Peering into the Post-COVID Nursing Curriculum

Peering into the Post-COVID Nursing Curriculum

Nursing education after COVID will rely more on technology and digital tools than ever. Simulation and online learning will be part and parcel of the curriculum for nursing students. It will also be more competency-based as the new AACN Essentials further integrate into nursing curriculums.

But what about the content of the curriculum?

Nursing education, according to Mary Dolansky, Ph.D., RN, FAAN, Sarah C. Hirsh Professor, Frances Payne Bolton School of Nursing and Director, QSEN Institute at the school, may include instruction on telehealth, an emphasis on systems thinking, stress on leadership, and a focus on innovation and design thinking.

Nursing education after COVID

Mary Dolansky, Ph.D., RN, FAAN, is a Sarah C. Hirsh Professor at the Frances Payne Bolton School of Nursing and Director, QSEN Institute at the school

A Look at Nursing Education After COVID

Telehealth

Understanding how to use telehealth in nursing is key, according to Dolansky. The Frances Payne Bolton School of Nursing at Case Western Reserve University, Cleveland, developed a series of four modules on telehealth so that all students received a basic foundation in telehealth nursing, including telehealth presence. It included teaching on using Zoom or the phone to assess and evaluate patients. She notes that interactive products that give students a feel for how such interactions occur and practice them can provide an excellent education.

Systems Thinking

Another aspect of post-COVID nursing education involves systems thinking, says Dolansky. This involves “really getting students to think beyond one-to-one patient care delivery and about populations. We need to create more curricula for nurses out in primary care sites and nurses out in the community, and that has not been a strong emphasis in schools of nursing. Instead, we focus mainly on acute care.”

More specifically, students should learn, for instance, how to use data registries to look at areas of patient need. One COVID example, notes Dolansky, would be to use registries to identify long-term COVID patients. Another could be to use a registry or database to discover what patients have followed up on their chronic disease since, during COVID, many patients stopped visiting healthcare providers.

Emphasizing Leadership

In the post-COVID curriculum, developing leadership skills may become more critical. “What we observed in the COVID crisis,” says Dolansky, “was an opportunity for nurses to stand up and speak out more. We were the ones at the frontline and had the potential to be more innovative and responsive. Many great nurses did step up and speak up, but we need to ensure that every nurse can speak up for patients in future crises or even advocate for our patients now. Nurses can be the biggest advocates for patients.”

Every school of nursing probably has a leadership course, Dolansky notes. But ensuring that there are case studies from COVID as to how nurses did stand up and speak out and how that made a difference would be a fundamental curriculum change.

“We want to prepare our students that you will be a leader and you will be on TV talking about how you are innovating and adapting to the changing needs of the health of our population. And COVID was a great example for that.”

Innovation

Post-COVID, nursing education needs to help students with innovation and design thinking, notes Dolansky. Over the past 10 years with QSEN, “what we’re trying to advocate is shifting the lens of a nurse from direct patient care delivery, which has been the focus of nursing, to shifting a little bit to systems thinking.”

Critical thinking, notes Dolansky, focuses on making decisions for an individual patient. Design thinking and innovation are more about “looking at the system in which we work and empowering the nurses to fix the systems. This is key to quality and safety, but it’s also key to the need for our nurses to contribute strongly to the health of the future population. They have to be at the table to respond to these crises. We need them to have the skill set of being a leader, standing up, being at the table and when they’re at the table, having ideas, being creative, and knowing how to test them. And having the technical skills to use the technology is probably where most of the solutions will be for the future.”

QSEN and Competencies

With the latest AACN Essentials, there is a drive for competencies in nursing education, notes Dolansky. The Essentials: Core Competencies for Professional Nursing Education, approved by the AACN in April 2021, calls for a transition to competency-based education focusing on entry-level and advanced nursing practice.

While revising the Essentials began before the pandemic, the experiences and learnings from the pandemic greatly impacted the work, notes a recent article in Academic Medicine. As a result, the Essentials includes population health competencies that specifically address disaster and pandemic response and will better prepare the next generation of nurses to respond safely in future events, the article says.

