Expanding capacity for publication in nursing: Experiences from a writing for publication group.

Nurses have valuable knowledge and expertise to share. Yet, for a variety of reasons, many nurses do not write for publication. Members in one Sigma Theta Tau International chapter requested information about publishing so a writing for publication program (WPP) was convened. Ten nurses from diverse clinical and academic backgrounds participated. The goal of the WPP was to support a small group of nurses to advance knowledge and develop practical skills through the development of a manuscript with mentorship from doctorally-prepared nurses with publishing experience. The anticipated effect was that participants would share what they learned with colleagues or mentor others to publish in the future. Beginning with informational sessions to lay the foundation for writing and publishing, the WPP included biweekly, two-hour online sessions over a seven-month period whereby individual and group writing with embedded peer and WPP leader feedback occurred. WPP participants gained proficiency in searching online databases, synthesizing published literature, and working as a member of a writing team. The group successfully published a manuscript based on a topic of interest. This current article describes the structured support and mentorship provided during the WPP with recommendations for overcoming publication barriers commonly described in the literature.

Above and Beyond the Call of Duty: Rural Home Care and Hospice Nurses' Experiences Caring for Veterans.

Approximately 4.7 million Veterans live in rural areas and face challenges receiving support and care for complex service-connected healthcare needs. The purpose of this qualitative descriptive study was to explore nurses' experiences caring for Veterans in rural home care/hospice settings. Semistructured interviews (N = 14) were conducted between August 2020 and March 2021. Content and thematic analysis resulted in three central themes: Mission readiness: Ensuring safe home environments, Partnering with Veterans: Knowing when to lead and when to follow, and It's my duty: Caring with purpose and honor. Study findings highlight the need for cultural competence in both rural and Veteran cultures. Implications for practice reinforce currently emerging national priorities, including personal safety considerations and need for further professional development associated with screening for firearms and gun safety. Other implications for home care/hospice agencies, as well as nursing education, are discussed.

Veteran Competencies in Nursing Textbooks: Implications for Educators.

AIM: The aim of this study was to examine the adequacy of military/veteran-related content in nursing textbooks used in prelicensure programs. BACKGROUND: With increased numbers of veterans receiving care in civilian settings, nurses may lack essential knowledge, skills, and attitudes outlined in competencies required to provide culturally sensitive veteran-centered care. One explanation for this may be inadequate preparation during prelicensure nursing education. METHOD: A quantitative, descriptive study guided the analysis and rating of 32 key words in 24 textbooks across eight content areas. RESULTS: Key words were included in most textbooks but frequently not connected to military service or veterans. The key word with the highest mean rating was posttraumatic stress disorder; the highest rated content area was psychiatric/mental health. CONCLUSION: With limited textbook resources, nurse faculty must engage in deliberate efforts to include veteran content in nursing curricula. As competency-based education trends evolve, these findings are relevant and should be considered in curricular design and revision.

Analysis of Content Gaps in Prelicensure Nursing Textbooks to Meet Veteran Care Competencies.

BACKGROUND: Despite the Joining Forces initiative and recently published veteran care competencies, nursing students and graduates are often unprepared to care for veterans who have unique service-connected illnesses and injuries. PURPOSE: The purpose was to evaluate identified content gaps in prelicensure nursing textbooks with the veteran care competencies knowledge, skills, and attitude (KSA) domains. METHODS: A secondary qualitative analysis was conducted of veteran content in prelicensure nursing textbooks. RESULTS: The skills and attitude domains of veteran care competencies were poorly addressed in nursing textbooks. Overall, the knowledge domain was adequately covered; however, most had limited connection with veterans and veteran care. Competency-focused recommendations for expanding and enhancing veteran content, KSAs, and teaching strategies are offered. CONCLUSIONS: Prelicensure textbooks met the knowledge domain for each veteran competency. Overcoming content gaps needed to achieve requisite skills and attitudes requires interaction with veterans through clinical immersion experiences in various care settings.

Predictors of student veterans progression and graduation in Veteran to Bachelor of Science in Nursing (VBSN) Programs: A multisite study.

