Nursing outlook (Nurs Outlook)

Publications in this journal

• Article: Stress and nurses’ horizontal mobbing: Moderating effects of group identity and group support

  Gabriela Topa, Juan A. Moriano
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  ABSTRACT: Horizontal mobbing is a process of systematic and repeated aggression towards a worker by coworkers. Among others, stress has been pointed out as one of the antecedents that favors the onset of horizontal mobbing, whereas group support to the target could act as a buffer. Moreover, the social identity approach emphasizes that group identity is an antecedent of group support. This study explores the interaction of group support and group identity in the explanation of horizontal mobbing in a sample (N = 388) of registered nurses and licensed practical nurses employed at two large hospitals in Madrid and Navarre (Spain). The results show that stress is positively associated to horizontal mobbing, whereas group support and group identity were negative predictors of horizontal mobbing. Furthermore, the combination of low group identity and low group support precipitated HM among nurses.
  Nursing outlook 05/2013; 61(3):25-31.
• Article: RN-BSN completion programs: Equipping nurses for the future.

  Norma E Conner, Patricia A Thielemann
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  ABSTRACT: The Institute of Medicine has outlined important components needed in nursing education to prepare the nursing workforce of the future. Previously published work on RN to BSN education has focused mainly on mode of delivery. The purpose of this paper is to examine RN to BSN program components for the facilitation of academic progression, innovative mechanisms of student engagement, and the curricular components that prepare graduates to meet future nursing challenges. Academic progression factors discussed include those relevant to recruiting RNs to BSN completion programs and factors important to retaining them through graduation. Recommendations for student engagement include the creation of honors programs, ethics teams, and practicum and service learning experiences. Suggestions for curriculum possibilities specifically address meeting the call of the Institute of Medicine report including content in community/public health, informatics, evidence-based practice, ethics, and health policy.
  Nursing outlook 04/2013;
• Article: Positive work environments of early-career registered nurses and the correlation with physician verbal abuse.

  Carol S Brewer, Christine T Kovner, Rana F Obeidat, Wendy C Budin
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  ABSTRACT: BACKGROUND: Verbal abuse in the workplace is experienced by registered nurses (RNs) worldwide; physicians are one of the main sources of verbal abuse. PURPOSE: To examine the relationship between levels of physician verbal abuse of early-career RNs and demographics, work attributes, and perceived work environment. METHOD: Fourth wave of a mailed national panel survey of early career RNs begun in 2006. DISCUSSION: RNs' perception of verbal abuse by physicians was significantly associated with poor workgroup cohesion, lower supervisory and mentor support, greater quantitative workload, organizational constraints, and nurse-colleague verbal abuse, as well as RNs' lower job satisfaction, organizational commitment, and intent to stay. CONCLUSION: RNs working in unfavorable work environments experience more physician abuse and have less favorable work attitudes. Causality is unclear: do poor working conditions create an environment in which physicians are more likely to be abusive, or does verbal abuse by physicians create an unfavorable work environment?
  Nursing outlook 03/2013;
• Article: Academic Service Partnerships: What do we learn from around the globe? A systematic literature review.

  Sabina De Geest, Fabienne Dobbels, Sandra Schönfeld, Nathalie Duerinckx, Eydis K Sveinbjarnardottir, Kris Denhaerynck
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  ABSTRACT: BACKGROUND: Academic Service Partnerships (ASPs) are structural linkages between universities and service entities that aim to share vision and collaboration, thereby improving patient care quality and encouraging innovation. PURPOSE: To identify structured ASPs in nursing worldwide and to describe their characteristics. METHOD: Systematic literature review of PubMed-, CINAHL-, PsycINFO-, and Embase- listed studies published up to August 31, 2010. ASPs were described in view of a predefined set of criteria. RESULTS: A total of 114 articles describing 119 ASPs were included. Of these, 85% were located in North America. The median duration of ASPs was 6 years (interquartile range, 2-6). The majority focused on education (86%) and clinical practice (50%). Community health facilities (57%) and hospitals (40%) were prime settings. Twenty-two percent of ASPs were defined by contracts, 3% were governed by bylaws, and 66% were part of strategic plans (28%). Funding sources were mentioned in 76%. However, although 66% of ASPs have been evaluated, the evaluations are generally neither consistent nor reliable. CONCLUSIONS: ASPs show variability in setup, and their development seems to be fueled by policy reports.
  Nursing outlook 03/2013;
• Article: Taking a stand.

