Advanced practice nurses as faculty.

This article details a program through which two child health faculty members who are advanced practice nurses (APNs) combined practice with teaching undergraduate students in a community-based clinical experience on nursing case management. A collaborative agreement between a university-based Children's Special Services Team (CSST) and school of nursing faculty was developed to extend services into the home communities of children with special healthcare needs. Senior students made visits to the homes of the team's clients, conducted assessments, interacted with families, and provided additional care. The team, which included physicians, nurses, a social worker, and therapists (occupational and physical) identified children and families who would benefit from home visits by students nurses who were directed by APNs. Both service and educational goals were accomplished by this community-based case-management experience. The children and their families received additional care from multiple healthcare providers. Students practiced components of community-based case management, and the CSST obtained vital information about their clients' living environments.

Using visual inquiry to reveal differences in nursing students' perception of case management.

An exploratory, qualitative study of 24 senior generic nursing students (GNSs) and 23 practicing registered nurse baccalaureate students (PRNSs) was conducted to evaluate students' perceptions about case management for community-based children with disabilities, and to examine the differences in the two student groups' perceptions utilizing the visual inquiry method. For a class project, the students used words and photographs to show how they solved one problem for a family caring for a child with a disability in the community. All students agreed on the overall theme, home environment; however, significant differences in each group's perception of this theme emerged. The GNSs described the home environment as a barrier, whereas the PRNSs described the home environment as being inside the home and outside the home. Moreover, two other themes emerged with the 23 PRNSs that were not perceived by the GNSs. The analysis of students' perceptions about case management of their clients was conducted from data analysis of the photographs. Though the literature does not support that differences in learning between the GNSs and PRNSs exist, this study demonstrates there are differences in perception about case management between the two groups.

Baccalaureate nursing students' perceptions of children's community-based case management: a photographic project.

Twenty-four baccalaureate nursing students described their perceptions of learning about children's community-based case management with photographs and text. Instructors categorized students' photographs, developed themes, and validated the themes with senior students.

Nursing attire: indicators of professionalism?

The purpose of this qualitative research was to explore the effect that current nursing attire has on the image of the nursing profession. A number of nurses and a nonnurse were interviewed to determine how attire affected their perception of today's nurses. The two research questions were as follows: (1) is the changing dress of nurses projecting a negative image to the public? and (2) What components of a nurse's apparel indicate professionalism? Content analysis was performed on transcriptions from the tape-recorded responses of a purposeful sample of health care workers: 12 registered nurses, 1 bachelor of nursing student, and 1 layperson. The responses for the first research question were not directly addressed by the participants. However, one overall theme emerged, which was labeled "I can't tell you what it is, but I know it when I see it." The main theme that emerged for the second research question was labeled "total package," with role identification and competency being related themes. As a result of this research, nursing administrators and other health care professionals could gain an understanding of the importance of nursing attire as an indicator of nursing professionalism. Future research needs to examine the same research questions with health care consumers in a variety of acute and community-based health care settings.

Teaching nursing research. Integrating quantitative and qualitative methods.

In the belief that graduate nursing students should be able to analyze, evaluate, and critique both qualitative and quantitative research methods and should be able to design their own research projects, two faculty members developed a two-course sequence integrating the two methods. The authors, each an expert in one of the methods, describe how they designed and co-taught these innovative courses.

Development of an outcome measure to document pain relief for home hospice patients: a collaboration between nursing education and practice.

In the spring of 1997, an Eastern Michigan University nursing educator, a master's nursing student, and a hospice clinical nursing director collaborated to develop a pain outcome instrument as a part of the student's clinical practicum. The instrument was designed to describe and measure pain control of home hospice patients in preparation for fall accreditation of a home hospice program by the Joint Commission on Accreditation of Healthcare Organizations. A chart audit of all on-call communications (n = 63 charts) by the educator and student supported the organization's need to improve patients' pain control. The collaborators reviewed the pain instrument literature, developed measurement instruments, and presented information to nurses at staff meetings for input and instrument revisions. A pilot study of the Home Hospice Patient Pain Assessment Instrument (HHPPAI) was conducted, the instrument was revised, and a second pilot was performed (n = 51 pain episodes). A description of those findings is presented. Further research needs to be conducted to examine instrument reliability and validity. The use of a pain outcome instrument, such as the HHPPAI, can improve patients' pain control and, therefore, promote their quality of life.

A childhood cancer sibling's oral history.

The diagnosis of childhood cancer in a family member alters a sibling's life, including exposing a sibling to the side effects of cancer therapy, feelings of being displaced, and a possible misunderstanding of what is happening. The purpose of this oral history was to gain a better understanding of the recall and long-term effects of a younger sister's diagnosis of cancer at age 6 on the child's sibling, who was then 8 years old. Data were gathered from a 22-year-old sibling of a leukemia survivor through three taped and transcribed semistructured interviews. Themes emerged through the process of content analysis. Six themes: closeness, activity, fearfulness, anger, worry, and spirituality, emerged and were supported by thick descriptions.

Navigating a nursing curriculum: bridges and barriers.

As increasing numbers of students from non-traditional sources enter the baccalaureate nursing program, retention of these educationally, socially, and economically disadvantaged and older students have become important to a nursing program's continued viability. To retain these students, nurse educators need to become more sensitive to the educational needs of these students. Through focus groups used to survey sophomore, junior, and senior nursing students, researchers identified academic and non-academic resources cited by successful traditional and non-traditional students. A telephone survey of local nursing programs, by a third researcher, identified student resources at other statewide baccalaureate nursing programs. Participating students cited curriculum resources most often, with emotional support and academic resources of next importance. Students also expressed frustration regarding accessing resources (e.g., class time, office support, parking). The long term goal was to develop a resource program for non-traditional nursing students.

Children's descriptions of their feelings and what they found helpful during bereavement.

Although clinicians have described the value of support groups in assisting children mourn the death of someone close, little is known about helping children with bereavement. By understanding what helps children mourn, nurses can better facilitate a healthy bereavement process. The purpose of this mini-ethnographic study, which used observation and participation procedures, was to identify what 16 children found helpful during their bereavement. Initially, the children's expressions of feelings were demonstrated both verbally and through art work. The patterns of the children's emotions were labeled as affective distress, somatic complaints, and for the boys, disruptive behavior. The children then described their mourning processes as being facilitated by out-of-door activity, yelling, and talking to others (e.g. God, mom, grandmother or grandfather).

An example of a successful collaboration effort between a nurse educator and a hospice clinical nurse specialist/director.

Collaboration between nursing education and nursing service recognizes the expertise of both the educator and the clinician. Nurses share information, ideas, and skills to promote quality nursing care, improve nursing practice, and reduce costs. One example of an effective nursing collaboration involved a child-rearing nurse educator and a children's hospice clinical nurse specialist/director. The methods of promoting collaboration between the educator and clinician will be examined. The advantages and disadvantages of collaboration between the two nursing divisions will be explored. Lastly, mutual nursing practice benefits for the two clinicians are explained.