From teaching to nursing with joy: a nurse educator writes of her return to nursing practice to gain clinical currency and credibility, and of how she now combines teaching and nursing, to mutual benefit.
Being a nurse educator is an all-consuming job. I love teaching, working with nursing students and the whole academic life that goes with teaching. I have been working as a nursing educator in New Zealand since 1990. When I was in clinical practice, it seemed I never had an opportunity to think nursing. As an educator, talking, sharing experiences and teaching nursing practice and theory, there were lots of thinking times and I loved that.
I had returned to part-time clinical practice when on maternity leave from teaching in 1999-2000, but since 20001 had been teaching full-time. I worked as the bachelor of nursing (BN) programme coordinator at Eastern Institute of Technology (EIT) from 2002-2006. This was an interesting but sometimes stressful job, involving a great deal of one-to-one work with students, as they struggled to achieve their goat of a BN and registration as a nurse. The work was so engrossing I didn't particularly notice how removed I was becoming from the practice of nursing. It wasn't until I worked alongside student nurses on their practicums that I began to realise the nursing I remembered, and the nursing of today, were different. In the five to six years of my absence, things had changed. Nurses had new demands on their time I had not appreciated--Trendcare, discharge planning, CarePlus, extra documentation, different ways of taking vital signs, new ways of getting information about the patient. Every time I went to the hospital or community setting, I felt more and more alienated and different. How could this be? I was a registered nurse (RN), I was a teacher, and yet I felt inadequate and somehow redundant.
Feelings of inadequacy led to soul-searching and reflection, and a number of concerns arose. How could I teach a subject as applied as nursing and not be engaged in clinical practice? How could I keep clinically current with a full-time demanding teaching workload? How could I be credible to nursing students, when I had been out of nursing practice for so long? I found no answers to quell my concerns. By now, I was also teaching in the clinical masters programme and my lack of currency became even more evident and I realised I could no longer sustain my position. To teach nursing I needed the currency and immediacy of nursing practice.
I had heard of joint appointments for teachers and nurses and this sounded an ideal approach. I approached the Dean of Faculty at EIT, Susan Jacobs, and discussed my dilemma with her. She was sympathetic. However, for a joint appointment with Hawked Bay DHB, given my current rote and the national NZNO/DHB multi-employer collective agreement, I needed a management rote in the DHB. That was not what I wanted. I wanted to be a regular nurse, to go to a patient and say "I am your nurse today". I approached the DHB and it was also supportive. Finally, I decided to take six months' leave from teaching and to work full-time at the DHB, then return to full-time teaching.
Feeling like a 'phoney'
On January 31, 2006 I started work as an RN in the children's ward at the regional hospital. Initially I felt like a phoney. It took months to begin to feel at home and not be afraid I would let my colleagues and myself down. I began a steep learning curve into the realities of nursing now and immersed myself in getting every certification there was to get--to be able to administer intravenous (IV) narcotics, manage patient-controlled analgesia (PCA), administer IV medications, cannulation and venepuncture. I went to every study day to soak it all up, but by far and away the most satisfying aspect of being a nurse was to meet a new patient and family and say "I am your nurse today" When I was with my patients, the knowledge I had as a teacher would come to the fore, and I knew I was a very different nurse than previously. I brought to clinical practice a research mindedness, my past research on parents caring for their hospitalised child, my reflections on clinical practice and how this phenomenon that was nursing had altered my view of the world. My life experience as a mother had changed me as well. All this experience gave more depth to my nursing. I thought about the way I communicated with the children and their families, and tried very hard to practise what I taught and read.
My colleagues and managers supported me as I coped with the workload. Clearly, some had reservations about my abilities--what was this lecturer doing "pretending" to be a nurse? However, I assured them I was there to team and I hoped they could see I was genuine in my need to nurse and to be part of their team.
Frequently there was very little reflection time because of the heavy workload. Time management became a priority, as I struggled to deliver the care I wanted to give and that these patients and families deserved. This was reality!
Well into my six-month stay in the ward, I realised I could not return to full-time teaching; I would miss clinical practice too much. In spite of having gained so much in such a short time, I felt I was just beginning to get a grip on the reality of clinical practice today. So I negotiated with EIT to teach six days a fortnight, and then with the DHB to work four shifts a fortnight.
On my return to teaching, it was wonderful to be able to discuss a recent clinical situation I had experienced, rather than one from years ago. Clearly, credibility was now not an issue. At the DHB, I enjoy every shift. Every day I took forward to work and wonder what my clinical practice will bring.
As an RN who works in clinical practice and education, I am indeed fortunate. Having a foot in both camps enables me to work cotlaboratively with nurses across the sectors. We are all able to draw on each others expertise, to improve the quality of patient care, of nursing education and the relevance of nursing research.
* I would like to thank my employers for their support and also for my RN colleagues in practice for their ongoing interest in my "other" life.
Ruth Crawford, RN, BA (SocSci), PGCert (Tertiary Tchng), MPhil (Nsng), is a nursing lecturer at EIT Hawke's Bay and a staff nurse in the children's ward at Hawke's Bay Regional Hospital.