Social network analysis: Exploring connections to advance military nursing science

BackgroundMilitary nurse scientists are embedded in service-affiliated branches (Army, Navy, Air Force) with different missions, but with the singular purpose of generating and disseminating research impacting the health and well-being of DoD beneficiaries.PurposeThis project examines collaboration among TriService Nursing Research Program (TSNRP) members, seeking opportunities to strengthen, diversify, and expand research collaboration.MethodSocial network analysis (SNA) is the empirical inquiry of relations among social actors at different levels of analysis. An electronic SNA assessment and total enumerative sampling were used to explore current collaborations among PhD-prepared military nurse scientists (N = 136).FindingsThe TSNRP collaboration network has a complex service-driven structure with high status actors whose advice, knowledge, or skills are sought by others, and who function as connectors or bridges across service branches.DiscussionFor military scientists, SNA is instrumental in identifying influential individuals, visualizing opportunities for intraservice mentoring, designing responsive policy, and directing career opportunities for novice scientists.     

Physician Satisfaction and Burnout at Different Career Stages

ObjectiveTo explore the work lives, professional satisfaction, and burnout of US physicians by career stage and differences across sexes, specialties, and practice setting.Participants and MethodsWe conducted a cross-sectional study that involved a large sample of US physicians from all specialty disciplines in June 2011. The survey included the Maslach Burnout Inventory and items that explored professional life and career satisfaction. Physicians who had been in practice 10 years or less, 11 to 20 years, and 21 years or more were considered to be in early, middle, and late career, respectively.ResultsEarly career physicians had the lowest satisfaction with overall career choice (being a physician), the highest frequency of work-home conflicts, and the highest rates of depersonalization (all P<.001). Physicians in middle career worked more hours, took more overnight calls, had the lowest satisfaction with their specialty choice and their work-life balance, and had the highest rates of emotional exhaustion and burnout (all P<.001). Middle career physicians were most likely to plan to leave the practice of medicine for reasons other than retirement in the next 24 months (4.8%, 12.5%, and 5.2% for early, middle, and late career, respectively). The challenges of middle career were observed in both men and women and across specialties and practice types.ConclusionBurnout, satisfaction, and other professional challenges for physicians vary by career stage. Middle career appears to be a particularly challenging time for physicians. Efforts to promote career satisfaction, reduce burnout, and facilitate retention need to be expanded beyond early career interventions and may need to be tailored by career stage.     

Moving the needle further and faster: Policy and leadership opportunities to support early career nurse faculty and build resilience in establishing and growing their programs of research

Nurse scientists play a critical role in advancing the nursing field and improving health, but early career faculty can enter the academic ranks with little training in how to effectively establish, manage, and grow a program of research (POR) or weather the storms that accompany a research-intensive academic path. This can lead many nurse scientists to leave academic positions or even abandon their POR altogether. This is problematic at a societal level because nurse scientists bring a unique and valuable holistic perspective to scientific inquiry and an orientation towards community-based work, team science, intersectionality, and participatory approaches essential to address urgent health challenges. To enhance the impact of nurse scientists as a collective on academic research and human health, more attention should be given to the concept of resilience in the context of a research-focused career and the necessary structural changes that effectively support early career faculty in establishing thriving PORs. This article offers considerations relevant to administrative leaders, policymakers, and established faculty, at both the institutional and disciplinary level, to support early career faculty in establishing PORs that take root and flourish.     

Strategies to Promote Nurses' Engagement in Clinical Research: Description of Two Nurse Scholar Programs

Innovative programs are needed to build a pipeline of future nurse scientists necessary to generate practice-based evidence for optimal healthcare and to address the serious shortage of PhD-prepared nurses. This paper describes two nurse scholar programs based in one large, Magnet® designated healthcare institution that aim to provide clinical registered nurses (RNs) with mentored research opportunities in order to ultimately build an internal pipeline of practice-based nurse scientists. The Clinical Nurse Scholar Program provides clinical RNs the opportunity to conduct a research study under the mentorship of a senior nurse scientist. The Nursing Research Scholar Program provides a clinical RN enrolled in a PhD program or who recently completed a PhD program with an opportunity to gain enhanced research training and acquire new research skills. These two scholar models have the potential to be replicated in other institutions to enhance the development of future nurse scientists and to address a critical national shortage of PhD-prepared nurse scientists.     

