The value of intentional self-care practices: The effects of mindfulness on improving job satisfaction, teamwork, and workplace environments.

BACKGROUND: Burnout rates among nurses have detrimental impact on job satisfaction, teamwork, and patient care. This costs millions of dollars in the healthcare system and challenges nurse leaders to address in order to keep up with the healthcare demands. Furthermore, burnout is especially relevant in our current healthcare climate, as frontline nurses have increased workload and multiple psychosocial stressors during the coronavirus disease (COVID-19) pandemic (Sultana, Sharma, Hossain, Bhattacharya, & Purohit, 2019). Literature also suggests that mindful self-care practices need to be reinforced in order to impact burnout long term (Chamorro-Premuzic & Lusk, 2017). Project7 Mindfulness Pledge© is an accessible and voluntary mindfulness tool that nurses can utilize in their individual practice to reduce burnout and does not require significant time commitment. OBJECTIVE: To evaluate the effectiveness of intentional self-care practices on nurse burnout and workplace environment by measuring job satisfaction and teamwork among nurses. METHODS: Comparisons between inpatient units on data from the National Database of Nursing Quality Indicators (NDNQI) with the Practice Environment Scale (PES), specifically on job enjoyment and teamwork, were done utilizing ANOVA. RESULTS: Results show that nurses in an inpatient unit that implemented Project7 has significantly higher job satisfaction as compared to units that did not implement Project7. CONCLUSIONS: This suggests that this tool provides an effective and accessible mindfulness framework managers and directors can utilize to improve job satisfaction, teamwork, and thereby reduce burnout to create healthier work environments.

Moving from practice to praxis: A qualitative descriptive study revealing the value of Project7 Mindfulness Pledge©.

AIM: To examine the experiences of nurses and nursing assistants who participated in a mindfulness project. BACKGROUND: Increased demands and fewer resources have become the norm in most health care settings. As a result, health care professionals face exceptional stress in their work environments and are vulnerable to burnout and compassion fatigue. Even more distressing, many new nurses are leaving their jobs within the first two years. METHODS: Qualitative interviews were conducted with nine participants to discover their experience with the project. RESULTS: The major theme, a process of moving from practice to praxis, is brought forth through in-depth descriptive analysis of nine individual interviews. The process occurred through three themes: fostering self-awareness and compassion; fostering other-awareness and compassion; and compelling transformation in the unit culture. CONCLUSIONS: This study develops an evidence base for incorporating and building mindfulness into health care environments at a time when there is a tremendous need for highly functioning practitioners. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse leaders are encouraged to examine how they can support their staff in moving from practice to praxis as a part of improving professional well-being, retention, quality and safety in health care.

A Meeting of Hearts and Minds: A Critical Reflection on Building, Enhancing, and Sustaining Global Partnerships in Nursing Education.

AIM: The aim of the study was to engage in a critical reflective dialogue through a purposeful and strategic process to build, enhance, and sustain global partnerships. BACKGROUND: Expanding global health through partnerships necessitates a critical dialogue on shared values and understandings. Appreciating philosophical orientations, ethical perspectives, and broadening what counts as evidence serves to further inform scholarship and practice partnerships. METHOD: We engaged in a critical reflective dialogue by exploring our experiences through a purposeful and strategic process where we described, examined, and articulated the learning that informs our partnership. RESULTS: By listening to each other's stories, reflecting individually, and dialoguing together, we have shared and compared experiences that gave us more insight into how to build, enhance, and sustain our partnership. CONCLUSION: Continuously examining issues and discussions around partnerships through a critical reflective process supports the development of shared values and meaning, strengthens connections, and leads to new knowledge for sustaining global health partnerships.

Reducing the Second Victim Phenomenon: Healing Our Healers With Caritas Coaching.

