For new nurses and midwives, resilience is essential for navigating the steep learning curve, and emotional challenges of transitioning from student to professional. This nonexperimental, descriptive study aimed to evaluate the resilience levels of newly qualified nurses and midwives in Western Australia (WA) who completed new graduate programs during 2021/2022. We sought to understand how graduates adapted to the challenges of clinical practice, at the time of the COVID-19 pandemic. A survey design was employed, targeting WA nurses and midwives who participated in structured new graduate programs. Participants were recruited via the WA Department of Health GradConnect system and completed an online survey, which included demographic questions and the 25-item Connor-Davidson Resilience Scale (CD-RISC). Data were analysed using RStudio to determine resilience scores and key contributing factors. Out of 400 invited participants, 88 responded (22%), with 75 completing the full survey (19% completion rate). The mean resilience score was 74.9 (SD = 9.1), placing most graduates in the lower to moderate quartiles of the general population. Key strengths included self-efficacy and adaptability, while lower scores were observed in emotional regulation, optimism, spiritual coping, and leadership confidence. WA graduate nurses and midwives showed promising levels of resilience amid significant workforce shortages and pandemic pressures. The findings affirm that resilience-building is not optional but essential for workforce sustainability, reinforcing the need for strategies that strengthen coping capacity and retention during times of crisis and beyond.
The 2008 Advanced Practice Registered Nurse (APRN) Consensus Model, developed by the APRN Consensus Work Group, defined four APRN roles and established that all APRNs must practice under recognized standards of practice. While Certified Nurse Practitioners, Certified Nurse Midwives, and Certified Registered Nurse Anesthetists have developed comprehensive Standards of Practice through their professional organizations, the Clinical Nurse Specialist (CNS) operates solely under competency frameworks organized within the three spheres of impact model. This absence of formal Standards of Practice creates a critical gap that undermines professional legitimacy, regulatory compliance, and public safety protections. Concurrently, the CNS role faces challenges including role confusion, inconsistent utilization, and declining educational programs. In this article, we examine the urgent need for CNS standards of practice by analyzing the current regulatory landscape, comparing the CNS model with other APRN roles, and exploring the multifaceted implications of this professional deficit. Our analysis revealed five critical areas of concern: compromised quality and safety oversight, regulatory compliance challenges, diminished professional recognition and utilization, educational inconsistencies, and workforce sustainability threats. The conclusion presents a compelling call to action for the immediate development of professional Standards of Practice to preserve the CNS role and ensure optimal patient outcomes. Without swift action to establish authoritative Standards of Practice, the CNS role risks continued marginalization in an increasingly regulated healthcare environment that demands clear professional accountability and evidence-based standards of practice.
U.S. Advanced Practice Registered Nurses (APRNs) are nationally certified but regulated by state law. States differ regarding scope of practice (SOP) restrictions imposed on APRNs. Little is known about provider attitudes toward these SOP-limiting policies in Ohio. This study was conducted in two phases. The first phase aimed to explore Ohio APRNs’ reported frustrations at work. The second phase further examined the most frequently reported frustration. A total of 262 Ohio APRNs participated in the survey. We expected that coronavirus concerns would be the most common work frustration, but that was not the case. The most frequently reported frustration was the law limiting APRN SOP in Ohio. This law was analyzed using the Theory of Planned Behavior to identify any links with actual behavior, including the frequency of collaborative events with the assigned physician (Ajzen, 1985, 1991). Frustration with state-mandated collaboration was found to be inversely related to the number of collaborative events. This leads to further investigation into APRN attitudes about mandatory collaboration in Ohio. Since most respondents are frustrated with the law, and collaboration decreases as frustration increases, more research is justified.
Human health and natural ecosystems are deeply interconnected, a relationship captured by the field of planetary health. Anthropogenic environmental changes increasingly undermine the ecological foundations that sustain human wellbeing. While nurses constitute the largest segment of the global health workforce and serve on the frontlines of climate-related health impacts, evidence suggests they often feel underprepared to address these issues due to gaps in formalized education and engagement. This article describes the development and impact of the Planetary Health Report Card for Nursing (PHRC-N), a student-driven, metric-based tool adapted from the original 2019 PHRC for medical schools. The PHRC-N evaluates nursing programs across five key domains: curriculum, interdisciplinary research, community outreach, student-led initiatives, and campus sustainability. Since its 2022 pilot, the tool has expanded to 13 institutions across seven countries. Findings indicate that repeated assessment cycles catalyze institutional change, with average curriculum scores rising from 66.3% to 80% and support for student-led initiatives increasing from 70.1% to 83.3% between cycles. By providing a standardized evaluative framework, the PHRC-N moves planetary health into nursing education so that graduates are better prepared to provide care and act as change agents in the ever urgent environmental crisis.
