Archive for the ‘nursing students’ Category

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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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What Advice Would You Give a New Nursing Student? Our Readers Respond…

April 9, 2014

KarenRoushBy Karen Roush, MSN, RN, FNP-C, AJN clinical managing editor

My daughter Kim is starting nursing school next month, so last week I asked AJN’s Facebook followers for the best piece of advice I could give her. The response was overwhelming: over 600 people offered wisdom, encouragement, and tips for success. I went through and read them all and the following is an attempt to synthesize the advice.

Of course, with so many responses, there were many valuable pieces of advice I had to leave out, from the practical to the profound, such as:

sit in the front of class, stick to your principles, invest in good shoes, choose clinicals that push you out of your comfort zone, be early for everything, celebrate the small victories, get a really good stethoscope up front, believe in yourself, pick the hardest patient you can at clinical, audiorecord the lectures, be truthful and committed to your work, eat healthy, get to know your instructors, coffee and chocolate!

And finally: look into the eyes of your patients and be sure they know you care. Every patient, every time.

(Oh, and not to leave out the lighthearted—Don’t hold your nose in clinicals. The teachers frown on that.)

Below are five areas of advice that stood out:

1) “Take a good picture of your friends and family and put it on your desk, because that’s all you’ll be seeing of them for the next two years.” There were many variations on the idea that nursing school “takes 100% dedication.” You need to warn your family and friends that they won’t be seeing you for a while, get rid of your TV, sleep when you can, learn good time management, and be prepared to spend Saturday nights with your books . . .

2) “Study, study, study, and study some more.” Respect the quantity and degree of difficulty of the material you will have to learn. There were a lot of ideas about how to optimize your studying—chief among them was to get in a study group and to study NCLEX questions from the beginning. Others were to read ahead, not procrastinate, use flashcards, attend practice and review sessions, and have a study partner or buddy system. Having a study buddy, though, is only a small part of the importance of friendships with your fellow students . . . Read the rest of this entry ?

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Don’t Write Off Community College to Start a Nursing Career

March 26, 2014

By Karen Roush, MSN, RN, FNP-C, AJN clinical managing editor

KarenRoushMy daughter is about to start her nursing career. She’s got all her prereqs out of the way and she’s waiting to hear from the half-dozen colleges she applied to. Among them is the community college where I started my career 35 years ago. That’s right—a community college that confers an associate degree.

I hope she gets in.

Community colleges are seen by many as the bottom of the ladder of desired schools of nursing. Not only do they offer only a two-year degree, but they’re not seen as being as selective as four-year colleges and they don’t have the big name professors.

But community colleges can and do produce great nurses. Programs are rigorous, so a more liberal admission standard at the onset doesn’t necessarily change the caliber of student who graduates at the end. And once they graduate, they must meet the same standards as students from four-year schools to attain licensure as an RN—everyone takes the same NCLEX. At the time of my graduation, my school had a 98% pass rate, one of the highest in the country.

Community colleges even have some advantages over a lot of four-year programs. They may not have the big names—but really, how many of those big name professors actually teach full courses? At community colleges, teaching is the focus. Community colleges are affordable; students don’t leave burdened with astronomical debt to start a career that, while setting them down firmly, and often permanently, in the middle class, can also saddle them with a burden of debt on top of all the expected financial struggles. And in many places, community colleges are truly embedded in their community; this can provide a level of support and open up opportunities for students that is not possible at larger detached universities.

I agree that all nurses should have a BSN, eventually. There is a lot of evidence that it improves patient outcomes. But the two-year community college can be a great place to start—two years of reasonably priced education that gives you a solid base of skills and knowledge to practice while you continue to take courses toward a bachelor degree. I remember when I returned to school for my bachelor’s: the wonderful sense of discovery that I was not just a nurse but a professional, and part of a profession with its own history and body of knowledge.

We need more nurses. All the experts agree that there is a shortage just waiting for the rest of the Baby Boomer nurses to hang up their stethoscopes. An education that starts at a community college can take a nurse far. I know mine has, from acute care staff nurse to long-term care educator, from oncology to urgent care to the IV team. Here in the U.S. and in India and Africa. As a nurse scholar at the WHO in Geneva, Switzerland, and as an NP in the Adirondacks of upstate New York.

Read the rest of this entry ?

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Three Nurses and a Doctor Go Sailing – Some Notes on Communication Style

March 24, 2014

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.

