Archive for the ‘Nursing students’ Category

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Seeing Potential: The Joys of Teaching Nursing

May 6, 2015

By Ruth Smillie, MSN, RN, associate professor of nursing at Saint Josephs College, Standish, Maine.

"Buck Up," by zenera / via Flickr.

by zenera / via Flickr.

The day I come to class pregnant is one of my favorites. I really hate to be pregnant; I’m 55, grey haired, and way too old to be pregnant. My students are obviously surprised when I waddle in swaybacked with my sudden eight-month pregnancy. They snicker and smile, and then the magic begins.

As each one brings up the “change” they were assigned, I acquire the mask of pregnancy: larger breasts (made from paper bowls), kidney stones and gallstones (collected from outside), more blood volume (once, in a soda bottle), varicose veins (pipe cleaners or string), and so on—all carefully attached to me by duct tape.

I look and feel ridiculous and we all laugh a lot, but that’s not the point. The point is that they remember the changes of pregnancy. Embarrassing as it is, I would do it every day if it helped them learn. I love to teach nursing and it has been an amazing experience.

Students have no idea how incredible they are. Most of mine are just out of high school, young and unaware of their potential. But they have it, and I can see and feel it. I love watching students help change a newborn’s diaper when they are as nervous as a new dad fumbling with the wipes.

Chatting and gently holding those brand-new legs, connecting with the family, becoming a nurse—not any nurse, an amazing nurse, right there before my eyes. These are the moments I get to be a part of; while they are caught up in their inexperience, I can begin to sense what they will become: nurses who will connect with families, talk to patients, care about people. These are nurses who I’ll be proud to have known long before they realized who they would become.

Nursing education isn’t known for its stellar paycheck. In fact I could make more working at the hospital, lots more. Others are quick to point out that we get summers and holidays off. Great perks: time to write, research, and develop new classes and improve old ones. Now snow days, those are cool, if only it didn’t put us behind in the classroom! Read the rest of this entry ?

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AJN’s Spring Break with the Student Nurses in Phoenix: Sunnier Job Outlook for New Graduates?

April 17, 2015

By Maureen Shawn Kennedy, MA, RN, AJN editor-in-chief

PhoenixSkylineAfter a long winter in the Northeast, it was wonderful to visit Phoenix last week for the 63rd annual convention of the National Student Nurses’ Association (NSNA).

Like other meetings, this one was packed from morning to late evening with educational sessions, exhibits, resume-writing consultation, and for some, deliberating over 60 resolutions at the House of Delegates. Keynotes addressed:

  • health care reform (Gerri Lamb).
  • progress on implementing recommendations from the Future of Nursing report (Susan Hassmiller).
  • clinical ethics and moral distress (Veronica Feeg and Cynda Rushton).
  • and, the closing speech, a charge to continue nursing’s legacy into the future (yours truly).

Concurrent sessions, most of them well attended by Starbucks-fueled students, covered nursing specialties, exam help, licensure and legal/ethical issues, and clinical topics. (Betsy Todd, AJN‘s clinical editor, who is also an epidemiologist, led a session called “Is It Safe: Protecting Ourselves and Our Patients from Infectious Diseases.”)

Changing job climate? Several students I spoke with who were graduating at the end of the semester didn’t seem to have the anxiety of previous years’ students over securing a job. Maybe this is because things are looking up in the job market for new graduate nurses, at least according to recent figures in NSNA’s annual survey of graduates.

Reporting in the January issue of Dean’s Notes, researcher Veronica Feeg, associate dean of Molloy School of Nursing, and NSNA executive director Diana J. Mancino note that, in a September 2014 survey of NSNA members who were 2014 graduates, 78% reported they had secured an RN position by six months following graduation. This is an increase over the prior two years, when results were 76% for 2013 graduates and 66% for 2012 graduates. Read the rest of this entry ?

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Bedpans and Learning: Nursing Basics Still Matter

April 8, 2015

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

Photo by Morrissey, via Flickr.

Photo by Morrissey, via Flickr.

There I was, orienting to a busy medical ICU, perplexed over a bedpan. You’d think, since I was just graduating from nursing school, that bedpans would be my area of expertise. Critical thinking and vent strategies came easy; how could I possible admit I had no idea how to give a bedpan to a patient?

Frightening, to graduate from nursing school and a competitive externship program without this competency. Somehow, though, every unit I’d experienced offered patient care assistants, or patients who didn’t need this age-old tool. I’d certainly helped patients to the bathroom and cleaned incontinent ones. Despite the barrage of clinical learning, the basics of offering the pink plastic tool hadn’t sunk in.

