Clinical Nurse Specialist

Advanced Practice Nurse EducatorPresentation by Sandra NewsomeNURS 500

IntroductionThis informative presentation is designed to explain the role of the advanced practice nurse educator to beginning masters level nursing students for recruitment to this specialty.

Good afternoon fellow colleagues and thank you for coming. The purpose of this informative presentation is to discuss and explain the role of the advanced practice nurse educator. I hope this presentation will clarify any questions about this role and convince you to choose the educator role as your concentration. 2ObjectiveTo examine the role of the advanced practice nurse educator Discussion of the historical evolution Discussion of the focus of the role Explain the scope of practice Explain the core competencies Discussion of the practice environments Practice outcomes for the advanced practice nurse

Historical EvolutionEvolution of nursing

Evolution of advance practice nursing

Evolution of nursing: Nursing in the 1900s was different than nursing today. The nurses of the past wore caps and capes rather than scrubs and casual clothing. The typical nurse was a single young woman who when married had to discard her profession to take care of her husband and family (Federwisch, 1999). Married nurses did not gain societal approval till after WWII (Federwisch, 1999). Nurses of this time were needed to treat infectious diseases and were seen as the difference between life and death because there wasnt treatment for a lot of the disease (Federwisch, 1999). Nursing care was centered on fever reduction, antiseptic techniques, good skin care, health education, proper nutrition and would manage everything about a patients life and environment (Federwisch, 1999). Student nurses staffed the hospitals, beginning their professional careers while they learned through hospital training programs (Federwish, 1999). Upon graduation from these programs they had three options: hospital supervisory roles, public health or private duty, and the very select few would become superintendents of nursing or teach nursing (Federwisch, 1999). The majority provided private duty care to the relatively affluent (Federwisch, 1999). There were no insurance programs at this time and nursing care cost about $4.00 a day, so only the extremely poor recipients of public care had access to nursing care (Federwisch, 1999). Those working private duty usually placed their names on a central registry list, and if they worked steadily they made a decent living (Federwisch, 1999). Training and nursing practice varied greatly at this time (Federwisch, 1999). In the United States, the mid-nineteenth century saw calls for formal training of nursing by organizations such as the American Medical Association (National League of Nursing, 2005). By 1902, there were 492 schools of nursing in the United States (NLN, 2005). These programs expected strong discipline, long hours, and a strong focus on learning through practice (NLN, 2005). During the early twentieth century, most nurses were prepared in hospital based programs, however, starting with the University of Minnesota in 1909, collegiate setting became the locus for programs of registered nursing education at the undergraduate and the graduate levels (NLN, 2005). The approach to providing registered nursing education in community colleges was developed in 1949 (NLN, 2005). As nursing progressed to become a profession, the science of nursing further delineated and the body of knowledge and skills unique to generalist and advanced practice nursing was developed and refined. Bachelor degree programs became more prominent in the early 1950s when community colleges started associate degree programs and hospital based programs phased out. (Federwisch, 1999).

Evolution of advanced practice nursing: The American Civil War in 1861 can be credited for the development and initial implementation of the advance practice nurse because there were no professional nurses at this time, Catholic sisters served as nurses and assisted surgeons with the administration of chloroform (Hudson, 2009). In reviewing history of the advanced practice nurse, this assistive act is considered to be the first reporting of the Nurse Anesthetist (Hudson, 2009). Similar to the Nurse Anesthetist, the roots of the Clinical Nurse Midwife can be traced to pre-professional times (Husdon, 2009). As the role of the advanced practice nurse continued to develop, other nursing specialties emerged such as Clinical Nurse Specialist and Nurse Practitioner (Hudson, 2009). Nurse practitioner programs began in the mid 1960s and by the 1980s the programs became popular (Federwisch, 1999). With the implementation of managed care, hospitals were forced to develop and implement a new model of health care delivery which required additional resources and the collaborative roles of the Advanced Practice Nurse (Hudson, 2009). Advanced practice nurses transformed nursing, putting the nursing profession further along the continuum of independence (Federwisch, 1999). 4Focus of Role Standards of practice describe the responsibilities for nurses in a particular role are accountable. (National League for Nursing, 2005)

