Trauma: Life in the ER Want to be an Emergency Nurse?

Trauma: Life in the ER Want to be an Emergency Nurse?

As a nursing student, I loved watching the show “Trauma: Life in the ER.” This show was based on real-life medical stories in the ER of various cities such as New Orleans, Las Vegas, and Detroit. As I watched, I said to myself that is what I want to do! I am going to be a Trauma Nurse in the ER.

In my last semester of nursing school, I requested to be in the Emergency Department, and thankfully, I was placed there for my last rotation. Well, that’s where I fell in love with Nursing. The adrenaline, fast-paced environment, and uncertainty of what will happen next kept me on my toes.

One of my clinical instructors asked me what type of nurse I wanted to be, and I told her with excitement, “I want to be an ER nurse,” and she replied, “you will never be an ER nurse.” I was shocked! I thought, wow, how could an educator be so negative and deter me from following my dream? Well, you already know my stubborn head did not listen. Watch me, I thought to myself. I am going to be a badass ER Nurse. I’m going to save lives.

I developed such great relationships during my clinical rotation that they encouraged me to apply! As a result, I got offered the ER position as a new nurse before I graduated or took my nursing boards in Canada. Hey, hey, hey! I was jumping up and down for joy when I got the offer. I got two offers, but I selected the ER with the trauma center.

Moral of the story: “Follow Your Dreams!”

I have worked in various Emergency Departments in Canada and the U.S., including level 1 trauma centers. I worked in the ER at Detroit Receiving Hospital where the show Trauma: Life in the ER was filmed and at New York Presbyterian Weill Cornell where NY ER was filmed. I also became a nurse educator and TNCC instructor and taught clinicals as an Adjunct Faculty. I hold the following three board certifications for Emergency Nursing: CEN-Certified Emergency Nurse, CPEN-Certified Pediatric Emergency Nurse, and TCRN-Trauma Certified RN.

These certifications can be obtained from the Board of Certification for Emergency Nursing (BCEN) once you have at least two years of experience in the Emergency Department.

My mission is to empower all nurses, especially new nurses, to follow their passion and dreams. For this reason, I decided to open up my own nurse coaching business in June 2021. I provide 1-1 coaching and group coaching to nurses. I teach you how to confidently land your dream position and be Badass Nurses too.

You, too, can become an Emergency Nurse if you want! IT IS POSSIBLE!

Was I nervous to start? Yes, but you will get a proper orientation and a preceptor to guide you along the way! Think about it, there is always an attending physician there, 24/7, nurses, charge nurses, respiratory therapists, and the list goes on! You are not alone!

5 Tips to Help You on Your Journey to Becoming an Emergency Nurse

  1. Request your last clinical rotation/placement to be in the Emergency Department
  2. If you are a nursing student, get any job in the Emergency Department, such as a Patient Care Tech, EKG Tech, Patient transporter, etc.
  3. Join the Emergency Nurses Association (ENA) as a student or a Nurse. (discounted price for students, access to ENA Journal, conferences, and educational content)
  4. Get a nursing mentor and or nursing coach who can guide you along your journey (hint: contact me)
  5. Develop your skills, build your resume, and get any certification:
  • EKG
  • IV
  • NIH Stroke
  • BLS
  • ACLS
  • PALS
  • ENPC
  • TNCC

Good luck on your journey to becoming a badass ER Nurse.

The Importance of Teaching Nursing Students How to Cope with their Mental Health

The Importance of Teaching Nursing Students How to Cope with their Mental Health

We’ve seen the statistics showing that nurses and future nurses need mental well-being more than ever.

With healthcare staffing shortages all over the country, healthcare facilities and consumers cannot afford to lose more nurses. At the root of it is that nursing is an incredibly stressful profession, with 63% of nurses reporting significant workplace stress, 70% saying they put the safety and well-being of the patient above their own, and 31% reporting a workload assignment higher than which they felt comfortable (American Nurses Association, 2021).

