Towards a new (or rearticulated) philosophy of mental health nursing: A dialogue-on-dialogue.

The following dialogue takes up recent calls within nursing scholarship to critically imagine alternative nursing futures through the relational process of call and response. Towards this end, the dialogue builds on letters which we, the authors, exchanged as part of the 25th International Nursing Philosophy Conference in 2022. In these letters, we asked of ourselves and each other: If we were to think about a new philosophy of mental health nursing, what are some of the critical questions that we would need to ask? What warrants exploration? In thinking through these questions, our letters facilitated a collaborative enquiry in which philosophy and theory were generative tools for thinking beyond what is and towards what is yet to come. In this paper, we expand the dialogue within these letters-in a 'dialogue-on-dialogue'-and take up one thread of our discussion to argue that a new philosophy of mental health nursing must rethink the relationships between 'practitioner'/'self' and 'self'/'other' if it is to create a radically different future. Further, we posit solidarity and public love as possible alternatives to foregrounding the 'work' of mental health nursing. The possibilities we present here should be received as partial, contingent and unfinished. Indeed, our purpose in this paper is to provoke discussion and, in so doing, to model what we believe is a necessary shift towards criticality in our communities of nursing scholarship.

A Concept Analysis of Structural Competency.

Structural competency is a concept that offers a way to understand and respond to health inequities and work toward antiracism in health care. This article undertakes a concept analysis of structural competency using Rodgers' evolutionary method. Based on this analysis, structural competency refers to the ability to recognize and act on structural inequities, skill development, multidisciplinary collaboration, and the reproduction of inequity over time. The meanings and use of this concept differ among disciplines. Multidisciplinary applications of structural competency offer insight into how this concept can foster health equity and antiracism in nursing care, education, research, and health services delivery.

Structural Competency in Health Care.

The pandemics of COVID-19, systemic racism, and accelerating climate crises that have unfolded over the last 2 years highlight how social structures bear significant and disparate effects on individual health. The framework of structural competency offers a new way to understand and respond to health inequities in clinical care and health services delivery. Clinicians can work toward achieving structural competency at the individual, interpersonal, clinic, and community levels using the interventions described in the article.

Exploring Readiness for Teleprecepting in Psychiatric Mental Health Nurse Practitioner Training.

OBJECTIVE: Telehealth offers a solution to many challenges in health care, including the shortage of psychiatric providers. Recently the need to limit patient and provider exposure to coronavirus disease 2019 (COVID-19) has escalated implementation of telehealth across the globe. As telehealth utilization expands, its role in nursing education and training requires systematic evaluation. Since publication of the National Organization of Nurse Practitioner Faculty white paper supporting telehealth in health care delivery and nurse practitioner education, several studies have demonstrated successful didactic instruction and training in telehealth. However, a recent literature review found no studies evaluating the use of telehealth technology as a means of precepting in clinical training. METHODS: This small-scale qualitative study investigates the readiness of one behavioral health clinic to provide teleprecepting to psychiatric mental health nurse practitioner students. Two preceptors and one student were interviewed using a peer-reviewed semistructured interview guide using video chat. Responses were reviewed, coded, and categorized into themes. RESULTS: Thematic analysis of the interviews revealed three categories for consideration in establishing teleprecepting. Clinical factors, logistics, and comparison with traditional precepting are discussed. Interviewees viewed teleprecepting as a viable method of increasing access to clinical training. CONCLUSIONS: This project supports teleprecepting as a feasible strategy for improving access to clinical training and as a technological resource that merits systematic evaluation. Practice guidelines are needed for teleprecepting of advanced practice registered nurse students, and both preceptors and students may benefit from training to support best practices prior to implementation.

Transitioning from clinician to nurse practitioner clinical faculty: A systematic review.

BACKGROUND: Schools of nursing are challenged with recruiting and retaining nurse practitioner (NP) clinical faculty in a job market where the few qualified candidates have competing professional opportunities. The role transition from clinician to clinical faculty is stressful, and many faculty have unmet needs for support. OBJECTIVES: This article will identify strategies universities can implement to increase retention in the faculty role by facilitating the transition from clinician to NP clinical faculty. DATA SOURCES: Articles were identified from the following databases: PubMed, Embase, PsychInfo, CINAHL Plus, Web of Science, Google Scholar, and Cochrane Library. CONCLUSIONS: The transition from clinician to the NP role can be very difficult. New faculty experience culture shock and concerns about maintenance of clinical practice. Orientation, peer support, and mentoring can mitigate the challenges and support the transition. IMPLICATIONS FOR PRACTICE: Schools of nursing can facilitate the transition from clinician to NP clinical faculty by developing an onboarding program that integrates mentoring, orientation, and ongoing support.

Two Different Buprenorphine Treatment Settings With Similar Retention Rates: Implications for Expanding Access to Treatment for Opioid Use Disorder.

INTRODUCTION: There is considerable need for effective and accessible treatment for opioid use disorder. AIMS: Our study explored differences in buprenorphine treatment retention and duration, with a focus on selected sociodemographic factors and treatment indicators, in two different settings: an office-based buprenorphine induction and stabilization clinic (OBIC) and a community-based primary care clinic (CPC). METHOD: This nonexperimental retrospective chart review compared demographic information and buprenorphine treatment details, including treatment retention and duration. RESULTS: There were no statistically significant differences in buprenorphine treatment indicators between the OBIC and CPC groups, with two exceptions: the number of written buprenorphine prescriptions was significantly greater for the OBIC group, as was the number of filled buprenorphine prescriptions. CONCLUSIONS: Given similar treatment retention and duration in two different buprenorphine treatment settings, our findings suggest that access to buprenorphine treatment in standard integrated care settings can be supplemented by novel treatment structures such as the OBIC in order to increase access to care during the current opioid epidemic.

Nurses' Communication of Safety Events to Nursing Home Residents and Families.

Although communication is an essential part of the nursing process, nurses have little to no formal education in how to best communicate patient safety event (PSE) information to nursing home (NH) residents and their family members. The current mixed-methods study tested an intervention aimed at educating nurses on how to communicate a PSE to residents/family members using a structured communication tool. Nurse participants improved their knowledge of PSE communication, especially about the cause of the event, what they would say to the resident/family member, and future prevention of the PSE. Through qualitative subgroup analysis, an increased number of empathic statements were noted post-intervention. The tool tested in this study provides structure to an important care process that is necessary for improving the culture of safety in NH settings. [Journal of Gerontological Nursing, 44(2), 25-32.].