Teaching~No go in the USA

Teaching~No go in the USA

Part of the reason I became a nurse was because of the opportunity to teach.

Many years ago, I was given an opportunity to go back to school. I was faced with the decision of what career path to take. After talking with many teachers and nurses, I realized that if I chose teaching, that’s what it would be, but if I chose nursing, it could be anything from research, patient care, and even teaching!

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Throughout my nursing career, my goals and direction were always clear to me. In my early nursing days, I took workshops in mentorship and volunteered to orientate and preceptor students and new staff. I felt pride in guiding the next generation of nurses towards a safe and fulfilling career. My health authority supported these efforts with available mentorship programs and my employer must have felt I was proficient at the mentorship process as they entrusted me with the role.

In 2012, an opportunity came up to clinically teach in the emergency nursing program. I enjoyed this level of teaching and stayed with the program for 2 years. I had so many amazing ED nurses in my clinical groups and felt so proud to be a catalyst in those nurse’s careers. But alas things change, and off to the USA we went.

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Shortly after starting my travel nursing career, I embarked on the difficult task of balancing life and the MN (master’s in nursing) program at UVIC. I won’t delve into this topic here as I have previously written about this topic but be sure to check out my previous posts!

We stayed long enough in the USA that not only did I start the MN program, but I also graduated!! So naturally, I wanted to use my new skills and move towards the career I had chosen for myself so many years ago.

I applied for any and all teaching/instructing opportunities both within the hospital system that I was working and at local colleges. As a travel nurse working on a TN visa, I’d need more than luck just to get my resume looked at!

I was able to secure a couple of phone conversations and a few interviews; however, each time the TN status became an issue. The outcome was always the same with a local person getting the job. I couldn’t help feeling that my credentials were valued but just not enough to trump someone local. Although I lack evidence, I am aware that at least one job I applied for that was rewarded to someone without an advanced degree, whatever the factors were, I can only know that I was completely qualified for the position.

After multiple denied applications, it became increasingly clear that I would not be teaching in the USA and the only way to further my career would be to return to Canada. Now, how could we make that happen?

What career decisions have you made that took a lot of effort to accomplish? I’d love to read your story in the comments!

fullsizeoutput_1e3c Trudi MN, RN

This is the way WE do it…

During my time as a nurse, I find myself often asking “how do you do this here?”, a question often used; yet, the frequency of this question seemed to quadruple while I was working in the USA. I guess it is a typical question asked at many new jobs; however, getting a reply of “that’s the way we do it here” was unsettling.

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Healthcare is more than just fixing boo boos. And nursing is more than just “caring”. We are educated and should be using our brains with each assessment, intervention, or treatment we do. There should be evidence-based research that supports what or why we do things, and we must be cautious of not falling into the “that’s the way we do it here” attitude…

When we accept the “that’s the way it’s done here” attitude, we are not taking an evidence-based approach. Sure, potentially when the action was first introduced into the department, it was evidenced-based. And initially, nurses were taught the “why” related to the action; however, over time details become blurred and content becomes saturated with “I don’t knows” or “I don’t remember why we do it this way” until the telephone game is played for so long that we no longer remember the “why”.

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One of the things that struck me while working in the USA, was the lack of specialty training for emergency nursing. Yes, eventually one could study the NENA (National Emergency Nursing Association) book and write an exam to be ED certified, but as we know nursing is more than book work. The norm for training USA ED nurses, in my experience, was preceptorships. Now, this is a changing field of study, and in 2017 there were some more formal education processes being initiated and developed to help establish some standards of education. However, prior to this point, nurses were hired into the ED, received approx. 12 weeks of preceptorship, and then were “ED nurses”. I’d also like to say, that I have worked with some amazing nurses whose knowledge base is/was tremendous; however, it’s a long road for some and no one can deny the gaps in knowledge discovered along the way.

As an ED nursing specialty certified RN (BCIT) and a grad student (at the time), I saw an opportunity to look at this issue deeper and found that very few schools in the USA offered specialty training but awareness on the lack of specialty training was gaining ground and specialty training was emerging as a new norm. The research indicates that patient outcomes, length of stay, and patient satisfaction are all improved with advanced trained nurses on staff. The numbers are significant enough to support advanced training for nurses and encourage employers to set this as a new standard!

Through developing these programs, even in-house ones, the field of emergency nursing can only benefit. Through standardization, nurses will receive the same education with smaller variances in information delivery, thereby increasing the understanding of why we do something verses the “just because” answers. Although, the USA is slow to introduce this level of education (in BC it’s been established since 1985), it is refreshing to know that it is in progress!

I am happy to share my research on this topic and encourage nurses to advocate for advance training in specialty areas! Keep up the brilliant work!

Well done my USA friends!

Do you have a story or comment you’d like to share, please feel free to contact me or leave a comment!

fullsizeoutput_1e3c Trudi

(some images in this post are from unknown sources, no copyright infringement intended)