OBJECTIVE:Determine whether differences in incivility exist in rural and urban settings, exploring how incivility impacts nurses' job satisfaction, intent to leave, nurse-reported quality of patient care and safety, with attention to educational background. BACKGROUND:Incivility can negatively impact the healthcare environment. Resilience, a protective factor, may support nurses during challenging times. METHODS:A descriptive correlational design was employed with 342 nurses in one Midwest state. Data were collected via online questionnaires and analyzed for relationships and predictors. RESULTS:A significant negative correlation (P=0.01) was found between resilience and workplace incivility, with significant predictors being job satisfaction (P=0.0003), plan to leave position (P=0.003), and incivility post-COVID-19 (P=0.002). A significant predictor of resilience was job satisfaction (P=0.01). There were no significant differences in incivility and resilience between rural and urban settings, or education preparation. CONCLUSIONS:These findings, consistent with other studies, can assist nurse administrators to move toward preventing workplace incivility.

Community health workers are projected to grow in number by 17 percent by 2030. A baccalaureate degree in nursing (BSN) provides a foundation for public health nursing practice. The Competencies for Public Health Nursing Practice instrument was distributed to BSN students at a Midwestern university before and after an educational intervention. Students completed a pretest (n = 269) and posttest (n = 154). All four subscales and total score indicated a significant increase in competence (p < .001). There is a need to develop interactive public health nursing simulations with an interprofessional venue to help students improve teamwork and communication competencies.

ABSTRACT:There is currently no evidence of undergraduate nursing students' self-efficacy and performance in self-management support for chronic diseases in rural primary care. Using the Self-Efficacy and Performance in Self-Management Support instrument, this quasi-experimental study assessed students' self-efficacy and performance in self-management support before and after implementation of a primary care enhanced curriculum. Nursing students ( n = 140) reported a significant increase in total mean scores (pretest, M = 268.01; posttest, M = 289.51), p = .0001. Providing a primary care enhanced curriculum increased nursing students' self-efficacy and performance in self-management support.

Background: Telepresence robots provide real-time audio, video, and mobility features, allowing faculty and students to engage in learning experiences without being physically present. Problem: With multiple students and faculty members needing to quarantine due to the COVID-19 pandemic, a flexible learning environment was essential. Approach: The telepresence robots were used as an innovative approach for both faculty and students to engage in learning experiences offered in a variety of settings. Outcome: Feedback was obtained from faculty and students about the use of and satisfaction with telepresence robots. The robots were easy to use and posed only a few technological challenges, which were easily overcome. Conclusions: Telepresence robots were effective tools in overcoming teaching and learning barriers caused by the COVID-19 pandemic. The telepresence robots have many applications, including use in clinical and community settings.

BACKGROUND:The intertwining of honors within collegiate nursing education can be rewarding and challenging for students. This study examined why students enroll in honors, why students persist in honors, why some students withdraw from honors, and what resources are beneficial to honors success.METHOD:An online survey was sent to 130 nursing students enrolled in an honors program at one midwestern university.RESULTS:Forty-six nursing students completed the survey. Students indicated they enrolled in honors programs to attend classes with fewer students, to achieve Honors College Distinction, and to gain skills in professionalism and leadership. Reasons for withdrawal from honors included lack of time, increased workload, and added stress.CONCLUSION:Nursing students face many challenges in successful completion of an honors program. The results from this study led to the development of Honors and Nursing: A Supplemental Honors Nursing Guidebook for Honors Student Success, a resource for nursing honors students at the university. [J Nurs Educ. 2021;60(6):333-336.].

