The Future…a discussion

We have entered that graduation time of year.  I remember making the life transition from being a nursing student to being a nurse.  I remember the stress I experienced over my licensing exam and the pride and excitement I felt when I passed and was finally able to call myself a nurse.  My transition from graduation to employment was seamless and now I realize how lucky I was.  Actually it wasn’t even a matter of luck. Timing had everything to do with it. I feel for those graduating from nursing programs all over this country without any idea of where they will be able get a job.  A blog article written in the Wall Street Journal this week by UVA nursing student Haley Stephens really hits home the frustrations these nursing graduates are feeling.

She speaks very honestly about the obstacles these new graduates face to getting a job.  Hospitals are interested in hiring mostly experienced nurses because they are faster, cheaper, and easier to train.  Though the double-edged sword is that how do you ever get to be an experienced nurse if no one will hire you.

I love new blood (pardon the ridiculous pun).  New nurses are exciting.  They bring a fresh perspective and new challenges.  They are challenging in a way that makes me love teaching them.  You can teach the same device over and over again and each new nurse will ask you a different question about it.  It keeps me on my toes and reminds me of the knowledge that I take for granted.  There are tasks and skills I do everyday caring for a patient and a preceptee will ask me a new question that I never even thought to teach.

While I was in nursing school, the best teachers I had were the registered nurses I worked with in the ICU where I worked as a nursing assistant.  They set and established for me practice standards and expectations.  They demonstrated through their interactions and collaborations with staff and patients what nursing expertise looks like.  As I would learn about disease processes, surgeries, or patient populations in school I could come to them and ask questions.  It also solidified for me what setting and with which populations I would want to practice professionally.

As I transitioned into a nursing role in that ICU, I was empowered by my preceptors to speak up for my patients and their families. I have never shied away from the important role and responsibilities of nursing advocacy in patient care.

How do you keep empowering the future?  The answer to this question is important to me.  I want to continue to see growth in the profession of nursing. I want to continue to see new nurses as inspired to embrace the importance of their role as I was.  Despite lacking knowledge, it is important to empower new nurses to question everything and speak up about situations that concern them:  medications prescribed by the physician, decisions that they face as a nurse, and decisions that their coworkers make on behalf of patients.  With this expectation, to question, we not only learn from each other but we improve patient safety by being open and honest, seeking information and advice, and practicing with teamwork.  So many decisions in health care are multifactorial and few to no outcomes are achieved from the decisions made by one person.  Even in a code situation it is standard practice for the physician leading the code to ask everyone in the room if we have thought of everything, done everything, and if everyone agrees on stopping. If not you continue together as a team.

The Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (RWJF) together; last October published a consensus report titled:  The Future of Nursing: Leading Change, Advancing Health.  While it is in depth in it’s discussions about the future of nursing: it covers and discusses nursing practice and education from ADN to PhD. One idea that was inspiring to me as I have read through it (slowly…it’s 700 pages long) so far is the idea of how education should adapt to fit the growing, changing, and diverse populations that our health care system serves and functions.  The idea of a multidisciplinary education is fascinating to me.  I had one class as an elective in my bachelors program that was interdisciplinary between social work, pharmacy, and nursing students and I got so much out if it.  I think that a transition to classes and schools offering courses with medical students and therapy students as well would be the beginning of a major culture shift.  Truly learning to work as an interdisciplinary team while learning about and understanding the roles and specialities between medicine and nursing would, I find, greatly empower nursing’s future practitioners.  Neither medical or nursing practice in a hospital setting is independent. We all rely on each other to make care complete and successful.

When I was in school, even not that long ago, it wasn’t common practice to empower nursing students to understand the importance and power of their specialty and how the profession works in collaboration with and not insubordinately to medicine. Now is the time to start teaching and empowering the voices of nursing students.  I want to hear your stories as nursing graduates.  Where and in what situations are the most overwhelming to speak up about? Join in the discussion and be heard.

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