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New Jersey's COVID-19 Temporary Emergency Reciprocity Licensure Program provided temporary licenses to more than 31000 out-of-state healthcare practitioners, over a quarter of whom were mental health providers. As the need for mental health care accelerated during the pandemic, especially among health disparity populations, expanding mental health provider pools may be a critical tool to increase access to care. In January 2021, we surveyed New Jersey's temporary licensees. We analyzed over 4500 mental health provider responses to examine the impact of the temporary licensure program on access to mental health care overall and on enhancing a diverse mental health workforce. Over 3700 respondents used their temporary license to provide mental health care to New Jersey patients. About 7% of respondents self-identified as Hispanic, 12% Black, 6% Asian, 1% American Indian or Alaska Native, and 0% (more than 5) Native Hawaiian or other Pacific Islander. They treated about 30100 New Jersey patients, 40% of whom were new to the provider, and 81% delivered care exclusively using telehealth. Respondents conversed with patients in at least 13 languages. About 53% served at least one patient from an underserved racial/ethnic minority group. Our findings suggest that temporary out-of-state mental health providers helped enhance mental health care continuity and access. Copyright 2023 Federation of State Medical Boards. All Rights Reserved.
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AIM: To explore pre-nursing students' experiences and identify factors influencing their well-being as learners during COVID-19. DESIGN: A qualitative descriptive design was used. METHODS: Short answer study data (n = 289) were collected in Fall 2020 as part of a larger IRB-approved survey-based study focused on pre-nursing students. Participants were presented with three short answer questions designed to elicit a description of their experiences as a pre-nursing student. NVivo and reflexive thematic analysis were used to analyse participant responses. RESULTS: Six themes related to learner well-being emerged from the data. Learner well-being was supported by achieving academic goals, experiencing positive feelings about current course content, creating connections with peers and envisioning themselves as nurses in the future. Negative contributors to pre-nursing student well-being included managing fears of program rejection and juggling multiple roles and demands. Online learning necessitated by COVID-19 created opportunities for loneliness and isolation from peers, technological difficulties and additional psychological stress, which also contributed negatively to learner well-being. CONCLUSION: These findings illustrate pre-nursing students' experiences and provide support for the influence of the learning environment and factors within the individual on the well-being of learners. IMPACT: Students preparing to apply to nursing programs are an understudied population and little is known about their well-being as learners. Survey-based open-ended short answer questions can be utilized to gain rich insight into their experiences. The study themes and sub-themes can be utilized for discussion and reflection in courses with pre-nursing students and as a starting point for additional conversations between pre-nursing students and educators regarding improving the support of well-being in learners. Additional research and evidence-based interventions that promote learner well-being in pre-nursing students are needed as they prepare for nursing program admission and to support their academic progression. PATIENT OR PUBLIC CONTRIBUTION: Members of the public were not involved in the design or conduct of the study, analysis, or interpretation of the data, or in the preparation of the manuscript because the study focus is on gaining an understanding the experiences of pre-nursing students and their well-being.
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After two years of the COVID-19 pandemic, telemedicine has become a critical and permanent component of the global healthcare spectrum. With the rising acceptance of telemedicine globally and the importance of providing patients with high-quality care via virtual technology, this chapter aims to educate the reader on the significant and emerging legal and regulatory issues related to the practice of telemedicine. The chapter provides a step-by-step summary of the primary legal and regulatory considerations that must be addressed in order to advance and maintain an effective and high-quality telemedicine platform. As explained herein, the current legal and regulatory landscape remains fluid and challenging. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022. All rights reserved.