The focus of the nurse educator role is as follows: Nurse educators are responsible for creating an environment in classroom, laboratory, and clinical settings that facilitates student learning and the achievement of desired cognitive, affective, and psychomotor outcomes.Nurse educators recognize their responsibility for helping students develop as nurses and integrate the values and behaviors expected of those who fulfill that role.Nurse educators use a variety of strategies to assess and evaluate student learning in classroom, laboratory, and clinical settings, as well as in all domains of learning.Nurse educators are responsible for formulating program outcomes and designing curricula that reflect contemporary health care trends and prepare graduates to function effectively in the health care environment.5) Nurse educators function as change agents and leaders to create a preferred future for nursing education and nursing practice.Nurse educators recognize that their role is multidimensional and that an ongoing commitment to develop and maintain competence in the role is essential.Nurse educators acknowledge that scholarship is an integral component of the faculty role, and that teaching itself is a scholar activity. Nurse educators are knowledgeable about the educational environment within which they practice and recognize how political, institutional, social and economic forces impact their role (NLN, 2005)5Scope of PracticeThe scope of practice statement describes the who, what, where, when, why, and how of nursing practice.(National League of Nursing, 2005)

The term academic nurse educator refers to individuals who fulfill a faculty role in an academic setting (National League of Nursing, 2005). The scope of practice described in the NLN (2005), states, Competence as an educator can be established, recognized, and expanded through masters and/or doctoral education, post masters certificate programs, continuing professional development, mentoring activities, and professional certification as a faculty member (NLN, 2005). 6Core CompetenciesFacilitate LearningFacilitate Learner Development and SocializationUse Assessment and Evaluation StrategiesParticipate in Curriculum Design and Evaluation of Program OutcomesFunction as a Change Agent and LeaderPursue Continuous Quality Improvement in the Nurse Educator RoleEngage in ScholarshipFunction within the Educational Environment(National League of Nursing, 2005)

