What to expect when you enroll in sections of first-semester nursing courses taught by Joe Niemczura #JoeNiemczura in Plant City Florida

You found this place by Googling my name

The “Youth of Today” have amazing resources at their finger tips and they will use them for “just-in-time” learning in ways we never considered Back In The Day. 

For that reason, I expect that you got here by googling my name since I am listed as the course faculty for first semester nursing courses at Plant City.

I am sure you also found me on RateMyProfessors, and God knows where else. I have a YouTube channel, two as a matter of fact, and one is the place where I post playlists of topics related to beginner nursing students. If you go to YouTube, you will also be able to listen to some teaching videos I did related to computer resources – how I use Canvas, how we use Evolve, and the Canvas Smartphone app. We rely on the computer apps quite a bit and these videos are intended to help you get up to speed – we will also help you in person when the time comes!

“Hybrid” classes?

I want to be clear about the degree of expected student involvement for my coursework. Each section of every course at school is now listed as “traditional,” “hybrid,” or “distance.” In the course catalog, my courses are listed as “hybrid” – a confusing term. According to ACEN, the accrediting body for nursing, Hybrid implies a mixture of remote and live. ACEN also includes a definition for “Web Enhanced,” which I think is a better descriptive term. “Web Enhanced” means that we use a Learning Management System ( in this case, “Canvas”) and a full complement of computer based activities during the course. (mostly the EVOLVE package from Elsevier that goes with our main textbook).

Here is the ACEN definition of “Web Enhanced”

“Web-Enhanced/Supported Course – A course where the instruction occurs through traditional face-to-face delivery, and students are expected to attend the in-person class. The learning management system (LMS), or other web-based system, is used to support the course. Course material, such as syllabi and calendars, are generally posted for easy student access. In addition, students may also be expected to participate in web-based learning activities, such as discussion boards or learning activities posted online. In addition, an LMS, or other web-based system, is used to support the course through the posting of course materials, such as syllabi or course announcements; however, students are not required to participate in web-based learning activities.”

ACEN also has answered a specific question for us. We can fit 24 people in the actual classroom, but we have a class size of about thirty so we have needed to take turns Zooming in from a nearby classroom. Since there is proximity between the faculty and students ( all the students need to do is get up and walk about thirty feet from one class to the other), ACEN has ruled that livestreaming to an adjacent class still counts as Web Enhanced, not Hybrid. Almost every lecture in my courses has been captured by “Narrated PowerPoint” available to the students who miss the live version or wish to review the content on their laptop when reviewing for study. Even though that is available, these same PowerPoints are delivered live so as to promote discussion as we proceed. We stop to answer questions and discuss salient points. And so, “Hybrid” does not conjure up the reality of what we do or how the classes operate.

Some people who signed up for the class were surprised by how much in-person interaction there was, when we began the semester. I wish to be clear about what to expect.

The Nursing courses at Plant City are LIVE and as traditional as I can make them.

Yes, it is Web Enhanced, but – I teach Live and In Person as much as I possibly can, and any person who signs up needs to know that I expect actual attendance in the classroom to the highest degree possible. Yes, I lecture using PowerPoint. But many class activities use principles of “the flipped classroom” to maximize active involvement in learning in small groups – a proven way to master the content. I am a big believer in the value of a good group mindset where each student is personally supported by their peers. So, if you want to learn nursing in a setting where you never have to leave your house? this is not the place.

Dear Reader: I would humbly suggest that nursing is a people-oriented field. The more you interact, the better off you will be!

Note: I strongly advise that you sign up for the whole cluster of all three first-semester courses, here. It’s best if you stay with the small group format for all class days. Mixing and matching (going to more than one campus) leads to confusion in my opinion. If you take the whole cluster, you make twenty-nine friends. If you enroll in a mix-and-match from two locations? the number goes to sixty ( thirty x two = sixty) and you dilute the prospect of group bonding that is so important in professional education. Let me give a practical example: Every class includes group projects as part of the grade. If you take three classes and you needed to do three group projects wouldn’t you prefer to do each with the same group? How would you keep track of three groups composed of different members from different campuses? Also, the clinical days are done in small groups – wouldn’t you want to go to clinical with a group that you already knew from lecture class and skills lab?

