Aneesah Coates, BSN, RN, is an experienced psychiatric mental health nurse with nearly ten years of experience in acute care, long-term care, and home health care. She is the owner of aneesahcoates.com and is passionate about helping nurses, current and aspiring, learn more about the profession.
Coates works at a mental health crisis center as a senior professional evaluation nurse, preceptor to new nurses, Nursing Journal Club facilitator, and nursing department trainer for new staff. She’ll graduate with her doctorate in nursing practice as a psychiatric mental health nurse practitioner in December 2023.
The series highlights healthcare leaders who are prominent figures in their organizations and are making transformational impacts in nursing.
Meet Aneesah Coates, BSN, RN, and senior professional evaluation nurse.
Talk about your role in nursing.
I wear several hats in my current nursing role. I am a senior professional evaluation nurse at a local mental health crisis center. We’re part of the University of Pittsburgh Medical Center, specifically under the Western Psychiatric Hospital umbrella, a national leader in diagnosing, managing, and treating mental health and addictive disorders. And we are located in an urban community setting, so we get consumers with various needs and diagnoses.
My duties include triaging consumers coming into the center, conducting intake assessments, making referrals to the appropriate level of care, and working with local pharmacies to ensure that our consumers can access the medications they need. I also serve as a resource for other nurses and clinicians in the facility, providing mentorship and guidance to new staff members and helping with problem-solving when necessary.
More formally, I am trained as a preceptor to new nurses, so I help lead nursing orientation and provide ongoing support during the onboarding process. As the trainer for the nursing department, I give presentations to new staff from all disciplines, providing them with an overview of the nurse’s role within the team. My goal is to ensure everyone who works here understands our role as nurses and how we fit into the team’s overall approach to helping our consumers.
Lastly, I serve as the Journal Club facilitator for the nursing department. I started this initiative by creating a presentation to refresh us on defining key research terms and levels of evidence. Every month, I select a journal article relevant to our work, conduct an article critique, and provide the group with a summary of the main findings. I also provide them with a blank copy of our research critique form and encourage them to reply to the initial email to share their thoughts to foster discussion. Each of my roles has this common thread of support for consumers and staff alike and empowering everyone in the process.
How long have you worked in the nursing field?
This year marks a decade as a nurse for me.
Why did you become a nurse?
Becoming a nurse was a natural progression for me. Seeing my dad in the hospital greatly impacted me as a child, and I was continually inspired by the nurses who cared for him. Despite being in and out of the hospital, my dad was involved in my education and invested a lot in my early education. He nurtured my curiosity and encouraged me to keep learning. My mother’s hard work ethic was also an influence on me.
Between their encouragement and my growing interest in healthcare, nursing seemed the perfect fit. I was drawn to all aspects of the profession and wanted to make a difference with my work. That desire has only grown since then, and I’m continually driven to learn more and improve my practice.
What are the most important attributes of today’s nursing leaders?
A great attribute for today’s nursing leaders is being able to role model the behaviors and attitudes they’d like to see in their staff. Nursing leaders should be able to demonstrate qualities such as professionalism, accountability, and integrity. It’s also important that nursing leaders are problem-solvers and innovators, ready to take on challenges and come up with creative solutions for their teams. Nursing leaders should strive to be lifelong learners and stay current on best practices and evidence-based research to improve care.
Many attributes that contribute to successful nursing leadership can be learned and developed over time. So if an aspiring leader still needs to possess the desired qualities, they can acquire them through professional development opportunities such as certifications and continuing education. Mentorship and networking can also be great resources for learning and developing these skills.
What does being a nursing leader mean to you, and what are you most proud of?
Being a nursing leader means taking an active role in helping shape healthcare’s future. It’s about understanding how my work can impact the lives of my patients, their families, and our community. It’s about being an advocate for all those I serve and working to ensure that everyone has equal access to healthcare. It’s also about empowering my colleagues, mentoring them, and encouraging them to reach their potential as healthcare professionals. And this can all be done no matter what level of nursing leadership you are in.
