“The dream begins with a teacher who believes in you, who tugs and pushes and leads you to the next plateau, sometimes poking you with a sharp stick called ‘truth’.” – Dan Rather
For those of you teaching nursing and those aspiring to teach nursing, there has never been a time when Dan Rather’s words resounded more loudly than they do today. Although compassion for others will always remain its essence, nursing continues to become more complex. Therein lies the challenge for each aspiring and current clinical nursing instructor!
How do we ensure that our students’ hearts remain firmly invested in the patient as a person, while the pull and stream of technology steers them away from the bedside? Truth is our most powerful tool. Truth in teaching the ideals of nursing and the true realities of nursing in today’s health care environment is our most difficult task.
If you are reading this blog, then you are possibly a clinical nursing instructor now, or may be thinking of becoming one. Either way, see how you score in answering a few questions below that are commonly posed to both aspiring and seasoned clinical instructors alike:
Place a T for true and F for false next to the following statements. Then, review the answers that follow below.
I will need to prove my clinical competency on a daily basis.
I will contribute to the nursing profession.
I must be friends with my students.
All of my students will like me.
All of the unit’s staff nurses and aides will be happy to take guidance from me.
I need to spend time on the clinical unit, and become familiar with the staff and the nursing systems before I bring my students to the clinical setting.
I must know every detail about every patient that my students are assigned to.
I must personally supervise every procedure and all interactions between my students and patients.
I will earn more money in this position as a clinical instructor than as a staff nurse.
All of my students will be motivated learners.
In the book that I co-authored with Eden Zabat Kan, Fast Facts for the Clinical Nursing Instructor, we share our combined classroom and clinical site teaching experience of over 50 years. In our book, you will find invaluable guides to such topics as:
Preparing for your clinical teaching assignment
Getting to know your nursing students: Who are the best and who are the rest
The performance appraisals: Clinical evaluations
Managing the clinical day
Satisfaction in the role
Here are the answers to 5 of the quiz questions, please see chapter 1 in our book for the remaining answers.
False. Some of you are transitioning from practice as expert staff, others are tenured professors, and advanced practice nurses. Whatever your background, remember that you are there to supervise and guide novice learners. Learning to refrain from doing the procedure yourself will be a challenge. Your role is not to prove your competency daily but to enhance student learning by supervising and not performing skills. Use strategies like questioning, role playing, and discussions to improve student thinking and problem solving skills.
True. Whether as a part-time or full-time professor, you are contributing to a profession that is in great need of successful instructors who can teach students how to effectively care for patients.
False. If you go into clinical teaching thinking that you can be “friends” with your students, then your tenure in this role will be short. Friendships with students can lead to difficult situations, particularly during evaluation periods. Keep personal information about yourself to a minimum.
False. Face it; we all want to be liked by our students. Stay away from focusing on where you are liked or disliked. Instead of focusing on “like” or dislike” be that instructor that fosters the “aha” moment with your questions and guidance.
False. Remember you are a GUEST on the unit. Your goal is to teach students. You can use any example on the unit as a teaching experience. Incorrect nursing examples often can teach the most to your students. You need some degree of humility as you foster growth in your student, and maintain working relationships with the nurses and staff on the units that you teach.
There is not a better job than that of being a clinical nursing instructor! Your legacy will continue as a nurse in each of the students that you teach.
Have fun and good luck.
Fast Facts for the Clinical Nursing Instructor
Clinical Teaching in a Nutshell
This Fast Facts guide for instructors offers pragmatic advice on how to tailor teaching to nurses of various backgrounds in different clinical sites and specialties. Delivered in a concise, quick-access, easy-to-read format, this book helps both new and experienced instructors optimize the learning experience for their students.
Dennis Hedge, provost and vice president of academic affairs at SDSU, tells BrookingsRegister.com, “On behalf of the administration, faculty and staff at South Dakota State University, I would like to thank Nancy for her service to our university and state. Dr. Fahrenwald has been a visionary leader for the betterment of nursing and health care during her time at SDSU, and her impact will be felt for many years. She continued a legacy within the College of Nursing of preparing health-care professionals to have a positive impact on their local communities and throughout the world.”
Fahrenwald received her BSN from SDSU, MSN at the University of Portland, and PhD in Nursing from University of Nebraska Medical Center. Prior to becoming a nurse educator, Fahrenwald pursued clinical specialization as a public health nurse, serving in community health nursing roles in South Dakota and Washington. She also served as a Peace Corps volunteer in Malawi, Africa, working on AIDS prevention and community health teaching.
