New Semester. New Students. New Challenges New Season

Its already October and I have been guilty of some serious blog neglect.  I feel like I lost September to new semester business, traveling and a nasty bout of pneumonia (apparently I am not superwoman!!)

However, now into the first few weeks of the semester I feel like I a hitting my stride and for the first time since August feel somewhat on top of things in terms of class prep and grading.  My Monday and Thursday pediatric clinical classes are in full swing and going really well.  Face to face teaching with students is really my favorite.  Especially when I have students who are likable, communicate well and are eager to learn.  Yet again I have groups that represent the United Nations very well, I think the school assumes that because I am a foreign nurse I can cope with these non-native speaking students, and to be honest I do not hate it but it does pose its own challenges.  I have students this semester from Haiti, Liberia, The Ivory Coast, Jamaica and its not so much the language that is the issue, they all have mastered the English language really well, but culturally there is a little disconnect.  I can only imagine what assumptions and faux pas I would be making if I was nursing in their country, so open and honest communication without judgement is key.  We are all learning together which is essential and fun.  Cold season is beginning with a vengeance so we have had our fair share of bronchiolitis and RSV so far, lots of babies.  These are good cases for mastering that first basic assessment.  So far so good.....we did not kill anyone yet.....always a good thing!!!!

Online teaching this semester I am focusing on 120 students in one class. My life was just that crazy I could not face bopping around with several different syllabi's, this class is the intro in the RN-BSN course.  It is where students orientate to the online learning environment, start to learn about APA and posting assignments.  However, we have had some very interesting assignments this week including writing a letter to your local legislator regarding an issue in your own clinical environment that is of concern.  Lots of great topics including violence in the ER, the cost of safety with the nursing shortage, how to make the transition from RN -BSN and better one for all.  All huge topics that are worthy of being visited in discussion and with more funding.

I love love love this time of year, although I am still waiting for it to cool down some, we are having a burst of heat here in the Northeast.  But October means its nearly November and that means my kids will almost be home for Thanksgiving.  The test kitchen already started in my house!!!!  Bring it on, cool weather, crisp mornings, sweaters and colorful scarves, evening fires, feeling blessed.

Nurses and Anxiety

While driving home from the grocery store on Sunday ( I know, I know my life is just that exciting).  I was listening to NPR and this show came on that had me so gripped I actually stopped in the driveway of my house to listen to the end of it and had to text my husband to come and get all the cold and frozen stuff out of the car because I could not move (I really did this....and he was really thrilled!).  The show was given by an Emergency Room Chief Attending who reports how he was the perfect student, aced everything, memorized everything and was going to be the best physician ever until....he made a mistake.  He sent an elderly woman home from the ER in acute congestive heart failure because he missed it, he was not perfect.  Two hours later the family rushed the woman back where she died in the ER. 

 This began a quest for this physician to not only face his own imperfection to find other physicians that had made mistakes too.  He found that not only did physicians not want to admit they made any kind of mistakes they did not want to talk about it as it was anxiety producing.  This anxiety led to a decrease in performance, increase in stress,  and a false culture in their profession that all is well.  Physicians have a reputation of closing ranks around each other when a mistake is made leading to sometimes never getting to the real story...but more importantly those involved and colleagues around them from learning from an important teachable moment.  Now this physician runs meetings where mistakes are openly talked about  so everyone can support each other and more importantly learn from it, be honest and support each other.

Several of the nursing students, who I love and adore, are entering their final semester of nursing school.  I stay in touch with many of these students on Face Book and their stress at facing their last semester, passing finals, onto the NCLEX and finding a job has sent their stress off the scale.  I could feel it and see it from their Face Book posts and the panicked multiple texts I was getting.  I realized this stress and anxiety was at worse going to hold back these hugely talented future nurses and at best deny them from really enjoying their final semester of nursing school.  This is not OK.  In Nurse Education we are very good at setting objectives, measuring academic progress through testing, evaluating clinical skills, benchmarks, case studies, computer generated tests over and over to give a normal person carpal tunnel syndrome.

So the first week of October we are starting a NCLEX review/support group at Angie's house.  All my students are invited, no-one will be denied.  There is no cost for this but you have to bring your A game and a good attitude ( I have a really low tolerance for whining!)  The session will start with 30 minutes of yoga, continue with lots of review and end with tea and cake and sympathy (it is a British house after all).  We are teaching these future nurses how to care for their patients and their families.  We must not forget to teach them how to care for each other and most importantly how to care for themselves. 

