Browsing by Author "Jarosinski, Judith M."
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- ItemAssessing climate change among faculty in academia: Perspectives of nursing administratorsJarosinski, Judith M.; Seldomridge, Lisa A.; Reid, Tina P. Brown; Willey, Jeffrey A.; Salisbury University, Salisbury, Maryland, USA; Lambda Eta
In a qualitative study, we explored perspectives of administrators assessing the nursing faculty shortage and workplace-climate. Themes were: Onboarding; Changing expectations; The Elephant in the room ;and Making do, getting by which highlighted the negative impact of the nursing faculty shortage on healthy work environments. “Morale is low-people are frustrated.”
- ItemAssessment and management of alcohol use disorder in older adults: A review of the evidence(2017-07-24) DiBartolo, Mary; Jarosinski, Judith M.; Salisbury University, Salisbury, Maryland, USA; Lambda Eta
Purpose: The aim of this presentation is to summarize and critically evaluate the recent literature on methods to better identify AUD in older adults, including instruments specifically developed or modified for this age group, as well as, delineate targeted treatment strategies which may be more effective in achieving and maintaining sobriety in this population.
Background: Alcohol Use Disorder (AUD) has been identified as a significant, under-recognized, underreported and hidden epidemic in the U.S. (Alpert, 2014). The prevalence is expected to rise dramatically as the number of adults aged 65 and older increases to one in five by 2030. Worldwide, older adults aged 60 and older are currently at 800 million and this figure is expected to climb to over two billion in 2050 (World Health Organization [WHO], 2012). With this escalation in the number of older adults comes a concomitant increase in those struggling with AUD, where the health consequences can be significant. According to WHO (2016), 5.9% of all global deaths are attributable to alcohol consumption.
Challenges in assessment include acknowledging differences in drinking patterns, onset (early vs. late onset), symptom presentation, difficulties in differentiating symptoms of AUD from other health complaints associated with aging, as well as the denial, shame, and stigma which can present major barriers to prompt identification. In the care setting, busy practitioners with limited resources and time often confine screening to persons with a known history. However, complex comorbidities that usually present in older adults can delay assessment and subsequent treatment. A latent missed diagnosis fails to capture individuals who may have AUD and may preclude or delay appropriate interventions, and ultimately, the goal of sustained sobriety. The inconsistent use of evidence-based screening instruments to identify those at risk is an obstacle to successful diagnosis and treatment.
With regard to management, older adults do achieve equivalent or better results than younger counterparts when they enter treatment (Bakhshi & While, 2014; Yasamy, Dua, Harper, & Saxena, 2013), especially when interventions are focused on the needs of this specific age group. Furthermore, a substantial “treatment gap” exists brought about by the inability to access and/or afford care. The literature also highlights treatment modalities as part of the alcohol screening and brief interventions (ASBI) model, such as cognitive-behavioral therapy (CBT) and mutual help (aid) groups (MHGs). There is emerging evidence that interventions must be both engaging and tailored to this specific age group to enhance compliance and optimize probability of ongoing recovery.
The issues surrounding the assessment and management of older adults with AUD are complex and poorly understood. Furthermore, both the literature and research on older adults with AUD has been minimal given the growing prevalence of this population. Nurses have the potential to enhance awareness, initiate screening with appropriate instruments, participate in treatment plans that are individualized to achieve treatment success and play a key role in advocacy for this underserved and vulnerable group.
Methods: An in-depth review of the literature was conducted to ascertain the state-of-the science related to instruments used in screening older adults for AUD, as well as, age-appropriate interventions. Key words included: alcohol use disorder (AUD), alcoholism, older adults, elderly and substance abuse. Articles on substance use disorder (SUD) were excluded unless there was a significant or updated component related to AUD. In addition to integrative reviews, an emphasis was on primary sources incorporated from the last decade to identify more recent trends and obtain the most pertinent and comprehensive information.