Background: We aimed to measure SARS-CoV-2 seroprevalence in a cohort of healthcare workers (HCWs) during the first UK wave of the COVID-19 pandemic, explore risk factors associated with infection, and investigate the impact of antibody titres on assay sensitivity. Methods: HCWs at Sheffield Teaching Hospitals NHS Foundation Trust were prospectively enrolled and sampled at two time points. SARS-CoV-2 antibodies were tested using an in-house assay for IgG and IgA reactivity against Spike and Nucleoprotein (sensitivity 99·47%, specificity 99·56%). Data were analysed using three statistical models: a seroprevalence model, an antibody kinetics model, and a heterogeneous sensitivity model. Results: As of 12th June 2020, 24·4% (n=311/1275) of HCWs were seropositive. Of these, 39·2% (n=122/311) were asymptomatic. The highest adjusted seroprevalence was measured in HCWs on the Acute Medical Unit (41·1%, 95% CrI 30·0–52·9) and in Physiotherapists and Occupational Therapists (39·2%, 95% CrI 24·4–56·5). Older age groups showed overall higher median antibody titres. Further modelling suggests that, for a serological assay with an overall sensitivity of 80%, antibody titres may be markedly affected by differences in age, with sensitivity estimates of 89% in those over 60 years but 61% in those ≤30 years. Conclusions: HCWs in acute medical units working closely with COVID-19 patients were at highest risk of infection, though whether these are infections acquired from patients or other staff is unknown. Current serological assays may underestimate seroprevalence in younger age groups if validated using sera from older and/or more symptomatic individuals.

BACKGROUND:Nurses are among the frontline healthcare workers directly impacted by the burden of the coronavirus disease of 2019 (COVID-19) pandemic. This study aimed to examine the prevalence of emotional distress and the associated factors among nurses practicing in South Dakota during the COVID-19 pandemic. METHODS:An online survey was conducted among practicing, licensed nurses in South Dakota during the pandemic (July 2020 - August 2020). Emotional distress was measured using the Depression, Anxiety, and Stress Scale (DASS-21). Logistic regression models were performed to examine the association of emotional distress and the three DASS-21 subscales with: sociodemographic and work environment factors (e.g., work setting, job satisfaction, number of COVID-19 cases seen at the facility, preparedness, concerns with worsening pre-exiting mental health conditions due to the pandemic, and contracting the illness). RESULTS:Among 1505 participants, overall emotional distress was reported by 22.2%, while anxiety, depression and stress were 15.8%, 14.5% and 11.9%, respectively. Factors associated with moderate to severe emotional distress, depression, anxiety, and stress were as follows: concerns for worsening of pre-existing mental health conditions, job dissatisfaction, encountering higher number of COVID-19 cases at one's work facility, feeling unprepared for the pandemic, and concern for contracting the illness (all p < 0.05). CONCLUSIONS:Our study suggests a high prevalence of emotional distress among nurses and highlights the factors associated with emotional distress during the COVID-19 pandemic. Promoting appropriate support is imperative to reduce nurses' emotional distress and promote psychological well-being during the COVID-19 world health crisis and in future pandemics.

AIM:The purpose of the study was to examine the influence of parenting stress, self-efficacy and COVID-19 health risks on general stress among nurses in the Midwest, United States, during the pandemic.BACKGROUND:As frontline workers amidst the coronavirus disease 2019 (COVID-19) pandemic, nurses have been subject to stressors at home and at work.METHOD:This quantitative, cross-sectional study included 896 nurses with at least one child below 18 years of age. Using purposive sampling, participants answered an online survey composed of demographic questions, perception of COVID-19 health risks, measures of self-efficacy, general stress and parenting stress. Bivariate correlation and multiple regression were conducted. Data were collected from July 13 to August 13, 2020.RESULTS:The four predictors, along with eight demographic covariates, accounted for 40% of the variance in general stress. Parenting stress and COVID-19 health risks were positively related to general stress, while self-efficacy was negatively associated with general stress.CONCLUSIONS:Results highlight the negative influence of parenting stress on nurses' general stress and the importance of self-efficacy in reducing stress. Findings suggest that support services for nurses should focus not only on work-related stressors but also consider parenting stressors, work-home imbalances and self-efficacy.

In Brief In healthcare, change is inevitable—and nurses who work in hospital settings aren't immune to the effects of organizational changes. This article explores the concept of resilience and how resilience training for nurses can help protect against the negative effects of stress caused by these changes.

BACKGROUND:Prelicensure nursing education has generally emphasized acute care; however, as primary care changes in the United States, academia must transform. The national call for transforming primary care requires innovation in the education of prelicensure nursing students.PROBLEM:To ensure future RNs can function in the primary care setting and assume enhanced roles within the interprofessional team, prelicensure nursing students need to be exposed to primary care. A key barrier to providing this essential education is the lack of partnerships with primary care facilities.APPROACH:The purpose of this project was to collaborate with rural practice partners to provide a primary care clinical experience for prelicensure nursing students.OUTCOMES:Collaboration between academic-practice partners to develop a clinical experience for prelicensure nursing students allowed exposure to the role of RNs in rural primary care.CONCLUSIONS:By sharing the process for planning the clinical experience, other interested academic institutions may replicate similar opportunities.

