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This study identified the types of caregiver stress and the caregiver and care management characteristics that are associated with this stress. 169 caregivers were recruited from a variety of community settings that cater to caregivers in a New England metropolitan area. They completed the Zarit Burden Interview (ZBI) and a questionnaire concerning their care recipient and caregiving arrangements. Principal Components Analysis on the ZBI resulted in five factors: personal strain/loss, uncertainty/inadequacy, social strain/embarrassment, anger, and dependency. The average age of the caregiver was 59.95 years (SD = 11.75) and the average age of the CR was 83.44 years (SD = 7.88). Of the 169 caregivers, 82% were women, 61.5% daughters/in-law or wives (12.9%), 34.3% were solo caregivers; 16.8% little or no burden, 39.9% reported mild to moderate burden, 35% moderate to severe burden, and 8.4% had severe burden. Dependency (22.4%) and personal strain/loss (13.7%) had the highest proportions reported as “often” to “nearly always.” The ZBI was predicted by only two caregiver characteristics, indicating that it is not sensitive to the experiences of different types of caregivers. Caregivers experience different types of burden depending on their gender, kinship roles, and levels of involvement in the care of their older relative. Solo caregiver status and age (younger) significantly predicted most if not all 5 burden types. Solo and young caregivers experienced the highest levels of caregiver burden. Social work practice must identify the caregiver’s life stage and other and self-expectations in relation to dependency, personal loss, embarrassment, anger, or uncertainty. © 2016 Taylor & Francis.

Novice nurses are often inadequately prepared to respond to complex, patient care situations where patients' conditions deteriorate. Exposure to a video-taped intervention that role-models and reinforces expected behavior of an expert nurse before participation in a simulation may improve student nurse performance in a cost-effective manner. The primary purpose of this quasi-experimental pre-test, post-test study was to assess the preliminary effectiveness of a theory based role-modeling intervention on enhancing student nurse competency in responding to a simulated response to rescue event. Performance was measured by a previously validated Heart Failure Simulation Competency Evaluation Tool (c) (HFSCET). Total mean scores on the HFSCET for the pre-test (59.08) and post-test (87.08) were significantly different (p = .000); students performed better on the post-test after exposure to the role-modeling intervention. A power analysis indicated a large effect size (effect size = .926; alpha = 0.50; power = 0.991). Students who had a greater number of days between the intervention and the post-test had a lower score. This innovative intervention based on established learning theory may change the way educators prepare novice students to achieve expected clinical competencies in graded simulation performance assessments. (c) 2013 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc. All rights reserved.

Background: Reliable and valid instruments are needed to assess patient safety competencies, specifically nursing students' ability to appropriately respond to simulated rescue events. Methods: This was an instrument development study conducted with 152 senior nursing students in 2 phases. Results: Student groups performed poorly during the simulation scenario, with mean scores on the Heart Failure Simulation Competency Evaluation Tool ranging from 46% to 56%. Interrater reliability increased to .839 after item revision during Phase 2 of the study. Discussion: This simulation competency assessment package is ready to be tested with more diverse student groups and novice nurses in the practice setting. © 2012 International Nursing Association for Clinical Simulation and Learning.

Nurse practitioners are playing an increasingly visible role in home care. The Institute of Medicine in collaboration with the Robert Wood Johnson Foundation recommends wider use of Advanced Practice Registered Nurses and there has been growing interest in using the role in home care.1 However, the physician remains the provider who must sign home health agency paperwork and orders. The "Home Health Care Planning Improvement Act" would allow nurse practitioners to certify Medicare-sponsored treatment plans.2 This article will discuss the status of the nurse practitioner role in home care, the impact of reimbursement on home care services, how the passage of the new act would change current practice, and a vision for the future role of the nurse practitioner in home health care. © 2012 SAGE Publications.

PURPOSE: To examine the worklife experiences of physicians, to further the exploration of the worklife experiences of nurses with disabilities, and to discover how the two healthcare professions compare with each other with regard to these experiences., METHODS: This study employed the research tradition of interpretive naturalistic inquiry and used constant comparative analysis to collect and analyze the data., FINDINGS: Despite the cultural and educational differences between physicians and RNs, their experiences as healthcare professionals with self-identified permanent physical and/or sensory disabilities were very similar. The research team identified five core themes., CONCLUSIONS: Healthcare professionals, including staff and administrators, need to make an effort to retain employees as turnover and predicted shortages are likely to jeopardize the current healthcare system., CLINICAL RELEVANCE: Modifications can be made within both professions to support people with disabilities and to enable them to contribute to their professions using their abilities to think critically, solve problems, and care for patients safely. Copyright © 2012 Association of Rehabilitation Nurses.

