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Inexperienced nursing staff can jeopardize patient safety and contribute to burnout. This quality improvement project evaluated a clinical resource nurse (CRN) role designed to address disparities in nurses' skills and experience. Survey results suggested that the CRN role effectively supported novice nurses. [ABSTRACT FROM AUTHOR]

Purpose: In vesicourethral anastomosis (VUA), which is part of robot-assisted radical prostatectomy, surgeons must proceed carefully to avoid urethral damage. We developed and evaluated a VUA bench-top model that can measure the traction force on the urethra during robotic surgery. Materials and methods: The VUA model included the urethra, bladder, pelvic bones, and a small force sensor that was capable of measuring the traction force on the urethra. Eight skilled and eight novice urologists performed a VUA task in robotic surgery. The skilled surgeons assessed the model's realism and usefulness as a training tool using a 5-point Likert scale. The evaluation items [task time, maximum force, force volume, and length of time that specific excessive forces were applied to the urethra (2, 3, 4, and ≥ 5 N)] were compared between the skilled and novice surgeons using the Mann–Whitney U test. Measurements were conducted in four directions with respect to the maximum force on the urethra: 11–1, 2–4, 5–7, and 8–10 o'clock. Results: The quality of the model was scored 3.7 to 4.9 points for all 16 items in 4 domains except for "Usefulness compared with animal models." There were differences in the task time and almost all force parameters between the skilled and novice surgeons. Conclusion: We developed a relatively high-quality VUA bench-top model that measures traction force on the urethra, and we have revealed differences in the forces of action on the urethra in two groups of surgeons with different skill levels. [ABSTRACT FROM AUTHOR]

Background: New intensive care unit (ICU) nurses often experience stress because of concerns about potentially harming their patients in a work environment that demands the rapid development of several skills in a limited training period. Aim: This study aimed to investigate the prioritisation of educational needs within adult ICUs, focusing on how new nurses evaluate their current knowledge and perceive the most critical competencies. Study Design: A cross‐sectional study was conducted among a convenience sample of 102 new ICU nurses in general and tertiary hospitals in South Korea. Educational needs were assessed using a structured questionnaire for new ICU nurses. This study investigated educational needs using paired t‐tests, Borich's assessment model and the Locus for Focus model. Results: Only 48% of participants were satisfied with their education. The highest‐rated educational content included preparing to use a defibrillator (95% CI = 2.44–3.28, p <.001), administering emergency drugs for cardiopulmonary resuscitation (CPR) (95% CI = 2.09–2.91, p <.001), starting and maintaining continuous renal replacement therapy (95% CI = 1.50–2.42, p <.001), applying and maintaining a ventilator (95% CI = 1.42–2.08, p <.001), preparing for intubation (95% CI = 1.23–1.97, p <.001), reporting to the emergency team, preparing equipment for CPR (95% CI = 1.12–1.94, p <.001) and drug calculation (95% CI = 0.87–1.53, p <.001). Conclusions: These findings indicate that educational programmes for new ICU nurses should be developed considering the aforementioned priorities. Furthermore, nurse educators should adopt a practical and active instructional method to repeatedly clarify content, prioritising the improvement of knowledge and performance of new ICU nurses. Relevance to Clinical Practice: This study guides clinical educators and managers in focusing on areas where new ICU nurses need additional training. Effective nurse residency programmes tailored to the specific needs of new ICU nurses can enhance their confidence and ability to handle ICU nursing challenges. [ABSTRACT FROM AUTHOR]

Background: The increasing complexity of care and the decrease in overall nursing experience pose a threat to patient safety and clinical outcomes in health care. Within the local environment, a critical need was identified to connect expert bedside nurses with novice nurses to support the development of critical thinking. Method: This article describes the development and pilot evaluation of a critical reflection mentorship program, Beyond the Bedside. The program was developed and deployed in three inpatient units within an adult academic health center. Critical thinking was evaluated using the Nursing Critical Thinking in Clinical Practice Questionnaire (N-CT-4 Practice) pre- and postprogram implementation. Results: Five nurses participated in the pre- and postevaluation, and the N-CT-4 Practice mean scores were significantly higher after program implementation. Conclusion: Education leaders should prioritize programs that support critical thinking among novice nurses, and the Beyond the Bedside program can be adapted for use in other health care settings. [J Contin Educ Nurs. 2024;55(9):456–460.] [ABSTRACT FROM AUTHOR]

Aims and Objective: To investigate the determinants of missed nursing care and to analyse the mediating effect of holistic nursing competence on the relationship between transition shock and missed nursing care. Background: Transition shock of newly graduated nurses is associated with missed nursing care. Previous studies have shown the determinants of missed nursing care among nurses, but little is known about the relationship between missed nursing care, transition shock and holistic nursing competence. Design: Descriptive and correlational design. Methods: The study was conducted among newly graduated nurses (n = 201) working in acute care hospitals for 1–12 months. The MISSCARE survey, Holistic Nursing Competence Scale and Nursing Transition Shock Scale were used for data collection, in addition to a sociodemographic question form. Data were analysed using Pearson correlation, multiple regression and mediation analyses. The study was reported following the STROBE checklist. Results: The determinants of missed nursing care among newly graduated nurses were sex, unit type, rotating shift work, holding a certificate, holistic nursing competence and transition shock. All these variables explain 35% of the variance in missed nursing care. Holistic nursing competence directly mediated 51.7% of the relationship between transition shock and missed nursing care. Conclusions: Holistic nursing competence may decrease missed nursing care by reducing the effects of transition shock on newly graduated nurses. Relevance to Clinical Practice: The study highlighted that newly graduated nurses are an important population regarding missed nursing care. The determinants of missed care should be considered in the nursing care delivery to prevent missed care by newly graduated nurses. Based on the study findings, some recommendations were made for nurse managers and faculty for the orientation program and undergraduate nursing education. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to explore the association between transition shocks and professional identity and the mediating roles of self‐efficacy and resilience among Chinese novice nurses. Background: Novice nurses experience transition shock when they start their careers, which might lead to decreased professional identity and ultimately turnover. By contrast, self‐efficacy and resilience are excellent psychological resources that may be associated with higher professional identity. It is unclear how transition shock affects professional identity by influencing these two internal resources. Design: A cross‐sectional survey. Methods: The STROBE guidelines were followed to report this study. Convenience sampling was used to recruit participants, and 252 novice nurses completed the Transition Shock of Novice Nurses Scale, the Professional Identity Assessment Scale, the General Self‐Efficacy Scale and the Connor‐Davidson Resilience Scale between April 2022 and May 2022. Influencing factors were primarily identified using independent‐sample t‐tests and a one‐way ANOVA. Structural equation modelling was used to detect the mediating effects of self‐efficacy and resilience. Results: Differences in novice nurses' levels of professional identity were found across age groups, hospitals and departments. Transition shock was negatively related to professional identity. Self‐efficacy and resilience mediated the complete chain relationship between transition shock and professional identity. Conclusion: To our knowledge, this study is the first to explore the mediating effect of self‐efficacy and resilience on transition shock and professional identity. Higher transition shock may lead to lower professional identity by reducing self‐efficacy and resilience. Relevance to Clinical Practice: Nursing managers ought to emphasise the significant role of psychological resources in the work adaptation process of novice nurses. It may be more effective to improve professional identity and maintain the stability of the health care system. Patient or Public Contribution: Nursing administrators working at seven preselected hospitals actively assisted us in the process of collecting self‐report questionnaires from novice nurses, such as by booking appointments and providing access for questionnaire administration. In addition, the participants were actively involved in the data collection process. [ABSTRACT FROM AUTHOR]

