Free Information Session: Carson-Newman Future of Nursing

Free Information Session: Carson-Newman Future of Nursing

Original Air Date: November 10, 2017

Description:
Listen as the Carson-Newman School of Nursing Faculty discuss The Future of Nursing in this previously-recorded Panel Discussion. Topics include: the nursing shortage, changes in the profession and how to avoid burnout on the job, and address the impact of technology and the role of advanced education on the future of nursing.

Guest Panelists:

  • Dr. Angela Wood, School of Nursing Dean
  • Sue McBee, Online RN-BSN Program Director
  • Mary Coleman, Nursing Faculty, as they discuss
  • Amy Skelton, Student Success Advisor
  • Riley Sellers, Senior Enrollment Advisor
  • Ligia Popescu, Host

Read the Full Transcript Here!

04:40 Dr. Angela Wood: I'm Angie Wood and I'm the Department Chair for Nursing here at Carson-Newman... Knoxville. My clinical experience mainly is in maternal-infant. I worked for several years in the NICU at University of Tennessee, returned to school a couple of times, but have been here at Carson-Newman for 24 years. I teach the research class in the online program, as well as on campus.

05:15 Ligia Popescu: Thank you. Now I'd like to introduce our next panelist, Sue McBee, who brings many years of experience in nursing and education. Sue, would you share a little bit about your background with our audience?

05:28 Sue McBee: Sure, thank you. I, actually have a Diploma in Nursing that's a hospital-based program from years gone by. You don't hear about those programs much anymore. And then I received my Bachelor of Science degree in Nursing from East Tennessee State University, and then my master's from the University of Tennessee in Knoxville. As far as background, I'm one of those masters of none, but jack of all trades. I have had critical care experience, I've had a lot of community health and global health experience, med surg experience, just a variety of different things; worked in an emergency room, nuclear medicine, one-day surgery, all kinds of things like that. So, I have a lot of varied background, do a lot of, as I mentioned, global health and my specialty in teaching is community and global health. That's pretty much what I really focus on as a nursing instructor.

06:28 Ligia Popescu: Thank you. Our next panelist, Mary Coleman, is an assistant professor and also an alumna of the school. Mary, would you share a little bit about your background with our audience today?

06:41 Mary Coleman: Sure. As you said, I graduated from Carson University. After leaving here, I went and worked in pediatric critical care in North Carolina. And during that time, also did some home health and got my Master's in Nursing Education from Duke University. And then moved back to the area and joined the faculty in 2015, and so this is my third year. And I currently am still in practice in pediatric critical care, as well as teaching here, so I teach pharmacology, pediatrics, community health, and will be teaching pharmacology in the RN to BSN program. I also direct our summer nursing camp for regional high school students who are interested in nursing.

07:38 Ligia Popescu: Thank you. So, let’s talk about the future of nursing.

07:45 Dr. Angela Wood: If you look at what's going on in the whole healthcare system and in nursing, in particular, there are some really significant things that are happening right now. One of them is that so many of the folks who have been nurses for years and years are now retiring. We know that those folks who we think of as the baby boomers, well, a lot of them, probably 50%, will be retiring in the next decade. We also know that 75% of the baby boomer nurses don't have their BSN, so we're starting a whole new crop, if you will, of nurses who will need to get their BSN to do the work that needs to be done in this century. We also know that Americans are living longer and that as people age, they have increasing health needs. And so, they have an increased need for nurses. The Affordable Care Act has had the effect of more people accessing healthcare. If you have insurance, the research shows very clearly, you go to the doctor more often. And so, you need nursing care more often. It remains to be seen what will happen with the Affordable Care Act and with insurance in the future. But there's really no reason to think that there will be a decreased need for nurses as time goes by. All of these things have put a real stress on the nursing profession.

