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  1. The proliferation of online nursing courses and degree programs presents nurses many options for career advancement. But choose wisely. There are misperceptions about online learning, as well as factors people forget to consider, that can derail the best of intentions. Picking the right online program can be the difference between taking your career to new levels or lamenting lost time and money. For more than forty years, Maryville University has demonstrated a true expertise in traditional nursing. This expertise has led to successful implementation of online nursing degrees. Maryville has been in the online nursing education space for six years, helping students like you bravely pursue a career in nursing with top-quality education and state-of-the-art training. We know what makes a quality online nursing program. And more importantly, we know the top considerations that students have when they make their choice. Here are five of the top factors that can influence your decision. How To Decide The Best Online Nursing Program STEP 1 Start with values. As a current or aspiring nurse, you are no doubt driven by your values. So it makes sense to earn your education from a school or program that shares your passion for service, health, improvement - or any other values that motivate you. Many programs make it clear what values and guiding principles inform their mission. Discovering this information typically only requires a simple check of a program's website, but it's important to verify that their values align with your own. By researching your program, you should get a sense from the site about what issues and elements they hold important: Advanced technology? Student success? Job placement? Faculty interaction? Do the program's values match with those that inform what you seek from an online education? If so, you have a solid foundation in your search. STEP 2 Check for accreditation of both the school and the program. To pursue your future in nursing as boldly and confidently as possible, the quality of your education matters. One of the best indicators of program quality is accreditation. At the institutional level, programs can earn national and regional accreditation. Of the two, regional accreditation is actually more rigorous than national. Credit, coursework, and degrees from regionally accredited schools are more widely accepted than from nationally accredited schools, particularly in career tracks that require licensing. Maryville, for example, is accredited regionally by the Higher Learning Commission, whose mission is to "[serve] the common good by assuring and advancing the quality of higher learning." In some cases, as with nursing, programmatic accreditation can be just as important as regional accreditation. Programs, departments, or schools within a larger college or university also can be accredited, verifying that they meet the standards of their field for education and relevant student experiences. An institution must already have regional or national accreditation before its programs, departments, or schools can earn programmatic accreditation from a specialized or programmatic accrediting agency, but programmatic accreditation indicates that the degree programs meet a high standard recognized by the field. Maryville University, for example, earned its accreditation from the Commission on Collegiate Nursing Education after many years of accreditation by its precursor, the National League for Nursing. STEP 3 Understand the technology required to be successful. Technology plays an important role in the life of any student pursuing an online education. Make sure you know what types of technology and related resources you will need to complete your coursework, engage with professors and students, and complete assessments. For example, some programs, like Maryville's, require proctored exams - meaning that students are on video while taking their exams, allowing us to confirm identity and ensure program integrity. This requires students to have access to a webcam and bandwidth speeds that can accommodate live video. Luckily, most modern computers, laptops, tablets, and other devices are powerful enough to function in an online learning environment and run the requisite software. And on top of that, schools like Maryville offer online technical support to students, so you can get 24/7 assistance whenever you need it. Ensure that the program offers the flexibility to fit around your life and schedule. Online learning can be just as rigorous and time-intensive as on-campus classes. In fact, at Maryville, our students earn the same education online as they have on-campus for forty years - only the delivery is different. With that in mind, it's important to choose a program flexible enough to allow you to give proper attention to your coursework without interfering with your personal or professional obligations. Online programs are designed to accommodate students who are balancing family, work, and school demands. But not all programs are created equal, especially for a field as tactile as nursing. When researching programs, be sure to check their structures and requirements. You likely will need to complete an on-site residency or clinical as you work toward your degree, and some online programs may require occasional campus visits, time-specific synchronous learning activities, and other non-flexible components. But these requirements don't have to interfere with your life. At Maryville, we offer an asynchronous degree that you can complete on your schedule, and we designed the experiential elements of our programs with our students' needs in mind. For example, our students can complete their clinicals locally where it's most convenient for them, so they don't have to worry about traveling or lengthy commutes to pre-approved locations. We also don't require any campus visits - but we do, of course, invite all our graduates who are interested to attend commencement. STEP 4 Know how the program teaches, and how you learn. Does your style of learning align with the way your program approaches coursework and instruction? Do you have the self-discipline required to tackle online coursework, engage with classmates and connect with faculty remotely? This can make or break your success as you pursue your nursing education online. All programs have to balance synchronous learning, which requires online students to participate at the same time as one another, and asynchronous learning, which allows students to work independently at their own pace. This is particularly important to understand when a program includes students from multiple time zones or on different schedules. We've been increasing the number of asynchronous activities at Maryville in response to our students' need for flexible scheduling. Regardless of a program's mix, you want to ensure that it keeps students engaged with the course content, faculty, and each other. Online programs should facilitate connections among all participants where, when, and how it makes sense. One way we approach this is with mandatory office hours, which allow faculty to be available for students to call or Skype with questions. Faculty record and post all of these interactions so all students, whether or not they were available during the office hours, can access the information shared. Students should never be more than an instant message or phone call away from classmates and professors, and, just like in a traditional classroom, should not hesitate to make those connections the moment they're needed. STEP 5 Your next step could be your biggest. Make it your best. Deciding to advance your nursing career is an admirable goal, and online programs certainly make that goal more accessible for many students. Of course, there are many other details to consider, such as program residency requirements, prerequisites, program length and cost, but taking the time to understand different programs and whether or not they're a good fit for you will give you a better chance for success, in and out of the classroom.
