{"title":"A Framework for Strategic Development and Integration of the Advanced Practice Executive","authors":"Amanda Comer DNP, FNP, ACNP, ENP, Alisha DeTroye MMS, PA-C, DFAAPA, Eileen Campbell MSN, FNP, Julie Creaden DNP, CPNP, Clair Kuriakose MBA, PA-C, FACHE, Dorothy Mullaney DNP, NNP, Bonnie Proulx DNP, PNP-BC, Julie Raaum DNP, FNP, Barbara Seymour DNP, RN, NE-BC, CPPS, Christen Hunt DNP, FNP, CPNP-AC","doi":"10.1016/j.mnl.2023.09.011","DOIUrl":"10.1016/j.mnl.2023.09.011","url":null,"abstract":"<div><p><span><span>Health care organizations<span> have immense opportunities to transform enterprise performance through strategic development and integration of advanced practice providers (APPs). The projected growth rate for APPs, which include </span></span>advanced practice registered nurses (APRNs) and physician assistants, is 45% and 31%, respectively. This projection is based on the shortfall of physicians and the increased need to provide cost-effective care. Successful integration of APPs requires organizations to invest in the infrastructure to support this rapidly growing </span>profession. Many health care organizations are preparing by creating a system advanced practice executive role to oversee the organizational design systemness, workforce strategy and optimization, and care design and innovation. This paper results from system advanced practice executives collaborating to define a system-level APP leader's role and responsibilities and the value brought to the health system.</p></div>","PeriodicalId":44980,"journal":{"name":"Nurse Leader","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135412514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nurse LeaderPub Date : 2024-04-01DOI: 10.1016/j.mnl.2023.09.008
Kathleen Ann DeMarco PhD, RN, NE-BC, CPHQ, Marci Resnicoff MSN, RN, AHN-BC, HWNC-BC
{"title":"Launching Lavender Response Teams Across a Health Care System","authors":"Kathleen Ann DeMarco PhD, RN, NE-BC, CPHQ, Marci Resnicoff MSN, RN, AHN-BC, HWNC-BC","doi":"10.1016/j.mnl.2023.09.008","DOIUrl":"10.1016/j.mnl.2023.09.008","url":null,"abstract":"<div><p>The COVID-19 pandemic highlighted the need for real-time support of health care workers after a stressful event occurrence. Code Lavender has been used in several hospitals for this purpose for over a decade. With the evolution of health care to include large health care systems comprised of several hospitals and clinics, one intercity health care system determined there was a need to implement a Code Lavender across all of its in-patient hospitals simultaneously. This article describes how this organization accomplished this and may serve as a resource for other health care systems interested in establishing their own version of Code Lavender.</p></div>","PeriodicalId":44980,"journal":{"name":"Nurse Leader","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136160774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diversity, Equity, Inclusion, and Belonging Is Not a One-Time Fix: An Enduring Program Requires Ongoing Efforts By Nurse Leaders in the Workplace","authors":"Deborah C. Stamps EdD, MBA, MS, RN, GNP, NE-BC, CDE, FAAN","doi":"10.1016/j.mnl.2023.11.011","DOIUrl":"10.1016/j.mnl.2023.11.011","url":null,"abstract":"<div><p>Anti-diversity, equity, inclusion, and belonging (DEIB) sentiment has been on the rise over the past couple of years. Unfortunately, this negativism, referred to as the “anti-woke” movement by some states, has sustained and expanded these feelings. With the escalation of global migration, it is imperative that nurse leaders build awareness of the importance of diversity, equity, inclusion, and belonging in their workplaces if they are to maintain a workforce that mirrors the communities they serve. A supportive and inclusive workplace culture can improve team engagement if robust training initiatives that address unconscious bias are ongoing, and changes to policies that address underrepresented groups are addressed. Cultural humility and responsiveness matters at all levels in the health care workplace and must be supported by senior management and nurse leaders from the bedside to the boardroom if a sustainable culture of diversity is possible.