The second victim phenomenon is one in which nurses and other health care providers use dysfunctional mechanisms, such as anger, projection of blame, or drugs and/or alcohol, to cope with serious mistakes in the absence of a healthier means for healing. The main purpose of this article is to provide evidence and practices that support the need for caring organizational support systems following serious adverse clinical events. Recommendations are provided on key elements of programs to prevent the prevalence, symptoms, and impact of the second victim phenomenon on our health care professionals, our patients, and our health care system.

Temporal Immediacy: A Two-System Theory of Mind for Understanding and Changing Health Behaviors.

BACKGROUND: Health promotion and chronic disease management both require behavior change, but people find it hard to change behavior despite having good intentions. The problem arises because patients' narratives about experiences and intentions are filtered through memory and language. These narratives inaccurately reflect intuitive decision-making or actual behaviors. OBJECTIVES: We propose a principle-temporal immediacy-as a moderator variable that explains which of two mental systems (narrative or intuitive) will be activated in any given situation. We reviewed multiple scientific areas to test temporal immediacy as an explanation for findings. METHODS: In an iterative process, we used evidence from philosophy, cognitive neuroscience, behavioral economics, symptom science, and ecological momentary assessment to develop our theoretical perspective. These perspectives each suggest two cognitive systems that differ in their level of temporal immediacy: an intuitive system that produces behavior in response to everyday states and a narrative system that interprets and explains these experiences after the fact. FINDINGS: Writers from Plato onward describe two competing influences on behavior-often with moral overtones. People tend to identify with the language-based narrative system and blame unhelpful results on the less accessible intuitive system, but neither is completely rational, and the intuitive system has strengths based on speed and serial processing. The systems differ based on temporal immediacy-the description of an experience as either "now" or "usually"-with the intuitive system generating behaviors automatically in real time and the narrative system producing beliefs about the past or future. DISCUSSION: The principle of temporal immediacy is a tool to integrate nursing science with other disciplinary traditions and to improve research and practice. Interventions should build on each system's strengths, rather than treating the intuitive system as a barrier for the narrative system to overcome. Nursing researchers need to study the roles and effects of both systems.

Reflective practices: meaningful recognition for healthy work environments.

Nurses' decisions about their intent to remain in the workforce are based on various factors. A healthy work environment in which work done well is recognised and appreciated contributes to nurses' satisfaction and better patient outcomes. This article examines the American Association of Critical-Care Nurses framework for a healthy work environment, focusing on standards for meaningful recognition. Reflective practice, which provides a self-analytical approach to appreciate and value one's work, is viewed as self-recognition. Neither boastful nor arrogant, reflective self-recognition is part of progression to professional maturity. It involves examining events at work continuously and systematically to learn, appreciate and move to higher levels of contribution in the workplace.

Becoming a nurse faculty leader: taking risks by doing the right thing.

Risk taking is a key aspect of academic leadership essential to meeting the challenges and opportunities in higher education. What are the practices of risk taking in nurse faculty leaders? This interpretive phenomenological study examines the experience and meaning of risk taking among nurse leaders. The theme of doing the right thing is brought forth through in-depth hermeneutic analysis of 14 individual interviews and two focus group narratives. The practice of doing the right thing is propelled and captured by leaders through a sense professional responsibility, visioning the future, and being true to self and follow one's core values. This study develops an evidence base for incorporating ways of doing the right thing in leadership development activities at a time when there is tremendous need for highly effective leaders in academic settings. Examining the practices of doing the right thing as a part of leadership development lays a foundation for building the next generation of nursing leaders prepared to navigate the ever-changing and complex academic and health care environments.

The nurse's lived experience of becoming an interprofessional leader.

In the current complex health care environment, nurses in all practice settings are called on to be leaders in advocating for a healthier future. Health care reform, the rise of the evidence-based practice movement, and the proliferation of new educational options are opening opportunities as never before for nurses to expand their leadership capacity to an interprofessional level. This interpretive phenomenological study conducted with eight nurse participants describes their experience of becoming an interprofessional leader. A team of three nurse researchers interpreted the texts individually and collectively. Interview texts were analyzed hermeneutically to uncover the common shared experience of moving toward common ground with interprofessional leadership as a process, one that not only took time, but also called for self-reflection, deliberate actions, and a new mind-set. This study develops the evidence base for leadership preparation at a time when there is a strong need for interprofessional leaders and educators in health care.

