Undergraduate nurse students' perspectives of spiritual care education in an Australian context

BackgroundThe Australian Nursing and Midwifery Accreditation Council competency standards highlight the need to provide holistic care that is inclusive of spiritual care. Literature shows that internationally many nurses feel unsure of how to provide spiritual care which has been attributed to a lack of spiritual care education during undergraduate nursing programs.AimThis study explores the impact of a spiritual care subject in an undergraduate nursing program in an Australian tertiary institution.MethodQualitative research design using in-depth semi-structured interviews.SettingA tertiary institution with a Christian orientation in Sydney, Australia.ParticipantsSix undergraduate nursing students who had completed the spiritual care subject.Data ResultsTwo themes emerged from the data: Seeing the person as a whole and Being with the person.ConclusionsThe spiritual care subject had a positive impact on the perceptions of undergraduate nursing students. In particular students perceived themselves more prepared to provide holistic care that was inclusive of spiritual care.     

Teaching nursing students about spiritual care – A review of the literature

AimThis paper examines that examines content, process and outcome of spirituality teaching programmes for nursing students.BackgroundIncreased secularisation in Europe and resulting ambivalent attitude towards spirituality and religion is contrasted with increased professional and public interest in this topic. Additionally there are concerns that patient's spiritual needs are not being met and nurses are often ill equipped to provide this care. Nurses while positively disposed towards spiritual care delivery, and often carrying out spiritual care in practice, do so with little preparation. While teaching spiritual care to nursing students is advocated there is little research on this topic.MethodA search was conducted using CINAHL database spanning the years 2007–2012 using the key words ‘spirituality’ and ‘education’.FindingsThree papers were identified that examined teaching approaches with nurses and nursing students. Due to methodological issues such as small sample sizes and limited testing generalising from these studies is difficult. Approaches used were firmly rooted in a religiosity framework.ConclusionFurther research is required, using rigorous approaches, examining the benefits of teaching approaches. Analysis of the need for spiritual education is also required. Issues that are of concern to educators are the definitions and understandings of spirituality, assessment and how, best to teach this topic.     

The effectiveness of spiritual intelligence educational interventions for nurses and nursing students: A systematic review and meta-analysis

AimTo synthesize the best available research evidence regarding the effectiveness of spiritual intelligence educational interventions on spiritual intelligence and professional outcomes in nurses and nursing students.BackgroundSpiritual intelligence is a form of intelligence with which individuals can deal with a crisis, alter situations, solve problems and achieve goals through a set of capacities and abilities. Possessing spiritual intelligence contributes to professional practice and competence in the workplace and has been seen to be beneficial for nurses and nursing students. Nursing interventions to teach and increase understanding of spiritual intelligence have been explored in the literature, but the effectiveness of spiritual intelligence training for nurses and nursing students remains uncertain.DesignA systematic review and meta-analysis.Data sourcesA three-step systematized search of sixteen electronic English and Persian databases was conducted to identify randomized and non-randomized trials published in English and Persian from January 2000 to November 2021.MethodsThe methodological quality of eligible studies was undertaken by two independent reviewers using the Medical Education Research Study Quality Instrument. Meta-analyses were undertaken where appropriate using STATA v16.ResultsSeven studies involving 512 participants were included. Pooled results demonstrated that those who received the educational intervention had significantly higher spiritual intelligence scores at 2 weeks (MD 13.38, 95 % CI: 5.76, 20.99) and one month follow up (MD 20.03, 95% CI: 6.61, 33.45) compared with those who did not. No difference in spiritual intelligence scores was observed among those who received spiritual intelligence education or life skills training (MD 7.52, 95 % CI −1.78, 16.82). Significantly higher communication skills (MD 5.41, 95 % CI: 2.16, 8.66), job satisfaction (MD; 11.30, 95 % CI: 8.63, 13.97) and spiritual care competence (MD; 28.55, 95 % CI: 26.08, 31.02) and decrease in overall stress (MD; 10.30, 95 % CI: 6.84, 13.76) among those who received the educational interventions were reported at the one-month follow-up. Significantly higher job satisfaction levels were also reported at 2-month follow-up among those who received the educational interventions (MD; 16, 95 % CI: 11.06, 20.94).ConclusionsThe evidence from this review demonstrates that spiritual intelligence educational interventions have a positive effect on spiritual intelligence and professional outcomes in nurses and nursing students. We noted that the outcomes in the studies included were mostly measured at one-month follow-up and with subjective measures. Longer trials with objective measures are required to provide higher levels of evidence. The results of this review are largely based on single trials and were limited in terms of the number of outcomes. Conducting further trials is warranted to identify the influence of such education on various professional outcomes in nursing practice.Tweetable AbstractSystematic review and meta-analysis shows spiritual intelligence educational interventions have a positive effect on nurses' and nursing students’ spiritual intelligence, work-related stress and professional practice.     

