<p> The purpose of this qualitative phenomenological study was to explore emergency nurses&rsquo; perception of patient-initiated violence in eastern Tennessee. Twenty-four rural eastern Tennessee nurses participated in the study. The 24 participants were assigned to one of four gender specific focus groups. The focus groups offered qualitative data associated with the phenomenon. Themes and subthemes emerged from the analysis of participants responses using Colaizzi&rsquo;s (1978) strategies. The responses were segmented and compared to identify similar phrases or words. The data analysis detected five themes. Victimization manifested as participants&rsquo; feelings and a lack of executive leadership support. Re-victimization due to rural nurses&rsquo; continual exposure to patients who previously committed violent acts. A lack of executive leadership support was identified. Self-care deficit resulting from the participants&rsquo; post-exposure symptoms. Distinct gender differences were evident in this study. Implications include exploring an open dialogue between emergency nurses, nursing leadership, and executive leadership to develop policies that support the rural emergency nurse and establish policies that mitigate violence. Gender differences can be explored through individual discussion with emergency leadership leading to an individualized action plan that can foster self-care, employee engagement, and retain staff at the bedside.</p><p>

Nurses are an integral part of the health care system and their job encompasses a wide range of responsibilities including the promotion of health, prevention of illness and care for physically, mentally ill and disabled people. Nurses have a mandate to be responsible and accountable to the public they serve. For these reasons, it is crucial that nurses possess attitudes that allow them to provide optimal care in a supportive manner for patients. Despite the fact that considerable research on the experiences of nurses caring for the mentally ill in general hospitals has been done globally, none has been conducted in the Eastern Cape, South Africa. Additionally, no studies could be obtained from anywhere in the world on the experiences of non-psychiatric trained nurses caring for mental health care users on 72 hour observations. Studies indicated that nurses have different experiences when caring for mental health care users. It was therefore considered necessary to find out how non-psychiatric trained nurses perceive the caring of mental health care users during the 72 hour observations. The research design used to explore and describe their experiences was qualitative, descriptive, explorative, phenomenological and contextual in character. Semi-structured interviews were conducted with eight (8) participants who were purposively selected. This was done after necessary permission from the Department of Health and informed consent from the research participants. Steps were taken throughout the course of the study to ensure trustworthiness. Data were analysed using Tesch’s methods and the services of an independent coder were used. The results indicate that there are different experiences with regard to the caring for mental health care users during the 72 hour observations. The major themes identified are: feelings experienced by these nurses, lack of knowledge, challenges and strategies used for coping with a violent user, need for support from security staff and lack of policies. v Guidelines as a supportive action are suggested. From the results of the study recommendations are made in the areas of nursing education, nursing practice and nursing research. It is concluded that for non-psychiatric trained nurses to provide optimal care to mental health care users, the nurses need knowledge and skills in order to facilitate the promotion, maintenance and restoration of mental health of these patients as an integral part of health.

<p> More than one third of all Americans are obese, causing a myriad of health ailments that put excessive strains upon the U.S. healthcare system. It is estimated that medical costs attributed to these health complications such as heart disease, stroke and diabetes, are nearly $150 billion dollars. These statistics, along with the increasing amount of older adults due to the aging Baby Boomer generation, will only continue to increase these costs. Fitness initiatives are instrumental in lowering the rates of obesity and increasing overall health and wellness for these individuals. </p><p> Long Beach Mobile Fitness, LLC will provide on-site athletic training services to assisted living communities and business districts that provide adapted CrossFit techniques, along with other athletic training programming to clients within the City of Long Beach and the surrounding areas. Low start-up and monthly costs, along with the ease of transporting a mobile gym facility, allows Long Beach Mobile Fitness, LLC the flexibility to provide fitness programming to a wide range of clientele with ease.</p><p>

