texa s nu r s e s .o rg
TEXASNURSING M A G A Z I N E
UNDER THE DOME 85TH LEGISLATIVE RECAP
THE NURSING FACULTY SHORTAGE TRANSITION TO ACADEMIA T N A : E m p o w e r i n g Te x a s N u r s e s t o a d v a n c e t h e p r o f e s s i o n | S u m m e r 2 0 1 7
SUMMER 2017 Volume 91, Number 3 EDITOR-IN-CHIEF: Cindy Zolnierek, PhD, RN MANAGING EDITOR: Kat Hinson 8501 North MoPac Expressway, Suite 400, Austin, TX 78759-1292 P: 800.TNA.2022 or 512.452.0645; F: 512.452.0648 tna@texasnurses.org | texasnurses.org
MISSION Empowering Texas Nurses to advance the profession
BOARD of DIRECTORS OFFICERS: Jeff Watson, DNP, RN-BC, NEA-BC, NE-BC, CRRN, President Kim Belcik, PhD, RN-BC, CNE, Vice President Kleanthe Caruso, RN, MSN, NEA-BC, Secretary Gayle Dasher, RN, PhD, ANP-BC, Treasurer DIRECTORS: Rhonda Winegar, DNP, RN, FNP-BC, CCRN, CPN Tamara “Tammy” Eades, DNP, MSN, RN Pam Greene, PhD, RN Patricia Freier, MSN, RN-BC, RCIS Shakyryn Napier, DHSc, MSN, RN, CPN EXECUTIVE DIRECTOR: Cindy Zolnierek, PhD, RN
TNA DISTRICT AND PRESIDENT
VISION Nurses Transforming Health TEXAS NURSING (ISSN 0095-36X) is published quarterly – Winter, Spring, Summer, Fall – by the Texas Nurses Association, 8501 N. MoPac Expy., Ste 400, Austin, TX 78759-8396 Periodical Postage is paid in Austin, Texas. One-year subscriptions: $25 (nursing schools, libraries, hospitals, non-nurses, out-of-state nurses) foreign, $30; single copy, $2.50. Subscription is not available to non-member Texas nurses. Some back issues may be viewed online at texasnurses.org. PUBLISHING PARTNER Monarch Media & Consulting, Inc. P: 512.680.3989 or 512.293.9277; F: 866.328.7199 monarchmediainc.com | chellie@monarchmediainc.com Advertising inquiries call Chellie Thompson at 512.293.9277.
Dist.1:
Paula Meagher, 915-831-4530, pmeagher@epcc.edu
Dist. 2:
Sharon Brewer, 806-414-9336, sharon.brewer@ttuhsc.edu
Dist. 3:
Linda Dunn, ladynurse101@aol.com, District office: 817-249-5071, tna3@usapathway.com, tna3.org
Dist. 4:
Jackie Michael, michaels@uta.edu, District office: Pat Pollock, P.O. Box 764468, Dallas, TX 75376; 972-435-2216; d4tna@flash.net; tnad4.org
Dist. 5:
El Burley, d4tna@flash.net
Dist. 7:
Patricia Phelps, psphelps1993@gmail.com, District office: P.O. Box 1482, Belton, TX 76513
Dist. 8:
Linda Juenke, 830-739-7028, ljsoaringeagle3@gmail.com
Dist. 9:
Lisa Boss, lisa.boss@uth.tmc.edu, District office: Melanie Truong, 7324 Southwest Freeway, Suite 2-1453, Houston, TX 77074; 713-523-3619; tna9@tnadistrict9.com; tnadistrict9.com
Dist. 10: Anita Farrish, 254-421-9797, anitafarrish2001@yahoo.com
TEXAS NURSING is indexed in The Cumulative Index to Nursing and Allied Health Literature and in the International Nursing Index. 16mm, 35mm microfilm, 105mm microfiche, article copies available from University Microfilms International: 1.800.521.3044
Dist. 11: Paula Parks, 940-224-3533, wfparksdept@gmail.com
Statements of fact and opinion are made on the responsibility of the authors alone and do not imply an opinion on the part of the officers or the membership of TNA.
Dist. 14: Eloisa Tamez, 956-882-5079, eloisa.tamez@utrgv.edu
POSTMASTER Send address changes to TEXAS NURSING, 8501 North MoPac Expy., Suite 400, Austin, TX 78759-8396 ARE YOU MOVING? Need to change your address? If so, provide it quickly and easily in the Members Only section of the TNA web site, texasnurses.org. Or mail us your new address — at least six weeks prior to your move — to Texas Nurses Association headquarters. We’ll make sure your TEXAS NURSING makes the move with you. FEEDBACK EMAIL OR LETTER GUIDELINES TEXAS NURSING will select emails/letters on the basis of readership interest and relevance to current nursing/health care events. TEXAS NURSING reserves the right to edit all letters. Guide: Limit to 200 words; focus on single issue; include writer’s name, mailing address, and daytime phone. Send to: editor@texasnurses.org.
Dist. 12: Heidi Wolf, 409-853-5900, HWolf@iasishealthcare.com Dist. 13: Nannette Kelley, nannettekelley@msn.com
Dist. 15: Andrea Kerley, 325-670-4230, akerley@hendrickhealth.org Dist. 16: Vacant Dist. 17: Cindy Keese, 361-332-1643, cakeese@aol.com Dist. 18: Darla Smith, darla.smith3@stjoe.org Dist. 19: Colleen Marzilli, cmarzilli@uttyler.edu Dist. 20: Deborah Peña, 361-570-0356, debbie.pena@victoriacollege.edu Dist. 21: Jessica Tully, 432-254-1949, jessica.tully@midland-memorial.com Dist. 22: Toni McDonald, 936-544-8823, t.mcdonald323@yahoo.com Dist. 26: Elizabeth Adamson, 956-362-3015, e.adamson@dhr-rgv.com Dist. 28: Jessica Smallwood, 903-280-2071, jessicasmallwood@me.com Dist. 35: Chrystal Brown, 903-434-8302, cbrown@ntcc.edu Dist. 40: Contact TNA, 800-862-2022, ext. 129, brichey@texasnurses.org.
Copyright 2017 © Texas Nurses Association Printed on Recycled Paper
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UNDER
16
THE DOME
GETTING HIRED IN ACADEMIA
LEGISLATIVE UPDATE 85TH LEGISLATIVE SESSION
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COVER: photo courtesy iStock
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PRESIDENT’S NOTES
TNA MEMBER NEWS
FROM CLINICAL TO CLASSROOM
The Gift of Ordinary
Kudos
THE NURSING FACULTY SHORTAGE
My Experience as a New Adjunct Clinical Faculty Member
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S U M M E R 2 017 | T E X A S N U R S I N G M AGA Z I N E
SAN ANTONIO, TX
YOUR STORY. YOUR PATH. YOUR TIME.