Pathfinding for nursing science in the 21st century: where to from here?

In late 2002, the Office of Nursing Policy convened a "Think Tank" of Canadian nurse scientists and policy-makers to create an opportunity to articulate the major challenges in advancing the nursing science agenda in Canada, and also to discuss what action(s) might be taken to address these challenges. Together, participants identified a number of challenges as follows: * increasing the pool and critical mass of nurse scientists * maximizing career trajectory * aligning focus of research with sources of research funding * enhancing linkages between practice and science * building research programs evaluating scientific productivity, and recognizing individual scientists * capitalizing on nursing research opportunities and * investing in leadership and succession planning. Participants subsequently selected four of these challenges as priorities and identified key collaborative opportunities to address them. Given this promising start, it seems that nursing is positioning itself to make a significant contribution to health research.     

Habitus,social capital,leadership, and reflection: insights for early career nurse academics

BackgroundIt has been identified that nurses moving into academia have felt similar experiences of transition shock as those of new nurse graduates entering clinical practice. Moving into higher education, the early career nurse academic can find foreign the notion of different leadership approaches that have less direct supervision, leaving them unsure of their role and what is expected of them.AimTo encourage early career nurse academics to undertake regular reflective practice within their habitus, to enhance their understanding of their social capital and facilitate the use of a transformative leadership approach.MethodsThe discussion draws on the theory of Bourdieu as a lens to explore the notion that if one has access to crucial resources, they will understand how to accrue them through their relationships with others.Findings and discussionEarly career nurse academics are required to have understanding into gaining and maintaining social capital and use this as part of their leadership style. To achieve this, reflection and engaging in peer review is required. The development of an academic identity requires the building of networks and receiving mentorship.ConclusionFrom undertaking a process of reflection, early career nurse academics can take an active role in their development from gaining insight into their leadership style utilising a transformative leader approach. A critical understanding of the levels of social capital nurse academics currently hold within an organisation, will enable them to seek opportunities and areas requiring further development for their professional leadership growth.     

Strategies to enhance the success of mid-career nurse scientists

BackgroundThe mid-career nurse scientist, defined as an associate professor with/without tenure, is often faced with a multitude of challenges and opportunitiesPurposeThis paper shares strategies to assist mid-career scientists as they juggle required career demands and navigate the mid-career phase in pursuit of the rank of full professor.MethodA review of the literature was performed on mid-career nurse scientists.DiscussionA combination of increased research responsibilities, increased institutional teaching and service demands, and dwindling support can result in a sense of overwhelm and burnout. The mid-career nurse scientist must balance several balls in the air at one time to remain successful.ConclusionStrategies aligned with the Ecological Framework, focus on intrapersonal, interpersonal, institutional, organizational, and public policy domains to provide a wide scope of strategies that target the mid-career scientist and engage the larger nursing community.     

The perceived reality and environment of the mid-career nurse scientist

Background/PurposeA qualitative study was designed to explore facilitators and barriers to success from the perspectives of self-identified mid-career nurse scientists.MethodsData were collected from 84 respondents using open-ended items as part of an electronic survey of self-identified mid-career nurse scientists who were members of regional nursing research societies.Discussion/ConclusionTwo main themes emerged: “Perceived Realities” and “What's Needed to Achieve Career Success.” Mid-career nurse scientists experience both joy from teaching and research roles and dissatisfaction with research support; difficulty balancing heavy teaching workload, administrative responsibilities, and research, and ineffective mentoring. Based on the challenges in their environment, respondents identified numerous ways to enhance career success including (1) increasing or enhancing release time for research activities, (2) formal infrastructure to support research activities, and (3) targeted, effective mentoring by senior scientists.     