<p>ABSTRACT The current increase in the population of older adults has created a high demand for more informal caregivers. Informal caregivers complain of many problems in providing care including psychological stresses and anxieties, as well as physical, emotional, financial, and other social burdens. The purpose of this phenomenological study was to understand and describe the essence of the lived experiences of informal caregivers. The study was also intended to make health professionals and policy makers aware of such problems. The study adopted a qualitative methodology and a hermeneutical phenomenological design. Purposeful sampling was used in selecting participants with informal caregiving experience. Eleven informal caregivers were interviewed via telephone for data collection. Data was analyzed using Nvivo 11 for the identification and description of patterns and themes from the perspectives of participants. Eight themes that emerged from data analysis were: (a) Gender, many females engaging in caregiving, (b) Caregivers feeling stressful, (c) Love played a crucial role in caregiving, (d) Need for training for caregivers, (e) Being cared for by loved family members, (f) Impacts on job performance, (g) Living arrangements between caregiver and care receiver, and (h) Lack of support from family, community or state agencies. The conclusions focused on the need for support to informal caregivers such as caregiver training, adult day care services, care leave or respite care, increased access to services, care payments, and expansion in the informal caregiver workforce.

<p> The rigors of labor and childbirth are incredibly demanding on the mother's body physically, emotionally, and psychology. Most new mothers deliver in a hospital setting where they are discharged after approximately two days. However, the mother's health and well-being does not improve that drastically within those two days of post-delivery recovery. Common struggles that new mothers face include postpartum depression, intimate partner violence, mood and body changes, as well as nutrition and sleep deprivation. Therefore, it is not only important to be attentive to the newborn but to the mother's recuperation as she adjusts to postnatal life. While there are many options for new mothers to deliver their baby through hospitals or birth centers, there is a lack of postnatal care facilities in comparison. </p><p> Pamper Partum, LLC is a private company with an organizational mission to offer quality service and care that eases the transition to motherhood, to empower a new mother through education and community support, and to reduce any preventable risks associated with the postnatal period. Pamper Partum, LLC is an all-inclusive healthcare facility that provides services such as breastfeeding assistance, peer-support groups, private counseling, nutrition, general health care, and 24/7 infant monitoring in a state-of-the-art nursery. Pamper Partum, LLC will seek to be the first postnatal care facility that serves Orange County.</p><p>

<p> The placement of an indwelling urinary catheter (IUC) is a commonly performed clinical procedure which may become challenging for the clinician and painful for the patient. In response to urologic complications attributed to repeated failed IUC insertion attempts by nurses, a difficult urinary catheter (DUC) team program was launched in October 2012. The purpose of the doctoral project was to conduct a quality improvement evaluation of the effectiveness of the DUC team program using retrospective data from May 1, 2013 through May 31, 2017. Benner&rsquo;s novice to expert model was chosen as the theoretical framework to guide the additional training, critical thinking, problem-solving, and skill acquisition necessary for team member inclusion. The practice-focused question for the project answered whether DUC team nurses, through advanced training and demonstrated procedural competence, have been effective with DUC insertions. Sources of evidence included primary and secondary articles in peer-reviewed journals, as well as clinical evidence collected from internal sources. During the project time-line, 463 DUC team consultations were recorded with an insertion success rate of 89.6%. Based on the DUC team concept, additional didactic content and simulation training may be developed for other cognitive and skill-based clinical procedures. The implications for positive social change include improved patient safety and comfort, as well as cost savings for the organization and overall healthcare system.</p><p>

