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Hear about two nurse educators who are leading and teaching the next generation of nurses. Patricia Davidson, Dean of the Johns Hopkins University School of Nursing, and Kimberly Dudas, Chair and Assistant Professor of Nursing at New Jersey City University talk about the current status of nursing education and what is in store for the future.
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Jamie Davis: Kim and Patricia, I want to welcome you to Nursing Notes Live and really I am excited to talk about this topic this time of year, getting started talking about nursing education.
Kimberly Dudas: Oh, it’s an exciting time of the year for us. It’s a very busy time, but it’s a wonderful time of the year. It’s encouraging and it’s kind of a chance to start afresh each year.
Patricia Davidson: Yes, I agree, Kimberly. It’s great to be walking around the school and seeing all this eager and excited faces. I’m really optimistic about the year ahead.
Kimberly: Yes.
Jamie: So, Kim, why don’t you share with me a little bit about why you wanted to become a nurse? I always ask that question first.
Kimberly: I actually don’t think there was ever a time that I didn’t think that I would be a nurse. I recall from a very young age nursing animals and nursing whoever happened to be sick in my vicinity and it just seemed like a very natural thing for me to do. So I think from a very young age I knew that and I geared my coursework all along to prepare myself to enter a baccalaureate program. So for me it was kind of intuitive from a very young age.
Jamie: Patricia, how about you?
Kimberly: Well, I’m a bit the opposite. I had not really thought about nursing as a career and had started off university and did a year of really doing political science and sociology, et cetera. I didn’t really found real attraction in what I was studying. And then I was just working with a woman who was going nursing. And when she started to talk to me about it, I thought, “Maybe I’ll have a look into that.” To cut a long story short, that was being the best decision of my life because very quickly I realized that this was the career for me and I was fortunate to be – I had the opportunity to undertake this phenomenal career.
Patricia: I would have to say that I agree. Nursing is a phenomenal profession to be in and I have never ever regretted my decision ever.
Jamie: So, Patricia, we are having all of these new nurses coming into the school system as they try to enter the nursing field. A lot of times because they’re coming from other degree positions and other programs, just like yourself, kind of shifting gears midstream, do you see that as a negative or do they bring a lot to the table from their previous career or previous ideas of what direction your life’s going to take?
Patricia: Well, I think really they bring a huge amount to the table. Here at Johns Hopkins, all of our students have a baccalaureate degree and a good number actually had a master’s degree. So these are people who, for a range of reasons, have decided that nursing is a good career option. So because this makes it very thoughtful, intentional decision, it’s not something that they’ve just sort of fallen into out of school because of career or counsel have might suggested it. It really comes with a commitment to doing this amazing job that we call nursing. One of the really interesting things about Johns Hopkins is that that 10% of our graduates are actually Returned Peace Corps volunteers. And so what’s really interesting is when you talk to them, many of them have been obviously doing this phenomenal work and I really not sure that I have the courage and the tenacity to work in some of the places they have. But when they’re in the field, it’s where they see the people that really get things done, the people that are really valued by the community and really make a difference are the nurses. So I think it’s a really interesting observation that many of those Returned Peace Corp volunteers come back with a very clear motive to be able to become a credentialed nurse working in a range of settings.
Kimberly: I think that’s so interesting that you say that. I teach primarily at New Jersey City University accelerated second-degree students and so they all had careers of some sort, so they come to this program and they often – when I ask them why they chose nursing at this point in their life, many of them talk about the experience that they had or a loved one had in dealing with a nurse and it made them think about their own careers and their life choices in a whole different way that they might not have ever considered nursing before and it really opened up an opportunity for them to look at nursing a little bit differently.
Patricia: I think that’s a great point, Kim. I think it really speaks to the importance of programs such as this where nurses get to share their stories because unless you’re exposed to other nursing or nurses, sometimes people don’t think about nursing as a career option. You know in popular media, that often we have mixed representations of nursing and nurse’s role. So I think being exposed to nurses and hearing frank conversations like we’re having now is a really important strategy for attracting people to our wonderful profession.
Kimberly: I couldn’t agree with you more.
Jamie: What do you think, Kim, the challenges are facing nursing education right now? There’s still a lot of schools trying to ramp up their programs, increase enrollment, increase the number of faculty members so that we can try to head off the impending shortage of nurses that’s going to start occurring here soon, what challenges face nursing education at this time?
Kimberly: I think there’s a number of challenges and I think of one of them is recruiting highly qualified faculty. The faculty role, the salaries, for example, don’t really necessarily compare to that in clinical practice and so for some that’s a deterrent and I think we are losing the opportunity to have some really skilled people educate. Sometimes programs are really limited by the amount that they can expand because they’re really limited by the ability to attract sufficient highly-qualified faculty. And that I certainly see here, we have, in New Jersey, a number, I think much richer source of highly qualified faculty available because we’re a very small dense state, for example. But it’s still a challenge even for us in the urban environment that we’re in where there are a lot of highly-educated nurses. That is, I think, the biggest challenge in this institution that we face.
