The health care system requires nurses with the language ability and the cultural knowledge to meet the health care needs of ethnic minority immigrants. The recruitment, admission, retention, and graduation of English as a Second Language (ESL) students are essential to provide the workforce to meet the demands of the multicultural community. Yet, ESL students possess language difficulties that affect their academic achievement in nursing programs. The application of the Cummins Model of language proficiency is discussed. The Cummins Model provides a framework for nursing faculty to develop educational support that meets the learning needs of ESL students.

<h4>ABSTRACT</h4> <P>This qualitative research study examined the perceived barriers and factors that hindered or facilitated ethnically diverse students’ completing their nursing education. It builds on a large qualitative study conducted by Yoder in 1996, describing the processes nurse educators use when teaching ethnically diverse students and the perceived special needs of these students. Seventeen recently graduated ethnic minority RNs in Central Coastal California were interviewed using an open-ended questionnaire. These nurses represented Latino, Portuguese, Asian, and African-American population groups. Grounded theory methodology was used for data analysis. The findings identified the needs and barriers that ethnically diverse nursing students may encounter while completing their nursing education. In addition, data revealed supportive factors that helped these students cope with the barriers.</P> <h4>AUTHORS</h4> <p>Received: August 28, 2004</P> <p>Accepted: May 20, 2005</p> <p>Ms. Amaro is Nursing Instructor, Gavilan Community College, Gilroy, and Dr. Abriam-Yago and Dr. Yoder are Professors, San Jose State University, San Jose, California.</p> <p>Address correspondence to Debra J. Amaro, MS, RN, 6760 Stephan Court, Gilroy, CA 95020; e-mail: <a href="mailto:damaro@gavilan.edu">damaro@gavilan.edu</a>. </p>

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Like physicians, nurse practitioners should become familiar with and utilize the updated guidelines as standards of practice to promote and improve patient outcomes over the life span.

Heart failure (HF) is the heart's inability to meet the body's need for blood and oxygen. According to the American Heart Association 2013 update, approximately 5.1 million people are diagnosed with HF in the United States in 2006. Heart failure is the most common diagnosis for hospitalization. In the United States, the HF direct and indirect costs are estimated to be US $39.2 billion in 2010. To address this issue, nursing educators designed innovative teaching frameworks on HF management both in academia and in clinical settings. The model was based on 2 resources: the American Association of Heart Failure Nurses (2012) national nursing certification and the award-winning Pierce County Responsive Care Coordination Program. The HF educational program is divided into 4 modules. The initial modules offer foundational levels of Bloom's Taxonomy then progress to incorporate higher-levels of learning when modules 3 and 4 are reached. The applicability of the key components within each module allows formatting to enhance learning in all areas of nursing, from the emergency department to intensive care units to the medical-surgical step-down units. Also applicable would be to provide specific aspects of the modules to nurses who care for HF patients in skilled nursing facility, rehabilitation centers, and in the home-health care setting.