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 AACNEssentials 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.
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.
Don’t say that the American Association of Critical-Care Nurses (AACN) doesn’t know how to have fun—during the holidays, they definitely do. AACN is currently in the midst of their second annual Elf on the Shelf social media photo sweepstakes. And it’s hilarious.
(If you don’t know what The Elf on the Shelf is, he’s a doll that is said to watch over children during the holidays for Santa. Some parents have gotten creative and set up entire scenarios for him each night—and many put him in a different place in the home each evening, so that in the morning, children think he is watching them. Adults in general have done many other things with The Elf on the Shelf, many of which are also hilarious.)
Nurses at units all over the country are taking your average Elf on the Shelf and dressing him up, sending him on adventures, and making him a part of the health care community.
We asked some nurses who have participated the following questions:
Tell us about your Elf on the Shelf.
What was the response to your Elf on the Shelf (from patients, colleagues, etc.)
What other activities does your team do to bring holiday spirit into the unit?
How does that help your unit?
The answers from three nurses, and photo of their Elves on Shelves follow.
If you’d like to enter the AACN sweepstakes, visit their Facebook page here. Note that it ends on December 23, 6 a.m. Pacific time.
Now, on to the Elves…
Heather Woods, BSN, RN, NRP, Critical Care Manager at Schneck Medical Center, Seymour, Indiana:
1. We are starting our third year with our Elf on the Shelf. I was just beginning as a manager in 2016. I bought the elf to help boost morale on my units to encourage team bonding, creativity, and build good old Christmas spirit. The nursing staff had a contest on naming our elf. It has now become our tradition, and staff asked where our elf was this year.
2. The patients, families, nurses, physicians, and other employees love to see what adventures our elf has on the unit. It amazes me how creative everyone gets with “Levophred” and “Amio.”
3. To bring Christmas spirit into the units, we adopt families and collect gifts for them. We go caroling together at the local nursing home. We pass socks, mittens, and blankets out to residents. (These items are provided by the staff.) This year, we added a wreath-making class into our activities. We do a traditional-themed Christmas party with secret Santa gifts as well. All of our events are decided upon with our unit-based council.
4. All of these activities really help boost morale in our ICU and Moderate Acute Adult Care Unit (MAACU) and bring our team together. I am very lucky to lead such a caring group.
Natalie Kresak, BSN, RN, Assistant Nurse Manager ICU, University Hospitals, UH Parma Medical Center, Parma Ohio:
1. The elves were inspired by all the employees in the Medical ICU at UH Parma Hospital. We work tirelessly and compassionately to provide the best care and experience for all our patients and their families just like Santa’s elves do! I made the elves using my cricut machine and decided the weekend after Thanksgiving (of course this was my weekend to work) to surprise the staff returning Monday to turn the unit into “Santa’s workshop” and spread the Holiday cheer.
2. The staff, families visiting, and all employees enjoyed the sight of the holiday elves. It brought a smile or laugh to them at times when sometimes that was impossible, given the setting.
3. We decorate every year with holiday-themed décor. We are a medical ICU department so we make heart rhythms out of garland and hang them up and add snowflakes to the windows of patients’ rooms with kind words on them. The staff also participates in a secret gift exchange to help spread the cheer amongst us all and partakes in a holiday party at a local restaurant or employee’s home.
4. This helps our unit feel more like home for the holidays to those who have to work and be away from their families, but also to the patients and families who are missing out as well. It brings us closer, sharing in gifts or treats that we exchange too!
Alexandra Del Barco, BSN, RN, PCCN, TCRN, Senior Clinical Nurse I, and Tiffany Coleman RN, CCRN, TCRN, Clinical Nurse II, Neurotrauma Critical Care, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center in Baltimore, Maryland:
1. Two years ago, Tiffany Coleman introduced “Trauma Trixie” to our Neurotrauma Critical Care Unit. Tiffany hoped Trauma Trixie would bring holiday cheer to the unit as a center-piece for our decorations. She also anticipated Trauma Trixie would give us an advantage in winning the holiday decorating contest sponsored by the Shock Trauma Center Healthy Work Environment Committee. (This contest judges holiday decorations on units throughout the Shock Trauma Center to determine winners in various categories such as Craziest or Most Elegant.)
Our unit staff worked together to create different scenes with Trauma Trixie as well as to find creative ways to make miniatures of the equipment we frequently use on our patient population such as a Stryker frame to prone patients made out of Yankauers and a Halo vest made from pipe cleaners. Tiffany even created an Instagram page for her @ntcc_trauma_trixie.
2. Trauma Trixie helped the unit staff to bond as we all brainstormed different creative ideas on what poses and accessories she would take on next. Families thought it was creative and the administration did as well! The first year was such a success that we won the 2017 Holiday Decorating Contest!
3. Our unit loves decorating for the holidays to get in the holiday spirit. We have a Secret Santa gift exchange for those that want to participate and hold a unit holiday party. At this year’s party we will be exchanging Secret Santa gifts as well as announcing our 2020 unit goals.
4. Doing activities such as working together to decorate Trauma Trixie, exchanging Secret Santa gifts, and having a holiday party definitely helps with teamwork, unit morale, and nurse satisfaction. Neurotrauma Critical Care is a very difficult unit to work on primarily because of the nature of our patients’ injuries–traumatic spinal cord and brain injuries. Having activities that boost unit morale are important in fostering a healthy work environment.
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