  Joanne Disch
  Nursing outlook 03/2013; 61(2):65-66.
• Article: Commentary on: Gun control, gun rights, and the role of nurses and the profession.

  Barbara A Smith
  Nursing outlook 03/2013; 61(2):61-62.
• Article: Continuing the conversation in nursing on race and racism.

  Joanne M Hall, Becky Fields
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  ABSTRACT: Nursing values include diversity and a commitment to the elimination of health disparities. However, nursing comprises predominantly white, female nurses. The authors explore structural and interpersonal sources of disparities experienced by black persons, including white privilege. Here, the authors advocate for a continuation of the racism conversation, specifically among white nurses. Racial disadvantages stem from structural inequalities from daily slights, and usually unintended subtle racism toward black people on the part of white people, including white nurses. By raising consciousness on how we propagate subtle racism, nursing can progress faster in eliminating health disparities. Topics include postracialism, colorblindness, institutional racism, white privilege, health disparities, clinical encounters, subtle racism, and racial microaggressions. Suggestions for open dialogue, historical awareness, education, research, and practice are highlighted. Difficulties involved in confronting racism and white privilege are explored.
  Nursing outlook 02/2013;
• Article: Challenges of cross-cultural research: Lessons from a U.S.-Asia HIV collaboration.

  Wei-Ti Chen, Cheng-Shi Shiu, Jane M Simoni, Peing Chuang, Hongxin Zhao, Meijuan Bao, Hongzhou Lu
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  ABSTRACT: Many Asian countries have scaled up their research to combat human immunodeficiency virus (HIV). HIV experts from the West have teamed up with these countries to assist in designing research protocols and providing necessary training. In this paper, we document the formation and maintenance of international and interdisciplinary HIV research collaboration among cross-disciplinary researchers working in the United States, Taiwan, and China. We conducted international social-behavioral HIV studies in several major metropolitan areas in Asia. Culturally sensitive issues that could be attributed to social and disciplinary differences have emerged throughout the collaboration process, including questions of who should be the research leader, where should resources be allocated, how should tasks be shared, which topics are valuable for investigation, and what survey questions are allowable. There is now a window of opportunity for greater international and interdisciplinary collaboration; however, for such collaboration to flourish, team dynamics in international research collaboration should be carefully identified and managed before studies are begun.
  Nursing outlook 02/2013;
• Article: Altruism is the heart of our story.

  Mary J Giuffra
  Nursing outlook 02/2013;
• Article: Oncology nurses' experiences with prognosis-related communication with patients who have advanced cancer.

  Susan M McLennon, Sue Lasiter, Wendy R Miller, Kathryn Amlin, Amy R Chamness, Paul R Helft
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  ABSTRACT: BACKGROUND: Oncology nurses have opportunities to engage in prognosis-related communication with patients who have advanced cancer but encounter barriers that impede the patient's understanding of prognosis, delay transitions to end-of-life care, and contribute to nonbeneficial treatments. PURPOSE: To describe nurses' experiences with prognosis-related communication with patients who have advanced cancer. METHOD: Thematic analysis of audio-recorded interviews with oncology nurses (n = 27). After data coding, themes were identified, and a thematic map was developed. Methods to ensure trustworthiness of the findings were used. RESULTS: Six themes were identified: being in the middle, assessing the situation, barriers to prognosis communication, nurse actions, benefits of prognosis understanding, and negative outcomes. Nurses managed barriers through facilitation, collaboration, or independent actions to help patients with prognosis understanding. CONCLUSIONS: Shortcomings in prognosis-related communication with patients who have advanced cancer may contribute to negative outcomes for patients and nurses. Interventions that empower nurses to engage in prognosis communications are needed. Interprofessional communication skills education also may be beneficial.
  Nursing outlook 02/2013;
• Article: Tackling complex problems, building evidence for practice, and educating doctoral nursing students to manage the tension.