PURPOSE: The authors sought to generate insights and hypotheses about the professional experiences of registered nurses and physicians with self-identified disabilities to inform local and national policy conversations on supporting a diverse health care workforce., METHOD: In 2009-2010, the authors conducted in-depth interviews in person and over the telephone with a sample of licensed registered nurses and physicians across the country who self-identified as having a permanent disability. They coded the interview transcripts to identify key themes across the participants' responses., RESULTS: The authors interviewed 10 registered nurses and 10 physicians. Five novel and consistent themes emerged from the data analysis: (1) Living and working with a physical/sensory disability narrows the career choices and trajectories of nurses and physicians, (2) nurses and physicians struggle with decisions regarding whether to disclose and discuss their disabilities at work, (3) nurses and physicians rarely seek legally guaranteed workplace accommodations, instead viewing patient safety as a personal responsibility, (4) interpersonal interactions often reflect the institutional climate and set the tone for how welcome nurses and physicians feel at work, and (5) reactions to workplace disability-related challenges run an emotional spectrum from anger and grief to resilience and optimism., CONCLUSIONS: The responses revealed several missed opportunities for supporting health care professionals with disabilities in the workplace. These findings should inform the continuing debate regarding what defines "reasonable accommodation" and how to create a workplace that is welcoming for nurses and physicians with disabilities.

A qualitative study was done to explore the perceptions of volunteering among retired registered nurses (RNs) in Kansas. Participants were volunteers in formal nursing roles or were using their nursing knowledge and experience in non-nursing roles, such as church work. Regardless of the type of volunteer position, retired RNs reported that they use what they have learned as nurses when they volunteer. Volunteering benefits include enhanced self-worth, intellectual stimulation, reduced social isolation, and opportunities to help others. Increased paperwork, new technology, difficulty finding nursing-specific volunteer opportunities, resistance from health care organizations, and a lack of respect for what these nurses know are challenges and barriers to volunteering. Retired RNs have accumulated years of clinical nursing experience and can be helpful to employed nurses. Health care organizations should launch targeted efforts to recruit and utilize retired RN volunteers. Health care professionals who care for older adults should recommend volunteering as a healthful endeavor. (Geriatr Nurs 2011;32:96-105)

A survey design was used to explore the perceptions and characteristics of registered nurses (RNs) with sensory disabilities and their risk for leaving their jobs. An earlier study found that nurses with disabilities are leaving nursing and that employers do not appear to support these nurses. Work instability and the mismatch between a nurse's perceptions of his or her ability and the demands of their work increase risk for job retention problems. This study's convenience sample of U.S. RNs had hearing, vision, or communication disabilities. Participants completed a demographic form, three U.S. Census questions, and the Nurse-Work Instability Survey. Hospital nurses were three times more likely to be at risk for retention problems. Nurses with hearing disabilities were frustrated at work. Hearing difficulties increased with years spent working as a nurse. Many nurses with sensory disabilities have left nursing. Early intervention may prevent work instability and increase retention, and rehabilitation nurses are ideally positioned to lead early intervention programs.

The Reconceptualized Uncertainty in Illness Theory (RUIT) was used to investigate antecedents to, appraisals of, and ways of coping with stressful caregiving. Four focus groups with caregivers (8 males and 16 females) of relatives with dementia were conducted; 15 cared for their parents and the remainder cared for their spouses. They were recruited from an adult care center and other community settings in a metropolitan area in New England. The discussions were audiotaped and transcribed verbatim. Two researchers independently coded the transcripts. Thematic analysis was structured according to the RUIT. The study is unique in its application to caregivers as opposed to patients and to all of the elements of the RUIT. Caregivers experience uncertainty in similar ways to patients with life-altering illness. Symptom severity--lack of personal boundaries, repetitive and aggressive behaviors, and the need for constant care--was the most frequent source of stress. The appraisals were mostly negative and included feelings of resentment, a lack of support from family members, financial strains, and loss of freedom. Self-improvement and self-care were important aspects of coping. Spirituality and humor were other coping skills that respondents used. Not all respondents said they were coping and some also reported that support from health care providers was not always helpful. Nurses can help improve coping by explaining the factors that contribute to caregiver strain and uncertainty, and by assisting caregivers to anticipate the effects of the caregiving role.

