Background: Despite the many noted benefits of collaborative online international learning (COlL) projects, it has rarely been used in nursing education. Nursing curricula must employ multiple strategies to prepare graduates for professional practice. With COIL’s benefits, its application to nursing education should be explored.

Methods: A qualitative case study approach guided by social constructivist theory was used to assess the impact of COIL on pre-licensure students' understanding of community/public health nursing, and the impact on preparedness for practice. 10 participants completed COIL projects and two surveys.

Results: Three themes were identified: enhanced perspectives of public health issues/practices/interventions; enhanced knowledge; and broadened understanding of role and scope of practice. 10 participants noted an impact on preparation for professional practice. 7/10 demonstrated a difference in definitions of community/public health nursing.

Conclusions: Further inclusion in pre-licensure curricula should be explored, particularly for its potential impact on preparation for professional practice.

Non-English speaking (NES) immigrant residents interact with the United States (U.S.). health care system in all settings, inpatient, outpatient and emergency departments. Medical interpreters occupy a central role in mental health care by bridging the communication gap between the patient and the Psychiatric Mental Health Registered Nurse (PMHRN) and the Advanced Practice Registered Nurse (APRN) providers. The authors’ interest in the nature and effects of the presence of the interpreter on the nurse-patient therapeutic relationship began during their clinical experiences in two mental health outpatient settings. The purpose of this article is to describe a clinical occurrence faced by psychiatric mental health nurses in routine practice. It reviews scant literature on changes in dynamics that occur in the provider-patient relationship when an interpreter is present. Secondarily, the authors present interventions for working within the triad partnership of the nurse-patient- interpreter through the lens of Hildegard Peplau’s Interpersonal Relations Theory. The intended outcome of this review is to describe specific interventions for nurses working with interpreters to ease the patient’s mental distress and assist their transition to a higher level of mental health wellness in a new country. Application of the Peplau theory can influence the interpreter's presence in establishing and maintaining the provider-patient therapeutic relationship, as it applies to nursing. The interpreter is essential to interventions for the NES person and is facilitated by the development of a meaningful and productive relationship within the Nurse-Patient-Interpreter triad. This process is critical in reducing the patient’s distress from entry to settlement in the U.S.

Background and objective: The assessment of nursing students' clinical competencies is a global concern, as different exam formats emphasize different types of knowledge and skills. There is a lack of research that uncovers the linkage between clinical exam formats, assessment practices and types of knowledge tested. This study investigates how two different formats of clinical exams—one based on written assignments (control exam), and one conducted in real patient situations (intervention exam)—influence educators’ assessment practices and the types of knowledge they enhance or limit respectively.

Methods: The study applied a comparative, ethnographic design, incorporating participant observations, focus group interviews with educators, and grade analysis of 104 nursing students. The analytical framework was informed by Institutional Ethnography (IE) and Donald Schön’s concepts of reflection in practice.

Results: The control exam is predictable and controlled facilitating assessment of theoretical knowledge and reflection-on-reflection-in-action but is detached from real-life patient interactions. In contrast, the intervention exam is unpredictable and complex emphasizing assessment of knowing-in-action and reflection-in-action but poses challenges in assessing theoretical reasoning and reflection-on-reflection-in-action. Despite these differences, no significant variation was found in students’ final grades between the two formats.

Conclusions: The findings highlight the impact of exam formats on assessment practices and suggest that nursing education should incorporate diverse assessment methods to balance theoretical rigor with clinical competence.

End-of-life care (EOLC) remains a pivotal aspect of nursing practice, yet its delivery often varies due to numerous influencing factors. Religiosity emerges as a significant but understudied determinant affecting EOLC provision. Religiosity is an all-encompassing term defining a person’s public or private involvement in religious groups or activities. This opinion piece delves into the nexus between religiosity and nursing practice, emphasizing the need for empirical inquiry to elucidate its role in shaping care dynamics. Drawing upon existing literature, it describes religiosity's multifaceted influence on nursing behaviours and decision-making in EOLC settings. The piece advocates for research efforts aimed at understanding its impact on care quality and equity. By fostering a deeper comprehension of how religiosity interacts with nursing practice, healthcare systems can strive towards delivering more personalized, equitable, and dignified EOLC experiences for patients and families.

Objective: The three-year Workforce Engagement for Compassionate Advocacy, Resiliency, and Empowerment (WE CARE) project targets well-being and resilience of post-pandemic nurses in a hospital environment as part of a 2020 grant-funded collaborative agreement with the Health Resources and Services Administration. This project aims to examine extrinsic factors associated with the perception of a toxic work environment among post-pandemic nursing personnel and further describe the toxicity present at work.

Methods: A mixed methods design was conducted at an academic medical center in the Southeastern United States to assess nursing well-being. An open-ended question to explore nurses’ perceptions of toxic work environment was added to an annual email survey on well-being topics. All nursing personnel were solicited and 1,359 responded.

Results: A total of 366 individuals (27%) selected toxic work environment as a stressor and 50 respondents commented contributing 218 instances of themes. Lack of leadership was the most frequent theme identified (63/218, 28.9%) but others included, in descending order, relational aggression, negative attitudes, lack of job accountability, gossip, favoritism, lack of teamwork, attitudes/bullying, negative work environment, cliques, and lack of trust. The respondents who perceived a toxic culture also reported significantly lower perceived organizational support (M = 7.22) than who did not (M = 9.21) (p ＜.001, Cohen’s D = 0.64); and other significantly worse outcomes including burnout (60.9% versus 33.5%, Cramer’s V = 0.22), and moral distress (34.4% versus 16.8%, Cramer’s V = 0.17).

