Paying it Forward

Susan Bindon, DNP, RN-BC, CNE is an Assistant Professor at the University of Maryland School of Nursing

I am very lucky.  I have a job that combines my two professional loves, nursing and teaching.  Like other nursing professional development (NPD) practitioners, the chance to do both keeps me busy, interested, and on my toes.  I’m constantly reading, thinking, asking questions, and learning.  My days go quickly and the weeks fly by.  But I certainly have not gotten here by myself! I have had incredible help along the way, in the form of generous others who’ve provided guidance, feedback, opportunities and support.  How I wish I could pay them all back!  I would tell them how much they meant to me, and how often I borrowed their confidence to bolster my own, used their words to strengthen my spirit and pictured their successes when I could only imagine my certain failures.

I grew up a Pennsylvania dairy farm.  There I learned to work hard, persist, and appreciate the generosity of family, neighbors, and friends.  I watched my parents help other families and contribute to the community that had once welcomed them as newcomers.  I remember my mother explaining to us that people can either be contributors or consumers. Basically, she was reminding us to give more than we receive.  I didn’t understand it at the time, but I’ve come to embrace her idea.  Now I encourage my own children to contribute however and whenever they can, and I share stories of my own good fortune.

Thirty-five years have passed since I decided to become a nurse.  I can’t pay back all of the professional debts I surely owe.  But I can pay it forward. Paying it forward is the notion that the recipient of a gift or good deed repays it to others instead of to the original benefactor.  I can now help others in some of the same ways I’ve been helped in the past. 

I remember my first preceptor, Marcella, who told me in no uncertain terms that I was her last “project” before retirement, and that I had exactly six weeks to learn what I needed to know.  I cherish those six weeks from so many summers ago.  The real-life experiences and pithy advice she shared set the course for my career.  She sparked my curiosity and helped me recognize that learning never ends.  I’m grateful to a part-time faculty member, Linda, who took me under her wing when I became a new clinical instructor.  She went out of her way to help me, and answered questions I didn’t even know enough to ask. Following her example, I developed my own style as a teacher. I can never repay Liz, who took a chance and hired me, with no experience, into an education specialist role during a difficult time in my life. Her straightforward “West Virginia wisdom”, as she called it, guided me through countless situations and decisions as my career forged ahead.  I often think about Jim, a retired military officer and NPD specialist whose keen instincts led him to a remote classroom one afternoon where I was in a worrisome situation with a disgruntled employee.  I was never so glad to hear the words “You ok, boss?” Wendy, the veteran nurse whose undeniable “people skills” (we didn’t call them that at the time!) showed me how a charge nurse gets everyone safely through a busy night shift.  Joanne, who put down her bags on the way out of the office one evening and stayed late to help me sort out an incredibly complex clinical schedule. Carol, a trusted advisor who encouraged me to take a leap and seek leadership positions.  My children, who keep me grounded and inspired.  Friends who not-so-gently remind me now and then that I’m missing in action.  There are hundreds of examples that come to mind.  Profound acts of kindness, perfectly timed opportunities, and invaluable pieces of advice have all come my way.  Peers, colleagues, friends, family members, and even strangers have contributed to and helped shape my professional path.

What does this have to do with teaching, nursing, and NPD?  A lot, I think!  All of us have benefitted from the contributions of others.  Regardless of where we are in our careers, there are opportunities to pay it forward every day.  I love talking with new grads during their nurse residency program, and imagining with them what they’ll be doing 2 or 30 years from now.  I enjoy working with new educators as they hone their teaching skills. I’m thrilled when students break through a real or imagined barrier. I share the excitement when a novice author gets published for the first time.  We can all look for ways to contribute (thanks Mom!) and help others succeed.  What might this look like?  We can help staff submit a poster abstract, offer to mentor a new committee member, nominate a colleague for a well-deserved award, take a team member to a leadership meeting, volunteer to precept a graduate student, contribute to a specialty panel, share expertise via a guest lecture or webinar.  The possibilities are endless!  The important thing is to be mindful of who and how we can help, and what we can do to “pay it forward” to the next lucky individual.  Let’s do so with enthusiasm and a nod to those who have done the same for us. You never know whose career you may be influencing! 

