Pub Date : 2024-07-01DOI: 10.1016/S2155-8256(24)00052-8
Khadejah F. Mahmoud PhD, MSN (Lecturer), Deborah S. Finnell PhD, RN, CARN-AP, FAAN (Professor Emerita), Susan M. Sereika PhD (Professor), Dawn Lindsay PhD, Ann M. Mitchell PhD, RN, AHN-BC, FIAAN, FAAN (Professor)
Background
Alcohol and opioid use have significant impacts economically and socially at the global and national levels and are associated with increased morbidity and mortality. In 2021, 94% of individuals with substance use disorders reported not receiving any specialty treatment. Thus, building the nursing workforce to care for this population is important.
Purpose
To compare the demographics, personal attitudes, professional attitudes, and motivation among three nursing specialty groups (medical-surgical, psychiatric–mental health, and addiction) relative to providing care to persons with alcohol and opioid use problems.
Methods
A nationwide online survey was used for this cross-sectional, correlational study. Nurses were recruited from four professional national nursing organizations representative of the three nursing specialty groups. The survey included questions about nurses’ demographics, personal attitudes, professional attitudes, and motivation relative to providing alcohol- and opioid-related care.
Results
The study revealed that among the 460 included respondents, nurses’ demographics differed significantly between the three nursing specialty groups in terms of age, years of experience in nursing, primary workplace, and highest degree obtained in nursing. In addition, there were significant differences among the three nursing specialty groups regarding familiarity, perceived dangerousness, social distance, personal responsibility beliefs, and disease model. All professional attitudes and motivation associated with alcohol- and opioid-related care also differed significantly among the three groups.
Conclusion
The study findings emphasize the need to prepare all nurses with the needed knowledge and skills to manage substance use–related problems within their workplace.
{"title":"Comparing Medical-Surgical, Psychiatric–Mental Health, and Addiction Specialty Nurses’ Personal Attitudes, Professional Attitudes, and Motivation Toward Working With Individuals With Alcohol and Opioid Use Problems: Implications for the Nursing Workforce Using a Nationwide Sample","authors":"Khadejah F. Mahmoud PhD, MSN (Lecturer), Deborah S. Finnell PhD, RN, CARN-AP, FAAN (Professor Emerita), Susan M. Sereika PhD (Professor), Dawn Lindsay PhD, Ann M. Mitchell PhD, RN, AHN-BC, FIAAN, FAAN (Professor)","doi":"10.1016/S2155-8256(24)00052-8","DOIUrl":"https://doi.org/10.1016/S2155-8256(24)00052-8","url":null,"abstract":"<div><h3>Background</h3><p>Alcohol and opioid use have significant impacts economically and socially at the global and national levels and are associated with increased morbidity and mortality. In 2021, 94% of individuals with substance use disorders reported not receiving any specialty treatment. Thus, building the nursing workforce to care for this population is important.</p></div><div><h3>Purpose</h3><p>To compare the demographics, personal attitudes, professional attitudes, and motivation among three nursing specialty groups (medical-surgical, psychiatric–mental health, and addiction) relative to providing care to persons with alcohol and opioid use problems.</p></div><div><h3>Methods</h3><p>A nationwide online survey was used for this cross-sectional, correlational study. Nurses were recruited from four professional national nursing organizations representative of the three nursing specialty groups. The survey included questions about nurses’ demographics, personal attitudes, professional attitudes, and motivation relative to providing alcohol- and opioid-related care.</p></div><div><h3>Results</h3><p>The study revealed that among the 460 included respondents, nurses’ demographics differed significantly between the three nursing specialty groups in terms of age, years of experience in nursing, primary workplace, and highest degree obtained in nursing. In addition, there were significant differences among the three nursing specialty groups regarding familiarity, perceived dangerousness, social distance, personal responsibility beliefs, and disease model. All professional attitudes and motivation associated with alcohol- and opioid-related care also differed significantly among the three groups.</p></div><div><h3>Conclusion</h3><p>The study findings emphasize the need to prepare all nurses with the needed knowledge and skills to manage substance use–related problems within their workplace.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"15 2","pages":"Pages 17-27"},"PeriodicalIF":4.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1016/S2155-8256(24)00054-1
Elizabeth H. Zhong PhD (Senior Research Scientist), Brendan Martin PhD (Director), Charlie O’Hara PhD (Data Scientist), Michaela Reid BA, BS (Research Assistant), Nicole Kaminski-Ozturk PhD (Senior Data Scientist), Michelle Buck MS, APRN, CNS (Senior Policy Advisor), Nicole Livanos JD, MPP (Director), Maryann Alexander PhD, FAAN (Chief Officer)
Background
The Nurse Licensure Compact (NLC), developed by the National Council of State Boards of Nursing (NCSBN), is designed to promote nurse mobility, increase access to care, and enhance public protection through uniform licensure requirements. The value of the NLC has been made evident during healthcare crises, especially during the recent COVID-19 pandemic. However, the NLC has not yet been adopted nationwide in the United States.
