Nurse Graduates' Perceived Educational Needs After the Death of a Patient: A Descriptive Qualitative Research Study.

BACKGROUND: Nurse graduates (NGs) are ill prepared when faced with patient death and dying, despite receiving educational preparation on end-of-life (EOL) care in their prelicensure nursing programs. METHOD: This qualitative descriptive study included a convenience sample of NGs (n = 20) who experienced a first adult patient death during their first 18 months of practice at a large teaching hospital with an extensive NG transition program, including preceptor-guided orientations, nurse internship programs, and nurse residency programs. RESULTS: Six major themes described the NG experience: Navigating the Process, Not Prepared, Support, Missed Opportunities, Preparing NGs for Death and Dying, and Guiding NGs Through Practice. Critical gaps in preparation were evident across all themes. CONCLUSION: Results of this study suggest specific opportunities for improvement of NGs' readiness to effectively care for patients and families in EOL situations by increasing their exposure to death and dying experiences before graduation and during their first year of practice. [J Contin Educ Nurs. 2020;50(6):267-273.].

Parents' experiences using medical cannabis for their child.

BACKGROUND: Parents across the United States use medical cannabis for their children, often without professional guidance. These parents have become more expert on medical cannabis than most health professionals. PURPOSE: Using a case-study design, this study was conducted to describe the experience of parents using medical cannabis for relief of seizures in their child or dependent. METHODS: Data were subjected to qualitative content analysis for the identification of patterns and themes. FINDINGS: Analysis of all data revealed seven themes including "Discovery of Cannabis as a Medication," "Guidance on Dosing," "Costs and Benefits of Cannabis," "Distrust of the Pharmaceutical Industry," "Federal Interference," "God and Cannabis," and "Changing Societal Perceptions about Medical Cannabis." DISCUSSION: Themes revealed a complex, multifaceted experience. Many parents report benefit from medical cannabis, and are not hindered by the financial costs or uncertainties. Political and social influences have significant impact on the stigmatization and normalization of cannabis.

Challenges to Studying Illicit Drug Users.

PURPOSE: Throughout the world, illicit drug use continues to pose a significant risk to public health. The opioid crisis in North America, the diversion of the prescription drug tramadol throughout Africa, and the increasing supply of methamphetamines in East and South Asia all contribute to increasing risks to individual and societal health. Furthermore, the violation of human rights in efforts to enforce prohibitionist values poses significant threats to many individuals worldwide. With these evolving situations, it is imperative that researchers direct their attention to the various populations of illicit drug users. However, the inclusion of illicit drug users, often considered a vulnerable population, as participants in research studies presents several increased risks that must be addressed in study protocols. Researchers are required to provide "additional safeguards" to all study protocols involving illicit drug users, but there is often substantial variability and inconsistency in how these safeguards are applied. Additional safeguards can be timely, costly, and unduly burdensome for researchers, ethical review boards, and research participants. APPROACH: Through synthesis of the current literature, this article addresses the barriers to studying illicit drug users and the methods researchers can utilize to minimize risk. A case study is provided to illustrate the high level of scrutiny of study protocols involving the participation of illicit drug users and the effect of such scrutiny on recruitment of participants. The article concludes with a discussion of the effects of the current political climate on the recruitment of illicit drug users in research. CONCLUSIONS: Individuals who participate in criminal or illegal behaviors such as illicit drug use, prostitution, illegal entry into a country, and human trafficking are susceptible to multiple physical, mental, and social health risks, as well as criminal prosecution. The importance of research on the health of marginalized populations cannot be overstated. This work must continue, and at the same time, we must continue to protect these individuals to the best of our ability through diligent attention to sound research methods. CLINICAL RELEVANCE: The use of illicit drugs continues to pose a substantial threat to global health. Individuals who use illicit drugs are susceptible to multiple physical, mental, and social health risks, as well as criminal prosecution. It is imperative that researchers study these vulnerable populations in order to develop interventions to minimize individual and societal harm. There are several barriers to the study of illicit drug users that must be addressed through rigorous methodology and the addition of safeguards.

Supporting Transitions in Care for Older Adults With Type 2 Diabetes Mellitus and Obesity.

