MARYLAND ASSOCIATION OF ASSOCIATE DEGREE NURSING DIRECTORS ANNUAL CONFERENCE OCTOBER 14, 2011...
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Transcript of MARYLAND ASSOCIATION OF ASSOCIATE DEGREE NURSING DIRECTORS ANNUAL CONFERENCE OCTOBER 14, 2011...
MARYLAND ASSOCIATION OF ASSOCIATE
DEGREE NURSING DIRECTORSANNUAL CONFERENCE
OCTOBER 14, 2011
Professionalism:Creating a Nurse
Barbara Cherry, DNSc, MBA, RN, NEA-BC
Maryland Association for Associate Degree
Nursing Directors
THE BENEFITS OF ASSOCIATE DEGREE NURSING – THE FOUR A’S
ACCOUNTABLE: 60% of all Maryland’s registered nurses graduate from AD programs Maryland AD grads consistently perform above the national average on
NCLEX 90% of graduates are employed in Maryland
ACCESSIBLE: Provide access to nursing education for students from broad socio-
economic strata Flexible scheduling options such as evening, weekend programs. Part-time educational opportunities to meet student needs
AFFORDABLE: Mainly publicly funded: cost is approximately $7,000-$9,000. Commands a starting salary range from $40,000 to $50,000 Graduates who continue their education may earn while they learn
ARTICULABLE: Articulation models exist to facilitate educational mobility LPN to AND, ADN to BSN, ADN to MSN, EMT-P to RN
Program Objectives
Analyze professionalism as an explicit set of behaviors and values that require ongoing learning and development.
Examine characteristics of today’s college student and their impact on the development of professional behaviors.
Outline academic infrastructure requirements to support the development of professional behavior among students.
Implement strategies to promote professional behavior in the classroom and clinical setting.
Treat professional development as an ongoing process of learning and development.
Today’s Agenda
Today’s college studentWhat is “professionalism”?The evidence for teaching professionalismModel for “creating a nurse”
Program standards – Leadership support Evidence-based teaching strategies Innovative programs and curricula
Student responsibilities
National League for Nursing: Excellence in Nursing Education
Questions to Consider
Professionalism: What is it and how can it be meaningful to students?
Professional development: How do students come to value and improve their professional behavior?
Teaching strategies: What strategies can be used in the classroom or clinical setting to promote professional behavior?
You are doing a great job!
“Nursing education is very strong in the pedagogies….that are effective in helping
students develop a deep sense of professional identify, commitment to the values of the
profession, and to act with ethical comportment”
(Benner et al, 2010, p. 11)
Benner, P., Sutphen, M., Leonard, V. & Day, L. Educating Nurses: A Call for Radical Transformation. San Francisco: Jossey-Bass.
Getting Started: What is the Problem?
What are the common unprofessional behaviors you observe in your
students?
TODAY’S COLLEGESTUDENTS
HTTP://WWW.YOUTUBE.COM/WATCH?V=DGCJ46VYR9O
Generational Differences
Millennials: Born 1982 – 2002Generation X: Born 1965 – 1982
Baby Boomers: Born 1946 - 1964Traditionalists: Born 1900 – 1946
Millennials
Grew up in a time of great prosperityMost protected generation in historyHighly scheduled and sheltered in
childhoodOften indulged and protected from the
concept of “losing”Generally optimistic and strive for a work-
life balance
Millennials
Maintain constant social contact via text, social media, etc..
Regularly use digital devices to interact with the world
Find information on-line rather than using a book
Multitasking is a way of lifeTend to be collaboratively, team-oriented
and prefer group work
Millennials
Today’s Students (Group Work!)
What are the positives and strengths about today’s students?
How can you capitalize on those strengths to improve their educational journey and promote professionalism?