Purpose
To gather empirical data on nurses’ views, concerns, and work experience related to the NLC.
Methods
This study is an aggregate summary of state-based online surveys conducted by NCSBN in partnership with the boards of nursing in Kansas, Alaska, Nevada, Vermont, and Minnesota from 2018 to 2022. All study participants were licensed nurses with a valid email account registered with one of the aforementioned boards of nursing. To determine whether nurses’ out-of-state practice patterns may have changed over time, data were compared to the findings from 2,612 nurses who participated in the 2014 NCSBN’s National NLC Evaluation Survey from the same five states.
Results
A total of 66,054 nurses responded to the survey for an overall response rate of 24%. At the time of the survey, 45% of respondents had provided nursing services outside of their licensure state during the previous 2 years, illustrating a 10% increase compared to the 35% of the respondents who reported out-of-state services in the 2014 survey. Among the respondents who practiced under their multistate license, 96% indicated that the NLC was beneficial to their nursing practice. Of the respondents who expressed their support or opposition, 95% indicated support for the NLC. These high rates of support for the NLC were consistent across study states, as well as across most demographics, including respondents’ state of residency, practice patterns, and union membership.
Conclusions
There is an increasing need for a flexible and mobile nursing workforce to practice across state borders. The multistate license benefits crossborder nursing practice and a majority of the respondents support and welcome the adoption of the NLC.
{"title":"Highlights of the Nurse Licensure Compact Survey Findings: Nurses’ Needs, Experiences, and Views","authors":"Elizabeth H. Zhong PhD (Senior Research Scientist), Brendan Martin PhD (Director), Charlie O’Hara PhD (Data Scientist), Michaela Reid BA, BS (Research Assistant), Nicole Kaminski-Ozturk PhD (Senior Data Scientist), Michelle Buck MS, APRN, CNS (Senior Policy Advisor), Nicole Livanos JD, MPP (Director), Maryann Alexander PhD, FAAN (Chief Officer)","doi":"10.1016/S2155-8256(24)00054-1","DOIUrl":"https://doi.org/10.1016/S2155-8256(24)00054-1","url":null,"abstract":"<div><h3>Background</h3><p>The Nurse Licensure Compact (NLC), developed by the National Council of State Boards of Nursing (NCSBN), is designed to promote nurse mobility, increase access to care, and enhance public protection through uniform licensure requirements. The value of the NLC has been made evident during healthcare crises, especially during the recent COVID-19 pandemic. However, the NLC has not yet been adopted nationwide in the United States.</p></div><div><h3>Purpose</h3><p>To gather empirical data on nurses’ views, concerns, and work experience related to the NLC.</p></div><div><h3>Methods</h3><p>This study is an aggregate summary of state-based online surveys conducted by NCSBN in partnership with the boards of nursing in Kansas, Alaska, Nevada, Vermont, and Minnesota from 2018 to 2022. All study participants were licensed nurses with a valid email account registered with one of the aforementioned boards of nursing. To determine whether nurses’ out-of-state practice patterns may have changed over time, data were compared to the findings from 2,612 nurses who participated in the 2014 NCSBN’s National NLC Evaluation Survey from the same five states.</p></div><div><h3>Results</h3><p>A total of 66,054 nurses responded to the survey for an overall response rate of 24%. At the time of the survey, 45% of respondents had provided nursing services outside of their licensure state during the previous 2 years, illustrating a 10% increase compared to the 35% of the respondents who reported out-of-state services in the 2014 survey. Among the respondents who practiced under their multistate license, 96% indicated that the NLC was beneficial to their nursing practice. Of the respondents who expressed their support or opposition, 95% indicated support for the NLC. These high rates of support for the NLC were consistent across study states, as well as across most demographics, including respondents’ state of residency, practice patterns, and union membership.</p></div><div><h3>Conclusions</h3><p>There is an increasing need for a flexible and mobile nursing workforce to practice across state borders. The multistate license benefits crossborder nursing practice and a majority of the respondents support and welcome the adoption of the NLC.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"15 2","pages":"Pages 38-44"},"PeriodicalIF":4.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1016/S2155-8256(24)00055-3
Melissa A. Lynn PhD, RN, CMSRN, CHSE (assistant professor), Christa Cook PhD, RN, PHNA-BC (Associate Professor), Donna Felber Neff PhD, RN, FNAP (professor), Elizabeth V. Kinchen PhD, RN, AHN-BC (associate professor), Jonathan Beever PhD (associate professor)
Background
Nurses use social media for both professional and personal purposes, but even personal posts that can be misconstrued or violate patient privacy can lead to severe consequences for nurses. To help nurses in preventing such social media errors, it is essential to understand how nurses make ethical choices when posting on various social media platforms.