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Background: Simulation education is needed to train a highly competent nursing workforce. In-person simulation requires many resources, such as faculty, space, and time, that can negatively affect its feasibility. These barriers have prompted educators to seek new technologies to provide experiential learning opportunities, such as virtual simulation (VS). The COVID-19 pandemic further highlighted the need for educators to investigate alternative learning opportunities.Methods: A quantitative cross-sectional study was conducted with pre-licensure and advanced practice nursing students. They participated in a VS learning experience that was evaluated using the System Usability Scale (SUS)(R), the Clinical Learning Environment Comparison Survey (CLECS 2.0), and the Simulation Effectiveness Tool-Modified (SET-M).Result: 197 pre-licensure and 11 advanced nursing practice students completed post-simulation eval-uations. The results from the SUS scale found the overall virtual system effective. Evaluating the CLECS tool found students' perceived experience was relatively similar for face-to-face simulation and screen-based simulation. The SET-M indicated students rated the VS simulation experience positively. Conclusion: VS for nursing education can be an effective experiential learning tool.
ABSTRACT
Nurses are facing increased mental health issues, substance use, and even suicide since the novel coronavirus pandemicarrived in the United States. Nurses with substance use disorder (SUD) may enroll in alternative-to-discipline (ATD)programs to retain their license during initial treatment with the goal to return to practice, but this process is not withoutchallenges. For example, previous analyses have shown that the time surrounding disciplinary/regulatory process regardingsubstance use disorder (SUD) by either employers or licensure boards was a trigger for nurses who died by suicide. Internetsearches are a common approach to find information on health-related topics. This limited critical review sought toreplicate and evaluate a simple internet search that a nurse seeking information on their state ATD program may complete.Google searches for information on ATD programs were completed on the 50 continental states and Washington, DCbetween April and September 2022. States with ATD programs were evaluated for evidence-based components andbarriers to accessing program information. Publicly available ATD program information ranged from requirements forcontact information to obtain details to websites that outline the entire program, including associated costs. While ATDprograms offer a significant improvement over traditional disciplinary responses to nurse substance use, a significantbarrier is program cost, which can often exclude participation. In this article, we discuss the detailed results of our criticalreview and offer implications for practice that include opportunities for research and a national database to track ATDprogram components and target outcomes to support return to practice for nurses with SUDs © 2023, Online Journal of Issues in Nursing.All Rights Reserved.
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This chapter describes the history, process, and current issues of psychology licensure and board certification. The discussion of licensure highlights both the licensing and oversight functions. Current issues confronting licensing boards are examined: (1) supervised professional experience needed for licensure and (2) testing for competency. The discussion of board certification focuses on the process of becoming board certified and describes three issues: (1) maintenance of competence, (2) interorganizational summit, and (3) evolving specialties. As this was written in the time of Covid-19, concluding comments focus on the opportunities and challenges presented with implications for the future. © 2022 Elsevier Ltd. All rights reserved
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Background: The COVID-19 pandemic placed intense pressure on nursing regulatory bodies to ensure an adequate healthcare workforce while maintaining public safety. Purpose: Our objectives were to analyze regulatory bodies' responses during the pandemic, examine how nursing regulators conceptualize the public interest during a public health crisis, and explore the influence of a public health crisis on the balancing of regulatory principles. We aimed to develop a clearer understanding of regulating during a crisis by identifying themes within regulatory responses. Methods: We conducted a qualitative comparative case study examining the pandemic responses of eight nursing regulators in three Canadian provinces and three U.S. states. Data were collected from semi-structured interviews with 19 representatives of nursing regulatory bodies and 206 publicly available documents and analyzed thematically. Results: Five themes were constructed from the data: (1) risk-based responses to reduce regulatory burden; (2) agility and flexibility in regulatory pandemic responses; (3) working with stakeholders for a systems-based approach; (4) valuing consistency in regulatory approaches across jurisdictions; and (5) the pandemic as a catalyst for innovation. Specifically, we identified that the meaning of "public interest" in the context of high workforce demand was a key consideration for regulators. Conclusion: Our results demonstrate the intensity of effort involved in nursing regulatory responses and the significant contribution of nursing regulation to the healthcare system's pandemic response. Our results also indicate a shift in thinking around broader public interest issues, beyond the conduct and competence of individual nurses, to include pressing societal issues. Regulators are beginning to grapple with these longer-term issues and policy tensions.