PROGRAM STANDARDSand
LEADERSHIP SUPPORT
Foundational Support to Promote Professionalism
Commitment to promote professionalism “from the top”Consistent expectations across all courses and
clinical experiencesConsistent consequences across all courses and
clinical experiences supported by policiesInclusion of professionalism in the formal
curriculum Commitment to faculty development
http://www.nursing.iupui.edu/students/professionalism.shtml
Policy Implementation
Increasing the chances for successful policy implementation VALUES: Views about what should be BELIEFS: Assumptions about what is INTERESTS: Responses to incentives and
rewards
Primary Goals for Students
To become a skilled and serious professional who knows how to
dress and act the part
To engage in the desire to become a respected member of their
chosen profession
Keys to Student Development
Faculty must be vested in the student’s success though role-
modeling
Create a sense of pride and excitement in the student’s chosen
profession
Faculty Expectations
Role model professional behaviorBe aware and responsible for your own behaviorOne study found observed faculty (Clark, 2007):
Belittling students Changing policies and procedures Demonstrating bias and discrimination Prevalence is estimated to be 50% of faculty
Clark, C. & Springer, P. (2007). Thoughts on incivility: Student and faculty perceptions of uncivil behavior in nursing education. Nursing Education Perspectives, 26(2), 93-97.
EVIDENCE-BASED TEACHING METHODS
Evidence-Based Teaching
Theoretical framework Situational learning theory
Cognitive learning combined with real-world activities or experiential learning
Explicitly teach the cognitive base of professionalism Knowledge and ability to articulate the concept
is essential Provide a list of traits and characteristics
expected of the professional
Promoting Professionalism
Cognitive Learning + Experiential Learning =
Development of Professionalism
Professionalism: Exactly what is it?
Basic Professional Behaviors Honesty and integrity Reliability and dependability Accountability Respect and courtesy towards others Professional appearance
Neat, well-dressed conveys a higher level of knowledge
Appearance cannot guarantee success but it can ensure failure
Professionalism: Exactly what is it?
Basic Professional Behaviors (continued) Discretion and confidentiality Professional communication Compassion Maintain appropriate boundaries Believe in and support colleagues Commitment to personal health
Development of Professionalism as a Continuum
Advanced Professional Behaviors Cultural humility
Avoid introducing irrelevant and destructive bias into clinical practice and professional relationships
Nonjudgmental behavior Commitment to excellence
Clinical excellence Personal standard of excellence – be the best
that you can be
Development of Professionalism as a Continuum
Advanced Professional Behaviors Willingness to examine one’s own
behavior and take responsibility for actions and reactions
Commitment to lifelong learning Patient advocacy Involvement in professional organizations Pursuit of advanced education
Development of Professionalism as a Continuum
“Partnership with the public” to provide safe patient care
“Excellence in nursing is not just about kindness. It’s about providing thoughtful,
complex intellectually-demanding care with compassion”Diana J. Mason
Fashioning the Right ImpressionImprint, February/March 2009, page 29
How do professional behaviorslook in practice?
Guide students to visualize how professional behaviors are actually practiced in classroom & clinical setting: Discusses patients in a respectful manner and only when
appropriate Takes responsibility for being on-time and prepared for
class Seeks help and guidance from instructors, preceptors,
and/or other health care professionals Maintains composure during difficult interactions Shows initiative for own learning Focuses on healthy behaviors – eating right, exercise and
adequate sleep
What does unprofessional behavior look like?
Sloppy, unkempt appearance with violations of the dress code Failure to be prepared for class or clinical assignments Requires continual reminders about responsibilities to fellow
students or to patient care assignments Lack of conscientiousness – failure to fulfill responsibilities –
doing only the minimum Lack of effort towards developing and improving clinical
skills Failure to accept responsibility for errors and to learn from
mistakes Poor interactions and/or a lack of respect for fellow students,
instructors, patients and families Chronic fatigue and sleep deprivation Arrogant and demeaning behavior
Skills for Professionalism
Specific skills needed by the novice professional Clinical skills Interpersonal skills
Professional communication Self-control to manage difficult encounters
Time management skills Planning Organizing Delegating Priority setting
Personal health and energy management
Consequences of Unprofessional Behaviors
Inability to get hiredInability to keep a jobFailure to be promotedLack of respect from clients and colleaguesPotential legal consequences
INNOVATIVE PROGRAMS & CURRICULA
What would you do to promote professionalism among your
students?