  2. I spent years in grade school trying to figure out why I could never comprehend new material during class like other students could. I would take notes in every way possible, sit and intently listen, prepare before by reading the material to be presented the next class but to no avail. I never made a GPA over 2 point something in high school so when I decided to returnto a community college for my LPN to RN bridge program, I knew I had to find a different way. I had to start from step 1 since all of my post high school education was a one year LPN vocational program which meant no transfer credits.I faced classes in subject areas that I failed time and time again: math and science. To even apply to the program, I needed chemistry, A+P 1 & 2, statistics, and microbiology. I started with A+P 1, I knew I would do fine in the anatomy portion, one thing that has always been my strength is memorization.As for physiology, I knew it wouldn't just be memorization, it would be complete understanding of all the little parts that make the whole system work well. I went in for the first class as I had done many times before,my notebook (I even had a special note taking one) ready with the chapter we were covering that day at the heading, and I prepped the night before by reading the chapter. At the end of the class I was more confused than I was the previous evening. My professor had said the key for most students in physiology was learning the big picture before learning all the little pieces that put the picture together. That's when I finally got it and that is all it took to solve years of educational frustration. I just don't learn like that. It is impossible for me to understand the big picture before I fully understand the little pieces and lecture is set up directly opposite of that idea. As much as I tried during lectures, my mind always wandered. I have always been a reader even though I performed so poorly in school and I have always been a visual learner as well but it didn't translate well when sittingfor a traditional lecture I had been forcing myself to learn a way all these years that my brain just couldn't work with. With that realization, I began to study for my first test in a completely different way than I had before. I had five chapters on my first exam which equaled hundreds of text book pages. I am an avid reader, yes, but I also lack the ability to sit for hours at a time. I did some research online and found most of the information in textbooks are filler information. I read only the boxes, bolded words/sentences,and the first and last sentence of every paragraph. I made concept maps insteadof notes, graphs instead of flashcards, and for things I needed to memorize I utilized online flash cards to save time. When I didn't fully understand a concept, I went in search of reputable academic sites that provided videos, illustrations, and alternative ways of explaining a concept. I found I must talk difficult concepts out and I did this by either helping a fellow student or explaining it to my very loyal but bored dog who often sighed during my pseudo physiology lectures. I went to every lecture and did keep an ear out for any pertinent information but instead of forcing myself to focus on something I would not learn from, I sat in the back, quietly used my laptop and concept maps to review information, and to study for the anatomy portion (also very handy to use online flashcards for) so I could focus my study time at home on physiology. I blew through that first test. It was the first time in my life that I ever left a test knowing I just aced it. I had always told myself that it was ok I was not a super smart academic person, but I had wasted many years telling myself I could never succeed in educational pursuits when Iwas the one stopping myself this entire time. I continued studying in my new way and before I knew it I was applying to my bridge program with a 3.96 GPA. There were some definite bumps, I took chemistry twice, had to study more for that class than NCLEX PN,and A+P 2 was one of the most difficult classes I have ever taken, the A minus I received as a final grade felt like an Olympic gold medal. I am someone who must study every day, as much as I wish I was one of those students that could read a chapter then pass a test without much effort, at least now I knew how to pass and gain knowledge at the same time. I am coming into my final semester of core nursing classes, I am due to graduate in April, and the study habits I developed for my firstA+P 1 test have changed some to meet the needs of those classes but my core study plan has stayed the same. I found I have had to study less in core nursing classes because I spent so much time on the foundational pre-requisites like anatomy and chemistry. When a student who is about to start nursing school asks me what my best piece of advice is for them it is always find which way you learn best during pre-requisites. If it's not the standard way you have been taught is best, that's okay as long as your getting results and actually learning. Search the internet for different ideas, try out different things, use the strengths you already have! I am not a genius by any means and have done well even while working, having 3 kids, and a husband. I hope this helps some for students who struggle with traditional lecture formats and if anyone would like recommendations for websites that have helped me I would be glad to pass along the information. Good luck to everyone!
