Nursing's Wicked Problems: Partnering With Academic Leadership to Develop Solutions.

Nursing is in a challenging place, and we are facing many incredibly complex issues that are steeped in culture and tradition. These "wicked problems" often arise when organizations face constant change or unprecedented challenges. In this article, we discuss current issues that hinder all nurse leaders from elevating nursing as a profession, with a particular focus on the role and contributions of the academic nurse leader in creating and sustaining positive change. By prioritizing meaningful collaboration, reimagining education for nursing outside the hospital walls, investing in evidence for practice, and advocating by amplifying new voices, we can identify shared goals and develop coordinated plans of action. The goal of academic nursing is to work to understand wicked disciplinary problems while also analyzing and critiquing what is not working, articulating possible solutions, and collaborating with other nurse leaders to address these complex issues. This also means that academic nursing should be held equally accountable for delivering results.

Support Methods for Healthcare Professionals Who Are Second Victims: An Integrative Review.

A second victim is a healthcare provider who has been involved in a critical event. A critical event is a clinical situation in which an unforeseen clinical outcome occurs, or the clinical deterioration of the patient takes place for many different reasons. The patient and his/her family are the first victims. The healthcare provider(s) involved in the event are second victims. After such an event, the healthcare provider may experience a constellation of negative emotions, such as guilt, sadness, depression, somatic symptoms, hypervigilance, and fear. Most second victims require support to cope with the adverse clinical situation. Many of the studies addressed in this integrative review, revealed that having a trusted colleague or staff member with whom to discuss the critical event is therapeutic. Some organizations have developed programs to support second victims in which specially trained staff members are deployed to discuss critical events with those involved, if the participant(s) desire the support. Other clinical facilities do not have established support programs; however, healthcare providers have expressed desire to discuss the critical event with supportive colleagues.

An examination of nurse-authored patents: Implications for nursing practice.

BACKGROUND: Recognition for medical inventions and innovations is largely associated with physician-researchers, scientists, and engineers. The term "nurse" is largely absent from patents awarded in the United States. Yet, as front-line healthcare providers, who better to add to the current population of inventors and innovators of new, meaningful scientific and engineering medical discoveries than specialized advanced practice nurses and their registered nurse colleagues? Although medical inventions and innovations are not entirely new activities for nurses, the authors speculate that greater opportunities exist for these healthcare professionals to lead in and be officially recognized for medical care discoveries and advancements by having their names on patents awarded. Also, we surmise that without the active and dedicated participation of nurses, important and significant discoveries may be missed. AIMS: The purpose of this paper is to address the importance of having nurses at all levels and specialties engaged in healthcare inventions and innovations. The foundation for this thesis begins by describing the findings from the first quantitative analysis of nurses' participation and/or recognition for the invention and innovation of medical devices and instruments, defined by having their names on awarded United States patents. In addition, we identify meaningful pathways for nurses to engage in this space. METHODS: Data to evaluate nurse participation and recognition for medical device and instrument inventions and innovations were collected through a publicly accessible website, the United States Patent and Trademark Office database, and analyzed with respect to whether the patent author(s) were nurses or nonnurses. RESULTS: More than 65 000 patents were identified with the terms "medical device" and "medical instrument." From the 65 000+ patent-population, 100 random patents were analyzed for the purposes of this first study and none were determined to have a nurse listed as a participating inventor or innovator. As a result of this analysis, the authors: (a) identify that nurses are largely unrecognized in the medical device invention and innovation space and (b) create models that explain nurses' engagement in this space from (i) historical and contemporary perspectives and (ii) for enhanced future involvement in healthcare patent activities. The future model is especially important as it provides a pathway for nurses to enhance their inventive and innovative competencies, effectiveness, and efficiency through new professional roles, additional education, creation of new educational programs, and formation of professional collaborations. It also calls for organizations that employ nurses to overtly allocate time, resources, and support for invention and innovation activities. We posit that fostering and facilitating nurses to enter the medical invention and innovation space stimulates discoveries that can improve patient care experiences, operations, and outcomes, reduce healthcare costs and provide myriad benefits to these professionals and the organizations that employ them. Examples of benefits from nursing inventions and innovations include prestige, scholarship, and the financial assets associated with intellectual property (ie, patents awarded) for both the nurse and the employing institution. Furthermore, direct involvement and engagement in inventions and innovations define a new practice space and contribution for nurses.