  Nancy C Sharts-Hopko
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  ABSTRACT: The mandate for evidence-based practice (EBP) arose in response to, among other catalysts, several Institute of Medicine reports beginning in the late 1990s. At the same time, the National Institutes of Health and others have recognized that the most complex, important, and challenging problems, termed "wicked problems," are inherently transdisciplinary and require thinking beyond the limits of existing theories. When nursing students are prepared for EBP, they operate within a fairly stable set of assumptions and they exercise a past orientation. Wicked problem-solving occurs within a context that is characterized as dynamic and ambiguous and requires a future orientation to imagine potential solutions to questions of "what if?" Both skills, EBP, and wicked problem-solving, are essential within the discipline of nursing. Students at all levels need to understand when each scientific approach is required. PhD students must be prepared to participate in wicked problem-solving.
  Nursing outlook 02/2013;
• Article: Senior scholars: Our profession's treasure trove.

  Marion E Broome
  Nursing outlook 01/2013; 61(1):1-2.
• Article: Prescription drug abuse: Problem, policies, and implications.

  Janice Phillips
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  ABSTRACT: This article provides an overview on prescription drug abuse and highlights a number of related legislative bills introduced during the 112th Congress in response to this growing epidemic. Prescription drug abuse has emerged as the nation's fastest growing drug problem. Although prescription drugs have been used effectively and appropriately for decades, deaths from prescription painkillers in particular have reached epidemic proportions. Bills related to prescription drug abuse introduced during the 112th Congress focus on strengthening provider and consumer education, tracking and monitoring prescription drug abuse, improving data collection on drug overdose fatalities, combating fraud and abuse in Medicare and Medicaid programs, reclassifying drugs to make them more difficult to prescribe and obtain, and enforcing stricter penalties for individuals who operate scam pain clinics and sell pain pills illegitimately. This article underscores the importance of a multifaceted approach to combating prescription drug abuse and concludes with implications for nursing.
  Nursing outlook 12/2012;
• Article: Black African immigrant community leaders' views on participation in genomics research and DNA biobanking.

  Aaron G Buseh, Sandra M Underwood, Patricia E Stevens, Leolia Townsend, Sheryl T Kelber
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  ABSTRACT: BACKGROUND: The emergence of DNA biobanks and the power they lend to genomics research promise substantial advances in disease prevention and treatment. Greater participation of racial/ethnic minority populations is necessary to assure a future of personalized medicine for all. PURPOSE: The purpose of this study was to explore perspectives on genomics research and DNA biobanking among black African immigrants, an often overlooked US subpopulation. METHODS: As part of a larger staged study using community-based participatory research (CBPR) methods, we conducted four focus groups with 27 leaders in the black African immigrant community, exploring perceptions about genomics, barriers, and facilitators to participation in DNA biobanks and ethical ways to engage communities. FINDINGS/DISCUSSION: Prominent in their views on genomics research was the legacy of colonial mistreatment and exploitation by Western researchers in their home countries in sub-Saharan Africa. The central dilemma for participants was balancing responsibilities to protect their people from harm and to find solutions for African generations to come. They insisted that nothing short of a transformation of research practice would elicit the full and sustained participation of African immigrants in the genomics enterprise. CONCLUSION: To better align practice and policy in the field of genomics research and DNA biobanking with values expressed by African immigrant leaders, it is recommended that the field adopt a CBPR model for research and a benefit-sharing model for policy.
  Nursing outlook 12/2012;
• Article: Nurse mentorship to improve the quality of health care delivery in rural Rwanda.

  Manzi Anatole, Hema Magge, Vanessa Redditt, Adolphe Karamaga, Saleh Niyonzima, Peter Drobac, Joia S Mukherjee, Joseph Ntaganira, Laetitia Nyirazinyoye, Lisa R Hirschhorn
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  ABSTRACT: Quality of care at rural health centers in Rwanda is often limited by gaps in individual nurses' knowledge and skills, as well as systems-level issues, such as supply and human resource management. Typically, nurse training is largely didactic and supervision infrequent. Partners In Health and the Rwandan Ministry of Health (MOH) collaborated to implement the nurse-focused Mentoring and Enhanced Supervision at Health Centers (MESH) program. Rwandan nurse-mentors trained in quality improvement and mentoring techniques were integrated into the MOH's district supervisory team to provide ongoing, on-site individual mentorship to health center nurses and to drive systems-level quality improvement activities. The program targeted 21 health centers in two rural districts and supported implementation of MOH evidence-based protocols. Initial results demonstrate significant improvement in a number of quality-of-care indicators. Emphasis on individual provider and systems-level issues, integration within MOH systems, and continuous monitoring efforts were instrumental to these early successes.
  Nursing outlook 11/2012;
• Article: Having influence: Faculty of color having influence in schools of nursing.

