Get to Know med-surg nurse educator Westley Foster, a clinical nurse at Banner University Medical Center in Phoenix, Arizona and nurse educator at Mesa Community College Nursing Department in Mesa, Ariz., and Northern Arizona University in Flagstaff, Arizona. On Nursing Notes Live this month we will focus on medical-surgical nursing. Here’s that interview.
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Jamie Davis: Hi, Wes, I want to thank you for taking some time out of your busy schedule and coming here on Nursing Notes Live to join us. It’s great to have you here on the show.
Wesley Foster: Well, thank you very much for having me.
Jamie: So, let’s start off and find out a little bit about your background. I understand you kind of took every steppingstone along the way to your nursing career in multiple stages. So why don’t you tell everybody a little bit about why you wanted to become a nurse and what’s your educational career looked like as you progressed.
Westley: Okay. Well, I always felt that I started off wanting to become a nurse from the time I was a little kid, around four years old, when my mother was working in a long-term care facility. We used to go there and hang out on Sunday afternoon to meet with the residents she was working with. I was just fascinated with seeing what everybody was doing and helping people with different things. I just remembered thinking that’s what I want to do when I grow up and that’s been my focus ever since that. So it’s always kind of been in my blood being raised in the family of nurses and nursing assistants. So it just seemed a natural fit. The educational path, I took the long way as I tell everybody, but I think it was a good way for me. I started off as a nursing assistant. I went back to school. I became a licensed practical nurse. I went back to school in a diploma program and became a registered nurse. I went back to school for my Bachelor’s degree. I went back to school for my Master’s in Nursing Education. Now I’m actually getting ready to start work on my Doctor of Nursing Practice. So my education is kind of varied and wild and it seems to be continuous which is exactly what we need to be doing anyway.
Jamie: I completely agree with you. Whether it’s getting formal degree education or just working hard at staying active in your profession and getting good continuing education in nursing, I think you’re absolutely right. It’s all about continuing to grow and learn because everything in nursing and medicine and healthcare is changing so quickly.
Westley: Oh, it is. If you don’t keep up – even if you don’t have to go, like you said, with formal education, just keeping up with what’s going on in your area, what’s going on in your nursing world, keep up with the changes. Because when I think back with how I’ve seen things changed when I started back in the ‘80s to what we’re doing now, it just boggles my mind how far we’ve come. I know that means more is going to happen, so we have to be ready for it.
Jamie: So what about nursing in the Medical-Surgical specialty drew you in? I know with your mother’s background maybe I would’ve thought you would have moved towards long-term care nursing program.
Westley: You know, that’s where my grandmother worked as well. She was in long-term care up until a couple of years ago when she finally retired. And I did work in that area as a nursing assistant but it just wasn’t – I’m not an adrenaline junkie per se, but it just wasn’t giving me what I was looking for. I’ve worked in other areas. Med-Surg was really where I felt I would be able to all of my skills to use. I really had to use critical-thinking skills and where I really had to be knowledgeable. Not just on one focused area, but have a good breadth of knowledge to work with people with a variety of problems. Help them to get back on the path to wellness and help them move along with their trajectory wherever that was going to take them. So Med-Surg really just gave me that full view of things and always keeps my brain functioning and thinking “Okay, so what’s going on here? What do I need to know next?” I really love that about Med-Surg. It’s just full of variety. I tell people it’s not the same thing every day. There’s always going to be something new, always something different, always something to learn and always something exciting. So I just love the area. I don’t ever see myself not working in the Med-Surg area.
Jamie: You know it’s changed so much because, once upon a time, Med-Surg was seen as the boot camp for new nurses and everyone who wanted to go to other specialties ended up there. But our patients have changed over the last 10 or 20 years and Medical-Surgical nursing has become one of the most important specialties in nursing.
Westley: Oh, absolutely. I still remember everybody say, “Get your year of Med-Surg and then go off into a specialty area.” We finally have recognized that Med-Surg is its own specialty area and the patients are changing. And what we’re seeing in Med-Surg is our patients years ago would be in the critical care area. So we’re doing more and more things in Med-Surg. We’re using more technology. We’re using more of everything in the Med-Surg setting. So it really has become a specialty onto itself. It is not just the area where – “Just go try it for a year and then go off to someplace else.” It’s really the area where you need to go, start off and hopefully stay because there is so many different ways you can go in the Med-Surg setting. You can do Med-Surg ICU. You can do a Med-Surg subspecialty. You can do a general Med-Surg area. It’s not the way it used to be in the “good old days” as I call it not long ago.
