After reading one of Stacey's blogs concerning speaking in front of our peers and becoming overwhelmingly nervous....I immediately thought of how I am dreading my assessment check off for my Final PE in Advanced Assessment.

After being a nurse for 5 1/2 years, there is no doubt I can perform a head to toe assessment. I am use to talking in front of a large group of people, because I do it everyday....but yet I am still so nervous about performing in front of an instructor for a grade. This past week at work we have been checking off first semester nursing students on their head to toe assessments and it never fails...they enter the room and tell me, "I am so nervous!" I remember being at that stage of my nursing career and suddenly I feel like I am back in the same position.

Assessing the Chart Versus Assessing the Patient

This week I had a nursing student share one of her clinical experiences with me and I wanted to share it with all of you. She had a 70 year old female patient admitted with pneumonia. After prepping for her patient and reading her chart she noted that many of the nurses had reported altered mental status and that the client had to be fed her meals by a nurse. After completing her morning shift assessment the student nurse reported the patient to be alert and oriented x 3 with her spouse sitting at the bedside. When she took the client's breakfast tray in, the student nurse asked the client if she would need assistance with her meal. The client reported she was fine and wondered why the nurses continued to try and feed her. After further assessment the student reported that after eating about 50% of her meal the patient became nauseated and did not want to continue to eat. When the student reported these findings to the primary nurse, the nurse informed the student that the patient needed to be fed due to her altered mental status. The student questioned the nurse regarding the prn medication of zofran and asked if she could give this to the patient. The nurse said she would give it, but she was too busy at the time, and 30 minutes later she still had not given the med.

It is obvious to me that the nurse was choosing to assess the patient chart rather than the patient. The clinical instructor was informed of the situation and the client did receive her medication, however I feel that if the student had not been with this particular patient that day this would have played out much differently.

Week #15 FINAL

The Count Down is ON! I can not wait until May 5th! After my final physical exam in Advanced Assessment, I will be completely finished with this semester. This was the heaviest load I have ever taken in my entire academic career; 17 hours (10 undergrad and 7 grad) and now my BSN is complete! The next date to look forward to, May 15th GRADUATION!

I was really looking forward to taking the ENTIRE summer off...but as it happens now I will be taking 6 hours of graduate courses to lighten by load Fall semester when I start FNP. This summer I am sure I will wonder why I decided to do this, but in the Fall I will be so glad I did.

Good luck to all of you and I wish you all much success in your nursing careers!

December 2011 here we come : )

Week #14 Change Paper Complete

With the semester coming to an end, I am finding many myself focused on completing my big projects. I am excited to say, my change project and paper is complete! I enjoyed working towards a successful change and have found that with the change of the dosage and calculations modules students are developing a better understanding of the material. I am pleased to say the pass rate of the first clinical math exam did increase from Fall 2009 to Spring 2010 semesters. Students have completed their evaluations, the reviews look great and with a few "tweaks", next semester should be even more successful.

Week #13 LVN/VN Educators

To comment on the post Dr. Anderson made concerning LVN instructors. I currently work in an ADN program and the majority of my work consists of helping students in the lab with assessment and skills. It just so happens our rooms and my office is located in the middle of the LVN education department. Prior to taking the position in the ADN dept. I had looked into the LVN department, however at the time because I did not have my BSN as odd as this sounds I did not qualify for a position with their dept. After working in this area over the past year, I have noticed a big difference in the attitudes of the LVN vs ADN students. For example, the first semester ADN students seem to "gripe" about more and expect to be "spoon fed" by the faculty; however the LVN students seem to work together and focus on learning the material and skills given to them. Before check-off's or exams I notice the LVN students focused on studying the material. The ADN students are more focused on wanting to study only the material in which they will be tested. Basically they want to memorize what you are going to test them on, regurgitate it and forget it. I am sure we have all been guilty of this before, however this is material they need to be retaining long term.

I also have the opportunity to sit in on the APA committee and review the students grades and letters of appeal who seek re-admittance into the ADN program after failure of a semester. I have found that many of the instructors are quick to deny their re-admittance to the ADN program and refer them to the LVN program. Is this really fair to the LVN program....It is saying "your not good enough for us, so we will send you to the LVN's". Personally I can see it both ways, however there is ALOT of animosity between the LVN and ADN department and I have not figured this out.

Week #12 Illuminate

This week my preceptor introduced me to illuminate. This is a method of communication for students and instructors taking online courses. In getting started each member needs a headset with ear pieces and a microphone. Once the instructor and the student are logged onto the website, the communication can begin. If the computers have a camera available you can turn the camera on and see each person the the circle of communication. This way the instructor could have one on one sessions or sessions with the entire class at once. The school also has a white board available which allows the instructor to draw and write and make available to the students just as they are sitting in class.
I am sure all my terminology is completely wrong with explaining this procedure! I am not very computer savvy. After seeing and learning this new way of communication, I was very impressed! So much more to learn.

Week #11 Professional Interview

This past week I had the opportunity to interview my preceptor. The interview went well and I enjoyed learning more about her. I have had the opportunity to work with my preceptor as a co-worker for the past year and feel that she is a great mentor. She is currently an RN, MSN, FNP-C practicing as an instructor at an associate degree nursing program. Her primary goal is to function as a strong student advocate and also serves on the curriculum committee. I enjoy learning from her and look forward to learning more as we come to a conclusion on my change project.