BACKGROUND: Capitalizing on the veteran's extensive service experience, values, and norms, Health Resources Services Administration (HRSA) proposed Nurse Education, Practice, Quality and Retention - Veterans' Bachelor of Science (VBSN) Program grants (2016-2019). PURPOSE: The purpose was to identify predictors of student veterans' (SV) progression and graduation rates in VBSN programs. METHODS: A descriptive correlational retrospective design was used. Two hundred and eighty-two (282) SV records were examined. RESULTS: One hundred and forty (140) SVs graduated (49.6%) and 107 (37.9%) were still enrolled. Only program delivery mode (hybrid) was significantly associated with completion and confirmed by logistic regression modeling. An increased representation of SVs' gender, race/ethnicity was present; however, gender, age, race, ethnicity, and veteran status did not significantly predict progression nor graduation. CONCLUSIONS: Hybrid program delivery became the single predictor influencing VBSN progression and graduation. As non-traditional students in higher education with a history of social isolation and help-seeking stigma, this delivery mode may have assisted SV retention and persistence. With a registered nurse shortage and workforce calls for increased gender, race, and ethnic diversity, the findings suggest nursing education programs designed for veterans are a viable solution.

COVID-19 Disruption of Nursing Education and the Effects on Students' Academic and Professional Confidence.

BACKGROUND: In spring 2020, the novel coronavirus prompted a sudden shift in nursing education. This study evaluated students' perceptions of their ability to adjust to these challenges. METHODS: A cross-sectional survey of students (n = 286) in BSN programs throughout the United States was conducted via email to examine 3 areas of student confidence (academic success, NCLEX-RN success, and patient care delivery) and to determine how these were affected by the abrupt transition to remote learning. RESULTS: Variables, including alignment of remote instruction styles with learning styles, ease of transition to distance learning, and educating children at home, were significantly associated with students' confidence in their ability to be successful academically, on NCLEX-RN, and in patient care. CONCLUSIONS: With potential for ongoing challenges due to the coronavirus, faculty need to identify and support students at greater risk of experiencing difficulties and threats to success, thereby preventing attrition and ensuring preparation of a diverse workforce.

Using Combined Tabletop and Simulation Activities to Improve Nursing Students' Attitudes About Quality Improvement: A Feasibility Study.

ABSTRACT: Nursing students' attitudes about quality improvement (QI) reflect poor understanding of its importance. In a mixed-method interventional feasibility study, students received instruction about QI processes, plus information about factors contributing to central line-associated bloodstream infection (CLABSI) rates at a hypothetical hospital. Experimental group students observed a high-fidelity simulation bedside report for a CLABSI-affected patient. Both groups independently completed tabletop QI exercises to solve the CLABSI problem and had equivalent improvement in attitudes. Joint debriefing revealed how experimental group students developed greater understanding of interrelated, system-wide contributing factors. Hybrid learning activities with tabletop and simulation positively influence students' attitudes about QI.

Relationship of Nurse-Led Education Interventions to Liver Transplant Early Readmission.

INTRODUCTION: Early hospital readmission following liver transplantation is associated with lower survival and worse long-term graft function. Language, cultural practices, and health literacy influence patient understanding of posttransplant care education. Complex medication regimes, changes in metabolism and nutrition absorption, and infection/rejection further complicate the prevention of readmission. PURPOSE: The purpose of this study was to compare the 30-day readmissions of single-organ liver transplant recipients for 1-year prior and 1-year following the implementation of nurse-led education. The study examined the demographics, clinical characteristics, and 30-day readmissions of 35 liver transplant recipients who participated in the newly designed nurse-led education and 51 liver transplant recipients who experienced the prior post-liver transplant education. DESIGN: A single-center, correlational study with a convenience sample was conducted at a Hispanic-serving South Texas hospital. The new education intervention maintained the standard education and added twice-daily mutual patient-focused goal setting between the nurse and the recipient that aligned with readiness for discharge activities/goals, structured education using abbreviated handouts written at a second-grade level available in both English and Spanish, and the use of repetition through multimodal methods. RESULTS: The odds for 30-day readmissions the year prior to the nurse-led patient education intervention were 2.088 times greater than the year following the implementation. Thirty-day readmissions were reduced by 16.3% from the 2017 cohort to the 2018 cohort. DISCUSSION: Understanding unique risk factors facilitates structured patient education which can be individualized to the patient and caregiver including collaborative nurse-patient goals.

