Student nurses don’t need anyone to tell them their lives are busy. With school, work, families, and a personal life, many student nurses are juggling more than most people. Tamar Rodney, MSN, RN, PMHNP-BC, CNE | PhD-c, is a Geneva Foundation/Jonas Veterans Healthcare Scholar 2016-2018 at the Johns Hopkins University School of Nursing and is no exception.
To celebrate today’s observation of National Student Nurses Day, Rodney gave some insight to what life is like for a graduate student in nursing school. As a PhD candidate in nursing, she has been through the rigors of nursing school for a while. What she knows is that her dedication and the time spent on her education is going to bring her to the place she wants to be. Along the way, says Rodney, the journey itself is pretty amazing.
“I love being a nurse, and having the opportunity to make someone’s day or life better,” she says. “I felt drawn to nursing because I admired my memories of childhood reactions to nurses. Their presence meant someone was here to help. I have always carried that image with me of bringing a sense of comfort, security, and a sense of care to someone else.”
Rodney knew going for her PhD would be hard work, but she says her patients were her inspiration and continue to be the motivation to learning as much as she can. “My journey to pursue a PhD was influenced by the day-to-day care of my patients,” she says. “I saw problems that were not addressed and felt like having concrete research would be a good way to start being able to answer those questions.”
And while continuing her education is far from easy, it has brought her a level of satisfaction and of personal and professional growth. “Graduate school is as challenging as I thought it would be,” she says, “but I also got the opportunity to think independently and explore questions that I was interested in. I could finally expand my thinking about ways to provide better care for my patients. I also saw the direct link and importance of collaborating with other healthcare providers and disseminating research for implementation at the bedside.” Eventually, she says, she would like to combine the teaching, research, and practice areas of nursing into one career.
Rodney completed her LPN and RN at Dickinson State University in Dickinson ND, and she started out her career as an LPN working in a nursing home. “I loved it,” she says, “and felt like I would get a new history lesson every day I went to work.” From there, she worked in inpatient psychiatry, primarily to learn more about mental health and how better to approach treatment and diagnosis. It was during that time that she began her MSN program at the University of Vermont.
Discovering a new passion for mental health, Rodney took advantage of certification and gained her psychiatric mental health nurse practitioner certification. “I recently completed my PhD studies at The Johns Hopkins University, exploring biomarkers for PTSD in military personnel and veterans with traumatic brain injuries.” All of her studies are helping her get closer to where she wants. “My ultimate goal is to change the way we approach diagnosis and treatment of mental health disorders,” she says.
Like nursing practice, a nursing career isn’t done in a vacuum. Joining a professional organization (Rodney belongs to the Graduate Nursing Student Academy) is a way to network and share resources with other student nurses. “Having completed my program I now have a large network of other young professionals with whom I can collaborate and have as supportive resources,” say Rodney.
And graduate school itself offers opportunities for growth that are unexpected, because you are finding the answers but also beginning to ask the deeper questions. “Graduate work in nursing is a unique way to advance one’s personal understanding of nursing practice, an opportunity to deliver the best care possible and advance nursing research and practice,” she says. “You can explore those questions that you have an interest in and explore innovative ways to answer it.”
Getting into nursing school is a huge achievement, but for many students, getting in is only the first step. Paying for nursing school is the next hurdle.
When you look at your final financial aid package, there’s likely a bit of a gap between the amount of aid you will get—including grants, federal loans, and scholarships from the school—and the final amount on the bill. There are a couple of ways to bridge this gap with personal savings and personal loans being common routes.
But if you do a little work, you’ll uncover a potential resource many people aren’t aware of.
Scholarships are an excellent way to help pay for your education. There are many scholarships available and they are not all dependent on having a 4.0 GPA. Of course, the Minority Nurse scholarshi p list is a great place to start, but there are also other places you can find funds to offset what you owe.