</p></div>","PeriodicalId":44980,"journal":{"name":"Nurse Leader","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139026612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Health Promoting Self-Care: Evaluating the Impact of 28-Day Food and Fitness Program on the Physical and Mental Well-Being of Health Care Workers","authors":"Gena Oppenheim MSN, RN, CNL, Giancarlo Lyle-Edrosolo DNP, RN, CENP, NEA-BC, FAONL, Ross Bindler PharmD, Emily Enos MSN, RN, Marlon Garzo Saria PhD, RN, AOCNS, NEA-BC, NPD-BC, FAAN","doi":"10.1016/j.mnl.2023.11.017","DOIUrl":"10.1016/j.mnl.2023.11.017","url":null,"abstract":"<div><p><span>The aim of this pilot study was to evaluate the impact of the 28-Day Food and Fitness Program on the physical and mental well-being of health care workers. Social determinants of health significantly impact an individual’s overall well-being and quality of life. Access to nutritious foods and physical activity is crucial to positive physical and mental well-being. The urgency for hospital executives, administrators, and leaders to prioritize the physical and mental well-being of health care workers has become increasingly evident with unprecedented rates of burnout, stress, and turnover following the COVID-19 pandemic. This 8-week </span>prospective cohort study followed 65 multidisciplinary health care workers from a single Santa Monica, California, hospital, who voluntarily signed-up for a 28-day Food and Fitness Program in the spring of 2022. Participants completed body composition testing pre- and-post-intervention, and were surveyed using the Professional Quality of Life (ProQOL) scale at baseline, 28 days (4 weeks), and 56 days (8 weeks). Pre- and-post-intervention data showed nonsignificant decreases in variables such as weight and body mass index with increases in lean body and skeletal muscle mass. Mean scores for all 3 subcategories of the ProQOL numerically improved from baseline, but did not reach statistical significance. Preliminary results support use of the 28-Day Food and Fitness Program to improve caregiver physical and mental well-being, but further research is needed to quantify impact more reliably.</p></div>","PeriodicalId":44980,"journal":{"name":"Nurse Leader","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139128006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nurse LeaderPub Date : 2024-04-01DOI: 10.1016/j.mnl.2023.12.002
Roberta Waite EdD, PMHCNS, ANEF, FAAN, Kenya Beard EdD, AGACNP-BC, ANEF, FAAN, G. Rumay Alexander EdD, RN, FAAN
{"title":"Anti-Black Racism and Nursing Leadership","authors":"Roberta Waite EdD, PMHCNS, ANEF, FAAN, Kenya Beard EdD, AGACNP-BC, ANEF, FAAN, G. Rumay Alexander EdD, RN, FAAN","doi":"10.1016/j.mnl.2023.12.002","DOIUrl":"10.1016/j.mnl.2023.12.002","url":null,"abstract":"<div><p>Leadership in the nursing profession plays a key role in upholding social justice and eradicating anti-Black racism. Recognizing that racism is a leading factor shaping health inequities is vital to strategies developed to ameliorate adverse health processes and outcomes. Taking proactive steps to prepare nurse leaders to develop and implement system improvement strategies that tackle internal and external system processes and structures that propagate structural racism and other forms of discrimination in health care systems must be prioritized. It would be advantageous for nursing leaders to take a humanistic mindset to effectively diversify the nursing workforce especially for those racialized as Black or brown and desire leadership roles. To advance these efforts, the purpose of this paper is threefold. First, the authors elucidate the ways that anti-Black racism interrupts efforts to advance health equity. Second, factors that contribute to a lack of racial diversity in nursing and nursing leadership are illuminated. Finally, astute strategies to counter anti-Black racism are provided along with reflective questions to facilitate the process.</p></div>","PeriodicalId":44980,"journal":{"name":"Nurse Leader","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139195759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nurse LeaderPub Date : 2024-04-01DOI: 10.1016/j.mnl.2023.11.010
Susan H. Weaver PhD, RN, CRNI, NEA-BC, Kimberly Dimino DNP, RN, CCRN, Kathryn Fleming PhD, RN, CPHQ, FACHE, Joan Harvey DNP, RN, GERO-BC, CCRN, Maria Manzella DNP, RN-C, HNB-BC, Paula O’Neill MS, RN, HNB-BC, MEDSURG-BC, Mani Paliwal MS, MBA, Maryjo Phillips DNP, RN-BC, CMSRN, Theresa A. Wurmser PhD, MPH, RN, NEA-BC
