From a student nurse deciding on a career path to a seasoned nurse looking to advance into administration, each step along a nurse’s career is filled with questions. Fortunately, mentors in the nursing industry are becoming a more visible presence.
The Nurse Mentorship Program at Stanford Health Care is one such valued and valuable mentoring program. Introduced in 2004 for graduate nurses, the program now encompasses a range of nurses in different areas of their careers.
Minority Nurse spoke with associate chief nursing officer for inpatient services and magnet program director at Stanford Health Care at Stanford University Anita Girard and with Stanford’s program manager of nursing excellence Kevin Tsui about the distinct benefits of this kind of program.
Girard and Tsui say many nurses seek mentoring for varied reasons. They might seek leadership advice or they might want guidance for switching specialties. Still others may be looking for assistance with specific tasks such as writing or giving a top-notch presentation at a conference.
Any nurse can gain from a mentoring relationship, says Girard, but a specific benefit is one that will help a nurse professionally and personally. “The biggest benefit is the networking nurses have being in a mentoring program,” she says. “Mentoring opens you up to a whole new world.”
Tsui agrees and notes the satisfaction nurses reap from establishing a firm footing in their careers and having someone who can help guide them. The resulting good feelings lead to happier nurses, and the benefits stretch far. “Those mentoring connections streamline goals, build positivity and retention, and nurses feel a sense of control,” he says.
Nurses, says Girard, can feel siloed. Despite being in the same profession, nurses have varying specialties and may not have opportunities to hear from nurses in different areas. Mentoring includes both the one-on-one discussions and the larger access to others in the industry that becomes available. “Mentoring gets you out of that box,” says Girard.
So how does a mentoring relationship benefit the nurses and their organizations? According to Tsui, “It’s crucial. By sharing an organization’s mission, vision, and values, it makes transparent the format for mentoring,” he says.
Nurses in a mentoring relationship within the same organization are working within the same culture, so are able to set clear goals and create objectives that are going to be important to the nurse’s career within that organization and in the larger industry. Often, says Girard, mentors will give guidance based on what they already know about the organization. They will be able to help a nurse put priorities in order for certification, advancement, skills development, and personal improvement.
Mentors are also able to be objective about a nurse’s path, so they can help nurses align their goals and use their own knowledge to help a nurse achieve those goals, says Tsui.
A mentoring relationship is definitely a give and take, says Girard. “You really need to make an effort to understand why you want to get into a mentoring relationship in the first place,” she says. And mentees need to make a solid commitment and understand that any mentoring activity needs to be given top priority, she says.
Mentees are responsible for reaching out, setting up clear timelines, and even using tools to streamline online tasks such as emails and calendar appointments. Any communication should have an agenda with clear and succinct ideas and questions. By doing this, the mentee shows the mentor clear goals and intentions mean they have a goal for mentoring and that it will be productive.
Tsui says that sometimes mentees are not clear about the process and expect the mentor to initiate or complete tasks for them. Instead they need to keep in mind they need to be committed to change and driven to use the guidance of the mentor to advance their goals.
At Stanford Health Care, the mentoring program satisfies a magnet hospital requirement, but the benefits have been extensive. “We are driven to excellence,” says Girard. “It is a journey of innovation and inquiry and what we can do to make things better.”
This year’s Certified Registered Nurse Anesthetists (CRNA) Week, celebrated from January 20-26, calls attention to the work of nurse anesthetists and the patient care they provide.
Sponsored by the American Association of Nurse Anesthetists (AANA) , this week of celebration was once known as National Nurse Anesthetists Week. The Additional of “certified registered” helps people understand the rigorous training and continuing education for this specialty.
Nurse anesthetists work closely with a medical team and in some states, they are often the sole anesthetist on a team. According to the AANA, nearly 53,000 certified nurse anesthetists and student nurse anesthetists provide care throughout the country. Career growth in the field continues to attract top talent as the opportunities for lifelong learning and fast-paced advancements offer a dynamic environment. In addition, nurse anesthetists are among the highest paid nurses with a median annual salary of $165,000.
CRNAs have a vital role in patient care at all stages of surgery or a procedure. They assess patients prior to anesthesia, monitor them during the procedure, and continue to watch for any difficulties or problems after they come out of anesthesia. In this role, nurses offer compassion, comfort, and an intense focus on the details of medical care. They must assess visually and with equipment readings to understand how a patient is tolerating anesthesia.
In this career, CRNAs can work with a wide range of medical teams. They can practice in hospitals, stand-alone facilities, dentist offices, trauma teams, surgical facilities, military units, or pain management clinics to name only a few areas. The variety of settings means a CRNA can choose to work in specialties that hold particular interest or match an educational background or a life experience best.
