Get a sneak peek into the September issue of Nursing Notes, which will highlight nurse educators and be distributed in mid-September. In this episode, I sit down with our Get to Know nurse Susan Kohl Malone who is currently working on her Ph.D. in hopes of becoming an independent nurse scientist. I also shared questions with her from current nursing students, as part of our “Ask A Nurse” portion of the podcast. To learn more about Susan, be sure to check out her “A Day in the Life” video on the JNJDiscoverNursing YouTube channel.
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Jamie Davis: Hi, Susan, and welcome to Nursing Notes Live. It’s great to have you join us on the show this time around.
Susan Malone: Hi, Jamie! Thank you. It’s great to be here. It’s my pleasure.
Jamie: So, Susan, I always ask our nurse guests to share with us a little bit about why they wanted to become a nurse. We have a lot of student nurses and people thinking about nursing careers listening to this. What was it that drew you to nursing as a profession?
Susan: That’s a great question. I was in high school and I liked everything. So I didn’t really have – I think sometimes some people really know right from very early age is that they wanted to be a nurse. That wasn’t necessarily me. I liked everything that I did. So it made choosing a career rather difficult. But one thing that happened in high school as I started teaching swimming lessons at our local YMCA and it was that experience that really made me realize how much I loved working with people and that whatever I decided to do in a future career that was a critical component, to be able to work with people and to be able to make some kind of difference in their lives. So I kind of knew that about myself during my later years in high school. My mother was a nurse and my older sister had just started her undergraduate degree pursuing a BSN. So I talked with my mother about it and she told me that if I was a nurse there would be a lot of opportunities and teaching would be one of those. So I went with what my mother said and she was right.
Jamie: Yes, it’s really interesting. I was originally a paramedic and before that I was a journalist, before I got into nursing school. As we went through school, I was amazed at the multitude of opportunities that nurses find for themselves as ways to help patients and help clients and help individuals and communities become healthier and well in many different ways.
Susan: Yes, and it’s a very flexible career which makes it particularly attractive also.
Jamie: So tell us a little bit – you’re a nurse educator now, but what was your progression of your career like that it got you to the point where you said, “I want to be a nurse educator”?
Susan: Yes. Well, again, I really knew that it was the teaching component that was very attractive to me. So I never really kind of let go of that. There had to be some teaching piece in whatever I did. So I was finishing my undergraduate degree and I was working at the time also in the graduate school of nursing where I was pursuing my undergraduate degree. I was getting really worried because I didn’t really think that acute care work was necessarily my calling and it seemed that most people were going along that track. So I got some really good guidance from the office there and they encouraged me that if teaching was something I was interested in down the road, that get a job in an acute-care setting but in a location where I was hoping to go to graduate school. So don’t delay was the message. Work for a year to get right on started with applying to graduate schools and taking the GREs and getting prepared in that way. So my first job was actually on a cardiothoracic surgical step down unit. It was acute-care. There were some aspects of that that I just really loved. But the floor beneath my unit was just a regular cardiac floor and at the time cardiac rehab was relatively new and they were doing a lot of patient education on the floor. So I’d always kind of drifting down there to kind of sitting on some of those classes and to see what that was all about. I applied to graduate school within that year focusing on cardiac rehab with the hopes of working in more than outpatient community type setting. I went to graduate school full time and then I relocated. There weren’t any openings in cardiac rehab but there were openings in diabetes education. Again this was largely outpatient in a community setting and that was where I found myself doing that. Pretty much I also had a family at that time. So I was doing that more or less once a week doing outpatient diabetes education classes and loved it. Then I stopped. Our youngest child was born, so this was our fourth child. So there was a little hiatus in my career there and I didn’t return until she was five. But over that five-year period, when she was a baby until she started school, I took some time to really rethink about what I really want to do with my nursing career. At that point, I realized that I was very much drawn to working with well-children and perhaps well-mothers. Again, I had returned to my undergraduate university and ran into a professor there and told her that this is the population that I think I saw myself drawn to and wanting to work with next. She told me that it sounded like I wanted to be a school nurse, so that kind of, I mean, I stepped back a bit. It wasn’t really something that ever crossed my mind about pursuing, but the more I thought about it and look into it, the more I realized that this really was something that seemed very attractive to me. As soon as I started doing it, I absolutely loved it. So I worked as a school nurse for many years and I also continued teaching outpatient diabetes education classes, one night a week. After that, I ended up as a specialist professor at one of our local universities. Then I decided to go back to school full time to pursue my PhD, which is where I am currently at right now.
Jamie: That’s exciting. I love to hear how your interaction with a mentor, an educator you worked with before, really helped steer you in different directions than you were anticipating. What do you think that role of the nurse educator as mentor for not just their students but nurses they’ve taught in the past?