Conclusions: Although this was a single site study and cannot be generalized, the findings of 27% of nursing personnel experiencing a toxic work environment is notable. Perceived lack of leadership was the most prominent theme. Those reporting a toxic culture also reported lower indicators of well-being. This project should provide an impetus for others to investigate this phenomenon among their respective workforces.

Background and objective: Anxiety disorders are prevalent among women attempting to conceive, contributing to emotional distress and potentially affecting fertility outcomes. Traditional pharmacological treatments pose concerns during preconception and pregnancy, emphasizing the need for effective non-pharmacological interventions. Mindfulness meditation has emerged as a promising approach for reducing anxiety, yet limited research focuses on its impact on women trying to conceive. This quality improvement project aimed to evaluate the effectiveness of daily mindfulness meditation in reducing anxiety levels among women actively attempting to conceive within one year.

Methods: A nine-week cross-sectional survey study was conducted with 14 women aged 32-42 receiving care at a private practice in Chicago, Illinois. Participants engaged in daily ten-minute guided mindfulness meditation sessions using the Insight Timer app. Anxiety levels were assessed using the Generalized Anxiety Disorder 7-item (GAD-7) scale at baseline, weeks 3, 6, and 9. Data analysis included one-way ANOVA to compare mean GAD-7 scores across time points.

Results: GAD-7 scores demonstrated a clinically meaningful decrease over time, with mean scores declining from 9.6 at baseline to 4.2 at week 9. Although the reduction was not statistically significant (p =.083), sustained improvement in anxiety levels suggests the intervention's potential benefit. The highest drop in anxiety occurred between weeks 3 and 6, with effects persisting post-intervention.

Conclusions: Daily mindfulness meditation may serve as a valuable, non-pharmacological strategy for reducing anxiety in women attempting to conceive. Despite the small sample size and lack of statistical significance, the observed clinical improvements highlight the need for larger-scale studies to further explore mindfulness meditation's role in fertility-related anxiety management.

Introduction: COVID-19 was considered a pandemic as of mid-March 2020 until May 2023. The first vaccine against COVID-19 gained approval at the end of 2020. Overall willingness to be vaccinated is high in Sweden, some people have refused the vaccine. The pandemic caused trauma to nurses around the world due to heavy workloads, deaths in the profession, and employers’ failure to prioritise nurses’ physical and mental well-being. This, together with hesitation to get vaccinated, might have affected nurses’ work. Therefore, it is important to investigate how nurses were affected during the COVID-19 pandemic and their work with unvaccinated patients. The aim was to explore nurses’ experience of caring for hospitalised unvaccinated patients with COVID-19.

Methods: A qualitative approach was used to describe nurses’ perceptions and experiences. Nine semi-structured interviews were conducted in the spring of 2022. The study was set in two departments of infectious care at tertiary care emergency hospitals in Stockholm, Sweden.

Results: The findings are presented with four themes: A difficult work situation; The strength of colleagues; Dealing with different opinions; and Lessons learned from the pandemic. Each theme has two subthemes.

Conclusions: The nurses were often working under stress during the pandemic, and they showed signs of compassion fatigue, which affected the nurses and, by extension, their unvaccinated patients. For pandemics, epidemics and challenges to come, our findings show that there is a need for mandatory reflection and scenario-based training to increase resilience and competence and to prevent compassion fatigue.

Background: Clinical learning is key for health professional students. As we face, worldwide, an aging healthcare workforce and widespread staff shortages, the urgency to adopt innovative and scalable models of clinical education has never been greater. These new approaches are essential not only to address the current capacity challenges but also to ensure the sustainability and quality of care, particularly as healthcare needs become more complex and patient populations continue to grow. Co-operative education (co-op) programs provide students with the opportunity to gain practical experiences in a clinical setting as part of their formal education while receiving some financial remuneration. Yet, little is known about the most effective ways to design, implement and evaluate these programs to best benefit patients, students, educational, and healthcare organizations. Our goal was to explore the available literature on paid co-op education models for students in health professional programs.

Methods: We conducted a scoping review following the six stages of the Arskey and O’Malley’s scoping review framework and the PRISMA-ScR reporting format. This included defining the research question, developing the search strategy, conducting a two-step screening process, and performing data extraction and analysis of the included studies.

Results: A total of 30 articles were included. Studies were from the United States (n = 14), the United Kingdom (n = 8), Canada (n = 4), Ireland (n = 2), New Zealand (n = 1) and Iran (n = 1). Most studies aimed to describe or evaluate the paid co-op programs (n = 12), or aimed to explore the experience of students, preceptors or faculty members who participated in a co-op program (n = 10). The studies included a wide range of healthcare professionals, including nursing (n = 21), pharmacy (n = 3), midwifery (n = 1), medicine (n = 1), occupational therapy (n = 1), audiology (n = 1), social work (n = 1), and a combination of occupational therapy, physiotherapy, and speech-language pathology (n = 1).

Conclusions: The results of this scoping review contributed to the existing literature on paid co-op education programs for students in health professional programs. We explored the current state of these programs, the benefits and the challenges of these programs, and the potential directions for future planning, implementation, and research in this area. Health care leaders, program directors, clinical educators, and curriculum developers will be able to use these findings to inform future co-op programs that fosters mutual benefits for students, educational, and healthcare organizations.