Online Journal of Issues in Nursing

Advances in computer software have provided interactive tools that perform many of the duties once in the domain of the nursing profession. Sometimes referred to as 'virtual nursing avatars,' the duties delegated to this technology include facilitating check-ins for patients and coaching patients as they make lifestyle changes. Researchers continue to develop computer applications for virtual nurse avatars. As computers and smartphones take on tasks once in the domain of humans, the roles of nurses will evolve...

Workplace bullying (WPB) behaviors are pervasive in some healthcare organizations leading to difficult work environments for registered nurses. We conducted an exploratory quantitative dominant (QUANT/qual) mixed method design study to determine the differences in respondents in three Midwestern states on psychological distress symptoms using WPB exposure levels and select nurse characteristics. This article discusses background information and WPB consequences. We report on the study purpose, methods, and Phase I qualitative results, including significant differences with perceived stress, anxiety, and posttraumatic symptoms reported by persons with frequent to daily WPB behavior exposure...

Information and communication technology (ICT) is integral in today’s healthcare as a critical piece of support to both track and improve patient and organizational outcomes. Facilitating nurses’ informatics competency development through continuing education is paramount to enhance their readiness to practice safely and accurately in technologically enabled work environments. In this article, we briefly describe progress in nursing informatics (NI) and share a project exemplar that describes our experience in the design, implementation, and evaluation of a NI educational event, a one-day boot camp format that was used to provide foundational knowledge in NI targeted primarily at frontline nurses in Alberta, Canada...

The complexity of healthcare calls for interprofessional collaboration to improve and sustain the best outcomes for safe and high quality patient care. Historically, rehabilitation nursing has been an area that relies heavily on interprofessional relationships. Professionals from various disciplines often subscribe to different change management theories for continuous quality improvement. Through a case review, authors describe how a large, Midwestern, rehabilitation hospital used the crosswalk methodology to facilitate interprofessional collaboration and develop an intervention model for implementing and sustaining bedside shift reporting...

Patient acuity in hospital settings continues to increase, and there is greater emphasis on patient outcomes. The current nursing workforce is comprised of four distinct generational cohorts that include veterans, baby boomers, millennials, and generation Xers. Each group has unique characteristics that add complexity to the workforce and this can add challenges to providing optimal patient care. Team building is one strategy to increase mutual understanding, communication, and respect, and thus potentially improve patient outcomes...

Since the early 1990s researchers have steadily built a broad evidence base for the association between nurse staffing and patient outcomes. However, the majority of the studies in the literature employ designs that are unable to robustly examine causal pathways to meaningful improvement in patient outcomes. A focus on causal inference is essential to moving the field of nursing research forward, and as part of the essential skill-set for all nurses as consumers of research. In this article, we aim to describe the importance of causal inference in nursing research and discuss study designs that are more likely to produce causal findings...

Nurses have a social responsibility to evaluate the effect of nursing practice on patient outcomes in the areas of health promotion; injury and illness prevention; and alleviation of suffering. Quality assessment initiatives are hindered by the paucity of available data related to nursing processes and patient outcomes across these three domains of practice. Direct care nurses are integral to self-regulation for the discipline as they are the best source of information about nursing practice and patient outcomes...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

In the United States, Advanced Practice Registered Nurse (APRN) regulations are determined at the state level, through legislation and rule making. The lack of an evidence base to APRN regulation has resulted in a patchwork of varied regulations and requirements for nurse practitioners. The author begins this article by reviewing the history of the Equal Rights Amendment (ERA) in the United States and describing her study that assessed APRN fullpractice authority in states that ratified the ERA versus states that opposed it...

If you have ever thought about serving on a board or being actively involved in meetings aimed at making policy decisions, but are not sure you have the knowledge, skills or abilities to serve competently, this article is for you! In this article, the authors describe six competencies needed by nurses who are serving on boards and/or policy committees so as to contribute in a productive manner. These competencies include a professional commitment to serving on a governing board; knowledge about board types, bylaws, and job descriptions; an understanding of standard business protocols, board member roles, and voting processes; a willingness to use principles for managing and leading effective and efficient board meetings; an appreciation for the ethical and legal processes for conducting meetings; and the ability to employ strategies for maintaining control during intense/uncivil situations...

More than a decade before the Civil Rights Act of 1964, as an African American teenager from Baltimore, Maryland, Esther McCready challenged the discriminatory admissions policies of the University of Maryland School of Nursing (UMSON). The article explores nurse advocacy and how Esther McCready advocated for herself and greater racial equity in nursing education during a time of civil rights turmoil. Her actions eventually resulted in the formation of numerous schools of nursing for African Americans across the south...

Internationally educated nurses (IEN) are a group who reflect Canada’s diverse population as a result of rising immigration trends. There is increasing diversity of the general population in Canada and health service disparities exist. Reducing these disparities among the healthcare workforce and the patients they care for is important to meet language and other cultural needs of patients from different ethnic backgrounds. This article describes a study that examined internationally educated nurses’ transition experiences in the field of nursing with the objective of describing their unique contributions to the patient care experience...

The public image of nurse professionalism is important. Attributes of a professional nurse, such as caring, attentive, empathetic, efficient, knowledgeable, competent, and approachable, or lack thereof, can contribute positively or negatively to the patient experience. Nurses at a hospital in central northeast Pennsylvania offer their story as they considered the impact of a wide variety of individual uniform and dress choices. This article describes an evidence based practice project and survey created to increase understanding of patient perceptions regarding the professional image of nurses in this facility...

Perspectives from patients who reside in nursing homes can inform administrators and providers about the patient experience in long-term care. In a study of preferences for care in the nursing home or hospital should an acute change in condition occur, nursing home residents offered spontaneous descriptions of their experiences in the nursing home and during their prior hospital stays. This article offers background information about nursing home reform and standards, and contemporary reports on the patient experience in nursing homes...

The concept of nurse engagement is often used to describe nurses’ commitment to and satisfaction with their jobs. In reality, these are just two facets of engagement. Additional considerations include nurses’ level of commitment to the organization that employs them, and their commitment to the nursing profession itself. Because nurse engagement correlates directly with critical safety, quality, and patient experience outcomes, understanding the current state of nurse engagement and its drivers must be a strategic imperative...

The concept of patient experience is surprisingly complex and generally linked with patient satisfaction. As reimbursement and performance policies have become more normative within healthcare, the patient experience has become a metric to measure payment systems for quality. However, we still have much to learn about the concept of patient experience and its influence on how patients report satisfaction with their care. This article discusses challenges for measurement of the patient experience, such as lack of consistent terminology and multiple contributing factors, by reviewing a brief selection of selected literature to help readers appreciate the complexity of measurement...

No abstract text is available yet for this article.

Nurses strive to provide holistic care, including spiritual care, for all patients. However, in busy critical care environments, nurses often feel driven to focus on patients’ physical care, possibly at the expense of emotional and spiritual care. This study examined how Palestinian nurses working in intensive care units (ICUs) understand spirituality and the provision of spiritual care at the end of life. In this article, the author presents background studies, encouraging an increased emphasis on spiritual care, and describes the qualitative method used to study 13 ICU Gaza Strip nurses’ understanding of spiritual care...

With the growing complexity of healthcare practice environments and pending nurse leader retirements, the development of future nurse leaders is increasingly important. This article reports on focus group research conducted with Generation Y nurses prior to their initiating coursework in a Master’s Degree program designed to support development of future nurse leaders. Forty-four emerging nurse leaders across three program cohorts participated in this qualitative study conducted to capture perspectives about nursing leaders and leadership...