Nurse's Watch: Conversations on contemporary nursing,
nursing education, leadership, spirituality and blogging.
~Start date February 2010~

Monday, December 26, 2011

Lessons Learned ~ "Life is the art of drawing without an eraser. " ~ John Gardner

What have I learned?
That teaching and planning take a great deal of time and study.
That teaching can be fun and terrifying.
That teaching is not static.
That it is a labor of love, a passionate venture.
That teaching involves caring.
That learning never ends.
That experience is a good teacher but guided experience is the best teacher.
That my students much like my patients are now my responsibility.
That I must be wise.
That with God’s help I am able.
That I am entering a whole new world with new and exciting challenges.
That as I teach and guide I am simply standing on the shoulders of all those who have invested their time and effort in me. This humbles me and fills me with gratitude.
And finally that we are all part of something much larger than ourselves, the noble profession of nursing.

       In January I will begin to work full-time as a pediatric nursing instructor with USC Upstate. This is so very exciting. God has ordered my steps and I am grateful. My goal was always to become a nurse educator. However, I had assumed that I would begin by teaching a fundamentals course before I would be able to move into my specialty. "Now to him who is able to do immeasurably more than all we ask or imagine, according to his power that is at work within us..." (Ephesians 3:20). I praise God.

        Finally, I love collecting bits of inspiration. The quote below is from The Quote Garden. 
~ Enjoy ~
~When I think about all the patients and their loved ones that I have worked with over the years, I know most of them don't remember me nor I them.  But I do know that I gave a little piece of myself to each of them and they to me and those threads make up the beautiful tapestry in my mind that is my career in nursing. 
 ~Donna Wilk Cardillo, A Daybook for Beginning Nurses

Sunday, December 4, 2011

Oh, Happy Day! Graduation Time...

Friday is pinning and graduation day.
 I will earn my Masters in Nursing Education from Charleston Southern University.
It is almost time to celebrate,
Oh, happy day!

Sunday, October 30, 2011

Leading by example...

                 Leadership in Clinical Education and Leadership Growth

                                             Creative Clinical Leadership

Jones (2005) proposes that senior nursing students can practice leadership by delegating responsibilities to novice nursing students. She outlines how they must gather patient information and give report to the junior students, as well as, inform them of the  time they are expected to arrive, while also providing directions to the medical facility (Jones, 2005). Most importantly, they must evaluate the patient and student to determine which duties can be delegated safely and within the student’s scope of practice (Jones, 2005). This takes quite a bit of preparatory planning and organization.

Further, Jones (2005) notes that Bos (1998) identified five benefits of this type of delegation; students receive practice in prioritization, critical thinking, technical skills, use of peers as resources, and management. Other authors also relate that this type of peer tutoring increases confidence, personal leadership and personal relationships between students (Jones, 2005).

Kling (2010) had two classes of senior students lead sophomore students on their first and second days of clinical. The purpose of this endeavor was to allow the senior students to be able to participate in an active leadership position (Kling, 2010). This also allowed the students to experience life as an educator and mentor (Kling, 2010). Additionally, numerous other benefits became apparent after the implementation of this project. Friendships and support groups between the students that were initiated during this time period continued (Kling, 2010). Most notably, however, several students reflected that they might consider the possibility of someday aspiring to be nurse educators (Kling, 2010). Lastly, this leadership class took place before the NCLEX exam; this allowed the senior students time to review skills and processes as they explained these to the younger students (Kling, 2010).

In order for this scenario to be successful, students must be prepared, have a good understanding of the expectations and they must be familiar with their state’s Nurse Practice Act (Jones, 2005). If the student does not understand or is not prepared, this learning experience can fail to produce the expected outcomes.

In conclusion, this is an excellent way to introduce leadership with senior level nurses and this could be expanded upon in a number of ways. What if these senior students were assigned a sophomore or junior level student at the first of the year? They could be responsible for many aspects of the student nurse experience. Perhaps they could call a couple of times each month to see how the student is doing and if the student has any needs for tutoring or support. Not only does this provide extra direction and understanding for the novice but it could also increase the empathy level of the senior nurses toward the junior students. Is it possible this type of peer support could eventually impact lateral violence by increasing this sense of caring, collaboration and camaraderie toward other nurses early in the educational experience?

It is possible that this type of activity could be associated with the nursing honor society or the student nurse association where it could be voluntary or it could flow from one class to another. The students that feel comfortable with this experience may desire to continue to mentor the novice students after the year is over. In conclusion, this method of leadership training has tremendous potential beyond the activity itself.

       Final Thoughts on Personal Growth

 Fights (2011) suggests that nurses from the floor to the boardroom need to assess where they wish to be in 5 years, set career goals, discern how to accomplish them, commit to lifelong learning and get involved in policymaking, data collection and planning. She poignantly states, “As nurses, we must measure the value of what we do. Nurses are counted upon; yet if we don’t count what nurses do, nurses don’t count” (Fight, 2011, p. 59). This is very prophetic; nurses must cease to be invisible. How can this be accomplished?

This course has increased my appreciation and understanding for who I am so that I too can effectively lend my voice, vision and energy to the profession I love in an educated and intelligent manner. As Fights (2011) suggested I have been encouraged to set career goals and determine what I must do to accomplish them. This is vital to the growth, empowerment and consequent visibility of all nurses.

As I look back over this last year and a half, my growth as a professional has been incredible. This course and program of study has helped me define leadership and followership; it has helped me identify my personal leadership potential and creativity (Grossman & Valiga, 2009). Further, this course has helped me identify my personal role as a visionary, expert, achiever, critical thinker, communicator and mentor (Feldman & Greenberg, 2005). Additionally, as an educator, it has provided instruction on compelling ways to integrate and teach leadership (Feldman & Greenberg, 2005). This transformation has been subtle, continuous and at times unperceivable, yet as I look back from where I came, I am in awe.

