A survey was conducted in Taiwan to assess the attitudes of in-service nurses towards web-based continuing learning. The survey included 221 nurses from various hospitals and used the Web-based Continuing Learning Survey (AWCL) as the data collection method. The prevalence of web-based learning is increasing in educational institutions, such as our university FEU. We have implemented a form of web-based learning called E-Learning, where students watch educational content and answer related questions online within a specific timeframe. E-Learning has also been integrated into our curriculum.
Within the realm of E-Learning, we observe online discussions and instructional demonstrations. A study conducted in Ontario, Canada aimed to assess the ongoing educational requirements of primary healthcare nurse practitioners throughout the province. It was found that 83% of surveyed nurse practitioners deemed continuing education as highly significant. They also identified various obstacles to participating in continuing education programs, such as the intensive time commitment, challenges in taking leave from work, familial responsibilities, financial constraints, and exhaustion.
One of the main reasons for discontinuing a continuing education program is the challenge of managing work and study responsibilities. Primary health care nurse practitioners in Ontario place great importance on continuing education opportunities. Although the use of digital curriculum and reading materials has become widespread among the general public, textbook providers are only now beginning to develop more advanced content experiences. I believe we will soon witness this shift, with some schools like the one in Turkey leading the way as early adopters.
Many schools use the opportunity to save money on traditional textbooks by purchasing devices. However, it is important for schools to consider this matter comprehensively and not merely replace textbooks with devices. Simply digitizing textbooks does not bring about transformative change. Instead, schools should focus on the complete learning process and explore how digital curriculum and content created by students and teachers can be integrated with back-end systems. This integration can facilitate the connection between student outcomes, assessments, personalized learning, and improved student achievement.
The new textbooks and content will be accessible on multiple devices such as Windows 7 notebooks, tablets and slates, Windows Phone, Xbox, Kinect, and Office 365. This reflects the need for diversity and personalization in the learning process. The issue of employees and students carrying sensitive data on their smartphones is a concern in the field of education as well.
According to Clark, if a student’s laptop or smartphone gets infected with malware from accessing a link on Facebook, the educational organization might still be vulnerable to the malware when the student logs back into their network. Clark mentions that over half of the survey respondents admitted to having no policy for protecting their networks from new mobile devices. Furthermore, developments in neuroscience and cognitive psychology are leading to fresh perspectives on the brain and its role in learning, known as Brain Train.
Music education classes have been proven to improve academic performance by engaging various areas of brain function. This idea is evident to individuals who study while listening to Bach or Mozart, which becomes even more significant considering the reduction of music classes across the country due to standardized test requirements. Additionally, two engineers from Vancouver who are also fathers are confident that their after-school education program, Einstein Wise, will enable students to excel in math and technology on a global scale.
Their “brain training center” offers a unique educational program for students in grades K-6. The program combines chess and computer tablet activities, math, Mandarin Chinese, Lego robotics, and yoga. The creators of this program have the hope to see it integrated into public school curricula in the near future.
Another significant trend for the upcoming academic year is the increasing importance of anti-bullying initiatives. In states like New Jersey, where strict anti-bullying laws have recently been enacted, educators are facing an overwhelming number of reports. Each complaint of bullying requires considerable time and resources to be properly investigated.
Concerns about monitoring bullies in non-school settings are shared by teachers, students, and parents. While some parents consider it an invasion of privacy for schools to investigate their children’s lives outside of school, others view outdoor education programs as a way to address problems such as obesity, digital burnout, and Vitamin D deficiencies. Salzman proposes that these programs offer an alternative to conventional classrooms and can be seen as a form of digital classroom without physical boundaries.
According to the Burlington Free Press, an expansion of green learning initiatives will incorporate classes in farming, nature studies, and the exploration of authors like Henry David Thoreau. This trend arises alongside a decrease in enrollment of new nursing students at various schools across the country, including the Adelphi University School of Nursing in Garden City, New York. Experts attribute this drop-off to a lack of confidence in new nurses’ job prospects.
The economy’s impact on higher education is evident across all fields. Experts believe that the decrease in confidence has led to fewer applications for various college programs nationwide. However, data indicates that there is still a shortage of qualified nurses throughout the country. The issue may lie in the availability of nurses in sought-after locations. On a positive note, there are new and advanced systems being implemented to facilitate the nursing school application process.
Recently, the American Association of Colleges of Nursing introduced a central application service, simplifying the application process for multiple programs. Furthermore, recent technological advancements have improved the educational process for nurses. These advancements include advanced simulation systems that offer more realistic clinical experiences for nurses in training. While these simulations cannot fully replace real patient experiences, schools like NYU incorporate them for up to half of nurses’ clinical training.