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The COVID-19 public health emergency required US states to respond rapidly on regulatory issues, including the process for licensing healthcare practitioners. At least 45 states enacted some form of a licensure waiver, enabling practitioners to temporarily work across state lines. We conducted 22 interviews with national and local (New Jersey) licensure stakeholders in September and October 2021 to capture perceptions of how emergency licensure impacted access to care. Five themes emerged: (1) Emergency licensing helped shift the nation's healthcare workforce supply into regions and specialties of high need;(2) Expanded telehealth capacities complemented emergency licensure programs;(3) Concerns about care quality were mitigated by the urgency of the pandemic, credentialing processes, and investigative authorities;(4) Relocation packages and the need to replace staff could lead to higher costs of care;and (5) Views on licensure reciprocity and interstate compacts were favorable, but smaller provider organizations need to be protected. Overall, stakeholders perceived emergency licensure as successful in expanding access to care during the pandemic. Findings suggest that stakeholders view interstate licensure compacts more favorably now than pre-COVID. While stakeholders may be in favor of licensure reciprocity, they raised concerns about its feasibility, cost, and quality. Copyright 2022 Federation of State Medical Boards. All Rights Reserved.
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The COVID-19 pandemic focused attention on the high levels of occupational stress experienced by frontline and essential workers. Occupational stress is also not unique to these workers as demonstrated by the consistently high rates of suicide within certain occupational groups. Occupational social work is the specialized field most suited to address the needs of workers under stress, yet it has been in decline in the United States since the 1990s. The factors contributing to this decline are put forward, including managed care, the dominance of the advanced clinical social work license, and the lack of a social work presence in occupational stress effectiveness research. The implications for practice regarding the actions that can be taken by the profession to revive this field and be more responsive to vulnerable workers are discussed. © The Author(s) 2023.
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Readiness of nurses to respond to disasters has become paramount with the advent and sequelae of the COVID-19 pandemic. The Future of Nursing 2020-2030 report calls for nurses to be knowledgeable in preparing and responding to disaster management. In New Mexico, five associate degree nursing programs and three university nursing programs collaborated to develop a novel project in teaching disaster preparedness using COVID-19 as the disaster. Tabletop methodology via Zoom was used to simulate incident command centers in Zoom breakout rooms. Students were assigned roles to carry out during the four-hour event using resources from FEMA's Emergency Management Institute. Student and faculty post-surveys were completed with themes identified. Students appreciated collaborating with students from different schools, but also identified challenges with the event posed by remote learning. Students reported their "biggest takeaways" and identified action steps for improving future events; particularly, requesting more information to better understand their roles.
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BACKGROUND: Virtual care is transforming the nature of healthcare, particularly with the accelerated shift to telehealth and virtual care during the COVID-19 pandemic. Health profession regulators face intense pressures to safely facilitate this type of healthcare while upholding their legislative mandate to protect the public. Challenges for health profession regulators have included providing practice guidance for virtual care, changing entry-to-practice requirements to include digital competencies, facilitating interjurisdictional virtual care through licensure and liability insurance requirements, and adapting disciplinary procedures. This scoping review will examine the literature on how the public interest is protected when regulating health professionals providing virtual care. METHODS: This review will follow the Joanna Briggs Institute (JBI) scoping review methodology. Academic and grey literature will be retrieved from health sciences, social sciences, and legal databases using a comprehensive search strategy underpinned by Population-Concept-Context (PCC) inclusion criteria. Articles published in English since January 2015 will be considered for inclusion. Two reviewers will independently screen titles and abstracts and full-text sources against specific inclusion and exclusion criteria. Discrepancies will be resolved through discussion or by a third reviewer. One research team member will extract relevant data from the selected documents and a second will validate the extractions. DISCUSSION: Results will be presented in a descriptive synthesis that highlights implications for regulatory policy and professional practice, as well as study limitations and knowledge gaps that warrant further research. Given the rapid expansion of virtual care provision by regulated health professionals in response to the COVID-19 pandemic, mapping the literature on how the public interest is protected in this rapidly evolving digital health sector may help inform future regulatory reform and innovation. SYSTEMATIC REVIEW REGISTRATION: This protocol is registered with the Open Science Framework ( https://doi.org/10.17605/OSF.IO/BD2ZX ).