Just a year ago, when we were instructed to write our personal philosophy; I wrote that the development of a philosophy is a process. I reflected, “Someday, I will more intimately know and understand my own personal philosophy. It will move beyond a way of doing and being to a personal philosophy of knowing. The journey has just begun” (Hiott, 2010). This has been accomplished! This class has expanded upon my “ways of knowing” (Jackson, Clements, Averill, & Zimbro, 2009, p.152). I know myself much more fully and have an appreciation for my strengths, my weaknesses, gifts, and passions all the better for participating in this program. I have been equipped, not only to teach, but also to dream and serve! Personal and professional exploration and education has increased my knowledge and confidence. Empirical knowledge helps me define the vision and set goals, while confidence from my personal, aesthetic and ethical knowing supplies the creative energy to embark upon the first step. Tyrrell (1994) shares, “Facilitation of student leadership development is an act of empowerment and an expression of caring” (Aroian, 2005, p.22). Thank you very much, Dr. Kling.
Feldman, H. R., & Greenberg, M. J. (2005). Educating nurses for leadership. New York, NY: Springer Publishing Company, Inc.
Fights, S. D. (2011). Future of nursing initiative: Nurses are the key. MEDSURG Nursing, 20(2), 58-59.
Grossman, S. C., & Valiga, T. M. (2009). The new leadership challenge: Creating the future of nursing (3rd ed.). Philadelphia, PA: F.A. Davis Company.
Hiott, D. B. (2010, October). Towards a personal philosophy of nursing education.
Jackson, J. P., Clements, P. T., Averill, J. B., & Zimbro, K. (2009). Patterns of knowing: Proposing a theory for nursing leadership. Nursing Economic$, 27(3), 149-159.
Jones, J. M. (2005). Chapter 26: Practicing delegation skills. In H. R. Feldman & M. J. Greenberg (Eds.), Educating nurses for leadership (pp. 279-287). New York, NY: Springer Publishing Company.
Kling, V. G. (2010). Clinical leadership project. Journal of Nursing Education, 49(11), 640-643. doi:10.3928/01484834-20100831-02


Friday, October 28, 2011

Reflecting on Nursing History

Focus on nursing history and the art of reflection
In the future leadership will be an even more important aspect of nursing education. Feldman and Greenberg (2005) have included several chapters, which demonstrate creative ways to tie this information into nursing classes. Many of these ideas are creative and relevant.
One chapter captured my attention due to its emphasis on nursing history. Lewenson (2005) uses nursing history to illustrate nursing leadership. This is a great way to integrate nursing history, ethics and leadership into any class. Many nursing leaders were revolutionary individuals who bravely stepped outside of the social expectations of their time. Holmes (2008) states, “ It is the vehicle for understanding and appreciating the human situation as it has developed and evolved over time, and without it we can not claim to understand our culture, institutions or practices…” (p.104).This teaching technique engages students with inspiring stories and shows what is possible with passion, persistence and creativity.
Lewenson (2005) recounts the value of our history by quoting Lynaugh (1996) noting this is “our cultural DNA” (p.103). Further, she reflects that Christy (1969a, 1969b, 1969c, 1969d, 1970a, 1970b, 1975) wrote a series about historical nursing leaders; she has used these to inspire students to see what these nurses had to overcome to achieve their goals (Lewenson, 2005). Lewenson (2005) cautions against students using “present-mindedness” however, when interpreting these leaders actions; “present-mindedness” occurs when one judges historical information using a contemporary perspective (p.108). This can be remedied by having the students include information regarding the historical environment at the time. In 1917 the National League for Nursing Education (NLNE) suggested nursing history be added to the nursing curriculum to generate enthusiasm in nursing’s history and in the occupation, as well as, to create an appreciation for the obstacles, which had been overcome; these issues and objectives are still relevant today (Lewenson, 2005).
Lewenson (2005) notes that serendipitously nursing students noted many of the issues related to nursing have not changed, shortages, recruitment difficulties, and entry into practice debates. Further, Kearney (2010) suggests that nurses reconnect with their past to continue to fuel their passion for their daily work.
I feel that the study of history is vital for nurses. Lewenson (2005) indicated the ways which she has integrated history into the classroom, however, I feel that she has just scratched the surface of what can be done with this medium. One suggestion that could be added to this strategy would be to add present day leaders into the class through visiting lecturers, contemporary journal or news articles. While history is important visualizing current events and efforts for improvement at the local and state level can also inspire. I know that I would love to hear of contemporary educators and leaders ideas and visions for the future. Dossey (2010) states that Florence Nightingale would not want us to focus too heavily on the past but look forward to the future; thus we should look back with pride but forward with vision and anticipation.
Another very vital chapter in Feldman and Greenberg’s book was chapter nine. Morgan, Johnson, and Garrison (2005) report on the importance of the use of reflection in teaching nursing leadership. This is such an important concept for teaching, however it particularly applies to leadership. Morgan et al. note that Schon (1982) emphasizes that reflection enhances nursing skills by allowing the student to relive an experience, think about it, evaluate it, and learn from it. This reflective process promotes learning in the cognitive domain, as well as, the affective domain (Morgan et al., 2005). Consequently, reflection promotes prioritization, clarification and understanding of individual nursing practice (Morgan et al., 2005).
Reflection encourages self-appraisal, fosters critical thinking, encourages values clarification and cultivates communication (Morgan, Johnson, & Garrison, 2005). Reflection also helps students recognize patterns, form relationships, generate hypotheses, provide explanations, and draw conclusions (Morgan et al., 2005). Occasionally, students have a tendency to concentrate only on the problems, which occurred during the experience, while this is appropriate, they should be encouraged to name at least one thing that went well (Morgan et al., 2005). Langley and Brown (2010) note that most researchers value the use of reflection and feel this medium provides nurses with numerous opportunities for growth; trust between teacher and student is vital, however. I love this particular type of exploratory writing and feel that the author’s description and usage is appropriate.
While reflection is a beneficial device for students, one could argue that the addition of a rubric would provide parameters to guide the student’s thoughts and measure outcomes. In this same vein asking students to back up their insights and opinions with references from current sources will ensure optimal growth and educated conclusions. Reflection without guidance and educational expectations offers little opportunity for measurable outcomes and the development of critical thinking.
In conclusion, Dossey (2010) emphasizes that nurses must “communicate to a wider audience. This means learning to write clearly and powerfully, not only for our colleagues but also for patients, consumers, and other health care professionals, about how we as nurses integrate caring and healing” (p.223). Practicing the art of reflection can help develop the skill of writing with insight and passion. This will be particularly important as the nursing profession heads into the future.


