Health Professional Redeployment and Cross-Training in Response to the COVID-19 Pandemic.

The onset of the COVID-19 pandemic in March 2020 required hospitals to respond quickly and effectively to ensure the availability of healthcare professionals to care for patients. The Ottawa Hospital in Ottawa, ON, used a five-step process to ensure organizational readiness for redeployment of regulated health professionals as and when necessary: (1) define current scopes of practice; (2) obtain discipline-specific input; (3) develop strategies based on literature review and government dictates; (4) identify potential duties; and (5) ensure support for staff. With hospital management support, this plan was readily implemented. Results are discussed in terms of operational outcomes (e.g., number and type of deployments) and staff experience. Outcomes were positive and led to recommendations for improved organizational readiness.

Enhancing Nursing Capacity to Provide Patient Care in a Pandemic.

At the onset of the COVID-19 pandemic, an immediate priority for nurse leaders was to develop a care delivery plan to address anticipated surges in patient volumes and potential staff shortages. This article describes actions taken to enhance patient care capacity. Strategies included reviewing the competencies of nurses and other health professionals, mapping out redeployment pathways, preparing nurses and other health professionals for redeployment as needed and creating a collaborative care team model. This article includes an in-depth focus on the design, implementation and outcomes of an innovative role for fourth-year nursing students in the collaborative care team model.

Cultivating a spirit of inquiry using a nursing leading-following model.

Healthcare systems have cocreated an environment in which the vast majority of nurses in staff positions have not been expected to lead for quality healthcare services. Both the nature of their work and the busyness of their schedules have prevented staff nurses from being available to generate ideas and to lead innovations in patient care and quality work environments. The purpose of this paper is to illuminate how a nursing leading-following model emanating from Parse's humanbecoming theory guided the enrichment of the context and practice of nursing in a large academic health science center by helping leaders to cultivate nurses' capacity to lead research projects that address patient-centered care and quality of work-life. Nurses' participation in an annual nursing research challenge is highlighted to demonstrate what happens when nurses in formal leadership positions focus on cultivating the capacity to lead and the spirit of inquiry among all nurses.

NursesforTomorrow: a proactive approach to nursing resource analysis.

This paper describes the background, development, implementation and utilization of NursesforTomorrow (N4T), a practical and comprehensive nursing human resources analysis method to capture regional, institutional and patient care unit-specific actual and predicted nurse vacancies, nurse staff characteristics and nurse staffing changes. Reports generated from the process include forecasted shortfalls or surpluses of nurses, percentage of novice nurses, occupancy, sick time, overtime, agency use and other metrics. Readers will benefit from a description of the ways in which the data generated from the nursing resource analysis process are utilized at senior leadership, program and unit levels to support proactive hiring and resource allocation decisions and to predict unit-specific recruitment and retention patterns across multiple healthcare organizations and regions.

The lived experience of waiting: a Parse method study.

The purposes of this study were to discover the structure of the lived experience of waiting and to generate new knowledge about health and quality of life. The participants in this study were 11 persons who were on a waiting list for a lung transplant. The Parse research method was used to answer the research question: What is the structure of the lived experience of waiting? The central finding of this study was: The lived experience of waiting is arduous constraint arising with anticipating the cherished in fortifying engagements. This finding illustrates waiting as an immensely difficult and agonizing experience of persistently expecting a prized opportunity, finding strength in being with other persons, and engaging in diverse activities. The findings are discussed in relation to nursing knowledge and as to how they inform future research and humanbecoming patient-centered nursing practices.

Nurses' experiences of feeling respected-not respected.

Feeling respected-not respected is an experience integral with the ways nurses choose to describe the quality of their work environments and with the quality of care they provide to patients and families. The purposes of this study were to enhance understanding of nurses' experiences of feeling respected-not respected, and to provide new knowledge about quality of work-life related to feeling respected-not respected. The Parse research method was used to answer the research question, What is the structure of the lived experience of feeling respected-not respected? Participants were 37 nurses in staff and leadership roles at a large teaching hospital. The structure, feeling respected-not respected is affirming-not affirming attentiveness with diverse affiliations arising with assuredness-unassuredness, is discussed in light of the humanbecoming theory, related literature, leadership, and future research.

Human becoming and 80/20: an innovative professional development model for nurses.

The authors describe a study that evaluated implementation of a professional development model in which nurses spend 80% of their salaried time in direct patient care and 20% of their salaried time on professional development. The professional development time includes focused learning about patient-centered practice guided by the human becoming nursing theory. A qualitative descriptive preproject-process-postproject method and a longitudinal, repeated measures, descriptive-comparative method were used to answer the research questions. Participants were 33 nurses, 11 other nurse leaders and health professionals, and 55 patients and family members. The findings show that on the study unit overtime hours decreased significantly, the education hours were sustained throughout the study period, workload hours per patient day increased significantly, sick time stayed low, patient satisfaction scores increased, staff satisfaction scores were significantly higher than for comparator groups, and turnover was non-existent among study participants in year 2. Average variable direct labor cost increased over time, but the increase was not significantly higher than on the control units. Themes from the interviews with participants are presented. Ongoing evaluation of the model and implications for future research are discussed.

Review of research related to Parse's Theory of Human Becoming.

Ninety-three retrievable studies guided by the human becoming theory between 1985 and 2006, are reviewed. A summary of the studies is tabulated according to the two basic human becoming research methods, the human becoming applied research method, and other qualitative research methods using human becoming as the frame of reference. The authors provide an overview of the studies and the human becoming research methods and further illuminate the findings of studies reviewed under four major themes that describe the phenomena studied.

