Sara Horton-Deutsch

Reflection: an educational strategy to develop emotionally-competent nurse leaders

AIM This paper explores educational strategies for nurses that focus on reflectivity and promote the development of self-awareness, relationship and communication skills and ability to lead with presence and compassion in the midst of change. BACKGROUND Today nurses move rapidly from carefully-controlled educational experiences to a fast-paced clinical world of increasing patient complexity amid calls for improved quality of care. Making the transition to clinical competence and leadership in practice requires a strong sense of self and emotional intelligence. EVALUATION Pedagogies that integrate theoretical and data-based textbook learning with experiential learning and reflection are a foundation for the development of emotionally- and intellectually-competent leaders and requires new ways of assessing learner outcomes. KEY ISSUES Reflection is a key instructional strategy for preparing transformational nurse leaders for interdisciplinary settings where they lead patient care management. The remarkable global spread of reflection in nursing education, practice and research follows an emphasis on developing self-awareness as a leadership strategy for improving individual and organizational performance. CONCLUSIONS Empirical, experiential and anecdotal evidence suggests that reflection has the potential to prepare emotionally-capable nurse leaders. IMPLICATIONS FOR NURSING MANAGEMENT As educators create more reflective and nurturing learning environments, they will promote the development of emotionally-competent nurse leaders who will, in turn, inspire individual and organizational growth and positive change in society.

LONELINESS AND DEPRESSION IN CAREGIVERS OF PERSONS WITH ALZHEIMER'S DISEASE OR RELATED DISORDERS

Secondary analysis of data from a sample of 242 husbands, wives, and daughters providing care for Alzheimers disease family members was conducted to examine the relationships among loneliness and depression and the following variables: quality of the past relationship, relational deprivation, quality of the current relationship, and distance felt due to caregiving. Loneliness was significantly related to depression (r=.66, p<.001), relational deprivation (r=.36, p<.001), and quality of the current relationship (r=.34, p<.001), indicating that the more loneliness reported by the caregivers, the more the caregiver experienced depression, relational deprivation, and a poorer quality of the current relationship. Significant gender differences were found with the caregiving wives and daughters reporting higher mean scores than caregiving husbands on relational deprivation, loneliness, and depression. Loneliness was the only variable significant for predicting depression in caregiving husbands, wives, and daughters. In order for loneliness and depression to be addressed in Alzheimers disease caregivers, they must first be recognised by nurses.

Health care decision-making of persons with dementia

This descriptive study examined the health care decision-making (HCDM) process of 20 community-dwelling care receivers (CR) with mild to moderate dementia and their family caregivers (CG). We conducted semi-structured interviews with the CR, focusing on their HCDM experiences. Additional data were obtained from the quantitative portion of the larger study. Major factors in the HCDM of the CRs were: symptoms, resources, function, trust in the health care system, and reliance on family. Poor congruence between CR and CG choices on treatment was analyzed in light of the qualitative findings. We found that older adults with mild to moderate dementia can participate in the HCDM process, make choices, and provide reasonable explanations for their choices. We concluded that disagreement on treatment choices in family dyads may be more fully explained by using a human needs-based model, as opposed to attributing care receivers’ choices to cognitive status alone.

Becoming a nurse faculty leader: facing challenges through reflecting, persevering and relating in new ways

AIM The aim of the present study was to explore the experience of becoming a nurse faculty leader. BACKGROUND In a recent interpretation of 23 interviews conducted with nurse faculty leaders from across the United States about their experiences of becoming a leader three themes were identified: being thrust into leadership, taking risks and facing challenges. EVALUATION This interpretive phenomenological study further explicates three aspects of how nurse educators faced challenges in becoming and serving as a leader. KEY ISSUES Facing challenges meant reflecting, persevering through difficulties and learning to relate to others in new ways. Exemplars of participant experiences are provided for concreteness, to assist readers in determining how findings resonate with their own experience and how they can actualize this resonance in their own leadership practice. CONCLUSIONS In the present study, reflecting, persevering through difficulties and learning to relate with others in a new way was how leaders faced challenges. IMPLICATIONS FOR NURSING MANAGEMENT Leadership development opportunities that facilitate self-exploration, caring and thoughtful interactions with others and values clarification serve as the foundation for becoming a nurse faculty leader who is, in turn, able to build leadership capacity in other individuals and organizations.