Mid Semester Self Evaluation

Mid Semester Self Evaluation

Course Objectives:
1. Communicate effectively, both verbally and in writing, with individuals, groups and health care providers.
I feel I have used effective communication skills with my preceptor in progressing with my change project and also with the faculty in presenting the idea, allowing discussion and ideas from within.

2. Discuss current trends and issues in the nursing profession.
I feel I have not only addressed this issue my change paper, but to the faculty as well. After much review with Dr. Pape, information was gathered to present to the faculty regarding the college's requirements for passing the math exam. Our facility has not accepted the "norm" for their requirements, which is 3 attempts and must pass with 100%. This dilemma is being incorporated into my change project.

Personal Objectives:
1. Function as a student advocate through collaboration with instructors.
I feel that I am acting as a student advocate in facilitating this online program. I am also encouraging the students to participate in the evaluation process to help facilitate the program to their learning requests.

2. Develop familiarity with and demonstrate understanding of Lewin's Theory of Change.
I have incorporated the levels of Lewin's Theory of change into my change paper.

Overall review of Personal Objectives:
At this point in the semester, I feel I have partially met my personal objectives. By initiating the process of change I feel I am acting as a student advocate but I will not feel satisified until the change is fully implemented and is place. By incorporating the Lewin's Change Theory into my paper, I feel I have developed a better understanding of the process.

One way these have fostered your growth as a professional nurse:
By meeting the objectives listed above and working on the "change project" with in my facility, I feel I have grown professionally as a nurse to become a better student advocate and mentor. Now when students ask the difference in an ADN and BSN, I truley understand the difference. I have also found many of the ADN students becoming more inquisitive about furthering their education even to the masters level. To me this is very exciting.

Week #9 Spring Break!

Spring Break!!!

Well it's almost over now and I had full intentions of getting ahead in all of my classes. I now realize I needed this break to pull myself together and get organized for the next six weeks. When I signed up for this Spring semester, I had no idea what I was getting myself into. I knew it was going to MAKE or BREAK me. I had never imagined taking 17 hours (7 hours of grad and 10 hours of undergrad) of nursing courses.

I am pushing to finish up my bachelors this May. This will allow me to take the entire summer session off to be with my 3 year old and new born who is expected the first of July. I can not wait! Then I will return in the Fall, diving into the FNP program.

Week # 8 Middle Man

This past week at work was a very interesting! Now that we are in the middle of Spring Semester, I am finding the students I work with becoming very frustrated with their lecture classes. I saw a glimpse of this last semester, but did not have time to pay much attention because I so busy with my new responsibilities as the lab coordinator. This semester I am finding myself stuck in the middle!

I have always tried to be a strong student advocate but because I am not an actual instructor my hands are tied to my specific areas (lab and clinical math). The students come to me for help with math and then begin "venting" about a test they were given in lecture. Of course there is not much that I can say, because I would never disrespect an instructor to a student. I am torn because I feel that the majority of the older faculty is acting more as the "nurses who feed on their young" and less as student advocates. I honestly do not feel that the students are learning because they are so focused on the fact that the instructors are out to fail them. I find it very insteresting that an instructor would not question his/her teaching methods or test questions when only 2 out of 45 students pass a unit exam. When the instructor shared this information with me, my response was, "WOW, that really suprizes me because they are a smart group and made great grades in their previous class." The instructor quickly responded, "Well I think the first semester instructor really babies them through their tests." What does this even mean? If the majority of students are making good grades than the instructor is being too easy?


Of course not all instructors are using this same approach and as the students come to me and "vent", I find myself becoming more passionate about teaching in the future.

Week #7 BSN

I am very excited to say....I will graduate this May with my BSN!! I do not feel that this will just be a piece of paper for me but a great accomplishment. I am looking forward to my nursing future as a BSN, as this will not only provide as a stepping stone to my MSN but also allow me a new position at work. As you know I currently work as the Lab Coordinator in an Associate Degree Nursing program, after graduating in May I will be able to work as a Clinical Instructor. This is very exciting as I truly enjoy working with the students.

I think if you would have asked me this question before I started my BSN, my view would have been different. I had always thought it was really "not that big of a deal" or not a big difference in Associate Degree Nureses and Bachelor's prepared Nurses. After completing the past year of requirements, I can see I was WRONG! I is definately a "Big Deal" and I now see how much this past year has allowed me to grow as nurse leader.

Week #6 Beginning Blog

Hello All,

Wow this is a BUSY semester! I am "tying up some loose ends" to several assignments in other courses this week-end. I am planning to meeting with my preceptor on Monday to begin the implementation of my Change Project.

Just to give a little back ground on the "Change" I proposed last semester in Leadership, my focus will be implementing an online based dosage and calculations course for ADN students at North Central Texas College. I am currently employed by this facility as the Lab Coordinator; however the focus of my job is to administer and remediate students on a self-taught dosage and calculation module. The students currently do not receive college credit for this course, it is a pass-fail module. They are required to take an exam each semester of nursing school and must pass with a 91% or higher. They are given two opportunities to do this, if they fail after the second attempt they are removed from the program.

Currently I feel little guidance is offered to the students in this area and would be better supported with at least a on-line module and discussion to follow and receive help.

The preceptor I will follow in this process is a Nurse Practitioner with over 10 years of experience in the clinical setting and over 4 years of service in education at NCTC. She is currently working to build the on-line transition program for the ADN program, so I am looking forward to working with her.

I hope everyone has a great week-end!