{"title":"Exploring Sleep and Fatigue of Clinical Nurses and Administrative Supervisors","authors":"Susan H. Weaver PhD, RN, CRNI, NEA-BC, Kimberly Dimino DNP, RN, CCRN, Kathryn Fleming PhD, RN, CPHQ, FACHE, Joan Harvey DNP, RN, GERO-BC, CCRN, Maria Manzella DNP, RN-C, HNB-BC, Paula O’Neill MS, RN, HNB-BC, MEDSURG-BC, Mani Paliwal MS, MBA, Maryjo Phillips DNP, RN-BC, CMSRN, Theresa A. Wurmser PhD, MPH, RN, NEA-BC","doi":"10.1016/j.mnl.2023.11.010","DOIUrl":"10.1016/j.mnl.2023.11.010","url":null,"abstract":"<div><p><span>Shiftwork disrupts nurses’ sleep patterns, leading to sleep deprivation. Consequently, nurses experience fatigue and reduced alertness, which impact their job performance, physical and mental health, and </span>patient safety. This study investigated the difference in fatigue and sleep quality between day and night shift clinical nurses and administrative supervisors. Significant differences were found between day and night shift clinical nurses in quality and patterns of sleep, perceptions of the severity and effects of fatigue, and work-related fatigue, but not with administrative supervisors. Furthermore, more night shift nurses and supervisors recalled a fatigue-related error, falling asleep at a red light, missing their exit, and having a car accident when driving home compared to those working day shift. In the interest of patient safety, it is imperative that nurses prioritize their sleep, and leaders must take proactive measures to mitigate fatigue.</p></div>","PeriodicalId":44980,"journal":{"name":"Nurse Leader","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139018398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nurse LeaderPub Date : 2024-04-01DOI: 10.1016/j.mnl.2023.09.009
Christopher H. Stucky PhD, RN, CSSM, CNOR, CNAMB, RN-BC, NEA-BC, FAORN, FAAN, Joshua A. Wymer DNP, RN, CNOR, RN-BC, NEA-BC, CHCIO, CDH-E, FACHE, FAAN
{"title":"Ethical Reasoning as a Core Nurse Leader Competency: Maximizing Strategic Decision-Making and Operational Outcomes","authors":"Christopher H. Stucky PhD, RN, CSSM, CNOR, CNAMB, RN-BC, NEA-BC, FAORN, FAAN, Joshua A. Wymer DNP, RN, CNOR, RN-BC, NEA-BC, CHCIO, CDH-E, FACHE, FAAN","doi":"10.1016/j.mnl.2023.09.009","DOIUrl":"10.1016/j.mnl.2023.09.009","url":null,"abstract":"<div><p>Nurse leaders practice across an exceedingly complex and dynamic healthcare landscape, requiring the highest levels of ethical reasoning, engagement, and leadership skills to guide decision-making. Nurse leaders shape the organizational climate and conditions supporting ethical practice and must identify ethical dilemmas, explore individual perspectives through multiple lenses, and make strategic decisions consistent with personal, professional, and organizational values. This manuscript educates nurse leaders on the critical adaptive competency of strategic ethical reasoning to guide just and ethical decision-making for their organizations and communities. We recommend nurse leaders use ethical reasoning to drive strategic decision-making and cultivate ethical practice environments.</p></div>","PeriodicalId":44980,"journal":{"name":"Nurse Leader","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136094535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nurse LeaderPub Date : 2024-04-01DOI: 10.1016/j.mnl.2023.09.006
Margaret E. LaFashia DNP, MBA, RN, NPD-BC, Cynthia Bowers DNP, RN, CNE, Catherine Haut DNP, CPNP-AC/PC, FAANP, FAAN, Norine Watson DNP, RN, NEA-BC
{"title":"Improve the Diversity of a Nursing Workforce Using a Pipeline Development Program","authors":"Margaret E. LaFashia DNP, MBA, RN, NPD-BC, Cynthia Bowers DNP, RN, CNE, Catherine Haut DNP, CPNP-AC/PC, FAANP, FAAN, Norine Watson DNP, RN, NEA-BC","doi":"10.1016/j.mnl.2023.09.006","DOIUrl":"10.1016/j.mnl.2023.09.006","url":null,"abstract":"<div><p><span>The Workforce Pipeline Development Program, established at a local children’s hospital, is a quality improvement initiative to address diversity in nursing, offering career-planning opportunity to underrepresented teens and young adults. The program strategy includes targeting local schools to bring in nursing assistant and medical assistant students for pediatric clinical training with possibility for employment, thus increasing the likelihood of achieving a diverse workforce and better balancing the workforce with the patient populations served. At the children’s hospital, 87.6% of </span>registered nurses report being White, whereas the patient population is only 58.3% White.</p></div>","PeriodicalId":44980,"journal":{"name":"Nurse Leader","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136128083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}