Competence in nursing practice must be evaluated by the individual nurse (self-assessment), nurse peers, and nurses in the roles of supervisor, coach, mentor, or preceptor (American Nurses Association, 2010). For academic nurse educators, those responsibilities relate to the eight core competencies I will discuss. Competency 1- is to facilitate learning. To facilitate this learning effectively, the nurse educator must: *Implement a variety of teaching strategies appropriate to learner needs, desired learner outcomes, content and context and ground teaching strategies in educational theory and evidence-based teaching practices *Recognize multicultural, gender, and experiential influences on teaching and learning. *Engage in self-reflection and continued learning to improve teaching practices that facilitate learning *Use information technologies skillfully to support the teaching-learning process *Practice skilled oral, written, and electronic communication that reflects an awareness of self and others, along with an ability to convey idea in a variety of contexts *Model critical and reflective thinking *Creates opportunities for learners to develop their critical thinking and critical reasoning skills *Show enthusiasm for teaching, learning, and nursing that inspires and motivates students *Demonstrate an interest in and respect learners and use personal attributes such as caring, confidence, patience, integrity, and flexibility that facilitate learning *Develop collegial working relationships with students, faculty colleagues, and clinical agency personnel to promote positive learning environments. *Be competent in this role must maintain the professional practice knowledge base needed to help learners prepare for contemporary nursing practice and serve as a role model of professional nursing. (NLN, 2005) Competency II- Facilitate Learner Development and Socialization. To facilitate learner development and socialization effectively, the nurse educator must: *Identify individual learning style and unique learning needs of international, adult, multicultural, educationally disadvantaged, physically challenged, at-risk, and second degree learners *Provide resources to diverse learners that help meet their individual needs *Engages in effective advisement and counseling strategies that help learners meet their professional goals *Creates learning environments that are focused on socialization to the role of the nurse and facilitate learners self-reflection and personal goal setting *Fosters the cognitive, psychomotor, and affective development of learners *Assists learners to develop the ability to engage in thoughtful and constructive self and peer evaluation *Models professional behaviors for learners including, but not limited to, involvement in professional organizations, engagement in lifelong learning activities, dissemination of information through publications and presentations, and advocacy (NLN, 2005). Competency III: Use Assessment and Evaluation Strategies. To use assessment and evaluation strategies effectively the nurse educator must: *Uses extant literature to develop evidence-based assessment and evaluation practices *Uses a variety of strategies to assess and evaluate learning in the cognitive, psychomotor, and affective domains *Implements evidence-based assessment and evaluation strategies that are appropriate to the learner and to learning goals *Uses assessment and evaluation data to enhance the learning process *Provides timely, constructive, and thoughtful feedback to learners *Demonstrates skill and design and use of tools for assessing clinical practice (NLN, 2005). Competency IV: Participate in Curriculum Design and Evaluation of Program Outcomes. To participate effectively in curriculum design and evaluation of program outcomes the nurse educator must: *Ensures that the curriculum reflects institutional philosophy and mission, current nursing and health care trends, and community and societal needs so as to prepare graduates for practice in a complex, dynamic, multicultural health care environment *Demonstrates knowledge of curriculum development including identifying program outcomes, developing competency statements, writing learning objectives, and selecting appropriate learning activities and evaluation strategies *Bases the curriculum based on assessment of program outcomes, learner needs, and societal and health care trends *Implements curricular revisions using appropriate change theories and strategies *Creates and maintains community and clinical partnerships that support educational goals *Collaborates with external constituencies throughout the process of curriculum revision *Designs and implements program assessment models that promote continuous quality improvement of all aspects of the program (NLN, 2005). Competency V: Function as a Change Agent and Leader. To function effectively as a change agent and leader the educator must: *Models cultural sensitivity when advocating for change *Integrates a long-term, innovative, and creative perspective into the nurse educator role *Participates in interdisciplinary efforts to address health care and educational needs locally, regionally, nationally, or internationally *Evaluates organizational effectiveness in nursing education *Implement strategies for organizational change *Provide leadership in the parent institution as well in the nursing program to enhance the visibility of nursing and its contributions to the academic community *Promotes innovative practices in educational environments (NLN, 2005). Competency VI: Pursue Continuous Quality Improvement in the Nurse Educator Role. To pursue continuous quality improvement in the nurse educator role, the individual must: *Demonstrate a commitment to life-long learning *Recognizes that career enhancement needs and activities change as experience is gained in the role *Participates in professional development opportunities that increase ones effectiveness in the role *Balances the teaching, scholarship, and service demand inherent in the role of educator and member of an academic institution *Uses feedback gained from self, peer, student, and administrative evaluation to improve role effectiveness *Engages in activities that promote ones socialization to the role *Uses knowledge of legal and ethical issues relevant to higher education and nursing education as a basis for influencing, designing, and implementing policies and procedures related to students, faculty, and the educational environment *Mentors and supports faculty colleagues (NLN, 2005). Competency VII: Engage in Scholarship. To engage effectively in scholarship, the nurse educator must: *Draws on extant literature to design evidence-based teaching and evaluation process *Exhibits a spirit of inquiry about teaching and learning, student development, evaluation methods, and other aspects of the role *Designs and implements scholarly activities in an established area of expertise *Disseminates nursing and teaching knowledge to a variety of audiences through various measures *Demonstrates skill in proposal writing for initiatives that include, but are not limited to, research, resource acquisition, program development, and policy development *Demonstrates qualities of a scholar, integrity, courage, perseverance, vitality, and creativity (NLN, 2005). Competency VIII: Function with the Educational Environment. To function as a good citizen of the academy, the nurse educator must: *Uses knowledge of history and current trends and issues higher education as a basis for making recommendations and decisions on educational issues *Identifies how social, economic, political, and institutional forces influence higher education in general and nursing education in particular *Develops networks, collaborations, and partnerships to enhance nursings influence within academic community *Determines own professional goals within the context of academic nursing and the mission of the parent institution and nursing program *Integrates the values of respect, collegiality, professionalism, and caring to build an organizational climate that fosters the development of students and teachers *Incorporates the goals of the nursing program and the mission of the parent institution when proposing change or managing issues *Assumes a leadership role in various levels of institutional governance *Advocates for nursing and nursing education in the political arena (NLN, 2005). To excel and be competent as a advanced practice nurse educator you must abide by these competencies set forth.7Practice Environments Nursing education takes place in diverse environments