Results: A total of 36 articles were found within the past decade, with four of those being integrative reviews. As far as AUD assessment instruments, the CAGE is considered a primary screening instrument because of its ease of use; its drawbacks include failure to identify binge drinking and separating a drinking history from current use. The MAST-G scale is specifically formulated for geriatric patients and has been gaining substantial support in the literature. Treatment approaches include inpatient detoxification followed by targeted interventions to maintain sobriety. Detoxification can be more problematic in the older adult population, with confusion rather than tremors being the predominant sign. The subsequent phase of implementing Alcohol Screening and Brief Interventions (ASBIs) is increasingly recognized in the literature as both a screening strategy and supportive treatment. ASBIs can include mutual help groups, cognitive behavioral therapy, motivational interviewing, the FRAMES model, and other related approaches (Blow & Barry, 2012). The literature specifically highlights mutual health groups, such as Alcoholics Anonymous (AA), as most beneficial when comprised primarily of older adults who have similar issues of retirement, loss, physical co-morbidities, diminished self-esteem, shame and stigma. The literature strongly supports that for the older adult, ASBIs should be both engaging and tailored to enhance compliance and optimize treatment success and sustained recovery.
- ItemA comprehensive needs assessment to gauge the impact and extent of the nursing faculty shortage(2017-06-07) Jarosinski, Judith M.; Seldomridge, Lisa A.; Reid, Tina P. Brown; Salisbury University, Salisbury, Maryland, USA; Lambda Eta
Purpose: The aim of this presentation was to explore the use of a comprehensive needs assessment to identify common and unique issues related to the statewide shortage of undergraduate and graduate clinical nursing faculty;this project assessed current efforts and resources that are in place for recruitment, training and mentoring of clinical nursing faculty across the State.
Background: Globally, two factors impact the nurse faculty shortage and subsequent student enrollments: Economic migration contributing to a “brain drain” for many countries, and an aging nurse faculty force. (Gutierrez, Candela, & Carver, 2012; ICN, 2015; Newton, Pillay, & Higginbottom, 2012). In the United States the lack of experienced nurses in specific specialty areas and the later age nurses enter graduate schools, also contribute to the nurse faculty shortage (AACN, 2012). The Eastern Shore-Western Shore Faculty Initiative (ES-WSFI) created a needs assessment with the sole purpose of identifying issues related to the clinical nurse faculty shortage in Maryland, U.S.A. The needs assessment provided direction for planning and modifying current strategies addressing the nursing faculty shortage in regionally diverse nursing programs and is supported by a Maryland Higher Education System, Nurse Support Program-2 grant.
Methods: In collaboration with 12 universities, colleges and community colleges, a mixed-methods approach comprised of web-based surveys, faculty focus groups and interviews with deans/directors of nursing education programs was conducted over a two year period. The comprehensive needs assessment included establishment of relationships with prospective partners, collection of demographic information about partner programs (educational offerings, staffing needs by clinical specialty and level), compilation of existing approaches to address staffing needs, identification of untapped resources, and discussions with partners about gaps and possible solutions. A dedicated website was constructed to facilitate communication about the project not only among partner institutions but across the state. A password protected database has been created to house the results of the needs assessment. With statewide data available in a single place, future initiatives can be planned and implemented, maximizing efficiency and effectiveness in utilization of resources while addressing the need for increasing capacity across all levels of nursing education from associate degree through doctoral degrees.
Results:
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In undergraduate programs the majority of respondents agree or strongly agree there is inadequate clinical faculty for growth; in the graduate programs, only 1/3 of respondents agree there is inadequate clinical faculty for growth.
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In both undergraduate and graduate programs 75%-80% agree or strongly agree it is difficult to recruit from underrepresented groups. 69% of undergraduate programs find it difficult to retain faculty from underrepresented groups, while 50% of graduate programs find it difficult to retain faculty from underrepresented groups.
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Clinical specialties in greatest demand or representing the greatest need included: pediatrics, mental health (both acute and community-based), obstetrics and women’s health.