Fahrenwald is also a nurse researcher who has impacted education on organ donation and transplants within American Indian populations, tobacco-free school policies, and tobacco-cessation programs for rural citizens. She has helped form a transdisciplinary rural health research team to provide improved health in the state and region. She is also a fellow of the American Academy of Nursing.
Excited for the new position at Texas A&M and the opportunity to serve another university, Fahrenwald feels well prepared by her experience at SDSU. To learn more about her nursing career, visit here.
Vanderbilt’s dean of nursing on her career path and advice to others
“The field has grown tremendously in terms of academic advancements, but also in terms of nurses being viewed as key players in healthcare decision-making,” explained Linda Norman, DSN, RN, Valere Potter Menefee Professor in nursing and dean of Vanderbilt University’s School of Nursing in Nashville.
I recently had the privilege of sitting down with her to ask her questions about her personal career, and about the field of nursing in general.
She says she knew from a young age that she wanted to go into nursing education. She completed both her Bachelor’s and Master’s Degrees at the University of Virginia. She gained experience between completing the two degrees by teaching at a Hospital-based program, and simultaneously working as a staff-nurse on the weekends, and in the summer.
After finishing up her Master’s, Norman became a part of a National Heart, Lung and Blood grant. She helped establish hypertension detection and adherence clinics in southwest Virginia and northwest Tennessee.
When the project ended, she took on a new role, teaching at East Tennessee State University (ETSU). After only a brief time at ETSU, she was promoted to serve as chair of her department.
Norman moved to Nashville a few years later, and began working as the director of Aquinas College’s Nursing program, while also earning her doctorate from the University of Alabama. After completing the degree, she was offered a position as the Associate Dean of Academics at Vanderbilt’s nursing school. In 2012, Norman was given the endowed chair, and in the following year, became dean.
While she earned her degrees and landed job offers, Norman had other responsibilities as well. She was already a wife and mother to two children. She always managed to strike a balance between work and family.
How has the field of nursing changed for the better and for the worse since your career began?
“I think the role that nurses play has grown exponentially. Today, we do not have to convince people of the value that nurses bring. Both healthcare professionals and the public understand that nurses play an important role, and that advanced practice nurses are vital to our industry. People have also realized that we need nurse scientists and Doctorally prepared nurses as clinicians and administrators. I think that the field has grown tremendously in terms of academic advancements, but also in terms of nurses being viewed as key players in healthcare decision-making. In my opinion, the most significant growth has occurred over the past ten or fifteen years.
“I feel that some change still needs to be made regarding entry into practice. It can be confusing because right now someone could become a nurse through an Associate’s program, a hospital-based diploma program, or a Bachelor’s program. I would like to think that changing the laws to make the bachelor degree the only route would decrease confusion so people would understand that a nurse is a nurse is a nurse.”
Why did you decide to get your Doctorate of Science in Nursing?
“I needed my doctoral degree to stay in academics. When I went for my master’s that was the terminal degree in nursing. Shortly after graduating, I knew that in order for me to do what I wanted to do – be a leader in the academic arena- I needed to get my doctorate.
“During the time when I was getting my education, it was typical to take years between degrees in order to gain experience. We have learned a lot now, and that mindset is not longer true … You do not need years of experience anymore. Whether you want to do a research doctorate or a practice doctorate I would recommend going straight through. There are a few advantages: one of which is that you’re in study mode, which makes for an easier transition; another one is that if you get your master’s and start your DNP as a part time student while you’re working as a licensed NP, you can start applying the learning from your coursework immediately.”
How do you effectively balance your personal life with your work life?
“When I started my master’s I had a 15-month-old and a three-year-old. Even though they were active little people, they fell asleep at 7 pm. So I could study from 8 pm until midnight.
“When I started my doctorate, I had a sixth-grader and an eighth-grader, and they did not fall asleep at 7 pm. At this point, in addition to school I was working full-time as director of a nursing program. I had to figure out when I was a student, when I was director, and when I was a wife and a mom.
“I found out that I could not study when everyone else in the house was awake. I also realized that going to the library was unrealistic. I determined that I could accomplish more between two and four in the morning than I could at any other time of the day. No one was up, and even the dog was asleep! I started waking up at about 2 AM naturally. I would get up, and do my reading, or start my paper. Then, around 4 am, I would start to get sleepy, and I would go back to sleep. I would wake up again around 6 am and fool myself into feeling as though I had gotten a full night of sleep. I still wake up in the middle of the night to this day, especially during budget season. Being able to compartmentalize your various roles in life in order to give attention to whatever is needed at a given moment is the key.”
