English-as-a-second language (ESL) nursing students: strategies for building verbal and written language skills

With the growing number of foreign-born residents in the United States, nurse educators face the challenge of educating students who may have difficulty with the English language. There are an estimated 28.4 million foreign-born residents in the United States, which is the largest number in the history of this country (U.S. Census Bureau, 2001). The U.S. census report (2001) shows that the Hispanic/Latino population has increased by 57.9% since 1990 and now accounts for 12.5% of the total population. Another fast growing group is the Asian population that has increased by 48.3% since 1990 and now accounts for 3.6% of the total population. The Annual Report of the American Association of Colleges of Nursing (AACN, 2001) shows that the minority representation in baccalaureate programs has also increased with the Hispanic/Latino students at 4.8% and the Asian/Pacific Islander/Hawaiian students at 4.7% of the undergraduate nursing student population. Several authors (Abriam-Yago, Yoder, & Kataoka-Yahiro, 1999; Lester, 1998; Davidhizar, Dowd, & Geiger, 1998; Dowell, 1996; Andrews, 1992) have discussed the importance of increasing the number of ethnic minority nurses to insure the quality of healthcare to an increasingly diverse population. As the nursing shortage deepens, recruiting minorities into nursing is essential to meet the increasing demand. This change presents unique challenges and opportunities in nursing education. Colleges and universities will need to develop innovative programs to attract these nontraditional students, and support programs to help them complete the nursing curriculum.     

Asian nursing students in the United States

It is obvious that there is a great need to familiarize faculty and students with the Asian culture and heritage and to sensitize them to the difficulties and problems that Asian nursing students encounter in their adjustment to the university nursing program in the United States. Recommendations and strategies to achieve the above goals are: (1) Organizing cross-cultural courses for Asians and non-Asians to familiarize them with different cultures, (2) sensitizing faculty and counselors to the detrimental effects of existing nursing programs on international students, and (3) helping Asian nursing students better adjust to the American culture by providing English tutorial classes, support groups and host families that will act as socializing agents during the student's adjustment process. Through such educational and support programs, it is hoped that Asian nursing students will experience fewer difficulties which in turn will make their studies more meaningful and applicable.     

Complementary and alternative therapies in nursing curricula: a new direction for nurse educators

The scope of nursing practice is expanding to include the use of complementary and alternative therapies (CAT). This expansion is occurring because of changes in professional and societal attitudes toward the use of such therapies. In this article, we discuss the use of CAT and the development of medical and nursing educational programs related to these therapies in Eastern and Western societies. In addition, we identify future directions for incorporating content on such therapies into nursing education programs in the United States. We suggest that undergraduate nursing programs need to introduce the philosophy of Oriental medicine and content on some of the common therapies and that graduate nursing programs that include content on the use of CAT in nursing practice can possibly be developed.     

Preregistration nursing education in Australia, New Zealand, the United Kingdom, and the United States of America

The debate concerning nurses' diverse entry into practice was enlivened in 1995, when the American Nurses Association reaffirmed its contention that a baccalaureate degree was necessary for professional nursing practice. This debate may be informed by an appreciation of the educational routes taken by other countries that have changed from hospital-based to college-based nursing education. This paper describes and analyzes preregistration nursing education in Australia, New Zealand, the United Kingdom, and the United States, from the late nineteenth century to the present. Nurses in Australia and New Zealand are currently educated entirely at the baccalaureate level. In the United Kingdom, nursing education is in the process of becoming completely university-based, resulting in a diploma or degree. In the United States, the majority of nurses graduate from two-year associate degree programs. This level of education, briefer than in the other countries described, potentially limits nurses' professional contributions.     

A mentoring pyramid for African American nursing students.

The purpose of this investigation was to ascertain the African American nursing students' perception of a need for a mentoring program for this population. The percentage of ethnic minorities graduating from baccalaureate nursing programs has continued to decline since 1990 (National League of Nursing, 1995). The March 1996 National Sample Survey of Registered Nurses estimated there were 2,559,000 registered nurses in the United States. Only 107,500 of these nurses were African American. Data from the 1996 U.S. Census revealed African Americans to be the largest ethnic minority group in the country (14 percent). Based upon the number of racially and culturally diverse clients seeking healthcare, there is a gross underrepresentation of racially and culturally diverse nurses available to administer that care. The attrition rate for African American nursing students is high. Some of the reasons for this failure to retain and graduate African American students from schools of nursing are associated with the lack of mentoring relationships with persons whom students can relate to, feel comfortable with, learn from, and emulate. This study examined the perceptions of African American nursing students enrolled at a predominantly European-American public university in the Southeast United States. The students identified certain categories of needs they felt could be met in a mentoring relationship with a nurse educator.     

Attitudes of Asian and American graduate nursing students towards death and dying

This study compared the difference in attitudes towards death and dying between 17 Asian and 11 American graduate nursing students. Asian and American students did not significantly differ in attitudes related to fear of death, of self, or others, but Asian students were significantly more afraid than American students of their own process of dying. Asian students were more averse than American students to interacting and discussing death with dying patients. Talking about death with dying patients was the most difficult aspect of care for both groups. However, Asian students gained more personal satisfaction than American students in caring for dying patients. The findings provoke discussion regarding differences in nursing practice by Asian and American graduate nursing students.     

