Please Join us...tomorrow at 11 am EST in the chatroom...

[1 Fine Spine RN]

I am lecturing about SCI to nursing students. I will be demonstrating the chatroom and hope for some people to come chat with about 90 students all signed in as me!...

Please hop in for a visit...I will be signing in as close to 11 as I can. No specific topic, just fielding questions. Thanks!!

Mary

If I can see it, then I can do it. If I believe it, there's nothing to it.

[cheesecake]

Can you please post what school and program this is for.Is this a masters program? Also what year the nursing students are in? Is it an RN or LN program? That will help in knowing how to answer the questions.

"A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles"....C. Reeve 1998

[1 Fine Spine RN]

It is an RN program at Northern VA community college. This is a fun activity after I give an hour long lecture on acute care of SCI. When we did it last time it was a free flow activity, where people in chat just felt free to say or share about what they want new nurses to know about their needs and what the chronic situation is like for them. It is not intended to be anything but an opportunity to ask basic questions.

PS these students are all scheduled to take their boards this spring or summer.



If I can see it, then I can do it. If I believe it, there's nothing to it.

[dogger]

Quote''It is an RN program at Northern VA community college. This is a fun activity after I give an hour long lecture on acute care of SCI.'' Unquote . this statement makes me wonder a little about where our Medical System is headed [ Australia generally mirrors what happens in the US ] . as someone who never gained a college education i may have completely misunderstood this too , but here goes . RN courses over here are a fully fledged University Degree course . is that the case in the US ? maybe i misunderstand what a ''Community College '' is . my next question is not meant to be directed at you or your abilities Mary . please forgive me if it appears to be or if i have my facts incorrect . my ex wife used to lecture to RN Degree students on SCI acute care . my ex had been an RN for about 10 years and ''SCI Certificated '' for nearly as long , spending nearly all that time working in SCI wards . therefore i am somewhat amazed to hear of an RN less than 2 years qualified , without a SCI Certificate [ i think that is right ? ] and not having worked in SCI wards for very long ; instructing in SCI acute cure . Mary , i would hope that this is because you are considered a special case and is not normal practice ? this is not an attempt to critise anyone, differnt countries , or health systems . it is more a case of wondering about the importance of SCI in the medical establishment [ something i have often thought about ] .
thank you ,
dogger

every day i wake up is a good one .

[SCI-Nurse]

Dogger, unfortunately in this country nursing education is still a mess. There are a few diploma schools still around, and there are many programs that are college/university based requiring a bachelor's degree, but many nurses just go to junior college for an ADN (2 year degree). It is essentially like trade school. All can take the RN licensure boards, and most hospitals pay them and employ them exactly the same. Of course to advance, most nurses must have at least their BSN, and for leadership positions either a MSN or PhD/DNSc is usually required. The American Nurses Association set a goal for there to be a BSN requirement for entry into practice in 1984. That date has been pushed back so many times it has become meaningless. Nurses spend an inordinate amount of time and energy arguing about this in the USA, and it is embarrassing to many that countries such as Brazil have settled on a professional degree (BSN) for entry into practice for many years while the USA cannot set and meet this standard.

The recent nursing shortage here has worsened the situation, as many states see the ADN as a way to churn out more nurses more quickly without looking down the road at career trajactory or quality of care. Some university programs have even closed. Several recent studies have shown improved patient outcomes when there is a higher ratio of BSN vs. ADN graduates on a nursing unit. Where I work we no longer hire ADNs, only BSNs, and all our older nurses with ADNs must go back to school to complete their BSNs if they want any promotions.

Unfortunately there is no "SCI Certificate" in the USA either. The closest certification would be in either neuroscience nursing (CNRN) or rehabilitation nursing (CRRN or CRRN-A). There are also currently no graduate programs offering a masters degree in rehabilitation nursing (there were four in the USA when I completed mine back in the 1980s). Many nursing instructors or professors teach SCI content who have never worked on a SCI unit or even cared for many SCI patients. Those of us who work in the field often do guest lecturing (as Mary is doing) at local universities and colleges to try to fill this gap. Most nursing students get no clinical rotations on SCI or rehabilitation unit during their generic preparation either. We work very hard to "sell" such rotations to local schools of nursing, but are often told that this is too small and specialized of an area for them to devote time to. With our increasing older population, more survivable trauma, and improved medical technology, rehabilitation is needed more than ever, and I fear we will have a lack of good rehabilitation nurses (or even nurses willing to enter this specialty)in the future. Even many of my good current SCI staff nurses (mostly new grads) are working in SCI only to get the two years of required medical-surgical experienced required for them to go into ICU nursing.

Nurses want to be treated as equals on the interdisciplinary team, but are not willing to step up to the plate and get equal education (which often dictates team status). Nurses are always the least educated member of the team that includes physician (many have PhD in addition to MD), PTs (masters), OT (at least bachelors, many masters), social workers (at least masters), psychologists (PhD), speech pathologists (masters or PhD), vocational counselors (at least masters), etc.