Paralyzed, I stood with it in my hand, looking at my intubated, awake patient. I’d had the wherewithal to ask the family to step out, but couldn’t figure out which end went first. The horror of my preceptor finding it backwards would end me. Did the pointed end go towards the patient’s back? The larger end toward the feet for better coverage? Why couldn’t I remember?

Somehow, I managed to decide, and with heart racing, I urged the patient: “Turn to the side!” We both grimaced: I grasped the bedpan with one hand and his right hip with the other, while he reached towards the opposite side rail. His body, heavy with fluid, resisted my timid and inexperienced grasp, and he rolled back onto his back, without bedpan.

My preceptor, just passing by, or discreetly watching from her secret post behind the curtain, arrived just as I was about to start my second try. From the opposite side of the bed, she pulled his body towards her and I placed the bedpan where I thought it should go, praying to the ghost of Florence Nightingale that I’d positioned it right.

If it hadn’t already been so, this experience made it clear to my preceptor that, while I was confident in my nursing knowledge, my skills weren’t up to snuff. Instead of choosing a final clinical placement in a med-surg unit or intensive care, I had opted to spend my senior year working in public health. When I decided that I wanted bedside experience before specializing, I figured I’d just pick up what I missed on orientation.

For some reason, understanding when to intubate a patient came easily, but giving a bed bath? Terrifying. In our unit, we had no patient care assistants, and my preceptor’s goal was to teach me how to perform all patient care without any help. “I don’t want you to do everything by yourself all the time; I just want you to know how to do everything by yourself.” Read the rest of this entry ?

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AJN in January: Long-Term Complications of CHD Repair, Obesity Interventions, Nurses Planning for Retirement, More

December 29, 2014

AJN0115.Cover.OnlineAJN’s January issue is now available on our Web site. Here’s a selection of what not to miss.

Complications after cardiac repair. Nurses often encounter patients with complications that occurred years after congenital heart defect (CHD) repair. Yet many patients whose CHD was repaired in childhood have not had regular follow-up. Our CE feature, “Long-Term Outcomes After Repair of Congenital Heart Defects: Part 1,” the first in a two-part series, reviews six congenital heart defects, their repairs, and common long-term outcomes, as well as implications for nurses in both cardiac and noncardiac settings. This CE feature offers 2.5 CE credits to those who take the test that follows the article.

To further explore the topic, listen to a podcast interview with the author (this and other free podcasts are accessible via the Behind the Article podcasts page on our Web site, in our iPad app, or on iTunes). A video of an atrial septal defect device placement is also available in the iPad edition of this article.

Obesity interventions. Patients with obesity often face stigma and bias, even from the nurses who care for them. “The Obesity Epidemic, Part 2: Nursing Assessment and Intervention,” the second article in a two-part series, presents a theoretical framework to guide nursing assessment of patients with obesity and their families and reviews the most common lifestyle, pharmacologic, and surgical interventions. This CE feature offers 2.5 CE credits to those who take the test that follows the article.

Are you ready for retirement? Nurses might be retiring later than ever, but are they planning for it? “Preparing for Retirement in Uncertain Times” shows nurses how to optimize their future financial security before leaving the workforce.

Essentials for clinical instructors.Fostering Clinical Reasoning in Nursing Students,” the third article in our Teaching for Practice series on the roles of adjunct clinical faculty and preceptors, describes the importance of developing clinical reasoning skills and how instructors can help students learn them. Read the rest of this entry ?

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Essentials for New Clinical Nursing Instructors, Especially Adjuncts

August 22, 2014

There are many things it’s helpful to know when you start work as a clinical instructor—and you might not get a lot of orientation first.

By Maureen Shawn Kennedy, AJN editor-in-chief

“So you’ve accepted the contract for your first part-time clinical teaching assignment and you’re wondering where to start in preparing for this new role. Perhaps you’ve been working in an administrative role, away from direct caregiving. Maybe you’ve been active in bedside nursing but have no formal preparation in clinical teaching. If you take the time to prepare for your teaching assignment, you can confidently lead your students through a meaningful clinical experience.”

Clinical instructor Betsy Moorhouse (second from right) reviews the contents of a pediatric code cart with her nursing students at Miles Memorial Hospital in Damariscotta, Maine. Photo © Getty Images.