Patricia: Yes, I agree. I think that it’s one of the big challenges that we face. And, also, coupled with the shortage of faculty is the need for people to have terminal degrees, whether it’s PhD or DNP. As well as not earning a salary that is equitable with the practice environment. People are finishing their studies carrying a huge amount of debt. So I think that’s a really important consideration is how we facilitate individuals dealing with this huge amount of financial loans.
Kimberly: I would have to say, another big factor that I see that really is a challenge for us in nursing education is that the practice world is changing so frequently and at a pace that I think it’s a challenge for us to keep up with in the education setting. There are so many new advances that are going on all the time and there are differences in how we as faculty practiced, compared to the practice now. I think that that’s another challenge is that we face is that we want graduates to be prepared when they graduate from our programs and with the change in technology and the pace of which that happens in the practice setting, it’s becoming a bigger challenge for us as educators to be able to keep up with that.
Patricia: Yes, I absolutely agree. I think some of the opportunities we have is increasing the interface between education and the clinical setting. I know many schools have some exciting programs. The other thing that I just wanted to mention about that insight, that we have this exciting new group of students who are second career nurses. But also that can also challenge many of us as faculty who – it’s pretty hard to be teaching biology to someone who has got a master’s in biology. So it also stretch us up as faculty members to develop and refine our knowledge and skills and to also teach within the adult learning framework. As we identified earlier, many of these students who are coming as second degree bring a huge amount of expertise just not in their life experience and skills but also many of them have expert knowledge in a range of settings that can support and develop nursing knowledge.
Kimberly: That’s true. The faculty need to have a comfort level with being challenged because this type of student is one who really is very focused, they know what they want and that’s all good, but there are some challenges with dealing with adult learners in that way that’s very different than dealing with a younger student that might be in a more traditional type of program. I’ve had faculty that are really very qualified and very skilled but really find it very difficult to work with these types of students that really are challenging and, in some cases, about some subjects no more than the faculty does.
Patricia: It’s true.
Jamie: We have so many other things that are changing so rapidly. I know you all talked about the changing clinical environment. There’s a lot of changes in the educational environment as well, the advent of simulation programs and projects to engage the students more closely and interactively. I know, Kim, you do a lot with interactive education. What do you see changing there?
Kimberly: Well, I think that, as the expression goes, a faculty is no longer the sage on the stage. They need to be the guide on the side. Really what that means is that we really have to have a student-centered approach to learning and it has to be a very interactive form of learning. Gone are the days where a faculty stood at the front of the class and lecture ad nauseam until the end of the class. The students were silent and took notes. That’s not the kind of classroom environment that is going to help prepare students for today’s work environment and we need to incorporate very active learning strategies into the classroom. Some faculties don’t necessarily feel comfortable with that and that can be a real challenge about changing the way that most of us as nurse faculty were taught in that very lecture-oriented format to something that’s much more engaging and requires a lot more effort in a different way on the student’s part.
Patricia: I think that that’s absolutely true. We have this huge range of tools that can assist us but also some of those are costly, require training and so many of us in nursing education requiring us to develop a new suite of skills, particularly, in terms of technological confidence. We’ve identified simulations as an important factor. It’s another area of specific expertise that we do need to develop more in our profession.
Kimberly: There are things that can be done in the classroom. Simulation might be done in the classroom not only in a practicum type of environment and the faculty don’t all feel comfortable with it so you have to kind of figure out who is the ones that are more amenable to those kinds of things and gear them towards that. We’re trying to tap into the faculty potential that meets those active learning styles to be able to engage students in a classroom.
Jamie: You know, Patricia, we have a lot of going on in nursing practice as well and there’s a lot of push to encourage nurses to continue their education, but I often believe that that starts with the very initial nursing education, that very first day where we start teaching them to be lifelong learners, how do you see that as helping to encourage nurses to continue on and expand their practice and their abilities and education throughout their careers?
Patricia: Well, I think what we as educators have to do is to help people to achieve their optimal potential and to really address what are their expectations to their career. As someone who has probably studied most of their life and did not receive their PhD into well into my 40s, I’m a great believer in really encouraging students to look at the terminal degree as not the end of their learning but just really, whether nurses do as DNP or PhD, to look at these degrees as providing them with the armamentarium for expert practice, whether in clinical practice or research or policy or education. But if you rightly say, the fact that you have a terminal degree does not preclude the fact that you have to engage in lifelong learning and professional development to achieve your goal.
Kimberly: I think that kind of builds on the fact that if we want to encourage our students to do but to move on in their education and certainly we do – I think faculty needs to role model that behavior. Students need to see their faculty attending continuing education, if they don’t have a terminal degree, pursuing that terminal degree, for example. And they need to see that we value that lifelong learning ourselves if we want to help instill that in our students.