Your career in nursing leadership begins at the University of the Incarnate Word (UIW). Here you’ll find one of the most successful nursing programs in the region offering excellent undergraduate and graduate programs including the Master of Science in Nursing Leadership degree. This flexible program of study allows the student to apply knowledge and expertise to improve healthcare for clients at the system level of care. Registered nurses seeking to advance their career will thrive in the RN to BSN pathway. Future Family Nurse Practitioners and Psychiatric Mental Health Nurse Practitioners have the opportunity to succeed in UIW’s BSN to DNP program. You have the potential to make a healthy difference. Discover how right here. uiw.edu/nursing DISCOVER THE POWER OF YOU
IT’S HERE.
President’s Notes Jeff Watson, DNP, RN-BC, NEA-BC, NE-BC, CRRN
THE GIFT OF ORDINARY
WHEN I UNLOCK THE DOOR to my office, this photograph (at right) is the first thing I see. It’s a print of my mother’s hand held by my own hands. Looking into this picture is part of my ordinary workday. When I take the time to linger over it, I’m reminded of truths and life lessons that continue to inform and guide me in life and in my practice as a professional registered nurse. I’m reminded of the power that resides in the ordinary aspects of our lives. Everything that late spring morning signaled that it was an ordinary day, except that it wasn’t. I unlocked the front door of my mom’s house and found her struggling to get out of bed. It was clear that she was at the point where she could no longer care for herself. Her condition had deteriorated and warranted more than I could offer, so I called the paramedics. Soon after, they arrived and performed their assessment. Without hesitation, they recommended further assessment at the emergency center. In what appeared to be a fatigued surrender, my mother agreed. As the paramedics began their preparation for transport, I noticed my mother looking around her bedroom. Her eyes scanned the room, stopping on the wall holding photos of all eight of her grandbabies — each one taken when they were three months old. I can’t begin to tell you how many mornings she roused to see those adorable faces looking down on her. Nor can I tell you how many nights those photos and the volumes of memories associated with them kept her warm as she closed her eyes to rest. But, I can tell you that it
was an ordinary part of her life. She kept looking about the room, as though to take a mental inventory of the space. After moving her onto the gurney, the paramedics started to maneuver her out of the bedroom and down the hallway. She asked them to go slowly. In response, one of the paramedics told her that they would be careful and promised not to damage the walls or doorframe. I think I knew that she wasn’t really concerned about physical damage to the house; I believe she wanted a chance to continue her inventory. I trailed behind, watching her as she turned her head to look at the photos of her children that had lined the hallway for decades. I can’t tell you how many hours she spent reminiscing and cherishing those photos. Nor can I tell you how many times she gave guided tours of them, telling stories about each one of us to other family members, friends, and neighbors. But, I can tell you that it was an ordinary part of her life. In retrospect, I believe my mother knew that the comfort and security of the life she had known was slipping away. I believe she knew that she wouldn’t be coming back. I assumed that her willful actions that morning indicated that she was trying to hold onto treasured memories. I don’t think that anymore. It’s taken me a long time to fully integrate the events of that morning with what I knew to be true about my mother. Over the years, I’ve come to appreciate that her deliberate actions were not a desperate attempt to hold on, but rather an acknowledgment of her gratitude for the gift of the ordinary.
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What would our practices look like if we took time each day for intentional awareness of the merits of the ordinary? In my practice and in my role as president of this association, I am consistently prompted to consider how valuing the ordinary in our lives might inform our nursing and health care-related policy initiatives. What would our practices look like if we took time each day for intentional awareness of the merits of the ordinary? How would our interactions with our colleagues and those who seek our care be changed? Is it possible that the perspective from the ordinary can become a liberating framework from which we promote health and strengthen health care? When you unlock the doors to the communities of life that you serve, what aspect of the ordinary do you see? Whatever it is, I hope that you will linger there and reflect on its immense importance. I also hope that you will join me in further considering the gift of the ordinary, and its potential, as we work together to influence the trajectory of health care in Texas. Peace, Jeff i
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TNA MEMBER NEWS SPOTLIGHT ON YOU KUDOS Alexa K. Stuifbergen, Ph.D., RN, FAAN, dean of the UT Austin School of Nursing and James Dougherty Centennial Professor; and Lorraine O. Walker, EdD, MPH, RN, FAAN, Luci B. Johnson Centennial Professor, were two of only 23 international nurse researchers inducted into the Sigma Theta Tau International Nurse Researcher Hall of Fame during the organization’s 28th International Nursing Research Congress in Dublin, Ireland. The Hall of Fame recognizes nurse researchers who have achieved significant and sustained national or international recognition and whose research has improved the profession and the people it serves. The honorees’ research projects will be shared through STTI’s Virginia Henderson Global Nursing e-Repository, enabling nurses everywhere to benefit from their discoveries and insights. Stacey Mitchell, DNP, MBA, RN, clinical associate professor at the Texas A&M College of Nursing, is one of the distinguished nurse leaders the American Academy of Nursing honored as a member of its 2017 class of academy fellows. Mitchell and the other 172 inductees will be honored at an October ceremony during the academy’s annual policy conference to take place in Washington, D.C. Fellow selection criteria include evidence of significant contributions to nursing and health care, along with the extent to which the nominee’s
DOCTOR OF NURSING PRACTICE
The
degree prepares advanced practice nurses and nurse administrators to be clinical scholars, nurse executives, or nurse educators. The program’s hybrid format concentrates classroom time to once a month so you can continue to work full time while pursuing your degree.
nursing career has influenced health policies and the wellbeing of all. Sponsorship by two current academy fellows
T E X A S N U R S I N G M AGA Z I N E | S U M M E R 2 017
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is also required, and the applicants are reviewed by a panel comprised of elected and appointed fellows. i
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UNDER THE DOME LEGISLATIVE UPDATE 85TH LEGISLATIVE SESSION
By Andrew Cates, Director of Government Affairs, Texas Nurses Association
AFTER 140 DAYS of what appeared from the outside to be a whirlwind of testimony and debate, the 85th session of the Texas Legislature has concluded. The Texas Nurses Association was active throughout, working to ensure that you and your patients are protected. TNA is proud to represent you, and your government affairs staff looks forward to working throughout the next 18 months preparing for the 2019 session! TNA worked hard this session to make sure appropriate protections for nurses were put into Texas law. We supported sunset legislation which made significant changes to the Board of Nursing's disciplinary process. The requirement for nursing peer review (NPR) committees was expanded so more nurses can access protections afforded by safe harbor and incident-based NPR. Finally, we championed bills that protect your safety in the workplace by removing handguns from state hospitals and supported legislation establishing an innovative grant program for strategies to reduce workplace violence.
