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Educating For Tomorrow

AS HEALTH CARE REFORM continues to dominate the headlines, the increasingly important role nurses will play in health care is undeniable, especially as baby boomers continue to age, adding an extra burden to the health care system and only exacerbating the already severe nursing shortage.

At a recent forum on the nursing profession and health care reform held at the School of Nursing and Health Studies in mid-October, Dean Nilda Peragallo, Dr.P.H., R.N., F.A.A.N., called for an “investment in nursing” as a way to recruit more nurses for the future as well as effectively educate nursing students for what’s to come. The school is committed to effectively educating the next generation of nurses by staying ahead of the curve on a variety of technological and academic fronts to ensure its students are as prepared as possible to enter the nursing profession upon graduation.

To do so, today it offers a variety of cutting-edge degree programs, uses advanced technology to teach pivotal clinical skills, incorporates current research (evidenced-based) practice into its course curriculum, and keeps abreast of relevant health care issues and concerns—all this in an effort to properly prepare tomorrow’s nurses for the future.

Creating New, Innovative Degree Programs

In addition to the traditional degree offerings such as the B.S.N, M.S.N., and Ph.D., faculty and staff have worked diligently over the last several months to adapt the school’s curriculum by offering a variety of new, cutting-edge degree programs. The accelerated B.S.N and the Doctorate in Nursing Practice (D.N.P.) program, for example, were specifically created to meet the learning needs of incoming students as well as address the marketplace’s everchanging health care needs.

The D.N.P. program, launched earlier this year, now prepares expert nurse practitioners to design, administer, and evaluate practice interventions and health care systems with a special focus on reducing health care disparities. The program helps address the national nursing shortage by increasing the number of clinical experts qualified to teach at the graduate and undergraduate levels.

Educating more doctorally-prepared nurses is central to the school’s mission. Without increasing the number of clinical faculty, the school cannot do its part to address the critical nursing shortage. More than 32,000 qualified applicants to baccalaureate and graduate nursing programs were turned away nationwide last year due to insufficient faculty and resource constraints, according to the American Association of Colleges of Nursing (AACN) (2007). A recent surge in individuals choosing nursing as a second career prompted the school to develop alternate pathways so that “mature learners,” or students with a bachelor’s degree in another field, can take an accelerated degree option and graduate with a B.S.N. degree in as quickly as 12 months.

Even the types of advanced practice nursing experiences graduate students are looking for has changed, and with it, what the school offers. To accommodate these varied interests the school created a nursing certificate program focusing on clinical nursing education in 2006. Soon after, a growing number of nurses who had completed the certificate program became interested in continuing their education with an M.S.N. in Nursing Education. In response, the school reactivated its M.S.N. in Education program this year.

Using Technology As A Clinical Tool

Teaching nursing students by simulating commonly encountered nursing situations is a dynamic teaching strategy that is becoming a standard part of nursing education. These patient simulators have names like “Harvey” or “Noelle” and can be programmed to mimic a variety of real-life patient characteristics: heart sounds, breath sounds, pupil reactions, blood pressure and in the case of Noelle, can even give birth. These high-fidelity simulators come in all sizes—from infant to adult—and represent a range of ethnic groups.

The school’s state-of-the-art International Academy for Clinical Simulation and Research— the first of its kind in the country—is now used across all of the school’s clinical programs, providing an ideal setting for nursing students to gain valuable hands-on experience. Virtually any type of patient situation can be simulated. On one recent Tuesday, for example, nine nursing students learned how to care for a patient with a tracheotomy, a surgical incision of the trachea through the neck that opens up the windpipe, allowing for more air to flow into the lungs.

“This patient could have throat cancer, be in a vegetative state, or be a small infant whose lungs never fully matured,” explains Susana Barroso, B.S.N., R.N., a nurse educator working with students in the simulation academy.

Students encounter each of these situations in an environment where they can practice suctioning the patient or changing the tracheotomy dressing over and over again, ensuring that by the time they perform this for a real patient their technique is flawless and they are confident.