Untitled from the series, Pareidolia. Charcoal and graphite on paper, 12" x 9," by julianna paradisi

Untitled from the series, Pareidolia. Charcoal and graphite on paper,
12″ x 9,” by julianna paradisi

There’s an old joke about the personality differences among nurses of different specialties. It goes like this:

A medical–surgical nurse, an ICU nurse, an ER nurse, and a doctor go sailing. The doctor stands at the bow of the boat and shouts to the nurses, “Trim the sail!”

The med–surg nurse asks, “How do you want it?”

The ICU nurse replies, “I’ll trim, okay. But I’m doing it my way.”

The ER nurse shouts back at the doctor, “Trim the sail yourself!”

ICU style. The joke is a generalization, of course. However, I was a pediatric intensive care nurse once upon a time, and I have to admit that the ICU nurse characterization resonates with my own experience. Like the nurse in the joke, I always have an opinion, and rarely mind sharing it. In the ICU, if another nurse, a physician, a pharmacist, or respiratory therapist didn’t agree, conversation ensued. My colleague, equally opinionated, would state her or his position. Data was consulted, and then, more often than not, consensus occurred.

And I often learned something from sharing information. It made me a better nurse. I learned to dig in on a position only if patient safety or my license was at risk. Everything else was pretty much negotiable, face-to-face. From this perspective, our ICU team was similar to a marriage—it would have been unrealistic to expect there would never be disagreement within our team. In fact, if there was never disagreement, someone probably wasn’t being honest about her or his feelings—an approach that can lead to passive-aggressive behavior.

I don’t know if it’s because I no longer work in ICU, or if nursing culture in general has changed, but lately I’ve noticed some confusion about the difference between open, honest communication and bullying. There’s a difference. Read the rest of this entry ?

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Are Hospitals Doing Enough to Help Newly Licensed RNs?

November 18, 2013

CalloutNewNursesVoices

Staff retention is a big issue in hospitals. There can be advantages in hiring newly licensed RNs, but some hospitals and workplaces may pay insufficient attention to helping new nurses with the challenging transition from classroom to clinical practice. In our November issue, some of these issues are brought more clearly to light by an original research article called “Hearing the Voices of Newly Licensed RNs: The Transition to Practice.”

“The first few months of employment is a crucial time in a nurse’s career,” write the authors of this small study. According to interviews with newly licensed RNs conducted by the authors, the following factors can make a big difference:

  • The quality of the preceptor—is the preceptor knowledgeable, adequately experienced, and nonjudgmental?
  • Professional growth and the development of confidence over time in terms of time-management, communication skills, and learning from experience.
  • A sense of being nurtured by the program, the preceptor, and peers.
  • The thoroughness and effectiveness of orientation.

Read the article, or listen to an author podcast on our Web site. What worked in your own transition to practice? What didn’t work? Or how do you help others with this transition? We’d love to know. —Jacob Molyneux, senior editor


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Future Nurses—No Shrinking Violets

June 24, 2013
Thelma Schorr and Kathryn Brownfield.

Thelma Schorr and Kathryn Brownfield

By Maureen Shawn Kennedy, AJN editor-in-chief

Last week I had the opportunity to meet several members of the National Student Nurses Association (NSNA) board of directors when they were here in New York for a board meeting. As is custom, NSNA chief executive officer Diane Mancino invites many of the NSNA sponsors and supporters to dinner to meet the new board.

I had the pleasure of meeting Kathryn Brownfield, the nursing student editor of Imprint, the NSNA’s official publication. She’s a nursing student at Nash Community College in North Carolina. We sat with Thelma Schorr, AJN’s former editor and publisher (and a consulting editor at Imprint) and Florence Huey, a former editor of AJN and of Geriatric Nursing (and a former president of the NSNA). It was like homecoming!

I was impressed—as I always seem to be—with these aspiring nurses. Many of them are second-degree students and come into nursing with work experience, a family, and a maturity that was lacking in my cohort, which was largely younger, right out of high school, with little work experience.

I wonder how these nursing students will fare in their first nursing jobs. One hears a lot about bullying and lateral violence and how it’s driving some new nurses away. I can’t imagine any of the students I met being cowed by overbearing coworkers.

In November, NSNA will host its mid-year conference, which typically draws 1,500 attendees; this year, it will be held in Louisville, Kentucky.

