Policy, Politics, and Nursing Practice最新文献

{"title":"Workplace Violence Against Nurses in Canada: A Legal Analysis.","authors":"Sioban Nelson,&nbsp;Kathleen Leslie,&nbsp;Aleah McCormick,&nbsp;JohnPaul Gonsalves,&nbsp;Andrea Baumann,&nbsp;Natalie J Thiessen,&nbsp;Catharine Schiller","doi":"10.1177/15271544231182583","DOIUrl":"10.1177/15271544231182583","url":null,"abstract":"<p><p>Workplace violence against nurses is a significant global occupational health problem, with incidents of violence increasing in frequency since the COVID-19 pandemic began. In this article, we provide a review of recent legislative amendments meant to bolster workplace safety in health care in Canada, analyze legal cases where nurses were the victims of violence, and discuss what these legal reforms and decisions reveal about how nurses' work is treated within the Canadian legal system. Under criminal law, the limited number of cases we could find with oral or written sentencing decisions show that, historically, the fact a victim was a nurse was not always considered an aggravating factor on sentencing. Recent legislative amendments make this a specified aggravating factor and it is important to track the impact of these amendments when judges exercise their discretion in sentencing. Under employment law, it appears that, despite the government's efforts to increase the deterrence factor under legislation with significantly increased fines for employers who fail to protect their employees from injury, courts remain reluctant to impose such sanctions. In these cases, it is also important to track the impact of harsher penalties. We conclude that combating the widespread normalization of workplace violence in health care, and specifically against nurses, is acutely needed to help ensure that these ongoing legal reforms aimed at improving the safety of health workers are effective.</p>","PeriodicalId":53177,"journal":{"name":"Policy, Politics, and Nursing Practice","volume":"24 4","pages":"239-254"},"PeriodicalIF":1.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10563371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10110749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Are Patients Who Legally Use Medical Marijuana Treated When Hospitalized?","authors":"Ellen T Kurtzman,&nbsp;Jessica Greene","doi":"10.1177/15271544231168607","DOIUrl":"10.1177/15271544231168607","url":null,"abstract":"<p><p>The majority of U.S. states have legalized marijuana for medical use and some states have legalized marijuana for recreational use; yet, marijuana remains illegal federally. Given the misalignment between state and federal policies, this paper seeks to explore how hospitals handle inpatients' medical marijuana use in states where medical marijuana is legal. To examine this phenomenon, we conducted an anonymous, online, cross-sectional survey of nurse leaders working in acute care inpatient settings in states that had legalized medical marijuana. Using descriptive statistics, we report on these nurse leaders' experiences. There were 811 survey responses-291 who worked in an acute care inpatient setting in a state that had legalized medical marijuana. Among those respondents, only a small percentage reported that inpatients had some access to their medical marijuana: 5.8% reported that the drug was kept in the pharmacy and dispensed like other prescriptions; another 3.4% indicated that patients kept the medical marijuana in their rooms and took it, as needed. Most respondents (55.6%) reported that patients were switched to an alternative medication during their inpatient hospital stays. Almost half (49.4%) of the nurse leaders who reported that alternative medications were used, reported that opioids were substituted, and the majority reported that the marijuana was safer than the opioids. These findings are concerning given the increase in opioid overdose deaths.</p>","PeriodicalId":53177,"journal":{"name":"Policy, Politics, and Nursing Practice","volume":" ","pages":"225-230"},"PeriodicalIF":1.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9743241","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":"An Examination of Self-Employed Nursing Regulation in Three Canadian Provinces.","authors":"Natalie J Thiessen,&nbsp;Kathleen Leslie,&nbsp;Jennifer M L Stephens","doi":"10.1177/15271544231175472","DOIUrl":"10.1177/15271544231175472","url":null,"abstract":"<p><p>The COVID-19 pandemic and its related stresses such as short-staffing, heavy workloads, and burnout are prompting nurses to re-consider institutional employment, bringing a renewed interest in self-employed nursing and its regulation. There is limited research on the regulation of self-employed nursing roles, and published work focuses on nurses' experiences rather than on regulatory practices themselves. This qualitative case study research aimed to examine the regulation of self-employed nurses by comparing the regulatory policies and processes of nursing regulatory bodies in Ontario, Alberta, and Saskatchewan. The findings demonstrated wide variation in the regulation of self-employed nurses across these jurisdictions. The article includes recommendations to clarify and harmonize the processes used to regulate self-employed nurses.