Spiritual development of nursing students: developing competence to provide spiritual care to patients at the end of life

Nurses spend more time with their patients than do other health care workers. Therefore, the spiritual needs of patients must be recognized as a domain of nursing care. Holism cannot exist without consideration of the spiritual aspects that create individuality and give meaning to people's lives. The purpose of this article is to provide nursing faculty with tools that may be used to develop spiritually knowledgeable nursing students who can overcome barriers to providing spiritual care to end-of-life patients. Our students were required to complete care maps to ensure they are prepared for patient care at the end of life. In this article, we present tools that faculty and students may use to complete the spiritual concept in care mapping. The literature on spirituality is reviewed, use of care mapping in nursing curricula is described, and our teaching approach to develop nursing students who are skilled at providing spiritual care is explained. Three case studies and care maps created by former students are also presented to demonstrate examples of spiritual competence.     

Investigating the self-perceived educational priorities among oncology nurses

AimTo understand the self-perceived educational priorities among oncology nurses.BackgroundOncology nurses are the main providers of care to people affected by cancer. However, little is known about the educational needs and priorities of oncology nurses when providing care to people living with cancer.DesignA national online survey.SettingThe Cancer Nurses Society of Australia (CNSA) is an Australian wide professional body for cancer nurses. At the time of conducting the research, there were approximately 1300 members. All members were invited to participate in the survey. CNSA provided access to nurses working in all areas of cancer care, including inpatient wards, outpatient centres, ambulatory day oncology units, radiation oncology, bone marrow transplant units, educational, and research units.ParticipantsRegistered nurses involved in direct care of people affected by cancer who were members of CNSA, and ability to communicate in English.MethodsThe instrument consisted of a 15-item online questionnaire which included demographic and professional questions related to the self-perceived oncology educational needs which were free-text. This survey was hosted using an online electronic data capture system (i.e., SurveyMonkey®), and the electronic link was sent to the CNSA who then sent an email invitation to the 1300 members.Results610 educational needs were identified and ranked. These individual answers were grouped into seven overarching categories with various sub-categories within each group. The oncology nurses identified important educational topics which included: a) cancer biology, b) treatments, c) direct patient care, d) age-specific cancer care, e) leadership and research, and f) law and ethics.ConclusionAs the number of people affected by cancer continue to rise, addressing the educational needs and priorities of oncology nurses has never been so important. Higher educational institutions and healthcare institutions should consider these findings in addressing the learning needs for the current oncology nursing workforce.     

Spiritual needs during COVID 19 pandemic in the perceptions of Spanish emergency critical care health professionals

ObjectivesTo investigate the perceptions and attitudes of health professionals working in emergency services and critical care units in Spain about spiritual care provided during the COVID-19 pandemic.MethodsA qualitative investigation was carried out using in-depth interviews.SettingEmergency and emergency and ICU health professionals from different regions of Spain.FindingsThe sample consisted of 47 nursing and one nursing assistant. The qualitative analysis yielded four main themes that reflect the following categories: “the experience with spirituality in clinical practice”; “resources and barriers to provide spiritual care”; “the COVID pandemic and spiritual care” and “training in spiritual care”. In addition, two subdeliveries were also obtained: “ethical dilemma” and “rituals of death”.ConclusionsThe majority of emergency and critical care nurses believe spiritual care is important to their clinical practice, but there are still several barriers to address patients’ spiritual needs. During the COVID-19 pandemic in Spain, professionals felt that spiritual beliefs have emerged as important needs of patients and the restrictions imposed by the pandemic made health professionals more exposed to ethical dilemmas and end-of-life religious issues. The general impression of health professionals is that more training and resources are needed on this topic.Implications for clinical practiceHealth professionals in emergency intensive care must provide nursing care that meets the spiritual needs of their patients to improve care in crisis situations such as the one suffered by the COVID-19 pandemic. For this, emergency services professionals must work and participate in the development of measures to overcome certain barriers present in emergency services, such as lack of time, lack of training and misconceptions that make it difficult to approach emergency services these needs.     

