Finding our way forward

It's disappointing to me as a regular subscriber and a long-term nurse that we continue to dramatize our profession to the point no one wants any part of it. Your cover (March 2022) says it all. COVID has been difficult for all of us, but not everyone spent the day in PPE and cared for patients with COVID. It would be interesting to know the percentage of nurses who actually did. We've done so much damage to our profession, I'm not sure we can find our way out. I love being a nurse, even during all the challenges we faced. We made a difference and continue to make a difference. However, if nurses continue to replay the drama, heartache, and stress, no one-and I do mean no one-will join our ranks. We have an obligation to be truthful and supportive of our profession.

-Dorothy A. Bybee, RN, MSN/MBA-HC, NEA-BC

VP Patient Care Services/Chief Nursing Officer

Columbus Community Hospital, Columbus, Neb.

Nursing Management editors respond: Although it's critical to report on the impact of the pandemic on nurses, we agree that it's important to change the narrative and move forward. It's with this mindset that we recently launched our "Great Dedication" project, honoring nurse leaders and nurses who remain dedicated to the profession and highlighting the many reasons why they love nursing. We're also promoting participation in an anonymous survey asking nurse leaders to share innovative nursing practices implemented during the COVID-19 pandemic (see p.7). Visit our website at http://www.nursingmanagement.com and click on the "#WhyIStay" tab to learn more about the Great Dedication initiative, and find additional information about the survey on our website's home page.

Inclusive images

I just read a very good article in Nursing Management on the value of achieving nursing certifications ("Specialty certification: Nurses' perceived value and barriers," May 2018, Vol. 49, Issue 5). I commend the authors for their good work. Although I clearly understand the intent of the associated image-to break through the barriers and achieve certification-the image isn't complimentary of the discipline of nursing. The article should have included an image that shows diversity and inclusion. For example, an image of nurses who are professionally dressed and show gender and ethnic diversity would have been more appropriate. I believe most professional writing guidelines support the use of gender-neutral language, which also applies to images that show bias. I found the image offensive for several reasons, and I'd imagine others did, too.

-Richard L. Pullen, Jr., EdD, MSN, RN, CMSRN, CNE, CNE-cl, ANEF

RN to BSN Program Director and Professor

Piper Professor of Texas

Fellow, Academy of Nursing Education

Texas Tech University Health Sciences Center

Nursing Management editors respond: We appreciate your honest feedback and apologize to anyone who was offended by the image. We aim to be inclusive and diverse in our selection of images and wish for all nurse leaders to feel represented in our journal. We'll continue to be mindful of this perspective going forward.

Clinical education during COVID

Regarding the article "Reimagining an academic-practice partnership during COVID-19" (September 2021, Volume 52, issue 9), I applaud the development of this baccalaureate leadership project through the academic-practice partnership. From associate to doctoral level, tens of thousands of nursing students were displaced from the clinical learning environment. This prolonged training program resulted in delayed program completion for many students. As the clinical coordinator for Certified Registered Nurse Anesthetist (CRNA) education at a large academic tertiary care center, I too faced the dilemma of students being displaced from the clinical environment. During the initial surge of the COVID-19 pandemic (March 2020 through May 2020), all CRNA schools in the US suspended clinical training. This unprecedented move required the Council on Accreditation of Nurse Anesthesia Educational Programs, the certifying body charged with certification of nurse anesthetists, to modify its education requirements for certification. All organizations educating CRNA students had to adopt a think-outside-the-box mentality. Due to anesthesia training requiring a large amount of direct patient care, an increase in virtual simulation programs was implemented to maintain muscle memory of skills. The swift transition from hands-on clinical education to virtual learning created additional stress for CRNA students. Keener et al. (2021) found that 91% of students reported increased stress and anxiety due to the COVID-19 pandemic and that stress negatively impacted learning and psychological well-being.

As the initial surge of patients with COVID-19 began to ease and point-of-care (POC) testing increased, CRNA students began to return to the clinical environment. At our academic hospital, policies were instituted to decrease the student's exposure to patients with COVID-19, such as ensuring that students were only assigned to elective cases where point-of-care testing had been completed. In addition, students were prohibited from providing care to emergency cases or acute resuscitation teams. Similar to the program instituted by your team, CRNA students were included in weekly departmental leadership meetings to determine anesthesia response to the increased need for critical care resources. This included discussion and planning of the reallocation of CRNAs to manage intensive care units and the development of additional airway and resuscitation response teams.

I'm inspired by the emphasis your team placed on baccalaureate leadership education during a time of crisis. The program developed allowed students to understand the logistics required to provide the equipment needed to care for patients. Many healthcare providers fail to recognize the complexities involved in providing the box of gloves they so effortlessly use daily. Furthermore, this project emphasized the framework needed for evidence-based practice and the steps necessary for Doctor of Nursing Practice synthesis projects. Hopefully, this will inspire students to pursue leadership positions and further their nursing education.

-Jason Jarrett, DNP, APRN, MSNA, CRNA

Clinical Coordinator for CRNA Education

Ochsner LSU Health-Shreveport

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