Thanks for letting me sound off on one of my big soap-box issues!

(KLD)

[FREEJ]

Hi KLD,,, you can get on your soap box and sound off anytime you need. Heck,,you are ALWAYS here waiting/listening to help all of us sci here.

What you did say was quite informative of the nursing field. And don't forget, your work here is VERY much appreciated. Freej http://sci.rutgers.edu/forum/images/smilies/smile.gif.

[dogger]

KLD , thank you for your reply . or system is still far from perfect . there are not many RNs who do the SCI certificate . during the 90s RN courses changed from being done in ''Training Hospitals '' with a combination of theory and practical , to being done as a University course . according to friends in the medical profession this had a mixture of advantages and disadvantages . everyone agrees that the knowledge base is better . as a converse to this , many think ''hands on nursing skills '' have slipped . from a SCI point of view , one difference i see , is that in the training hospital that had an SCI unit , student nurses were rotated through there and so got some SCI ''hands on experience '' , nowdays a busload of student nurses get bussed out to the SCI unit for a day and have a guided tour , no real hands on . general consenus seems to be that the best nurses are those who did their training in the Teaching Hospitals , then did their degree afterwards . i suppose all this shows is that no system is perfect .
thank you ,
dogger

every day i wake up is a good one .

[1 Fine Spine RN]

Well I have stewed on this matter for days. I only have one thing to say about it myself:

I am very special, an exception to many rules and there is no one that I know of like me. http://sci.rutgers.edu/forum/images/smilies/biggrin.gif

Thank you,

Mary

If I can see it, then I can do it. If I believe it, there's nothing to it.

[SCI-Nurse]

Wade right in, Mary.

Many physicians claim to prefer hospital school nurses. I suspect this is because hospital schools train nurses more than they educate them (there is a difference) and part of the training is to be subservient to physicians. University trained nurses are more likely to practice autonomously and not kow-tow to the physicians as much. They are much more likely to advocate for their patients with both the physician and the hospital.

The psychomotor skills are relatively easy to teach...remember that we teach them daily to our patients and their PCAs, but that does not make them a nurse. An RN needs most importantly the ability to critically think, to integrate research and best practices into practice, and to evaluate and plan nursing care. More than 2 years of school is needed to develop these skills fully.

At least Mary's students are getting some perspective on disability and SCI, which is more than many generic RN students get in most schools, ADN or BSN.

(KLD)

[1 Fine Spine RN]

FYI,

I hold a B.S. in Education, have taught in a variety of venues over 25 years. I spent four years in business, both computers and hospital, am requested for public speaking, and writing, and chose the Associates of Applied Science in Nursing as a step to a Masters. I am to begin an MBA/MSN in the fall, and in my case the bridge courses were waived.My degree is recognized as a college degree, CUM LAUDE, it better be. I have hours towards certificates in both Neuroscience and Case Management, although because I am still raising children and working part time, it will be forever before I can sit for those exams. I am the first RN to be offered the Neuroscience Fellowship as a part time employee and I finished it in the same amount of time as full time BSN grads. I am requested to be followed by student nurses over other nurses because I take the time to teach them things. Oh and by next month I will be NIH Stroke Certified, and am certified in telemetry as well. I do not get paid to represent this specialty, and no one I know will touch it with a ten foot pole. Oh and I knocked off the state boards in 55 minutes and 75 questions. I am glad I got all that off my chest..phew.

Thanks KLD, every experience I accomplish, I gain more ability. That is the basis for independence is it not? More ability. That is the last time I will speak to my credentials.

If I could have gotten SCI NURSE to speak to my students, I would have gladly sat in the corner!

Peace, http://sci.rutgers.edu/forum/images/smilies/smile.gif

Mary

PS

"An RN needs most importantly the ability to critically think, to integrate research and best practices into practice, and to evaluate and plan nursing care. More than 2 years of school is needed to develop these skills fully."

With all due respect KLD, passing the NCLEX makes a person an RN. Obtaining the judgement and knowlege and abilities you speak of takes more than 2 and more than 4 years of schooling.Plenty of 4 year nurses bomb out of the NCLEX. You and I both know that nursing is a practice and takes just that..practice. Continuing education, journals, seminars and personal advancement are part of the bargain when you jump in. If a nurse insists on avoiding the clinical ladder it is their business, but I for one am not one of them.



If I can see it, then I can do it. If I believe it, there's nothing to it.

[This message was edited by 1FINERN on 04-16-04 at 10:34 PM.]

[cheesecake]

"I hold a B.S. in Education, have taught in a variety of venues over 25 years."

Wow, Mary, you don't look that old in your avitar. You have accomplished so much at such a young age. I don't know how you squeezed it all in. Business, computers, nursing as well as a son who was so sick when he was little. No one can call you a slacker.

"A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles"....C. Reeve 1998

[marco25]

Mary thanks for sharing all you have to offer with us here. Like cheesecake I didn't realize you'd accomplished so much in your life. http://sci.rutgers.edu/forum/images/smilies/smile.gif