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  1. The Boss, and it's Urgent My phone buzzed. It was a Friday night, but it was my boss, so I picked up. “Beth, please, please, can you come in tomorrow to orient a group of California Department of Public Health (CDPH) Strike Force Nurses?” “Who? What? Tomorrow...on Saturday?” “Yes, it’s urgent. They need mask-fit testing and skills validation before we can send them to the floor. They’ll be flying in in the morning, and be escorted straight to Human Resources. Charlene in HR is coming in to do their ID badges. They’re only here for 72 hours, they’ll go straight to the floor from you, and then work Sunday, Monday and Tuesday”. “That’s it? Seventy-two hours?” It sounded crazy to me, but we were in surge and desperate for nurses. Many of our own nurses were off sick themselves or working far too much overtime. The CDPH Strike Force CDPH had apparently reached out and contacted active and non-active CA nurses to recruit them to work short contracts during the pandemic. They were assured that they would be of help no matter what their background, and that they would be doing a great service in time of the pandemic. Our hospital was in disaster staffing mode, and nurses were streaming in from all different agencies to be oriented and sent to the floors. My job was to make sure they were competent on our Alaris infusion pumps and glucometer machines, to validate their Restraint competencies, and make sure they could document in our platform, Cerner. It was basically a week's orientation compressed to one day. Saturday morning I turned up early at 0730 to greet the new nurses. At 0800, a group of four nurses walked in. "Oh. My. Goodness.", I thought. This was a non-nurse-looking group if ever there was one. Hippy Harry Leading the pack was Hippy Harry. He walked in wearing a triangular red bandana on his deeply tanned and lined face, like a cowboy on a movie set. He wore a black T-shirt, khaki cargo shorts, leather sandals, and sported a puka shell necklace. Whenever he talked, his makeshift bandana slipped down off of his nose. I pointedly handed him a surgical mask and he reluctantly stuffed his red bandana into one of his pockets, donning the mask. I learned Hippy Harry had been volunteering in Africa and had not worked in a hospital in 15 years. I guessed Harry to be 73, but he volunteered that he was 68. He was warm and charming with twinkly blue eyes, and he struck me as quite the ladies man. Geriatric Barbie Next was Geriatric Barbie, a frail-looking, petite, retired school nurse in a pastel blue matching sweater set complete with a strand of pearls. She had bony hands with age spots and pink painted nails. Her manner was kind and gentle, and she really tried, but after several attempts, Barbie simply could not bar code scan the glucometer strips. Later, while I was teaching basic computer documentation, she needed 1:1 help with commands such as “right-click” and “re-size your window”. Dapper Dan Dapper Dan was a tall man with a chiseled face and artfully trimmed beard, looking as if he’d stepped right off of a GQ magazine cover. I could not mask-fit test him because of the beard and asked if he’d shave it. He stroked his jaw protectively “No way, my partner would kill me”. ‘OK, well, last I heard we were out of PAPRs but let me check again”. “Thanks”, said Dan, “and, I’ll need some scrubs to change into. Size medium but medium/tall if you have them. The agency said you’d provide them”. Right. Let's see if I can get those from Surgery. Tattoo Tonya Next was Tattoo Tonya. In the computer room when I was standing over her is when I first noticed the tattoos on her scalp, in between her dyed-blonde cornrows. The tats were black and swirly, vaguely matching the ones on her arms. She had ear cuffs and a nose piercing. She picked up on everything super fast, and leaned in to help Barbie frequently. It didn’t take long before I saw past her colorful presentation and realized she was the star of the group. She documented easily in Cerner and knew how to use the Alaris pump and NovaStat strip. I had no qualms sending her to ICU. Nurse Beth Pulls it All Together While they were busy on the computer, I started to make preceptor arrangements. I called the ICU Charge Nurse to find a preceptor for Hippy Harry. “Hi Ashley, I know you’re busy but I have a Strike Force nurse here who needs to be precepted from 1400-1930 today.” “Beth, my preceptors are all so burned out <sigh>, I hate to ask them. Let me ask Lindsey...no, she already has someone with her. I’ll call you back”. Later, Ashley called to say she had persuaded Stephanie to precept Harry. “Ashley, thank you so much! I appreciate it”. Right about then, Harry approached me. “Beth, I know I’m hired for ICU- and I can do it, don’t get me wrong, but you know- it’s been a while. I think I’d be more comfortable in ED”. He smiled charmingly and all I could say was, “Let me call ED and see what I can do”. After all, they were volunteers, right? ..Update Monday morning Harry walked into my office, hospital-issued scrubs neatly folded and badge in extended hand. “I’ve realized this just isn’t going to work out. I worked a half shift in ED and things have changed too much. I'm too far behind. I’m sorry to have taken up your time.” I smiled ruefully. It had truly been my pleasure to meet Harry and the whole group. Perhaps Harry was a romantic, responding to the plea for help, and seeking an adventure. I wished him the best. Later, I talked with Karen, the ICU educator. She said Barbie was not assigned patients but kept herself busy by going around patting patient’s hands and smoothing their covers. She was going to work one more shift. Tonya was a superstar as predicted and they were trying to recruit her to stay longer. A PAPR was found for Dan but it was discovered he did not pass his Basic Arrhythmia exam and he had to be pulled from the floor. Then she confided a bit of gossip. Apparently Harry and Barbie had spent quite a bit of time together in the hotel. Actually, the term “hooked-up” was used. Maybe Harry found his romance and adventure, after all.
