Imagining in Time: The Legacy of Olive Berger (1898-1981).

Olive Berger was a true nurse anesthesia pioneer for our profession. She dedicated her life to the advancement of nurse anesthesia through her leadership, advocacy, scholarly writing, clinical achievements and innovation. She blazed the trail by forming and establishing education requirements for nurse anesthesia programs, established a state nurse anesthesia organization, and led the American Association of Nurse Anesthetists as its 14th president in 1958. She was the Chief Certified Registered Nurse Anesthetist and Program Director at the Johns Hopkins Hospital and is best known for her collaboration with surgeons Dr. Alfred Blalock and Dr. Helen Taussig, providing anesthesia care during the groundbreaking repair of tetralogy of Fallot on infants.

Curricular Integration of Virtual Reality in Nursing Education.

AIM: The purpose of this article was to evaluate the ability of an interactive virtual reality (VR) platform guided by standards of best practice to provide an effective immersive learning environment. We specifically evaluated usability of the platform and learners' perceptions of the experience. BACKGROUND: A variety of strategies are needed to train a highly competent nursing workforce. METHODS: We conducted a quantitative cross-sectional study to evaluate the VR experience using the System Usability Scale (SUS)® and the Simulation Effectiveness Tool-Modified (SET-M). RESULTS: Post-simulation evaluations were completed by 127 prelicensure and 28 advanced practice students. On the SUS scale, students found the overall VR system easy to navigate, and on the SET-M, they rated the VR experience positively. CONCLUSION: Immersive technology such as VR with a defined curriculum and facilitated debriefing can be valuable for student learning and may ultimately effect patient care. [J Nurs Educ. 2023;62(6):364-373.].

The Silence Is Deafening: Are Certified Registered Nurse Anesthetists Quiet Quitting?

Quiet quitting is a term used to describe the idea of doing the minimum that is required to do your job but not outright quitting. With the extended fatigue from the COVID-19 pandemic and escalating workforce staffing shortages, quiet quitting could be a phenomenon occurring with certified registered nurse anesthetists. Wellness strategies to mitigate quiet quitting are discussed.

Pandemic, Economic Uncertainty, and Protests: What Will Happen to Student Registered Nurse Anesthetists--Resiliency or Burnout?

Nurse anesthesiology education is inherently stressful, and student registered nurse anesthetists (SRNAs) must demonstrate a high level of resilience for successful completion. Because of the coronavirus disease 2019 (COVID-19) pandemic, social unrest from racial protests, and uncertain economic conditions, SRNAs are facing unprecedented levels of stress. Additionally, traditional clinical and didactic training has been drastically interrupted, leading to feelings of anxiety and uneasiness. Much research has demonstrated that high levels of stress and anxiety can lead to burnout and mental health concerns, including fatigue, depression, substance abuse, and suicidal ideation. To prevent burnout, promote resilience, and decrease the risk of severe mental health conditions, nurse anesthesiology educational programs must explore ways to promote students' well-being, through offered wellness interventions and resources.

Redeployment of Certified Registered Nurse Anesthetists During the Coronavirus Disease 2019 Pandemic.

Certified Registered Nurse Anesthetists (CRNAs) are uniquely skilled anesthesia providers with substantial experience managing critically ill patients. During the coronavirus disease 2019 (COVID) pandemic, CRNAs at a large academic medical center in the Mid-Atlantic United States experienced a shift in their daily responsibilities. As the hospital transitioned to the management of patients who tested positive for the virus that causes COVID, the severe acute respiratory syndrome-coronavirus type 2 (SARS-CoV-2), CRNAs were redeployed into the roles of respiratory therapists and intensive care unit registered nurses. Although facing the stress of the global pandemic, this facility's CRNAs proved to be flexible, capable, and necessary members of the care team for patients with COVID-19.

Marijuana Use in the Anesthetized Patient: History, Pharmacology, and Anesthetic Considerations.

Marijuana consumption is growing in the United States because of state legalization for recreational and medical use. However, many anesthesia practitioners are unaware of the potential adverse effects that may occur if marijuana is taken before the administration of an anesthetic. This review provides a history of marijuana use, the current laws and regulations, the pharmacology of marijuana, and best evidence-based practices related to anesthetic care of the marijuana user.

From Metacognition to Practice Cognition: The DNP e-Portfolio to Promote Integrated Learning.

BACKGROUND: Educating Doctor of Nursing Practice (DNP) students for an increasingly complex health care environment requires novel applications of learning concepts and technology. A deliberate and thoughtful process is required to integrate concepts of the DNP program into practice paradigm changes to subsequently improve students' abilities to innovate solutions to complex practice problems. METHOD: The authors constructed or participated in electronic portfolio development inspired by theories of metacognition and integrated learning. The objective was to develop DNP student's reflection, integration of concepts, and technological capabilities to foster the deliberative competencies related to the DNP Essentials and the foundations of the DNP program. RESULTS: The pedagogical process demonstrates how e-portfolios adapted into the doctoral-level curriculum for DNP students can address the Essentials and foster the development of metacognitive capabilities, which translates into practice changes. CONCLUSION: The authors suggest that this pedagogical approach has the potential to optimize reflective and deliberative competencies among DNP students. [J Nurs Educ. 2017;56(8):497-500.].

Implementation of a new method to track propofol in an endoscopy unit.

AIM: Propofol is a widely used anesthesia induction agent and is easily accessible in most healthcare facilities. Unlike regulated or schedule drugs, propofol is inconsistently tracked, leading to inaccurate inventories, incorrect billing, and unrecognized diversion. The goal of this project was to implement a new method of tracking propofol in a single setting, with the aim of accounting for 100% of the drug. METHODS: For two, 2-week observation periods, data were extracted from an automated medication management system or pharmacy inventory system, anesthesia records, and pharmacy billing sheets for cases in a Gastrointestinal (GI) Endoscopy Unit, and compared pre-implementation and post-implementation of a new tracking and accounting protocol. Variables included amount of propofol inventoried, dispensed, administered, returned, billed, wasted, and missing. RESULTS: Pre-implementation (n = 300), 10% cases had no record of propofol removal from the automated medication system. Of the 90% that did, 25% had an amount signed out that did not match the amount administered. Thirty-one percent of all propofol was unaccounted for during this 2-week period. Furthermore, 19.7% of cases did not have a billing form located. Post-implementation of the process change, unaccounted for propofol decreased to 26% of all cases (P = ns). The percentage of missing billing forms decreased from 19.7 to 5.8% (P = 0.00). CONCLUSION: Data suggest notable amounts of propofol were unaccounted for and not billed for in the GI Endoscopy Unit prior to the protocol change. Post-protocol change data reveal modest improved accounting of the medication and significant cost-capture. Improvements may enhance inventory reconciliation, availability of drug stock, and potentially result in a decreased risk of unrecognized diversion.

Implementation of a teaching assistant program in graduate nursing education.

Identifying and educating students who have an interest and talent to be future educators is a challenge throughout academia, including nursing. The ideal scenario is to identify students early in their education and construct or scaffold a unique relationship between professor and student. The authors discuss a teaching assistant model, implemented in a nursing graduate program, which augments the education process while developing potential future nursing educators.