School-related expenses, living expenses, and income sources for graduate students in nurse anesthesia programs

Nurse anesthesia programs (NAPs) are the highest priced programs for graduate students compared with 7 other nursing master's degree programs. Not only are nurse anesthesia programs expensive, but also most students are encouraged by the policies within their individual programs to terminate full-time employment before matriculation. The purpose of this study was to determine school-related and living expenses, as well as the income and sources of income for graduate students in the second year of their NAP. To obtain the information, a student cost survey was designed and administered to participants attending NAPs across the United States during the 2001 school year. In addition, total degree costs were analyzed using a cost model assessing 4 components: educational costs, living expenses, net income foregone, and loan costs. The results showed that total degree costs incurred by graduate students in NAPs to complete their nurse anesthesia education totals $173,007. The analysis of the sources of income showed the following sources were used by respondents: guaranteed student loans; a spouse's income; agreements with future employers; stipends from universities, hospitals, and/or the military; grants; family support; and self-income. Completing a nurse anesthesia education program is expensive, although the expected return on the investment is high. Nevertheless, the expense may keep qualified graduate students from entering NAPs.     

Nursing administration graduate programs in the United States

Providing nursing administrators with excellent educational programming is imperative for the profession. The author analyzes trends in nursing administration education in the United States and how they compare with standards and future recommendations for graduate curricula. The degrees conferred, curricula, hours of study, and educational modalities are examined in 57 master's degrees in nursing programs with concentrations in administration.     

A Case for an International Health Elective Training Program During Residency: A Four-Points Call for Action

Background: International Health Electives (IHE) are becoming more popular among graduate training programs. This is likely due to the high demands from graduating medical students who are seeking to have an international health experience during their post-graduate training. Despite the important educational experiences associated with an IHE, this opportunity does not exist in all graduate medical programs and fewer have formal established programs. Summary: We are suggesting that graduate training programs are in a unique position to provide such experiences to our future physicians, in turn creating immediate benefits to host nations as well as long-term impacts on our society in the United States. We are proposing Four Points for stakeholders involved in training future physicians to use as they consider designing such opportunities for future trainees. The four points include: residents are capable of providing service to host nations, improve the quality of care to communities in the U.S., foster graduating medical students' global health interests and increase global health mentorship. Conclusions: We hope that addressing these four points will reemphasize the importance of establishing an IHE in all graduate training programs.     

Disaster preparedness for nurses: a teaching guide

As one of the largest groups of health care providers in the United States, nurses are trained to attend to the physical, psychological, and spiritual needs of their patients, making them highly qualified to influence the outcomes of victims of an emergency situation. Unfortunately, nursing programs offer limited content on delivering care under extreme conditions, and few continuing education programs are available to practicing nurses. This article provides a brief educational presentation that can be used without an extensive time commitment or in-depth instructor knowledge of the subject. The course content has been presented to nurses at the American Red Cross, at local chapter meetings of professional nursing organizations, and to both graduate and undergraduate nursing students. This presentation is not designed to be a comprehensive study of disaster nursing, but serves as a starting point that might lead to further study and encourage active participation in preparedness education and planning.     

护士职业倦怠与工作领域心理社会因素的相关研究

目的探讨护士职业倦怠与工作领域心理社会因素的关系.方法对425名护士进行问卷调查,问卷包括了解护士的职业倦怠水平以及工作控制体验(控制感和控制需求)、角色压力(角色冲突和角色模糊)、工作负荷以及领导支持自我评价.结果调查中,护士职业紧张感(48.7%)、负荷感(55.1%)较高,职业倦怠各因子与工作领域社会心理因素均显著相关(r=0.122～0.491).回归分析提示,工作负荷、工作控制感以及角色冲突是3个主要的预测因素.结论工作领域心理社会因素与护士职业倦怠水平密切相关.     

Spasm or transformation? Advanced practice psychiatric nursing education in the United States

Psychiatric nursing graduate programs are in precipitous decline in the United States, leading many advanced practice psychiatric nurses to question the viability of their field. This article examines the current crisis in advanced practice psychiatric nursing education in the United States by identifying core concerns and exploring the reasons for these concerns. Suggestions for securing the future of this practice area are also discussed. These suggestions include identifying a more clearly focused role for advanced practice psychiatric nurses, development of realistic educational expectations, achievement of greater uniformity in curricula, and the establishment of a strong and rigorous process of accreditation.     

Waiting and watching: Nurse migration trends before a change to the National Council Licensure Examination as entry to practice for Canada's nurses

Background

A number of factors in the health care environment, including a change in regulatory policy, may affect a country's nursing workforce and nurse migration and mobility.

Purpose

This study compared the characteristics of Canadian-educated nurses who had migrated to the United States to work with their colleagues in the United States and Canada in anticipation of a change in Canada's RN entry to practice requirements in 2015.

