Nov. 29-30 Over the course of 2 days, I performed 10 SN clinical evaluations. What a taxing 2 days! My initial thought was that SN evaluations would take 15-20 minutes for each student. The plan was to perform 5 evaluations, during our clinicals on Thursday and finish the other 5 evaluations on Friday. I would take one student at a time which would be convenient for them to leave their patient assignments for 15 minutes. The class agreed that the Friday evaluations would take place at a local restaurant.
On Thursday, the room I planned to perform the evaluations in was occupied by other SJGH staff members who were in full conference mode during the hours I had reserved for the evaluations. So, I had to find a different room that would allow privacy for our evaluations. Three SN evaluations were performed, each evaluation took 30-45mins., in 3 different rooms.
During the post-clinical conference, I ask SNs to tell me about their Leadership and Management learning experiences during their rotation. All of them were especially grateful for the time spent with the Nursing Supervisor, the delegation of Safety Auditor tasks, and the opportunity to make SN assignments on clinical days as the SA. They also expressed that their experience helped them relate to the "busy work" of writing ICU/ER Observation, Organizational Structure, Diversity in the Workplace, and Hospital Mission Statement papers.
On Friday, the room I reserved to perform the evaluations was occupied, again by other SJGH staff members, Stroke Certification Review. This time, I asked if my SNs would be welcomed to attend the in-service. Once the in-service concluded, we were allowed to resume SN evaluations. One SN became angry because he did not like the evaluation of his paper, so I concluded the session. I was able to perform 2 evaluations before my group left for the restaurant. The remaining evaluations concluded at around midnight.
My SJDC clinical instructor experience during these last clinical days has been both taxing and rewarding. Despite, my repeated review of clinical expectations and respectful re-enforcement of their nursing programs objectives, tears and anger surfaced. The professional growth I observed in my clinical group, priceless! I could see the confidence and pride in their accomplishments over these few weeks. I hope and pray that I have contributed in some small way to their transformation to practice as safe confident nursing professionals. I have a greater appreciation of all my professors efforts to make me a better nurse. I look forward to future opportunities to serve my profession as a nurse educator, a reward that I did not expect.
My2cents!
Coffee break?
Whatever happened to working smarter and not harder?
Saturday, December 1, 2012
Wednesday, November 14, 2012
To eat or not to eat?
Nov. 10th Teaching high school girls about nutrition. What an opportunity! The AAWs mentor program wanted to educate the high school girls about healthy eating habits. There were 5 young ladies who attended the class. These young ladies are intelligent college bound students who come from poor households. High school girls who have body image, peer pressure, fast food eating habits, and limited resources available for healthy meal influences...a challenge to say the least!
My teaching intent was to provide an array of materials for teaching healthy affordable eating options and exercise, not dieting. My plan was to engage the young ladies in a discussion about healthy meal and snack choices by reading the labels of some of their favorite snacks and talk about the importance of physical activity. I had planned to use "choosemyplate.gov" website for healthy eating and one YouTube video on stress management.
I arrived on the CSU, Stanislaus Stockton campus with my power point on a USB drive ready to talk about healthy affordable eating practice and physical activity for stress management and weight control. Well, the classroom did not have a projector. No power point, website, or YouTube video for this teacher. I had a white board, my teaching outline, some affordable healthy snack recipes, and pictures of 5min. stretch exercises to use as visual aids. I ran out to the local convenience store and bought a bag of Doritos, 1 can of Coke, a Cup of Noodles, a bag of trail mix, a Special K snack bar, and my favorite, Kitkat candy bar.
We used the items purchased to practice label reading . The girls really liked this activity and stated that they learned a lot about the lack of nutritional value in their favorite snacks. We talked about the importance of eating breakfast, choosing healthy fast food options, and the "new healthy choices guidelines" using the plate for food serving choices. I had them share three goals that they would focus on right now and what step they would take to reach them. Everyone participated and it was great!
One of the AAW members frequently interrupted me and preached to these young ladies about portion size, avoiding meat, and their weight! Well, my challenge became to refrain from asking the member to please not preach, but to focus on healthy eating habits. I reiterated the importance of eating a variety of healthy foods, developing an exercise routine, and eating breakfast to jump start their day. Additionally, I included the importance of eating regularly and not to focus on portion size, but healthy foods. We talked about eating when hungry and avoiding eating when stressed. I encouraged them to try an activity other than eating such as deep breathing exercises and meditation when stressed.
