When I was in nursing school, I was a huge fan of the TV show "ER". I loved recognizing the language they used and adored Noah Wyle's Dr. Carter, especially after I learned that his mother was a nurse. Fast forward to now, and I have found the same enthusiasm for HBO's "The Pitt." But at this point in my nursing career, viewing the show leaves me occasionally perplexed by the show's portrayal of emergency room dynamics. While it captures certain aspects of our profession with commendable accuracy and enticing entertainment, there are moments where reality takes a backseat to dramatization. Let's delve into some of these portrayals.

Nursing Workforce Diversity

In "The Pitt," nurses are easily identifiable by their gray scrubs and clear occupational identifiers on their name badges. This is a detail that mirrors real-world best practice. However, the show's depiction of staff diversity doesn't quite align with current statistics. According to the National Sample Survey of Registered Nurses1, as of 2022, the registered nurse (RN) workforce was predominantly White/Caucasian (80%), with Black/African American nurses comprising 6.3%, Asian nurses 7.4%, and Hispanic nurses 6.9%. Men represented 11.2% of the RN workforce during the same period. These figures highlight the ongoing challenge of recruiting a nursing workforce that truly reflects the diverse patient populations we serve.

The Charge Nurse Unicorn

The series often portrays the charge nurse as a prescient guide at the nurses' station, always ready to dole out timely advice. While charge nurses indeed play pivotal roles in mentoring and supporting staff, the reality is that they are frequently immersed elbow-deep in patient care and administrative duties. While things have improved regarding nurse shortages, there are still many reports that nurse staffing and retention are a significant concern, with many nurses considering leaving the profession due to burnout and increased workloads2. This means that charge nurses are often stretched thin, balancing multiple responsibilities simultaneously.​

Workplace Violence (spoiler alert!)

One particularly resonant storyline involves a patient growing increasingly agitated in the waiting room, culminating in an act of violence against a healthcare worker. I doubt there is a single nurse out there who didn't see where this storyline was going from the very first episode. This depiction, though unsettling, reflects a troubling reality. We Arizonans know all too well that violence in hospitals continues to be a significant concern. While health care workers represent about 10% of the total workforce, they comprise nearly half of all non-fatal injuries resulting from workplace violence3.

Throughput and Psychiatric Holds

Despite the show's portrayal of an "unusually busy day," the ED appears surprisingly orderly, with minimal hallway stretchers and psychiatric holds. In contrast, many real-life EDs grapple with significant throughput challenges, particularly concerning mental health patients. As of April 2025, over 122 million Americans resided in areas designated as Mental Health Professional Shortage Areas4, leading to increased reliance on EDs for psychiatric care. This shortage often results in prolonged ED stays for patients awaiting appropriate mental health interventions.​

Opioids and Overdoses

One storyline The Pitt gets right is the ongoing toll of the opioid crisis, particularly the role of fentanyl, which is involved in about 80% of opioid-related overdose deaths. However, it misses the mark in who is most affected---overdose deaths are highest among Black and Indigenous communities5, not white college students studying too hard. While overall deaths have slightly declined, fentanyl continues to devastate communities, and EDs remain on the frontlines of this public health crisis.

While "The Pitt" offers a dramatized yet entertaining glimpse into the world of emergency nursing, it's essential to recognize the complexities and challenges that define our daily experiences. Modern healthcare is rich with storylines that will keep the show going for countless seasons. Issues like workforce diversity, staffing shortages, workplace violence, and mental health care access aren't going away soon. Perhaps airtime, some great acting, and a larger audience may help generate broader support for the solutions we need. Of course, it is just Hollywood, and the show is a surprisingly accurate take on emergency medicine. So, go grab some popcorn and give it a watch if you haven't already. Sometimes it is OK for entertainment to just be fun.

HPV Vaccine

The first HPV vaccine, Gardasil, was approved in 2006 and protects against four strains of HPV (The College of Physicians of Philadelphia, n.d.). Cervarix was the second HPV vaccine approved in the U.S. in 2009 and protects against only two high-risk strains of HPV (The College of Physicians of Philadelphia, n.d.). Finally, Gardasil 9 was approved for use in 2014 and is currently the only HPV vaccine available / in the U.S. (The College of Physicians of Philadelphia, n.d.). When given between the ages of nine and 14, two doses of the HPV vaccine are required spaced six to 12 months apart (CDC, 2023). When initiating vaccination between the ages of 15 and 45, three doses are required at 0, 1-2 /, and 6 months (CDC, 2023). The American Cancer Society (2024) recommends giving the vaccine to all children between the ages of nine and 12. Doing so allows for immunization prior to exposure to HPV and produces a strong immune response, leading to the prevention of more than 90 percent of HPV-related cancers (American Cancer Society [ACS], 2024).

