Intrinsic Factors and Psychological Safety Among Nursing Students During Simulation-Based Learning-A Correlational Design.

INTRODUCTION: Well-designed simulation-based learning (SBL) experiences enhance students' self-confidence, self-efficacy, clinical judgment, and psychomotor skill development. An emerging concept in SBL research is psychological safety. There is currently no research on factors influencing psychological safety specifically related to the SBL environment, nor is there any literature found to determine whether intrinsic student characteristic, such as self-compassion and resilience, contributes to SBL learning outcomes. The aim of this study is to determine whether there is a relationship between nursing students' intrinsic characteristics (self-compassion, resilience, and anxiety sensitivity) and their psychological safety. METHODS: Bivariate correlation was used to examine associations among sociodemographic variables and outcome variables. Multiple regression was used to determine the predictive nature of the sociodemographic variables. Assumptions for variables in multiple regression models were tested (normal distribution, heteroscedasticity, multicollinearity). All data were analyzed in SPSS, Version 28. The P value of significance was set at 0.05 for all analyses. RESULTS: Most of the 118 participants were non-Hispanic (89%), White (65%), and females (95%). Results of the demographic bivariate analysis revealed no significant differences among this diverse group or semester in the curriculum for psychological safety. The multiple regression found self-compassion (ß = 29, P = 0.004), anxiety sensitivity (ß = -0.16, P = 0.049), and resilience (ß = 0.26, P = 0.004) predict psychological safety. CONCLUSIONS: The importance of creating a psychologically safe learning environment has been recognized as essential to best practices. Our findings suggest that an understanding of student characteristics that impact their perception of psychological safety will allow educators to develop strategies to better support learners in the simulation environment.

Nursing Faculty Job Satisfaction During COVID-19: A Mixed-Methods Study.

AIM: The aim of this study was to understand stress, resilience, and compassion satisfaction of nursing faculty during the COVID-19 pandemic and identify factors related to their job satisfaction. BACKGROUND: The impacts of COVID-19 on faculty stress, resilience, compassion satisfaction, and job satisfaction were unknown. METHOD: A mixed-methods survey was distributed electronically to nursing faculty in the United States. RESULTS: Compassion satisfaction and resilience were positively correlated with job satisfaction; stress and job satisfaction were negatively correlated. Feeling safe to teach, feeling supported by administration, and spending more hours teaching online were positively associated with job satisfaction. Three themes were identified: challenges in the workplace, struggles with personal stressors, and building capacity in the face of the unknown. CONCLUSION: Faculty reported a strong professional commitment to nursing education during the COVID-19 pandemic. Leadership that supported faculty through concern for their safety contributed to participants' ability to respond to the challenges experienced.

Exploring the experiences of nursing faculty during the coronavirus (COVID-19) pandemic-A qualitative descriptive study.

Aim: To gain an understanding of the experiences of nurse educators during the COVID-19 crisis. Background: The pandemic forced the closure of colleges and universities nationwide. Nurse educators were challenged to offer didactic and experiential learning in online formats. Design: Qualitative description. Method: A purposive sample of 27 nurse educators employed in Maryland participated in semi-structured interviews from February to April 2021. Content analysis was performed by two researchers independently and results compared for thematic analysis. Results: Three themes were identified: (1) uncertainty within pandemic ambiguity, (2) prioritizing pedagogy, and (3) professional commitment. Conclusion: Faculty need increased pedagogical support for online teaching. Online pedagogies must include ways to support student emotional well-being and development of clinical judgment. A profession-wide reflection of how nursing education can meet the evolving needs of the health care system, especially when access to clinical sites is limited, is warranted.

Coming of Age During Coronavirus: New Nurses' Perceptions of Transitioning to Practice During a Pandemic.

BACKGROUND: The global COVID-19 pandemic has created unprecedented challenges to the health care workforce. Little is known about the effect of the pandemic on new RNs and their preparedness for such a crisis. This study explored the lived experiences of RNs transitioning from students to professionals during the pandemic. METHOD: Semistructured interviews were conducted with 15 new RNs working in acute care facilities during the Maryland COVID-19 State of Emergency. RESULTS: Three themes were identified to describe the experiences of new nurses transitioning to practice in the midst of the COVID-19 pandemic: uncertainty, vulnerability, and resilience. CONCLUSION: New nurses need greater support during transition to practice. Initiatives to improve trusting relationships between new nurses and their organizations and support of the development of essential relationships (e.g., peers, frontline management, and educators) could enhance new nurses' resilience and commitment to stay with the organization. [J Contin Educ Nurs. 2021;52(6):294-300.].