Teaching Activities
Exposure to expert, highly respected role models Role models across several levels from student
leaders, staff, faculty and practicing professionals
Story Telling Address negative role modeling Provide opportunities to discuss professional issues in
a safe environment Tell about a time when a coworker or fellow student
showed true professionalism
Teaching Activities
Encourage self-reflection through journaling Keep a log of experiences and reflect on the
professional behaviors experienced or reinforced Learning from lapses in professionalism
Internet Exercises – Social MediaInvolvement in professional activities outside
the classroom or clinical setting Journal clubs National Student Nurses Association Seminars with local, state and national nurse leaders
Free from the National Student Nurses Association
Diana J. Mason: Fashioning the Right Impression. February/March 2009
Donna Cardillo: Projecting Your Professionalism, February/March 2009
Kathleen Pagana: Your Professional Presence: Advice on Dress and Appearance. February/March 2009
Teaching Activities
Make expectations and consequences completely clear and CONSISTENT Ground rules for conduct, dress and
behavior in clinical and classroom settings Learning contracts for individual students Clear communication about how the student
is or is not meeting professional expectations
Teaching Activities
Use case scenarios Example: During lunch, a student makes
demeaning remarks about a patient he has seen in the clinic today; Discussion questions What do you think of this behavior? Is the student
acting professionally? Is the student breaching confidentiality by
describing details about the patient to other students who are not directly involved in the patient’s care?
How would you respond to the student’s remarks? Student experiences Scenarios from popular TV shows
Professional Code of Conduct
Sample statements from the Code of Conduct for Student Nurses (from the National Student Nurses Association) Advocate for the rights of all clients. Maintain client confidentiality. Take appropriate action to ensure the safety of clients, self, and others. Provide care for the client in a timely, compassionate and professional
manner. Communicate client care in a truthful, timely and accurate manner. Actively promote the highest level of moral and ethical principles and accept
responsibility for our actions. Promote excellence in nursing by encouraging lifelong learning and
professional development. Treat others with respect and promote an environment that respects human
rights, values and choice of cultural and spiritual beliefs. Strive to achieve and maintain an optimal level of personal health.
What Now? Start on the Right Side
Wait and hopeBlame selfBlame othersDenial“Somebody should do
something”
Take action and learnFind solutionsAccept ownershipAcknowledge
situation“It starts with me”“It starts with me”
Complex WorkGlouberman, S. & Zimmerman, B. (2001). Complicated and Complex Systems: What Would Successful Reform of Medicare Look Like? Available
online at http://www.plexusinstitute.org/resource/collection/6528ED29-9907-4BC7-8D00-8DC907679FED/ComplicatedAndComplexSystems-ZimmermanReport_Medicare_reform.pdf
Simple: Following a Recipe Complicated: Sending a Rocket to the Moon
Complex: Raising a Child
The recipe is essential Formulae are critical and necessary Formulae have a limited application
Raising one child provides experience
Recipes are tested to assure easy replication
Sending one rocket increases assurance that the next will be OK
No assurance of success with the next child
No particular expertise is required. But cooking expertise increasessuccess rate
High levels of expertise in a variety of fields are necessary for success
Expertise can contribute but is neither necessary nor sufficient to assuresuccess
Recipes produce standardized products
Rockets are similar in critical ways
Every child is unique and must be understood as an individual
The best recipes give good results every time
There is a high degree of certainty of outcome
Uncertainty of outcome remains
Optimistic approach to problem possible
Optimistic approach to problem possible
Optimistic approach to problem possible