Life as a Nurse Educator

Outsider Insider View

2009-08-29T18:06:00.003-04:00

I am not a nurse, nor do I play one on TV. I'm a professor of English appointed to a school of nursing where I support faculty and students in their writing projects. This gives me an outsider insider view of nursing education.

No one goes into nursing because they love writing. A high school or college student doesn't tell an admissions counselor, "I'm a talented and gifted writer, so I thought I'd become a nurse."

However, writing is essential to nursing in a variety of ways. Nurses write documentation of patients' conditions and treatments. Nurses write care plans. Nurses research and write proposals for changes in practice. Nurses write educational materials for patients. Nurses write health-promotion articles for general-audience periodicals. Nurse scholars and researchers disseminate their findings in written articles and prepared presentations.

Nurses also write creatively in essays and poetry about their experiences.

So while writing is not the attraction of nursing (improving the health or quality of life for patients is that), writing is central to the work of nursing.

Nursing undergraduates (like undergraduates in other practice or technical fields) should be encouraged to write in a variety of media, genres and forms, including informal (like blogs) and creative (like poetry, personal essays, and narrative) writing.

--Thomas Lawrence Long, PhD
http://nursingwriting.wordpress.com/

Inpatient clinical

2009-08-26T14:10:00.002-04:00

I think I mentioned before that I'll also be teaching 2 sections of clinical in a children's hospital. I had one last semester and thoroughly enjoyed myself. And I learned a tremendous amount being in the clinical setting.

Orientation to the unit and hospital is a bit overwhelming for students. They need to become familiar with

Using the electronic medical record
Medication administration (and many other) policies
Fire and safety routines
Confidentiality rules and regulations
Growth and development and how they're affected by hospitalization
Physical assessment approaches to be used with children
Calculation of medication doses
Use of IV (and several other) infusion pumps
Use of cardiorespiratory monitors
Ways to work with paraprofessional staff
Where the dining room and restrooms are
How to chart on the paper flowsheet
How to monitor IVs and document their infusion
How to alphanumerically page staff
Location of the Code cart
Written requirements for the clinical
How they'll be evaluated
Working collaboratively with families

And that's just a partial list of what we'll do the first day after getting our ID badges!

One of the hardest and most frustrating tasks for students is figuring out what I, as their instructor, expect of them. They're seniors so they've experienced subacute, adult, and mental health clinical. While they're doing pediatric nursing, they'll also be doing maternity nursing. So they've had to learn to "go with the flow" and I'm sure they'll do fine.

Despite the lengthy "to do" list for that first day, I'm REALLY looking forward to it. I can't say I'm looking forward to being on the unit at 0630, but there it is.... That's life, right?

Art

Thoughts about school health projects...

2009-08-26T13:40:00.000-04:00

We have our pre-semester meeting for undergraduate pediatric nursing today. The goal is for us all to have the same requirements and the same evaluation methods. Seemingly simple but amazingly challenging to accomplish, even with fewer than 10 faculty!

I've been working on the projects we might take on in the school health component of this course. There are many, many possibilities in addition to the usual height, weight, BMI, vision, and hearing screening. We might be able to do BP and asthma screening. I also got a number of good ideas looking at a calendar of health-related events, for example, School Lunch Week, Peak Experience USA (asthma management), and Henry the Hand (a delightful curriculum on hand hygiene for all grades).

Another community-based clinical learning experience consists of a visit to a local pharmacy (Lieber, 1997). There students examine the number of over-the-counter remedies available for a preassigned common infant/child problem, for example, pediculosis (did you know there's actually a National Pediculosis Association? Their website is www.headlice.org!), contact dermatitis, colds and coughs, and others. The purposes of this assignment are to

Help students learn about the management of common pediatric health problems by nonprescription drugs
Identify problems that parents may have with administration of medications
Identify the nurse's responsibility in recommending medications

Students gather these data about the medications for their assigned condition:

Name and ingredients
Classification
Dosage and frequency
Administration directions
Any difficulties with the directions
Number of days to be given
Expected results
Side effects
Price
Availability of other drugs for same condition

We'll discuss the findings in post-conferences and see if we can come to any decisions about recommendations for parents regarding these medications. For more information on this project, check out Marilyn T. Lieber's 1997 article, "Community-Based Pediatric Experiences: Education for the Future," in Journal of Pediatric Nursing, 12(2), 85-88.

Other ideas? I'd love to hear them.

Art

Year 17 coming up....

2009-08-09T10:49:00.000-04:00

I've been a nurse half my life! I can hardly imagine being anything else. Before I became a nurse though, I worked as a hospital orderly, a farm worker/construction worker/cowherd, day care worker, and junior high school teacher. Nursing is the only job I've had that makes me want to come back to work, regardless of what kind of day I've had. As I tell my students, nurses can (and do) make a difference to patients and families every single day you go to work, without fail.

I began my nursing career in the neonatal intensive care unit as a staff nurse, then a charge nurse, and finally a transport nurse. I worked in that setting for 11 years, enjoying almost all of the experiences I had. I think being a charge nurse was the least satisfying tho. I'm just not a manager/leader. I also worked in the PICU some and found that not as attractive because of the shorter lengths of stay and the limited opportunities to engage with families and children over longer periods.

As a nurse practitioner, I found a lot of satisfaction in the different kind of relationship I was able to establish with families and babies. It wasn't the hands-on care of feeding, diapering, vital signs, medications, and all the myriad responsibilities and tasks of the staff nurse. I found tho that as a staff nurse I would be taking care of different babies almost every day I went to work. So, yes, for that 12 hours, I had an intimate relationship with that baby and that family, but it didn't continue.

As a nurse practitioner, I was able to have a relationship that extended over days, weeks, and sometimes months because babies on the NNP team were cared for by the same NNPs for their entire hospitalization. I liked knowing what was going on and being part of the decision-making process involved in the care of these fragile patients and their families.

I finished my master's degree in pediatric primary care and obtained my certificate as a neonatal nurse practitioner while working as a neonatal transport nurse. Finally, I began my doctorate in nursing to learn more about families and helping them to cope with the stresses of having a sick newborn.

When I was approached about the possibility of teaching in a new NNP master's program, I took the chance. Although it meant a huge cut in salary, I was able to make the change.

I began my first teaching job in the NNP master's program in 1993 and continued in that position through 1999, when I finished my doctorate. I then moved to a different university and continued to teach master's students. I also became involved in teaching undergraduate nursing students, which I found very rewarding and challenging. Over the course of the next few years, my interests shifted from neonatal intensive care to general pediatric nurse, a field in which I hadn't really practiced before.

My undergraduate teaching experience has included teaching nursing research, an introduction to health, pediatric nursing, nursing leadership, and nursing ethics. Up until last fall, tho, I had not taught undergraduate clinical. During Fall 2008 I was in Cape Town, South Africa, where I did teach undergraduate pediatric clinical, pediatric nursing, and nursing ethics with a group of 14 senior nursing students from my university. I thoroughly enjoyed it, especially being back in a setting with families and children, and asked to teach a clinical section during Spring 2009, which I did (more about this later).

I'm just finishing up teaching pediatric nursing for our second-degree students this week. It's been a hectic five weeks, but we're almost finished. At the end of the month, I'll have 2 sections of pediatric clinical in a children's hospital, and 1 in a school. Interestingly, my son will be in kindergarten at the school where I'll have my students. In the spring I'll have one section of clinical at the children's hospital and two sections of nursing leadership.

So much for the first post on this blog. I'm hoping to reflect on my experiences as an educator and see what others might be able to share about their own.

Art