Immunization Rates and Vaccine Hesitancy

The Healthy People 2030 target goal for adolescents receiving the recommended doses of the HPV vaccine is 80 percent (Office of Disease Prevention and Health Promotion [ODPHP], n.d.). While the percentage of adolescents up to date with the recommended doses of the HPV vaccine has steadily increased over the years, current data shows that only 58.5% of U.S. adolescents aged 13 to 15 are appropriately vaccinated (ODPHP, n.d.). Here in Arizona, the rate of those adolescents fully vaccinated is higher, 62 percent but again well below the Healthy People 2030 target goal of 80 percent (America's Health Rankings, n.d.).

Why do HPV vaccination rates continue to fall below the target goal of 80 percent? Some of the reasons cited in the literature regarding vaccine hesitancy include vaccine safety, side effects, lack of information provided, and vaccine necessity (Beavis et al., 2022). Other reasons cited include parents' belief that their child does not need the HPV vaccine if they are not sexually active or that getting the HPV vaccine will promote sexual activity (Shawhan & Ruppe, 2019).

Strategies and Interventions

There are several strategies available that can be implemented to help increase HPV vaccine rates. Research has shown that implementing multiple interventions concomitantly can be even more effective than using a single tactic (ACS, 2021). One such strategy is to bundle the HPV vaccine with other immunizations, such as the routinely administered tetanus, diphtheria, acellular pertussis (Tdap), and meningococcal vaccines between the ages of 11 and 12 (ACS, 2021). When recommending the HPV vaccine, it should be made very clear that this immunization prevents future HPV-related diseases and cancers. Furthermore, missed opportunities can be minimized when vaccine status is assessed with every office visit, not just during well exams (ACS, 2021). Other strategies include using electronic health record alerts and scheduling an appointment for subsequent doses when the first dose is received (ACS, 2021). Social media, emails, and text messages can also disseminate information and remind parents when their child is due for a dose of the HPV vaccine (ACS, 2021).

Conclusion

HPV is a common STI that affects millions each year. While the virus can clear the body spontaneously, it can also go on to cause genital warts, precancerous cells, and even cancer. The HPV vaccine is more than 90 percent effective at preventing HPV-related disease, yet immunization rates remain substandard. More needs to be done to ensure our adolescent patients are being vaccinated appropriately against HPV. Several interventions exist that can ensure parents receive the information they need to make an informed decision, and strategies are available to reduce missed opportunities for immunization.

Introduction

As a nurse educator in Arizona, I have seen how clinical rotations shape students' confidence, competence, and commitment to the profession. With Arizona's growing and diverse population, we need well-prepared nurses who can adapt to the challenges of different healthcare settings. However, many students struggle during clinical rotations due to inconsistent mentorship, limited hands-on opportunities, and the emotional stress of caring for patients (Jafarian-Amiri et al., 2020). Improving the clinical experience can prepare nursing students for success and strengthen our future workforce.

The Importance of a Supportive Clinical Environment

Clinical rotations are students' first exposure to patient care, making them a critical part of their education. Research shows that students who receive strong mentorship and hands-on learning opportunities are more likely to feel prepared and committed to nursing (Zhang et al., 2022). A well-structured clinical environment fosters confidence and skill development, while deficient experiences such as lack of guidance or overwhelming workloads can lead to anxiety and disengagement (George et al., 2020).

Common Challenges in Clinical Rotations

• Lack of Supervision and Mentorship: Many students report that preceptors are too busy to provide guidance, leading to uncertainty and decreased learning opportunities (Hopeck, 2023).

• Emotional and Psychological Stress: Clinical settings can be overwhelming, especially for students encountering critically ill patients for the first time. Stress and anxiety can hinder learning and performance (Aryuwat et al., 2024).

• Limited Hands-On Opportunities: In some cases, students spend more time observing than practicing essential skills, thereby reducing their confidence in performing procedures independently after graduation (Dolokelena et al., 2024).

