Creative Nursing

Health equity is an aspirational goal for health outcomes that can be achieved when systemic inequalities are addressed. The human cost of health inequities is without number; we can and must ameliorate health inequities. This essay summarizes the impact of continued health disparities and inequities in the United States and outlines the ways in which increasing diversity in the nursing workforce and graduating equity-minded nurses can promote innovation and problem-solving to address these disparities and inequities...

Marginalization encompasses structural, interpersonal, and intergroup dynamics that perpetuate inequality and exclusion. This manuscript advocates that the solution to marginalization lies in fostering a sense of belonging. Belonging is a fundamental human need, critical for mental well-being, academic success, and personal growth. It significantly impacts engagement, retention, and overall development, especially in health professional education settings like nursing schools. When individuals feel they belong, they are more likely to seek support, engage actively in learning, and perform better academically...

Being the least-represented ethnic/racial group in college settings, American Indian students may experience loneliness and self-doubt related to the challenges of adapting to an environment that embodies values, norms, and culture so different from those represented in their traditional culture. Ongoing health disparities and psychosocial inequities, and persisting impacts of historical colonization, have led to additional hardships for these students that further complicate their academic experiences. Fostering culturally safe learning environments where compassionate and caring faculty provide culturally aligned teaching is important in addressing these complex disparities...

This article addresses low retention and graduation rates among historically marginalized students in nursing programs at Historically Black Colleges and Universities (HBCUs). Mentoring is a proven success strategy to support systems for historically marginalized students, helping them navigate challenges, improving academic outcomes, and increasing the diversity of the nursing workforce. The article highlights the mentoring initiative of AARP's Center for Health Equity through Nursing and the Future of Nursing: Campaign for Action, an initiative of AARP Foundation, AARP, and the Robert Wood Johnson Foundation, and the outcomes of this collaboration...

Aim: To fill the gap in research that historically has been limited by focusing on the health problems experienced by people of color. Method: A simulation exercise was developed for senior pre-licensure nursing students in their senior year of a pre-licensure nursing program at a Midwest liberal arts college to intervene when a health-care provider in the hospital acted in an oppressive manner toward a client. Results: Qualitative findings suggest the value of addressing structural racism during a simulated learning experience to facilitate an understanding of the extent of racism inherent in the health-care system and biases that can be perpetuated by health-care providers...

In her book, The Sum of Us: What Racism Costs Everyone and How We Can Prosper Together , historian Heather McGhee tallies the cost of racism and identifies a zero-sum thinking for everyone who engages in the us-versus-them ideology. Chronicling racial hierarchy dating back to colonial America, McGhee uncovers the impact of racism in almost every societal sector including politics, the economy, education, housing, criminal justice, and climate change. McGhee challenges the fallacy that racial equity is only for people of color, demonstrating that political, socioeconomic, and financial equity for Black and Brown people is equity for all people...

Background: Cystic fibrosis (CF) is a rare genetic disease affecting approximately 30,000 people in the United States (US). African American persons with CF are even rarer, comprising approximately 5% of this population. Purpose: The purpose of this study was to explore the lived experiences of African American persons with CF to identify potential disparities in health care. Methods: Descriptive phenomenology was used to explore lived experiences of African American persons with CF over age 18 recruited from CF Foundation-accredited Centers in the US, CF-specific social media, and via snowball sampling...

Background: This manuscript describes an in-state nursing student global health-care experience. The 2021 Rio Grande Valley service learning team at Louise Herrington School of Nursing at Baylor University traveled from Dallas to McAllen, Texas to volunteer in a COVID vaccination clinic and refugee respite center on the U.S.-Mexican border. Method: A competency-based evaluation utilized the American Association of Colleges of Nursing's The Essentials: Core Competencies for Professional Nursing Education Featured Concepts , with a focus on social determinants of health, as a framework...

The purpose of this paper is to explore the potential of dialectical pluralism (DP) for nursing knowledge development. Nursing scholars have discussed ways of developing nursing knowledge, exploring the fit and relevance of various worldviews for knowledge development and examining the dynamic and perpetual processes of knowledge development. Scholars have argued that knowledge development occurs under a certain worldview to which the researcher adheres. Many nurses employ various worldviews, which can give rise to ontological and epistemological conflicts...

The World Health Organization defines social determinants of health as "the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life." This current journal issue has the theme of structural determinants of health. In 2016 ( Creative Nursing Vol. 22), we published 49 articles in four issues addressing Determinants of Health: Social Determinants, Structural Determinants, Caregiver Determinants, and Global Determinants. This editorial presents the highlights of those four journal issues, then connects each of the articles in this current issue to the theme; these articles reveal the systems and structures that support our caring from many angles, levels, and perspectives...

