barb4575 4,374 Views
Joined: Dec 28, '00;
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I do not like the HESI exams other than to be used at the end of a semester course for remediation. I questioned their statistics because the majority of the students failed their HESI exams (course and exit), yet they all passed the NCLEX-RN. I sent my questions via e-mail to HESI, and it was deleted without being read. I am curious about the Masters' level research findings conducted by a fellow educator? I am also interested in knowing what NCLEX-RN review sessions and study/review books are being used out there? So far, my favorite online review is hurstreview.com. I love the Saunders Review Book and Silvestri's Strategies for Success--so did my students!
I totally agree with you, Amy in regard to your comment about Crown Nursing. Don't try to verify your employment with them either because they have lost your employee record.
I agree with you, llg. I would never make such an assignment, but if the students are upset about it--it does need to be addressed. Like I said, postconference is also a debriefing. Often times, the outcome is that the student misunderstood what was appropriate and what was not. They also have those rose-colored glasses on and have to be reminded that they have 1-2 patients and not the caseload that the staff nurse has...when it is addressed in this manner, they often times understand the situation and the nurse better.
If there is something that is observed and it was inaccurate, it is best to discuss how it could have been handled better and not a discussion about the RN. Issues that occurred this last rotation included: sterile dressings not being performed per sterile technique and not even washing hands between dirty and clean dressing changes, throwing dirty linens with BM onto the floor, not verifying identity and birthdate when administering meds (this is their policy), no discharge teaching, and not wearing gloves with injections and IV inserts. These are things that I want them to know are absolutely inappropriate.
Those are terrific ideas for a postconference and I will remember it. In my clinical postconferences, we have always discussed professionalism because it is a debriefing time as well. There has always been at least one staff member that the students do not want to work with and it is usually due to their behavior. So, the behavior of the nurse would be discussed and it is imperative to focus on the behavior, not the RN. It is also important that students are aware that postconference is confidential.
A perfect example is when a student really liked this staff RN and considered her a "good" RN. However, she learned that being nice does not equate with the standard of being a "good nurse". This particular RN made four major errors in her practice that we witnessed. I evaluated each incident and when I decided it was unsafe practice, I reported it to hospital representative.
The bad part was that the nurse was spoken to by the clinical nurse specialist/educator and the nurse was hateful to all of us for the remainder of our clinical time. I also believe that the nurse discussed this with one of my students.
The good part is that this particular student did withdraw. She was the same student who's first patient requested that she not take care of her any longer. The staff RN informed the student not to tell me or she would get in trouble. I found that action highly unprofessional and inappropriate.
When I did find out, the patient was so upset. A nurse manager and the staff RN had already been in her room discussing these issues. With ten minutes of talking to the patient and explaining that the student would not be back in that room, she was fine. The patient went a step further with her discussion and stated that it was her opinion that this student should not be a nurse. This was a first for me.
That is precisely the problem, the owner knows that you put so much into writing that proposal and curriculum that he doubts you will walk away. When you do get students, it will be even more difficult to leave them.
Even though my programs were ADN, we also had LPN programs. The college had the word, "technical" in it which bothered me for ADN students. There were three college campuses: one main and two branch campuses.
I can tell you that the behavior the owner is exhibiting is precisely the same as the owners of the college where I was employed. My advice to you is to inform him that you are bound by Minimum Standards in the State of IL to administer that program and he must respect the regulatory power of the board. You are focused on quality and consistency and he is focused on money. You must implement the program as the proposal was stated and approved by the board or you must send a request for changes to the board. For now, you may be able to stay there, but eventually, I suspect that your integrity will force you to leave.
Do not allow this owner to control your program and remind him that he may be your employer, but you are a licensed nurse professional in IL and you will uphold those standards first and foremost. The President of our college never understood this part. She only understood, Money for the Not-for-Profit organization.
