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Jun 14

Planned featured topic: Nursing Theory for 2020


The significance of nursing perspectives has gained renewed interest as social pressures to reform healthcare have created challenges for care that is more effective, more effective and more economically sound. In both theory and in practice, nursing offers possibilities that address each of these goals.  We are inviting articles that address the state of the art of nursing theory as we approach the third decade of the 21st century, revealing important contributions that nursing brings to create needed change.  We welcome articles addressing the full range of theoretic development: articles that report empiric research structured from existing nursing theories, philosophic analyses related to theory and knowledge of the discipline, critiques of existing theoretical approaches, and descriptions of new and evolving nursing theories. Manuscripts are due by: July 15, 2019, but are welcomed any time!

Jun 1

Philosophy, Nursing Knowledge, and Nursing Practice


In the current featured ANS article, the authors explain how two philosophic lines of thought — realism and relativism — are useful in helping nurses improve the health of patients and society at large. The article is titled “Realism and Relativism in the Development of Nursing as a Discipline” by Shela Akbar Ali Hirani, MScN, RN, BScN, IBCLC; Solina Richter, PhD, RN, DCur and Bukola Oladunni Salami, PhD, RN, MN. The article is available to download at no cost while it is featured; we welcome your comments and feedback. Ms. Hirani sent this description of the experience that drew her to explore these philosophic ideas and relationship to nursing practice and nursing knowledge development:

On entering into my doctoral studies, during my nursing philosophy class, I came across the terms realism and relativism. Upon learning about theses philosophical schools of thoughts and listening to my colleagues who often used to find these philosophical schools of thought a bit

Shela Hirani

confusing and challenging, I had a feeling that we as nurses often apply these schools of thoughts in a variety of our practice settings without being aware of them. To give tribute to the work of nurses that is often based on the philosophical schools of thought of realism and relativism, under the mentorship of my professors, I decided to write this article entitled “Realism and relativism in the development of nursing as a discipline”. This paper presents the role of realism and relativism in the development of the discipline of nursing, as well as underscores the contribution of these two schools of thought to the work of nurse clinicians, nurse researchers, nurse educators and nurse theorists. As the target audience of the journal “Advances in Nursing Science” include nurses from different specialty areas who have varying levels of understanding about philosophy, while touching upon the basics, this paper intends to discuss the role of realism and relativism in nursing education, nursing research, evidence-based nursing practice, and nursing theory. Specific examples of nursing activities have been discussed in the paper to facilitate the readers to understand how realism and relativism shape the amazing work of nurses and contribute to the development of nursing as a discipline.

May 17

Commercial Sexual Exploitation of Children


The current ANS featured article addresses a hidden, but urgent, threat to the health of children.  The article is titled “School Nurses’ Awareness and Attitudes Toward Commercial Sexual Exploitation of Children” authored by Hannah E. Fraley, PhD, RN; Teri Aronowitz, PhD, APRN, FNP-BC, FAAN; and Emily J. Jones, PhD, RNC-OB.  We are offering continuing education credit with this article because this type of challenge is significant for all nurses. This study reveals the key roles that nurses play in protecting the health and well-being of people who are vulnerable and disadvantaged.  The article is available to download at no cost while it is featured, and we invite you to read it, and share your comments here!  Dr. Fraley has shared this information about her work for ANS blog readers!

I am a nurse educator and scholar and am passionate about vulnerable populations, health disparities, health access, and human rights. With an extensive background in working with vulnerable women and children, I have developed a focused research program targeting youth

Hannah Fraley

violence prevention and risk reduction. As I became aware of the nation-wide problem of child sex trafficking I knew that nurses are in such a pivotal position to be able to identify trafficking victims and intervene. Further, in my extensive study of child trafficking in the U.S. I was led to the unique and frontline role specifically of school nurses; school nurses have routine interaction with youth and are often the only health care provider youth interact with. I knew that school nurses can intervene and prevent child sexual exploitation, but also knew from studying the health care provider role that providers may lack awareness of child sex trafficking and also may have negative perceptions about youth who are most vulnerable impeding identification and intervention. Understanding that perceptions that we internally hold are shaped by our own life experiences and also shaped by societal and institutional influences became the backbone of my work with school nurses given youth who are most at risk of sexual exploitation are often those whom society, institutions, ourselves label as ‘difficult to work with’ or ‘trouble’. These children cross their school nurses’ path day in and day out and their exploitation may not be seen or recognized due to low awareness of sex trafficking coupled with shaped perceptions. This has become the driving force of my work aiming to build sustainable programs for school nurses and multidisciplinary school teams targeting prevention of commercial sexual exploitation of children.