In addition, 29% of nurses reported feeling sad, down, or depressed for two weeks before the pandemic, with an increase to 34% during the pandemic (American Nurses Association, 2021).

So how do educators ensure future nurses don’t enter the workforce without the skills to cope with the demands of the job? Modeling support for students in nursing school is the start for future nurses to learn resilience through the challenges of school so that they can manage the stress throughout their nursing career.

Nursing school is a demanding career path and one of the most challenging programs. Students enter the field from diverse backgrounds and often with many personal struggles – from academic challenges, medical conditions, strenuous family responsibilities, mental health challenges, and even prior traumas.

In addition, many students worked through the pandemic assisting nurses who were helping to save lives while experiencing high levels of stress and depression.

When faculty understand and agree that nursing students are experiencing stress and mental health issues, this is the time to provide support and model how to endure these challenges for long-term success. To give students the instruction they need to care for patients holistically, Chamberlain University established the Chamberlain CARE® model.

Educating Students on Mental Health

My career goal has been to combat the stigma of mental illness. The Chamberlain CARE® model has further inspired me to support students through nursing school to become strong and compassionate nurses. As a faculty of mental health nursing, it is crucial to educate students on mental health because every patient and family member they meet will likely experience some form of anxiety.

When patients and families come in, they often deal with a long list of emotions – from apprehension about a diagnosis, severity of the condition, recommended treatment, long-term implications, and even future medical bills. When experiencing this anxiety, the patients and families may display uncharacteristic behaviors as they try to cope with an unpredictable and stressful situation.

It is important to remember the feelings of fear and anxiety people have when seeking healthcare services, as these can be their most vulnerable moments. As nurses, we are in hospitals routinely and become comfortable with the environment. However, we are generally not the ones dealing with an illness or injury and facing uncertainties. Therefore, all nurses must interact with patients compassionately and without judgment.

When teaching mental health, we connect the students to a true understanding of the individual in crisis to develop greater compassion and empathy. We are in a unique position because there is greater subjectivity involved. Diagnosing and treating mental illness involves creating trust with the patient so they feel comfortable disclosing their deepest thoughts, fears, and feelings.

As educators, our role is to provide delicate guidance to help connect the students’ emotions to the reality of the patient’s trauma and life horrors. Without this connection, the students will more likely display stigmatizing behavior that prevents patients from seeking and complying with treatment.

Mental illness is a critical issue, and stigma infects societal attitudes. Many need mental health services but never seek treatment due to that stigma. As a result, some patients can accept their diagnosis, while others grapple with the idea of being seen from a vulnerable and stigmatized perspective. In healthcare, everyone is perceived as caring and compassionate, but empathy toward those with mental health issues is lacking.

This prevents follow-through on appropriate treatment and services and exacerbates the mental health issues, potentially leading to further development of mental illness diagnoses. Interventions to combat stigma are critical to the stability of these individuals and society.

Everyone Has Bias

If we confront the preconceptions nursing students may have, we can help reduce the stigma toward individuals with mental illness throughout all areas of healthcare. The first point to recognize is that everyone has bias.

We all have certain beliefs about people or groups formed throughout childhood and other experiences. Some biases we have are not even rational. Some thoughts jump into our heads, but then we may even realize that we do not believe or support those thoughts. The most important part is acknowledging that we have these thoughts. Without acknowledgment, we allow our behaviors to support those biases. For example, common biases toward mental illness are that these individuals are more aggressive or do not take care of themselves. If a nurse has these thoughts about a patient and does not acknowledge them, that nurse is likely to judge and stigmatize.

Deconstructing the Stigma

Before delving into mental illness diagnoses, we have a class discussion about stigma. We discuss what it is, where it comes from, and how it impacts everyone involved. We examine cases of some of the worst traumatic experiences and how the surviving individuals will struggle for the rest of their lives no matter the other circumstances of their lives. From that understanding, we can recognize that any one of us is a moment away from the potential of a similar life-changing tragedy.