Mindfulness: Overcoming Intractable Conflict

Intractable conflict involves reoccurring patterns of ineffective communication in which issues are not resolved and build over time. These situations can lead to bad feelings, damaged relationships, depression, aggression, anxiety and substance abuse. Grounded theory methods were used to study the processes involved in intractable conflicts and to identify ways of responding that promote growth and/or resolution. Results indicate that developing mindfulness over mindlessness is the basic social process that threads through three phases of working through intractable conflict. Phases include: growing awareness, self-realization, and regaining equilibrium. Mental health professionals can use this knowledge to support mindful practices as a means to protect against destructive conflict and mental health woes.

Treating Postpartum Depression in Immigrant Muslim Women

Distinct challenges face psychiatric-mental health nurses who treat a growing population of ethnically, racially, and culturally diverse patients. Nurses must be educated about the cultural beliefs and health practices within specific patient populations to provide comprehensive health care to patients. The purpose of this article is to educate nurses on postpartum depression among immigrant Muslim women.

BECOMING a Nursing Faculty Leader

ABSTRACT Academic leaders are one component of a well‐prepared faculty that is required to achieve and sustain excellent educational programs. But what is it like to become an academic leader? How does one become a leader? These questions were addressed in an interpretive study in which nurse faculty leaders were interviewed about the experience of becoming a leader. Interview texts were analyzed hermeneutically by a research team to uncover three themes (common, shared experiences): Being Thrust into Leadership, Taking Risks, and Facing Challenges, which are explicated in this article.This study develops the evidence base for leadership preparation at a time when there is a strong need for nursing education leaders in academia.

Malfeasance and Regaining Nursing’s Moral Voice and Integrity

This article discusses some of the most recent developments in US mental health services that follow on the heels of the for-profit hospital scandal that was brought to public attention less than a decade ago. As individuals and as a profession, nurses have a responsibility to uncover, openly discuss and condemn malfeasance when it occurs, yet there has been a collective silence about these developments. The authors explore the reasons for this and make recommendations for regaining nursing’s moral voice and integrity.

Improving Quality and Safety in Graduate Education Using an Electronic Student Tracking System

TOPIC The Institute of Medicine report on the future of nursing, the Quality and Safety Education for Nurses initiative, and the Technology Informatics Guiding Education Reform movement are among the most prominent forces guiding change related to information technology and informatics in nursing to improve quality and safety in practice. Informatics competencies are essential for psychiatric nurses to leverage and integrate information technology into education, practice, and research. PURPOSE This article examines informatics and information technology from the perspective of educational preparation of the psychiatric mental health nurse practitioner. SOURCES OF INFORMATION Literature related to informatics, information technology, and quality and safety in advanced practice psychiatric nursing. CONCLUSION Strategies for integration of information technology in educating psychiatric mental health nurse practitioner students are described. Informatics competency will result in safer and higher quality care.

Becoming a nurse faculty leader: Taking risks by doing the right thing

Risk taking is a key aspect of academic leadership essential to meeting the challenges and opportunities in higher education. What are the practices of risk taking in nurse faculty leaders? This interpretive phenomenological study examines the experience and meaning of risk taking among nurse leaders. The theme of doing the right thing is brought forth through in-depth hermeneutic analysis of 14 individual interviews and two focus group narratives. The practice of doing the right thing is propelled and captured by leaders through a sense professional responsibility, visioning the future, and being true to self and follow ones core values. This study develops an evidence base for incorporating ways of doing the right thing in leadership development activities at a time when there is tremendous need for highly effective leaders in academic settings. Examining the practices of doing the right thing as a part of leadership development lays a foundation for building the next generation of nursing leaders prepared to navigate the ever-changing and complex academic and health care environments.