Learning never stops: Evaluation of peer teachers in high fidelity simulation.

BACKGROUND: Nurse educators have used peer teaching as a means of providing effective learning to peer learners and enhancing peer teachers' comfort with teaching. There is a lack of evidence related to providing feedback to peer teachers. Receiving feedback may enhance peer teachers' knowledge synthesis and understanding of the teaching process. METHODS: We utilized a mixed methods approach to determine if an evaluation instrument was valid and helpful to peer teachers. Both peer learners and educators completed evaluations of peer teachers, which were then compared. After receiving summarized feedback, peer teachers completed a survey regarding their experience. RESULTS: There were no statistical differences between peer learner and educator ratings of peer teachers. Peer learners indicated they found peer teachers to be helpful in the high fidelity simulation setting. Peer teachers indicated satisfaction with the experience. Analysis of qualitative comments on peer-teacher surveys resulted in the identification of three themes: (a) validation of knowledge growth; (b) increased comfort with teaching; and (c) enhanced appreciation of teaching. CONCLUSIONS: Peer teaching may enhance knowledge gain and synthesis for both peer teachers and peer learners. Enhanced comfort with teaching may lead to enhanced comfort in teaching both patients and peers in future practice.

Committing to my mission: Faculty experiences with student veterans in baccalaureate nursing education.

Veterans transition to baccalaureate nursing education with significant experiences from their military service. Faculty play a role in facilitating this transition, in and out of the classroom. Approaches to enhance nursing education programs to better meet student veterans' needs have been proposed. However, less is known about the experiences of faculty teaching student veterans. A qualitative descriptive design was used to examine nursing faculty experiences teaching veterans, and in facilitating veterans' transfer of learning and knowledge from their military experience to baccalaureate nursing education. Semi-structured interviews with twelve faculty from the United States were conducted and data analyzed using content and thematic analysis. Three major themes included: committing to my mission, facilitating a shared understanding between military service and nursing, and appreciating a new duty. Results support faculty purposefully engaging in activities to increase their cultural sensitivity, while continuously developing humility and competence, to be successful teaching student veterans. Nursing faculty are positioned to leverage education as a means to improve the social status of veterans, ultimately improving their health and well-being, as well as academic success. It is recommended schools of nursing encourage and support faculty in attending professional development activities aimed at improving individual cultural sensitivity.

Understanding learning transfer of veterans in baccalaureate nursing programs: Their experience as student nurses.

With the continued growth of the numbers of veterans in nursing programs, faculty need to be aware of how to best facilitate their learning and build on their diverse experiences and expertise. Understanding how veterans transfer learning from the military context to an academic context is crucial for nursing education. The findings of this qualitative descriptive study support that veterans transfer learning from their military experience to their nursing education. Eleven veterans comprised the sample. The themes were: Embracing and living core professional values, Learning from a team-based framework to achieve a common goal, Learning how and when to communicate with faculty and healthcare members, and Incorporating learned behaviors into everyday professional practice. One recommendation for faculty included gaining basic knowledge of military culture and how that influences veterans once they transition to civilian life. The study findings can help faculty to build on previously acquired knowledge and enrich the learning experience for students and faculty. Ultimately, this may help to recruit and retain veterans in nursing programs; thus, impacting the global workforce.

Discovering a New Purpose: Veterans' Transition to Nursing Education.

With the downsizing of military forces and the support of GI Bill benefits, a growing number of veterans are returning to college. Using a qualitative descriptive approach, the researchers sought to understand the transition experiences of 11 veterans enrolled in baccalaureate nursing programs. Data suggest the transition process is challenging, marked by significant change in structure and culture from one context to the next. Veterans return to school to learn and seek meaning and purpose in the pursuit of a nursing degree. Faculty understanding of military culture is a first step in guiding the student veteran to success in nursing education.

Cultural and Generational Considerations in RN Retention.

