PamtheNurse BSN, MSN

PamtheNurse has 26 years experience as a BSN, MSN and specializes in Education.

PamtheNurse's Latest Activity

1. 

   A Writer's Learning Journey

   PamtheNurse posted a topic in Educators

   Like the teen going to Summer camp, I have had on my journey the anxiety; did I bring with me what I needed? Yet I had, like the teen in Summer camp, the excitement of discovery while leaving behind the known and finding the new. The experiences gathered along the way were invaluable to my practice and my life. Yet wisdom is fleeting, and I have many more questions than I have answers. The most recent leg of my journey, my doctoral effort, has led me down paths both circuitous, narrow, and unexpected, but the learning has changed me in ways I could never anticipate. The writing of articles for allnurses was at first daunting and difficult, however, this became a part of the learning process. Also, it resulted in the realization of the joy of creation. Article #1 I started with The Overlapping Roles of Nursing Faculty article as I became aware of the challenges of nursing faculty shortages coupled with nurse shortages and the pressures to produce more nurse graduates such as expectations in fulfilling the nurse faculty role, the lack of mentorship, and the compensation at roughly 1/3 of hospital compensation for comparable roles. In that article, I spoke of possible coping, with an eye to prevention as I became more aware of the high risk of burnout for nursing faculty members. Article #2 My next article, Degree or Not Degree, That is the Question, was the result of my continuing interviews with experienced nursing faculty members. They reported and I began to observe the student perception of a successful nurse. For many nursing students, it was not working at the bedside, nor was it a calling to care for others. It was financial gain. There was much discussion in the responses to that article of the relative dedication to expertise and commitment of the nurse graduate intent on the immediate goal of a greater degree. Article #3 My reading of research of nursing faculty doctorally related and nursing students/graduates from the previous article with continuing nursing faculty members’ conversation regarding their frustrations led to the next article, What is Wrong with These Students? Millennial students were of primary discussion as the greatest challenge in accommodating educational efforts for learning. That article garnered some almost strident commentary. Also, the article commentary revealed some assumptions of the composition of prelicensure bachelor program students as opposed to other level programs. Article #4 The article after that one, Are Nursing Students Burned Out Before or After They Graduate? did not seem to strike a similar note as did the previous article although there was a commentary of skepticism of the existence of burnout in general as well as nursing students and graduates experiencing it. Also, the commentary did lean in the direction of burnout as a state of mind that can be prevented or resolved with a change in mindset rather than an understanding of the seminal and current burnout research that has established the Maslach Burnout Model as the gold standard. Article #5 The article, Burnout, the Literature, and Understanding, drew the least response. It was composed as an attempt to present what I had discovered in my doctoral pursuit as an understanding of burnout. An article-length response to the lack of burnout understanding that I discovered in the commentary of the article, Are Nursing Students Burned Out Before or After They Graduate? A synopsis of the commentary to Burnout, the Literature and Understanding, is difficult due to so little commentary. However, one wonders why so few responses? The tone of the article was different as it was a discussion of research literature as opposed to the previous articles that addressed issues current in the nursing faculty experience and maybe that led to less commentary. Which brings this article and this author to this point... What is this article’s purpose? It is to recognize the path taken as a teen does experiencing Summer camp; a door opening to the world. I experienced the input received, and the learning that happened with the participation. I wrote the articles with assistance at first to fledgling sole flight later; the learning was truly an adventure in the process. I am nearing the point of posting here on allnurses, the research invitation for participants. I can see the leg of this journey's goal before me, finally, as it has been long, however, I see learning as never-ending, bending, turning, and taking me down yet another adventurous path. Resources American Association of Colleges of Nursing. (2019). Nursing faculty shortage [White sheet Fact sheet]. American Association of Colleges of Nursing. (2019). Special survey on vacant faculty positions for academic year 2018-2019. American Association of Colleges of Nursing. (2019). The impact of education on nursing practice [White Sheet].
2. 

