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.

The ICN Leadership For Change™ Programme--20 years of growing influence.

AIM: The aim of this article was to present experiences from the field in the context of the International Council of Nurses' Leadership for Change™ programme, which celebrates 20 years of excellence in 2016 for developing the leadership and management capacity of nurses worldwide. BACKGROUND: The programme was launched in 1996 in order to boost nurse participation in the healthcare policy-making process, globally, and to foster within the nursing profession the requisite skills for nurses to lobby for and assume a greater responsibility in the leadership and management of health care services. INTRODUCTION: Over the course of two decades, the programme has been implemented in cooperation between ICN, national nurses associations, the World Health Organization, Ministries of Health and a variety of donor organizations such as the W.K. Kellogg Foundation and development agencies such as USAID and AUSAID. The programme has been implemented in more than 60 nations throughout Africa, Asia, Europe, the Middle East, Latin America and the Pacific Islands, to name a few regions. METHODS: This article offers an overview of the impact that certified ICN LFC nurse trainers and their colleagues have had in the United Arab Emirates, Vietnam and the United States of America and is affiliated islands and the North Pacific Islands. RESULTS: Twenty years of growth and empowerment are now the ongoing legacy of the ICN LFC Program, which has graduated and deployed nurse trainers around the world and achieved significant advances in the professional development of nurse leaders on an international scale. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nurse leaders can improve the health and well-being of their nations in collaboration with consumers and other key stakeholders. Nurse leaders are critical in improving health systems, their work places and broader societal challenges through sound nursing practice, education, research and evidence-based health and social policy change.

Facilitating Community Participants' Research Engagement: Community Members' Perceptions of Community-based Research.

OBJECTIVES: To describe the perspectives of community participants about engaging in community-based participatory research, and then to use the information to develop a model to depict the community participants' perceptions of interfacing with academic researchers. METHOD: A diverse group of Native Hawaiian community-dwelling participants engaged in open-ended and semi-structured focus group interviews, addressing community members' perceptions of community-based participatory research. RESULTS: Three key areas were identified: (1) reciprocal trustable is needed; (2) perceptions about the purpose, research intent and expectations; (3) expectations of roles and responsibilities of the researcher(s). A model showing the reciprocity between the academic partner and the community partner is needed to establish the full CBPR process is proposed. CONCLUSION: The three themes implied the community participants' expectations of reciprocal relationships. The dimensions influencing community members' perceptions of community-based research need to be taken into account when academic researchers interface with community participants. Successful community-based participatory research approaches for addressing the challenges of translating research findings into community actions is enhanced when the expectations of community members are taken into account.

A statewide consortium's adoption of a unified nursing curriculum: evaluation of the first two years.

AIM: This article provides an evaluation of the first two years of implementation of a statewide nursing consortium (SNC) curriculum on nursing faculty work life, teaching productivity, and quality of education. BACKGROUND: In response to the call for nursing education reform, the SNC incorporated new approaches to competency-based, student-centered learning and clinical education. METHOD: Faculty and two cohorts of students were measured at three points over the first two years of the curriculum implementation. RESULTS: The expected positive impact of the SNC was documented at the start of the first year, but not sustained. Students reported having more confidence in their clinical skills at the start of the first year, yet demonstrated significantly less confidence in their ability after two years. CONCLUSION: Faculty indicated that the SNC allowed greater opportunity for collaboration, but that the experience did not alter their classroom performance or satisfaction beyond the first year.

Care delivery for Filipino Americans using the Neuman systems model.

Filipino Americans are at risk of coronary heart disease due to the presence of multiple cardiometabolic factors. Selecting a framework that addresses the factors leading to coronary heart disease is vital when providing care for this population. The Neuman systems model is a comprehensive and wholistic framework that offers an innovative method of viewing clients, their families, and the healthcare system across multiple dimensions. Using the Neuman systems model, advanced practice nurses can develop and implement interventions that will help reduce the potential cardiovascular problems of clients with multiple risk factors. The authors in this article provides insight into the cardiovascular health of Filipino Americans and has implications for nurses and other healthcare providers working with various Southeast Asian groups in the United States.

Evaluating the impact of a school-based prevention program on self-esteem, body image, and risky dieting attitudes and behaviors among Kaua'i youth.

Eating disorders and obesity (EDO) are increasing among youth, having serious long-term physical and psychological consequences. The purpose of this study was to determine if significant differences exist in EDO risk factors following participation of 4-6th grade students in a school-based EDO prevention curriculum. This community-based research project assessed students at baseline and one week following EDO intervention. Primary outcome variables measured self-esteem, body dissatisfaction, and high risk eating attitudes and behaviors. Pre and post-test differences were calculated using mixed models, correcting for clustering within schools and teachers. This study found mean changes in all scores in healthy directions, as well as movement of students into lower risk groups post-intervention. This program demonstrated that a classroom curriculum is associated with decreased risks of EDO in boys and girls, supporting prevention programs at an early age for both sexes. Studies to determine long term benefit and guide booster interventions are warranted.

Application of guided imagery to facilitate the transition of new graduate registered nurses.