May 12

Nursing Practice and the Criminal Justice System


The current issue of ANS features two articles focused on Crime, Justice and Health.  The first of these two articles is titled “In a Spirit of Restoration: A Phenomenology of NursingPractice and the Criminal Justice System” by Geraldine Gorman, PhD; Rebecca M. Singer, ND; Erin Christmas, MS; Catherine Herbstritt, MS; Layne Miller, MS; Mary Murphy, MS; Cailan Shannon, MS; and Katrina Wyss, MS.  We invite ANS readers to download this article while it is featured (no cost), and share your reflections in the comments section below.  Dr. Gorman shared this summary of her work, and how she became dedicated to addressing this timely and important social justice issue, followed by a message from co-author and faculty colleague Rebecca Singer:

From Geraldine Gorman:

Tragedy and crisis divert our attention from other tragedy and crisis. I became interested in prison reform back in the 90’s when I attended a forum focused on the impact of Buddhism on healthcare.  A Religious Studies professor from DePaul University in Chicago talked about  the

Geraldine Gorman

sangha he initiated for the men imprisoned in the maximum security facility in Michigan City, IN. I was intrigued and Ron invited me to attend one of their Zen Buddhist sittings. For the next 15 years I went into the prison as a volunteer with the Buddhist group, sitting and chanting in Korean– not a word of which I understood– and getting to know the men, some of whom had spent time on death row. During those years  3 executions took place, one which took the life of one of the members of the sangha. A peaceful protest accompanied each state-sanctioned murder with black robed Buddhists  sitting silently in the parking lot, from dusk till dawn. The reverberations from each death ran deeply.

But then 9/11 shook the world and my nursing conscience turned from the injustices of the prison industrial complex to the horrors of war. I continued going into the prison but war dominated my thoughts and words and  outrage.  This is what happens when the dike starts springing too many leaks. We have only so many hands, so much time.  It goes without saying that our current political dike has become a sieve.

Ten years ago as part of our public health nursing class, I began bringing students to the Indiana prison. They were able to walk through the cell blocks, observe what passes for healthcare, listen to men describe their journey to and through incarceration. Chicago’s own Cook County Jail had remained an impenetrable fortress until very recently when our reform-minded Sheriff reached out to the College of Nursing and we began providing health education to the men and women detained in the cavernous jail. Our article describes the initiation of this project, along with the gratifications and challenges faculty and students encountered.

We appreciate the opportunity to share this with the ANS audience. While we must pay close attention to the ever present rumors of war and more war, we cannot allow our attention to be diverted from the injustices in our own communities.  And we need to expose our students to what is done in our names without paralyzing them. Such is the challenge for nursing practice, education and scholarship: to witness and confront insurmountable suffering and to move forward.

From Rebecca Singer:

My primary area of practice is within humanitarian response work which takes me to conflict or post-conflict zones where I try to provide services with few resources to displaced peoples who have lost nearly everything but their lives. In my work with students, they express interest in this work and often ask what they should do to prepare for a job in humanitarian response. After

Rebecca Singer

several weeks in the jail, I realized that Cook County Jail was the closest I had ever come to a refugee camp in Tanzania or a displaced persons’ settlement in South Sudan while never traveling beyond my own city’s limits. The students and I needed to travel no further than 26th and California, just over 2.5 miles from our own College of Nursing, to be surrounded by displaced peoples who have lost nearly everything but their lives and to provide health education with few resources but our wits, several pieces of paper and a poster board.

As the weeks passed and we struggled to understand the rules, to navigate the bleak halls, and to be heard over the din, I came to see how much like a foreign country the jail was. Each time we enter the jail, we repeatedly are asked to show our ID and permission letter, which serve as our passport to this foreign land. We pass through metal detectors and check-points which remind me of the international borders and military check-points I cross to get to my other work. They check our bags and confiscate anything that might pass as contraband; this week a permanent marker and next week a roll of tape. We must pack our bags with care.

