Nursing Administration Quarterly最新文献

The nursing shortage that is upon us is the result of a confluence of factors, some simple and some complex. Legacy solutions are not working. Recovery from the current situation involves examining and reshaping the nursing work environment. Creative and innovative solutions are being developed and tested. The call for addressing the work environment is surfacing in the literature, yet methods for doing so in an orderly, progressive manner have been elusive. To solve complex problems, structure helps lead to clear thinking. This work presents a conceptual framework for nurse retention derived from concept analysis of initiatives with empirical outcomes for intent to stay, intent to leave, turnover, and retention. It layers in 2 simple theorists and presents an intuitive, understandable model to guide strategic planning and decision making. The Framework has been used for several applications, one of which is a unit-based action planning method that is systematic, cyclic, and uses data relevant to specific unit culture. Improvements occurred in retention and engagement metrics, work effectiveness scores, and cost. Nurse managers extol the process's simplicity and ease of use, and the role the Framework plays in shaping the way they think about nurse retention.

Poor well-being and burnout among the nursing workforce were heightened by the COVID-19 pandemic. The purpose of this study was to deliver, spread, and sustain an evidence-based wellness program, Workforce Engagement for Compassionate Advocacy, Resilience, and Empowerment (WE CARE), for nurse leaders, staff registered nurses (RNs), and patient care technicians (PCTs) to ameliorate or prevent burnout, promote resilience, and improve the work environment. The program included Community Resiliency Model (CRM) training provided by a certified 6-member wellness team. A baseline and 6-month follow-up survey included measures of well-being, moral distress, burnout, resilience, perceived organizational support (POS), job satisfaction, intent to leave (ITL), and work environment. A total of 4900 inpatient RNs, PCTs, and leaders of a 1207-bed academic medical center in the southeastern United States were analyzed. From baseline (n = 1533) to 6-month follow-up (n = 1457), well-being, moral distress, burnout, job satisfaction, and work environment improved; however, resilience, POS, and ITL did not. Although we have seen some improvements in well-being and mental health indicators, it is still early in the intervention period to have reached a critical mass with the training and other interventions. The mental health and work environment issues among nurses are so complex, no one-size-fits-all intervention can resolve.

The pandemic exposed existing weaknesses in the health care system, and innovative leaders stepped up to address the compounding effects the novel anomaly created. Postpandemic disruption persists, and the behaviors and actions of these positive deviants demonstrate that new ways of leadership are available to those who are willing to embrace the dynamic leadership model and teaming methodology to shape health care delivery of the future. As we look to new ways of being and leading, we begin from a changed world-one that has been reset and cannot go back. Dynamic leaders are called upon to create cultures that reflect the needs of the future workplace and workforce. They pave new pathways and new ways of thinking, reimagine new realities, and create abundance. Their consistent practice of 5 essential behaviors-self-awareness, deep listening, curiosity, empathy, and decisiveness-strengthen their leadership and ability to meet the demands of health care today.

When nurses care for dying patients, their compassion fatigue may increase and lead to burnout and feelings of professional bereavement. However, if a nurse perceives that the patient had a "good death," it may have a positive impact on them and reduce their emotional distress. The purpose of this project is to reduce nurses' feelings of professional bereavement by implementing a Bereavement Care Team (BCT) in the intensive care unit (ICU). This study is a pre-post quasi-experimental design. The Chen and Chow bereavement subscales Factor 1 and Factor 2 measured elements of a nurse's professional bereavement, and 5 items were statistically significant. Nurses felt a reduction in their exhaustion, frustration, and feeling fatigue in their job, reduced feelings about being nervous and worried about potential professional/patient conflicts, and nurses were moved by the patient's family's understanding of the patient's death. Implementing a BCT in the ICU provided an environment that created a "good death" for the patient and their loved ones. These findings supported the need for the BCT as they demonstrated an improvement in the ICU nurses' feelings of professional bereavement.

The recent COVID-19 pandemic exacerbated pre-existing stressful conditions in health care, further elevating the risk of negative health outcomes for nurses and particularly nurse leaders. The aim of this pilot project was to assess the efficacy of mindfulness practices in attenuating nurse leaders' perceived stress levels. There is a lack of evidence regarding the outcomes of stress reduction programs aimed at health care staff, especially for nurse leaders within the clinical setting. Mindfulness has been shown to have a significant positive effect on attenuating stress in a wide variety of populations. This study used a prospective longitudinal design with a volunteer nurse leader group comparing self-reported perceived stress levels before and after a brief mindfulness intervention. Results indicated a significant reduction in perceived stress among volunteer nurse leader participants postintervention. Further investigation is needed in a variety of settings to more fully understand and evaluate the potential impact of introducing mindfulness practices to support nurse leaders in hospital or clinical settings.

Nurses' demands and challenges can sometimes lead to burnout, compassion fatigue, and a lack of focus on self-care. Implementing innovative strategies, such as role-play, may be instrumental in nurturing and rejuvenating the health care workforce. Role-play simulations offer a promising method to support essential skills and practices for health care workers. Using health care simulation is a widely accepted method to enhance critical thinking and decision-making among health care professionals. The International Nursing Association for Clinical Simulation and Learning (INACSL) Standards Committee in 2021 released the Healthcare Simulation Standards of Best Practice (HSSOBP), providing a structured framework to build and implement quality simulation-based education. These standards guide simulation scenarios' development, implementation, and evaluation, ensuring they align with educational objectives and promote experiential learning. This article describes role-play and how to develop and implement role-play scenarios built upon the HSSOBP.

This column is an interview of Michael Bleich PhD, RN, FAAN and focuses on the current state of DNP education. As a thought leader in nursing education, Michael shares his views on the state of DNP nursing education and the opportunity it provides to transform health care through nursing.