09:13 Dr. Angela Wood: And as folks are working as nurses now with their associate degree and RNs, what they are experiencing, if they work in the hospital, first is heavy workload. Patients are so much more acutely ill when they are out on the floor and taken care of by nurses. So that there is that increased workload that nurses share. There also is the inability to ensure patient safety. We have all kinds of dangers, everything from microbes, to active shooters in hospitals. And so, there is this constant awareness of the need for safety. I think a lot of times, nurses tend to come back to school related to the idea that they would like a better kind of schedule. And certainly, as more and more nurses are in management and become aware that they are losing nurses in the hospital because of scheduling that just doesn't work with their family life or with going back to school, that we're going to have to address that problem. Somebody has to be there at night, and somebody has to be there on Christmas day, but maybe as we let nurses move towards self-scheduling, that can be worked around and can make a schedule that fits each nurse. Right now, nurses have a lack of autonomous practice.

10:49 Dr. Angela Wood: Nurses know so much more than they get to use in a lot of situations, and a lot of times, we have the responsibility, but we don't have the power to act on that. And as nurses move in to higher ed, and obviously if you have your BSN then you're ready to move to higher ed, we start to see some changes with that. There also is this lack of intrinsic and extrinsic rewards. I heard someone speak at a conference one time, and her question to the audience was, "So how much money would it take for you to say, 'Okay, nurses make enough money?'" And we know that the reality is, that nurses are underpaid for what they do and for what they know, but we also know that pay is not the total reward that people are after. And as nurses move away from the bedside, as nurses move to more technology, they lose a lot of that reward that comes from working with patients, from seeing that patients get better because of what you did for them. So, I think, we in nursing, are going to have to focus on what other kinds of rewards bedsides salary do we really need to provide to keep nurses at the bedside?

12:22 Dr. Angela Wood: If you think about what the shortage for nurses really means in terms of future, we know that there are a lot of innovations that are happening right now. Just two weeks ago, I was at the deans and directors' meeting for the AACN and there was a lot of talk there about what will nursing really look like 10 years from now? And it was very clear that a lot of the day to day kind of technical things that we do, even things like taking vital signs are not going to be done by people in the future. There's not going to be that CNA going around taking vital signs every four hours. So, we're going to have to have nurses that move away from that technical aspect of those day to day kinds of low level skills, and move up to higher level skills that have to do with holistic care of patients, that have to do with looking at what's the whole picture look like for this patient? Not just what are their vital signs right now and how can I keep them alive 'til the end of my shift? We also are going to have to have nurses that have technological skills, that can use computers to really work towards taking care of patients and to move toward a higher level of care. So, we've got to have high tech, high touch, as we look at how to get nurses ready for future use.

14:00 Dr. Angela Wood: We've also got to look at how the Affordable Care Act and whatever we end up in this country with, in terms of insurance, uses advanced practice nurses. We know that to move to this master's level nurse practitioner kind of role, you've got to have a BSN to start with and so our program starts to move you in that direction. We get you ready to move to a graduate program by giving you the classes that you may not have gotten in your associate degree, things like leadership and community. You know, a lot of times I hear people say, "Well I work in a hospital, so I don't really need to know about community," but we know that every patient we take care in the hospital is going back to the community.

14:46 Dr. Angela Wood: And so, if that nurse that's in the hospital doesn't know what services are available in the community and how to help their patient access those, then that patient's not going to have the outcome that we would have hoped for. We also know that there is an increased need for nurse specialization. Some of these specialties have been around for a long time. Some of them are brand new. Just recently, we have really started looking at elderly, as its own specialty. Now we've looked at Obstetrics, we've looked at Pediatrics, those kinds of groups for a long time as specialties, but we know that the elderly have their own set of problems; they react to medications differently, they have physiologic changes that are different, they need their own specialty.

15:40 Dr. Angela Wood: Here on this faculty, we have a nurse who has her DNP and her specialty was forensic nursing, and we know that that's a growing need. And certainly, one that our students need to be able to access. Informatics is huge, computers don't do any good at all if you don't know how to use them and don't know what you can get it to do for you. So, bioinformatics is huge. Radiology, cardiac, all of those things that this aging population will need, we've got to focus on. We also have to focus on the nurse's ability to teach. If you think about not only teaching patients but also teaching students. Students are on your floor all the time and how you interact with them depends a lot on their ability to interact with you and on your ability to teach. So, we're going to give you, in this program, a lot of help in terms of learning to teach and to make that more effective. Traveling nurses have become a huge industry in this country and so hopefully, as you get your BSN, you will be suited to that role, if that's what you're interested in. We can get you ready for that.