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The nurse faculty shortage indirectly impacts faculty member’s ability to mentor, engage in scholarship and meet increasingly stringent promotion requirements. “Everybody is stretched really, really thin”
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Despite concerted efforts to “grow our own” and by encouraging clinical specialists and alumni to teach on a part-time basis, these proactive initiatives to attract potential clinical faculty, as well as nationwide searches for nursing faculty, continue to be a challenge for most programs.
“We have 4-5 open positions at any given time; we are constantly serving on search committees.”
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Challenges confronting universities, colleges and community colleges differ regionally and programmatically.
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In this initiative, primary strategies currently in use to address the faculty shortage are incorporation of weekend clinical experiences or classes, hiring more clinical faculty and limiting the number of students that can be enrolled.
Conclusion: Current practices are insufficient to meet the growing need for nursing faculty. In order to maximize human capital, a renewed focus on twin strategies of attracting faculty and retaining current faculty must include incentives for seasoned faculty such as: increased salaries for experienced faculty, release time or reduced workloads to provide time for scholarship, as well as support strategies for research and mentorship. In order to attract nurses to academia, Nardi and Gyurko (2013) suggest the inception of international cooperatives that would make possible collaborative teaching and enhance the global attractiveness and reach of nursing. They caution that the diminishing pipeline of PhD prepared nurses provide few “role models with whom nursing students can work and emulate in the practice setting” (p. 320).
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- ItemDeveloping clinicians as faculty through statewide partnershipsSeldomridge, Lisa A.; Jarosinski, Judith M.; Reid, Tina P. Brown; Hauck, Brad; Payne, Beverly; Salisbury University, Salisbury, Maryland, USA; Lambda Eta
A mixed method program evaluation was conducted to assess the success of a multi-faceted educational program to prepare expert clinicians as clinical faculty at various locations across Maryland.
- ItemDeveloping expert clinicians into clinical faculty: A mentoring-teaching experience(2016-03-17) Jarosinski, Judith M.; Brown Reid, Tina P.; Hinderer, Katherine A.; Seldomridge, Lisa A.; Salisbury University, Salisbury, Maryland, USA; Lambda Eta
Session presented on Monday, July 27, 2015:
Purpose: To prepare expert nurse clinicians to become educators through participation in a clinical faculty academy and mentorship program. The aim of the study was to explore the transition from the role of nurse clinician to nurse educator and the influence of mentoring in this process. Globally, nurse educators have identified the faculty shortage as central to the evolving nursing shortage. Recruitment and retention of highly qualified individuals, from diverse backgrounds, to teach students in clinical settings is challenging. Educating practicing nurse experts about the complexity of the clinical academic environment requires a multifaceted approach. Mentoring opportunities that are laissez-faire provide little structure for the mentee, whereas formalized mentoring experiences with clearly defined goals are far more beneficial to novice educators.
Methods: A mixed-methods design was used. Institutional review board approval was obtained. A diverse group of participants were selected from a competitive pool of applicants to a structured training and mentoring academy. Nurse clinicians participated in the Eastern Shore Faculty Academy and Mentoring Initiative (ES-FAMI), a regional hybrid educational program, incorporating a partnership of three schools of nursing in the region. The ES-FAMI experience included face-to-face meetings, interactive online modules, simulated clinical teaching experiences, and mentoring experiences. Upon completion of the didactic program, academy graduates completed the Academy Experience Evaluation (AEE) tool electronically through a learning management system. The AEE included 13 multiple choice items on a 5-point Likert scale (higher scores indicating greater satisfaction) and four additional open-ended questions. Space was included after each question for comments. Four focus groups were held annually to evaluate the program. Additionally, all participants who had completed the ES-FAMI course were invited to return or a mentorship session and mentorship focus group. A focus group methodology was selected for data collection since it offers interaction among group members who can provide in-depth data, not always elicited through surveys and interviews. Quantitative data were analyzed using descriptive statistics. In order to enhance and expand the findings of the larger study, and to provide a broader meaning of the experience related to the quantitative study, a Heidegerrian, interpretive, perspective was chosen for qualitative data analysis. With participant permission, mentorship focus group conversations were audio-taped and transcribed. The interpretive analytic method of Dieklemann, Allen, and Tanner (1989) method was used. This interpretive method involved a hermeneutic research team whose goal was to provide written interpretations of the groups' discussions. The focus group question was limited to one question with two parts, with follow up questions and probes asked throughout the session.