“The Institute of Medicine made patient safety a priority nationwide,” explains Gail C. McCain, Ph.D., R.N., F.A.A.N., professor and vice-dean and the school’s senior associate dean for academic affairs. “And that is one of the main goals of patient simulation so that if practitioners and students make mistakes these mistakes do not occur in a real setting, where potential harm to a real person exists.”

The simulators also can “talk back” to the nurse, saying that they are in pain, that they cannot breathe or a variety of other phrases. “Simulators provide us with a great deal of feedback because they can be programmed to enact specific scenarios so that the nurse obtains a realistic feeling of the situation,” says nursing student Vincent Smith, B.A., a former opera singer who recently enrolled in the accelerated B.S.N. program.

The academy is comprised of four high-tech simulation laboratories, equipped with a critical care unit, a fully functioning ER and operating room (with working anesthesia machine), and includes a post-op and pre-op area, private and semi-private patient rooms, as well as all of the necessary supplies and equipment a nurse could need—including a blood bank.

As students progress through the program, they are able to experience a wide array of clinical simulation situations such as witnessing a birth and performing cardiorespiratory resuscitation on infants as well as child and adult simulators. Here too, Certified Registered Nurse Anesthesist (CRNA) students learn how to induce anesthesia and manage complications that might arise in the OR. Acute Care Nurse Practitioner (ACNP) students practice inserting monitoring lines and managing other emergencies they will encounter one day in an intensive care unit. In addition, the ACNP students practice “taking call” for in hospital emergencies, advising the undergraduate nurse at the bedside by phone in the management of simulated emergency situations.

“I would say the last five years in nursing education have been the most exciting because of the rapid explosion of the use of technology,” says JoAnn Trybulski, Ph.D., A.N.P.-B.C., associate dean for master’s and D.N.P. (Doctorate in Nursing) programs at the school. “Students not only want this type of education, they expect it.”

Incorporating Evidenced-based Practice Into The Cirriculum

The school now places much emphasis on teaching graduate and undergraduate students how to interpret research so they can provide the best [nursing] practice to their patients. As a result, the school continually incorporates evidence-based (or research-based) practice into its curriculum.

“We not only teach our students how to interpret research and how to make sense of it, we also teach them the value of research in their practice, even at the bedside,” says Elias Provencio-Vasquez, Ph.D., N.P., F.A.A.N., F.A.A.N.P., associate professor and 2009 Robert Wood Johnson Nurse Executive Fellow.

The way premature babies are fed in the neonatal unit has changed significantly during the past decade, notes Vasquez. This is due, in part, to new research findings from the school’s own faculty such as McCain, who is nationally and internationally known for her work in this area.

“How these babies are fed, how much they are fed, the method of feeding, that’s all evidencebased and extremely important, because the more weight these infants gain the sooner they can leave the hospital,” Vasquez explains.

The Community As Classroom

The school also takes cues from the community it serves to ensure its course offerings are in line with local health care needs and trends. And when larger medical issues dominate the news, such as when the H1N1 (swine flu) epidemic hit the United States earlier this year, some of the school’s faculty quickly used the news as an innovative teaching tool.

“We now know we can prevent the spread of H1N1, and in a way, it has helped us to reinforce infection control principles in the classroom and in the clinical setting,” explains Joseph DeSantis, Ph.D., A.R.N.P., A.C.R.N., assistant professor. “We constantly are looking at what is going on in the community and globally and then adapting and updating our programs in response.”

Whether students enter nursing as a second career, are attracted by the variety of degree options available at the school, or are lured by the high-tech clinical experiences the school’s state-of-the art simulation academy can offer them, most students enrolling in the field also have an eye on the future.

“I want to progress the field of nursing,” notes accelerated B.S.N. student Smith, who plans to graduate in May 2010 and then go on to obtain an advanced degree. “And one day I can help the next generation of nurses by teaching them what I’ve learned.”