What advice do you have for nursing students of today?
“Look broadly for opportunities that you are truly interested in. I look at people who really flourish, and they find that one area that they are particularly passionate about. Try to land your first job in an area of healthcare that you love. This way, you will be energized to learn a lot. Whether it’s chronic disease, prevention, or anything else, find a niche that you love, and then what you do will not be your job … it will be your career.”
This story was originally published by MedPage Today, a trusted and reliable source for clinical and policy coverage that directly affects the lives and practices of health care professionals and provider of free CME.
My transition to a distance educator began in June 2007 when we moved 5 hours away from my university campus. As a long-time faculty member, I had no plans to abandon my hard-won tenure. At that time, I taught graduate core courses in advanced pathophysiology and applied evidence-based practice (EBP); in addition to an advanced practice role course and the clinical nurse specialist (CNS) specialty courses.
The core courses of advanced pathophysiology and applied EBP were traditional offerings delivered in the classroom. Because I knew that the distance from campus would make a weekly commute for me unsustainable, in 2006, I began a process of transitioning my classroom-only courses to, first, a hybrid model (where I taught one face-to-face (F2F) class a month and then the rest of the content was online), and then to a fully online format. The students liked this model because the flexibility of the scheduling allowed them to work (without needing to ask for one to two days off per week for school), and they still got to physically interact with the instructor and other students.
The hybrid model for the core courses was a pilot of sorts to see if the students would object to core classes (in this case, advanced pathophysiology and applied EBP) being delivered in a mostly or purely online format. Online learning in nursing schools was not yet widespread. Though our school of nursing was among the earliest to embrace online learning, most of the core classes were still being taught as traditional classroom offerings.
The advanced practice role course was already being taught as a hybrid of two intensive days F2F content (one day at the beginning of the semester and one day at the end) with the rest of the content being delivered online. The CNS students’ specialty courses were also being taught as face-to-face intensives with the students meeting two full days a month and then engaging online for other assignments.
Because there was no course code for hybrid classes, at the time, the core courses I taught were listed as being delivered as an online-only format, but students were made aware of the optional F2F class once a month in the registration materials; the optional classes were also clearly identified in the syllabus course schedule. The F2F classes typically had a small number of students attend – mostly those who lived close to the campus. The classes were also taped and made available on the course webpages for students to view.
Every month I came to campus at least once for 5-10 days to teach and to attend to other faculty responsibilities. Depending on other faculty events or requirements, I sometimes made multiple trips in a month. This “commute” involved extra personal expenses (lodging, automobile expenses, meals, etc.) for which I received no reimbursement; additionally, I could not write off the expenses because moving was my choice and not a requirement of the job. As an Associate Professor, I was not released from my obligations to meet the traditional academic missions (research, scholarship, and service) of tenured faculty. I continued to chair and attend committee meetings (in person and virtually), coordinate a master’s option, advise students and mentor new faculty, conduct research, publish, and participate in faculty governance.
Thankfully, student evaluations were positive – that was a big relief! One of the most common fears of faculty in transitioning their classroom courses to an online format is the Fear of the Unknown: how will students evaluate the effectiveness of the teacher and the content delivered when there was no physical interaction between the students and faculty? Student acceptance and enthusiasm for my hybrid and then fully online courses gave me evidence to convince the dean that I could be an effective faculty member, even if I was not on-campus every day. Overall, this arrangement worked well for many years, though it was not without its challenges.
Disruptive innovations are frequently looked upon with suspicion at the outset. This arrangement was a major change from the normal routine of faculty being physically present on campus – a definite disruption of the status quo. Even faculty who taught mainly online were expected to be in their offices during the week. A change in mindset among the faculty, individually and as a whole, was necessary for this plan to succeed.
Distance faculty (also known as distance educators or remote faculty) are faculty members whose teaching is “geographically independent of students and colleagues” (McLean, 2006, Background, ¶1). I never thought of myself as “forgotten” faculty, as McLean noted – I just was a dedicated faculty member who happened to live far from campus. Because I came to campus on a regular basis, I didn’t quite meet the definition of being separated from my students and I always felt connected to my colleagues, students, and college. I’ve since read a study by Pearsall and colleagues (2012) on full-time faculty-at-a-distance nurse educators — that’s probably how I would have been classified today.
With the current nursing faculty shortage, more universities and colleges are looking for faculty to teach in their programs – hiring faculty who teach from a distance may be the “innovation” that keeps some nursing schools from closing down programs.
