<p> A quazi-experimental, one-group, pretest/posttest study was conducted with a group of 25 hospice workers employed by a medium sized county hospice organization in the southeastern United States that was experiencing rapid personnel turn-over. Participants in the study included a doctor, a physician&rsquo;s assistant, a nurse practitioner, a massage therapist, a grief counselor, a licensed practical nurse, a certified nursing assistant, two clergy, three administrative staff, three social workers, seven volunteers, eight registered nurses and one other. The purpose was to investigate whether attending four 1-hour art therapy sessions could help reduce stress and thereby Burnout. Stamm&rsquo;s (2010) Professional Quality of Life theory was utilized to frame the study and Stamm&rsquo;s ProQOL-5 was used as both pretest and posttest. The ProQOL-5 tested three elements of Stamm&rsquo;s theory which cannot be combined: Compassion Satisfaction, Burnout and Secondary Traumatic Stress, and a paired sample t-test were applied to each element. No statistical differences were found between pretest and posttest scores on the ProQOL-5 in the areas of Compassion Satisfaction and Secondary Traumatic Stress. Interestingly, posttest scores on the ProQOL-5 went up instead of down significantly, after participants received four 1-hour sessions of art therapy. No quantitative evidence was found to support the use of art therapy to reduce Burnout and increase Compassion Satisfaction and Secondary Traumatic Stress. There were some minor qualitative data to indicate art therapy was helpful in reducing stress at least temporarily. More investigation needs to be done in order to develop evidence-based interventions to relieve stress and reduce Burnout in hospice/palliative care workers as the field is growing rapidly.</p>

<p> Nursing students often harbor negative stereotypes and feel unknowledgeable and unprepared to work with mentally ill people. In addition, nursing students rarely choose the psychiatric specialty as a career option. A quantitative quasi-experimental study was conducted to examine nursing student feelings about engaging those with behavioral health problems. Over 300 nursing students in eight Bachelor of Science in Nursing professional nursing programs were surveyed on the first and last day of their program&rsquo;s psychiatric mental health nursing course (the independent variable). A valid and reliable survey instrument was used to collect nursing student responses characterizing attitudes, impressions of knowledge and preparedness, and career interests relative to psychiatric nursing. This work was supported by the theoretical tenants of Labeling Theory, Benner&rsquo;s Model, and Peplau&rsquo;s Theory on Interpersonal Relations. Statistical Package for Social Sciences software was used for exploration of the data. Data examination included descriptive analysis and paired <i> t</i> tests of four component subscales identified by the survey tool authors which were associated with the research questions and research hypotheses in this study. The results indicated nursing students manifest negative attitudes and a moderate sense of knowledge of and preparedness for interacting with the mentally ill. In addition, nursing students had a low interest in behavioral health as a career path. However, significant improvements in all of these factors except the latter were observed at the end of the psychiatric mental health nursing course. Nurse educators may use the information generated from this project to modify psychiatric nursing courses for fostering improvement in student feelings about the mental health specialty.</p>

<p> Although there is a growing body of knowledge concerning service-learning in professional nursing education, nursing research reports minimal studies that sufficiently address the effects of service-learning strategies on baccalaureate nursing alumni in promoting self-efficacy toward long-term civic engagement or development of professional practice. The purpose of this predictive, correlational study was to determine if a relationship existed between participation in the service-learning experience and self-efficacy toward civic engagement as a long-term outcome of professional nursing education and the development of professional practice in nursing alumni. Spearman's Rho was used to correlate the independent variable of service-learning with the dependent variables of civic engagement and professional practice. Multiple regression analysis indicated that service-learning had less than a 4% effect on civic engagement attitudes and a 6% effect on community service hours (behavior). The Social Cognitive Theory, specifically self-efficacy coupled with the construct of practical reasoning provided framework for the study. Results concluded that service-learning had a low to moderate relationship with both long-term civic engagement and the development of professional nursing practice.</p>

