Orientation of New Graduate Registered Nurses Postpandemic: A Follow-up Study.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has increased the rate of nurses leaving practice, which has highlighted the importance of new graduate nurse orientation. The literature has limited recommendations for orientation strategies. METHOD: The goal of this study was to determine what changes have occurred in orientation processes for new graduate nurses since the COVID-19 pandemic. A survey of nurse leaders was used to examine changes and opportunities. RESULTS: Leaders are more intentional with orientation processes, including frequent check-ins and increased discussion of time management, difficult conversations, and workplace violence. Individualized orientation plans are used, along with a stronger focus on nurse wellness. CONCLUSION: Recommendations include continuing support after orientation is completed and partnering with academia to provide content on stress management and wellness. Innovative and cost-effective transition to practice programs are needed to meet the needs of new nurses. [J Contin Educ Nurs. 2024;55(7):345-350.].

Palliative Care Knowledge Following an Interdisciplinary Palliative Care Seminar.

BACKGROUND: The COVID-19 pandemic created a unique opportunity to evolve an interdisciplinary palliative care seminar (IPC) into a virtual platform. This seminar provides foundational palliative and hospice concepts, introductions into palliative care disciplines, integration of teamwork, and incorporates interdisciplinary student led patient encounters. Traditionally, this experience had been in person, however during the COVID-19 pandemic, healthcare restrictions transitioned the educational delivery to a virtual platform. METHODS: To assess the knowledge gained from this novel experience, the Palliative Care Knowledge Test (PCKT) was administered before and after the IPC Seminar. A 1-year follow up survey was also administered to evaluate how the IPC Seminar was applicable to the students' clinical experiences and practice. RESULTS: The virtual didactics and virtual student led patient encounters significantly improved learners understanding of palliative and hospice care. This gain of knowledge was noted across undergraduate and graduate programs, which highlights the need for and benefit from foundational concepts. Furthermore, a 1-year follow up survey noted the IPC seminar was applicable to their practices and suggests that this experience will impact future patients. DISCUSSION: Many of the students practice in rural areas where access to palliative care services is limited or non-existent. This experience exponentially impacts the growth of palliative and hospice care understanding and access to care across the region. CONCLUSION: Evolving our IPC Seminar has shown to significantly improve knowledge, foster collaboration of student led interdisciplinary teams, and increases capacity to meet the needs of more learners.

Future Catastrophic Event Preparation: Recommendations From Clinical Nurses Aligning With the Future of Nursing 2020-2030 Report.

Nurses play an important role in pandemic and disaster response, often at a personal cost to their overall well-being. Interviews with 19 frontline COVID-19 nurses helped illuminate priority focus areas involving nurses in the planning process, providing clear communication and offering mental health services. These recommendations align with and reinforce conclusions and recommendations from The Future of Nursing 2020-2030 Report.

Attribution of Space-Time Variability in Global-Ocean Dissolved Inorganic Carbon.

The inventory and variability of oceanic dissolved inorganic carbon (DIC) is driven by the interplay of physical, chemical, and biological processes. Quantifying the spatiotemporal variability of these drivers is crucial for a mechanistic understanding of the ocean carbon sink and its future trajectory. Here, we use the Estimating the Circulation and Climate of the Ocean-Darwin ocean biogeochemistry state estimate to generate a global-ocean, data-constrained DIC budget and investigate how spatial and seasonal-to-interannual variability in three-dimensional circulation, air-sea CO2 flux, and biological processes have modulated the ocean sink for 1995-2018. Our results demonstrate substantial compensation between budget terms, resulting in distinct upper-ocean carbon regimes. For example, boundary current regions have strong contributions from vertical diffusion while equatorial regions exhibit compensation between upwelling and biological processes. When integrated across the full ocean depth, the 24-year DIC mass increase of 64 Pg C (2.7 Pg C year-1) primarily tracks the anthropogenic CO2 growth rate, with biological processes providing a small contribution of 2% (1.4 Pg C). In the upper 100 m, which stores roughly 13% (8.1 Pg C) of the global increase, we find that circulation provides the largest DIC gain (6.3 Pg C year-1) and biological processes are the largest loss (8.6 Pg C year-1). Interannual variability is dominated by vertical advection in equatorial regions, with the 1997-1998 El Niño-Southern Oscillation causing the largest year-to-year change in upper-ocean DIC (2.1 Pg C). Our results provide a novel, data-constrained framework for an improved mechanistic understanding of natural and anthropogenic perturbations to the ocean sink.