Jamie: No, but it just points to how fast nursing is changing in general. I mean so much is different even from year to year. You’re an educator as well and I know you have students that come in and maybe two years ago what you told students going out the door as graduate nurses is completely different. If you said the same thing today, it wouldn’t necessarily hold as much weight.
Westley: Oh, yes, I tell students all the time is what we’re teaching, with the way advances are going in healthcare, what you’re learning today it may change by the time you graduate and you’re a licensed nurse working out there. So always be open to looking for new information and looking at how things are changing. We even see that while they’re in school. We may be educating on a new concept, a new procedure and, lo and behold, there’s something that’s better that comes along now. Now the thing I always think about now is just the latest things what’s going on which a lot of the chronic conditions that used to be fatal. And even just last year, we’re seeing such radical changes in – “Okay, this is now going even further and getting long-term benefits.” Where before when we were teaching students about these things we kept saying, “Maybe in 20 years these diseases will have effects.” But now we’re saying, “Well, maybe there won’t be anything.” That’s just one example. It always is changing. The information is always changing. So you have to be open to learning and seeing and growing. You really do.
Jamie: How important as nurses being actively involved in nursing research? I’ve really been trying to impress upon people that listen to my programming and educational settings to try to encourage them to see those opportunities for finding best practices in nursing care because we are having such an impact on a higher acuity patient and we’re on the front lines of caring for patients that before would’ve died 15 or 20 years ago.
Westley: Oh, god, that’s so true. The thing with research, I think that word needs to change because people are so intimidated when they hear “research” and what they don’t recognize – and I had my mentor, when I was in my Master’s program, really explained this to me – we do research every day, we just don’t knowledge that it’s research. We’re always looking for ways to make things better and we always have those ideas in our head that they – “Well, why we are doing it this way? What would happen if we try it this way?” And we do this, but we don’t formalize because we’re afraid of “research”. I think we need to get over that. That’s something I impress upon my students. I teach first semester nursing students and I teach them from day one, “Don’t be afraid of those ideas percolating in your head. Don’t be afraid to bring it up. Don’t be afraid to think about trying it later on. It may change into something. It may bring an idea that nobody else ever thought of. We need to change that mindset. Again, I just think it’s that term, “research”, it just used to be scary and it used to be intimidating. So I tell everybody, “Don’t call it research. Call it “Expanding evidence-based for nursing.” I think that seems to make it a little less intimidating but we have to do it.
Jamie: I like that. That’s great. It’s interesting because I think it’s important to talk to the nursing students that are out there listening to the show that there’s some amazing research coming out of nursing schools run by nursing students right now.
Westley: Oh, it’s amazing what’s out there and the changes that are coming forth with just people having those ideas and getting over that intimidation factor saying, “Well, why didn’t we do this? What is the research behind that?” Once they start talking with students about the evidence-base and looking at what it is that we do especially when we know that a lot of what we do is still based on tradition, you can see the idea formulating. You can see them starting to think and they’re getting the appreciation. And I think nursing schools are getting better because we’re not waiting until the end of their educational process where no matter what the degree is, we’re not waiting for the end to start talking about evidence-base. We’re bringing it in earlier. So I think that’s going to help really promote the profession of nursing. I hope it’s going to generate much more research especially since I’m going to school for a doctorate coming up. So I hope that.
Jamie: Time to heal yourself, right, follow your own direction and find that uncertainties.
Westley: Yes, exactly. Thankfully, I have a couple of research topics formulating and going on. So hopefully it’s going to be good.
Jamie: So what is it that somebody needs to be a good Med-Surg nurse? We talked about nursing skills and different things, but Med-Surg covers so many things. Like you said, there are subspecialties of Med-Surg nursing now because it’s so broad. What does a nurse need to be a good Med-Surg nurse?
Westley: You have to be open to change. You have to look and find what’s going to be the best niche for you in that specialty area. And you have to just be prepared for knowing that what you’re doing now may change very well in the future. But you also need to be the person that’s going to be able to educate patients, families, people you are interacting with about what it is that you do, why you need to be open to the change and be somebody that can really be out there and not be afraid of it. And it’s really just keeping your mind open because everybody has that idea of, “Oh, I’m going to work in this area and that’s the only thing I’m going to work in.” But you have to be open because there’s so many ways you can work and so many things you can see and so many things you can do. So be open, be prepared for change and just enjoy the ride that goes with it because it’s going to be an exciting time. It’s still in the future for what we’re doing in healthcare. So just be open.
Jamie: What do you see about the future? Because like we said, we talked about the past and where Med-Surg nursing has come from, but looking forward, there’s just so much on the horizon. What do you see?
