The practice of meditation is used in many cultures to reduce stress and anxiety and to maintain optimal psychological and spiritual well-being. Meditation has been extensively studied as a treatment for not only improving cardiovascular health, but also anxiety disorders as well. Since burnout and anxiety are common conditions plaguing health care professionals around the world, nurses must understand the healing power that meditation has in assisting them maintain physical, mental, and emotional balance. By learning how to incorporate the complementary practice of meditation and mindfulness into their lives, nurses have the ability to learn advantageous coping skills to handle potentially stressful situations.
The Art of Meditation and Mindfulness
The ancient art of meditation and mindfulness was derived from ancient Buddhist and yoga practices around 1500 BCE. Mindfulness refers to a process that guides individuals in maintaining a mental state characterized by nonjudgmental awareness of the present moment. The basic premise underlying meditation and mindfulness centers on how experiencing the present moment nonjudgmentally and openly can effectively counter the effects of stressors, because excessive orientation toward the past or future can be related to feelings of depression and anxiety. It is further believed that by teaching nurses to respond to stressful situations more reflectively rather than reflexively, meditation can effectively counter experiential avoidance strategies, which are attempts to alter the intensity or frequency of unwanted internal experiences from the outside realm.
Mindfulness-Based Stress Reduction
Due to the incredible health benefits that meditation and mindfulness possesses, Kabat-Zinn conceptualized a highly effective and integrative approach for reducing the physical, emotional, and mental consequences of chronic stress and anxiety. Mindfulness-based stress reduction (MBSR) is an innovative therapy that blends various elements of different Eastern meditation practices with western psychology. MBSR is a formal eight-week evidence-based program that challenges the patient to cultivate a greater awareness of the unity of the mind and body as well as the unconscious thoughts, feelings, and behaviors that can influence their overall health. During MBSR therapy, the individual learns various coping skills and techniques aimed to reduce the physiological effects of stress, pain, or illness by participating in experiential exploration of stress and distress to develop less emotional reactivity.
Since the mind is known to play an influential role in stress and stress-related disorders, MBSR has been shown to positively affect a range of autonomic physiological processes, such as lowering blood pressure and reducing parasympathetic arousal and emotional reactivity. In addition to mindfulness practices, MBSR also utilizes yoga to help promote wholesome physical activity and prevent unhealthy complications associated with living a sedentary lifestyle.
Due to the many health benefits it possesses, MBSR has been shown to relieve pain and improve psychological well-being across the health care spectrum. Because of this realization, nurses should make a more concerted effort in incorporating mindfulness meditation practices into their daily lives to not only improve their own stress reactivity, but also imbue resiliency to stressful and arduous psychological challenges associated with working in the health care setting.
Due to the rising cost and complexity of health care, nurse practitioners (NP) are considered to be one of the most in demand professionals in contemporary society. According to the American Association of Nurse Practitioners (AANP), there are more than 205,000 NPs in the United States as of 2014, with an estimated growth to 244,000 by 2025. Nurse practitioners care for patients across the lifespan in a variety of settings and are one of the four recognized advanced practice registered nurse (APRN) roles, which also include Clinical Nurse Specialists, Nurse Anesthetists, and Certified Nurse Midwives. Since nurse practitioners provide high quality and comprehensive patient-centered care in the health care arena, standardized procedures are necessary to ensure that nurse practitioners not only have a clear understanding of their roles but also their responsibilities depending on their specialization and place of employment.
Roles and Specialties of Nurse Practitioners
According to the AANP, nurse practitioners (NPs) are licensed, autonomous clinicians focused on managing people’s health conditions and preventing disease across the lifespan. All nurse practitioners must complete a master’s or doctoral degree program and have advanced clinical training beyond their initial professional registered nurse experience which include comprehensive didactic and clinical preparation coupled with specialized knowledge and clinical competency to practice in primary care, acute care, and long-term health care settings. What sets nurse practitioners apart from other health care professionals are their unique emphasis on holistic healing which focuses on health promotion, disease prevention, and health education and counseling. By providing high-quality care, management, and advocacy, NPs guide patients in making smarter lifestyle choices, which lowers patients’ out-of-pocket expenses and provides innumerable solutions to the primary care shortage facing America today.
