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

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.

The Greatest Challenge to Success

The Greatest Challenge to Success
       As I began to approach this time of practicum, I was much more nervous than I expected. Why? I am a nurse with fifteen years experience in labor, delivery, mom, baby, newborn nursery, and pediatrics. This is a pretty varied background. Although I do confess to feeling a bit under equipped at times, particularly in the medical surgical area. In my own area, I may be considered an expert. However, teaching is a whole new experience. Yes, I have home-schooled my children, but the students in my future will be adults and will not related to me! Ultimately, I realize the most difficult part of this whole experience goes far beyond creating lesson plans, outlining objectives and organizing a practicum. It is much more personal. It is realizing I will be a novice again. Cangelosi, Crocker, and Sorrell (2009) affirm that moving from an area of expertise to an area of inexperience can create anxiety and tension. Thus, the thought of starting over in a new career is as exciting, as it is excruciating. I, like most people, like to be comfortable.
        However, I also can see first hand how the nursing instructor shortage is affecting everyone. My own son is on the waiting list for a BSN program at a local college after preparing for two years in the undergraduate arena. Nursing instructors are needed. Who better to teach them than a nurse who loves what she does, loves to teach and loves to care for others? Murphy (2007) observes that just as nurses care for patients, nurse educators care for students. So what is the answer? If lack of experience, lack of confidence and lack of knowledge are the challenges I face, how can these challenges be remedied?
       Education and experience are the keys to growing in confidence and comfort but these tasks have been initiated. I know I have the desire. I love the thought of someday pursuing my doctorate. However, with essentially three different jobs right now I often feel divided and conflicted.  What are other contributors to these feelings of insecurity? How can I address the challenges awaiting me? Are there steps to take that can help an adult in midlife who changes careers? If there are, what are they? How can a nurse prepare to become a nurse educator?
       Rose Kearney-Nunnery (2008) recounts that Bridges’ Stages for Managing Transitions is comprised of three phases. The first phase involves letting go of the comfort and safety of routine and to experience loss (Kearney-Nunnery, 2008). This I have definitely experienced. In the second phase the individual has let go of the old ways and yet needs support and assistance to grow in the new area (Kearney-Nunnery, 2008). This is where I am now. Lastly, the final phase is the new beginning; here the individual moves in an alternative direction with energy but must operate in a culture of respect to grow and become confident and competent (Kearney-Nunnery, 2008). This makes a great deal of sense. I do feel uneasy at times about moving into a new job, however, I have gathered supporters who are assisting me. Consequently, it will be vital as I move into the educational environment to seek out positive mentors and schools that encourage the use of preceptors. Murphy (2007) notes that the mentor relationship is more informal than the preceptor relationship and lasts for a longer period of time. Generally, in this situation it is best if the student is allowed to pick a mentor to ensure compatibility (Murphy, 2007). In some respects it would be easier to move into the hospital environment as an educator, however, I passionately desire to enter the academic environment. Therefore, it will be especially important for me to garner the friendships of fellow educators for encouragement.
       Chapter fourteen from Nursing Education: Foundations for Practice Excellence addresses mentoring in nursing education. When I read this material, I recognized that Charleston Southern University has followed the same steps suggested for novice nurse educators in setting up the masters in nursing education program. The more of this chapter I read, the more comforted I became. Though it will be a long time before I am an expert nurse educator, all the prerequisites have been provided for me. I have had the opportunity to select a mentor who can serve as a role model and who can scaffold her guidance and support. As well as, the opportunity as a student to expand my experience level, reflect upon this new practice and articulate this growth (Murphy, 2007).  As I reflect upon the skills that have already been attained, I am reassured that I will indeed be competent when I complete the program. I have already had the opportunity to learn about curriculum design, staff development, portfolios, leadership, lesson planning, objective development, learning and teaching strategies, technology, research and the statistics behind the research. These are just a few of the skills, which have been worked on thus far and it has only been seven months! This is a tremendous base as a novice educator to build upon and yet I still have nine months to go! Imagine all I have yet to learn and grow comfortable with. Yes, I am in Bridges’ stage two with my sights set on the future!
       Completing this essay has helped me realize how far I have come in a short period of time. This has been very reassuring. As I reviewed the recommended tactics for assisting novice nurse educators to become experienced, I realized afresh that my school is aware of these strategies. This realization alone increased my confidence. Reviewing Bridges’ Stages for Managing Transitions encouraged me that the ambiguity I feel at times is normal. Thus, my greatest dilemma, which was hesitancy, a lack of confidence and the fear of being a novice, has been faced and replaced with peace.   


Cangelosi, P., Crocker, S., & Sorrell, J. (2009). Expert to novice: Clinicians learning new roles   as clinical nurse educators. Nursing Education Perspectives, 30(6), 367-371. 

Kearney-Nunnery, R. (2008). Advancing Your Career: Concepts of Professional Nursing (4th 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).