Exploring Perceptions of Staff Registered Nurse Preceptors for Undergraduate, Pre-licensure Nursing Students

Staff nurses are increasingly called upon to accept more responsibilities and roles in addition to provider of patient care, including that of preceptor. Aside from dealing with demands of high acuity patients, working long hours with inadequate staffing, and carrying heavy workloads, nurses may view teaching and supervising students as an additional burden, time-consuming, and not part of their role. The purpose of this dissertation was to explore staff nurse experiences as preceptors to undergraduate, pre-licensure nursing students. Emphasis was placed on exploring RN’s perceptions of the role, specifically the preparation for, support in, and understanding of what the role entails. The following question was used to guide the study: What are staff nurses’ experiences with precepting undergraduate, pre-licensure nursing students? A naturalistic inquiry within an interpretive paradigm guided this qualitative exploratory study. The sample consisted of nine licensed registered staff nurses with experience as preceptors in tertiary care settings in Northeast Tennessee. Most participants were currently working in or had worked in the role of preceptor for undergraduate nursing students within the past six months. All nine participants were female. Most participants were between the ages of 30-39. Participants were licensed as registered nurses anywhere from 2 to 14 years. Participants attended one of two focus groups lasting between 60-90 minutes each. A semi-structured interview guide assisted in data collection. Transcripts were analyzed using conventional content analysis. Findings suggest that while preceptors perceive information about teaching and learning styles to be beneficial, they did not perceive a formal class essential to preparing them for the preceptor role. Preceptors perceived most support from their co-workers and least support from nurse managers. Faculty seemed to be silent partners. The primary role function is Protector, with Socializer and Teacher as secondary role functions. Preceptors have a strong empathetic drive to protect students from negative experiences, to protect patients from harm, to protect their own professional identities, and to protect the nature of the nursing profession itself. Preceptors perceived students with overconfident attitudes as unsafe. Findings have significant implications for development of professional values in practice and education

Toxic Positivity: A Concept Analysis

Purpose: Post-COVID-19 workforce issues have pushed terms like resilience and burnout further into the forefront of professional discourse. Strategies aimed to improve resilience, decrease burnout, and increase retention appear to be less effective in the current climate. One potential unexplored contributor is toxic positivity. The purpose of this research is to analyze the concept of toxic positivity and its relevance to nursing. Aims: Research questions; “1) How is toxic positivity used across contexts?; 2) Whose perspectives are represented and whose are not?; 3) What are the dimensions of toxic positivity?; 4) How are the dimensions related?; and 5) How is toxic positivity constructed and used in nursing? Methods: Using Schatzman’s dimensional analysis approach, the first analytic phase, Identification, elucidates relevant conceptual dimensions. The second analytic phase, Logistics, examines relationships among dimensions and contexts. Finally, a dimensional matrix provides conceptualization of toxic positivity for nursing. Results: Preliminary results reveal roots of toxic positivity in the realm of positive psychology with relevant dimensions including unrealistic optimism, inauthentic platitudes, and emotional invalidation and identified contexts including business, psychology, and medicine with no identified contexts in nursing. Primary limitations include limited time to complete this analysis, lack of empirical evidence regarding toxic positivity, and the potential for other unrealized dimensions or contexts. Conclusions: Results suggest nursing perspectives are missing from the literature about toxic positivity. Identifying toxic positivity as a phenomenon in nursing work environments has potential to inform future research and theoretical work related to nursing workforce burnout, retention, and coping strategies

Older Adults Perspectives of Bed Bathing

The purpose of this qualitative pilot study is to explore the patient perspectives about what it is like to receive a bed bath. Examining studies of bath basins versus alternative methods has shown a decrease in the spread of nosocominal infections. However, there is not sufficient evidence evaluating the patient perspectives of assistive bed bathing and interactions with nurses and nursing support staff. This information can provide healthcare providers, especially nurses, with a better understanding of patient perspectives and values. It also supports the national healthcare approach towards patient-centered care

KCNQ potassium channels modulate Wnt activity in gastro-oesophageal adenocarcinomas

Voltage-sensitive potassium channels play an important role in controlling membrane potential and ionic homeostasis in the gut and have been implicated in gastrointestinal (GI) cancers. Through large-scale analysis of 897 patients with gastro-oesophageal adenocarcinomas (GOAs) coupled with in vitro models, we find KCNQ family genes are mutated in ∼30% of patients, and play therapeutically targetable roles in GOA cancer growth. KCNQ1 and KCNQ3 mediate the WNT pathway and MYC to increase proliferation through resultant effects on cadherin junctions. This also highlights novel roles of KCNQ3 in non-excitable tissues. We also discover that activity of KCNQ3 sensitises cancer cells to existing potassium channel inhibitors and that inhibition of KCNQ activity reduces proliferation of GOA cancer cells. These findings reveal a novel and exploitable role of potassium channels in the advancement of human cancer, and highlight that supplemental treatments for GOAs may exist through KCNQ inhibitors