Purpose
The objective was to uncover nurses’ decision-making process in evaluating ethical choices when participating in social media through the identification of influencing situational factors, their consideration of professional boundaries, and their current understanding of professional expectations.
Methods
A qualitative grounded theory approach was utilized. The organizing theory was Schwartz’s Integrated Ethical Decision Making. Participants were recruited through Facebook, X (formerly Twitter), and LinkedIn. After completing a short survey to verify that participants met inclusion criteria, 21 participants were interviewed via video conferencing or telephone using a semi-structured interview technique. All participants reported that they were registered nurses currently practicing in an inpatient hospital setting in the United States.
Results
Nurses are multidimensional individuals with different personalities and motivations for participating in social media. Professional obligations, employer policies, and Health Insurance Portability and Accountability Act regulations trigger fear of repercussions or ramifications for content included in social media. Knowledge of social media expectations helps elicit a healthy balance between motivations for interacting with others via social media and fearing any negative outcomes. Experiencing outcomes, whether personal or observed, impacts how the nurse continues to make decisions about interacting on social media.
Conclusion
Nurses have different levels of understanding of what is acceptable and not acceptable, and this study emphasizes the need to educate nurses regarding professional guidelines, expectations, laws, and employer policies.
{"title":"Ethical Decision-Making Among Nurses Participating in Social Media: A Grounded Theory Study","authors":"Melissa A. Lynn PhD, RN, CMSRN, CHSE (assistant professor), Christa Cook PhD, RN, PHNA-BC (Associate Professor), Donna Felber Neff PhD, RN, FNAP (professor), Elizabeth V. Kinchen PhD, RN, AHN-BC (associate professor), Jonathan Beever PhD (associate professor)","doi":"10.1016/S2155-8256(24)00055-3","DOIUrl":"https://doi.org/10.1016/S2155-8256(24)00055-3","url":null,"abstract":"<div><h3>Background</h3><p>Nurses use social media for both professional and personal purposes, but even personal posts that can be misconstrued or violate patient privacy can lead to severe consequences for nurses. To help nurses in preventing such social media errors, it is essential to understand how nurses make ethical choices when posting on various social media platforms.</p></div><div><h3>Purpose</h3><p>The objective was to uncover nurses’ decision-making process in evaluating ethical choices when participating in social media through the identification of influencing situational factors, their consideration of professional boundaries, and their current understanding of professional expectations.</p></div><div><h3>Methods</h3><p>A qualitative grounded theory approach was utilized. The organizing theory was Schwartz’s Integrated Ethical Decision Making. Participants were recruited through Facebook, X (formerly Twitter), and LinkedIn. After completing a short survey to verify that participants met inclusion criteria, 21 participants were interviewed via video conferencing or telephone using a semi-structured interview technique. All participants reported that they were registered nurses currently practicing in an inpatient hospital setting in the United States.</p></div><div><h3>Results</h3><p>Nurses are multidimensional individuals with different personalities and motivations for participating in social media. Professional obligations, employer policies, and Health Insurance Portability and Accountability Act regulations trigger fear of repercussions or ramifications for content included in social media. Knowledge of social media expectations helps elicit a healthy balance between motivations for interacting with others via social media and fearing any negative outcomes. Experiencing outcomes, whether personal or observed, impacts how the nurse continues to make decisions about interacting on social media.</p></div><div><h3>Conclusion</h3><p>Nurses have different levels of understanding of what is acceptable and not acceptable, and this study emphasizes the need to educate nurses regarding professional guidelines, expectations, laws, and employer policies.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"15 2","pages":"Pages 45-56"},"PeriodicalIF":4.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1016/S2155-8256(24)00051-6
Jessica G. Rainbow PhD, RN, CNE, Melanie Arnold BSN, RN (PhD student), Sara Richter MS (Principal Statistician), Mengting Zhao MS (Associate Analyst), Kristina Medvescek MPH (Data Scientist), Shawn Gallagher PhD, PMHNP-BC, PMHCNS-BS, FNP-BC (Assistant Clinical Professor), Alicia M. Allen PhD, MPH (Associate Professor)
Background
As cannabis legalization continues to expand across the United States, there is a growing need to understand its use among nurses, particularly how cannabis use compares to other substance use and how the timing of its use relates to nurses’ patient care responsibilities. Purpose: To describe patterns of nurse cannabis and other substance use generally and timing of use in relation to patient care.
