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AOx1

AOx1

Nurse!
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  1. AOx1

    Nurturing Confidence In Nursing Students

    i completely agree. This was very helpful to me when I was a student.
  2. AOx1

    Selecting A Nursing School, Part 1

    Thanksvery much!
  3. AOx1

    Nurturing Confidence In Nursing Students

    You are most welcome! Keep going. It took me time to realize that while the majority of students were great, there are some that are not ready to change! Eventually, I could still find my calm place even in the face of it. Of course, the calm is never 100%!
  4. AOx1

    Dear Incoming Class of Nurses

    Seeing great exam grades, high NCLEX pass rates, and watching students "get it" for the first time are all great rewards!
  5. AOx1

    Nurturing Confidence In Nursing Students

    Heathermaizey, this seems like wisdom to me! Avoid the drama at all costs. I've only had one class with this attitude towards each other, and it was very difficult.
  6. AOx1

    Selecting A Nursing School, Part 1

    Did you notice that it says part 1? This is actually something I cover in part 2, and surely you realize that articles can only be so long.
  7. AOx1

    Dear Incoming Class of Nurses

    Hello, new and established students! I wish you all success, challenges, and great learning experiences in your journey. Try not to think of yourself as "just" a student. May you all find good mentors to push you and help you recognize your strengths!
  8. AOx1

    Nurturing Confidence In Nursing Students

    It does sound very frustrating. I hope this doesn't discourage you from being a mentor in the future! One of the most difficult things, whether you're a nurse, educator, mentor, preceptor, etc is seeing someone stuck in a negative mindset. It can be situational or due to underlying issues like anxiety or depression. Just try not to take it personally. It can be hard to deal with.
  9. AOx1

    Nurturing Confidence In Nursing Students

    I do know that every class has its own personality. Has anyone in authority ever talked to the class about this, especially early in the program?
  10. AOx1

    Nurturing Confidence In Nursing Students

    Oops, sorry, new tablet and accidentally posted midway!
  11. AOx1

    Nurturing Confidence In Nursing Students

    Educators should also play a role in encouraging teamwork. In the real world, that is what helps you survive the bad days. I believe extreme competitiveness arises from several areas. If you are confident and know your true abilities or lack thereof, you don't need to always show off. If you are acing your exams and understand the material, there is no need to make others feel "less." In reality, safe practice is high stakes. What should not be high stakes is every single thing in nursing school. Yes, poor grades can bar the way to graduating, but if every single skill, quiz, exam, paper, etc is high stakes, we never allow students to SAFELY fail. Yes, students will fail. So do nurses. After all these years, I still have the days when I don't spend time listening to someone who is lonely because I'm running a code. I still question if I did all I could have done. If the school creates a high-strung environment in which any faltering leads to failure of the course, is it any wonder that the environment is cut-throat? And as for those who still lack confidence, you do what you can. You assess the reasons behind it, continue to work with them, and refer them as needed. A nurse educator is not going to cure all issues all students are having, just as a nurse won't and can't make all patients well and whole. This is about creating the best environment possible, and partnering with students as adults to help them reach their full potential, whatever that may be. Your mentee might benefit from being asked for a concrete plan. Example: Mentee: I just can't do this! It's too hard everyone knows so much more than me. Mentor: I understand that it can feel that way. What is your plan to help yourself? Will you spend more time in the skills lab? Will you get an internship this summer? Honestly, just like patients, students must choose to improve and learn, just as educators must be willing to create a climate that allows for learning to be appealing.
  12. AOx1