</p>","PeriodicalId":53177,"journal":{"name":"Policy, Politics, and Nursing Practice","volume":"24 4","pages":"265-277"},"PeriodicalIF":1.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10563374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9617510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Workplace Violence Against Nurses: Challenges and Solutions for Europe.","authors":"Paul de Raeve,&nbsp;Andreas Xyrichis,&nbsp;Francesco Bolzonella,&nbsp;Jochen Bergs,&nbsp;Patricia M Davidson","doi":"10.1177/15271544231182586","DOIUrl":"10.1177/15271544231182586","url":null,"abstract":"<p><p>We report the results of a mapping exercise by the European Federation of Nurses (EFN) on challenges and solutions related to violence against nurses. This is an issue of growing international concern, with the problem accentuated during and following the COVID-19 pandemic. Following a cross-sectional observational design, an online questionnaire was distributed among 35 national nurses' associations across Europe in March 2021. Face validity was achieved through an expert panel. Descriptive statistics were used for data analysis, including counts, percentages, and tabulation. Qualitative data analysis followed thematic synthesis techniques. Three main findings are noted. First, violent incidents against nurses are under-reported due to fear of victimization, employer discouragement, and the perception that reporting will not make any difference. Second, perpetrators of violent acts extend beyond patients and families to include health professionals of different ranks. Third, violent incidences have a significant adverse effect on nurses' health and retention, leading to nurses reducing their working hours or opting for part-time work. Violence against nurses is an expression of a broader problem that is rooted in the failure to recognize and manage violence at the level of the healthcare organization, and the absence of appropriate legislation to maintain minimum standards of safe working environments. This is partly the result of inadequate European Union-wide legislation targeting workplace violence in the health professions. Nurses need more institutional support through dedicated funding aimed at targeted interventions, more legislative commitment to ratify policies against discrimination, and an opportunity to voice the needs to the appropriate policymakers with the ability to bring significant change to existing conditions. Given the severity of the situation, inaction could lead to irreplaceable damage to the nursing workforce, compounding pressures resulting from the COVID-19 pandemic. Ultimately, this situation can further drive existing nurses out of the profession, weakening health systems worldwide.</p>","PeriodicalId":53177,"journal":{"name":"Policy, Politics, and Nursing Practice","volume":"24 4","pages":"255-264"},"PeriodicalIF":1.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10563370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9847169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Policy Analysis of Return to Learn After Sport and Recreational Related Concussion for Secondary Schools in New England: Relevance to School Nurses and Nursing Practice.","authors":"Joseph M Fetta,&nbsp;Angela R Starkweather,&nbsp;Thomas Van Hoof,&nbsp;Robert Huggins,&nbsp;Douglas Casa,&nbsp;Jessica Gill","doi":"10.1177/15271544231186359","DOIUrl":"10.1177/15271544231186359","url":null,"abstract":"<p><p>Return to learn (RTL) is the individualized process of coordinating cognitive care and reintegration for students into the academic setting after any sport and recreational-related concussion (SRRC). The guidelines for RTL are based on empirical evidence, however, implementation differs by institution. The purpose of the policy analysis is to evaluate RTL guidelines after SRRC of student-athletes in New England secondary school public school systems. A review of the six New England states' policies surrounding RTL was conducted. The Comprehensive Analysis of Physical Activity Framework was referenced to identify the analytic components of existing legislation and because of the relatively new implementation of RTL-specific policy, a novel policy analysis tool was utilized. States with RTL-specific language scored on average 7.9 to 11.1 points higher when compared to states without RTL-specific language. This difference was associated with disparities in access to RTL resources for residents according to their geographic location. Lobbying efforts should be targeted toward states without RTL-specific language to provide equal care and opportunities for student-athletes to receive RTL services. RTL policy provides a responsibility to assist students who have suffered from an SRRC and can serve to improve health outcomes and academic achievement.