A pilot resiliency course for Doctor of Nursing Practice (DNP) students: Lessons learned.

Graduate nursing students can face varied and significant stressors during their programs of study. The need for interventions to promote nursing student resiliency has been reported in the literature, by accrediting bodies, and in previous research conducted with students at the same university. Thus, the purpose of this project was to pilot a resilience course for Doctor of Nursing Practice (DNP) students. The theoretical frameworks guiding the design and implementation of the resiliency pilot program were andragogy (the science of adult learning) and rapid cycle quality improvement. The course included eleven monthly modules addressing resiliency content with written material, original videos, and online discussions and meetings. The first module overviewed the resiliency skills (Belief, Persistence, Trust, Strength, and Adaptability), five modules were dedicated to a specific resiliency skill, two modules addressed recent and anticipated challenges, two modules concentrated on the application (clinical and academic) of the resiliency skills, and the last module focused on reflection. Results of this pilot program indicate that DNP students can benefit from receiving resiliency content during their studies, especially from faculty involvement and increased peer support; however, future resiliency content may be more accepted and effective if embedded into nursing program curriculum and activities.

Nurse practitioner educational preparation and confidence related to managing antipsychotic medications and associated drug-induced movement disorders.

BACKGROUND: Antipsychotic medications (APMs) have been used to treat multiple psychiatric disorders for decades. The conditions to use these medications have expanded from primarily psychotic disorders to Food and Drug Administration-approved uses as first-line mood stabilizers in bipolar disorder and adjunctive pharmacotherapy in unipolar depression. Antipsychotic medications can have serious side effects, including drug-induced movement disorders (DIMDs). Nurse practitioners (NPs) in non-psychiatric-mental health specialties are increasingly managing psychotropic medication regimes. There is a void in peer-reviewed literature capturing the scope of NPs managing APMs, such as whether they received training to prescribe and manage risks of APM, and if so, what type (e.g., continuing education, attending conferences, consulting), and their confidence assessing and managing DIMDs. PURPOSE: To describe the scope of NP management, knowledge, and confidence related to APMs and associated risks of DIMDs. METHODOLOGY: Nonexperimental, descriptive, cross-sectional survey. Participants ( n = 400) recruited through a professional association membership portal. RESULTS: Nearly two-thirds of participants reported managing APMs (64%) and receiving training to prescribe and manage risks of APMs (63%). More than half (54%) reported they received training to do so in their NP education program. Thirty-five percent of participants indicated they were either completely (6%) or fairly (29%) confident, whereas most (65%) endorsed being somewhat (26%), slightly (20%), or not (19%) confident in assessing and managing DIMDs. CONCLUSIONS/IMPLICATIONS: Opportunities exist to broaden NP education in managing APMs and associated risks of DIMDs.

Promoting Professional Quality of Life and Resiliency in Sexual Assault Nurse Examiners.

BACKGROUND: Sexual assault nurse examiners (SANEs) have received specialized education and clinical training in providing forensic care for sexual assault and abuse victims. SANEs provide compassionate and competent care that promotes emotional recovery for their patients; however, caring for this population puts SANEs at risk for secondary traumatic stress, professional burnout, and compassion fatigue. The research regarding SANEs indicates that there may be multiple personal and organizational factors that affect their development of negative outcomes related to professional quality of life. PURPOSE: This study explored challenges SANEs experience in their work and what resources are utilized to promote their resiliency and professional quality of life. METHODS: SANEs were recruited to complete an anonymous online survey through the International Association of Forensic Nurses community; 69 SANEs completed the survey. Eight of the SANEs also participated in follow-up focus groups. RESULTS: The participants reported many gratifying aspects of their work. They also described challenges related to personal, professional, organizational, and community factors. Many of the reported negative effects align with secondary traumatic stress and professional burnout. The SANEs identified multiple ways to support their resiliency in the context of this difficult work. IMPLICATIONS: The nature of this work puts SANEs at risk for developing adverse symptoms related to professional quality of life. SANEs need better support and resources to cope with the demands of their work. Findings of this study will be used to design SANE Well, a support application to promote SANE wellness and resiliency.