Abstract Purpose: Primary care in rural areas of the U.S. urgently need competent healthcare providers, especially registered nurses (RNs). Registered nurses are ideal team members to help meet the primary care needs in rural communities, yet RNs are underutilized in primary care settings and rarely practice to the full scope of their license in these settings. The purpose of the project was to conduct a needs assessment with rural primary care practice partners to address the need for RNs in primary care. Sample: A needs assessment was sent to nurse leaders at 13 rural primary care facilities via an online survey in December 2018. Methods: This descriptive exploratory study utilized an online needs assessment survey to gather information from 13 rural clinical practice partners regarding their knowledge, interest, and use of RNs in primary care. Results: Twelve of the 13 rural clinical practice partners completed the needs assessment survey. A majority of the clinical partners indicated they felt knowledgeable about the RN full scope of license and expressed a high interest in the expanded role of the RN in primary care. The clinical practice partners reported interest in providing independent RN chronic and acute care visits, care management, medication management, and collaborative provider and RN visits. Conclusion: Conducting a needs assessment and collaborating with rural primary care practice partners to address the need for RNs in primary care is the first step in developing policies and utilizing RNs to the full scope of their license. Keywords: primary care, rural, registered nurses

PURPOSEThe purpose of this study was to examine relationships between change fatigue, resilience, and job satisfaction among novice and seasoned hospital staff nurses.BACKGROUNDHealth care is typified by change. Frequent and vast changes in acute care hospitals can take a toll on nurses and cause change fatigue, which has been largely overlooked and under-researched.DESIGN AND METHODA descriptive correlational design was employed with 521 hospital staff nurses in one midwestern state. Participants completed three online surveys: (a) Change Fatigue Scale, (b) Connor-Davidson Resilience Scale, and (c) McCloskey/Mueller Satisfaction Scale.FINDINGSIn a multiple regression model, job satisfaction had a statistically significant negative association with change fatigue (p < .001) and significant positive association with resilience (p < .001). A linear trend was found with hospital size (number of beds) and change fatigue (p = .001) and education level and resilience (p = .03).CONCLUSIONSThe results are consistent with job satisfaction among hospital nursing staff being negatively influenced by change fatigue and positively influenced by resilience, although reverse causal connections are also possible. Change fatigue may be increased by larger hospital size (number of beds), and resilience may be increased by higher educational level of hospital staff nurses.CLINICAL RELEVANCEThe study advanced the nursing knowledge on change fatigue, resilience, and job satisfaction of staff nurses working in acute care hospitals. Engaging in strategies aimed at preventing change fatigue in nursing staff can enhance workplace environments, job satisfaction, and retention of nurses.

DETERMING THE RELATIONSHIP AMONG CHANGE FATIGUE, RESILIENCE, AND JOB SATISFACTION AMONG HOSPITAL STAFF NURSES ROBIN BROWN 2016 Purpose: The purpose of the study was to determine if there is a relationship among change fatigue, resilience, and job satisfaction of hospital staff nurses and if differences exist between novice and experienced staff nurses. Background: Healthcare is typified by change. Organizational changes have a negative impact on nurses and the effects of organizational change are being overlooked and under researched. Change fatigue is a result of constant organizational change and has not been researched with nurses. Methods: The study utilized a descriptive correlational design. Participants completed an online survey, using three tools: Change Fatigue Scale, Connor-Davidson Resilience Scale (CD-RISC), and McCloskey/Mueller Satisfaction Scale (MMSS). Results: The participants were 535 hospital staff nurses. The findings of the study report a significant difference between novice and experienced staff nurses in change fatigue (t = -2.9, p = .003), resilience (t = -2.3, p =.01), and job satisfaction (t= -2.0, p = .04). Experienced nurses had higher change fatigue, resilience, and job satisfaction mean scores. The study also found a significant negative association between change fatigue and job satisfaction (r = -.295, p = .000) and change fatigue and resilience (r = -.145, p