How Entering Students View Nursing as a Profession After COVID-19: A Qualitative Study.

ABSTRACT: The COVID-19 pandemic significantly affected the nursing profession. Nurses were called heroes during the pandemic, yet nursing is now suffering a staffing crisis. This phenomenological study asked 15 incoming first-semester nursing students about their perceptions of the nursing profession. Verbatim transcripts were analyzed, and three themes emerged: Vicarious Pride, Raw Gratitude, and Help Is Coming. With a need to attract more applicants and graduate more nurses, nursing schools might use these identified concepts to recruit and motivate prospective students. This research provides insight into the motivation to attend nursing school following the pandemic.

The Gut Microbiome and Mental Health.

The gut microbiome has been well researched in the past few years and may be a target for treating mental illness. Trillions of bacteria in the digestive system work with the brain, immune function, and endocrine pathways. This gut microbiome ecosystem mediates the interaction between the human being and the environment making its inclusion in holistic nursing essential. Changes in normal balance of the gut microbiome occur with diet, antibiotics and other medications, stress, cancer treatment, geography and environment, and current illnesses. When the microbiome is challenged a "dysbiotic" state leads to inadequate production of needed neurotransmitters such as serotonin and dopamine. Research has shown links between the dysbiosis, and the inflammatory response system that are known to contribute to depression, anxiety, and schizophrenia. Understanding the role of the gut microbiome can be beneficial to holistic nurses, providing a new tool to prevent, treat, or reduce symptoms of mental illness and improve general immune function. This innocuous holistic approach to mental wellness is becoming an important evidenced-based approach.

Detection of concealed knowledge via the ERP-based technique Brain Fingerprinting: Real-life and real-crime incidents.

Brain Fingerprinting (BFP) is an electroencephalogram-based system used to detect knowledge, or absence of knowledge of a real-life incident (e.g., a crime) in a person's memory. With the help of BFP, a potential crime suspect can be classified as possessing crime-related information (Information-Present), not possessing crime-related information (Information-Absent), or Indeterminate (BFP unable to classify a subject). In the lab setting, we compare the ground-truth of a subject (i.e., real-life involvement in an incident) against their classification based on BFP testing. We report two studies: replication of BFP with university students (Study 1) and replication of BFP with parolees (Study 2). In Study 1, we tested 31 subjects (24 females, seven males, mean age = 21.3) on either their own or another subject's real-life incident. BFP correctly classified nine Information-Present and 18 Information-Absent subjects, but with one false positive and three exclusions. In Study 2, we tested 17 male parolees (mean age = 47.5) on their own or another parolee's crime incident. BFP correctly classified two Information-Present and six Information-Absent subjects. However, there was also one false positive classification and three Indeterminates. Additionally, we identified three subjects who could not complete the BFP testing and two exclusions. We posit that BFP is not yet at a stage to be considered a robust and accurate crime-detection tool as claimed in former articles. Nevertheless, after addressing the limitations, BFP has considerable potential as an information detection tool in forensic investigations, especially for detecting idiosyncratic crime-relevant knowledge in a perpetrator, in addition to helping to confirm the accuracy of a suspect's claim of innocence.

Systematic Review of Burnout in US Nurses.

Nurses experience high levels of burnout, and this has become a major factor in recruitment and retention of nurses. Several factors have been associated with burnout, but it is not clear which factors are the most significant predictors. Understanding the most prevalent factors that are associated with burnout will allow for the development and implementation of interventions to ameliorate and/or reduce burnout in the nursing workforce.

Nursing Burnout and Its Impact on Health.

Burnout in nurses can have negative consequences for the organizational health of the institution and the mental and physical health of the nurse. In this article, the authors identify the incidence of burnout in nursing and risk and protective factors. Next, they discuss the relationship between burnout and health, highlighting the critical relationship between burnout, stress, inflammation, and declines in physical health. Lastly, they review articles from the Zangaro and colleagues' systematic review related to mental and physical health to create a picture of the existing research on burnout and health.

Medical surgical nurses describe missed nursing care tasks-Evaluating our work environment.