TNA CELEBRATES ANOTHER LEGISLATIVE SESSION PROTECTING NURSES’ RIGHTS UNDER THE LAW T E X A S N U R S I N G M AGA Z I N E | S U M M E R 2 017
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Special thanks to the hundreds of Texas nurses who attended TNA’s Nurse Day at the Capitol or any of the APRN Alliance Legislative Days, visited legislative offices, and wrote or called your legislator. Your efforts made a huge difference! If you would like to help us make the next legislative session even more successful, please consider getting involved in your local TNA district so we can have a presence in the hometowns of our legislators!
We've compiled information about this year’s session as well as specifics on the bills followed by TNA.
OVERALL LANDSCAPE The 2017 Texas legislative session began under the auspices of a new presidential inauguration for the first time in four sessions. It also began with a number of new faces and the loss of several well-established members. Fourteen members of the Legislature retired prior to the elections and, all told, we ended up with 26 new legislators for this session.
from around the state and takes collective action on health care bills. The Coalition for Health Care Access and APRN Alliance are newer coalitions. The APRN Alliance consists of TNA and the four statewide associations dedicated to each respective role of APRN practice, and its goal was passage of APRNspecific legislation. The Coalition for Health Care Access is a broader coalition made up of APRN Alliance groups plus business and consumer organizations dedicated to seeing APRN full practice become a reality. It’s because of these groups — and our involvement in them — that so much progress was made in APRN legislation this session.
ADVANCED PRACTICE REGISTERED NURSES
HOUSE
HB 1415 by Klick – The first full practice bill in Texas history to receive a hearing in committee! Would have eliminated the requirement for a Prescriptive Authority Agreement for APRNs.
Republicans – 95 seats out of 150 Democrats – 55 seats out of 150
SENATE Republicans – 20 seats out of 31 Democrats – 11 seats out of 31
Would not have granted Schedule II authority or changed any other practice authority.
What did the changing lawmaker demographics mean for TNA and the nursing agenda? We did significantly more education on nursing issues for legislators who were not aware of the problems currently facing nursing!
Heard in the Public Health Committee. There was pushback from physicians, specifically anesthesiologists, who argued that this would allow APRNs to practice as physicians.
Watch the hearing online here (starting at the 53-minute mark): bit.ly/HB1415Hearing.
While it did not make it into law this time, this bill had a committee hearing for the first time in history because of our work in building the Coalition for Health Care Access and the strong support from the community. We will continue to push the issue during the interim leading into the next legislative session!
Here are the final numbers for the 85th regular session: 6,631 bills filed (second-most bills filed in history) 1,211 bills passed – 8% decrease from the 2015 session – 50 bills vetoed 1,161 bills total became law this year = 17.5% passage rate
SB 919 by Rodriguez/HB 3857 by Coleman – DNR and Death Certificates The bill would have allowed APRNs to sign out-of-hospital Do Not Resuscitate forms and sign death certificates. It was amended to only apply to death certificates for patients receiving hospice and palliative care.
TNA worked overtime to ensure elected officials could filter through the noise and understand the most pertinent nursing issues the legislature needed to address. We tracked over 860 of these bills. That means that TNA actively tracked more than 1/8th of all bills filed during the 2017 session, and we registered public support or opposition to almost 50 bills this session.
Special thanks to the hundreds of Texas nurses who attended TNA’s Nurse Day at the Capitol or any of the APRN Alliance Legislative Days, visited legislative offices, and wrote or called your legislator. Your efforts made a huge difference! Many of the bills that kept legislators busy had nothing to do with nursing: bathrooms, property taxes, Uber, etc. But many were related to health care, including nursing homes, CPS and child welfare, mental health, and balanced billing. TNA was at the forefront working on many of these issues and others that pertained directly to the practice of nursing.
SB 654 by Seliger – APRN Provider Networks The bill as filed went through the insurance code and allowed APRNs to be included in various types of provider networks, regardless of whether their supervising physician is in network.
It was amended to only apply to Medicaid, MCOs, and CHIP, and it passed in that form.
HB 1846 by Coleman – Discharge prescriptions Would have cleaned up an issue relating to discharge prescriptions and in-house pharmacies.
TNA led the way through the legislative session, convening and leading multiple coalitions. The Nursing Legislative Agenda Coalition (NLAC), formed in 1989, includes over 20 nursing groups
The death certificate language was also tacked on to the BON sunset bill as a failsafe.
This bill was never given a hearing because of disagreements on the issue by certain legislators. We tried a number of different ways to amend it onto other legislation, but to no avail. We intend to actively pursue the issue in the interim through regulatory and legal means.
HB 2141 by Oliverson – Meeting requirements under a Prescriptive Authority Agreements (PAA) Would have required monthly meetings between
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delegating physicians and APRNs/PAs, but the meetings would not have to be face-to-face. Essentially, it would have allowed delegating physicians to hold videoconference meetings with APRNs/PAs.
The bill died because of deadlines, but it was attached to SB 1625, a PA safe harbor bill that was amended lastminute to allow for periodic meetings for PA delegees only. The amendment left off APRNs because it wouldn’t have been germane on a PA-specific bill. We are pursuing solutions to get APRNs included in this language.
HB 3406 by Oliverson – Prohibiting payment for a PAA This bill would have prohibited physicians from charging an APRN/PA for having a prescriptive authority agreement. The bill died in committee. HB 2525 by Zerwas – Establishing Anesthesiologist Assistant licensure Would have created Anesthesiologist Assistant licensure. Their licensure would have been optional, and it would have been available to persons who completed physician assistant training.
TNA worked overtime to ensure elected officials could filter through the noise and understand the most pertinent nursing issues the legislature needed to address. and from the public side of the NURSYS website hosted by the NCSBN.
HB 2561 by Thompson – Board of Pharmacy Sunset bill PMP language added – all providers except veterinarians must check the Prescription Monitoring Program (PMP) Database, phase-in begins September 2019.
Gives Board of Pharmacy the ability to coordinate with other agencies to identify prescribing practices that may be potentially harmful and that may suggest drug diversion. The bill requires the BOP to develop indicators for levels of prescriber or patient activity that suggest a harmful prescribing pattern. Allows the BOP to send a notice to the provider if they see anything based on the indicators, but there is no enforcement authority.