An international panel perspective: Exploring nursing scholarship in academia.

BACKGROUND: Boyer's framework of scholarship, the basis of many academic models for faculty promotion, is comprised of the components of discovery, teaching, integration, application, and engagement. Yet, the scholarship component of application (containing goal-based clinical practice) is undervalued by many academic models. PURPOSE: This study explores the nursing activities currently qualifying as scholarship in several international academic models. METHODS: Using the Delphi approach, an international nine-member panel from seven countries participated in a six-question, structured brainstorming session to explore the nursing activities qualifying as scholarship by academic models. Follow-up sessions were attended by six panel members. RESULTS: Panel members reported that the nursing activities, which most often were recognized as scholarship, fit the scholarship components of discovery, teaching and integration but few fit the components of application or engagement. Although this project originally focused on clinical practice, far more recommendations for an academic model targeted the scholarship component of engagement. CONCLUSION: Academic models' lack of appreciation for the scholarship components of application (goal-based clinical practice) and engagement (partnering with community groups) discourages faculty from participating in these activities. Yet, these nursing activities demonstrate scholarship and are essential for the continued development of the nursing profession and discipline.

Integrating Compassion and Theoretical Premises of Caring Science into Undergraduate Health Professions Education.

Compassion and caring are critical foundational concepts for the education of health professions students. Yet many curricula emphasize skill-based learning and test-taking preparation, which often limits the opportunities for students to practice compassionately caring for themselves and others. In 2019, an elective wellness course was introduced into a School of Nursing and Health Professions curriculum to provide students with the knowledge, understanding, and practice of self-compassion and caring as the foundation for holistically caring for others. The goal of the course is to use ethics, values, and ontological competencies of self-compassion and Caritas literacy to awaken students to their being, not just doing, and how it evolves throughout their professional careers. Narrative feedback from students demonstrated a deeper understanding of the necessity for compassion and caring for self to provide compassionate care to others.

Improving quality and safety in graduate education using an electronic student tracking system.

TOPIC: The Institute of Medicine report on the future of nursing, the Quality and Safety Education for Nurses initiative, and the Technology Informatics Guiding Education Reform movement are among the most prominent forces guiding change related to information technology and informatics in nursing to improve quality and safety in practice. Informatics competencies are essential for psychiatric nurses to leverage and integrate information technology into education, practice, and research. PURPOSE: This article examines informatics and information technology from the perspective of educational preparation of the psychiatric mental health nurse practitioner. SOURCES OF INFORMATION: Literature related to informatics, information technology, and quality and safety in advanced practice psychiatric nursing. CONCLUSION: Strategies for integration of information technology in educating psychiatric mental health nurse practitioner students are described. Informatics competency will result in safer and higher quality care.

Developing a reflection-centered curriculum for graduate psychiatric nursing education.

This article discusses theoretical underpinnings, teaching strategies, and preliminary evaluation relative to the development of a reflective curriculum used in our distance-accessible graduate psychiatric nursing program. Influenced by the collective ideas of J. Dewey (1993), J. Reed and S. Proctor (1993), D. A. Kolbe (1984), J. Mezirow (1981), C. Johns (2006), D. Schön (1983), D. Freshwater (2008), and others who have promoted reflection as a transformative teaching and learning process, we sought to develop a curriculum that balanced knowledge and skill acquisition with critical reflective practices that would instill habits of lifelong learning. We began with traditional approaches to psychiatric nursing education, including case study analysis and modified lectures that we call mini lectures. We then added principles and practices of reflection to allow for merging these traditional approaches with contemporary reflection-focused approaches. Specific ways to use reflection in a graduate psychiatric nursing curriculum are described to demonstrate how we have taken our curriculum beyond traditional ways of teaching and learning toward one that emphasizes building knowledge and skill through reflective practice.