Traditionally, the new graduate registered nurse (RN) transition has included a didactic and skills-based orientation accompanied by a period of preceptored practice. However, these methods do not ensure that new RNs are in a state of reduced anxiety to fully interact with their new environment. Transition to practice may cause anxiety, and the new graduate RN may perceive moderate to severe stress. One method of stress reduction is the use of guided imagery, which has shown strong potential with a variety of populations undergoing stressful events. Today, new graduate RNs expect institutions to facilitate orientation to their new employment settings and assist in the transition to their role as a professional nurse. This article proposes a model that incorporates guided imagery for refining the new graduate RN transition process. The model can be adapted for use in the context of orienting other adult learners to unfamiliar practice situations.

Dietary issues inpatients face with being vegetarian: an integrative review.

This article reviews the literature from 1985 through 2010 on research related to the dietary issues vegetarian inpatients may encounter in the acute care setting. A thematic portrayal of vegetarianism in the context of the inpatient setting is described. Implications for future research and nursing practice are identified.

Body Ideals and Body Dissatisfaction Among a Community Sample of Ethnically Diverse Adolescents on Kauai, Hawaii.

INTRODUCTION: Body dissatisfaction (BD), a risk factor for eating disorders, is occurring at younger ages and among a wide range of socioeconomic and cultural groups. OBJECTIVE: To describe body ideals and prevalence of body satisfaction among an ethnically diverse population of male and female students in Hawaii. METHODS: An anonymous cross-sectional survey including biographical information and the figure drawing screen was distributed to 7th through 12th grade students. RESULTS: Of the 1330 completed surveys, 19% of students were significantly dissatisfied with their bodies. Males were at greater risk than females for total BD (25.8% vs. 13.3%; p<0.001) and for BD in the direction of wanting to be larger (11.3% vs. 2.3%; p<0.001). Males and females were at similar risk for BD in the direction of wanting to be thinner (14.6% vs. 11.6%; p=0.11). Prevalence of BD in the direction of wanting to be thinner was significantly different (p<0.05) among ethnic groups. There were no significant differences in BD based on grade level or SES. CONCLUSIONS: BD exists among nearly 1 out of 5 adolescents, with differing patterns for males and females, and with certain ethnic groups being at higher risk. IMPLICATIONS: Studies to understand risk and protective factors by sex and among different ethnic groups may help generate tailored prevention strategies. Further research is needed to better understand the mechanisms underlying the bidirectional BD seen in males and potential outcomes.

Use of complementary and alternative medical interventions for the management of procedure-related pain, anxiety, and distress in pediatric oncology: an integrative review.

This integrative review aims to identify evidence in four electronic databases (MEDLINE, CINAHL, PsyINFO, and COCHRANE) regarding the effectiveness of complementary and alternative medical interventions, either alone or as an adjunct to pharmacological therapy, in alleviating procedure-related pain, anxiety, and distress in children and adolescents with cancer. A total of 32 articles met inclusion criteria. Results suggest that mind-body interventions, including hypnosis, distraction, and imagery, may be effective, alone or as adjuncts to pharmacological interventions, in managing procedure-related pain, anxiety, and distress in pediatric oncology.

A collaborative approach to developing a validated competence-based curriculum for health professions students.

PROBLEM: Curricula are developed to educate health professions students to provide efficient and effective health services. In addition to learning their disciplinary perspective, today's students must master the concepts of multidisciplinary team care. Traditionally, curriculum was developed based primarily on the perspectives of the discipline faculty, administration and accrediting agencies. However, now there are multiple groups (other academic educators, consumers and employers of health care providers) who may hold differing perspectives about outcomes expected from these programs. PURPOSE: The purpose of this investigation was to use an innovative methodology to generate and validate a curriculum for health professions students from multiple disciplines. METHOD: A multi-phased method using focus groups, surveys, dissemination and affirmation was presented to identify the concepts and best practices that should be included. RESULTS: Several performance-based themes evolved during the interviews and a questionnaire was generated. Academic educators, consumers and employers of health care providers indicated agreement that the components on the survey were realistic and important for health professions students to achieve. Thus, outcomes for a curriculum were validated. The faculty rated several components of the curriculum as less realistic for students to achieve than did the consumers and employers. This investigation suggests it may be necessary for faculty to assist providers and parents in developing more realistic expectations about what students can achieve during their educational program. The approach used in this current project moves the field of the health professions curriculum development to a different level when compared with the traditional curriculum development approaches and should be used by others concerned with multi-professional education to assure the validity of the curricula.

Contrast of pediatric asthma management approaches in a multicultural and collectivistic population.

BACKGROUND: Although asthma is the most prevalent chronic illness in childhood and affects approximately 9 million children, the management approaches used by practitioners may not be efficient from the perspective of families. Clinicians often maintain their usual customs of practice, and the context of the clinical encounter is defined in terms of an individual illness management. In collectivistic and multiethnic settings, the extended kin group or extended family shares responsibility for illness management. The goal of this study is to describe health care providers' strategies to manage children with asthma in a multicultural and collectivistic cultural context. METHODS: Data were obtained through semistructured in-depth practitioner interviews. Western-trained and traditional practitioners participated. RESULTS: Narrative analysis strategies produced two major themes: 1) fix the asthma and 2) making connections. Practitioners who perceived their responsibility to fix the asthma (make things physiologically normal) often ran into constraints with dealing with the extended family group. Other practitioners who used strategies of making connections often capitalized on the assistance of others to problem-solve the asthma management. CONCLUSION: In terms of asthma management, the barriers most frequently reported by practitioners were related to the sociocultural and physical environment. There may be vast differences in asthma management approaches for populations from collectivistic cultural orientation.