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Affiliation(s)
- Pamela F Cipriano
- President, International Council of Nurses, Geneva, Switzerland; Dean and Sadie Heath Cabaniss Professor, University of Virginia School of Nursing, Charlottesville, Virginia
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Kelsey EA, West CP, Cipriano PF, Peterson C, Satele D, Shanafelt T, Dyrbye LN. Original Research: Suicidal Ideation and Attitudes Toward Help Seeking in U.S. Nurses Relative to the General Working Population. Am J Nurs 2021; 121:24-36. [PMID: 34629376 DOI: 10.1097/01.naj.0000798056.73563.fa] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Although previous studies have revealed professional consequences of burnout among nurses, less is known about the potential personal consequences. This study investigated the prevalence of suicidal ideation and attitudes toward help seeking among U.S. nurses relative to other workers, and the extent to which personal and professional factors, including burnout, were related to suicidal ideation. METHODS In November 2017, a cross-sectional survey was sent to 86,858 nurses who were members of the American Nurses Association and to a probability-based sample of 5,198 U.S. workers. The survey included questions regarding suicidal ideation, burnout, symptoms of depression, individual and professional characteristics, and willingness to seek professional help if a serious emotional problem arose. Multivariable logistic regression analyses were conducted to identify factors associated with suicidal ideation after controlling for other factors. RESULTS Among the 7,378 nurse respondents, 403 (5.5%) reported having suicidal ideation within the past year. Most nurses (84.2%) indicated willingness to seek professional help for a serious emotional problem. Yet nurses with suicidal ideation were less likely to report that they'd seek such help (72.6%) than nurses without suicidal ideation (85%). In a multivariable analysis of nurses' data, after controlling for other personal and professional characteristics, we found that burnout was strongly associated with suicidal ideation. Adjusted combined multivariable analyses showed that nurses were more likely than other workers to have suicidal ideation. Both nurses and other workers who reported suicidal ideation were less likely to seek help than were those who did not report such ideation. CONCLUSIONS Compared with other U.S. workers, nurses are at higher risk for suicidal ideation, and nurses with such ideation are more reluctant to seek help than those without it. Burnout contributes to the risk of suicidal ideation. These issues warrant greater attention. Systems- and practice-level interventions must be identified and implemented, both to address the higher prevalences of burnout and suicidal ideation in nurses and to mitigate the stigma about mental health problems and other barriers to seeking help.
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Affiliation(s)
- Elizabeth A Kelsey
- Elizabeth A. Kelsey is an NP and assistant professor at Mayo Clinic Minnesota in Rochester, where Colin P. West and Liselotte N. Dyrbye are professors and codirectors of the Mayo Clinic Program on Physician Well-Being and Daniel Satele is a statistician. Pamela F. Cipriano is first vice president of the International Council of Nurses and dean of the University of Virginia School of Nursing, Charlottesville; she is also a former president of the American Nurses Association (ANA). Cheryl Peterson is vice president-nursing programs at the ANA in Silver Springs, MD. Tait Shanafelt is chief wellness officer and associate dean at the Stanford University School of Medicine, Stanford, CA. Funding for this study was provided by the Mayo Clinic Program on Physician Well-Being and the ANA and was based on work partially supported by a National Science Foundation (NSF) grant (No. 2041339). Any opinions, findings, and conclusions or recommendations expressed in this article are those of the authors and do not necessarily reflect the views of the NSF. Funding sources had no role in study design; in the collection, analysis, and interpretation of data; or in the writing and publication of this article. Contact author: Elizabeth A. Kelsey, . The authors have disclosed no potential conflicts of interest, financial or otherwise
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Cipriano PF, Blanchard KA, Rosa WE. Preventing Violence to Achieve Peaceful and Inclusive Societies. Am J Nurs 2021; 121:58-63. [PMID: 34438434 PMCID: PMC8569614 DOI: 10.1097/01.naj.0000790652.74669.ec] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article is one in a series in which contributing authors discuss how the United Nations (UN) Sustainable Development Goals (SDGs) are linked to everyday clinical issues; national public health emergencies; and other nursing issues, such as leadership, shared governance, and advocacy. The 2030 Agenda for Sustainable Development, a 15-year plan of action to achieve the goals, was unanimously adopted by all UN member states in September 2015 and took effect on January 1, 2016. The Agenda consists of 17 SDGs addressing social, economic, and environmental determinants of health and 169 associated targets focused on five themes: people, planet, peace, prosperity, and partnership. The SDGs build on the work of the UN Millennium Development Goals, which were in effect from 2000 to 2015. The current article highlights SDG 16: "Promote peaceful and inclusive societies for sustainable development, provide access to justice for all, and build effective, accountable, and inclusive institutions at all levels."
