Medicaid expansion: the dynamic health care policy landscape.

The Supreme Court decision of June 2012 left states free to decide on how to undertake Medicaid expansion without facing the substantial financial penalties envisioned by the Affordable Care Act. Currently, 25 states and the District of Columbia are moving forward with the expansion; 22 have decided not to move forward and the remaining 3 are still debating the issue. The evidence to date suggests Medicaid expansion would have several benefits to states including improved population health from expanded coverage, improved financial positions of hospitals and other providers, and economic benefits such as increased employment and tax revenues. Because of these potential impacts of Medicaid expansion on patients and providers of health care, the nursing profession may wish to play an educational or advocacy role in the ongoing debate.

Demystifiying state health insurance marketplaces.

The state health insurance exchanges, mandated under the Patient Protection and Affordable Care Act, will impact how health care is delivered and reimbursed, and will touch the lives of nurses in all professional roles. The dynamics of how each model will operate within each state is currently a work in progress. Nurses have a tradition of providing voice and leadership in the health care reform arena from the unique position as both consumers and health care professionals. The time is right to contact state legislators and advocate for nurses to sit on the governing boards of the state health care exchanges. Communication between nurses in all states should be an ongoing dialogue through specialty and state nursing organizations to ensure nursing is aware of both issues and best practices nationwide.

BLAST model: an innovative approach to prepare second-degree accelerated BSN students for inpatient psychiatric clinical experiences.

This article describes the design, development, and implementation of an innovative teaching/learning model involving integration of classroom teaching, clinical simulation, and debriefing/critical thinking to prepare accelerated baccalaureate nursing students for clinical practice experiences in the inpatient psychiatric setting. Lessons learned and future directions for simulation experiences involving standardized patient scenarios in undergraduate psychiatric nursing education are shared.

Practicum projects of value: a successful strategic partnership between nurse executives and master's level academia.

The opportunity exists for academia and the nursing executive community to collaboratively create cultures of excellence. One university formed relationships of collaborative synergy with nurse executives to provide practicum experiences of value for both the graduate nursing administration students and the health care facilities. The strategic preceptor partnerships offer graduate students the invaluable opportunity to experience the in-depth, real world perspective of nursing administration resulting in the enrichment of their academic scholarship. A final practicum work project is designed collaboratively with the preceptor and completed by the end of the second practicum semester. The resulting practicum project is an example of a mutually rewarding experience for the graduate nursing administration student and the preceptor. The collaborative synergistic model is a win-win situation for the university and the health care facility.

The perceptions and experiences of national regulatory nurse leaders in advancing the advanced practice registered nurse compact policy agenda.

BACKGROUND AND PURPOSE: The Advanced Practice Registered Nurse (APRN) Compact was approved at the National Council of State Boards of Nursing Delegate Assembly in May 2015. Since that date, only three states have been successful in the legislative adoption of the compact. Thus, the purpose of this study was to explore the experiences and perceptions of nursing regulatory leaders involved with the individual state adoption of the APRN Compact. METHODS: This qualitative study followed a phenomenological-hermeneutic methodology approach. CONCLUSIONS: Four themes emerged from within the data: legislative political environment; professional organizational barriers; strategies to push past barriers; and moving forward. An overarching theme of consistent communication was evident. IMPLICATIONS FOR PRACTICE: This study identifies barriers experienced in the legislative state adoption process and successful strategies to overcome these barriers to move the APRN compact forward.

Managing multiple generations: scenarios from the workplace.

PROBLEM: The current nursing workforce is composed of multigenerational staff members creating challenges and at times conflict for managers. METHODS: Generational cohorts are defined and two multigenerational scenarios are presented and discussed using the ACORN imperatives and Hahn's Five Managerial Strategies for effectively managing a multigenerational staff. FINDINGS: Communication and respect are the underlying key strategies to understanding and bridging the generational gap in the workplace. CONCLUSION: Embracing and respecting generational differences can bring strength and cohesiveness to nursing teams on the managerial or unit level.