17:02 Ligia Popescu: Thank you, Dr. Wood. Now I'd like to turn it over to Mary Coleman to discuss the future of nursing.

17:15 Mary Coleman: And the development of nursing as a profession, we see more and more. We have always seen examples of nurses on the front lines, help people, saving lives, working with families. As we start to come more into evidence-based practice and into concepts, looking really at the holistic care of our patients and their families, nursing has grown from a task-based career field to a much more of a holistic care that requires a lot of critical thinking on the part of the nurse. And so, when we think about nurses and nurses being professional, it's a responsibility of a strong nurse to take their practice and try and continue to learn, continue to learn best practice, continue to learn more about what their patient population needs, and to learn how to be a leader within their community.

18:28 Mary Coleman: So, learn how to not only teach families and nursing students, but how do we help with our colleagues that need new best practice examples? I know in my pharmacology class, that's one of the things we focus on is how to do an in-service with other nurses on your floor because it's really different to teach students versus to teach your peers about different new products or a new evidence-based practice that's making a practice change. These kind of things are very important to our career field and the professional attributes of advancing our care of our patients. In hand with this, we also see the impact of technology, because we see that in the vast majority of institutions you're going to see that patient records are almost completely digital. There's a lot less paperwork.

19:33 Mary Coleman: You may find that the charts that used to be full and stuffed full of papers on the unit are now maybe have this stray paper here and there, but the vast majority of charting, of information, of everything, is on the computer. And so, it's really help if you know how to work that computer to get it to tell the information that you need. But also, there are safety features on the computer that help to flag different issues or flag potential drug interactions. All of these things are really help, and there's a lot of ways for us to have computers to help us to work smarter. It doesn't replace the nurse's critical thinking, but it augments it. We also see an increased responsibility for the nurses in the number of patients they care for, as well as a higher expectation of having input during rounds or during interactions with the doctor. They're no longer just, "What do you think we should do?" But even the language that we use when we want to communicate a problem, the last part of that SBAR when we're communicating a problem is our recommendation on what we think should happen, right?

20:58 Mary Coleman: And so, the nice part about this is it puts the nurse as a key member of the healthcare team, and we find that we're starting to see, when we look at this healthcare team, when we look at our best practices, and a great example of best practice that we're seeing is that research has seen, with a 10% increase in the number of BSN nurses correlates with a 5% decrease in patient mortality, okay? So, we're seeing fewer hospital acquired infections, lower risks of DVTs, with bachelor's-prepared nurses, an increased number of bachelor's-prepared nurses present. So, when we think about all of these things coming together, we see that the technological advances, they're very help but we need people who have been at the bedside, who understand what's going on, to be help in the technological advances arena and to help to make recommendations about different...

22:23 Ligia Popescu: Thank you, Mary. Now, if I can turn it over to Program Director Sue McBee to discuss the future of education.

22:32 Sue McBee: Thank you. Yes, we're looking at, because of the IOM report, the Institute of Medicine report several years ago that came out that said that there are, with higher levels of bachelor degree nurses working on the units, that we had better patient outcomes and less complications. Then they came out and said that we need 80% of the workforce having baccalaureate degrees, so that we can continue to have these outcomes. So that kind of put nursing in a situation where, "Okay, what are we going to do about this?" And a lot of the hospitals I know in our area and I've talked to some other students in other states who've told me the same thing, is a lot of them because of magnet status and a lot of them because they're just trying to provide a higher quality of care to their clients are suggesting or requiring nurses who have associate's degrees to go back and get their bachelor's degree.

23:26 Sue McBee: So that's one of the issues that we're dealing with at this point in time. And then, another issue that comes up, we just talked about this in community health, is the need for more diversity in nursing. And when you look at the populations of different groups such as the Hispanic group, African American, and so on, the percentage doesn't equate. There are a whole lot more Caucasian nurses relative to the percentage of Caucasians. And so, we really need more diversity in nursing and that's another thing that we look at, at Carson-Newman, and we encourage different, various cultural groups to come in and try to get through the nursing curriculum, for sure. And so, we're looking at that. Also, online degrees is another way to really help, especially our associate degree nurses, to be able to continue to work after they get out of school and then go back to school and get that baccalaureate degree. Of course, the concern there always is that do we make sure... And we do at Carson-Newman, I can assure you that... Hold the standard up and make sure that the students who come through our program actually come out with the knowledge and skill level of a baccalaureate-prepared nurse? So, we really focus on that.