Methods
A nationwide cross-sectional survey was distributed to practicing registered nurses via social media and listservs. The survey questions concerned the use of cannabis and other substance use as well as the timing of cannabis use in relation to patient care. Data were weighted to reflect the nationwide nursing population. Descriptive statistical analyses of cannabis and other substance use and timing of use were completed.
Results
The study sample comprised a weighted total of 1,010 registered nurses. The majority of participants (77.0%; 95% CI: 73.4%, 79.1%) reported drinking alcohol, whereas cannabis use was reported by a quarter of participants (weighted 23.6%; 95% CI: 20.9%, 26.4%). Just over one-fifth of participants (21%; n = 211) reported using both alcohol and cannabis. The most common cannabis use pattern among those who reported cannabis use across 263 workdays was use after work only (81.37%). Alcohol was the most common substance used alongside cannabis after work.
Conclusion
Nurses are using cannabis and other substances, but they are generally using these substances after work and using them at rates similar to the rates of use among the general public. The many ways cannabis can be consumed—edibles, smoking, vaping, THC (tetrahydrocannabinol) extracts, and CBD (cannabidiol) products—means that more study into the kinds and concentrations of cannabinoids is required because the effects may differ greatly. Regulators, employers, and researchers can focus on understanding drivers of use and providing education for nurses about cannabis and alcohol use. This education may also be beneficial for providing patient care where cannabis is being used medicinally as well as recreationally.
{"title":"Uncovering Trends in U.S. Nurse Cannabis Use in Relation to Patient Care","authors":"Jessica G. Rainbow PhD, RN, CNE, Melanie Arnold BSN, RN (PhD student), Sara Richter MS (Principal Statistician), Mengting Zhao MS (Associate Analyst), Kristina Medvescek MPH (Data Scientist), Shawn Gallagher PhD, PMHNP-BC, PMHCNS-BS, FNP-BC (Assistant Clinical Professor), Alicia M. Allen PhD, MPH (Associate Professor)","doi":"10.1016/S2155-8256(24)00051-6","DOIUrl":"https://doi.org/10.1016/S2155-8256(24)00051-6","url":null,"abstract":"<div><h3>Background</h3><p>As cannabis legalization continues to expand across the United States, there is a growing need to understand its use among nurses, particularly how cannabis use compares to other substance use and how the timing of its use relates to nurses’ patient care responsibilities. <strong>Purpose:</strong> To describe patterns of nurse cannabis and other substance use generally and timing of use in relation to patient care.</p></div><div><h3>Methods</h3><p>A nationwide cross-sectional survey was distributed to practicing registered nurses via social media and listservs. The survey questions concerned the use of cannabis and other substance use as well as the timing of cannabis use in relation to patient care. Data were weighted to reflect the nationwide nursing population. Descriptive statistical analyses of cannabis and other substance use and timing of use were completed.</p></div><div><h3>Results</h3><p>The study sample comprised a weighted total of 1,010 registered nurses. The majority of participants (77.0%; 95% CI: 73.4%, 79.1%) reported drinking alcohol, whereas cannabis use was reported by a quarter of participants (weighted 23.6%; 95% CI: 20.9%, 26.4%). Just over one-fifth of participants (21%; <em>n</em> = 211) reported using both alcohol and cannabis. The most common cannabis use pattern among those who reported cannabis use across 263 workdays was use after work only (81.37%). Alcohol was the most common substance used alongside cannabis after work.</p></div><div><h3>Conclusion</h3><p>Nurses are using cannabis and other substances, but they are generally using these substances after work and using them at rates similar to the rates of use among the general public. The many ways cannabis can be consumed—edibles, smoking, vaping, THC (tetrahydrocannabinol) extracts, and CBD (cannabidiol) products—means that more study into the kinds and concentrations of cannabinoids is required because the effects may differ greatly. Regulators, employers, and researchers can focus on understanding drivers of use and providing education for nurses about cannabis and alcohol use. This education may also be beneficial for providing patient care where cannabis is being used medicinally as well as recreationally.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"15 2","pages":"Pages 5-16"},"PeriodicalIF":4.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1016/S2155-8256(24)00053-X
Cynthia Sherraden Bradley PhD, RN, CNE, CHSE, ANEF, Michelle Aebersold PhD, RN, CHSE, FSSH, FAAN, Linda DiClimente DNP, RN, BA, Carol Flaten DNP, RN, PHN, Marshall K. Muehlbauer BSN, RN, PHN, Ann Loomis PhD, RN, CNEcl
Background
Immersive virtual reality (IVR) is sparking significant interest among nursing educators as a new method of simulation in clinical education. IVR maximizes the power of presence, which stimulates senses, creating a feeling of being situated in the given virtual environment more than in the physical environment, providing more realistic learning experiences for students to practice clinical decision-making and clinical judgment skills.