    Nurturing Confidence In Nursing Students

    Educators should also play a role in encouraging teamwork. I believe extreme competitiveness arises from several areas. If you are confident and know your true abilities or lack thereof, you don't need to always show off. If you are acing your exams and understand the material, there is no need to make others feel "less." In reality, safe practice is high stakes. What should not be high stakes is every single thing in nursing school. Yes, poor grades can bar the way to graduating, but if every single skill, quiz, exam, paper, etc is high stakes, we never allow students to SAFELY fail. Yes, students will fail. So do nurses. After all these years, I still have the days when I don't spend time listening to someone who is lonely because I'm running a code. I still question if I did all I could have done. If the school creates a high-strung environment in which any faltering leads to failure of the course, is it any wonder that the environment is cut-throat? And as for those who still lack confidence, you do what you can. You assess the reasons behind it, continue to work with them, and refer them as needed. A nurse educator is not going to cure all issues all students are having, just as a nurse won't and can't make all patients well and whole. This is about creating the best environment possible, and partnering with students as adults to help them reach their full potential, whatever that may be.
  13. As a nursing student, my primary focus was to excel at my pre-requisites and to gain admittance to nursing school. As many of you know, nursing school admission is competitive, and I was focused on only one thing: getting in. And yet, with increasing tuition prices, the average college education costs significantly more than most things you will buy over your lifetime, with the exception of a home. You would think that with the rising cost of education, that I would have been a better-research consumer. I can tell you that I was not. I did not even know the right questions to ask. As a nurse educator, I now counsel all prospective students to ask the right questions. This is a sampling. What are the most recent trends in your program's NCLEX pass rate, retention rates, and in your college/university four-year graduation rates? NCLEX, the nursing licensure examination, shows whether the program's graduates are prepared to practice entry-level nursing. This information is often readily available on your state Board of Nursing website. Ideally, the pass rate should be well above national and state averages over a period of years. Do not look only at isolated pass rates of one year, look for trends. However, the NCLEX pass rate does not tell everything that you need to know. You should also look at retention rates. In other words, how many of the students who start the nursing program will graduate with a nursing degree? How many graduate on time? For example, if you are attending a nursing program that generally takes two years to complete, what percentage of graduates receive their degree within that time frame? Does the school flunk out anyone who is unlikely to succeed at NCLEX? Is the school accredited, and through what organization? Note that state Boards of Nursing review programs to ensure that basic standards of education are met. This is not the same as regional or national accreditation. Ideally, look for a program with ACEN (Accreditation Commission for Education in Nursing) or CCNE (Commission on Collegiate Nursing Education). This type of accreditation is rigorous and shows that your program meets or exceeds high standards for education. This type of accreditation can pave the way to continue your education at the masters or doctoral level. As a student, I just wanted to be a bedside nurse. I never imagined that I would one day decide to be a nurse educator. If I had not graduated from a program with this type of accreditation, it would have made continuing my education much more difficult and expensive. Also, look to see if your program passed their most recent accreditation or if they had any issues or follow-up reports. If they needed a follow-up report or visit, check to see what was the cause. How many clinical hours will my program have and in what settings? What is the faculty: student ratio in the classroom and the clinical setting? This information can tell you several things. Most states set minimum faculty to student ratios and a minimum number of clinical hours. Ideally, look for a program in which each faculty member is responsible for a small number of students in the clinical setting, especially in your first clinical rotations. I have worked for programs that have used ratios ranging from one faculty member to six students to one faculty member to ten students. I can assure you that for first-semester students, the 1:6 ratio is far preferable so that I can give each student the individual attention that they deserve. The number of clinical hours can give you one estimate of whether you will be prepared to practice as a new graduate. Nursing education should be a good blend of skills, evidence-based practice, and didactic (lecture). At my school, students have more clinical hours than any other program in the state, and our graduates are highly sought after and ready to practice as entry-level nurses. Additionally, in what settings will you be able to practice in clinicals? Ideally, your exposure will be broad, not just in terms of clinical specialty such as pediatrics or ICU, but also in both rural and urban settings, hospital and community settings, and with diverse patient populations. You may find your specialty in an unexpected area!