Anyone interested in this field should have the correct path of educational attainment. According to the AANA, “graduates of nurse anesthesia educational programs have an average of 9,369 hours of clinical experience.” Programs for nurse anesthetists can range from 24 to 51 months. Program requirements can vary with the university, but will include essential clinical placements. Certification and recertification are also required to become a CRNA and maintain that professional standing. By 2022, students will be required to enter doctoral programs for this field.
Many CRNAs say the direct patient care, the satisfaction of being an essential part of the medical team, and the technical challenges of the work make this an exciting career path. In some states, CRNAs provide the majority, if not all of, the anesthesia care. Anesthesiologists work with patients of all ages and in settings so varied, their days are never the same. But the responsibility of keeping patients safe and being their advocate in a vulnerable time is rewarding.
Sometimes nurses know they are destined for a lifelong nursing career; for other nurses, it’s as if the career chooses them.
That’s how Jonathan Llamas DNP (c), BSN, RN-BC, PHN, found his way to nursing. Knowing the career would be a good fit for his compassionate nature and his innate ability to have empathy for others, Llamas applied for nursing school right out of high school.
“I knew the work was selfless and inspiring,” he says, “but I went into nursing school with some naiveté. I knew I had the qualities to be a successful nurse, but I didn’t understand the amount of hard work and dedication required for me to excel in the heavily science-based coursework.”
Llamas was unprepared and struggled with the demands of the course load. Looking back, Llamas sees how his path started to become rockier, even as he wanted to succeed. He lacked the mindset to focus on his work. “I didn’t commit the time necessary for me to be successful,” he says.
Transferring to community college, Llamas finished his prereq courses, but says his lackluster GPA set him up for a cycle of rejections from other nursing programs. Determined, Llamas pressed on but struggled with setbacks that would have had other students choosing another path.
“Based on my GPA, my community college counselor said, ‘You don’t have what it takes to be a nurse,’” says Llamas. Feeling demoralized by the comment, Llamas still felt that nursing was his calling. He just had to find a way to get there. “I had to prove to myself I could do it,” he says, “and that I could do well under pressure.”
The toll from the rejection was growing though. As a first-generation college student from a supportive Filipino family, Llamas recalls his mother’s upset at all the rejection for him and it struck a nerve.
“I looked in the mirror and thought, ‘How do I want to be remembered? Do I want to be a father who inspires his kid to rise above adversity or fold under pressure?’” Llamas says. “I didn’t want to be the latter. I wanted to make something of myself.”
Determined to succeed, Llamas applied to West Coast University’s nursing program, and they gave him another chance. He didn’t throw it away and graduated in 2013. I learned that if I wanted to be successful, I have to apply myself,” he says. “I carry that now. If you want something, you have to work for what you want. We are all different in terms of the resources we have initially. We are not all starting at the same starting line.”
“Hopefully my story will inspire others,” says Llamas. He wants students to be academically and mentally ready at the outset so they aren’t surprised by the intensity and high expectations of nursing school. “You have to sacrifice to be successful,” he says. “It’s hard, but it’s temporary. Do your research, and know why you want to be a nurse. Have a vision for yourself and your future.”
As Llamas has learned, there is a level of commitment to nursing that is necessary to be an exceptional nurse. “There’s a difference between your passion and your purpose,” he says. Having the inherent ability to be a successful nurse often makes one’s passion for nursing grow stronger, he says. “I understand that nursing requires sacrifice, but the most rewarding thing you can do is provide such incredible care to a patient.”
For Llamas, persistence has paid off. He is set to graduate this spring with his DNP from Loma Linda University and juggles his academic load with a full-time schedule as a psychiatric mental-health nurse. “I am fortunate to have hit this stride in my career,” he says. The advanced degree will help him reach his future goals of influencing change in nursing by providing a different form of influence beyond the bedside. He envisions working as an NP, becoming an educator to help future nurses, and using his platform to help other nurses.
“If you had said to me 10 years ago that I would accomplish this, I would have said you were crazy,” he says. “If I have impacted someone’s life for the better, then I have lived a life worth living. I feel blessed, humbled, and grateful for the opportunities that have come my way.”
Nursing education is the foundational pillar that enables future nurses to become competent and knowledgeable in their respective practices. This education was normally provided to nursing students through various didactic theoretical lectures and practical clinical training but recently, the use of advanced simulation technology as an adjunct educational tool has slowly become a significant addition to student centric learning.
