Experiences of nurse practitioners with telehealth during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic brought many changes to the way nurse practitioners (NPs) provided care for patients, including the explosive and instantaneous use of telehealth in lieu of face-to-face services to maintain safe health care access and provision for patients and providers. PURPOSE: Although the literature abounds with patient perspectives and benefits of telehealth, little is found about the perceptions and experiences of NPs providing telehealth services during this time when telehealth was the primary care mode of providing nonacute care. METHODOLOGY: This mixed-methods, descriptive, exploratory study describes demographic and quantitative data about telehealth experiences collected from NPs across the nation early in the pandemic during fall 2020, and similar quantitative data collected later in spring 2021 from NPs in one state. RESULTS: Significant findings between the 2020 national and 2021 state NP data include years of NP experience and the NP perceived barriers in the provision of telehealth services. CONCLUSIONS: Major patient-centric telehealth barriers were patient comfort with and accessibility to telehealth software. Major NP perceived telehealth barriers were regulatory laws, difficulty including telehealth visits into workflow when seeing patients in person, and comfort using telehealth software. IMPLICATIONS: Specific strategies can help to overcome identified telehealth barriers.

Comparison of Rural Childhood BMI Percentiles: Prevalence and Trends in a Midwest County, 2008-2016.

The number of children who are obese and overweight continues as a public health challenge despite decades of research. The purpose of this article is to describe trends in body mass index (BMI) percentile data collected from 11- to 14-year-old school children in 2008-2009 and 2015-2016 in rural Wisconsin. The BMI percentiles from 1,347 students were compared using time, gender, age, and school (public vs. parochial) as predictors. The trend over time indicated a decrease in students of healthy weight and an increase in those overweight or obese. Also noted was a significantly higher proportion of children who were overweight or obese in parochial compared to public schools. Discussed are the observed trends, community-wide initiatives implemented, as well as how schools can employ a more comprehensive approach to childhood obesity that first ensures community readiness and involves school, home, and community.

Implementing Relationship-Based Care as a Professional Practice Model: Promoting Nurses' Understanding and Confidence to Apply in Practice.

Professional practice models (PPMs) guide nursing practice, professional behaviors, and clinical leadership. Health care continues to evolve (e.g., through health system mergers), and nurses may need to adopt and understand new PPMs to confidently align their interventions and professional nursing practice accordingly. The purpose of this project was to create an educational module about a new PPM based on the model of relationship-based care (RBC), which was adopted following a health system merger. The module was presented to a sample of nursing staff and leaders, who subsequently evaluated how it changed their confidence in and understanding and application of RBC in their professional nursing practice. Quantitative data showed that the module was an effective method to increase nurses' understanding of, and confidence in providing care utilizing, the RBC model. Qualitative data analysis generated themes (team building, need for self-care, being present, lack of time and resources, and resistance to or fear of change) about how implementation of RBC as the organization's PPM would change professional nursing practice, and barriers related to its implementation.

An Innovative Exchange Model for Global and Community Health Nursing Education.

Understanding different cultures is important in the education of nursing students who will become the health care workforce of our future interdependent and globalized societies. International practicum courses help students and nurses understand different cultures. This article describes an innovative approach to nursing education and understanding diverse cultures, in the context of a hybrid course (online course coupled with face-to-face practicum experiences), which enrolled nursing students from opposite hemispheres.

DNP-Prepared Nurse Leaders: Part of the Solution to the Growing Faculty Shortage.

It is no secret that there is a nursing faculty shortage due to aging faculty, retention issues, and an increased need for more nurses with the DNP degree. This parallels the ongoing nursing shortage, as lack of faculty limits nursing student capacity. Explanation of how DNP-prepared faculty can help fill the nursing faculty shortage and strategies are explored in this article.

Are Virtual Classrooms Colorblind?

E-learning, increasingly employed in nursing education, has been embraced as a means to enhance options for all students, particularly those with limited educational opportunities. Although a desire to increase access for underserved students is often cited, disparities in availability, usage, and quality of e-learning persist among diverse households and student populations when compared to the general population. In this article, these issues will be examined along with reflection on the extent to which culture has been integrated into on-line design and instruction. Historical and cultural aspects, circumscribing virtual classrooms, are discussed using African Americans as an exemplar. The imperative to harness the democratizing potential of this educational format is underscored. In this article, culture will be examined in light of the significant growth in on-line nursing education over the past several decades.