Nursing students with special educational needs in Japan

AimTo reveal the prevalence of nursing students with special educational needs in Japan.MethodA mail survey of 833 nursing programs was conducted. Nurse educators were asked to report on their program's profiles and the number of extremely difficult students who belonged to the March 2011 class of graduates. They were also asked to fill a modified questionnaire developed by the Ministry of Education, Culture, Sports, Science and Technology about each extremely difficult student.ResultsAmong the 14,325 students enrolled the class of 2011, 146 students (1.02%) were identified as having one or more special educational needs for “listening,” “speaking,” “reading,” “writing,” “math,” “reasoning,” “inattentiveness,” “hyperactivity/impulsivity,” or “social interaction/restricted interests.” The most prevalent need was “social interaction/restricted interests,” followed by “listening” and “inattentiveness.” These students had the most difficulty participating in “nursing care for patients during clinical practicum.”ConclusionThe proportion of nursing students with special educational needs is small but may have a large impact on the clinical practicum. Evaluation and support systems at multiple levels, including entrance examinations, course placement, and special educational programs, are warranted.     

Family nursing telesimulation: Teaching therapeutic communication in an authentic way

BackgroundA nurse's skill in establishing therapeutic communication is central to family nursing. Using a family-centered approach, nurses can facilitate relationship building with members of a family unit. Through authentic learning activities such as simulation, students can practice the competencies required to provide effective family nursing care.DesignOne hundred and one nursing students participated in a two-part family nursing telesimulation. Students were sent an online evaluation about their simulation experience immediately afterwards.ResultsFifty-six percent (n = 57) of the 101 students completed the online evaluation. Students overwhelmingly appreciated the opportunity to apply theory in a real-world manner, engaging in family nursing in an authentic way.ConclusionThe telesimulation strongly supported students’ ability to practice their clinical decision-making skills and respond to changing family needs. Telesimulation is a promising teaching strategy that allowed students to practice their therapeutic communication in the context of family nursing.     

Nursing informatics in undergraduate nursing education in Australia before COVID-19: A scoping review

BackgroundTechnology can support transformational outcomes of high quality and evidenced-based care and education. Embedding nursing informatics into the undergraduate nursing curriculum enhances nursing students’ digital health literacy, whilst preparing them to use health information systems and technological innovations to support their learning both at university and in the clinical environment.AimThis scoping review aimed to provide an overview of the published literature on how nursing informatics was embedded and integrated into the undergraduate nursing curriculum in Australia before coronavirus disease (COVID-19).MethodologyA scoping review approach guided this study using the Levac, Colquhoun, and O'Brien framework, and the following databases were searched: CINAHL Plus, EMCARE, MEDLINE Ovid, Scopus, ERIC ProQuest, and Web of Science. A total of 26 articles were included: Five quantitative studies, eight qualitative studies and 13 mixed-methods studies.FindingsFew studies focused on the concept of nursing informatics itself, and only two studies described the process of developing curricula that contain nursing informatics competencies and their implementation: the educational scaffolding and modular development approach and a Community of Inquiry Framework (COI). Most studies centred on nursing informatics tools to facilitate teaching and learning in classrooms and skills laboratories. The reported pedagogical strategies were online learning, blended learning, and technology-enabled simulations. Hindrances to nursing informatics being integrated into undergraduate curricula were disparities of the informatics content, a lack of guidelines and/or frameworks, and poor digital literacy.ConclusionThis study provided a baseline perspective of how nursing informatics was embedded and integrated into nursing education in Australia before COVID-19. Overwhelmingly, the focus of research to date was found to be mainly on the utilisation of technological tools to support learning and teaching.     

