One of the most frustrating hurdles for aspiring nurses is to leap and land on their feet while jumping over the directive of “think like a nurse.” Thinking like a nurse and speaking the language of nursing is like going into a foreign land and not speaking or understanding the native tongue. Helping both students and new nurses to realize they already have the intuition to use the nursing process and critically think is an essential key in both education and leadership.
In recent months I’ve worked to create assignments that covertly guide the student nurse through the primary roles of nursing. One focus has been on the nursing process: Assessment, Diagnosis, Planning, Implementation and Evaluation; ADPIE. One assignment requires the students to bake.* They can choose to bake any kind of cake: bundt, layered, cupcakes, etc. I provide only a few requirements such as they must use measuring tools for at least two ingredients. Then they must document various pieces of information. This assignment serves many objectives. First, it allows the instructor to have one common activity that all the students can relate to. For example when reviewing any area of the nursing process, I’m able to say to the students, “Just like when you…” and put in whatever fits.
In every class at least one student remarks with trepidation, “I’ve never baked before!” To which I respond, “Have you ever placed a catheter before? Then this will be good practice to learn something new.”
This assignment brings in topics of hand hygiene, personal protective equipment, the need to note allergies, and much more. The entire nursing process from assessment to evaluation is developed. The real excitement begins when students speak of having someone guide them in the kitchen, a need to alter the recipe due to allergies, or how they burned their cake. Some students go above and beyond the basic “order” and elaborately decorate the cake. Oh, to have that kind of nurse in the field!
Now when I ask, “When does the evaluation phase start?” I’m able to ask questions like, “When you broke the eggs into the bowl during the intervention stage, what did you do?” Students then connect that the evaluation phase begins as early as when implementation begins. They then discover evaluation spans far into the future—years from now they will still be thinking about the cake they made in crazy Professor Haynes’ class.
Are we dumbing down?
Making things relatable works in all areas of teaching. An English as a second language teacher was sharing the hurdle of teaching new writing skills to her adult foreign speaker. I suggested she draw a basic flower (a line with a big circle and little circles) and then in time add a diagonal lines (leaves) to demonstrate printing letters. Her first response was, “I’d never do that because it’s insulting to the adult student.” We had a great conversation about how this approach can be empowering rather than insulting. Allowing any student to feel they are on the same footing as us gives them a sense of confidence. The information is not only approachable, it’s applicable and relatable to all involved.
When one goes to a foreign country, they often use gestures and maybe a few key words to communicate what they are trying to get across. As elementary as it may seem to gesture with fingers to your mouth to indicate “food” or “eat” it’s not insulting; it’s an effort that is understood by both parties.
Like with the cake assignment, nurses may think this is a silly and unrelated approach to the very serious business of being a nurse. My students often also feel that way at first. However, once we review the bridge between the assignment and the nursing process itself, they appreciate all it has taught them. As an educator, I have watched our students testing scores rise almost 30%. That indicates not only a shift in learning, but also in retention and application.
Empowering through application
Use of real-life activities empower the learner. Often the fear of failing at a skill, which ultimately means the potential to harm a patient, leads the student to a deer-in-headlights moment. It’s like the student who was fearful to make a cake for the first time, just magnified. Allowing students to succeed, or even burn their cake, allows for great learning. I always tell my students, the same thing I tell my kids, “As long as you learned something, it was worth it!”
I would much rather teach the value of washing one’s hands and wearing an apron before the student is exposed to harmful pathogens in the clinical setting. Afterall, it only takes getting chocolate batter on your new blouse or jersey once to help you remember that personal protective equipment is an essential part of nursing when secretions are involved.
Those who desire to be a nurse have an underlying fear they won’t be able to think and perform as they should. Human lives are in our hands, and we want nothing more than to be safe and effective in our role. Eradicating fear and making learning approachable really can be a piece of cake.
*Other options are available for low-income students or those without necessary resources.
Christine V. Haynes is a nursing faculty member and creator of Brighter Nursing (#brighternursing).