Nursing Research Day

The Experience of Emergency Department Nurses During the COVID-19 Pandemic

Lisa Alphonsus is a registered nurse and actively practicing emergency department nurse for the past 10 years, working in both a rural and urban setting. She is completing her Master of Nursing thesis degree studying the experience of emergency nurses during the COVID-19 pandemic. 

Abstract

The COVID-19 pandemic has profoundly impacted healthcare professionals. Prior to the pandemic, emergency nurses were already susceptible to psychological distress and being at the frontline of the pandemic they have experienced increased rates of depression, anxiety, post-traumatic stress, moral distress, and burnout. There is limited qualitative research on emergency nurses' experience that spans the entirety of the pandemic, particularly in the third year. Using qualitative description, the aim of this research was to understand the experience of emergency nurses during the COVID-19 pandemic. 

Semi-structured interviews with five experienced emergency nurses were conducted and analysed using Braun and Clark's (2006) framework of reflexive thematic analysis. Four themes emerged and were described: fear and anxiety of the unknown, a ton of sadness, it's just nice to get our side of the story out, and it's just worse. This research allows us to see the long-term effects of pandemic, demonstrating that emergency nurses experienced the pandemic as getting worse over time. 

Emergency nurses have demonstrated profound courage, compassion, resilience, strength, and determination throughout the pandemic; however, it has resulted in them experiencing a heavy toll. The pandemic has left emergency nurses heartbroken, hopeless, exhausted, and feeling helpless with many nurses leaving the ED as well as the nursing profession. Urgent support, resources, and advocacy is needed to help mitigate the toll of the pandemic and the effect it has had on emergency nurses. Understanding their experience is the first step in this essential process.

Making Sense of Praxis in an Evolving Clinical Context

Sandra Carless-Kane is a fourth-year doctoral candidate with the University of Calgary Faculty of Nursing. Sandra received her Diploma in Nursing in 1988, her BScN in 2005 from the University of Alberta, and her MN in 2010 from Athabasca University. She comes to the Doctoral program with over 10 years experience in rural acute and community nursing practice. Her teaching experience includes over 20 years of classroom, nursing lab, and clinical instruction in practical nurse and undergraduate nursing programs. Her research focuses on nursing students' learning experiences, with a special interest in learning transfer between classroom and clinical practice. 

Abstract

Nursing students are challenged to prepare for their future nursing practice by developing connections between theoretical knowledge and demonstrating those connections in clinical practice. Understanding how nursing students transfer learning into clinical practice is essential in the development of well-prepared and knowledgeable nurses who can meet the increasing demands of nursing practice. 

Using a classic grounded theory methodology, I conducted 19 semi-structured interviews with undergraduate students from four Alberta higher education institutions to explore the processes and strategies they use to transfer learning from the classroom into clinical practice. Through transcription of the interviews and open coding of the data, the emerging core category is tentatively "Making sense of praxis in an evolving clinical context". I analyzed the data line-by-line and assigned codes to theoretically relevant words or phrases. These codes helped in identifying patterns and themes in the data. I then used the constant comparative method to compare the codes to identify similarities and differences. This method helped me to refine the codes and developing categories. 

Throughout the data analysis, I used memo writing to capture thoughts and ideas about the relationships between the data, codes and emerging categories. In this presentation, I will discuss the emerging core category and related categories. Understanding the processes/strategies nursing students use to transfer learning into clinical practice will provide meaningful direction for nursing course development and innovative teaching strategies. This study will inform best-practice guidelines for meeting the learning needs of today's nursing students as they prepare to enter nursing practice.

Interprofessional socialization of healthcare educators in the practice setting: A mixed methods study

Sara Dolan is a nursing PhD candidate whose doctoral work focuses on interprofessional socialization of healthcare educators. Other research interests include simulation, interprofessional education, and patient safety. In addition to her doctoral studies, Sara works with the eSIM provincial simulation program as a research student assisting in program evaluation of simulation initiatives across the province. When Sara is not working, she enjoys spending time in the mountains with her partner, daughter, and pups. 

Abstract

Background: Interprofessional education has been cited as a way to increase interprofessional socialization, thereby prompting collaborative care. Healthcare educators in the practice setting are responsible for providing interprofessional education opportunities to frontline staff; however, little is known about interprofessional socialization among healthcare educators. The purpose of this study was to examine healthcare educators' perceptions and experiences related to interprofessional socialization following an interprofessional training.

Methods: An explanatory sequential mixed methods study was conducted. Quantitative data (retrospective pre- and post-course surveys) were collected as secondary data from program evaluation surveys following a simulation facilitator training program. Then, qualitative data were collected via semi-structured interviews to explore the quantitative data findings in greater depth. Descriptive and inferential statistics were used to analyze the quantitative data. Qualitative data were analyzed with the interpretive description methodology. Data integration occurred at two points: (a) quantitative data was used to inform the sampling and interview guide for the qualitative phase, and (b) both sets of data were integrated, and interpretations were developed.