This article explores the power of resilience in helping nurse executive leaders who are working to effect change in structural determinants of health at direct care, interprofessional, organizational, and policy levels. It leverages research, literature, and personal experiences to outline techniques that can help leaders in health care overcome challenges. Specifically, it considers self-care, building relationships, seeking support, maintaining a positive attitude, and practicing mindfulness as critical to driving meaningful change...

Nursing theories and conceptual models shape nursing knowledge. This study applied the philosophical and theoretical basis of the Neuman Systems Model, which focuses on the use of primary, secondary, and tertiary nursing prevention for retention, attainment, and maintenance of patient system wellness, to a patient with pre-existing mental health conditions struggling to cope with depression and COVID-19 in a dedicated COVID-19 hospital in an urban area of Iran. The single intrinsic case study design used interviews, nursing observations, and document analysis to evaluate environmental factors and intra-, inter-, and extra-personal stressors...

This analysis elucidates the concept of stigma in the sexual and gender diverse population, and how it impacts interactions with the health-care system. Significant research into social determinants of health has given rise to a greater understanding of their impact on health-care accessibility and utilization. The impact of stigma experienced by persons with diverse gender identities and sexual orientations has not been similarly studied. Utilizing Walker and Avant's method of concept analysis and the Minority Stress Model, this article explicates stigma in an inclusive manner that directly addresses health care...

Developing a diverse talent pool starting at the high-school level, while students are making future education and career decisions, should be a national priority, given the need to build a diverse health-care workforce. This article describes a 6-week immersive simulation-based summer program to introduce 20 junior high-school students (13-15 years old) to the range of health professions. Because precollege students typically receive limited exposure to clinical settings, high-fidelity simulation is an excellent surrogate for providing realistic experiences in health care...

The Hispanic population is the largest and fastest-growing minority group in the United States, and is disproportionately impacted by health problems, including heart disease, stroke, diabetes, obesity, cancer, and unintentional injuries. Factors contributing to these disparities include cultural practices, lack of access to health care, language barriers, and a lack of cultural competence by health-care providers. Family, religion, and gender roles play an essential part in the cultural heritage of Hispanic people, which heavily impacts health outcomes in this population...

This study explored the application of mind mapping in the nursing care of neurology patients during the COVID-19 epidemic. Mind mapping was used to streamline and systematize all the links involved in the care process, from admission to discharge, giving nurses increased clarity in accurately implementing quality and safety measures.

The care of the person who has been sexually assaulted is challenging because of the neurobiology of trauma, susceptibility to re-victimization, and time constraints. Everyone involved with their care needs to be cognizant of the psychological-physiological phenomena of trauma in order to provide sensitive, high-quality care to these individuals. The neurobiology of trauma explains why the person's memory may be fragmented or impaired. Trauma-informed care offers choices and empowerment to the person along with safety, cultural awareness, trust, and collaboration...

Graduate students in a psychiatric mental health nurse practitioner program in the United States and undergraduate students in a first-year English course, Writing and Rhetoric, at a university in Ecuador participated in a Collaborative Online International Learning (COIL) experience in Fall Semester 2021. The purpose of the COIL experience was to develop global perspectives and cultural competencies regarding diversity and inclusion in mental health. The objectives of the COIL experience were to identify and discuss changes in thinking in four areas: eugenics and cultural bias, cultural bias in research, culture and mental illness, and institutional and care policies...

Background: Diabetes mellitus is a chronic disease that needs long-term management. Mobile health is an emerging field that is being used for diabetes self-management. Aim: Evaluate the effect of a diabetes self-management mobile application on self-efficacy, self-care agency, and self-care management among 128 Jordanian patients with Type 1 Diabetes Mellitus. Methods: The study utilized a non-equivalent controlled groups quasi-experimental design, with 64 patients in the control and in the intervention groups...

Background: Virtual reality (VR) simulation in nursing education, especially about non-acute care including community health, is an emerging learning strategy; more research is needed about its effectiveness. Purpose: This study aimed to evaluate the effectiveness of an innovative community health nursing VR simulation on prelicensure students' knowledge about social determinants of health and cultural competence, with a goal of enhancing students' preparation for practice. Methods: In a convergent mixed methods study, 100 prelicensure nursing students in a community health nursing course at a Midwestern U...