Now, a crosswalk has developed between QSEN competency statements and the 2021 AACN Essential Statements, notes Dolansky. However, she notes that the AACN is taking the QSEN foundation and moving it forward, stating to the public that “the nursing profession has these competencies that are providing safe quality care to the public.” Since 2012, the QSEN effort has been based on the Frances Payne Bolton School of Nursing.

“Own Their Competency”

In the culture of nursing education, students now need to be educated to “own their competency,” says Dolansky. “Students will see that competency development is part of their lifelong professional development.

4 Tips for Planning a Return to School

4 Tips for Planning a Return to School

If the coming fall season makes you think about someday returning to school or even getting a new certification, then it’s time to start planning how you can turn your thoughts into actions. There’s a lot to consider as you compare programs and courses that will boost your knowledge, move your career forward, and appeal to your interests.

Evaluate the best programs

Before you send in an application, be sure the school meets high educational standards. “Nurses should definitely look for an accredited program, either by the CCNE or ACEN (NLN), which ensures the quality and integrity of the program,” says Ayanna Lopez, Director of Academic Advising for Graduate Student Services at the University of Central Florida (UCF) College of Nursing.

Find that work/life balance

Going to school takes a lot of time and is considered a financial investment in your future, so assess the resources and any available benefits you have to devote and plan accordingly. “I would recommend they find a program that aligns with their career goals and meets their personal needs,” says Lopez. “Oftentimes, graduate students are still working in their nursing careers and balancing a family. A program with full- or part-time options as well as online would provide flexibility and convenience.”  In addition, online programs may also be more affordable. For example, UCF’s online programs offer reduced tuition through fee waivers for some campus-based amenities.

Map your route

No matter what your level of education, you’ll find several options to reach your goal in your return to school. In some accelerated degree programs, RNs can pursue a graduate degree without a BSN. The same goes for some nurses who want to pursue a doctorate degree–there are accelerated programs that help them combine some MSN and DNP or PhD requirements so it takes less time to complete the degree. Even some prerequisite courses that nurses will need to complete for a degree program can be flexible. Those courses can often be taken before or during the course of studies. All those details will help you plan how long different programs will take and how much each will cost.

Know your expectations

Most nurses with advanced degrees will encourage others to strive for a higher level of education, but they also advise giving it careful thought. Nurses should do the work to understand their real motivation for wanting that additional degree. Is it for a promotion opportunity or to meet a personal goal? Are they looking for a salary increase and how would they view their efforts without a salary bump? “I would advise applicants to review the policies within their organization first to determine the best path for advancement,” says Lopez, “as some employers have policies about degrees required for promotion and salary increases.”

There’s a lot of information to consider when thinking of returning to school. With careful thought and planning, you can find the right program for you.

Student Nurses’ Day: Meet Azariah Torain

Student Nurses’ Day: Meet Azariah Torain

Current student nurses have had an academic path that has been influenced in all ways by a global pandemic. This year, Minority Nurse celebrates National Student Nurse Day (honored every year on May 8) by learning more about Azariah Torain, a sophomore at the University of Pittsburgh. Torain also is involved in the National Student Nurses’ Association where she is the 2022-2023 Imprint Editor and chair of the Image of Nursing Committee.

What made you decide to go to nursing school

Nursing school was a clear choice for me. I wanted to go into a career path where I could both challenge myself and positively impact another person’s life. I knew that nursing school would offer me the flexibility to switch my specialty if I ever got bored with what I was doing. I am very indecisive so I appreciate this option.

Do you know what nursing specialty you would like to go into?

The specialty I think I would enjoy the most would likely be the neonatal intensive care unit (NICU). Taking care of the worlds’ smallest patients would be so rewarding but also an extremely challenging role. This could change tomorrow though. I am set on my end goal of going back to school and eventually becoming involved in executive leadership in some form.

What excites you most about the nursing industry? 