Strategies to Improve the Clinical Experience

1. Effective Preceptor-Student Relationships

Students thrive when they have consistent, engaged preceptors. Training preceptors on mentoring students effectively and creating a supportive environment (Zhang et al., 2022) is essential. Assigning students to dedicated preceptors rather than rotating them among different nurses improves learning and professional socialization (Hopeck, 2023).

2. Structured Pre-Clinical Preparation

Students should feel prepared before stepping into clinical settings. Simulations, case-based learning, and orientation sessions help bridge the gap between classroom knowledge and real-world practice (George et al., 2020). In my experience, students who complete hands-on skills labs before their first clinical day are more confident and engaged.

3. Debriefing and Reflection

Clinical rotations are emotionally demanding. Debriefing sessions allow students to process their experiences, ask questions, and receive feedback. Reflective journaling and peer discussions also help students develop critical thinking and emotional resilience (Aryuwat et al., 2024).

4. Maximizing Hands-On Opportunities

Students learn best by doing. Preceptors should involve them in patient care activities rather than limiting them to shadowing. Allowing students to perform assessments, administer medications, and document care under supervision increases their competence and confidence (Dolokelena et al., 2024).

Conclusion

Providing nursing students with a favorable clinical experience is essential for developing competent and confident nurses. Addressing mentorship, emotional support, and hands-on learning challenges can improve student engagement and readiness for practice. Implementing evidence-based strategies can strengthen nursing educational training and ensure the best possible patient care.

BACKGROUND AND SIGNIFICANCE:

Most nurses are all too familiar with the potential complications related to urinary catheters, such as infection, bleeding/blood clots, irritation, urethral injury, discomfort, and anxiety. These complications are increasingly likely when patients are asked to manage their urinary catheters at home after surgery.

At HonorHealth Scottsdale Shea Medical Center (HHSSMC), we frequently send patients home with a urinary catheter after surgery from the Post-Anesthesia Care Unit (PACU). Our perianesthesia nurses identified the need for improved education and the discharge process for this patient population. The following PICOT question was developed to identify best-practice strategies: (P) In patients being discharged home from the PACU with a urinary catheter (I) how do best practices for patient education (C) compared to current practice (O) affect patient satisfaction with the discharge process (T) over three months?

EVIDENCE-BASED BEST PRACTICES:

As the team reviewed the literature, three main best-practice strategies for this patient population were identified: 1) early education, 2) multimodal teaching methods, and 3) providing a standard supply kit. The team created and implemented an IRB-approved research study using these evidence-based interventions.

METHODS:

Design: Post-survey quantitative research study to assess the impact of a patient education intervention for discharge from the PACU with a urinary catheter. Setting: Conducted in a 13-bed PACU at HHSSMC. Sample: Patients discharged home with a urinary catheter from the HHSSMC PACU after surgery over 3 months.

IMPLEMENTATION:

To promote early education, the perianesthesia staff at HHSSMC partnered with the pre-anesthesia teaching and testing (PATT) department on a process to include urinary catheter care education before the day of surgery. Additionally, the preoperative nurses provide the patient/family with the video QR code to watch before surgery. After surgery, the PACU nurses at HHSSMC utilize multi-modal patient education, including an instructional video, printed instructions, verbal education, and hands-on demonstration. All patients with a urinary catheter are sent home with a standard go-home kit with the needed supplies.

RESULTS/FINDINGS:

Between April 1st and June 22nd, 2024, ninety patients went home with a urinary catheter from the HHSSMC PACU. Of these patients, sixty-nine (77%)​ were surveyed via follow-up phone calls about their experience. Seventeen patients were not reachable by phone after two attempts and four patients had a language barrier that prevented follow-up phone calls.

Early Education: We identified room for improvement in early education as only ten (14.5%) patients out of sixty-nine stated that they received urinary catheter care education before surgery. Five patients indicated receiving preprocedural urinary catheter education from the preoperative nurse. Four stated they received this education from their urologist. One said they received education on urinary catheter care from the pre-anesthesia teaching and testing (PATT) nurse.  

Multimodal Teaching Methods: Patients were asked which methods of urinary catheter education they received. Thirty-three patients (47%) stated that they received all four teaching methods, i.e., hands-on, printed, verbal, and video. Twenty (29%) stated they received three of the four methods. Twelve (17%) received only two of the four available methods, and three (4%) remembered receiving only one method of education.

Standard Supply Kits: When asked about receiving the standardized supply kits, fifty-nine (85.5%) patients identified being sent home with the standard supply kit and printed instructions. These patients stated that they had everything they needed to care for their urinary catheter at home.