  2. Calling all nursing students! I will be accepting my first job as a nursing faculty - teaching complex and acute care - it will likely be on an online platform - I want to hear from YOU! What did you like and dislike about your profs and lectures - I want to do a good job at this and I am super nervous but excited. Looking for any and all feedback!
  3. is JulieAllison

    Nurse Educator Career Path

    I am in an entry-level MSN program, recently passed the NCLEX (woohoo!), and now have nine months left until I graduate. I have realized that I am drawn toward teaching or possibly some type of coordinating position. I certainly appreciate and respect the value in having hands-on nursing experience before transitioning into teaching, but I also know that most bedside nursing isn't for me. To clarify, I am interested in teaching foundational, didactic coursework or topics like leadership or ethics. Can you share any thoughts on pursuing this career path without 2+ years of floor experience, as is usually recommended/required on faculty job postings? Do you have any recommendations on other jobs that I might not know about? Thanks so much!
  4. Hey everyone, quick question for all you Nurse Educators. The Nurse Educator on my unit is graduating with his NP in a year and a half and is leaving the hospital. I want to know what I can do in that time to increase my chances of being able to take his place when he leaves. This is a rather new idea of mine because I only just found out that he is leaving. So I'm beginning my research journey here. It is a burn unit in a level 1 trauma center/teaching hospital. It's a step down with ICU capabilities and all RNs are ICU competent. It's also important to note that my educator does not have his Masters, just a BSN. The burn unit is specialized and I assume he was accepted for the position due to being a skilled burn nurse for many years, trumping the masters degree requirement. I have my BSN (and would like to skip the masters degree for now since it appears to not be required), and have been working on the unit for 2 years. Due to a mass exit, there are only two RNs with more burn experience than me, so even though I'm still rather new, I think I have good enough odds to get my hopes up and start aiming for this position. I have my ACLS, ABLS (advanced burn life support), and currently in the process of getting my CCRN. Is there anything else that I can do to really make my resume stand out and increase my chances of taking the unit educator job in 1.5 years? Thank you all for your input!
  5. I'm on a committee looking at the most effective use of certain resources within our hospital that support nursing. Specifically I'm looking to develop some ideal aspects of a nurse educator position and would love to hear feedback from anyone based on successful (or not) use of this role. Some of the suggestions I've got so far: Develop a needs assessment and platform for nurses in the unit to take on an annual basis. Attend interdisciplinary rounds at least once a week to hear some of the issues that might come up related to education. Post a calendar at least monthly with anticipated hours on the unit- be sure that 4 (2?) hour increment minimum is scheduled to allow nurses to time to accommodate workflow. Have to have some hours that cover at least a little of all three shifts (not on the same day). Develop - slide decks by e-mail? poster boards in the huddle space? alternative education formats? Educator trivia game night jeopardy style? I'm thinking Audreysmagic might have some excellent ideas about what doesn't work- based on the recent lonely educator ballad. We really don't want to waste anyone's time, nurses on the unit say they want more education, but are we setting ourselves up to have one frustrated educator and a bunch of avoidant nurses? Thanks for any suggestions?