The people who get caught up in our criminal justice system live in the same city that we do, yet their lived reality is essentially foreign to me and to most of the students.  They often speak a different language, using slang that I have never heard.  Coming from parts of the city with higher rates of unemployment and lower rates levels of education, they function in an economy far removed from the Loop that I can see from our campus. The exchange of illegal items, including illicit drugs and the firearms that drive up the rates of violence in their communities, render the currency they use different from ours. And while our city is diverse, the range of brown and black people I meet in the jail do not look like the faculty I call my colleagues at our university.

Yet, it is only like a foreign country, because, in fact, this jail is in our city. It houses fellow citizens of our Midwestern city–polite, friendly sports’ fans who love to complain about the weather. They are fellow citizens whose current conditions serve as a stark and vivid reminder that the social determinants of health are at play right here. Now when students ask me about my humanitarian response work and express interest in doing it, I can encourage them to come with us to do that very work without traveling more than 2.5 miles—no passport necessary—just pack with care.

Apr 26

1 Comment

Ethnic Diversity and Advanced Health-related Decisions


Our latest featured article it titles “Health-Related Decisions for Serious Illness Among Ethnically Diverse Older Adults” by Zahra Rahemi, PhD, RN; Christine Lisa Williams, DNSc, RN, PMHCNS; Ruth Marchand Tappen, EdD, RN, FAAN and Gabriella Anna Engstrom, PhD. The article is available for free download while it is featured, and we welcome your comments here! In this article, the authors discuss the evidence from their study that supports the great variability in individual situations at the end of life, and the importance of nursing care that remains responsive to each particular situation.  Dr. Rahemi provided this background for ANS reviewers:

Universally, the population of older adults is dramatically growing. In the United States, culturally and ethnically diverse older adults are one of the fastest growing population. Cultural factors, including ethnicity, acculturation, and spirituality, have significant influence on diverse older adults and how and what they plan for their healthcare. Therefore, there is a need for multiple care options to avoid predetermined clinical practice guidelines for ethnically diverse older adults.

Cultural beliefs and value systems frequently prevent people from healthcare service use and healthcare decision making, which contribute to healthcare disparities for ethnically diverse older adults. In my current studies, I am interested in investigating factors that are pivotal for communication of decisions in advance. Innovative strategies to help individuals determine their goals of care are needed to clarify health-related decisions that ethnically diverse individuals may find challenging to articulate. Because ethnically diverse communities have strong family ties in general, the authors encourage informal and general discussions about goals of care among these communities. These conversations may ultimately inform significant others who are called upon to make decisions when older adults cannot. The new strategies recommended in this study may open new venues for professional development in nursing and ultimately promote culturally competent care.

In the field of ethnically diverse older adults and their healthcare decisions and preferences, the I started with a broad literature review and an integrative review that was published in ANS. Later, I continued my research in different ethnically diverse communities using different lenses, such as end-of-life preferences, health-related decisions for serious illness, and attitudes and behaviors regarding planning ahead for end-of-life care. I hope to introduce more innovative strategies to encourage ethnically diverse older adults to communicate their desired care choice when they are capable to communicate.

 

Apr 12

1 Comment

Caring for People with Dementia


Our current featured article is a report of a phenomenological, hermeneutic investigation titled “Former Work Life and People With Dementia” authored by Bente Nordtug, PhD, MA, RN; Karin Torvik, PhD, MA, RN; Hildfrid V. Brataas, PhD, MA, RN; Are Holen, PhD, MD (psychiatrist); and Birthe Loa Knizek, PhD, MA.   The research team was led by Dr. Bente Nordtug, a registered nurse, specializing

Bente Nordtug

in dementia care. She has a PhD in Health Science from Norwegian Science and Technology University (NTNU). Currently she works as an associate professor at the Department of Nursing and Health Sciences at Nord University (NU). Her research has mainly concerned issues such as the mental health of informal caregivers of patients, and how social support affects the caregivers’ caring burden.

This article is available to download at no cost while it is featured!  We invite all comments and ideas related to this work – leave you message below!

