Nursing Outlook最新文献

There is increased national attention to the impact nurses can and should have in advancing health equity. Nurses of color have made important contributions in nursing and other sectors to this end, but their efforts remain invisible. To amplify the contribution of Latino nurses in advancing health equity, we use oral histories and supplemental records to examine the career of Henrietta Villaescusa, RN, FAAN to illuminate her impact across government, health, and nursing sectors in advocating for the health of Latino communities. She was skilled in community activism, political savvy, and developing and leading intersectoral networks to address and identify Hispanic health issues and strategies to address them. Her career serves as an exemplar to the importance of including and supporting diverse nurses in leading health equity efforts.

Background

A need exists for a unified curriculum framework for nurse educators, recognizing racism as a central driver of health inequities.

Purpose

This paper provides nurse educators with a unifying curriculum framework that centers racism as a root cause of health inequity shaping SSDH.

Methods

A critical examination of the social and structural determinants of health (SSDH) and Yob’s (2018) Framework for a Curriculum in Social Change was conducted, to develop a curriculum framework tailored to the intersection of SSDH and social change within nursing education.

Discussion

The “Nursing Education Integrating Social Change for Health Equity (NISCHE)” framework was developed as a comprehensive curriculum framework for SSDH and social change specifically tailored for nursing education. Practical examples of curricular activities across various settings are offered, thus illustrating implementation and potential impact.

Conclusion

By centering racism in the curriculum framework and emphasizing its role in perpetuating health inequities, this paper advances a crucial agenda in nursing education.

Background

Labor trafficking of registered nurses (RNs) in the USA impedes justice by denying inalienable human rights and equal economic opportunities. Nursing shortages in developed countries, poverty, social upheaval, and government actions influence migration, as do other factors related to determinants of health. Migrant RNs are visa workers, displaced, refugees, immigrants, or asylum seekers. Labor traffickers target vulnerable migrant RNs seeking employment outside their home country. Unlike ethical recruiters, traffickers lure migrant RNs into indentured contracts in work environments that result in health-threatening conditions, long shifts, and exorbitant fines that threaten families with financial retribution.

Purpose

The purpose of the paper is to raise awareness.

Methods

Authors explain the background of influences and nuances in migrant RN labor trafficking.

Discussion

Identifying labor traffickers’ deceitful, coercive, fraudulent, and illegal methods, assist organizational approaches for establishing Total Worker Health, trauma-informed care, coordinated community response, and No Door Closed actions when wanting to mitigate or eradicate labor trafficking of migrant RNs.

Black, Hispanic, Indigenous, Native American, Asian, and Pacific Islander nurses have played a critical role in shaping professional nursing and health care. Despite their contributions, the narrative of nursing's origin has predominantly revolved around the legacy of a single white British nurse, Florence Nightingale. This paper presents the development of the Nurses You Should Know (NYSK) project, which sought to decolonize the narrative surrounding nursing's history and highlight the contributions and experiences of past and present-day nurses of color.

The NYSK project utilized an Equity-Centered Community Design process, incorporating microlearning strategies, storytelling, and history to develop a digital library of over 100 stories of nurses of color that capture nursing’s rich and complex history. Utilized as a resource within nursing curricula, the NYSK project stands as a testament to the power of history in promoting a more inclusive and equitable future for nursing, offering valuable insights for educators, researchers, and practitioners.

Background

The rate of preterm birth (PTB) is high in the United States and Black infants remain disproportionately affected, with the disparity between Black and White infant deaths greater today than it was under antebellum slavery.

Purpose

The National Institute on Minority Health and Disparities Research Framework reflects a unique set of determinants relevant to the understanding and promotion of minority health.

Methods

We have applied this framework to better understand the effects of PTB on Black parents and the distribution of the social determinants of health, including structural determinants and root causes of inequities.

Discussion

This adaptation shows the intersection in maternal and infant health that shapes individuals’ experiences, drives disparities and impacts perinatal outcomes in critical periods over the lifecourse.

Conclusion

In our efforts to achieve health equity, it is imperative that we study the underlying mechanisms and recognize that policies, institutional structures, and social factors are drivers of racism.

Background

A conceptual, methodological, and theoretical framework is needed in Nursing Education to center racism, in the curriculum, as a root cause of health inequity.