The aim of the current study was to compare outcomes for older adults with type 2 diabetes mellitus and obesity following participation in a transitional care intervention that included diabetes self-management education (DSME) and homecare. The three groups analyzed comprised an inpatient DSME plus homecare group (n = 35); an inpatient DSME only group (n = 100); and a group who received usual care (n = 45). Outcomes of interest included rehospitalization rates and hemoglobin A1C (A1C) for up to 1-year post hospital discharge. Rates of rehospitalization and A1C improved for older adults who received nurse-led inpatient DSME and homecare during transitions of care from hospital to home. Rehospitalization rates up to 90 days were decreased for the DSME plus homecare group (10%) compared to DSME only (20%) and usual care groups (26.7%) (p < 0.05). A decrease of -0.4 and -2.3 A1C units was observed for the DSME group and DSME plus homecare group, respectively, at 90 days. These results support a transitional care educational intervention for older adults with type 2 diabetes mellitus and obesity. TARGETS: Older adults with type 2 diabetes mellitus and obesity. INTERVENTION DESCRIPTION: Transitional care intervention including diabetes self-management education and homecare. MECHANISMS OF ACTION: Inpatient diabetes education and homecare helps improve rates of rehospitalization and hemoglobin A1C during care transitions from hospital to home. OUTCOMES: Rehospitalization rates, glycemic control (i.e., A1C level). [Res Gerontol Nurs. 2018; 11(2):71-81.].

Perceptions of academic administrators of the effect of involvement in doctoral programs on faculty members' research and work-life balance.

BACKGROUND: Support for research strongly predicts doctoral program faculty members' research productivity. Although academic administrators affect such support, their views of faculty members' use of support are unknown. PURPOSE: We examined academic administrators' perceptions of institutional support and their perceptions of the effects of teaching doctoral students on faculty members' scholarship productivity and work-life balance. METHODS: An online survey was completed by a random sample of 180 deans/directors of schools of nursing and doctoral programs directors. Data were analyzed with descriptive statistics, chi-square analysis, and analysis of variance. DISCUSSION: Deans and doctoral program directors viewed the level of productivity of program faculty as high to moderately high and unchanged since faculty started teaching doctoral students. Deans perceived better administrative research supports, productivity, and work-life balance of doctoral program faculty than did program directors. CONCLUSION: Findings indicate the need for greater administrative support for scholarship and mentoring given the changes in the composition of doctoral program faculty.

Nursing Doctoral Faculty Perceptions Related to the Effect of Increasing Enrollments on Productivity.

Nursing faculty teaching in research and clinical doctoral programs participated in a national survey study to examine the impact of expanded doctoral enrollments on the doctoral faculty's scholarly productivity. They were invited to respond to an open-ended question soliciting information not already addressed in the survey. Results of the analysis are reported here. Findings corroborated the review of literature and results of the survey and focus groups that provided the basis for the survey's development. Current workloads may be unsustainable, jeopardizing the profession's response to Institute of Medicine recommendations.

Growing Clinical and Academic Nursing Leaders: Building the Pipeline.

Nursing faces a crisis because there exists a dearth of qualified nurse academicians and administrators willing to step up to high-level leadership positions such as deanships and chief nursing operators. This article critically appraises the available literature regarding succession planning in the nursing profession and offers pragmatic suggestions to the profession to engage in succession planning in a deliberate and thoughtful manner.

Assessment of the Impact of Teaching Demands on Research Productivity Among Doctoral Nursing Program Faculty.

This article reports the findings of a study that examined the research and scholarship productivity of doctorally prepared nursing faculty teaching and mentoring doctoral students and the conflicting demands on them to maintain programs of research and scholarship. The specific aims were to (a) examine the research productivity and scholarship of faculty members teaching in doctoral programs and mentoring doctoral students to examine the perceived effectiveness of existing institutional mechanisms to support scholarship, (b) explore institutional features and personal practices used by doctoral program faculty to develop and maintain research and scholarship productivity, and (c) analyze predictors of scholarship productivity. Data were collected via an on-line researcher-developed survey that examined doctoral faculty roles/responsibilities and their relationship to their scholarly productivity, overall research productivity, and institutional features and personal practices to support research/scholarship activities. Survey respondents reported spending a large amount of time engaged in research-related activities with 58.9% (n = 326) spending anywhere from 6 to 20 hours per week conducting research, writing research-based papers, giving presentations, grant writing, or conducting evidence-based improvement projects. Scholar productivity among the respondents was robust. Personal practices that most strongly supported faculty members' scholarship productivity were the belief that engaging in scholarship made them better teachers and the personal gratification in experiencing doctoral students' successes. A multiple regression analysis conducted to determine predictors of productivity indicated that the strongest predictor was the average number of hours spent on research/scholarship-related activities, followed by time bought out from teaching and other responsibilities of the faculty role for research.