Synchronous Vs Asynchronous

These are “synchronous” courses. You are expected to do the in-class activities alongside your classmates, and to submit the assignments the day they are due. If you work nights, don’t get scheduled the night before any class session (especially, NOT the night before clinical, it’s unsafe). If the class is doing a group activity, you do not have the option to skip it and snooze in the back of the room.

About Covid 19 safety

I want to emphasize that we meticulously follow all the college guidelines to limit the spread of covid19. These guidelines are published in great detail elsewhere. In the past three semesters since the beginning of the outbreak, there have been NO documented cases where a student caught the illness in my classes.

None.

Zip.

Nada.

Yes, we have had students who were exposed to it by family members, and needed to be quarantined for two weeks in the middle of the semester. Yes, we had students who actually came down with the fullblown illness. I repeat, none of these persons transmitted it to their classmates and I attribute that success to college procedures and policies. We will do whatever we can to keep it that way! We made accommodations for exposed students so they could keep up from home by focusing on the Web Enhanced learning materials from the Learning Management System.

If a class member reported as much as the sniffles or a headache, we flat-out tell them in a cheery voice to not attend class (No questions asked. No doctor’s note needed!). They screen themselves every day at breakfast time before they leave their house, but we also screen at the school. We make extensive use of computer resources and a lot of the classwork is assigned using apps you are given as part of the class. I intend to keep doing everything I can to ensure the safety of every person in the room or nearby. ( by the way, the covid vaccine is not required by the college but the Health Sciences Division is strongly urging everyone to get vaccinated). 

To Learn Teamwork

The student embarking on this career choice often has a relative already working in health care. They have been told about the teamwork and collaboration that makes a successful nursing team no matter whether it’s a hospital, Long-term care facility, home health agency, or any of the other places nurses provide care. I do everything I can to promote teamwork and collective problemsolving. This is best done Live and In Person.  With an in-person class, if you come early you can chat with a buddy before class starts. You learn from each other, not just the teacher and the textbook.

Being in a  group of thirty

When you walk into class at the beginning, you will be with 29 strangers. In actuality, lifelong friendships are made during nursing school and you will gain the benefit of twentynine new friends along the way. 

I will expand on the advantages of joining a cohort in nursing school, in a future blog.

For Nursing Students who are English Language Learners, some YouTube tips

These days many nursing students represent communities where English was/is not the “mother tongue.” Strangely, there isn’t much specific to the content of the curriculum out there written directly for Spanish speakers.

First, any journey is more fun with the right travelling companions. Watch this:

Where I teach there are many Spanish students, and of course at the clinical sites there are many nurses and doctors and patients who are Spanish speakers.

I got some of these tips from RegisteredNurseRN dot com. I can’t recommend this site highly enough. The videos are meticulously researched, and if you get familiar with the search bar you could probably find a video on just about every topic in nursing school. This would be ideal if you are an audio-visual learner.

Here are some quick YouTube tips that will help you tremendously!

Speed

First, on YouTube you can slow  down the speed of the audio so as to catch the words better. To do this?

1) find the little gear-wheel on the bottom edge,

2) click on it and you will see “Playback Speed.”

3)click on that one and choose 75%.

voila! On the video, the guy jokes about slowing it to 25% but that makes it sounds like they are on drugs ( which of course, they are not!).

Automatic Language Translation!!

Second, you can set the video so that captions are auto-translated into the language of your choice.

How?

1) go to the little settings gear-wheel on the bottom margin of the video, click on it.

2) Go to “subtitles/CC” – at first it says “English (autogenerated).”

3) Click on that and it says “Translate.”

4) Click on that one and scroll through the list until you find the language you want.

The audio will still be in English but the subtitles will be in the language of your choice!

I checked to see if the list of languages included Nepali – and it does. Using devanagari no less.

This subtitle feature will also be useful if you are an English speaker but need a brushup on vocabulary and pronunciation. You can use English  subtitles to reinforce your audio exposure.

For first-semester students

It is the beginning of summer. If you need to work on language skills, start now!

For Nursing Faculty

I also highly recommend the work of Diane Staehr Fenner. Her book, Unlocking English Language Learner’s Potential is an amazing resource and a way to think about classroom management and student success. Here is part of a review from Amazon:

“Much may be debated about what English learners need in order to be successful in school, but while that debate continues, teachers need access to sensible and accessible assistance to teach language and content to English learners right now. This new book by Diane Staehr Fenner and Sydney Snyder is the book to fill that need. In clear prose, accompanied by lively classroom examples and a series of engaging application activities, the authors target the topics of culturally responsive teaching, scaffolded instruction for oral language and reading, understanding academic language, and how to formatively assess student development in these areas. There is something here for both novice teachers and their more seasoned colleagues as Staehr Fenner and Snyder skillfully bring together the necessary ingredients to help teachers advance the language and content learning of their English learners.” Author: Alison L. Bailey, Professor Human Development and Psychology Published On: 2017-01-17

Code Switching

I first found Dr. Fenner’s work because I became aware of Code-Switching. In 2018 I  wrote about the need to code-switch, on my other blog.

Now is the time!

Fall semester 2019 may seem like light years away, but it is not. What can you do to incorporate these strategies into your teaching?

Finally, a shameless request

Bag-Valve-Mask devices we use in our classes in Nepal. There are no Respiratory Therapists in the country.

I am here in Nepal, teaching critical care skills to nurses and doctors, something I have done since 2011. I only am able to go while on summer break from my USA nursing faculty position. This year I decided to create a GoFundMe campaign to upgrade the available training in airway management at one the of the key Medical Colleges here. This Airway Management Trainer will be used to teach doctors and nurses form throughout the Terai region of Nepal, how to do a variety of airway skills that are fundamental to critical care skills. Please consider contributing….

 

 

 

 

 

 

Welcome to Nursing in Hawaii blog

I don’t often add to this blog these days. Most often I blog at www.joeniemczura.wordpress.com and I invite you to go there. That other blog is pretty much focused on health care and nursing in Nepal (and by extrapolation, South Asia). And even there I go through fits and starts of activity. As you may guess, I am more active when I am actually in Nepal. Interacting and having dialog with my colleagues there provides inspiration for new commentary.

When I was more active I tended to write about issues faced by new graduates when entering the workforce, from the perspective of being a faculty member who was sending them forward with great pride and hopefulness.

Hawaii

I loved Hawaii during the ten years I lived there, and I wish every nurse could have gotten the positive reception I did. The spirit of Aloha is real. I think people from Da Mainland expect that somehow everyone is happy-go-lucky… some sort of cartoon stereotype of what it means to be “native.” But the spirit of Aloha is something you can adopt as a hard-working member of the community.

One of the big surprises is the intelligence and work ethic of the average nurse or health care worker in the Aloha State. Hawaii is a model of how to have a diverse society for the rest of the USA.

Books, did you say?

I also have written two books, on the subject of health care in Nepal, and these can be obtained via Amazon. There is a separate blog for the second book, The Sacrament of the Goddess. I have been asked when the third will come out. Usually the question comes from a person who has no idea what it entails to write a book, (even a book as humble as mine). The answer? I don’t presently think I have it in me to devote that kind of obsessive effort.

Right Here, Right Now

I am back on the mainland USA, this time in Florida where my relatives have established a beachhead. I teach nursing to – “beginners.” This is the most fun level at which to introduce what it’s like to do this work. I am fortunate to share my job with colleagues and administrators I respect and enjoy.

Browse

Feel free to browse this blog!

Part Two: How to Get Soul if Your lab doesn’t have it

Note: I spent nine years as a critical care manager coaching staff for peak performance during crisis situations, and I know a thing or two about psychomotor skills performance under pressure (which we’ll get to in a future blog). If your educational practice does not incorporate elements of sports psychology, you are missing the boat. We want our team to win and our players to love the sport.

Yesterday the blog entry here was titled “Does your Simulation Program have “Soul?” http://wp.me/p1Kwij-nF and it was a teaser. I just laid out  the problem but didn’t offer the solutions. In the education business this is called “creating the need to know”  – It’s like catching mice. When the mice are hungry enough, even the worst cheese is alluring and irresistible.

Um, maybe not the best metaphor. My professional colleagues are not laboratory specimens running a maze. The point being, I know I am not the best writer – let’s focus on the aromatic cheese (me) , not the mouse (you) per se. Words sometimes fail me but I still try to speak my truth.

And – it was a joke.

Floor Plan and square footage

So the first set of solutions to developing a heart and soul for your sim program/lab is in the physical layout. If you look back at yesterday’s blog I was pointing out things that could have been mitigated with better design and more space. Now, space is a problem when a sim lab and/or skills lab is retrofitted into a previously existing space. But – there does need to be adequate waiting area and closet space.

I’m told there is a specialized architectural firm that houses a specific team to design these “state-of-the-art” labs everybody is trying to have.

Think of the actual sim room, or even the actual skills lab, as if it were a ride at Disneyworld, or perhaps a room in an O.R. suite. There needs to be a place for the next batch to wait, and a room at the exit doors for the previous batch to exit. The room gets turned over for the next batch. The ideal is to have a de-briefing room right next to the actual sim room; but if you need quick turnover it’s actually better for each group to exit the area when their scenario is completed.

tip: If you are in a cold climate, expect that the students will wear a winter jacket, they will need to hang it up, along with boots and book backpacks.

If the lab is so tightly scheduled that groups of students need to wait outside and then flood  in as soon as the class time begins, you need to think about the waiting area. tip: Give them chairs. Designate a staging area nearby. You may think this is obvious, but it’s not. given a choice between students sitting on the floor versus a cluttered hallway, I’d be happy with clutter.

“A well organized desk is a sign of a cluttered mind”

I have now seen a number of labs where they simply didn’t design enough closet and storage space, or it’s not efficiently done. You can’t wait to set up a lab event by beginning at the start of class time.

The logistical chain goes like this:

The students arrive > the equipment is there and the disposables are too > the class happens > the process is repeated for the next “performance” with a new audience. Maybe the same equipment and disposables, maybe a different performance altogether.  Dos it sound too basic? may be for you it will, but maybe a new faculty never really thought about it before.

Failing to execute logistics is like waiting until the code starts before you stock the crash cart. From the beginning, effective lab management needs to build in the prep time and a system. tip: think of the supply logistics the way an O.R. nurse would. In late afternoon, You look at the cases for the following day, and pull the equipment needed, placing it on a rolling exchange cart. tip: don’t overbuild shelving for storage. exchange carts give you a more flexible system.

Eye Candy from Johns Hopkins

This YouTube was going around a week or two ago, and it showed JHU doing the “#mannequinchallenge  I would point out several things. First, the JHU Dean has enough of a sense of humor to make a cameo appearance at 1:42. Next, each little tableau is posing for a different activity (you would never have all of these things happening simultaneously even if they were on drugs, which they are obviously not). Thirdly, I suspect they have “soul” down there…..  to me, the video implied a sense of giddy fun. The best way to learn.

http://hub.jhu.edu/2016/11/18/mannequin-challenge-school-of-nursing/

tip: every time you can think of a way to have the students “own” the lab, implement it. If a student shows up early before the first class of the day – let them in, and engage them in assisting you setting things up.  You are modeling planning skills when you let them in on the secret. tip: At the end of a session? always end the content delivery five minutes early so the students clean it up, not you. Your energy should be directed toward preparing for the next class, not cleaning up after the previous one. You as lab manager are need to focus on finding ways to create, not simply do the laundry or clean up after the event. Having said that, there does need to be a system to put stuff away so it will be in ready condition when it is next retrieved. tip: at the end of each session, thank everyone who helped do the behind-the-scenes with you. Or even during the session you can ask them to stand and get a round of applause. (Yes, groups are often inhibited from doing any “spirit” things – but time to break that expectation and create a new one. Being willing to create positive motivation in this way is a behavior that will carry  over into clinical practice and become just as critical there as sterile technique).

I think this is enough for today. If you have tips to add please make a comment.

Tomorrow is part three

Tomorrow I will write more about ways to get “soul” and create a love of sim and a love of lab. If your students seem to dread a psychomotor session, never fear! the secrets will be revealed! Be sure to subscribe to this blog to make sure you don’t miss anything. Also, if you have faculty who don’t get it in terms of how to use lab to revolutionize attitudes, feel free to forward this to them….why not!?!??!?!!

 

 

 

 

 

Does your Simulation Program have “Soul?”

Because I use Sim in Nepal and have been involved in scenario-based education, I have interviewed for about five nursing faculty jobs here in USA where they are looking for a person to run their Sim Lab. I visited a School of Nursing not too long ago where the corridors were sterile. You know the kind of place I mean – maybe you work at one. When I walk around such a place I can hear my own footsteps. Every door is the same and every person is dressed like a bank executive.

They showed me their learning lab. Outside, thirty students waited in a corridor – sitting on the floor because nobody thought to set chairs out there. Two huge bulletin boards – with nothing on them. A monotonous color scheme, nothing on the walls, everything very neat. (had it ever been used?)

I do not recall the source of this meme. It can be seen in many skills labs. Which one do you prefer?

Nursing students were doing scenarios with Sim Man, and I overheard one faculty member needing to stop the scenario to instruct the student on female catheterization technique. They were using Sim as a means of individual evaluation, no audience other than the faculty. Punitive overtones if you ask me. There was no nearby practice/pre-test prep area that I could discern.

Two international graduate students who looked like they were Somali, sat at a table reading. They were there to work with the undergraduates, but – they didn’t seem to be interacting at all.

Are we having fun yet?

It reminded me of this:

When this dynamic is ingrained into a corporate culture, it is difficult to overcome

 

Yes folks, the literature of Scenario-based education is replete with examples of joyous learning described as “transformative.” But – your school can invest in all the manikins, build a multi-million-dollar Skill and Sim suite, and – still not “get it.”

I’ll admit, during the tour I started to compose a list of strategies that might help them grow. The faculty had a comfort zone – it was just not in the right place.

I guess my question is, “what are we teaching the students when the environment is like this?”

We’re teaching them they don’t really matter. They are cogs in a corporate machine and we are teaching them to say “Do you want fries with that?” When we adopt the micro-managing of interpersonal behavior, we now control how they interact. Because of closed circuit cameras and two-way mirrors we now have the capability to document whether the person is smiling enough.

Consistency is a goal, but – does that also mean “conformity?”

Got Soul?

A simulation/scenario-based education program needs to have a certain joie de vivre in order to capture the student’s imagination and engage their passion. Help them love nursing not dread it. That’s what I call “soul.”

Here is the point where we all go look it up and present the dictionary definition. Soul is not strictly a religious term. For a bit of edge I always seek definitions at Urban Dictionary.

Soul

having an outstanding aura, with a brilliant and loving attitude.
Being exceptionally well at a task.
Completeing a task with an indellible inquisitive nature or spiritual quality.

I love this job I do it well cause I got soul.

source: http://www.urbandictionary.com/define.php?term=Soul&page=2

Here’s another one:

soul

Technically: a religious concept of an immortal individual conciousness, the mind superimposed on an invisible and supposedly indestructible and universal substance called “spirit.”
Colloquially: authenticity, style, or passion. Used almost exclusively in expressions similar to “he’s got soul,” often used to refer to individual (e.g. improvisational) expression in music styles such as jazz.
Also, a harmonically simple, often syncopated, style of music made by black people such as James Brown, usually played by small groups, though occasionally involving horn sections, related to funk and rock and always having vocals. This music is claimed to embody the above characteristic.

Everything they did, seemed designed to remove the authenticity, style and passion.

They didn’t offer me the job.

Not sure I wanted it, after all. 

Next blog entry? Part Two is live as of Monday Dec 5th. The title?  How to Get Soul if Your lab doesn’t have it.  Here is the link: http://wp.me/p1Kwij-oY

“Friday Night at the ER” is also Simulation and – your school needs it!

It’s been more than a year since I posted in this blog, but the all-time top two entries are still attracting views. the first is “Myths about becoming a nurse practitioner – things to consider about grad school in nursing”  http://wp.me/p1Kwij-au and the second is “part 1: Secrets of a Nurse’s Brain – six steps to success at clinical practice, or anywhere!”

I mostly blog about Global Health nursing and Nepal healthcare these days since I no longer live in Hawaii. go to http://www.joeniemczura.wordpress.com

Friday Night at the ER and Scenario-based education strategies

These days one of the trends in nursing education is to adopt scenario-based learning. Most often this turns out to include investing in a skills lab upgrade so as to incorporate much more sophisticated training manikins that require use of a computer as well as a trained operator who can make the manikin breathe, talk or have a cardiac arrest. These are wonders to behold, and supported by marketing from the main company that sells them. Over time, this approach has built an eco-system of professional journals, conferences, web pages and user networks to support dissemination of wisdom about how to provide simulation. Your simulation site can get certified, and there is a book of Standards you can use for ideas.

I’ve been in favor of scenario-based education for a long time, probably ever since I became an EMT in 1975. (was still in nursing school at the time). The American Heart Association uses “megacode” scenarios to advance psychomotor skills and I always enjoyed the game aspect of this approach. In Nepal, I use scenario-based education to promote better critical care response. Minimal lecture, lots and lots of role play.

Scenario-based education is more than just the fancy manikin.

In 2002 I was hired by a school of nursing that suffered a dismal NCLEX first-time takers pass rate and decided to replace some faculty members. Voila, because of my prior management experience I was now teaching the Management and Leadership class with a specific mandate to focus on delegation skills.  I re-wrote the course outline to include activities for this. I was determined to teach it in a manner that reflected the real world.

“Delegation is very boring as a lecture topic, up until that exquisite moment when you realize that you are in legal trouble and could lose your license if you do it improperly, then all of a sudden it is crystal clear and very exciting” I used to say.

Friday Night at the ER is a key vehicle to teach concepts of nursing administration firsthand, that go on all the time, but which nobody ever explains to the new RN. The processes in the game board are extremely well-designed to illustrate the ongoing slog of bed-control and patient flow-through decisions, and players get to apply them. The scoring reflects the financial incentives associated with these processes. Sometimes schools of nursing will assign each senior to shadow a house supervisor for a day to get exposed to these things, but this is a hit-or-miss prospect; Friday Night at the ER guarantees that each participant will get the feel of being a house supervisor.

One game board. Best played in a rally format with may game boards. Like Monopoly, there are many twists and turns and the outcome depends on certain skills possessed by the players.

It’s a game board. And each board accommodates four (maybe five) players. Do the math. A cohort of thirty will require six or more game boards. We had a cohort of fiftysix, and divided the experience into two halves, with eight boards each day. To fully implement it at your school requires buying a set of game boards (I took this to another large school of nursing and once they committed they bought eight game boards) and it requires logistical set-up ( lot of small pieces need to be set out on the board, like Monopoly). Also, the way we did it required an all-day scheduling commitment, taking about six hours to include two de-briefings along the way. A strong recommendation? don’t try to squeeze it into just one three-hour class sessions. Do it in lieu of a clinical day.

If you adopt Friday Night at the ER?

Facilitator: Like the manikin-based approach to simulation, the facilitator of Friday Night at the ER does a better job if they also have real-world experience as a mid-level manager, because they have a better idea of the relative value of insights  available during an open-ended event such as Friday Night at the ER.

Debriefing: the academic nursing journals and websites devoted to manikin-based scenario learning are amply stocked with testimonials as to the need for debriefing, as a means to frame the experience. Like using a manikin, it’s possible to do the experience and not actually learn anything or gain insight. De-briefing is absolutely critical. If you adopt Friday Night at the ER,  you need to include ample time for this, and the students need to commit to the idea that they can’t run out of the class as soon as the last score is tallied up.

Integration: Friday Night at the ER is billed as “discovery learning”  and the company that sells it will tell you not to pre-warn the participants in advance as to how to “win” or to share the scoring system, etc.  This presents a challenge, because it’s harder to “sell” people on the merits of playing. In addition to the usual suspension of disbelief required for good simulation, Friday Night at the ER is more fun and experiential when you all learn as a team ( that’s why it is used by non-nursing and non-health care teambuilding consultants – it forces people to communicate and problem-solve.)

Having said that, since the game applies principles of delegation and illustrates they way a health care organization works, you can prepare the students to play it as part of a sequence of learning about delegation, the Nurse Practice Act, etc. I wrote a four-part sequence of blog entries to describe the how I taught delegation, right here on this blog.

Where to get Friday Night at the ER

go to http://blearning.com/

Disclaimer: I am not associated with the company in any way not am I being compensated for this full-throated endorsement in any way. I am merely a satisfied user since 2003. I have led this exercise about forty times I think. (memory is a bit fuzzy). I am very experienced in use of scenario-based education for critical care, especially debriefing.

While we are on it, the company needs to grow their followers on Twitter. go to @TheERGame and you will find them. pass the word!

My other blog entries on this topic

The first was part 1: Secrets of a Nurse’s Brain – six steps to success at clinical practice, or anywhere! This one addresses personal organization to promote personal accountability, the first step to understand delegation.

The second was part two: checklist culture and your role in quality

The third was How to teach delegation and the Nurse Practice Act, part 1 dec 29 2013 This one explores how delegation is defined in (most) state Nurse Practice Acts.

Another was teaching delegation and the Nurse Practice Act, part 3 Jan 1 2014 This one will show you a free resource from NCSBN that is absolutely critical for every school of nursing to teach, and for every future NCLEX test-takers to read.

And finally, to teach delegation part 4 – getting “street smart” Jan 3 2014 How an organization made up of individually-accountable nurses will support legal practice.

Here is my offer to consult with you on delegation issues in the curriculum

As you can see from the above, I believe strongly that delegation can not be “integrated” into the curriculum as some sort of subliminal brain telepathy. Subtlety does not become it, delegation needs to be laid right out there and preached. And, delegation is not well delivered when presented by a “talking head” as a dry academic experience.   In the paper “Working Well With Others” from the National Council of State Boards of Nursing (NCSBN) a key statement is:

“The strongest set of delegation rules will not work unless the nurse possesses the interpersonal communication skills to enforce them” (paraphrased).

The best way to hone interpersonal skills is to use them and get feedback.

Please note: the Friday Night at the ER site lists experts you can hire. UPDATE: at first glance I thought there weren’t any  nursing educators, but I have been gently reminded (below)  that there are two – Dr Mary Dolansky at Case Western, and Dr Carol Durham at UNC. They come highly recommended.

Dr. Mary Dolansky’s  page is https://nursing.case.edu/about/directories/faculty/dolansky/

and

Dr. Carol Durham’s faculty webpage is http://nursing.unc.edu/people/carol-fowler-durham/

I plan to ask Breakthrough Learning to add me to their list. If your school’s aggregate NCLEX scores show the need to buff up the area of delegation,  I will happily work with you to revise the senior-year curriculum, including coming to your school to help you do it (for a fee). Alas, I do not own any of my own game boards. You would need to buy or rent these on your own.

Hello from USA October 15th

Welcome to this blog.

Feel free to browse. There’s lots of advice for new nurses here.

You will see that I have many interests, and I’ve written two books. These days I am spending more time on my Global Nursing blog. Periodically I go to the country of Nepal and teach nursing there.

I spent 2014-2015 in Nepal and yes, I was there for the earthquake.

My second book is fiction. I wanted to describe the role of women in Nepal society. This was a more readable way to do it. Nepal is HIindu and Buddhist yet they fought a civil war. How could that be? The book looks at that question as well…..

The earthquake shook up the political situation in that country. I am not a political expert, but one thing I noticed: the USA news is not covering the politics.

So lately I’ve been blogging on that. When, I post on DailyKOS. It’s got a different format which makes it easier for readers to find me.

welcome.

Sept 1st back in USA

Hi –

I’m back in USA and still following the Nepal news.

I’ m keeping this blog “up” but not focusing on it right now. My main effort has been going to the blog that accompanies my second book, the novel about Nepal.

Nepal is presently in political turmoil (to say the least) and you can read my thoughts about it here.

sending the best karma to all my readers.

from CCNEPal about Joe Niemczura, post-earthquake April 26th, 2015

For readers of this blog, you know that it has not been active during this year that I am teaching critical care nursing skills in Nepal.

I am actively blogging on CCNEPal page, go there to read what I have to say.

For the record, I was in Bhairawaha Nepal on the day of the quake. In Bhairawaha, I noticed something odd at 11:56: the water in the glass was sloshing back and forth all by itself. I immediately got up, alerted the other people nearby that it was an earthquake, and we all left the building.

Here, nothing was damaged. not only that, but it was mild enough that things stayed on the shelves and tables. I spent much of the day (it was my day off) answering emails and messages to re-assure my friends that I was safe.  I am fine. I am not personally inconvenienced in any way.

I am on my long-planned “Road Trip” – fifteen sessions of my course outside the Kathmandu Valley. Five have been completed and ten remain. I am teaching today.

I would point out that CCNEPal, my organization, has trained 1,775 nurses and docs in Life Support skills, and about 800 are in Kathmandu. For that reason, I suppose you could say that CCNEPal has “pre-positioned” for this event (though I would not wish this on anybody). I am 100% certain that the Nepalese people will be helping each other, it is something I have always admired about this beautiful country. There is ample capacity to shift medical personnel from within the country, and I am sure that such a move will be easier than to bring in people from outside.  For those who wish to help, I guess the first thing is – send money to aid organization of your choice. (not to me!)

In general, I think it’s too early for nurses and doctors to come here unless they speak fluent Nepali and already know about the hospital system (most hospitals are intact). I do not think the needs will be quite the same as they were directly after Haiti, for example. Logistically, a self-contained team would be good.

From reading about other disasters in other parts of the world, I think that the early period will focus on recovery of victims. The time when foreign nurses can help will be down the road, when disaster fatigue sets in, and also to “backfill”  basic health services in unaffected areas where the Nepali nurses have and doctors have been shifted to Kathmandu.

We will all learn more as the full extent of damage is revealed in coming days.

the perfect #NurseWeek present for the #nurse in your life, or for a new graduate

This blog entry will be brief.

Nurses Week comes up soon, in May.

Also, this year’s crop of new graduates will proudly walk on to the stage and accept their diploma.

If you need an idea for a present?

give them money.

But sometimes money is not enough, or too crass, so – buy this book. The Sacrament of the Goddess was written as an adventure story that will appeal to health care workers who have the daydream of using their skills in a Low Income Country. If you order it now it will get to your house before May 6th.

It’s a page turner, set in a hospital in Nepal during the Nepal Civil War.