   Nurse Graduates, Nurses, and Nursing Faculty Burnout

   PamtheNurse posted a topic in Educators

   Previous articles have garnered comments regarding graduate nurse proclivity toward advanced degrees and not remaining at the patient bedside. Graduate nurses self-describe as wanting to be the best, excel, and achieve the greatest compensation. In addition, there are those encouragements left from the Magnet programs (A new model, 2010; Drenkard, 2013; Stimpfel, Rosen & McHugh, 2014; Wolf & Reid-Pointe, 2008) for graduates to achieve degrees. The patient bedside care is comparable to primary health care. Primary health care is described as essential health care much like bedside nursing. Calma, Halcomb, and Stephens (2019) discuss curriculum, nursing student attitude, and perceptions, preparing them for primary health care workers. They discovered a focus on acute care in curricula that color the nursing student perception. Acute care curricula content and the encouragement to pursue advanced degrees is that having a greater impact? Is it truly a lack of awareness of essential healthcare career possibilities, therefore desire and confidence are lacking as suggested by Calma, Halcomb, and Stephens (2019)? Or could it be the student nurse experience that affects a nurse? When I was a student driver in a car with my driver education instructor (yes it was a long time ago), he pointed out to myself and the two other bored high school student drivers in the car that watching pedestrian reaction at seeing the student driver sign on the top of the car was indicative of their student driver experience. A smile indicated a positive experience a frown a negative one. Interestingly I noticed a reaction was universal despite age and gender. It has me thinking is it the same for nurses? Does their student nursing experience color their nursing practice or just their reaction when reminded of it? Or is it burnout? Burnout is defined in the ICD-11 as “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions: 1) feelings of energy depletion or exhaustion; 2) increased mental distance from one’s job or feelings of negativism or cynicism related to one’s job; and 3) reduced professional efficacy” (WHO, 2019). As discussed in previous articles by this author, burnout was first researched and identified in educators and healthcare providers primarily nurses in the 1980s. Since burnout has been extensively researched and led to the identification of it in many work settings and roles. Additionally, the research has continued for those in education and healthcare. More recently, nursing students have been included. My own study is of nursing faculty burnout. The research survey will be available soon. I began this article with thoughts of nursing graduates, many of which who have expressed intentions of not remaining at the bedside but to continue their education. This author has previously posted articles on allnurses.com which have garnered anecdotal lamentation commentary of educating graduates to advanced degree levels taking them away from the bedside resulting in leaving future patient bedside unattended. Interestingly, research and data that established the advantageous use of bachelor prepared nurses at the bedside for the patient also gave impetus to the Magnet programs (A new model, 2010; Drenkard, 2013; Stimpfel, Rosen & McHugh, 2014; Wolf & Reid-Pointe, 2008). There is the research conducted by Calma, Halcomb, and Stephens (2019) that offers the possibility of nurse graduates simply unaware of primary health care or bedside nursing as a viable opportunity. Another thought offered is the student nurse experience affecting the nurse as a graduate and beyond. There is current research of the nursing student and burnout that begins during the nursing education experience. Also, research has linked burnout in nurses and nursing faculty to nursing shortages. Is burnout leading the graduates to seek further education to leave the bedside? Will future bedside nursing experience shortages to the extent that patients will go untended? Given we have experienced nursing shortages in the past and are currently experiencing nursing shortages, is this happening now? Your thoughts? 
3. 

   Burnout, the Literature, and Understanding

   PamtheNurse replied to PamtheNurse's topic in Educators

   Susie2310, I have my own research I am attending at the moment. My topic is nursing faculty member burnout. Variables are perceived organizational support and self-efficacy. However, is this a study topic one you would want to pursue? You certainly have a grasp of the idea. A qualitative study would be an interesting one. Deciding design and analysis procedures is a bit down the road. First, a discussion of possible variables and then an investigation of previous research would give insight on proceeding. I am happy to be involved in the discussion of the possible variables. Your thoughts? PamtheNurse
4. 

   What Is Wrong with These Students?

   PamtheNurse replied to PamtheNurse's topic in Educators

   NurseLizabeeRN, It sounds like you do have a doable plan. It is interesting you have mentioned "adequate support from leadership and peers, some level of work-life balance" and "an innate desire to teach amid the politics". My research variables are nursing faculty member self-efficacy, perceived organizational support, and burnout. Your other indicated factor is "coupled with growing a fair amount of thick skin" would you define that as resilience? If so there is some research that does indicate resilience does mediate burnout. Have you read any research that you arrived at these factors as part of a successful plan? There is also research (not nursing - physician) that explored the possibility of physicians as graduates actually more successful in diagnosing and treating patient than their elder counterparts. What caused you to determine to work with nursing faculty members with >10 years of experience? PamtheNurse
5. 

   Burnout, the Literature, and Understanding

   PamtheNurse replied to PamtheNurse's topic in Educators

   Faculty Burnout Preceptor burn out! I just finished with precepting 2 nurses back to back. I had no flexibility to trade shifts and do it my way for 3 months! my solution? no more until end of the year. RN to BSN, You have me thinking. I have an interest in nursing faculty members and burnout, however, I hadn't thought about preceptors. Would doing it your way have prevented or preempted the burnout? PamtheNurse
6. 