Requires all prescribers to access the PMP prior to prescribing or dispensing opioids, benzos, barbiturates, or carisoprodol. Failure to do so is grounds for disciplinary action.
Exceptions: Cancer patients or hospice care.
The bill died in the calendars committee.
HB 2548 by Zerwas – Schedule II authority for PAs Would have allowed PAs to prescribe Schedule IIs at the practice site of the delegating physician.
Original bill died, but it was tacked on to SB 1625 as an amendment.
SB 1625 amended to add CSII authority for PAs, but it was stripped off in conference committee because of APRN Alliance lobbying.
SB 315 by Hinojosa – TMB non-sunset bill Allows TMB to issue subpoenas for: »» production, inspecting, and copying of medical and billing records. »» initiating investigations of physicians and their delegates regarding opioid prescribing.
TNA led the way through the legislative session, convening and leading multiple coalitions. BON/REGULATORY HB 2950 by Burkett – Board of Nursing Sunset bill Every 12 years, the Board of Nursing (along with other regulatory agencies) goes through the Sunset process. The Sunset Commission reviews the duties of the agency and determines which are still necessary. The bill and its Commission recommendations then pass through the typical legislative process. TNA has been instrumental in adding new provisions to the Nursing Practice Act to protect the rights of nurses.
Discipline: The Sunset Commission directed the BON to only discipline for criminal offenses that directly relate to the practice of nursing.
Expunction of Minor Offenses: A provision was added to the sunset bill that requires the BON to remove punishment for incidents unrelated to nursing practice from its website
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Contested cases: The BON will no longer be able to shift the costs of a hearing before the State Office of Administrative Hearings to a nurse.
Allows TMB to inspect pain management clinics to see if they require certification.
Limits liability for physicians who prescribe or fail to prescribe opioid antagonists.
Sunset provisions were stripped out, and the TMB will likely have to go through the sunset process again next session.
WORKPLACE HB 280 by Howard – Passed This bill supports the development of innovative approaches to reducing workplace violence against nurses by creating a grant program to fund such initiatives. HB 3296 by Klick – Peer Review – TNA-Initiated Legislation Passed This bill extends the requirements for NPR to health care organizations who employ or contract with eight or more nurses, thus expanding access to NPR protections to more nurses.
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EDUCATION SB 2118 by Seliger — Authorizes BSNs in community colleges with very specific requirements – Passed Community colleges are now authorized to offer BSN programs if they can show: » they are located in a junior college district with a taxable property valuation of not less than $6 billion. » a demonstrated workforce need in the area. » the college’s ability to support the new program with student enrollment. » that current articulation agreements are not sufficient to meet need. » that they have secured long-term clinical space with a letter from each clinical site in the area indicating availability for clinical placement. » they have a corresponding ADN program that has been successful as indicated by job placement rates and licensing exam scores.
Restrictions: » Cannot charge more than the ADN program tuition » No additional state funding, must create with current funding
» Specific to nursing programs: Must be a BSN, and be an accredited nursing program Must maintain current level of ADN enrollees for nursing program — can’t redirect resources to BSN (expires Jan. 1, 2023)
Texas Higher Education Coordinating Board will require the following report of the community college before approving a bachelor’s program: » A long-term financial plan for accreditation from the Commission on Colleges of the Southern Association of Colleges and Schools » A long-term plan for faculty recruitment that indicates the ability to pay the increased salaries of doctoral faculty, identifies recruitment strategies for new faculty, and ensures the program would not draw faculty from a neighboring institution offering a similar program » Details on the manner of program and course delivery » Details on existing articulation and dual enrollment agreements with BSN programs
continued on page 23
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Why TCU? ■ Outstanding faculty credentialed specifically for online education ■ Largest Nurse Faculty Loan Program participant in Texas ■ A Collaborating Center of the Joanna Briggs Institute ■ The Master’s and DNP programs at Texas Christian University
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https://nursing.tcu.edu/graduate TEXAS CHRISTIAN UNIVERSITY
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THE NURSING FACULTY SHORTAGE What Is Being Done in Texas? By Texas Team Education Committee Taskforce Membership
TEXAS NURSING’S summer 2016 issue featured an article by Executive Director Cindy Zolneirek, Ph.D., RN, and Director of Practice Ellen Martin, Ph.D., RN, CPHQ, about the nursing faculty shortage in the state and its possible drivers.
The lack of appropriately credentialed faculty to teach the qualified students who apply to nursing programs is a major factor in the shortage of nurses in Texas.
The article reviewed TNA’s work on this issue and provided a call-to-action, urging researchers to tackle important questions related to the faculty role. It also outlined additional data needed to make progress on reducing the faculty shortage.
The results of the analysis were reported in the "Nurse Supply and Demand Projections, 2015-2030" executive summary. Nurse supply was based on full-time equivalents (FTEs), which can include both full-time employees and part-time employees whose combined workloads are comparable to a full-time employee.
A year has passed. Where are we now? To answer that question, we should first review the statistics illustrating the current faculty shortage and its impact on the supply of nurses caring for Texans. In 2015, the Texas Center for Nursing Workforce Studies was able to accurately model the future need for nurses in Texas. This was accomplished using Health Resources and Services Administration (HRSA) projection models and Texas-specific data.
According to this report, the supply of Texas RNs in 2015 was projected to be 200,663 RN FTEs. Demand was projected to be 215,636 RN FTEs, leaving a deficit of 14,973 RN FTEs. By 2030, the supply of RN FTEs is expected to grow by 35.4 percent to 271,667. Demand will grow by 53.8 percent to 331,638. That will leave a deficit of 59,970 RN FTEs.
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Based on these projections, 20 percent of the projected demand for RNs in 2030 will not be met. The lack of appropriately credentialed faculty to teach the qualified students who apply to nursing programs is a major factor in the shortage of nurses in Texas, as well as in many other areas of the country. The average age of nursing faculty in the United States is currently 56.4. Anticipated retirements will exacerbate this need for faculty. Greater demands are being placed on nursing schools, not only to supply an adequate number of new nurses, but to also support nurses returning to school for more advanced degrees (AACN, 2015).