Aim: To explore the career decisions and aspirations of early‐career registered nurses in New Brunswick, Canada. Design: A qualitative study using an interpretive description approach was conducted. Methods: Semi‐structured one‐on‐one interviews were conducted with a purposive sample of nurses (n = 22) currently working in New Brunswick, Canada, with up to 5 years of experience from February to April 2022. Results: Participants described diverse career paths and aspirations. Personal factors affecting these included the desire for meaningful work, career satisfaction, work‐life balance, spending time with family, working in a preferred location, and finances. Professionally, working conditions were the dominant factor influencing early‐career nurses' career decisions and aspirations. Participants described how short staffing, safety, support, and scheduling influenced their day‐to‐day work, mental and physical health, job and career satisfaction, and intent to leave. Conclusion: The findings highlighted the abundant and diverse career opportunities available to nurses early in their careers. Early‐career nurses are interested in finding nursing positions with a high degree of person‐job fit and value opportunities for ongoing professional education and growth. Impact: This study in New Brunswick, Canada, explores early‐career nurses' career decisions and aspirations during nursing shortages and the pandemic, emphasizing the importance of person‐job fit. Recommendations include improving working conditions and career pathways to enhance the sustainability of the nursing profession. Reporting Method: Standards for Reporting Qualitative Research (SRQR). Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

The article discusses research which explored the relationship between authentic nurse leadership (ANL) and moral injury (MI) from the perspective of novice nurses. The study measured perceived ANL using the Authentic Nurse Leadership Questionnaire by the elements that characterized ANL including integrity, transparency and altruism, while MI was measured using the MI Symptom Scale: Healthcare Professionals version. The study's limitations and implications for nurse leaders are discussed.

Background: The Gratitude at Work Scale, originally developed by American scholars, has been widely administered to mental health professionals and human service workers to explore gratitude in the workplace. No Chinese-language instrument is currently available for assessing workplace gratitude. Purposes: The aims of this study were to (a) translate the original English version of the Gratitude at Work Scale into a traditional Chinese version (TC-GAWS), confirm its factor structure, and analyze its psychometric properties among newly employed nurses and (b) develop and evaluate the psychometric properties of the TC-GAWS short form. Methods: A psychometric study using a cross-sectional webbased design was conducted in Taiwan. Three hundred twentytwo employed nurses completed a battery of self-administered online questionnaires that included a demographic datasheet, the Gratitude Questionnaire–Six-Item Form, the Connor–Davidson Resilience Scale-10, and the Thoughts of Quitting Scale. IBM SPSS 24.0 and AMOS 28.0 were used for data analysis, and Cronbach's alpha and Pearson's correlation were used to assess reliability and concurrent validity. Exploratory factor analysis and confirmatory factor analysis (CFA) were conducted. Results: The internal consistency and stability of the TC-GAWS total scale were .88 and .91, respectively. The exploratory factor analysis showed a satisfactory Kaiser–Meyer–Olkin value of .88 and a Bartlett's test value of 654.01 (p < .001), suggesting that 64.55% of the total variance was explained by the two-factor TC-GAWS. After item reduction, the CFA of the six remaining items of the TC-GAWS short form revealed adequate fit statistics for a two-factor structure and a second-order factor. Strong correlations were found between the 10-item and six-item TCGAWS (r > .94) in the two samples, suggesting good concurrent validity. The overall scores for the 10-item and six-item TCGAWS had similar convergent validity, with moderate-tostrong correlations for the Gratitude Questionnaire–Six-Item Form (r = .45 and .540), Connor–Davidson Resilience Scale-10 (r = .49 and .51), and Thoughts of Quitting Scale (r = −.57 and −.53). The CFA yielded a two-factor, six-item model that exhibited good fit with the latent constructs of χ² /df = 11.06/8 = 1.38, p = .198, comparative fit index = .996, goodness-of-fit index = .979, root mean square error of approximation = .045, root mean square residual = .030, and standardized root mean squared residual = .023. Conclusions/Implications for Practice: Both the 10- and sixitem TC-GAWS instruments demonstrated good reliability and validity in nurse participants. The TC-GAWS may be used to measure gratitude in nurses in the workplace. This instrument has the potential to facilitate a better understanding of gratitude in nurses, which may be applied to the improvement of nursing management, research, and education. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to analyze the experiences of new nurses during their first year of hospital employment to gather data for the development of an evidence-based new nurse residency program focused on adaptability. Methods: This study was conducted at a tertiary hospital in Korea between March and August 2021 with 80 new nurses who wrote in critical reflective journals during their first year of work. NetMiner 4.5.0 was used to conduct a text network analysis of the critical reflective journals to uncover core keywords and topics across three periods. Results: In the journals, over time, degree centrality emerged as "study" and "patient understanding" for 1 to 3 months, "insufficient" and "stress" for 4 to 6 months, and "handover" and "preparation" for 7 to 12 months. Major sub-themes at 1 to 3 months were: "rounds," "intravenous-cannulation," "medical device," and "patient understanding"; at 4 to 6 months they were "admission," "discharge," "oxygen therapy," and "disease"; and at 7 to 12 months they were "burden," "independence," and "solution." Conclusion: These results provide valuable insights into the challenges and experiences encountered by new nurses during different stages of their field adaptation process. This information may highlight the best nurse leadership methods for improving institutional education and supporting new nurses' transitions to the hospital work environment. [ABSTRACT FROM AUTHOR]

Background: The objective was to assess the agreement between therapeutic proposals derived from basic critical care echocardiography performed by novice operators in ultrasonography after a limited training (residents) and by experts considered as reference. Secondary objectives were to assess the agreement between operators' answers to simple clinical questions and the concordance between basic two-dimensional measurements. Methods: This observational, prospective, single-center study was conducted over a 3-year period in a medical-surgical intensive care unit. Adult patients with acute circulatory and/or respiratory failure requiring a transthoracic echocardiography (TTE) examination were studied. In each patient, a TTE was performed by a resident novice in ultrasonography after a short training program and by an expert, independently but within 1 h and in random order. Each operator addressed standardized simple clinical questions and subsequently proposed a therapeutic strategy based on a predefined algorithm. Results: Residents performed an average of 33 TTE studies in 244 patients (156 men; age: 63 years [52–74]; SAPS2: 45 [34–59]; 182 (75%) mechanically ventilated). Agreement between the therapeutic proposals of residents and experienced operators was good-to-excellent. The concordance was excellent for suggesting fluid loading, inotrope or vasopressor support (all Kappa values > 0.80). Inter-observer agreement was only moderate when considering the indication of negative fluid balance (Kappa: 0.65; 95% CI 0.50–0.80), since residents proposed diuretics in 23 patients (9.5%) while their counterparts had the same suggestion in 35 patients (14.4%). Overall agreement of responses to simple clinical questions was also good-to-excellent. Intraclass correlation coefficient exceeded 0.75 for measurement of ventricular and inferior vena cava size. Conclusions: A limited training program aiming at acquiring the basic level in critical care echocardiography enables ICU residents novice in ultrasonography to propose therapeutic interventions with a good-to-excellent agreement with experienced operators. [ABSTRACT FROM AUTHOR]