I take my leadership role very seriously. I am continuing my education to obtain my doctorate in nursing practice (DNP) to become a psychiatric mental health nurse practitioner (PMHNP). I plan to graduate this December and am excited about the opportunities this degree will bring. I am also excited about the work I have done to create aneesahcoates.com, a website devoted to helping students and new and seasoned nurses navigate the world of nursing by providing access to resources and insights on a variety of topics.
Tell us about your career path and how you ascended to that role.
My career path in healthcare began 20 years ago as a dietary aide in a hospital cafeteria. My nursing career started sometime after that when I decided to attend a local community college and obtain my associate’s degree in nursing science. From there, I went to the California University of Pennsylvania for my bachelor’s degree in nursing. And three years ago, I entered Robert Morris University’s BSN-DNP program to become a psychiatric mental health nurse practitioner. As a nurse, I have worked in an acute care setting caring for lung transplant patients. I have also worked in skilled nursing, home health care, long-term care, and psychiatric mental health care.
What is the most significant challenge facing nursing today?
The most significant challenge facing nursing today is the shortage of nurses (source). The nursing shortage results from multiple factors, including low enrollment in nursing programs, a lack of nursing school faculty, and a significant segment of the nursing workforce nearing retirement age. Not to mention how the pandemic has put an even more tremendous strain on the nursing profession. And the shortage is likely to have several downstream effects, including a strain on staffing ratios, leaving nurses overworked and stressed out, which can lead to nurse burnout. This can negatively impact patient outcomes and the quality of patient care. To address this, we need to focus on initiatives such as recruitment and retention programs and professional development opportunities that focus on building leadership skills. We should also continue to invest in incentives such as tuition reimbursement and scholarships to encourage more people to enter and stay in the profession.
These initiatives can create a pathway for nurses to move up the ladder, which not only increases retention but also helps to foster an environment of strong leadership among nurses. I don’t want to minimize the challenge the nursing shortage presents. It’s a complex issue that requires innovative solutions and collaboration between multiple stakeholders.
As a nursing leader, how are you working to overcome this challenge?
I am working to overcome this challenge by engaging in various initiatives and activities to help recruit, retain, and mentor nurses. I am doing this through my website, which provides essential nursing resources to students and new nurses looking to enter the profession. My current professional role allows me to precept students and new nurses, allowing me to share my passion and excitement for the profession. I make it a point to express how nursing is a dynamic profession that can be whatever we make it. In the future, I plan to use the knowledge I have gained through my DNP program to contribute to initiatives and programs that will empower nurses through education and advocacy.
I am interested in health economics and policy, so we’ll see what opportunities open up.
What nursing leader inspires you the most and why?
Nurse Alice Benjamin inspires me. She does so much that you can’t help but be inspired by her. Nurse Alice has achieved so much in her career and is passionate about helping others do the same. She is a leader who uses her platform to promote health and wellness while advocating for nurses and patients. Nurse Alice is a force of positivity, and her passion for nursing is contagious. She’s an author, TV medical contributor, ambassador for the American Heart Association, Chief Nursing Officer at Nurse.org, and the list goes on. Her work goes beyond the traditional boundaries of nursing leadership, and she is an excellent example of how nurses can impact healthcare through direct patient care and advocacy.
What inspirational message would you like to share with the next generation of nurses?
My inspirational message to the next generation of nurses is this: the sky is truly the limit. You can make a real difference in healthcare and positively impact the lives of those who need it most. Believe in your professional abilities, stay true to your values, and don’t be afraid to push the boundaries of being a great nurse.
Is there anything else you’d like to share with our readers?
I want to remind readers that we all have the power to make a difference in the healthcare field and that each of us has unique skills and talents that we can use to help others. No matter what role you play in healthcare or how much experience you have, your contribution matters. So stay motivated, focus on the task at hand, and always remember why you decided to pursue a career in healthcare in the first place.
Dr. Jamil Norman is the Tempo Academic Program Coordinator for the RN to BSN Program at Walden University and a certified nurse educator with over twenty years of experience as a registered nurse and over fifteen years in higher education.