   Burnout, the Literature, and Understanding

   PamtheNurse replied to PamtheNurse's topic in Educators

   Susie2310, You have certainly piqued my interest. I could see the possibility of this study. For a quantitative study: demographics questions could include those that would indicate the monetary motivation and number of years in nursing. The best bet for a validated tool would be the Maslach Burnout Inventory, which would indicate the degree of burnout. Your thoughts on variables? Or would a qualitative study be best? PamtheNurse
7. 

   Burnout, the Literature, and Understanding

   PamtheNurse replied to PamtheNurse's topic in Educators

   "I would be interested to know if the rate of burnout is higher in student nurses/nurses whose primary motivation for becoming a nurse is money, job security/status, family pressure, etc., versus those who are primarily motivated by wanting to care for sick people." Susie2310, Thank you for your question. I can imagine that a study of such would be fascinating. However, the difficulty would be in determining the population that would represent those nurses that are in the profession for the monetary gain only. Thoughts? PamtheNurse
8. 

   Burnout, the Literature, and Understanding

   PamtheNurse replied to PamtheNurse's topic in Educators

   Arafelle, Thank you for your commentary. Tenure and the associated drawbacks have been a subject of conversation for many years in higher education. It is on the downward trend of availability for faculty, particularly nursing faculty members. If you are interested there is further information, discussion boards, articles, and research publication(s) regarding tenure at higheredjobs.com. PamtheNurse
9. 

   Burnout, the Literature, and Understanding

   PamtheNurse replied to PamtheNurse's topic in Educators

   I am extending my gratitude to all of the article commentators and their observations. Burnout, or at least the subject of it and ensuing discussion has caused some consternation. Maslach et al. (1986) would be gratified to know that the study they initiated of burnout, and the continued extensive study conducted by them and many others in the intervening years continue to be a subject of discussion and concern. As demonstrated in the article commentary it is of serious concern in nursing. A concern that has been justified by many researchers of burnout who focused on healthcare providers primarily nurses and educators. My work is focused on the existence of burnout in nursing faculty members. Nursing faculty members are both healthcare providers and educators, yet there is little research focused on their possible burnout experience. I hope to bring attention to that gap and assist in filling it with my research. Research that will begin here in allnurses.com, soon. PamtheNurse Maslach, C., Jackson, S. E., Leiter, M. P., Schaufeli, W. B., & Schwab, R. L. (1986). Maslach burnout inventory, 21, pp. 3463-3464. Palo Alto, CA: Consulting Psychologists Press.
10. 

    Burnout, the Literature, and Understanding

    PamtheNurse posted a topic in Educators

    Preventative Measures Burnout has been a topic well researched starting with Maslach, Jackson, Leiter, Schaufeli, and Schwab (1986). As someone who has been reading literature and spending a tremendous amount of time over the past few years thinking about burnout, I have often been asked what is the cure or the preventative actions. The research is consistent in establishing the existence of burnout and the all too commonality of it. In my reading, I found articles reporting nursing student burnout. Recent research is attempting to pinpoint where it begins for nurses, before graduation during the educative process? Or as a graduate nurse? The article I wrote recently and published here in allnurses.com titled "Are Nursing Students Burned Out Before or After They Graduate?" (2020) does delve into the topic with much greater depth. Currently, there are many more questions about student nurses and burnout than answers. Change in Mindset? Another nurse posted a question in allnurses.com (Destin293, March 17, 2019) "Burnout...what to do about it" had a respondent that stated “There is nothing wrong with YOU or your very reasonable feelings about this. Burnout is not the appropriate label for it. Chin up. Put your confidence and self-worth back in order, as this weight is not yours to bear. You have no professional duty to imposed nonsense. Instead be impowered. Formulate plan B and put it into action” (JKL33, March 17, 2019). A response that is well-meaning but not helpful. If burnout is the perceived experience, it is the individual’s state of being. And the description of burnout as put forth by Maslach et al. (1986) is one the encompasses an individual incapable of self-directed action as described by the respondent above. However, the respondent that posted the above comment is not alone, many believe that burnout can be defeated with a positive attitude or thinking, pulling oneself up by bootstraps or change of outlook. Maslach et al.’s (1986) beginning and subsequent work along with a plethora of other researchers have established the construct of burnout as valid with many different mediating factors. Little research has found burnout to be mediated simply by a change in mindset. Self-Care and Mindfulness Some recent study, however, has explored the impact of preventative measures for nursing students e.g. self-care (Nevins et al., 2019) and mindfulness for nurses Montanari, Bowe, Chesak & Cutshall, 2019). Nevins et al. (2019) reported that an increase in exercise and hydration in baccalaureate nursing students did increase students’ described levels of wellness. Montantari et al. (2019) found that nurses’ use of mindfulness “positive implications for the well-being of nurses” to stress and burnout (p. 175). Increased resilience in nurses mediated burnout (Guo et al., 2019). All increase my hopefulness that research is on track to illuminate a burnout preventative pathway. Faculty Burnout Additionally, my literature reading has included the topic I plan to research, nursing faculty member burnout. Aquino, Young-Me, Spawn, and Bishop-Royse (2018) found in their descriptive survey study of doctorate nursing faculty members’ intent to leave their academic position that degree type, age, and burnout were significant predictors. Their recommendations in addressing the nursing faculty member shortage as “critical to creat[ing] supportive and positive work environments to promote the well-being of nursing faculty” (p. 35). I have found the reading and contemplating burnout and nursing faculty members’ possible experience of it as interesting. The plethora of burnout research mentioned previously consists primarily of educators and healthcare providers as subjects. Little burnout research is of nursing faculty members despite the “great demands placed on many nursing faculty” (Aquino, Young-Me, Spawn & Bishop-Royse, 2018, p. 35). My doctorate topic is nursing faculty member burnout. I plan to offer qualifying allnurse.com members access to a survey. The qualifications include current full-time employment and one year of experience as a nursing faculty member. Interested? It is coming soon.
11. 