I know how difficult this is with all of the excitement and hard work you have done, but I am fearful that you may be working for the same type of individual I was and it only deteriorated with time.
I did not accept this position initially because it was clear to me that the curriculum design was faulty and could not be changed the first two years in any major way...plus, it was obvious that there was no money. Her main campus was open for 11 years and she claimed she held a Masters' in Education. No one has seen that degree to date and she did not operate like someone with that background.
It was a nightmare of an experience, but it was a wealth of experience as well. Have you spoken to the Education Administrator of the state board of nursing?
I was wondering if the hospital director has spoken to the director for the college about these issues? There may be much more to the story than you are all aware of--I do agree with the rule you will be making that they need to be oriented by a certain time frame. The director of the college will have to realize that if she doesn't hire by that date, they won't be able to use your site for clinical. It is amazing how people tend to make deadlines when forced to do so.
I also have some empathy for the director because I know how difficult it is to attract faculty especially to an organization that does not advertise, offers poor salary and benefits, and the word does get around about their reputation. I was doing three FT roles at once because of these very reasons and I only stayed as long as I did for the students. The organization is not-for-profit, yet trust me, it was all about money. Once the board of nursing approved the start-up date, the President did what she wanted and had absolutely no respect for the regulatory power of the board of nursing. She terminated a large majority of individuals because quite frankly, she had no money to pay them and she had some people who were employed and would do anything for the students...including working many roles for the price of one.
Spyder has a thread about a new LPN school in IL and I am sorry to hear what is going on with her as it reminds me of the same situation I was in- I fought it for 1.25 years. The President did leave me alone for the first year as she was so busy micromanaging the LPN Director. I wanted to resign in the summer, but when I informed the board, I was told that they would close both of my programs like they did the LPN programs due to the instability. I knew that no other school would accept them and they would have wasted one year of their lives and $10k, so I stayed awhile longer. One month after I resigned, one campus was closed. The other branch campus is still open to allow these students to actually graduate. I am curious to see if they will close their branch campuses completely down when these students are finished. I hope the board of nursing and accrediting body will act appropriately. There are also some very powerful, wealthy men involved and politicians too--so it is unclear of what will happen at this time.
I had a reporter tell me that it is a great story. I find it to be the saddest story in nursing education.
I had to laugh when you said, my neck of the "woods" because trust me, these are woods here
Good luck in the new policy development and the implementation of such changes. I would guess that the director of these colleges will follow suit because they need you as a clinical site. I would also question if they come to your hospital so infrequently, perhaps the entire experience could be observational?
llg and Vicky,
I agree with all of Vicky's suggestions. I also know that a thorough agency orientation is necessary and if the agency doesn't provide it, this becomes the responsibility of the educator to get the orientation. Shadowing a RN for at least one shift does help to familiarize oneself to the facility and their procedures/policies/routine. I can say that most of the orientations I have received have not been helpful until I shadowed that staff RN. Even if the staff nurse did not enjoy teaching, I would get the information I needed by asking questions and stressing that I needed to know how they did things so I could be consistent with them. Suddenly, their attitude would change. Many staff RN's have negative views of faculty and this only helps to change those views.
Just as staff RN's have to complete skill competency exams, the educator should have to do this local credentialing as well. The hospital Staff Education and Development representative can learn a great deal about the faculty member prior to him/her ever reaching the unit. I did have one hospital call me about two of my faculty members--one before she started and the other was after her first clinical day teaching. The dilemma was that both nurses were "no rehires" at those institutions.
When the Chief Nursing Officer informed me of this, I also informed her that I had received excellent references on them from her nursing staff and told her how difficult it was to find faculty and I could not teach every course.
I then went to the clinical area and spent the day; I did regular rounds (often times being present the entire shift) so she was not suspiscious. I spent hours talking to this faculty member afterwards and she then became the best clinical instructor I had...she had no idea that she was coming across to students and nurses in the manner that she had been up to that point. To this day, there has been no other faculty member as skilled in clinical education.
