dudette10

It's ridiculous that your colleagues are not sharing their materials with you. It helps to have a basic template that you can then revise to fit your style, especially for a someone teaching a course for the first time. My issue has always been (and still is) when my colleagues take my materials without asking, don't make changes to the materials but do remove my name from the materials and put their names on them. But, that's a whole different discussion...

I have taken care of AIDS patients and HIV positive patients. Standard precautions. I had a spot of blood come from a kinked catheter during IV removal on an HIV positive patient. It landed on my uncovered wrist above my gloves. He looked at me with an alarmed look on his face. I looked at him and said, "Your viral load is undetectable and my skin is intact. It's ok." I'm ok. You're ok.

Students LOVE skills labs because they feel more "nursey," and it increases their self-efficacy. They will love it, regardless. There are some teaching-learning strategies to consider. The most critical part of a skills lab is assessing the students' needs. Is it a required lab? If so, where are the students in the program (early...close to graduating)? Is it an open lab with students coming in for their own edification? Is it a structured remediation session? Another important point to consider is alignment with their classroom sessions, especially required labs. How closely is the required lab aligned with the didactic portion? Do you have access to the instructional materials for the didactic portion for reinforcement of concepts? One thing that is often overlooked in skills labs with new instructors is the entire nursing process. As nurses, we don't just go in and do a skill...we assess, teach, evaluate. Include that as part of your skills lab, as appropriate, based on where they are in the program. Also, be sure to reinforce good habits, such as hand hygiene and patient identification, and expect that to be a part of their return demonstration. By nature, skills labs are formative experiences; only skills check-offs are usually summative, so be sure to treat your skills lab that way. Consider debriefing sessions with the whole group. I've done them with simulation and lab...and, believe me, students are harder on themselves than we could ever be! Doing a debriefing of affective, psychomotor, and cognitive learning creates a judgment-free zone of learning. They will make mistakes, but you should see improvement over time. Those who make the same mistakes over and over may need remediation. I know my post didn't give you the information you asked for, but I hope it's helpful anyway.

Most brick-and-mortar schools use adjuncts for clinical teaching and full-time faculty for classroom teaching (along with clinical responsibilities). Online teaching may be a different situation for online only schools. Others may have input on that.

For academic nurse educator, it really depends on the type of program/school you will be teaching for to determine if you can get by with an MSN or need a doctorate to even get your foot in the door. An MSN is always required; doctorate is always encouraged and may be required. For programs, my opinion is to stay away from the for-profits. I know that some swear by them, but I've precepted a few from the for-profits, and it makes me wonder about the curricula. You will also be limited to what you can teach based on your job experience, as that is a requirement of the HLC. You must be credentialed to teach the classes you teach. Your experience would be very appropriate for community health classes and any of the three Ps (patho, pharm, physical assessment). Adjuncts get very, very low pay. You can't make a career out of it, but you could do it on the side. I work in a year-round program, so I don't have summers off. I work A LOT but mainly because I over-extend myself in committee work and the like, and I have a lot of grading in the classes I teach. There are so many variables to nursing education that it's difficult to give a single overview on it.

The burnout in academia is based on leadership decision-making to 1) let students slide through for things that are clearly expulsion-worthy (and stated as such in the student handbook) and 2) leadership decision-making to pass students who objectively did not meet the minimum requirements of the course. Then, everyone freaks out when the NCLEX pass rates drop. Duh. But, I do love academia, and I'm very, very good at it. Plus, where I work, I'm very well compensated with opportunities for pay above my salary. Last year, I made over 100K...at a non-profit.

This. Clinical sites require it. No vax; no clinical. You've entered the wrong profession.

Most things are definitely avoidable. If you saw the reasons for the 20 "exceptions" request per term, you would agree.

This is what you don't understand about teaching. I get about 20 requests for "exceptions" every single term. One out of the 20 is unavoidable. The rest are bad planning or special snowflake requests. The rules need to be applied in a non-arbitrary manner. So, if you want to talk about fairness, how is it fair to allow some to slide for bad planning when others are never late because they are good planners? I am not going into the details of when something is an emergency and when something is not. I am a compassionate instructor, but I'm often put into a position where I have to say no to ensure that my decisions are not arbitrary. And, I can tell you with 100% certainty that saying "no" to a student is not something I look forward to. However, I have to for fairness.

