Professional culture brokers: Nursing faculty perceptions of nursing culture and their role in student formation

Socialization, or formation of students to the professional nurse role, is an expectation of nursing education. This process is complex and challenging for students, who continue to experience culture shock moving from academe to practice settings. Viewing formation as enculturation is one way to address culture shock. Nursing faculty are key figures in this process, yet their views are not known. This focused ethnography study explored nursing faculty's perceptions about the culture of nursing and how they bring students into that culture. Data collected at two accredited, undergraduate pre-licensure baccalaureate nursing programs were analyzed using Leininger's four phases of data analysis. Four themes emerged: 1. The culture of nursing is multifaceted, multivalent and at times contradictory 2. Many factors interact and have influence on the culture of nursing 3. Navigating the subcultures (academia, service and organizational culture) is challenging for faculty, and 4. Nursing faculty believe that the right conditions facilitate the enculturation of students.Nursing faculty believe nursing has a professional culture and they bring students into that culture. Viewing the faculty role in enculturation to professional nursing as a culture broker can facilitate the process for students and mitigate the culture shock new graduate nurses experience.     

Community as Client: A 'Hands-On' Experience for Baccalurate Nursing Students

This article describes how Bachelor of Science in Nursing (BSN) students are introduced to the concept of community as client. Although this concept is widely accepted, at least theoretically, the majority of community health nursing practicums for baccalaureate students are in working with individuals and families as clients. The community health nursing faculty at La Roche College believe that undergraduate students should not only have the experience of decision making and problem solving at the individual and family level but also at the aggregate or community level. The process of actualizing the community as client concept through 'hands on' experience is the focus of this article. Our student body consists of registered nurses seeking their baccalaureate degree in nursing.     

Transition to Nursing Faculty: Exploring the Barriers

The future nursing workforce is dependent upon qualified nursing faculty to teach nursing students. The purpose of this qualitative research study was to explore the perceived barriers to becoming an academic nurse educator by nurses who have graduate degrees. Themes identified include the perception of academic nurse educator role and barriers to becoming an academic nurse educator. Findings have the potential to help stakeholders begin to develop strategies to mitigate the shortage of nursing faculty.     

Nursing students' perceptions of anxiety-producing situations in the clinical setting

Aspects of nursing students' clinical experiences are anxiety provoking. High anxiety may contribute to decreased learning. The purpose of this study was to identify potentially anxiety-producing clinical experiences for student nurses. Thirty-nine junior and 53 senior nursing students from a BS degree program completed the "Clinical Experience Assessment Form," a 16-item Likert scale. The items included communication and procedural aspects of patient care, interpersonal relationships with healthcare providers, and interactions with faculty. An open-ended question asked students to identify the most anxiety-producing aspects of their clinical practice. The students expressed the highest anxiety for the initial clinical experience on a unit and the fear of making mistakes. Faculty evaluation and observation were also anxiety-producing. The results of the student t-test indicated that juniors were significantly higher in their expression of anxiety was that students's anxiety was increased in the clinical setting by their perceptions of nonsupportive faculty.     

The impaired nursing student

Nursing students are at risk for abusing chemical substances during the nursing education experience. To assist faculty and administrators address this issue, characteristics of the chemically dependent nursing student are described. The authors also discuss teaching strategies and preventive approaches that might impact on the student's current or potential substance abuse.     

Student nurse attitudes towards homeless clients: a challenge for education and practice

The purpose of this research was to describe attitudes of nursing students (and paramedic officers) towards marginalized clients. Convenience quota sampling in a major health faculty was employed. Students participated on a voluntary basis. A 58-item Likert scale, developed by the authors, assessed the student nurses' attitudes. In general, attitudes towards homeless clients were neutral; detailed analyses, however, revealed that student nurses would decline to care for homeless clients in various situations. Personal experience with homeless patients and positive attitudes of nurses significantly contributed to increased quality of care and equality of treatment for homeless clients. Certain student nurse behaviors warrant immediate attention to prevent marginalized patients from being exposed to unfair, inaccessible and biased nursing care. Based on our results, we recommend that further research attention be paid to the role of ethics education and faculty behaviors, as faculty members serve as role models for professionalization.     