Dossey, B. M. (2010). Florence Nightingale's vision for health and healing. Journal of Holistic Nursing, 28(4), 221-224. doi:10.1177/0898010110383111
Holmes, C. A. (2008). Historical enquiry and understanding our past. Contemporary Nurse, 30(2), 101-105.
Kearney, G. (2010). We must not forget what we once knew: An exemplar for helping nurses reconnect with their history and rediscover their passion for nursing. Journal of Holistic Nursing, 28(4), 260-262. doi:10.1177/0898010110376322
Langley, M. E., & Brown, S. T. (2010). Perceptions of the use of reflective learning journals in online graduate nursing education. Nursing Education Perspectives, 31(1), 12-17.
Lewenson, S. B. (2005). Chapter 8: Using nursing history to educate for leadership. In H. R. Feldman & M. J. Greenberg (Eds.), Educating nurses for leadership (pp. 101-109). New York, NY: Springer Publishing Company.
Morgan, D. A., Johnson, J. G., & Garrison, D. R. (2005). Chapter 9: Reflective journaling: Bridging the theory-practice gap. In H. R. Feldman & M. J. Greenberg (Eds.), Educating nurses for leadership (pp. 110-118). New York, NY: Springer Publishing Company.

Saturday, October 22, 2011

Nursing Theorists ~

Today when I checked the stats on this blog, I found I have had over 5,000 visitors! Thanks for visiting!

I notice that a lot of people are looking up the nursing theorist page. So In an effort to be collegial I want to share my nursing wiki that I have developed for teaching. I have a page on my Nursing Class Wiki that covers most of the major theorists. I am fascinated by them. I found several videos on You Tube and have these on this page. So for all you budding nurse theorist enthusiasts, enjoy!

Nursing Class wiki

By the way, this is a photo of the Yale library. Isn't it beautiful? Someday I want to go there... if only to breathe in the beauty...

Sunday, October 16, 2011

Mentoring: To be or not to be...

                                         Mentoring: To be or not to be
      Results of mentor assessments
       The results of the mentor assessment were enlightening. On the one hand, it indicated I am 95% ready to be mentored. This I suspected. I have been on the lookout for a mentor but I often feel reluctant and hesitant to ask anyone to commit to such a task. Personally, I would enjoy the wisdom of an older woman in my life, especially since the deaths of my mother and mother in law. I have missed having older women in my life, who are secure in who they are and what they have been through. Harris and DeSimone (1998) propose that mentors can address life and career development (Vance, 2005).
       Often women of the same age can be quite competitive. This is not what I am looking for at all. Grossman and Valiga (2009) write that often the mentor serves as a mixture of “good parent” and “good friend” by providing counsel during stressful moments, encouragement during challenges, and assistance with the development of professional skills (p.169). Optimally, they serve as exemplary role models and provide honest feedback (Grossman & Valiga, 2005).
       The second part of the survey detailed my personal characteristics and what I am looking for in a mentor relationship. This portion of the survey indicated I value partnerships over competition and am overwhelmingly trusting. I like to question more than being told and my teaching style is also largely learner-centered. I am very tolerant but tend toward enjoying social interaction.
       Having a mentor is not having someone to hold my hand as I negotiate the future. I perceive them more as a comrade in arms. Vance (2005) reflects that teaching and learning go together hand in hand and mentoring is also relational. Further, she purports that the mentor inspires, guides, models, encourages, facilitates, and nurtures (Vance, 2005). Mentoring often is reciprocal, with the mentee also committing to mentor others (Vance, 2005). What a beautiful picture.
      Importance of mentors
       Zilembo and Monterosso (2008) report that our current nursing shortage is global; this shortage combined with an aging nursing force and work recruitment and retention difficulties make it imperative that we proactively begin to recruit and mentor. Recently, as I reflected on my RN-BSN program, I felt that additional guidance would have been so helpful as I searched for and applied to graduate schools. This is an area that I would love to propose to explore in a PhD program. Do our RN-BSN students get the additional guidance and encouragement they need to enter graduate school?
       It appears that undergraduate advisors help steer students but second degree nursing students’ or generational students who opt to enter accelerated programs or RN-BSN programs often are not afforded this guidance. These students frequently work full-time, in conjunction with raising families. Though they may be distracted by familial or financial obligations, they may be more inclined to pursue masters or doctoral degrees, if identified and encouraged. They generally have the bedside experience. Methods of identification and guidance could easily be implemented into the academic environment. This early identification could provide mentors to students interested in continuing their education. What are we doing to capture these motivated students? Are there methods of identification in place? In order to continue to ‘grow’ the profession, the best and brightest need to be gleaned from every level of the nursing educational environment. This activity needs to be purposeful. Chance and individually motivated students will not address this looming shortage. Nursing needs to proactively recruit, support, mentor and educate with an eye on the future. 
      Views supported
       The literature supports the benefits of mentors. Dattilo, Brewer, and Streit (2009) note that new educators need an orientation to the educational environment and after they are acclimated, they need a mentor to help them with their professional goals. Sauter, Johnson, and Gillespie (2009) also report on the need for these same measures. Zilembo and Monterosso (2008) further expound upon the benefits of knowledgeable preceptors who demonstrate leadership skills. And finally, Murphy (2007) proposes that partnering with other faculty can help the novice nurse educator attain success. The literature overwhelmingly points to the benefits of mentors.
       In addition to the benefits of mentors, Vance (2005) points to Erikson’s theory of human development and the stage called generativity to demonstrate that the concept is supported by theory. Jung also purports that the first part of life is spent on an outward journey and the second half of life is spent on an inner journey (Wiggs, 2010). Further Wiggs (2010) quotes Schachter-Shalomi and Miller (1995) as noting:

