Journal of Nursing Regulation最新文献

Background:

Early career nurses face higher levels of burnout and stress than other nurses, and burnout and stress among this group was amplified by the COVID-19 pandemic. The sustainability of the U.S. nursing workforce is dependent upon understanding whether these issues are causing young nurses to leave the workforce at increased rates.

Purpose:

To identify the personal and professional characteristics that distinguish early career registered nurses (RNs) and to examine factors that may contribute to early career nurses reporting an intent to leave the profession in the next 5 years.

Methods:

The National Council of State Boards of Nursing’s 2022 National Nursing Workforce Survey data were used for analysis. Binary logistic regression analysis was used to assess the significance of observed trends, and inductive thematic analysis was used to develop an understanding of free response data.

Results:

The sample in this study represents 1,011,972 RNs younger than 35 years (24% of the RN workforce). Younger nurses were overrepresented in hospital settings as well as among travel and staff nurses. Although nontravel nurses younger than 35 years were less likely to indicate they plan to leave nursing in the next 5 years (14.5%) compared to older nurses (31.8%), young travel nurses reported a high rate that was comparable to older travel nurses’ high rate (35.4% vs. 36.2%). Young nurses were more likely to attribute their burnout and stress to staffing issues rather than the COVID-19 pandemic.

Conclusion:

Nurses younger than 35 years disproportionately reported high levels of stress and burnout during the COVID-19 pandemic. However, a majority identified long-standing issues as the source of their stress and burnout rather than the transient aspects of the pandemic that may fade with time. Travel nurses seem particularly unlikely to return to staff nursing, which would likely result in lower wages and less control over their working conditions. To retain young nurses and reintegrate some of the young nurses who have already left the workforce, nursing leaders will need to be intentional about retention efforts and recruitment strategies.

Background

The healthcare industry is experiencing a rise in substance use disorder (SUD) as healthcare professionals who have access to controlled substances are at increased risk of developing SUD. However, individuals with SUD do not typically self-report, leaving authorities and state licensing boards to depend on whistleblowers to report suspected SUD or drug diversion, placing considerable psychosocial stress on those reporting.

Purpose

The present study examined existing literature on whistleblowing, drug diversion, and substance use disorder (SUD) among healthcare professionals. The present study’s primary aim was to identify unexplored areas related to whistleblowing, especially the psychosocial effects experienced by whistleblowers.

Methods

The authors performed a scoping review to investigate existing literature regarding whistleblowing, drug diversion, and SUD among healthcare professionals

Results

Forty-seven articles met inclusion criteria and were chosen for comprehensive data extraction. A gap in the literature regarding the psychosocial impact on the whistleblower reporting SUD was identified. Based on the articles reviewed, healthcare professionals do not always report colleagues for suspected SUD, despite this being a professional obligation. Fear of retribution is the most commonly cited barrier to whistleblowing. This is not surprising considering that whistleblowing laws in the United States vary and have led to legal charges against nurse whistleblowers.

Conclusion

The present review highlights numerous unaddressed areas in the current literature related to whistleblowing in healthcare. Creating a safety-centric and whistleblowing ethos within healthcare settings is essential to improved handling of whistleblower allegations and to alleviate associated psychosocial burdens.

The COVID-19 pandemic brought virtual care to the forefront of healthcare delivery. Virtual care can provide many benefits and in fact supports the proposed quadruple aim of (a) optimizing the patient’s experience with care, (b) promoting population health, (c) reducing per capita healthcare costs, and (d) improving healthcare worker experience. However, establishing interjurisdictional regulations in virtual care is key to expanding healthcare access. In 2021, the College of Registered Nurses of Alberta (CRNA) collaborated with the College of Registered Nurses of Saskatchewan (CRNS, formerly the Saskatchewan Registered Nurses Association) to develop a memorandum of agreement (MOA) to facilitate and expedite the registration of registered nurses and nurse practitioners for the provision of virtual care across provincial borders. The MOA addressed key regulatory requirements (including registration, licensing, continuing competence, professional liability insurance, complaints and discipline, and information sharing) for the provision of interjurisdictional virtual care services. This pilot program enabled both regulators to adopt a common regulatory framework while ensuring that quality of care, accountability, and protection of the public were not compromised. In late 2021, the CRNA and the CRNS also engaged the Registered Nurses Association of the Northwest Territories and Nunavut to join, which they did in 2022. This enabled a streamlined approach to virtual care between Alberta, Saskatchewan, the Northwest Territories, and Nunavut. The present article discusses the CRNA’s approach to meeting the healthcare system’s ongoing challenges and needs related to virtual care, as highlighted by a pandemic-era MOA across four Canadian jurisdictions to facilitate access to care while maintaining public protection.

Background

The 2022 National Nursing Workforce study projected a worsening nursing shortage in the wake of the COVID-19 pandemic. An International Council of Nurses report also identified the shortage of nurses as a global health emergency. In response, policymakers and researchers are now exploring interstate licensure compacts as a long-term policy option to mitigate healthcare workforce crises and improve access to care through increased workforce mobility.

Purpose

To assess and quantify the interest and possible concerns of advanced practice registered nurses (APRNs) regarding the APRN Compact licensure model.

Methods

This study is an aggregate report of findings from state-based online surveys conducted by the National Council of State Boards of Nursing from 2021 to 2023. APRN responses from Arizona, Maryland, Montana, West Virginia, and Wyoming are included. The survey instrument contained 12 questions, which included respondents’ demographics (e.g., license type, APRN practice experience) and opinions about adopting the APRN Compact.

Results

A total of 8,453 APRNs completed the survey for an overall response rate of 26%. At the time of the survey, 46% of respondents held an active APRN license in at least one state other than the state in which they were surveyed. Eighty-six percent of respondents supported the APRN Compact, 4% opposed it, and the remaining 10% did not specify an opinion. Of the 7,409 respondents who expressed their support or opposition, 96% reported a favorable opinion of the APRN Compact. Increased patient access to high-quality healthcare was the most frequently cited reason for supporting the APRN Compact, whereas the 2,080 hours of experience requirement was the most frequently cited concern. The high support rate for the APRN Compact was consistent across practice patterns, provider roles, experience, and state of residency. Eighty-four percent of respondents indicated that they would apply for an APRN Compact license if it becomes available.

Conclusion

The majority of responding APRNs would welcome the APRN Compact, would apply for the multistate license, and reasoned that the Compact would increase patient access to high-quality care.