Standardized Procedure Requirements for Nurse Practitioners
Since NPs are considered to be vital leaders of the health care team, standardized procedures are required to ensure that they function within their scope of practice to meet the primary health care needs of their patients. According to the Board of Registered Nursing (BRN), standardized procedures are the legal mechanism for NPs to perform functions which would otherwise be considered the practice of medicine. Standardized procedures must be developed collaboratively by nursing, medicine, and administration in the organized health care system where they will be utilized. Since NPs work at various locations such as organized health care systems, acute care clinics, and home health agencies, standardized procedures must be formulated to ensure that the health care system functions competently and correctly.
Because of the nature of the Medical Practice Act and its strict authorization for physicians to diagnose mental and physical conditions, prescribe medications, and use other methods in the treatment of diseases, injuries, deformities, or other physical or mental conditions, standardized procedures are often required if any of these will be performed by a nurse practitioner. According to the BRN, a nurse practitioner may perform standardized procedure functions only under the conditions specified in a health care system’s standardized procedure and must provide the system with satisfactory evidence that the nurse meets its experience, training, and/or educational requirements to perform these functions competently. Since NPs provide services that frequently overlap the practice between nursing and medicine, standardized procedures include guidelines that require the nurse practitioner to seek physician consultation when clinically necessary. Because of this realization, only nurse practitioners that satisfactorily meet the standards delineated by the BRN are allowed to assume responsibility and accountability for the continuity of health care for all individuals seeking inpatient treatment and stabilization.
Although the scope of practice and demand for nurse practitioners are growing, written policies and protocols are still necessary in some states for advanced practice nurses to function safely and competently in the health care arena. As a result of this realization, NPs must understand that standardized procedures are not only necessary in providing uniformity but also consistency in protecting consumers from harm by meeting the mandatory requirements to practice safely in their area of employment according to state and legislative regulations.
Nursing education is the foundational pillar that enables future nurses to become competent and knowledgeable in their respective practices. This education was normally provided to nursing students through various didactic theoretical lectures and practical clinical training but recently, the use of advanced simulation technology as an adjunct educational tool has slowly become a significant addition to student centric learning.
History of Simulation
The concept of simulation practice can be traced back to the fields of military, aviation, and nuclear power (with military having used simulation the longest), dating back to the 18th century. Simulation was initially created as a cost-effective strategy for training professionals because it was considered exorbitant to train in these areas in the real world. As the years progressed however, the healthcare profession realized the practicality and usefulness of incorporating advanced simulation technology into educational practice and as a result, spurred the growing movement of simulation in healthcare training settings and educational establishments around the world.
The Impact of Simulation on Nursing Students
The emergence of computer technology has led to the development of innovative tools for healthcare professionals such as simulation technology and patient simulators Simulation technologies have had a profound effect on the nursing profession because it allows nursing students to apply their recently learned skills and knowledge to solve real life scenarios in a safe and structured setting.
In a typical simulation session, two students are often asked to participate and mimic the roles of a registered nurse or a certified nurse assistant (CNA). The rest of the remaining students are then asked to go to a separate room and observe the scenario through a one-way mirror and a live video stream. At the start of the session, the facilitator usually gives report on the patient, which allows the students to familiarize themselves with the patient’s situation, history, charts, and medications in order to successfully manage and implement high quality nursing care for the patient. As the simulation progresses, the facilitator controls the patient’s prognosis and provides cues to the team to enhance the realism of the situation. Once the simulation is completed, the students are then asked to head back to the debriefing room to discuss their experiences.