TABLE A The American Association of Colleges of Nursing’s (AACN) report titled "2014-2015 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing" noted that U.S. nursing schools turned away 68,938 qualified applicants from baccalaureate and graduate nursing programs in 2014. Almost two-thirds of the nursing schools responding to the survey pointed to faculty shortages as a major reason for not accepting all qualified applicants into baccalaureate programs (aacn.nche.edu/research-data). In addition, a 2014 AACN Special Survey on Vacant Faculty Position found that 714 baccalaureate and/or higher education programs across the country identified 1,236 faculty vacancies — leaving a national faculty vacancy rate of 6.9 percent. Most of these vacancies included positions that require or prefer a doctorate degree (aacn.nche.edu). The 2015 NLN Faculty Census Survey found that there were a total of 1,072 faculty vacancies in all types of nursing schools. BSN and ADN nursing programs represented the largest percentage of the total vacancies (34 percent and 28 percent, respectively). This is to be expected, since these two types of programs are likely to have the greatest number of potential students. The National League for Nursing (NLN) survey also asked deans and directors to indicate the maximum number of students who could have been annually admitted if all faculty vacancies were filled — a figure called the maximum capacity. The percentage of the maximum capacity reached in 2015 is shown in Table A. Table B outlines the percentage of nursing education administrators who endorsed each of the identified reasons/ obstacles to hiring sufficient nurse faculty. The concern regarding lack of competitive salaries is validated by the 2016-2017 College and University Personnel Association Faculty Survey, which indicates that the median annual salary for nurse faculty in four-year universities is $66,000. MSN-prepared nurses in Texas practice settings annually earn $92,400 on average (Institute of Medicine, 2010, p.265). The Texas Center for Nursing Workforce released a 2016 report titled "Faculty Demographics in Professional Nursing Programs." It found in 2015 a total of
TYPE OF NURSING PROGRAM
% OF MAXIMUM CAPACITY ADMITTED TO PROGRAMS
LVN/LPN
85%
ADN
92%
Diploma
93%
BSN
73%
RN to BSN
62%
MSN
64%
Doctoral
41%
(NLN Faculty Census Survey, 2015)
TABLE B
REASON FOR INABILITY TO HIRE
% OF AGREEMENT BY ADMINISTRATORS
Not enough qualified candidates
37%
Not able to offer competitive salaries
33%
Faculty jobs less attractive than others
12%
Not enough budget lines
6%
Other difficulties
12%
235.5 FTE faculty vacancies in nursing schools — 15.4 percent more than the 204 vacancies reported in 2014. There were 64.0 FTE retirements and 341.0 FTE resignations during Academic Year (AY) 2014-2015. That amounted to a 22.4 percent increase in FTE resignations compared to the previous year (TCNWS, 2016, para 4).
ROBERT WOOD JOHNSON FOUNDATION CALL TO ACTION In an April 2007 report titled "Charting Nursing’s Future: The Nursing Faculty Shortage," the Robert Wood Johnson Foundation (RWJF) proposed nurse educator shortage reduction strategies that had been previously obscured by concern over the shortage of nurses at the bedside. The strategies included: Raising salaries or other reimbursement for nurse educators.
Developing new pathways to becoming a nurse educator. These strategies may include bridge courses, such as RN to BSN/MSN or BSN to Ph.D./DNP programs, and
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(NLN Faculty Census report, 2015)
second degree tracts for pre-licensure programs.
Using current nurse educators more effectively, through distance education or simulation, and partnering with clinical staff to support teaching.
Increasing federal funding for nurse education.
Although these recommendations were published five to 10 years ago, they are still applicable today.
WHAT ARE TEXAS NURSING ORGANIZATIONS DOING? The lack of sufficient nurse educators on a state-by-state basis causes concern for all who are interested in meeting the health care needs of U.S. citizens. This concern in Texas drove the development of the conference Challenges for Texas Nurse Educators, held on Feb. 17, 2017. This conference was designed to: 1. confirm that the shortages identified in the literature accurately illustrate the current experience in Texas. 2.
explore reasons for the insufficient
S U M M E R 2 017 | T E X A S N U R S I N G M AGA Z I N E
number of nurse educators in Texas and strategies to resolve this issue. It was funded by the foundation of the National Student Nurses Association through the Texas Team Action Coalition. The coalition is an initiative of RWJF and the Center to Champion Nursing in America. Workshop participants, primarily from Texas organizations, heard remarks from seven leading nursing groups. They then engaged in group discussions to address the following challenge: There is a direct relationship between the number of nurse educators employed in Texas and the number of undergraduate and graduate nursing students who can be prepared for the nursing educational workforce. Currently, insufficient educators are available to prepare nurses to meet Texas' projected demand for nurses in all health care settings. The results of these conversations were recorded during the workshop and later grouped into four themes: facts, awareness, competencies, and marketing. Within each of these themes, challenges were identified and potential solutions were generated. A white paper outlining the recommendations in each of these areas has been developed by a sub-committee of the Texas Team and will be soon be available on a national publisher’s website. In addition, Texas Nursing will highlight the recommendations in subsequent editions. It will take all of us to resolve the current faculty shortage. Acquaint yourself with the recommendations that will be forthcoming. Consider whether you would be interested in full-time or adjunct positions in a college or university close to you. If you don’t have the appropriate degree to teach in the organization you prefer, evaluate the possibilities for further preparation. If you know colleagues who are great teachers in their practice, encourage them to explore the options for including education in their career. The nursing faculty shortage is a serious problem, but when Texas nurses work with our colleagues and stakeholders, there is nothing we can’t accomplish. i REFERENCES: National League for Nursing. Highlights from the 2015 NLN Faculty Census Survey of Schools of Nursing. www.nln.org/advocacy-public-policy/issues/facultyshortage/nln-annual-survey-of-schools-of-nursing”
National League for Nursing NLN Nurse Educator Shortage Fact Sheet. www.nln.org/docs/defaultsource/advocacy-public-policy/nurse-facultyshortage-fact-sheet-pdf.pdf?sfvrsn=0. Rosseter, R. Fact Sheet: Creating a More Highly Qualified Nursing Workforce. Updated. March 15, 2016. www.aacn.nche.edu/media-relations/factsheets/nursing-faculty-shortage.
Joyce Batcheller DNP, RN, NEA-BC, FAAN The Center for the Advancement of Healthcare Professionals, AMN Healthcare Carol Boswell, Ed.D., RN, CNE, ANEF, FAAN Texas Tech University HSC, School of Nursing
Institute of Medicine (2010) The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press.