One of the key points to remember is that those without a mental illness diagnosis are not so different from those with a diagnosis. Many patients we help in an inpatient behavioral health setting have a history of trauma, hence the greater insistence on more mainstream trauma-informed care. In the current healthcare environment, it is becoming increasingly common for nurses to experience trauma through violent events and the workplace’s compounding stress.

Impactful Self-Assessment Activity

One of the other activities the class participates in is a self-assessment using the Adverse Childhood Experiences (ACEs) scale. Ten traumatic experience categories are tallied to determine an ACEs score. The range is from zero to 10 in the scoring of traumatic childhood experiences. Once the students confidentially calculate their scores, I have them anonymously enter them into a poll that presents the class scores on the screen for everyone to see.

It is an incredibly impactful experience for the students to see the scores of their classmates. Through discussion, we realize how many students in that class have experienced high levels of trauma, primarily as they reflect on the description of each question. Some realize they are not alone in their traumatic childhoods while also, at times recognizing for the first time that those experiences are not typical for a child to experience.

This has become one of the most important activities I have implemented. It causes the students to recognize that they do not even know their classmates well enough, so how would they be able to understand their patients well enough to justify judging them? As we reflect on the numbers, I emphasize to the students that none deserved any of those traumas, just as none of our patients deserve the traumas that destabilized their mental well-being.

Support is often the most critical factor in overcoming and enduring trauma, mental illness, and life challenges. Throughout the course, there is a continual emphasis on self-care and coping skills for teaching others and as a resource for themselves. We know what nursing today looks like with nurses experiencing stress and trauma. Collectively reducing stigma can strengthen the mental health support and treatment we can provide, which can also help the nursing field. With a non-judgmental approach from healthcare professionals, we can better support each other in our times of need.

The impact of self-realization that my students experience drives me to continue supporting them. And notes from students like Larry Pitts, a senior at Chamberlain’s Addison campus who is finalizing his program, are my inspiration. “In 2020, I wasn’t doing the best in school. I was careless, unfocused, and unmotivated. Once I found my motivation and started doing better in school, Professor Mayo always made it her priority to acknowledge my progress and let me know I was doing a great job! She was a haven because she welcomed everyone to discuss anything without passing any judgment. I am forever thankful for her.”

References

Culturally Competent Nursing Mentorship

Culturally Competent Nursing Mentorship

Culturally competent nursing mentorship for nursing students, nurses, or faculty often remains challenging when the mentor needs to reflect on the mentee. Understanding diversity in higher education and the strategies to improve culturally competent guidance is looked at through the lens of mentoring.

Brief History

The term ‘mentor’ was adopted from Mentor, a Greek mythological figure in Homer’s “Odyssey.” Mentor was placed in charge of Odyssey’s son, Telemachus. Their mythological relationship consisted of Mentor imparting wisdom, guiding, and sharing knowledge with Telemachus. In modern times the word mentor has come to mean a very experienced and trusted advisor. A mentee is the term for the person in the position of receiving the mentor’s training, guidance, advice, or wisdom (Grant & Hazel, 1993).

Nursing Mentorship

Becoming a nurse, advancing a nursing degree, or being a nursing professor all require skills and knowledge to be learned. A part of that learning comes from mentor-mentee relationships. Ideally, each nursing student or new faculty should have an available mentor sensitive to the mentee’s needs. Mentors that reflect or identify with their mentees would be optimal (Schuler, 2021). However, in the absence of availability, the mentor must practice culturally competent mentorship. The importance of the mentorship role becomes evident when the mentee does not reach their full potential or partake in opportunities within the profession.

U.S. Census Statistics and Nursing Numbers

According to the U.S. Census Bureau (2020), 57.8% of the American population is White, forming the majority; Hispanic and Latino Americans are the largest ethnic minority comprising 18.7%; Black or African Americans are the largest racial minority making up 12.1% of the population. Also noted on the census was an increase in multicultural populations. Additionally, according to the National Council of the Board of Nursing statistics (2021), ethnic/racial minorities represent 19.2% of the RN workforce. According to the numbers that represent the U.S. population and the population of the nursing workforce, there is a representation of minority nurses ranging from the bedside to academia.