Purpose
This multi-site descriptive study sought to develop and integrate five IVR scenarios (IVRSs) in a prelicensure senior-level baccalaureate course and to investigate students’ perceptions of cognitive workload, usability, and learning while using IVR.
Methods
Five IVRSs were developed and integrated, accompanied by a step-by-step guide for implementing IVRSs. Students were scheduled in five 2-hour sessions to independently complete each IVRS followed by a reflective debriefing led by a trained debriefer. The National Aeronautics and Space Administration Task Load Index, the System Usability Scale, and one open-response item were used to collect data.
Results
All senior-level students completed the five IVRSs as part of their regularly scheduled course, and 222 consented to inclusion of their deidentified data. Participants rated IVR as requiring a high level of cognitive workload and having below average usability, yet qualitative responses demonstrated a positive perception of learning using IVR.
Conclusion
IVR has promising potential for nursing education, contributing a simulation method that leverages technological advancements and cognitive principles. IVR simulation can be integrated into nursing courses following the Healthcare Simulation Standards of Best Practice to ensure that the quality required of clinical education is achieved. To fully realize the benefits IVR in nursing education and inform regulatory guidelines, further research and collaboration are essential.
{"title":"Breaking Boundaries: How Immersive Virtual Reality Is Reshaping Nursing Education","authors":"Cynthia Sherraden Bradley PhD, RN, CNE, CHSE, ANEF, Michelle Aebersold PhD, RN, CHSE, FSSH, FAAN, Linda DiClimente DNP, RN, BA, Carol Flaten DNP, RN, PHN, Marshall K. Muehlbauer BSN, RN, PHN, Ann Loomis PhD, RN, CNEcl","doi":"10.1016/S2155-8256(24)00053-X","DOIUrl":"https://doi.org/10.1016/S2155-8256(24)00053-X","url":null,"abstract":"<div><h3>Background</h3><p>Immersive virtual reality (IVR) is sparking significant interest among nursing educators as a new method of simulation in clinical education. IVR maximizes the power of presence, which stimulates senses, creating a feeling of being situated in the given virtual environment more than in the physical environment, providing more realistic learning experiences for students to practice clinical decision-making and clinical judgment skills.</p></div><div><h3>Purpose</h3><p>This multi-site descriptive study sought to develop and integrate five IVR scenarios (IVRSs) in a prelicensure senior-level baccalaureate course and to investigate students’ perceptions of cognitive workload, usability, and learning while using IVR.</p></div><div><h3>Methods</h3><p>Five IVRSs were developed and integrated, accompanied by a step-by-step guide for implementing IVRSs. Students were scheduled in five 2-hour sessions to independently complete each IVRS followed by a reflective debriefing led by a trained debriefer. The National Aeronautics and Space Administration Task Load Index, the System Usability Scale, and one open-response item were used to collect data.</p></div><div><h3>Results</h3><p>All senior-level students completed the five IVRSs as part of their regularly scheduled course, and 222 consented to inclusion of their deidentified data. Participants rated IVR as requiring a high level of cognitive workload and having below average usability, yet qualitative responses demonstrated a positive perception of learning using IVR.</p></div><div><h3>Conclusion</h3><p>IVR has promising potential for nursing education, contributing a simulation method that leverages technological advancements and cognitive principles. IVR simulation can be integrated into nursing courses following the Healthcare Simulation Standards of Best Practice to ensure that the quality required of clinical education is achieved. To fully realize the benefits IVR in nursing education and inform regulatory guidelines, further research and collaboration are essential.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"15 2","pages":"Pages 28-37"},"PeriodicalIF":4.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1016/S2155-8256(24)00032-2
Elizabeth H. Zhong PhD, Richard Smiley MA, MS, Charlie O’Hara PhD, Brendan Martin PhD
Background
Travel nurses play a pivotal role in filling acute staffing gaps, thereby adding resilience to the country’s healthcare service. Never has the value of travel nurses been clearer than it was during the COVID-19 pandemic. However, a comprehensive national assessment of travel nurses’ demographic and professional profiles has not yet been conducted, nor is there any detailed accounting of the specific challenges these nurses encountered.
Purpose
To gain a better understanding of the demographic and practice characteristics of travel nurses.
