Have you ever thought about changing career paths and teaching up-and-coming nurses? For those of you who have, we wanted to provide you with some information about what it’s like to teach, including the challenges and the benefits.
Michelle DeCoux Hampton, RN, PhD, MS, Professor and Doctor of Nursing Practice Program Director at Samuel Merritt University School of Nursing in Oakland, California, took time to talk with us about her experiences in teaching.
Following is an edited version of our Q&A:
What does your job entail? Do you specialize in specific topics that you teach? How many courses do you teach each semester?
I started in 2005 as a full-time faculty member teaching psychiatric mental-health nursing, health assessment, and synthesis for students throughout our accelerated bachelor’s program in nursing. Later, I began teaching an online course in research in the Master’s program and then the Doctor of Nursing Practice Program.
In 2013, I became the Director of the Doctor of Nursing Practice Program, and now I teach evidence-based research and several of the DNP Project courses that are geared toward providing mentorship to doctoral students as they complete their scholarly projects.
In my administrative role, 75% of my time is administrative work involving admissions, student advisement and progression, faculty support, as well as curriculum review and improvement, among other responsibilities. In my full-time teaching role, I taught about two courses per semester.
Why did you choose to teach?
My interest in teaching stemmed from my enjoyment of education from the student perspective and my many positive experiences with faculty and mentors.
I first tested myself as the Director of Staff Development in a skilled nursing facility to see how I would like being “on stage” before I ever applied for a teaching position at a university. I was able to learn a lot about adult education and enjoyed the opportunity to connect with the facility staff through our orientation and continuing education programs.
I advised many of our staff nurses about how to go about continuing their formal education and found it was one of the most enjoyable parts of my role in staff development.
What are the biggest challenges of your job?
Compared to being a staff nurse, one of the biggest challenges in teaching is that there is often no one to fill in for you—at least not at a moment’s notice. You often find that you work when you’re ill, on semester breaks to prepare for the next semester, and on your vacations. The flexibility is nice in a lot of ways, but the tradeoff is that you’re never really off the grid.
What are the greatest rewards?
One of my favorite parts of my job is to work with my doctoral students on their DNP Projects—usually an evidence-based practice implementation project. These students evaluate best practices through critical appraisal of the research literature, design practice change programs, implement changes that involve policy and procedure changes of the staff in a variety of health care settings, and evaluate the outcomes. Through each of their projects, they have provided improved health care to individual patients, communities, and within organizations. Seeing these projects develop from an idea to influencing real people’s lives is incredibly rewarding, and it never gets old.
What would you say to someone considering this type of work?
To me, the best teachers that I’ve known and worked with take a service-oriented approach to education—providing what the student needs to progress to the next level, to continue growth. This takes good observation skills, flexibility to change your approach based on where your student is and what his/her needs are, and a willingness to keep learning. The field of education, beyond what we need to know as nurses, continues to evolve and we have to evolve with it.
Is there anything else that is important for nurses to know?
In my early years of teaching, I felt like I needed to know everything—to answer all of my students’ questions on the spot. This expectation of myself produced a lot of anxiety and self-doubt for me.
Over time, I relaxed a bit more and accepted that even if students wanted me to have all the answers, that was not possible 100% of the time. Feeling confident in the knowledge that I had and my ability to research answers that I couldn’t answer right away effectively, enabled me to say that I didn’t know, but would find out or even enlist the support of other students to find the answer. It was a turning point for me. I don’t think I would have been able to sustain a career in education long term with my previous mindset.
Keondra Rustan, RN, MSN, PhD(c), visiting assistant professor at Linfield College in Portland, OR, has overcome many challenges in her decade-long career as a nurse and nurse educator. Raised in a single-parent home with limited resources, she discovered how she could channel her interest in science into a nursing career by reaching out to mentors along the way.
Today, she shares her story and offers advice to other minority nursing students and nurses who may face similar challenges in their education and careers.
How long have you been in the nursing field and what has been your career history until now?
I have been a nurse for nine and a half years. I started out working in cardiac health care in Virginia. I did cardiac stepdown, some cath lab work, and I floated to some cardiac ICUs. I then went to the ICU where I learned a great deal and developed some professionalism and leadership traits. I then went on to become an assistant manager of an ICU and IMCU. I finished my master’s degree and became a professor at a private college where I rediscovered simulation and developed a great love for it. I became the simulation lab coordinator and for a time was the interim director of the LPN program, and went on to become the assistant director of the LPN program so that I could make more time for my doctoral schooling.
I am currently working in the dissertation phase of my doctoral program and enjoying my work at Linfield College as a visiting assistant professor working in simulation as lead faculty.
What inspired you to enter the nursing profession?
At first I didn’t want to be a nurse. I went through all of my primary schooling without having the decision of wanting to be a nurse. I wanted to be a scientist at first like those scientists in Jurassic Park.