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Affiliation(s)
- Pamela F Cipriano
- Pamela F. Cipriano is the dean of the University of Virginia School of Nursing in Charlottesville; Katie Ann Blanchard is a graduate student at the University of Washington in Seattle; and William E. Rosa is the psycho-oncology chief research fellow at Memorial Sloan Kettering Cancer Center in New York City. Contact author: William E. Rosa, . William E. Rosa is funded by the NIH/NCI Cancer Center Support Grant P30 CA008748 and the NCI award number T32 CA009461
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Melnick ER, West CP, Nath B, Cipriano PF, Peterson C, Satele DV, Shanafelt T, Dyrbye LN. The association between perceived electronic health record usability and professional burnout among US nurses. J Am Med Inform Assoc 2021; 28:1632-1641. [PMID: 33871018 PMCID: PMC8324227 DOI: 10.1093/jamia/ocab059] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/05/2021] [Accepted: 03/11/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To measure nurse-perceived electronic health records (EHR) usability with a standardized metric of technology usability and evaluate its association with professional burnout. METHODS A cross-sectional survey of a random sample of US nurses was conducted in November 2017. EHR usability was measured with the System Usability Scale (SUS; range 0-100) and burnout with the Maslach Burnout Inventory. RESULTS Among the 86 858 nurses who were invited, 8638 (9.9%) completed the survey. The mean nurse-rated EHR SUS score was 57.6 (SD 16.3). A score of 57.6 is in the bottom 24% of scores across previous studies and categorized with a grade of "F." On multivariable analysis adjusting for age, gender, race, ethnicity, relationship status, children, highest nursing-related degree, mean hours worked per week, years of nursing experience, advanced certification, and practice setting, nurse-rated EHR usability was associated with burnout with each 1 point more favorable SUS score and associated with a 2% lower odds of burnout (OR 0.98; 95% CI, 0.97-0.99; P < .001). CONCLUSIONS Nurses rated the usability of their current EHR in the low marginal range of acceptability using a standardized metric of technology usability. EHR usability and the odds of burnout were strongly associated with a dose-response relationship.
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Affiliation(s)
- Edward R Melnick
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Colin P West
- Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Bidisha Nath
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Pamela F Cipriano
- Office of the Dean, University of Virginia School of Nursing, Charlottesville, Virginia, USA
- American Nurses Association, Silver Spring, Maryland, USA
| | | | - Daniel V Satele
- Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Tait Shanafelt
- Department of Medicine, Stanford School of Medicine, Palo Alto, California, USA
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Abstract
The United States leads the world in COVID-19 cases and deaths. The government's poorly coordinated response has lacked national mandates, failed to deploy adequate personal protective equipment, supplies and testing and devalued advice of science experts. COVID-19 exposed racial disparities in health care and as protests against racial injustice erupted, nurses have responded to the call to confront racism as a public health crisis. Nurses also suffer from lack of personal protective equipment, burnout, extreme workloads, overwhelming deaths and fear of contracting COVID-19. While facing danger, nurses have implemented practice changes and fostered new roles and teamwork to provide safer care. Advancing policy to provide personal protective equipment as well as financial and mental health support for nurses is a priority nationally and globally.