What excites me the most about nursing is the fact that it is an industry full of innovative people. We are fast-paced and our practice is always shifting and evolving based on evidence-based practice. The amount of career paths are endless and so is the potential for growth.

What has been your biggest surprise as a student nurse?

My biggest surprise as a student nurse was definitely how quickly we are learning new things, especially this past semester. We would learn a skill in lab one week and the next we would have a competency evaluation and we are completing the skill from memory. Soon after that we are doing the skill on actual patients. My confidence in my ability has increased significantly as the year has gone by, but never too confident to ask for help.

Has the pandemic changed your path, outlook, or educational plans at all? 

The pandemic has shined a light on so many previously overlooked job opportunities in nursing. The prevalence of travel nursing and telehealth have me considering new possibilities! Being a freshman in 2020 was not fun, and I didn’t accomplish as much as I wanted to. With this school year a bit tamer, I have gotten to participate in so much more, and I truly feel like I’m getting the full nursing student experience.

Do you have mentors or supporters? 

My parents are easily my number-one supporters, I had a skateboarding incident and broke my front tooth in half three days before my white coat ceremony. My mom somehow was able to find someone to fix it just in time. Even from hours away she still saves the day.

How do you envision your nursing educational and career paths? 

I envision the two being very closely intertwined. As I advance in my education I will hopefully advance through my career. I plan on getting a Masters’ in Business Administration and possibly a doctorate level nursing degree in executive leadership.

What would you say to others considering who are thinking of becoming student nurses?

I would encourage anyone looking into nursing to make sure that they are at a stable place in life before enrolling in school. Nursing school can be done and it can be extremely rewarding but it is also incredibly taxing. I welcome anyone to join the nursing profession and if you are thinking of nursing school, you should be active and join a professional organization like NSNA.

Five Unusual Nursing Jobs: Is One of Them Right for You?

Five Unusual Nursing Jobs: Is One of Them Right for You?

One of the best things about nursing is that there is a rewarding job for everyone. While some professionals prefer to care for patients inside a hospital, others do their work while spending time outdoors, educating people or traveling the globe. No matter your personality or your working style, you can start an exciting career as soon as you get your registered nurse (RN) license. The following unique nursing jobs may require casual jogger scrub pants or a stylish, formal lab coat. Whatever you wear or how you like to contribute to others, one of these fresh and interesting roles is sure to suit you.

1. Forensic Nurse

If you have an investigative mind and like to advocate for your patients, forensic nursing may be right for you. These experienced RNs help to treat patients who are survivors of assault or abuse. They also collect evidence and may be asked to testify in some court cases. While it takes some training to become a forensic nurse, the field is growing. Nurses can also expect to earn between $59,000 and $89,000 per year.

Forensic nursing is always a rewarding challenge. Professionals with critical thinking skills, compassion and an understanding of the criminal justice system are encouraged to apply. While you will develop relationships with survivors, families and law enforcement, you will also make a difference in helping victims through a traumatic experience. Forensic nurses may work in hospitals, community centers and even in medical examiner offices.

Some of the biggest benefits of becoming a professional in the forensics field include a more flexible shift schedule, additional RN skills and a good salary. To become a forensic nurse, you will need at least an RN license and a BSN. Some roles will require you to obtain a certification as a sexual assault nurse examiner (SANE). There is even a SANE-P designation for caring for child and adolescent patients. Even if it is not a requirement at your current job, the SANE certification from the International Association of Forensic Nurses is invaluable to your career.

2. Occupational Nurse

Also referred to as employee health nurses, occupational nurses have a unique role outside of the hospital room. These experienced RNs work in factories, chemical plants and companies of all sizes to recognize and prevent damaging effects from hazardous exposures in the workplace. They may also be hired to treat workers’ illnesses and injuries and partner with other professionals at their company to analyze company medical benefits. Some work for private organizations, while others are hired by the government as contractors or consultants.