Scholarships do require work. You’ll have to do some research to find them, but with so many sites and lists available, you shouldn’t have too much trouble. Many scholarships require a short essay, but some only require an application. Scholarships based on financial need will likely require you to fill out information about your financial status and your income.
As a nursing student, there are many options to look into. If you are a a member of a professional organization, like the National Black Nurses Association, look into what they might offer. Student nurses can check into the Foundation of the National Student Nurses’ Association, Inc., to see what kinds of opportunities they have available. You can investigate opportunities specifically for minority nursing students as well like the one offered by Cherokee Nation.
One you have looked into professional organizations, check your community for scholarships, too. May local groups have specific funds set aside for students pursing higher education. If you have actively volunteered, say for a local fair or a community event, look into those parent organizations as well.
Once you have found scholarships, apply! Triple check to make sure you have included all the information they need to consider your application, and then get everything in by the due date.
With a little work, you can graduate with less debt.
Did you ever look back upon your career and reflect on those humble beginnings? As educators, we sometimes forget that it was not easy to aspire to the higher academic goals we have been so fortunate to have attained. When we counsel our students, we must not disregard that they too have many barriers to overcome in their journey to be successful. In retrospect, we can embrace the challenges we must face in the effort to ensure our students’ academic success.
One morning during break, I overheard one of my student’s discussion with her colleague regarding how lucky she was that her children would be cared for over the weekend. This would allow her time needed to study for the final exam. Knowing this student, I was aware that she was a single parent and working mom, and more importantly, my student was pursuing a future career in nursing no less. It was a revelation that this fortunate incident for her was not expected, but was a gift. I began to ponder how this student would have prepared for the final if the childcare issues had not been resolved. Upon review, I realized that this student’s grades were not always consistent. During counsel, her excuses for poor grades or incomplete homework assignments were due to illness (whether be it her own or one of her children’s) or because of a busy work schedule, which entailed all shifts conceivable. So, when did she have time to study?
Lack of study time was also noticeable in the part-time evening students. I recall the blank stares on their faces during a Q&A session in preparation for the day’s lesson. Upon inquiry, the group confessed that they had not prepared for the evening’s lecture in their attempt to balance work, family, homework, and study hours. The weekends had been relegated to study time in preparation for the upcoming week’s assignments, albeit incomplete. Add this to childcare, spousal duties, and familial responsibilities and you have one overworked, fatigued, and ill-prepared nursing student.
Many times, as educators we focus on the negative aspects of our students: the fatigue, lack of engagement during lecture or clinical, and the behavioral issues (tardiness, absenteeism, and disputes with colleagues). This can hinder our ability to focus on putting interventions into place to enhance our students’ learning abilities. We might complain about time consumed due to providing an inordinate amount of time with a student that was not responding to intense tutelage. Perhaps we should invest in discussions about the ever-changing policies affecting our curriculum or work hours. Somehow, the drudgery of this negative outlook overshadows a focus on the academic pursuits of those struggling to attain a portion of our accomplishments. We must be sensitive to the vulnerability of this population during their journey. Whether it be in the case of the traditional, the returning, or the recycled adult learner, financial constraints are taxing. Adhering to professional and attendance policies takes effort. Striving to maintain a precarious balancing act to function commendably in multiple roles are all central themes of the adult learner. In acknowledging this, it is incumbent upon us to assist our students in getting past these barriers.
I have contemplated methods to assist nursing students, which have resulted in better outcomes. Some interventions I have put into place have made the difference in my students’ success as evidenced in their test scores. The following interventions are worth noting:
- Games: the Millennials love them. Who said learning should be boring? The younger generation thrives off the technological support, which surreptitiously enhances learning. The games can be competitive, informal, and applied individually or after breaking the class into groups. Games are used best when they can be accessed as a resource after classroom sessions as a study tool before testing.