Introduction: With current technology, ultrasound imaging in remote conditions, such as the International Space Station, is performed with vocal guidance or using a teleoperated echograph controlled by an expert. Both methods require real-time communications between the novice operator and expert to locate the probe over the appropriate acoustic windows (AW). The current study presents the development and testing of a new augmented reality software (Echo-QR) that would allow novice operators (with no medical imaging background) to correctly locate the ultrasound probe over the AW of interest without expert assistance. Methods: On the first day of the study, the positions of the probe over the AWs were identified for each organ by an expert sonographer and saved in the Echo-QR software. On the second day, the novices independently performed the ultrasound investigation using the Echo-QR software to correctly position the probe over each organ's AW. Results: Using the Echo-QR software, novice operators found the AWin 73 (92%) of the 79 organs. The 2D images acquired by the novices "2D direct image" were acceptable for medical evaluation in 41% of the cases. However, when the "2D direct image" did not show the entire organ, a 3D capture of the volume below the probe was also performed, which allowed for the extraction of the appropriate 2D image "2D/3D image" for medical evaluation in 85% of the cases. Discussion: Therefore, in the absence of real-time communication between an isolated participant and an expert sonographer, novel software (Echo-QR) and automated 3D volume capture can be used to obtain images usable for ultrasound diagnostics. [ABSTRACT FROM AUTHOR]

Expert nurses, as described by the work of Patricia Benner, are at the peak of clinical nursing practice and vitally important in ensuring the best possible patient care and clinical outcomes. The development of Benner's theory and its relationship with the Dreyfus model of skill acquisition provides context for understanding the progression necessary for expert development. Contemporary healthcare challenges present implications to the development of advancing levels of nursing practice. Engagement has been identified as critical to achieving expert practice. I propose the incorporation of the philosophical framework of self‐appropriation from Benard Lonergan as a strategy to develop internal engagement in nurses to facilitate expert practice. I outline the synergy between Benner's theory and the work of Lonergan, which provide overlap and opportunity to overcome barriers to developing expert nursing practice. In the challenging climate of healthcare, there is an obligation to promote engagement and facilitate expert nurse development, necessary for patient outcomes as well as clinical role models, preceptors, and leaders to guide future nurses. [ABSTRACT FROM AUTHOR]

Introduction This article uses recent survey data from a study on gender integration at recruit training across the U.S. Armed Forces to examine service, gender, and training differences in recruit's gender attitudes, beliefs, and cohesion metrics. In addition to providing a descriptive understanding of our recruit sample, this article examines factors germane to gender integration at recruit training such as gender attitudes, sexist beliefs, and unit cohesion. Materials and Methods This article uses data from a survey of U.S. Marine Corps (USMC), U.S. Army, U.S. Air Force, U.S. Navy, and U.S. Coast Guard recruits as part of a USMC-commissioned study to develop alternate models and recommendations for increasing gender integration in USMC recruit training. At all sites but the USMC, recruits completed the survey 1 to 2 weeks before graduation. At the Marine Corps Recruit Depots, recruits participated in the survey at the beginning (week 2) and end (week 11) of their 13-week training cycle. A 19-question survey captured sociodemographic information, perspectives and experiences during recruit training, and gender attitudes and beliefs. Analyses were conducted on the sample with complete data on the measures reported, including those USMC recruits observed at both week 2 and week 11 (n  = 629). Descriptive statistics (percentage) were calculated for all categorical outcome variables. Outcome variables (cohesion, gender, and sexism attitudes) were compared between groups using chi-squared tests or Fisher's exact tests, as appropriate. Results Recruits differed significantly across services in perceptions of unit cohesion on 3 of the 4 indicators: Platoon members are cooperative, know they can depend on each other, and really respect each other (P <  .05). These differences appear to be driven by female recruit difference across service. They reported significant differences in gender role attitudes across the services, with USMC recruits being most likely to endorse traditional gender roles compared to other service recruits. Male USMC recruits were significantly more likely than their female peers to agree that men should achieve outside the home and women should take care of the home and family (21.3% versus 6.3%, P <  .05). The only statistical differences in attitudes about equality of treatment and opportunity among recruits were between male and female USMC recruits. All items capturing sexist attitudes elicited statistically significant differences between male USMC recruits and male recruits in other services (P <  .05). There were significant differences in all sexism measures between male and female USMC recruits (P <  .05). There is a significant decline in some sexist attitudes between weeks 2 and 11 of training among male USMC recruits (P <  .05). Nearly one-half to three-fourths of male USMC recruits hold sexist attitudes, even near the end of recruit training. Conclusions The disparate gender and sexism attitudes of male USMC recruits compared with their peers in other services, and their fellow female USMC recruits suggest efforts to increase gender integration at entry-level training are needed, but also may be challenging since male USMC recruits report the highest levels of sexist attitudes among all recruits. [ABSTRACT FROM AUTHOR]

Background: Tissue handling is a crucial skill for surgeons and is challenging to learn. The aim of this study was to develop laparoscopic instruments with different integrated tactile vibration feedback by varying different tactile modalities and assess its effect on tissue handling skills. Methods: Standard laparoscopic instruments were equipped with a vibration effector, which was controlled by a microcomputer attached to a force sensor platform. One of three different vibration feedbacks (F1: double vibration > 2 N; F2: increasing vibration relative to force; F3: one vibration > 1.5 N and double vibration > 2 N) was applied to the instruments. In this multicenter crossover trial, surgical novices and expert surgeons performed two laparoscopic tasks (Peg transfer, laparoscopic suture, and knot) each with all the three vibration feedback modalities and once without any feedback, in a randomized order. The primary endpoint was force exertion. Results: A total of 57 subjects (15 surgeons, 42 surgical novices) were included in the trial. In the Peg transfer task, there were no differences between the tactile feedback modalities in terms of force application. However, in subgroup analysis, the use of F2 resulted in a significantly lower mean-force application (p-value = 0.02) among the student group. In the laparoscopic suture and knot task, all participants exerted significantly lower mean and peak forces using F2 (p-value < 0.01). These findings remained significant after subgroup analysis for both, the student and surgeon groups individually. The condition without tactile feedback led to the highest mean and peak force exertion compared to the three other feedback modalities. Conclusion: Continuous tactile vibration feedback decreases the mean and peak force applied during laparoscopic training tasks. This effect is more pronounced in demanding tasks such as laparoscopic suturing and knot tying and might be more beneficial for students. Laparoscopic tasks without feedback lead to increased force application. [ABSTRACT FROM AUTHOR]