Nursing education takes place in diverse settings which include, but are not limited to, high schools, technical schools, hospitals, two and four year colleges, universities. The implementation of the faculty role may occur in traditional classroom based environments or in non traditional environments that include distance delivery via video, closed circuit television, and on the web. Nurse educators are critical players in assuring quality educational experiences that prepare the nursing workforce for a diverse, ever changing health care environment (Nurses for a Healthier Tomorrow, 2010). 8Practice OutcomesCritical thinkerCulturally competentKnowledge coordinator of community resourcesPolitically AwareEthically and legally groundedEffective communicatorCompetent health care providerModeler of the professional roleResponsible manager of human, fiscal, and material resources(Billings, D. M., & Halstead, J. A., 2009)

Practice Outcomes are qualities that educators want graduates to display. Critical Thinker: graduate is a critical thinker who is able to demonstrate intellectual curiosity, rational inquiry,, problem solving skills, and creativity in framing problems. Culturally Competent: graduate has the ability to provide congruent culturally competent care, to diverse populations. Knowledge Coordinator of Community Resources: the graduate has the ability and knowledge to provide community resources as necessary to patients, families, and as a case manager of care. Politically Aware: engages in a health related political activity that promotes the importance of the nursing profession in creating change in health care environments (Lenburg, 2001). Ethically and Legally Grounded: upon graduation students will be ethically and legally grounded with the ability to make appropriate decisions including being accountable for ones actions. Effective Communicator: the graduate student will be an effective communicator in all aspects of nursing practice. Competent Health Care Provider: the graduate will be a competent health care provider and will provide quality, safe care, maximizing client care outcomes. Modeler of the Professional Role: the graduate will be a role model of perfection to other in the advanced practice professional role. Responsible Manager of Human, Fiscal, and Material Resources: the graduate will be a responsible manager of human, fiscal, and material resources.9Why Education?Faculty shortage

Rewarding career

Other benefits

By 2016, a predicted 1 million new replacement nurses will be needed (Danna & Jones, 2010). The demand for nurses is increasing 3% each year (Danna et al., 2010). With 75% of current faculty expected to retire by 2019, increasing the number of nurse faculty is crucial (Danna et al., 2010). Given the growing shortage of nurse educators, the career outlook is strong for those interested in teaching careers, allowing a high level of job security and opportunities (Nurses for a Healthier Tomorrow, 2010).

Nurse educators combine clinical expertise and a passion for teaching into a rich and rewarding career (Nurses, et al., 2010). Educators that work in the classroom and practice settings, are responsible for preparing and mentoring current and future generations of nurses by playing a pivotal role in strengthening the nursing workforce, serving as a role models and providing leadership needed to implement evidence-based practice (Nurses, et al., 2010).

Other benefits of careers in nursing education include access to cutting-edge knowledge and research, opportunities to collaborate with health professionals, an intellectually stimulating workplace and flexible work scheduling (Nurses, et al., 2010).10SummarySociety needs Nurse Educators that display a commitment to lifelong learning, exercise leadership and be concerned with the scholarly development of the discipline.

Nurse Educators should have a strong knowledge based on theories of teaching, learning, and evaluation; be able to design curricula and programs that reflect sound educational principles; be able to assess learner needs; be innovative; and enjoy teaching (Nurses for a Healthier Tomorrow, 2010). 11ReferencesAmerican Nurses Association, (2010). Nursing: Scope and Standards of Practice. 2nd ed. Silver Spring, Maryland. Nursesbooks.org.Bethel University Graduate School, (2010). Focus on the Nurse-Educator Role. Retrieved from http://gs.bethel.edu/certificates/nursing-education/Billings, D. M., & Halstead, J. A., (2009) Teaching in nursing: A guide for faculty (3rd Ed.). Philadelphia: W.B. Saunders Danna, D., & Jones, J., (2010). From Practice to Education: Perspectives From Three Nurse Leaders. The Journal of Continuing Education in Nursing. 41. (2). Federwisch, A., (1999). Talk About an Evolution: A century of change and continuity in nursing. Nurseweek. Retrieved from http://www.nurseweeki.com/features/99-12/achieve.htmlHudson, K., (2009). The History and Evolution of the APN role: The Impact on Healthcare. Dynamic Nursing Education. Retrieved from http://dynamicnursingeducation.com/class.php?class_id=86&pid=18National League for Nursing, (2005). The Scope and Practice for Academic Nurse Educators. New York, NY. Nurses for a Healthier Tomorrow, (2010). Nurse Educator. Retrieved from http://www.nursesource.org/nurse_educator.html