Nurse educators

I was just working with one of my other classes of nurse educators and it occurred to me that many VN instructors are nurses with BS degrees. Have any of you ever considered working with VN students? I have taught every level of nursing student (NA to PhD) and I have to say that VN students are one of my favorite. As many of your surely know, there are quite a few 'mercenaries' in ADN and prelicensure BSN programs - people who are only coming to nursing for the paycheck. Now while I will defend the right of a person to do a job for whatever reason they like, they need to do a good job, and many of these types of students seem unable or unwilling to adopt the attitude that a nurse requires to provide quality care.

What struck me about VN students is that almost all of them really wanted to be nurses. They weren't looking at 60k/year graduating, but $8-12/hour. And they were willing to go through an enormously stressful year in school to do it. They had the sort of passion that I imagine all nurses used to have back when they were paid poorly (before my time), and teaching them was truly a joy. It provided a way for me to help teach nurses how to be better nurses than I was taught to be - to learn from my experience and exponentially improve the care of patients and the culture of acute and long-term care.

It's an interesting job also in that it provides a decent amount of time off and is not terribly difficult once you get the first year or two out of the way (learning to teach your classes, etc). Unfortunately, the pay is lousy, and the rewards are more intrinsic than extrinsic.  What do you think? Is anyone interested in teaching VNs? It would make an interesting job for a student who was working their way up to an MS in nursing education. Let me know if you have questions about this, as I have a lot of experience to share on the topic.

 

A post in another class reminded me of a student I taught in a health science technology program in South Texas - let's call her Astria. Having had some experience with nursing care as a cerebral palsy patient, she had decided that caring for others was what she wanted to do with her life. Of course, the nursing schools in the area (a wide area) roundly rejected her on the basis that she would not have been able to preform the clinical skills necessary to be a nurse. Bear in mind, this was not yet even 20 year ago, in the early 1990s.

Is there no room in our professional culture for someone who does not practice clinically, at the bedside? Our mandate, to promote health, is not limited to activities requiring fine motor skills. It never has, really, at least not since I began work as an RN (1991). We've been all about organizing and managing patient care, in my experience, a responsibility for which Astria was quite well suited. Of course, we still get our hands dirty, but even with the magnet emphasis on BSNs providing primary care there are plenty of nursing jobs that do not require any clinical patient contact whatsoever.

Yet somehow, to work in one of those non-clinical positions, nurses are typically required to demonstrate clinical experience. We're expected to have "paid our dues" in the trenches. I recall graduating and being strongly urged to head for med-surg to "get my skills." I refused. Why go learn something I don't want to learn? Instead, I headed straight for the NICU, and later went to home health, where even "lacking skills" I did a fine job. As we seek to evolve into the administrative, consulting, and educational roles that health care desperately needs from us, what is it in our culture that prevents us from stepping up and realizing those roles? Certainly, nobody is suggesting that nurses give up clinical roles, just that those of us with the vision to take our unique set of intellectual skills away from the bedside be allowed to do so - and still lay claim to the title of nurse.

This is why I wonder what your plans are as soon-to-be BS and MS prepared nurses. Many positions for which your new degrees are required will remove you from the clinical setting. Is that OK? Will you still consider yourself nurses? What do you think? Does nursing = direct, skilled patient care?

Spring Break!

Praise the Lord and pass the ammunition: We made it!

Spring break is a landmark for a teacher, much as it is for student, but a bit different. Even if you teach full time in the summer, there are no meetings to speak of at most universities (unless you have a dreaded administrative position* or on a 12 month contract) and it's generally just more pleasant. To a faculty member in this position, spring break means that summer is just ahead, and if we can hold out just a little longer then we have three glorious months of relative freedom. 

So what do we do during spring break and the summer time? Ironically, we actually get some real work done. For instance, I am toiling on a manuscript over my spring break. And you know what? While it may seem crazy to work while you're on break, it's pretty fun working on this stuff without having to worry about meetings and such. It gives you time to enjoy life as well. I have a huge garden planned this summer. It's going to be awesome. 