</p>","PeriodicalId":53177,"journal":{"name":"Policy, Politics, and Nursing Practice","volume":"24 4","pages":"278-287"},"PeriodicalIF":1.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9900712","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":"Opioid Misuse and Opioid Overdose Mortality Among the Black Population in the United States: An Integrative Review.","authors":"Evans F Kyei,&nbsp;Suzanne Leveille","doi":"10.1177/15271544231164323","DOIUrl":"https://doi.org/10.1177/15271544231164323","url":null,"abstract":"<p><p>Opioid misuse is a growing public health concern in the United States (U.S.). This problem continues to claim many lives and has affected the life expectancy of the U.S. population. In the past few years, the Black population has witnessed an increased rate of overdose deaths compared to their white counterparts. This review seeks to characterize recent trends in opioid prescription practices and overdose deaths among the Black population in the U.S. An integrative review was conducted with a literature search from CINHAL, MEDLINE, and PsycINFO databases. The literature search identified 11 articles for the analysis. All studies were quantitative. Six studies focused on overdose mortality and five on opioid prescription practices. The results indicate a rising trend in opioid overdose mortality among Black people due to the availability of synthetic opioids on the illegal drug market. Black people receive fewer opioid prescriptions and experience higher rates of opioid dose reduction compared to Whites. The Black population has experienced an increase in opioid overdose mortality compared to the White population within the last two decades. Opioid overdose deaths among Black people are highly associated with the proliferation of synthetic opioids, and Black men have been more affected than Black women. Black people experience lower rates of opioid prescription during E.R. visits compared to Whites. The issue of low opioid prescribing among Black people needs to be addressed since it affects their health outcomes and is a factor that contributes to the use of illicit synthetic opioids.</p>","PeriodicalId":53177,"journal":{"name":"Policy, Politics, and Nursing Practice","volume":"24 3","pages":"208-218"},"PeriodicalIF":1.8,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10148528","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":"The Intersection of Media and Policy: A Case Study.","authors":"Diana J Mason,&nbsp;David Keepnews","doi":"10.1177/15271544231168612","DOIUrl":"https://doi.org/10.1177/15271544231168612","url":null,"abstract":"<p><p>From October 2008 through 2010, journalists Charles Ornstein and Tracey Weber produced for the <i>Los Angeles Times</i> and <i>ProPublica</i> a series of investigative reports on the performance of the California Board of Registered Nursing (BRN), finding that it took an average of 3.5 years to act on complaints of professional misconduct by registered nurses, including sexual assault of patients, substance use, and repeat medication errors that resulted in patients dying. In June 2009, Governor Arnold Schwarzenegger announced that he was firing members of the BRN. Its executive officer resigned shortly thereafter. This case study analyzes interviews with nine participants, including the journalists and individuals who were public and nurse members of the BRN in 2009. Four themes emerged: (1) There is a tension between what are perceived to be the public's interests versus nursing's interests; (2) Political naiveté about government and organizational culture can lead to the personalization of actions directed at institutions; (3) A sense of fatalism may be reinforced by organizational culture; and (4) The role and use of media in a free society may be obscured when one is the focus of investigative journalism. Nurses who seek to operate in the public sector must be grounded in the political realities of complex governmental forces that may appear to be illogical or personally offensive. Media, particularly news media, is a powerful tool for influencing these forces. Nurses should employ strategic approaches to the use of media in order to advance their voices as advocates for the public's interests.