  6. VickyRN

    Rubrics and Their Many Uses

    A rubric is a scoring tool that communicates expectations of quality concerning a particular type of work or assignment. It specifies in objective terms criteria for assessment of student performance. For each criterion there are levels of potential achievement. These levels are graduated benchmarks (for example, 'superior, strong, adequate, needs improvement, inadequate,' or 'superlative, satisfactory, poor') that are defined by clear and objective descriptors. These are linked to numerical scores (for example, '5, 4, 3, 2, 1' from highest to lowest). The scores for each criterion are added up and the summary score for the entire rubric is then converted into a letter grade, percentage, or 'pass-fail' designation. Rubrics are useful for gauging student performance for assignments that are subjective in nature and otherwise difficult to grade accurately and fairly. Examples are writing assignments, careplans, teaching projects, portfolios, research posters, and student presentations. Rubrics should be shared with the learners at the beginning of the task or assignment process, to help guide their efforts. It gives students a clear idea of what they need to do to earn a certain grade. There are two main types of rubrics: scoring rubrics and instructional rubrics. Scoring rubrics guide students in focusing on content, whereas instructional rubrics guide students in creating presentations and reports, both oral and written. Students tend to focus on content areas that will impact their grade. Rubrics may be adapted according to the type of assignment and student needs. The first step is to determine specific criteria that are crucial to the assignment's outcomes. There should be no more than seven criteria, or the rubric will become unwieldy. The criteria become the "rows" in the grid. the second step is to describe the levels of achievement. The assessment scale may consist of three to six levels; these become the "columns" on the grid. the end product is a grid with columns and rows, such as this persuasive writing rubric or this brochure rubric. Questions to keep in mind while developing a rubric include the following: What are the critical areas of quality work? What are the levels of achievement? What are the clear descriptors for the criteria at each level? Here are just a couple of the many resources available on the web concerning rubrics: Rubistar - free tool to help educators create quality rubrics. Irubric - another free rubric creator tool, as well as an extensive library of existing rubrics. Grading stacks and stacks of writing assignments or careplans is challenging. A good rubric, however, can make the grading task easier and helps our assessment of student work be more fair, balanced, and authentic.
  7. Lane Therrell FNP, MSN, RN

    The Future of Nursing: Reflections of a Nurse Educator

    Download allnurses Magazine Golden thread and soft skills The future of nursing parallels the future of medicine, which is bright with technological innovations. From robotics, telemedicine, smart sensors, artificial intelligence, gene editing and more, the game-changing technological advances available now and on the horizon promise incredible improvements in healthcare across the board. It’s an exciting time to work in the biosciences. And it’s also a time when clinicians and caregivers must remain vigilant in recalling the reason healthcare exists: To improve the lives of human beings. Communication is the golden thread that ties future to present and past, and connects individuals to one another. Communication involving digital screens and online connections creates convenience and leverages time and money but it also changes the nature and dynamics of human connections. I believe technology has created a real and relevant need for genuine human contact, a revival of the art part of nursing. In recent years other professions including medicine have formally acknowledged the value of “soft skills,” which include interpersonal communication. That’s because interpersonal communication skills really aren’t that “soft” after all. Communication skills are powerful, and mastering them can be just as rigorous, difficult, and demanding as learning other clinical nursing skills can be. There is an academic and technical rigor associated with communication skills that too often remains unrecognized in nursing. Nursing must treat soft skills as clinical skills that are worthy of development. My perspective Before I get too carried away, let me clarify my perspective. I entered nursing at midlife after a successful 20-year career in public relations for agriculture. I hold two master’s degrees in two very different areas of inquiry—rhetoric and nursing—which gives me a truly multidisciplinary academic background. I bring a mature, holistic, mindset to my practice that embraces a full spectrum of thought and ideas. My perspective matches the ideals of advanced practice nursing and offers the kind of outside perspective that exposes insular thinking and promotes innovation. And because I’ve been academically trained to deliver instruction in communication and leadership, I can teach people how to communicate more effectively. My diverse experience in classrooms and clinics has shown me that better communication translates into better nursing care. It has also brought to light a great opportunity, as I see it, for nurses at all levels of practice to improve their interpersonal communication skills. The Patient-Centered Illusion Patient. Centered. Care. Those three words when used together capture the essence of why I became a nurse. Yet, without effective interpersonal communication, patient-centered care is merely an illusion. In nursing, we perpetuate the illusion by failing to communicate effectively. Three ways this can happen are: 1) treating numbers instead of patients; 2) using words that separate patients from their health; 3) establishing plans of care for our patients instead of with our patients. Treating numbers At its core, patient-centered care is built on individual conversations between patients and providers of care. These conversations allow us to treat the patient, not the numbers. Too often, though we become so heavily invested in counting quality measures or improving patient satisfaction scores, that we forget to check in with the actual patient. We even get tempted to use lab results alone to