Community Resilience After Hurricanes: Can Neuman's Systems Theory Guide Public Health Nursing?

Objective: Examination of community resilience after Hurricane Harvey and -applicability of Neuman's systems model to the role of public health nurses in applying primary, secondary, and tertiary prevention strategies to communities susceptible to natural disasters. Design: Descriptive, exploratory study. Sample: A convenience sample (N = 1,470). Measurements: Hurricane Harvey Survey. Results: Respondents from seven counties in southeast Texas report previously experiencing a hurricane (80%) with no weather-related flooding (79%), adequate preparation (54%), failure to comprehend the potential severity of Hurricane Harvey (62%), damage to their homes (45%), and a 68% loss of personal belongings. Anxiety, frustration, disbelief, determination, and hopefulness were rated highest after the storm. Residents received updates from family and friends, social media, and online news reports regarding rising water, even though, in many cases, a mandatory evacuation was not officially announced. Only 35% of respondents reported being aware of resources available, possibly due to flooding or inaccessibility of typical resources (e.g., hospitals, shelters). Communicating through social networks (social media, family, and friends) provided avenues for arranging evacuations and assistance. Respondents report giving assistance to others and receiving assistance from family, friends, and their faith community. The majority of respondents reported that the community provided adequate services during the hurricane (59%), and they plan to stay in southeast Texas (70%). Conclusions: Southeast Texas residents demonstrated individual and community resilience which may be further supported with primary, secondary, and tertiary nursing interventions as illustrated by Neuman's systems model. The rise in positive emotional response traits demonstrates positive coping, which is consistent with resilience. Effective and timely communication through social networks provides an additional line of resistance to protect and promote the resilience of the community. The lack of medical resources indicates a break in the normal line of defense and an area for potential improvement with the utilization of mobile medical units to provide healthcare for areas not easily accessible during a disaster. Public health nurses are strategically positioned in the international community to lead prevention and recovery efforts by applying theory-based community interventions.

Developing and Evaluating the Effectiveness of a Nursing Leadership Mentoring Pilot Program.

The nurse leader role is a vital role in ensuring quality, safety, and staff retention in the health care setting. A new nurse manager often receives little mentoring support when assuming a new role. Fifteen mentor/mentee pairs were provided with 6 training sessions specifically designed using the Hale Mentoring Up theoretical framework. Surveys and focus groups were conducted at mid- and endpoints. Data were digitally recorded, transcribed verbatim, and loaded into NVivo 12. Two attributes that facilitated a positive mentoring relationship emerged from the qualitative analysis: interpersonal and organizational skills. Interpersonal skills included a mentor-mentee relationship that was built upon trust, flexibility, and learning and development; and organizational skills included building relationships both internally and externally. Furthermore, time was identified as a barrier to mentoring. A mentoring program is a vehicle to help support new nurse leaders through an educational intervention and mentoring support program. The development of a mentoring pilot program helps to strengthen future nursing leadership to support new leaders in their roles.

Improving nursing students' confidence in caring for persons with dementia.

BACKGROUND: Nursing students need experiences providing patient centered care for persons with dementia. METHODS: Students were provided with a voluntary opportunity to complete an online educational module that focused on caring for persons with dementia. Dementia knowledge was measured with the Alzheimer Dementia and Knowledge Scale and confidence was assessed with the Sense of Competence in Dementia Care Staff Scale. RESULTS: Data suggested that students developed an increased confidence in caring for persons with dementia after the education. Key to person centered care, students demonstrated an increased ability to sustain person hood and build relationships. CONCLUSIONS: The growing complexity and needs of persons with dementia in various practice settings requires a nursing workforce able to apply clinical reasoning and provide person centered care. Further studies are needed exploring the effects of online educational opportunities on learning outcomes and clinical reasoning to build confidence in caring for persons with dementia.

Increasing student involvement in research: a collaborative approach between faculty and students.

Baccalaureate nursing curriculum generally include a research or evidence-based practice course, but students may have little opportunity for specific application of the research process during their nursing education. Using Modeling and Role-modeling as a theoretical framework, a scholarly collaboration between faculty and student was developed to promote a unique and engaging undergraduate research endeavor. Faculty researchers developed an exploratory community-based research study to survey the local population about the immediate and lingering physical, financial, psychological, and emotional effects of Hurricane Harvey on the community. The project allowed students to gain invaluable knowledge about the research process, time management techniques, application of theory to the practice setting, community health assessment, collaboration among team members, and achieve student learning outcomes. Student participation in this research project provided necessary collaboration and leadership experiences that will benefit students during school and in their professional practice.

Mentoring up: A grounded theory of nurse-to-nurse mentoring.

AIMS AND OBJECTIVES: To generate a theoretical explanation of nurse-to-nurse mentoring in the clinical setting. BACKGROUND: Despite an abundance of mentoring literature, the processes involved between nurses in mentoring relationships have yet to be studied. Nursing literature has focused on mentor attributes and relationship outcomes rather than focusing on theoretical discovery. DESIGN: Classical grounded theory (CGT). METHODS: CGT procedures (constant comparative method, coding and memoing) were used to analyse interview data exploring fifteen nurse protégés' experiences of mentoring. RESULTS: Confidencing, the protégés' need to become confident in the professional role, emerged as the main concern of study participants. Three dimensions are threaded throughout nurse-to-nurse mentoring: earnest intentions, filial bond and trust-worthiness. Earnest intentions are the sincere attitude that protégés and mentors demonstrate regarding their mentoring relationship. An exclusive, familial-type connection, filial bond, attends to the affective needs of protégés and mentors. Trust-worthiness, the explicit feeling of trust between protégés and mentors, strengthens as each demonstrates being worthy of the other's trust. Mentoring Up theory explains five phases of mentoring: seeding, opening, laddering, equalising and reframing. The initial phases are periods of relationship discovery (seeding) and testing (opening). Laddering is an intense period of reciprocal interactions between mentors and protégés. Equalising begins as protégés perceive themselves to be equal to their mentors in terms of their professional capability. Protégés reflect on the meaning of the relationship in the reframing phase. CONCLUSIONS: Mentoring Up is a dense theory that reveals insights, explanations and predictions for initiating, developing and engaging in mentoring relationships. Mentoring Up fills a gap in the existing literature and provides a framework for future mentoring research. RELEVANCE TO CLINICAL PRACTICE: The theory has implications for healthcare organisations, nursing education and individual nurses. Mentoring Up expounds on the interpersonal connections and reciprocal interactions vital for successful nurse-to-nurse mentoring.