This resource review collated some of the materials available that could be helpful for the speech pathologist in the hospital setting. We looked at a variety of resources including podcasts, textbooks and artificial intelligence. The aim of this review was to highlight the more relevant, and easily accessible resources that could have clinical and professional applications for speech pathologists of varying levels of experience. [ABSTRACT FROM AUTHOR]

Aims: To (a) compare student nurses' health status and levels of ergonomics knowledge and awareness to those of first‐year nursing staff and (b) investigate the association between nurses' ergonomic compliance and health status with their educational preparedness. Design: This cohort study compared ergonomics awareness and knowledge, and health status of nurses when they were students and after their first‐year working in medical facilities. Methods: In total, 133 4th‐year student nurses completed a survey; 45 of them completed a second survey after working 1 year in a medical facility. Their health status was compared over time using repeated‐measures ANOVA. Correlation tests were used to analyse associations between ergonomics knowledge and awareness, health status, demographic variables and educational preparedness. Results: Respondents in both surveys displayed weak knowledge of ergonomic principles significantly associated with increased pain intensity and educational preparedness. Patient contribution: Ergonomics training should be expanded during nursing studies and first‐year training to prevent long‐term health disorders. [ABSTRACT FROM AUTHOR]

In recent decades, nursing has been integrated into increasingly advanced and complex healthcare settings. One of the environments in which the level of preparation and expertise required of nurses is most adaptable is the operating room, where the variety of surgical approaches and the use of sometimes complex equipment at times requires a long learning curve. One of the specialties most affected in this regard is urology, with several techniques having emerged in recent years, particularly in the field of endoscopic treatment of benign prostatic hyperplasia (BPH). Understanding how the expertise of the surgical nurse may be influenced by the learning of new surgical procedures allows us to grasp how different the learning curve may differ between experienced and less experienced nurses in dealing with new surgical approaches. A total of 36 patients diagnosed with BPH and eligible for endoscopic treatments were enrolled (9 candidates for TURP, 9 for Holmium laser enucleation of the prostate (HoLEP), 9 for REZUM water vapour therapy, and 9 for UROLIFT). The nursing expertise was divided into three levels: novice (endoscopic room experience <6 months), competent (>1 year and 6 months of experience), and expert (experience >6 years). Objectively measurable data were collected regarding the instrumentation required to perform procedures, the setup time of the operating room and surgical devices, and the transition time between procedures in the same operating room. Surgical nurses were also asked to provide subjective commentary on the perceived difficulty in dealing with the four types of procedures. Regarding the learning curve of the surgical nurse, minimally invasive procedures were found to be more accessible to less experienced nurses. In particular, REZUM showed the most significant impact on reducing skill assimilation time. The impact of experience gained was notable for the endoscopic approaches of TURP and HoLEP: experienced surgical nurses were faster in acquiring new skills and setting up the materials needed for the surgical procedure. Considering nursing staff expertise and learning needs in the urologic endoscopy operating room is necessary and desirable because it allows easier and faster learning of new surgical approaches, especially in more complex techniques. Relying on experienced nursing staff is also desirable because it has an impact on overall operating time. [ABSTRACT FROM AUTHOR]

Often, nurses new to the school setting find they have more questions than answers about school nursing practice but no mentor to ask. Questions often arise regarding medication administration, health records, health requirements to attend school, student illness, school health legislation, and state reporting requirements in the school setting, plus many more. This article outlines how one Regional Office of Education (ROE) in central Illinois partnered with a Certified School Nurse to establish a mentoring and networking program to foster relationships and information sharing among school nurses. [ABSTRACT FROM AUTHOR]

This phenomenological qualitative study examined the lived experience of pediatric nurse residents' transition to practice during the COVID-19 pandemic. The purposive sample included nine pediatric nurses, participating in a nurse residency program, who entered the nursing profession during the first year of the pandemic. The setting was a free-standing, Magnet-recognized, pediatric academic medical center in the Northeastern U.S. Individual interviews were audio recorded and transcribed. Narratives were analyzed using a hermeneutic phenomenological approach. Five themes emerged from the data: Our New Normal; The Rules Keep Changing; I'm Not Ready for This (transition to practice); The Toll of COVID; and Shattered Family-Centered Care. Sub-themes emerged in The Toll of COVID theme: COVID and the Nursing Care Environment, Emotional Toll of COVID, Burnout: A Universal Truth, and The Pandemic within the Pandemic. The nurse residents' narratives uncovered the essence of their uncertainty, sorrow, growth, and resilience. Through the eyes of pediatric nurse residents, this study illuminated the experiences of these novices as they entered the nursing profession amid a pandemic. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to explore the clinical and training experiences of recently qualified, LGBTQ+ identifying therapists who work with sexuality and gender diverse clients, in order to discover ways in which counselling training organisations might better prepare their trainees to work competently with this particular client group. Method: One‐to‐one, semistructured interviews with five therapists were conducted. Data collected from these interviews were subsequently analysed using the seven steps of interpretative phenomenological analysis. Findings: The analysis revealed six superordinate themes: Enhance tutors' LGBTQ+ knowledge and cultural awareness; Provide students with adequate supervision; Teach a range of LGBTQ+ topics; Integrate LGBTQ cultural competence training throughout the curriculum; Invite LGBTQ+ specialists; and Signpost students to additional resources. Conclusions: Participants felt unprepared by their entry‐level counselling training to work with LGBTQ+ clients. The perceived lack of LGBTQ+ knowledge and understanding of their tutors was regarded as a contributing factor to the limited time and depth of LGBTQ cultural competence training received. Several suggestions to improve training in this area were offered. Recommendations: Entry‐level counselling training courses should integrate LGBTQ cultural competence training throughout their curriculums in order to adequately prepare their trainees to work competently with LGBTQ+ clients. Additionally, it is important that counselling educators maintain their own LGBTQ+ knowledge, understanding and skills. [ABSTRACT FROM AUTHOR]

Objectives: There is concern that junior doctors are not prepared for their post-graduate attachments in ENT. The aims of this study were to capture the learning priorities of those in the ENT first on-call role and facilitate further educational opportunities to address these needs. Method: Semi-structured interviews were undertaken to explore the learning needs of junior doctors with seven junior and two senior ENT clinicians. Results: The thematic analysis generated three themes: the role of the ENT Junior; the perceived, expressed and prescribed learning needs; and attitudes towards future learning. These themes explored the misalignment between undergraduate training and post-graduate expectations, the lack of competence in ENT practical skills and the need for focused ENT training prior to commencing on-call shifts. Conclusion: All interviewees identified the need for greater experience in practical interventional skills prior to their ENT attachments and expressed interest towards a standardised, bootcamp-style induction with simulated emergency experience. [ABSTRACT FROM AUTHOR]

Medical and technological advances have made it possible to keep people alive well beyond what was once possible, leading health care providers to focus on life-sustaining measures rather than questioning the futility of such measures and considering quality of life. In the midst of the struggle to foster dying well in a medicalized environment, acute care nurses may be challenged with shifting the focus to providing optimal end-of-life care because of lack of training, time, and resources. A remedy for the current western societal approach to medicalized dying is to look back in history to a time during the late Middle Ages, when death was an accepted part of medieval life. A literary genre called Ars Moriendi (translated "the art of dying") was written and illustrated to provide instruction on how to die well and how to care for the dying. Nurses can apply lessons from this text to fulfill the ethical obligation to practice with dignity and provide compassionate end-of-life care. These lessons include helping patients and families identify goals of care and accept finitude, encouraging the participation of loved ones at the bedside, and fostering reconciliation at the end of life. [ABSTRACT FROM AUTHOR]