develop care plans, short-circuiting full patient assessment. Delivering care that is truly patient-centered means addressing the needs of the individual in front of you, not blindly following an algorithm. Ultimately, no matter how advanced the technology becomes, the best way to discover what is going on with our patients is through careful assessments, focused conversations, and critical thinking. Disempowering words Consider how we use our medical vocabulary. Indeed, medical terms have a place, and we must communicate accurately and collaborate effectively with our highly educated colleagues. But we also must use words with our patients that are appropriate and easy to understand. Words that are unfamiliar or unsupportive to our patients can create and perpetuate gaps in understanding, and contribute to feelings of helplessness and lack of control. Any type of disempowering language in a clinical setting leaves patients disconnected from their health and disengaged from their health behaviors. Planning in a vacuum Too often we are guilty of establishing plans of care for our patients instead of with our patients. If the plan of care is not relevant to the patient, and they’re not invested in it, they won’t honor it. This goes beyond “teach back” all the way to buy-in. If the patient can’t tell you step by step what he’s going to do to honor the plan between now and when you see him next, he likely won’t. As an educator, I work hard to make abstract concepts relevant to my students. I tell them why it matters, and relate it to something they already know so they can remember and “own” the information. We must all do the same with our patients if we want them to engage and comply with their plans of care. The teaching aspect of patient education is not about reciting massive amounts of information to patients, it’s about making any new concepts and information relevant to their daily lives so they can own the plan and take appropriate informed action for themselves between visits. But we’ll never know what’s relevant to the patient if we don’t have a meaningful conversation first. Barrier, value, and taking action The biggest barrier to improving interpersonal communication in nursing is thinking we’ve already mastered it. We talk about effective communication a great deal, and we’re communicating all day every day, so we think we already know how to do it. But are we doing it well? Most of us are blind to the fact that we’re not being effective. And we’re missing an opportunity to teach interpersonal communication as a skill in nursing. Effective communication is so much more than delivering information to a patient in their native language, following APA style to the letter when writing a term paper, or composing a persuasive letter to a legislator. All of this is important, but interpersonal communication skills are worthy of close academic scrutiny. To break the barrier, nursing must value interpersonal communication as a skill and teach it as one. It’s not that we don’t value interpersonal communication at all in nursing, it’s that we don’t formally recognize it as a skill to be taught. If we did, we’d have communication labs the same way we have health assessment labs. What if nursing did treat interpersonal communication skills with the intellectual and clinical practical heft I think they deserve? I believe nursing would thrive, improve, and facilitate the delivery of true patient-centered care in an age of booming technology. The bottom line is: Communication skills are as important as clinical nursing skills. Without them, empathy cannot be expressed, ethics cannot be honored, and a true patient-centered environment cannot be created. What are we doing to support nursing students’ mastery of the skills underlying our target competencies and course objectives? Effective communication is the unnamed skill that supports virtually all the advanced practice competencies. And yet, who is teaching these fundamental skills to nursing students actively and experientially? Future benefits Advances in biomedical science are happening faster than the slow-moving wheels of academia and clinical practice can turn. Fortunately, effective interpersonal communication happens in real time and moves at the patient’s pace. Effective interpersonal communication is the single best mechanism I know for meeting patients where they are on their individual continuum of change. From that perspective, what could be more patient-centered than engaging in interpersonal communication? The best strategy for keeping healthcare patient-centric in response to technological integration is improving interpersonal communication skills. Communication skills improvement has great potential to improve outcomes in primary, pediatric, and geriatric care, among cancer survivors, and in any situation that involves patients with multiple chronic comorbidities. It is a topic that nursing scholars and doctoral candidates may wish to tackle. Nursing is both art and science. While our education and industry may be biased toward science, it’s the art part that keeps us focused on our purpose and our patients. I infuse this ideal into all my interactions with students, patients, and clients. And I leverage my background in communication to do so. I celebrate nursing for the connections it allows me to create with others. And as professionals, we can strengthen those connections by improving our communication. I challenge my fellow nurses to begin valuing communication more highly for the good of the future of nursing, and for the good of the patients we serve. No matter what technology emerges in the future, there will always be a need for nurses to connect with patients as they deliver quality care. The future of nursing holds great possibilities and opportunities which we can embrace by integrating effective interpersonal communication into everything we do. Article Sources: 5 Key Trends for the Future of Healthcare Communication in Nursing Practice Effective Communication Skills in Nursing Practice Effective Interpersonal Communication: A Practical Guide to Improve Your Life Integrating the Art and Science of Medical Practice: Innovations in Teaching Medical Communication Skills Nursing Students’ Perceptions of Soft Skills Training in Ghana The Most Important Soft Skills Employers Seek The Art and Science of Nursing: Similarities, Differences, and Relations What are the NP Core Competencies?