24:45 Sue McBee: It's really important because there are a lot of skills that are part of the baccalaureate program that we really focus on that they just don't have time, when you're trying to get a two-year degree, to be able to include in their content. And so, we really focus on those areas like leadership and how to be confident. Most of the area hospitals or other areas where nurses may be employed in order to have a management position, most of them will require at least a baccalaureate degree, and some of them actually are requiring master's now. And so, there are a lot of things that we do in our leadership course, that help with development, to help nurses make the decisions that they need to make at that level and certainly try to make sure that whoever there is their nurse manager or whatever position they may be in, that the care that is given to those patients on that unit is quality care and high-level care.

25:40 Sue McBee: Another important thing, when we look at the BSN impact on practice, is evidence-based practice. I know that's a big focus in a lot of the courses that we have, and we look at that from the perspective of the research that's done. It gives us information that says, "This is the best way to do this particular situation," and we combine that with nursing experience. And we learn how to give and provide the best care with that.

26:05 Sue McBee: Another thing that I would include in looking at BS impact on nursing practice is that that's the pathway or what will help nursing students who have a desire to go on and get a Master's degree. That's kind of the bridge that gets them there. If you have a good baccalaureate Program then that pretty much sets you to be able to go into a Master's program and be successful. I know here in talking to some of our Master's program faculty, that we've had several situations where RN to BSN students have come and applied after they got their BSN online or on-ground, wherever it may be, but they just didn't have the level of rigor at the baccalaureate level that it needs to be. And so, it is very difficult for those students to be successful in Master's program, and again, that's one of the things that our program, that we said we're going to hold the standard high, we're going to make sure that these students who come through our program, our online program, will have the Bachelor's degree knowledge and skill level that we expect out of our generic students that graduate from our program.

27:11 Ligia Popescu: Thank you, Sue. Dr. Wood, would you give us an overview of Carson-Newman?

27:16 Dr. Angela Wood: Carson-Newman was founded in 1851 and... A lot of universities, they're very focused on publishing and on doing research and other aspects of nursing, but our faculty really focuses on teaching. It's very important for us, as we do an online program, that we still have that level of connection with students that we would have if you were in our classroom two or three days a week. And so, what you'll see in our class online, is this attempt to begin right from day one to meet you, to find out about you, to let you find out about us, so that we do have that learning relationship that is ongoing.

28:08 Dr. Angela Wood: We are a faith-based college, and so we're going to approach caring for patients in a respectful way that we feel like really is consistent with a Christian approach to dealing with people. As Sue mentioned, we are very evidence-based. In the research class that you will take if you enroll at Carson-Newman, you will actually get to do an evidence-based practice project and maybe even implement that in your own nursing area where you work. So, when we approach the online student, we're trying to give you something besides just BSN after your name. We really want you to practice differently when you finish. And so that's our goal, is to give you the tools you need to be able to practice at that higher level.

29:02 Ligia Popescu: Thank you. Sue, would you give us an overview of the online RN to BSN program?

29:09 Sue McBee: Yes, thank you. We are fully accredited. That's one of the first things we tell prospective students that you need to know, "go to the accredited program." And we are accredited by the Commission on Collegiate Nursing Education. We call it CCNE. They may have heard that before. And approved by the Tennessee Board of Nursing. One of the things that I think really is distinctive about our faculty, not only they have advanced degrees, but they're involved in a lot of things in their communities and do a lot of volunteerism. A lot of things that are part of that professional attribute, if you will. And certainly, keep up with... Like Mary mentioned awhile ago, one of her specialties, I think she has several, but one of them is the pediatric critical care area, and so she continues to keep her skills valid reliable there because she continues to work there along with her teaching and education, and we have a lot of faculty who have... They do continue to work in areas or maybe in the community and again, with volunteerism, to be part of that holistic care that we talk about and that we encourage our students to be a part of.