Aim. The aim of the study was to analyse the level of cultural intelligence and multicultural personality profile of novice nurses in Poland in the context of the increase of migration and refugee crises. Material and methods. A cross-sectional study of 234 novice nurses working in clinical, district or city hospitals was conducted. The Polish version of the Cultural Intelligence Scale and the Multicultural Personality Questionnaire were used. Statistica™ 13.3 software was used for analysis. Results. The results indicate a moderate level of cultural intelligence and diversity in the levels of intensity of the multicultural personality traits. The highest levels were found in cultural empathy. A positive correlation was found between cultural intelligence and multicultural personality. The global dimension of cultural intelligence and its four domains were found to be related to three multicultural personality traits – cultural sensitivity, social initiative and open-mindedness. Conclusions. The study highlights the importance of cultural competence in healthcare and the need to strengthen it among novice nurses, especially amidst contemporary social changes and challenges associated with migration. The implementation of systematic training programmes aimed at increasing cultural competence among nurses is recommended to enhance and develop these skills. [ABSTRACT FROM AUTHOR]

Background: The United States currently is experiencing a nursing faculty shortage that greatly affects the number of nurses entering professional practice. Nurse faculty transitioning from clinical practice to academia face challenges that may have negative effects on job satisfaction and feelings of competence. Despite barriers, quality nursing faculty are needed. Method: This quality improvement project evaluated the effects of an 8-week structured onboarding mentorship on novice nursing faculty's job satisfaction and feelings of competence. Novice faculty were paired with a mentor and completed weekly meetings and an online on-boarding curriculum based on National League for Nursing Nurse Educator Core Competencies. A pretest-posttest design assessed feelings of competence and job satisfaction before and after the 8-week intervention. Results: Findings indicated increased feelings of competence and no change in job satisfaction. Conclusion: Outcomes demonstrate how mentorship and structured orientation can positively benefit novice faculty's experiences and competence during their transition into academia. [J Nurs Educ. 2024;63(6):405–408.] [ABSTRACT FROM AUTHOR]

Introduction: Mental health is a serious concern among novice school nurses in Japan. Numerous novice school nurses with various health problems experience high stress levels, affecting their mental health. They may be experiencing reality shock, a known risk factor for burnout and turnover, or its factor, the "reality gap." Objective: This study aimed to examine the hypothetical model by which the reality gap affects the mental health of novice school nurses. Methods: This cross-sectional study conducted a self-administered questionnaire survey, and responses were obtained from 102 novice school nurses. A path model was created based on a hypothetical model. Results: After several revisions on the hypothesis model, a modified path model was generated (CFI =.98, TLI =.93, RMSEA =.06). The path model showed that reality gaps negatively affected work engagement, work engagement positively affected intention to stay, and intention to stay positively affected mental health. Reality gap was also directly negatively associated with mental health. Having various support networks reduced the effects of reality gaps on mental health. Additionally, social support in the workplace boosted work engagement. Conclusion: Unique from other studies, this study contributed to understanding the effects of reality gaps on mental health. School managers and administrators should establish a support system that enables school nurses to receive various supports from within and outside the school. In addition, novice school nurses should take advantage of networks and support inside and outside school to reduce reality gaps and grow as professionals. [ABSTRACT FROM AUTHOR]

Numerous nursing roles in a variety of work environments are available to nurses specializing in nephrology nursing. This article describes the various roles and work settings available to nurses new to nephrology and experienced nephrology nurses, intending to promote awareness of the specialty and increase the number of nurses working in nephrology. The information provided can be shared with those working within the specialty, and be included in nephrology nursing recruitment and retention strategies implemented to address the current and future anticipated nephrology nursing void. [ABSTRACT FROM AUTHOR]

As newly licensed nurses transition to practice, opportunities exist to optimize self-care. An onboarding layer of support was provided through a nurse residency program that incorporated the SMILE Scale™, a quick and easy tool for self-assessment of well-being. This tool can be incorporated for use with healthcare staff in any environment. [ABSTRACT FROM AUTHOR]

Understanding newly licensed registered nurses' perceived confidence in the Quality and Safety Education for Nurses (QSEN) competency domains and corresponding knowledge, skills, and attitudes will help inform clinical leaders to develop successful transition-to-practice programs. Newly licensed registered nurses and prelicensure nursing students had confidence in their understanding of QSEN competencies as they began their transition to practice. Online learning and virtual practicums were effective for attaining QSEN competencies, offering support for using these interventions in academic settings and transition-to-practice programs. [ABSTRACT FROM AUTHOR]

Background: Job satisfaction has garnered significant interest across multiple disciplines as it plays a vital role in shaping human resource strategies. In the field of nursing, enhancing job satisfaction can help prevent workforce shortages. Work values and job-related characteristics are significant predictors of job satisfaction. However, the influence of factors may change as younger generations join the nursing workforce. Although research on generational commonalities and differences in work values is increasing, there is insufficient information on generational differences in the interplay between work values and job satisfaction. This study investigated the factors associated with job satisfaction of new nurses in each generational group based on a work value perspective. Methods: A total of 280 new nurses (151 from Generation Y and 129 from Generation Z) were selected from the Graduates Occupational Mobility Survey. Multiple linear regression analyses were performed to determine the factors associated with job satisfaction in both groups. Results: Most participants graduated with a diploma (61.1%), were paid less than the average salary of each group (60.4%), and conducted shift (72.9%) and overtime work (64.3%). Work values and job satisfaction levels were not significantly different between the two groups. Multiple linear regression analyses showed that career growth and task work values were associated with job satisfaction for Generation Z, while task, reputation, and environment work values were associated with job satisfaction for Generation Y. Among the job-related characteristics, nurses' job tenure was associated with job satisfaction in both groups; salary and overtime had varying relationships with job satisfaction between the two generations. Conclusions: Understanding generational differences is crucial for improving the effective management of new generational nurses. Our study findings support that different work value dimensions and job-related characteristics were associated with job satisfaction in each generation. Accordingly, it is essential to develop distinct initiatives, such as a well-structured program, to support the continued career growth of the new Generation Z nurses, thereby enhancing their job satisfaction. Furthermore, providing a conducive working environment that helps new-generation nurses overcome challenges and ensures personal lives should be considered. [ABSTRACT FROM AUTHOR]

