Nurses are largely unaware of the problems of night-shift-nurse sleepiness and available strategies to manage night-shift sleepiness. The purpose of this project was to examine nurses' self-perception, awareness of sleepiness, and current strategies to manage this problem in the emergency medicine department of a major academic hospital in the western United States. The validated de-identified Karolinska Sleepiness Scale (KSS) was used to measure the prevalence and intensity of night shift nurses' sleepiness prior to the development of an educational program on strategies to manage sleepiness. Of the 164 registered nurses surveyed, 72 (43.9%) reported sleepiness greater than 7 on the KSS. An educational program was developed and evaluated by a panel of 6 experts who were selected on their clinical, educational, quality improvement, and research in sleep studies. Expert reviews indicated that the education program was 100% relevant, appropriate, and understandable, and provided adequate information on the topic with no recommended changes. The education program was presented to 16 night shift nurses with a pre/posttest survey completed by 14 nurses. Results indicated that participating nurses increased their knowledge of managing strategies for sleepiness from 69% (agree or strongly agree) preintervention to 92% postintervention. Postintervention, there was a 50% increase in the number of nurses who reported benefits from the education intervention. The findings of this project contribute to positive social change by improving nurses' health and quality patient care by advancing nurses' awareness of night shift sleepiness and countermeasure management strategies.

Indiana University-Purdue University Indianapolis (IUPUI) / National calls for a better-educated nursing workforce are proliferating. The Institute of Medicine (IOM) challenged the nursing profession by setting the goal of having 80% of the nation's nurses prepared at the baccalaureate level (BSN) or higher by 2020. This is an ambitious goal given that, nationally, only 50% of nurses have a BSN. In fact, only 40% of nurses in Michigan have a BSN, and in the rural North-Central Region of this state, only 29% (the lowest in the state) of the nurses have a BSN. The purpose of this hermeneutic phenomenological study was to understand and interpret the meaning of being an associate degree (AD) nurse, the meaning attaining a BSN has for rural registered nurses who currently have an AD, and the barriers they experience that inform their decisions to return to school (or not). The investigator interviewed 11 AD nurses from rural North-Central Michigan and analyzed interview transcripts to identify common experiences and shared meanings using methods identified by Diekelmann, Allen, and Tanner (1989). Two themes were explicated in this study: "Getting in and Getting out" and "What Difference Does it Make?" The findings in this study challenge many of the common assumptions about academic progression in nursing and provide educators, administrators, and legislators with insight about the strategies that may be most helpful for achieving the IOM goal in rural Michigan.