</p>","PeriodicalId":53177,"journal":{"name":"Policy, Politics, and Nursing Practice","volume":"24 3","pages":"157-167"},"PeriodicalIF":1.8,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9790211","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":"Using Punctuated Equilibrium Theory: Policy Momentum in Traditional Medicare Telehealth Reimbursement During COVID-19.","authors":"Bethany Golden","doi":"10.1177/15271544231157382","DOIUrl":"https://doi.org/10.1177/15271544231157382","url":null,"abstract":"<p><p>This article seeks to understand the changes in federal health care policy that led to greater telehealth adoption during COVID-19 pandemic. For decades, telehealth was identified as a possibility for increasing health care access, but the policies needed for greater telehealth reimbursement were stalled until the public health emergency was declared. Applying the dynamic concepts within punctuated equilibrium theory (PET) model to traditional fee-for-service Medicare policy, the influential factors are identified and specify how policy change occurred as a response to the pandemic, resulting in swift and large-scale changes in Medicare telehealth reimbursement requirements and widespread telehealth adoption. The model also explains how the same forces that led to Medicare policy response are at work to maintain and broaden or contract and limit the future of telehealth reimbursement as the public health emergency recedes.</p>","PeriodicalId":53177,"journal":{"name":"Policy, Politics, and Nursing Practice","volume":"24 3","pages":"198-207"},"PeriodicalIF":1.8,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947389/pdf/10.1177_15271544231157382.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9819478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Migrating Nurses: More Than Addressing the U.S. Nurse Shortage.","authors":"Peter Preziosi,&nbsp;Christine Kovner","doi":"10.1177/15271544231183857","DOIUrl":"https://doi.org/10.1177/15271544231183857","url":null,"abstract":"","PeriodicalId":53177,"journal":{"name":"Policy, Politics, and Nursing Practice","volume":"24 3","pages":"155-156"},"PeriodicalIF":1.8,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9923630","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":"The Impact of the Early COVID-19 Pandemic on Registered Nurses' Intent to Stay in Nursing.","authors":"Gary Yu,&nbsp;Christine T Kovner,&nbsp;Kimberly Glassman,&nbsp;Nancy Van Devanter,&nbsp;Laura Jean Ridge,&nbsp;Victoria H Raveis","doi":"10.1177/15271544231160694","DOIUrl":"https://doi.org/10.1177/15271544231160694","url":null,"abstract":"<p><p>The COVID-19 pandemic has been difficult for registered nurses. Media reports, most of them anecdotal, have reported upticks in nurse resignations, and plans to resign and/or leave nursing due to COVID-19. This article reports findings from an online anonymous 95-item survey completed by about 1,600 nurses from a New York City metropolitan area health system's (HS) four hospitals and ambulatory care centers about their COVID-19 experience in the spring of 2020, their intent to stay at the HS, and their intent to stay working as a nurse. Conducted early in the pandemic, this survey addresses a major gap in the literature, as there was no timely evaluation of nurses' intent to leave during the \"Great Attrition\" wave or to stay during the \"Great Attraction\" trend. Among those nurses completing the survey, 85.7% reported that they planned to work as a nurse one year later and 77.9% reported that they planned to work at the HS one year later. Those nurses who obtained a master's or doctoral degree as their first professional degree in nursing, or had a high level of mastery, were less likely to report an intent to stay at the HS. Those with no children, those who thought the HS was more supportive, and those who thought that registered nurse-medical doctor relations were higher were more likely to intend to stay at the HS. Those nurses who reported worse communication with their nurse manager were less likely to report an intent to stay in nursing. Those who reported lower stress, who were unmarried and had no children were more likely to intend to work as nurses. Our findings on nurses' intent to leave their organization and their intent to leave nursing are much lower than reports in the popular press. Our data were collected early in the pandemic and it may not reflect the accumulated stress nurses experienced from witnessing the death of so many patients.</p>","PeriodicalId":53177,"journal":{"name":"Policy, Politics, and Nursing Practice","volume":"24 3","pages":"168-177"},"PeriodicalIF":1.8,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10159790/pdf/10.1177_15271544231160694.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10150160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}