Later on in high school I decided that I wanted to be a scientist that could help cure diseases and study microbes. However, I lost my grandmother when I was in high school and some of the care that she received wasn’t the best and lacked empathy. I decided that I wanted to help people more directly and show them that they aren’t just a room number but a thriving person who was deserving of care. I wanted to be a person who made a difference in the lives of others.
As nurses we often aren’t remembered individually; but if a patient has less exacerbations and starts feeling better because of your care and the education that you provided, it is very rewarding.
What inspired you to become a nurse educator?
I discovered that I liked teaching by precepting new nurses and nursing students. I enjoyed seeing the potential in them. I loved teaching them how to do things based on evidence and why it was so important for it to be done that way. I wanted to show them how to provide holistic care to patients and help them grow into future leaders.
I also enjoyed telling them stories so they could directly apply the teachings to their practice. Most importantly, I wanted them to have things I did not have prior to becoming a nurse: resources and a mentor. I wanted to apply these principles on a broader and larger scale so I went into the field of nurse education.
I would say the first year or so I was not very good at it. Or at least I did not feel as though I was a good teacher. I did not have a mentor or anyone to show me the ropes so I just taught them the way I was thought, which did not work.
What challenges have you faced in your career and how have you overcome them?
In my career my biggest challenges have come from lack of resources and lack of mentors. I grew up in a low-income single parent home with no vehicle. We did not have the funding or access to resources to get informed about career programs while in high school or even most scholarships. I wasn’t aggressive enough in thinking of my future and did not have enough drive when I was younger to seek those resources.
Once I decided to become a nurse, I didn’t really know how to become one, what nurses actually did, and what type of nurse I wanted to be (even when I graduated I still did not know that part). I had a lot of ideas, but I did not know how to bring them into fruition.
I overcame the lack of resources and lack of mentoring by joining organizations (good old-fashion Google search) based on my interests. When I was obtaining my BSN I got accepted into Sigma Theta Tau (the nursing honor society). Going to those conferences really opened a lot of doors for me. I am so grateful for the aid of the nurses and educators that I have met throughout my nursing career. They were able to point me into a lot of great directions. I am still growing and have a great deal more that I want to accomplish.
What challenges do you see minority nursing students face and what is your advice for them?
I see lack of resources as a big one and lack of mentors. Minority students (and I include males in this) have a high risk of falling through the cracks in nursing school. There seems to be a reluctance to seek aid when dealing with difficulties. It is hard to get over, because typically it is culturally ingrained.
My advice is to seek help right away when you are having trouble. If your school does not assign faculty mentors, seek out an instructor that you feel you can connect with. Shadow a nurse if you are not experienced with the duties of a nurse, so you have an idea of if it is right for you. Don’t be afraid to ask for help; if you do not understand, seek help (think of the patient’s safety).
Most nursing schools have scholarships, open labs, writing labs, and tutors available for their students; make use of these resources and give yourself support. View any setback as a learning opportunity and grow from the experience. Never stop learning even after you are licensed and working on the floor. Google search some nursing organizations (you can even join some as a student for a cheaper price) and they can lead you down some interesting paths. Also, once you obtain your knowledge, pass it on. You never know who you will be helping with your expertise and experience.
Where do you see yourself in 5-10 years?
I see myself with at least 10 articles published and maybe a book, of course having obtained my PhD. I want to still be educating nursing students and maybe have obtained my NP. I want to continue to learn and grow each day to become the best educator that I can be. I want to do more in community and be a greater help to those in need.
Like many minority nurses, Jackie F. Webb, DNP, FNP-BC, RN, associate professor at Linfield College School of Nursing in Portland, Oregon, had to overcome many challenges on her career path to becoming a family nurse practitioner.
Webb is the daughter of immigrants to the United States and is a first-generation college graduate. Her parents worked hard to provide for their family and instilled the importance of going to college. It wasn’t until Webb got a job in a nursing home that she set her sights on becoming a nurse.
“I did not start out college knowing I wanted to be a nurse,” says Webb. “It was the experience of working in a nursing home and meeting an incredible nurse who exposed me to the challenges of nursing that convinced me to major in nursing. Looking back, I realize the time this nurse took to help me see the power and art of nursing, and her support is what gave me the belief I, too, could be a nurse.”
Webb initially thought she wanted to work as a critical care nurse, but soon realized she was most interested in preventing patients from ever needing a critical care unit.
“Working as a public health nurse opened my eyes to the challenges of seeing patients in their own homes, without fancy equipment but my stethoscope and a BP cuff, and my ability to really listen and take a thorough health history.”
This experience motivated Webb to go to graduate school and become a nurse practitioner where she learned how to manage chronic illnesses and how to incorporate cultural beliefs into the patient’s management plans. She has been a family nurse practitioner for more than 30 years.