I learned that the topic of diet in this population of teens should be approached delicately. As a health care professional, my opinion is considered seriously. Today's young ladies have an enormous challenge to maintain their physical and mental health! The chances of developing diabetes, bulimia, or anorexia is very real. It is my responsibility to ensure that a balance exists in any topic of nursing education. My topic outline did not include addressing potential problems that might arise from dieting, anorexia and bulemia. I encouraged them to develop healthy affordable eating habits, offered physical activity options, and discussed positive body image as the core of discussion while addressing this population of individuals. This opportunity to teach did not go as planned. However, I feel that I fulfilled my obligation to provide updated responsible information to this population of high school girls.
My teaching intent was to provide an array of materials for teaching healthy affordable eating options and exercise, not dieting. My plan was to engage the young ladies in a discussion about healthy meal and snack choices by reading the labels of some of their favorite snacks and talk about the importance of physical activity. I had planned to use "choosemyplate.gov" website for healthy eating and one YouTube video on stress management.
I arrived on the CSU, Stanislaus Stockton campus with my power point on a USB drive ready to talk about healthy affordable eating practice and physical activity for stress management and weight control. Well, the classroom did not have a projector. No power point, website, or YouTube video for this teacher. I had a white board, my teaching outline, some affordable healthy snack recipes, and pictures of 5min. stretch exercises to use as visual aids. I ran out to the local convenience store and bought a bag of Doritos, 1 can of Coke, a Cup of Noodles, a bag of trail mix, a Special K snack bar, and my favorite, Kitkat candy bar.
We used the items purchased to practice label reading . The girls really liked this activity and stated that they learned a lot about the lack of nutritional value in their favorite snacks. We talked about the importance of eating breakfast, choosing healthy fast food options, and the "new healthy choices guidelines" using the plate for food serving choices. I had them share three goals that they would focus on right now and what step they would take to reach them. Everyone participated and it was great!
One of the AAW members frequently interrupted me and preached to these young ladies about portion size, avoiding meat, and their weight! Well, my challenge became to refrain from asking the member to please not preach, but to focus on healthy eating habits. I reiterated the importance of eating a variety of healthy foods, developing an exercise routine, and eating breakfast to jump start their day. Additionally, I included the importance of eating regularly and not to focus on portion size, but healthy foods. We talked about eating when hungry and avoiding eating when stressed. I encouraged them to try an activity other than eating such as deep breathing exercises and meditation when stressed.
I learned that the topic of diet in this population of teens should be approached delicately. As a health care professional, my opinion is considered seriously. Today's young ladies have an enormous challenge to maintain their physical and mental health! The chances of developing diabetes, bulimia, or anorexia is very real. It is my responsibility to ensure that a balance exists in any topic of nursing education. My topic outline did not include addressing potential problems that might arise from dieting, anorexia and bulemia. I encouraged them to develop healthy affordable eating habits, offered physical activity options, and discussed positive body image as the core of discussion while addressing this population of individuals. This opportunity to teach did not go as planned. However, I feel that I fulfilled my obligation to provide updated responsible information to this population of high school girls.
Sunday, November 11, 2012
What was I thinking?
Nov.7-8, 2012 Mid-term evaluations for SN clinical can be tough! For the SNs whose clinical performance has been acceptable, no problem. However, the SNs who are marginal, not so easy! I have one SN who has challenged my input on their physical assessment and proper documentation. This same SN does not write papers with any concept of what the assignment entails, nor does this SN use required APA format. I needed to return 2 papers that SN wrote after I found myself rewriting each paper. Proceeding papers written by this SN were not any better. So, I handed those papers over to my lead instructor to read. I hope that my lead instructor could offer a different perspective for the SN. Additionally, I referred this SN to the skills lab for remediation of physical assessment skill...tough!
