Indiana University-Purdue University Indianapolis (IUPUI) / The growing and aging population has created an increased demand for health care, resulting in a need for hundreds of thousands more nurses across the United States. As a result, additional nurse faculty are needed to teach the next generation of nurses. However, nurses who enter the faculty role in academia often come from various professional backgrounds with different educational preparation that may not equate to success with the tripartite faculty role of teaching, scholarship, and service. As a way to retain and develop novice faculty, mentoring relationships and programs are promoted as an intervention for career and psychosocial development within academia. Mentoring is an interpersonal process built on mutual trust and friendship to create a professional and personal bond. Mentoring relationships can help develop self-confidence, productivity, and career satisfaction among nurse faculty members. Effective mentoring relationships can ease the transition into academia and provide a vital foundation for productive academic careers. However, the interpersonal process that is the hallmark of mentoring can differ between a mentor and protégé, leading to vast differences in quality and effectiveness. Although mentoring is widely recommended, little is known about the process of mentoring relationships in academia or how novice nurse faculty utilize mentoring to transition into academia. The purpose of this qualitative grounded theory study is to uncover a theoretical framework that describes how mentoring relationships, as experienced by novice nurse faculty, unfold. Charmaz's method of grounded theory was used to interview full-time novice nurse faculty (N = 21) with three years or less in the faculty role from nursing programs across the United States. The grounded theory theoretical framework, Creating Mentorship Pathways to Navigate Academia captures the process of mentoring as experienced by novice nurse faculty within academia. The theoretical framework contains five main phases as described by novice nurse faculty being assigned a formal mentor, not having mentoring needs met, seeking an informal mentor, connecting with mentor, and doing the work of mentoring. Participants created mentorship pathways through both formal and informal mentoring relationships to navigate academia by acquiring knowledge, meeting expectations, and functioning in the role as a faculty member.

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The purpose of this descriptive study was to explore the concept of moral turpitude and related terms as they are used in the process of licensing professional nurses. The researchers reviewed applications for licensure and nurse practice acts or rules and regulations for nursing for the 50 states and Washington, DC. Terms such as moral turpitude, moral character, and morality are used by approximately half of the states and, when used, are not usually defined. Agreement among states on uniform definitions and standards of nursing practice can be a step toward aligning practice acts, bringing consistency to disciplinary actions, and informing the public about the profession's standards for practice.

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Introduktion: Det finns många fördelar med amning både för barnet och mammansamt att bröstmjölken är färdig i en behändig förpackning och innehåller allanäringsämnen som barnet behöver. Trots detta har en minskning av amningsfrekvensensetts de senaste åren. Syfte: Syftet var att beskriva mammors upplevelser avamningsstöd efter födsel och hur det påverkar amningen. Metod: En systematisklitteraturstudie grundad på 15 artiklar som söktes fram genom databaserna CINAHL,PubMed och PsykInfo. Urvalet genomfördes med hjälp av Polit & Becks niostegsflödesschema och dataanalysen genomfördes enligt kvalitativ innehållsanalys enligtLundman och Hällgren-Granheim. Resultat: Två huvudkategorier identifierades: Stödvid amning och hindrande faktorer som påverkade amningen. Slutsats: Stöd från bådeanhöriga och sjukvårdspersonal spelade en stor roll när mamman skulle börja, fortsättaeller sluta amma. Information om både fördelar och nackdelar med amning önskadesav mammorna för att de skulle kunna förbereda sig och lättare kunna bemästra deutmaningar som kunde uppstå.

Florida is one of two states that do not allow ARNPs to prescribe controlled substances. The Florida Legislature has expressed concern regarding the safety of ARNPs prescribing controlled substances. The purpose of this study was to compare malpractice rates of ARNPs and physicians in states with and without controlled substance prescribing. The design was a direct comparison of malpractice rates in states with and without ARNP controlled substance prescriptive authority. Comparison of malpractice claims was made between physicians (MDs and DOs collectively) and ARNPs in the United States and by state ARNP prescribing authority. Comparison of malpractice claims was also made between Florida and states that were demographically similar. The results showed that ARNPs have significantly less malpractice than physicians in the United States. In addition, there were no significant differences in malpractice, whether or not the ARNP was allowed to prescribe controlled substances. Finally, ARNPs working in states that are demographically similar to Florida, but allowed to prescribe controlled substances had no significant increase in malpractice. This study showed that there is no increase in malpractice rates in states where ARNPs prescribe controlled substances, either fully or partially, supporting the hypothesis.