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Affiliation(s)
| | | | - Kendra Mcmillan
- Department of Nursing Practice and Work EnvironmentAmerican Nurses AssociationSilver SpringMDUSA
| | - Cheryl Peterson
- Nursing ProgramsAmerican Nurses AssociationSilver SpringMDUSA
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Ommaya AK, Cipriano PF, Hoyt DB, Horvath KA, Tang P, Paz HL, DeFrancesco MS, Hingle ST, Butler S, Sinsky CA. Care-Centered Clinical Documentation in the Digital Environment: Solutions to Alleviate Burnout. NAM Perspect 2018. [DOI: 10.31478/201801c] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Dyrbye LN, Shanafelt TD, Sinsky CA, Cipriano PF, Bhatt J, Ommaya A, West CP, Meyers D. Burnout Among Health Care Professionals: A Call to Explore and Address This Underrecognized Threat to Safe, High-Quality Care. NAM Perspect 2017. [DOI: 10.31478/201707b] [Citation(s) in RCA: 182] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Cipriano PF. EHRs and the glide path to value. Am Nurse 2016; 48:3. [PMID: 27439243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Cipriano PF. No health without mental health. Am Nurse 2016; 48:3. [PMID: 27215064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Cipriano PF, Berkowitz B. Nursing strong--the American Academy of Nursing and ANA. Am Nurse 2016; 48:3. [PMID: 27017684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Cipriano PF. Nurses unite with pride (and stethoscopes). Am Nurse 2015; 47:3. [PMID: 26975150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Cipriano PF. Nurses at the table: in the United States and around the world. Am Nurse 2015; 47:3. [PMID: 26563038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Cipriano PF. Ethics: Integrity, courage and leadership. Am Nurse 2015; 47:3. [PMID: 26399079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Cipriano PF. Ethical practice environments, empowered nurses. Am Nurse 2015; 47:3. [PMID: 26827397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Cipriano PF. Fighting fear. Am Nurse 2015; 47:3. [PMID: 26827417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Cipriano PF. What we measure, we can improve. Am Nurse 2014; 46:3. [PMID: 26062378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Cipriano PF. Technology in transition. Am Nurse 2014; 46:3. [PMID: 26072647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Cipriano PF. Meet ANA's new president. Am Nurse 2014; 46:3. [PMID: 25204036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Cipriano PF, Bowles K, Dailey M, Dykes P, Lamb G, Naylor M. The importance of health information technology in care coordination and transitional care. Nurs Outlook 2014; 61:475-89. [PMID: 24409517 DOI: 10.1016/j.outlook.2013.10.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Care coordination and transitional care services are strategically important for achieving the priorities of better care, better health, and reduced costs embodied in the National Strategy for Quality Improvement in Health Care (National Quality Strategy [NQS]). Some of the most vulnerable times in a person’s care occur with changes in condition as well as movement within and between settings of care. The American Academy of Nursing (AAN) believes it is essential to facilitate the coordination of care and transitions by using health information technology (HIT) to collect, share, and analyze data that communicate patient-centered information among patients, families, and care providers across communities. HIT makes information accessible, actionable, timely, customizable, and portable. Rapid access to information also creates efficiencies in care by eliminating redundancies and illuminating health history and prior care. The adoption of electronic health records (EHRs) and information systems can enable care coordination to be more effective but only when a number of essential elements are addressed to reflect the team-based nature of care coordination as well as a focus on the individual’s needs and preferences. To that end, the AAN offers a set of recommendations to guide the development of the infrastructure, standards, content, and measures for electronically enabled care coordination and transitions in care as well as research needed to build the evidence base to assess outcomes of the associated interventions.
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Abstract
Nurse executives are responsible for a workforce that can provide safer and more efficient care in a complex sociotechnical environment. National quality priorities rely on technologies to provide data collection, share information, and leverage analytic capabilities to interpret findings and inform approaches to care that will achieve better outcomes. As a key steward for quality, the nurse executive exercises leadership to provide the infrastructure to build and manage nursing knowledge and instill accountability for following evidence-based practices. These actions contribute to a learning health system where new knowledge is captured as a by-product of care delivery enabled by knowledge-based electronic systems. The learning health system also relies on rigorous scientific evidence embedded into practice at the point of care. The nurse executive optimizes use of knowledge-based technologies, integrated throughout the organization, that have the capacity to help transform health care.