Throughout her career, Dr. Norman has served as an agent of social change in the roles of educator, researcher, and mentor. She is a member of the American Association of Colleges of Nursing Diversity, Equity, and Inclusion Leadership Network. As a nurse researcher, Dr. Norman works to advance the body of evidence on pregnancy-related health disparities among African American women.
In February, we’ve been highlighting healthcare leaders who are prominent figures in their organizations and are making transformational impacts in nursing.
Meet Dr. Jamil Norman, the Tempo Academic Program Coordinator for the RN to BSN Program at Walden University
Talk about your career path and how you ascended to that role.
So when I started, I worked as a labor and delivery nurse at the bedside. And so I worked as a labor delivery nurse for three years before I decided to get my master’s degree in nursing education. After I got my master’s degree, I started working at Grambling State University, and I taught women’s health because that was the only area I ever wanted to work or teach. I love women’s health and everything with laboring women and babies until it’s time to hand them off to somebody else. So then I taught clinical and women’s health for several years before I decided to get my PhD in nursing. And that’s kind of when I transitioned into more leadership. I was the BSN program director at an HBCU where I taught before transitioning to online teaching at Walden. Between that was having babies and I needed to be more available for my family, yet still having a career, so I transitioned into full-time on my teaching, which I call a work-life juggle, not a work-life balance. I could still advance my career and pick up my babies from school. And so it’s been wonderful. I get to do a little bit of research and also teach and have leadership in management for being the coordinator of our program.
You mentioned that you always wanted to work in women’s women’s health. Is that what inspired you to become a nurse?
I wanted to be a pediatrician until it was time to take all my biology courses. In my first semester of school, I took a micro and cellular biology class and scored a 32% on a test. I thought I was going to faint! I thought, oh, this must be a 32 out of 50. But it was an F. It was the worst grade I’d ever gotten in my education, and I quickly dropped that course and talked to family and friends to figure out if this was really what I wanted to do.
My sister is also a nurse, and when I talked to her, what I thought doctors were doing was actually what nurses were doing. So that’s when I pursued nursing, but I always knew I wanted to be in medicine. And in fact, I went from I’ll be a pediatrician to I’ll be a pediatric nurse. However, when I went through that rotation, I thought, no, this isn’t for me. And I got pulled down to the labor and delivery unit when I was a patient care tech, going through nursing school, and fell in love. I couldn’t believe that I loved it. And that was it. I was sold. It was the trifecta. And being with mom during the happy time. I love that. Women, you come into the hospital for a happy moment, right? When you’re in the hospital, you’re not feeling well, you know, something’s wrong. This is the hospital’s main area where you come in happy. And, yes, there are sad times, but most of the time, you leave happy. That was it. I was sold after that. I never wanted to do anything else at the bedside.After going through nursing school, I was like, nurses can do so much. Nurses do just so much that I love that about the profession. You can do anything in nursing.
What are the most important attributes of today’s nursing leaders?
Number one, for me, is always going to be passion. Because if you are not passionate about what you do, especially, you know, passionate about the profession of nursing, the hard days, they’re going to make you give up, and you’re not going to want to do it. I’ve seen it, some people go into nursing for money, but they don’t last. So you have to love what you do. And then it’s just accountability. And you’ve got to be a leader. You must be able to show up for those depending on you. And then the other thing right now, which is heavier in my mind, is you have to be ethical. And just everything that’s going on with the fake nursing degrees through Florida. I was heartbroken. When I saw that news, this wasn’t very good. And we’ve got to be able to protect the public. So you must have high ethics and moral standards to be a good nurse leader.
What is the most significant challenge facing nursing today?
It is burnout. Burnout has always been there. But after the pandemic, it’s challenging to be a nurse. Now, you’re short-handed. Sometimes you’re not very trusting of how people care for you whenever you’re in the workplace. And so burnout has got to be the biggest challenge. We have a lot of nurses who are educated to be nurses who are not working. And it’s because, you know, I’m not sure that we’ve always created the best environment for nurses to be able to, to live and to work and do what they, you know, love to do. So definitely, for me, the number one challenge is burnout, and at the bedside, as educators, the shortage is still there. For educators, when you have large classes, it’s exhausting.