Background: At the onset of their professional journey, novice nurses often undergo a multifaceted psychological experience as they transition from theoretical knowledge to clinical practice, potentially impacting their development of professional identity. However, limited research has been conducted on the psychological aspects pertaining to newly graduated nurses in stomatological hospitals in our country. Methods: The phenomenological method and semi-structured interviews were used in this study, and the sample size of the interview was purposive sampling method. A semi-structured virtual interview was conducted with 21 new nurses in the department of stomatology. Colaizzi's analysis method was used to analyse the interview data. Results: Based on Kramer's reality shock theoretical framework and analyzing interview data, this study extracted the psychological experiences of novice nurses during their first year of employment across four distinct stages. The four stages include: cheerful period, frustration period, adjustment period and competency period. Six themes and nine sub-themes were derived from the four period. Conclusion: Due to the lack of professional knowledge, novice oral nurses will experience a series of complex positive and negative emotions at the beginning of their career. Through the research, the training of oral specialty theory, good psychological counseling and peer support can improve their participation in oral outpatient nursing. At the same time, the establishment of oral care quality assurance system and the improvement of oral care higher education in our country will become the focus of future research. [ABSTRACT FROM AUTHOR]

There is global recognition that mental health nursing can be stressful and have detrimental effects on nurses' well‐being and retention. With substantial nursing shortages, there is an urgent need to attract and retain nurses to sustain this workforce and provide effective mental healthcare. Mental health transition programs provide vital recruitment pathways and support novice registered nurses, enrolled nurses and experienced registered generalist nurses moving into this field. There is little evidence, however, on the well‐being, resilience, and retention of nurses transitioning into mental health. The primary aims for this cross‐sectional study were to describe demographic characteristics, perceived stress, well‐being, resilience, mental illness stigma attitudes, work satisfaction, and turnover intention of four nurse cohorts entering mental health transition programs: generalist registered nurses, graduate and post‐graduate registered nurses, and enrolled nurses; to explore relationships between these variables; and explore differences between these four nurse cohorts. Findings (n = 87) included overall moderate perceived stress, moderate well‐being and resilience, high work satisfaction, low stigma, and low turnover intention. Higher turnover intention was associated with lower age and work satisfaction, and higher perceived stress. Generalist RNs had significantly higher stress and stigmatizing attitudes than Enrolled Nurses. Secondary analysis of well‐being scores identified 14 nurses with scores indicating depression, with significantly lower resilience and work satisfaction, and significantly higher stress than the rest of the sample. To help prevent attrition, it is vital that mental health services provide tailored well‐being initiatives during transition and intervene early to provide support for nurses with mental distress. [ABSTRACT FROM AUTHOR]

Background: Mastering laparoscopy is challenging—it requires specific psychomotor skills which are difficult to obtain in the operating room without potentially compromising patient safety. Proficiency-based training programs using virtual reality simulators allow novices to practice and develop their skills in a patient-safe learning environment. Variable practice leads to stronger retention and skills transfer in a non-surgical setting. The objective of this trial was to investigate if variable practice was superior to self-directed training. Methods: A randomized trial where participants (n = 36) were randomized to proficiency-based laparoscopic simulator training of basic skills using either variable practice or self-directed training, followed by a transfer test with proficiency-based training on a procedural task (a salpingectomy). All participants returned after a period of 3–5 weeks to perform a retention test. Results: The mean time to proficiency for the basic skills tasks were 119 min (SD: 93) for the variable practice group versus 182 min (SD: 46) for the self-directed training group (p = 0.015). The time to reach proficiency during the transfer test was 103 min (SD: 57) versus 183 min (SD: 64) for the variable practice group versus the self-directed training group, respectively (p < 0.001). The mean time to proficiency for the retention test was 51 min (SD: 26) and 109 min (SD: 53) for the variable practice group and self-directed training group, respectively (p < 0.001). Conclusion: Variable practice is superior to self-directed training for proficiency-based laparoscopic training. With variable time to practice proficiency is reduced, there is higher transfer to a procedural task, and retention is improved. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise the importance of effective nursing leadership in clinical practice • To understand the factors that affect early career nurses’ motivation to develop leadership skills • To consider the approaches that organisations could use to encourage nurses to adopt leadership roles. Effective nursing leadership has been shown to improve patient outcomes, but there has been little exploration of the factors that influence early career nurses to develop their leadership skills and adopt leadership roles. This article presents a rapid review of the literature on these factors, integrating data from 25 articles. Findings suggest that improving leadership confidence and self-efficacy, particularly in relation to system leadership, can increase nurses’ motivation for adopting leadership roles. Supportive organisations that value leadership and give nurses opportunities to exercise it are equally important. Training and education, preceptorship, peer-to-peer shadowing, modelling and mentoring can all be useful in improving leadership skills and inspiring the next generation of nurse leaders. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the novices' learning curves and proficiency level reached in laparoendoscopic single-site (LESS) surgery using three surgical training programs. Participants were randomly divided into three groups, who trained in a specific practice regimen for 12 days using a laparoscopic box simulator and three tasks. Group A trained in three stages using conventional laparoscopic surgery (CLS) with straight instruments, and LESS with straight and articulating instruments for four days each. Group B trained in two stages in LESS with straight and articulating instruments for six days each. Group C trained only in LESS with articulating instruments exclusively for all 12 days. Performance was registered daily during the 12 days to evaluate the participants' progress. Pre- and post-training analysis of the three groups showed significant differences in performance, denoting the significant improvement in their LESS skills, with no difference between the groups. Group C reached a high level of technical competence with their specific training program in LESS, obtaining a lower asymptote and slow learning rate. Specific training programs in LESS settings using articulated instruments showed a slower learning rate than the other programs but better proficiency in the technique with the best surgical performance. [ABSTRACT FROM AUTHOR]

Background It is necessary to provide safe care for patients with acute and life-threatening conditions by nurses working in the emergency departments (EDs). These nurses need higher levels of independent performance. Therefore, the competency to provide safe care and having professional nursing autonomy in novice nurses working in the EDs are very important. Objective The purpose of this study was to determine the relationship between professional nursing autonomy and safe nursing care in newly graduated nurses working in the EDs. Methods In this analytical cross-sectional study, the study population consists of all newly graduated nurses working in EDs of hospitals in Guilan, Iran. They all were included in the study using a census sampling method. The tools for collecting information were a demographic form, the assessment of safe nursing care questionnaire, and the professional nursing autonomy scale. Descriptive and inferential statistics (independent t-test, Spearman or Pearson correlation test, and linear regression analysis) were used to analyze the collected data. Results There was a significant relationship between professional nursing autonomy and safe nursing care; for every one unit increase in professional autonomy, the chance of providing safe nursing care increases by 0.133 (P=0.009). Conclusion The significant relationship of professional nursing autonomy with safe nursing care among the EDS nurses shows that if nurses have a greater control over their performance, decision-making ability, and autonomy to act based on patient safety, they can provide better quality care to patients. Therefore, empowering nurses by providing conditions to perform based on professional autonomy, can ultimately lead to better results for the patients and cause overall safety in the EDs. [ABSTRACT FROM AUTHOR]

