PART ONE: I surveyed Associate Degree nursing programs in the state to see how they
taught the following subjects: aging, death, dying, grief, and ethics. I also
attended a workshop on teaching nursing students about death and dying. At
the workshop I obtained a copy of a CD complete with course outlines and
scenarios for use with students. I attended, via audiotape, and series of
lectures on ethics problems and interpretations. I interviewed and shared
ideas with faculty from all over the state.
Result?, All seem to teach the subjects well, but all instructors worried that
they didn't have the time to do the subjects justice. I think that we can be
very proud of our program, but I learned ways to make it better. For example,
teaching "Aging" as a content area has been fashionable for the last 5 or 10
years. LCC has been including it in our content for over 25 years. Still, we
can always be more effective. One learning experience, used at Portland
Community College, includes students interviewing older adults functioning
in their own homes. The students find their own interviewees, with the
condition that it not be a family member. (Students tend to interview each
others' relatives or their own friends and neighbors.) This is an experience I
hope to try at LCC.
PART TWO: I've been in nursing nearly 40 years, counting my nursing school years. Ive been
at LCC for 27. I have kept pretty current in hospital nursing because
we take students to hospitals. I have sent students to see various procedures and go
with nurses as they do their various jobs. The students come back enthused and
excited about nursing. I finally decided it was my turn. This is what I
did:
I went with home health nurses and hospice nurses. I saw the patients and their families as
they coped with health problems and sometimes impending death. I saw nurses adapt
familiar procedures to the unfamiliar settings of people's homes. I was instructed in the
to political realities of home health care and I happened to be there when Alan Yordy
of Sacred Heart addressed the troops on the impending move of the hospital. THAT was
really interesting. I had originally thought that we might send students with the hospice
and home health nurses. I have since concluded that students could learn a lot from the
home health nurses, the hospice experience is probably beyond all but the most mature and
experienced
students.
For the last few years, I have been teaching students on an obstetrics floor.
I actually got the assignment because we were desperate and I missed a meeting. During
that meeting, I was nominated and elected to teach OB. At the time I insisted on being
oriented in order to be safe, but this term I decided I'd like more training. Our students
only observe in delivery rooms, so I don't need to be trained in depth, but I wanted
to be better able to prepare students and interpret what they saw. So I ended up
attending two deliveries* one of a teenager, unmarried and having her second child. She had
an epidural and was as comfortable as a woman having a baby can be*.which is not all that
comfortable. The second delivery was of a much-cherished baby to a couple married nearly 10
years*. No anesthetic. We used lots of nonpharmacological methods*hot and cold pack
massage, meditation, showers, etc. I had done a lot of reading ahead on these methods and
so was
able to help. It really was very gratifying*
I also spent a day with the lactation consultant at SHMC and learned lots of tips to help Mom's
breastfeed. Time spent with the post delivery nurses was probably the most transferable to
teaching students. I am now sending students to go with lactation
consultants.
I saw an ultrasound of a baby- 4 months gestation. It was really wonderful. If any of you
get chance to see one , don't miss it. Even at 4 months, the tiny heart beats with all four
chambers and the bladder holds a visible drop or two of urine. Each finger and toe can be
counted.
There were lots of other procedures I have read about, sent students to see, but never had seen
myself. I went to see cardiac ultrasounds and cardiac catheterization to see if the people need
heart surgery or are fine or are pretty hopeless. I found that before long, I could tell the
difference between the extremes. I also saw a procedure to repair the aorta that is being
done in only a very few places in the US*.and one of them is in Eugene. It allows for repairs
to be done on people who would not survive the surgical approach.
I spent a day with the wound care specialists and saw before and after shots of people with
huge wounds*..gradually healing under the skilled care of the nurse specialists. These are
people who would definitely have lost limbs or even life a decade or two
ago.
I watched open heart surgery*.. stood at the head of the patient and watched as the
stopped his heart and cut it open. I saw a valve repair and replacement and a 4- vessel
by-pass. We can all feel very good about the competence of the surgical team. They were
truly like the proverbial well-oiled machine. Even when things went a bit wrong., they
quickly and calmly adapted. It is probably also worth noting that the surgery began at 7:30
AM and lasted over six hours. The team was standing with no breaks, for the
entire time. The stamina of those people is
amazing!
When I was a student taking anatomy, we used cats instead of cadavers.
A year ago I sent students to see an autopsy and was very envious of their experience,
so I called the county coroners office and asked to see an autopsy. Finally, I received the
call. The coroners office is only called in the event of an unexpected death*either
natural or not. It is sort of a detective job. In the autopsy I saw a women was found dead in
her apartment*apparently several days after she died. The pathologist
explained each step of the way. The anatomy lesson was great! He sliced through the heart
and quizzed me about the possibly cause of death. "How much of this vessel is occluded?
Would that be enough to kill her? " and on and on with the brain, and all of the internal
organs. It was all done respectfully and I think I wouldn't mind having an autopsy done on
me. It was also FASCINATING. While I was there, the pathologist took several calls and
then he discussed the cases afterwards. He said he was experienced enough to be comfortable
with "unknown" for cause of death.
The leave gave me a chance to explore new aspects of nursing and medicine, so I can
better teach It also gave me a shot of enthusiasm. I think the most enriching experiences
were at the extremes*births and the autopsy.
One of the surprising things that happened to me was that I got to see so many former
students functioning in the real world! Nearly everywhere I went I saw former students.
Usually they expressed their gratitude for the experience at LCC which provided them with
life- changing careers*. both life changing in the sense of their patients, but also of
themselves. Not all of theses nurses had been stellar students* ..some were terrified as
students and now skillfully worked in very, very complicated environments.
MANY TEACHERS FROM ALL OVER CAMPUS WORKED WITH THESE STUDENTS.
I THINK WE SHOULD ALL BE
VERY VERY PROUD OF OUR
CONTRIBUTIONS!