  3. I sit in my car outside of the hospital where I'm doing my second term clinicals at. Tears are just rolling down my cheeks. They won't stop. In LVN school, we have 13 week terms. This is only week 7. The tears increase with this sudden thought. I cannot do this anymore. I want to drive to campus and quit this very instant. Instead, I drive home through the tears, remembering the horrible 7 weeks I've had... The last week of Term I, we all received our clinical assignments. I was so excited! I got the clinical instructor I was hoping for, at a site I was hoping for, life looked like it was going to be great in Term II. We even started at an acute care facility this term. I was tired of the nursing home. The first day comes. The group I'm with is different. All of them older than I am, except for two new girls who were restarts. I befriend them. There's all the wonderful paperwork, and video watching that comes with orientation. Then our instructor has us write down some things she wants us to know and use this term. She goes on to tell us how our day will work. I think I can handle things. She tells us that we'll rotate through Cath lab, ER, OR, GI lab and radiology. I leave feeling confident. That was the only day I felt confident. I started off the best I could. Introduced myself to the patients as soon as I got on the floor. Vitals, AM care. I read the charts completely. I knew my patients inside and out. I even went above and beyond what was expected of me. I would write out every abnormal lab, every medication, and learn all I needed to about both. I checked on my patients every half hour or so. I helped out my fellow student nurses when I could. Stayed on top of my paperwork. I was working so hard. I'm not exactly sure when my instructor started hating me, or if she disliked me from the beginning. But she broke me. Any answer I would give in pre or post conference would be wrong, or not good enough. But any other student who said what I said would be right. If I was passing meds that day, she would rush me through med confession and then accuse me of not knowing my medications. She always gave me the most complicated patients, which for a while I took in stride. I figured I was getting more experience. She would not allow other students to help me, but I was expected to help them. Checking on my patients every half hour wasn't good enough, she wanted me in a patient room at all times. I never rotated to any specialty. She would barge in on me when I was bathing or changing patients, and have a complete disrespect for my patients dignity. While I was doing AM care with one patient, she would go to my other patient rooms and find things wrong with them, then chew me out in front of all the staff after. The day I sat crying in my car in front of the hospital was one of the worst. By this time I knew she hated me. I still wasn't sure why. But she did. The patient load she gave me that day was just like any other. One total care, one was a custody patient (I was the only student to receive those, go figure), and one who had stasis ulcers on both legs and ulcers on the toes. I was to do wound care with her watching me. I asked the student leader to be there as well, for moral support. I gathered my supplies and headed into the room. I let the patient know I would be changing his dressings and asked him if he needed any pain medication. The patient was a dear old man, sweet as could be. Everything was set. I went and got my instructor. I set up and began. She stood there with a horrible look upon her face, as she always did when she was with me. I went through each step, talking with the patient while continuing. I got to a point where I was slightly confused about how to put on the medicated strip. I told her as much, and asked her how I should apply it. She just stood there. Didn't even respond to my question. My patient was also expecting an answer, both of us looked at each other and I just tried to figure things out. The patient became more aware of my instructors attitude towards me and attempted to converse with her. She gave him very short answers, not showing any interest in what he was saying. I finished up about 10 minutes after I had began. I will never forget what she said. She told me it took me too long to do the dressing change, that I was unprepared and I shouldn't be allowed to do procedures, period! She stormed out of the room. I stood there, in shock. I began to shake, out of pure humiliation and anger. I felt like an utter failure. The student leader looked at me and told me I did everything by the book. The patient tried to console me, he told me that I did a better job than most of the staff nurses before me. He even asked me what was wrong with the instructor! He couldn't believe an instructor would treat a student, let alone a patient, like that. I worked hard to maintain composure in the room, and throughout the rest of the day. When I arrive home that day, I thanked God for getting me there safely. I called my step-mom who is an RN and explained everything that had gone on in the past 7 weeks, topping the story off with what happened today. She talked me out of quitting, and told me some clinical instructors were just awful people. The next 6 weeks weren't any better. I still was kept on the floor. The charge nurse came to know me well. She even bragged to my instructor about how much progress I had made. My instructor just muttered something under her breath and walked away. She would call the director of nursing to come to our site weekly, for the main purpose of making me seem incompetent. I was accused of a medication error, which wasn't an error at all. The review she gave me at the end of the term was absolutely awful. By the end of the 13 weeks, my confidence was completely shattered. Term III started the week after. I was at a site which was about a hundred times more difficult than before. The patients were what we called train wrecks. Multi-system failures, diseases I'd only read about in textbooks, and more! How could I survive this if I couldn't survive the less complicated patients before? My confidence was gone and I had two instructors to impress this time around! Because of the way I was treated during my second term, I made sure I was always on top of everything. Meds, AM care, vitals, team work, documentation... while some students were struggling to finish up charting before post conference let out, I was done hours before we even started. I was doing everything I could to stay off the radar of my instructors. I just wanted to finish the term in peace. By the time mid-term evaluations rolled around, I was expecting the worst. I had never received a good eval, why should I be getting one now? My main instructor called me in, and I sat down. She looked at me, and asked me flat out how my second term was. I was a little confused by the question, but I told her. After I was done, she looked at me and smiled. She told me that she could tell that I tried to avoid her when at all possible, and had been curious as to why. Now she knew. She pulled out my evaluation. She proceeded to tell me that I was the best student nurse she had ever seen. She was highly impressed with everything I had done so far, my extensive knowledge of medications and lab values. The other instructor was impressed as well. Apparently she had a few complaints about every other student, but not me. I was floored. I was good? It was in that moment that I realized I was going to make it. My previous instructor, as horrible to me as she was, gave me motivation to be on top of everything, know everything about my patient and try to be the perfect student nurse. Even though nothing was good enough for her, she turned me into the best student nurse I could've possibly been. It was the worst 13 weeks in LVN school, but out of it came something positive, I knew how to be a good nurse. I think about that instructor from time to time. Because of her, I have the confidence to tackle just about anything a patient throws my way.