  14. As I work on my latest research, one common theme is evident in nursing students. Many lack confidence. Among several areas of research interest, I am most passionate about several issues: nursing students and bullying, predictors of nursing student success, and the relationship between a student's expressed level of confidence and their ability to persevere in nursing school. As a child, I saw a comic strip called Pogo, and the most famous comic strip they released said "We have met the enemy and he is us." I did not understand what this meant when I was young. I believe that I am beginning to understand now. As a nurse educator, my role is multi-faceted. I believe it is both my duty and privilege to serve as an example of professionalism and life-long learning, to teach students both the information and the skills that they need to succeed, and to help them develop professional habits and coping skills to deal with the reality of nursing. When I first began researching students' experiences with bullying, I noted that students often referred to feeling worthless and unsure in their abilities as a nursing student. These feelings appeared to be especially common in first-semester students. Students reported wishing that they could hide at clinicals, feeling unsure in their skills, and experiencing pressure and feeling like a failure when their skills are not perfect and their knowledge is not complete. One of the most difficult aspects of nursing education is releasing control, allowing your student a measure of free reign to learn and to succeed, while ensuring patient safety and excellent care. The first time that I saw a student start a foley catheter, it was all that I could do not to grab it and do it myself! This was not due poor technique on the part of the student, but simply to my inability to relinquish control! It took me time (and learning to put my hands behind my back) to watch my students and to demonstrate trust, while still offering support and guidance. When nursing students encounter dark humor in the clinical setting for the first time, it can be shocking. Hearing a nurse joke about death can lead to the view that the nurse is cruel or callous. I believe there is a similar phenomenon in education. Someone from outside our practice setting is less likely to understand our particular challenges. It is difficult when you put everything you have into nurturing students, only to have the only thing that is mentioned on your evaluation be the thing that you did "wrong" in the eyes of the student. It is frustrating when you try to create fair rules, only to have a manipulative student flout them. When you catch a student cheating, it can destroy your trust. However, as educators, we have a duty to manage our own stress, and not to take this out on the students. That majority of the students are excellent and hard-working. We also have a responsibility to demonstrate open dialogue with students and to "think out loud" as we educate them and perform skills. For example, one of the things I have noticed with beginning students is the confusion they face when learning a new skill. For example, when starting and securing an IV, the student may see several methods of securing the IV catheter, and be unsure which is "right." They fear failing a skills check off when they see several methods and each instructor insists that their way is best. I believe we owe it to the students to convey which aspects of the skill are essential, such as preparing the site, vein and IV catheter selection, and how we dress the site so that we can view it. However, we should also convey why some areas of a given skill are a matter of personal preference. We should also back up our practice with current evidence. I remember my time as a student, watching a "real nurse" perform a skill, and just knowing that there was no possibility that I could ever replicate that skill, and yet in time I learned to do so. What your nurse educators often fail to convey is that we've all been there. We've all been the student who felt like an idiot at clinical despite adequate preparation. We've been the student who wanted to hide from the instructor because we were afraid of not knowing. Many of us have been near graduation, terrified that at any moment someone would discover that we are not competent and refuse to allow us to graduate. I spent the first year in the ICU in mortal fear that I would make a mistake, that I would kill someone, that someone would find out that I was really just an imposter, not worthy of caring for patients. As the year went on and I learned to love the ICU and grown in confidence, I could recognize that same look in the faces of most students and new graduates. The response to a student or new graduate who lacks confidence can vary from bullying the weak to nurturing them. It has taken me years to find the right balance of high expectations, but delivered with compassion and with an understanding that students often lack confidence. I have had so many students tell me in the course of my research that they felt belittled, demeaned, and constantly in fear of failure or reprimand as students. Are nurse educators the enemy? We can be, if we are not transparent. I believe it is a good thing to be transparent, to be human. I tell my students that I know how they feel. I have felt like an idiot on every "first day" I've ever had, from kindergarten to my doctoral education, and at every new job I've ever held. The key is to know what you do know, what you still don't know, and try your best to learn. Have faith in yourself and your ability to learn in time. You will never know it all! As an educator, we can avoid being the enemy. Never back down on your standards or expectations, but explain to your students why you hold them. I hold high expectations of students because I know in time that they will be capable of meeting them. I want them to be the best. I want to see them move from a point of fear and uncertainty to a point of confidence and security. I see glimpses of this while they are in school. I see their potential begin to come to fruition when they return to visit and tell me of their latest accomplishments in their career. Tell your students early and often that the lack of confidence that they feel is normal, but that it is not a permanent condition! Encourage them to reach their highest potential. I do believe that as educators we can have a great influence on whether our students are confident and whether they love to learn or if learning is something that is motivated only by fear of failure.
  15. All of this! I have been told that I am evil for failing a student who twice tried to perform skills outside the scope of practice despite warnings. A student tried to poison her entire class against me by claiming I am a racist and targeted her (she was caught stealing and dismissed). The vast majority of students are great, but just as there are terrible instructors, there are also terrible, incompetent students. Never once have I heard the dangerous student admit that failure was his/her fault. It is ALWAYS the instructor's fault. I make about half of what I could in full-time practice because I am dedicated to the future of nursing. I can say that I've never seen a student failed out of clinicals that I would want caring for me or my family. There are scary, incompetent, and hateful people who are instructors, students, and members of every profession/group under the sun.my experience is that this is a small percentage and not the norm.
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