What does it mean to you to be a nursing leader, and how are you making a difference?
The biggest thing for me is to embrace some of the changes occurring in the profession. Some nurses will tell you, don’t be a nurse. And I would never be that person because I think nursing is a wonderful profession. So I’m always trying to bring others into the profession and teach them to care for themselves. There are things that you can do to make sure that you don’t get burned out. I always tell my students if they don’t like what they’re doing, then change it. Don’t be afraid to change. Don’t just stay on at that job because you’re comfortable. If you’re tired, sometimes just learning something new and being in a different environment will bring back that passion you had when you first started and help with burnout and self-care. No one gets any awards for not using their days off. I tell everybody to use all their days and vacations, take time off with the family, and put the work aside so when they come back, they’re a better person for the people they work with and those care for.
What nursing leader inspires you the most?
I have had the pleasure of having a magnificent mentor throughout my nursing career. Her name is Dr. Afua Arhin, and I met her when I had just started as a nurse educator. She has been so impactful on me because she was the first African American nurse with a PhD that I’d ever met. She came in and taught me so much about effective leadership. She told me to get my PhD, and at that time, I was like, Are you crazy? PhD? If she told me to jump off the bridge, I’d be like, yes, we’re jumping off the bridge, and it will be fabulous. She’s just that encouraging, but she has been with me throughout my career. She helped me to go out and present at my first conference. I’d never been a presenter at a conference before. I always thought that was what somebody else did. It wasn’t what I did. And she said I have information and research to share. She just held my hand through being the educator in the classroom and developing me as a professional nurse, researcher, scholar, and presenter. And she still does that. Currently, she’s working on a Fulbright and researching in Ghana.
She has just been when there is anything I want to do professionally, and I always bounce ideas off of her. And it’s just been wonderful to have someone like that in my corner throughout these years. And the ways she’s helped me to be, she is for me to others. If she’s helping me, I’m helping to mentor students and lead them throughout their careers. So I learned how to be a mentor from having an amazing mentor.
What inspirational message would you like to share with the next generation of nurses?
My thing is always to be the change. I always tell everyone, there are many things that people will complain about, they don’t like, but they’re not doing anything about it. If you want something to change, you have to be the change. You got to get out there and make a difference, whether at the bedside, as an educator, as a researcher, or in whatever avenue you want to make an impact. So get out there and do it. Even if it seems too small, or it might even be too big, start chipping away at it, and get out there and be the change, even if it’s just for one person. I’ve helped students in courses where we’ll talk about social change. That’s our mission at Walden University. And sometimes they think they’re not doing anything. If you’re out there caring for patients, you don’t even realize it, but you are doing something. There may be something that you want to do on a bigger scale in your community. But whatever it is, figure it out, and go out there and do it. But be the change.
You’ve been working as a shift nurse for a few years. You love it, and you love caring for patients. But there’s always been something else calling to you: leadership.
How do you start? What steps should you take? Do you need more education?
Don’t worry; we’ve got you covered.
Making the Shift to Leadership
“Think about how you want to influence the health care system at large,” says Rachel Neill, MSN, RN, CPPS, Founder of InnovatRN Consulting, Chief Clinical Advisor for HealthEdGlobal, and a Clinician Advocate at Vivian Health. “Leadership roles often provide opportunities to affect change at higher levels and support health care teams across disciplines.”
If you’re not certain that leadership is for you, Ophelia M. Byers, DNP, APRN, WHNP-BC, NEA-BC, CPXP, CDE, Chief Nursing Office, Overlook Medical Center, and Associate Chief Nurse Executive, Atlantic Health System says “it’s important to gain knowledge that will inform decision-making.” Read nurse leadership textbooks, journal articles, and books by or including nurse leaders. She suggests Fast Facts for Making the Most of Your Career in Nursing, edited by Dr. Rhoda Redulla.