Satisfaction with preparedness: Finally, patients were asked to rate their satisfaction on a scale of 1-5 for how prepared they were to care for their urinary catheter at home upon discharge from the PACU. Forty-four were "very satisfied," twelve were "satisfied," seven were "somewhat satisfied," and one stated that they were "definitely not satisfied." 

NURSING IMPLICATIONS:

This successful nurse-driven, patient-focused research project aimed to provide an evidence-based process to prepare patients for self-care of their urinary catheter. The perianesthesia nurses identified an area for improved patient care and utilized evidence-based strategies to address the need. Eighty-one percent of surveyed patients stated they were "very satisfied" or "satisfied" with their preparedness to care for their urinary catheter after discharge.

Artificial Intelligence (AI) is rapidly advancing and becoming an integral part of daily life and specialized fields, including nursing academics and patient care. As AI becomes more conversational and intuitive, AI can understand context with better accuracy and is being used more and more to support students and patients alike. The purpose of this article is to discuss AI's potential to reshape patient care in the clinical setting.

What is Artificial Intelligence?

The National Institutes of Health National Cancer Institute (2025) defines AI as a feature or ability of a computer to learn and perform tasks that have historically required human intelligence and decision-making abilities to perform. Computers can review and analyze large amounts of data and information in less time than human intelligence. AI excels in learning and identifying patterns and relationships from extensive, multidimensional, and multimodal datasets. For instance, AI systems can condense a patient's entire medical record into a single number indicating a probable diagnosis (Bajwa, Munir, Nori, & Williams, 2021).

AI is not a single, all-encompassing technology; rather, it encompasses various subfields, such as machine learning and deep learning, which individually or collectively enhance the intelligence of applications (Bajwa et al., 2021). Artificial Intelligence (AI) is already being used in the healthcare setting. Robots assist with surgery, algorithms guide clinical decision-making, and talk-to-text devices facilitate documentation.

Artificial Intelligence and Healthcare

As AI impacts our personal and professional lives, several questions are raised. Can AI help reshape patient care for improved outcomes? Is AI appropriate for the clinical setting? Are we relying too much on "machines" to guide our decision-making or treatment modalities? What amount of AI use is too much? Is AI elevating our knowledge or replacing it? These, as well as many other questions, enter healthcare professionals' minds as well as the general population.

Artificial Intelligence and Healthcare Providers

Healthcare uses AI for patient complications and communication, remote monitoring of patients, new drug development, medical imaging, and predictive analysis (Cato & Tiase, 2025). The development of early diagnostic tools is particularly difficult due to the complexity of various disease mechanisms and their underlying symptoms. AI can potentially transform multiple aspects of healthcare, including personalized treatment plans, early detection and prevention of disease, and diagnosis (Alowais et al., 2023).

Machine learning (ML), a subset of AI, leverages data as an input resource, with its accuracy heavily reliant on the quantity and quality of the input data. This can help address some of the challenges and complexities of diagnosis. In essence, ML can aid in decision-making, streamline workflows, and automate tasks efficiently and cost-effectively. Additionally, deep learning, which incorporates "layers such as Convolutional Neural Networks (CNN) and data mining techniques, helps identify data patterns" (Alowais et al., 2023). These methods are particularly useful in detecting key disease patterns within large datasets. Such tools are highly applicable in healthcare systems for diagnosing, predicting, and classifying diseases (Alowais et al., 2023).

Artificial Intelligence and The Human Element of Care

The American Medical Association, in collaboration with Manatt Health Strategies, published an executive summary titled "Future of Health: The Emerging Landscape of Augmented Intelligence in Health Care" (AMA, 2024) summarizing the current use of Augmented Intelligence (AI) and its possible future developmental potentials, to help providers make informed decision on the usage of AI tools. The AMA uses augmented intelligence, not artificial intelligence, as it shows its use is in a supportive capacity and not a replacement for human intelligence. "As of October 2023, the U.S. Food and Drug Administration (FDA) has approved 692 artificial intelligence/machine learning medical devices, of which 531 are in radiology, 71 are in cardiology, and 20 are in neurology" (AMA, 2024).