OBJECTIVE: The aim of this study was to identify evolving cultural and generational factors influencing nurse retention. BACKGROUND: Multigenerational/culturally diverse workforces challenge the nurse leader's understanding of nurse satisfaction. METHODS: A survey was designed to identify the RN's career intentions, desired leadership traits, and practice environment appraisal. RESULTS: While generally satisfied with their current position, generational differences in the average number of years nurses intend to stay at their current employer exist with Millennials anticipating staying 3.03 years; Generation X, 5.83 years; and Boomers, 8.25 years. Perceived inability to meet patient needs, which varied by generation, was significantly related to nurse satisfaction (P < .01). Factors identified by the nurses that may improve retention, regardless of generation, were pay, staffing, and nursing leadership support. Preferred leader traits varied by generation and ethnicity. Hispanic nurses value hardworking, honest leaders, whereas non-Hispanic nurses value dependability. CONCLUSION: Nurse leaders must individualize efforts to retain an ethnically diverse and multigenerational nursing workforce.

Impact of Population Differences: Post-Kidney Transplant Readmissions.

Early hospital readmissions after kidney transplantation are common and considered an indicator of healthcare quality. The purpose of this study was to identify and describe the risk factors for and causes of 30-day readmission post-kidney transplant for adults in a predominantly Hispanic Southern Texas population in comparison to the United States kidney transplant population and published research. A single-center, descriptive, retrospective study of adult kidney transplant recipients readmitted to a hospital in southern Texas was conducted. Results indicated that this population had lower education levels, a greater percentage of Spanish-speaking patients, and a high number of patients with either or both diabetes mellitus and hypertension, necessitating the development of additional methods of increasing understanding and adherence to restrictions, requirements, and medication regimes.

From Military to Academic Nursing: Embracing an Untapped Leadership Resource.

BACKGROUND: Strong leaders are essential for nursing program success, yet few faculty are interested or qualified to assume leadership positions within academia. This generates concern over lingering shortages and lack of succession planning. METHOD: A qualitative, descriptive study examined the transition experience of military nurses who became nurse educators. Emerging from an analysis of interviews with 13 Veteran nurses, the subtheme of "using my leadership toolbox" is explored within the context of leadership development. RESULTS: Grounded in their military leadership development, the participants modeled essential leader qualities. They demonstrated confidence, vision, humility, a strong work ethic, clear communication, and a willingness to assume risk. CONCLUSION: Veteran nurses may be a viable solution to bring leadership knowledge, behaviors, and experience to the faculty role. Current academic leaders should facilitate the translation of these leadership attributes to address ongoing challenges facing nursing education. [J Nurs Educ. 2018;57(6):355-358.].

The Transition from Military Nurse to Nurse Faculty: A Descriptive Study.

Aim The aim of this qualitative descriptive study was to describe the transition from military nurse to nurse faculty. Background There is a global shortage of qualified nurse faculty. Recruitment of retiring or separating military nurses is a viable solution. Methods Content and thematic analysis of semi-structured interviews of former military nurses (N=13) was undertaken. Results The transition from military nurse to nurse faculty includes acknowledgment of the reality of academic culture, appreciation of the journey to bridge the gap, and culmination of a new identity. Leadership skills acquired during military service proved instrumental to a successful transition. Conclusions Recognizing this transition and the strengths these nurses offer provides evidence for focused orientation programs to increase recruitment and retention of these faculty.

Becoming an Air Force Nurse: The Experience of Transition A New Perspective of a Known Phenomenon.

PROBLEM: Transitions in nursing have consistently been described as complex and stressful. While the literature is replete with studies investigating role transitions in civilian healthcare settings, there is no known research that explores the role transition of experienced nurses who move from civilian to military nursing practice. Using nurses in the U.S. Air Force as an exemplar, this study serves as a starting point to understand the transition process and challenges likely encountered by nurses new to the military. The outcomes of this study could influence future efforts to recruit and retain qualified nurses. METHODS: A hermeneutic, phenomenologic approach was used to explore and describe the lived experience of transition from civilian staff nurse to Air Force staff nurse. FINDINGS: The results indicated that new Air Force nurses encounter challenges related to a lack of knowledge and role preparedness, which led to feelings of stress and frustration. Support from peers, mentors, and managers helped the new Air Force nurses bridge the gap in knowledge and successfully integrate into the military culture. IMPLICATIONS: Efforts to reduce the perceived lack of knowledge through improvements to the Commissioned Officer Training program and the clinical orientation period are recommended.