I thought beginning my new role as a clinical instructor would challenging, but this week has made me question my intergrity and concern for patient advocacy on a new level. I wonder how the SN was able to progress through a nursing program to the 4th semester with such poor physical assessment skills, no concept of classroom theory, and poor writing skills. If there were only one issue to consider such as physical assessment, I might not lament. But, after several attempts to work with SN in so many aspects of required nursing basics I feel compelled to FAIL this SN!
To offer a failure to a 4th semester SN as a new clinical instructor speaks volumes about two things. One, I do not know what I am doing as a clinical nursing instructor, I am learning. Or, the program itself has failed to provide this SN every available opportunity to prepare for a challenging and rewarding career in nursing. As a new clinical instructor, do I allow SN to pass clinicals and graduate? I know that SN is not prepared to meet the basic needs of the community. What was I thinking??
I thought beginning my new role as a clinical instructor would challenging, but this week has made me question my intergrity and concern for patient advocacy on a new level. I wonder how the SN was able to progress through a nursing program to the 4th semester with such poor physical assessment skills, no concept of classroom theory, and poor writing skills. If there were only one issue to consider such as physical assessment, I might not lament. But, after several attempts to work with SN in so many aspects of required nursing basics I feel compelled to FAIL this SN!
To offer a failure to a 4th semester SN as a new clinical instructor speaks volumes about two things. One, I do not know what I am doing as a clinical nursing instructor, I am learning. Or, the program itself has failed to provide this SN every available opportunity to prepare for a challenging and rewarding career in nursing. As a new clinical instructor, do I allow SN to pass clinicals and graduate? I know that SN is not prepared to meet the basic needs of the community. What was I thinking??
Monday, October 29, 2012
October 26, 2012 On track with assignments and documentation on the nursing units. In the ED with students to direct the emergency set-up for chest tube insertion. The students do not document in the ED record, but can assist with procedures. An opportunity to engage SNs in an important task and reveiw of important documentation for any procedure of this type. SNs were reminded to talk to their patient and offer comfort to the patient and his daughter. Early communication with the surgeon who would perform the procedure, the primary ED nurse, and respiratory therapist helped the procedure go well for all involved. The SN confirmed the drug and dose in the orders, set-up the equipment, and visualized the signed consent for chest tube insertion.
During the post care conference, I gave a 30min. lecture on hospital policies and procedures. The SNs were directed to the SJGH website for nursing policies on Fall Risk, Environmental Rounds, and hospital approved abbreviations. Everyone was given a copy to review. Following the policy review, two SNs presented their Patient Education Projects for discussion.
My experience for this day taught me to be an example for my SNs. Professional courtesy and respect for others should be at the forefront of all we do as nurses. Also, institutional policies are in place and to be shared, from the beginning.
My2cents
During the post care conference, I gave a 30min. lecture on hospital policies and procedures. The SNs were directed to the SJGH website for nursing policies on Fall Risk, Environmental Rounds, and hospital approved abbreviations. Everyone was given a copy to review. Following the policy review, two SNs presented their Patient Education Projects for discussion.
My experience for this day taught me to be an example for my SNs. Professional courtesy and respect for others should be at the forefront of all we do as nurses. Also, institutional policies are in place and to be shared, from the beginning.
My2cents
Mission possible!
October 25, 2912 My students received assignments from the team leader (SA) and were on task to perform their duties for the evening. The SA escorted SNs to the Employee Health Clinic for their influenza vaccines and mask fit testing. Four SNs refused the vaccine. Those SNs were informed that they would be required to wear a mask at all times while working on the units starting Nov.1, 2012. I had them sign waiver forms of refusal.
Physical assessments were the focus of my observations. The nursing staff on the unit had high praise for the SNs perofmance. They were encouraged to offer shift change reports and their primary nurses were very supportive. The SNs expressed their delight for the experience. The night shift nurses were impressed! The SNs completed their shift on time. During the post conference SNs discussed their increased confidence in documentation and shift change reports.
I learned that clinical instructing requires communication and coordination with all SJGH nursing team members. A few phone calls and face-face requests to make the clinical rotation run smoothly helped me keep my SNs safe, engaged, and excited. I called the SJGH infection control nurse to arrange for the influenza vaccines for all of my SNs. She was happy to inform me that my SNs would receive the shots for free! Once in EHC, the nurses were ready to fit test the SNs. Primary nurses on the unit are helpful in offering learning opportunities to SNs who are motivated to learn. The nursing supervisor has offered to have team leaders shadow her for 2 hours during the next rotation.