Clinical instructor Betsy Moorhouse (second from right) reviews the contents of a pediatric code cart with her nursing students at
Miles Memorial Hospital in Damariscotta, Maine. Photo © Getty Images.

So begins “Starting a Job as an Adjunct Clinical Instructor,” the second article in our quarterly column, Teaching for Practice (published in AJN‘s August issue, the article is free until the end of September).

When I was working as a clinical nurse specialist, I was also adjunct faculty for a local school of nursing, working with students in the acute care setting. Fortunately, I had taken an education minor in graduate school—otherwise, I would have felt lost when faced with setting objectives, planning pre- and postclinical conferences, and student evaluations. Read the rest of this entry ?

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Revisiting Reality Shock – What’s Changed for New Nurses?

July 28, 2014
julie kertesz/ via flickr creative common

julie kertesz/ via flickr creative common

By Maureen Shawn Kennedy, AJN editor-in-chief

Last month, we highlighted on Facebook a blog post I had written in 2010, “New Nurses Face Reality Shock in Hospital Settings – So What Else is New?” (It seemed timely in terms of all the June graduations.)

I wrote that original post in response to a study that had just been published in Nursing Outlook (here’s the abstract) describing the experiences of new nurses. Generally, these newbies felt harried, unprepared, overworked, and unsupported—all similar concerns voiced by nurses in Marlene Kramer’s 1974 book, Reality Shock: Why Nurses Leave Nursing. (Here’s AJN’s 1975 review of the book. It will be free for a month; note that you have to click the PDF link at the article landing page to read it.)

My post back in 2009 noted how nothing much seemed to have changed since the publication of Kramer’s book. Now, once again, this post has generated many comments, a number of them on our Facebook page as well as on the original blog post.

Here are a few. I’ll start with Facebook:

I’m almost a 20yr RN and have experienced [this] in a new job. I’ve developed skills to deal with this over the course of my career, so it doesn’t impact me like it did as a new nurse…but to new nurses out there: just know that bullies have some personality disorder that extend[s] beyond the workplace (even if you never get to see it). Learn, be happy, and go on your way. It’s them, not you.

It’s up to nursing leaders at all levels to set the expectations and role model professional behavior.

The real problem is that we will no longer want to work as nurses . . . it has become so difficult for so many reasons. So at the end of a long shift you wonder, “Is it worth it? Is it?”

And some comments from the blog: Read the rest of this entry ?

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Nursing Students and Then Some – In Opryland, Revisiting AJN’s Long Connection With NSNA

April 14, 2014

Revisiting AJN’s long connection with this vibrant student nursing association. 

By Maureen Shawn Kennedy, MA, RN, editor-in-chief

Opryland critters

Opryland critters

I’ve said it a number of times over the years, most recently in my editorial in the April issue of AJN: the National Student Nurses Association (NSNA) is a vibrant organization and produces one of the most well-organized annual meetings in nursing. This year, it broke attendance records, drawing approximately 3,200 students and faculty advisors to the Opryland Hotel in Nashville, where I spent part of last week.*

Supporting NSNA since its founding. The American Journal of Nursing has been a supporter and and sponsor of the NSNA since the organization began in 1952. The NSNA offices used to be part of the AJN offices at one time, and before NSNA had its own publication (Imprint), AJN published “The Student Pages.” We sponsor Project InTouch, an award given to the student who recruits the most new members for the organization. This year, winner Joanna Laufer from East Carolina University, Greenville, North Carolina, recruited 130 new members; overall, this initiative brought in over 1,600 new members this year. Impressive.

Impressive, and sharp dressers too! The students I met—mostly junior and senior nursing students—were also impressive. They were enthusiastic, eager to learn, and professional. I have to say this group as a whole was better dressed than many attendees I’ve seen at other nursing conferences—they clearly got the message about what business casual meant; I rarely saw anyone in jeans.

The students’ major concern was of course, finding a job in this tight market. And there were few recruiters other than the military services among the couple of hundred exhibitors—most were schools of nursing and companies with educational products for passing the licensing exam. Many speakers reinforced the message that the tradition of working in a hospital for a year before working in other settings is not necessary (and likely never was), and students seemed a bit relieved to hear that. But more jobs will be opening in primary care settings and preventive care services; senior care centers and long term care will grow along with the aging population, so jobs will be there, too. And while it might be tough now to get a job in a hospital, the market will be very different in a few years as older nurses retire. Read the rest of this entry ?

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