Nurses' perceptions of high-alert medication administration safety: A qualitative descriptive study.

AIMS: The aim of this study was to determine nurses' perceptions of supports and barriers to high-alert medication (HAM) administration safety. DESIGN: A qualitative descriptive design was used. METHODS: Eighteen acute care nurses were interviewed about HAM administration practices. Registered nurses (RNs) working with acutely ill adults in two hospitals participated in one-on-one interviews from July-September, 2017. Content analysis was conducted for data analysis. RESULTS: Three themes contributed to HAM administration safety: Organizational Culture of Safety, Collaboration, and RN Competence and Engagement. Error factors included distractions, workload and acuity. Work arounds bypassing bar code scanning and independent double check procedures were common. Findings highlighted the importance of intra- and interprofessional collaboration, nurse engagement and incorporating the patient in HAM safety. CONCLUSIONS: Current HAM safety strategies are not consistently used. An organizational culture that supports collaboration, education on safe HAM practices, pragmatic HAM policies and enhanced technology are recommended to prevent HAM errors. IMPACT: Hospitals incorporating these findings could reduce HAM errors. Research on nurse engagement, intra- and interprofessional collaboration and inclusion of patients in HAM safety strategies is needed.

The beta-agonist isoproterenol attenuates EGF-stimulated wound closure in human airway epithelial cells.

Asthma is a disease characterized by reversible airway obstruction. An additional hallmark of chronic asthma is altered wound healing that leads to airway remodeling. Although beta-agonists are effective in treating the bronchospasm associated with asthma, their effects on airway wound healing, which are related to airway remodeling, are unknown. It has been demonstrated that beta-agonists can alter the signaling of epidermal growth factor (EGF) receptors, which are important in timely wound healing. Therefore, we hypothesized that the beta-agonist isoproterenol would affect wound healing. Using an in vitro scrape wound assay, we demonstrated that isoproterenol attenuates EGF-stimulated wound healing in 16HBE airway epithelial cell cultures. Through experiments with forskolin and cells overexpressing beta2-adrenergic receptor-yellow fluorescent protein, we show that attenuation is due to the accumulation of cAMP and the involvement of at least one additional pathway. Furthermore, attenuation is not due to a direct effect on the EGF receptor or to an alteration of the ERK/MAPK signaling cascade. Based on these results, we propose that isoproterenol may exert its effects through other MAPK signaling pathways (JNK and/or p38) or through parallel mechanisms. These results also demonstrate a problem of potential therapeutic relevance in which a commonly prescribed medication may alter wound healing and contribute to the remodeling of asthmatic airways.

Coordinating epidermal growth factor-induced motility promotes efficient wound closure.

Wound healing is a response to injury that is initiated to reconstruct damaged tissue. In skin, reepithelialization involves both epithelial cells and fibroblasts and contributes to the reformation of a barrier between the external environment and internal milieu. Growth factors including epidermal growth factor (EGF) play important roles in promoting this process. In the present studies we employed CV-1 fibroblasts in a tissue culture model of reepithelialization to develop strategies for optimizing wound closure stimulated by EGF. We found that EGF enhanced cell motility within 6-8 h of EGF treatment in serum-free medium but wounds failed to close within 24 h. However, if medium on these cultures was exchanged for medium containing serum, cells pretreated with EGF closed new scrape wounds more rapidly than did cells that were not pretreated. These results indicate that serum factors work in concert with EGF to coordinate cell motility for efficient wound closure. Indeed, EGF enhanced the rate of wound closure in the presence of serum, and this effect also persisted for at least 24 h after EGF was removed. This coordination of EGF-induced cell motility was accompanied by an increase in the transient phosphorylation of ERK1 and ERK2. The persistent effects of EGF were blocked by transient exposure to reversible inhibitors of transcription and translation, indicating that the expression of new proteins mediated this response. We propose that EGF-stimulated CV-1 fibroblast motility is coordinated by a serum component that induces cell-cell adhesive properties consistent with an epithelial phenotype, thereby enhancing the reepithelialization process.