The chemically dependent nurse. A management issue

Chemical dependency among nurses is a problem that the nursing profession has only recently begun to examine. This article discusses the origins of chemical dependency among nurses, outlines strategies for confronting the chemically dependent nurse, and suggests how the nursing profession can deal more effectively with this problem.     

How Do Nursing Students Perceive Substance Abusing Nurses?

Substance abuse among nurses was recognized by nurse leaders and professional nursing organizations as a growing threat to patient safety and to the health of the abusing nurse more than 30 years ago. Although numerous studies on nurse impairment were published in the 1980s and 1990s, there was minimal focus on student nurses' perceptions about impaired nurses and less research has been published more recently, despite a growing rate of substance abuse. A quasi-experimental study to explore the perceptions of student nurses toward nurses who are chemically dependent was conducted using a two-group, pretest–posttest design. The Perception of Nurse Impairment Inventory (PNII) was completed by student nurses at the beginning of their junior course work, prior to formal education about substance abuse. The PNII was repeated after the students received substance abuse education. The PNII was also completed by a control group of sophomore student nurses who did not receive the formal substance abuse education. A repeated measures analysis of variance was used to measure the differences between the two groups of students. Students who received the education chose more compassionate responses on the PNII and were more likely to respond that an impaired nurse's supervisor is responsible for supporting and guiding the impaired nurse to access professional care. Discrepancies in study findings about the efficacy of education for effecting positive attitudes of student nurses toward impaired nurses may be related to the length and type of the education.     

Using Feedback to Improve Clinical Education of Nursing Students in an Academic-Practice Partnership

There is growing evidence to support partnerships between academic and practice institutions. In one of the Veterans Affairs Nursing Academic Partnerships (VANAP), nurses supervised undergraduate nursing students during the clinical practicum of acute care courses. To evaluate the partnership, faculty solicited feedback from nurses, clinical site leaders, and students. In this quality improvement project, feedback, in the form of written questionnaires and informal debriefing, was collected over four years at the end of sophomore and junior courses. Six site leaders, 71 students, and 34 nurses provided feedback. Common themes were: (1) all participants valued faculty presence during the clinical day, (2) students benefited from being paired with the same nurse throughout the course, (3) clinical teaching associates and site leaders suggested students be present for entire 12-hour shifts, and (4) clinical teaching associates, desired more training to address student needs. Several changes were made using this feedback: piloting a 12-hour shift and providing nurses with in-services on strategies to coach nursing students. Follow-up feedback showed high levels of satisfaction with these changes. Collecting feedback from students and staff provides guidelines for changing educational practices. Implementing changes based on the feedback strengthens partnerships, supports student learning needs, and improves student experiences.     

American Academy of Nursing Expert Panel on Global Nursing and Health: white paper on Global Nursing And Health.

The American Academy of Nursing's (AAN) Expert Panel on Global Health's white paper examines critical issues in the international nursing arena, including the global shortage of nurses, legal and ethical issues in recruiting international students for nursing positions in developed countries, the nurse faculty shortage, faculty and student exchanges, effects of the U.S. Citizenship and Immigration Services law, and laws governing new practice within the public domain. Realistic models directed toward viable solutions to these issues are critically needed. It offers 13 recommendations to address issues from a global perspective, including hosting a conference on global nursing, health research, and faculty exchanges; annual meetings; and an international conference of world nurse leaders, the AAN, and Global Panel representatives to discuss this white paper and plan follow-up actions. The final white paper approved by the AAN in 2005 and is published here to stimulate discussion regarding current and future initiatives.     

