Systematic Review: Bridging the Gap in RPN-to-RN Transitions.

PURPOSE: To review the evidence examining the influences of successful education and professional role transition for registered practical nurses (RPNs) pursuing a baccalaureate degree in nursing (BScN) and registered nurse (RN) licensure through RPN-to-RN bridging programs. DESIGN: Systematic review of papers published between 1995 and 2014 that evaluated students' education and professional role transitions from RPN to RN. METHODS: Thirty-nine papers were selected that observed or studied the change or transition in designation from RPN to RN, or its equivalent, through bridging programs and analyzed thematically according to Meleis, Sawyer, Im, Hilfinger Messias, and Schumacher's transition model. FINDINGS: Personal, community, and social conditions related to preparation for entry, program enrolment, and postgraduate clinical integration influence successful education and professional role transitions for RPN-to-RN bridging students. CONCLUSIONS: Providing key transition supports may enhance the potential for successful student transition into and throughout a bridging program, but further research is necessary to enhance this understanding and to recommend best practices for optimizing students' success. CLINICAL RELEVANCE: The evidence from this review identifies facilitators and barriers to successful education and professional role transition for RPN-to-RN bridging students, and identifies important considerations for future research.

Knowing self and caring through service learning.

Professional caring is the essence of nursing practice. Reflection on personal assumptions and beliefs challenge stereotypic views that influence professional caring and nursing care. An innovative educational pedagogy known as service learning creates an opportunity for students to reflect on self in the context of service to others; it is through this pedagogy that personal assumptions and beliefs are challenged as students become registered nurses. A qualitative descriptive study engaged undergraduate first and second year nursing students through interviews and reflections. The purposes of this study were to describe students' perception of self and caring in service learning, any changes in the perceptions of self over time, and the connection of self to others. Results identified three major themes: understanding self, becoming a nurse and learning to care with increasing depth over the two years. Implications for nursing curriculum and further research are discussed.

Primary angioplasty in acute myocardial infarction at hospitals with no surgery on-site (the PAMI-No SOS study) versus transfer to surgical centers for primary angioplasty.

OBJECTIVES: To investigate primary angioplasty (PA) for high-risk acute myocardial infarction (AMI) at hospitals with no cardiac surgery on-site (No SOS), we hypothesized that a nonrandomized registry of such patients treated with PA would show clinical outcomes similar to those of a group randomized to transfer for PA, and that reperfusion would occur faster. BACKGROUND: Primary angioplasty provides outcomes superior to fibrinolytic therapy in AMI, but its use in community hospitals with No SOS has been limited. METHODS: Fibrinolytic-eligible patients with high-risk AMI prospectively consented if they had one or more high-risk characteristic. Nineteen hospitals with No SOS prospectively enrolled 500 patients for PA on-site. Seventy-one similar Air Primary Angioplasty in Myocardial Infarction trial patients were randomized to transfer for PA. RESULTS: Primary angioplasty was performed in 88% of patients. Patients transferred for PA had a longer mean time to treatment (187 vs. 120 min; p < 0.0001). Thrombolysis In Myocardial Infarction (TIMI) flow grade 3 was achieved in 96% for on-site PA, 86% in the transfer group (p = 0.004). The combined primary end point of 30-day mortality, re-infarction, and disabling stroke occurred in 27 (5%) on-site PA patients and 6 (8.5%) transfer patients (p = 0.27). Unadjusted one-year mortality was improved in on-site PA patients compared with those transferred (6% vs. 13%, p = 0.043), but after adjustment for differences in baseline variables, this difference was not significant. CONCLUSIONS: On-site PA and transfer groups had similar 30-day outcomes and more rapid reperfusion for on-site PA. Primary angioplasty in high-risk AMI patients at hospitals with No SOS is safe, effective, and faster than PA after transfer to a surgical facility.

Group size regulates self-assertive versus self-deprecating responses to interpersonal competition.

The current study examined the hypothesis that group size can influence whether children display self-assertive versus self-deprecating responses to interpersonal competition, especially under stress. Twenty same-sex play-groups (N = 120) of 9- to 10-year-old children played a competitive game in groups and in dyads. Stress was induced by causing some of the children to lose the game and watch as their opponents received psychological and material rewards. Results demonstrated that both the dynamics of the game and individual reactions to stress varied consistently as a function of the social context. Individuals displayed more assertive behaviors in groups than in dyads. In contrast, individuals exhibited more self-deprecating behaviors in dyads than in groups. Given that under naturalistic conditions males are more likely than are females to interact in groups and females are more likely than are males to interact in dyads, group size provides one possible mechanism for the development of sex differences in self-assertive versus self-deprecating behaviors.