My2cents
Physical assessments were the focus of my observations. The nursing staff on the unit had high praise for the SNs perofmance. They were encouraged to offer shift change reports and their primary nurses were very supportive. The SNs expressed their delight for the experience. The night shift nurses were impressed! The SNs completed their shift on time. During the post conference SNs discussed their increased confidence in documentation and shift change reports.
I learned that clinical instructing requires communication and coordination with all SJGH nursing team members. A few phone calls and face-face requests to make the clinical rotation run smoothly helped me keep my SNs safe, engaged, and excited. I called the SJGH infection control nurse to arrange for the influenza vaccines for all of my SNs. She was happy to inform me that my SNs would receive the shots for free! Once in EHC, the nurses were ready to fit test the SNs. Primary nurses on the unit are helpful in offering learning opportunities to SNs who are motivated to learn. The nursing supervisor has offered to have team leaders shadow her for 2 hours during the next rotation.
My2cents
Wednesday, October 24, 2012
October 19, 2012 My clinical group was on their game in the busy Med/Surg. unit. The Safety Auditor (SA) arrived and made the student nurse (SN) assignments. Everyone was ready to take on a full three patient assignment. The SNs received report from the SJDC student nurses leaving the floor, read their patients charts, and made introductions to the primary nurses.The Med/Surg nurses were very happy to have SJDC SNs the entire shift for their high acuity patients. The SA and I quickly informed the SNs that they would only have two patients.
During the SA rounds, one SN was assigned to care for an inmate. This mis-step was remedied with a soft reminder to the SN and SA that it is not appropriate to assign students to inmates. During clinical orientation, the SNs were made aware of two things that they could NOT do:
1) may NOT care for inmates(SNs are vulnerable to this population and must be kept safe).
2) may NOT do finger stick/glucometer without their primary nurse present.
The SNs assigned to the ICU/ED had a very different story. Low census in the ICU meant few opportunities for SN clinical experiences.The primary ICU nurse for one SN refused to have a SN. The ICU nurse stated that she was too busy to have a SN. This nurse was reminded that she would be leaving at three o'clock, she then reconsidered having a SN. In the ED, the charge nurse was not thrilled about having SN and she told us so. As diplomatic as I could be, my request to leave the SNs in the ED was granted!
What a day! I am very proud of myself and my students. The time spent on the concept mapping and nursing care plans really paid off when it was time to document in the patients records. The students were able to use clinical reasoning skills based on information collected, formulated their plans for care, and offered rationals for what they were doing and why! I learned that My students need to be protected and it is up to me to speak on their behalf... My2cents
During the SA rounds, one SN was assigned to care for an inmate. This mis-step was remedied with a soft reminder to the SN and SA that it is not appropriate to assign students to inmates. During clinical orientation, the SNs were made aware of two things that they could NOT do:
1) may NOT care for inmates(SNs are vulnerable to this population and must be kept safe).
2) may NOT do finger stick/glucometer without their primary nurse present.
The SNs assigned to the ICU/ED had a very different story. Low census in the ICU meant few opportunities for SN clinical experiences.The primary ICU nurse for one SN refused to have a SN. The ICU nurse stated that she was too busy to have a SN. This nurse was reminded that she would be leaving at three o'clock, she then reconsidered having a SN. In the ED, the charge nurse was not thrilled about having SN and she told us so. As diplomatic as I could be, my request to leave the SNs in the ED was granted!
What a day! I am very proud of myself and my students. The time spent on the concept mapping and nursing care plans really paid off when it was time to document in the patients records. The students were able to use clinical reasoning skills based on information collected, formulated their plans for care, and offered rationals for what they were doing and why! I learned that My students need to be protected and it is up to me to speak on their behalf... My2cents
Sunday, October 21, 2012
Student Orientation to Clinical Site
October 18, 2012 Student nusre (SN) orientation to clinical site started at 1300 in the lobby at SJGH. It was my responsiblity to create a form and distribute hospital access badges for my 10 students. Once everyone received their assigned badges we proceeded to our reserved conference room which was conveniently located on the floor where our clinical experience would begin. After I welcomed the students to "Transition to Nursing Practice" which involves nursing leadership and management skill development, we discussed expectations for their clinical experience. I gave a brief introduction about myself, then I discussed changes in the syllabus. The students signed a student agreement statement form that they were made aware of the changes to the syllabus.