Susan: I just can’t emphasize enough how important it is to have not just one mentor but many mentors to guide you along your career journey because I think sometimes, at least for myself I can speak, I get set in the way of thinking and it’s hard for me to step outside and think about things differently and you sometimes need that outside voice who also is aware of what else is going on in the healthcare system and can be very forward thinking and interject a little bit. Those mentorships take time also; time to get to know people. And I think that the time that nurse educators take to really get to know their students as individuals it is truly a gift to finding mentors. I think if you cannot be shy about asking someone to be your mentor, particularly, if you look up to them and you respect them and see them given the type of work you might like to do or just that they do impressive work.
Jamie: I agree. It’s something that is really incumbent upon us to grow is to find that mentor. It’s also a responsibility to turn around and mentor others as well.
Susan: Yes, that’s something I very much hope to be able to do myself someday because when you receive a gift like that, you realize how valuable it is and to be able to give that gift to somebody else. I think it would be a truly amazing thing to do in one’s career.
Jamie: So you are working on your doctoral degree right now, what are you focusing on? What is the gist of your dissertation focus?
Susan: Yes, so I am actually pursuing my PhD. It is a very research-focused degree. When I applied to graduate school, I really blended some issues that I saw that were happening in the outpatient diabetes world for patients with type II diabetes and also what was happening with school children. I would be working in the evening, and I was fascinated with the literature that was beginning to show a link between sleep and obesity. So I was telling my adult patients with type II diabetes the less you sleep the more you weigh. Then I would go to school, and I was at a high school at this time, and I taught 7:30 AM health class to adolescents. So I knew what sleepy teens were like and this was in the mid-2000s, in the overweight/obesity crisis, it was well-publicized and we were all very much of that, but there wasn’t any research going on that I was aware of or to get my hands on that was looking at a potential association between sleep and overweight or obesity in adolescents. So that was where I went into my PhD program, I’m interested in pursuing. But it became very clear that a more interesting question was that really not all short sleepers are overweight or obese, so there must be something else going on here. So I began to dig a little deeper and this was a rather painful process of heavy thinking, knowing I really wasn’t quite on the edge of where I could be with my research question. So it took a lot of hard thinking, probably about two years. I became interested in getting at this conundrum: why aren’t all short sleepers overweight or obese? So I began to consider this concept which I’ll call “chronotype” and then I’ll tell you what that is. I thought that maybe chronotype might actually modify this between short sleep and overweight/obesity. So chronotype is individual differences in sleep/wake time. If you think about it, somebody who goes to bed late and gets up late, sometimes we call those people “owls”, and people who go to bed early and get up early, sometimes we call those people “larks” and you may even notice about yourself if you’re more of an owl or more of a lark. So it looks at those types of differences in sleep/wake timing and tries to see if that has an impact on this relationship between sleep and obesity.
Jamie: That is fascinating and I am looking forward to seeing the results of what you find because anything we can do to help find ways to combat this obesity issue is certainly going to have huge results for public health but also for individual health.
Susan: Yes. Really, 90% of obese adolescents go on to be obese adults. So this is really a population where, I think, if we try to begin to understand what are some of the things that are driving this at this young age, how can we prevent it and/or reverse it? It will really have a trickle-down effect then to what we see in individuals when they go on to become adults.
Jamie: There are probably some nurses out there considering graduate programs and listening to the some of the challenges you had trying to narrow down your research focus and drill down to the final point that you’re really looking at that may be frightening to them, what would you say to them about moving forward?
Susan: Oh, I would say it’s probably one of the most wonderful things I’ve ever done. So don’t hesitate. Don’t feel like you have to go in knowing because, like myself, I think I probably was – my ideas were fairly well-developed, so I went in thinking I knew exactly what I was going to do and then it kind of did change and you’re supposed to change and evolve and grow throughout your program. So I would really encourage people that even if they don’t have an idea, part of what that PhD program will do, it will be able to expose you to a lot of different ideas and a lot of different ways of thinking about things. In terms of being scary or frightening, you have a wonderful supportive environment that you usually enter into. For myself, I know my classmates, my cohort that I was with, we supported each other every step of the way and faculty also was there to help in that process.
Jamie: Let shift gears a little bit and look at your role as a nurse educator and talking about new nurses coming into the picture. There’s a lot of people starting nursing school this time of year, what do you see the role of the relationship that can develop between the new nurse student and their nurse faculty members?
Susan: I’m thinking about the typical undergraduate nursing student, that I was myself at one point, and it’s really quite a time of personal growth, often being away from home for the first time when you are in a university setting. So they are being exposed to a lot of different ideas and trying still I think to find out who they are and how they fit in the world. And when I say that I think the role of a nurse educator – yes, part of it is delivering content, but it’s also really taking that time to get to know your students and helping them to find themselves and how do they fit into this bigger world and how will they fit in as a nurse pursuing this as their career down the road. Did that answer your question?
