Follow Your Passion and Discover the Beauty of Being a Nurse Scientist.

Following one's passion can lead nursing educators and scientists to develop nursing knowledge. Influenced by her and her family's experiences with healthcare, Dr. Shannon Avery-Desmarais, a nurse practitioner, nurse educator, and scientist, has developed a theoretical framework with her colleagues to promote minority PhD and DNP student success in nursing education. In addition, she and other colleagues are looking at stigma in nursing students and how nursing education can decrease stigma toward patients with opioid use disorder (OUD). In this column, Dr. Avery-Desmarais shares her influences on nursing knowledge and discusses her early contributions to nursing.

Improving Nurses' Attitudes Toward Substance Use Disorder: Screening, Brief Intervention, and Referral to Treatment.

ABSTRACT: Patients with substance use disorder (SUD) encounter many barriers to healthcare, including negative attitudes of healthcare personnel. Compared with other healthcare professions, nurses have been reported as having less tolerant attitudes toward patients with SUD. Knowledge acquisition combined with role support has been shown to improve therapeutic attitudes of nurses toward patients with SUD. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based educational intervention aimed to improve the outcomes of patients at risk and with SUD. SBIRT education has been shown as an effective educational tool with licensed nurses. Therefore, the aim of this study was to evaluate whether a 2-hour educational session on SBIRT (Mitchell et al., 2013) improved the therapeutic attitudes of nurses toward patients with SUD. Peplau's theory of interpersonal relations guided this study with an emphasis on the nurse-patient relationship. A quasi-experimental pretest/posttest design was used to evaluate nurses' attitudes pre and post a 2-hour educational session. Participants included 65 registered nurses employed in a 247-bed teaching hospital in New England. Attitudes were measured before and after the educational session using the 20-item, five-subscale Drug and Drug Problems Perceptions Questionnaire. A paired t test was performed, showing statistically significant improvements in attitudes postintervention. Prior education on SUD significantly correlated with baseline attitudes. A standard regression model, with practice setting, family history of SUD, and prior education as dependent variables, was not predictive of baseline attitudes. The results suggest conducting SBIRT should be considered a mandatory nursing competency, both in undergraduate curriculum and among licensed nurses.

Perceived stigma, barriers, and facilitators experienced by members of the opioid use disorder community when seeking healthcare.

INTRODUCTION: Healthcare professionals, particularly nurses, have negative attitudes towards individuals with opioid use disorder (OUD) and these attitudes can contribute to suboptimal care. The aim of this study was to identify stigma, barriers and facilitators experienced by members of the OUD community when interacting with the healthcare system. DESIGN: A qualitative exploratory design used semi-structured focus group interviews to address the study aim. METHODS: Following IRB approval, purposive sampling was used to recruit participants with a history of OUD, family caregivers of individuals with OUD, and support group leaders from regional recovery groups to provide a broad perspective of stigmatizing issues and barriers to care. Focus group discussions were conducted, and video recorded using web-based conferencing software. Transcripts from the focus groups and field notes were analyzed and coded into themes. RESULTS: Both structural and social determinants of health were identified by participants as stigmatizing and/or barriers to care. Thematic content analysis resulted in eight themes: stigmatizing language, being labeled, inequitable care, OUD as a chronic illness, insurance barriers, stigma associated with medications for OUD (MOUD), community resources, and nursing knowledge and care. CONCLUSION: Members of the OUD community are challenged by both internal and external stigma when seeking healthcare. Stigma negatively affects public support for allocation of resources to treat OUD. Interventions aimed at reducing stigma are critical to support effective OUD treatment and prevent barriers to OUD care. CLINICAL RELEVANCE: Understanding the complex relationships between stigma and structural determinants of health will allow nursing science to develop educational interventions that provide the next generation of nurses with the knowledge, skills, and attitudes needed to advance health equity for individuals with OUD.

Internet Recruitment of a Diverse Population of Lesbian, Gay, and Bisexual Nurses in a Study of Substance Use and Minority Stress.

INTRODUCTION: There is a lack of lesbian, bisexual and gay (LGB)-focused nursing research, in part, because the population is traditionally difficult to access. This article explores the effectiveness, benefits, and limitations of online recruitment of a distinct population of LGB-identified nurses in a study of substance use and minority stress. METHODOLOGY: A sample of nurses who self-identified as LGB were recruited for an online survey using organic Facebook outreach. A $5 Amazon gift card was offered as an incentive. Facebook insights data and demographic data were analyzed. RESULTS: Within 96 hours, 394 participants had completed the 101-question online survey. The majority (n = 269, 68.6%) reported accessing the survey through Facebook. Email (n = 79, 20.2%) and word of mouth (n = 44, 11.2%) also contributed to recruitment. DISCUSSION: The effectiveness of this Facebook recruitment protocol speaks to the importance of social media, survey incentives, and the "power of visibility" in recruitment of this population.

A theoretical framework to promote minority PhD and DNP student success in nursing education.

BACKGROUND: Nursing PhD and DNP programs lack diversity and cultural responsiveness and, as a result, minority students are underrepresented in these programs. Stressors specific to being a member of a minority population, defined as minority stress, contribute to a range of barriers for ethnic/racial minority, male and LGBTQ PhD and DNP students. There is an urgent need for faculty and administrators to support minority doctoral student success by taking proactive steps to identify and begin to deconstruct these barriers. Doctorally-prepared nursing faculty serve as mentors and role models for doctoral students, provide exemplars for how to use scientific humility to research health inequities, implement evidence-based practice and develop the next generation of nurse scientists. Combating educational inequities for minority doctoral students is a first step in advancing health equity beyond academia. PURPOSE: The purpose of this paper is to develop a theoretical synthesis to promote minority PhD and DNP student success in academia. THEORETICAL FRAMEWORK: The minority doctoral student success (MDSS) framework was developed using Schneider's attraction-selection-attrition framework, key concepts from the literature, and professional and personal experience to capture the minority doctoral student experience. A systems approach was used to identify multi-level influences on the minority student experience, including antecedents at each stage of the academic journey, and how minority stress and opportunity inherently affect the process. CONCLUSIONS: Diversity is essential to reimagine nursing doctoral education. This theoretical framework provides an approach to understanding the minority PhD and DNP student experience and the role of faculty and the academic organization in mediating barriers and creating opportunities to enhance diversity, equity, and inclusion.

Substance Use and Minority Stress in a Population of Lesbian, Gay and Bisexual Nurses.

PURPOSE: The aim of this study was to explore the incidence of problematic substance use (PSU) and the relationship between level of substance use, minority stress, and general stressors in a population of lesbian, gay and bisexual (LGB) identified nurses. Methods: A national, convenience sample of 394 self-identified LGB nurses completed an online survey in March 2019. Using data from the ASSIST V3.1 measurement tool, the incidence of problematic and non-problematic tobacco, alcohol and illicit substance use was described as a percentage of respondents in each group. Hierarchical regression assessed the impact of demographic variables, sexual orientation, gender identity, race/ethnicity, and level of substance use. Multiple regression assessed the impact of general stressors, minority stress processes, including coping and social support and internalized homophobia, on level of substance use. Results: The incidence of PSU was higher in this population of LGB-identified nurses than previously described in either the general population of nurses or the general LGB population. Demographic variables and minority status had variable associations with level of tobacco, alcohol and illicit substance use. Components of Meyer's minority stress model had a stronger and more consistent association with level of tobacco, alcohol and illicit substance use than general stress. Predictors of level of substance use across groups suggest community involvement may be significant. These results have potential implications for public health and the prevention and treatment of substance use in LGB-identified nurses.