Safety concerns of hospital-based new-to-practice registered nurses and their preceptors.

BACKGROUND: On graduation, nursing students enter a critical transition process to become professional registered nurses (RNs). METHODS: Six new-to-practice RN groups and seven preceptor groups convened to explore their views of the safety concerns of new-to-practice RNs. RESULTS: The main learning needs of new-to-practice RNs identified by both preceptors and new-to-practice RNs centered on perceptions of uncertainty about technical aspects of nursing care. Lack of critical thinking and inability to think holistically contributed to increased stress. Preceptors who provided frequent feedback in a positive manner were rated as important to the developmental process of becoming a skilled RN. CONCLUSION: Safety and learning needs identified in this study are amenable to teaching solutions, both in academia and in the hospital work setting.

Early clinical assessment for harsh child discipline strategies.

PURPOSE: To examine the relationships among four maternal variables: 1) prenatal report of discipline expectant mothers received when they were children, 2) prenatal intentions for disciplining one's own child, 3) report of intended child discipline strategies when infant is 8 months old, and 4) observed maternal role sufficiency behaviors. DESIGN: Replication and extension study; 3-wave prospective longitudinal design. METHODS: The procedure consisted of prenatal clinic interviews in which women (N = 185) reported how their mothers handled specific child behaviors and how they intended to handle the same behaviors with their children. During a home visit when their babies were 8 months old, the mothers (n = 126) were again asked how they intended to handle these behaviors, and observations were made of maternal role sufficiency behaviors. Correlation and regression analyses were performed with data generated from an adaptation of the Ways of Handling Irritating Behavior scale, the NCAST Teaching Scale, and the HOME scale. RESULTS: A significant relationship was found between mothers' prenatal reports of discipline received as a child and prenatal reports of intentions for disciplining their own children. For mothers of infants, reported intentions for future child discipline strategies were predicted by their prenatal reports. Mothers with clinically at-risk scores on the NCAST Teaching Scale and HOME scale reported more intended harsh child discipline strategies than those not at-risk. CLINICAL IMPLICATIONS: Assessment for harsh, nonnurturing child discipline strategies during prenatal and well-baby health maintenance checks may assist in uncovering "red flags" for early intervention to reduce the risk of later child abuse and neglect.