We don’t see you enough…….

I am a Clinical Nurse Educator. Most people outside of healthcare hear that and assume I am some kind of teacher for nurses. Fair enough: at times I am. But I don’t teach in a school. I teach in a clinical setting: I work for a hospital. I am not focused on training people to become a nurse. By the time I meet someone in my role they are already a nurse. They know how to care for and assess patients. They don’t need me to critique their practice. I help them understand their job role when they first start a job and then support them in learning any changes their role may experience after that. Sounds so much easier than it really is.

Want to hear what I spend most of my time doing? Talking to people. I talk to managers so that they can give me updates on changes in the wards. I talk to staff members to find out what’s going well or badly in their job. I talk to C-suite (CEO, CFO, CMO, etc.) executives to tell them what staff and managers need educational support with and ask them for money. After I’ve used that money, I keep meeting with everyone to explain how the money was spent and quantify that all the work I’ve done made an impact.

Somewhere in between meetings and the conversations, I get time to plan sessions for training. Other times I find specialists to provide training that I cannot: it’s not about me being the teacher all the time. It’s about knowing my staff and giving them what they need. It takes planning and research and taking chances. There aren’t nice and easy templates for what I do. It involves a lot of figure-it-out-as-you-go and requires adaptability and resilience. In all honesty, I probably spend a grand total of 10 days per year in a classroom teaching.

But the feedback I get from staff (nurses and managers) constantly? That I am not available enough for them and they don’t know what I do. They expect that I am there for their personal disposal at all times. And that I teach and teach constantly. Some managers even think my job should be to act as some kind of Catholic nun that catches you doing your job wrong and brings you to them for punishment. I can tell them over and over what I am doing to their face, in newsletters and on posters, but it never seems to be enough.

What don’t they see? In all the talking, people are telling me the things they are frustrated with, don’t understand, and what isn’t going well in their jobs. And if they are talking to me about it, it’s because they don’t know how to make it better. It is my job to help them make it better. I am a nurse: the hospital staff are now my patients.

I spend countless hours gathering information so that I can get to the root of our problems. When I identify the problem, I find a way to fix it and I work with staff to help them fix it. And, after training is complete, I trend the problem to see if it gets fixed or if we need to do more training or change our training. But there is never just one problem. And multiple wards I work with. And only one of me.

What don’t they see? My sleepless nights. My panic attacks in traffic. My hours in the office on weekends and overnight (less distraction that way). Me venting frustrations in kickboxing class. Or crying in yoga. I keep that from them because they are already stressed. They don’t need to worry about me. They see me when I have answers, when I can be supportive. The person they expect me to be. Need me to be.

Sometimes my schedule just doesn’t align with theirs.

How did you become an Educator?

Nurse education is a growing field. It is no surprise to many that there is a world-wide shortage of nurses ill-prepared for the demands of an aging and ailing Boomer genderation. And while we would like to have a whole fleet of experienced nurses at our disposal, it just isn’t feasible. So what do we do?

One approach nursing has taken to prepare for the increasing demand is to create more nursing programs to pump more people through nursing school. But with increasing numbers of less-experienced nurses in the workforce, many facilities have started to invest in on-site educational support to help identify educational needs on the job, retain staff and meet increasing governmental requirements to prove competency of staff.

However, nursing was faced with the problem of defining how a person is qualified to teach and educate the next generations of nurses. Many areas are still working on this definition, but generally speaking, most hospitals require that Clinical Nurse Educators have or are working towards a Masters of Nursing degree with an Informatics or Education emphasis. My former and current facility required this. I do not have that degree. I’ve completed some courses in a Masters program, but haven’t completed it. And definitely didn’t start working on it until I was far into my first role as an Educator. So, I am often asked how I got my job. Here’s my story……

I have a lot of interests. I always have, always will. I like to know how things work and especially enjoy learning about what makes people tick. This curiosity has driven me to become what most people call a “jack of many trades, master of none”. Don’t get me wrong: I am a damn good nurse. I care about people and their well-being. I know how to restart your heart if it stops beating. I can ease your pain and make sure you keep breathing. I will clean up your pee, poop, vomit, snot or whatever else oozes out of you while not making you feel bad about it. But, after awhile, it didn’t feel like enough.

I started to see the dark side of nursing. Unsupported staff feeling overworked and taking it out on themselves or loved ones. Older nurses “eating their young”. Young nurses doing the job because “it’s guaranteed work”. Patients dying. Co-workers dying. Patients coming back again and again for the same problems. I tried to focus on the positive, but it was hard.

I didn’t want to leave nursing, so I looked at what else I could do to reignite my love of nursing. I got involved in precepting and committees. I became an unofficial leader on my unit, a co-chair of the hospital-wide Pain Committee. But I still felt like I wasn’t doing enough. So, when we were going through massive managerial upheaval and reorganization, I applied for a Charge Nurse position. And I was told no.

Before I go too far, let me give some background for non-nurses. In nursing, there aren’t historically many ways to “move up”. There are a few nurses that move completely away from shift work into management or operational jobs, but most nurses shy away from that “advancement” because they want to keep up their skills. So, one of the ways we can advance is by becoming a Charge Nurse.

What exactly is a Charge Nurse? While duties and expectations can vary region to region, most Charge Nurses are seen as a formal leader on the unit. They typically decide patient assignments for each shift (while managing their own patient assignment as well), schedule staff, manage emergent or difficult issues and generally make sure the unit works day to day. So, when I was told no, I felt like our new manager was telling me I wasn’t a good leader. And for exactly 5 seconds I was devastated.

Then he told me why.

He told me I wasn’t a good fit for the Charge Nurse role because I was a good precepter. I liked to explain and teach and took my time helping staff feel comfortable. And he wanted to know if I’d change my mind and apply for the Clinical Educator job that was open instead.

I was floored. I didn’t even know that was a possibility. I didn’t have the credentials. But, he identified my strength, desire and drive, chose to overlook the credentials, and took a chance to support me. So, I did it. And, looking back on this later, I realized that this moment for me was a defining one. Not because it helped me “find my path”, but because it was the first time in a long time that I had witnessed something I didn’t realize was missing from my work area: a leader with a vision supporting staff to excel in a climate of change and overall negativity.

Much of my theory about adaptability and change management comes not only from researching and utilizing theories and concepts from literature but from good and bad experiences I’ve had. And that is what I will reflect upon as we go on.

How did I become an educator? I didn’t get a degree and just expect a job to fall into my lap. I got experience. I reached out and asked for every oportunity to advance that I could. I cried, got pissed off and even hated my job for awhile. Eventually I found someone that supported me and valued that expertise. It wasn’t quick and it didn’t happen when I expected it. But I sure as shit jumped on that opportunity when it landed in front of me. And I want to share what I’ve learned (and am still learning) with you.