The Nurse-Engineer: A New Role to Improve Nurse Technology Interface and Patient Care Device Innovations.

PURPOSE: The purpose of this article is to describe two innovative biomedical engineering and nursing collaborations designed to educate a new cadre of professionals and develop new knowledge and innovations (robots, patient care devices, and computer simulation). ORGANIZING CONSTRUCT: Complex health problems demand a highly skilled response that uses teams of professionals from various disciplines. When the biomedical engineering lens is expanded to include the practical perspective of nursing, opportunities emerge for greater technology-nurse interface and subsequent innovation. A joint nursing-engineering degree program provides the ideal preparation for a well-informed nurse-engineer who can explore new and innovative solutions that will improve care and patient outcomes. APPROACH: A review of the literature provides the background on innovation and engineering in nursing and a rationale for the development of two innovative joint degrees, as well as a description of those programs. FINDINGS: These innovative programs will advance healthcare-related technology and maximize the potential contribution of the nursing profession in the design and implementation of creative solutions. They also have the potential to increase the skills and knowledge for students enrolled in biomedical engineering or Bachelor of Science in nursing programs individually, providing them with interdisciplinary training and exposure. CLINICAL RELEVANCE: Important patient care improvement opportunities are missed when nurses are not actively engaged in patient care device innovation and creation. Innovative nurse and engineer collaborations are needed in various forms to leverage nurse ingenuity and create patient care innovations.

Using a nursing student conduct committee to foster professionalism among nursing students.

This article explains how a university nursing program in the United States created and implemented a nursing student code of conduct and a faculty-led nursing student conduct committee to review and adjudicate violations of academic or professional misconduct. The need for and role of the nursing student conduct committee in providing substantive and fair due process is illustrated with two cases. Professional misconduct has been associated with preventable error and patient safety and is of great concern to nurse educators who are entrusted with producing the next generation of nursing professionals. Accountability and consequences for violations of professional standards must be an integral part of the nursing education curriculum throughout the world to ensure quality and safety and mitigate the adverse effects of nursing error. Given the professional and patient safety implication of such violations, the authors believe that it is prudent to have nursing programs adjudicate nursing majors' professional violations as an alternative or supplement to the general university judicial board.

A report on a national study of doctoral nursing faculty.

This article reports on a national study of doctoral nursing faculty, including both PhD and Doctor of Nursing Practice (DNP) faculty. Using a national sample of 624 doctoral nursing faculty, we surveyed individuals on a variety of issues, including succession planning, retirement, quality of life as a doctoral faculty member, their views on the new DNP degree, and how they view the future of doctoral nursing education. Study implications for both DNP and PhD faculty are explored and the meaning of the findings of the study for the future are discussed, including new items that will be investigated in a repeat survey in 2012.

Student drug testing in nursing education.

Nursing faculty and administrators have a responsibility to keep abreast of current research, legal regulations, and professional standards that affect students in the classroom and clinical setting. The purpose of this article is to examine whether empirical research supports the current trend of mandatory drug testing, provide a synopsis of current practice, and discuss the legal and ethical implications for nursing faculty.

Faculty colleagues in your classroom as doctoral students: is there a conflict of interest?

The 4 authors, a faculty member, department chair, associate dean, and college dean, identify and analyze issues surrounding nursing faculty as doctoral student, particularly when faculty members are enrolled in their employer's doctoral nursing program.

Innovative nursing educational curriculum for the 21st century.

The changing landscape of health care in America requires that clinicians be skilled in responding to varying patient expectations and values; provide ongoing patient management; deliver and coordinate care across teams, settings, and time frames; and support patients' endeavors to change behavior and lifestyle--education that is in short supply in today's academic and clinical settings (Institute of Medicine, 2003). Nursing education needs to innovate at the micro and macro system levels for the 21st century. It cannot be business as usual. In order to truly transform care, practice and education will need to partner on curriculum development and the professional socialization of the new nurse.

