Incivility in nursing education has become an increasingly bothersome problem; however, it has especially become a nuisance in online education. Suplee, Lachman, Siebert, and Anselmi (2008) indicated that a faculty witnesses daily encounters in classes and clinical settings. Incivility is defined as behavior that is unprofessional, rude, and disrespectful. It can result in burnout and psychological and physiological distress for the parties on the receiving end, especially if left unaddressed (Butler & Strouse, 2022).
Another term that has especially been seen in the online realm is bullying, which can occur student-to-faculty and faculty-to-student. Unfortunately, it can also occur in faculty-to-faculty (Butler & Strouse, 2022). There has been an increase seen in student-to-faculty students’ displeasure with their achieved grades.
We must evaluate the reasons that the behavior is happening.
Stress from many walks of life can be the culprit, including working too many hours, mismanagement of work-life balance, stressful work assignments, financial strains, relationship strains, biases, and so on. Butler and Strouse (2022) also indicated that burnout and demanding workloads contribute to the greatest stressors. Personally, I have observed these behaviors displayed when providing constructive criticism. How can we, the faculty, help to ease the burden and create the traditional professional environment that many of us were able to participate in our educational journey?
As a part of a nursing faculty for ten years, I feel it is my calling. I enjoy helping deploy educated and competent novice nurses and advanced practice nurses into the workforce. However, the stress and incivility sometimes make one feel burned out. Many of us ponder going back into the clinical setting, feeling unappreciated and undeserved.
Caputi (2015) reported that the faculty can assist students in engaging in constructive evaluation of themselves and others. One factor is professional maturity, which can allow the students to analyze their own performance. As a faculty, providing feedback that is useful in the workplace and not hurtful can be helpful for growth and development. Self-reflection and guided introspection can be useful (Caputi, 2015). Discussing values, morals, attitudes, and the AACN essentials, pertaining to professionalism and leadership can be useful in developing students with incivility and assisting students in understanding (Caputi, 2015). However, the most important element is support from the administration and the appropriate follow-up and disciplinary actions.
For decades, online nursing education options offered nurses a different path to a nursing degree, but the choices were limited. Today’s nurses enjoy nursing degree program choices that provide variations in everything from how and when they take a course to the length of a program.
For many nurses, particularly those seeking advanced degrees, this expansion in online programs allows flexibility to balance work, school, and personal obligations. Despite the proliferation of programs, online coursework isn’t for everyone; some nurses work better in a more traditional classroom-based curriculum. The key is assessing each program you’re interested in, your learning style, and finding a match that sets you up for success.
For nurses considering this path, taking the time to find out essential details is time well invested. “There’s a growing number of online programs, so you have to know what you’re looking for,” says Patricia Bruckenthal, PhD, APRN-BC, FAAN, dean and professor at Stony Brook University School of Nursing, Stony Brook, New York. “You’re making one of the more important decisions in your life, and you have to place a high level of importance on how you’re going to fit that into your life and schedule.”
Assess the Program
Finding a program won’t be difficult, and they should be assessed carefully as any other program. “Students considering an online program should use the same criteria for selecting a program that they would use for assessing a traditional program, including choosing an accredited program, locating programs that will help you reach your professional goals, and finding schools that specialize in your primary area of interest,” says the American Association of Colleges of Nursing (AACN) president and chief executive officer Deborah Trautman, PhD, RN, FAAN.
In addition to considering the school’s reputation and accreditation, students are encouraged to use all the available information about the school and faculty members, says Bruckenthal. “Look at the level of experience the school has with online learning,” she says. “Are there any faculty who are published in online learning? Faculty who are that engaged will know students have different learning styles.”
Evaluate Your Lifestyle
Undoubtedly, online programs give a level of flexibility that makes a degree possible for nurses to juggle many obligations. “Due to the work and family responsibilities, working RNs often benefit from being able to attend class and complete coursework during non-traditional times,” says Mashawna Hamilton, DNP, RN, associate professor and associate director, RN to BSN Nursing at Ohio University, Athens, Ohio.
If students believe online learning offers flexibility, they still have to plan how to fit the class time and all the required work into their day. “It’s important to know what you’re looking for,” says Bruckenthal.