- Provide a quick recap at the end of class. Some students may be so attentive during lecture that they do not take notes that were imperative to have as a review for the next test. This is easy to rectify by providing a short review of pertinent facts at the end of the day, paying special attention to the material that will be included on the test. This quick review gives the learner another chance to process and make note of what the instructor was attempting to stress in the previous lecture(s). This may seem redundant, but we cannot forget that this is all new information for the learner.
- Remind the student of your availability. I state my office hours on a weekly basis most emphatically after testing. This publicly reinforces my commitment to their learning needs and hopefully abates their reluctance to seek my instruction.
- Review one-on-one over the previous tests taken with students who have scored poorly. Allow the student to reflect, write, and question the material covered in the test(s). Educators have gained insight about their students during these sessions (e.g., what type of learner they are, if there are linguistic barriers, and/or if there is a lack of effective study habits). This session also establishes a rapport between you and the learner, which can be motivational.
- Allocate extra time to be available for hours before testing. You would be surprised to see how many students will attend for review after a long, clinical day in anticipation of a test pending the next day. Is it more time consuming? Not nearly as much as counseling them one-on-one would be.
These are a few tips I have used to incorporate in teaching my students before I notice a decline in test scores. As I look back on my humble beginnings, I realize that the barriers I encountered are not so different. I am fortunate enough to have had support and encouragement throughout my career as a student and as a practitioner. It is as challenging for both the educator and the learner; diligence is required from all parties. But we are in the trenches together. We all had to start somewhere.
National Patient Safety Awareness Week (March 11 – 17) focuses attention squarely on one thing at the top of every nurse’s list – keeping patients safe.
Minority Nurse spoke with Patricia McGaffigan, RN, MS, CPPS, vice president, safety programs at the Institute for Healthcare Improvement (IHI) about the ongoing issues around patient safety and how nurses can continue to implement positive and productive change.
While nurses provide a majority of care in inpatient settings, McGaffigan says the issue of patient safety extends to a wider setting as interprofessional teams are responsible for so many levels of care.
Because of the nurse’s role, they are especially able to impact patient care. “Nurses represent the largest segment of the healthcare workforce, in roles that range from the bedside to the boardroom,” says McGaffigan. “One specific and relatively easy way that nurses can effect change is to become educated in foundational safety science.” Nurses who aren’t trained in safety science can obtain training, and many student nurses receive the training as part of the curriculum. “Nurses are perfectly positioned to be able to identify risks and hazards in their work environments that may be mitigated before harm occurs, and this daily commitment to mindfulness about preventing harm before it happens is vital.”
As nurses, ongoing education, and maintaining and obtaining appropriate certifications help nurses provide the optimal care when they are with patients. Consistency in providing care and following a standard of care plan help patient outcomes as well.
“Nurse-sensitive indicators that reflect structure, process, and outcome are of great importance to nurses.” she says. “As a profession, we want to ensure that we have appropriate numbers of skilled nursing professionals who are able to meet the unique needs of patients and families. Process measures are focused on ensuring that we deliver the right care in a consistent and reliable manner.”
Patient harm can result when there is a lack of guidance or an absent standard to follow, says McGaffigan. For instance, harm can result when patients aren’t regularly repositioned or when oral care in ventilated patients is neglected. Other areas of particular importance include medication errors, falls, hospital-acquired infections, or complications, and other injury.
To provide the best care, nurses must also be able to care for themselves. If they are overly fatigued, do not feel supported or able to thrive in their organizations or if they are working in an organization where a culture of safety is not emphasized, patients cannot receive optimal care and nurses themselves might be at greater risk.
“Nurses are increasingly and very appropriately focused on their own physical and emotional safety, as well as cultures of safety,” she says.
The interactions that build relationships between nurses and patients are key to keeping patients safe. “Nurses are often the profession that has the most interaction with patients and families,” says McGaffigan. “We can consistently strive to identify the needs and preferences of patients and families, and also ask patients and family members what matters to them, and what they might be worried about.” McGaffigan knows this first hand. “As a former pediatric critical care nurse, one of my greatest ‘early warning systems’ was when a parent might tell me that ‘something just doesn’t feel right about my child,’” she says.
