I sort of remember nursing school

Another assignment that I figured would be nice to share here.

The book I am referencing is

Benner, P. E., Sutphen, M., Leonard, V., & Day, L. (2010). Educating Nurses: A Call for Radical Transformation. San Francisco: Jossey-Bass.

Educating Nurses was published 10 years after I graduated, yet my experience has similarities to the descriptions in the book.  In all honesty, it is tricky to reflect back on my undergrad without the bias of my own experience as a nurse educator. In fact, much of my motivation to study nursing education and become well versed in it was a result of my perception of my own educational experience- and my continued assessment of the state of nursing education while working as a full-time faculty in ADN and RN-BSN programs.

I went to nursing school at a private Baptist college in Texas., University of Mary-Hardin Baylor (UMHB). I was not Baptist, but it was the closest BSN program. I already had my AA in English and Music and when I decided to study nursing instead, I figured I should get my bachelors instead of another associate’s degree.

I took pre-req courses from a variety of community colleges- from Kentucky, Oklahoma, California and Texas. I was the ultimate transfer student. I took more than I needed because I did not what program I would apply to (or where I was going to live even- Army life) so I went in with a very solid foundation.  I think I only took one or two non-nursing classes at UMHB. Instead I had transcripts from 5 different schools. And I was a nontraditional student in that I was in my late 20s with two small children and my husband was active duty army.

So, with all that, my only goal in that program was to get done. I came in with a lot of pathophysiology knowledge (I used to read the Merck Manual as a teenager for fun) and a solid science- and liberal arts background. There was not as much of a crunch of content into our brains as things were more spread out over the curriculum. That’s in contrast to the ADN program I taught at- that concept that nursing education is additive is SO true, every year it seemed we added more material and never felt like we could let things go.  As a student in my BSN program, we did have mostly lecture (overheads not powerpoints!) and multiple choice exams. And usually one written assignment per semester. That was how the diadatic content was covered.

My favorite class was our senior leadership class, I think the instructor enjoyed teaching it also. She had an MBA and marched to her own drum. And it was not “life or death” content, so she could have fun with it- it was very much applied knowledge- teaching presentation (I made overhead slides!), a change project on our assigned units (mine was developing a policy about whose responsibility it was to change out full sharps containers). Overall there were other elements presented in the book that occurred in my program: team teaching, heavy emphasis on the NANDA diagnoses and all the crazy strict rules about how to write a nursing diagnosis, lots of sage on the stage style lecturing and the occasional game to make things interesting.

My clinical is even harder to recollect. I was not paying attention to how I was being taught and I was kind of on survival mode most of the time (my husband was deployed to Korea my entire senior year). How much my instructors took time to question me and help me find learning opportunities was completely lost on me. I showed up exhausted from staying up late, after my small children went to bed, making my drug cards and getting up way too early. I honestly cannot remember a single post conference. I have a blur of a few key moments- putting a foley in a small child, who they thought had Kawasaki disease and she had a terrible rash all over her peri area, yet no one guided me to consider NOT putting iodine on that raw tender skin. Now I know I could have used soap and water.  I got in big trouble taking a Dr. up on his invitation to observe a circumcision during my OB rotation- I still have no idea why it upset my instructor so much. That was one of those clinicals where our hands were tied and all we could do is observe anyhow! There was some bullying by faculty in that program for sure, but also some kind and compassionate instructors. I also struggled with feeling comfortable taking care of patients and asking them all the questions on our assessment paperwork. They were so tired, miserable and in pain. And I was supposed to ask them about their sex life? Finally, I have a distinct memory of working up a sweat while trying to put TED hose on a knee replacement patient. That was most likely because of the terrible, hot, impractical, polyester uniform, complete with purple apron, we had to wear.

I spent most of my clinicals feeling terrified and unsure of what I was doing. The instructors overall (with a few exceptions) were kind and supportive. I think some of my anxiety stemmed from the fact that while I had a great deal of knowledge, I had very little patient care skill or experience. And our lab experience was dismal to say the least. This was pre-simulators and we did not even have mannikins to practice on. The only hands on practicing we had was assessment on each other (in our sports bras, with the 2 boys in the class sent to another room) and injections – of saline into our thighs.  Everything else was talked about and we hoped to get a chance to see it in action and maybe try it out.  I went into nursing terrified of doing any skills… and eventually became a skills lab instructor. What a way to face my fears!

So reading Benner’s book, I mostly find myself going, “yup, seen that, did that, still do that” when they discuss some of the challenges in nursing education. I think my own experiences as a nursing student were what drove my obsession with giving my students a good solid lab experience, yet balanced by understanding I could teach them everything and allowing some things to fall away for other things to move in (for example no longer testing trach care in exchange for some informatics content).