Online learning takes as much discipline as in-class courses. Look at your habits, motivations, and realities to decide if an online program will provide you with more opportunities for success or with unanticipated roadblocks.
Students working remotely must be highly motivated to complete the work when they have other obligations. There are other potential obstacles to be aware of, says Bruckenthal. Do you have quiet and sufficient study space? Do you have childcare if you need it? Is your family willing to take on additional duties such as cleaning or grocery shopping so you can carve out time for school?
Be Ready for a Challenge
Flexibility also doesn’t mean anything is simplified. “The biggest mistake a student can make is assuming that online courses are less rigorous than traditional programs,” says Trautman. “These programs take discipline, strong writing skills, and keen organizational abilities. Students in online courses are expected to answer all questions, provide regular feedback through discussion forums, and complete just as many assignments.”
If you’re looking for a program that fits your criteria, digging a little deeper into the school, the program, admission, and curriculum requirements will give the complete picture you need to make an accurate decision.
Here are some options to consider:
What is the program cost, and how will you pay for it?
What is the average program completion time?
Are online students ever required to be on campus?
What is the curriculum delivery (is it asynchronous or synchronous)?
What do postgraduate career outcomes look like?
What are the technology requirements?
What happens if you need more time to complete the program?
Knowing what happens for students postgraduation—from employment to alum networking—is critical to the whole program. “Students should consider the reputation of the online programs,” says Hamilton. “In doing so, consider comments from employers of previous graduates. What is the graduate employment rate? What accolades has the program received from national agencies?”
When you find a program that fits your learning expectations, schedule, and budget, some final details need clarification before committing to a program.
Trautman recommends contacting each school to assess how the learning format, clinical experience, and academic and professional development supports offered will help you. “School advisors will know what options and assistance is available to offset costs, including scholarships and loan repayment programs,” she says. “The only way to fully know what institution-specific programs are available is to contact the nursing school.”
And when planning when you’ll have that degree in hand, remember the course schedule of each school can vary. An average program completion time can indicate the pace of courses and flexibility, but sometimes required courses are offered only once or twice a year. If you aren’t aware of the schedule, it can derail your expected graduation date. “Students should also inquire about the frequency courses are delivered, the expected time dedication for courses, and requirements for part-time and or full-time enrollment,” says Hamilton.
During your research, find out what assistance is offered to online students. Because a program is online, it may seem more difficult to access help when you can’t just go to a physical office. “The strength of student support programs can significantly impact the student’s success during their academic journey,” says Hamilton.
Good online nursing programs will have support, including online office hours for faculty members, remote technology support, online study, social groups, and even one-on-one student support from the college. Students may want to ask about online libraries, learning labs, online writing help, skill-building webinars, wellness services, and opportunities for online student engagement as well, says Trautman.
And students also have options that are outside the campus to help them succeed in an online program, including professional nursing organizations. For example, master’s and doctoral program students can access a free membership to AACN’s Graduate Nursing Student Academy, which provides focused support opportunities for students in online and traditional programs.
For many nurses, remote degree programs open possibilities and help bring more nurses into the workforce. “Since these programs are generally directed toward individuals who are already licensed registered nurses, most students are working and trying to juggle life’s many demands,” says Trautman. “Online programs make that possible.”
In today’s climate, nursing is everywhere. It’s in the news and social media, but the coverage is rarely positive. Nursing has been America’s most trusted profession for years, but COVID-19 changed the perception of nursing.
No longer are nurses viewed as the safe harbor for patients who were battered by the winds and wrath of an industrial health care complex. Instead, nurses are publicly placed on trial for system errors and named in lawsuits for medical malpractice. What does the future of nursing look like in America? No one knows for certain, but I do know who can reframe the perception of nursing, and that is the nurse educator.
Soul of Nursing
The nurse educator is truly the master of the soul of nursing. Still, they are rarely esteemed for the critical work accomplished. The nurse educator takes the raw material of an eager student and pours endless knowledge and skills to form the building blocks of a nurse. There is not a single nurse in existence who has not passed through the skilled hands of a nurse educator. The educator can genuinely alter the perception of a new nurse before the nurse even realizes they have been altered. The nurse educator can transfer tolerance and understanding through their formative teachings, prejudice, and judgment. The responsibility to develop the future of the entire profession rests on a select few, rarely acknowledged, who guard our profession with love and passion.