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Cipriano PF. The future of nursing and health IT: the quality elixir. Nurs Econ 2011; 29:286-282. [PMID: 22372088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Cipriano PF. An update from the American Academy of Nursing's Workforce Commission. Nurs Outlook 2009. [DOI: 10.1016/j.outlook.2009.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bolton LB, Gassert CA, Cipriano PF. Technology solutions can make nursing care safer and more efficient. J Healthc Inf Manag 2008; 22:24-30. [PMID: 19267016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The shortage of registered nurses in hospitals threatens to cripple healthcare delivery in the next three to five years. The demand for nursing care has increased while the willingness of nurses to stay at the bedside in acute-care settings has decreased. The American Academy of Nursing Workforce Commission developed and tested a process called Technology Drill Down in more than 200 medical-surgical patient care units in a study supported by The Robert Wood Johnson Foundation. The process identified workflow inefficiencies that could be addressed through the deployment of technology. Findings from the study indicate the need for smart, portable, point-of-care solutions that are interoperable across devices and systems. Nurses believe that technology can reduce waste and workflow inefficiency and enable nurses to provide safe, reliable, quality patient care.
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Cipriano PF. Statement of the American Academy of Nursing and the American Organization of Nurse Executives for the Food and Drug Administration regarding bar code labeling for human drug products. Nurs Outlook 2002; 50:263-5. [PMID: 12523316 DOI: 10.1016/s0029-6554(02)70003-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Brady M, Leuner JD, Bellack JP, Loquist RS, Cipriano PF, O'Neil EH. A proposed framework for differentiating the 21 Pew competencies by level of nursing education. Nurs Health Care Perspect 2001; 22:30-5. [PMID: 11221178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Now nearly a decade old, the original Pew Health Professions Commission Competencies have stood up well to the test of time. The competencies were designed to provide all health professionals, from physicians to physical therapists, with a general guide to the values, skills, and knowledge they would need to be successful in the health care system that was beginning to emerge in the late 1980s. They have been used across the range of health professions and in many practice settings to create a framework for curricular change, work redesign, and assessment of professional competence. The interpretation of the competencies offered here should prove to be a useful tool to nurses and health system leaders as they carry on the hard work of adapting the current model of nursing practice to the demands and realties of the contemporary and continually evolving health care environment. This work is important for two reasons. First, many of the skills and attributes of the professional nurse are not adequately used or valued by the health care system because the profession is both fragmented and poorly differentiated and articulated. Without markers that define and promote collaborative practice within nursing, the full potential of nurses at all levels of preparation will continue to be inadequately and inappropriately deployed. This model exacerbates the current nursing shortage because it fails to use nurses in appropriate, well-delineated, and challenging roles. Without this kind of differentiation, one that can be owned and supported by all nurses, there will continue to be suboptimal use of the nursing workforce in the United States. The framework of differentiated Pew competencies and the companion teaching-learning strategies proposed here offer one approach to rationalizing both nursing education and practice, with the potential for improving the quality of care, and reducing fragmentation, cost, and public confusion.
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Affiliation(s)
- M Brady
- Division of Nursing, Trident Technical College, Charleston, SC, USA
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Brockopp DY, Pilon BA, Cason CL, Cipriano PF. Nursing the system. Key users are sometimes "out of the loop". South Hosp 1992; 58:10-2. [PMID: 10120390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Among those with a particular interest in hospital information systems are those who teach nursing students at the college level. To get their views, Southern Hospitals interviewed four Nurse Scholars involved with nursing and research projects for universities across the South. In 1989, Atlanta-based vendors HealthQuest and HBO & Company of Georgia established the Nurse Scholars Program in an effort to help academia stay abreast of technology. It provides nurse educators with comprehensive instruction in emerging technologies and uses of automated patient care systems. The scholars are encouraged to share their new knowledge with students, faculty, practitioners and administrators so that future nurse executives will better understand and communicate what they need and want from information systems.
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Affiliation(s)
- D Y Brockopp
- College of Nursing, University of Kentucky, Lexington
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Cipriano PF. Certification: self-regulation for specialty practice. NLN Publ 1986:77-82. [PMID: 3636796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Cipriano PF. Surviving on the job: hints for the new graduate. Imprint 1981; 28:48-51, 72, 79. [PMID: 6907168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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