The lived experience of nursing students who were unsuccessful in an undergraduate nursing program-A narrative inquiry.

BACKGROUND: Historically, attrition rates among nursing students in the United States have been a significant problem. However, beyond academic struggles, little is known about the unsuccessful experiences of nursing students. A glimpse into unsuccessful nursing students' perceptions and stressors, other than academic requirements, provides a framework for nurse educators to develop an identification system for at-risk students. DESIGN: This study aimed to focus on the student perception of failure, beyond academic results. A phenomenological study using narrative inquiry methodology was used for the study. PARTICIPANTS: The purposive sampling approach included thirty-seven students who were unsuccessful in a baccalaureate nursing program. All students were interviewed and analysis was completed. METHODS: Our analysis revealed both intrinsic and extrinsic motivators presented as an important factor for each student's success. Although each participant had unique circumstances, common themes emerged. These findings support the need for support that goes beyond support with academic studies. RESULTS: Holistic admissions processes need to be utilized, ensuring the best candidates, are admitted to nursing programs. Admission criteria should expand beyond grade point average requirements, and possibly include some form of stress management evaluation, or consideration of extrinsic influences.

Self-Efficacy: Changing the Tide of Evidence-Based Practice.

AIMS: The specific aim for this study was to describe differences in evidence-based practice (EBP) and self-efficacy in frontline RNs. This project utilized a national study with a convenience selection of acute care agencies to examine the relationship between organizational and unit culture, EBP, and self-efficacy in frontline nurses. METHODS: This national study used descriptive correlational methodology to describe differences in EBP and self-efficacy among RNs. The sample included 245 frontline RNs employed in acute care settings. To measure the study variables, the Nursing Evidence-Based Practice Survey (Titler, Hill, Matthews, & Reed, 1999)  and the Evidence-Based Nursing Practice Self-Efficacy Scale were used (Tucker, Olson, & Frusti, 2009). Each instrument was delivered via the Qualtrics online platform. RESULTS: The correlation of bivariate interval level variables was analyzed using Pearson's r. The correlation between EBP and self-efficacy was strongly correlated: r(170) = .537, p = .01. Sections within the Nursing Evidence-Based Practice Survey were calculated and found to be significant (unit culture r = .241, p = .01; organizational culture r = .570, p = .01; knowledge, skills, attitude r = .538, p = .01). LINKING EVIDENCE TO ACTION: Several implications exist for education, staff development, and nursing management. Nursing school programs incorporate EBP into the curriculum so that nurses have a foundation for EBP. However, staff development professionals in clinical settings must continue to build on the nurses' knowledge and skill, thus increasing self-confidence for EBP. Nursing management can provide the resources for staffing models and policies to reinforce the value of EBP and positive patient outcomes. This combination provides frontline staff with EBP participation and increased self-efficacy in its usage.

ADN to BSN Transitioning: An Early Decision Model.

Incentivizing nursing students in associate degree programs (ADN) and facilitating transition into RN-to-BSN studies has been a goal of the nursing profession. One partnership has established an "early decision" model for students who want to declare their intent to seek a BSN while earning the ADN. This article discusses how the model creates a relationship between the college, the university, and the student to support the student's transition to the university and academic success.

Students' perceptions of holistic nursing care.

AIM: This qualitative study aimed to investigate the trends and perceptions related to the provision of spiritual care for patients. BACKGROUND: Holistic nursing integrates the body, mind, and spirit into care. However, nursing students from a traditional program, an RN-BSN program, and a graduate nurse practitioner program voiced discomfort with providing such spiritual care. METHOD: The study was a retrospective review of a convenience sample of journal entries about specific questions of how and when three groups of students developed ideas and concepts about spirituality. RESULTS: Students embraced the idea of spirituality connected to their experiences. As students developed as registered nurses, their manner of including spirituality mirrored Benner's model. CONCLUSION: Additional education is needed for professional nurses concerning spirituality and the provision of spiritual care in a holistic manner.

Best practices in academic mentoring: a model for excellence.

Mentoring is important for the recruitment and retention of qualified nurse faculty, their ongoing career development, and leadership development. However, what are current best practices of mentoring? The purpose of this paper is to provide an overview of a model for excellence in establishing a formal mentoring program for academic nurse educators. Six themes for establishing a formal mentoring program are presented, highlighting best practices in mentoring as culled from experience and the literature. Themes reflect aims to achieve appropriately matched dyads, establish clear mentorship purpose and goals, solidify the dyad relationship, advocate for and guide the protégé, integrate the protégé into the academic culture, and mobilize institutional resources for mentoring support. Attending to the six themes will help mentors achieve important protégé outcomes, such as orientation to the educator role, integration into the academic community, development of teaching, scholarship, and service skills, as well as leadership development. The model is intended to be generalizable for faculty teaching in a variety of academic nursing institution types and sizes. Mentoring that integrates the six themes assists faculty members to better navigate the academic environment and more easily transition to new roles and responsibilities.

West Texas nursing education portal project: developing a regional centralized application system.