However, the reality of these numbers is striking. Due to the lower numbers of minorities in the nursing field, mentors must commit themselves to cultivate culturally appropriate mentoring relationships. Working within the framework of who is represented then requires solutions to effective and appropriate mentoring. Employing creative and Evidence-Based Practice (EBP) mentoring styles is mandatory for successful mentor-mentee relationships.
Relevance

Mentoring advances the science of nursing; it helps develop and move forward the discipline along with its leaders and educators. However, cultural awareness and carefully suited mentoring styles to accommodate minoritized mentees are imperative for successful outcomes. Diversity is defined as different or varied. Whether the diversity is cultural, racial, religious, gender, class, or sexual orientation of a mentee, it must be acknowledged and understood by the mentor to help build a stronger mentoring relationship. This will add to the mentee’s development and foster meaningful results (Dirks, 2021).

Challenges

Some causes of the underrepresentation of minorities in nursing have been noted as lack of opportunity, educational finances, emotional and social support from the discipline, and lack of diversified mentors (Firth, 2021). However, when focusing on the need for diversified mentorship in the formation of nursing students, new nurses, RN to BSN students, and new nursing faculty, there are many obstacles for the mentor.

Some examples of challenges a mentor may face include assessing a mentee’s motivation, having the proper time to mentor, setting reasonable goals, and the mentor’s ability to properly assess the mentee’s knowledge, skills, or background. One prominent challenge in mentee assessment is correctly identifying diversity to incorporate appropriate mentoring into the relationship. Schuler (2021) states that nurse mentees recognize support and are thankful for shared insights from culturally competent mentors.

Recommendations  

While acknowledging the low numbers of minority students, nurses, and faculty, how then will professors of any ethnic, racial, religious, or any diverse background be a mentor to their diverse minoritized students or new faculty? The answer is already in practice.

The very steps that the professors teach their nursing students to form nurse-patient relationships regarding cultural diversity. The movement to include culturally competent care in nursing is currently operational in practice and academia. Nursing professors teach their students to be culturally competent as it is woven throughout EBP curricula (Hung et al., 2019). Students are taught the values and how to incorporate, accommodate, and respect culture into their healthcare-providing practices. This level of teaching students culturally competent care must be transferred and utilized with mentor-mentee relationships between professors and students, nurse administrators and new nurses, and professors and new faculty.

First and foremost, the mentor must self-reflect on their thoughts and feelings. They must recognize any biases and explore how this will affect the mentoring relationship, therefore working to acknowledge and eliminate them honestly. Secondly, they must get to know their mentees through inquiry. Asking mentees to share their backgrounds and how they prefer to learn is an act of openness and accommodation.

Thirdly, the mentor must create an atmosphere of judgment-free mentoring to allow the mentee to receive the advice in their way.

Finally, and perhaps most importantly, the mentor and mentee must commit to being open, honest, and respectful in their roles. Without their commitment, the relationship is not built on a trusted foundation, and all that follows may be tainted. The lack of diverse nursing mentors may or may not be able to be wholly addressed by looking purely at the census numbers.

As nursing advances, there is a recommendation to include and support minoritized nurses in all roles of the profession. Regardless, whoever is in the role of mentor, must accept the current challenges and comply with the prerequisite to pledge to deliver EBP culturally competent guidance using the above-mentioned mentoring strategies.


References:

Dirks, J., L. (2021). Alternate approaches to mentoring. Critical Care Nurses, 41(1), 9-16. https://doi.org/10.4037/ccn2021789

Firth, S. (2021, August 12). Why are they so few people of color in nursing? Washington Correspondent, Medpage Today. https://www.medpagetoday.com/nursing/nursing/94025

Grant, M., & Hazel, J. (1993). Gods and Mortals in Classical Mythology. Springfield: Merriam-Webster.