Mar 26

Emancipatory Policies for Environmental Health


Our current featured article addresses one of the most pressing issues of our time – environmental health.  The article is titled “Environmental Health: Advancing Emancipatory Policies for the Common Good,” authored by Sarah K. Valentine-Maher, MSN, RN,

Sarah Valentine-Maher

FNP; Patricia G. Butterfield, PhD, RN, FAAN; and Gary Laustsen, PhD, RN, FNP, FAANP, FAAN.  The article is available at no cost while it is featured on the ANS website.  Authors Valentine-Maher and Butterfield  talk about their work in this video we recorded for ANS blog followers; we welcome your comments below!

Message from Sarah Valentine-Maher:

Nurses hold a great potential to improve human wellbeing by addressing the environment that determines health.  Many of us will recognize this ethos within nursing. Yet, our potential to address one of the major determinants of health, the integrity of the natural environment, is not yet actualized.  In the article “Environmental Health: Advancing Emancipatory Policies for the Common Good” we point towards a way forward. Overviews of contextual issues and specific environmental concerns are paired with recommendations for nurses’ actions.

The discussion in the video posted here touches on an overview of the paper as well as the themes of; ‘why nursing and environmental health’ and the emancipatory implications of such work.

Mar 14

3 Comments

Healing Genocide Rape Trauma


Our current featured article is representative of a long ANS tradition – articles that address topics that are rarely brought to public attention.  The article is titled “Genocide Rape Trauma Management: An Integrated Framework for Supporting Survivors” authored by Donatilla Mukamana, PhD, RN; Petra Brysiewicz, PhD, RN; Anthony Collins, PhD; and William Rosa, MS, RN, LMT, AHN-BC, AGPCNP-BC, CCRN-CMC. The article is available for download here at no coast while it is featured. Dr. Mukamana shared this information about the background of this article:

The idea of writing about  genocide rape trauma came after a discussion I had with one of my patients in 2000. She had been gang

Donatilla Mukamana

raped and contaminated with HIV during the genocide against Tutsi in 1994,  At that time we met in 2000 she  was  dying.

She told me: “ Go and tell the world about the unspeakable cruelty of genocide rape which leaves the victim as living dead… then those who are in power should  prevent the occurrence of rape”

Rape used as a weapon of genocide affects all aspects of the survivor’s life. Therefore the healing process requires a holistic approach, one that I attempt to present in the current article.

I join the authors in welcoming your ideas, comments and questions about this work in the “comments” section below.

Mar 8

New – ANS Continuing Education!


With the current issue of ANS, we have launched Continuing Education for at least one article each issue!  When you visit the online Table of Contents of each issue, you will see a red “CE” symbol, indicating that you can visit the ANS page on Nursing Center CEConnection to proceed with the process to obtain continuing education credits. In the current issue, CE credit is available for the article titled End-of-Life Communication: Nurses Cocreating the Closing Composition With Patients and Families by Mary J. Isaacson and Minton, Mary E.

In addition we have provided CE credit for two other recently published articles, which you can see on the CEConnections ANS page:

A Qualitative Study of Difficult Nurse-Patient Encounters in Home Healthcare by Mary Kate Falkenstrom that appeared in ANS 40:2, April-June 2017.

Embedding a palliative approach in nursing care delivery: An integrated knowledge synthesis by Richard Sawatzky, Pat Porterfield, Della Roberts, Joyce Lee; Leah Liang, Sheryl Reimer-Kirkham, Barb Pesut, Tilly Schalkwyk, Kelli Stajduhar, Carolyn Tayler, Jennifer Baumbusch, and Sally Thorne that also appeared in ANS 40:2, April-June 2017.

These articles, and the future articles that will be available for continuing education, have implications for practice, education, policy and research. I trust that this new initiative will provide an important resource for our discipline!

Mar 2

Standards of Rigor in Literature Reviews in Nursing


We are currently featuring an article focused on methodology for literature reviews titled “Characteristics of Reviews Published in Nursing Literature: A Methodological Review” authored by Coleen E. Toronto, PhD, RN, CNE; Brenna L. Quinn, PhD, RN, NCSN; and Ruth Remington, PhD, AGPCNP-BC. The article is available for download at no cost while it is featured, and we welcome you to read the article and return here to share your comments and feedback!  Here is a message from each of the authors describing how they came to be part of this project:

Coleen:

            During my graduate and doctoral programs I had published two integrative reviews: one in my masters program and one in my doctoral program.   Since my first student experiences conducting integrative reviews, I have found methodological approaches for conducting integrative reviews to be unclear.