<p> When a traumatic event such as intimate partner violence occurs, resilience can help define recovery from that event. Women who experience the adverse event of intimate partner violence suffer injury, loss of physical and mental health, and possible death. Specifically, numerous women suffer injury and adverse health as a result of experiencing intimate partner violence (Krug, Mercy, Dahlberg, &amp; Zwi, 2002). The internal quality of resilience is what allows a person to mend or heal from trauma (Wagnild, 2009). Resilience is demonstrated by hardiness of spirit and a person's ability to return to their lifestyle (Atkinson, Martin, &amp; Rankin, 2009; Earvolino-Ramirez, 2007). This study is designed to explore resilience scores among older women who have been exposed to intimate partner violence earlier in life as well as investigate resilience scores with type of violence exposure. In addition, the self-reported health status among older women exposed to IPV earlier in life will be compared with the self-reported health status of women who have not been exposed to IPV. Finally, it will be determined if resilience scores in older women vary by demographic variables. A quantitative design will use The Resilience Scale, The Severity of Violence Against Women instrument, and a health status 1 questionnaire will be utilized to collect data. Participants will be obtained through convenience and snowball sampling from women 65 and older living in southern New Mexico.</p><p> These study findings show that older women who have been exposed to IPV between 10-49 years ago have the same resilience scores as older women who have not been exposed to IPV. In addition, self-reported health status is the same. Finally, demographic variables do not impact resilience scores among the two groups of older women. These findings indicate older women are able to recover from the trauma of IPV. They arc able to bounce back and go on with their lives and their long-term self-reported health recovers. When considered as a whole, the findings of this study lend hope to the idea that women are able to recover from the trauma of IPV exposure.</p><p> <i>Keywords</i>: abuse, health, intimate partner violence, older women, resilience</p><p>

<p> The purpose of this study was to explore the relationship between nurses' use of intuition, years of worked nursing experience, and nurses' perceived ethical decision making ability. Additionally, recognizing the relationship between the intuitive/experiential and the analytic/rational systems, this research extended beyond the intuitive/experiential system capturing analytic/rational thought. A sample of 182 nurses from the Emergency Nurses Association (ENA) was recruited for this investigation. A nonexperimental, correlational research design was used to examine the relationship between the variables. Intuition was measured using the Experiential scale of the Rational-Experiential Inventory (REI) and analytic/rational was measured using Rationality scale of the REI. Perceived ethical decision making ability was measured with the Clinical Decision Making in Nursing Scale (CDMNS) applied to an ethical dilemma within the participants own practice. Cognitive-Experiential Self-Theory (CEST) provided the theoretical framework for this study. According to CEST, information is processed by two independent, interactive conceptual systems; a preconscious intuitive/experiential system and a conscious analytic/rational system. These are thought to function parallel from yet interactively with each other. One-way ANOVAs, independent sample <i>t</i>-tests, Pearson's <i>r</i> correlation, and multiple regressions analysis provided the statistical methods used to answer nine research questions. A significant relationship was found between intuition and perceived ethical decision making (<i>r</i> = .252,<i> p</i> = .001). This contributes to a broader understanding of the different thought processes used by emergency nurses to make ethical decisions.</p><p>