Healthcare providers need to ensure they can leverage AI benefits while still maintaining expertise in their fields, maintaining ethical care, and not compromising patient well-being. If providers rely on AI too much, provider-patient relationships may be compromised, and critical factors such as cultural and psychological concerns or needs may be missed. Privacy and security issues may become more of a concern as technology surrounding AI advances. Although AI continues to be used in healthcare, ethical guidelines should continue to be followed, there should be robust oversight of healthcare providers and other professionals, and patient-centered care should remain an important component (Alowais et al., 2023; AMA, 2024).

Conclusion

Healthcare providers are curious about the potential use of AI to enhance diagnostic precision, reduce errors or misdiagnoses, and increase efficiency while reducing the burden of financial responsibility of hiring more staff during times of shortage (Robeznieks, 2024). As AI continues to have the potential to improve patient care outcomes, healthcare providers will need to find a balance between using AI and traditional methods for patient care.

The U.S. measles outbreak, as of March 27, 2025, includes 483 confirmed cases across 20 jurisdictions. Fourteen percent have been hospitalized, and, sadly, there is one confirmed measles death and one death under investigation (Centers for Disease Control and Prevention, 2025). Will Humble, Executive Director of the Arizona Public Health Association, stated, "Measles outbreaks are like wildfires: both get out of control fast if they're not immediately detected and managed" (Humble, 2025, para. 1). Will, like me, is a measles survivor. I was too young to remember my symptoms, but my mother and Will's mother did as he shared on KJZZ (2025) detailing the severity of his illness. Any parent with children before developing the measles vaccine in the 1950s (World Health Organization, n.d.) was acutely aware of the danger measles posed. Unfortunately, by the time you read this article, there will be more cases and likely spread beyond Texas and New Mexico.

As a 1992 Arizona hospital nurse, I was advised during a report that my patient in the isolation room) had a high fever, photophobia, and a rash of unknown origin. The infectious disease docs were stymied, but Alice, an older nurse on the unit, pulled me by the arm to the room, stood at the door, and flashed the lights on. My patient shielded her eyes, and Alice, hands on her hips, said, "Measles! I've seen it a million times!" By 1992, measles was a mere memory for most contemporary U.S. healthcare providers due to the widespread access and acceptance of vaccines.

Measles and other vaccine-preventable diseases are not a memory for all families around the globe. A child dies every 20 seconds around the world from a vaccine-preventable disease. Measles vaccinations alone, from 2000 to 2022, prevented 57 million deaths (2025, U.N. Foundation, Shot@Life Summit). Nurses know that disease prevention is morally and ethically the right thing to do. Supporting international vaccine delivery systems is fiscally responsible as well. Fifty dollars in healthcare costs, lost wages, and lost productivity are saved for every dollar spent on vaccine support systems. Do you remember the 2008 Tucson measles outbreak of 14 cases? The two hospitals involved spent nearly $800,000 ($1,000,000 in 2025 dollars) responding to and containing the 7 cases in their facilities (Chen et al., 2011). The cited article did not capture the costs of community containment by the health department.

Preventing disease is always better than treating it; we know that U.S. measles cases originate from unvaccinated international travelers (Mathis et al., 2024), and sustaining global vaccination programs saves lives and dollars. Provision 9 of the Code of Ethics for Nurses states, "Nurses and their professional organizations work to enact and resource practices, policies, and legislation to promote social justice, eliminate health inequities, and facilitate human flourishing" (American Nurses Association, 2025, para.1) with further direction to engage in the political process and remain vigilant influencing our leaders and legislators. Our professional duty is to educate our leaders and legislators that global equitable access to vaccines is morally, ethically, and fiscally right.

Discovering a New Perspective

Neva L. Crogan-Pomilla, PhD, ARNP, GNP-BC, FAAN

Sometimes, experiencing healthcare helps a person gain a new perspective. I've been a nurse for 45 years, so I've seen practices come and go. But this last January 2024, I experienced a situation that made me wonder. My 63-year-old disabled husband with Parkinson's disease was diagnosed with prostate cancer and underwent a laparoscopic prostatectomy using robotics. We were both thankful for the high-tech nature of the surgery and his skilled surgeon. Soon after the surgery, he was scooped up and wheelchaired out to our car. Our neighbor helped him into the backseat of the car, and we headed home. Upon getting home, he was weak, groggy, and unsteady. My neighbor practically carried him into the house to his lounge chair. I could not have done this alone.

We soon settled down into him being the patient and me being the nurse on duty for the next 72 hours. I got little sleep during this time due to his need for pain management (the surgeon provided no pain Rx), his need for assistance managing his Foley catheter, and the constant need/requests for food, water, and/or coffee.