A qualitative inquiry was launched to explore occupational stress among Certified Registered Nurse Anesthetists (CRNAs). Four research questions were posed: 1) What are the roles and responsibilities of the CRNAs as they see them? 2) What are the CRNAs perceived stressors encountered on the job? 3) What are their coping strategies related to the perceived stressors? 4) What is the relationship between CRNA job stress and interpersonal work connections? Twenty CRNAs, with varying anesthetic backgrounds, and 15 of their co-workers from North Carolina and Tennessee participated in the study. Semi-structured interviews, clinical observations, and artifact data (i.e., photographs) were employed to answer the research questions. The perceived occupational-related stressors that were recognized by the CRNAs pertain specifically to patient care, anesthesia work in general, interpersonal job relationships, inadequate surgical preparation, the operating room environment, and physical stressors. Staying focused upon the task at hand (i.e., patient care), the use of humor, verbalization and internalization of concerns, along with adopting personal hobbies were identified by the anesthetists as coping mechanisms to combat work-related stress. The participants take their professional duties to their patients and devotion to their fellow colleagues seriously - so much so that they rarely take vacation time or sick leave. After data analysis, six major themes surfaced: the role of being an attentive, reliable co-worker alleviates the antagonism found within OR relationships; maintaining open lines of communication is an effective way to address concerns and prevent staff conflict; among the CRNAs, occupational-related stressors create concern for patient safety; interpersonal work relations cause more stress than any of the other perceived job stressors; engaging in personal hobbies assists the CRNA in coping with work-related stress; and the nurse anesthetists' work lives are not as stressful as their personal lives. The answers to the research questions and the themes underscore the necessity that the shortage of Registered Nurses and anesthetists needs to be addressed in order to more effectively tackle the participants perceived stressors. In addition, employers can adopt concrete measures in assisting CRNAs with handling occupational stress, such as offering mandatory in-servicing and adequate time to attend in-servicing. / Ph. D.

The purpose of the study was to test a theoretical model explaining nurse practitioner judgments about the amount of interaction and participatory decision-making between nurse practitioners and physicians. The specific aims of the study included: (1) to examine the influence of nurse practitioner perceptions of care complexity and expected benefit-cost ratio of physician involvement on interaction and participatory decision-making; (2) to test a theory that integrates two alternative explanations of amount of interaction and participatory decision-making derived from social exchange theory and technology theory; and (3) to investigate the effect of practice rules on the relationships in the theoretical model. The study used a mathematical correlational design with a causal modeling methodology for model testing. A convenience sample of 38 nurse practitioners participated. Major concepts in the model were measured using a four scale magnitude estimation instrument developed for the study. The instrument consisted of operational definitions for each of the concepts and a set of 18 clinical situations scaled according to care complexity. Psychometric properties of the instrument including stability, internal consistency, content and construct validity were estimated. Matching of responses across two modalities was used to validate the production of ratio level data. Multiple regression techniques were used for theoretical model testing. In the test of the theoretical model, both care complexity and expected benefit-cost ratio had a significant impact on the nurse practitioners' judgments about amount of interaction and participatory decision-making. Predictions derived from social exchange theory and technology theory were supported. The effect of practice rules on the relationships in the model could not be determined since the index of practice rules did not achieve an acceptable level of stability. Nurse practitioner judgments about interaction and participatory decision-making were influenced by perceptions of care complexity and expectations of the benefits and costs of interaction with a specific physician. An understanding of the factors that affect nurse practitioner judgments about interaction and participatory decision-making may be used to guide interventions that enhance the fit between these structures and outcomes of care.

Many newly graduated registered nurses (NGRNs) leave the nursing profession within the first 2 years of employment in a rural hospital located in the Southwestern region of Oklahoma. A strategy to address this problem was to introduce a mentorship process that would help support the NGRNs as they transition into independent practice in the clinical setting. The goal of this project was to develop a mentorship program for future implementation. The Partners In Nursing (PIN) program sponsored by the Robert Wood Johnson Foundation, and developed by the American Association of Colleges of Nursing and the American Nurses Association, was selected to support the NGRN transition from student nurse to practicing clinician with a goal to improve retention rates by 10 percent. Benner's novice to expert framework and the Psychological Empowerment model were used in the development of activities contained within the mentorship program modules. Barrett's theory of power helped to guide the development of resilience activities for the future participants. An evaluation plan was developed to monitor new nurse progress before and during the program using the Casey and Fink questionnaire to evaluate the needs and job performance of the participants. The target hospital National Database of Nursing Quality Indicators (NDNQI) was analyzed to help justify the project abe used in future evaluations. Facilitating mentorship will result in social change through increased autonomy of the new professionals, along with improved retention which positively impacts patient outcomes. Social change will bridge the gap in retention and the cost of replacing a NGRN. Dissemination of this project is planned to occur both within the facility and at the relevant national organizations supporting nurse educators.