Because of the nursing shortage and a demand for maximum enrollment, a group of five baccalaureate and seven associate degree nursing programs in West Texas first met in 2007 to form the West Texas Nursing Education Consortium (WTNEC). To emphasize the importance of scale and distance, the West Texas region is larger than all of the northeastern states combined. The founding group agreed that the first mission of WTNEC should be to pool resources in order to increase admission and graduation rates for WTNEC schools. Two years later, this mission is being accomplished by the implementation of a plan designed to increase participating schools' admissions, retention, and graduation rates. A grant proposal was written and funded to develop a central regionalization of the application process for entry into WTNEC generic programs (associates degree in nursing and bachelor of science in nursing), with the goal of decreasing and possibly eliminating student vacancy rates in member schools and perhaps reducing the resources needed by each school for the admission process. The implemented centralized application system allowed prospective students to apply online to the centralized admission portal. Students maintained the freedom to choose the nursing program(s) they wanted to attend, but they were also made aware of possible openings in other participating schools. The admission portal also saved potential students time and money by submitting one centralized application, resulting in consolidation of the nursing school application process. Eleven of the 12 consortium schools participated in the centralized application system.

Filling gaps in knowledge: educating nurses to provide appropriate patient materials.

Assessing and addressing health literacy is a key issue in providing quality patient education. Often, nurses do not know how to do this. Continuing nursing education provides a venue for filling this gap in knowledge, contributing to better and safer patient care.

Application of evidence-based practice through a float project.

Evidence-based practice must become a common, acceptable process for the bedside nurse. This paper demonstrates a process for engaging nurses in the use of evidence for direct practice. An example using the revision of a float policy is provided as a model for staff nurses to incorporate evidence in a mechanism to elicit change.

Planning and implementing an interdisciplinary diabetes workshop for healthcare professionals.

A diabetes education program for healthcare professionals evolved out of a series of discussions among healthcare providers. This group realized the importance and the necessity of developing a current knowledge base for themselves, their clients, and their clients' families. The target audiences for this program were physicians, nurses, pharmacists, and dietitians who could be eligible to work toward becoming a certified diabetes educator. This article discusses the process used to develop and conduct these workshops. The lessons learned during this project are provided for consideration by others seeking to address common concerns and challenges in other areas of clinical practice.

The need for a community diabetes education curriculum for healthcare professionals.

Healthcare professionals need valuable up-to-date information on diabetes management and skills to treat and educate patients with diabetes mellitus. The Diabetes Education for Healthcare Professionals program was developed to provide healthcare professionals with current diabetes management skills. It was also designed to increase the number of certified diabetes educators in the area in which it was delivered. The program enrolled 147 participants and was delivered on four different occasions. Fifty-five of those participants stated a strong interest in pursuing certified diabetes educator certification, which may significantly increase the number of certified diabetes educators in both rural and urban areas of West Texas.

Developing and establishing online student learning communities.

Developing effective learning communities is an important component of Web-based courses. Learning communities offer a social context for learning that greatly enhances the knowledge acquisition of all involved parties. This article describes the development of an effective learning community among Web-based RN-BSN students. The characteristics of the cohort leading to an effective learning community included supportiveness, open sharing of oneself, and socialization.

Nurses' political involvement: responsibility versus privilege.

Nursing apathy toward participation in the political process is pandemic. Never more so than today has the profession needed a strong united stand within the political arena. Political involvement encompasses being knowledgeable about issues, laws, and health policy. Barriers to political activism are thought to encompass several spectra including heavy workloads, feelings of powerlessness, time constraints, sex issues, and lack of understanding of a complex political process. The implementation of a political role for a nurse is based on three levels of commitment including survival, success, and significance. Survival includes individual involvement within communities. Success accepts challenges in addressing injustices especially within the health-care arena. Significant involvement uses visionary nurses toward the betterment of the nurse profession. Strategies for involvement include political awareness, incorporation of course/program expectations on both undergraduate and graduate levels and teamwork. As patient advocates, nurses cannot continue to be spectators in the political arena.

New horizons for collaborative partnershipss.

The need for partnerships between health care professionals within geographical communities is becoming increasingly important as new health care needs, trends, and issues are identified. Frequently, nurses are key stakeholders within these alliances or partnerships. This article identifies three essential elements associated with successful collaborative partnerships, namely networking, leadership, and vision. It shares examples of various collaborative efforts in which the authors have engaged, illustrating how networking, leadership, and vision have enhanced these collaborative efforts.

An application of health literacy research.

Finding methods to improve the delivery of educational materials by the practicing nurse is imperative in the current health care arena. Time, energy, and effectiveness are all aspects that are critical as the health care provider attempts to meet the growing needs of the compromised client. Low functional health literacy is one public health problem that impacts the nurse's ability to effectively provide health instruction in a timely, organized manner. This article presents a pilot research project used to investigate the mastery of educational information by clients in a West Texas area. The research project is used as the foundation for discussion of several interesting facets resulting from the initial research. Ideas are presented as a direction for implementation for practice within the health care community. Low health literacy is a grave challenge, which currently is not understood nor considered by the nurse at the bedside. Practicing health care providers need the opportunity to carefully and specifically investigate the role of health care literacy in producing positive client outcomes.