Managing the challenges of role diversification in an interdisciplinary environment.

Advanced practice nurses are increasing in number. Such nurses include the nurse practitioner, clinical nurse specialist, nurse anesthetist, and nurse midwife. The roles of nurse practitioners and clinical nurse specialists have been recommended by the American Nurses Association to merge. The frustrations related to this merger are identified, and strategies are proposed to resolve them. Examples of military, civilian, and international models are provided.

Summary statements of the NIH Nursing Research Grant Applications.

Summary statements from the Nursing Research Study Section, Division of Research Grants, NIH, between October, 1986 and June, 1988 were used to identify reasons for recommending approval or disapproval of grant applications with RO1 and R29 activity codes. The 917 comments (25 +/- 4 per critique), sorted into one of nine categories (Aims, Significance, Investigator, Budget, Resources, Design, Sample, Techniques, Data Analysis) for analysis, were classified as Strengths (positive comments) or Weaknesses (negative comments). The weaknesses of approved applications were confined mostly to the categories of Design and Techniques. Disapproved applications had few strengths and many weaknesses in Design, Sample, Techniques, and Data Analysis. Critiques of First Award (R29) and traditional research project grant applications (RO1) were similar. The approved applications addressed meaningful problems, had well-synthesized literature reviews, and were solvable by available techniques. The research plans were consonant with stated aims, and the methods sections reflected understanding of the principles underlying the techniques to be used. A supportive environment and adequate research resources, including access to the study population were common to these applications. Disapproved applications provided poor synthesis of the literature, methods inconsistent with the aims, and often reflected inadequate understanding of techniques to be used.

The nursing shortage: dynamics and solutions. Reflections on a recurring theme.

The passage of individual state nurse practice acts in the 1900s sharpened and focused attention on the practice and function of professional nurses. However, this had little effect on increasing the demand for nurses. In the 1930s student nurses were in ample supply. They staffed units in hospitals, and seniors served as charge or head nurses. It was World War II when one finally began to see the theme of nursing shortage emerge with a vengeance. The demand far exceeded the supply, creating a severe imbalance. The intervening next 4 decades brought forth many excellent models to minimize the shortage. Even the federal government contributed to the nursing shortage by offering opportunities for better-educated practitioners, teachers, and supervisors. Thus, as the nurse became better prepared, the demand for services increased. Several milestone studies are referenced during the 1970s and 1980s that attempted to balance the nursing shortage equation. The US objectives for the year 2000 provide specific guidelines as to what demands will be placed upon the nurse practitioner and educator. Can we meet those demands? Yes--with the full utilization of information technology to prepare the student and nurse practitioner to take advantage of this enormous information explosion. Will the nursing shortage continue to be a recurring theme? Yes! As nurses become better educated and ready for practice and patient-client problem solving, and as they provide strong voices in health policy formulation, the demands for their services will continue to far exceed the supply.