Like many minority nurses, along the way Webb had several challenges to overcome.
“Not having role models, not having parents who knew how to navigate the world of college applications, finances, scholarships, etc. Additional challenges for me included not having good writing skills, not having a rich vocabulary, and not having experiences like so many of my friends. My parents didn’t take vacations, they didn’t belong to book clubs, they didn’t have dinner parties nor did they have their brothers and sisters or any family member close by. They both had to work long hours to afford a roof over our head. The isolation of being a first-generation immigrant was at times difficult.”
Webb believes that there are ways for colleges and universities to help immigrant and first-generation college students overcome the unique challenges they face.
“Colleges and universities who work with immigrant students and/or first-generation college students need to know that these students are for the most part willing to work harder than any other student population,” says Webb. “For some they see how hard their parents work to just keep food on the table, they don’t take anything for granted. These students are grateful for any type of assistance and will overcome amazing barriers to obtain their college degrees. Many of these students end up inspiring other students and take on challenges many students are fearful to take. Many students value their college community and will take on various leadership roles.”
So what advice would Webb offer to minority nursing students today? “I would tell them to value their personal stories,” says Webb. “Value your history and that of your family. Be proud of the hard work your family has gone through to get to where you are now. The passion, the self-reliance, and support students have will get them very far.
Webb also encourages minority students to reach out for support. “For many students of color they are the first to attend college. This is an incredible journey they are undertaking and they cannot do it alone,” says Webb. “It is so important that they find a mentor or advisor so they can feel comfortable asking how to navigate this new journey. Use every available resource so you are able to be successful. Don’t be afraid, embarrassed, or feel that asking for help is a sign of weakness. I believe it is absolutely the reverse: asking for help is a definite sign of strength as it shows you are ready to do the work.”
Having a strong mentor and academic advisor can make a huge difference in the lives of undergraduate and graduate nursing students. Being that mentor is what motivates Ronald Hickman, PhD, RN, ACNP-BC, FNAP, FAAN, associate professor of nursing at the Frances Payne Bolton School of Nursing at Case Western Reserve University in Cleveland, OH.
Hickman has been honored with two esteemed awards for student mentorship at Case Western Reserve University: the John S. Diekhoff Award for Excellence in Graduate Mentoring, which is presented to four full-time faculty members who make exemplary contributions to the education and development of graduate students; and the J. Bruce Jackson Award for Excellence in Undergraduate Mentoring, which celebrates faculty and staff who have guided a student in their academic and career paths; fostered the student’s long-term personal development; challenged the student to reflect, explore, and grow as an individual; and supported and/or facilitated the student’s goals and life choices.
“Mentoring has been a cornerstone approach to making a difference in the lives of undergraduate and graduate nursing students,” says Hickman. “The receipt of two of the university’s top honors for mentoring undergraduate and graduate students is a testament to my commitment to making sure that I pay it forward.”
Hickman says the mentorship he received across his undergraduate and graduate studies has been invaluable. “My mentors shared their lived experiences and lessons learned to help me avoid pitfalls and inspire me toward a career in academe. These honors highlight my commitment to mentoring and acknowledge the impact of effective mentorship on the lives of emerging leaders in nursing practice and research.”
However, nursing was not Hickman’s original career plan. “As an undergraduate student, I majored in biological sciences with the intention to attend medical school after graduation.”
He was not admitted to medical school, but upon reflection about potential career paths he decided to pursue nursing because it aligned with his personal philosophy of health. “Although nursing was not my first choice for a career, it was the right choice for me,” he says.
Hickman acknowledges that pursing a nursing career can be challenging for minorities.
“Many minority nurses are the first in their families to attend college and are standouts in their communities,” he says. “When entering the nursing profession, the academic preparation is challenging and, in most instances, the diversity of nursing faculty is often not representative. This can create situations where minority nurses do not wish to speak up and seek help when needed. Whether you are pursuing a nursing degree or transitioning to a new role in nursing, do not suffer in silence. Asking for assistance often facilitates your success and delivery of safe nursing care.”
Another key to success that Hickman recommends for minority nursing students is to find a strong mentor and strongly consider pursing a doctoral degree in nursing.
Hickman is truly paying it forward. “As a nurse educator, I am inspired daily by helping students develop as competent nurse clinicians and scientists,” he says. “Helping others achieve their goals is an invaluable and enduring experience for most educators. The opportunity to inspire and challenge future nurse leaders is a priceless reward.”
Hickman sees himself in a senior leadership position in a school or college of nursing in the future. “My aspiration to secure a senior leadership position aligns with my commitment to help an organization and its’ faculty achieve their goals and impact the health of Americans.”