Background: There have been recurring UK initiatives to increase nurse research capability but little robust evaluation of long-term effectiveness. More nurses undertake doctorates, yet few lead major funded projects. Previous research suggests potential explanations but the perspectives of nurse lead-investigators themselves have not been examined. Aim: To explore the perceptions of nurse lead-investigators about what has helped or hindered them to lead funded research projects. Methods: Lead investigators of research projects from major UK funders (1 Apr 2017–Sept 2022) were identified from publicly available data. University profiles were screened to identify registered nurses. Entire population was approached (no sample size calculation required). Consenting participants completed an online survey (five open questions). Results: A total of 65 nurse-lead investigators were identified, 36 (55%) completed the survey (20 December 2022 to 17 February 2023). Participants identified Building (multi-disciplinary) collaborations and mentorship as having been most important to their success. High-quality mentoring was also identified as most important in helping novice nurse researchers become leaders. Participants highlighted the critical importance of being supported by individuals with a track record of funding success and benefits of being situated in research-supportive environments. Lack of career pathway/ infrastructure and being unable to pursue research due to competing clinical/teaching priorities were identified as most unhelpful to this group AND the most common reasons for peers not going on to lead research. Conclusions: Ensuring access to mentors with an established track record is an important component of schemes to increase research capability in nurses. Funded, protected time for research and career structures that reward the significant skill development required to succeed in a competitive, multi-disciplinary funding arena is important. Impact: Interdisciplinary collaboration and mentorship by experienced researchers are critical to success and should be incorporated into future interventions to increase research capability in nurses. No patient or public contribution (as exploring a professional issue). [ABSTRACT FROM AUTHOR]

Background: Arterial punctures are a common procedure used to obtain blood samples for lab tests that guide treatment of neonatal patients. These punctures can be painful and have associated risks, emphasizing the importance of keeping attempts to a minimum. Purpose: The purpose of this quality improvement initiative was to determine whether using transillumination to visualize arteries before and while obtaining a blood sample would improve outcomes in neonatal patients. Methods: Quantitative data were collected pre- and postimplementation of education for the use of a transillumination device for arterial punctures on neonates in a level III neonatal intensive care unit (NICU). Outcomes followed included the success rate, average time to obtain a blood sample, and the average number of sticks to obtain a blood sample. Data were collected on 47 blood draw attempts in the control group (preimplementation) and 19 blood draw attempts in the experimental group (postimplementation). Results: A statistical analysis concluded that the use of the studied transillumination device does positively affect the incidence of successful blood draws, particularly for the novice NICU nurse. In addition, the average number of sticks to obtain a blood sample significantly decreased in the experimental group. Finally, the average time to obtain a blood sample using the device was not impacted in this study. Implications for Practice and Research: Use of a transillumination device does appear to result in improved outcomes for arterial punctures in neonatal patients. More research is needed to confirm these findings due to the small sample size of the study. [ABSTRACT FROM AUTHOR]

Prehospital intubation is a high-risk, relatively low frequency procedure. Provider experience plays a key role in first-pass success rates, especially in the setting of a difficult airway. While strong foundational knowledge is necessary to equip providers with an adequate understanding of intubation procedures and the skill set needed to manage a difficult airway, effective equipment may provide an extra boost in first-pass success for novice airway providers. First-pass success is correlated with decreased adverse events and should be maximized in the prehospital setting. After evaluating overall first-pass success of 66% to 83% from 2016 to 2020, AHN LifeFlight enacted changes in education, training, and video laryngoscopy equipment to successfully increase first-pass success to over 90%. [ABSTRACT FROM AUTHOR]

Nurse leaders depend upon resiliency skills to support their practice. It is important to provide opportunities for nursing students to learn, practice, and observe these skills, which are needed to navigate challenging work environments. This article describes the impact of a resiliency curricular component in a grant-funded BSN elective course, Concepts of Primary Care. Program evaluation was performed using a pre/posttest format and 2 surveys, the Brief Resilience Scale (BRS) and the Brief Resilience Coping Scale (BRCS). Three open-ended questions were administered upon completion of the elective course. A concurrent nested design was utilized with a thematic analysis undertaken to analyze qualitative data. Analysis of quantitative data was performed using descriptive statistics. Undergraduate BSN students showed an overall increase in resiliency (BRS: P =.112; BCRS: P =.064), and responses to open-ended questions supported the ability to apply and analyze most of the resiliency skills presented during the didactic portion of the elective course. This course promoted the development and refinement of undergraduate BSN student resilience skills. Integration of resilience content in the primary care course also supported student professional development. The addition of resiliency concepts and skills into undergraduate nursing curricula is recommended to enhance the ability of novice nurses to address work-related challenges and promote career satisfaction for the future. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to describe the design and evaluation of a pilot leadership development programme for infection prevention and control (IPAC) professionals during the COVID-19 pandemic. The programme's aim was to improve IPAC knowledge and capacity in the health-care system by developing the leadership skills and capacities of novice and advanced Infection Control Professionals (ICPs), to respond flexibly, and competently, in their expanding and ever-changing roles. Design/methodology/approach: The leadership programme was piloted with seven nurses, who were part of a clinical nursing team in New South Wales, Australia, over a 12-month period between 2021 and 2022. The programme was designed using a leadership development framework underpinned by transformational leadership theory, practice development approaches and collaborative and experiential learning. These principles were applied during programme design, with components adapted to learners' interests and regular opportunities provided for collaboration in active learning and critical reflection on workplace experiences. Findings: The authors' evaluation suggests that the programme was feasible, acceptable and considered to be effective by this cohort. Moreover, participants valued the opportunities to engage in active and experience-based learning with peers, and with the support of senior and experienced ICPs. The action learning sets were well-received and allowed participants to critically reflect on and learn from one another's experiences. The mentoring programme allowed them to apply their developing leadership skills to real workplace challenges that they face. Research limitations/implications: Despite a small sample size, the authors' results provide empirical evidence about the effectiveness of using a practice development approach for strengthening ICP leadership capacity. The success of this pilot study has paved the way for a bigger second cohort of participants in the programme, for which further evaluation will be conducted. Practical implications: The success of this leadership programme reflects both the need for leadership development in the IPAC professions and the applicability of this approach, with appropriate facilitation, for other professions and organizations. Originality/value: ICP leadership programmes have not been previously reported in the literature. This pilot study builds on the growing interest in IPAC leadership to foster health system responsiveness and change. [ABSTRACT FROM AUTHOR]

Research suggests long hours and frequent travel contribute to an overwork climate and negative employee outcomes (e.g. turnover) in the sports industry. Recent studies indicate individual factors like job position and gender may impact employees' work experiences while also suggesting sport industry employees remain highly committed to the industry. Therefore, four hypotheses were examined to better understand the impacts of career commitment, job position, and gender on the relationship between overwork climate and turnover intentions. Survey data collection methods were used to sample intercollegiate athletic department employees (N = 4,627). Hayes' PROCESS macro was used to examine career adaptability and the dual-moderated mediation of career commitment, job position, and gender on the relationship between overwork climate and turnover intentions. Results indicated overwork climate impacted the intent to change job and industry. Additionally, career commitment was found to mediate the relationship between overwork climate and intent to change jobs and industry. Finally, gender and job position significantly impacted the moderated mediation relationship between overwork climate, career commitment, and intent to change to jobs but not industries. These findings suggest employees with higher levels of career commitment are less likely to change jobs and industries in the presence of an overwork climate. However, in overwork climates, certain employees (i.e. women, entry-level employees) are more likely to change jobs or leave their organization, but not the sport industry, illustrating the acceptance of an industry-wide overwork culture. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