.SCHOOL NURSE RESOURCE MANUAL NINTH EDITION EVIDENCED-BASED POLICIES and PROCEDURES for SAFE STUDENT CARE. The School Nurse Resource Manual was created for school nurses as a quick reference on the many issues they encounter in their practice, and to assist them, their administrators and consulting physicians to develop consistent evidenced-based policies and procedures for safe student care. This ninth edition contains clinical guidelines that have been completely updated, expanded and revised to reflect current clinical guidelines for safe student care. ALL GUIDELINES ARE RESEARCHED, REFERENCED AND PEER REVIEWED.

.SCHOOL NURSE RESOURCE MANUAL NINTH EDITION EVIDENCED-BASED POLICIES and PROCEDURES for SAFE STUDENT CARE. The School Nurse Resource Manual was created for school nurses as a quick reference on the many issues they encounter in their practice, and to assist them, their administrators and consulting physicians to develop consistent evidenced-based policies and procedures for safe student care. This ninth edition contains clinical guidelines that have been completely updated, expanded and revised to reflect current clinical guidelines for safe student care. ALL GUIDELINES ARE RESEARCHED, REFERENCED AND PEER REVIEWED.

.SCHOOL NURSE RESOURCE MANUAL NINTH EDITION EVIDENCED-BASED POLICIES and PROCEDURES for SAFE STUDENT CARE. The School Nurse Resource Manual was created for school nurses as a quick reference on the many issues they encounter in their practice, and to assist them, their administrators and consulting physicians to develop consistent evidenced-based policies and procedures for safe student care. This ninth edition contains clinical guidelines that have been completely updated, expanded and revised to reflect current clinical guidelines for safe student care. ALL GUIDELINES ARE RESEARCHED, REFERENCED AND PEER REVIEWED.

SCHOOL NURSE RESOURCE MANUAL NINTH EDITION EVIDENCED-BASED POLICIES and PROCEDURES for SAFE STUDENT CARE. The School Nurse Resource Manual was created for school nurses as a quick reference on the many issues they encounter in their practice, and to assist them, their administrators and consulting physicians to develop consistent evidenced-based policies and procedures for safe student care. This ninth edition contains clinical guidelines that have been completely updated, expanded and revised to reflect current clinical guidelines for safe student care. ALL GUIDELINES ARE RESEARCHED, REFERENCED AND PEER REVIEWED.

The purpose of this study was to gain an understanding of the ambiguities and uncertainties experienced by a diverse group of African-American caregivers. The study applied Schlossberg's transition theory (TT) and Mishel’s revised uncertainty theory to narratives of self-identified African-American caregivers who provided care at least 5 h a week. The men (6) and women (8) were mostly unmarried, mostly caring for a parent or grandparent. The caregivers’ average age was 52 (SD = 19; ages ranged from 24 to 82 years); and the care recipients’ average age was 84 (SD = 9). Six care recipients had dementia and the remainder had multiple disease diagnoses. Narratives were obtained by in-depth interviews or focus group discussions. These were audio-recorded, transcribed verbatim professionally and analyzed independently by trained coders. Schlossberg’s TT contextualized whereas Mishel’s RUIT illuminated the characteristics of the transition, its associated uncertainty, and their relationship to the development of caregiver stress. Situational factors such as difficulties with illness symptoms of the care recipient, conflict between previous experience and current expectations and the adjustments to the new caregiving role, burdened younger caregivers more than older caregivers. Self-factors related to lack of knowledge about the illness and feelings of lack of control. Social support was predominantly provided by family members, and its absence resulted in conflict among siblings and caregiver stress. The most common coping strategies include religiosity, expectations of reciprocity, and coming to terms with the uncertainty. Understanding the feelings, perceptions and needs of caregivers in transition is tantamount to providing nursing care.