30:19 Sue McBee: As far as our curriculum plan, I will tell you that we're looking at this as adult learners, adult education and we continue to try to refine what we're doing to make sure we provide the best education and to make it workable with the working students. So, we're always in a state of trying to make sure that we look at things that might help make it easier for the student as far as being able to take the classes but also keep the rigor and the standard, the level of what we expect out of a baccalaureate nurse in our classes. And so, there is quite a bit of rigor there.

31:01 Sue McBee: The curriculum plan that we have, certainly, it follows along with our generic program, but we do a few classes because they have had some exposure in associate degree programs such as pharmacology, health assessment, and a little bit of leadership, I think, in some of the programs, but we look at that as being... They already have some knowledge base in that and so we give 'em a pre-test to see what they know and tell 'em what we would expect them to know at that level and then we build on that. Mary was just telling me the other day, she's teaching pharmacology and she did this pre-test and found out that one particular student had some expertise in some of the areas and so that student will not have to do those assignments in those areas 'because she already has the content. And so, that's what we look at. We say, these courses are for RNs, we know you come in with a lot of knowledge. We need to know what you know and when we find that out, we try to build on that to get you up to the level that we expect for our baccalaureate nurses.

32:06 Sue McBee: As far as our program's concerned, you have to have 120 hours to get a degree from Carson-Newman University. Right now, we have 31 hours that are actually nursing courses and then we also have 30 hours that we actually give each student who has an associate degree. And then, there are liberal arts requirements at this point, about 59 hours and again, a lot of our associate degree nurses come in with a lot of those courses. So hopefully it won't be a whole lot of general education or liberal arts, we call it here, that they'll have to do to complete but certainly, would have to take all the nursing courses.

32:49 Sue McBee: We do have some courses in which students can test out if they have the educational level to do that and so they certainly are able to do that. What we do in that case in general is they take a final exam for that particular course, like, again, our generic students would have taken for that course and then if they're able to be successful in that, then they move on. I might mention here that we do have a couple of courses that include clinical experience. And so, community health being one of those, an associate degree program, occasionally, we'll have students who've gone in to maybe some home health areas. Occasionally, sometimes school health but for the most part there's been no content with community 'because it's not taught in associate degree programs.

33:33 Sue McBee: And so, I can give you an example again with that, where we look and see what students know coming in, and I had a student that graduated a couple of years ago and he had done some home health and school health. And so, what I had done is I gave him the guidelines that we have for our clinical experience in those areas and asked him to look at those objectives and then write out for me how he achieved those objectives with his previous experience. And then I looked at that and I could make a determination, did he really get and grasp what we would anticipate a student should get from that? And he did a great job of articulating that. And so, he didn't have to do those particular clinicals because I felt like he already had at least achieved and maybe even surpassed what we would anticipate for that.

34:19 Sue McBee: And so, that's one class that they have, clinical with and the other class would be with leadership. There's another, we call it Professional Synthesis, and actually that's their last class, that's kind of the capstone, we call it, where students pull everything together they've had throughout this nursing curriculum that we have. It's a very self-directed, they work with that particular faculty and they design their own clinical experiences on what they want to achieve based on the knowledge level that they have. And so, for each particular person that we've had in the past, it's been a very different experience and we've actually seen some things done where policies have been changed on units where students have gone in and done some of their practicum there and had a particular project, and it came out to show that this is a better way of doing something. It works with our research, it works with our leadership, just really help to grow that student into that leader that we're hoping that they will become.

35:24 Ligia Popescu: Thank you. So, Mary, as a graduate of the program, can you give our audience an idea of why they should consider Carson-Newman to get an RN to BSN degree?

35:38 Mary Coleman: Yes, thank you. As we've talked about, I graduated from here and then have come back here. And so, I do really love this institution and there's some key points that really, we want to make sure that as you're considering the different options, that what makes us special here. As far as transferring here, and as Sue have mentioned, we do give credit for what education you bring, but we also like to, in different classes, try and give credit for the knowledge that you've learned working as a nurse on your unit or in your community, wherever you are. And so that's really important to us, to be able to build upon what you already know, instead of just repeating what you're well aware of. So, we also have a great reputation here. We have a high reputation of excellence, especially in this area, but I went and practiced afterwards not in this immediate area and there were people that knew Carson-Newman far and wide that I've seen.