I do believe that if the instructor is confident in his/her clinical skills, most nurses will pick this up immediately. If the staff nurse or manager does not find that the instructor is competent, it is their responsibility to report it to the Dean/Director and hospital nursing administration. Afterall, they are responsible for the quality care delivered by all which includes students and instructors.
With the board of nursing, it is imperative that their Minimum Standards for nurse administrators and educators address this dilemma. The process of getting a faculty member approved does not appear to be adequate and is too rushed. The standards are so vague and this is something that the board staff need to rectify. They do need to close colleges that are not offering quality education. What I have found in my experience is that the board would like to put that responsibility on the Dean or Director and they may be fearful about acting due to their liabilities. I had no idea how political a board of nursing was until I worked for a not-for-profit new college organization and couldn't seem to close it down. There was no one in education who did not agree that they needed closed either, but the politics of it all, kept them partially in business. This is where my current doctoral research lies: with the professional nurse educator who becomes a whistleblower.
I do not think that nurse practice employees should be involved in the hiring of faculty other than providing references for them. When these references are offered, they should be honest or not provided at all. A great deal can be said on the phone reference check without saying much at all.
Many colleges are partnering with the hospitals to obtain qualified, experienced nurse clinical educators. The more we involve ourself in this process, the better we will be in the professions of nursing and education. We want them to help us.
Thank you for this thought-provoking thread,
I was worried that you would take offense to my post and I am happy that you did not...afterall, we are both educators and employed in the same state. I do know that what llg is saying is absolutely right on, but I don't have any specific solutions, other than practitioners and educators must work together to promote quality care and a good learning experience for students. They are our future and if we can give to them just as my preceptor gave to me, we will be ahead. I will never forget my preceptor and I was lucky that she had the diploma, work experience, and patience of Job. There was no way that I was ready to lead an evening Med-Surg unit. Not once did she make me feel that I was ignorant or that my education as a BSN was inadequate...even though at that time, I felt it was very inadequate. I do not think it matters what program one graduates from, most do feel this way as a new grad. What concerns me most of all is how very difficult nursing on these Med-Surg units has become and I applaud those nurse administrators who are standing up for their nurses and won't allow more than a 4:1 ratio. The patients are that acutely ill and require that much attention.
You know the old saying about educators, they teach because they cannot do. I can finally see some truth to it today. I am doing some PRN Med-Surg because it is challenging and I love to learn. But, there is absolutely no way that I am going to do it FT with 9 patients per shift. I know I would be unhappy because I could not give the care they deserved. My question is how do staff nurses today cope with those feelings? I could never be ok with saying, I did the best I could, because over the past two years--it was never good enough and I just could not uphold my standards in that situation.
llg, I realize you are talking about Peds, but that is not my background. I can say that when I was an agency nurse, the staff nurses did not allow the agency nurses to accept peds patients and trust me, that never hurt my feelings. I am an adult health nurse and I don't pretend to know much about Pediatrics. One time I worked in a small hospital as a PRN nurse and I had to take Peds patients, but the difference was that the house supervisor was an expert in Peds and she was willing to answer questions and assist us. That was the only way I felt safe.
I will work on some problem-solving for this issue and see what I can come up with for resolution. It is an excellent, thought-provoking thread.
I do understand your concerns and they are valid. This is where I believe nursing education and practice need to come together. We all know that the real problem with the nursing shortage is the severe faculty shortage. It would be terrific if the nurse practice experts would teach clinical, but most either don't want to make the low salary or don't want to teach or both. What has happened in nursing education is that if one has an advanced degree and is breathing, he/she gets hired and yes, much of it is occurring at the last minute. The Director/Dean may have one standard, but the reality is that these days, you have to take who you can get...often times, there is only one applicant.