Westley: Yes, there is – and what we do in nursing is radically going to change. We’re going to see more and more things being treated as an outpatient and we’re going to patients in the hospital being sicker and sicker. And I think that’s where Med-Surg is really going to shine because we’re going to be the ones that are going to have to look at what’s going on. Have that big global picture of what’s happening. I don’t mean that sounds insulting but we know if somebody’s in critical care, they’re going to move out of that critical care area mostly to a Med-Surg unit, some sort of stepdown Med-Surg unit, before they get discharged. So it’s the Med-Surg nurse that’s going to be coordinating all that and looking at how can we do successful transitions out? And it’s going to really be something that we’re going to have to just have a strong knowledge base like we do now, but even more so because things are going to happen quicker than they are now. Patients are going to be out there. Then it’s going to be that Med-Surg nurse that is going to have to have that knowledge base and that flexibility and be able to handle the fact that people are just going to be moving faster and we need to know what’s going on, how we’re going to handle that case load. What we’re going to be able to do successfully to really get through. And Med-Surg is going to be the key cornerstone of that. If I can impress anything upon what the changes that are going on is that we will need to get folks involved in a nursing organization because that’s what’s going to really help them with all the changes that can help with that to increase that knowledge globally. It is not just within your institution or within your region but we need to have that global knowledge as well to help with that.
Jamie: It’s so important to be part of your professional organization as a nurse whether that’s Medical-Surgical nursing, critical care, emergency nursing, whatever the specialty, because it offers you those opportunities not only to define best practices but to – I find going to these conferences that I have more learning that goes on in the hallways than in the formal sessions. Do you find that true as well?
Westley: Oh, absolutely. It’s funny that you mentioned that because I wrote an article about the Institute of Medicine’s Future of Nursing report and how that works with lifelong learning and with nursing certifications and nursing organizations. That is so true. I learned more when I go to conferences and conventions, whether it’s for my oncology subspecialty or my Med-Surg work, with attending sessions where I really don’t see something that often are talking with people, networking at break time or in the hallways or with the person sitting next to you. I learned so much more information from kinds that way and then I can bring it back and talk about it. It’s amazing how many people will say, “Oh, yes, I’ve read something about that but I really didn’t pay attention to it” or “Oh, yes, we know about that and we’re looking at how we’re going to change that and incorporate that and try to pass this year.” We have learned so much more. And it’s always something that you’re going to learn at these conferences and with lifelong learning aspects of nursing through your organizations. It’s absolutely phenomenal. There’s so much out there. It’s a wonderful thing. I tell students too – I have to jump back to students – that I tell students, “If you think you know an area where you’re going to want to work, join a professional organization now. They’ll really be helpful for you in the long run if you start early by joining them.”
Jamie: And a lot of them have student nurse rates. They really encourage students to be members early. So I completely agree with you there. I think that’s such an important thing. You talked earlier about a mentor really influencing you in what you were doing. I am curious about your thoughts on developing mentors in nursing. It’s great to have a mentor, but we need more – I feel like we need more mentors in nursing.
Westley: Yes. It’s really interesting when I see that. We have lots of people who work as bedside clinicians who are doing amazing jobs through all – for some reason think, “I would be no good at being a mentor, being a preceptor because I just don’t like teaching.” But they don’t recognize that they do it every day and we need to help people who are the bedside clinicians recognize that and understand that and appreciate that. You have all the capabilities in the world to be a good mentor, good preceptor. Don’t sell yourself short. You have great knowledge, share it with others. You can do it. If I can do it, anybody can. I think it’s where we have to work now. It’s just getting those people to recognize that. That we did have good mentors and we just have to help get them out of that shell of thinking that they can’t do it too. Yes, you can, and here’s how we can help you.
Jamie: That’s fantastic. I always get a couple of questions that come in to us from students out there and I’m sure you get these questions from your students too, but maybe we can ask one of those as we wrap up here today. What is the piece of advice you’ve received that’s carried you through your nursing career?
Westley: It really has been just be open to change, don’t be resistant, and learn from your mistakes. That’s really the best one that I can give to folks. That’s what I’ve learned and always remember. Because everything’s going to change and you’re going to make errors along the way and learn from it and help educate others through the process.
Make sure you check out the entire March 2015 issue of Nursing Notes where we look at the medical-surgical nursing specialty. 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 had a panel discussion on medical-surgical nursing with Jill Arzouman, President of the Academy of Medical-Surgical Nurses and a clinical nurse specialist at Banner University Medical Center in Tucson, Arizona, and Mimi Haskins, president of the Medical-Surgical Nurse Certification Board and a clinical assistant professor at the State University of New York School of Nursing in Buffalo, New York. You’ll find this and other episodes of Nursing Notes Live in the podcast area on iTunes and check out the new podcast player at DiscoverNursing.com!