Many of us are rich without knowing it, because we have not permitted ourselves to examine and take delight in the successes that we planted in the past. When we harvest our lives, we receive return on our investment in the form of inner riches. We see that our work wasn’t in vain; that our relationships have brought forth rich fruit; that our struggles for meaning and value have been worthwhile; and that even our failures, stumbling, and ill-conceived actions unwittingly have led to unexpected successes and to wisdom that is beyond any price tag. (pp. 53–54)

                  Steps to find and become a mentor
       Consequently, it is my goal to continue to look for a mentor and I believe that God will provide. While this may sound simplistic, the literature supports the need for the relationship to be the right fit, so I will be patient (Vance, 2005). Grossman and Valiga (2009) suggest that nurses who wish to find a mentor should reflect upon their strengths and weaknesses and examine their vision, goals, abilities, character and persistence. This I have done. They note that the individuals should be willing to take responsibility, respect confidences, provide feedback, accept constructive criticism and move through the logical phases of a mentoring relationship (Grossman & Valiga, 2009). I am ready for these steps.
       In the mean time, I will continue to help those who ask me for assistance and direction for their plans with school. I will continue to apply myself at work and at school to increase my leadership potential and abilities. I will forge ahead with the plans I have made and follow God’s lead. Lastly, I will continue to enjoy my peer pals, guides and sponsors and try to continue to be the same to those in need (Grossman & Valiga, 2009).

Dattilo, J., Brewer, M.  K., & Streit, L. (2009). Voices of experience: Reflections of nurse educators. The Journal of Continuing Education in Nursing, 40(8), 367-370.
Grossman, S. C., & Valiga, T. M. (2009). The new leadership challenge: Creating the future of nursing (3rd ed.). Philadelphia, PA: F.A. Davis Company.
Murphy, J. (2007). Role transition: Using partnerships and cognitive apprenticeship to become a nurse educator. In Moyer, F. (Ed.), Nursing education: Foundations for practice excellence (pp. 265-281).
Sauter, M. K., Johnson, D. R., & Gillespie, N. N. (2009). Educational program evaluation. In D. M. Billings &J. A. Halstead (Eds.), Teaching in nursing: A guide for faculty (3rd ed., pp. 467-511). St. Louis, Missouri: Saunders Elsevier.
Vance, C. (2005). Chapter 7: Leader as mentor. In H. R. Feldman & M. J. Greenberg (Eds.), Educating nurses for leadership (pp. 80-97). New York, NY: Springer Publishing Company.
Wiggs, C. M. (2010). Creating the self: Exploring the life journey of late-midlife women. Journal of Women & Aging, 22, 218-233. doi:10.1080/08952841.2010.495574
Zilembo, M., & Monterosso, L. (2008). Nursing students' perceptions of desirable leadership qualities in nurse preceptors: A descriptive survey. Contemporary Nurse, 27(2), 194-206.

Monday, October 10, 2011

Leadership ~ Sometimes means following...