Methods
This is a cross-sectional descriptive analysis of 2,006 travel nurses (1,239 registered nurses [RNs] and 767 licensed practical nurses/licensed vocational nurses [simply referred to as licensed practical nurses, or LPNs, throughout the abstract]) who participated in the 2022 National Nursing Workforce Survey. Information on their demographic characteristics, practice experiences during the pandemic, and future practice plans was collected and evaluated. The comparison group was made up of 41,729 nontravel nurses (22,803 RNs and 18,926 LPNs) who participated in the same survey.
Results
Travel nurses tended to be younger, exhibit greater gender diversity, and report better pay than nontravel nurses. A significantly higher proportion of travel nurses held multistate licenses (64% versus 34% for RNs, and 55% versus 31% for LPNs). The odds of travel nurses using their multistate license in practice were about 5 times greater than they were for nontravel nurses (RNs: OR = 5.93; 95% CI: 5.02–7.00, p < .01; LPNs: OR = 5.09; 95% CI: 4.11–6.29, p < .01). Travel nurses reported higher work stress and burnout than nontravel nurses: 64% versus 47% of RNs and 53% versus 48% of LPNs reported being emotionally drained either a few times per week or every day. A significantly higher proportion of travel nurses younger than 60 years planned to leave nursing in the next 5 years compared to nontravel nurses (33% versus 17% for RNs, OR = 2.27, 95% CI: 2.00–2.59, p < .01, and 21% versus 17% for LPNs, OR = 1.28, 95% CI: 1.05–1.56, p < .05).
Conclusion
Despite comparatively higher pay and younger age, travel nurses experienced elevated work stress and were more likely than nontravel nurses to consider leaving their nursing career early. Healthcare regulators, travel nurse agencies, and nursing employers should be aware of the unique demographics and practice characteristics of travel nurses to develop more effective retention strategies to maintain a healthy and stable nursing workforce.
{"title":"Healthcare on the Go: A Comparative Analysis Profiling the Travel Nurse Workforce in the United States","authors":"Elizabeth H. Zhong PhD, Richard Smiley MA, MS, Charlie O’Hara PhD, Brendan Martin PhD","doi":"10.1016/S2155-8256(24)00032-2","DOIUrl":"https://doi.org/10.1016/S2155-8256(24)00032-2","url":null,"abstract":"<div><h3>Background</h3><p>Travel nurses play a pivotal role in filling acute staffing gaps, thereby adding resilience to the country’s healthcare service. Never has the value of travel nurses been clearer than it was during the COVID-19 pandemic. However, a comprehensive national assessment of travel nurses’ demographic and professional profiles has not yet been conducted, nor is there any detailed accounting of the specific challenges these nurses encountered.</p></div><div><h3>Purpose</h3><p>To gain a better understanding of the demographic and practice characteristics of travel nurses.</p></div><div><h3>Methods</h3><p>This is a cross-sectional descriptive analysis of 2,006 travel nurses (1,239 registered nurses [RNs] and 767 licensed practical nurses/licensed vocational nurses [simply referred to as licensed practical nurses, or LPNs, throughout the abstract]) who participated in the 2022 National Nursing Workforce Survey. Information on their demographic characteristics, practice experiences during the pandemic, and future practice plans was collected and evaluated. The comparison group was made up of 41,729 nontravel nurses (22,803 RNs and 18,926 LPNs) who participated in the same survey.</p></div><div><h3>Results</h3><p>Travel nurses tended to be younger, exhibit greater gender diversity, and report better pay than nontravel nurses. A significantly higher proportion of travel nurses held multistate licenses (64% versus 34% for RNs, and 55% versus 31% for LPNs). The odds of travel nurses using their multistate license in practice were about 5 times greater than they were for nontravel nurses (RNs: <em>OR</em> = 5.93; 95% CI: 5.02–7.00, <em>p</em> < .01; LPNs: <em>OR</em> = 5.09; 95% CI: 4.11–6.29, <em>p</em> < .01). Travel nurses reported higher work stress and burnout than nontravel nurses: 64% versus 47% of RNs and 53% versus 48% of LPNs reported being emotionally drained either a few times per week or every day. A significantly higher proportion of travel nurses younger than 60 years planned to leave nursing in the next 5 years compared to nontravel nurses (33% versus 17% for RNs, <em>OR</em> = 2.27, 95% CI: 2.00–2.59, <em>p</em> < .01, and 21% versus 17% for LPNs, <em>OR</em> = 1.28, 95% CI: 1.05–1.56, <em>p</em> < .05).</p></div><div><h3>Conclusion</h3><p>Despite comparatively higher pay and younger age, travel nurses experienced elevated work stress and were more likely than nontravel nurses to consider leaving their nursing career early. Healthcare regulators, travel nurse agencies, and nursing employers should be aware of the unique demographics and practice characteristics of travel nurses to develop more effective retention strategies to maintain a healthy and stable nursing workforce.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"15 1","pages":"Pages 88-97"},"PeriodicalIF":2.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140638580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1016/S2155-8256(24)00027-9
Nicole Kaminski-Ozturk PhD (Senior Data Scientist), Michaela Reid BS, BA (Research Assistant), Brendan Martin PhD (Director)
Background:
Licensed practical nurses/licensed vocational nurses, referred to as licensed practical nurses (LPNs) in the present article, provide foundational, direct patient care under the direction of registered nurses (RNs), advanced practice registered nurses (APRNs), and physicians. Overall, the LPN workforce is the most racially and ethnically diverse cohort of nurses in the United States, but their numbers are in decline as a result of slowing educational program growth, reduced program enrollment, and broader workforce turnover.