The whole experience was disturbing to me. First, why weren't pain management or better instructions provided? The discharging nurse said to take Tylenol. That was it. What about other non-opioid interventions? Second, why was my husband sent home when he could not care for himself? What do older adults do when they get home to an empty house? I at least had some knowledge of what to do, even though 72 hours of being on "duty" was not anticipated and was too much for me.

How would the average older adult cope with my situation? Reviewing the materials provided by the surgery center, they could call the surgeon's office with questions. However, how much hands-on help can be provided via phone? If they no longer deal with the situation, they could call 911 and have him transported to the Emergency Department via ambulance. I wonder how many times this happens.

Thinking about this situation, I wondered: How often do Medicare patients go to the ED following an outpatient prostatectomy? A review of PubMed and CINAHL databases found no recent (past 5 years) research on this subject. Findings revolved around orthopedic procedures such as hand surgery, hip arthroscopy, rotator cuff repair, and total joint replacement.

As the nurse, what could you do? Become a strong advocate for your patients. Ask them what resources they have at home. Do not discharge someone home unless they can care for themselves or there is help waiting for them. Discuss pain management. Make sure the patient and family know the plan and when to call for assistance.

Whether on-ground or virtually, there are multiple generations enrolled in nursing program classrooms as well as practicing in simulation laboratories and clinical settings. Generational characteristics suggest a varied and different set of attitudes, beliefs, and experiences (Pick et al, 2017). Taking this into consideration will need a multigenerational approach in preparing tomorrow's nurses by using different generational teams to foster an appreciation of each other's beliefs, values, learning, communication styles, and thinking processes (Kramer, 2010).

The recent 2023-2024 National League of Nurses Survey of Schools of Nursing indicates that approximately 7.2% of students who attend nursing programs are from the Baby Boomer generation (ages 55 to 73) or Generation X ( ages 40-54) generations. At the same time, 92% of students are from Generation Y (ages 25-39) and Generation Z (ages <24). These figures suggest that nursing schools should look deeper into the current teaching and learning styles employed to manage the multigenerational landscape.

Navigating these multigenerational classrooms and clinical experiences involves leveraging the unique skills, perspectives, and experiences of the learners from these generations to ensure and create a dynamic, interactive, and innovative learning environment.

Here are some suggested ways to best manage opportunities in multigenerational classrooms:

• Cultivate open communication that takes into consideration the preferred communication mode of each generation. This can be done by recognizing the preferred communication style of each group and various modalities that match each generation's preference, such as face-to-face opportunities, email, or other digital tools available like chat groups and other communication applications, such as short messaging systems (SMS) that facilitate faster and convenient exchange of ideas.

• Provide activities in the classroom, simulation laboratories, and clinical settings that promote collaboration among different generations, where they can each contribute their unique generational strengths. For example, Baby boomers have vast and longer experiences in the work setting, which include leadership skills. At the same time, Generation X students can incorporate their high adaptability skills and result-driven mindset. Generation Y, also known as the Millennial group, can contribute their tech savviness that pervades not only the school setting but also the workplace, and Generation Z can contribute their digital fluency and entrepreneurial mindset. As we see the beginning of the Alpha generation (born between 2010 and 2025) entering college, there will be students highly adept in handling the latest technology as much as Generation Z and Y, which includes their use and comfort with artificial intelligence.

• Promote an environment where the learning experience can be tailored uniquely to each individual or group by reflecting on the importance of the "why" of the topic instead of just teaching the "need to know" and "must know." This shift in perspective is directly aligned with Generation Z's approach, which is the fast turnaround of information, but also for all other generations to maintain focus on the meaning and purpose of the teaching and learning experience.

• Invest in technology and resources to promote continuous learning for students, especially those from the Baby Boomer and Generation X groups. Examples of this technology can include electronic health charting (EHR) applications and medication scanning equipment that mirror similar programs used in clinical settings, which will assist in familiarizing the older generations to be more comfortable using these technologies.

By creating a culture that values the preparation of multigenerational students, we can help prepare practice-ready nurses who are comfortable to care for clients across the lifespan.

