Recognizing the demanding working conditions its members and all emergency nurses face as this long public health crisis continues, the Emergency Nurses Association on Friday announced Emergency Nursing 2021 will shift to a fully virtual event taking place Sept. 22-24. ENA’s annual General Assembly will also be held virtually.
Right now, with many emergency departments reporting the highest COVID-19 case numbers seen in months, ENA members are where they are needed most: ready and available to support their patients and communities facing the ongoing challenges of COVID-19 – just as they have since March 2020.
Changing Emergency Nursing 2021’s format allows attendees to focus on their work, knowing that high-quality emergency nursing education is available to them virtually everywhere later this month or, with on-demand access through Jan. 31, 2022, whenever they’re ready to log on to learn.
ENA President Ron Kraus, MSN, RN, EMT, CEN, ACNS-BC, TCRN, said the difficult decision to shift the format for Emergency Nursing 2021 followed lengthy discussion of many factors, including travel restrictions imposed on some emergency nurses, but the key focus was on doing what is best for ENA members at this stage of the pandemic.
“There’s no hiding from the disappointment. Our members are physically and emotionally exhausted, and those who planned to travel to Orlando looked forward to Emergency Nursing 2021 as a chance to reunite and re-energize during the most challenging time in their careers,” Kraus said. “The move to a fully virtual event allows ENA members, and all emergency nurses, to rightfully focus on caring for patients, educating others on the importance of vaccinations and, most importantly, their own health and well-being.”
Kraus emphasized that similar to 2020, when ENA hosted it first fully virtual education and networking conference, Emergency Nursing 2021 will once again offer attendees high-quality emergency nursing education and engagement on a dynamic virtual platform. Live sessions, a virtual exhibit hall, an on-demand content library and more are just some of what attendees can expect beginning Sept. 22.
“Just as it has for the last 18 months, ENA continues to find the best ways to support its members during these difficult moments we are all facing. Emergency Nursing 2021 will be a time to rally together once again,” Kraus added.
For more information on the virtual Emergency Nursing 2021, visit ena.org/EN21.
As nursing practice becomes more complex, the NCLEX® is following suit. The innovative new item types being introduced as part of the Next Generation transition will bring the most significant change to nursing licensure testing since computerized adaptive testing. Every 3 years, educators anticipate a fleeting dip in student performance following the introduction of each new test plan. However, candidate performance has not yet recovered following the most recent test plan update in 2019. In fact, first-time pass rates of US-educated graduates have steadily declined for three consecutive years now.In the face of the heightened NCLEX® challenges and upcoming Next Generation transition, we must re-examine how we coach our students to approach questions.
While nursing’s conventional test strategies (such as Maslow’s or “assess first”) can be useful, the practice environment and its licensing exam are now asking much more of graduates. Fortunately, the National Council of State Boards of Nursing (NCSBN) Clinical Judgment Model (CJM) has answered with a cognitive model for clinical judgment:
Form Hypotheses
Refine Hypotheses
Evaluate
Applying the CJM as a testing strategy can facilitate students’ application of clinical judgment in test item scenarios. This model incorporates several familiar bedrocks of testing strategy, yet the streamlined, three-step process will enable students to keep salient steps in mind without becoming overwhelmed. Practicing this approach now will benefit students who will later be tested under the Next Generation NCLEX®, which walks students through the same cognitive steps in an unfolding manner that is summarized in the acronym FREE: Form Hypotheses, Refine Hypotheses, Evaluate Outcomes, Explanation Review.
1.Form Hypotheses
The first step is to read the stem carefully—before looking at the options—and visualize the clinical scenario. You can also picture each client scenario using every descriptor provided.At face value, a client with COPD who has “an oxygen saturation of 90% while eating breakfast,” may sound scary and set off students’ alarm bells for issues of airway or breathing. However, visualizing the same scenario in detail helps reproduce the clinical picture the item writers intended to convey.
The hypothesis is based on:
What is currently happening with the client(s);
What needs to happen; and
In what time frame
Is the stem asking what you would do next, first, or as a priority? Once you decide what needs to happen with the client, you may read the options.