The lived experience of nurses transitioning to professional practice during the COVID-19 pandemic.

As a result of the COVID-19 pandemic, newly graduating nurses have entered into rapidly changing clinical environments, experiencing healthcare in a manner for which they were not fully prepared. The purpose of this study is to describe the lived experience of these newly graduated registered nurses (RNs) who transitioned to practice during the COVID-19 pandemic, and to gain understanding of how to better prepare future graduates for similar situations. A multisite qualitative phenomenological design was used in this study of 12 frontline nurses that graduated in the spring of 2020 and transitioned into their new role as RNs. A trained research team conducted semistructured interviews and completed a thematic analysis of the data. The results were six themes that emerged from the study participants' interviews: (1) fear, (2) emotional conflict, (3) self-doubt, (4) alone, (5) communication barriers, and (6) finding the positive.

The lived experience of frontline nurses: COVID-19 in rural America.

AIM: This multisite study describes the lived experience of registered nurses (RNs) caring for coronavirus (COVID-19) patients during the pandemic in rural America. DESIGN: A qualitative phenomenological design was used. METHODS: From January to June 2021, using the purposeful sampling method, 19 frontline nurses were interviewed regarding their experience caring for seriously ill COVID-19 patients in three Upper Midwest tertiary care hospitals. Three doctoral prepared nurses transcribed and analyzed verbatim interviews with data interpreted separately and conjointly. Approved qualitative methods specific to transcendental phenomenology were used. RESULTS: This phenomenological study identified four themes describing the lived experience: (1) feeling of being overwhelmed, (2) feeling of role frustration related to chaos in the care environment, (3) feeling of abandonment by leaders, families, and communities, and (4) progressing from perseverance to resilience. IMPLICATIONS FOR PRACTICE: Significant implications include ensuring frontline RNs are in communication with leaders, and are involved in tactical planning. Leaders can provide a stabilizing presence, build resilience, confidence, and security. Recommendations for additional research are provided. CONCLUSION: Nurses in intensive care and COVID-19 designated medical units had experiences similar to high population United States and international cities. Their shared experience included high volumes of critically ill patients in hospitals frenzied by rapid change, uncertainty, and capacity strain. Differences in the experience of rural nurses included close social connection to patients, families, and community members. This rural connectedness had both positive and negative effects.

Students Practicing Interprofessional Collaboration in the Context of Hospice and Palliative Care.

Interprofessional education allows students to collaborate with students and professionals of multiple disciplines. An Interdisciplinary Palliative Care (IPC) Seminar, held in the Midwest, involves students from disciplines of medicine, nursing, pharmacy, social work, and chaplaincy. The curriculum of the seminar incorporates asynchronous and synchronous didactic presentations, experiential learning through group exercises and discussion, along with home visits by students in interdisciplinary dyads. The purpose of this study was to determine whether students' participation in a 3-week IPC seminar would positively influence their socialization and value of interprofessional collaboration with the ultimate goal of developing skilled professionals who engage in interprofessional practice in hospice and palliative care settings. This descriptive study invited participants to take a pre- and postseminar online survey using the Interprofessional Socialization and Valuing Scale-21 (ISVS-21) to assess shifts in students' perceptions of interprofessional socialization and the value of collaborative health-care practice. In their pre-and postseminar scores, 71 participants reported they more strongly agreed with all items on the ISVS-21 after completing the seminar. The results from this study suggest the IPC Seminar is an effective educational model for advancing the value of interprofessional socialization and collaborative practice in hospice and palliative health-care.

Creating a culture of caring: A collaborative academic-practice approach to clinical education.

