[Jen]

1. Look back at the research tool for your two articles from last week (week 4) focusing on the last Question: How does this research study relate to your own practice?
2. Reflect on how you would translate this knowledge into your practice to address your research question.
3. Based on your reflection from this week’s module, modify and re-submit your response to How does this research study relate to your own practice? for each article from last week.

[Ashley]

Article 1: Cost-Benefit Study of School Nursing Services
It’s old, beyond five years, and based in the American system, however I do feel like it provided some strength to my question about the positives of having nursing support in the school system.

Although finances are only one part of the puzzle this article did reinforce the loss of productivity for teachers and parents, shedding light on future study options related to caregiver experiences with or without nursing support.

The lack of research available on my topic lends to the need for more research to occur and I think this study would be well cited to entice funding and interest to further research the population and question at hand. Simply speaking it posed the possibility of support at the school level being a net investment for the community so I think it would be a good option to refer to this study when presenting a case for more research.

Article #2: The psychosocial impact of rare diseases among children and adolescents attending mainstream schools in Western Australia

This paper affirms my feelings that starting inclusion early and often creates more empathetic students all around. My patient deals with questions from peers and adults daily regarding her care needs and differences. A huge part of the school nurse role is to help steer these conversations in a way that empowers the child to share their truth and maintain their privacy as they see fit. I have had the privilege of running a circle time where students could ask questions and share how they are all different and we celebrate our differences. This reminds me to keep thinking of new ways to bridge the gap for my patients and their peers.

[Jen]

Hi Ashley,

Literature reviews are helpful for us to consider what information currently exists on our topic of inquiry. Findings from previous research and grey literature sources (e.g., government and professional reports, white papers, media etc.) can support the position and justification for why a particular topics needs to be addressed client and their families experience with nursing supports in school-based environments.

Some food for thought – what are some ethical considerations to conduct research regarding a participant population under age 18 years (minors)?

Great work!

Jen

[Megan]

Hi Ashley,
There seems to be a limited model in place to support students in the school system. With multiple agencies sharing responsibility. You’ve got the ministry of community health and support services, the different district health units, and home care agencies all involved. I can’t help wonder if they provided a model of care and funding to the school boards, to staff each school with qualified nurses if this would better support the students families, and education staff. It also gives the school a chance to have consistency of care, whilst taking the weight of finding resources away from schools and families. I’m having a hard time understanding why the province doesn’t allocate funds directly to school boards, rather than dispersing the funding across multiple agencies and organizations. Furthermore, for nurses wishing to work as a school nurse, they must apply to either community nursing agencies, health units and private families hiring nurses, all which may require additional commitments beyond working within school hours. It’s evident that my daughter’s school is providing allied health staff such as occupational therapists to assist with students needing more assistance, so why not have the school boards be responsible for hiring trained nurses to provide first aid, and support to students needing skilled nursing care during school? I’m interested to follow your research topic into next week’s assignment.
Megan S

[Megan]

Hi Everyone,

Article 1: Systemic Failures in nursing home care – A scoping study

My nursing practice has been on pause since working in long-term care. During my time there, I felt the challenges of insufficient staffing of RNs, RPNs and PSWs. When we were short PSWs, RPNs and RNs would need to step in to help complete tasks, leaving their other work to be put on hold. If there was a shortage of RPNs, RNs on duty would step in to do that role. Insufficient staffing issues was a persistent conflict that I faced almost daily. This article helped me to see that these issues are in fact a global issue that extends far beyond my singular experience.

Working in long-term care helped me to develop my research question.
This article depicts several reasons for failures in nursing homes on a global scale. It alludes to a need to make the safety and quality of life of residents the top priority at all levels. A common link between my research question and this article is the need to increase staffing in such a way that it makes an impact to provide more resident-centred care.

Article 2: Aged care residents’ prioritization of care: A mixed-methods study

This article I felt was linked to my research question in terms of the connection between staffing ratios and their impacts on residents. In the article it referred to long waits for call bells to be answered, and a delay of care. It was also part of the article’s recommendations for policy and practice that safe staffing ratios was in the top 3 of priorities to residents. Whilst the study has limitations such as being isolated to the residents at one singular care home, it amplifies the voices of those in care, and their feelings of living with insufficient care.

I developed my research question as a result of my previous experience working in long-term care. I wished to research the current state of long-term care in terms of staffing ratios to determine if there was evidence to support a need to devise and implement safer ratios of nursing staff. This article demonstrates there is a need for safer staffing ratios from the perspective of the residents.