As an occupational nurse, you can expect to earn a higher annual salary with the more experience you have. According to PayScale, most nurses can be expected to bring in an average of $71,883 per year, while some of the highest-paid employee health nurses in the country make around $96,000. Some nurses can earn overtime pay, while others are on a fixed salary. Check with the organizations and employers in your area for specifics.

To become a nurse in this interesting field, you will need an RN license and at least two years of nursing experience. Some careers will require you to become certified as an occupational health nurse before you apply, while others will let you earn your certification in the first year on the job. The COHN or COHN-S exams take a few hours to complete. You must also submit an exam fee and recertify your license every five years. If you are committed to the effort it takes to make a difference as an occupational nurse, you will benefit the companies and employees that you work with.

3. Cruise Ship/Resort Nurse

A cruise ship nurse, resort nurse or yacht nurse gets to care for patients, all while working in relaxing or picturesque environments. Some are employed as registered nurses (RNs) in an onboard walk-in clinic, while others are authorized to provide higher-level care in a state-of-the-art medical facility. A resort nurse’s duties vary and may include everything from treating cuts and scrapes to prescribing medication.

While the nurse should have years of experience managing emergencies and triage, some common daily responsibilities include providing first aid and educating guests on how to care for medical conditions. They may also be in charge of education courses and care for onboard employees. Experienced nurses at sea could be hired to provide the company with expert information on how to deal with medical data and healthcare services.

If you would like to travel the world as a cruise ship or resort nurse, you will need an active RN license. Professionals with bachelor’s degrees or master’s degrees are even more attractive applicants for worldwide resorts, cruise lines and luxury yacht companies. Start by browsing jobs in the city or home port of your choice. Be sure to apply for your passport as you begin the interviewing process. You may be headed to a gorgeous international location before you know it.

4. Nurse Informaticist

Nursing informatics is a field of study that combines the fields of information science, communication and computer science. By gathering and analyzing data, nurse informaticists help hospitals and clinic administrators improve the flow of communication and information within their facilities. Other job responsibilities include interpreting and communicating data that will help to increase a clinic’s efficiency, promote excellent patient care and cut unnecessary costs.

To become a nurse informaticist, you will need an RN license, experience with patients and a BSN. Experienced RNs may find a job if they have an additional bachelor’s degree in healthcare or information technology. To be successful in this role, you should be analytical, with robust technical skills and an interest in solving problems. If you are willing to study and earn additional degrees or certifications, nursing informatics is sure to interest you and challenge you throughout your career.

This recent survey of nurse informaticists revealed that over half of them have a postgraduate degree. With all of the experience and specialty skills that nurse informaticists have, it is no surprise that they make a good living. According to the salary professionals at ZipRecruiter, this type of nurse makes an average of over $102,000 per year. While you will love what you do, you will also know you are contributing to the improvement of your hospital and the enhancement of patient care. This is what makes being a nurse informaticist so rewarding.

5. Travel Nurse

Well, travel nursing can’t really be described as “unusual” now, but have you thought about it? Do you thrive on fresh experiences? Going to new places and meeting new people? Does the idea of being an ad hoc nurse while “living out of a suitcase” sound… sort of exciting? If this sounds like you, travel nursing is both a fulfilling and lucrative career. The traveling nurse is in high demand, so you will need to be a well-qualified RN with years of experience caring for patients or have a Bachelor of Science in Nursing (BSN). If this sounds like you, it is time to bolster your resume and explore a new location.

You will need a minimum of 12-18 months of bedside experience in an advanced care clinic or hospital, as well as a willingness to fill staffing shortages in facilities that need you. You should also be comfortable with living in a different location every few months. Since some healthcare specialties are in more demand than others, recruiters may need you faster if you are experienced in high-demand nursing roles such as dialysis or emergency room (ER) care.

While flexibility is key, you will be able to spend your off-time exploring somewhere new. You may also be able to schedule your time in your old hometown or a favorite vacation spot. Another benefit is compensation. Travel nursing salaries are competitive and often include housing credits or travel stipends. Talk to a travel nursing recruiter about which openings are available in your area. It is also possible to search online for travel nursing jobs that are open in larger hospital systems.