It is passion that drives the nurse educator. It surely is not the ability to earn a high income. According to the Bureau of Labor Statistics, the average nurse educator earns an annual income of $78,000. For a job that requires an advanced degree, any nurse educator could be better served with more lucrative uses of their degree, such as a nurse practitioner or joining an organization’s nursing leadership. It’s not the hours that drive the nurse educator. Is getting Christmas off a perk? Absolutely! Is waking up to 13 texts from a student who could not upload an assignment a benefit! Absolutely not. As a nurse educator, the breaks from classes are spent reworking material, developing new experiences, and continuing to grow professionally. It is truly a passion and a calling that drives the nurse educator.
Need for Nursing Faculty
Why should every nurse be aware of the need for nursing faculty? According to the American Association of Colleges of Nursing, a faculty vacancy rate of 8.8% nationwide has remained. This has resulted in a horrendous outcome of over 91,000 qualified applicants being turned away from nursing programs. Turning away applicants continues to exacerbate the nursing shortage. With the current projection from NCSBN of close to one-fifth of the nursing workforce looking to exit in the next five years, every applicant to a nursing school is a building block to the solution.
Know Your Influence
So why consider nursing education? The nurse educator is an artist. They take a piece of unformed clay and place pressure to mold and change the clay into a beautiful vase. With every student, educators leave a tiny part of themselves to transform a corner of the world. As a bedside nurse, I touch a few lives every shift. But if, as an educator, I have taught the floor of nurses, my reach is far greater than I will ever know. Knowing that your influence can affect the health care of a region, state, or nation is a pride and privilege few know. Nursing education is a beautiful profession that is far too often overlooked but should be dutifully considered.
My nursing education journey began when I received my BSN in Nursing at Rutgers College of Nursing in 2011. During my time there, I met some strong, professional women professors. They took such a personal interest in me that, over a decade later, I think of them with much gratitude. Their strength helped me to see myself as a strong but caring nurse.
A Strong Caring Nurse
My education gave me the confidence to care for my patients competently. I had a tough clinical practice specialist on the Med/Surg/Tele unit I first worked on. When she asked me questions on the spot, I almost always knew the answer. I credit Rutgers and fellow student nurses who supported each other through nursing school.
Prisca Benson, MSN, RN is a a nurse navigator for the neuroscience department at The Valley Hospital
While there was a lot to learn on the job, the education I received provided a foundation I used to excel clinically. It was not long before I started picking up per diem job opportunities to explore and broaden my horizons as a nurse. I worked in home care as an intake nurse, home care nurse, and infusion nurse for different companies.
In 2014, I got a job as a neurology nurse at my dream hospital, NYP-Columbia University Hospital. While per diem there, I joined committees I was interested in and disseminated the information to the staff in my unit to improve our practice.
I also noticed that some patients lacked a basic understanding of their medical history and medication. So I used the principles I learned in school to educate them effectively so they could be more knowledgeable about their health and care.
A Life’s Passion Realized
I soon realized that my passion was teaching.
I began searching for nursing opportunities to give me more time to teach patients. I applied for a position as Neuroscience Nurse Navigator at The Valley Hospital, which allowed me to create and develop the role to support the patients during their admission and help them maintain outpatient follow-up.
This was a dream come true! I finally had the time to sit at a patient’s bedside, teach them about their new diagnosis and answer all their questions.
While working this job, I received my MSN in Nurse Education at Chamberlain University. The modalities taught have allowed me to be a better peer and patient educator. It encouraged me to start with the other person’s understanding as a foundation for effectively educating someone. I participated in my organization’s student nurse externship by teaching skills, theory, and even creating an educational game to increase knowledge retention.
Love and Desire to Educate
My love and desire to educate led me to start a personal finance and health blog, Our Green Life, during the pandemic. The fear and misinformation were very unsettling, so I wanted to provide a reliable but approachable space for information. I use what I have learned through my education and experience to make the information easy to grasp and to demonstrate how it could be applied.
My nursing education helped shape my career, goals, and values, and I will be forever grateful for it.
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
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.
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.
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.”
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.”
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.