We’ve been able to publish some very engaging blog posts by NSNA members in the past. These two posts by Medora McGinnis, a former editor of Imprint, were particularly popular:

“Don’t Cling to Tradition: A Nursing Student’s Call for Realism, Respect”

“Practically a Nurse: Life as a New Graduate RN”

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Watch a Student Nurse in the UK Give a Voice to Nurses Everywhere

May 6, 2013

This is really pretty wonderful: a video showing a student nurse, Molly Case, addressing the Royal College of Nursing 2013 Congress with an eloquent poem that is the best response possible to the criticisms recently leveled at England’s National Health Service. Please take a minute and watch it. It’s worth it.

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Finding Future Leaders – and a NICHE in Nursing

April 15, 2013

By Maureen Shawn Kennedy, AJN editor-in-chief

It has been a hectic few weeks, as I’ve been traveling to the early spring nursing meetings (with still more to come).

With John Gransbach at NSNA meeting

With John Gransbach at NSNA meeting

First I went to Charlotte, North Carolina, to attend the National Student Nurses Association (NSNA) annual meeting (April 3–7). AJN has had a long association with the NSNA, supporting it in various ways since its 1952 founding, from hosting board meetings at AJN offices to producing the convention newsletter to convention scholarships for key contributors. In recent years, we’ve sponsored travel expenses to the annual meeting for the winner of Project InTouch, the member incentive plan. This year, the winner was John Gransbach, who graduated from the Goldfarb School of Nursing at Barnes-Jewish College in St Louis. He recruited 228 new NSNA members—an achievement certainly worth recognizing.

Future leaders. As I told the audience when I presented the plaque to Mr. Gransbach, this award isn’t just about growing membership in the NSNA—it’s about contributing to the future of the profession. Students who join the NSNA are already demonstrating a commitment to nursing by going beyond what’s required of them. They’ve joined an organization that provides considerable resources to help them begin their careers. Not only does it provide practical help with passing the NCLEX exam, writing a resume, and finding a job, but it informs them about what it means to be a nurse. NSNA members are the future of nursing and likely the future leaders of nursing. We’re pleased to support this award and NSNA.

NICHE. And this past week I was in Philadelphia for a meeting of the Nurses Improving Care for Healthsystem Elders (NICHE) initiative, a program based at New York University College of Nursing that seeks to provide education and resources to improve care for hospitalized older adults. It provides training curricula and tools to the 450 hospitals that are members of the NICHE network. Much of the agenda focuses on initiatives that NICHE members have successfully implemented to improve care.

NichePhotoAJN partnered with NICHE in a joint initiative, “Professional Partners Supporting Diverse Family Caregivers Across Settings,” funded by the Jacob and Valeria Langeloth Foundation in collaboration with the AARP Foundation. (Pictured in the photo are, from left: Liz Capezuti, director, NICHE; Susan Reinhard, senior VP, AARP Public Policy Institute; Rita Choula, program manager, strategic initiatives, AARP; myself.)

Helping family caregivers. We worked with NICHE to develop a series of articles and videos designed to teach nurses concepts and skills to help them better support family caregivers in assuming care for loved ones after hospital discharge. These materials were used in training staff and as a basis for developing family-centered practices, which were then piloted in five NICHE hospitals. Dennise Lavrenz, the NICHE coordinator on the project, presented some initial results that were encouraging. Overall, as measured by Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPS) scores, caregivers showed increased satisfaction with their experience and with staff communication and felt more prepared to care for family members.

At the meeting, presenters from Carolinas Medical Center-Mercy in Charlotte, North Carolina, discussed their success in improving caregivers’ experience through employing a caregiver assessment tool, paying closer attention to caregivers’ information needs, and providing the caregiver with a tote bag of personal items for their use when their family member was admitted to the hospital. What started as a nurse-driven pilot on two units was now being rolled out hospital-wide—certainly a success story for the nurses who spearheaded the project and and the hospital, but most of all, a win for the caregivers.

The NICHE Web site offers a wealth of information; you can also find AJN-produced, foundation-funded resources for caring for older adults at this Web page; or access AJN’s family caregiver videos here.

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Well On His Way: A Nursing Professor’s Humbling Experience

February 26, 2013
Holding On / D'Arcy Norman, via Flickr

Holding On / D’Arcy Norman, via Flickr

By Martina Harris, EdD, RN, a UC Foundation assistant professor at the University of Tennessee at Chattanooga School of Nursing

It was 6 am and I was on my way to make patient assignments for my first semester nursing students. Inside the long term-care facility, the hallways were quiet, the majority of patients still in bed. I made my way to the second floor to begin identifying and assigning patients for my fundamental nursing students. Standing at the nurse’s station, my focus was on finding patients who would provide students varied opportunities to reinforce the basic skills they’d been learning at campus lab.