            For four years, Ruth and I had co-taught a master’s level nursing research course where students produced integrative reviews.  During that time, we had found that many of the nursing research textbooks did not cover the integrative review process. We would direct our students to look to the literature for published integrative reviews to help guide them when conducting their reviews, but many reviews did not follow a standard format and instead confused our students. These educational experiences were the impetus for our need to explore in depth the characteristics of published nurse led reviews.

            One goal in conducting our review was to gain a better understanding of what a well-done review should look like and help us guide our students. However, our review’s findings confirmed what we had been witnessing in the classroom with our students, in that there was much variation on how this type of review is conducted and published.  An important implication from our review is that there needs to be consensus among editors, peer reviewers, researchers, faculty and students alike of what an integrative review is and how it should be performed and reported.  In the future, we hope to continue on with our research and explore this issue more fully.

            I feel fortunate to have connected with Brenna at the NLN Writing Retreat in 2016 and have her join our research team.  At that point, Ruth and I had been working on the project for over two years and so it was extremely helpful to have Brenna’s energy and fresh perspective move our project to completion.  Our wish for this blog is that it will generate discussion among the ANS readership.  Have readers experienced similar confusion about reviews as an editor, peer reviewer, researcher, educator or graduate student?  We would love to hear your thoughts, ideas and suggestions related to our research.

Ruth:

            Having published several integrative reviews, as well as serving as a reviewer for several prestigious nursing journals, I felt comfortable in taking on the co-teaching of the integrative review process as part of a graduate nursing research course. I started this process with what I thought was a good understanding of the difference between integrative reviews, systematic reviews and literature reviews.

            It was not long before I realized how much inconsistency there was in methodologies in published reviews and contradictory instruction to be found in the few textbooks that addressed conducting these reviews. I found that, as Coleen mentioned, the available resources confused students, rather than help them to produce a rigorous review.

            My naive hope for this review was to clarify the characteristics of types of reviews. Well, having spent many hours reading and analyzing nurse-authored reviews, I became even more aware of the variation in rigor of the methods in published reviews. In an attempt to clarify some of this confusion, we contacted the editors of journals that published reviews in our sample, to identify the evaluation criteria that reviewers were expected to follow, similar to what was done by Jackson nearly 40 years ago (Jackson, 1980). Similar to Jackson, we found that many editors rely on the authors’ and reviewers’ expertise. Could this be why the inconsistencies persist?

            I would like to add a word about the value of working in writing teams. As nurses, many of us like to think that we can do it all alone. However, diversity among research team members can improve the quality of the science. Stronger scientific contributions are produced when combining experienced writers’ knowledge and skills with the enthusiasm and energy of nurses new to professional writing.

Jackson GB. Methods for Integrative Reviews. Rev Educ Res. 1980;50(3):438. doi:10.2307/1170440.

Brenna:

            I attended the 2016 Scholarly Writing Retreat sponsored by the National League for Nursing and Chamberlain College of Nursing, and was very happy to begin a friendship with Coleen. We, along with eight other nurse faculty attendees, enjoyed a productive weekend of mentored writing in Washington, DC.  After returning home, Coleen reached out to ask me to join a project she and Ruth were working on about nursing literature reviews. Coleen did not know this, but Ruth was my undergraduate pharmacology instructor! Coleen and Ruth had, at this point, reviewed all nurse-authored literature reviews published in the year 2013 and wanted to add 2014 and 2015. They were in search of another team member to help with data collection, analysis, and writing, as well as keeping the team moving along on a reasonable schedule. I had published a few literature reviews, and was interested to learn more about what methods nurses were really using and how we could use data about current review methods to make suggestions to strengthen the quality of reviews in nursing. We had a few phone and video chat conferences and two face-to-face meetings throughout the project, but relied mostly on Dropbox for communication and file sharing. We efficiently completed our study and put together a manuscript we hope ANS readers will find informative.

L to R: Coleen Toronto, Ruth Remington and Brenna Quinn

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