There are many benefits for the faculty member, students, and institution as a whole to employing more distance faculty. This is the focus of my next Educator’s Corner column for the Clinical Nurse Specialist journal; this column should be in the January/February 2017 issue. I’ll let you know when it comes out.
Pearsall, C., Hodson-Carlton, K., & Flowers, J. C. (2012). Barriers and strategies toward the implementation of a full-time faculty-at-a-distance nurse educator role. Nursing Education Perspectives, 33(6), 399-405.
Other articles of interest on this topic:
Goodfellow, L. M., Zungolo, E. Lockhart, J. S., Turk, M., & Dean, B. (2014). Successes and challenges of a distant faculty model. Nursing Forum, 49(4), 288-297. DOI:10.1111/nuf.12060
Hoffmann, R. K., & Dudjak, L. A. (2012). From onsite to online: Lessons learned from faculty pioneers. Journal of Professional Nursing, 28(4), 255–258. DOI:10.1016/j.profnurs.2011.11.015
Stewart, B. L., Goodson, C., & Miertschin, S. (2012). Off-site distance education faculty: A checklist of considerations. Journal of Family & Consumer Sciences, 104(4),15-27.
“Give every day the chance to become the most beautiful day of your life.” —Mark Twain
Today more than ever, nurse educators must consider global health when planning and developing nursing courses. A 2007 study published in the National League for Nursing’s research journal, Nursing Education Perspectives, found that globalization has had a significant impact on health and it is imperative to include global health topics in all nursing curricula. Topics should include: the role of the global health nurse, various diseases, and the impact of global diseases on health care. Cole Edmonson and colleagues argue that in order to effectively address global health preparedness there needs to be interprofessional cooperation among non-profits, private companies, and governments.
Global Health Nursing
Global health nursing roles include short and long-term engagements, and some schools even provide opportunities for their students, which can be quite rewarding. Global nurses can also practice within their own borders by practicing with a focus on health equity, says Thomas Quinn, MD, MSc, the director of Johns Hopkins Center for Global Health. For example, nurses can volunteer to teach in community-based education programs.
Nurses who are interested in global health can also make monetary donations or collect donation items for global groups that support a variety of global initiatives. For instance, the Peace Corps has volunteer opportunities and paid positions for nurses, and the International Volunteer HQ has myriad opportunities for nurses and students nurses to serve overseas. Another agency, Health Volunteers Overseas, seeks to recruit nurse educators and nurse practitioners to serve as clinical mentors and teachers. The assignments range from 2-4 weeks. Some nurses may choose to obtain full-time employment as international health nurses and/or international travel nurses and may work in a variety of settings and countries. There are many requirements to fulfill, and it can be a daunting experience to arrange for licensure, visas, travel, housing accommodations, and health requirements.
General Requirements for Nurses
Minimum of two years experience
Knowledgeable on communicable diseases
Up to date on immunizations
Available for entire length of time required
It is best to work with an agency who can help facilitate the experience and ensure that all requirements are met.
World Health Organization
The Peace Corps
The American Red Cross
Catholic Relief Services
Centers for Disease Control
Nurse educators must stay abreast of current and future global health issues and continually update their courses. Global health topics may be incorporated into the curriculum as a standalone course or integrated throughout the curriculum. Hospital-based educators should also incorporate global health topics into their orientation and competency programs.
The New Nurse Educator, Second Edition
This unequaled resource guides novice nurse educators step by step through the challenging process of transitioning from service to academe. This second edition delivers two new chapters devoted to the hospital-based educator and global health issues, including the future of nursing education.
Dr. Lynch was born in Saigon, Vietnam, and realized at a young age that she wanted to become a nurse after encountering the kind and caring nature of her own nurses during a hospital stay as a young patient. Lynch grew up in Huntsville, AL, and after graduating high school with honors she enrolled in the Bachelor of Science in Nursing program at UAH. Explaining her decision to pursue higher education, Lynch tells UAH.edu:
“I was inspired and encouraged by my hospital nursing director to pursue a Master’s degree in Nursing. I believe in life-long learning, so naturally I enrolled in a PhD nursing program at The University of Alabama at Birmingham (UAB). My studies in the doctoral program helped to shape my worldview and better understand the experiences of others.”
Lynch graduated from UAB in 2012 with distinguished doctoral student honors and a specialty in pediatric nursing. She is honored to be among the faculty at UAH and give back to the nursing program where her career started. This fall she will be teaching Mental Health Nursing in the undergraduate program at UAH.
To learn more about Dr. Thuy Lam Lynch and her career in nursing, visit here.