Leadership week 2: Follower, critical thinker and achiever
Followership Assessment
The Grossman and Valiga (2009) follower test was very insightful. Prior to starting the test, I envisioned myself as a good follower. I always try and devote myself to my work environments and educational projects by following those in the lead. My goal is to be an excellent follower and support my leader because I value and appreciate my leaders efforts. It is not an easy job. As a follower, I realize that while my role is often invisible, it is practical and important.
The Grossman and Valiga (2009) test demonstrated that I have a pretty good idea of my strengths and weaknesses as a follower. My score was 4.06; this indicates that I am a democratic self-starter who occasionally enjoys a challenge to a moderately participative follower who is an independent worker that, while not needing close supervision, does appreciate a bit of feedback (Grossman & Valiga, 2009). This I can see. I love assessing a situation or environment and seeing what I can suggest or do to make it better. Sullivan (1998) notes that followers are adept at finding solutions, not just pointing out problems (Grossman & Valiga, 2009). My natural tendency is to optimistically help things run smoothly and make sure everyone else is also a happy camper. I love encouraging people. I find that it seems everyone from our secretaries to other nurses’ come to me to ask me for advice concerning their educational ventures. I enjoy encouraging people to take the leap of faith into furthering their career and education. 
 I have also learned a lot about leaders and followers by participating actively in the work environment and observing those around me. Leaders who are not emotionally secure may not be able to appreciate or utilize followers to the best of their ability. Followers enjoy leaders who provide for autonomy, resources, individuality, as well as leaders who value relationships and lead effectively (Germain & Cummings, 2010). Kerfoot (2011) reports that when nurses feel safe and empowered the brain engages more actively in the work at hand, while insecurity propagates withdrawal from this same work environment. I have witnessed nurse managers whose insecurity led them to passively thwart their follower’s best efforts to support their leadership; this prompts an atmosphere of confusion and hurt. This makes sense as Kerfoot (2011) notes that leaders must manage themselves and their environment to gain and maintain the trust of employees.
Morrison (2008) also reflects that emotional intelligence can help nurses handle job stress and notes that these traits can be acquired. Therefore, I hope to continue to observe and learn how to handle conflict and collaborate with nursing colleagues to increase teamwork and productivity (Morrison, 2008).
Sullivan (1998) notes the role differences between leaders and followers are often very fluid with followers often performing as leaders and vice versa (Grossman & Valiga, 2009). Grossman and Valiga (2009) also reflect that being a good follower is excellent preparation for becoming a good leader. I agree. Most of the leaders I have followed were in positions of legitimate authority (Grossman & Valiga, 2009). Observing these different leaders has given me amazing insight into the mechanics of management, more so than leadership. However, personal growth can occur during times of good and bad leadership. My goal as a future leader is to remember not only what I have read, studied, and learned but also what I have seen and experienced. It is my hope that combining history, theory and reality can aid me to become an effective leader in the not too distant future.
Critical Thinker
The longer I have been a nurse the more my critical thinking has developed; Lemire (2005) noted that this is often the case. Each area I have worked in has had its own inherent needs and potential patient emergencies. On my first job, in labor and delivery, I can remember playing out in my mind the emergency steps necessary for various scenarios. I wanted to be ready and prepared. Each job since then has called for different skill sets and emergency applications.
The first challenge in each new job, after I determined possible emergencies, was to understand the mechanisms behind the emergency. Remembering systemically what was happening helped me determine correct nursing actions and understand the mechanisms behind them. The interventions were easier to remember when the dynamics of the situation were understood. Morgan, Johnson, and Garrison (2005) note that reflective thinking is “essential to identifying, analyzing, and solving complex problems” (p.111). After understanding the actual systemic mechanics of the emergency, the interventions were easier to remember, as were the expected nursing outcomes. Though I could not know it at the time, this process of reflection is an ongoing skill for all nurses (Morgan, Johnson, & Garrison, 2005). My graduate education has helped me name the processes I used as a young nurse to understand and organize my environment and patient care. This education will now enable me to equip others to do the same.
Further, my education challenges me as an instructor to try and find ways to increase critical thinking in the class. Lemire (2005) reports that is often difficult to execute due to the vast amounts of information, which needs to be taught. However, each step in the critical thinking process can help students remember and respond. Consequently, the skills I have developed as a nurse will now assist me as a nurse educator.
My new patient, in essence, is a student eager to pass the class and boards. Possible emergencies are misunderstanding of classroom material, which can delay learning. My goal is to assess ways to help the student assimilate the necessary knowledge, understand it, plan nursing interventions and measure outcomes. Helping them understand this process can assist them to prepare for each new unit they may work on and equip them with the skills to learn and prepare long after I have exited their lives. Vance (2005) concludes, “the teacher-mentor inspires, guides, models, encourages, facilitates, and nurtures students in their learning journey” (p.87). My education has equipped me to be a life-long learner and to influence others to recognize the value and merit in this choice as well.
 Dienemann (2005) notes “evidence of leadership is achievements” (p.37). My accomplishments as a nurse achiever stem from my personal desire to be an active part of each department I work in and my personal tendency to dissect the environment for possible improvements. When I started to teach in the clinical environment, I noticed that from week to week much of the basic clinic specific information we discussed did not change. I felt that if I could provide this basic information to the students’ prior to the clinical class, more time could be spent on discussing the experiential portion of the class. Consequently, I developed a clinical wiki, which provided the students with background information about the clinic. This allowed my co-teacher and I to concentrate on the more immediate and practical nursing interventions that the students were responsible for.
At the Center of Pediatric Medicine (CPM) my goal has been to participate in the CPM community and offer what support I can. The wiki has been useful for the clinic, as well as, the students in that it offers great basic information to assist with student and employee orientation. 
            Teaching is near and dear to my heart, consequently, I also joined the literacy committee at CPM. This committee serves as a liaison with the Reach Out and Read Initiative. Reach Out and Read is a grant that provides children ages 6 months to six years with a new book each time they attend a well child check up. While serving on this committee, I suggested that we find a way to give out books to older children, which do not qualify for this initiative. Therefore, we have had several book drives to collect books for these children. Being an achiever is a goal of mine wherever I go.
Dienemann (2005) reflects that nursing interventions and outcomes currently are somewhat invisible to the public; this makes outcomes for nursing care hard to measure and quantify. The more nurses find ways to achieve recognition and visibility in their perspective nursing arenas the easier it will be to see the value of the profession in measurable terms.
I feel that I have a great deal to offer the nursing profession. My graduate education has enabled me to see weaknesses in the media portrayals of nurses and opened my eyes to numerous ways the image of nursing could be improved upon and projected into the community at large. Ultimately, nurses who are passionate about what they do, need to ensure that the work of nurses is no longer invisible. We must labor to increase the public’s knowledge and appreciation of nursing so that the profession is portrayed as the valuable asset it is to humanity.