Growing Number of Field Specialties: One of the current hot trends in nursing education is the increasing number of specialties in the field. Forensic nursing is particularly gaining popularity as a specialization. Such trends indicate the diversification of the nursing field, which presents numerous fresh opportunities for present and future nursing students.
Issues – Patient Autonomy: Nurses must be ready to confront challenges related to patient autonomy. The Health Insurance Portability and Accountability Act (HIPAA) safeguards patient information, and nurses are prohibited from disclosing any patient information without obtaining consent.
Nurses play a crucial role in healthcare by dealing with ethical concerns, especially when it comes to sharing sensitive information with a patient’s family. These challenges often involve decisions related to patient autonomy, such as do not resuscitate (DNR) orders and discontinuing care. Given their extensive interaction with patients, nurses have an essential responsibility within the healthcare team to address issues surrounding end-of-life care. They must navigate the delicate task of honoring the patient’s wishes while delivering exceptional end-of-life care and effectively communicating these decisions to the patient’s family.
Nurses are important in helping patients and their families make decisions about end-of-life matters, such as creating living wills, advanced powers of attorney, and facilitating organ donation. In the Philippines, unemployment and underemployment are widespread problems that greatly affect the number of nursing students. Given this situation, it is crucial for nursing education to recognize its role in addressing the devaluation of fundamental nurse caring and work towards restoring public trust in nursing as a compassionate service. The UK Council of Deans of Health (2012) states that nursing education has minimal responsibility for tackling this issue.
The response to the UK Chief Nurse’s ‘6Cs manifesto’ shows self-congratulation and suggests the need for more investment in nursing education to continue its current practices. The Willis Commission Report also states that no major issues in nursing education have been found to be responsible for poor practice or declining standards of care.
We are uncertain and lack reassurance. Nursing education must engage in critical thinking, which we highly esteem in our students. Nurses from Australasia, North America, and Europe consistently express similar concerns about nursing education. These issues should not be unknown to those in nursing education, so what actions do we plan to take? Specifically, let’s address the neglect of “basic nursing care” towards an increasing number of unqualified and predominantly unregulated care assistants.
A hospital CEO in Australia has introduced a novel method to enhance the effectiveness of nurses by providing them training in procedures like colonoscopies, endoscopies, cystoscopies, and X-rays. This enables nurses to focus on advanced tasks while delegating basic responsibilities like patient washing and feeding to lower-paid nursing assistants. This raises concerns about the impact of nurse education on devaluing and marginalizing traditional forms of care.
The situation where essential nursing care is being seen as the responsibility of health care assistants (HCA) raises questions about what we have done or failed to do in our curricula, teaching, and relationships with service partners. The Willis Report highlights the concern of having unregulated and unmonitored staff caring for vulnerable citizens, which is deemed unacceptable. It is also deemed unacceptable that registered nurses have to supervise colleagues whose competency they cannot rely on. The report also raises the question of whether nursing education prepares nurses to manage care delivered by others, nurse patients themselves, or a combination of both. This raises deep concerns about the core purpose of nursing education. It is painful to read and brings us into what can be seen as Nursing’s ‘Heart of Darkness’, a situation that can be compared to Kurtzian Horror.
Health services and clinicians often express concerns about students or graduates lacking a clear sense of nursing purpose or struggling to establish a coherent professional nursing identity. They also observe ambivalence among nurses regarding the importance of fundamental nurse caring and their role in delivering it. These concerns are not unfounded. Likewise, it is understandable how fundamental nursing care can be seen as an optional aspect that nurses can choose to prioritize or neglect as they see fit.
The text suggests that perhaps the main role of HCAs is to oversee the care provided by others, even though those others may have more expertise in delivering this basic care. Hasson et al. (2012) inquire whether it is appropriate for HCAs to be teaching these skills to student nurses if they are the ones primarily delivering patient care. The text poses the question: Why not have RNs teach these skills instead?
Has nursing education advanced from the criticized “see one, do one, teach one” approach to today’s specialized “hear about one, simulate one, supervise all the others” austerity measures? How has nursing education played a role in this negative state of affairs? What occurs (or doesn’t occur) within a school’s “education process” that leads to a decrease in students’ empathetic actions? Does your school have both overt and covert curricula that neglect nurse caring, kindness, compassion, and fundamental care and instead prioritize other things?
