A simulation based difficult conversations intervention for neonatal intensive care unit nurse practitioners: A randomized controlled trial.

BACKGROUND: Neonatal nurse practitioners are often the front line providers in discussing unexpected news with parents. This study seeks to evaluate whether a simulation based Difficult Conversations Workshop for neonatal nurse practitioners leads to improved skills in conducting difficult conversations. METHODS: We performed a randomized controlled study of a simulation based Difficult Conversations Workshop for neonatal nurse practitioners (n = 13) in a regional level IV neonatal intensive care unit to test the hypothesis that this intervention would improve communication skills. A simulated test conversation was performed after the workshop by the intervention group and before the workshop by the control group. Two independent blinded content experts scored each conversation using a quantitative communication skills performance checklist and by assigning an empathy score. Standard statistical analysis was performed. RESULTS: Randomization occurred as follows: n = 5 to the intervention group, n = 7 to the control group. All participants were analyzed in each group. Participation in the simulation based Difficult Conversations Workshop increases participants' empathy score (p = 0.015) and the use of communication skills (p = 0.013) in a simulated clinical encounter. CONCLUSIONS: Our study demonstrates that a lecture and simulation based Difficult Conversations Workshop for neonatal nurse practitioners improves objective communication skills and empathy in conducting difficult conversations.

The "Voice" and Perspectives of Adolescents Participating in a Short-Term Psychotherapy Group.

Group psychotherapy is an ideal choice for adolescents who engage in mental health treatment. It is considered a "natural" fit, as adolescents are focused on their peer group. This research study presents the effectiveness of an adolescent psychotherapy group with an interpersonal approach, using their "voices" and perspectives. A qualitative descriptive design was selected. Semi-structured, open-ended interviews were conducted with eight adolescents who attended a process-oriented psychotherapy group for a period of three months. The data were analyzed using manifest content analysis. All eight participants described their experiences and the meaning of their experiences. A number of therapeutic factors emerged from the data consistent with Yalom's theoretical framework. The participants also described a number of benefits and identified several recommendations for group therapists.

An educational program to promote competency in pediatric psychiatric mental health nursing.

Hospital "boarding" of pediatric psychiatric patients awaiting inpatient placement is a growing problem. To address this need, a dedicated inpatient pediatric medical-psychiatric unit was opened at an urban university-affiliated pediatric hospital. An educational program for pediatric medical-surgical nurses who were expected to staff the pediatric medical-psychiatric unit was developed and implemented prior to the opening of the new unit. The rationale for the establishment of the new inpatient unit, educational program development, goals and objectives for the education, implementation, and evaluation of the program are described. Challenges, lessons learned, limitations, resource allocation, and staff attitudes are discussed. Implications for the future of this and similar hospitals are considered.