New Jersey Nurse - April 2021

Page 10 New Jersey Nurse & Institute for Nursing Newsletter April 2021
Caught in the Chaos:
The Pandemic Precepting Predicament
Clinical Professor Clarese M. Bradley
MSN, RN, ACNP
Identifying your calling in life is something that few
get the opportunity to experience. When the calling
is greater than yourself one may consider themselves’
fortunate. They map their route and set out on their
journey, establishing benchmarks. Nurses are no
stranger to this, anxiously setting high hopes for the
day they are able to put their skills to use. Before
that day they must endure intense training, endless
study nights and challenging exams. They yearn to
complete benchmarks; graduation, National Council
Licensure Examination (NCLEX) and their first
nursing assignment. These are the tales I, a clinical
professor, hear nursing students speak of.
What does a novice nurse do when their dreams
are met with a reality nightmare - the Corona Virus
Pandemic, infamously known as “COVID-19?”
COVID-19 has overshadowed the medical field casting
anxiety, fear, doubt and hopelessness in even the most
experienced of medical professionals. The normal rite
of passage for new nurses, preceptorship, has been
marred by COVID-19. Nurses have had to endure
increased work demand, lack of medical supplies
and support. Although not new, burnout has been
exacerbated at an accelerated rate, within nursing.
Welcoming first day orientation by experienced nurses
has been replaced with exhausted and frustrated
nurses forced to find the emotional strength to nurture
impressionable new nurses. More disconcerting is
preceptorship by first year nurses, due to insufficient
staffing. I have personally witnessed both in my time
at the bedside during this pandemic.
Where does this leave our new nurses? How does
the exhausted bring up the apprehensive novice?
What little strength that is left in our experienced
nurse is reserved for their families and/or personal
lives. This misrepresentation orients the novice nurse
into a fight or flight response, creating a two-prong
problem:
Fight: Those that stay may be trained by
unseasoned nurses resulting in the compromise of
patient care. Should this become the new norm we
can expect to see more medical errors, threatening
the positive outcome of patient care.
Flight: Novice nurses overwhelmed by lack of
guidance, affirmation, and emotional support may
feel inept. They may feel their personal calling was
illogical and instead may seek alternative career
options, risking the continued nursing shortage across
the nation.
Where will this leave the future of nursing?
Recruitment, retainment and resiliency should be
made priority. Nurses represent approximately 50% of
the healthcare work force.
To the community, nurses are the icons of trust in
healthcare. It is because of this high regard nursing
needs to be viewed as a profession rather than a
vocation. The pandemic has been brutal but when
has the nursing profession been for the fainthearted!
This is a time that we look to nursing leaders,
educators, and mentors to exemplify why their role
is so imperative. Our new nurses deserve dedicated
training. This is a call to uphold the pride of nursing
through strong leadership, guidance, and composure.
This is a call to all education programs to put their
best recruitment and training efforts forward. Lastly
this is a call to all professional nursing associations
and boards to highlight the vitality of this profession
and charge our leaders to remain the consistent
caregivers we are.
What more could I have done?
A nurse educator’s reflection on student outcomes.
Dr. Erica Edfort, DNP, NVRN-BC, RN-BC, FAHA
As nurse educators, we provide our students with knowledge coming from
years of experience in various health care settings. We mentor them through
their academic careers. However, at times, we see our efforts are not enough for
our students to achieve successful outcomes. We deliver the traditional classroom
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instruction which usually includes multiple teaching/learning methods such as
lectures, case studies, classroom discussions, to name a few. As faculty, we mentor
our students through difficult times, holding tutoring sessions, offer additional
aids to our students, such as 1-on-1 consultations, review sessions, or hands on
demonstrations to support our students. With the efforts we provide as nurse
educators, we hope that the outcome of our efforts has empowered our students
to succeed.
There may be many issues in today’s world that lead students down an
unproductive path. The problem may be time management (work-school-life
balance), personal issues, comprehension of academic material, or a myriad of
other things. Unless we, as nursing faculty, can identify the barriers, the outcome
may not be as expected and result in unsuccessful completion of a nursing
course. With this outcome comes a variety of issues on the faculty side – realizing
that our efforts were in vain for some students may place a faculty member at
a disadvantage – will he/she feel that they did everything in their power to help
the student to succeed? Will the faculty member look at the student’s path to see
“is there anything else I could have done for this student?” Unless there is an
established plan, the faculty member must act accordingly – notify the student of
his/her unsuccessful attempt in the class.
Looking back on the efforts of the student throughout the academic session,
is the accountability on the student to seek assistance if he/she is not performing
effectively? Has the faculty member kept the student in his/her sights and
identified them as an “at risk” student, offering all resources to lead the student
down a different path? But is the issue only on the student’s shoulders? Are faculty
prepared to “fail” a student if he/she underperforms in the academic setting? The
support faculty provide will not only be to assist the student to gain knowledge in
subject matter; however, if needed, they must also support the student during the
difficult time of realizing their efforts have not been successful in the academic
setting. Elliott (2016) recognized that faculty may require knowledge and skill to
support an unsuccessful student while in the process of discussing the potential
negative outcome. Peate (2018) identified that faculty may be reluctant to fail
students who do not meet the learning outcomes. Do faculty require additional
training to identify the need to make the appropriate decisions in these situations?
Do they need to gain knowledge of how to mentor students effectively who are
falling behind and have difficulty meeting the course requirements?
As faculty, we must first identify students who do not demonstrate the
application of knowledge in the classroom setting as an “at-risk” student.
North, Kennedy, Wray (2019) identified several reasons which may deter faculty
from recognizing underperforming students, such as faculty who exhibit lack of
confidence; unwillingness to devote time required to fail a student and emotional
impact of failing a student. So, as an educator, we need to look deeply to
determine… is it me or is it my student who needs assistance?
References:
Elliott, C., (2016). Identifying and managing underperformance in nursing students. British
Journal of Nursing. 25(5). 250-255
North, H., Kennedy, M., Wray, J. (2019). Are mentors failing to fail underperforming
student nurses? An integrative literature review. British Journal of Nursing. 28(4),
250-255.
Peate, I. (2018). Failing to Fail. British Journal of Nursing, 27(7): 355-355.
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