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Lack of full practice authority (FPA) for advanced practice registered nurses (APRNs) is a barrier to the provision of efficient, cost-effective, high-quality, and comprehensive health care services for some of our most vulnerable citizens ( Agency for Healthcare Research and Quality, 2014 , Buerhaus et al., 2015 , Pohl et al., 2010a , Seibert et al., 2004 ). APRNs have the education, knowledge, skills, and experience necessary to provide basic and comprehensive primary care services; they are a ready workforce, ideally positioned to improve access to care, contribute to health disparities reduction efforts, and lower the cost of providing such care ( National Center for Workforce Analysis 2013 , Perloff et al., 2016 ). However, barriers at the state and national levels continue to prevent these highly qualified health care providers from practicing to the full extent to which their education and training have prepared them. It is the position of the American Academy of Nursing (academy) that FPA of APRNs is essential to achieving health equity.

The United States, as of October 2021, is the country with the most reported COVID-19 cases and COVID-19 deaths in the world. Since the first case was confirmed, Registered Nurses working in the acute care setting have been at the forefront of this public health crisis. As the pandemic has continued, studies have been conducted to collect, analyze, and reveal the effect of COVID-19-related stress on Registered Nurses in the United States. This critical literature review takes eleven published studies related to this topic, discusses the commonalities between them, addresses limitations in the literature and offers recommendations for future research. This review discusses five themes among the studies: the impact of inadequate PPE supply, COVID-19-related stress from direct contact with COVID-19 patients, stress levels reported by those working in the ICU setting, nurses self-isolating and the fear of infection or infecting others with COVID-19, and continued exposure to stressful work conditions during the pandemic, resulting in long-term effects, including chronic stress and post-traumatic stress disorder (PTSD). The databases used for this project were CINAHL Plus with Full Text, APA PsychInfo, and MEDLINE. This literature review suggests that COVID-19-related stress in the nursing profession in the United States produced acute and chronic stress responses. Nurses experienced various negative emotions, including burnout, stress, anxiety, and depression. Additional findings included insomnia, fatigue, and feelings of not being supported adequately by hospital administration. Based on the results, the researcher identified several recommendations to aid future research exploring the topic of COVID-19-related stress among registered nurses in the United States and how this research can be utilized when considering ways to address work-related stress and PSTD among acute care nurses in the future.

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This project study addressed the problem of knowledge and skills lost by new graduate RNs while delayed in transitioning to professional nursing practice. There is a paucity of knowledge about how new RNs experience their delay and how a delay may affect their future clinical performance. Mezirow's transformation learning theory was the conceptual framework for this qualitative case study. Research questions addressed new RNs' understanding of their experiences during a delay to professional practice. A purposeful sample included 8 new RNs who had completed a New Graduate Residency Transition Program (NGRTP) after a delay to practice of 6 months to 3 years. Four managers of the RN participants were also included in the sample. Data were collected through audio-recorded semistructured interviews and manager questionnaires. Qualitative data were coded and analyzed to identify themes. Findings indicated that while waiting for a RN position, the delay to practice new RN (DTP-RN) passed through stages that reflected clinical and professional needs. The consequences of the new RNs' delay to practice may impact the required NGRTP process. Findings influenced the development of a white paper to educate hospital nurse educators and managers about the DTP-RNs' unique needs. Recommendations include a NGRTP designed to meet the transition needs of the DTP-RN. Implementation of recommendations for a NGRTP may enhance the DTP-RNs' successful transition into professional practice with a result of greater job satisfaction and decreased RN turnover.

The increased use of technology has affected almost every aspect of how data are collected, stored, retrieved, and analyzed across the health care system. The health information management (HIM) workforce in the United States is predominantly composed of women. With HIM employment rising by 2020, additional education of the current workforce is a necessity. This qualitative phenomenological study evaluated women working with HIM associate degrees and RHIT certifications to determine their perceived need for advanced education for career advancement. This study used the social cognitive career theory (SCCT) to determine how women in HIM perceive needs based on self-efficacy, expected outcomes, and goals. The research questions evaluated education type, subject matters, and ability to advance. The study recruitment process included the use of HIM online research forums resulting and narrative inquiry data collection from 22 personal interviews across 19 states in the Unites States. Colaizzi's data analysis strategy demonstrated themes of HIM education access, barriers, preparedness, and role interests. The data gathered showed need and interest in further education directly correlated to time remaining in career and role aspirations. Recommendations for further research include evaluation of advanced HIM education needs in a male population or individuals with post-graduate education. To affect positive change, dissemination of this study's findings to HIM leaders may create awareness and rationale for women to obtain technology and data related advanced education. In addition, this study may influence educational institutions to promote HIM as a field of study and fill the anticipated gap in HIM field expertise in the coming decade.