Searching for content on female genital cutting/mutilation in curriculums of U.S. Nursing Schools

BackgroundOver 500,000 women and girls in the U.S. are at risk for female genital cutting/mutilation, (FGC/M) because their cultural heritage is from countries where FGC/M is prevalent. Nurses lack knowledge about FGC/M, making them less likely to provide culturally congruent care. Little is known about FGC/M-related information in nursing school curriculums.MethodsA total of 403 schools of nursing (SONs) responded to an anonymous online survey to identify the extent, placement, and educational approaches regarding FGC/M found in curricular content in nursing schools in the U.S.ResultsFifty-seven percent of respondents did not know if nurses cared for FGC/M-affected women in the region where their nursing school was located. Only 27% of responding schools indicated FGC/M was taught in their curriculums, mostly in undergraduate programs, and primarily during classroom lectures, and rarely by simulation. SONs that were aware that nurses in their region provided care to women and girls at risk for FGC/M were more likely to have content on FGC/M in their curriculums.ConclusionThough respondents indicated that this topic is important to global nursing education, it appears that few U.S. nursing students are learning to provide culturally congruent care to women and girls at risk for FGC/M. It is vital that nurse educators include this topic in appropriate places in the curriculum, so that students learn the unique healthcare needs of this population.     

Role-play simulation to teach nursing students how to provide culturally sensitive care to transgender patients

ObjectiveIncrease student knowledge and comfort with caring for a transgender individual and confronting colleagues when exhibiting poor cultural intelligence.BackgroundTransgender patients often experience health care inequities, including heteronormative microaggressions in communication and policies. Simulation has been a successful means of providing students with the education, tools, and experience necessary to combat systemic injustice in health care. Simulation is an interactive pedagogy that allows nursing students to practice assessment, patient care, and difficult conversations in a controlled, risk-free environment.Design/ MethodsPrelicensure nursing students role-played a simulation created as an interactive learning strategy to promote culturally sensitive assessment of a transgender patient and their caregiver, including assessing for pronouns and providing patient-centered care. The simulation included preforming a difficult conversation between nurses to cultivate an environment of being an upstander. The simulation demonstrated holistic methods of assessing and supporting unique patient needs for the patient who is transgender.ResultsNursing students reported they felt that their comfort with advocacy and ability to communicate with transgender patients, as well as with their families, and health care team members was enhanced after completing the simulation.ConclusionSimulation has the ability to reduce discomfort and discrimination in health care for transgender patients by equipping students with culturally sensitive and inclusive communication tools and providing them with risk-free environment where they can learn to provide care for this vulnerable population in preparation for successful future encounters.     

Knowledge and attitudes towards patients with Alzheimer's disease across different educational levels of nursing and in different care settings: A cross-sectional study

AimTo evaluate Alzheimer’s disease (AD) knowledge and attitudes among Israeli nursing students and nurses with different educational backgrounds working in varied geriatric settingsBackgroundAlzheimer’s disease (AD) management and treatment relies on multidisciplinary care, providing comprehensive treatment to these patients. Nurses are vital to treatment provision. However, less nursing students are expressing interest to work with the geriatric population, including those with dementia.DesignThis was a cross-sectional study.MethodsParticipants were 231 nursing students and nurses of various educational backgrounds and from varied geriatric settings. Study measures included sociodemographic characteristics, the Alzheimer’s disease Knowledge Scale, and the Dementia Attitude Scale. Participants were recruited via social media, nursing administrations in medical facilities, and snowballing methods. Overall scores by educational background and correlations between the measures and select sociodemographic variables were evaluated.ResultsThe overall knowledge and attitudes towards dementia among Israeli nurses is moderate to high. The mean knowledge score was 23.32/30. The highest scores (for knowledge and attitude) were found among geriatric nurse practitioners. The lowest knowledge scores were found among registered nurses without a degree, while the lowest attitude scores was found among nursing students.ConclusionsDespite relatively high scores, there is still a need to minimize the gap in specific knowledge and attitude domains. There is a need for domain-specific training, such as risk factors related to dementia, and providing nurses of all educational backgrounds with the tools they need to feel comfortable in caring for AD patients.     