Discover an Exciting Nursing Career

Once you get your RN license and gain valuable skills, there will be a variety of job roles available to you. This list of unique jobs will help you to think about which career in the nursing field will suit you. If necessary, you can also begin to obtain the necessary education and certification to land your dream job. The field of nursing is ever-changing, which means you will always have an exciting career, along with a meaningful purpose.

Cultivating a Culture of Success in an Undergraduate Nursing Program: Meeting Students Where They Are

Cultivating a Culture of Success in an Undergraduate Nursing Program: Meeting Students Where They Are

Achieving a 100% pass rate on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) was a goal that seemed impossible, especially in 2021.  Nursing schools were in the midst of a national pandemic and learning how to teach nursing in both face-to-face and virtual settings.  If past performance rates on the NCLEX-RN were an indication of things to come, the University of West Alabama Division of Nursing (DON) could have expected a disastrous 2021 year. In 2013, the program’s NCLEX-RN pass rate fell to 74%. While it rebounded during 2014-2017 (82.4, 85, 88, and 81.6%, respectively), the nursing faculty realized there was a pattern in NCLEX-RN rates that directly correlated to their student population. Scores declined again in 2018 (77.3%).

Multi-Pronged Approach

A multi-pronged approach had to be used to help the UWA DON prepare its students for success, not only during a pandemic, but post-pandemic. In 2013, one nursing faculty member was enrolled in a doctor of education program, while the other six faculty held a Master’s degree in nursing. A focus on faculty development for young faculty was crucial, but faculty development in education was also beneficial to those who lacked the tools to understand curriculum development, test-item development, and test-taking strategies. Currently, six faculty members hold doctorate degrees with an emphasis in nursing education, while one is enrolled in a doctoral program. As faculty members were earning degrees, they were learning to use research practices and methodologies to understand and predict the habits of their students.

Located in the Blackbelt region of west Alabama, the University of West Alabama serves some of the poorest counties in the nation. Students come from educationally and economically disadvantaged backgrounds, adding a layer of complexity to a curriculum fraught with rigor and time constraints.

Students are expected to attend class, skills labs, simulation labs, and clinical labs Monday through Friday. For those who have to work to make ends meet, have children or older relatives to care for, or who are ill-equipped for the study and time demands of a nursing curriculum, the first and second semester of the nursing program may prove too much to endure. To determine student learning needs and implement initiatives to support progression and graduation from the nursing program, the faculty assessed the needs of the program’s student population and diagnosed the issues hindering progression, program completion, and passing the NCLEX-RN. They could then plan interventions that would lead to better student outcomes, implement the plan promptly, and evaluate the plan for areas of strength, weakness, and opportunities.

Program Assessment

Program assessment was key to the process. Students were having difficulty in the third semester of the nursing program. Retention of content appeared to be an issue for the fourth-semester nursing students. Foundational principles of basic care and comfort were troublesome, as were the dreaded multiple-answer questions, also known as “select all that apply” (SATA). Students in the first and second semesters appeared to have trouble understanding what the question was asking them to determine. It was evident that reading comprehension was an issue for some students.

For others, a review of ACT scores on file revealed students were not very good standardized test-takers and needed intentional practice to improve test-taking skills, not merely testing for content knowledge. If a student was repeating the nursing program, they were less likely to pass the NCLEX-RN exam on the first attempt than students who completed the program in five semesters. Finally, students needed help with goal-setting, time-management, and study skills that would allow them to progress and graduate on time. With this information on board, it was time to implement strategies to help the associate in science nursing students reach their full potential and successfully graduate from the nursing program while preparing them to successfully pass the national licensure exam.

The nursing program functions from a multi-tiered approach to engage students and monitor progress throughout the semester. Each approach is needed to provide a comprehensive and inclusive model to facilitate a culture of success in the nursing program.