That's the other thing I'll be doing over the next week (no, not just drinking, the beer is metaphorical): Enjoying a well-earned academic cease fire, bringing the wounded off of the battlefield, and resting up for another push. I advise you to do the same. Take some time and take care of yourselves, even if it's just a couple of hours per day, leftover minutes from catching up with all the things you've neglected, or whatever time you can beg, borrow, or steal. Enjoy! 

Btw, I know I owe you another blog post, and I have one coming. I was hoping for some response to my earlier post. Is anyone getting these still? Nobody has complained, but I'm getting the idea that folks are somehow even busier this semester than they usually are.

There was a lot of excellent discussion about professionalization or nursing and public policy on the discussion forums for Module One. Do you know what frustrates me the most about nursing (and scholars in general, really): A near complete lack of public intellectual scholarship. We don't talk to people! For the most part, we (faculty, that is) spend our time writing to be published rather than writing to be read. When we do write for an audience, it is typically for other scholars and peer-reviewed journals rather than for the lay public. I believe that we should be writing for an intelligent audience that lies outside of nursing. 

Especially considering the current climate of concern re: healthcare costs. Nursing has the answer to many of the problems facing American healthcare today, but we elect not to discuss these answers with the public for some reason. We tell our hospital administrators in the hopes they will do something, and we publish in journals that other nurses and academic read, but we do not publish in newspapers, online lay journals, and books that describe healthcare from our perspective.

My questions are these: 

• Why not? 
• How can we change?
• What might be some of the consequences of making waves? 
• How can we manage those waves as individuals and as a profession?

Sadly, my expertise lies in nursing education, and I therefore have little to contribute to this particular discussion from a standpoint of authority. We need to encourage practical-minded scholars –that is, nurse scholars who have one foot in academia and one foot in practice– and practicing professional nurses such as yourselves to take this ball and run with it. Who has ideas for how to get things started? I've done my best as a teacher of graduate and doctoral students, but there seems to be little reward for authors of such publications in a conventional sense. Still, is this not what is necessary to be a patient advocate? Did I miss something, or is patient advocacy not still our primary imperative as professional nurses?

Professional development

My biggest wonder around this time is "How do these students, who are finishing their capstone. feel about having nearly completed their bachelor's degrees?" Until I advanced my own education, I always felt that as baccalaureate meant little or nothing, simply because it typically didn't mean any more money. "If it was important," I would think to myself, "then they would be paid more." But I eventually came to realize that it wasn't so much about what you earned, but about what you were doing. While many RNs with BS degrees do work in the same positions as those without BS degrees, the baccalaureate opens a number of doors that would have hitherto been closed. It give you options. So who is exercising those options? Who wants to stay where they are? Does anyone feel any difference?  

For me, coming to TWU was a form of professional development. I had not previously taught doctoral students until I began working here and I have learned a tremendous amount in the past four years about doctoral education. That experience has given me options. Like yourself, I now have the ability and the vision to undertake different work than I did a few short years ago. It seems like whenever I look back a few years and reflect on my life, I see that I've changed and grown enormously in a short period of time.

What better way could there be to live than in constant growth? "Growth for the sake of growth," said John Dewey, referring to learning in order to develop the ability to learn more, was the primary goal of education. He was talking about students who were children, but I find that the same goes for teachers who are adults - or at least for me. I feel that I am at much the same stage that I perceive you to be: I have grown significantly and am ready for new challenges!

Am I wrong about that with you? Is the BS just a piece of paper? Or is it something more? Did you always feel that way or has something changed while you've been in the program?

Spring 2010 underway!

I'm back, and settled, and ready to go! I've been in communication with a few of you, and see that others are humming along nicely. How exciting it must be for you to be getting your BS! Will many of you be changing jobs? I'm looking forward to beginning reading your blogs in Module Two, but you have another week or two before that comes. Make sure you let me know if you have questions or need anything. The Help! forum on Bb is also a great way to get help from classmates (many of whom may have already had to wrestle with the same question or problem). I hope your semester if off to as good a start as mine! 

Greetings NURS 4823!

This blog will serve as a course hub for NURS 4823 that allows you quick access to your classmates' blogs as well as your instructors reflections on professional nursing. Once I have everyone's blog addresses, links to those will appear in the upper right side of this page. Check back in Module Two and we should be ready to go.

Have a great semester!