Certified nursing assistants' perspectives of the CARES® activities of daily living dementia care program

BackgroundThere has been a proliferation of online training programs for nursing home direct care staff related to dementia care, yet little is known about the effectiveness of the training. Some evidence exists that online training is effective in addressing problem behaviors of nursing home residents with dementia by enhancing self-efficacy, improving attitudes, and increasing knowledge of nursing home staff.Study aimThe current study aim was to evaluate the implementation of an online training program consisting of ten, one-hour modules which applies the CARES® concepts and learning framework to activities of daily living (ADL) care for persons with dementia.MethodsResponses from Likert-type items, and open-ended questions were analyzed in a sample of 48 certified nursing assistants (CNAs) from 10 nursing homes in six states (ME, MT, ND, WI, MN, MO) that were part of a National Institute of Aging funded intervention study (Grant #AG026210).ResultsThe mixed-method study findings indicated that CNAs gained a better understanding, more knowledge, and more confidence in caring for persons with dementia. Recommendations were made regarding training length and technical issues, and some questioned the practicality of providing person-centered care when resident assignment was very high. CNAs expressed satisfaction with the online training, found it easy to use, and many said they would recommend the training. CARES® ADL Dementia Care online training appears to be a viable way of helping CNAs address the personal care needs of long-term care residents. Future CARES® ADL Dementia Care program research should include more racially diverse CNAs.     

The effectiveness of an educational programme for nursing students on developing competence in the provision of spiritual care

Aim. To determine the effects of a course for nursing students on developing competence in spiritual care and the factors that might influence the effects. Background. Studies suggest that role preparation in nursing for spiritual care is poor. For the assessment of competence, few or no explicit competency framework or assessment tools seemed to be used. Design. Quasi‐experimental crossover design (pre–post‐test). Method. The subjects were students from Christian nursing schools in the Netherlands (n = 97). The intervention consisted of a course in spiritual care. Competencies were measured with an assessment tool, the Spiritual Care Competence Scale. Data were analysed by t‐test procedures (paired‐samples t‐test). At T₁ vignettes were added to assess the quality of the students’ own analyses. These data were analysed by a Mann–Whitney test. Regression analyses were performed on the influence of student characteristics on the subscales of the assessment tool. Results. Ninety‐seven students participated in this study. Analysis showed statistically significant changes in scores on three subscales of the Spiritual Care Competence Scale between groups (T₁) and over time for the whole cohort of students on all subscales (T₂). Clinical placement showed as a negative predictor for three subscales of the Spiritual Care Competence Scale. Experience in spiritual care and a holistic vision of nursing both showed as positive predictors on certain competencies. A statistically significant difference was observed between groups in the student analysis of a vignette with explicit spiritual content. Conclusions. The outcomes raise questions about the content of education in spiritual care, the measurement of competencies and the factors that influence competency development. Relevance to clinical practice. The results provide nurse educators with insight into the effects of education in spiritual care on students’ competencies and help them consider a systematic place for spiritual care within the nursing curriculum.     

Implementation of a Registered Undergraduate Student of Nursing (RUSON) program: The nurses’ perspective

ProblemUndergraduate nursing students remain an underutilised workforce within healthcare. This paper explores the establishment of a Registered Undergraduate Students of Nursing (RUSON) model through a university and healthcare partnership.BackgroundNursing continues to adapt to increasingly complex patient populations. Initiatives are needed to enable nurses to focus on patients’ care needs amidst increasing healthcare costs. This study identifies opportunities and strategies for engaging undergraduate nursing students as part of the healthcare workforce through the RUSON model, from the perspective of nurse leaders.AimThis project aimed to explore nurse leaders’ perspectives surrounding implementation of a RUSON model.MethodA qualitative exploratory design was employed for this study. Thematic analysis from a focus group with the nurse leaders was undertaken.FindingsTwo key themes were identified from the analysis, i) Establishing the RUSON; with sub-themes: “Who are RUSONs?”, “You are not on clinical placement” and “The importance of inclusivity” and ii) Benefits of the RUSONs; with sub-themes: “Addressing patient care needs”, “Value to the nursing team” and “Creating future ready employees”. Participants identified barriers that were overcome, subsequently leading to the model being considered advantageous to the clinical environment.DiscussionThe establishment of a RUSON workforce in acute care settings brings with it benefits to the nursing staff and the RUSONs themselves. In order to successfully embed a RUSON model in an organisation, it is important to collaborate with the nursing leadership team in the implementation process.ConclusionA RUSON workforce is an appropriate human resource strategy, both at the immediate point of implementation and longitudinally, as a recruitment strategy for future employment. Successful implementation of a RUSON model requires engagement and collaboration with nursing leaders.