We toured the Intensive Care Unit, Emergency Department, and Med/Surg units. Two students would be assigned to a primary nurse in the ICU and ED for each day of clinicals. Clinical area assignments were made with student input. One student, the Safety Auditor (SA) for each clinical day is expected to make student assignments and check in with each SN in the clinical areas. In order to give the SA a global perspective of nursing responsibilties as a leader, the SA/ charge nurse duties included a two hour shadowing with the nursing supervisor for the hospital. A math test was administered and I gave a one hour lecture on Data Action Response (DAR) charting with a SJGH policy review. A documentation activity was incorporated in the lecture that engaged the students in care planning. They were encouraged to use concept mapping tool to formulate a plan of care, clinical reasoning skill development. The SNs were oriented to IV pump and each SN practiced how to use it.
My experience for the orientation to clinical area was exciting and exhausting! I had an agenda with scheduled breaks and we finished the day on-time, 2100! The last minute syllabus changes, conference room reservation/confirmation, and post-conference lecture preparations was stressful. Flexibility and a sense of urgency got me through the day, successfully. The students were eager to hear my expectations and they were patient with me. I look forward to the interaction with my students in the clinical environment... My2cents
We toured the Intensive Care Unit, Emergency Department, and Med/Surg units. Two students would be assigned to a primary nurse in the ICU and ED for each day of clinicals. Clinical area assignments were made with student input. One student, the Safety Auditor (SA) for each clinical day is expected to make student assignments and check in with each SN in the clinical areas. In order to give the SA a global perspective of nursing responsibilties as a leader, the SA/ charge nurse duties included a two hour shadowing with the nursing supervisor for the hospital. A math test was administered and I gave a one hour lecture on Data Action Response (DAR) charting with a SJGH policy review. A documentation activity was incorporated in the lecture that engaged the students in care planning. They were encouraged to use concept mapping tool to formulate a plan of care, clinical reasoning skill development. The SNs were oriented to IV pump and each SN practiced how to use it.
My experience for the orientation to clinical area was exciting and exhausting! I had an agenda with scheduled breaks and we finished the day on-time, 2100! The last minute syllabus changes, conference room reservation/confirmation, and post-conference lecture preparations was stressful. Flexibility and a sense of urgency got me through the day, successfully. The students were eager to hear my expectations and they were patient with me. I look forward to the interaction with my students in the clinical environment... My2cents
Monday, September 17, 2012
First day of clinicals.
September 12, 2012 was my first experience as a clinical instructor for San Joaquin Delta College RN students, awesome! I showed up on a regularly scheduled work day to find my unit was over staffed. I saw the SJDC student nurses arrive on the unit and had an "ah-ha" moment. The clinical instructor for the day Terrye Moore-Harper, RN, MSN was very excited about allowing me to shadow her for the day.
Terrye has ten students assigned; two in the intensive care unit, two students are assigned to the emergency department, and six students remain with Terrye on the medical-surgical unit. Each student is expected to care for and administer medications to two patients. Pharmacology is a major focus because the students take an online pharmacology course. They must be prepared with the why is this patient taking this drug? how is it excreted? and what are the possible side effects? before any medication is administered. In the post-clinical conference, Terrye gave a 15min. lecture that focused on time management strategies to help the student organize themselves.
Terrye has ten students assigned; two in the intensive care unit, two students are assigned to the emergency department, and six students remain with Terrye on the medical-surgical unit. Each student is expected to care for and administer medications to two patients. Pharmacology is a major focus because the students take an online pharmacology course. They must be prepared with the why is this patient taking this drug? how is it excreted? and what are the possible side effects? before any medication is administered. In the post-clinical conference, Terrye gave a 15min. lecture that focused on time management strategies to help the student organize themselves.
"Your big opportunity may be right where you are now"
~Napolean Hill
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