During the debriefing session, the students learn through self-reflection, group interaction, and questions asked by the facilitator. The use of group discussion engages students in reflective learning and enables the group members to consider a situation from multiple perspectives and consider other alternatives in order to broaden their scope of practice and clinical understanding. By performing simulation scenarios on a regular basis, students are able to develop better critical thinking skills, decision-making abilities, and application of theoretical knowledge in real-life situations.
Facilitating Simulation into Nursing Practice
According to the Institute of Medicine (IOM), approximately 98,000 people die every year from medical errors in U.S. hospitals, and a significant number of those deaths are associated with medication errors. This means that adverse events affect nearly 1 of 10 patients in the hospital setting. Based on this staggering number, the IOM called for a systematic change in healthcare practices and identified simulation practice as a resource to address the needed reform. By fostering experiential learning, simulation ingrains good nursing habits early, while discouraging bad nursing habits from forming before it becomes second nature.
In addition to allowing individuals to hone their nursing skills, simulation has also proven to increase student confidence and self-efficacy once they transition into the clinical setting. Nursing efficacy is an important aspect in nursing practice because it gives the students the confidence required to provide excellent nursing care to their patients. By incorporating what they have learned in simulation, more students are self-reliant in their capabilities, which are invaluable in ensuring that patient safety is implemented in the hospital setting.
Implications for Future Nursing Practice and Further Study
The shortage of availability of clinical sites is quickly becoming the norm for many nursing schools due to changing healthcare reform and the struggling economic crisis. One solution to combat the shortage of clinical sites however is to utilize simulation practice to replicate essential aspects of clinical situations for beginning nursing students. The National Council of State Boards of Nursing is currently conducting a landmark, longitudinal study to examine the knowledge and clinical competency outcomes of students when simulation technology is used in the place of actual clinical experiences. Although calls for additional research in these areas need to be performed, simulation is still quickly gaining momentum as the gold standard for effective learning practice in nursing education.
The concept of effectual leadership is an important aspect in the field of nursing and health care. Leaders have a significant role in creating a culture and mindset that not only inspire but also unite individuals within a group or society. Since the perception of leadership is different to certain individuals however, various leaders around the world function and interpret leadership in unique and distinct ways. As a result of this realization, the following principles and philosophies are necessary to becoming an effective and successful leader in the health care arena.
1. Master and Perfect your Unique Craft.
Since all leaders have distinct leadership styles and abilities, every leader must learn to recognize and master their unique leadership craft. Understanding this concept is crucial because all leaders are responsible for the effectiveness of organizations and provide a guiding purpose to those who need them. In order for this to occur, an individual must be willing to listen to his or her inner voice and remain true to who they are. Only after the individual fully accepts themselves and their idiosyncrasies can they move on to the second step in the leadership hierarchy.
2. Appreciate the Fundamentals of Leadership.
Fundamental leadership is composed of various ingredients that an individual must grasp before he or she can successfully lead. The first ingredient is defined as the guiding vision, which is the individual’s overall goal for himself or herself. All leaders must have a clear idea of what he or she wants to do—professionally and personally—and the strength to persist in the face of setbacks or failures. This ingredient is vital because it exemplifies the importance of possessing a strong sense of conviction in both aspects of the individual’s life as well as the importance of knowing what you desire and how you plan to achieve it. The second and third ingredient in fundamental leadership is passion and integrity. Passion is when you put more energy into something than is required to do it. It is more than just enthusiasm or excitement, but ambition that is materialized into action to put as much heart, mind, body, and soul into something as humanly possible. In addition to this, integrity is also a much-needed component in becoming an effectual leader because it is based on honesty and a steadfast devotion to principle and ethics. Without these three ingredients, leaders will have a difficult time not only motivating others but also gaining the trust and support necessary to accomplish a shared goal or objective.
