Background: The 2019 coronavirus (COVID-19) pandemic placed unprecedented strains on the U.S. health care system, putting health care workers (HCWs) at increased risk for experiencing moral injury (MI). Moral resilience (MR), the ability to preserve or restore integrity, has been proposed as a resource to mitigate the detrimental effects of MI among HCWs. Objectives: The objectives of this study were to investigate the prevalence of MI among HCWs, to identify the relationship among factors that predict MI, and to determine whether MR can act as buffer against it. Design: Web-based exploratory survey. Setting/Subjects: HCWs from a research network in the U.S. mid-Atlantic region. Measurements: Survey items included: our outcome, Moral Injury Symptoms Scale–Health Professional (MISS-HP), and predictors including demographics, items derived from the Rushton Moral Resilience Scale (RMRS), and ethical concerns index (ECI). Results: Sixty-five percent of 595 respondents provided COVID-19 care. The overall prevalence of clinically significant MI in HCWs was 32.4%; nurses reporting the highest occurrence. Higher scores on each of the ECI items were significantly positively associated with higher MI symptoms ( p < 0.05). MI among HCWs was significantly related to the following: MR score, ECI score, religious affiliation, and having ≥20 years in their profession. MR was a moderator of the effect of years of experience on MI. Conclusions: HCWs are experiencing MI during the pandemic. MR offers a promising individual resource to buffer the detrimental impact of MI. Further research is needed to understand how to cultivate MR, reduce ECI, and understand other systems level factors to prevent MI symptoms in U.S. HCWs.

The words, "you have breast cancer," is possibly one of the most devastating statements an individual could image hearing from his or her physician even though breast cancer is the most common cancer among women. The diagnosis bears a significant amount of anxiety and fear in regards to treatment and overall survival. However, research has increased healthcare professionals' knowledge on the benefits of early screening, diagnosis, and treatments, which has steadily reduced the death rate from breast cancer over the past 20 years. Physicians are better able to predict how particular breast cancers will react to treatment; therefore, they are able to choose more effective treatment options based on these findings. The goal of this article is to highlight the incidence, staging and diagnostic studies, types, treatments, and follow-up of breast cancer dispelling some of the common societal stigmas and unfounded fears surrounding this diagnosis.

Chemotherapy involves an intricate, high-risk, multidisciplinary process of prescribing, dispensing, and administering complex multimedication regimens with narrow therapeutic indices. Chemotherapeutic agents also require safe-handling precautions for patients and healthcare providers. In addition, a number of chemotherapy and targeted therapies have expanded to nononcology populations. This complexity demands standardization of chemotherapy practice for all healthcare providers to ensure safe outcomes. This article describes one organization's multidisciplinary effort to standardize chemotherapy practice according to the American Society of Clinical Oncology and Oncology Nursing Society's 31 safety standards for chemotherapy administration. The article also describes how the organization integrated and developed standards of practice using interdisciplinary approaches. The educational processes used during implementation and the lessons learned are discussed to assist healthcare providers involved in standardizing chemotherapy administration. The article equips healthcare professionals with a multidisciplinary process for high-quality clinical standards of practice that may reduce errors and ensure safety.

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The national nursing shortage demands innovative strategies to attract students to the nursing profession. This article provides a potential solution for recruiting and retaining nurses for specialty areas of nursing as well as professional nursing associations by pairing student nurses with professional nurses who belong to nursing associations. An immersion program such as the one described in this article provides a strategy that addresses the nursing work force shortage and professional association membership. The experiential knowledge gained through this type of program may advance the profession throughout the country.