Abstract: Introduction: To explore the information seeking behavior of Internationally Educated Nurses (IENs) and to investigate their exposure to libraries and library training in both their home countries and after being hired in Saskatchewan. Methods: This two-phase multi-method project was carried out in Saskatchewan, Canada. A questionnaire was developed based on survey instruments used in previously conducted studies on the topic. Librarians in two academic institutions assisted with validation of the survey. In Phase 1, data were collected via an online questionnaire from IENs in three health regions: Saskatoon, Regina, and Sunrise. In Phase 2, the study was expanded to IENs in all the health regions in the province. The same questionnaire from Phase 1 was used during telephone interviews with participants. Results: A total of 17 IENs responded (Phase 1, n = 9, Phase 2, n = 8). Results show that IENs, although interested in looking for information for their practice, are hindered by a lack of knowledge of how and where to seek relevant clinical information as well as a lack of library training. As a result, their main source of information is the Internet (Google). Discusion: Despite barriers such as time to information seeking, results revealed that given the opportunity IENs would like to receive library training to enhance their information seeking skills.

The overall aim of this thesis was to study palliative end-of-life care outside specialist palliative care settings, from an organizational perspective and from professionals’ and relatives’ experiences. In Study I 174 individuals were identified retrospectively from nursing records and palliative care identification forms as being in a palliative phase. Data were analyzed with descriptive and analytic statistical methods. In Study II a total of nine nurses working in primary home care, community care, and hospitals were interviewed. Phenomenological methodology was used to analyze data. In Study III 17 enrolled nurses, who worked in community or primary care and in a sitting service organization, participated in four focus group interviews. Data were analyzed with qualitative content analysis. In Study IV seven relatives from four families were interviewed twice. They had each cared in the private home for a dying family member who had received sitting service. Direct interpretation and categorical aggregation were used to analyze data. The results highlight challenges in palliative care, vulnerable situations, and a need of support (I–IV). Individuals’ needs for both palliative care and sitting service were identified, including those of a smaller part of the population who actually received the sitting service. (I). Registered nurses’ responsibilities included care at the same time for individuals in both palliative and curative phases. This created vulnerable situations for the nurses, since their ambitions concerning the care did not correspond to available resources (II). The enrolled nurses’ task was to manage ongoing life and dying in different care settings, to meet individual needs and still provide equivalent care. Despite experiences of vulnerable situations, they felt safe (III). Relatives experienced care situations differently, related to differences in families, the illness trajectory, the need for support, and the support offered. Without sufficient support, vulnerable situations occurred, which made the relatives feel insecure (IV). Thus, care situations in palliative end-of-life care can be experienced in different ways, with different levels of vulnerability. One implication of the research might be to suggest that professional caregivers, to supplement the relatives’ own resources with support tailored to the individual’s and the family’s needs

Genom tiderna har homosexuella och de som inte varit heterosexuella klassats som avvikande. Även idag är vi styrda av normer över hur folk ska bete sig och vara. De som inte är heterosexuella har ofta i dagens samhälle ett större vårdbehov, men undviker gärna att söka vård då de inte känner att de får en förståelse från vårdpersonalen. Sjuksköterskans roll är att ge vård på lika villkor utan fördomar och genom att ha respekt för en människas egen integritet. Studiens syfte är att se hur kunskap och attityder hos sjuksköterskan påverkar vårdandet av sexuella minoriteter. Litteraturöversikten som gjorts har granskat fyra kvalitativa och fyra kvantitativa studier. Dessa åtta studier sammanställdes och Kunskap samt Attityder och värderingar uppstod då som huvudkategorier, vartefter underkategorier skapades. I dessa två huvudkategorier framkom att det finns en vilja hos sjuksköterskor att vårda sexuella minoriteter men att kunskapen saknas. Vidare diskuterades hur attityder och kunskapsbrist påverkar patienterna och att utbildning inom detta område behöver bli mer framträdande i vården samt i grundutbildningen.