This research investigates the relative effectiveness of independent online and blended learning approaches for novice analysts' development of videofluoroscopic swallowing study (VFSS) analytical skills. The secondary aims were to explore the impact of training on decision-making and to describe learners' perspectives of training outcomes. Undergraduate speech-language pathology students (n = 74) who had completed the dysphagia academic curriculum in an undergraduate speech-language pathology program were recruited for a randomised control trial. The ability to identify swallowing impairments in adults was compared pre- and post-training across three conditions: independent online (n = 23), peer-supported (n = 23), and expert-facilitated training (n = 28). The training comprised online VFSS training and practice with a commercially available digital video disc (DVD). The three training approaches were equal in improving novice analysts' identification of impairments on VFSS. Participants' analysis improved pre- to post-training (p = <.001), with no statistical difference amongst training conditions (p =.280). However, the expert facilitation condition resulted in better decision-making skill for novice analysts, as well as higher levels of confidence and greater engagement in the learning. Well-designed independent online methods are appropriate to prepare novice analysts for VFSS analytical training. Expert facilitation and peer-supported environments may have benefits for more advanced skill development and engagement, and should be investigated in future studies. [ABSTRACT FROM AUTHOR]

Patients at the end of life may experience dyspnea but be unable to report symptoms. The Respiratory Distress Observation Scale measures respiratory distress in patients who are unable to self-report and helps decrease any hesitation nurses may have about administering opioids to a patient who is dying. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding and human milk have well-documented health benefits for newborn infants, particularly those who are sick. However, breastfeeding rates and human milk feeding among infants in neonatal intensive units (NICU) in Thailand are still low; thus, breastfeeding promotion and support are required for Thai mothers of premature infants. Newly graduated nurses can play a critical role within the healthcare support system and can have a significant impact on improving breastfeeding practices in the NICU. The objective of this study was to investigate the lived experiences and perspectives of Thai novice nurses on supporting breastfeeding and human milk feeding in the NICU. Methods: The study was conducted between March 2021 and May 2022 at three medical centers in the central region of Thailand. This study employed a descriptive phenomenological approach to explore Thai novice nurses' experiences and perspectives on breastfeeding. Purposive sampling was used to invite Thai novice nurses who have work experience in providing breastfeeding support to NICU mothers and their infants to participate in online interviews using a video conference platform (Zoom). Semi-structured questions were used to interview study participants in their native language. Data were analyzed using Colaizzi's method of data analysis to identify emergent themes. Member checks, peer debriefing, and self-reflection were applied to ensure the validity and trustworthiness of the study results. Back-translation was also used as a quality and accuracy assurance. Results: A total of thirteen novice nurses agreed to participate in the study. All were female, and their ages ranged from 21 to 24 years old at the time of the interview. The researchers identified five major themes related to the overall study objectives and research questions. They are: positive attitude toward breastfeeding and human milk, facing breastfeeding challenges at work, self-confidence rooted in experience, professional skill needs, and requiring further support. Conclusions: Our results suggest that breastfeeding education plays a vital role in encouraging new nurses to provide breastfeeding support to mothers of preterm infants. Establishing breastfeeding support training and innovative learning strategies can be crucial in developing appropriate breastfeeding practice guidelines and policies to support Thai breastfeeding mothers in the NICU. [ABSTRACT FROM AUTHOR]

Introduction. Rural nursing careers offer a multitude of benefits for individuals. Despite this, there continues to be a growing deficit in the number of nurses choosing to practice in rural areas. As the first 12–18 months of a nursing career are fundamental in shaping career location decisions, it is important to explore factors that influence early career nurses' employment decisions. Methods. A phenomenological study was undertaken to explore early career nurses' experiences during their first year of rural practice and describe how the nurses' experiences influenced their decision to remain in rural employment. Data were collected via semistructured interviews and underwent inductive thematic analysis. Results. Seven early career nurses practicing in rural locations were interviewed and described several influences on their career location decisions, particularly related to whether they would stay in or leave their rural employer. The themes derived from the nurses' stories included the effect of their vulnerability entering a new workplace, the importance of connection to person, place, and profession and the nuances of rural nursing rhythms. These had implications on their employment decisions. Conclusion. This research demonstrates the distinct form of nursing practice that occurs in rural areas which was experienced by the early career nurses as a breadth of skills, volume of presentations, and continuity of care. The nurses described the importance of establishing connections to person, place, and their profession. These connections can support nurses through a period of vulnerability entering a new workplace. [ABSTRACT FROM AUTHOR]

Nursing assistants are vital healthcare team members who often experience personal challenges to professional success. The Transformational Healthcare Readiness through Innovative Vocational Education (THRIVE) program is designed to combat these challenges through coaching and curriculum that is steeped in adult learning and social theories. The program's goal is to increase retention and success of newly hired nursing assistants through personal and professional support. Components of THRIVE can be adapted in a variety of healthcare settings. [ABSTRACT FROM AUTHOR]

Purpose: Therapists' insights into practising narrative therapy (NT) with children can elucidate the strengths and challenges associated with this practice. Aim: The aim of this study was to investigate how therapists experience the application of NT with children. Method: Nine Danish narrative therapists working with children participated in semi‐structured qualitative interviews. The data were analysed using Braun and Clarke's thematic analysis. Results: Three overall themes were identified; "you have to be crazy about children," "practised ethics" and "practical challenges." Two subthemes were generated: "acting is the key" and "the importance of the system surrounding the child." Conclusion: The narrative therapists experienced NT as applicable for children due to its potential to facilitate a safe place that integrates the child's current stage of development. NT does not serve to "fit" the child but should be perceived as a practised ethic. Therapists accentuated challenges working with NT, specifically related to outsider‐witnessing and staying in a decentred position. The results are discussed regarding their contribution to the evolvement of the narrative therapy profession and to the training and supervision of novice practitioners. [ABSTRACT FROM AUTHOR]

Transition shock, experienced during the first two years of employment, has been attributed to decreased clinical performance and an overall decrease in work productivity among newly graduated nurses, as well as compromised patient safety outcomes. This study tested the intermediary effect of emotional exhaustion on the association between transition shock in novice emergency room (ER) nurses, adverse patient events, and nursing care quality. A descriptive study was carried out involving 303 novice ER nurses from various emergency units in five different hospitals in Central Philippines, utilizing four standardized scales. Mediation testing was performed using Hayes' PROCESS macro in SPSS (Model 4). Transition shock in novice ER nurses was associated with an increased incidence of adverse patient events (β = 0.3897, p = 0.0005) and poorer nursing care quality (β = −0.2146, p = 0.0021). Furthermore, emotional exhaustion partially mediated the association between transition shock and the two patient-related outcomes: adverse patient events (β = 0.0477, 95 % CI = 0.0078–0.0997) and nursing care quality (β = −0.0142, 95 % CI = −0.0412 to −0.0095). Transition shock in novice ER nurses contributed to heightened emotional exhaustion, which subsequently led to an increased incidence of adverse patient events and a decline in the quality of nursing care. [ABSTRACT FROM AUTHOR]