The Ever-Changing Work Environment During COVID-19: Nurses' Experiences in the Early Phase.

The COVID-19 pandemic is a history-changing event affecting all nurses. This study sought to explore nurses' experiences during the pandemic's early phase using a phenomenological approach. One hundred sixty-one participants enrolled in the study. Demographic data, written narratives, and digital images were collected. Ever-changing environment emerged as the overarching theme, along with six subthemes. Because of a crisis situation created by the pandemic, nurses need specialized support and education to manage their constantly changing environment.

Strategies to improve nurses' stress response during the COVID-19 pandemic.

ABSTRACT: Pandemic-related stress factors have been profoundly impacting the wellness of nurses, resulting in job burnout, moral distress, and some nurses deciding to leave the profession. This article examines strategies to identify stressors and develop self-care and coping skills.

Barriers to Care and Root Cause Analysis of LGBTQ+ Patients' Experiences: A Qualitative Study.

BACKGROUND: LGBTQ+ (lesbian, gay, bisexual, transgender, queer/questioning, and others) people face a unique set of barriers to receiving quality healthcare. Very little exists in nursing literature that addresses these barriers. OBJECTIVE: This study aimed to analyze patient experience data to better understand the context of barriers to care that LGBTQ+ patients experience, in addition to institutional responses. METHODS: Documentary analysis was employed to review four LGBTQ+ patient experiences that resulted in formal feedback provided to the Office of Patient Relations. Each case was analyzed for content, process, and outcomes. RESULTS: Through the outlined analysis, the study team found three primary themes and five secondary themes across the four cases. The overarching themes identified through the study's case review include (a) lack of provider knowledge, (b) lack of patient-centered care, and (c) lack of institutional infrastructures associated with the provision of affirming care to LGBTQ+ individuals. DISCUSSION: Findings suggest the need for a multipronged approach when addressing the care of LGBTQ+ communities. A combination of provider-level education and institutional capacity building to treat diverse patient populations is necessary for addressing the issues demonstrated within the data. Moreover, further research is needed to identify unique needs of transgender and nonbinary patients and determine efficacy of institutional efforts to build capacity for caring and studying the health needs of LGBTQ+ communities.

An Exploration of Characteristics and Behavioral Traits of DAISY Honorees and Nominees: A Qualitative Study.

BACKGROUND: In the literature, an abundance of stories exist describing patient situations and caregiver actions, but only 2 studies were identified that outline DAISY honorees' actions and behavioral characteristics. OBJECTIVE: This study utilized patient nomination data and DAISY honoree insight to identify and gain better understanding of the characteristics and behavioral traits of DAISY nurses. METHODS: A grounded theory approach and purposive sample were used in this study, which was conducted in 2 phases using 2 different data sets. In phase 1, the NarrativeDx AI platform generated insights from DAISY nomination comments. In phase 2, a survey was administered to DAISY honorees collecting descriptive data that were analyzed in SPSS, whereas insights on DAISY nurses were collected via open-ended responses and analyzed using NVivo software. RESULTS: Three themes emerged in phase 1 from DAISY nomination data: caring, knowledge/skills, and reliability. A total of 37 DAISY honorees participated in phase 2. Most participants were bachelor's degree-prepared and worked day shift in the emergency department, critical care units, or medical-surgical units; some entered leadership roles post award, and 34% cited nursing as a 2nd career. Four themes emerged from their open-ended responses: engaging in care, environment of care, dedicated to care, and competence of care. Subthemes emerged in both analyses. CONCLUSIONS: The essence of caring was noted continuously in both nomination and honoree data. Further research aimed at discovering the characteristics and behaviors of DAISY honorees is recommended as examination of these factors may provide a deeper understanding of this exemplary group of nurses. Insights could be incorporated into training and practice programs aimed at increasing patient and nursing satisfaction.

Increasing nursing research capacity: The roles and contributions of nurse scientists within healthcare systems in the Greater Philadelphia region.

PhD prepared nurse scientists within healthcare systems are uniquely positioned to advance nursing science through research and evidence-based practice (EBP) initiatives due to their ability to closely collaborate with nurses and other healthcare professionals in the clinical setting. The purpose of this paper is threefold: 1) to describe the roles and contributions of Nurse Scientists, from their perspectives, in four different health care systems in the Greater Philadelphia area, three of which are Magnet® designated hospitals; 2) to highlight organizational approaches to increase nursing research and EBP capacity; and 3) to explore strategies that Nurse Scientists used to overcome barriers to build nursing research capacity. Nurse Scientists employed in these healthcare systems share many of the same essential roles and contributions focused on developing nursing research and EBP initiatives through education and mentorship of clinical nurses, conduct and oversight of independent research, and dissemination activities. With supportive executive nurse leadership, the Nurse Scientists within each healthcare system employed different strategies to overcome barriers in building nursing research and EBP capacity. Nurse scientists within healthcare settings have potentially powerful positions to generate and apply new knowledge to guide nursing practice and improve outcomes.