Purpose:
This descriptive cross-sectional study seeks to more closely examine the LPN workforce through the lens of race and ethnicity. In particular, this work seeks to understand the unique experiences of self-identified Black, Indigenous, and other People of Color (BIPOC) and Hispanic/Latino LPNs during the COVID-19 pandemic.
Methods:
Data from the 2022 National Nursing Workforce Survey were drawn upon for analysis. Descriptive statistics along with generalized logit statistical models were employed.
Results:
Proportionally, more BIPOC LPNs indicated they work in nursing homes or extended care facilities (36.5%, n = 90,219) relative to their White/Caucasian peers (27.3%, n = 126,223). BIPOC LPNs were more than two times more likely (OR = 2.34, 95% CI: 2.28–2.39, p < .001) to become travel nurses relative to White/Caucasian LPNs; similarly, Hispanic/Latino LPNs were more likely to become travel nurses relative to their non-Hispanic/ Latino peers, even after controlling for the highest nursing education credential earned, gender, and years of experience (adjusted OR = 1.23, 95% CI: 1.20–1.27, p < .001). Additionally, more BIPOC LPNs (12.1%, n = 34,286) changed their practice setting compared to White/Caucasian LPNs (10.9%, n = 58,498). Nearly half of all LPNs reported feeling burned out, and around a third indicated they were at the end of their rope.
Conclusion:
The LPN workforce is the most diverse cohort of nurses in the United States. However, as the discrepancy between the supply and demand of LPNs continues to grow, regulators and employers need to collaborate on ways to support and grow this diverse and critical workforce. The results of this analysis offer insights into the practice profiles of these historically marginalized LPNs and how their experiences during the COVID-19 pandemic may inform their intent to leave the profession in the years to come.
{"title":"The Licensed Practical/Vocational Nurse Workforce: Examining Nurses’ Practice Patterns, Workloads, and Burnout by Race and Ethnicity","authors":"Nicole Kaminski-Ozturk PhD (Senior Data Scientist), Michaela Reid BS, BA (Research Assistant), Brendan Martin PhD (Director)","doi":"10.1016/S2155-8256(24)00027-9","DOIUrl":"https://doi.org/10.1016/S2155-8256(24)00027-9","url":null,"abstract":"<div><h3>Background:</h3><p>Licensed practical nurses/licensed vocational nurses, referred to as licensed practical nurses (LPNs) in the present article, provide foundational, direct patient care under the direction of registered nurses (RNs), advanced practice registered nurses (APRNs), and physicians. Overall, the LPN workforce is the most racially and ethnically diverse cohort of nurses in the United States, but their numbers are in decline as a result of slowing educational program growth, reduced program enrollment, and broader workforce turnover.</p></div><div><h3>Purpose:</h3><p>This descriptive cross-sectional study seeks to more closely examine the LPN workforce through the lens of race and ethnicity. In particular, this work seeks to understand the unique experiences of self-identified Black, Indigenous, and other People of Color (BIPOC) and Hispanic/Latino LPNs during the COVID-19 pandemic.</p></div><div><h3>Methods:</h3><p>Data from the 2022 National Nursing Workforce Survey were drawn upon for analysis. Descriptive statistics along with generalized logit statistical models were employed.</p></div><div><h3>Results:</h3><p>Proportionally, more BIPOC LPNs indicated they work in nursing homes or extended care facilities (36.5%, <em>n</em> = 90,219) relative to their White/Caucasian peers (27.3%, <em>n</em> = 126,223). BIPOC LPNs were more than two times more likely (<em>OR</em> = 2.34, 95% CI: 2.28–2.39, <em>p</em> < .001) to become travel nurses relative to White/Caucasian LPNs; similarly, Hispanic/Latino LPNs were more likely to become travel nurses relative to their non-Hispanic/ Latino peers, even after controlling for the highest nursing education credential earned, gender, and years of experience (adjusted <em>OR</em> = 1.23, 95% CI: 1.20–1.27, <em>p</em> < .001). Additionally, more BIPOC LPNs (12.1%, <em>n</em> = 34,286) changed their practice setting compared to White/Caucasian LPNs (10.9%, <em>n</em> = 58,498). Nearly half of all LPNs reported feeling burned out, and around a third indicated they were at the end of their rope.</p></div><div><h3>Conclusion:</h3><p>The LPN workforce is the most diverse cohort of nurses in the United States. However, as the discrepancy between the supply and demand of LPNs continues to grow, regulators and employers need to collaborate on ways to support and grow this diverse and critical workforce. The results of this analysis offer insights into the practice profiles of these historically marginalized LPNs and how their experiences during the COVID-19 pandemic may inform their intent to leave the profession in the years to come.