Sharon Cannon, Ed.D., RN, ANEF Texas Tech University HSC, School of Nursing
TEXAS TEAM EDUCATION COMMITTEE TASKFORCE MEMBERSHIP
Michael Evans, Ph.D., FAAN Texas Tech University HSC, School of Nursing
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Marvella Starlin, MSN, RN Cisco College Jayson T. Valerio DNP, RN Nursing & Allied Health Division, South Texas College
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THINK LIKE A FORENSIC NURSE By Stacey A. Mitchell, DNP, MBA, RN, SANE-A, SANE-P Coordinator, Forensic Health Care Program, Texas A&M College of Nursing
The Texas Council on Family Violence reports that 1 in 3 Texans will experience domestic violence in their lifetimes. With many of these victims being treated in emergency departments, clinics and doctor’s offices, patients would benefit if health care providers were able to think like a forensic nurse. CASE STUDY Amy, a 28 year old female was brought into the emergency department stating that she had fallen. With yellow and purple bruises on her face, inner and outer forearms and torso, it was unlikely that an accidental fall explained the trauma. The nurses asked Amy questions and recorded her history. During the examination, Amy’s speech began to slur and she lost the ability to move one side of her body. She was immediately sent for a CT scan which revealed that the patient had a dissection in one of her carotid arteries. As more information came to light, Amy eventually disclosed that her husband had beaten her, thrown her against a dresser and left her injured and helpless on the floor. It was hours before she was able to crawl to the telephone and call 911. With her consent, the police were called, resources were provided and plans were made to ensure that she remained safe throughout her hospital stay and beyond. DEBRIEF The emergency department nurses followed forensic nursing protocols resulting in the patient receiving necessary treatment and services while collecting and preserving evidence that could be used to prosecute her abuser if charges were filed.
In addition to caring for Amy’s injuries, the nurses helped her by: • Comparing the explanations for her specific injuries with the injuries themselves. Checking to see whether the history being given matched the physical evidence. • Asking questions about the events that occurred leading up to the injuries, her home life and safety.
Graduate Certificate in Forensic Health Care to prepare nurses to better address the needs of patients who experienced abuse or sexual assault. Additional continuing education courses in forensic nursing will soon be added to support the educational needs of nurses wherever they are in their careers. For more information about the Texas A&M College of Nursing, visit: nursing.tamhsc.edu.
• Sitting with Amy and reassuring her that they were there to take care of her. • Documenting injuries accurately, clearly and completely (including color, shape, size, and location of bruises) to insure that health care or legal professionals would be able to understand the patient’s condition. With Amy’s permission, her injuries were photographed. • Learning about local resources and referring Amy to the advocacy agency and shelter which support patients who have experienced domestic abuse. HELP PATIENTS AND ADVANCE YOUR CAREER To help more patients like Amy, learn how you can think like a forensic nurse while advancing your nursing career. Texas A&M College of Nursing offers a MSN in forensic nursing and a Multidisciplinary
FORENSIC NURSING FACULTY Fellows of the American Academy of Nursing Hold local and state government appointments Leaders in forensic nursing
GETTING HIRED IN ACADEMIA ADVICE FROM A NURSING SCHOOL DIRECTOR By Marla Erbin-Roesemann PhD, RN, Director and Professor, St. David’s School of Nursing at Texas State University
HOW CAN YOU MAKE A DIFFERENCE? AS A NURSE EDUCATOR, you can impact an entire generation of nurses. The academe is looking for this next wave of nurse educators who will lead the profession into the mid-21st century and develop frontline leaders for an ever-changing health care system. As a nursing school director, I’m seeking a diverse group of individuals who are interested in working with students and have a passion for learning. Our students come from a wide range of ethnic, economic, and geographic backgrounds, and having those traits reflected by faculty plays a role in increased student success. The faculty shortage and demand for alternative delivery formats has challenged deans and directors to be creative and flexible with faculty hiring and assignments. Clinicians with a zeal for
The academe is looking for this next wave of nurse educators who will lead the profession into the mid-21st century and develop frontline leaders for an ever-changing health care system. teaching will find some wonderful opportunities at Texas schools of nursing.
THE FACULTY ROLE The faculty role is multifaceted and encompasses more than teaching a clinical section or a course. Teaching and the associated elements, such as curriculum development and evaluation, are critical to the full-time role. However, most colleges and universities also require service. This can be service to the university, college, department, profession, or the community. It comes in many forms, including mentoring, serving on committees, student ad-
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visement, service projects, involvement in professional organizations, and activities to improve your community. Scholarship is another expectation of many faculty roles. However, scholarship can encompass a wide swath of activities — not necessarily research. Presentations, publications, posters, publicly disseminated teaching tools, and grants are all forms of scholarship. Tenure-track positions, at least at the university level, typically come with expectations for research and grant activity. Some institutions may have a practice expectation for clinical faculty for the individual to keep current in their
specialty. This requires faculty to work in that specialty area one or two days per week or during the breaks. Before you interview for an education position, or even inquire about a position, conduct a skills self-assessment. What would you be comfortable teaching, and what would be a stretch for you? Perhaps you have only worked in obstetrics (OB) and there are no positions for teaching OB. What other skills do you have? Can you teach fundamentals of nursing or health assessment? These are skills that you utilize daily as a nurse, and it should be fairly easy to brush up to ensure you are teaching with the latest evidence. Many new textbooks make evidence easy to locate by citing it throughout the text.
TRANSITION TO THE ACADEME What if you already have a master’s degree and are looking for a job? To begin your research, first do a search of the Board of Nursing site for all approved nursing education programs in your area. Review their websites — do you like the mission, vision, and values of the school? Do they have a good reputation in the community? When I am approached by nurses interested in teaching positions, I first find out in which clinical areas the individual has interest and the nursing degree they hold. You are well-equipped for a clinical-track faculty role with an MSN and/or a Ph.D., DNP, or EdD. However, you will most likely need a doctorate for tenure-track positions. It is important to read the requirements, as the schools adhere to their criteria posted to be fair to all applicants. The shortage of faculty exists across the state, with rural areas having a need for all types of faculty. In general, the major universities have the greatest need for faculty who hold doctorates, especially for the BSN and graduate programs.
JOB SEARCH STRATEGIES Networking can be invaluable in finding a faculty job. Nursing is not any different than other professions — sometimes it is who you know that will get your name (on an application) recognized.
PATHWAYS TO BECOMING A NURSE EDUCATOR By Texas Nurses Association Education Committee
Must have an unencumbered RN License (Texas or Compact) and must have recent nursing practice experience (two years in the last four years) for the course you will be teaching.
ASSOCIATE DEGREE IN NURSING
This degree is the minimum credential necessary to teach in CNA or LVN programs.
BACHELOR OF SCIENCE IN NURSING (BSN)
BSN holders may teach in CNA or LVN programs.
This degree is the minimum credential necessary to serve in Clinical Teaching Assistant Role in ADN and BSN programs for clinical areas where you have clinical experience.