Psychometric Analysis of the Work/Life Balance Self-Assessment Scale.

BACKGROUND AND PURPOSE: This study investigated the psychometric properties of the Work/Life Balance Self-Assessment scale among nurse faculty involved in doctoral education. METHODS: A national random sample of 554 respondents completed the Work/Life Balance Self-Assessment scale, which addresses 3 factors: work interference with personal life (WIPL), personal life interference with work (PLIW), and work/personal life enhancement (WPLE). RESULTS: A principal components analysis with varimax rotation revealed 3 internally consistent aspects of work-life balance, explaining 40.5% of the variance. The Cronbach's alpha coefficients for reliability of the scale were .88 for the total scale and for the subscales, .93 (WIPL), .85 (PLIW), and .69 (WPLE). CONCLUSION: The Work/Life Balance Self-Assessment scale appears to be a reliable and valid instrument to examine work-life balance among nurse faculty.

Work-life balance of nursing faculty in research- and practice-focused doctoral programs.

OBJECTIVES: The growing shortage of nursing faculty and the need for faculty to teach doctoral students to address the shortage call for examination of factors that may contribute to the shortage, including those that are potentially modifiable, including work-life balance.This descriptive study examined work-life balance of a national sample of nursing faculty teaching in research-focused and practice-focused doctoral programs. METHODS: Data were collected through an online survey of 554 doctoral program faculty members to identify their perceptions of work-life balance and predictors of work-life balance. RESULTS: Work-life balance scores indicated better work-life balance than expected. Factors associated with good work-life balance included higher academic rank, having tenure, older age, years in education, current faculty position, and no involvement in clinical practice. Current faculty position was the best predictor of work-life balance. CONCLUSIONS: Although work-life balance was viewed positively by study participants, efforts are needed to strengthen factors related to positive work/life in view of the increasing workload of doctoral faculty as the numbers of doctoral students increase and the number of seasoned faculty decrease with anticipated waves of retirements.

A profile of U.S. nursing faculty in research- and practice-focused doctoral education.

PURPOSE: This study, which is part of a larger project, was conducted to profile the nursing faculty in the United States teaching in PhD and DNP programs. DESIGN: This is a descriptive study. A sample of 554 nursing faculty who teach in PhD and DNP programs was recruited by email solicitation to represent all geographic regions of the United States. Data were collected from November 2013 through January 2014 using an online survey instrument. METHODS: The instrument was developed based on results of review of the literature and of focus groups of doctoral faculty (faculty teaching in doctoral programs) to ascertain characteristics of faculty teaching in doctoral programs and of the schools in which they teach. Frequencies and descriptive statistics are reported. FINDINGS: Growth in DNP programs has outpaced growth in PhD programs, and DNP graduates have moved into doctoral education in greater numbers than PhD graduates. DNP faculty report less prior experience and current productivity scholarship than faculty in PhD programs only or both types of programs. CONCLUSIONS: Strategies are needed to ensure that doctoral programs are staffed by faculty who are prepared for doctoral education and the development of nursing science. CLINICAL RELEVANCE: The Institute of Medicine has recommended doubling the number of doctorally prepared nurses in the United States by 2020 to ensure that sufficient numbers of faculty are available to prepare the nursing labor force that is needed for delivery of healthcare services. Nurse scientists are needed to contribute to improvement in patient care quality and safety, and practice leaders are needed to facilitate the translation of research into safe, high-quality, and cost-effective care. The landscape of doctoral education in nursing is rapidly changing.

Comparison of demographics, professional outcomes, and career satisfaction in accelerated and traditional baccalaureate nursing graduates.

This cross-sectional study examined accelerated second-degree (n = 117) and traditional (n = 71) baccalaureate nursing (BSN) graduates from a large, private, urban university in the mid-Atlantic United States regarding demographics, professional outcomes, and career satisfaction using an electronic survey. Results showed a statistically significant difference in two professional development variables: plans to return for an advanced nursing degree and membership in nursing professional organizations. There was no statistically significant difference in career satisfaction between accelerated second-degree and traditional BSN graduates. These findings indicated that both accelerated second-degree and traditional BSN graduates, despite matriculation in different nursing curricular models, have similar professional outcomes and career satisfaction.