Hung, H., Y., Wanf, Y., W., Feng, J., Y., Wang, C., J., Lin, E., C., L., & Chang, Y., J. (2019). Evidenced-based practice curriculum development for undergraduate nursing students:The preliminary results of an action research study in Taiwan. Journal of Nursing Research, 27(4), 30. doi: 10.1097/jnr.0000000000000298

Schuler, E. (2021). Evaluation of an evidence-based practice mentorship programme in a paediatric quaternary care setting. Journal of Research in Nursing, 26(1-2),149-165.

https://www.census.gov/

https://www.ncsbn.org/exams/exam-statistics-and-publications.page

Tips on Passing the NCLEX Exam

Tips on Passing the NCLEX Exam

The National Council Licensure Examination is a prerequisite for becoming a nurse, and with increased nursing school applicants, we thought it would be worthwhile to offer tips on how best to pass the NCLEX. We each tried our techniques and utilized similar options to help us pass the exam in May of this year. With some guidance from our parents, we also have plenty of tips to help others pass this challenging exam with much more confidence than you otherwise might have exhibited.

 

Watch Tips and Tutorials on YouTube

YouTube has tons of great material on every subject, including the NCLEX. We recommend finding some tutorials and tips to help you pass. Shannon, in particular, used this study method for subjects she didn’t fully understand. It enables you to gain knowledge in areas where you’re lacking and is just a fun, easy way to gain more information and help you feel more confident with that material.

Allot Yourself So Many NCLEX Questions Per Day

Don’t try to push yourself to get through hundreds of practice questions when you don’t have the mental capacity. Instead, give yourself a few months to take your time and practice until you feel comfortable. It’s best to allot yourself so many questions daily and only focus on getting through one set at a time. Shannon stuck with the 75 questions per day rule, and it helped.

You can also go with Kristyn’s technique and allot yourself so many daily topics. Then, pick two or three and work on the material until you feel like you’ve nailed it. She spent one month working this way until she felt confident she could pass the test.

Study and Correct Your Incorrect Answers

By only focusing on so many questions each day, you have time to go back over the answers. You can correct anything you got wrong and take the time to understand why it was wrong. Then, use your results to help you study better and refocus on the problems you’re having trouble tackling.

Let Your Family Help

You don’t have to do this alone. Sure, you’ll be the only one taking the test, but that doesn’t mean you can’t get help practicing and preparing in the meantime. Let your family help you in any way they can—we both did. Kristyn’s mom helped her by being a pretend patient. Her aunt and uncle let her stay with them while in college to help save on costs. Shannon’s dad tried to help keep their dog occupied, so he wasn’t in her way or disturbing her studies.

Be Sure to Eat Healthily

Speaking of Shannon’s dad, Mark stresses the importance of eating well. It’s important to eat something healthy and keep your body full and your brain working to the best of its ability while studying and before you have a big exam. So, eat something healthy and keep your body full and your brain working to the best of its ability. That will go a long way toward ensuring you can pass your NCLEX without the pangs of hunger interrupting your thought process.

Also, Enjoy a Snack

You don’t have to eat all the time healthily, however. Sometimes, it’s good to get your favorite snack and reward yourself a little for the hard work you’ve been doing. So, grab your favorite candy bar and savor every bite before you get back to the work at hand. That little bit of goodness in your day can be a huge motivator and help when feeling down.

Add Vitamin D to Your Day

It’s also essential to make sure you’re staying healthy overall. Adding Vitamin D to your day, especially by soaking it up outside, is beneficial for how you feel mentally. Don’t just sit and study for the entire day. Get outside. Enjoy the fresh air. Take the break you need and deserve. It will help give you mental clarity so you can return to your study routine afterward.

Utilize UWorld

One of the best things you can do for yourself (or a family member) is to purchase a pretest system that allows you to see how well you would do on your NCLEX. It’s excellent practice and shows you the areas where you need additional guidance before you take the actual test. We used UWorld, and it offers options for both RNs and PNs. It helped us gain the information and experience necessary to help us feel genuinely prepared for the exam in real life. In addition, the UWorld NCLEX-RNⓇ provides more than 2,000 questions to help prepare for your impending. If you want easy-to-understand information, this program is for you.