Results: Over a three year period, a total of six academies with 32 participants were held. Twenty-six of the 32 participants completed the AEE for an 81.3% response rate. Thirty (93.8%) of the participants were female. Slightly more than half of the participants were Caucasian (n=18, 56.3%), with 37.6% (n=12) of academy graduates were from diverse, underrepresented groups including male and non-white racial backgrounds. Age ranged from 23 to 56 years with a mean age of 38.79 (SD = 8.48). At the time of academy participation, most participants had no clinical teaching experience. To date, 25 of 32 academy graduates have taught a clinical course for one of the partner schools. Responses on the AEE revealed an overall positive experience with the ES-FAMI program. Of the multiple choice items, mean scores ranged from 4.40(+.50) to 4.76(+.52). The highest scoring items on the AEE related to applicability of the modules to clinical faculty role, simulation experience preparing for clinical faculty role, and ability to identify potential problematic student issues. In open-ended responses, participants identified mentoring opportunities as integral to their learning. In the mentoring focus group, nurse clinicians provided detailed first-person descriptions of their fears concerning student problems, their self-perceived ability to teach in a clinical setting and ability to adequately evaluate nursing students. Emergent themes included: Theme 1: Collaborating with peers. This theme depicted the teamwork that ensued as participants helped each other and eventually developed an informal network of support. Theme 2: Putting it all together. This theme described the mentor/mentee relationship as integral to participant's personal transition in becoming educators. Theme 3: Mentorship as a sounding board, identified participants' own cognitive and emotional search as they thought about their teaching future, and their expectations. Theme 4: Learning is continuous, focused on participants' desire to continue the mentorship process.
Conclusion: The findings of this study have global implications for nursing education. Helping clinicians actualize the faculty role through education and mentoring partnerships not only is a personal gain, but also provides the academic setting with a pool of talented clinical educators. We have found on a local and regional level, a structured mentorship format strengthens the transition from clinician to nursing academia. In teaching today's students, participants found they had to learn new skills, develop new expectations, and adjust previous expectations. The themes identified, demonstrated this push and pull in the mentorship process, but also provided a picture of what happens when mentorship works.
- ItemA global perspective of caring for the mentally ill: Empowering individuals who live with schizophrenia(2013-10-22) Jarosinski, Judith M.; Salisbury University, Salisbury, Maryland, USA; Non-member
Session presented on: Friday, July 26, 2013:
Purpose: Despite improved treatment, significant global health disparities exist for those living with schizophrenia. The onset of symptoms, such as halluciantions and delusions, generally predicts worsening psychotic symptomatology. Clients continue to experience repeated relapses and symptom reoccurrence, and increased numbers of clients comprise the homeless population. The purpose of this study was to understand this experience for those living with mental illness, as they live in their communities.
Methods: A qualitative, Heideggerian approach guided data collection and analysis following Diekleman, Allen & Tanner's (1989) method. Twelve individuals with schizophrenia described their experience of the onset of symptomatolgy. Implicit/explicit meanings were extracted. Hermeneutic stories were developed by the team.
Results: An overarching pattern, 'A life disrupted: Still lived,' described surviving the experience of schizophrenia and persevering on one's own terms. While symptoms such as hallucinations and delusions, revealed the loss of realistic appraisal, living with this illness was analogous to living with loss. Participants recalled the experience of'mental illness as giving them something positive in how they cared and related to others. Participants were overpowered by the 'business of getting better', and the language of nursing, a language of empowerment, was overwhelming.
Conclusion: Incorporating a different language of caring for individuals living with mental illness underscores creative strategies currently used multinationallly.