Yes, because of clinical hour requirements. Those requirements by the accrediting bodies are not a "monster" to keep nursing students in line. They are there to avoid predatory schools that do not provide the minimum standards of education to students. Most instructors try to be compassionate people, but an emergency is an emergency--and taking your sister to school is not an emergency--it's bad planning. Here's the other thing...as much as I hate it...we have to have rules for this stuff because if we don't, it gets a little chaotic. I have foregone rules about attendance, and every class has two to three stragglers up to 30 minutes late who then ask me to stay after class so they can make up for the missed quiz that I always give within the first 30 minutes of class. I have had rules about attendance in a classroom (no on-time arrival, no quiz makeup), and everyone shows up on time. Funny how rules actually work.

I earned my online nursing education degree from a brick-and-mortar in another state that had been around for more than 100 years. I had an excellent nursing education experience. I secured my own academic rotation and clinical educator rotation through networking. I would suggest that you change the questions you are asking, actually. Do the practicum experiences require deliverables? For example, in my academic rotation, I had to create a lesson plan, deliver a week's worth of didactic, and document my activities for clinical supervision. For my clinical educator rotation, I had to design and deliver an in-service. Everything was recorded and I sent the video file to my instructor. We also had an online component where we took a section of the CNE review book and created a course module on it, complete with lecture, activities, assignments, and grading rubrics for online learning. I ask that because I'm currently precepting a student in online nursing education, and she is not required to do anything for her academic rotation! There is no way I can evaluate her on the NE competencies with her just shadowing me all the time! So, I am requiring her to design a lesson plan and deliver one of my classes. In my opinion, her school is failing her.

Yes, yes, and YES!!!

It is well documented that expert nurses have a significant learning curve to be expert educators. And, the methods of teaching and assessment are the foundations of teaching....it's a specialty in and of itself with a body of research, so it's not as easy as just "direction." In addition, there is a substantial body of research on faculty on-boarding and how it is insufficient in institutions of higher learning.

I worked acute care floors, and I became a master at documentation. Determining what was necessary for the care of my patient and skipping everything else. The following was my standard routine. Of course, any significant events would be charted. Do and chart a complete H2T at the start of your shift. Know what you EHR considers "WNL" and chart exceptions only. Charting normals is a WASTE OF TIME. My unit required a second assessment to be documented. I did the assessment, but I did not waste time with the full H2T click boxes again. I documented changes from my previous assessment, if any. Then, I created a SmartText that essentially stated changes from first assessment were documented in the flow sheet. The office RNs want you to fill out extra paperwork for their audits with info already charted on the EHR as part of your normal documentation? Screw that. They can do the audits themselves. Chart pt-stated reasons for refusal and education interventions for those refusals. Chart the name of the RN you give or receive report, especially during transitions of care. Charting education in that stupid and unwieldy education module of the EHR is just for the Informatics and Reporting team. I know it's important during audits and everything, but it's a waste of time. Get in the habit of educating your patient on meds as you give them, on procedures as they are ordered, and then you can safely and truthfully create a SmartText on your usual education routine to drop into your end-of shift note. Make your After Visit Summary actually useful to your patients with written education on home care and times they should take their next doses of home or new medications. Go over it with them prior to discharge. Have them sign it. Your documentation is complete....no need to re-document what the system will save anyway. There are others, but those are my main time savers that provided accurate and complete documentation for the care of the patient....not the care of the Informatics team.

Yes, a million times. Depending on the way things are done on a particular unit, doing a CHG bath and making someone NPO overnight is no big deal, even if surgery is decided against or delayed. NOT doing it with all that information at your disposal would have put you in a heap of trouble. So physician notes, patient understanding of the plan, and off-going nurse confirmation of surgery isn't enough to implement simple prep, which leads to a delay of patient care? And the surgeons are cool with that? Really?

Treat each hour as a separate class session. No more than two concepts per 50 minutes, break for 10. Fifteen-minute lecture, 10-minute class activity, repeat x 1, break. Depending on your content, the class activities can be scaffolded. A scaffolded activity doesn't have to be complete at the end of 10 minutes--it only needs to be complete for the concept you just taught. Try not to re-teach what they have already been taught in previous classes. If your school has a separate patho class, don't re-teach patho. Instead, include pre-class homework assignments for a small amount of points about the patho of the conditions you will be teaching that day. Have them complete med cards prior to class for a small amount of points so that you can concentrate on evaluation and nursing implications rather than teaching the pharmacology. Maybe start out with a quick, ungraded quiz on the homework, review the answers, have them keep the quiz as a study tool. (My class LOVED that.) For focused assessment of a condition, use the Socratic method. "What assessment techniques are we going to use and why?" "What are the most likely abnormal findings for this condition?" Guide the class through the discussion and write their correct answers/rationale/abnormal findings on the board. Provide them a pre-made template chart that they can complete as notes. If you spend too much time dumping knowledge into their brain, they won't know what to do with it--and they get bored quickly. Homework can be the knowledge acquisition part; doing a quick review of the knowledge, then teaching them to work with the knowledge can be the focus of your class. Those are just a few suggestions. I don't know what class you are teaching, so these may not work for you.