These curricula are responsible for neglecting the practice of “basic/fundamental nursing care”, overshadowed by extensive content on concepts like ‘autonomy’, ‘ethics’, ‘health promotion’, ’empowerment’, ‘equity’, ‘reflection’, ‘issues’, ‘leadership’, ‘wellness’ and related topics. In these curricula, fundamental nursing care and caring are deemed to be ‘implicit’, ‘integrated’, ‘blended’ or ‘thematised’, essentially invisible and ranked as low priority in terms of care skills (Thomas et al. 2011, p. 662). It is embarrassing that we even have to discuss the importance of caring and kindness in nursing education, and whether it is a core purpose of nurses. It is a direct insult to the profession. If nursing education cannot clearly state that nurses are meant to care for patients and people, then we should expect criticism.
Additionally, we will likely have to make way for the next form of nursing education that does not view qualities such as caring, compassion, kindness, service, and the ability to “assist the individual, sick or well” as an insult to one’s professionalism or intellect. Do not dismiss this as exaggeration. To illustrate, a social enterprise company called ‘Nurse Next Door’ (www.nursenextdoor.com) was established in Canada due to the founders’ unsatisfactory encounters with traditional home care services for their family members.
Nurse Next Door is distinguished from other home nursing services by its unwavering commitment to caring. They believe that “It’s about caring, not just health care™” and this mindset permeates every aspect of their operations, including their values, hiring and firing practices, and overall business approach. Without this core value of caring, their service would lack purpose. As a result of this unique foundation based on caring, Nurse Next Door has achieved significant success in the industry.
The remarkable thing is that the ‘gap in the market’ they fill is the very essence of ‘Caring’ that was once considered inherent in Nursing. It may not be long before other social entrepreneurs observe hospitals and mainstream health services and realize that they could offer and manage such services in a much more effective manner. Some argue that it won’t take too long. Returning to the Article Outline, what do we truly need – intelligence or compassion? We unequivocally require intelligent, insightful, diligent, inventive, resourceful, and questioning students and nurses who are eager to become more passionate, knowledgeable, and humbled by how much they do not know about the world, nursing, and the human condition. This is never a conflict between ‘intelligence’ and ‘caring’. The public insists on having nurses who embody both qualities.
Various studies have indicated that individuals desire proficient, capable nurses who effectively handle and aid in managing the technical, procedural, and treatment aspects of their condition and care. They seek nurses who actively listen, comprehend, and communicate with them as equals. They seek nurses who provide unwavering support and assistance in navigating unfamiliar and impersonal healthcare systems. Most importantly, they desire nurses who accomplish all of this while expressing care, kindness, compassion, and thoughtfulness in their daily interactions concerning health. Is this an immense request? Absolutely.
This is why great nursing is not easy and not everyone who wants to do it can or should. A recent study by Griffiths et al (2012) confirmed this finding, stating that nurses need to have technical competence and knowledge, as well as the ability to find information and seek help when lacking in knowledge or skills. However, service users and carers emphasized the importance of “softer” qualities in nursing such as empathy, listening, a non-judgmental attitude, and individualized care, which they believe have sometimes been lost within the nursing profession.
Expressing concern about the perceived incompatibility between the valued softer skills and ‘academic’ nursing, Griffiths et al. (2012, p. 125) highlight the irony. However, it is unlikely that the public does not desire smart, knowledgeable, and well-educated nurses. People are discerning and can quickly differentiate between a nurse who is knowledgeable and a nurse who is arrogant.
It is valuable and admirable to possess qualities such as intelligence, critical thinking skills, qualifications, and knowledge. However, a nurse who possesses these qualities but fails to employ them properly runs the risk of negative consequences. In the multitude of nursing stories we hear about today, there are no instances where the complaint was solely that a nurse was “too intelligent” or “too well-educated”. If these nurses were excelling in other important aspects of their job, it is likely that patients and families would never have an issue with their level of intelligence or qualifications.
Where patients and the general public find fault, with valid reasons, is with the nurse who demonstrates a lack of concern and exhibits behaviors that suggest they have no interest. The public may not necessarily be strongly against intellectualism, but instead, they may struggle to comprehend, as Christina Patterson (2011) painfully realized, “Why nurses aren’t compassionate.” They are unable to grasp why someone who lacks empathy and kindness would choose to pursue a career in nursing. They cannot fathom why a nursing education system would accept individuals like them and ultimately enable them to become a registered nurse.
They cannot comprehend how a hospital or health system can tolerate and accept such uncaring behavior and lamentable ‘nursing’. As they search for reasons that might make sense to them, they witness a mixture of self-interest, self-justification, and blame shifting. Education blames the corrupting influence of the service side, while services blame the irrelevant nature of current education. Meanwhile, governments across the globe believe they can impose austerity economics on their beloved political tool, the health service, without facing any adverse effects. The words ‘plague’, ‘all’, and ‘houses’ come to one’s mind.
