A mixed methods study: The grief experience of registered nurses working on the frontlines during the COVID-19 pandemic.

AIM AND OBJECTIVE: The purpose of this study was to generate a conceptual definition and theory of grief for nurses working on the frontlines during the COVID-19 pandemic using grounded theory methodology. BACKGROUND: The COVID-19 pandemic has had a negative impact on nurses working on the frontlines. The increasing flow of diagnosed COVID-19 cases, diverse unknowns and demands in the treatment of patients with COVID-19, and depression related to countless deaths can trigger grief experiences. DESIGN: A mixed methods approach, including the qualitative method of grounded theory and a quantitative 30-question survey, was used in this study. METHODS: Eight focus group sessions were conducted with registered nurses working on the frontlines during the pandemic. Sessions were audio recorded and analysed using constant comparative data analysis. Following the interviews, a survey including demographics and self-report inventories was completed by participants. The COREQ checklist was used to assess study quality. RESULTS: Major concepts that emerged include 'facing a new reality', 'frustrations', 'stress' and 'coping'. Core concepts were combined into a conceptual definition of grief and a grounded theory of the experience of nurses working on the frontlines during the pandemic. Cross comparisons of qualitative and quantitative findings were made and compared with the literature. CONCLUSIONS: This study provides a better understanding of the grief experience of nurses working on the frontlines during the COVID-19 pandemic. It is necessary to recognise professional grief and develop intervention strategies that lead to grief reconciliation. RELEVANCE TO CLINICAL PRACTICE: Findings provide useful insights for healthcare administrators to provide support and develop interventions to reduce frustrations and stress of frontline registered nurses. PATIENT OR PUBLIC CONTRIBUTION: This study design involved registered nurses participating in focus group sessions. Participants detailed their experience working on the frontlines of the COVID-19 pandemic with patients, family and hospital administration.

Using portfolios to introduce the clinical nurse leader to the job market.

Development of a portfolio is an effective strategy used by clinical nurse leaders (CNLs) to inform prospective employers of their specialized skills in quality improvement, patient safety, error prevention, and teamwork. The portfolio provides evidence of competence relative to the role of clinician, outcomes manager, client advocate, educator, information manager, systems analyst/risk anticipator, team manager, healthcare professional, and lifelong learner. This article describes the CNL portfolio developed by experts from the University of Tennessee Health Science Center and Methodist LeBonheur Healthcare. Examples of portfolio documents generated throughout the master's entry CNL curriculum are provided, along with student experiences using the portfolio in the employment interview process.

The challenge of closing the diversity gap: development of Hispanic nursing faculty through a Health Resources and Services Administration Minority Faculty Fellowship Program grant.

Underrepresentation of minority faculty in schools of nursing is well reported. Recently, there have been multiple initiatives from both public and private sectors to alleviate the shortage of minority faculty. This article describes how the University of Tennessee Health Science Center (UTHSC) College of Nursing took advantage of one such initiative: the Health Resources and Services Administration (HRSA) Minority Faculty Fellowship Program (MFFP) grant. This program grant provides stipends to enable health professions educational programs to increase the number of faculty who are racial and ethnic minorities underrepresented in the health professions. It enabled the college to recruit a Hispanic nurse and to assist her in preparing for a successful academic career. HRSA provided a stipend in an amount not exceeding 50% of regular faculty salary of the institution for 3 years, to be matched by the institution. Expert faculty mentored the nurse's development in the areas of pedagogy, administration and leadership, design and conduct of research, grant writing and scientific writing for publication in peer-reviewed journals, and cultural competence. Dr. Susan Jacob was the project director of the MFFP grant received by the College of Nursing at UTHSC, and Zoila Sanchez, a Cuban American, was the minority faculty fellow supported by an HRSA MFFP grant. Dr. Sanchez was the first minority faculty fellow selected from the nursing profession. Past fellows represented the other health professions such as medicine and dentistry.

Perceived barriers and facilitators to physical activity in kidney transplant recipients.

BACKGROUND: Relatively few transplant recipients participate in regular physical activity. There is a paucity of information regarding barriers and facilitators to physical activity in kidney transplant recipients. OBJECTIVE: To investigate factors that transplant recipients perceive as barriers and facilitators to physical activity and whether these barriers and facilitators differ on the basis of transplant patients' reported level of physical activity. METHOD: Using a descriptive, cross-sectional design, a convenience sample of 100 kidney transplant recipients provided survey data on a physical activity questionnaire on their current levels of physical activity and determinants that influence participation in physical activity. RESULTS: The "rarely/never" (32%) physical activity group reported more frequent barriers and the "often" (20%) group reported the least. Overall, perceived facilitators were reported most frequently by the "often" (80%) physical activity group and least by the "rarely/never" (67%) group. CONCLUSIONS: Motivational interventions should focus on diminishing perceived barriers in the less physically active transplant recipients and enhancing perception of health-related facilitators. Nurses should be innovative in customizing interventions, recommending structured physical activity programs, and encouraging less structured, enjoyable ways to increase activities that expend energy. Interventions with achievable outcomes and realistic expectations are more acceptable to patients.

Inactive nurses: a source for alleviating the nursing shortage?

OBJECTIVE: This study seeks to provide an understanding of why inactive registered nurses chose to become inactive and what they would require for them to return to nursing. BACKGROUND: In 2000, a shortage of 110,000 (6%) registered nurses existed in the United States. If the current trends continue, the shortage is projected to grow to 29% by 2020. One solution to the nursing shortage may be attracting nurses with inactive licenses back into employment. METHODS: This study used a quantitative, cross-sectional survey design. Data analysis included descriptive and inferential statistics. RESULTS: Inactive nurses (N = 428) younger than 60 years in 1 Southern state were surveyed. A major portion (27.6%) of these nurses left nursing because of a conflict between parenting duties and scheduling requirements (13.5%) at work and indicated that they would return to nursing if given the opportunity to work part-time, especially if shifts were flexible and shorter. CONCLUSION: Although the group of registered nurses younger than 60 years do not constitute a large percentage of nurses in this country, they are a potential source of alleviating, to some extent, the critical nursing shortage. Employers can encourage many of these nurses to return to work by providing more flexible work schedules, including part-time and shorter shifts, as well as decreased workloads.