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Context: Patients with cancer-related pain and concurrent substance use disorder (SUD) present a unique set of challenges for palliative care clinicians. A structured forum for interdisciplinary collaboration is needed to effectively manage this complex population. Objectives: Describe the feasibility and acceptability of a palliative care Complex Pain Board (CPB), an interdisciplinary team meeting to provide concrete care recommendations for patients with cancer-related pain and concurrent SUD and/or psychosocial complexity. Methods: We conducted a retrospective analysis of cases presented at CPB between May 2021 and June 2022 and a cross-sectional analysis of CBP participant surveys. Results: Among 28 cases included for analysis, gastrointestinal cancers (n = 7, 25.9%) and multiple myeloma (n = 5, 18.5%) were the most frequent cancer diagnoses. Primary reasons for referral were SUD (n = 22, 78.6%) and provider/team distress (n = 13, 46.4%). The most frequent recommendations made at CBP were encouraging interdisciplinary collaboration (n = 18, 64.3%), maintaining healthy boundaries (n = 15, 53.6%), and SUD management (n = 13, 46.4%). Of 14 scheduled meetings, most meetings involved the presentation of ≥1 cases (n = 12, 86%). Among 40 CBP participant surveys, most attendees (n = 38, 95%) were likely or highly likely to continue to attend. Conclusion: CPB is a feasible and acceptable intervention that allows for palliative care clinicians to collaborate and receive interdisciplinary team feedback and peer support on the management of patients with cancer-related pain and concurrent SUD and/or psychosocial complexity in the ambulatory care setting. Key Message: A regular, interdisciplinary team meeting (CPB) is a feasible and acceptable intervention to help palliative care clinicians manage challenging cases involving patients with cancer and concurrent SUD and/or psychosocial complexity.

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In this column, Dr Reid Ponte interviews Monica O'Reilly-Jacob, PhD, FNP-BC, Assistant Professor of Nursing, Connell School of Nursing, Chestnut Hill, MA. Dr O'Reilly-Jacob addresses her personal and professional commitment to timely and cost-effective healthcare provided by nurse practitioners working at their full scope of practice.

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In this column, Dr J. Margo Brooks Carthon discusses her work to support access to quality healthcare services for patients in minority and less than affluent circumstances. Dr Brooks Carthon has worked in a collaborative known as THRIVE. The program has offered intensive wrap-around clinical and social services and has positively impacted the wellness of chronically ill individuals.

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This month's column is an interview with Dr Janeane N. Anderson, assistant professor, College of Nursing, at the University of Tennessee Health Science Center (UTHSC) in Memphis who is a health communication scholar with a focus on patient-provider communication and healthcare disparities.

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This month's column is an interview with Dr Judy Davidson, nurse scientist, University of California, San Diego Health Sciences Center. Dr Davidson has devoted a large part of her research to the reporting and prevention of nurse suicide.

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This past year brought the deadliest pandemic of our time and a huge social awakening and movement for racial justice. It became clear to me in late spring that I needed to learn more about structural racism, White supremacy, racial healthcare disparities, unconscious bias, and my own prejudices that govern my attitudes, values, behaviors, and decisions as a nurse leader, faculty member, board member, and a human being. To that end, I began to read, watch, and listen to both scholarly and lay journals and media that provide historical and current empirical accounts and studies of how racism and White supremacy have dominated our society, organizations, and communities in the United States for hundreds of years.

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In this Inspiration Column, Pat Reid Ponte interviews Lisa J. Sundean, PhD, MHA, RN, associate professor, University of Massachusetts Boston. Dr Sundean has devoted her career to support the inclusion of nurses on boards.

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In this month's Inspiration Point, Dr Patricia Reid Ponte interviews Dr Karen Bankston, PhD, MSN, FACHE.

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In this column, Dr Reid-Ponte interviews Dr Karen Cox, current president of the American Academy of Nursing and chief operating officer for Children's Mercy Hospital in Kansas City. Dr Cox discusses her leadership trajectory and lessons learned.

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BACKGROUND: The hospitalization of a family member in an intensive care unit can be stressful for the family. Family bedside rounds is a way for the care team to inform family members, answer questions, and involve them in care decisions. The experiences of family members with intensive care unit bedside rounds have been examined in few studies. OBJECTIVES: To describe (1) the experiences of family members of patients in the intensive care unit who participated in family bedside rounds (ie, view of the illness, role in future management, and long-term consequences on individual and family functioning) and (2) the experiences of families who chose not to participate in family bedside rounds and their perspectives regarding its value, their illness view, and future involvement in care. METHODS: A qualitative descriptive study was done, undergirded by the Family Management Style Framework, examining families that participated and those that did not. RESULTS: Most families that participated (80%) found the process helpful. One overarching theme, Making a Connection: Comfort and Confidence, emerged from participating families. Two major factors influenced how that connection was made: consistency and preparing families for the future. Three types of consistency were identified: consistency in information being shared, in when rounds were being held, and in informing families of rounding delays. In terms of preparing families for the future, families appeared to feel comfortable with the situation when a connection was present. When any of the factors were missing, families described feelings of anger, frustration, and fear. Family members who did not participate described similar feelings and fear of the unknown because of not having participated. CONCLUSION: What health care providers say to patients' families matters. Families may need to be included in decision-making with honest, consistent, easy-to-understand information.