Megan S.

[Jen]

Hi Megan,

Your critical reflection brings forward information that the staffing challenges in LTC extend beyond the local organizational context into systemic issues nationally and internationally.

Have you had an opportunity to join RPNs at WeRPN’s Queen’s Park day or other advocacy events? One area of advocacy is focused on safe staff to resident ratios.

Here are a couple links that may be of interest to you based on your findings:
– https://journal.werpn.com/queens-park-dispatches-3/
– https://www.youtube.com/watch?v=tq81ZjIuybw

Considering the systemic staffing challenging for nursing and personal care work – do you think this information is helpful or hindering for nurses to organize their workloads and contributions/collaborations in strategic planning in their day to day work?

Jen

[Marissa]

Your experience in long-term care highlighted the daily challenges of insufficient staffing, which directly informed your research question on safe staffing ratios. The first article, Systemic Failures in Nursing Home Care, validated your experience by showing that staffing shortages are a global issue that affects resident safety and care quality. The second article, Aged Care Residents’ Prioritization of Care, reinforced the importance of adequate staffing from the residents’ perspective, linking delays in care to understaffing. Together, these studies support the need for evidence-based staffing models that prioritize resident-centred care.

[Brandon]

Article 1 –

How does this research study relate to your own practice?
After reviewing this article again, I realized it mainly focused on RNs, which was an oversight on my part. I selected it thinking it would help strengthen my reasoning around role development and leadership within nursing, but it doesn’t fully align with my research focus on RPNs and PN education in Ontario. Like many of us do, I saw a strong piece of research and thought it would fit, but in reality, it didn’t connect as well as I’d hoped. That said, it still offered valuable insight. The study highlighted how nurses grow into leadership roles and take ownership of their practice when they’re empowered and supported. I can still take away that same principle for my research, as this has been a personal professional experience. I have been in a supervisor role over the past year, and by integrating formal research education into PN programs, we can empower future RPNs to use evidence confidently and take initiative in improving care. Even though the population was different, the message about empowerment through education and professional growth still relates closely to my overall research purpose.

Article 2 –

How does this research study relate to your own practice?
This study connects well to my own research focus. It shows how structured frameworks and education can really help bridge the gap between research and practice, something I believe is essential in nursing education. Relating this to my research question, which looks at whether adding formal research education into PN programs improves RPNs’ preparedness for evidence-informed practice, this article supports that idea. By embedding structured, consistent research education early on, we can help RPNs feel more confident and capable of applying evidence in real clinical situations. It reinforces my belief that practical, hands-on learning combined with clear frameworks is key to strengthening research use among RPNs once they’re out in practice.

[Ashley]

I’m curious how putting formal research education into the PN programs would shape to reflect the obvious need here. When I was completing the PN program it was a condensed class with no breaks and many things felt like a blur. I’m curious how the traditional delivery model vs the condensed model helps with retention and learned skills. I’m wondering if it would receive the importance it deserves as part of the curriculum or get lost in the sea of to-dos that can seem so overwhelming. I hope the schools keep promoting this option for new grads to pursue research post-graduation as a learning plan priority. I can’t agree more that it needs to get into the curriculum somewhere. Excited to see how your plans unfold!

[Jen]

Hi Brandon,

It is great to see that you are finding relevant literature for your area of inquiry. As you have noted – nursing publications in different nursing classification and across national and international jurisdictions may not be generalizable to the Ontario context for PN students and RPNs.

According to the CNO entry to practice standards – new graduate RPNs are expected to possess competencies that are transferable across all areas of responsibility including research, and RPNs to use knowledge, critical thinking, critical inquiry and research to build an evidence-informed practice. During your research so far, have you found elements of research education embedded within the current Ontario PN curriculum? For example: critical thinking or critical appraisal of existing evidence, nursing theory and practice, pharmacology etc?