The benefits of a leadership program and executive coaching for new nursing academic administrators: one college's experience.

Despite attention given to the nursing shortage and now the nursing faculty shortage, what is perhaps less visible but equally critical are the pending retirements of most of the current cadre of academic nursing administrators in the next decade. With only 2.1% of current deans, directors, and department chairs in 2006 aged 45 years or younger, there may be a pending crisis in leadership development and succession planning in our nursing schools and colleges. This article describes an innovative leadership development program for largely new nursing academic administrators, which combined a formal campus-based leadership symposia and executive coaching. This article is particularly useful and practical in that actual case studies are described (albeit modified slightly to protect the identity of the individual administrator), providing a real-life narrative that rarely makes its way into the nursing academic administration literature. The executive coaching focus is very sparsely used in nursing academia, and this college's success using this professional development strategy is likely to become a template for other institutions to follow.

Teaching innovation.

Innovation in healthcare is essential to solve the "wicked problems" currently facing healthcare. This article focuses on nature of innovation and how it operates, how innovators think and view problems, how the theory and practice of innovation can be taught in novel ways, and how organizational cultures foster or suppress innovation. Examples of teaching strategies and nurse-driven innovation illustrate the theory and practice of innovation.

Bone marrow donation: factors influencing intentions in African Americans.

PURPOSE/OBJECTIVES: To identify factors influencing the intentions of African Americans to donate or not to donate bone marrow. DESIGN: Exploratory, descriptive. SETTING: Participants were recruited from three churches, four public housing developments, and a university teaching hospital-all in the Philadelphia, PA, area. SAMPLE: African American adults aged 18-60 years and able to read, write, and speak English. METHODS: Focus groups were conducted for the purpose of instrument development. A factor analysis was conducted on questionnaire data. A multiple regression was conducted of the demographic variables and the factors that contributed to behavioral intention to donate or not to donate bone marrow. MAIN RESEARCH VARIABLES: Attitudes, subjective norms, perceived behavioral control, and behavioral intentions regarding bone marrow donation. FINDINGS: "Fear or not trusting," "external influences," and "concerned about resources" correlated significantly with the intention not to donate bone marrow. Helping others, approval of people, and value of knowledge correlated significantly with the intention to donate bone marrow. CONCLUSIONS: Greater attention must be paid to increasing donations and improving the critical need for bone marrow donors. Patient education programs should be expanded to improve African Americans' knowledge of the importance of bone marrow donation, including the process, associated costs, and resources available to donors. IMPLICATIONS FOR NURSING: Nurses--irrespective of practice areas--are key contributors to increase the rate of bone marrow donation, particularly among African Americans.

Benefits and costs of integrating technology into undergraduate nursing programs.

Advances in technology over the last decade have resulted in increased opportunities for educators to become more innovative in classroom and clinical teaching. These innovations have allowed students and faculty to access essential clinical information at the point of care/need. By capitalizing on technologies such as personal digital assistants and course delivery shells, faculty and students have both portable and remote access to information that can guide practice and learning activities in clinical, classroom, and distance settings. For instance, a student can use a personal digital assistant to research a patient's new medication at the bedside, study course information, access references during class in response to a question, or download clinical materials from home. Although the benefits of having ready access to information seem obvious, there are costs and strategic planning activities associated with implementing these projects. Clearly, the objective of any academic nursing program is to develop skills among students so they can efficiently access information and use that information to guide their nursing practice. To do so, academic nursing administrators must have the forethought to envision how new technologies can support achieving this goal as well as the ability to put in place the infrastructure supports needed for success. This article presents a case study of how one institution developed the necessary infrastructure and garnished the appropriate resources to implement an ambitious technology initiative integrated throughout a large undergraduate nursing program. In addition, how the integration of technology, online and mobile, can enhance clinical learning will be discussed.