For nursing students there is one final hurdle after graduation to becoming a nurse – passing the NCLEX. The National Council Licensure Examination is the standard state exam that all graduating nurses must pass in order to start their career as an entry-level nurse.
It can be a stress-inducing time for a young nurse. But there are some things you can do while you’re still in nursing school to lessen the stress on exam day.
Follow these tips to prepare for test day.
1. Study All Through School
First and foremost, don’t wait to begin studying. Use your time throughout nursing school to prepare. “NCLEX tests safety competency and is not a test you can cram knowledge in a short period of time,” says Dr. Joanna Rowe, interim dean of nursing at Linfield College in McMinnville, OR.
Dr. Rowe says there are several study programs available including Kaplan, HESI, and ATI.
Another resource Dr. Rowe recommends is a PassPoint, which can be purchased for $100 for use on your phone or computer. “Students can design their own tests and they can select areas for the program to generate a test. Also, the National State Board of Nursing has an NCLEX study plan they can download that is very inexpensive.”
Dr. Rowe advises students to take practice tests in an environment similar to the one you’ll take the real NCLEX. That means no music, headphones, noise, or anything to drink or eat. Take your practice tests in a quiet, uncluttered space and take the whole practice test in one sitting.
3. Take Time to Review
“Review each question on the practice test even if you got it correct. Look at why you got it correct,” says Dr. Rowe. “Did you know the answer or guess at the answer and does your rationale match the rationale offered? If you got it wrong, why did you get it wrong? Did you not know the answer, read too fast, misread the question, knew parts of the answer but not in depth?”
Taking the time to review after your practice tests will offer key insights that will help you ultimately pass the NCLEX.
4. Take the NCLEX Right After Graduation
Finally, Dr. Rowe advises students to take the NCLEX within six weeks of graduating from nursing school. “The statistics are clear that students who take NCLEX within the first six weeks of graduation have a significantly higher pass rate,” says Dr. Rowe.
The American Association of Critical-Care Nurses held its annual National Teaching Institute and Critical Care Exposition this week in Houston, TX. During the four-day event, 25 acute and critical care nurses were presented with the Circle of Excellence Award, recognizing their efforts to achieve optimal patient outcomes.
Jose Sala, night nurse manager, surgical and liver ICU at Houston Methodist Hospital, was among this year’s honorees.
“I feel so honored and privileged to be a recipient of this prestigious award,” says Sala. “I consider it one of my most rewarding accomplishments. I dedicate it to my family, my former professors, and preceptors, and most importantly, the patients whom I’ve cared for at the bedside during the past nine years. They have been my best teachers.”
Sala earned his BSN in 2012 from the University of Texas Health Science Center at the Houston School of Nursing and feel in love with critical care nursing during his capstone preceptorship in a general medical/surgical trauma ICU in South Texas.
“I was awed and impressed by how knowledgeable my preceptor was about pharmacology, pathophysiology, and patient management,” says Sala. “I saw how she was such an integral part of the critical care team, and how she had finesse, confidence, and a strong rapport with the surgeons and intensivists and all the other professionals in the unit. That two-month period played a seminal role in my journey in critical care.”
In his current role as the night nurse manager in the surgical and liver ICU, Sala has had the opportunity to work on initiatives that have improved not only patient care, but the overall work environment for his team. These initiatives led to his Circle of Excellence award.
He is most proud of his work to develop “flash rounds” in his unit – an initiative that directly impacts patient outcomes.
“Together with Dr. Atiya Dhala, one of our intensivists, and with the support of my director, Michele Ramirez, I implemented what we called “flash rounds” in our unit that focused on the ABCDEF bundle,” explains Sala. “This bundle aims to prevent the unintended consequences of critical illness, including delirium, prolonged ventilation, and excessive muscular deterioration. Every morning, at 8 a.m., each and every bedside staff nurse presented their patient to the team – the intensivists, nurse practitioners, residents, physical therapists, and respiratory therapists – as they rounded on the whole unit. Strictly focusing on these components and separate from teaching rounds, the flash rounds set the tone for the day for the team. This was not only met with much enthusiasm and support by most of our staff, but it also helped increase the mobilization rate, decreased our self-extubations, and reduced our ventilator days.”
Sala has also worked hard to improve his unit’s work environment.
“One of our key challenges in our unit was the rocky transition of our new graduate nurses (GNs) into clinical practice,” he says. “I mentored a group of GNs whose project for their nurse residency program was to create a buddy program that paired upcoming GNs with a buddy (who is a different person from their preceptor). This allowed them to integrate more easily into the culture and fellowship in the unit.”
Sala offers this advice to aspiring critical care nurses: “Work hard and study hard, and don’t lose sight of your goals. When you do rotations in nursing school, or work in any unit, find key mentors who can either directly guide you in the process of becoming a critical care nurse, or introduce you to people who can. Be inquisitive, read widely, and always ask questions.”