When errors do happen, a transparent process to understand what went wrong, assess the cause, and prevent future harm is essential. “Punitive cultures exacerbate reluctance to report near-misses and errors,” says McGaffigan. “Nurses can become more familiar with Surveys of Patient Safety Culture, identify areas where unit and organizational performance is stronger or weaker, and play a key role as leaders and participants in initiatives to improve scores on their survey domains.”
Patient safety continues to evolve as new medical technologies are introduced and as patient care continues to become more complex and more challenging.
“Nurses, as well as our other colleagues in healthcare, have chosen our profession because we have a core value of ensuring that our care is not only technically sound and appropriate, but is safe,” says McGaffigan. “As nursing professionals, we come to work every day to ensure nothing less than safe care. Whether we are in traditional roles at the bedside or as nursing leaders, educating our next generation of nurses, sitting on boards of directors of health care organizations, serving in formal patient safety positions, contributing to progress in the medical device and pharmaceutical industries, or more, we individually and collectively embody safety as our core value.”
Those who enter the profession do so knowing they are often a patient’s greatest advocate and a crucial partner in receiving the best care. “We are committed to creating a world where patients are free from harm,” she says, “and we advocate and anchor our healthcare system to not simply regard safety as ‘one more thing that we do,’ but understand that ‘it is the one thing that must permeate and provide the foundation for all that we do.’”
As Black History Month closes, Minority Nurse interviewed Martha Dawson, DNP, RN, FACHE, and assistant professor in the Nursing and Health Systems Administration at the University of Alabama at Birmingham School of Nursing (UABSON). Dawson is also director for the Nursing Health Systems Leadership (NHSL) Division at UAB. The NHSL division includes nursing administration, clinical nurse leaders (CNL), and nursing informatics students. She is also the historian for the National Black Nurses Association.
Dawson, who knew early on that nursing was her path, earned her doctoral degree in nursing after many of her colleagues encouraged and prodded her to advance her studies. The challenges she faced, the experiences she had and her determination will resonate with many minority nurses.
“As I would mentor younger nurses and encouraged them to continue their education to the doctorate level many would say, ‘But, you don’t have a doctorate,’” says Dawson. “I knew then that I had to be the role model and earn a doctorate so I would not become a barrier to young nurses seeking higher education. I have always enjoyed learning and sharing my knowledge.”
The following is our Q&A with Dawson.
Why did you choose to become a nurse?
Becoming a nurse was just something I wanted do from a very young age because I could help people from birth to end-of-life. I can recall telling my father that I wanted to be a nurse. When he asked me repeatedly what type of nurse, I kept replying an RN—I had no idea about the vast career options at such a young age.
I can recall begging my mom one Christmas for a doll that had a medical kit including syringe, stethoscope, bandages, clutches, and arm and leg casts. Nursing provides me with so many career options from providing hands-on care, teaching, mentoring, research, and leadership, and most importantly paying it forward to help others become nurses. Then, there were the times when I took care of my grandmother when she broke her knee and my father when he burned his back. I can also recall when my brother dislocated his leg and I my big toe—mom reset or aligned them using wood splints without us going to a doctor. I was impressed and hooked on being a nurse.
How did you choose your path?
For me this a limiting question because nursing offers pathways, not just a path. Currently, I guess one would say that I am an educator.
I am a planner and strong believer in career mapping and progression. My current educator role is the result of taking a systematic approach to my nursing career by setting short- and long-term goals. I decided early in my nursing career that I wanted to teach, but only after I acquired the expertise to share both lived experiences and book knowledge—in short, I wanted to walk in the shoes of those I would be educating. Therefore, my nursing career started as a BSN nurse in a cardiovascular open-heart intensive care unit where I provided direct care and worked as relief charge nurse and then charge nurse.