PURPOSE: The purpose of the study was to explore the nurse work environment by evaluating the self-report of missed nursing care and the reasons for the missed care. METHODS: A convenience sample of medical surgical nurses from four hospitals was invited to complete the survey for this descriptive study. The sample included 168 nurses. The MISSCARE survey assessed the frequency and reason of 24 routine nursing care elements. RESULTS: The most frequently reported missed care was ambulation as ordered, medications given within a 30 minute window, and mouth care. Moderate or significant reasons reported for the missed care were: unexpected rise in volume/acuity, heavy admissions/discharges, inadequate assistants, inadequate staff, meds not available when needed, and urgent situations. CONCLUSION: Identifying missed nursing care and reasons for missed care provides an opportunity for exploring strategies to reduce interruptions, develop unit cohesiveness, improve the nurse work environment, and ultimately leading to improved patient outcomes.

Assessment of an educational intervention on nurses' knowledge and retention of heart failure self-care principles and the Teach Back method.

BACKGROUND: Nurses must have optimum knowledge of heart failure self-care principles to adequately prepare patients for self-care at home. However, study findings demonstrate that nurses have knowledge deficits in self-care concepts for heart failure. METHODS: A quasi-experimental, repeated measures design was used to assess nurses' knowledge of heart failure self-care before, immediately after, and 3-months following an educational intervention, which also included the Teach Back method. Follow-up reinforcement was provided after the educational intervention. RESULTS: One hundred fifty nurses participated in the study. Significant differences were found between pre-test (65.1%) and post-test (80.6%) scores (p < 0.001). Teach Back proficiency was achieved by 98.3%. Only 61 participants completed the 3-month assessment of knowledge. In this group, mean knowledge scores increased significantly across all three measurements (p < 0.001): 66.5% (pre-test); 82.1% (post-test); 89.5% (follow up post-test). CONCLUSIONS: Participation in a comprehensive educational program resulted in increased nurses' knowledge of heart failure self-care principles and the knowledge was sustained and increased over time.

Clinical nurse specialist assessment of nurses' knowledge of heart failure.

PURPOSE/OBJECTIVE: Patients' self-management of heart failure (HF) is associated with improved adherence and reduced readmissions. Nurses' knowledge about self-management of HF may influence their ability to adequately perform discharge education. Inadequate nurse knowledge may lead to insufficient patient education, and insufficient education may decrease patients' ability to perform self-management. Prior to developing interventions to improve patient education, clinical nurse specialists should assess nurses' knowledge of HF. The purpose of this study was to determine nurses' knowledge of HF self-management principles. DESIGN: This was a prospective, exploratory, and descriptive online test. SETTINGS: There were 3 patient care settings: tertiary care teaching hospital, community hospital, and home healthcare division. SAMPLE: The sample was composed of 90 registered nurses who worked directly with patients with HF. METHODS: Nurses completed an online test of knowledge using the Nurses' Knowledge of Heart Failure Education Principles instrument. FINDINGS: Registered nurses (n = 90) completed the knowledge test instrument; their average score was 71% (SD, 10.8%) (range, 20%-90%). The percentage of correct items on each subscale ranged from 63.9% (SD, 30.0) for medications to 83.3% (SD, 25.0) for exercise. Only 8.9% of respondents achieved a passing score of greater than 85%, and a passing score was not associated with any demographic characteristics. CONCLUSIONS: Overall, nursing knowledge of HF self-management principles was low. Scores from our nurses were similar to those found in other studies. IMPLICATIONS: There is a need to develop interventions to improve nursing knowledge of HF self-management principles. Clinical nurse specialists can be instrumental in developing knowledge interventions for nurses.

How to grow our own: an evaluation of preceptorship in New Zealand graduate nurse programmes.

Effective preceptorship has consistently been identified as an essential support process for graduate nurses in their first year of practice. Quality preceptorship supports a new graduate to develop confidence and competence and is seen as a critical component of any new graduate programme. This paper provides an overview of nurse entry to practice (NETP) programmes within New Zealand, along with key findings from a commissioned evaluation study during 2007-2009 that focused on preceptorship support for new graduate nurses. Findings from the evaluation identified access to preceptors, the importance of the preceptor/new graduate relationship, preceptor preparation for their role and the overall culture of support as important. Nursing leadership is additionally identified as a critical component to support effective preceptorship in any new graduate nursing programme.

Entry to nursing practice preceptor education and support: could we do it better?