36:54 Mary Coleman: One of the things that I most enjoy about here is that we integrate the faith in learning. And so, we integrate faith into our practice by honoring the faith of our patients and being respectful and culturally sensitive and culturally responsive to their needs. And Carson-Newman provides an opportunity to spend some time in some of our liberal arts classes, examining your own faith as well as, we talk a lot in our classes about how to care for patients through a Christian world view, while honoring what the patients bring and partnering to care for them holistically. We do offer small class sizes, most of them are 25 students or less, and this really results in good interaction, good discussions, and I'll add to this, that the professors are very acceptable. And so, being responsive and knowing people as they go through the program, it's really help.

38:09 Mary Coleman: The program can be completed in as few as 14 months based on your transfer evaluation. And we do look at your credit evaluations and can give you that kind of plan and an idea of how long it'll take, and we have multiple start dates. So, if you can't start in the fall, the very beginning, in August, in the fall semester, there are a lot of different options for you based on your work schedule. We understand that you all are working professionals and that's something that we need to support as you go through this. And so, there's multiple start dates, there's also no application fee, complementary credit evaluation. And going along with this no fee, it is, when we compare the pricing of Carson-Newman with nationwide competitors, we run about $100 to $200 less per credit hour as compared. So, the degree is affordable compared to those around the nation.

39:15 Ligia Popescu: Thank you, Mary. At this point, I'd like to introduce our Student Success Advisor Amy Skelton to talk about the supported online learning experience and what that means for you.

39:27 Amy Skelton: Thanks, Lig. The Carson-Newman online environment promotes a sense of community and connection. The students will interact with the professors, the faculty and the other students in the class. The faculty support is extremely responsive and provides real time feedback to the students on their academic questions and information about the practicum project. The students are going to be able to build a career network, so their interaction with the professors, the other students in the class are really going to drive that network. They're going to get access to the classes 24 hours a day and all of the online materials. They're also going to get a Student Success Advisor, which will provide them with a lot of guidance. They should expect to be in constant contact with their Advisor and they're going to be part of their support team throughout their educational journey with Carson-Newman, monitoring their academic progress, just the same as registration, course planning and being the real liaison between all the other departments.

40:31 Ligia Popescu: Thank you. So, Senior Enrollment Advisor Riley Sellers is also here with us today. She's going to give an overview of the requirements for admission into the program.

40:44 Riley Sellers: Thanks, Lig. So yes. First, the requirement is that you must be an RN with an unencumbered RN license. You do need your Associate's Degree in Nursing or a Diploma in Nursing. You must have had at least a 2.7 cumulative GPA from your previous college and including all official transcripts from previous attended colleges or universities. And as everybody knows, we are now accepting applications for our January 15th start and for our February 19th classes. So please contact me if you're thinking about beginning an application, I'd be happy to walk you through the application process and help you prepare the strongest application possible.

41:25 Ligia Popescu: Thank you. We've now reached the Q&A portion of our presentation. So, our first question is, what courses can students challenge out of?

[background conversation]

41:46 Sue McBee: This is Sue. As far as challenge courses, they can challenge out of Pathophysiology, Health Assessment. Actually, if you have experience in community health, you have to have at least three years experience, you could actually potentially challenge out of Community Health, you can also challenge out of Pharmacology. Let's see, there's one more, Healthcare for the Elderly, I think.

42:25 Ligia Popescu: Thank you, Dr. Wood, would you give our audience an idea of some of the characteristics of the faculty?

42:32 Dr. Angela Wood: Our faculty are all advanced practice nurses, they all have at least a master's and about half of them have a doctoral degree, either a PhD or a DNP. They are all cutting edge clinicians, they are very interested in being up-to-date on patient care, and they are all interested in student success. That seems to be a thread that runs through the people who come here to teach is they want students to be successful and they will do everything they can to make that happen.

43:13 Ligia Popescu: Thank you and now a question for Sue. Can you explain how the idea of a community health nurse fits into the bigger picture of public health?

43:27 Sue McBee: When we look at public health, we think more about the nurses who are like a state employee or a federal government employee or something of that nature and they actually focus on populations of people. They're really responsible for the people in that county or that particular region, or whatever it may be. And then, when we look at community health nursing, even though we consider public health as part of that, we're looking at home health, school health, there are nurses, for example, we go to a lot of different clinical areas and we have a nurse who actually does a program in a culture of poverty area that help families in crisis and she works with like a men's program there.

