Students' experiences of clinical immersion in operating room and emergency department.

Specialty areas, such as the operating room and emergency department, are being hit especially hard by the nursing shortage in the United States. Recruitment and retention is a challenge in these specialty units and may, in part, be due to limited or no exposure in nursing school. Kolb's theory of experiential learning was used to guide this project. The purpose was to investigate students' experiences and intent to pursue employment after a clinical immersion course in either the operating room or emergency department. Six Bachelor of Science in Nursing students participated in a five-week course that included 10 h of web-based education and 80 h of clinical practicum. The objectives of the course were to identify the role and responsibilities of the nurse in the specialty area, explore the standards and recommended practices established by the specialty professional organization, and collaborate with the healthcare team in the specialty area to provide safe, quality care. A thematic analysis of focus group transcripts and students' weekly reflections was conducted. The results of this project suggest immersing students in a specialty area may be a first step in alleviating the shortage in these areas.

The Dedicated Education Unit Experience: What's in It for Professional Development Nurses?

Dedicated Education Units (DEU) may be one strategy for staff development educators to address new graduate nurse transition to practice and turnover within the first year of practice. This qualitative study explored the experiences of students and staff nurses from the inaugural DEU at Research College of Nursing and Research Medical Center. The themes identified suggest that students who were educated in the DEU model may be better prepared to practice in the "real world" of nursing than their peers who were not.

An Academic Practice Partnership: Helping New Registered Nurses to Advance Quality and Patient Safety.

Significant changes in the healthcare environment have occurred that offer challenges for quality improvement and nursing education programs, and thus impact both nursing practice and education. We formed an academic-practice partnership to actively engage students enrolled in an undergraduate nursing research course in quality processes with participation in a medical center's performance improvement program. This article describes the development of the partnership; and projects, results, and implications for practice. Students worked collaboratively in groups with hospital staff performance improvement preceptors and a course faculty member. Using the Plan, Do, Check, Act (PDCA) model, students collected, analyzed, and disseminated data from existing projects, or those for which the organization had identified a need. Leaders involved in the inception of this partnership agreed that it achieved its goals of enabling the college to effectively teach recently mandated quality improvement methodologies to achieve competency and enhancing the medical center's capabilities to obtain data for quality improvement purposes. The academic-practice partnership continues to evolve, and we offer discussion about lessons learned and partnership growth.

Communication skills training to address disruptive physician behavior.

Disruptive behavior among health care providers has been linked to negative patient outcomes. High-stress areas, including the perioperative setting, are especially prone to this behavior. The purpose of this study was to develop, implement, and evaluate an educational communication skills intervention aimed at increasing the perceived self-efficacy of perioperative nurses to address disruptive physician behavior. Seventeen perioperative nurses participated in a two-day communication skills program presented by a certified Crucial Conversations trainer. By using paired t test analysis, I found that there was a statistically significant increase in total mean self-efficacy scores immediately after the intervention and four weeks after the intervention. In addition, four weeks after the intervention, participants reported the ability to address disruptive physician behavior 71% of the time. The results of this study suggest that one intervention strategy to address the serious threat of disruptive physician behavior to patient safety is to educate nurses in communication skills.

The negative impact of nurse-physician disruptive behavior on patient safety: a review of the literature.

OBJECTIVE: To review what is known about the impact of nurse-physician disruptive behavior on patient safety to inform appropriate intervention programs to address this health care problem. METHODS: A systematic review of the literature using the key words "disruptive physician behavior" and "physician verbal abuse" was conducted. RESULTS: Ten articles were reviewed. All were descriptive in nature and used a nonexperimental approach to measure the incidence of disruptive behavior and/or verbal abuse in various health care settings via self-report surveys. All studies confirmed the alarming prevalence of disruptive behavior. CONCLUSIONS: A standard definition of "disruptive behavior" is needed, as is a valid and reliable measure of the phenomenon before interventions to address the problem can be developed.