- ItemLeadNursingForward.org: A free web-based resource to develop nurse faculty and address the national shortageFreda, Kaynabess R.; Seldomridge, Lisa A.; Jarosinski, Judith M.; Johnson, Abigail; Salisbury University, Salisbury, Maryland, USA; Lambda Eta
LeadNursingForward.org is a beneficial 'one-stop shop' that provides personal narratives, resources, opportunities, and nurse educator positions for nurses interested in advancing their career in nursing education.
- ItemLeadNursingForward.org: A one-stop web resource to address the nursing faculty shortageSeldomridge, Lisa A.; Jarosinski, Judith M.; Freda, Kaynabess R.; Johnson, Abigail; Salisbury University, Salisbury, Maryland, USA; Lambda Eta
A needs assessment explored issues related to the nurse faculty shortage finding that a single information source to learn about the educator role, paths to advanced degrees, and available educator positions was needed. A one-stop web portal was developed to provide accurate information and promote the image of nurse educators.
- ItemLeadNursingForward.org: Development of a web resource to address the nursing faculty shortageSeldomridge, Lisa A.; Jarosinski, Judith M.; Freda, Kaynabess R.; Salisbury University, Salisbury, Maryland, USA; Lambda Eta
To address concerns about the nursing and nursing faculty shortage, a web portal was developed to provide a one-stop-shop for information about becoming a nurse educator, educational pathways, and types of educator positions. Multiple interactive features allow job seekers to find educator positions in academic settings and healthcare organizations.
- ItemLearning how to teach: Using simulations to prepare new clinical faculty(2018-03-28) Seldomridge, Lisa A.; Jarosinski, Judith M.; Reid, Tina P. Brown; Salisbury University, Salisbury, Maryland, USA; Lambda Eta
The aim of this study was to explore the effectiveness of simulated teaching encounters using standardized “students” as part of a hybrid educational experience to prepare expert nurse clinicians for new roles as part-time clinical faculty. Data from three simulation sessions (n = 21 participants) will be presented.
- ItemNursing administrators perspective of the nurse faculty shortage in their schools: A "bird's eye view"Jarosinski, Judith M.; Seldomridge, Lisa A.; Reid, Tina P. Brown; Willey, Jeffrey A.; Salisbury University, Salisbury, Maryland, USA; Lambda Eta
This qualitative research explored the experience of the nurse faculty shortage from the perspective of nursing administrators from community colleges and baccalaureate nursing programs. Four themes emerged reflecting how administrators are managing current challenges related to recruitment and retention of faculty.
- ItemThe nursing faculty shortage in Maryland: Findings of a statewide needs assessment(2018-03-22) Seldomridge, Lisa A.; Jarosinski, Judith M.; Reid, Tina P. Brown; Salisbury University, Salisbury, Maryland, USA; Lambda Eta
The aim of this project was to explore common and unique issues related to the nursing faculty shortage in Maryland using a comprehensive needs assessment. Quantitative findings from twelve programs will be presented along with recommendations for future statewide initiatives.
- ItemOutcomes of a structured mentorship program for expert clinicians in new roles as clinical facultyJarosinski, Judith M.; Seldomridge, Lisa A.; Reid, Tina P. Brown; Hauck, Brad; Payne, Beverly; Salisbury University, Salisbury, Maryland, USA; Lambda Eta
A mentorship program is a necessary component for the preparation of expert clinicians. The purpose of this research was to evaluate various aspects of the one-to-one mentorship experience. Mentor/mentee focus group data was used to uncover perspectives of this formal mentorship experience using a qualitative approach.