Measures of Wellness in Young Adult College Students: An Integrative Review.

BACKGROUND AND PURPOSE: Wellness behaviors typically form during the college years, making wellness evaluation crucial during this time frame. Instruments often assess health rather than wellness. Thus, the purpose of this integrative review is to identify and evaluate instruments measuring wellness among young adult college students. METHODS: Google Scholar, CINAHL, PubMed, MEDLINE, PsycINFO, ERIC, and other databases were searched yielding 350 studies initially. RESULTS: Seven studies met inclusion criteria and were retained for this review. Reliability and validity is reported in each study with ongoing analysis. Homogeneous samples were reported in each study, and administering concurrent instruments created feasibility issues. CONCLUSIONS: A summary of instruments measuring wellness in young adult college students is provided. However, few wellness instruments exist in this population. Thus, further development is needed.

Alcohol Use, Misuse, and Abuse Among Nursing Students: A Photovoice Study.

BACKGROUND: Rates and frequencies of alcohol consumption remain unknown among nursing students, and risk and protective factors associated with alcohol misuse are poorly understood. Nursing curricula often lack content on substance use disorders among nurses, which is reported to begin prior to or during college. PURPOSE: The aims of the study were to examine nursing students' perceptions of the risk and protective factors associated with alcohol behaviors among themselves and their peers and to identify substance use policies and their influence. METHODS: We used the Photovoice method, which employs participatory action research. Participants were screened for alcohol misuse via AUDIT-C, and thoughts and perceptions were obtained regarding their alcohol consumption behaviors through self-expression and group advocacy. Data were collected from four focus groups that included nine undergraduate nursing students. RESULTS: Data reflected the following key issues: stress, environmental influences, societal acceptance, and availability of alcohol. Participants identified that the following problems place them at risk for alcohol misuse: lack of addiction/alcohol education; nursing program expectations increase stress/anxiety; unhealthy habits, social isolation, and individual influences; peer influence/the college experience; and ineffective and unenforced campus policies. Protective factors included university policies; life experiences; and nursing program policies, responsibilities, peer influences, and perceived reputation. CONCLUSION: This action research informed a dialogue with colleagues regarding nursing students' stressors and resulting professional ramifications. Recommendations for future work include investigation of expressed social isolation from university peers and its effects on their alcohol consumption behaviors and increase alcohol education with emphasis on adaptive coping strategies in a stressful professional role in Bachelor of Science in Nursing curricula.

Alcohol Misuse Among Nursing Students.

BACKGROUND: The self-reported prevalence of alcohol use among U.S. college students decreased from 90.5% in 1980 to 79.2% in 2012. National efforts exist to reduce alcohol misuse among college students in the United States, yet little research addresses substance abuse among nursing students and even less addresses alcohol misuse. Alcohol misuse in nursing students may result in patient harm. PURPOSE: This scoping study describes the state of the science of alcohol misuse among nursing students, guided by the research question: "What is the current state of alcohol misuse among U.S. nursing students?" METHODS: Evidence was drawn from several scholarly sources. Articles were included if they addressed U.S. nursing students; alcohol misuse; substance abuse or chemical impairment; prevalence rates; and/or characteristics including nursing student behaviors, attitudes, and beliefs. Using thematic analysis, common themes were extracted, followed by hand coding those themes and using NVivo qualitative software. RESULTS: Six studies met inclusion criteria. Three themes, eight subthemes, and several gaps in knowledge were identified. The themes include "high prevalence exists," "necessity of supportive environments," and "hopelessness without policies." Subthemes include "root cause," "vulnerable population," "scholarship and substance use," "education," "identification of risk factors," "prevention and deterrents," "safety," "ethical and legal issues," and "consequences." CONCLUSIONS: On the basis of this analysis, several research questions were developed to explore alcohol misuse in this population. Alcohol was the most often used substance. Nursing students were unaware of a safe level of consumption and the potential negative health-related and professional effects associated with alcohol misuse.