The charge nurse approached me and asked if I would be willing to assign a student to Mr. Hugh, an 84-year-old who was proving to be very “complicated.” Assuming that “complicated” meant that his care required lots of psychomotor tasks, I agreed to her request. She then explained that this patient had been using his call light frequently, but that each time the staff responded, he only wanted someone to sit and visit with him. Though this didn’t seem an ideal opportunity for a student to practice basic nursing skills, I felt the gracious thing to do was to take the assignment.

In the hallway, my group of fundamental nursing students huddled together, dressed in their white uniforms and nervously awaiting the start of their first clinical day. One by one, I went down the list, assigning individual students to particular patients and explaining to each what additional tasks needed to be done for their patient on top of taking vital signs and changing linen.

I decided to assign Mr. Hugh to James, the only male student in this rotation. I told him that there were not a lot of “interesting” skills to practice on this assignment, so he could basically just “hang out” with the patient.

After assignments had been made, I began working with individual students as they administered oral medications, performed subcutaneous injections, and assisted with dressing changes. After a couple of hours, I poked my head in the door to check on Mr. Hugh and James. They were engaged in conversation. “Are you doing okay?” I asked James, to which he emphatically replied that they were “fine.”

I was amazed that James had been in the room for two hours and not complained. When it was time for follow-up conferencing, I began with James, apologizing to him that he had to be stuck in that patient’s room the entire time, without a chance to practice any of the psychomotor skills learned in campus lab.

“No need to apologize,” said James. “I should thank you for this assignment. This was an amazing clinical experience.” He began to describe how the patient had told him all about his life, his world travels, and his time in the military. He’d heard stories about the patient’s beautiful wife of 50 years, who had recently died, and how much Mr. Hugh missed her. He said the patient told him he reminded him of his own son, the one he didn’t get to see as often as he would like. James told me that having a chance to listen to and “swap stories” with this patient had been very rewarding, far exceeding his expectations.

It was at this moment that I realized James was well on his way to becoming a nurse in the truest sense. He’d been able to see the patient holistically, while I’d focused on ensuring the student could perform tasks.

I felt humbled by this experience and determined I’d learn from it. The following week, I returned to the same long-term care facility, expecting to assign that same patient to a different student. This time, I eagerly approached the charge nurse to request a list of potential patients and to let her know I’d love to have a student work with Mr. Hugh. She looked at me with pained eyes and said, “I thought you knew. He died later that evening after your student left.”

I’ve never forgotten that clinical day with Mr. Hugh and James. I often wonder what Mr. Hugh was thinking when he was sitting and talking with James, and if Mr. Hugh in fact knew that he, too, was “well on his way.”

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What Can’t Be Taught in Nursing School

January 17, 2013

JanuaryReflectionsBy Jacob Molyneux, senior editor

The January Reflections essay in AJN, “A Special Kind of Knowledge,” is a revised excerpt from a forthcoming book, Crossing the River Sorrow, One Nurse’s Story, by Janet L. Richards. (The book will be published in June by Vantage Press.) In the essay, the author remembers an encounter she had several decades ago as a nursing student caring for a newly paralyzed young woman. Here’s a paragraph from near the start:

I stood by Carrie during those first harrowing hours in the ICU as she awaited surgery, everyone still hoping for the best. As a brand-new student, I was a silent observer, unsure of how to participate. Her young husband also watched, slumped against the heater under the window at his wife’s bedside. His eyes blazed, wild with fear and disbelief as he struggled to make sense of his sudden immersion into the alien world of disability. I could identify. Pressure sores, urinary catheters, bowel programs, and spasms—these were now part of my new and ever-expanding medical vocabulary. A spinal cord severed at C6 meant life as a quadriplegic. Suddenly this book knowledge seemed all too real.

And here’s a few lines from near the end, to give a sense of the crucial insight the author gained as she struggled to bridge the gap between herself, her patient, and the patient’s husband:

Pain can be palpable as it moves across the space between two people, molten, unrelenting. Like joy and laughter, it’s quite contagious. This is the special kind of knowledge I wanted, even craved going into nursing, and yet it’s not at all what I expected.

But take a couple of minutes and read this short, powerful essay in entirety. Just click either the image above or the essay title (for the best reading experience, click through to the PDF version). We welcome comments.

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