Once you’ve decided to move to leadership, Byers says you need to determine your track. “There are two formal leadership roles: supervisory/managerial and non-supervisory/functional. In supervisory or managerial leadership, the leader has direct and indirect reports that comprise a team and is responsible for the care of those people and the operation, e.g., staff on a clinical unit. In non-supervisory or functional leadership, the leader does not have any reporting team members but rather is responsible for overseeing a specific function (e.g., Nurse Educator) or program (e.g., Magnet Program Director),” she explains.
Find a mentor, says Desiree Hodges, MBA, RN, CCRN, NE-BC, The Vice President of Care Services at the ALS Association North Carolina. “Having someone in your corner is truly key. I recommend having a trusted source give you a 360 evaluation, taking personality surveys, etc. We all have blind spots when it comes to communication, which allows you to recognize your bias,” she explains.
Know about the tasks you may be doing that you aren’t doing now. “You may oversee budgets, organize staff training, and otherwise ensure that nurses follow the right procedures and protocols,” advises Kelly Conklin, MSN, CENP, SVP, Chief Clinical Officer for PerfectServe.
If you don’t have that experience, you may need to earn a higher degree than the one you hold and/or obtain certifications. “Know your organization’s requirements, reach out to your current leader and discuss your plans to obtain the necessary degrees or certifications,” says Hodges. “The American Association of Critical-Care Nurses has an online course designed just for nurses new to leadership roles that cover the basics of finance, human resources, safety, and quality, as well as the leadership skills to be successful in the role of nurse manager.”
Trust your instincts as well, Neill says. And don’t forget your experiences as a nurse at patients’ bedsides. “When moving into a leadership role, it is important to have a direct leader and health care system that will support you as you navigate this transition. In addition, the nurse leader serves as the first-line advocate for the nurses doing the daily work. You cannot support the nurses adequately without a team/system to support you as a leader,” she says.
Conklin says that no matter what you choose to do, “Don’t cut yourself off from opportunities—whatever they may be—that challenge your thinking and bring you to a higher knowledge.”
How to be a charge nurse may not be part of your nursing school curriculum, but it will likely become part of your nursing career, particularly if you are working in a hospital. Generally, it’s a position that appeals to only a few nurses because it comes with a tremendous amount of responsibility, both clinical and logistical.
The charge nurse can be described as the sieve through which all information and people must pass on a given unit. The role may have mild variations depending on the type of unit, but ultimately, the charge nurse oversees the nursing staff, patient bed assignments, and almost anything that affects those two factors. The nurse in charge is the first tier in the “bumping up” process, whether it be a staff grievance, patient complaint, near miss, or sentinel event.
Needless to say, one of the prerequisites is relatively thick skin. However, if you are the sensitive type, acting as charge nurse need not be faced with dread; it can either be the bane of your existence or perhaps simply a valuable exercise in character development.
When a patient is scheduled for admission to the unit, whether immediately or with just several hours’ notice, the charge nurse finds and assigns the patient a bed and a nurse. The process is hardly ever simple. If the unit is full, the charge nurse must find a way to either justify another patient’s discharge or to fight the incoming patient’s admission. One rarely finds a consensus among stakeholders in this situation: the receiving unit of your discharged patient may push back, the incoming patient’s team may hurry you, the staff nurses may argue for changes to their assignment, and the patient’s physicians or families will have their own agenda. Depending on where you work, this may all be happening while you manage your own patient load.
There is good news. The key to success for any charge nurse is awareness, namely awareness of resources. It is absolutely essential that every charge nurse knows the boundaries of his or her scope. That will likely be institution-specific and thus easily accessible. For example, if you are a charge nurse in the OR and two surgeons try to book emergency cases at the same time, it behooves you to know who makes the call of who goes first. (Hint, it’s probably not you.)
Navigating your work within the confines of the boundaries established by your employer will arm you with the tools necessary to find the sweet spot between authority and your peers as a charge nurse. And no matter how pressured the work may feel, you must always take time for a deep breath.
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.