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"15 1","pages":"Pages 33-44"},"PeriodicalIF":2.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140638575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Many Western countries rely on internationally educated health professionals (IEHPs) to complement the domestically educated workforce and meet healthcare workforce needs. Traditionally, health regulators have focused on potential registrants’ required technical competencies rather than their cultural and workplace integration. As a result, the workplace integration experience of IEHPs has not been well studied, nor have systems evolved to enhance the workforce integration experience with the objective of optimizing delivery of patient care.
Objective
This study sought to examine and characterize the workforce integration of IEHPs into Canadian health systems with particular emphasis on implications for regulators.
Methods
We recruited IEHPs as well as representatives from regulatory bodies and health systems to participate in semistructured interviews over the telephone. Interviews were recorded, and transcripts were used for qualitative analysis, coding, and generation of themes related to IEHPs’ integration into the Canadian workforce.
Results
A total of 48 individuals, including 29 IEHPs and 19 representatives from health regulatory bodies and health systems, participated in this study. Six major themes were identified, highlighting various roadblocks to successful integration of IEHPs. Themes concerned roadblocks to integration, including IEHPs’ unmet complex personal integration needs, that mastery of domestic professional culture is essential, that social/contextual skills and communication (not just language) skills are crucial, and that patient-centeredness and interprofessionalism in Canada often are very different that those in IEHPs’ home countries.
Conclusion
Additional work is required to support IEHPs as they become a more prominent component of the healthcare workforce in many jurisdictions, including the United States, the United Kingdom, Australia, New Zealand, and Ireland.
{"title":"Enhancing Integration of Internationally Educated Health Professionals in the Healthcare Workforce: Implications for Regulators","authors":"Zubin Austin BSc, Phm (BScPhm), MBA, MISc, PhD, FCAHS, Paul A.M. Gregory BA, MLS","doi":"10.1016/S2155-8256(24)00026-7","DOIUrl":"https://doi.org/10.1016/S2155-8256(24)00026-7","url":null,"abstract":"<div><h3>Background</h3><p>Many Western countries rely on internationally educated health professionals (IEHPs) to complement the domestically educated workforce and meet healthcare workforce needs. Traditionally, health regulators have focused on potential registrants’ required technical competencies rather than their cultural and workplace integration. As a result, the workplace integration experience of IEHPs has not been well studied, nor have systems evolved to enhance the workforce integration experience with the objective of optimizing delivery of patient care.</p></div><div><h3>Objective</h3><p>This study sought to examine and characterize the workforce integration of IEHPs into Canadian health systems with particular emphasis on implications for regulators.</p></div><div><h3>Methods</h3><p>We recruited IEHPs as well as representatives from regulatory bodies and health systems to participate in semistructured interviews over the telephone. Interviews were recorded, and transcripts were used for qualitative analysis, coding, and generation of themes related to IEHPs’ integration into the Canadian workforce.</p></div><div><h3>Results</h3><p>A total of 48 individuals, including 29 IEHPs and 19 representatives from health regulatory bodies and health systems, participated in this study. Six major themes were identified, highlighting various roadblocks to successful integration of IEHPs. Themes concerned roadblocks to integration, including IEHPs’ unmet complex personal integration needs, that mastery of domestic professional culture is essential, that social/contextual skills and communication (not just language) skills are crucial, and that patient-centeredness and interprofessionalism in Canada often are very different that those in IEHPs’ home countries.</p></div><div><h3>Conclusion</h3><p>Additional work is required to support IEHPs as they become a more prominent component of the healthcare workforce in many jurisdictions, including the United States, the United Kingdom, Australia, New Zealand, and Ireland.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"15 1","pages":"Pages 24-32"},"PeriodicalIF":2.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140638574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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