Nursing handoff education: An integrative literature review

AimThis integrative review aimed to identify nursing students' experiences of handoff practices and the effects of handoff education in the curriculum on nursing student learning outcomes.BackgroundAppropriate handoff communication skills are essential for nursing students to maintain patient safety and prevent adverse events.MethodA systematic literature search was conducted with keywords related to nursing, student, and handoff in April 2020. Articles should focus on nursing students' handoff education published in English in 2015–2020. Eight articles met the inclusion criteria and were included in this review.ResultsNursing students reported discrepancies in handoff experiences; diverse factors influenced their handoff experiences, such as knowledge, anxiety, confidence, and type of student supervision. Various handoff educations were implemented across studies. Some handoff educations significantly improved nursing students' attitudes toward other disciplinary providers, satisfaction, confidence, quality, and clarity in handoff communication; some did not substantially affect their selected outcomes.ConclusionThis review identified that there are still limited handoff experiences among nursing students and many factors affecting opportunities for their handoff experience. Some handoff education (e.g., structured handoff formats, role-play, simulated scenarios) effectively improved students' communication clarity, confidence levels, and handoff education satisfaction. More handoff education is needed for nursing students to learn safe and quality handoff practices.     

Sex Addiction and Women: A Nursing Issue

Addiction in women is a growing problem in the United States and is recognized as a very serious disease. Today researchers are able to document the neurochemistry of addiction in the brain. It has been found that sexual activity can create a “high” equal to that of crack cocaine.

Sexual addiction includes behaviors such as extramarital affairs, compulsive use of pornography, cybersex, compulsive masturbation, exhibitionism, voyeurism, prostitution, child molestation, incest, and rape. Currently there is limited information on the prevalence rate of sexual addiction in women. This is due to the sexualization of women in our culture; sexually addictive behaviors are often masked and misconstrued as expressions of “normal” social and interpersonal conduct, not as indicators of addictive sexual behavior.

The purpose of this paper is to increase nurses' awareness and knowledge about sexual addiction, how it manifests in women, how to assess a woman for sexual addiction, and provide some suggestions on how to help these women. Topics covered include: a definition of addiction, the neurochemistry of addiction, elements of sexual addiction in women including barriers to diagnosis, consequences of sexual addiction, and sexual addiction's relevance to nursing. Also included are case studies of women suffering from sex addiction.     

Attitudes of registered nurses toward euthanasia

We sought to identify variables that contribute to euthanasia attitude and behavior, including demographics, death fears, experience with death, attitudes toward patient autonomy, and level of moral development.

Subjects were 137 registered nurses from the southeastern United States representing 13 clinical nursing areas. Principal components analysis identified four factors that together explained 62.9% of total variance. These factors were belief in afterlife, nursing experience, liberal or conservative political view, and personal values. Variables identified through factor analysis were entered into regression analyses. These analyses showed that increased religious belief, years of nursing experience, and propensity to view death as an end of existence predicted opposition to euthanasia. Predictors for euthanasia support included a liberal political view, more experience with dying patients, and the belief that patients should have a personal responsibility for their own health-care decisions.     

Incivility in Nursing Education: Generational Differences

The purpose of this study was to investigate differences in the experiences of incivility of 2 generations of associate degree nursing faculty. A quantitative study was conducted using the Incivility in Nursing Education Survey to determine whether a difference exists between Baby Boomer (n = 50) and Generation X (n = 21) faculty's experience of incivility. Results indicate significant difference in reported student disruption, frequency of disruptive student behaviors, and number of student threats reported by the 2 generations.     

Of Lillian Wald, Community Health Nursing Education, and Health Care Reform

Abstract A pilot project is described that was initiated to provide a comprehensive clinical experience for community health nursing (CHN) students despite local cutbacks in field nursing services. The project, entitled the Nursing Elementary Education Outreach Project (NEEOP), is used as a basis for discussion on the CHN role in community-focused health care reform. One-third of the CHN students in one school of nursing during one academic year ( n = 16) participated in the NEEOP. One salaried CHN faculty member assumed primary responsibility, and equipment funding was granted by a local corporation. Collaboration was established with the county's proactive school nurses' association. CHN students developed and conducted health education presentations in elementary schools, worked with school nurses, and participated in other community health activities. Three levels of evaluation were utilized: elementary students to nursing students, nursing students to nursing faculty, and school nurses to nursing faculty. The NEEOP was a success by all evaluation criteria, and plans are currently in progress to expand its focus. Innovative clinical placements such as the one described can promote student understanding of CHN practice with its broad-based emphasis on the promotion of healthier communities.