Then, like many nurses, after transferring to a pre- and post-cardiovascular unit, I was asked to step into the nurse manager role with no preparation. Management and leadership came naturally to me, but I knew that I needed business and organization skills and knowledge. Therefore, I completed a dual master’s as a cardiovascular clinical nurse specialist (CNS) and in nursing administration that required completion of a 10-month hospital residency certificate program.
By the time I started the nursing administration studies, I had become hooked on leading and influencing change, plus being a voice for nursing both internal and external to the organization. Nursing administration became my passion, and I committed myself to learning as much as I could. I have held positions at the director level, associate chief operating positions, chief nurse, and executive VP level in practice setting, mostly academic medical centers. These roles provided me with the experience to teach the next generation of nurse leaders. I am still growing and determining the next chapters in my career.
I am a life-long leader and forever a student of our great profession.
What kinds of challenges did you face in your career and how did you overcome them?
My challenges would fill a book. There were very few minority students in my school, and it was rarely that more than two of us would be assigned to the same clinical group. In addition, there were very few African American faculty. During my BSN and MSN studies, I did not have a faculty member of color from any ethnicity. Most of the time, I felt the grading was fair, but then I had experiences where I would receive a B on a paper with no correction or remarks only the letter grade. Yes, I did follow up with the faculty and administration as needed.
My advice, and what helped me, is that challenges are there to overcome and to be used as stepping stones. When someone said that I could not do something or advance my career, I felt that it was my God-given right to prove the person wrong. My faith has made and kept me strong. I really try to set my goals and pathways in life and not allow others to determine my destiny. I know and respect that this approach and mental model will not work for everyone. Therefore, I try to help others find their voice.
Mentoring is important for any nurse, but especially for minority nurses. Did you have any kind of mentoring relationship?
I really did not have a mentor(s) early in my career, as I progressed in my career there were leaders that I would say have served as good coaches for me. During my doctorate education, I had my first African American nursing faculty—31 years after becoming a nurse.
Do you mentor young (or new-to-nursing) nurses now?
I mentor everyone that will allow me, from elementary school to doctorate level students. Giving back and investing in others is a personal charge that I have accepted to afford others a smoother path. I mentor nurses, other healthcare professionals and those who aren’t nurses/healthcare professionals. Mentorship is a bidirectional relationship.
However, as a mentor it has to be about the mentee and their career goals. For me as a mentor, the relationship keep me current with professional and society issues, and it improves my listening skills so I can hear and support the mentee. It is key that mentees come to the relationship with a desire to focus and put in the time. Too often, I believe the mentees fail to appreciate the work that will be required of them. However, a good mentor will help mentees step outside of their comfort zones and encourage them to excel beyond the level of the mentor.
True mentorship must include self-assessment, self-reflection, and the willingness to change and reinvent oneself if necessary. It is a learning and growing process that never ends. I encourage my mentees to outgrow me and seek advice from others. In addition, I tell them that if I can only get them to my level of performance, accomplishment, or achievement, then I have failed them because it is not about me, but them. I should help them do more, give more, achieve more, and go further. The mentees help and allow me to sow into their success and support them as I transition into a different phase of my career.
In short, each mentee is a part of my succession plan to ensure that the profession and world are in good hands with the next generations of nurses, nurse leaders, and teachers.
What is the most beneficial outcome of increasing the diversity of the current nursing workforce?
I believe the greatest benefit of having a diverse nursing workforce is the role model and mentoring that can be provided to students of different races and ethnicities to help them enter, matriculate, and graduate from nursing programs. Next, if the profession truly wants to improve population health, then we must have nurses that have lived experiences of the populations we are trying to help.
In the same manner, if we want to create a culture of health, it is important that the owners of culture are engaged on the front end and that the engagers look like them and understand them. There is also a business and economic case to be made that we rarely read about in the literature; nursing is a great profession and one of the few occupations that can continue to earn a livable wage during an economic recession. Nursing as a career can help improve the economic status of families and improve the long-term health outcomes of whole communities for generations. I appreciate diversity at all levels. However, we have to be careful of the global approach to diversity, i.e., where we are counting everything to avoid addressing the real issues of race and ethnicity.