Link: https://cno.org/Assets/CNO/Documents/Become-a-Nurse/41042_entrypracrpn-2020.pdf

Jen

[Marissa]

Article 1 — Suzuki, E., Itomine, I., Saito, M., Katsuki, T., & Sato, C. (2008)
Suzuki et al. (2008) highlight that novice nurse turnover is strongly linked to a lack of peer support and workplace dissatisfaction. This directly maps onto the day-to-day retention challenges in my unit, where newly hired nurses report experiencing reality shock and burnout within months. Translating this into practice means implementing structured socialization and early support systems like a formalized buddy/mentor assignment from day one, protected weekly orientation time for the first three months, and scheduled reflective debriefs at 2, 6, and 12 weeks to identify reality‑shock stressors. I would operationalize these changes with a simple, anonymous early‑warning feedback tool completed at each check‑in that flags workload mismatch, skill gaps, or interpersonal issues for swift mentor or manager follow‑up. Since the study was conducted in university hospitals, I will pilot these measures locally and collect data on retention and burnout to evaluate their effectiveness and adapt them for our context. Anticipated barriers include staffing constraints for mentors and competing priorities. This suggests the need to negotiate protected mentor hours and start with a small cohort pilot to demonstrate feasibility and outcomes before broader roll‑out.

Article 2 – Gregory S. Anderson, Paula M. Di Nota, Dianne Groll and R. Nicholas Carleton (2020)
Anderson et al. (2020) synthesise evidence on peer support and crisis‑focused interventions for public safety and frontline healthcare workers, highlighting inconsistent effectiveness and the need for tailored, rigorously evaluated programs. This directly informs my practice as a frontline nurse working in high‑stress clinical settings where potentially psychologically traumatic exposure and burnout are common. Translating this knowledge means prioritizing peer‑based supports that are evidence‑informed and context‑specific rather than implementing generic debriefing models. I would advocate for a ward‑level peer support programme with structured training, clear role definitions, and supervisory oversight, explicitly avoiding one‑off Critical incident stress debriefing approaches that lack robust support. Implementation would follow a pilot‑and‑evaluate model: co‑design the intervention with frontline staff, train selected peer supporters in active listening, psychological first aid, and referral pathways, and embed routine supervision and wellbeing checks. Evaluation measures would be standardized and longitudinal with baseline data collected to control for pre‑existing conditions as recommended by the review. Anticipated barriers include time constraints, stigma about help‑seeking, limited access to mental‑health specialists for referrals, and organisational resistance. Mitigation strategies include protected time for peer roles, leadership endorsement, anonymous feedback mechanisms, and clear escalation pathways to professional supports. Overall, the review supports a cautious, tailored approach in my setting. Implement small, co‑produced peer supports with robust training and standardized outcome tracking to build local evidence before wider scale‑up.

[April]

Discussion article # 1: Systemic Failures in nursing home care – A scoping study.

Hi Megan
It has been many years since I worked in long-term care, but I can tell you that it was at a time when the provincial government decided to cut funding to most health care programs as well as other areas supported by the provincial government. At this time there was a wage freeze and twelve mandatory unpaid leave days per year for anyone that was classified as a civil service worker, which included nurses, teachers and other civil services workers. The wage freeze and unpaid leave days were an initiative by the provincial government to help mitigate the negative impact of the early 1990s recession. The very unhappy employees called the unpaid leave days, Rae Days as it was Premier Bob Rae that brought them about. It was a horrible time for nurses and patients. I had just graduated nursing school and could not find a nursing position where I lived so I took a job an hour away from home so that I could work in a hospital and I was lucky enough to get a position working on the postpartum/newborn nursery and I loved my position. I had been working at the hospital in Oshawa for three years in that position in1993 and the Rae Days were introduced, and I was bumped off my floor into a non-registered position and moved to long-term care. The hospital created a new position in long-term care, and they gave it the title of “Patient Care Assistant”. I could take this position or be laid off, so I took it. The problem with this position was that they took employee from different areas of the hospital, some staff were originally dietary staff, orderlies and housekeeping. It was trying for all staff, and I felt so bad for the patients as most of the new staff had no idea on how to do a bed bath, offer a bed pan or do mouth care etc. To me this was a time when the provincial government should have stayed out of health care as they had no idea as to how this was affecting staffing morale and patients.

I think that while this was happening across Ontario, it would have been an excellent time to do a systemic scoping study. So, that they could have addressed it as a systemic failure which could have used a holistic approach, focusing on redesigning the process, improving communication, and fostering a culture that embraced change. If, the leaders at the time recognized the signs of systemic failure they could have implemented effective solutions to ensure safety and quality of life of patients at all levels of care.
Thankfully times are changing, and nurses are getting greater education and are realizing the issue and that a research study would have shown how it was not practical for patients or nurses to work with unregulated health care providers.

Working on the research questions has opened my eyes to all kinds of research studies that can be done by nurses especially RPN’s as we need more research studies done by RPNs that can be translated to clinical nursing practice.
April

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