Dienemann, J. A. (2005). Chapter 4: Leader as achiever. In H. R. Feldman & M. J. Greenberg (Eds.), Educating nurses for leadership (pp. 37-50). New York, NY: Springer Publishing Company.
Germain, P. B., & Cummings, G. G. (2010). The influence of nursing leadership on nurse performance: a systematic literature review. Journal of Nursing Management, 18, 425-439.
Grossman, S. C., & Valiga, T. M. (2009). The new leadership challenge: Creating the future of nursing (3rd ed.). Philadelphia, PA: F.A. Davis Company.
Kerfoot, K. M. (2011). The art and neurobiology of connection: The leader's challenge. Nursing Economic$, 29(2), 94-95.
Lemire, J.  A. (2005). Chapter 5: Leader as critical thinker. In H. R. Feldman & M. J. Greenberg (Eds.), Educating nurses for leadership (pp. 51-66). New York, NY: Springer Publishing Company.
Morgan, D. A., Johnson, J. G., & Garrison, D. R. (2005). Chapter 9: Reflective journaling: Bridging the theory-practice gap. In H. R. Feldman & M. J. Greenberg (Eds.), Educating nurses for leadership (pp. 110-118). New York, NY: Springer Publishing Company.
Morrison, J. (2008). The relationship between emotional intelligence competencies and preferred conflict-handling styles. Journal of Nursing Management, 16, 974-983. doi:10.1111/j.1365-2834.2008.00876.x
Vance, C. (2005). Chapter 7: Leader as mentor. In H. R. Feldman & M. J. Greenberg (Eds.), Educating nurses for leadership (pp. 80-97). New York, NY: Springer Publishing Company.

Monday, October 3, 2011

"Let me tell you the secret that has led me to my goal. My strength lies solely in my tenacity." ~ Louis Pasteur

I have decided to post my leadership portfolio on my nursing blog, Nurse’s Watch. This blog began as an undergraduate RN-BSN attempt to explore nursing blogs in informatics. It has since included discussions on theory and ethics as I have progressed through my undergraduate RN-BSN program and my Masters in Nursing Education program.
Further, I have discussed how I have used wikis in the classroom and the developed an e-portfolio. These posts have not been written as a showy demonstration of anything that I can do, but as a guide to others who may be called upon to navigate these self-same waters.
    Therefore, Nurse’s Watch will now house my Leadership portfolio. My personal objectives for this course are simple; by the conclusion of this course I hope to have a even clearer idea of my future goals as a nurse and a plan on how to get there! I hope to refine my personal vision to more fully harness the energy and passion I have for nursing. Consequently, I invite you to follow along as I conclude my MSN program and begin the next chapter of my career as a nurse leader with my sights set on a PhD in nursing!
  I feel so very, very fortunate to have been able to attend graduate school. I love nursing; what could be more perfect than teaching others what you love? The program I am attending has been phenomenal. I cannot believe how much I have learned and grown! This program has taught me about a myriad of teaching methodologies that are utilized in the classroom with the accompanying rationale and evaluative techniques. I am ready to teach! However, this program has also developed me as a leader. How, you may ask?
Leading does not necessarily involve holding positions of power (Grossman & Valiga, 2009).  Grossman and Valiga (2009) note that often leadership and management are used interchangeably; they are, however, vastly different. Aroian (2005) reflects “ great leadership demands the ability to create and communicate a personal vision that points the way for others” (p.16). Further, she ends the chapter by noting that educators need to assist students to create and share their visions of the future (Aroian, 2005). Consequently, finding and developing a personal vision is important for me on two levels, as an educator and as an aspiring leader.
Jackson, Clements, Averill, and Zimbro (2009) discussed the attributes of a theory for leadership that involves Carper’s Ways of Knowing. I am intrigued by theories of all shapes and sizes and this one I especially liked. Basically, they observed that just as nurses must practice with a holistic approach to patient care, so must nurse leaders (Jackson et al., 2009). Carper’s Ways of Knowing (1978) includes empirical, aesthetic, ethical, and personal knowing (Jackson et al., 2009). It has been added to through the years with the inclusion of sociopolitical and unknowing ways of knowing (Jackson et al., 2009). Further, Jackson, Clements, Averill, and Zimbro (2009) contrast this leadership theory with the transformational leader. This explorative article concludes with the proposal of a leadership theory that encompasses all the appropriate and theory specific ways of knowing for nurses (Jackson et al., 2009). Over the next few weeks I intend to study this theory and others to increase my understanding and ‘knowing’ of leadership (Jackson et al., 2009).
                                                    The Vision
In order to reach my full leadership potential, there are steps I must accomplish in the short run and the long run. First, I am hoping to secure a full-time teaching position! Once I find my university ‘home’, I want to immerse myself in teaching and also find other areas to contribute in the overall academic environment. Public service is an area that I feel is part of this job as well.
Next, I hope to join my local and national nursing associations. This I would have done before now, except that I have no money for these things at present. Currently, any extra funds are going towards PhD program application fees, transcripts and the GRE! However, lending our voices and talents to our local and national associations ensures that they reflect our values and vision. Also, as Aroian (2005) suggests interaction can bring together people with a common vision and this is what will be needed to set the future course of nursing practice.
Which brings me to my ultimate goal, to begin a PhD program by next summer or fall! Why you may query would I just finish one program and desire to begin another? First, I am afraid if I stop and get out of the paper writing, studying mode I may never wish to return to this level of commitment. More importantly though, I have spent time reflecting upon my ultimate goals and this is where it led me. I asked myself, if I could do tomorrow what I most desire, what would it be? The answer is to teach, lead and write; I love to write. There is only one degree that really supports these goals, and that is a PhD in nursing. Holland (1996) and Schumaker (1998) reflect, “a vision is not just a direction; it also has a destination” (Aroian, 2005, p.22). Consequently, the journey continues. 
                                           Leader as Expert
Frank (2005) notes, “the leader as expert is one who uses multiple ways of knowing for gathering information” (p.25). Further, the expert leader is skillful and knowledgeable; he or she is able to impact their surroundings in a positive and creative way to accomplish goals (Frank, 2005). I have been fortunate to have accumulated quite a bit of life experience; this has led to growth in empirical, personal, ethical, and aesthetic knowing.
Fifteen years in labor and delivery and pediatrics has contributed to empirical knowing, as has my educational background. While Frank (2005) notes that this type of knowledge is an important foundation for leading, “having knowledge of self helps one to use the empirical knowledge gained” (p. 26). Reflective practices experienced during writing and blogging have increased my personal knowing or “knowledge of self” tremendously (Frank, 2005, p. 26). My faith and service opportunities have impacted my ethical knowing. Frank (2005) reports that ethical knowing helps leaders with decision making, while aesthetic knowing beautifully weaves these areas of strength together. I love to reflect, write, garden and create; these experiences have increased my awareness of aesthetic knowing. Consequently, I feel that I am a expert leader due in part to the diversity of my life experiences. Embracing all these facets of my life has increased my ways of knowing and increased my leadership abilities and potential.
Aroian, J. (2005). Chapter 2: Leader as visionary. In H. R. Feldman & M. J. Greenberg (Eds.), Educating nurses for leadership (pp. 16-23). New York, NY: Springer Publishing Company.  
Frank, B. (2005). Chapter 3: Leader as expert. In H. R. Feldman & M. J. Greenberg (Eds.), Educating nurses for leadership (pp. 24-36). New York, NY: Springer Publishing Company.  Grossman, S. C., & Valiga, T. M. (2009). The new leadership challenge: Creating the future of nursing (3rd ed.). Philadelphia, PA: F.A. Davis Company.
Jackson, J. P., Clements, P. T., Averill, J. B., & Zimbro, K. (2009). Patterns of knowing: Proposing a theory for nursing leadership. Nursing Economic$, 27(3), 149-159.