Subject(s)
COVID-19 , Pandemics , Humans , Pandemics/prevention & control , COVID-19/prevention & control , Health Personnel , Databases, Factual , Gray Literature , Review Literature as TopicABSTRACT
The annual ACSM's Health & Fitness Journal® worldwide survey to determine industry trends by health and fitness professionals is now in its 17th consecutive year. The COVID-19 pandemic certainly made an impact on the 2021 survey and continued for 2022, but for 2023, some current trends are emerging whereas others are weakening because of the world's recovery from the isolation caused by COVID-19. The #1 trend for 2023, as it was for 2022, is wearable technology. Home exercise gyms was #2 for 2022 but has dropped to #13 for 2023. Fitness programs for older adults will make a comeback in 2023, breaking the top 10 at #4. Functional fitness training, a popular form of exercise for the older adult, is the #5 trend for 2023. Apply It!: From this article, the reader should understand the following concepts: • Explain the differences between a fitness fad and a fitness trend • Use the worldwide fitness trends in the commercial, corporate, clinical (including medical fitness), and community health and fitness industry to further promote physical activity • Study expert opinions about identified fitness trends for 2023
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Background: As part of program evaluation, the New Mexico Nursing Education Consortium, a consortium of eleven state-funded nursing schools, asks that students complete end-of-term surveys. In Spring 2020, a question was added to the survey to elicit challenges experienced by students during the COVID-19 pandemic: "What was the biggest challenge that you had in completing the semester/term?" This question again was asked of students in Spring 2021. Objectives: To determine challenges faced by nursing students in 2020 and 2021 due to the pandemic. Design: Qualitative. Settings: Eleven state-funded nursing schools belonging to the New Mexico Nursing Education Consortium. Participants: Students enrolled in member nursing programs. Methods: Braun and Clarke's 2006 thematic analysis. Results: Eight themes were identified for each of the two years. Conclusions: Nursing faculty must anticipate and respond to student feedback while maintaining proficiency in face-to-face and online teaching-learning strategies. Waiting until emergencies arise that require different types of pedagogy is not sufficient to ensure instructor proficiency with online pedagogies.
ABSTRACT
Background: The public health emergencies such as the COVID-19 pandemic resulted in mental and psychological ramifications on the healthcare professionals. The pre-licensure nursing students found themselves not only fighting against the baneful virus but also weak ego resilience. At this point, enriching the pre-licensure nursing students with psychological first aid (PFA) could help them to recover from the feeling of psychological distress and improve their resilience capacity to encounter any upcoming outbreaks. Methods: A quasi-experimental two groups, a pre-post-test study was used in which sixty-four pre-licensure nursing students completed a baseline survey which revealed high levels of psychological distress and low resilience capacity due to the COVID-19 crisis. The study group engaged in the Psychological First- aid Intervention (PFA) at the end of the clinical practicum course period, while the comparison group received routine psychological support. Results: A significant reduction in the psychological distress levels among students in the PFA group (FET=7.83, P = 0. 001). Likewise, significant improvements in the students' resilience capacity level immediately after the intervention (FET=3.34, P = 0.019) and during the two-month follow-up (FET=12.94, P = 0. 001). The implementation of PFA enhanced the pre-licensure nursing students' psychological health status and resilience capacity levels after their clinical training amid the ambiance of the COVID-19 crisis. Conclusion: The PFA effectively fostered the pre-licensure nursing students' recovery from the COVID-19 related- psychological distress and improve their resilience capacity. The application of RAPID model is recommended to reduce stress and prevent burnout among novice and future nurses who show signs of psychological exhaustion.
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Resident acuity, Medicaid's increased role in funding assisted living, and the COVID-19 pandemic have brought increased attention to the regulatory environment of assisted living facilities (ALFs) and the responsibilities of ALF administrators (ALFAs) are growing increasingly complex. This study explores, describes, and compares the education (degree and assisted living-specific training), experience, exam (competency), and continuing education requirements for ALFAs across all states, and how states' requirements compare to national assisted living associations' suggested standards for entry-level and ongoing practice. Wide variation in ALFA qualifications are identified, with some states found to have extremely low qualification requirements.