Nursing doctoral faculty perceptions of factors that affect their continued scholarship.

This focus group study was undertaken as part of a larger investigation of how the demand for increased production of nurses with doctorates affects doctoral faculty's scholarly productivity. This study provided a basis for development of the national survey questionnaire. Two focus groups that included 29 faculty teaching in doctor of philosophy and/or doctor of nursing practice programs took place at one of two national conferences. The focus group interviews were transcribed and content analyzed for the identification of themes; all members of the research team reached consensus. The three major themes were the demands of teaching, the importance of institutional structure and climate, and the sustainability of one's self, the institution, and the discipline. Participants identified strategies for enhancing scholarly productivity. Findings are limited by the small sample size and the voluntary participation of conference attendees. The strength of emotion that participants revealed underscores the need for nursing leaders to address the increasing academic expectations for faculty. If the profession does not address the needs of its current and future faculty, goals explicated by the Institute of Medicine in The Future of Nursing cannot be achieved, and the health of the nation will suffer.

Challenges to research productivity of doctoral program nursing faculty.

The Institute of Medicine, responding to a national health care crisis and related nursing labor force concerns, has called for an increase in the proportion of registered nurses with baccalaureate or higher degrees to 80% and a doubling of the number of nurses with doctorates by 2020. Simultaneously, large numbers of senior faculty are starting to retire, whereas the movement of doctorally prepared nurses into academia is insufficient to replace them. Issues associated with the efforts of nursing programs to increase their capacity to respond to the Institute of Medicine's recommendations, particularly the effect on scholarly productivity among nursing faculty in doctoral programs, are examined in this article. Creative strategies for promoting scholarly productivity among doctoral program faculty are identified.

The coming revolution in personal care robotics: what does it mean for nurses?

The business sector provides regular reportage on the development of personal care robots to enable elders and people with disabilities to remain in their homes. Technology in this area is advancing rapidly in Asia, Europe, and North America. To date, the nursing literature has not addressed how nurses will assist these vulnerable populations in the selection and use of robotic technology or how robotics could effect nursing care and patient outcomes. This article provides an overview of development in the area of personal care robotics to address societal needs reflecting demographic trends. Selected relevant issues related to the human-robotic interface including ethical concerns are identified. Implications for nursing education and the delivery of nursing services are identified. Collaboration with engineers in the development of personal care robotic technology has the potential to contribute to the creation of products that optimally address the needs of elders and people with disabilities.

From committee to commission: the history of the NLN's Academic Certified Nurse Educator Program.

AIM: To describe the historical events surrounding the development of the National League for Nursing (NLN) Academic Nurse Educator Certification Program (ANECP) and document its transition from a committee to a commission. BACKGROUND: During the latter half of the 20th century, certification became a demonstrated standard of excellence in nursing. A few visionaries suggested that nursing education itself was a specialty, but the timing for certification was not right. METHOD: The events have been studied through three primary sources: archived minutes, oral interviews, and the authors' eyewitness accounts. RESULTS: Growing pains, personnel changes and the rapid growth from committee to commission occurred during a few short years. While the NLN made sound decisions during the change process by seeking evidence and the guidance of experts and consultants, unexpected challenges occurred. CONCLUSION: The tremendous growth of the ANECP in its first years demonstrated that change was clearly desired so long as it was anchored in an evidence-based process focused on quality.

Tackling complex problems, building evidence for practice, and educating doctoral nursing students to manage the tension.

The mandate for evidence-based practice (EBP) arose in response to, among other catalysts, several Institute of Medicine reports beginning in the late 1990s. At the same time, the National Institutes of Health and others have recognized that the most complex, important, and challenging problems, termed "wicked problems," are inherently transdisciplinary and require thinking beyond the limits of existing theories. When nursing students are prepared for EBP, they operate within a fairly stable set of assumptions and they exercise a past orientation. Wicked problem-solving occurs within a context that is characterized as dynamic and ambiguous and requires a future orientation to imagine potential solutions to questions of "what if?" Both skills, EBP, and wicked problem-solving, are essential within the discipline of nursing. Students at all levels need to understand when each scientific approach is required. PhD students must be prepared to participate in wicked problem-solving.