  Dena Hassouneh, Kristin F Lutz
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  ABSTRACT: Faculty of color (FOC) play an important role in mentoring students and other FOC in schools of nursing. However, the unique nature of mentoring that FOC provide, which includes transmission of expert knowledge of the operations of racism in nursing academe, is not well understood. Furthermore, the influence FOC have on school cultures has not been well documented. To address this gap in knowledge we conducted a critical grounded theory study with 23 FOC in predominately Euro-American schools of nursing. Findings indicate that FOC Having Influence is a key process that explicates the influence FOC wield, exposing their work, which is often taken for granted, hidden, and, unacknowledged. FOC Having Influence occurred in two areas: 1) the survival and success of students and FOC and 2) shaping practices in schools of nursing and impacting health in communities. Implications for educational practice and future research are presented, based on study findings.
  Nursing outlook 11/2012;
• Article: The era of "e": The use of new technologies in advance care planning.

  Michael J Green, Benjamin H Levi
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  ABSTRACT: In this article, the authors review developments in technology that can help patients, their loved ones, and healthcare providers engage in more effective advance care planning (ACP). The article begins with a brief description of ACP and its purpose and then discusses various electronically available resources for ACP in the U.S. Finally the authors provide a critical assessment of the achievements, challenges, and future prospects for electronic advance care planning, or "e-planning."
  Nursing outlook 11/2012; 60(6):376-383.e2.
• Article: Patient-centered care/student-centered learning.

  Joanne Disch
  Nursing outlook 11/2012; 60(6):340-1.
• Article: Palliative and end-of-life care research: Embracing new opportunities.

  Noreen M Aziz, Jeri L Miller, J Randall Curtis
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  ABSTRACT: The past two decades have witnessed dramatic advances in palliative and end-of-life care research with increased understanding of the burden of life-limiting diseases on patients, families, clinicians, and our healthcare system; and researchers have documented palliative care interventions that improve patient and family outcomes and reduce the costs of care (Detering, Hancock, Reade, & Silvester, 2010). These advances have led to a new era of palliative and end-of-life care research and practice with widespread recognition of its accomplishments and successes. Consequently, we now have an important opportunity to reassess our recent successes and challenges and to identify the goals and benchmarks that will ensure ongoing robust advances in this now-recognized and critical scientific area. High-quality palliative and end-of-life care will be best informed by methodologically strong research efforts that generate a body of evidence with the capacity to support and direct care and effect changes in practice. It is in this context that the National Institute of Nursing Research conceptualized and led a Summit titled The Science of Compassion: Future Directions in End-of-Life and Palliative Care Research in August, 2011. In this summary article, we present brief overviews of the six articles chosen for this Special Issue of Nursing Outlook, examine their key conclusions, articulate gaps and needs, and discuss next steps in palliative and end-of-life care research through the lens of these six topics.
  Nursing outlook 11/2012; 60(6):384-90.
• Article: Palliative care and end of life: The caregiver.

  Deborah B McGuire, Marian Grant, Jumin Park
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  ABSTRACT: Informal caregivers are a key component of end-of-life/palliative care and are increasingly recognized as recipients of care. Numerous factors affect the care they give and they have significant care needs themselves. The purpose of this survey was to identify key research questions, priorities, and next steps for research on caregivers and palliative care. A literature search of publications between 2006 and 2011 was conducted, yielding 109 studies that were evaluated on type, quality, topic, and other factors. An interdisciplinary group of healthcare professionals examined results and recommended research priorities. Existing research is primarily descriptive in nature, with few interventions to guide practice. Future research priorities include factors influencing caregivers and roles, information and support needs, caregiver health, end-of-life issues, healthcare disparities, and delivery and costs of care. Conclusions include that expanding the science will contribute to improving caregiver performance and health.
  Nursing outlook 11/2012; 60(6):351-356.e20.