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The COVID-19 pandemic led to temporary relaxations for telehealth with respect to physician licensure, geographic location, and eligible sites for reimbursement. Earlier policies had impacted the rate of adoption of telehealth and retarded the ability to derive full benefits related to cost, access to care, and quality of care. This aspect is analyzed using 2018 Medicare fee-for-service codes and rates for 10 telemedicine services. Based on the analysis of these data, additional research, and literature review, this report describes how interstate practices can be better leveraged to achieve maximum potential for direct and indirect savings that can accrue through such pragmatic approaches for certain services. The interstate collaborations proposed in this report provide examples of broader telehealth policies that could foster increasing access to quality health care for Medicare beneficiaries and can potentially be used as insight to assist federal and state agencies as they review the continuation, cessation, or modifications of relaxations granted due to the COVID-19 pandemic.
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The COVID-19 pandemic put an unprecedented strain on the nursing workforce. In response, many states issued executive orders waiving licensure requirements for their state if nurses have a license in good standing in another state. However, such efforts were not without risk. For example, a nurse who was working in a state under an executive order was terminated by the employer after the nurse was found diverting controlled substances and diluting vials of controlled substances with normal saline. This case study highlights the importance of the authority provisions granted in the Nurse Licensure Compact and the risk to public protection that can potentially result when executive orders waive the requirement for an in-state nursing license.
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COVID-19 highlights the need for portability of social work licensure to be a priority. The Association of Social Work Boards (ASWB) spearheaded some initiatives, such as the creation and promotion of the Social Work Registry and Model Social Work Practice Act, with the hope that these efforts would enhance the ability of social workers to be licensed in multiple states. Neither has solved the portability problem. Licensure endorsement, an approach historically supported by ASWB, does not have the advantages of mutual recognition that is being supported by other professions to facilitate interstate practice. This article, the first written on licensure portability in the social work scholarly literature, examines existing licensure portability models and supports the establishment of a social work interstate compact to overcome barriers to social work mobility and access to client care.
Subject(s)
COVID-19 , Social Work , Humans , Licensure , United StatesABSTRACT
The purpose of this study was to explore the perceptions of undergraduate, prelicensure nursing students, in a public university in the Northeast, utilizing brief mindfulness interventions as a method of coping with the anxiety associated with high fidelity patient simulation (HFPS) during the COVID-19 pandemic. Fifty-seven students enrolled in an original pre-test post-test quantitative study, utilizing the State-Trait Anxiety inventory to assess the possible correlation between Koru mindfulness minutes practiced and anxiety associated with HFPS. In March of 2020, the COVID-19 pandemic had a sudden, profound effect on nursing education resulting in face-to-face classes being converted to online formats, and simulation and clinical education converting to virtual learning. At the same time, participation in the brief mindfulness interventions dropped and the researcher pivoted to exploring qualitative responses from participants. The researcher recruited 16 of the 57 students, who had agreed to be in the original study, to respond to written questions designed to capture their perceptions of the utility of brief mindfulness interventions in coping with the anxiety associated with HFPS during the COVID-19 pandemic. Their written responses were coded, categorized, and themes emerged related to the two research questions: What are the perceptions of undergraduate nursing students regarding brief mindfulness interventions? How has COVID-19 impacted the use of mindfulness interventions? Responses revealed that participants' perceived value in learning and utilizing brief mindfulness strategies to manage anxiety. Subthemes included perceived value related to HFPS, and perceived value related to being a prelicensure nursing student. Participants expressed feeling overwhelmed related to curricular changes, social changes, and fear. A second theme emerged related to coping strategies utilized during this time. These promising results indicate that brief mindfulness interventions have the potential to be a tool for prelicensure students to utilize in managing the anxiety associated with various aspects of the nursing curriculum. The practical implications for integrating these findings into a pre-licensure nursing curriculum are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved)