In her second example a supposedly stable patient was deteriorating rapidly. Yet the staff nurse responsible for the patient did not think the changes warranted action. The instructor insisted the patient should go to ICU. She engaged the student by asking her What one test could we do to prove the deterioration? They decided on the blood gasses test which was done immediately. The test showed the patient needed to go to ICU.
The last pillar is ethical formation and ‘comportment’. Formation involves looking beyond technical skill of the profession to the moral content eg obligations and demands which involves character formation. For instance when students see less than ideal practice that involves nurses treating patients badly how does one deal with that as a nurse? How does a nurse help peers look at their practice to make positive change? Is that possible when in the beginning one doesn’t have institutional authority? Can a nurse help make changes in the professionalism of their peers? What about when a patient refuses a simple life prolonging intervention?
At present only around 20% of ADN graduates go on to the BSN. This is in part due to the time it can take to get any degree, which is time taken away from work and family. The goal of articulated programs is to streamline the process from ADN to BSN and beyond. Regional innovations in nursing education are addressing this challenge. One of them is the Oregon Consortium of Nursing Education. Schools in Oregon have partnered to first of all envision the type of nurse that the population would need. Building on this vision they created a common curriculum and share resources. The consortium is committed to ongoing faculty development. City University of New York has received a Robert Wood Johnson Foundation grant for their program.
Because nursing practices in the space between medical diagnosis /treatment and the patients experience of wellness and illness a nurse requires both technical knowledge and expert relational skills. The education of nurses must prepare them to be lifelong clinical learners.
As one student said: “I have the honor of being present with and learning from patients in intimate, vulnerable, scary situations. I get to regularly advocate for the underserved in the hospital setting. I have access to environments I would otherwise never been exposed to, I have learned, grown and broadened my world perspective. I better understand how our system works and hope some day this knowledge will help me make changes in the system.”
Health care systems and society must recognize that improving education of nurses is a high priority. But nurses must take the initiative if they do not.
- Sources:
Educating Nurses: A Call For Radical Transformation. P Benner et al. The Carnegie Foundation for the Advancement of Teaching 2010 Jossey Bass
http://www.ocne.org
http://www.rwjf.org/grants/grant.jsp?id=67700
© MyNursingUniforms.com 2011