    Are Nursing Students Burned Out Before or After They Graduate?

    PamtheNurse posted a topic in Educators

    The burnout study of nursing is extensive and ongoing. Evidently, nurses are either burning out or burned out. However, when does the burning out begin, nursing school? Graduate nursing? Beginning practice? Or possibly later, after many years of practice? There is an ongoing study of nursing students’ burnout, however, without the extensive history that is found in nurse burnout study. The most recent research of nursing student burnout suggests that it may start in nursing school (Ching, Cheung & Rees, 2020; Rios-Risquez et al., 2016; Robins, Roberts & Sarris, 2018; Valero- Chillerón et al., 2019). If burnout does start in nursing school for nursing students, the questions of immediate thought are many, is burnout and the nursing student personality or some other personal factor of the nursing student need investigation (Majerníková, 2017)? Is it the environment either societal, home, or school (Njim et al., 2018)? Is the presentation or volume of information required? Or the teaching approach? Nursing student perception of instruction and/or supervision? And/or other nursing school factors such as clinical learning leading to burnout in nursing students (Babenko-Mould & Laschinger, 2014)? I discovered the articles reporting the study of nursing students’ burnout when conducting a literature search for my doctorate study topic: Nursing Faculty Burnout. The discovery caused another avalanche of thought, and the question: Is the nursing faculty burnout related to nursing student burnout? A literature search of nursing student burnout using CINAHL Complete, Academic Search Complete, and Gale Academic OneFile with peer review and 2017-2020 as limiters revealed 549 research articles. However, none were of nursing faculty burnout and nursing student burnout. Why? If nursing faculty are experiencing burnout symptoms of emotional exhaustion, depersonalization, and reduced personal accomplishment would that influence nursing student stress and present modeling of burnout behavior creating students at increased risk for burnout? Moreover, of greater prevalence particularly recently is the study of nursing student incivility, violence, bullying, and aggression (Hogan et al., 2018; Hostetier, 2019; Streiff, 2019). Is nursing burnout and/or nursing faculty burnout factors in this extreme behavior? Nursing faculty burnout has been linked to the nursing faculty shortage and further has been linked to the global nurse shortage (AACN, 2019; WHO, 2017; WHOA, 2018). The nurse shortage creates an environment that exacerbates the burnout factors with overwork and overburdening demands that lead to chronically incomplete tasks. That environment causes an increase in suffering and decreased safety for patients that are unacceptable to the caring nurse. The typical nursing faculty member has 20 years of experience before joining the ranks of academia. Burnout tends to stick like burrs. Nursing faculty burned out leads to less nursing faculty. Less nursing faculty causes fewer openings for nursing students to attend nursing school. Moreover, it results in nursing student exposure to burned-out nursing faculty (AACN, 2019). The nursing student after experiencing nursing faculty modeling burnout behavior, exposed to the nursing school environment graduates to hire into the selfsame situation that caused the nursing faculty members’ burnout some twenty years previous. Is that circular linkage a factor? Further, is resilience as the counterpoint to burnout a factor? There are a few, mostly recent, studies of resilience, nurses, and nursing students as a predictor of burnout experience with interesting results. Garcia-Izquierdo et al. (2018) in a study of 218 nursing students found a significant relationship between resilience, burnout, and psychological health. Brown (2018) conducted an integrative review of the impact of resiliency on nurse burnout that yielded yet more interesting and positive recommendations. What is happening in nursing schools? The nursing faculty burnout survey that I will be posting for allnurses.com members to complete will have some interesting outcomes? Will it not? There are many more questions I am sure that will occur to others. Previous articles regarding nursing students and nursing faculty have instigated comments and exchange of ideas here in allnurses.com, I hope for more.
12. 

