Paula Milone-Nuzzo

Advancing health policy in nursing education through service learning.

Knowledge of health policy is an increasingly important aspect of nursing practice and education, especially as nurses strive to improve the rapidly changing health care delivery system. At the same time, many educators, researchers, foundations, and government officials are touting the benefits of service learning. In particular, service learning offers ways to enhance partnerships between academia and community agencies and to extend learning beyond the traditional classroom. We present a model for educating nurses as advanced practice nurses in health policy that links service learning with a framework for the political development of nurses. Under the rubric of service learning, the curriculum is based on the overlap among health policy, the role of the nurse as consultant, and community-based care. After discussing the importance of health policy for graduate nursing education and reviewing the essentials of service learning, we describe a three-semester graduate sequence in health policy service learning. The focus is on the clinical and classroom components of both individual and group practica and their relationship to stages of nursings political development. The article concludes with evaluation considerations and the implications of our work for nursing theory, research, practice, and education.

Factors attracting and keeping nurses in home care.

The nursing shortage relates not only to recruiting nurses into the profession but also retaining nurses in practice. Although several studies have examined nurse retention in general, few have addressed retention as a home care issue. This descriptive study identifies factors that attracted nurses to home care and factors that contributed to job satisfaction and dissatisfaction in the state of Connecticut. These findings provide insights to home care agencies on issues that should be addressed to reduce turnover and improve retention in home care.

What it takes: perspectives from developing nurse scientists.

The need for nurse scientists has never been greater, given the complexity of health problems facing our world and the rising cost of providing care to prevent and treat them. The development of nurse researchers is critical to preserve and advance the scientific foundation of the discipline. In this article, two successful doctoral students present their personal views about the cognitive and behavioral transformation they experienced during their program of study, highlighting what they believe to be important resources that enhance doctoral education and sharing how they overcame the challenges encountered. The framework of transformational leadership is used to highlight important aspects of their development as nurse scientists. Action steps for attracting a greater number of nurses to a career in science are recommended.

Looking Through the Right End of the Telescope: Creating a Focused Vision for a School of Nursing

The challenges facing nursing higher education necessitate that academic administrators have a focused vision for their schools of nursing. Nursing, like other areas of higher education, embraced the concept of strategic planning to set priorities, use resources wisely, and take advantage of available opportunities that were consistent with the strategic direction. While there has been a shift toward a less-structured approach to planning, nursing deans need tools to assess the environment, make rational decisions, set priorities, plan for change, and develop strategies to meet the short-term and long-term goals of the unit. Given the challenges facing nursing education and higher education, the need for a planning approach is critical. The case study in this article describes a flexible and creative approach to the planning process that helped the University of Virginia School of Nursing set priorities and achieve its goals.

Home care nursing orientation model. Justification and structure.

An orientation program for new nurses in a home care agency can be an effective tool that increases job satisfaction, alleviates a potentially high employee attrition rate, boosts morale, and thereby improves overall quality of patient care.

Advanced Practice Nurses in Home Care: Is there a Role?

The current challenges affecting home care make the environment ripe for the development of new models of advanced practice nursing in home care. This article explores the barriers and benefits of advanced practice nursing in home care and describes the changes needed to fully integrate the advanced practice nurse into the home care delivery system.

Home care nursing orientation model: content and strategies.

Orientation for the home healthcare nurse consists of specific content areas that are organized into a comprehensive program. The teaching strategies used to deliver the content are just as important as the information included in the orientation program.

Key Attributes of LPN Job Satisfaction and Dissatisfaction in Long-Term Care Settings

Increasing job satisfaction and decreasing job dissatisfaction have been found to improve staff retention, ultimately resulting in improved patient outcomes.The goal of this study was to examine job satisfaction and dissatisfaction of long-term care licensed practical nurses (LPNs). A total of 37 LPNs participated in focus-group sessions. Four themes were found to contribute to LPN job satisfaction: value, real connection, empowerment, and growth. One theme, working conditions, was found to contribute to LPN job dissatisfaction. Based on the results of this study, this article provides specific strategies to assist diverse stakeholders in addressing LPN job satisfaction.

Merging person-centered care with translational research to improve the lives of older adults: creating community-based nursing research networks.

Translational research is a leading trend in science with the aim of bridging the research-practice gap to significantly speed the implementation of effective interventions in clinical practice. Integrating the values and preferences of older adults and their families into this process is critical to the success of translational research. Engaging communities in meaningful research is an important part of advancing translational science in which older adults are partners in developing solutions to the health needs of individuals within communities. The current article describes one approach to developing an infrastructure (i.e., community-based nursing research network) to support patient-centered care within translational research. Nurses are uniquely poised and prepared to assume leadership roles in community-based research networks to support a true collaboration among stakeholders that prizes the voices of older adults and integrates them into practice efforts.

A tool to assess homebound status.

Although this specific instrument focuses solely on helping the home care nurse determine homebound status, this type of instrument can be developed for the other criteria used in assessing a client for Medicare-eligible home care services. For example, a similar instrument can be developed to assess whether a patient meets the criteria for part-time intermittent care or skilled care using the Medicare definitions as a guide to tool development. As we move into a time when there is more scrutiny of home care for compliance to Medicare regulations and increased productivity to assure cost effectiveness, instruments like this are essential for careful documentation that allows the agency to demonstrate accountability. In addition, home care agencies are expecting new home care nurses to know and be able to apply the Medicare regulations after a brief orientation. Instruments like this can shorten the orientation process and provide support for the home care nurse in the field.