History of Simulation
The concept of simulation practice can be traced back to the fields of military, aviation, and nuclear power (with military having used simulation the longest), dating back to the 18th century. Simulation was initially created as a cost-effective strategy for training professionals because it was considered exorbitant to train in these areas in the real world. As the years progressed however, the healthcare profession realized the practicality and usefulness of incorporating advanced simulation technology into educational practice and as a result, spurred the growing movement of simulation in healthcare training settings and educational establishments around the world.
The Impact of Simulation on Nursing Students
The emergence of computer technology has led to the development of innovative tools for healthcare professionals such as simulation technology and patient simulators Simulation technologies have had a profound effect on the nursing profession because it allows nursing students to apply their recently learned skills and knowledge to solve real life scenarios in a safe and structured setting.
In a typical simulation session, two students are often asked to participate and mimic the roles of a registered nurse or a certified nurse assistant (CNA). The rest of the remaining students are then asked to go to a separate room and observe the scenario through a one-way mirror and a live video stream. At the start of the session, the facilitator usually gives report on the patient, which allows the students to familiarize themselves with the patient’s situation, history, charts, and medications in order to successfully manage and implement high quality nursing care for the patient. As the simulation progresses, the facilitator controls the patient’s prognosis and provides cues to the team to enhance the realism of the situation. Once the simulation is completed, the students are then asked to head back to the debriefing room to discuss their experiences.
During the debriefing session, the students learn through self-reflection, group interaction, and questions asked by the facilitator. The use of group discussion engages students in reflective learning and enables the group members to consider a situation from multiple perspectives and consider other alternatives in order to broaden their scope of practice and clinical understanding. By performing simulation scenarios on a regular basis, students are able to develop better critical thinking skills, decision-making abilities, and application of theoretical knowledge in real-life situations.
Facilitating Simulation into Nursing Practice
According to the Institute of Medicine (IOM), approximately 98,000 people die every year from medical errors in U.S. hospitals, and a significant number of those deaths are associated with medication errors. This means that adverse events affect nearly 1 of 10 patients in the hospital setting. Based on this staggering number, the IOM called for a systematic change in healthcare practices and identified simulation practice as a resource to address the needed reform. By fostering experiential learning, simulation ingrains good nursing habits early, while discouraging bad nursing habits from forming before it becomes second nature.
In addition to allowing individuals to hone their nursing skills, simulation has also proven to increase student confidence and self-efficacy once they transition into the clinical setting. Nursing efficacy is an important aspect in nursing practice because it gives the students the confidence required to provide excellent nursing care to their patients. By incorporating what they have learned in simulation, more students are self-reliant in their capabilities, which are invaluable in ensuring that patient safety is implemented in the hospital setting.
Implications for Future Nursing Practice and Further Study
The shortage of availability of clinical sites is quickly becoming the norm for many nursing schools due to changing healthcare reform and the struggling economic crisis. One solution to combat the shortage of clinical sites however is to utilize simulation practice to replicate essential aspects of clinical situations for beginning nursing students. The National Council of State Boards of Nursing is currently conducting a landmark, longitudinal study to examine the knowledge and clinical competency outcomes of students when simulation technology is used in the place of actual clinical experiences. Although calls for additional research in these areas need to be performed, simulation is still quickly gaining momentum as the gold standard for effective learning practice in nursing education.
Enrolling in a Doctor of Nursing Practice (DNP) program can be a daunting task for many students due to the rigorous academic requirements often associated with it. Although DNP school can be intimidating, students who choose to enroll not only embrace the significance of pursuing higher education but also the possibility of advancing their roles as prominent health care leaders in the nursing profession. As a DNP candidate myself, I’ve grown to appreciate the triumph and struggles associated with pursuing a terminal degree. Therefore, I believe students who are considering pursuing their DNP degree must harness these seven attributes to ensure that they are not only readily prepared but also successful in their scholastic endeavors.
1. Clear Vision
Setting a vision and goal for the future is vital for success in the DNP program. Possessing a clear vision is necessary because it helps you organize your individual objectives and helps you maintain accountability throughout the program. If choosing to enroll in DNP school perfectly aligns with your personal and professional goals, having a vision that is well defined will not only help you focus on your objectives but also create a sense of purpose that ultimately becomes your own measurement for success.
2. Ability to Prioritize
Students who know what and how to prioritize tend to be more successful in DNP school because they know how to differentiate tasks as either critical or noncritical. One of the best ways to prioritize in DNP school is by looking over the program and course objectives of each class and determine which tasks need to be completed first. By knowing how to prioritize your tasks wisely you will not only be able to minimize stress but also maximize results more effortlessly and efficiently.