Results: A statistically significant increase in attitude towards interprofessional socialization was observed. There were six major themes identified: (a) interprofessional exposure, (b) interprofessional socialization activities and influences, (c) interprofessional, uniprofessional, or both (dual identity), (d) facilitators to interprofessional socialization, and (e) barriers to interprofessional socialization and (f) looking forward.

Conclusion: Although healthcare educators in the practice settings have positive views of interprofessional socialization following interprofessional training, the level of interprofessional exposure and collaboration with educators from other professions is inconsistent across diverse healthcare settings.  

The Role of Metacognition in Undergraduate Nursing Education: A Scoping Review Protocol

Cathy Lee is a UCalgary Faculty of Nursing undergraduate alum that is now doing her Master's in the program. A Registered Nurse since 2020, she has worked in acute care areas including Internal Medicine, COVID, and Pulmonary, and now works in Burns, Plastics & Head/Neck Surgeries. She has various roles within the faculty including graduate assistant teaching, tutoring, and as a clinical instructor for second and third-year students. Passionate about education, her thesis focus is on metacognition and improving student learning, and she hopes to continue her work in education research and working closely with students.

Abstract

Metacognition can be understood as "thinking about thinking" or the higher order (meta) thinking (cognition) that involves the deliberate and active awareness of learning and making decisions. Metacognition has been identified as an essential skill for healthcare professionals, but there are inconsistencies in how it is understood and utilized within undergraduate nursing education. This scoping review aims to locate and summarize what is known about metacognition within nursing education. The findings of this study may reveal ways in which students, educators, and institutions can utilize metacognitive strategies to improve student learning that better fits and reflects the unique complexities of nursing work.

I will use the JBI Manual for Evidence Review for Scoping Reviews to develop my review and search the databases CINAHL Plus, Medline, PsycINFO, and ERIC with the keywords: “metacognition,” “nursing,” “students,” “undergraduate” and “education.” Findings will be summarized through a table highlighting frequency counts of concepts, characteristics and other relevant fields of data, along with a more in-depth descriptive content analysis that may assist in addressing the study objectives. The results of this study may lead to a better understanding of metacognition within the context of nursing education and developing methods of assessment that reflect cognitive practices more aligned with nursing work. I also expect that a more comprehensive definition of metacognition may arise from an analysis of the existing literature. Researchers can use these results to identify what areas of work are needed in the current research of metacognition and begin to investigate ways to improve them to enhance student learning. 

Exploring the experience of gender diverse individuals accessing emergency healthcare services

Sondra is a first-year master of nursing student with eight years of experience in acute and emergency care nursing in Calgary Alberta. She is passionate about ensuring that safe and equitable healthcare is accessible for all Albertans regardless of sex, gender identity, or sexual orientation. Sondra is planning to use a narrative inquiry approach to explore the experience of gender diverse individuals accessing emergency health care in Alberta with the hope that this knowledge can be used to argue for, enter into, and develop systems and practice related initiatives towards more equitable, person-centered, accessible, and gender affirming emergency healthcare.  

Abstract

For people that identify as gender diverse or transgender a visit to the emergency room can be a stressful, even traumatic, experience. Often this population must decide whether it is safe to explain their gender identity to healthcare staff, if their privacy and confidentiality will be respected, or whether their doctor will understand how to treat their medical condition in the context of their gender identity. These considerations can cause additional anxiety and stress on top of existing medical complexity. This additional stress can lead to gender diverse people avoiding visiting the emergency room and worsening health as a result.

The proposed research will examine the complications gender diverse people face during an emergency room visit by working closely with 2-3 gender diverse people that have visited an emergency room within the last year. Using a narrative inquiry approach, the researcher and participant will meet frequently in semi structured interviews that focus on the person's experience and aims to tell their unique story as a gender diverse individual receiving emergency health care services, the estimated time in the research field is 4-6 months. The overall goal is to understand the stressors faced by gender diverse people and ways that emergency room settings and staff members can improve the experience of an emergency room visit for those identifying as gender diverse to contribute to emergency care services that are safe and accessible to everyone.

Exploring Academic Success in Non-University-Affiliated Polytechnic Nursing Programs         

As a seasoned registered nurse with 22 years of experience spanning mental health, paediatrics, community health and academia, Harroop brings appreciable insight into her doctoral journey at the University of Calgary. Presently, she serves as the nursing research capacity lead at the British Columbia Institute of Technology, in Vancouver, British Columbia, where she lives. She is passionate about elevating the nursing profession, particularly through reshaping undergraduate nursing education. Academic achievement by students in polytechnic nursing programs is the focus of Harroop's PhD study. Through this research she aims to develop a theory to enhance equity and inclusion in undergraduate nursing education.