Back From Vacation

I'm back.  Hope you had a great summer.  I cannot believe that summer is almost over but for me I am afraid it is.  This week was the start of faculty meetings at the Philadelphia university I teach at, and I am well into 2....yes 2 online classes that are lots of fun but proving quite time consuming.

One of the classes I have taught before, its a Community Health class which is one of my nursing passions.  I know the syllabus quite well by now and its fun to be back, have not been involved in this class for a few months.  The other class is called The Professional Nurse.  It is the very first class that online students take and is a means of orientating them to the online world, sending them on scavenger hunts to access the library, put references in the APA correct way (I always found this a curse until I found a very handy dandy online tool to help me!).  Anyhoo these students need a fair amount of hand holding, I remember well my first online class and how stressful it was. It has kept me occupied

But back to Summer.  It had to be one of the best summers I have had in many many years.  For the first time in living memory I worked from home and loved every minute of it.  Another advantage of being my own boss, I am always employee of the month!  My boss (me) gives me days or hours off whenever I want.  One look from Toby and we were out the door running around the reservoir.  It was a stress free, wonderful 4 months.

However, I feel ready to get back to a routine of teaching outside the house, continuing with my online teaching and some other business opportunities I have been building.  One of those is building my health and fitness business. I launched a new website that has been fun to build and blog about.  Here is the link

Curves and Carrots

Pop in and enjoy, I try to blog on this site several times a week.

More to come on a weekly basis.  Its good to be back even if the days are warm and the evenings are balmy.  Toby sure loved having me around and we acquired 2 new kittens.  All I know is I have never been that much of an animal person until all the kids left for University, now I have these surrogate children.  I am going to end up being that cat lady.  One day I will be found dead in my home at a very elderly age surrounded by 15 cats and 5 dogs......perish the thought!!!

Taking A Little Break

I am in serious Summer mode and as a result seem to be having some writers block when it comes to Nurseology.  Not wanting to create a load of forced garbage I have decided to take a few weeks break and recommence this blog in September when I start my face to face teaching gig again.  Maybe by the then the creative juices will have started to flow again!

In the meantime meet me over at my other website curves and carrots which has a blog that I try to update at least four times a week.

http://www.curvesandcarrots.com/

Have a fun summer and I will see you in September

An Online Education vs Traditional Classroom Setting

As someone who has been educated as a nurse in both venues, that is, in the traditional classroom and in the online environment, and as someone who teaches in both places I thought it would be interesting to do a comparison of both mediums and see what you guys think.

I did my general nursing diploma and first post graduate nursing qualification in the classroom before the online education world ever existed (showing my age, I know!).  I enjoyed both these experiences immensely.  As a novice nurse who is a visual learner I definitely benefited from the face to face clinical experience and would recommend this form of education to anyone starting out in nursing.  The clinical and academic parts of nursing are so married together, and when you are starting out I think there is a great benefit of having a physical presence in the classroom and clinical area.  A place where you can ask questions and get feedback real time and relate it to your practice is essential in not just building your confidence but your competency.

Later on in my nursing career I attended graduate school online.  I chose the University of Phoenix to complete my MSN.  This school, I know has varied reviews but I have to say I had a fabulous experience there.  I found the quality of teaching and the sense of community extremely high.  The reason this worked for me is the same reason it works for many people.  I had a growing family and a full time job and just did not have more time in my week to "attend" class.  Working online meant I could go at my pace day or night (and I did alot of nights!!).  When you get to the graduate level, research and projects are done collaboratively in the remote setting anyways so doing it online did not seem to skip a beat.  However, the downside was when technology had a glitch, a power cut, the server being down, email platforms not working efficiently and the dreaded help desk that can be of no help at all.

Many Universities are now 'blended" in that they offer classroom and online classes, I predict this from of educating our nurses will only grow.

I love teaching face to face.  I find I can get to know my students quickly and there is nothing like that non-verbal communication to assess their strengths and areas that need to be worked on.  However, I get to know my online students also, but not in the same way or at the same depth.  When you are a student online you can develop your own online persona.  This can be a plus is you are quiet and shy in the classroom, you can have more of a voice in the online environment.....its not as intimidating.