MASTER OF SCIENCE IN NURSING (MSN)
This degree is the minimum credential necessary to teach in ADN, BSN, and MSN programs.*
Some colleges and universities hire MSNs on a clinical track whereas others hire as clinical instructor level faculty. *APRN programs require faculty to hold both an RN and an APRN license. Some MSN programs require a DNP or Ph.D. If a program cannot find RNs with a master's in nursing, the program may apply for a waiver from the BON in an emergency situation. Waivers require that RNs with a Masters in another discipline have a BSN and six credits of graduate nursing coursework to teach in a Diploma or ADN program. To teach in a BSN program, they must have 12 credits of graduate nursing coursework. Waiver forms can be found on the Board of Nursing website (www.bne.state.tx.us).
DOCTOR OF NURSING PRACTICE (DNP)
DNP-prepared faculty members teach in LVN, ADN, BSN, MSN, and DNP programs.
Some colleges and universities will hire DNPs on the tenure- track. Others will only hire DNPs on the clinical track.
DOCTOR OF PHILOSOPHY (PH.D.)
Ph.D.-prepared faculty members teach in LVN, ADN, BSN, MSN, DNP, and Ph.D. programs.
Many colleges and universities require a Ph.D. for tenure-track positions.
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continued from page 17 When I am at a professional event, I enjoy meeting nurses who are engaged in their profession and who will serve as role models for the students. Attending professional meetings is a wonderful opportunity to network and to get to know other educators who attend often. Make it known that you would like to teach and share your reasons. The Texas Nurses Association (TNA) is an example of a good organization where you may connect with other like-minded professionals. Other organizations have regular meetings, including TNP (Texas Nurse Practitioners) and regional advanced practice associations. It is a great way to meet educators and nursing program directors to express your interest in teaching. Be ready to send an updated résumé (highlights accomplishments) or curriculum vitae (showcases education and teaching) and letter of interest outlining why you would be a good fit for the program. I prefer to receive a letter of interest that is tailored for the position and the institution, as it demonstrates that the applicant has read the requirements. In an interview setting, I look for applicants who are prompt and professionally dressed. For both women and men, a nice shirt and slacks/skirt are considered minimum appropriate attire. Natural hair colors and limited body piercings are preferred because we ask the faculty to be the role models for our students.
Do you want to work as an educator in a hospital or in the academe? Look at the job market in your area — is anyone hiring, and what degree do they expect you to have? Additionally, there is a proliferation of online nursing education programs; however, not everyone is prepared to teach online. Knowing how to communicate online is necessary but not sufficient. If you have had a course or training in online education, highlight this in your introductory letter. Even having taken online courses gives an upper hand because you experienced this as a user of the technology. Perhaps look up best practices for online education and be prepared to speak to how you would engage the students in an online course. This shows initiative and preparation.
PURSUING A MASTER’S IN NURSING EDUCATION For those who are just getting started and contemplating a master’s degree in nursing education, it is helpful to do some prior research. Assess the job market to see what positions are available for someone with a Master’s in nursing education.
It is always gratifying to meet a potential faculty member who can speak to why they would like to be employed by our nursing school in particular. Perhaps mention something you read about the program on the website, as it shows initiative.
Do you want to work as an educator in a hospital or in the academe? Look at the job market in your area — is anyone hiring, and what degree do they expect you to have? Is the degree required, or is it preferred? Perhaps a more attractive route for those who have a passion for education and advanced practice is to explore clinical master’s programs that offer nursing education courses in addition to the clinical curriculum. This gives you extended opportunities in both education and practice.
You can also look for a mentor who is already a faculty member and observe them teaching. Take advantage of their knowledge base and ask questions. I value individuals who take initiative to learn about aspects of teaching nursing with which they are unfamiliar, such as simulation. Just having a basic knowledge of teaching with simulation is helpful.
If you feel that you need more education prior to assuming a faculty role, consider enrolling in a nurse educator certificate program. Certificate programs typically cover curriculum design, teaching strategies, evaluation, and technology in three to four courses. They also teach you the tools used by nurse educators in their everyday roles.
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Many nurse educators learned on the job, as Ph.D. programs often did not provide formal education courses. If you have the opportunity, my suggestion is to take the courses prior to assuming a position.
FOOT IN THE DOOR You may not get your ideal job fresh out of a master’s in nursing education program or if you have never taught. Don’t be discouraged. Instead, look for alternatives. Consider an adjunct position to get your foot in the door. As a director, I look for potential faculty who are committed to the role, show up for team meetings, do their homework, and — most importantly — connect with the students. Positive student evaluations that mention faculty passion for teaching and availability speak volumes when interviewing faculty for full-time positions. Many programs do not advertise their adjunct positions on their employment site, so you will have to figure out how to get this information. It doesn’t hurt to send a polite, brief email to the dean or director of the program to ask if there are potential openings. Check back with them if they do not respond to your inquiry; sometimes they just get busy and forget to reply. If they do respond and say there are no openings at the time, check back with them the next semester as things changes frequently.
BE THE NEXT GENERATION OF NURSE EDUCATORS As an educator, I can think of no more fulfilling role than teaching nursing. You will be remembered long after the ink has dried on the diploma, and your influence will be felt in the hundreds of lives touched because you took the leap of faith to become an educator. i
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What starts here changes the world!
FROM CLINICAL TO CLASSROOM My Experience as a New Adjunct Clinical Faculty Member By Catherine Mbango, MBA, MSN, RN, NE-BC, OCN
MY INSPIRATION for teaching began when I first enrolled in nursing school. My fundamental clinical instructor was passionate about what she did and provided a nurturing, positive, and encouraging environment for her students. She listened and showed genuine interest in everything that the students had to say about their learning experience. She challenged us to develop additional skills and take on complex patient care as she evaluated our clinical progress. My passion to become an educator grew during my preceptorship in my first clinical nursing position as a stem cell transplant nurse. My nurse preceptor facilitated my immersion into clinical practice with patience and kindness, and this allowed me to transition successfully into my clinical role in a very fast-paced critical care inpatient unit. Although I had not considered pursuing
a formal teaching role after practicing as a clinician and a nurse leader for 11 years, I was encouraged to take on a clinical instructor role at a local baccalaureate nursing program. This invitation was extended by a member of the Texas Nurses Association District 9 board of directors with whom I had the opportunity to serve with in 2014. I currently facilitate adult health and critical care clinical experiences at local baccalaureate schools of nursing.