Take Your Time During the NCLEX

Our final piece of advice is to take your time. It isn’t necessary to feel rushed during the NCLEX because you get five total hours for the entirety of it. Don’t rush through any questions. Please read it thoroughly so that you’re entirely comprehending what it’s asking. Some questions can be tricky, and you’ll misinterpret what it’s asking for if you don’t read them all the way through and give yourself time to sort through the possible answers.

Why Preparing to Be a Nurse Is So Important

It takes a village to support nursing students and current nurses, particularly given the added stress of the pandemic. In addition, as current nurses are exiting the profession due to burnout or attrition in large numbers, student nurses must find the resources they need to support their academic and career goals. A family and friends support network can also help make all the difference in reaching your goal of being a nurse with a healthy work-life balance.

This article written by Shannon Rosen and Kristyn Smith was published in the September 2022 issue of Minority Nurse. 

About the authors

Shannon Rosen graduated from Nova Southeastern University, passed the NCLEX in May 2022, and is an Operating Room Nurse at Naples Community Hospital in Naples, Florida.

Kristyn Smith graduated from Chamberlain University, passed the NCLEX in May 2022, and is a Pediatric ER Nurse at a hospital in Houston, Texas.

 

University of Pennsylvania Announces New Tuition-free Program to Recruit, Train and Deploy Nurse Practitioners to Underserved Communities Across the U.S.

University of Pennsylvania Announces New Tuition-free Program to Recruit, Train and Deploy Nurse Practitioners to Underserved Communities Across the U.S.

The University of Pennsylvania announces the Leonard A. Lauder Community Care Nurse Practitioner Program, which will recruit and prepare a diverse cadre of expert nurse practitioners to provide primary care to individuals and families in underserved communities across the U.S.

The $125 million donation by Penn alumnus Leonard A. Lauder, Chairman Emeritus of The Estee Lauder Companies, to create this first-of-its-kind, tuition-free program is the largest gift ever to an American nursing school.

The gift comes at a time when the COVID-19 pandemic has magnified the nation’s acute shortage of primary care providers and persisting inequities in access to quality healthcare.

“This is the most timely and consequential gift not only for our university but for our country. It is unprecedented in its potential to address America’s most critical need of providing primary health care to all who currently lack it by investing in nurses,” says former Penn President Amy Gutmann. “Growing the number of nurse practitioners who are prepared and committed to working in underserved areas is the most practical and inspiring way to ensure a healthier country. I am grateful and honored that Leonard would make this gift to Penn Nursing, and thrilled to know that it will have an immediate impact that will last far into the future.”

penn-nurse-practitioners

University of Pennsylvania’s new tuition-free program to recruit, train and deploy nurse practitioners to underserved communities across the U.S.

Nurse practitioners are leaders on the front lines of care, a role never more important as Americans confront a primary healthcare shortage in their communities. With their advanced clinical training and graduate education, nurse practitioners have the knowledge and skill to supervise and manage critical aspects of care in decision-making, from patient diagnosis to ordering and interpreting tests, to prescribing medication. In addition, nurse practitioners deliver high-quality primary care to people of all ages, such as treating common illnesses, managing chronic conditions, and providing preventive care that helps patients stay healthy.

Nurse practitioners can also able to take on key leadership roles, from managing and operating walk-in or community clinics to leading interdisciplinary teams within health systems. The new program will better the lives of patients and communities most in need while providing a pathway for the many nurses interested in advanced education who may not otherwise have the

“Now more than ever, the country needs greater and more equitable access to quality primary care—and highly-skilled nurse practitioners are the key to making that happen,” says Leonard A. Lauder. “The program will ensure that more Americans receive the essential healthcare services that everyone deserves, and I’m so pleased to be working with Penn Nursing on this initiative. I look forward to welcoming our first class of future nurse practitioners this fall. I know their expertise will be matched only by their commitment to serving our communities.”

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.

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