  4. My first year in nursing school began with high hopes. I'm passionate about helping those in need. My motto is "we are all here to serve each other." I thought that I should become a nurse because so many nurses that I've met in hospitals are generally caring people who give all of their attention to me and the people I accompany to the hospital. Discouraged By The Wall Imagine my surprise when the first course in nursing school (after the 18 months of pre-requisites like Philosophy, Writing, Math, A and P, Biology and the HESI entrance test were behind me) was to hear, "I am the CEO of this classroom!" Professor Christine (I'll withhold her last name) has been teaching for 11 years. She was teaching my first course, Fundamentals of Nursing (introduction to nursing), for only the second year. Most of her teaching career had been in higher level courses. So when she was assigned the entry-level students, she treated us like higher-level students. "I'm here to facilitate you. Not teach you. You need to read and figure things out for yourself. That's called critical thinking." She assumed that giving a lecture about how to build a "Plan of Care" was enough. "When I don't finish a chapter, because I run out of time, I expect you to cover the rest of the chapter by reading. Then you will be ready for the exam." Instead of giving us practice questions to assist in preparing for the exam, she highlights the parts of each chapter (the "learning objectives") and then created detailed questions "click on all that apply" ... and if we get 3 out of 4 correct, the entire question is marked incorrect. It's like she has built a tall wall and she's waiting on the other side of the wall to see who gets over. When one of my classmates wondered aloud, "I wonder what sign of the zodiac she is...", another classmate muttered, "The dragon." Readers, this is when it's a good idea to take a deep breath and look at the options. There is little use in asking to switch to a different professor... Professor Christine is the only professor for the entry level course. (2) There is little choice but to drop the class and try again next semester... (3) transfer. Yes, there is power in strategic quitting. The entry level course is typically paired with another course and it's OKAY to focus on one course, rather than struggling to keep up with both courses. This is what it takes to survive a course with a dragon. Oh, There Are Some Questions That Are Stupid We often hear that "there is no such thing as a stupid question." Well, Professor Christine hasn't heard that aphorism. "Billy, you are not doing me a favor by showing up today. I don't need any of your questions." Can you imagine what the mood in the class was while she berated Billy? I decided to take an F for the course and re-take the course later. I kept attending to learn the head to toe assessment. Professor Christine was my evaluator and said, "Oh, since this is not going to count for points, you don't have to do this assessment." ... that distracted me so much, I missed several items that I knew by heart. In short, she is a person who delights in cutting down students. "I like playing with you all. You know that it makes you stronger." ugh. Expect More I'm writing this article for the audience of first-year students. Please don't assume, as I did, that all nursing programs are alike. "We just have to accept what they are doing to us." Don't accept a dragon professor. Go to the program director and share your experience. If you don't get relief, find another school. Some schools tolerate such professors and that is just the system. These are not bad people. W. Edwards Deming, the quality control expert, once said that 94 percent of errors made by a company are caused by procedures and rules. Only 6 percent comes from bad actors. Most mistakes are caused by the expectations of the organization. I'm shifting to the Chamberlain program in September 2018 in Miramar, Florida. I'm hoping to connect with current Chamberlain allnurses.com readers. Please leave me your comments. a) do all nursing programs have a dragon professor? (I hope not). b) at Chamberlain, is it possible to retake a course if things get tough and I need a re-do? c) If I'm taking a course as an audit (not for credit, just for practice), would any professor say what Professor Christine did? "Oh, since this is not going to count for points, you don't have to do this assessment." REFERENCES Appreciation for a System - The W. Edwards Deming Institute Blog

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