Strong academic and practice partnerships are needed in the ever-changing health care environment. Sometimes an invisible barrier exists between clinical practice and academia; academic-practice partnerships are a way to bridge this barrier. Since 2008a team-based model of clinical education known as the Culture of Caring (COC) has brought together three academic institutions with a large hospital system to develop a unified clinical experience and curriculum that improves the student, provider, and patient experience. In the COC model the team consists of academic-practice leaders, clinical instructors, staff nurses, and students. Together they engage in a structured curriculum that is integrated into both the clinical environment and the academic setting. Each week of clinical the students focus on a topic that is paired with journal articles and learning activities that allow the team to engage in learning that is applicable to the clinical practice environment. The learning activities allow students to engage in learning about evidence-based practice and quality improvement initiatives that are taking place on the unit. The implementation of this collaborative approach to a clinical nursing education model has had a positive impact on the working relationships between the academic partners and clinical practice leaders.

Response to Comment on "Contrasting carbon cycle responses of the tropical continents to the 2015-2016 El Niño".

Chevallier showed a column CO2 ([Formula: see text]) anomaly of ±0.5 parts per million forced by a uniform net biosphere exchange (NBE) anomaly of 2.5 gigatonnes of carbon over the tropical continents within a year, so he claimed that the inferred NBE uncertainties should be larger than presented in Liu et al We show that a much concentrated NBE anomaly led to much larger [Formula: see text] perturbations.

Contrasting carbon cycle responses of the tropical continents to the 2015-2016 El Niño.

The 2015-2016 El Niño led to historically high temperatures and low precipitation over the tropics, while the growth rate of atmospheric carbon dioxide (CO2) was the largest on record. Here we quantify the response of tropical net biosphere exchange, gross primary production, biomass burning, and respiration to these climate anomalies by assimilating column CO2, solar-induced chlorophyll fluorescence, and carbon monoxide observations from multiple satellites. Relative to the 2011 La Niña, the pantropical biosphere released 2.5 ± 0.34 gigatons more carbon into the atmosphere in 2015, consisting of approximately even contributions from three tropical continents but dominated by diverse carbon exchange processes. The heterogeneity of the carbon-exchange processes indicated here challenges previous studies that suggested that a single dominant process determines carbon cycle interannual variability.

Stormwater runoff plumes in the Southern California Bight: A comparison study with SAR and MODIS imagery.

Stormwater runoff is the largest source of pollution in the Southern California Bight (SCB), resulting from untreated runoff and pollutants from urban watersheds entering the coastal waters after rainstorms. We make use of both satellite SAR and MODIS-Aqua ocean color imagery to examine two different components of runoff plumes, the surface slick and the sediment discharge. We expand on earlier satellite SAR studies by examining an extensive collection of multi-platform SAR imagery, spanning from 1992 to 2014, that provides a more comprehensive view of the plume surface slick characteristics, illustrated with distribution maps of the extent and flow direction of the plumes. The SAR-detected surface plumes are compared with coincident rain and runoff measurements, and with available measured shoreline fecal bacteria loads. We illustrate differences in the detection of SAR surface plumes with the sediment-related discharge plumes derived from MODIS imagery. A conceptual satellite stormwater runoff monitoring approach is presented.

High-Resolution Remote Sensing of Water Quality in the San Francisco Bay-Delta Estuary.

The San Francisco Bay-Delta Estuary watershed is a major source of freshwater for California and a profoundly human-impacted environment. The water quality monitoring that is critical to the management of this important water resource and ecosystem relies primarily on a system of fixed water-quality monitoring stations, but the limited spatial coverage often hinders understanding. Here, we show how the latest technology in visible/near-infrared imaging spectroscopy can facilitate water quality monitoring in this highly dynamic and heterogeneous system by enabling simultaneous depictions of several water quality indicators at very high spatial resolution. The airborne portable remote imaging spectrometer (PRISM) was used to derive high-spatial-resolution (2.6 × 2.6 m) distributions of turbidity, and dissolved organic carbon (DOC) and chlorophyll-a concentrations in a wetland-influenced region of this estuary. A filter-passing methylmercury vs DOC relationship was also developed using in situ samples and enabled the high-spatial-resolution depiction of surface methylmercury concentrations in this area. The results illustrate how high-resolution imaging spectroscopy can inform management and policy development in important inland and estuarine water bodies by facilitating the detection of point- and nonpoint-source pollution, and by providing data to help assess the complex impacts of wetland restoration and climate change on water quality and ecosystem productivity.