Purpose

To provide Nursing and health professions’ educators with a comprehensive unifying framework to fundamentally conceptualize and deliver a curriculum which positions racism’s impact as a root cause of health inequities.

Methods

Critical race theory is the underpinning for a historical analysis of racism and a critique of scientific racism, whiteness, and white supremacy ideologies that perpetuate harmful and lethal outcomes for racialized individuals and communities.

Results

This framework conceptualizes learning, unlearning, relearning, and reflective practice as the fundamental process needed to transformative nursing education and advance health equity.

Discussion

Methodological application is given for 1) unlearning harmful white supremacy ideology 2) learning that racism as it is embedded in every sector of American life and racial inequities are inherent in the health care system 3) relearning the importance of counternarratives and building structural competency and 4) engaging in reflective practice to challenge deficit paradigms assigned to racialized people and their communities.

Conclusion

The Antiracism Framework provides foundational principles, guiding steps, and rationale for curricula that acknowledges the critical role of racism as a barrier to achieving health equity.

Xylazine-associated wounds are a distinct, novel clinical entity characterized by co-occurrence with substance use, progressive necrosis of skin, muscle, tendon, and bone, and slow healing. In Philadelphia, the specter of limb loss, stigma, and shame has hung over hospital-based care for xylazine-associated wounds among people who use drugs (PWUD) and kept many people away from engaging in care. Continued engagement in harm reduction wound care nursing, however, offers an opportunity for PWUD to address their wounds and their fears with members of the medical world. In the absence of established best practices, harm reduction’s model of risk-reductive care offers a way forward for patients and practitioners alike. Here, “harm reduction” describes an ethic of practical, trauma-informed, patient-centered care. It is this integration of harm reduction into medicine and public health that effectively promotes the safety, survival, and recovery of PWUD across all spectrums of drug use habits and housing stability.

Background

In January 2021, the Commonwealth of Massachusetts granted nurse practitioners (NPs) full practice authority (FPA). Little is known about how care delivery changed after FPA legislation.

Purpose

To understand the NP perception of early implementation of FPA in Massachusetts.

Methods

Qualitative descriptive design using inductive thematic analysis of open-ended responses to a web-based survey of NPs in Massachusetts from October to December 2021.

Findings

Survey response rate was 50.3% (N = 144). Inductive thematic analysis of open-ended responses identified four themes, including: (a) internal and external barriers obstructed FPA implementation, (b) employer communication about scope-of-practice changes was minimal, (c) NPs led initiatives to implement FPA, and (d) some efforts effectively implemented FPA.

Discussion

Almost 1 year after FPA was passed, external policies persisted that financially incentivized employers to not change NP scope-of-practice. Concerted efforts are needed to ensure that federal and payer policies, such as incident-to billing, are aligned with state law to encourage the implementation of FPA.

Nursing is renowned for its high ethical standards and is considered one of the most trusted professions globally, yet it has deep historical ties to Eurocentric and white supremacist ideologies. These entrenched ideologies in nursing raise significant concerns regarding equity, diversity, and inclusion within the profession as they shape nursing education, research, and practice. Western nursing institutions are deeply engrained in a system designed to center and uphold whiteness, which frequently serves to safeguard dominant groups in power while detrimentally affecting faculty from underrepresented backgrounds. Consequently, faculty members from underrepresented groups depart academia due to systemic racism and inadequate institutional accountability and support. To decenter whiteness in nursing, we have shared our experiences to underscore how systems of oppression marginalize underrepresented faculty in nursing academia.

Background

The Robert Wood Johnson Foundation Future of Nursing Scholars program supported nurses to complete PhDs in 3 years. Support mechanisms included mentoring by the program office and school faculty, and leadership development activities.

Purpose

To describe scholars’ perspectives of mentoring received by faculty during the accelerated timeline.

Methods

Of 201 scholars, 157 (78%) completed exit surveys, providing qualitative data on their experiences working with faculty mentors.

Discussion

Scholars highlighted strong mentorship (i.e., accessibility, emotional support) as the most important facilitator to program completion. Mentor challenges were identified as the second-most mentioned barrier to success, while the first was the accelerated timeline.

Conclusion

The scholars’ most-reported mentor-provided facilitators to success were availability and emotional support. Among scholars who noted barriers to their success caused by their mentor relationship, the most-reported issue was lack of access to their mentors.