CREATING A SUPPORT SYSTEM The learning curve during my initial transition to an official educator role in 2014 was challenging, yet very interesting. Because of the lack of a formal orientation or mentoring process into the clinical faculty role, I took it upon myself to seek out a mentor and observe how she facilitated her clinical group. After
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my recruitment to the school of nursing, I was granted electronic access to the student learning modules and was assigned to a clinical group. Through the observation of my selffound mentor, I learned how to facilitate pre- and post-conferences, perform unit rounds, and complete clinical evaluation paperwork that was provided by the school of nursing. I took the initiative to meet with my mentor before and after every clinical semester to discuss my experience as well as get her feedback and advice on challenging student interactions.
TACKLING A NEW CHALLENGE One unexpected challenge was the complexity of teaching in nursing as I tried to facilitate student learning outcomes and communicate my knowledge effectively to students. In retrospect, some training on involving stu-
dents in the learning process and on the diverse ways in which they learn would have been beneficial.
LE NE AD W #1 1 RA ERS EXE IN 20 HI CU NK 18 PD T U. S. NE ED NP IVE GR W AD S & D N TR SC W HO OR P P OL LD RO ACK RA REP G NK OR IN T N R GS UR AM
My personal experience of learning was that the teacher did all the teaching, and students listened and took notes. Today’s academic environment envisions teaching as collaboration between the faculty and the student. I quickly learned that I needed to explore the most effective way of meeting the learning needs of each individual student, and this has proved to be a major responsibility.
SIN G
One course of action of which I was not initially aware was instructors’ ability to send students back to the simulation lab or the skill lab. This is considered a nonpunitive approach that allows them to gain more confidence performing skills at the bedside and reduce their anxiety level during their clinical experience. Learning about this option earlier would have made it easier for me to provide appropriate feedback to students as well as monitor their progress effectively.
Today’s academic environment envisions teaching as collaboration between the faculty and the student. I quickly learned that I needed to explore the most effective way of meeting the learning needs of each individual student.
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EVALUATING STUDENTS, DEVELOPING LESSONS I developed competencies around student evaluation through the utilization of clinical practice guidelines and skills checklists that were provided by the school of nursing. I am expected to use these tools to evaluate clinical performance, and students are expected to use them to perform outlined skills to meet required competencies.
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continued on page 22
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TEX AS NURS ES AS SOCIATION
continued from page 21 grade student documentation of the data they gathered and the interventions that were provided to assigned patients during the clinical experience. I have continued to develop additional evaluation competencies during my interactions with other clinical faculty as well as in my current doctoral course work. The combination of various student evaluation tools and the unstructured faculty orientation approach created a lot of variability in the student clinical evaluation processes. In relation to designing clinical learning experiences, I review the student course syllabi and try to integrate classroom and clinical content by seeking out student clinical learning opportunities that are consistent with the subject matter that is being discussed in the classroom. I also use our post-conference sessions to reiterate key learning concepts as they relate to the quality of care that the patient needs. The current student curriculum incorporates simulation and skills lab check-off prior to the student’s clinical experience. This allows the student to practice clinical skills such as venipuncture, indwelling foley catheter insertion, etc. in a controlled environment prior to performing these skills on an actual patient in the clinical setting.
PAYING IT FORWARD Teaching allows me to provide a service to both the individual
student or patient and the community. I constantly tell my students they are in a profession that transforms the lives of patients, their families, and the community as a whole through the demonstration of caring behaviors and patient education. My passion for teaching has been heightened even further as I pursue teaching as a scholarly endeavor.
I constantly tell my students they are in a profession that transforms the lives of patients, their families, and the community as a whole through the demonstration of caring behaviors and patient education. I purposefully seek out and engage in faculty development programs as these opportunities are not currently made available to adjunct clinical faculty. I find personal fulfillment when I see the students fulfill their dream of becoming a nurse, while my professional fulfillment is achieved when students graduate and pass their state board exams. i
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LEGISLATIVE RECAP
continued from page 11
Must have at least three articulation agreements in place, and must be at capacity
BUDGET ITEMS SB 1 by Sen. Nelson In the budget that passed, appropriations related to nursing, include: $20 million for the Professional Nursing Shortage Reduction Program to increase RN graduates. » This is a 40 percent reduction from 2015. While this is a difficult budget year, Graduate Medical Education expansion was budgeted with almost $100 million this session. » TNA will work to restore this funding through collaboration with colleges and universities.
$822,000 was reauthorized for the Texas Center for Nursing Workforce Studies.
$4.5 million for trauma fellowships for emergency physicians and nurses.
$3 million set aside for the Nurse Faculty Loan Repayment Program (NFLRP) which was not previous dedicated.
» This was a priority for TNA, and the NFLRP received a dedicated budget account for the first time. SB 1505 by Hinojosa – Did not pass This bill would have closed a tobacco tax loophole and given the new revenue to graduate medical education and the nursing faculty loan repayment program.
Because of political differences over the idea of creating new taxes, the bill did not make it out of the senate.
TNA will pursue again.
Immunizations – None passed 17 bills filed by 10 legislators.
NURSING LEGISLATIVE AGENDA COALITION BILLS HB 62 by Rep. Craddick – Texting While Driving Ban This bill prohibits the use of a “portable wireless communication device” to read, write, or send a text-based communication while operating a motor vehicle, with certain exceptions. The texting and driving ban was sent to and signed by the governor.
HB 1076 by Rep. Oliverson – Scoliosis Screenings This bill implements recommendations by multiple nationwide orthopaedic associations to screen students based on prevailing scientific data. This passed and was signed by the governor. SB 196 by Sen. Garcia – School Nurse Notification This bill would have required a school district to notify parents if a school does not have a school nurse, counselor, or librarian on duty. This bill passed only to be vetoed by the governor. SB 1107 by Schwertner – Telemedicine Clarifies that “telemedicine” is a service delivered by a physician or delegate; “telehealth” is a service performed by anyone else. HB 435 by King – Guns out of psych hospitals Allows state hospitals to prohibit carrying of handguns by licensed carriers by posting notice. i
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Join the Texas Nurses Association for the 2017 Leadership Conference as we explore relational competence by analyzing creative work, featuring:
TNA 2017 Leadership Conference
RELATIONAL COMPETENCE
Changing the Future Through Conversation SEPT. 28-29, 2017 | GEORGETOWN, TX Register at www.texasnurses.org
Bonnie Wesorick, RN, MSN, FAAN – A healthcare visionary, Wesorick works every day to change the dynamics of health care institutions and create the best possible environment for providers and patients. Margaret J. Wheatley – She has authored nine books, including the classic “Leadership and the New Science.” She has been honored for her ground-breaking work by many professional associations, universities and organizations.
This year’s Leadership Conference will also feature the first comprehensive nursing analysis on the 85th Legislative Session and the work of the Center for Nursing Workforce Studies.