Preparing BSN students for a new workplace: Experiences in a COVID-19 designated unit as an RN extender.

Academic nursing programs were impacted by the onset of the pandemic with the challenges of social distancing, detecting, and controlling the spread of the virus. Many traditionally campus-based, face-to-face programs transitioned quickly to include virtual activities for classes, laboratories, and clinical experiences for students. Initially direct patient care clinical activities came to a halt due to concerns for student safety and overwhelming numbers of COVID-19 cases stressing health system resources. However, as COVID-19 cases began to rise and hospitals struggled with staffing shortages, it became necessary to explore how nursing students could contribute to relieving the staffing burden while obtaining critical education as RN Extenders. Students that participated in the RN Extender program were seniors entering the nursing workforce within the next two months. Significant student screening and preparation was provided to support students serving as RN Extenders in COVID-19 units. The prior working relationships and personal contact between academic and practice leaders, a sense of equal participation, clear and realistic expectations of the benefits and responsibilities of each group were crucial. Building ongoing and frequent opportunities for formal and informal communication among all stakeholders was vital and the major contributor to the success of this program.

The Effect of Educational Intervention on Nurses' Attitudes and Beliefs about Depression in Heart Failure Patients.

Systematic depression screening is feasible, efficient, and well accepted; however the lack of consistent assessment in heart failure inpatients suggests barriers preventing its effective diagnosis and treatment. This pilot study assessed the impact of an educational intervention on nurses' beliefs about depression and their likelihood of routinely screening heart failure patients. Registered nurses (n = 35) from adult medical-surgical units were surveyed before and after an educational intervention to assess their beliefs about depression prevalence and screening in heart failure patients. There was no significant influence on nurses' beliefs about depression, but the results suggested an increased likelihood that nurses would routinely screen for depression. The moderately significant correlation between beliefs and intent to screen for depression indicates that educational intervention could ultimately have a positive influence on patient outcomes through early detection and treatment of depression in patients with cardiovascular disease; however the observed increase in the intent to screen without a corresponding change in beliefs indicates other influences affecting nurses' intent to screen heart failure patients for depression.

Factors affecting nurses' intent to assess for depression in heart failure patients.

The association between depression and cardiovascular disease has been well established and has been shown to decrease patients' quality of life and increase the risk of mortality, frequency and duration of hospitalization, and health care costs. The inpatient setting provides a potentially valuable opportunity to assess and treat depression among patients with acute cardiac illness, allowing for daily monitoring of treatment side effects. Although systematic depression screening appears to be feasible, efficient, and well accepted on inpatient cardiac units, the current lack of consistent inpatient assessment for depression in heart failure patients suggests the presence of barriers influencing the effective diagnosis and treatment of depression among inpatients with heart failure. The theory of planned behavior describes the cognitive mechanism by which behavioral intent is formed, giving some insight into how nurses' attitudes and beliefs affect their performance of routine depression screening. In addition, application of this cognitive theory suggests that nurses may be influenced to adopt more positive attitudes and beliefs about depression through educational intervention, leading to greater likelihood of routine assessment for depression, ultimately leading to more timely diagnosis and treatment and improved patient outcomes.

The effects of depression in heart failure.

Depression is commonly seen in patients with heart failure. Studies have shown an increase in hospitalizations and healthcare costs. Patients with depression are twice as likely to die prematurely. However, the diagnosis and treatment of depression in heart failure are difficult because of the similarity of symptoms. Early detection of depression in these patients will increase their quality of life and overall survival.

Postpartum mothers' disclosure of abuse, role, and conflict.

Experts evaluating evidence of the occurrence and effects of abuse before, during, and after pregnancy have called for research on the context within which violence occurs. This study elicited postpartum mothers' perceptions of roles and conflict in their abusive intimate relationships. Thirty newly delivered African-, Anglo-, and Hispanic-American abused mothers consented to be interviewed. While ethnicity, cultural norms, and economic issues framed their descriptions, more than half (57%) described their relationships as not abusive even though they reported experiencing behaviors defined as abuse on standardized abuse screening instruments. Several women found ways to take care of themselves within the abusive relationship. The concerns that these diverse abused postpartum mothers expressed can serve as a foundation for the development of culturally sensitive interventions.

Relationships among self-care agency, self-efficacy, self-care, and glycemic control.

Costly complications of diabetes often arise from poor glycemic control. Appropriate diabetes self-care management may improve control. This study examined whether self-care management affects glycemic control and mediates relationships between self-efficacy and self-care agency with glycemic control. In a cross-sectional correlational design, data from a prior study of 141 insulin-requiring adults with type 1 or type 2 diabetes were examined using descriptive statistics, Pearson's correlation, and multiple hierarchical regression. Findings indicated that greater self-care agency and self-efficacy lead to greater self-care management, in turn leading to better glycemic control. Self-care management did not mediate between self-efficacy or self-care agency and glycemic control. Thus, beliefs or capabilities for self-care are insufficient to improve glycemic control; doing so requires self-care management.