Friday, July 29, 2011

An exciting assessment...

    This blog began in February 2010 in response to a BSN school project for informatics. I started by visiting nursing blogs to try and determine 'what makes nurse bloggers tick'. Get it, nurse's watch, tick? Corny, I know...almost as bad as the proverbial knock, knock joke. Anyway, I soon enrolled in graduate school and this blog has followed right along with me, my partner in work and education. It has provided a reservoir for all kinds of project studies from nursing theory to Wiki development.

       Well, who would have thought it; I'm on the web! Nursing Watch was noted in the article below located at Masters in Nursing: Online Nursing Degree Programs in a blog article from Linda. Thank you, Linda! Some of these blogs are sites, which I have visited, commented on, and follow as well. Congratulations to them and give them a read. To review the importance and reasons for nursing blogging you can go back to the first of this blog; otherwise hitch a ride as I continue to finish my MSN in Nursing Education and hope to start a PhD or DNP soon. I have included the article and link below. Enjoy ;)

50 Best Nursing Blogs You Aren’t Reading Yet!


by Linda on January 3, 2011

Nurse blogs are popular, not just for their medical content, but for the humor, insights and advocacy that male and female nurses display in their joy and in their frustrations with their jobs. This list of the 50 best nursing blogs you aren’t reading yet were created during and after January 2009. The blogs are categorized by year, and each blog is listed by the creation month. We may have missed some great up and coming nursing blogs in this process, so feel free to share your popular picks with us.

  1. Nursing School the Accelerated Route: Follow the blog of a student enrolled in an accelerated BSN program (January).
  2. The Student Nurse: Read about the adventures of a student nurse who is embarking on a second career (January).
  3. Travelista, RN: This blogger is pursuing both an ASN/RN and MS in Management (January).
  4. Just Call Me Nurse…Eventually: A wife and mother decides to return to nursing school (February).
  5. Nurse’s Watch: Registered nurse with a background in pediatrics, labor and delivery, recovery, postpartum and newborn nursing (February).
  6. Nursebound: A former journalist goes back to school for nursing, where “It’ll only hurt for 16 months” (February).
  7. The Medical RNinja: A third-year medical student and RN blogs about nursing, medicine and considerations on becoming a doctor (February).
  8. Mom, Wife, Student, Nurse, Ahhh! This full time executive assistant is starting an evening CNA course and plans to become a nurse (March).
  9. Nursing & EDS! A 24-year-old with EDS has one more year of nursing school to go. This blog is dedicated to recording the bumps, bruises, and dislocations along the way (March).
  10. The Nerdy Nurse: A wife and mother and self-proclaimed “nerdy nurse” writes about her experiences (March).
  11. NurseXY: This nurse is starting a new grad critical care internship on the CVICU in a 1000 bed, Level I hospital in one of the largest metro areas in the country (April).
  12. R (etired) N: This retired RN still focuses on health, especially for women (April).
  13. GamecockNurse’s Brave New World: A male emergency room nurse uses this blog to work through the anger and tears to get to the smiles and laughs (May).
  14. Happy Hospitalist: This blog is dedicated to bringing the latest information about hospitals, hospital jobs, hospital equipment and more to readers (May).
  15. Madness: tales of an emergency room nurse: This blog is about the adventures of a veteran nurse in an inner city ER (June).
  16. Frazzled_razzleRN: A wife and mother talks about her return to nursing school (September).
  17. Tales of a School Zoned Nurse: A school nurse rigid in the frontlines of the war against lice, patching up playground boo-boos, begging parents to bring their child’s emergency medication to school, and helping the snacks in the teacher’s lounge mysteriously disappear (September).
  18. The Doctor Stole My Stethoscope: Raquel is not Florence Nightingale from her own admission…but she is a nurse and mom who tries to do an above average job at both (September).
  19. Sam the RN: Sam is an RN in a hospital located somewhere in the U.S. (October).
  20. The Nursing Ethics Blog: Dr. Nancy Walton is an Associate Professor of Nursing in Daphne Cockwell School of Nursing at Ryerson University and Dr. Chris MacDonald is a philosopher by training who has written widely in the area of applied and professional ethics, including nursing ethics (October).