Human becoming-guided patient-centered care: A new model transforms nursing practice.

Nurses working on an orthopedic surgery and rheumatology unit in a large teaching hospital in Canada participated in a 24-month research project to evaluate what happens when nurses are provided 20% of their time for the purpose of learning and self-development. Half of the teaching-learning was aligned with the commitment of the organization to advance patient-centered care, and in particular patient-centered care guided by the nursing theory, human becoming. The other half was self-directed by nurse participants according to their learning interests and self-development priorities. The purpose of this column is to describe the teaching-learning and mentoring processes in which the nurses were engaged and to highlight the subsequent changes in nursing practice that have happened on the unit from the perspectives of nurse participants.

Human becoming practice around the globe: exploring the art of living true presence.

In this column, the human becoming practice methodology is illuminated and some of the questions that people have asked about living the art of human becoming are presented. The human becoming teaching-learning processes are discussed as a way of coming to know what it takes to live true presence, and the role of stories in teaching-learning human becoming practice is explored. Previously published human becoming practice stories are presented as an answer to many of the questions that persons have asked about human becoming-guided practice.

Challenging the atheoretical production of nursing knowledge: a response to Reed and Rolfe's column.

This column is a response to Reed and Rolfe's column in the January 2006 issue of Nursing Science Quarterly. The authors present their views about Reed and Rolfe's ideas by focusing their discussion and questions on three main topics: the impact of nurses' conceptual thinking, values, and culture on their perspectives and experiences; the reality that nursing theory-guided practice is already a meaningful reality in nursing; and the belief that in order not to limit knowledge development, science must be viewed as more than a study of proximal causes.

Persevering through a difficult time during the SARS outbreak in Toronto.

The purpose of this study was to describe the experience of persevering through a difficult time for patients, family members of patients, nurses, and allied health professionals during the severe acute respiratory syndrome outbreak. van Kaam's phenomenological research method, with the human becoming theory as the theoretical perspective, was used to gather and analyse data from 63 participants who agreed to describe a situation that illuminated their experience of persevering through a difficult time (either online or using a voicemail system). Data gathering occurred in early April 2003 in the midst of the severe acute respiratory syndrome outbreak in Toronto, Canada. The finding was the structural definition, persevering through a difficult time is dispiriting trepidation arising with witnessing suffering. It is a smothering connectedness with sequestering protection as unsettling contentment emerges amid unburdening hope. It sheds light on what is important for preparing for possible future outbreaks of this and other infectious diseases.

Community dwellers' perspectives on the experience of feeling very tired.

Feeling very tired is a phenomenon experienced by all humans at some point in their life. As a means of more fully understanding the human experience of feeling very tired, this concept was explored with a group of 10 community dwelling individuals who had no expressed health concerns. The Parse research method was used to answer the research question, What is the structure of the lived experience of feeling very tired? The central finding of this study is the structure: The lived experience of feeling very tired is dissipated vigor arising with monotonous disquietude amid spirited cherished engagements. The structure was conceptually integrated with the human becoming theory as: feeling very tired is powering the languaging of valuing connecting-separating. The findings are discussed in relation to human becoming and future research.

Mis-takes: mistakes in the nurse-person process.

This column supports the global mantra to develop mechanisms that address the worldwide crisis in patient safety and demonstrates, using nursing as an example, that the mechanisms currently being developed are too limited. Patient safety initiatives must be expanded to acknowledge and make ways to minimize mis-takes, that is, misconceptions of meaning that emerge when healthcare professionals dismiss, misconstrue, guess, or undervalue patients' perspectives. Commitment to the human becoming school of thought as a guide for practice is suggested as one way to address mis-takes in the nurse-person process.

Research evaluating human becoming in practice.

In this column the author synthesizes and discusses the findings of six studies conducted to examine what happens for nurses and patients when human becoming is the guide for practice. In all of the studies, nurse participants' descriptions led to three main themes: transforming intent, unburdening joy, and struggling with change. Patient and family participants' descriptions of nursing care guided by human becoming are also summarized. This column concludes with a presentation of the universal and overarching values for knowledge development in nursing that emerged with the synthesis of the findings and that have the potential to ensure personalized, meaningful, and dignified nursing service delivery.

Having courage: a lived experience of human becoming.

The purposes of this research were to discover the structure of the experience of having courage and to contribute to knowledge about human becoming. Participants were 10 persons with spinal cord injuries. The Parse research method was used to answer the research question, What is the structure of the lived experience of having courage? The central finding of this study is the following structure: The lived experience of having courage is a fortifying tenacity arising with triumph amid the burdensome, while guarded confidence emerges with the treasured. The findings are discussed in relation to human becoming, relevant literature, and future research.

Waiting: the experience of persons in a critical care waiting room.

The purposes of this study were to discover the essences of the experience of waiting, to provide new knowledge about what it is like to wait, and to contribute to nursing knowledge. Participants were 12 persons who were family members or friends of persons in an adult critical care unit. The Parse research method was used to answer the research question: What is the structure of the lived experience of waiting? The central finding of this study was this structure: The lived experience of waiting is a vigilant attentiveness surfacing amid an ambiguous turbulent lull as contentment emerges with uplifting engagements. The structure is discussed in relation to nursing knowledge and in relation to how it can inform future research and practice.