2. Refine Hypotheses
The second step involves reviewing the options and eliminating any known incorrect answers.
If something registers as a known safety risk, you should immediately eliminate this option and focus only on those remaining.
If a safety risk would satisfy the hypothesis for a negatively worded stem, instead highlight this option before examining the others.
Then consider which options satisfy the hypothesis.
Maybe the most important intervention you envisioned for a client with acute hemorrhage is to be taken to the operating room immediately. However, you now see that the only option available that might satisfy this hypothesis is to page the healthcare provider. Refer to the time frame defined in the prior step, which asked what to do first. This decreases the strength of such a distractor that would delay care.
3. Evaluate Outcomes
For each remaining option, what will happen? In the case of a client hemorrhaging from an open wound:
If you choose to page the healthcare provider, what happens next? Will you stand there and watch the client bleed while waiting for the provider to arrive?
Maybe the item includes an option to “take the client’s blood pressure.” This incorrect option is attractive to students according to the “assess first” prioritization principle. However, visualizing this option’s outcome should reduce its attractiveness as a distractor: should you stand there waiting for the blood pressure cuff to cycle while the client continues to bleed? Additionally, will taking the client’s blood pressure change anything? No, the client likely requires emergent surgery regardless of what the blood pressure is.
Finally, what about the option to “place pressure on the site and call for help”?
This step is crucial to navigate away from strong distractors and second-guessing options that do not follow the ABC, Maslow’s, or “assess first” conventions. You can now select the best answer.
4. Explanation Review
Maybe most importantly, you should review the explanation regardless of whether you answered the question correctly or incorrectly. You’re now primed and ready to receive new information that will translate to future scenarios and test questions you encounter. This exercise has effectively taken you from the knowledge level (“clients with hemorrhage require emergent surgery”) to the application level (“clients with hemorrhage need surgery, and I should do whatever I can to stop the bleeding now, such as hold pressure or apply a tourniquet.”)
Explanations should break down precisely why each option is correct or incorrect, and incorrect options should contain strong teaching points. This enables students to translate their new understanding to as many other questions as possible. In our example scenario, you have not only learned to apply hemorrhage management but also have a better sense of when something is too urgent to delay care or when “assessing first” may not be useful. This single practice question will help you on numerous others.
If this process seems tedious at first, keep in mind that you’ll refine this approach over thousands of questions practiced. Over many weeks, this process should become second nature. We want our students to be so comfortable in their practice that they report “the NCLEX felt like just another practice test.”
The earlier you begin practicing in this way, the more you’ll be able to space out your practice sessions. This regular, repeated practice is called “the spacing effect,” and produces significantly better performance than if the same number of questions were reviewed over a shorter period of weeks or months. This is why question bank review using an organized framework should be introduced as early as the first semester of pre-licensure programs. Consistent test practice in this structured fashion will help facilitate the transition to Next Generation-style testing for students and educators alike, while enhancing clinical reasoning, increasing test confidence, and guiding students through specific, deliberate practice.
Vanderbilt University School of Nursing Associate Professor Laurie Connors, DNP, FAANP, has received a grant from the National Institutes of Health National Human Genome Research Institute to train doctoral nurses—doctors of nursing practice and Ph.D. nurses—in the translation and integration of genomics into academics, research, and clinical practice. The five-year grant, called Translation and Integration of Genomics is Essential to Doctoral Nursing, aims to facilitate personalized health care through this national educational effort.
Genomics, the study of all of a person’s genes, is a growing field within health care and the burgeoning health technology space. Genomics is a complex competency and has been identified as a core trend shaping health care’s future. With the vast amount of information made available by genetic testing, data science, and advanced sequencing technologies, there is an increased need for nurses trained in genomics, who can interpret the information and translate it in a way that patients can understand.
The largest patient-facing workforce in health care, nurses play an integral role in the effective delivery of genomic health care for patients, their families, communities, and populations. Research over the past decade has shown that many nurses have knowledge gaps in the basics of human genetics, Connors said. Totaling nearly $700,000, the TIGER grant will enable Connors and her collaborators at Clemson University and Loyola University Chicago to increase the capacity and capability of doctoral nurses in genomics over the course of the grant’s timeline.