If these two systems cannot work together more effectively, we will certainly be entering the ‘Endgame’ of this era’s nursing education system. There is no easy solution for the crisis in nursing and every nurse in practice, education, research, and management must contribute. Nursing education cannot just rely on current safety measures and hope for societal change, implementation of the Francis Report recommendations, a shift in public perception of nursing, or any other perfect alignment of societal and professional factors.
According to Bernie Carter, the concept of ‘managerialism’ is redefining the field of nursing. Carter argues that nursing is undergoing a transformation, as it is being reshaped to align with managerial, commercial, and business standards, rather than focusing on the needs and preferences of nurses and patients. This shift is eroding our collective memory of what nursing truly entails.
Is there a counterpart to managerialism called educationalism? This counterpart may be reforming nursing in a way that may make sense academically and professionally but is unrecognizable to health services and others in the field. The crisis shows no signs of getting better, as indicated by the latest update from UK Patients Association (2012) and the shocking findings of the second Francis Report (2013).
Until we put a stop to the devaluation and downgrading of what we refer to as ‘fundamental care’, ‘basic care’, ‘core nursing’, or ‘skilled compassion’ in Nursing and our health services, the public and the media will rightly question why nursing and healthcare “cannot get basic care right” (Triggle, 2012). If our current nursing education system is unable to spearhead the efforts for change alongside our clinical colleagues, then there may be an alternative system in the future that will.
The role of Advanced Practice Registered Nurses (APRNs) is constantly expanding. In 2013, Medicare implemented a final rule on physician fees allowing Certified Registered Nurse Anesthetists to be paid for their services based on the full extent of their state scope of practice. APRNs in various states have been fighting for and successfully gaining autonomy. However, this battle is expected to continue into the future. Karen Daley, the president of the American Nurses Association (ANA), has stated that addressing regulatory barriers and granting APRNs the ability to practice to their full scope is one of the organization’s top issues for 2013. These barriers should be eliminated nationwide.
The rise of care coordination and the concept of a “medical extensivist” is catching attention in the healthcare industry. This term, included in the top 13 healthcare buzzwords for 2013, refers to clinicians, like advance practice nurses, who expand their responsibilities beyond the hospital to provide care in homes or other environments. The goal of these professionals is to improve the health of patients with chronic illnesses outside of the hospital setting.
Regular, routine patient visits could potentially prevent patients from going to the emergency room and hospital, thereby reducing readmissions, improving patient health, and saving money. Although the term may be recent, nurses have been at the forefront of this movement for years. Additionally, a new Medicare rule will now compensate nurses for assisting patients in transitioning successfully from hospitals to other environments, which could potentially lead to job opportunities.
Extending the culture of safety to nurses: It is ironic that professional caregivers are frequently neglected themselves in the nursing field. However, for nurses to effectively provide care for patients, they need to prioritize their own safety. This involves addressing concerns such as creating a secure workplace, free from violence and abuse, as well as promoting healthy lifestyle habits and adequate sleep for nurses.
The ANA is prioritizing safe patient handling as a key concern this year in order to prevent musculoskeletal disorders that may result from lifting patients. Currently, the ANA is taking the lead in creating national interdisciplinary safe patient handling standards. These standards aim to assist hospitals and other healthcare employers in establishing long-lasting, effective programs that prioritize safety. According to ANA president Karen Daley, the standards are scheduled to be released in spring 2013.
Continuing to advance nurse education: The year 2013 brings us one year closer to the goal set by the Institute of Medicine’s Future of Nursing report that calls for increasing the proportion of nurses with a baccalaureate degree to 80% by 2020. In addition, there is evidence suggesting that increasing the number of nurses with specialty certifications can improve patient care. As a result, more nurses will likely pursue further education. Innovative programs, like portfolio credentialing alternatives, will be introduced to assist nurses in achieving this.
What is the commonality among the four issues mentioned above? Quality, quality, quality.
They all have the common goal of enhancing healthcare quality. In fact, according to the 2012 HealthLeaders Industry Survey’s Nurse Leaders Report, nurse leaders identified patient experience and satisfaction, as well as clinical quality and safety, as the top two priorities for their organization in the next three years. The survey revealed that 72% of nurse leaders consider patient experience and satisfaction among their top three priorities, while 55% have the same view regarding clinical quality and safety. The presence of a language barrier can impede the provision of nursing care on a global scale.
