Unique Educational Needs of Emergency Nurse Practitioners.

The purpose of this study is to identify the unique educational needs of emergency nurse practitioners (ENPs). A survey from 167 nurse practitioners (NPs) practicing in the emergency department (ED) settings was analyzed. A variety of certified NPs practice in EDs: family NPs (30%), adult NPs (18%), acute care NPs (40%), and some with 2 or more certifications (12%). NPs come with a variety of basic educational preparations. The top educational needs specific to ENP preparation identified were managing critically ill patients, pharmacology, interpretation of laboratory tests, electrocardiograms, radiographs, and computed tomographic scans, suturing superficial lacerations, and mentoring by MDs and NPs. The unique and complex ED environment requires that NPs practicing in the ED receive a unique set of standardized education and skills to meet the demands of current practice. A standardized educational curriculum that includes the findings from this and other studies, along with additional clinical and a national certification examination, is discussed.

Creating innovative programs for the future.

Although several major national mandates advocate for a better educated workforce, this push comes at a time when the competition for faculty, financial resources, advanced technology, and students remains strong. If nurse educators are seriously considering creating a new nurse program at their school, some key points are essential during the development stage. Using the innovation frameworks from the Institute of Healthcare Improvement, from the global design firm IDEO, and from Gladwell's The Tipping Point: How Little Things Can Make a Big Difference, this article examines the informal, formal, internal, and external work needed during program conceptualization, initial program exploration, resource infrastructure, support, and evaluation for an effective and innovative plan.

Nurse practitioner certification and practice settings: implications for education and practice.

PURPOSE: Nurse Practitioners (NPs) are certified within a population-focused specialty area, practice in a variety of settings, and treat a wide range of patients. Little is known about what agreement exists between certification obtained and actual site of practice. The purpose of this study was to examine NP practice sites as compared with their certification and examine additional education they received after employment. DESIGN: Adult (ANP), family (FNP), and acute care nurse practitioners (ACNPs) certified by the American Nurses Credentialing Center were surveyed regarding certification, demographic information, practice setting, routine responsibilities, and additional training they may have obtained. METHODS: An expert panel defined categories of traditional practice settings consistent with NP credentialing examinations and scopes of practice. Equal numbers of randomly chosen ANPs, ACNPs, and FNPs (N = 2,000) were mailed surveys. Responses were coded and analyzed. FINDINGS: The overall survey response was 69.8% (n= 1216). Of the FNP, ANP, and ACNP respondents, 5%, 7%, and 42%, respectively, reported practicing in a nontraditional practice setting. Of nurses practicing in a nontraditional setting, 74% (135 of 182) were ACNPs, with 90% practicing in a nontraditional, ambulatory care setting. Sixty-five percent (13 of 20) of the FNPs practicing in a nontraditional setting were practicing in a high-acuity emergency department, and 56% (15 of 27) of the ANPs practicing in a nontraditional setting were practicing in a high-acuity intensive care unit. The top responses of additional education received were pharmacology, laboratory interpretation, and ordering diagnostic tests. CONCLUSIONS: While greater than 90% of ANPs and FNPs practice in settings consistent with their certification, a proportion of NPs practice in nontraditional settings and may benefit from additional education (formal, on-the-job, and continuing education) and mentoring.

Including a screening and brief alcohol intervention program in the care of the obstetric patient.

Alcohol is the drug most commonly abused by pregnant women and the leading cause of preventable birth defects across the United States. Screening, Brief Intervention, and Referral for Treatment is a program developed by the Emergency Nurses Association that has demonstrated success in treating patients who have alcohol use disorders. This interventional program can be useful to perinatal nurses caring for pregnant women with alcohol use disorders in a variety of settings.

A collaborative framework for managing pregnancy loss in the emergency department.

The purpose of this article is to examine how nurses can improve comprehensive care for women who suffer an early pregnancy loss in the emergency department and highlight the integral role of obstetric and emergency department nurses within a new holistic framework of collaborative care. These nurses are integral in the proposed collaborative "fetal loss framework," which provides an innovative approach for holistic care for this population.

Quality of life in caregivers providing care for lung transplant candidates.

CONTEXT: Caregivers are essential members of the health care team who provide care, valued at more than $250 billion each year, to millions of persons who require assistance with health and daily care. Patients with respiratory diseases who are waiting for a lung transplant are required to have an identified caregiver. The caregivers are rarely studied. OBJECTIVE: To explore the relationships among the health status of caregivers of lung transplant candidates, caregivers' reaction to caregiving, and caregivers' perceived quality of life. DESIGN: This descriptive study examined the quality of life of lung transplant caregivers from a multidimensional perspective. SETTING AND PARTICIPANTS: Twenty-nine dyads of lung transplant candidates and their caregivers were recruited from a Midwestern medical center. MEASURES: Data were collected by self-report: caregivers completed the Quality of Life Index, SF-12 health survey, Profile of Mood States-Short Form, and the Caregiver Reaction Assessment. RESULTS: Caregivers reported favorable levels of quality of life, physical health, and mood during the pretransplant waiting phase. However, problem areas for caregivers during this time included fatigue, depression, and the financial impact of the transplant. Data analyses indicated that depression, caregiver general health, impact on finances, and lack of family support had the greatest effect on caregivers' quality of life. Nurses are urged to recognize the role of caregivers in the transplant process, ask about and listen to caregivers' needs, and include caregivers in the plan of care.

Serendipitous findings from an Illinois ED nursing educational survey reflect a crisis in emergency nursing.

INTRODUCTION: A survey conducted by the Research Council Of Illinois ENA was intended to assess educational needs, but it revealed some very important serendipitous findings. This survey gave a voice to the frustrations of emergency nurses. METHOD: A 31-question survey was distributed to 900 Illinois ENA members requesting information about their educational needs. The last question, which formed the basis of this report, asked respondents to list the 3 biggest challenges they face on a daily basis. RESULTS: In addition to the information regarding educational offerings, the survey revealed that ED nurses were overburdened and frustrated in their jobs. Specifically, the nurses identified 7 areas of greatest concern: (1) insufficient and inexperienced staff; (2) increased responsibilities; (3) lack of administrative support; (4) lack of rewards or incentives to stay; (5) low morale among staff; (6) difficulty balancing work and family; and (7) increasing violence in the emergency department. DISCUSSION: The first step toward addressing a growing crisis in emergency nursing is to listen to the voices of emergency nurses themselves and let their frustrations be heard. The spontaneous comments of emergency nurses point to serious, pervasive, systemic problems in emergency nursing. Such problems will not be solved by "quick fixes" such as sign on bonuses, but rather by listening carefully to the concerns of experienced nurses.