Academic and health systems leadership have experienced a rapid season of change following the COVID-19 pandemic amidst a wave of retirements and normal job turnover. The increased availability of permanent leadership positions, juxtaposed against a dwindling experienced workforce, has caused many organizations to move nurses into interim or acting leadership roles. The challenges facing nurses in these leadership positions are numerous, not the least of which is uncertainty over how long the "temporary" position will last. Having experienced this uncertainty in academia and health systems, the authors have crafted some lessons learned to help others navigate this journey.

Functioning as an interim leader can be compared to the scenario of serving as an understudy in a play. Thus, "playing the part" means preparing yourself to step in for the permanent leader when necessary, being willing to take on the trappings of the role, and functioning as the active leader- even if permanence is not guaranteed. When interim leadership is necessary, changes are underway, and timing may be urgent. For some people, being overseen by the interim leader can create uncertainty.

When leading during a season of uncertainty, principles from adaptive leadership can be helpful in navigating the role. Based on the framework of Adaptive Leadership described by Heifetz and Linsky (2009), the effective leader demonstrates three key features: relational congruence, technical competence, and adaptive capacity. Relational congruence is shown by knowing the people you work with and establishing trust. Technical competence involves managing the day-to-day work with completeness and in accountable ways. Adaptive capacity is developed by the leader and those they lead by working through challenges with a growth mindset. A good way to operationalize adaptive leadership is to stay calm, stay connected with others, and stay the course.

Yet, the question remains: how do you enact "playing the part" if you are not assured you will have the permanent role? In short, you don't. Yet, there is value and learning in serving regardless. Our experience taught us the value of "showing up," acknowledging institutional history, supporting people to engage in the daily work, demonstrating staff support to build trust, and collaborating effectively with others at all levels of leadership. Using organization resources for supervisor training, peer leadership groups, and engaging with professional networks provides useful support for navigating policies and managing others. Supporting effective interim management requires collaborating with long-term staff and engaging with informal leaders in your specific setting.

Accepting an interim leadership role is exciting and challenging. Remember, you were asked to step into the role because others saw the potential for you to be successful in playing the part. Whether you ultimately secure the permanent position or not, it is essential to leverage your existing relationships to sustain others' trust while growing in confidence as you learn the new role.

Saturday, July 26, 2025 - 37th Annual Nurse Practitioner Symposium

Registration Now Open!

Accepting Exhibitors and Sponsors

Friday, September 12 - Saturday, September 13, 2025 - AzNA Convention

More info coming soon

Accepting Exhibitors and Sponsors

For more information, visit www.aznurse.org/events.

Registration is now open for the 37th Annual Nurse Practitioner Symposium, to be held on July 26, 2025 at the Sheraton Mesa Hotel at Wrigleyville West in Mesa, Arizona.

This event is held to review and update current concepts in clinical and practice management for advanced practice nurses and advanced practice nursing students. Most breakout sessions contain pharmacology contact hours.

This year's keynote presentation will feature April Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN and her presentation, "Empowering the NP Profession: Where We've Been and Where We're Going."

This year's breakout speakers:

Pharmacology and Clinical Updates:

• Top New Meds for 2025 with Angie Golden

• New Cardio Tech with Vidette Argente

• Pharmacology in Women's Health with Melanie Logue

• Primary Care Cardio and Afib Updates with Dani Piar

• Sleep Apnea 

• Community of Practice: Environmental Impacts/Social Determinants of Health with Adriana Perez

• Nephrology Updates for 2025 with Kristin Larson

• Human Trafficking with John Fraleigh

Best Practices for Independent Practice: 

• Current trends in NP liability claims

• Billing and Coding with Bessie Burk

• AI for NPs with April Kapu

• Legal Implications of Independent Practice with Randy Quinn

Advance Your Career:

• New to Practice CV Writing and Contract Negotiation with Heidi Sanborn, Bessie Burk and Shelley Vaughn

• CVs for Specialties and Academia with Heidi Sanborn, Bessie Burk and Shelley Vaughn

• Participate in Mock Interviews

• NP Career Fields and Opportunities with Erlinda Singarajah, Courtney McMeekin

Learn more and register at www.aznurse.org/npsymposium.

Call for Exhibitors and Sponsors

AzNA is looking for exciting companies to be exhibitors at its upcoming events. The following events have open spaces for exhibitors:

• Nurse Practitioner Symposium, July 26, 2025

For more information, visit www.aznurse.org/events or email Madi Moyer, AzNA Communication and Event Manager at madi@aznurse.org.

Happy Anniversary to our dedicated AzNA members celebrating these special milestones for this past quarter: December 2024 - February 2025

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