Methods

We conducted a retrospective comparative study of nurses in Canada and the U.S. using 2008 data from the US National Sample Survey of Registered Nurses and the Canadian Institute of Health Information.

Discussion

There was little change in the number of Canadian-educated nurses working in the United States in 2008 compared with 2004. We found differences between U.S. nurses and Canadian-educated nurses working in the United States in educational level, work status, work location, and age. No differences were found between Canadian-educated nurses working in the United States and those working in Canada.

Conclusions

This research highlights the value of international comparisons of the nursing workforce, especially in the context of anticipated regulatory changes, which may affect a country's nursing health human resources.     

Affirming At-Risk Minorities for Success (ARMS): retention, graduation, and success on the NCLEX-RN

Increasing ethnic and racial diversity in the U.S. population combined with inadequate minority representation in the nursing profession requires innovative strategies to recruit, retain, and graduate nurses from diverse ethnic and racial populations. Affirming At-Risk Minorities for Success (ARMS) was funded by a U.S. Department of Health and Human Services Basic Nurse Education and Practice Program grant. Participants (N = 64) were enrolled in a baccalaureate degree nursing program that has been predominantly White/ Anglo and is located in the south-central region of the United States. Research objectives were to increase program retention, graduation rates, and success on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) for minority or educationally disadvantaged students through programmatic interventions, including mentoring and advising, tutoring, and educational seminars. The comparison group was non-ARMS students derived from a comprehensive database (N = 265). Results indicated that interventions positively affected graduation rates (measure of retention = 98%), significantly affected grades in the Leadership-Management capstone course, and eliminated the effects of ethnicity on NCLEX-RN success.     

Community/public health nursing: Is there a future for the specialty?

Graduate nursing education in the United States has undergone significant changes over the last decade with institution of the doctorate in nursing practice (2006) and the revised Essentials of Master's Education in Nursing (2011). An overview of the status of community/public health nursing (C/PHN) education and practice during the past 100 years provides a historic context for understanding the current situation of the specialty. An analysis of U.S. graduate nursing programs in C/PHN is used to foreground a discussion of the factors that may significantly affect community/public health nurses' interest in graduate education and the ability to sustain a master's-prepared C/PHN workforce. Questions are raised about how the potential loss of this particular specialty may influence the practice of C/PHN and the role of nursing in general in ensuring the public's health. Recommendations are offered for strengthening the specialty long-term, with a particular focus on C/PHN education and practice.     

Nursing information technology knowledge,skills, and preparation of student nurses,nursing faculty,and clinicians: a U.S. survey

Because health care delivery increasingly requires timely information for effective decision making, information technology must be integrated into nursing education curricula for all future nurse clinicians and educators. This article reports findings from an online survey of deans and directors of 266 baccalaureate and higher nursing programs in the United States. Approximately half of the programs reported requiring word processing and e-mail skill competency for students entering nursing undergraduate programs. Less than one third of the programs addressed the use of standardized languages or terminologies in nursing and telehealth applications of nursing. One third of the programs cited inclusion of evidence-based practice as part of graduate curricula. Program faculty, who were rated at the "novice" or "advanced beginner" level for teaching information technology content and using information technology tools, are teaching information literacy skills. The southeastern central and Pacific regions of the United States projected the greatest future need for information technology-prepared nurses. Implications for nurse educators and program directors are discussed.     

Opportunities in preparing global leaders in nursing.

During the past decade, there has been a large increase in the number of international nurses pursuing doctoral education in the United States. The influx of these nurses has ramifications for the institutional systems providing education as well as on international and American nursing students. To begin understanding the issues presented by international doctoral nursing education, a survey of U.S. schools of nursing as well as a focus group of currently enrolled international doctoral students was conducted. The survey revealed that both international students and nursing programs experience challenges with regard to language, communication, financing, and support systems. More specifically, information gathered from the focus group identified issues regarding (1) lack of familiarity with the U.S. health care system, (2) lack of previous experience with the seminar format used in doctoral programs, (3) restricted opportunities to participate in faculty research, and (4) stress from a heavy course load to finish the program within a very short time period. Universally, the surveys and focus group lauded the positive global perspective imbued on all students and faculties via the international connection. Nonetheless, schools of nursing need to identify more effective strategies to aid international students in their development as successful global leaders. Meleis's framework for culturally competent scholarship is offered as a guide for schools of nursing.     

Perceptions, orientation, and transition into nursing practice of accelerated second-degree nursing program graduates

This study discusses factors that influence newly graduated accelerated second-degree nursing students to remain at the bedside. It also identifies areas for improvement within the program curriculum to better prepare these unique nursing graduates for the transition into nursing practice. Twenty-nine graduate second-degree nursing students were surveyed 3 months after graduation from an accelerated second-degree nursing program. Key findings indicated that preceptorship within nursing courses and orientation programs was the most significant factor in preparing the graduates for the transition from student nurse to registered nurse. Also important to the successful transition into practice was the acceptance and support of the nursing staff on the clinical unit. The participants overwhelmingly cited preceptorships, at both the student nurse and recent graduate levels, as critical to preparing them for the transition from student nurse to registered nurse.