3. Embrace your Inner Self.
The third and most important step in becoming an effectual leader is learning how to embrace your inner self. The premise of authenticity is a central theme in effectual leadership because the most charismatic and effective leaders are those who are genuine representations of their innermost nature. One of the best ways individuals can gain this is by experiential learning, which provides the individual with a rich and solid foundation for the future. Through experiential learning, individuals are exposed to the repercussions of their choices and as such, decide for themselves whether or not to make the same choices in the future. This exposure ultimately shapes and forms the leader to become emotionally mature and develop the mental acumen required to be authentic and transparent leaders across the health care spectrum.
Enrolling in a Doctor of Nursing Practice (DNP) program can be a daunting task for many students due to the rigorous academic requirements often associated with it. Although DNP school can be intimidating, students who choose to enroll not only embrace the significance of pursuing higher education but also the possibility of advancing their roles as prominent health care leaders in the nursing profession. As a DNP candidate myself, I’ve grown to appreciate the triumph and struggles associated with pursuing a terminal degree. Therefore, I believe students who are considering pursuing their DNP degree must harness these seven attributes to ensure that they are not only readily prepared but also successful in their scholastic endeavors.
1. Clear Vision
Setting a vision and goal for the future is vital for success in the DNP program. Possessing a clear vision is necessary because it helps you organize your individual objectives and helps you maintain accountability throughout the program. If choosing to enroll in DNP school perfectly aligns with your personal and professional goals, having a vision that is well defined will not only help you focus on your objectives but also create a sense of purpose that ultimately becomes your own measurement for success.
2. Ability to Prioritize
Students who know what and how to prioritize tend to be more successful in DNP school because they know how to differentiate tasks as either critical or noncritical. One of the best ways to prioritize in DNP school is by looking over the program and course objectives of each class and determine which tasks need to be completed first. By knowing how to prioritize your tasks wisely you will not only be able to minimize stress but also maximize results more effortlessly and efficiently.
3. Effective Time Management Skills
Possessing excellent time management skills is an important trait prior to beginning DNP school because of the high academic workload associated with pursuing a doctoral degree. Managing your time effectively will allow you to accomplish more tasks in a shorter period of time and help lower your stress and increase your concentration and attention. To ensure that your time is properly managed, it helps to keep a written or electronic record, diary, or calendar to ensure that you know what tasks are required and when they must be completed.
4. Strong Work Ethic
Maintaining a strong work ethic is essential in determining your overall success in DNP school. Students who possess a strong work ethic understand that success can only be achieved by practicing the ideals of discipline and hard work on a regular basis. To maintain a strong work ethic, it is vital to practice positive habits consistently every day so that hard work is almost automatic. Forming respectable habits such as exercising daily, staying punctual, maintaining your obligations, and finishing tasks immediately help establish your credibility and image as a doctorally prepared nurse.
5. Healthy Work-Life Balance
While it is important to study and work hard in DNP school, it is equally important to create a healthy work-life balance and set aside much needed time for yourself and your loved ones. Learning how to care for yourself is extremely important in DNP school as working too much can ultimately cause you to become overwhelmed, overworked, and overstressed. To avoid this, it is best that you take consistent breaks throughout the day to maintain your overall well-being. Learning how to take ample rest breaks is vital to ensure your physical, mental, and emotional health is adequately cared for in DNP school.
6. An Understanding that Excellence is a Lifelong Process
One of the key principles that DNP students must understand is that excellence is a lifelong process. Understanding this concept is vital because sustainable success in DNP school and in life is not something that is built overnight but rather an extended period of time. As leaders in the nursing realm, DNP students must understand that sustainable excellence requires constant monitoring, learning, and improvement with the realization that the journey is just as important as the destination.
7. Perpetual Curiosity
DNP students who remain perpetually curious are more susceptible to success because curiosity not only propels innovation but also self-reflection. Fostering your curiosity in DNP school is essential because it allows you to be fully present in the moment. Curious people are not only happier but also more successful because they are non-blaming, non-shaming, supportive, and focused on exploring options to find the best solution that supports collaboration and innovation.