“We will deploy a ‘train the trainer’ model,” Connors said. “Our participants will take their skills back to their universities to serve as champions to incorporate genomics into curriculum, research, scholarship and clinical practice.
“Genomics impacts nursing practice across the lifespan from before birth to end of life. Nursing is one of the oldest and largest health care professions, and we must continue to ask ourselves if we have the necessary knowledge and workforce skilling to participate in genomic health care.”
An advanced practice nurse in genetics, Connors aims to close the space between students with higher levels of proficiency in genomics and their educators. In her four years at Vanderbilt University School of Nursing, she has developed and implemented multiple genomic and oncology clinical-focused courses. Her specialty in genomics was sparked by looking deeper into hereditary predispositions to breast cancer during her time as an oncology nurse.
“Nursing is a profession where you are a lifelong learner,” Connors said. “Genomics has allowed me the opportunity to pursue new knowledge and to assist individuals and families in understanding their genetic risk assessment and risk of disease and what they can do about it.”
The training Connors is developing will begin with a half-day genomics course provided at the American Association of Colleges of Nursing annual doctoral conference in January, followed by monthly webinars posted to a learning management system from February to December 2022. To find out more information about this educational project, contact Connors at tiger@vanderbilt.edu.
As Nurse of the Week Charlotte Thrall, DNP, FNP-C, CNE, FAANP sat anxiously waiting in the emergency room at Mayo Clinic for news of her husband’s condition after a pickleball accident left him unconscious and unresponsive, her mind spun with uncertainty. Then, among the health care workers that began to fill the room, her eyes settled on a familiar face.
It was her former nursing student, Lexy Richards. Lexy was now a neurosurgery NP for the Mayo team treating Dr. Thrall’s husband.
Their unexpected reunion was bittersweet but welcome, and the following morning, Richards was at Billy Thrall’s bedside, reviewing imaging and lab work, answering whatever questions they had and doing everything in her power to make sure Billy and Charlotte, whom Richards had known since she was a student at Arizona State University’s Edson College of Nursing and Health Innovation, were taken care of.
“My depth of gratitude to her will always be tremendous for all the ways she has shaped my life. It has been a gift for me to be able, in some small way, to help her and her husband through this experience.”
—Neurosurgery NP Lexy Richards
“It was so humbling to be in a position where someone who taught you everything you know and who you respect to the highest degree is now in a position of vulnerability,” Richards said.
Fortunately, Billy did not require surgery. But having Richards to reach out to during his recovery was invaluable to Charlotte.
Thrall’s former student, NP Lexy Richards is now studying to become a neurosurgeon.
“Those first eight weeks of recovery were particularly difficult, and she was … I don’t even have the words,” Charlotte said.
Now, nearly 20 weeks out from the accident, Billy is making good progress. And Charlotte and Richards are still frequently in touch — though not always concerning Billy.
A clinical assistant professor and coordinator of the Family Nurse Practitioner program at Edson College, Charlotte first met Richards as her professor. Equally impressed by each other, they quickly developed a mentor-mentee relationship, with Richards serving on the leadership team for HopeFest, an annual community health care event Charlotte and her husband launched in 2012, and Charlotte writing a letter of recommendation for Richards’ application to medical school to become a neurosurgeon, mere months before Billy’s accident.
Richards received word that her application had been accepted while Billy was still recovering in the hospital. She’ll begin attending the TCU and UNTHSC School of Medicine in Fort Worth, Texas, this summer.
“Charlotte and her husband are exceptional people, and she has been hugely supportive of my career,” Richards said. “Even on a personal level, she was so supportive when my husband deployed to the military. My depth of gratitude to her will always be tremendous for all the ways she has shaped my life. It has been a gift for me to be able, in some small way, to help her and her husband through this experience.”