<p> Access to safe abortion care has been linked to better maternal and child health outcomes (Sedgh et al., 2012) and identified as essential for advancing women&rsquo;s economic and social equality (Lang, 2013; Bengsch, 2015). Around the world, nurses, including nurse practitioners (NPs) and certified nurse midwives (CNMs), are integral members of the health care teams that provide care to women considering or electing to have an abortion. Evidence supports NPs and CNMs as safe and effective providers of comprehensive early abortion care, and acceptable to patients (Barnard, Kim, Park, &amp; Ngo, 2015; Kallner et al., 2015; Weitz et al., 2013). </p><p> Currently in the United States (US), almost one million women have an induced abortion each year (Jones &amp; Jerman, 2017). National abortion data reveal significant disparities in rates, and inequities in access (Jerman, Jones, &amp; Onda, 2016). An inconsistent legal and regulatory landscape precludes NPs and CNMs from providing comprehensive abortion care in many states, including some where there are few providers. Vermont and New Hampshire comprise two of the four states where laws and practice regulations allow NPs and CNMs to perform aspiration abortion, and across New England. These advanced practice nurses (APRNs) are extensively involved in providing and managing the care of women undergoing medication abortion. </p><p> Little literature describes nurses&rsquo; experiences providing comprehensive early abortion care around the world, including in the US. The aim of this qualitative, exploratory, descriptive research study was to explore the experiences of NPs and CNMs who provide comprehensive early abortion care in New England. Data were collected through in-person individual interviews with seven NPs and one NP/CNM. Providing comprehensive early abortion care was generally a positive experience for most participants, though it did include challenges. Critical influences to becoming an NP or CNM who provided comprehensive early abortion care included the era in which participants came of age, values of their family of origin, exposure to feminism, reproductive rights and social justice during emerging adulthood, having a role model or mentor, and a personal experience of having an abortion were. Support at every level from interpersonal to societal was found to be a key enabling or constraining factor. Laws and regulations at the societal level were also noted to facilitate or impede abortion care provision by NPs and CNMs in the study. Finally, participants offered words of wisdom to others considering providing comprehensive early abortion care that ranged from clinical pearls to inspirational statements. They were universally encouraging in recommending this as a service to incorporate into clinical practice. This study has a number of implications for the future including the need for further research on NPs and CNMs experiences providing early abortion care in other regions of the US, and to remove state legislative and regulations that constrain practice for clinicians in this area of reproductive health care.</p><p>

<p> Healthcare management is an industry where skill sets are incremental, and Registered Nurses (RNs) must gain their clinical skills before they develop their management skills. Professional training for management-bound RNs seldom comprises more than a few disjointed days or weeklong development seminars, which is valuable but inadequate. The purpose of this original basic qualitative study, which employed Husserl and Heidegger&rsquo;s approach of phenomenology, was to explore the lived experiences of staff RNs who transitioned into the Clinical Nursing Supervisor (Nurse Manager) role within a small rural community hospital in North Carolina. Semi-structured interviews using open-ended questions were utilized to collect rich, contextual data until data saturation occurred. Open and axial coding of the data, documented in a code/theme frequency table, facilitated the discovery of central themes within the data including: a lack of orientation to the new role; inconsistent expectations of the new role; the benefits of a formal program or structured orientation for the new role, and a need to focus the hospital administration on formal leadership orientation and succession planning. The evidence from this original basic qualitative study aligns with the published literature regarding the transition from a staff RN role into a nursing leadership role and supports making a proposal to the hospital&rsquo;s administration for a systems-oriented Clinical Nursing Supervisor training opportunity such as a 90-day nursing leadership orientation that included formal classes on budgeting, common human resource management issues, and how to evaluate staff. This formalized training, in concert with one-on-one mentoring with experienced Clinical Nursing Supervisors, would ensure a smoother transition from the staff RN role into a Clinical Nursing Supervisor role and would produce more efficient, more satisfied nursing leadership professionals who are more inclined to stay with the organization that helped their career growth.</p><p>

M.Tech.

The purpose of this study was to determine if a shared governance management structure significantly affects the level of job satisfaction of registered nurses who work in hospitals. It was also intended to document which components are identified by registered nurses as impacting on their job satisfaction or dissatisfaction. The index of Work Satisfaction (IWS) was used to measure job satisfaction among two groups of nurses, one working in a hospital with a shared governance management structure (n = 99) and the other working in a hospital without a shared governance management structure (n = 143). IWS results indicated higher levels of satisfaction among nurses at the hospital with the shared governance management structure in three of the six components, namely Autonomy, Task Requirements, and Organizational Policies. Nurses at the hospital with the shared governance management structure were asked to respond to four additional questions. These were designed to measure to what degree nurses perceived shared governance to be working on their unit as well as in their hospital. These nurses were also asked to what degree they valued shared governance for Nursing. Results indicate the majority of nurses perceived shared governance to be "working well" on their unit and at their hospital. The majority also highly valued shared governance for Nursing. The findings of this study suggest that there may be a relationship between job satisfaction of registered nurses and a management structure which encourages decision making at the staff nurse level. Implications for the restructuring of nursing organizations are drawn. Recommendations for further research are provided.