Redesigning nursing for 2020

For University of Wisconsin Oshkosh College of Nursing students, a lifelong commitment to learning is the rule, not the exception.

As the newest cohort of nursing majors recited the Professional Nursing Pledge during their February Welcoming Ceremony and began to take their first classes in the core curriculum this spring, members of the College of Nursing faculty were gearing up for some major studying and learning of their own.

“Since 2000, the healthcare system has been under reform,” CON Dean Rosemary Smith said. “Tomorrow’s nurses won’t be delivering healthcare in the same way as they do today. Therefore, we need to transition how we teach.”

The transformation in the healthcare industry coupled with the current economic downturn has meant that the need for nursing care is shifting away from hospitals toward a greater diversity of settings, from outpatient and in-home care to public health and school environments.

Nurses are performing more of the necessary direct patient care, while juggling increasingly complicated diagnostic and treatment regimes. In addition, a shortage of nurses in America since 1998 has staff stretched thin, putting patients at risk.

A Call for Change

Smith points to a number of key forces driving higher education’s response to the healthcare transformation.

First, the American Association of Colleges of Nursing (AACN) has called for more transparency in healthcare.

For instance, as soon as a problem arises with a patient, members of the healthcare team must immediately begin problem-solving a solution not spend time hiding the problem or covering for each other, Smith explained.

Junior I nursing student Ross Hietpas, of Appleton, assesses SimMan, a computerized patient, during a clinical simulation in the Simulation Laboratory.

The AACN also calls for a greater emphasis on informatics and electronic charting; more evidence-based nursing practice; and a better understanding of the impact of changing technology on nursing.

“Training for nursing students in informatics is crucial to building a coordinated standard of care across the profession,” said Tom Veeser, chief nursing officer for Affinity Health System and a member of the CON’s Board of Visitors.

Another key influencer for change in nursing education is the Carnegie Foundation for the Advancement of Teaching’s 2009 study, Educating Nurses: A Call for Radical Transformation.

“Educating Nurses challenges us to increase the rigor of science for nurses to the same level as doctors and to work to increase the number of nurses with associate degrees to pursue their BSNs,” Smith explained.

Finally, in October 2010, the Institute of Medicine released its report, The Future of Nursing: Leading Change, Advancing Health, which offers a blueprint for transforming nursing education.

The report’s four key messages include:

  • Nurses should practice to the full extent of their education and training.
  • Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.
  • Nurses should be full partners, with physicians and other healthcare professionals, in redesigning healthcare in the United States.
  • Effective workforce planning and policy making require better data collection and information infrastructure.

“The Future of Nursing tells us that nurses need to be in leadership roles on the healthcare team and be equal partners in problem-solving. They need to be transformational leaders,” Smith said.

Veeser said in order for today’s nurses to act as change agents, they need to understand how to apply concepts from the business world, such as total quality management, to the nursing profession.

The College’s Response

At the top of the CON faculty’s plans for change is moving toward spending less time lecturing and more time applying knowledge.

“There’s no time to have our students attend lectures and just spit back the facts on a test,” Smith said. “Today, it’s about getting to the ’so, what?’ of a concept. We can’t just teach a concept, such as the body’s acid/base balance. We need to teach students how to apply the concept in their nursing practice and consider implications for a patient’s health.”

Senior I students Amanda Bodjanac, of Green Bay; and Crystal Kennedy, of Fall River, provide care during a simulation exercise in the Elmer Leach Laboratory.

With best practices changing so fast, CON faculty also will be spending more time teaching students where to look for the latest, up-to-date information and search out the most relevant treatment for their patients. Already, all students in the major are required to have a laptop and a PDA (personal digital assistant) for their coursework.

In addition, UWO’s nursing students will spend more time in small groups, learning how to solve problems as a team.

As for the coursework itself, CON faculty members have spent weeks researching and developing critical curriculum revisions that address the changing needs of the profession without adding additional credits to the program.

Undergraduate program director Suzanne Marnocha said the changes include:

  • Making a current popular elective, Heathcare of Ethnic Groups, a core prerequisite for acceptance into the clinical major.
  • Building a new seven-week informatics course for second-semester sophomores.
  • Increasing the number of clinical hours spent learning about home care and caring for the elderly as part of the Long-Term Care Focus class.
  • Adding an Advance Care Concepts theory course and clinical to the final semester of the senior year to act as a synthesizing capstone of the entire curriculum.

“The changes are really exciting, and they don’t increase credits required or time spent in the program,” Marnocha said. “We also want our students to know that we aren’t throwing out our current solid academic program, we’re making it stronger.”

Veeser agrees that UWO is providing a broad-based educational experience. “Students are getting the core knowledge that they need before heading into the industry where their skills are fine-tuned according to the specialty area that they pursue.”

Training the Trainers

With the curriculum revisions for next fall underway, the College faculty members continue to practice their own lifelong learning, as they sit in on webinars, learn the latest techniques at in-service sessions and attend national conventions.

Nursing students Gina Buzzanca, junior I, Mequon; Josie Petrie, junior I, Mount Calvary; David Vogt, junior I, Mount Horeb; Hannah Evans, junior II, Omro; and Jessy Glaser, junior I, Oshkosh, collaborate during a medical/surgical study group.

In March, CON’s assistant director of student academic affairs Becki Cleveland and assistant professor Shelly Lancaster attended the AACN’s landmark Quality and Safety Education in Nursing Consortium Institute in Chicago to learn the skills, knowledge and resources necessary to educate UWO’s nursing students.

The institute’s aim is to “train the trainer,” so participants can return to their campuses ready to lead other faculty in efforts to incorporate the latest innovative techniques into the classroom.

Indeed, Cleveland and Lancaster returned with “tons” of information and inspiration to implement the necessary changes. “The institute impressed on us that the focus on safety is beyond just being important, Cleveland said. “We heard over and over that people’s lives depend on this. I believe this mantra will resonate with students.”

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  1. I need to to thank you for this great read!! I absolutely loved every bit of it. I have you saved as a favorite to look at new stuff you post…

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