Charlotte and Billy met in Paris in 1984 on a service trip when she was 19 and he was 21. They’ve been married for almost 33 years now, and during that time, they have become well known for their various community outreach efforts in the Phoenix area, where Charlotte works as a nurse and Billy works as a nonprofit consultant.
“… I thought that I could actually see them utilizing some of the things that I had taught them, like motivational interviewing or compassionate care, and in my mind, I thought, ‘I need to tell them later what a good job they’re doing.’ “
It was around 2009 when Charlotte realized she wanted to be able to practice clinically in an independent manner, in order to better serve her community. So she enrolled in Edson College’s Doctor of Nursing Practice program and graduated in 2012. She began teaching for the college as an adjunct faculty member in 2013, then became coordinator of the Family Nurse Practitioner program in 2017.
While teaching in the program, Charlotte also served as a mentor to another student, Jonathan Helman. Like Richards, Helman served on the HopeFest leadership team and was moved by Charlotte’s example of care and compassion, both for her students and for the community.
Charlotte Thrall, DNP, FNP-C, CNE, FAANP, clinical assistant professor at ASU’s Edson School of Nursing
“She’s one of those people you realize pretty quickly is a special individual,” he said.
Helman now teaches at Edson College himself, sometimes alongside Charlotte. He also works in a field very similar to Richards’ — neurology. And when it came time for Billy to transition from recovering at the hospital to recovering at home, Helman was more than willing to provide consult.
“When I heard what happened, I immediately wanted to give back, I suppose almost as a way to repay her for the incredible influence she’s had on my life,” he said. “I’m not just blowing smoke, I quite often think about the type of provider she is and try to emulate that in my everyday practice. She is one of most empathetic people I know. … She has touched so many lives, either directly as a practitioner and through her outreach efforts, or indirectly as a professor who is teaching students who will eventually go out and serve the community, too.”
Former classmates who have remained good friends, Helman and Richards frequently consult with one another about patients because of their closely related specialties. This time around, it was for the benefit of someone for whom they care deeply.
Despite the reason for this, their most recent collaboration, Charlotte feels grateful to have been able to observe them in action.
“They were a gift to us,” she said. “I would never have anticipated having to rely so much on former students to guide us through such a difficult medical situation, but I knew the kind of students they were, I knew how prepared they were and how well they had done, and I knew I could really trust them.
“There were moments I thought that I could actually see them utilizing some of the things that I had taught them, like motivational interviewing or compassionate care, and in my mind, I thought, ‘I need to tell them later what a good job they’re doing.’ I was just so grateful for them, and it really encouraged me and reminded me that what we do when we train people to be clinicians is really, really important. And there’s a reason why we want to do a good job. There’s a reason why the program is challenging. There’s a reason why we are so careful about who we select to be in the program. Because it matters every day to patients like my husband and the hundreds of others out there.”.
SILVER SPRING, MD –Jessica Castner, PhD, RN-BC, FAEN, FAAN, has been selected as the 2021-2022 National Academy of Medicine (NAM) Distinguished Nurse Scholar-in-Residence. Supported for nearly 30 years by the American Academy of Nursing (Academy), the American Nurses Association (ANA), and the American Nurses Foundation (Foundation), the Distinguished Nurse Scholar-in-Residence is a year-long immersion experience for an Academy Fellow to leverage their expertise and play a prominent role in developing health policy at the federal level while engaging in interprofessional collaboration with scholars at NAM.
Operating under a Congressional charter, the National Academy of Medicine is a premier institution that provides evidence-based solutions and offers comprehensive policies to advance public health and address health inequities, such as the recently released Future of Nursing 2020-2030: Charting a Path to Achieve Health Equityreport. Through these reports and their work, NAM is catalyzing critical health issues to the forefront of the public eye as well as to policymakers’ agendas. The Distinguished Nurse Scholar-in-Residence position provides crucial nursing perspectives to better support the public’s health.
Dr. Castner is the President and Principal Investigator/Consultant of Castner Incorporated, as well as Editor-in-Chief of the Journal of Emergency Nursing. An expert in emergency and environmental health, Dr. Castner hones her clinical, entrepreneurial, and research experience to develop the next generation of telehealth and emergency care that understands and addresses social determinants of emergency medicine utilization in order to create more equitable care. Her pioneering work to integrate environmental health research, emergency nursing, and data science modelling within a social justice framework has enabled her promotion of healthy environments and prevention of health emergencies.
