Leveraging National Reports to Transform Ambulatory Care Practice

Multiple national reports identify actionable recommendations to transform education and practice to meet the needs of health care and healthcare delivery beyond the hospital walls. The Josiah Macy Jr. Conference (2016) focused on transforming primary care and changing healthcare culture to support expansion of roles for registered nurses (RNs). Partnerships between academia and clinical practice are critical to expanding learning opportunities beyond traditional acute care settings. Development of primary care expertise in nursing faculty and adjunct faculty, in collaboration with primary care and ambulatory care nursing leaders, is essential. Academic-practice partnerships must advocate for removing regulatory and practice barriers to allow RNs to practice to the full scope of education and training. Recommendations from national reports extend beyond enhanced roles in primary care practice and have global implication

Integrating Correctional and Community Health Care: An Innovative Approach for Clinical Learning in a Baccalaureate Nursing Program.

PROBLEM: With an evolving focus on primary, community-based, and patient-centered care rather than acute, hospital-centric, disease-focused care, and recognition of the importance of coordinating care and managing transitions across providers and settings of care, registered nurses need to be prepared from a different and broader knowledge base and skills set. A culture change among nurse educators and administrators and in nursing education is needed to prepare competent registered nurses capable of practicing from a health promotion, disease prevention, community- and population-focused construct in caring for a population of patients who are presenting health problems and conditions that persist across decades and/or lifetimes. While healthcare delivery is moving from the hospital to ambulatory and community settings, community-based educational opportunities for nursing students are shrinking due to a variety of reasons, including but not limited to increased regulatory requirements, the presence of competing numbers of nursing schools and their increased enrollment of students, and decreasing availability of community resources capable and willing to precept students in an all-day interactive learning environment. METHODS: A detailed discussion of one college of nursings\u27 journey to find an innovative solution and approach to the dilemma of limited and decreasing available community clinical sites to prepare senior level prelicensure baccalaureate nursing students for healthcare practice in the twenty-first century. FINDINGS: This article demonstrated how medium/maximum prisons can provide an ideal learning experience for not only technical nursing skills but more importantly for reinforcing key learning goals for community-based care, raising population-based awareness, and promoting cultural awareness and sensitivity. In addition, this college of nursing overcame the challenges of initiating and maintaining clinical placement in a prison facility, collaboratively developed strategies to insure student and faculty safety satisfying legal and administrative concerns for both the college of nursing and the prison, and developed educational postclinical assignments that solidified clinical course and nursing program objectives. Lastly, this college of nursing quickly learned that not only did nursing students agree to clinical placement in an all-male medium- to maximum-security prison despite its accompanying restrictive regulations especially as it relates to their access to personal technology devices, but there was an unknown desire for a unique clinical experience. CONCLUSION: The initial pilot program of placing eight senior level prelicensure baccalaureate nursing students in a 4,000-person all male medium- to maximum-security prison for their community clinical rotation has expanded to include three state-run maximum all male prisons in two states, a 3,000-person male/female federal prison, and several juvenile detention centers. Clinical placement of students in these sites is by request only, resulting in lengthy student waiting lists. This innovative approach to clinical learning has piqued the interest of graduate nurse practitioner (NP) students as well. One MSN, NP student has been placed in the federal prison every semester for over a year. Due to increasing interest from graduate students to learn correctional health nursing, the college of nursing is now expanding NP placement to the other contracted maximum-security prisons. This entire experience has changed clinical policies within a well-established academic culture and promoted creative thinking regarding how and where to clinically educate and prepare registered baccalaureate nurses for the new culture of health and wellness

A Retrospective Analysis of Nursing Students\u27 Clinical Experience in an All-Male Maximum Security Prison.

Prisons provide an ideal learning experience to prepare prelicensure students with the knowledge and skill set needed for practice in the 21st century. Beginning descriptive evidence demonstrates that correctional health is an innovative community resource to educate nursing students in today\u27s changing model of health care delivery and practice. This article shares results from a retrospective analysis of the perceptions and experiences of nursing students during their community clinical rotation in an all-male maximum security prison

The periphery as the centre: trajectories of responsibility and community support in contemporary Maputo, Mozambique

Development researchers have long held a belief that developed states use their power to provide Aid or other forms of external assistance such as private philanthropy, assistance of Non-Governmental Organisations, and other private financing to underdeveloped, or developing, nations to achieve global economic and political stability. Development scholars (including geographers) have largely attributed this to a sense of responsibility. Many have assumed this assistance to travel in one direction, i.e. from Global North to Global South, thus overlooking the modalities of care and hospitality among individuals within countries of the Global South. In this thesis, I posit that looking at everyday modes of assistance at the community level would challenge scholars to re-think the ways in which place matters in development. Analysing qualitative data gathered through interviews and focus groups in two neighbourhoods in Maputo, Mozambique, this study is ultimately an investigation of proximity. I argue that the closeness of people in these complex community relationships matters in three ways: (i) the everyday practices of assistance in these communities are modes of resistance to an oppressive state; (ii) forms of assistance serve as expressions of local (as opposed to national) identity; and (iii) religious institutions play a significant role in fostering public discourse, rather than motivating assistance itself. In speaking more specifically about how proximity matters, this study contributes uniquely to the growing realisation that development must come from within

No-till Forage Establishment in Alaska

We assessed the effectiveness of no-till forage establishment at six Alaska locations: Anchor Point, Sterling, Point MacKenzie, Palmer, Delta Junction, and Fairbanks. Directly seeding grass into established grass stands generally did not improve forage yields or quality. Seeding rate had little effect on establishment of newly seeded forages in no-till. Grass yields were depressed when companion crop yields were high, and they typically did not recover in subsequent years. Red clover established well, producing high yields of good quality forage under no-till at Point MacKenzie, but established poorly at Anchor Point and Delta Junction. These results indicated that no-till seeding of most forage crops into declining grass stands is not likely to be successful in Alaska with current available technology

Mapping the Surgical Landscape: Resonances and Divergences Between Theories of Cosmetic and Transsexual Body Modification

This paper explores the limitations of the disciplinary divide between feminist studies of cosmetic surgery and trans studies of sex reassignment surgery, in order to unpack assumptions that may otherwise go unchallenged within each field. We focus on themes of conformity and transgression, and borders and identity. Résumé Cet article explore les limites de la division entre les études des femmes sur la chirurgie cosmétique et les études sur les trans sur les chirurgie de réassignation de sexe, afin de déballer les assomption qui ne serait autrement pas mises au défi chacune dans leur domaine. Nous nous concentrons sur les thèmes de conformité et de transgression, et des frontières et de l'identité