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Patient- and family-centered care is a central tenet of nursing practice. This concept has evolved to include patient partnerships, patient engagement, and patient activation. This column differentiates these concepts and describes the core principles embedded in the overriding intention of ensuring that patients (and their families or significant others) are orchestrators of their health and their care plans. In this interview, Karen Drenkard, PhD, RN, FAAN, NEA-BC, CNO, of the GetWellNetwork, discusses work by the O'Neil Center as a leader in this area.

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In this column, nurse scientist Lusine Poghosyan, PhD, MPH, RN, FAAN, is interviewed. Dr Poghosyan has focused her research on advancing the role of nurse practitioners in primary care.

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OBJECTIVES: To examine accountability and performance measurement in health care and present a case study that illustrates the link between goal setting and measurement and how a strategic plan can provide a framework for metric selection. DATA SOURCES: National reports, literature review and institutional experience. CONCLUSION: Nurse leaders and clinicians in oncology settings are challenged to anticipate future trends in oncology care and create a culture, infrastructure, and practice environment that supports innovation, advancement of oncology nursing practice and excellence in patient- and family-centered care. Performance metrics assessing key processes and outcomes of care are essential to meet this challenge. IMPLICATIONS FOR NURSING PRACTICE: With an increasing number of national organizations offering their version of key quality standards and metrics, it is critical for nurses to have a formal process in place to determine and implement the measures most useful in guiding change for a particular clinical setting.

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Nurse residency programs have been developed with the goal of helping newly licensed nurses successfully transition to independent practice. The authors propose that all newly licensed nurses hired in acute care hospitals be required to complete an accredited residency program. An evidence table examines the state of the science related to transition-to-practice programs and provides the basis for recommendations.

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PURPOSE: This article examines the evolution of Doctor of Nursing Science (DNS or DNSc) and Doctor of Science in Nursing (DSN) degrees, including their emergence as research-intensive doctoral degrees in the 1960s, efforts to distinguish the degrees from the Doctor of Philosophy (PhD) and Doctor of Nursing Practice (DNP) degrees, the recent decline in program numbers, and implications for degree holders. APPROACH: The article reviews the U.S. history of doctoral education in nursing, research examining similarities and differences between the PhD and DNS, DNSc, or DSN degrees, and how the DNS, DNSc, or DSN degree differs from DNP programs. The article also examines the confusion regarding the focus of the DNS, DNSc, or DSN degree among nurses, patients, and potential funders; and describes actions taken by universities to address the confusion, with examples provided by academic deans, nurse leaders, and nurse researchers. FINDINGS: Longstanding confusion about the research merits of the DNS, DNSc, or DSN degree, and the growing prominence of the similarly-titled DNP degree, has created confusion about the focus of DNS, DNSc, or DSN programs and the capabilities of degree holders. Many universities have addressed this confusion by converting their DNS, DNSc, and DSN programs to a PhD or retroactively converting degrees to a PhD. Other universities have chosen not to pursue this route. CONCLUSIONS: The DNS, DNSc, or DSN experience highlights the importance of clarifying and standardizing the purpose and goals of nursing education programs and the repercussions for degree holders when such clarity is lacking. The international academic nursing communities have consistently pursued one doctoral-level nursing degree and therefore have not shared this challenging landscape in nursing education. CLINICAL RELEVANCE: Findings and recommendations presented in this article have implications for schools of nursing and professional groups that oversee the development of educational programs and pathways for nurses.

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The University of Massachusetts Boston and Dana-Farber/Harvard Cancer Center joined forces in 2009 to create a Postdoctoral Nursing Research Fellowship in Cancer and Health Disparities. In combining the resources of a large university and a research-intensive service institution, the postdoctoral program provides a new model for preparing nurse scientists to conduct independent research that advances nursing knowledge and interdisciplinary understanding of complex health issues. The multifaceted program consists of educational programming, research training, and career planning components. Additionally, each fellow is assigned a nurse scientist mentor and interdisciplinary co-mentor. The mentors support the fellows with scholarly activities and research training and help the fellows craft individualized career plans, including proposals for postfellowship career development research. In this article, the postdoctoral program leaders describe the program structure, strategies used to recruit minority and nonminority candidates, and data describing program outcomes and share lessons learned and recommendations for organizations that may be interested in establishing similar postdoctoral fellowships at their institutions.

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Nurse practitioners (NPs) and physician assistants (PAs) have long been part of the care model at our institution. Over the years, however, we have demonstrated a preference for NPs based on the belief that they can better meet our patients' needs. A recent evaluation of our care model led us to question these preferential hiring practices. After carefully examining NP and PA education and licensure requirements, scope of practice, and roles at our institution, we concluded that similarities between the roles far outweighed the differences and that our preferential hiring practices should be replaced by an individualized approach, in which advanced practice positions are filled by whichever candidate best meets the role requirements. This inclusive and analytic approach may be a useful model for other nurse leaders considering the NP/PA question.

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The chairperson of the Commission on Magnet Recognition provides an overview of current and future initiatives supporting cultures of excellence. The article examines the evolving focus on outcomes data and evidence, as well as the commitment of the commission to advancing nursing education at all levels.

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Over the past 13 years, the Dana-Farber Cancer Institute has embraced a patient- and family-centered model of care and culture of quality and safety. The authors discuss how their care delivery model and quality and safety efforts reinforce one another, and how they have shaped the organization's practice environment, governance structures, and systems and processes that support care delivery. The authors also discuss key values, structures, and processes that must be upheld to assure the advancement of patient- and family-centered care and quality and safety efforts within an institution.

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