Emotional intelligence (EI) and nursing leadership styles among nurse managers.

Less than 12.5% of nurses aspire to leadership roles, noting lack of support and stress as major factors in their decision not to pursue this area of practice. Psychological resiliency, described as the ability to properly adapt to stress and adversity, is key to successful nurse managers. Emotional intelligence (EI) is a related concept to resiliency and is another noteworthy predictor of leadership and management success. This study was undertaken to determine the level of and relationship between EI and leadership style of nurse managers employed in Wisconsin and Illinois facilities. A descriptive, exploratory study design was utilized, with a convenience sample of nurse managers working in 6 large Midwestern health systems. Nurse managers were invited to participate in the study by their employer, completing the online consent form and the demographic, Multifactor Leadership Questionnaire (MLQ) Form 5X and the Emotional Quotient Inventory (EQ-i 2.0) surveys. Statistically significant positive relationships were noted between EI and transformational leadership and the outcomes of leadership (extra effort, effectiveness, and satisfaction). No statistically significant relationships were noted between EI and transactional or laissez-faire leadership styles.

"Me and my computer": emotional factors in online learning.

This study focused on nursing student perceptions of sense of community in the online classroom. Using qualitative analysis of data gathered from five student focus groups, themes related to the affective domain in online learning were identified: aloneness, anonymity, nonverbal communication, trepidations, and unknowns. This article provides detailed examples of student experiences under each theme and suggests that greater attention to the affective domain is needed, particularly in asynchronous online learning. Pedagogical strategies that foster a sense of community in online courses between students and faculty enhance cognition through affective engagement of students. Strategies for instructors are given.

Collaborative design and use of an agency feedback form for student clinical practicum experience in community/public health nursing.

Evaluation of students in community and public health (C/PH) nursing clinical practica is a challenge, especially when preceptors are expected to evaluate students from different academic nursing programs. The need for a standardized student evaluation tool was identified during federally funded collaborative meetings held between C/PH academic and practice partners in Northeastern Wisconsin. This article focuses on the development and appraisal of the standardized Agency Feedback Form (AFF) for Student Practicum Experience in Community/Public Health Nursing, which was designed to meet the identified need. Four baccalaureate nursing programs implemented the AFF for 3 purposes: (1) to provide a consistent and easy evaluation form for preceptors to complete; (2) to communicate useful information about students' individual professional behaviors observed during practicum; and (3) to increase students' and preceptors' understanding of the population-based nursing interventions, using the Public Health Intervention Wheel. Future uses and implications of the AFF are also discussed.

Spread the word, not the germs: a toolkit for faith communities.

A volunteer workgroup of public health personnel and parish nurses in Wisconsin collaborated to develop the Infection Control and Emergency Preparedness Toolkit for the Faith Community to help prepare congregations for health emergencies and prevent the spread of disease. This article reports a pilot study of the toolkit with 30 parishes/churches, focusing on the infection control portion of the materials.

Nursing student perceptions of community in online learning.

Nursing faculty need to understand the unique aspects of online learning environments and develop new pedagogies for teaching in the virtual classroom. The concept of community is important in online learning and a strong sense of community can enhance student engagement and improve learning outcomes in online courses. Student perceptions of community in online learning environments were explored in this study. Five focus group sessions were held and online nursing students were asked to give examples of experiences related to sense of community. Fifteen major themes emerged: class structure, required participation, teamwork, technology, becoming, commonalities, disconnects, mutual exchange, online etiquette, informal discussions, aloneness, trepidation, unknowns, nonverbal communication and anonymity. Themes sorted into the categories of structural, processual and emotional factors. Theme descriptions show how sense of community can be enhanced and/or diminished in online courses. This study adds depth and detail to the limited body of research on sense of community in distance education in nursing courses.

Perceived stress and sense of belonging in doctor of nursing practice students.

There is little research among doctor of nursing practice (DNP) students, a fast-growing population of nurses engaged in doctoral study. In this descriptive correlational study, levels of perceived stress, sense of belonging, and the relationship between these variables were examined. The sample included 89 female, predominantly White, post-master's DNP students from a Midwest university. A statistically significant inverse relationship (r = -.49, P < .01) between perceived stress and sense of belonging was found. Recommendations for future research include additional studies of perceived stress and sense of belonging in diverse DNP student populations and in various DNP education models.