High quality preceptorship during their first year of practice is seen as critical for new graduate nurses' development of competence and confidence. Quality preceptorship is dependent upon skilled and knowledgeable preceptors who are committed to this role. A recent longitudinal evaluation of 21 Nursing Entry to Practice (NETP) programmes in New Zealand identified that preceptorship selection, education and support do not always receive the attention they warrant. Failure to plan preceptor selection leads to ad hoc selection and consequent allocations of many preceptors who may not have attended appropriate education, or have a desire to undertake this role. Such a situation is detrimental to the job satisfaction of both preceptors and new graduate nurses. High workloads, rostering difficulties and increased acuity in many clinical areas often prevent preceptors from attending appropriate education and that, in turn, impacts negatively on the preceptor's expectations and clarity with respect to the role. To offset this effect the authors recommend development of a clearly defined preceptor selection process, along with flexible preceptor education programmes that provide a good foundation for support of new graduates in their first year of practice; but do not increase preceptor workloads.

Health consequences of childhood sexual abuse.

PURPOSE: This article provides a summary for advocacy, court testimony, assessment, treatment, prevention, and further research studies in the field of childhood sexual abuse. FINDINGS: A literature review identifies the psychiatric, social, and disease disorders to which this population is predisposed. Adult survivors experience more depression, obesity, autoimmune disorders (irritable bowel syndrome, asthma, fibromyalgia), eating disorders, and addictions. PRACTICE IMPLICATIONS: A holistic perspective allows understanding of health consequences for survivors. A model through which to consider these phenomena is presented. CONCLUSIONS: The long-term consequences of childhood sexual abuse must be assessed and addressed by healthcare professionals.

Stress management for adult survivors of childhood sexual abuse: a holistic inquiry.

Among the many sequelae of childhood sexual abuse is a maladaptive response to stress. Stress has been linked to a reduction in the immune system's ability to resist disease. The purpose of this exploratory mixed-method study is to examine the experience of stress management training for 35 adult survivors of childhood sexual abuse. Data gathered for analysis include pre- and postintervention saliva samples for sIgA, Ways of Coping Questionnaire, and a postintervention qualitative interview. Stress management strategies enhance immunity (increase in salivary immunoglobulin A, p < .05) and coping (less distancing, p < .001; less escape-avoidance, p < .001; more planful problem solving, p < .01; and more positive reappraisal, p < .001). Grounded theory analysis finds three themes emerging: hypervigilance , an outward-focused hyperawareness; somatic detachment, a lack of inward focus on self; and healing pathway, the process of healing from the abuse. Healing is possible.

The experience of providing young people attending general practice with an online risk assessment tool to assess their own sexual health risk.

BACKGROUND: Targeted chlamydia screening has been advocated to reduce chlamydia associated reproductive sequelae. General practitioners are well positioned to play a major role in chlamydia control. The primary aim of this pilot study was to measure the effect of offering an online sexual health assessment tool, Youth Check Your Risk, on chlamydia testing rates among young people attending general practices. The secondary aim was to test the acceptability of the tool among general practitioners and young people. METHODS: General practitioners at three practices in Melbourne, Australia, referred patients aged 16 to 24 years to Youth Check Your Risk http://www.checkyourrisk.org.au for use post-consultation between March to October 2007. The proportion of young people tested for chlamydia before and during the implementation of the tool was compared. Acceptability was assessed through a structured interviewer-administered questionnaire with general practitioners, and anonymous online data provided by Youth Check Your Risk users. RESULTS: The intervention did not result in any significant increases in the proportion of 16 to 24 year old males (2.7% to 3.0%) or females (6.3% to 6.4%) tested for chlamydia. A small increase in the proportion of 16 to 19 year old females tested was seen (4.1% to 7.2%). Of the 2997 patients seen during the intervention phase, 871 (29.1%) were referred to Youth Check Your Risk and 120 used it (13.8%). Major reasons for low referral rates reported by practitioners included lack of time, discomfort with raising the issue of testing, and difficulty in remembering to refer patients. CONCLUSION: Offering an online sexual risk assessment tool in general practice did not significantly increase the proportion of young people tested for chlamydia, with GPs identifying a number of barriers to referring young people to Youth Check Your Risk. Future interventions aimed at increasing chlamydia screening in general practice with the aid of an online risk assessment tool need to identify and overcome barriers to testing.