As far as the board approving someone in MO, I know personally that I cannot rely on that method. I hired someone from another well-known, large college and three of those faculty gave this applicant glowing references. Once hired, I realized that working on a doctorate does not equate with knowing the fundamentals of nursing and people are afraid to tell the truth on reference checks. You would not believe what this individual did and I won't reveal it here...incredible really.
I have decided about the time that I retire, nurse educators will have a great salary and this will attract more experts into education. But, we also will be having more faculty who are working for the money and not have the passion for education. There are many terrific nurse educators who do keep active in practice via various methods, but like practice, there are many that are not competent or caring.
The solution lies with both groups: nursing practice leaders and nurse educators. I do not think the nursing practice leaders should only be admin-types, I am referring to including those who are actually working actively in practice.
Regardless if I remain active in practice, it is my 25 years of experience that gives me the insight to ask the expert when I need to do so and to quickly realize who the experts on the unit really are...usually takes me one day to figure it out.
I agree with this idea, llg, but I think many educators would take offense to it. Of course, if they did react that way, this would be a grave concern too. The problem is: many of the instructors do not stay active in practice so they really are not effective.
I can also say that as a faculty member, I have seen many in nursing practice who are incompetent. The experience I just had was a perfect example of it. I met one nurse who was competent and a good role model for the students. If I can't trust the staff RN, this limits the students' experience. They do learn from staff nurses too. Sometimes, they learn valuable information about what they do not want to be when they graduate.
I think you will do very well in this position and I wish you nothing short of success! I was referring to whether or not the college had the money for the start up. My wage wasn't bad for the area, but when you divided out the hours, I could have been working as a CNA and made more.
The skills lab took a great deal of time to set up and organize. Do you have the manikins, supplies, and visual aids available to the students? We had an inventory of all of the items in there and kept expensive items locked up. The instructor that used the equipment had to sign out for it so that we always had a current inventory; this helped with ordering. The PN students had nursing bags with equipment, but I thought that was too expensive. I bought individual items for them to practice in the lab and kept them stored in a closet in the lab. When they had to do invasive procedures, such as Foley cath insertion, I gave each student one so they could practice at home. I also had a sign-up sheet in the lab so that I knew who was using the skills lab on their own time. When I noticed they were slacking, I would speak to them about being independent learners. Somehow, that usually motivated them to get back in there.
I liked one company for the pin--better than the other two and can share that with you via e-mail if you want. The mold costs about $200 since this will be the first pin for your school. But, the pin wasn't that expensive for the students. The company is in the midwest, but not IL.
I loved Nightingale uniforms. They were high quality and the students looked very professional in them. The service was excellent. They are in AL. Just remember to be thinking of all students' sizes when selecting your uniform. Some uniforms do not look well on certain body types.
For graduation, I think it is imperative that there be a graduation committee and allow the students' input. I allowed them to vote on the date, location, pin, cap/gown/tassle (for an ADN program), and it works best to get them involved. It is their ceremony and some will want to work hard to make it nice.
I loved the powerpoint presentation during the ceremony with the students' individual pictures and group pictures, plus music. Don't forget to take pictures of them throughout the year so they can do it this way if they want to do so. I also am older and I love the Nightingale pledge with the candle lighting. I also allowed them to choose a speaker besides the Director. Make sure that the reception is nice too--it isn't something that should be put together at the last minute or done cheaply. With your excitement, I doubt you would allow it. I wouldn't and paid to make it nice.
I wish you the best and keep that excitement up. You can always e-mail me as I do not check this site as often since I am working on my doctorate and employed.
Congratulations on getting your proposal approved! Wow, what an accomplishment. I did not do that part, but took over before the students arrived. It was an ADN program-two branches, and trust me, if you are the type of educator and Director that gives too much, be very careful. I am the same way and I can tell you that I allowed them all to drain me dry, especially my boss; directed two campuses and taught full-time at one campus for five months. At the end of the first year, I wanted to resign, but the board of nursing stated they would close the programs if I did so.