    What Is Wrong with These Students?

    PamtheNurse replied to PamtheNurse's topic in Educators

    BabyNP,, The university BSN program within which I teach the average age of student is between 32-34, therefore millennial. Interestingly, with every semester the average age is rising not decreasing. Therefore, we have been teaching the millennials for some time. That and my assessment of generational differences from legitimate research data was the basis for my statements. Thank you for your comments. My fascination with the environment of education particularly nursing education and the experience of the nursing faculty lead to my doctoral work on the topic of nursing faculty burnout. My research survey will be coming soon!
13. 

    What Is Wrong with These Students?

    PamtheNurse replied to PamtheNurse's topic in Educators

    KalipsoRed21, Our college is actively teaching the tail-end of the millennials, the average age of our students is 32-34. You are correct, in the 70’s and 80’s corporate management changed employee treatment. Someone got the bright idea losing “lifers” would save money. And, true, degrees seem useless no matter the number or years of experience acquired. Why get a terminal degree when there is no financial benefit? My stated overall assessment of generational differences is from legitimate study research data. The work environment has changed, for all nurses, not just for younger nurses. Hospital systems have become money generating corporations, the emphasis is the more work for less pay - all the better! Corporate healthcare focus is not in quality of care, but in accomplishing patient care with as few lawsuits and government penalty fees as possible. That is another topic for another day. Many states do not have unionized nurses. Many that do complain the unions have changed and no longer look out for members. I’ll agree to disagree that some young people feel entitled and are ungrateful. I will however add this here ""The world is passing through troublous times. The young people of today think of nothing but themselves. They have no reverence for parents or old age. They are impatient of all restraint. They talk as if they knew everything, and what passes for wisdom with us is foolishness with them." (Peter the Hermit in A.D. 1274) Also, let me explain my impression of the circumstances that patients now appear more ill. Back in the day, patients were just as ill but spent a reasonable amount of time in the hospital to recover. Patients were not forced to discharge home before they were ready. Today they are, resulting in patient ER visits in very serious condition and are often re-hospitalized. As part of my nursing practice as an educator, I regularly take students to the hospital for clinical rotations, the increased acuity of returning patients is obvious. I see the younger, more recent grads struggling to keep up. And, as you so aptly stated, modern nursing schools do not have adequate hands-on clinical practice. Education is cyclical, we moved from a focus on hands-on clinical practice of the hospital based training to university based theory and science education. I foresee a time when backtracking will happen and the curriculum focus will change from theory and science to actual patient care. Thank you for your thoughtful comments.
14. 

    What Is Wrong with These Students?

    PamtheNurse replied to PamtheNurse's topic in Educators

    Tegridy, Lecturing is only one tool or approach to conveying the information. And yes with the technology that is available there are other ways to convey information and confirm that the information has been absorbed. However, that has created problems for instructors, which and what do they use, where and how long, and what is allowed. Add to that the number of and varying types of portals of information and the multifaceted role required of nursing faculty are leading factors in burnout as I am sure you can imagine. At first, participating in that environment and then witnessing it is why I got fascinated enough to want to explore if there is truly a correlation. Hence the research and survey soon to come out here in allnurses.com. Pam the Nurse
15. 

    What Is Wrong with These Students?

    PamtheNurse replied to PamtheNurse's topic in Educators

    Tegridy, TBL is somewhat like flipped because of the communication format but not quite. It certainly is different than reading slides. I hesitate to summarize it here because it is a little involved. A good article on it is Flipped Classroom Approach Ozdamli, Fezile; Asiksoy, Gulsum World Journal on Educational Technology: Current Issues, v8 n2 p98-105 2016 Let me know what you think. I've seen it work and students report less of that classroom experience you report as having experienced. Pam the Nurse
16. 

    What Is Wrong with These Students?

    PamtheNurse replied to PamtheNurse's topic in Educators

    Hoosier_RN, It does make you wonder is it that students are displaying student like behavior despite their age or generation? Pam the Nurse