Faculty-Student Mentoring

A faculty-student mentoring program was important to understand the academic and non-academic challenges that nursing students would face as individuals. Individualized action plans could be created for each student to assist in program progression. The faculty-student mentoring program requires all students entering the nursing program to be assigned to a faculty mentor. Students meet with their mentors two weeks into the semester and at regular intervals during the semester to monitor academic progress and discuss issues that may deter progression or strategies that will foster success.

Retention and Progression Methodologies

Once students have been admitted to the nursing program, student progression and retention become the focal point. Students enter the program with a multitude of life affairs – children, work, bills that need to be paid.

For these reasons and others, the nursing curriculum was infused with ways to integrate positive study habits, reiterate test-taking skills, and repeat information deemed “need-to-know.” While Faculty-Student Mentors introduce students to these habits and reinforce them as necessary, a Retention Specialist (RS) would be assigned to students who were at-risk of failing the nursing program due to class performance. Student grades were monitored closely and referrals were made to the RS when needed. Some students are assigned to a RS at the outset of the nursing program and are required to meet with the RS before the first exam to review the importance of class attendance, note-taking, study habits, and test-taking strategies.

The use of repetition throughout the program has proven to be very useful. Students are encouraged to use practice test items to prepare for examinations. Students are also encouraged to create peer study groups of no more than four students to study before the exam. Students need to understand that nursing content is to be learned and not memorized for test purposes only. Convincing students to change their study habits and teaching them how to study plays an important role in progression.

NCLEX-RN Preparation

Students who graduated from the nursing program were not always successful at passing their licensure examination on the first attempt. For some, a second attempt was needed. Finding a solution to prevent this second attempt was important to the nursing program due to the financial burden that it can place on graduates, and the real and perceived negative burden placed on nursing programs by accrediting bodies. The first-time pass rate continues to be a program outcome standard that nursing programs are measured by, in spite of the increased test anxiety seen in students today.

In 2019, the Division of Nursing found a game-changer to its preparation for licensure. The introduction of UWorld NCLEX-RN QBank as a means to create practice exams for the licensure exam was one of the most significant changes made in improving licensure scores. Initially, faculty implemented the prep system without a policy to guide student behavior. Minimal gains were noted. With the introduction of a formal policy on UWorld QBank, the nursing program’s graduates were able to earn a 100% first-time pass rate on the NCLEX-RN in 2021. The UWorld policy is housed in the NS 204: Advanced Adult Health and Critical Care course taken in the final semester. Students must complete a minimum of 2000 questions in the UWorld QBank and achieve a minimum score of 65% correctly answered questions. To achieve this goal, most students have to answer in excess of 3,000 questions.

In addition to prepping, students also needed to understand the time-sensitive nature of learned content and test-taking strategies. The nursing program fully believes that its graduates are prepared to care for patients as advanced beginners as bedside nurses. But there is an awareness that test-taking behaviors and learned content will begin to fade over time. As graduates begin to practice, their new behavior will replace learned behavior. The second critical step to licensure prep for our students was testing in a timely manner. Nursing graduates were encouraged to take the NCLEX-RN by June 15th, a date that generally falls six weeks post-graduation. Students have had their NCLEX-RN review, they have completed the prep question set as stated in the course syllabus, and they have completed a predictor on NCLEX performance. The six weeks give them more time to prepare if needed, but most are ready to take the exam when a test date is available.

Financial Support

In 2020, the Division of Nursing was awarded a grant through Health Resources and Services Administration (HRSA) to support students from disadvantaged backgrounds. Project EARN (Educating Alabama’s Rural Nurses), in the amount of $2.4 million, is dedicated exclusively to scholarships. Nursing programs add costs to college students with the purchase of uniforms, assessment tools, NCLEX preparation, and travel to and from clinical sites. Many UWA students are nontraditional and/or from disadvantaged backgrounds. Alleviating the financial stress of getting a college degree has allowed students to focus on studying and graduation.

For the UWA DON, a multifaceted approach to program progression and completion has always been necessary.  The mystery lay in passing the NCLEX-RN on the first attempt. The addition of a prep tool for licensure has proven to be a game-changer for nursing students. As 2022 nursing students gear up for the licensure exam, the policy is in place and UWA nursing faculty are anxious to learn if they have found the key to NCLEX success for their program.

