic nursing students. The article responds to this call by analyzing an innovative clinical practicum teaching method, the Scaffolding Clinical Model, in relation to the cultural competence needs of Hispanic nursing students. The analysis is presented through a case study of a cohort of predominantly (90%) Hispanic baccalaureate nursing students at a university on the United States-Mexico border. The cultural competence of the Scaffolding Clinical Model is analyzed by identifying how well it acknowledges and fosters the application of the four metaparadigms of Hispanic culture--conquest, collectivism, familism, and personalism--for Hispanic students. The metaparadigms are described and specific examples are offered about how the Model promotes application of the metaparadigms to accomplish cultural competence for Hispanic students. Recommendations for educators are also presented.

Lessons learned in instrument pilot testing with Mexican American caregivers of elders.

Given the fast-growing Mexican American (MA) population, it is common for investigators to be pressured into using Spanish translated instruments developed for English-speaking populations. However, these translated instruments may have limited relevance for data collection without adequate assessment and vetting. The purpose of this paper is to present lessons learned from the pilot testing of instruments designed for use with Mexican Americans. Pilot testing of two instruments was conducted with 22 Mexican American family caregivers of older adults. Issues that emerged were classified into three categories-instrumentation, methodology, and demographic data. Within the area of instrumentation, six issues were identified-level of abstraction, concreteness, pronoun use, clarity, exclusiveness, and response format. Methodological concerns were focused on test-retest administration and inclusion criteria. Issues within the demographic data were concerned with marital status, country of birth, household size and income, and validity of self-rated scales. By addressing those concerns, investigators may be more likely to have culturally sensitive measures and greater generalization to relevant MA populations.

Linguistic and cultural adaptation needs of Mexican American nursing students related to multiple-choice tests.

Hispanic nurses represent less than 2% of the current U.S. nursing workforce, despite that approximately 14% of the nation's population is Hispanic. There is an urgent need to correct the gross underrepresentation of Mexican Americans, the largest subgroup among Hispanics, in the U.S. nursing workforce to provide culturally concordant care. One solution is to increase the academic success of Mexican American nursing students with English as a second language through improved linguistic and cultural adaptation to multiple-choice tests. This article will discuss these students' linguistic and cultural adaptation needs related to multiple-choice tests and will also present several intervention strategies and a case study.

Promotora diabetes intervention for Mexican Americans.

PURPOSE: The purpose of this randomized controlled trial is to determine the effectiveness of an intervention led by promotoras (community lay workers) on the glycemic control, diabetes knowledge, and diabetes health beliefs of Mexican Americans with type 2 diabetes living in a major city on the Texas-Mexico border. METHODS: One hundred fifty Mexican American participants were recruited at a Catholic faith-based clinic and randomized into 2 groups. Personal characteristics, acculturation, baseline A1C level, diabetes knowledge, and diabetes health beliefs were measured. The intervention was culturally specific and consisted of participative group education, telephone contact, and follow-up using inspirational faith-based health behavior change postcards. The A1C levels, diabetes knowledge, and diabetes health beliefs were measured 3 and 6 months postbaseline, and the mean change between the groups was analyzed. RESULTS: The 80% female sample, with a mean age of 58 years, demonstrated low acculturation, income, education, health insurance coverage, and strong Catholicism. No significant changes were noted at the 3-month assessment, but the mean change of the A1C levels, F(1, 148) = 10.28, P < .001, and the diabetes knowledge scores, F(1, 148) = 9.0, P < .002, of the intervention group improved significantly at 6 months, adjusting for health insurance coverage. The health belief scores decreased in both groups. CONCLUSIONS: The intervention resulted in decreased A1C levels and increased diabetes knowledge, suggesting that using promotoras as part of an interdisciplinary team can result in positive outcomes for Mexican Americans who have type 2 diabetes. Clinical implications and recommendations for future research are suggested.