Do you think there will be a time when we do not need the traditional classroom at all?  My personal feeling is do your BSN in the traditional setting but after that the choice is yours and it can be a very good and flexible experience if you decide to go the online route.

Patients, Families And Social Media

Last week I blogged about nurses and social media and although I stand by all I said about being very wary I realize that social media can be a great source of support and community for many nurses and as long as we respect the boundaries that it should  have all should be well in your online world.

Of course everyone has access to the Internet and that includes families and patients and this is a really really good thing and sometimes it can be really bad.  So I have separated this into the pros and cons.

PROS

• Great way for families to share news and updates without having to talk to a zillion people
• A good way to spread patient education to a wide audience very quickly
• Chat rooms and support rooms are a lifeline for many families and patients
• Patient/Family Blogs are growing and can be very therapeutic for all involved to write down what they are going through and connect with others

CONS

• There can be blurry lines when it comes to privacy, patient and families can identify other staff and patients without their consent
• There is an opportunity here for bullying of staff online if the family is not satisfied with care, it is a place for them to vent if they do not feel they can do it face to face
• When/if a staff member friends a patient or family member it can develop the relationship in a non-therapeutic way, I would strongly advise against this.
• Families who are hooked up to other blogs with patients in the same speciality/institution have an opportunity to compare treatment protocols and often bring up why they did not get this "drug" or "treatment" at a clinic visit (I have seen this happen in pediatric oncology) when there is no understanding of the need for customized care in many situations.

There is more I am sure, so much more to discuss but I do not want to make this two part blog series into series akin to War and Peace.  Its meant to get you thinking and start a conversation.  

And now.....for something completely different, here are Coco and Toby meeting a new friend (Timmy The Turtle) on our morning run.  I think they were more excited than Timmy was, he looks a little shy don't you think?

The Pitfalls of Nursing and Social Media Part 1

When I first started my nursing career we were warned never to talk about a patient and their details in an elevator or a public place.  Later on I learned about the value of a therapeutic relationship where you keep your personal information private and focus on the patients needs and don't talk about them by name after work.  Then in the States came the advent of HIPPA, where all information became protected and it was hard to even have a conversation on the phone with a colleague without the HIPPA Gods slamming on your head a $10,000 fine for infringement of privacy.

However, has nursing caught up with technology, especially in the world of social media?  I think not, as nurses we have to be so careful as not only do we put our patients privacy in jeopardy but also our jobs.  Just about everyone has a camera on their smart phone, which are also connected to twitter, facebook, instagram and other social networking sites.  Information and pictures are uploaded in real time and even if you take down a picture or a post it can live on in Internet land.  This is rocky ground for nurses who have become accustomed and enjoy the daily connection that an online community bring.  I am one of those people, now the owner of two blogs, a business website, two facebook pages, a daily instagram habit I consider myself pretty connected, it fills a need and builds my business and it has been a wonderful addition to my daily life.  This is not a commentary on why social media is bad, it is a caution on how are frequent and unedited posting habits can detrimentally affect the lives of our patients and our livelihoods. We need to have a filter people, a very strong one! 

It is common place to post about a bad day, a good day, a difficult experience but you cannot have any patient or institutional content in there that may be traced back to an individual or place of employment.  Taking pictures of patients and posting them, especially children is a huge no-no, they cannot give consent, its unfair to ask them and your employer will be hopping mad if they find out.

I recently posted a couple of pictures of my students at the end of semester in the clinical environment and I am double thinking that move.  As a person who has a position of authority over my students it was probably unfair to take and post picture of them as it is difficult for them to decline (who wants to tick off the person who is writing your evaluation even if you have a good perceived relationship with them).

So, after doing some research on nurses and social media I am rethinking my personal code of ethics on the whole thing and will emphasize much stronger with my students what they can and cannot do regarding their clinical experience and social media, and unfortunately there is a whole lot more cannot than can.

Undoubtedly we need more education for employers and employees on this issue.  We need support and not blame but all health care professionals need to know the consequences if we stray.

There is so much to say on this topic and I could go on and on but then I would bore you (maybe more than you are already) so lets talk about this again.......next week!