“I am honored to be selected as the Distinguished Nurse Scholar-in-Residence at NAM as this role will provide an opportunity to use my skills in a way that will have a profound impact on climate policy, nursing’s role in environmental justice, and the future well-being of our nation,” said Dr. Castner. During her time as the NAM Distinguished Nurse Scholar-in-Residence, Dr. Castner will maximize the opportunity for interprofessional collaboration to continue her work on environmental health equity initiatives.
“Our relationship with NAM, especially in regard to selecting a Distinguished Nurse Scholar-in-Residence, helps to reinforce the Academy’s mission to improve health and advance health equity by collaborating with experts and disseminating nursing knowledge. Selection to this post enables our Fellows to use their nursing lens to chart a course for improved health outcomes through policy,” said Academy President Eileen Sullivan-Marx, PhD, RN, FAAN.
“Congratulations to Dr. Castner. Her work at the intersection of telehealth and emergency care to bolster health equity is more important than ever as health care delivery systems recover and rebuild in communities across the nation. I look forward to supporting Dr. Castner’s journey as a NAM scholar,” said ANA President Ernest Grant, PhD, RN, FAAN. “The Distinguished Nurse Scholar-in-Residence program is a shining example of nurse excellence that continues to bridge contemporary nursing practice and health policy.”
“Dr. Castner will bring a wealth of nursing knowledge and innovative concepts to NAM to address social and particularly environmental determinants of health, which contribute to the vast health disparities in our society,” said American Nurses Foundation Executive Director Kate Judge. “We must have nurses’ expertise and voice at every policy table to change the trajectory of equitable health for all.”
The review committee responsible for selecting this year’s Distinguished Nurse Scholar-in-Residence included Academy Board member Debra Barksdale, PhD, FNP-BC, ANP-BC, FAANP, FAAN; ANA President Ernest Grant; Foundation Executive Director Kate Judge; and NAM Director of Health Policy Fellowships and Leadership Programs Gregg Margolis, PhD. To learn more about application process and the NAM Distinguished Nurse Scholar-in-Residence program, visit www.aannet.org.
Orientation week is a pivotal event to help new higher education students bond with your school. Orientation is your school’s opportunity to get a student’s education experience kicked off on the right foot. In-person orientation usually takes place for about a week. During this week, students engage with a series of events, have the opportunity to mingle, and learn more about the school’s services.
Over the last few years, we’ve run many student engagement events, from open houses to research symposiums, all the way to events for exam preparation and student de-stressors. We’ve used these events to discover crucial insights into what students expect from online event experiences.
This article will highlight some key areas that can help you run successful online student orientation events.
1. Make it EASY
For first-year students, it can be an overwhelming period. It will represent the most significant environment shift they’ve ever experienced in their lives for many students. With so many changes in their lives, the last thing any student wants is to figure out and navigate a jam-packed and overwhelming school orientation week. As an orientation planner, you want to do your best to simplify the orientation experience for students.
A key aspect to simplifying the navigation experience is to minimize the amount of reading students need to process to access event activities. Do your best to make the experience highly visual – with images that will engage and excite students about the available opportunities during orientation. Students are immersed in TikTok and Instagram and respond better to visual cues than web page listings.
An online virtual orientation lobby.
Click to enlarge.
You also want to avoid complicated event schedules or have students join a series of Zoom/online calls, which students have told us can be exhausting. An excellent way to break up the monotony of live sessions and allow your online student orientation to ‘breathe’ is to place key event breaks to enable students to be more exploratory and access content on-demand. For example, a networking or mentorship zone, a company sponsorship hall with give-aways, a student clubs showcase zone, a games-room zone, and more.
