The purpose of the life histories is to introduce doctoral students to a methodology that is not usually covered in qualitative texts but that has applicability to the study of nursing phenomena. Three doctoral students conducted abbreviated life history interviews as a class assignment for their course on qualitative methods. Their interviews were part of a larger study by de Chesnay on successfully overcoming adversity, for which she obtained institutional review board (IRB) approval from the university. The first publication was a set of life histories with successful African American adults. The second publication was a series of life histories conducted by master’s degree students on clinical topics related to their interests. These topics were surviving colostomy surgery, multiple sclerosis, and bereavement. The third publication involved undergraduate nursing students who interviewed affluent adolescents about their experiences of substance abuse.
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Healthcare is in a state of rapid change. Although practice environments have become more complex, educational delivery methods have remained stagnant. Innovative technologies provide opportunities to enhance nursing student learning and help nursing programs become more responsive to changes in the practice environment; however, obstacles may hinder successful implementation. With the increasing complexity of today’s health care environment, innovations in nursing curricula are necessary. This chapter explores some of the general challenges associated with the integration of innovative educational technologies, as well as some challenges unique to virtual simulation. It helps the reader to analyze the challenges of integrating educational technologies into nursing education associated with faculty, administrators, and students. It also helps the reader to examine practical and philosophical barriers related to technology integration and explores challenges unique to the adoption of virtual simulation.
Simulation has many advantages for nursing education, some of which include creating safe learning environments for students and reinforcing information learned in the classroom; it also has the advantage of being available in inclement weather as well as 24 hours a day for student access. Simulation in nursing is one of many methods used for teaching students. Teaching and learning in a virtual learning environment has many advantages for administrators, faculty, and students. One of the advantages includes the use of other disciplines to help create or participate in a virtual world learning experience. The virtual learning environment can be created to look similar to real communities, disaster areas, or homes, with avatars populating that environment. The advantage to using virtual reality, rather than a real-life experience, is that in real life, students could be immersed in an environment that could cause them harm.
Students are able to “experience” rare and complex clinical situations before entering into practice so that the first time they care for these types of patients is not in a crisis situation. The scenario presented in this chapter demonstrates the use of simulation in increasingly complex situations and will be applicable to senior- level undergraduate and entry-level advanced practice students (master’s and doctoral preparation). This chapter focuses on the assessment, differential diagnosis, and initial management of the patient who presents to the emergency department (ED) with complaints of crushing sub-sternal chest pain. The student is required to conduct a rapid history and physical; develop an initial diagnosis; initiate lifesaving therapy; and use effective communication techniques with the patient, family, and members of the interdisciplinary health care team in order to successfully meet the objectives of the scenario.
This chapter helps the reader to understand several models of faith community nursing practice. In addition to several models of the practice of faith community nursing, there are four models through which faith community nursing practice is delivered: the institutional model, the congregational paid model, the congregational volunteer model, and the paid consortium model. The goal of parish nursing in this model is to enhance the holistic health and well-being of the faith community members. Many parish nursing programs were established in the 1990s, when hospitals and health care systems were seeking community-based partnerships. Because of the economic constraints of today’s world, faith communities and health care providers will creatively design new models of delivering faith-based nursing care. The collaborative partnerships extend and expand services to congregations as well as meet the learning needs of nursing students.
This book is geared to nursing professionals who need to know about health care financing in non-CPA (certified public account) term. It is deductive, beginning with the big picture of health care financing and then applying a financial management perspective to nursing practice and general health care issues. The book is organized into four parts. Part I, The Big Picture of Health Care Finance, effectively covers the complexity inherent in reimbursement and insurance coverage. This section includes discussion of hospitals and health systems as businesses, the economics of health care, and insurance coverage and reimbursement in both acute and non acute settings. Part II, Budgeting for Acute and Ambulatory Care, lays the foundation for students to acquire budgeting skills and to prepare to make executive-type financial decisions at the macro and micro levels. Part III, Quality, Data Analysis, and Legal/Ethical Issues, emphasizes business skills such as project management and grant writing for Doctors of nursing practice (DNPs). It points out the fiscal and ethical responsibility of all providers of care to ensure that data are appropriately used to support the cost of care and the importance of data to providing quality. Part IV, Entrepreneurship and the Future, wraps focuses on what the hospital and health system of the future may look like as well as business skills for the DNP, including a sample business plan. This section includes being an entrepreneur, writing a business plan, financial management in academia, and issues behind global health care financing. Critical thinking exercises have been added to each chapter for use in the classroom. The book is designed to provide DNP students with the knowledge and skills needed to practice at a doctoral level.
This chapter examines the musculoskeletal and integumentary systems and reviews physiological and systematic assessment of the musculoskeletal system and related nursing tools. It describes pressure ulcers, passive range of motion (PROM) and active range of motion (AROM), burn management, traction, and the effects of decreased mobility. Instructors are encouraged to discuss the costs of pressure ulcers and the reimbursement process related to health care organizations when patients develop nosocomial pressure ulcers. Pressure ulcers are also costly to the patient in terms of pain and suffering. PROM exercises are exercises that the nurse or nursing student can perform for the patient who cannot independently exercise or move an extremity. AROM exercises are an exercise therapy that the patient can perform independently. There are three phases of burn management: emergent phase, acute phase, and rehabilitation phase.
- Go to chapter: The Use of Simulation in the Recognition and Response of the Rapidly Deteriorating Patient
This chapter explains how simulation-based pedagogy has contributed to improved student outcomes and presents the guidelines to be used in the deteriorating patient simulation initiative. As simulation continues to gain traction in the preparation of undergraduate nursing students, specific strategies are being developed to enhance performance in the practice area. One such strategy includes a comprehensive high-fidelity simulation (HFS) intervention that is aimed at improving recognition and response to the rapidly deteriorating patient. The intervention includes pediatric- and adult-based acute care scenarios. There may be opportunity to expand the simulation initiative to other nursing specialties, to less experienced nursing students, and in a variety of geographical locations. There is also opportunity to conduct further research in understanding the role of simulation in improving competence and confidence in the recognition and response to rapidly deteriorating patients.
The field of perinatal grief, or working with families that experience a pregnancy or neonatal loss, requires excellent communication and interpersonal skills. In an exploratory descriptive study, Modiba identified that midwives and physicians lacked appropriate knowledge of how to support mothers experiencing a pregnancy loss. McCreight, in an exploratory qualitative study, identified that nurses’ own emotion and personal beliefs impact their own philosophy of caring for bereaved parents. Research by Chan and Arthur further identified that nurses need increased knowledge and training on how to cope with bereaved parents. They concluded that bereavement counseling education and preceptorship supervision should be included in nursing education to reduce the stressfulness of the experience, increase the confidence and expertise of novice nurses, and promote better care for bereaved parents. As traditional undergraduate nursing students often have limited exposure to bereavement, it is important to provide opportunities in their education to address perinatal grief.
During the past several years, simulation pedagogy has taken off in leaps and bounds. The breadth of simulation design and implementation has become woven into the fabric of the majority of nursing education in the United States and beyond. As faculty members who teach in both graduate and undergraduate courses, the authors of this chapter find that simulation can be challenging to both the novice and seasoned educator. This chapter focuses on the use of simulation in the fundamental physical assessment course. The use of simulation technology is especially useful in creating the equivalent of “muscle memory” for the students because of the ability to do frequent and repetitive exercises using this technology. It is especially useful in assisting students to learn, develop, and mature their assessment skills. The chapter briefly describes specific objectives for simulation usage within a specific course and the overall program.