<p> <b>Background:</b> Incivility in health care settings was first identified in 1976. Ten years later, a nurse published an article asking colleagues, &ldquo;Do we eat our young?&rdquo;. In 2000, the Institute of Medicine (IOM) sent a challenge for a safer health care environment and in 2008 the Joint Commission emphasized that disruptive behavior continued to compromise patient safety. Incivility in nursing is quickly becoming a topic of interest, yet it had not been studied from a qualitative approach by exploring it as a social process. </p><p> <b>Purpose:</b> The purpose of this grounded theory study was to adopt an abductive process to acquire an in-depth understanding of the critical factors that trigger the existence and fuel the persistence incivility in nursing and to develop a substantive theory to address the concept of incivility. </p><p> <b>Philosophical Underpinnings:</b> The philosophical underpinnings that guided this study were symbolic interactionism and pragmatism. Method: A constructionist grounded theory approach by Charmaz guided the qualitative research method. Individual and focus group face-to-face interviews were conducted to collect data from 29 Registered Nurses. Data analysis involved initial, focused, axial, and theoretical coding alongside memo-writing and reflexive journaling. </p><p> <b>Results:</b> The theory that developed from the data grounded in the voices of Registered Nurses was <i>self-positioning.</i> The four main categories that emerged from the gathered data supporting the theory are <i>neglecting, alienating, relinquishing,</i> and <i> finding oneself.</i> These categories represent the critical factors triggering the existence and fueling the persistence of incivility in nursing. </p><p> <b>Conclusion:</b> An in-depth understanding of the critical factors triggering the existence and fueling the persistence of incivility in nursing has been acquired by adopting an abductive process through a constructionist grounded theory approach by Charmaz. The <b>theory of self-positioning </b> serve as a guideline to nursing education, nursing practice, nursing research, and health/public policy in implementing specific plans of action to diminish the incidence of incivility, address the health and well-being of Registered Nurses, provide quality care, and ensure patient safety.</p>

Hair loss has been ranked as a source of considerable distress and may add to the losses associated with the experience of cancer. Chemotherapy-induced hair loss (alopecia) is a public consequence of the non-selective action of specific antineoplastic agents on healthy tissue. The literature demonstrates a lack of research on hair loss. Nursing studies have focused on efforts to prevent hair loss or measure the impact of hair loss using body-image instruments. The purpose of this study was the detailed examination of the meanings of hair loss over time in a sample of women receiving alopecia-inducing cancer chemotherapy. A qualitative descriptive design using a semi-structured multiple interview format examined the meaning of hair loss over time. A purposive sample of ten women receiving alopecia-inducing chemotherapeutic agents at a metropolitan teaching hospital was used. Each woman was interviewed prior to hair loss, at the time of hair loss, and two-three months after initial hair loss. The specific research questions described the meanings of hair loss in the lives of women receiving alopecia-inducing agents. Supporting questions explored the status of hair loss among sources of cancer-related distress, the role of past experiences and expectations, and the role of other people and social demands on the experiences. Data analysis was based upon the words, metaphors, and language patterns used by participants in describing their feelings and experiences. Findings reflect the meaning and real substantive losses associated with both the threat and actual hair loss. Symptom responses are shaped by personal history, experiences as well as meanings of cancer images and one's hair. Analysis of the findings reflect three processes: affective anticipation rehearsal, confrontation of the hair losses, and management of the hair loss experience. The coping outcomes may be positive, regaining one's stride, or negative, not regaining one's stride. The findings are congruent with a number of theoretical frameworks, such as Lazarus, Benner, Mishel and Wright. The findings support both the significance of hair loss and its amenability to nursing treatment approaches. Nurses have the opportunity to explore the meanings of hair loss with an individual and to lessen the distress associated with the threat and actual impact of that experience.

<p> Nurse Residency programs have been developed to ease the transition for new graduates to the workplace, one in which they face fast-paced patient encounters such as emergency response situations. During this one year educational experience, nurse residents persistently cite caring for deteriorating patients as a clinical challenge. There is a paucity of research on the unique needs of nurse residents when encountering such challenges. Philosophically underpinning this Hermeneutic study were tenets of Heidegger and Gadamer within which nurse residents' lived experiences of caring for a deteriorating patient were explored. In-depth interviews with eight nurse residents were analyzed and interpreted using Diekelmann's process for narrative analysis. The <i>Journey from Uncertainty to Salient Being</i> described the ontological-existential meaning of participants' lived experiences of caring for a deteriorating patient during their residency year. Three distinct constitutive patterns were identified each with themes: <i>dwelling with uncertainty</i>, <i>building me up</i>, and <i>a new lifeline: salient being.</i> Dwelling with <i>uncertainty</i> was experienced during encounters with deteriorating patients with its deeply felt impact upon nurse residents as they transitioned from student to professional nurse. The pattern of <i>building me up</i> was influenced by the participants' expressed need for, and importance of, trusted relationships with preceptors, nurse colleagues, and/or mentors. Because of these relationships, and through reflection on their experiences, they were able to develop a sense of <i> salience.</i> To situate and explain the study's findings within existing nursing knowledge, these patterns were then compared and contrasted with nurse residency research findings, and theories and research in nursing and sociology such as transition, socialization, professional role development, and role formation. The findings from this study extend and support role adaptation and transition theories. Implications from the study's findings can be used to improve the transition to the professional role, for preceptor development, and for refining nurse residency curricula.</p>