We need more men in nursing but not to just increase the “diversity count.” In other words, I still want to know the breakdown of male nurses by age, race, and ethnicity. Then, we have to address the issue of diversity and inclusivity. Diversity without inclusivity is just a pen, paper, and number game. My motto is that diversity is the quilt that creates a beauty pattern, but inclusivity is like tapestry, many different colors of threads creating a picture. Therefore, an organization has to ask, “Is our vision of diversity a pattern or a picture of interconnectivity?”
What are the biggest barriers for young students of color to become nurses and how can that be changed?
After serving as the principal investigator for two HRSA workforce grants, I am convinced that if we want to increase diversity in nursing and the medical field, we have to start with pre-K through 7th grade.
Nursing is a science-based discipline, and students must be introduced to the profession with the understanding that they have to take the STEM-related courses. The lack of preparation in math and science is the biggest problem facing our students. Prerequisite courses derail many of our pre-nursing students of color. Therefore, they cannot wait to take chemistry, advanced math, anatomy, and physiology, and other related science courses. These courses are needed prior to college entry.
The second major problem is related to high school and freshman counselors. Top performing high school students are receiving information on nursing as a career option. Then many students of color, even some with the GPA, are being mis-counseled and advised against nursing because of the rigor of the program. In addition, many schools of nursing that are concerned about their NCLEX pass rates are growing and holding more and more seats for their “honor programs” thus making it more difficult for that pre-nursing student with an ACT of 20 and GPA of 3.5 to even be considered for the nursing program.
Finally, we still have the issue of lack of diversity among SON faculty. Nursing must become more committed to developing a diverse academic workforce. A great starting point would be to increase faculty diversity to be 10% higher than the state demographic profile because we have a lot of catching up to do.
I still love nursing and think it was the best choice for me. I am not sure what I will be when I grow up, but it will have something to do with nursing. Oh, not grow up, but when I retire.
If you ever need a reason to feel proud of the lifesaving treatment and the compassionate caregiving, you offer every day in your nursing career, the launch of Nursing Now on February 27 is a big one.
In an effort to raise the profile of nursing as a career and as a worldwide factor in improving health, the International Council of Nurses and the World Health Organization are launching Nursing Now across the globe.
Nursing Now is organized by the Burdett Trust for Nursing, a UK-based charitable trust. As nurses’ status increases, their influence will be felt in policy, reputation, and the status of the professional nurse. Nurses themselves can begin to tackle some of the biggest challenges that are facing humanity in the next century.
No matter what location nurses practice, they face similar challenges. They want the best opportunity and training to offer their patients top-notch care so they can lead better and healthier lives on their own and within their communities. Nursing Now will push for those changes, but nurses will see them happen slowly in their own communities and then on a broader national level before becoming a worldwide trend.
The launch is the first step in an initiative that runs through 2020. Nursing Now will support other programs around the world and hep nurses become more able to influence the ways in which they work and effect change with patient and community health.
The initiative has five stated goals:
1. Greater investment in improving education, professional development, standards, regulation and employment conditions for nurses.
2. Increased and improved dissemination of effective and innovative practice in nursing.
3. Greater influence for nurses and midwives on global and national health policy, as part of broader efforts to ensure health workforces are more involved in decision-making.
4. More nurses in leadership positions and more opportunities for development at all levels.
5. More evidence for policy and decision makers about: where nursing can have the greatest impact, what is stopping nurses from reaching their full potential and how to address these obstacles.
Nursing Now recognizes that global change begins as people work together in each and every community. As nurses band together for change, the momentum will grow and impact greater people and reach into higher changes.
The University of North Carolina Chapel Hill School of Nursing will host with United States launch event, and nurses will be able to check the main website throughout the day to learn about other events worldwide.
On February 27, check out Nursing Now and envision and even stronger and more influential nursing future.