Compassion fatigue, presenteeism, Adverse Childhood Experiences (ACES), and resiliency levels of Doctor of Nursing Practice (DNP) students.

BACKGROUND: Doctor of Nursing Practice (DNP) students often experience challenges that can cause poor academic performance and attrition. Known threats to nurses' professional quality of life and patient care include compassion fatigue and presenteeism; it is not known how these phenomena carry over from prior nursing experience to DNP students' academic experiences and subsequent NP practice. Adverse Childhood Experiences (ACEs) can also threaten nursing students' coping ability and overall wellbeing. Building resilience can combat the negative effects related to professional quality of life and traumatic experiences and promote nursing student success. OBJECTIVES: Measure compassion fatigue, presenteeism, ACEs, and resiliency in DNP students. DESIGN: A cross-sectional survey was conducted with three cohorts of DNP students. SETTING: A DNP program at a large public American University. PARTICIPANTS: DNP students (n = 118) from four NP specialty tracks: Family, Pediatric, Psychiatric Mental Health, and Adult-Gerontology Acute Care. METHODS: Online surveys were sent to three cohorts of DNP students: one group before beginning the program and two groups, one year apart, before starting clinical rotations in the program. Surveys included measures for compassion fatigue, presenteeism, ACEs, and resiliency. RESULTS: The demographics of this study sample was similar to other published DNP student samples. The students reported moderate levels of compassion fatigue, presenteeism, and resiliency. ACE scores ranged from 0 to 8 out of 10, and 50% reported at least one ACE. CONCLUSIONS: Survey results from three DNP student cohorts indicate that many are pursuing advanced practice nursing education with a history of traumatic childhood events, demands of balancing work and school, and moderate resiliency levels. Many have symptoms of negative professional quality of life and presenteeism that could inhibit their job satisfaction and quality of care as an NP. Promoting DNP students' resiliency may improve their ability to thrive amidst academic and professional challenges.

Compassion Fatigue in Advanced Practice Registered Nurses: Why Don't We Know More?

Compassion fatigue (CF) can be detrimental to health care providers' mental and physical health, efficiency, and quality of patient care. Although many studies explore CF in physicians and nurses, there is currently limited published research regarding how advanced practice registered nurses (APRNs) develop and address CF. APRNs may be at high risk for developing CF due to their work responsibilities, patient interaction, and personal characteristics. Because of its impact on health care providers, patients, and organizations, APRNs should be aware of the potential causes, symptoms, and negative effects of this phenomenon.

Peer support among inpatients in an adult mental health setting.

Existing literature indicates peer support is beneficial for people with mental illnesses and plays an important role in recovery. While many studies in the mental health field have focused on formalized peer support within the community, none have explored the experience of peer support among hospitalized patients. The purpose of the current study was to explore the perceptions and experiences of naturally occurring peer support among adult mental health inpatients. In-depth interviews were conducted with ten inpatients across four mental health units, two acute and two long-term. Interviews were transcribed verbatim and analyzed using a qualitative descriptive design. The data show that peer support among inpatients is extensive and beneficial, and occurs independently of staff involvement. The findings illustrate that peer support is a thoughtful process that involves observing, reflecting, taking action, and evaluating outcomes. Supportive actions include helping with activities of daily living, sharing material goods, providing information and advice, sharing a social life, and offering emotional support. This leads to various positive outcomes for providers and recipients of peer support, such as improved mental health outcomes and quality of life. Attempts to provide supportive interactions occur within a particular context, which can hinder or facilitate peer support. The new insights from this study could provide health professionals with an increased recognition of peer support and an appreciation for the unique role patients play in their own and in their peers' recovery. These findings have important implications for establishing collaborative working partnerships with mental health inpatients.