44:08 Sue McBee: There's all kinds of opportunities for nurses out in the community and that becomes, as Dr. Wood alluded to earlier, where we keep saying and it's in the literature, we're moving more and more out into the community to provide healthcare to individuals, families and populations of people. So, they're all really considered community health nurses but because of the particular agency in which they're employed, sometimes they're considered more of a public health and again to me, the division there is that they're really responsible for that population of people, as opposed to where a home health nurse would be looking at individual patients and sometimes families. And then again there's a lot of other community experiences as well as far as nursing jobs.

44:54 Ligia Popescu: Thank you, and here's a question for Mary. What excites you the most about the future of nursing?

45:05 Mary Coleman: And we talked a little bit about it already, is the evidence-based practice and the move towards knowing why we're doing everything that we do. Knowing not...

[pause]

45:22 Mary Coleman: Because that's what we've always done, or because that's what somebody told us to do, but really making sure that we're using critical thinking in all of our patient interactions, and I'm really excited that that seems to be the general theme of nurses as care partners or nurses as key members of our healthcare team that have voices that are heard and respected, and have the educational preparation to be able to speak intelligently about their patients and their patients' needs.

[pause]

46:08 Ligia Popescu: Thank you, here's another question for Sue. What type of assignments can students expect in the nursing courses?

46:18 Sue McBee: Well, they're going to have, of course, obviously with any kind of educational preparation, there's going to be some reading obviously involved and so there's a lot of reading assignments, sometimes students will have case studies, there's discussion boards, certainly exams, and then a lot of what we call professional or formal papers. We do have, I know with health assessment, they begin with virtual labs and then they actually at the end, pull it all together and do a video of themselves completing a complete physical examination, so there's just a lot of different learning strategies that are part of this curriculum.

46:55 Ligia Popescu: Thank you. Regarding the practicum, can students complete the practicum at their place of work?

47:03 Sue McBee: They can, there are some stipulations there, if they were going to actually try to complete their practicum on their unit and we have had students do that before, then there has to be that relationship with the nurse manager where we have like a formal paper where they complete saying that they understand, that the particular nurse is in a student role at this point, when they're trying to achieve whatever their objectives are for that particular practicum. So, it can be done, but again, it has to be done in a way that the people who are there employed, the administrator or the manager knows that they're actually fulfilling their student role at that point.

47:44 Ligia Popescu: Thank you. So how would that work if you were say, a school nurse for example?

47:50 Sue McBee: And they were going to get their experience in school nursing, is that what you're saying? For their clinical?

47:58 Ligia Popescu: Well say they're already an RN practicing as a school nurse?

48:03 Sue McBee: Okay. If they're already a school nurse, I would say they would not have to do that particular clinical. Now, if you're looking at the Professional Synthesis and they want to do a project that's relative to school nursing, that's a different scenario and they would have to complete those hours and actually complete that project that they were doing based on, again, what they... It's very self-directed and they say, "this is what I want to accomplish". They set their objectives and then it would be, whoever the school health coordinator would have to know that this nurse is functioning as a student during these hours.

48:52 Ligia Popescu: So, how many hours of on-the-job work do students need to complete in the practicum?

48:58 Se McBee: Okay. They actually have 90 hours in Nursing 404, which is Community Health, and then in their Synthesis, it's 135 hours.

49:10 Ligia Popescu: And one last question, how many hours per week should students plan to set aside for studying and homework?

49:24 Sue Mcbee: For each hour, the student would expect to plan for three hours. If they take a three-hour course, then they're looking at nine hours.

49:34 Ligia Popescu: Okay. Thank you. So, if anyone listening today has any additional questions or looking for more information or if you're ready to apply, please contact Riley Sellers, Senior Enrollment Advisor on this program. Her contact information is on the screen. You have probably, already spoken to her and I recommend giving her a call if you need anything at all. This concludes our webinar presentation today. I want to thank our panelists for joining us and thank you to our audience for joining us. Wishing everyone a great rest of your day. Thanks again. Bye-bye.

50:12 Sue McBee: Thank you.