 

 

Vivienne McDaniel Ensures Inclusion in Nursing Simulation

Vivienne McDaniel Ensures Inclusion in Nursing Simulation

As technology continues to change healthcare practices, patient care simulation is transforming nursing education.

Vivienne Pierce McDaniel DNP, MSN, RN, works as the diversity equity, and inclusion consultant for Sentinel U® where she ensures that all simulation products create a lifelike healthcare environment that is sound and inclusive.

“Sentinel U® values nurses, and healthcare outcomes depend on how well prepared nurses are to address the social determinants of health and to provide equitable care across the continuum of care,” McDaniel says. “Sentinel U® is committed to healthcare equity through their products, and they are created to expose the learner to a diverse set of patients.”

As part of growing nursing advances and trends, simulations are used to help nurses experience various situations and individuals they could encounter during their nursing practice. Ensuring the products represent accurate and realistic diversity of all forms helps nurses gain essential skills. Whether a nurse practices in a highly diverse community or in a more homogeneous community, simulation provides needed guidance.

Because they can train with simulation products, nurses don’t have to learn on the fly when they are presented with a situation they have never encountered before. “It allows nursing students and novice nurses to increase their critical thinking and develop sound clinical judgment in an environment that is risk free,” says McDaniel. Because the simulations are realistic but tech-based, nurses can make mistakes without the risk of any harm.

For nurse educators, simulations that represent all kinds of diversity–from race and ethnicity to mobility or religious beliefs–offer a robust pedagogy for teaching diversity and inclusion concepts as they apply directly to nursing, she says. Nurses become aware of any implicit bias they may have–to an accent or condition a patient has. They also become aware of the subtle ways their implicit biases may impact the care they give inadvertently such as through terminology they use or an assumption they hold.

McDaniel’s commitment to ensuring equity in healthcare drives her to assess each simulation meticulously. Recently, she spent time reaching out to a leader of an indigenous tribe to make sure the simulation she was reviewing was accurate. She also wanted to learn more to understand how Sentinel U® could fine-tune it even more. Those details make a difference to nurses, patients, and residents of long-term care facilities. “People from underrepresented and underserved populations are going to be the first to notice that there’s bias and a lack of cultural competence and sensitivity,” she says.

When nurses train using all kinds of simulation scenarios, they help close a chasm that McDaniel sees in achieving health equity. Nurses who invest time in simulation will gain enough knowledge and practical experience to be positioned to achieve that with their patients. “To me it’s pivotal,” says McDaniel. “Simulation healthcare-based interventions help them achieve that. To achieve diversity, you must first foster an environment that’s inclusive and equitable.”

Vivienne McDaniel with US Representative John Lewis

Vivienne McDaniel with the late US Representative John Lewis

McDaniel’s work as a nurse is her second career; she became a nurse in her 40s. A family-based commitment to civil rights runs throughout her work–she is family of Rev. Curtis Harris, civil rights activist who marched with Dr. Martin Luther King, Jr., in Selma, AL (her mother is a first cousin). “He put it in my head that we have to represent those who are underrepresented and serve those who are underserved,” she says. “That played a huge role in what I do.” And she knows that each nurse bring a set of lived experiences to their work.

Her own experiences are based in part on growing up in a rural setting. McDaniel recalls watching airplanes fly overhead and wanting to be on them one day. When she was able to travel, she used the opportunity to immerse herself into the communities and cultures around the globe to learn from them. “That all prepared me for what I was going to do later,” she says.

Each nurse, she says, brings a history that enriches patient care. “My favorite thing is diversity of thought,” she says. “What experience will that person bring to the bedside.” Simulation work adds to a nurse’s body of experience to broaden their understanding of inclusive patient care. “We must address all these topics because they might be encountered in a nursing practice,” she says. “Simulations are realistic and they will encounter characters and experience environments that some nursing students might never otherwise be exposed to.”

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