<p> In the United States, 40% of the contemporary nursing workforce is comprised of women of childbearing age, 65% of whom are employed full-time. Hence, the likelihood of pregnancy occurring for this population at some point in their employment is high. A holistic exploration of how nurses integrate pregnancy and full-time employment has been lacking. The purpose of this research was to explore how primiparous nurses managed pregnancy and full-time employment. Using a grounded theory approach, nurses who were pregnant and delivered their first baby, while employed full-time on 12-hour work shifts, provided a firsthand account of how they incorporated pregnancy with employment. </p><p> Nurses, as social actors, experience many interactions in their workplace environment. The basic social process, <i>becoming someone different </i>, emerged to explain those interactions and allowed a substantive grounded theory to be developed. From that exploration, the researcher will present the basic social process, <i>becoming someone different</i>, and the four core categories that arose from the analysis: 1) <i> looking different, feeling different</i> &ndash; to explain how the physical and emotional changes of pregnancy result in nurses looking and feeling differently about themselves as nurses; 2) <i>expectations while expecting</i> &ndash; where the nurse, with previous experiences and ideas about what is expected of her and what she expects from others, changes how she sees herself, based upon her interactions in the workplace with her peers and coworkers; 3) <i>connecting differently</i> &ndash; explains how the nurse, while pregnant, develops new relationships and interactions with the people in her environment, specifically her peers, coworkers and patients, and 4) <i>transitioning labor</i> &ndash; where, despite challenges from interactions within the workplace from coworkers or tasks, the participant nurses began to focus on their eventual maternity leave and working as long as possible up to the time of delivery in order to prolong that maternity leave.</p>

<p> Lived experiences and the power of memories of significant personal events to influence an individual's choice of career path is well documented in studies of students pursing careers in nursing. Less researched are the personal motivators that influence students' choices of specialization within career paths. Gerontology focused educational research provides a growing body of evidence pointing to the attitudinal disposition of students based on their life experiences and attachment to family members or significant others, not classroom exposure, as the primary predictor of vocational choice. What remain unclear are the types of naturally occurring motivators that propel students either toward or away from professional involvement with the elderly and in particular, the chronically and terminally ill. The questions of what motivates so many non-traditional nursing students, in particular, to work with elderly patients and what might motivate others who have shown no interest in this patient group to specialize in gerontology, is central to this interpretative phenomenological inquiry and frames the methodology used to define and interpret motivators among nursing students expressing an interest in or selecting gerontology as a career specialization. A synthesis of seven themes identified and analyzed from data collected through 30 in-depth interviews with 15 nursing students and other individuals closely associating with nursing education, suggests familial attachments, maturity, and traumatic or transformative experience, as the primary three motivators fueling an expressed desire to work with older patients. Conclusions also suggest motivators are identifiable and may be artificially replicated, and that strategic recruitment may also provide a solution for meeting geriatric nursing shortfalls. The purpose of the study has been to understand this complex phenomenon and to add to the body of knowledge surrounding nursing students' motivations and preferences for career specialization. The goal of the study has been to understand what elements might lead to new ways of increasing interest in the field of gerontology and specifically in direct care to elderly patients. Improvement in the numbers of BSN graduates electing to pursue early careers in geriatric direct care would provide a systemic remedy to the real-world problem of inadequate numbers of qualified nurses with adequate competencies to serve this high needs patient population. </p>