Nursing leadership (Toronto, Ont.)最新文献

Homecare nurses provide essential healthcare services at home. Changes in the nature of homecare nursing practice, however, suggest that older and frail homecare clients are less likely to have timely access to needed homecare nursing services as acute management takes priority. This has an impact on people's ability to be cared for and to die at home, a reported priority for many Canadians. This study highlights how health system changes may be constraining homecare nurses' abilities to enact care that is consistent with palliative care principles and philosophies, and calls for consideration of how shifts in homecare nursing practice have implications for families and clients receiving palliative care at home.

Existing engagement and retention strategies fall short in comprehensively addressing the ongoing nursing workforce crisis and need to be supplemented with proactive, relationship-building approaches such as stay interviews. Stay interviews are structured discussions that leaders conduct with staff members to learn the specific actions that must be taken to strengthen their engagement with the organization. Nurse leaders play a critical role in responding to the current workforce challenges, and stay interviews can support them in developing interventions to promote engagement and retention. This paper discusses core features and advantages of stay interviews and outlines how nurse leaders can implement stay interviews.

Founded in 1945, the United Nations (UN) system has become the place where countries come together to discuss complex and multifaceted issues that no one country can tackle alone. Civil society continues to be an integral part of the UN system, supporting the work of various entities and providing expertise on core pillars such as development, human rights and peace and security. Some global nursing leaders have made considerable progress in increasing nursing engagement and visibility across the system; however, representation remains small. Despite a strong appetite to be involved in global public policy, there is also a need to increase awareness and knowledge of how to engage with and navigate key global organizations. Numerous opportunities exist for civil society to participate in, learn from and influence the work of the UN. This article provides Canadian nursing leaders with examples of pathways to explore to become formally affiliated with entities within the UN system.

Decades of commissioned reports have pointed to solutions for nurturing nursing practice environments as essential to sustaining a nursing workforce. Beyond salary compensation and other solutions, we discuss the critical need for collaborative leadership in practice and education as a priority policy agenda aimed at confronting the shortage of nurses. The COVID-19 pandemic has intensified the nursing shortage and shortage of capacity in practice education, and we explore some learning in this context. Our paper draws on two initiatives in the province of British Columbia: the development of a transformative practice education model and an expanded Collaborative Learning Unit initiative. We propose building the following learning cultures: formal collaborative governance processes, intentional supports for graduate transitions and implementation of advanced nursing practice leadership and educator roles across the system. While transformative solutions are a tough sell in crisis-oriented contexts, this paper is a call for nurse leaders in all sectors to advance deep policy solutions with lasting impact on sustainable nursing human resources.

This issue is the last of the three-part series focused on the critically important challenge of nurse retention. The articles that we have selected span a range of topics from the personal to political with implications for readers in leadership positions across nursing practice, policy and education. What we are learning is that retention is as multi-faceted and dynamic as the times we are living in. There is no one-size-fits-all solution, no Holy Grail - if we could only find it - that will turn the tide of exodus from the profession. Retention is fundamentally about valuing nurses and demonstrating that worth in concrete tangible ways that are meaningful to nurses as a group and as individuals. It is a tall order that can only be achieved with leadership that embraces the unprecedented challenges we are living through as windows of opportunity to lean into and make transformative changes that will engage nurses and benefit local and global health.

Aim: We aimed to differentiate the practice patterns of nurses in specialized and advanced roles in a cross-sectional study.

Method: Canadian nurses completed a self-report questionnaire (June 2017-September 2017). Demographic data and time spent in five domains of advanced practice were compared across three nurse groups. Regression analysis examined factors associated with domain involvement.

Results: Respondents (n = 1,107) represented all provinces/territories, including 396 specialized nurses (SNs), 211 clinical nurse specialists (CNSs) and 490 nurse practitioners (NPs). Nurses across all groups were the most involved in direct comprehensive care and the least involved in research. NPs were more involved in direct comprehensive care compared to CNSs (p < 0.001) and SNs (p < 0.001). CNSs were more involved than SNs and NPs in support of systems, education, research and professional leadership (p < 0.001). Role type, years as an advanced practice nurse and specialist certification were modest predictors of domain involvement.

Conclusion: Distinguishing how specialized and advanced nursing roles contribute to healthcare can inform policies to support their optimal utilization in healthcare systems.

The purpose of this paper is to describe a nursing informatics engagement strategy at an academic teaching hospital in Canada aimed at sustaining and retaining the nursing workforce by (1) enhancing nursing engagement and leadership in informatics decision making; (2) improving nurses' experiences using the electronic health record (EHR) by creating a process of rapid handling of technology issues; (3) leveraging data about nurses' EHR system use to identify opportunities to further streamline documentation; and (4) enhancing and optimizing informatics education/training and communication strategies. The nursing informatics strategy aims to improve engagement among nursing staff, as well as decrease the burden of using the EHR as a way of addressing possible causes of burnout.

The Black Nurses Leadership Institute launched in May 2022 to provide a community-driven and leadership training program for nurses and nursing students who identify as Black and/or of African descent (Black Nurses Leadership Institute 2022). The aim of the program is to acknowledge and address the presence of a "black ceiling" that can often challenge and impede professional advancement for Black nurses in traditionally white-dominated healthcare leadership systems (Erskine et al. 2021; McGirt 2017). This collaborative experience creates a sense of belonging and offers a welcome space for learning among like-minded individuals with shared experiences.

Inadequate staffing, excessive workloads, endemic violence and unhealthy workplaces are some of the challenges facing Canadian nurses. Leaving these issues unaddressed has had pernicious impacts on the nursing workforce: thousands of nurses across Canada have been suffering from extreme stress, anxiety and burnout, leading many of them to leave their current jobs and, for some, the profession of nursing altogether. We conducted a comprehensive yet rapid review of evidence-based solutions from the peer-reviewed and policy literature, stakeholder dialogues and member surveys commissioned by the Canadian Federation of Nurses Unions that could be implemented and scaled across Canada. Our findings support coordinated series of collectively planned, carefully sequenced and evidence-based interventions to retain, return, integrate and recruit nurses targeted to support the nursing workforce from training to early-, mid- and late-career stages. The implementation of these reactive solution bundles will also enhance the quality of healthcare services and, more broadly, the healthcare system.

Rural and remote Indigenous communities face unique challenges, and they must drive solutions for sustaining and maintaining distinct nursing practices. Resourcing Indigenous community needs and aspirations for health depends on sustainable funding and an appropriately resourced nursing workforce. An Indigenous community-engaged research team led a program of study exploring Indigenous systems of care with three distinct communities. We used Indigenous research methodologies to identify obstacles to care and ways to advance nursing and healthcare delivery according to unique values and demographical and geographical influences. Using a collaborative analysis approach with communities, we identified themes related to resourcing nursing positions, supporting nursing education and valuing nursing influence in determining program priorities. The voice of the community in research is a powerful force for advocacy, ensuring that nurses are supported in relationships with communities and in designing programs that fit the community's vision for health and wellness. We recognize the essential contributions of nurse leaders to policy processes in formulating and coordinating ideas for program redesign across and within levels of organizations for health and social justice impacts. We conclude our paper by noting implications for nursing leadership in diverse settings with the goal of sustaining a nursing workforce to provide culturally safe, wellness-focused care.