3. Effective Time Management Skills
Possessing excellent time management skills is an important trait prior to beginning DNP school because of the high academic workload associated with pursuing a doctoral degree. Managing your time effectively will allow you to accomplish more tasks in a shorter period of time and help lower your stress and increase your concentration and attention. To ensure that your time is properly managed, it helps to keep a written or electronic record, diary, or calendar to ensure that you know what tasks are required and when they must be completed.
4. Strong Work Ethic
Maintaining a strong work ethic is essential in determining your overall success in DNP school. Students who possess a strong work ethic understand that success can only be achieved by practicing the ideals of discipline and hard work on a regular basis. To maintain a strong work ethic, it is vital to practice positive habits consistently every day so that hard work is almost automatic. Forming respectable habits such as exercising daily, staying punctual, maintaining your obligations, and finishing tasks immediately help establish your credibility and image as a doctorally prepared nurse.
5. Healthy Work-Life Balance
While it is important to study and work hard in DNP school, it is equally important to create a healthy work-life balance and set aside much needed time for yourself and your loved ones. Learning how to care for yourself is extremely important in DNP school as working too much can ultimately cause you to become overwhelmed, overworked, and overstressed. To avoid this, it is best that you take consistent breaks throughout the day to maintain your overall well-being. Learning how to take ample rest breaks is vital to ensure your physical, mental, and emotional health is adequately cared for in DNP school.
6. An Understanding that Excellence is a Lifelong Process
One of the key principles that DNP students must understand is that excellence is a lifelong process. Understanding this concept is vital because sustainable success in DNP school and in life is not something that is built overnight but rather an extended period of time. As leaders in the nursing realm, DNP students must understand that sustainable excellence requires constant monitoring, learning, and improvement with the realization that the journey is just as important as the destination.
7. Perpetual Curiosity
DNP students who remain perpetually curious are more susceptible to success because curiosity not only propels innovation but also self-reflection. Fostering your curiosity in DNP school is essential because it allows you to be fully present in the moment. Curious people are not only happier but also more successful because they are non-blaming, non-shaming, supportive, and focused on exploring options to find the best solution that supports collaboration and innovation.
During the last three months, I had the opportunity and privilege to participate in a work program that collaboratively raises standards for learning and teaching, leading students to the highest levels of engagement and success. This was an eye-opening experience, allowing me to evaluate my own teaching practices in higher education and giving me additional tools to be more adventurous as I continue on with my role in academia.
Here are my five takeaways from the experience:
1. Make sure your students are actively learning enough.
Current evidence in higher learning no longer supports the effectiveness of sole lectures in the classroom setting. Instead, increase use of Active Learning Strategies (ALS) in the classroom setting to offer improved student learning and outcomes. Examples of ALS include: Minute Paper, Think-Pair-Share, Small and Large Groups, Role Playing, Storytelling, etc. One of the biggest student complaints with ALS is the idea that students are teaching themselves. When properly implemented, ALS helps to initiate learners and faculties into effective ways to help learners engage in activities that encourage deep learning.
2. Traditional “lecturing” still has a place in the classroom.
Many educators are considered the “experts” and offer a wealth of knowledge when they step foot in their classrooms. Most of us are familiar with traditional lectures in the classroom setting, where we had a professor “lecture” for hours in front of the classroom. However, many can argue that these professors are not necessarily “Sages on the Stage” but rather “Bores at the Board” for the majority of the time. Do not forget that higher education encourages educators to be more “Guides on the Sides” and become facilitators of student learning as they guide them from the sideline. Whichever method you choose to do in the classroom, you must be humble enough to accept if certain practices require tweaking for improvement.
3. Preparing the adult brain for learning: Evidence has shown that deep learning requires the adult brain learner to be primed.
But how does one prepare the brain to be at the optimal state in which the learner is alert and focused on learning? Several techniques have been noted to help students learn best, including but not limited to: Breathing Exercises, Nutrition, Music, Aroma, and Visualization. All these techniques work in various ways, but more importantly can help in how the adult brain is able to process information. How are you helping prepare your students for learning?
4. Technology belongs in the classroom.
Imagine a classroom without technology… For most of us, this can be very strange, as we are surrounded by technology on a regular basis. And our students are ALWAYS using technology, whether they are using laptops or tablets to take notes or their own personal devices (mobile phones) to stay in touch with their social media world. We must embrace that technology is here to stay, and figure out better solutions in including them in the classroom setting.
5. As educators, we must also be willing to learn (from peers and our own students).
Just because we have completed our studies and are now educators does not preclude us from learning new things. We must never cease to inquire and acquire knowledge. If anything, being an educator challenges us to be the best that we can possibly be for the students that we serve.
What has been your experience with student learning, both good and bad? Please share your own experiences, as I want to better myself as an educator. To be able to meet the students from where they are at, and take them on their own educational journey!