2. Think about the experience from the students’ point of view
We’ve been fortunate to speak with highly experienced orientation week coordinators across North America, and we’ve also been able to talk to first, second, third, and fourth-year students. Interestingly, students tell us that there are two big highlights or attractions for them during orientation week:
(1) the exhibitors and companies that give students unique deals and promotions and
(2) finding and learning about relevant clubs and social circles to join to make friends around their interests and affinities.
Club and sponsor displays.
Click to enlarge.
These two highlights are often placed on the back burner by coordinators when planning online orientation events. They are unsure how to fit these elements alongside the more traditional orientation week events in the online environment. It is easier to organize school resources, but a lot of the value of orientation week to students are social events that welcome them to the community and enable them to plant strong social roots that make them feel they belong. In this sense, orientation week is a critical retention tool for schools.
3. Leverage the benefits of online by staging your orientation
In-person orientation weeks are typically framed and managed within the limitations of location and time. Students need to be at a particular place to see a specific faculty member at a certain time. If they miss that session, then they will typically lose access to critical information or experiences. Online student orientation provides a unique opportunity to overcome this limitation. Within an online orientation week, you have the chance to create live, on-demand, and blended experiences. You also have the opportunity to segment content that needs to be consumed live and content that can be seen ahead of time by students or seen after orientation week by those who may not have had the time.
Students can access orientation resources at any time.
Click to enlarge.
For example, students can access some resources ahead of time on demand, like tips and tricks on getting the most out of the LMS or an info session on academic writing and then mixing in Live sessions from key professors and campus leaders to address more targeted questions. You can also blend the two, combine a pre-recorded talk with the recreation center (gym), and provide a live QA session with a representative for students to talk to. This flexibility is an exciting lens to view planning an orientation week with and can dramatically increase student access to campus resources and be a differentiator for schools with more developed student resources seeking more avenues for student engagement with these resources and improving their ROI.
4. Find ways to get current students engaged and involved in the online orientation
Many online orientation weeks lack support from existing students. The lack of student involvement can make the event feel more clinical and boring for incoming students. So greater student involvement can make orientation week festivities more genuine but can also dramatically improve participation. We often see 10-20X greater student participation in school online events run by students during the regular year versus those organized solely by school administrators. Why? They ensure they invite their friends and their network to participate. They can influence and promote an online event far better than most school event organizers.
A great way to get students engaged is to ensure that your student clubs have a fundamental role to play. School clubs are always interested in easy and convenient opportunities to promote their name and recruit new members. Student club involvement gives your orientation week two key features. It allows incoming students to identify and join relevant clubs more quickly, and the additional voices create campus-like energy. A school club fair organized as a part of orientation week also allows for earlier student networking and relationship-building.
Other vital members that you should consider involving are orientation leaders, student’ mentors,’ residence dons, and other campus student leaders.
5. Don’t ask students to download an app, but be ready for mobile
The world is going increasingly mobile. We see as much as 30% of online academic event participants joining using their smartphone devices (some open house events we have run have over 50% smartphone access). To serve this audience better, many orientation coordinators make the mistake of working with virtual event platforms requiring a dedicated app to run their orientation week.
Using a dedicated smartphone app can be counterproductive for events like student orientation. When students already have a whole slew of new apps to install (LMS, Email to setup, etc.), installing an app for a singular event can be seen as an unnecessary complexity and often discourages large groups of students from participating. Instead, you want to ensure that your online orientation can be instantly opened on any smartphone device using a hyperlink. Avoiding a dedicated app also enables you to have a more consistent experience across smartphones and desktop devices.
In Closing
Student expectations when it comes to school events are shifting. There are increasing expectations for schools to provide a well-thought-out digital alternative to on-campus events. Schools should see this as an opportunity to provide their students with a more robust student experience while simultaneously ensuring a legitimate backup solution for students who cannot attend in-person campus events (weather conditions, pandemic restrictions, travel, or timing issues).
I hope that this article has given you some insights or, at the very least, some food for thought as you think about your student orientation events. We are currently at an exciting juncture in figuring out how academia leverages online technologies to provide next-level experiences for their students. If you are interested in how Acadiate can support your events, don’t hesitate to reach out to us, we’d love to talk!