Abstract

Background: Undergraduate nursing education in Canada faces challenges due to the inability of existing university-based programs to meet the increasing demand for nursing professionals. As a result, polytechnic nursing programs, independent from university affiliations, have emerged to grant undergraduate degrees. However, little is understood about the factors influencing academic success in these programs, especially as they expand seat capacity across the country. Current assessments of academic success typically rely on narrow metrics like grade point averages and program completion rates, overlooking the nuanced processes students undergo in transitioning to independent clinical practice and the impact of the educational environment on their success.

Purpose: The aim of this PhD study is to explore the strategies and processes utilized by final-year undergraduate nursing students in non-university-affiliated polytechnic programs to achieve academic success.

Method: Employing constructivist grounded theory, the research will be conducted using an iterative approach involving open-ended interviews, constant comparative analysis, and theoretical sampling. Thirty final-year undergraduate nursing students from three Canadian non-university-affiliated polytechnic institutions are being invited to participate, aiming to construct a theory rooted in the experiences and perspectives of the participants.

Implications: Understanding the dynamics of academic success in these programs holds significant implications for nursing education. Developing a comprehensive theory of academic success can inform strategies to support at-risk students and foster their persistence and success in non-university-affiliated polytechnic nursing programs. This understanding is crucial in preparing nursing students for the multifaceted demands of the nursing profession.

Understanding healthcare aides' experiences with death and dying in the context of the coronavirus pandemic

Katherine Stelfox is a doctoral candidate in the Faculty of Nursing, University of Calgary. Her research centres around older adults and long-term care. Katherine is an instructor for Nunavut Arctic College, where she teaches nursing research and gerontological nursing. Katherine has a diverse nursing background, having worked as a registered nurse in Nunavut and the Yukon, as well intensive care in Edmonton and long-term care in Calgary. Having done her master's degree in global health with a focus on healthcare policy and economics, Katherine feels passionately about the intersectionality of policy, economics, and quality of care in long-term care facilities. 

Abstract

Healthcare aides have been on the front lines of the COVID-19 pandemic, caring for society's most vulnerable citizens: older adults living in Long-Term Care (LTC) facilities. Often belonging to visible minorities and a mostly female-dominated workforce, healthcare aides are a marginalized and vulnerable population, and considered an undervalued workforce. With little support or public attention, healthcare aides were forced to navigate death and dying within LTC facilities despite longstanding structural inadequacies during the unprecedented event of the COVID-19 pandemic. 

Although LTC facilities are significant places of death and dying, healthcare aides are unprepared and not well supported to provide quality care to dying residents, and there has been little research on healthcare aides' experiences with the subject. This research study aims to better understand how healthcare aides in LTC understood their experiences of death and dying during the COVID-19 pandemic to better prepare for pandemic-level events in the future that may impede the quality of care. 

In taking a hermeneutic approach to this research study, the objective is to seek to understand this topic within a concrete context for the purpose of understanding, not explanation. Interviews have been conducted with eight healthcare aides who were able to speak to their experiences with death and dying in LTC during the COVID-19 pandemic. In hermeneutic research, the analysis of transcribed interview data is synonymous with interpretation, of which will take shape in the form of interpretive writing for the purpose of sharing meaningful research that helps us think and practice differently. 

Understanding Nurse-Parent Relational Complexity Within Pediatric Oncology Contexts

Katie Webber began her work as a pediatric oncology nurse in 2011 and she is currently working on her doctoral research in the Faculty of Nursing at the University of Calgary. Katie's doctoral research is focused on understanding relational complexity in parent-nurse relationships within pediatric oncology contexts. Katie hopes that her research will contribute to improving psychosocial supports for parents of children diagnosed with cancer, and the nurses who care for these families. 

Abstract

As a result of the complex nature of childhood cancer, involving intense treatments and extended hospital stays, it is not uncommon for nurses and parents to develop meaningful and close relationships. However, this closeness can lead to dilemmas about how to navigate professional boundaries, in both online and offline contexts. The purpose of this research was to seek understanding about complexity in nurse-parent relationships, from both nurse and parent perspectives.

Hermeneutics, with its rich philosophical foundation, was applied methodologically to this research using the approach detailed by Moules et al. (2015).  Using purposive sampling, data collection involved 12 topic-focused interviews with six parents and six nurses, within a Canadian pediatric oncology context. Data analysis involved the hermeneutic tradition of interpretation, with careful reading and re-reading of the transcribed interviews. 

After an in-depth analysis of the data, the following interpretations were developed: 1) Crawling into bed with them: Intimacy and strangeness in nurse-parent relationships 2) Seeing red: Considering anger, frustration, and conflict in nurse-parent relationships; 3) Friend request pending: Navigating online and offline professional boundaries; 4) Finding language that works: Understanding closeness in nurse-parent relationships.

Preliminary findings demonstrate the significance of relational care to strengthen the communication and connection between nurses and parents who care for children with cancer. Additionally, this research also demonstrated that parents require earlier and ongoing access to psychosocial, mental health, and relational supports. Finally, there are a lack of supports available to facilitate closure in nurse-parent relationships, particularly after the death of a child.