She paid me slave labor wages and had no money to administer these colleges. Hopefully, she will soon be removed from this state. She lost one campus one month after I resigned. What I can tell you is that the accrediting bodies should never have approved that proposal or curriculum. I am writing professionally about the nightmare of an experience and I pray it will be published. It will also be my dissertation focus: Corruption, Greed, and Politics in Nursing Education. I am passionate about keeping these types of individuals out of nursing education; it is not a money-maker, so why go into that business if that is your goal? The students paid $5k a semester for a new program. The students did not receive a quality education as no one of quality and integrity would come to work there. Plus, she rarely advertised and her salary range was very low.
One of the branch campuses is still open so these students can graduate. The local hospital CEO will support them financially because he wants the graduates because no one would travel to his hospital for the low wages he pays.
It has not been printed by the media, but it will be soon. The reporter said, this makes a great story. In my opinion, it is the saddest story in nursing education. I did testify against them in a board hearing and for that part, I am proud. There have been several very sad stories in this part of the country and this one has to beat them all.
She was ignorant enough to slander me on the phone during a job reference check. I was not terminated, but a large majority were terminated and I am not so sure some of them will recover. When I said I hoped she returned to AZ, a friend said the ultimate laugh of the day, he hoped she would go to Iraq or North Korea. It is difficult to love and forgive the unlovable.
Both programs were in compliance with the board when I resigned. There are not many advanced practice nurses in this area and they had difficulty finding a Director. Of course, it helps to advertise for that need as well.
I hope you do not have this experience...does the admin have the money for the new college? If not, get out quick! We had to have the skills lab ready for approval by the board first, then I got the final approval. The LPN Director of the programs is no longer there, but she has 35 years of experience in PN education so let me know if you have any questions via PM and I will ask her.
Good luck and above all else: be consistent, take care of yourself physically and emotionally, and stand up for YOU--trust me, when you are exhausted, no one will stand up for you.
I was curious if there are any nurse educators out there who also served in the US Army Nurse Corps? I was on active duty from 84-87, then served in the reserves for eight years. For me, it was the worst career decision to leave active duty. I am curious if there are any nurse educators who are also veterans on this website as I would like to share that comraderie.
Recently, I went to a VAMC and I could have stayed all day talking to those veterans. I also taught a clinical rotation at a VA in mental health and found how very sad it is that there are so many with substance abuse and homelessness. I really was ignorant to it all. When I was speaking to one gentleman, he said he was divorced and kicked out of his house and had nowhere to go. Thankfully, he had the VA to depend upon and it was on this day, I realized that regardless of what happens to me in my life, I can lose my insurance and my career...the VA will always find a way to help. It is my understanding that a large part of the Salvation Army funds go towards helping these veterans. Tomorrow, we will serve dinner to those in need and I really can't wait to do it.
I have not heard it called a 3 year ADN program, but I have seen many ADN programs with a three year curriculum. Many request or encourage the applicant to take as many general education or support courses as possible prior to entering nursing school. I can't understand why anyone would want to take this track; why not go one more year and attain the BSN?
I do believe there needs to be a revision in nursing education. I would like to see the strength and beauty of the diploma program combined with the theory of the baccalaureate program. The first year would be purely general education and the sciences; then, begin the actual nursing program in the sophomore year. I know there are nursing programs that do start their theoretical content in the sophomore year, but I don't know anyone personally who has taught or attended such a program.
In the rural parts of our country, the BSN is not highly valued. I think much differently than I did a few years ago when I taught at the BSN level. After living in rural Missouri, I have learned why applicants are not interested in the BSN. Quite frankly, with the low wages and being able to serve in the role of nurse manager with an ADN, what motivation does this give them to seek the BSN? Therefore, management and leadership must be taught at the ADN level as well.
Have you noticed this in your area of the country?
Written and explained perfectly. I enjoyed this post, thank you!
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