Experiential clinical learning for newly licensed PhD students: Transforming nursing PhD education through academic-practice partnerships

The growing national and international need for nurse scientists to transform health care has encouraged advances in nursing doctoral programs. The Hillman Scholars in Nursing Innovation, a program integrating BSN and PhD education, inspired the creation of the Hillman Clinical Fellowship (“Fellowship”). The Fellowship helps students transitioning from the BSN to PhD gain clinical experiences as newly graduated registered nurses, thus mitigating a common concern that students are naïve about the clinical setting. In collaboration with a practice partner, the Fellowship fosters development of clinical skills consistent with Patricia Benner's Novice to Expert Model. Fellows build clinical skills concurrent with the development of research proficiencies in the PhD program. This Fellowship can be adapted by other schools seeking to introduce curricular innovations that address the needs of early career PhD students, enhance academic-practice partnerships, and meet the growing need for more clinically focused PhD prepared nurses.     

Challenges and opportunities faced by nurse scientists in integrating data and technology in research to promote health equity

Advances in technologies including omics, apps, imaging, sensors, and big data are increasingly being integrated into research by nurse scientists, but the impact on improving health equity is still unclear. In this article, nursing research faculty from one institution discuss challenges and opportunities experienced when integrating various technologies into their research aimed at promoting health equity. Using exemplars from faculty experiences, a three-pronged approach to keeping patients and communities and the goal of health equity central in research while incorporating advancing technologies is described. This approach includes establishing long-term engagement with populations underrepresented in research, adopting strategies to increase diversity in study participant recruitment, and training and collaboration among a diverse workforce of educators, clinicians, and researchers. Training nurse scientists in integrating data and technology for advancing the science on health equity will shift the culture of how we understand, collaborate, and grow with the communities in which we train and practice as nurse scientists.     

The social context of career choice among millennial nurses: implications for interprofessional practice

Abstract

Health human resource and workforce planning is a global priority. Given the critical nursing shortage, and the fact that nurses are the largest group of healthcare providers, health workforce planning must focus on strategies to enhance both recruitment and retention of nurses. Understanding early socialization to career choice can provide insight into professional perceptions and expectations that have implications for recruitment, retention and interprofessional collaboration. This interpretive narrative inquiry utilized Polkinghorne’s theory of narrative emplotment to understand the career choice experiences of 12 millennial nurses (born between 1980 and 2000) in Eastern Canada. Participants were interviewed twice, face-to-face, 4 to 6 weeks apart prior to commencing their nursing program. The narratives present career choice as a complex consideration of social positioning. The findings provide insight into how nursing is perceived to be positioned in relation to medicine and how the participants struggled to locate themselves within this social hierarchy. Implications of this research highlight the need to ensure that recruitment messaging and organizational policies promote interprofessional collaboration from the onset of choosing a career in the health professions. Early professional socialization strategies during recruitment and education can enhance future collaboration between the health professions.     

A Dedicated Education Unit and a Novel Resident Nurse Transition-to-Practice Program in an Ambulatory Oncology Setting

ObjectiveTo summarize an innovative initiative in oncology nurse workforce development that addresses critical current and future gaps and encompasses use of dedicated education units for student nurse rotation and a transition-to-practice residency program.Data SourcesReview of institutional data including original pilot analysis and ongoing programmatic metrics (N=8 years), consensus, professional guidelines, and published literature.ConclusionThe dedicated education unit serves as a conduit for recruitment into institutional oncology nurse residency positions, and retention rates in the residency program continue to exceed national averages. Subsequent mentoring of these nurses in transition to practice has manifested high rates of promotion into nurse leadership roles year over year.Implications for Nursing PracticeOncology nurse practice incorporates state-of-the-science approved therapies, early phase clinical trial implementation, and evidence-based complex oncology patient care management. A new model of student clinical nurse rotations in ambulatory settings, nurse resident transition to practice, and ongoing leadership mentoring is essential in creating a sustainable, highly skilled, and robust oncology nurse work force.     