- ItemStandardized patients in psychiatric mental health nursing simulations: Taking care of our actorsJarosinski, Judith M.; Webster, Debra A.; Salisbury University, Salisbury, Maryland, USA; Lambda EtaWe explored experiences of standardized patients in high-fidelity simulations in the psychiatric/mental-health course of senior nursing students. Using interviews/art as data, the phenomenological perspective of Colaizzi (1978) guided inquiry resulting in four themes. Standardized patients emerged as educators; yet, noted the intensity of the roles and difficulty “shaking-off” roles. Late Breaking Reason: Given the COVID-19 environment, high fidelity simulations are increasingly used to replace lost clinical sites. Actors, as standardized patients (SPs) have expanded their roles to include more disciplines and additional courses. As nursing educators, our role is also one of caring and vigilance as highlighted in this research.
- ItemA structured mentorship program to support expert clinicians in new roles as clinical faculty(2017-06-16) Seldomridge, Lisa A.; Jarosinski, Judith M.; Salisbury University, Salisbury, Maryland, USA; Lambda Eta
Purpose: The international shortage of qualified nursing faculty has been identified as a key factor in the inability to educate additional students to become registered nurses (Nardi & Gyurko, 2015) and was a focus of the 2010 Sigma Theta Tau International and International Council of Nurses summit (International Summit, 2010). Because the faculty shortage is the result of multiple, decades-old problems, solutions must be coordinated and comprehensive (Kowalski & Kelly, 2013).
One solution to the nurse faculty shortage is the recruitment, training, and mentoring of expert clinicians to become part-time clinical teachers (Hinderer, Jarosinski, Seldomridge, & Reid, 2015). The aim of this program, the Eastern Shore Faculty Academy and Mentorship Initiative (ES-FAMI), was to develop a diverse group of new clinical faculty and support them through the transition from clinician to educator. The Academy provided a foundation in educational theory, legal aspects of clinical teaching, methods of providing formative and summative feedback, and strategies for dealing with difficult students using a variety of face-to-face, online, and simulation activities. Upon completion of the Academy, a year-long structured one-to-one mentorship experience was offered to graduates. Mentoring opportunities that are laissez-faire provide little structure for the mentee, whereas formalized mentoring experiences with clearly defined goals are far more beneficial to novice educators (Cunningham, 2016; University of Melbourne, 2012). By pairing novice teachers with expert nursing faculty from one of the three area nursing programs, additional support and professional development was provided to assist the novices through their first teaching assignments. The purpose of this research was to evaluate various aspects of the structured, comprehensive, one-to-one mentorship experience.
Methods: A review of the literature was undertaken to identify best practices for structured mentorship programs. Using this information, the team developed a web-based Mentorship Resource site containing all training materials, survey instruments, and resources needed for the program. After approval by the University Committee on Human Research, prospective mentors and mentees completed several instruments to assist in the matching process. Mentors also completed an online training module and 2 hour face-to-face training. Mentees completed a 1/1/2 hour orientation to the mentorship program, expectations, and responsibilities. Mentor-mentee pairs completed a mentorship agreement stipulating their goals, meeting arrangements, and expectations for confidentiality and feedback. Data were collected on the focus and method of each contact. Information on mentor and mentee satisfaction with the mentorship experience were collected after 6 months and again at 1 year.
Results: Data from 12 matches support a need for careful matching of mentors and mentees, separate training of mentors and mentees to prepare them for the mentorship experience, flexibility in meeting the expectation for twice per month contacts, development of separate resource websites for mentors and mentees, and open communication with program participants to problem-solve along the way.
Conclusion: A structured, comprehensive mentorship program is a necessary component of the preparation of expert clinicians as new nursing faculty and can be implemented in any nursing program regardless of geographic location. Since it takes one full-time faculty to produce six graduates per year who in turn provide $704,000 in annual health care services (Kowalski & Kelly, 2013), assuring a successful transition to the role of clinical teacher is a sensible investment. Though it requires time and effort to develop, implement, and evaluate, an extended mentorship experience may be the missing link in supporting new clinical teachers through their first teaching assignments. This new model for professional development can add to the number of available nursing faculty and enhance “nursing’s capacity to meet global healthcare needs” (Nardi & Gyurko, 2013, p. 324). The role of mentoring is vital in the advancement of individual nurses as well as the advancement of the profession as a whole (Institute of Medicine, 2010).