Jamie: It certainly did and I see a lot of new nurses. I teach as well and talk to a lot of people about healthcare in various ways and I find that the nurses that are educators carry that nursing caring approach that they use with patient care into their relationships with their students in so many times. It’s really a special thing. You don’t always see them in the higher education setting.
Susan: I would agree it’s actually something we often joke about that we are nurses first and that we really do carry that sense of caring about individuals and we are interested in getting to know them. I think that’s what makes being a nursing student in the University something actually really nice. I’ll share with you one short story. I’m always hoping to grow and to develop and certainly it’s an area that I need to be cognizant of because you know as an educator that sometimes your time is very precious also and these relationships you need to invest in with your students. So one of the faculty at the school I’m at has decided that one of the ways he would to know he’s current students who were all freshmen was that he would find out what was their favorite meal that they had at home. And he had been given the recipe and each week he brought in a dish of what food it was that they were missing from home. So I think that’s just a really sweet way of letting students know that you really care about them above and beyond their performance in the classroom.
Jamie: What do you say to the nursing student that they need to have developed as a responsibility to define their role in the learning process?
Susan: I think that we talked about this sense of being caring even when we’re educators, carrying that piece of nursing with us and really caring about individuals whoever they are even if it’s a nursing student. But I also really believe that one of our responsibilities is we want our students to feel confident, and yet we also know that we need to stretch them really outside of these comfort zones. So I think one thing I would like them to know is that I’m not always going to make life comfy-cozy. It’s not always going to feel comfortable here in the classroom because I’m going to ask you to engage the difficult questions and to think about things in multiple perspectives in ways that you haven’t before. So you really do need to think and you need to work hard.
Jamie: I think it’s similar to the caring approach we use with patients. It’s not always pain-free, but it’s with the goal towards making them better and we use that same approach with our students.
Susan: That’s a great analogy, yes, I haven’t thought of it that way before. I think that something important that they do need to know that it’s not always going to be easy and it is not always going to feel good, that they need to step up to the plate and fulfill their obligations as students.
Jamie: As we wrap up our time together and, boy, I think you and I could probably chat for quite a long time about everything nursing, what do you see as the future of nursing? We have so many things going on in healthcare right now and with the ways that people interact and nurses are really stepping forward into new roles, what is it that makes nurses so suited to doing that?
Susan: That’s a great question and I agree with you. I can’t remember, I’ve been a nurse for quite a while, and I can’t remember a brighter time for nurses to really step up to the plate and shine. So ask me that question one more time, I’m sorry.
Jamie: No, just thinking about all the changes that are going on with healthcare right now, why is it the nurses are so well-suited to stepping forward and taking on that leadership role?
Susan: Well, I can say, for me, anyway, what do I think it is? And I think there’s certainly been a shift in our way of thinking about health. I think we, at least in the 20th century, had a very disease-oriented model. I think what the public wants now is not really just healthcare, but better health. So this kind of sense of health promotion and being able to live as solely as possible and to prevent some of those chronic diseases that we see, that are now the leading causes of death, I think that has opened up a lot of opportunities for nurses because, I believe, as opposed to maybe other professions in our healthcare delivery system who are very disease-oriented and it’s wonderful that we have those partners to partner with. But I feel our little niche has always been in health promotion and also perhaps chronic disease management, where people are living with these diseases for many years.
Jamie: What is it that has been the greatest moment of your nursing career? What highlight, as you look back at your career, really stands out to you as the shining moment that defines your nursing?
Susan: Yes, I actually was thinking about this question a little bit. As I was thinking about it, I really thrive on a stimulating intellectual environment of academia, that I thought, “Well, what’s my greatest moment? What has meant the most to me?” And I keep coming back to the times that I really felt like I touched the lives of patients I cared for, whether that was as a staff nurse on the cardiothoracic unit or as a diabetes educator, or the school nurse and the faces of the people who I remember and feel like I really helped them move along. To me, they’re still the greatest moments of my career.
Make sure you check out the entire September 2014 issue of Nursing Notes, which will discuss nurse educators and be published online at www.discovernursing.com in mid-September. And don’t miss the other Nursing Notes Live episode this month where I chat with two nurse educators who are leading and teaching the next generation of nurses. Patricia Davidson is Dean of the Johns Hopkins University School of Nursing and Kimberly Dudas is Chair and Assistant Professor of Nursing at New Jersey City University. We sat down and talked about the current status of nursing education and what is in store for the future. You’ll find this and other episodes of Nursing Notes Live in the podcast area on iTunes.