Patricia: Yes. I think the best thing that faculty can do is to motivate and inspire our nurses to keep going in this wonderful career. And I think that is one of the great joys of teaching is to be able to light that spark in someone and to maybe get that individual thinking, “Gee, that’s the kind of nurse I want to be,” and recognize that it is a lifelong process of knowledge acquisition, reflection on what you have learned, and also an important journey not just professional development but the personal development. And nursing certainly provides us with a range of opportunities that really develops personal growth.
Kimberly: I still get giddy, Patricia, I don’t know about you, but I still get giddy when I hear of graduates that have gone on in advanced degrees and have achieved certification and become experts in their practice field. It brings me joy. I could see that they have been successful and then, to me, that’s the evidence that we really are helping to instill that type of love for lifelong learning in this profession.
Patricia: I agree absolutely. I think it’s the same whether you’re in practice or in the classroom. You often don’t have an appreciation of how your knowledge and actions can influence an individual’s life choices. So I think that is a huge responsibility both as a teacher in the classroom and as a nurse in clinical practice to really take that responsibility to model our profession to the type values and where it’s possible to really engage an individual, particularly, in showing them how wonderful our profession is and how we make a difference.
Kimberly: Right. I couldn’t agree more.
Jamie: Kim, you talked earlier about modeling behaviors as an educator for your students and continuing on in your education. I assume you also see that as an important role for educators to encourage students to become educators themselves?
Kimberly: Absolutely. I think that nursing education and being a nurse educator requires a certain skill set certainly, and some of that is certainly acquired in their graduate work. I think there are some individuals that are natural-born teachers. I think that there is something in them that I see and I encourage that. It’s wonderful when I see that they go ahead and do that because I keep trying to tell them, “Your nurse faculty is getting older. We’re the oldest of the group of nurse professionals that are out there. Nurse faculty are the oldest practicing group, and I need people that will be able to fill my shoes when I no longer able to fill those shoes,” and we need to encourage the students to think ahead and to think – their career plans can certainly change. In my 27 years as a nurse, I’ve certainly taken a few different paths to finally get where I am today. And that’s okay, but I want them to think about nursing education and that it is a valued and important part of nursing and we can’t exclude that as a potential future career choice in any way, shape or form.
Patricia: Yes, I agree absolutely. I think the nurse educator has a role across the spectrum from interaction with patients and their families, interacting with colleagues from the range of health professionals. Of course, in academic institutions and clinical settings as well, we really have this evolution of the unique role of the nurse educator whose primary role is to provide information, resources, knowledge and inspiration to prepare the next generation of nurses. Increasingly, the paradigm of professional contexts, particularly at a place like Johns Hopkins, nurses are not just teaching nurses, but nurses are teaching medical students, pharmacists, et cetera. I think that’s a really important role in how we are extending to nursing how important our role is in improving outcomes for patients and their families.
Jamie: Yes, I absolutely in see it is important that nurses be that educational leader for all of the healthcare professions and it’s exciting to hear about nurses teaching in other areas of expertise to share their unique nursing perspective on patient care.
Patricia: I think that’s right and, as we know, we’re in an era of healthcare reform, where there’s an increased emphasis on personal standard care, assessing need. From time immemorial these have been the fundamentals of nursing as a profession. So I think we have a lot to share in terms of in particular managing the increasing number of older individuals living with chronic and complex conditions. Nursing is the nuts and bolts that really can provide an important toolkit to improve their health outcomes of this increasing number of people with multiple conditions.
Jamie: Well, I want to thank both of you for taking some time out of your very busy schedules this time of year to chat with me. One final thought from each of you – I’ll start with you, Kim – that you’d like to share to encourage a nurse that’s listening to this to consider becoming a nurse educator.
Kimberly: I think that being a nurse educator is so very rewarding from a personal standpoint and a professional standpoint. We need to value the nurse educators. They’re the first nurses that students encounter before they enter practice. We want to be good role models for them. I think that by valuing nursing education, that that is an important piece of making sure that we get the right faculty to be able to be nurse educators.
Patricia: I agree to Kimberly. I think it’s really important about valuing the nurse educator in the range of specialties that nurses can undertake from being nurse practitioners or nurse managers or nurses work in policy. Nursing education in our modern world is a lot more than just information transfer. As Kimberly eloquently said, we move beyond the stage on the stage. That “Educator is the future” is about the meeting the student at the place where they’re at. Being able to tailor and target educational activity to best meet their needs. And I think when nursing education works best is when we can motivate and inspire students to really feel the passion for nursing to really see that we got expert clinical knowledge and also our care and compassion. We can make a huge difference to individuals and community.
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Make sure you check out the entire September 2014 issue of Nursing Notes, where we take a look at nurse educators. You can read the entire issue online at www.discovernursing.com and don’t miss the other Nursing Notes Live episode this month where 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. You’ll find this and other episodes of Nursing Notes Live in the podcast area on iTunes.
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