Advancing nursing leadership: a model for program implementation and measurement

Despite the abundant literature documenting the need for nurse management education and career development, only recently have professional standards been targeted for this group. Competency standards for nurse leaders repeatedly identify systems-level concepts including finance and budget, communication skills, strategic management, human resources management, change management, and computer technology skills. However, educational initiatives to meet these standards are still at the early stages and most nurse leaders continue to acquire knowledge and experience through "on-the-job" training. This article will illustrate the need for partnerships and collaboration between academia and hospitals to advance nursing leadership to the next century. In addition, a tool to measure the impact of a graduate certificate program in nursing administration on nurse leader competencies is presented. Overall, the certificate program has been successful in multiple ways; it has "graduated" almost 80 nurse leaders, improved participant competence in their role at the systems level, as well as providing an impetus for completion of a graduate degree post program.     

Call to action to support the success of midcareer nurse scientists

Mid-career nurse scientists in academia are at risk for burnout and departing scientific careers, particularly those in research-intensive academic settings. With the shortage of nursing faculty and the public health need for high-quality nursing research, it is critical to retain current research-focused individuals in nursing. In this paper, we discuss definitions and expectations of mid-career scientists, challenges and barriers faced by mid-career scientists, and opportunities for mid-career scientists, informed by both nursing and non-nursing literature. Finally, we focus on definitions and expectations, challenges, and opportunities specifically related to mid-career nurse scientists in research-intensive academic settings.     

Creating Synergy between Academia and Practice: The Arizona State University and Mayo Clinic Arizona Model

BackgroundThe academic-practice partnership began in 2005 with a collaborative Pre-licensure Bachelor of Science in Nursing (BSN) program. Since that time the partnership has broadened to include faculty development, evidence-based practice, interprofessional education, and research initiatives.PurposeThe purpose is to share the outcomes of this academic-practice partnership and to provide a model for other institutions.MethodsThis successful partnership is grounded in the American Association of Colleges of Nursing and the American Organization of Nurse Executives' eight guiding principles for academic-practice partnerships. The cornerstones to the partnership are communication, collaboration, and mutual respect.ResultsThe initial outcomes of this collaboration increased enrollment, thereby increasing the number of BSN prepared registered nurses; created opportunities for clinical nurses to teach; increased the number of nursing faculty; and capitalized on the strengths of each partner.ConclusionThe most exciting aspect of this partnership is the shared commitment to decrease the gap between nursing education and practice; thus, improving the quality of nursing education, advancing the practice of nursing and healthcare delivery, and enhancing the health of our community. Consistent with the AACN-AONE recommendations, this academic-practice partnership prepares nurses of the future to be evidence-based practitioners and creates opportunities for nurses to achieve educational and career advancements.     

Pre-entry perceptions of students entering five health professions: implications for interprofessional education and collaboration

ABSTRACT

Dysfunctional interprofessional teams are a threat to health system performance and the delivery of quality patient outcomes. Implementing strategies that prepare future health professionals to be effective collaborators requires a comprehensive understanding of how early professional socialization and professional identity formation occur. We present findings from a qualitative study, grounded in narrative methodology, examining early professional socialization among students across five health professional programs (dentistry, medicine, nursing, pharmacy, physiotherapy) in the first year of health professional training. Between April and September 2015, students (n = 49) entering programs at an Atlantic Canadian University participated in one-on-one, audiotaped interviews starting before formal program orientation. Pre-entry interviews focused on factors influencing students’ career choice and expectations of future profession and interprofessional collaboration (IPC). Findings revealed that many different experiences influenced participants’ career choice and framed the social positioning of their future career (e.g., leadership, prestige, autonomy). Participant narratives revealed the existence of stereotypes pertaining to their chosen and other health professions. Study findings provided insights that may help strengthen initiatives to promote positive professional identity formation within the context of IPC. Implications of this research highlight the need for the early introduction of IPC including pre-entry recruitment messaging for prospective health professionals.     

The professional nurse education program: a work force development model

Invariably, healthcare institutions respond to repeated voids in professional nurse positions by recruiting persons external to the organization, rather than examining their nonprofessional ranks for high achievers worthy of formal career advancement opportunities. The authors describe why and how their professional work force development operates, the demographics of participants, and outcomes, such as retention rate, gains in college preparatory competencies, changes in self-reported psychosocial aspects of participants, influence of work hours on academic achievement, and financial investment.