Sunday, June 26, 2011

Faith Integration...

The school I am attending is a Christian University. One of the courses I'm taking this summer is called Faith Integration; I love it. The book we are using for this course is Called to Care by Shelley and Miller. It is excellent. Someday soon, I will be writing my own Christian nursing theology paper. I am excited. I know, I know, I am such a nerd...

Saturday, March 26, 2011

Reflections of an Educator: The Beginning

                                             An Overview
As I reflect on the completion of the nurse educator projects, it is amazing how transformative this course has been. Not only has it provided a brief and insightful glance into the world of education, but also, it has illuminated the complete picture of the nursing educational environment for me. This course has filled in many gaps in my concept of nursing education that I was unaware even existed. Previously, my idea of this environment was very compartmentalized. In addition to broadening my vision of nursing education, it has also motivated me to begin to organize and plan now for my practicum in the fall.
First, I generally consider myself very organized. This project has demonstrated that even an organized person needs to have a plan B! Having completed my previous clinical practicum with G.H.S., it never occurred to me that I would not be able to be a student there again! Imagine that? I can work for them, teach in the clinical environment for a local technical college there, but I cannot be a student there. I now know all about rules and contracts with schools; needless to say, I was unprepared for this little glitch. Fortunately, the instructors at the college where I teach in the clinical environment were very kind and accommodating. I made numerous calls, left endless panicked messages and was able to find an instructor who worked somewhere besides G.H.S. Consequently, for my practicum, I worked in an extended care facility (a far cry from pediatrics) and in several simulation labs. This broadened my view of the nursing program tremendously, however. Consequently, while this was not my first choice for the clinical environment, it proved to be the most enlightening.
While working in the simulation lab, oddly enough, I actually met another instructor who is due to graduate this spring from a different school who had encountered the same practicum problem. Wow! Note to self, there is no such thing as too much planning and organizing! Thus, I will start now planning for the 180 hours due this fall! Therefore, lesson number one involved a simple (well, maybe not so simple) lesson in mechanics!
                                         Clinical Reflections
The simulation labs were amazing. I had never participated in these before. The students of the fundamentals class, which attended the simulation lab, were required to either perform a wet to dry dressing, a female catherization, or nasopharyngeal suctioning. The students each had a backpack full of their own supplies such as catherization kits and suction kits. This was great. This would have been so helpful for me as a tactile learner when I was in school. It would have been wonderful to be able to practice procedural steps over and over with the actual equipment. This could have significantly reduced anxiety and stress! Another simulation lab required more advanced students to enter a room as a team to take care of a patient who was in respiratory distress. Other simulation experiences included having the students work with a mentally ill patient and the delivery of a baby.
I was really impressed with the simulation labs and the experiences they could provide. The ‘patients’ could talk, perspire, cry, cough and groan. They had appropriate pulses, blood pressures and color changes. This provided the students with much needed practice, as well as, the opportunity to critique the care they provided, much like a football coach reviews game footage with the players each week.
The clinical experiences in the extended care facility were also very revealing. This rotation was not just to allow the students to experience elder care but was also structured so that the students learned to work as a team. Each day a charge nurse and a medication nurse were chosen, the other nurses were then assigned patient care. The charge nurse was responsible for checking on the other nurses to ensure that everything was going smoothly and to assist in any way possible. The medication nurse dispensed the required meds and worked with the staff nurses to assure that vital signs were noted and within normal range before medication administration. This experience was very profitable for the students and me. It was interesting how the teacher had combined the experiences of nursing care, leadership and delegation. Teamwork is an essential part of nursing and this provided an excellent environment to teach this.
                                       Didactic Reflections
Didactic teaching was an eye opener! In order to teach the instructor must first and foremost know the material. Consequently, I learned that teaching is very time consuming! I could not simply write some case studies and present them. I had to know the material. This required hours of review. After I digested the material. I then looked for applicable case studies and more often than not, wrote my own. I was excited and pleased when the instructor asked for copies of them when the class was over. Later, I also learned that the students had all performed very well on their test. Yay! While this endeavor was very challenging and time consuming, it was a great experience.
Each week I was able to observe the primary teacher; this included her teaching techniques and some interesting class dynamics. This instructor utilized a PowerPoint and lecture as her main teaching focus, however, embedded in this PowerPoint were tests and relevant video links. Her technique was very interactive and informative. I was impressed that despite one small group of disruptive students she always remained calm and focused. The last day of my presentation the disruptive students were actually sent to a meeting with another teacher and the department head. This situation made it clear that teaching is not for the weak of heart, it takes passion, organization, time, strength of character and dedication!
In conclusion, nothing can replace clinical experiences, for the student nurse or for this budding nurse educator. One can read about teaching all day long but until objectives are written, outlines designed and materials organized and presented, it is not the same. Ultimately, my dream is to educate. Consequently, I am excited to have had this glimpse into the future. This peek has provided a glance into the responsibilities and challenges that await me this fall, for this I am very grateful.