Resistance of Human Cytomegalovirus to Cyclopropavir Maps to a Base Pair Deletion in the Open Reading Frame of \u3cem\u3eUL97\u3c/em\u3e

Human cytomegalovirus (HCMV) is a widespread pathogen in the human population, affecting many immunologically immature and immunocompromised patients, and can result in severe complications, such as interstitial pneumonia and mental retardation. Current chemotherapies for the treatment of HCMV infections include ganciclovir (GCV), foscarnet, and cidofovir. However, the high incidences of adverse effects (neutropenia and nephrotoxicity) limit the use of these drugs. Cyclopropavir (CPV), a guanosine nucleoside analog, is 10-fold more active against HCMV than GCV (50% effective concentrations [EC50s] = 0.46 and 4.1 μM, respectively). We hypothesize that the mechanism of action of CPV is similar to that of GCV: phosphorylation to a monophosphate by viral pUL97 protein kinase with further phosphorylation to a triphosphate by endogenous kinases, re- sulting in inhibition of viral DNA synthesis. To test this hypothesis, we isolated a CPV-resistant virus, sequenced its genome, and discovered that bp 498 of UL97 was deleted. This mutation caused a frameshift in UL97 resulting in a truncated protein that lacks a kinase domain. To determine if this base pair deletion was responsible for drug resistance, the mutation was engineered into the wild-type viral genome, which was then exposed to increasing concentrations of CPV. The results demonstrate that the engineered virus was approximately 72-fold more resistant to CPV (EC50 = 25.8 ± 3.1 μM) than the wild-type virus (EC50 = 0.36 ± 0.11 μM). We conclude, therefore, that this mutation is sufficient for drug resistance and that pUL97 is involved in the mechanism of action of CPV

Synthesis of enantiomerically-pure and racemic benzyl-tethered Ru (II)/TsDPEN complexes by direct arene substitution : further complexes and application

The use of a direct arene-exchange method for the synthesis of benzyl-tethered arene/Ru/TsDPEN complexes for use in asymmetric transfer hydrogenation is reported. A series of complexes tethered through a three-carbon linear chain was also prepared. The arene-exchange approach significantly simplifies the synthetic approach to this class of catalyst and permits the ready formation of modified analogues. The approach also provides a route to racemic catalysts for use in general reductions with either hydrogen or transfer hydrogenatio

Why do models overestimate surface ozone in the Southeast United States

Ozone pollution in the Southeast US involves complex chemistry driven by emissions of anthropogenic nitrogen oxide radicals (NOx  ≡  NO + NO2) and biogenic isoprene. Model estimates of surface ozone concentrations tend to be biased high in the region and this is of concern for designing effective emission control strategies to meet air quality standards. We use detailed chemical observations from the SEAC4RS aircraft campaign in August and September 2013, interpreted with the GEOS-Chem chemical transport model at 0.25°  ×  0.3125° horizontal resolution, to better understand the factors controlling surface ozone in the Southeast US. We find that the National Emission Inventory (NEI) for NOx from the US Environmental Protection Agency (EPA) is too high. This finding is based on SEAC4RS observations of NOx and its oxidation products, surface network observations of nitrate wet deposition fluxes, and OMI satellite observations of tropospheric NO2 columns. Our results indicate that NEI NOx emissions from mobile and industrial sources must be reduced by 30–60 %, dependent on the assumption of the contribution by soil NOx emissions. Upper-tropospheric NO2 from lightning makes a large contribution to satellite observations of tropospheric NO2 that must be accounted for when using these data to estimate surface NOx emissions. We find that only half of isoprene oxidation proceeds by the high-NOx pathway to produce ozone; this fraction is only moderately sensitive to changes in NOx emissions because isoprene and NOx emissions are spatially segregated. GEOS-Chem with reduced NOx emissions provides an unbiased simulation of ozone observations from the aircraft and reproduces the observed ozone production efficiency in the boundary layer as derived from a regression of ozone and NOx oxidation products. However, the model is still biased high by 6 ± 14 ppb relative to observed surface ozone in the Southeast US. Ozonesondes launched during midday hours show a 7 ppb ozone decrease from 1.5 km to the surface that GEOS-Chem does not capture. This bias may reflect a combination of excessive vertical mixing and net ozone production in the model boundary layer