Balancing technology with face-to-face interaction: navigating the path to psychiatric nursing education at a distance.

In 2008, we created a program that incorporated pedagogical approaches to support distance education for graduate psychiatric mental health nursing students in Indiana and adjacent states. This narrative provides a brief description of the five initiatives we originally proposed, our experiences with them, and future plans as our program continues to evolve.

Stories of the Heart: Illness Narratives of Veterans Living With Heart Failure.

Background: Illness narratives for veterans living with heart failure (HF) have been largely unexplored, yet HF is a significant and impactful illness affecting the lives of many veterans. Methods: This study used narrative inquiry to explore the domains of psychosocial adjustments using the model of adjustment to illness, including self-schema, world schema, and meaning. Results: Five illness narratives of veterans living with HF were cocreated and explored domains which were found across all the narratives explored in this study. Emergent themes included: uniqueness of the veteran experience and the social, historical, and cultural context of narrator and researcher. Conclusions: Veterans living with HF are a unique population who experience changes in their self-schema, world schema, and meaning through their illness experience. These findings have important implications for interdisciplinary health care research and clinical practice, providing important insight into how people live with chronic illness.

Becoming a nursing faculty leader.

Academic leaders are one component of a well-prepared faculty that is required to achieve and sustain excellent educational programs. But what is it like to become an academic leader? How does one become a leader? These questions were addressed in an interpretive study in which nurse faculty leaders were interviewed about the experience of becoming a leader. Interview texts were analyzed hermeneutically by a research team to uncover three themes (common, shared experiences): Being Thrust into Leadership, Taking Risks, and Facing Challenges, which are explicated in this article. This study develops the evidence base for leadership preparation at a time when there is a strong need for nursing education leaders in academia.

Enhancing mutual accountability to promote quality, safety, and nurses' recovery from substance use disorders.

Year after year, the public view nurses at the top of the list of the most honest and ethical professionals. However, nurses impaired with substance use disorders are subject to the tremendous stigma associated with addiction. Successful treatment programs protect public safety and support nurses' recovery and reentry into practice. The purpose of this study was to explore the nurses' experience in an alternative-to-discipline treatment program, the Indiana State Nurses Assistance Program (ISNAP), administered by the Indiana State Nurses Association. For this study, focus groups were used to capture nurses' experience with the ISNAP, a nurse-monitoring program for substance use. Three focus groups were conducted with 25 participants. The overall theme of the focus groups was enhancing mutual accountability. Nurses' views were grouped into four major areas of importance, including accountability, clear expectations, addressing individual concerns, and educating others about substance use disorders. Nurses described how each of these factors supported and impeded their recovery. The findings support the need for further education and research on how to best promote and sustain recovery.

Becoming a nurse faculty leader: facing challenges through reflecting, persevering and relating in new ways.

AIM: The aim of the present study was to explore the experience of becoming a nurse faculty leader. BACKGROUND: In a recent interpretation of 23 interviews conducted with nurse faculty leaders from across the United States about their experiences of becoming a leader three themes were identified: being thrust into leadership, taking risks and facing challenges. EVALUATION: This interpretive phenomenological study further explicates three aspects of how nurse educators faced challenges in becoming and serving as a leader. KEY ISSUES: Facing challenges meant reflecting, persevering through difficulties and learning to relate to others in new ways. Exemplars of participant experiences are provided for concreteness, to assist readers in determining how findings resonate with their own experience and how they can actualize this resonance in their own leadership practice. CONCLUSIONS: In the present study, reflecting, persevering through difficulties and learning to relate with others in a new way was how leaders faced challenges. IMPLICATIONS FOR NURSING MANAGEMENT: Leadership development opportunities that facilitate self-exploration, caring and thoughtful interactions with others and values clarification serve as the foundation for becoming a nurse faculty leader who is, in turn, able to build leadership capacity in other individuals and organizations.