Four 4-oz cups of cranberry juice over a cup of ice was my dehydration elixir at around 3 p.m. on a 12-hour shift. No guilt. At all.

Are you talking about holding heparin for possible HIT? There is a way to determine via labs and clinical signs and symptoms if HIT is a possibility. I would have to look it up--it's something like a 50% drop in platelet count X number of days after starting heparin. At any rate, you can hold heparin for a short period of time and call the provider with your concerns. But, no, you don't hold it as an independent nursing action--you can hold and CALL, but don't just hold.

I'm not retiring, but the hubs is soon. When he gets SS at 66, his monthly take-home (pension + SS) will be more than he brings home now, and that's not counting the 401k, which we will probably just let sit unless we want to do something extravagant. Plus, I'm still working, the house is paid off, and the kids are paying for their own education.

Oh, what a load of ****. (Not at you klone...at the whole 'nurses are idiots' way that the accreditors are acting.) And, as you indicated at your workplace, this is just a matter of 'tightening up order sets.' Does it really change anything about our practice, except cost the facility money for the HIIM group to change the way the orders read?

Here is a novel idea that will take some additional research that we currently don't have. This is a bit of a long-winded explanation, but bear with me. Is it possible that today's children are different from yesterday's? I don't mean in family values or culture or upbringing, but BIOLOGICALLY different. Aaron Lerner, Patricia Jeremias, and Torsten Matthias, "The World Incidence and Prevalence of Autoimmune Diseases is Increasing." International Journal of Celiac Disease, vol. 3, no. 4 (2015): 151-155. doi: 10.12691/ijcd-3-4-8. Anecdote: My oldest son is now 20. When he was in 2nd grade, his teacher with 40 year experience said, "When I first started teaching, I could easily handle a class of 40. Now, I'm struggling with 20. The kids are different now. I'm convinced it's our environment." Where are our studies on autoimmune diseases and the environmental factors that may have a role in it. Our food is genetically modified, our air is filled with waves that we can't see and know NOTHING about the effects on our bodies, our waterways are contaminated, and we sit in traffic inhaling fumes. Why are our girls and boys hitting puberty earlier and earlier? Why do we have a growing incidence of autoimmune diseases in the developed world? Do we really think that none of this has affected the growing bodies and brains of our children? We need to found out what type of damage our technological advances can cause. We simply don't know, but we are seeing the effects of without cause.

Yes, our culture may be a bit different from Australia (but not apples and oranges, by any means), but that doesn't mean we can't look at their INTERVENTIONS and ADAPT them for our own setting.

Only two of those were a stranger walking in to a building and shooting indiscriminately--the Monash University killing and the Sydney Hostage Crisis. The rest were familicides or feuds with specific people that turned violent. There is a qualitative difference between those kinds of shootings and the kind the US is experiencing.

I am a new instructor, and there are a number of issues. The first is the amount of content that schools expect us to teach. It's ridiculous. So many of my colleagues agree. I'm now on our curriculum committee with these same colleagues, and we are committed to making a change. I usually teach a class where I can control the content, unlike most of the classes in our current curriculum. I love it. I have finally gotten my class to the point where students realize they MUST do the reading beforehand to participate fully in the classroom and actually learn something. I haven't completely flipped the classroom, but it is definitely a mixed classroom (the term for the lecture/active learning activity combo). I feel good about it, they are engaged, and they have shown me, through formative "quizzes," that they are learning too. The content creep MUST be addressed for every classroom to be an active one. That takes a lot of hard work via curriculum development and talking the frightened instructors who don't know how to create an active learning classroom off the ledge.

My last bedside job eliminated the on-call pay all together, but required you to be available after cancellation until four hours after start of shift. I had one instance where I was cancelled, I was called at 11 and told that I wasn't needed, but that I had to remain on-call until 3 p.m. I said, "No, I'm not required to do that. Do you need me now or not?" The answer was "no," so I said, "Then I am no longer on-call" and hung up.