My Path to NPD

Cathy Gage, MHA, RN-BC is a Professional Development Coordinator at UNC Hospitals
in Chapel Hill, NC. 

I have been in Nursing Professional Development for about 8 years, before that management had been my life. When I graduated nursing school I knew I would end up in education (we did not call it professional development at that time), but my career path seemed to take me down the management road.  Even when I went back to school for my masters, I assumed I would stay with management, but the more I learned the more I realized management was not my passion, nursing education and professional development was.  Once I completed my masters I watched and waited for the perfect job to appear.  I’m not sure I knew what that perfect job was, but knew I would know it when I found it. That perfect opportunity came my way a year after I finished my masters, being the smart woman my mother raised, I immediately applied.  The role was Professional Development Coordinator; in this position I would supervise the program component of Nursing Practice and Professional Development Department but I would also serve as Liaison to the schools of nursing as well as coordinate several professional development programs. My role still involves management, as they say- once a manager always a manager, but as a Professional Development Coordinator I have been able to embrace my passion for education and professional development as well. 

My use of the terms education and professional development together is not to imply they are the same thing, they are not.  I use them together because my role enables me to have a hand in both education and professional development. 

Education to me means new knowledge and concepts.  As I work with schools of nursing in their placements and regulatory requirements I have opportunity to do guest lectures/education about professional development and leadership.  Interacting with nursing students is energizing and it gives hope for the future of nursing; they are so eager to learn everything.  Observing them comprehend nursing as an art, adopt evidence-based practices, and participate in research is exciting.  Their enthusiasm is inspiring.

Teaching our nurses how to teach is another component of education.  Nurses teach every day; from patient education to precepting, coaching, and mentoring.  Unfortunately, teaching is not necessarily a natural skill for everyone.  Providing education for charge nurses so they may embrace and apply the concepts of leadership, communication and collaboration, and financial understanding of the impact of their decisions they must make is rewarding. 

Providing education for preceptors, coaches, and mentors in adult learning and teaching principles is crucial for nurse satisfaction and retention. We, as Nursing Professional Development Specialist (NPDS), understand the importance of a good beginning for a new employee and the impact it has on retention, and the importance of developing a nurse's leadership skills as their career develops and changes.

I view Professional Development as expanding their base knowledge and understanding of nursing concepts. My role in the hospital as a professional development coordinator allows me to assist nurses in their pursuit of lifelong learning, maintaining competency, and enhancing the professional practice environment.  It is amazing to follow someone as they progress from a new graduate to a fully confident, competent nurse. 

I don’t know of another role in nursing that impacts so many areas of an organization. We impact patient outcomes, nurse satisfaction and retention, patient satisfaction, as well as organizational reputation and financial stability - just to name a few.  The Nursing Professional Development Specialist (NPDS) role is crucial, how we each operationalize the role in our organizations may vary, but the impact we make is beyond measure. I am proud to be an NPDS!I found the Nursing Professional: Scope and Standards of Practice a good foundation to define the role of an NPDS.  Our department has used this guide as the basis for our core behaviors and structure. This model defines why I chose to go into Professional Development,  I look at the outcomes and see “goals not met”  and desire to help our staff meet the goals and have an impact. 

All this leads to the discussion, what are your views of education and professional development? How valuable do you see your role and what impact are you making? Ask yourself, "Why did I go into Nursing Professional Development?”

I'm an Educator, Not a Juggler!: 4 Ways to Manage Your Day

Greg Durkin, MEd, RN-BC wears a lot of hats, literally and figuratively! Greg is a Staff Development Specialist at Boston Children's Hospital. 

Many people think that our role is to do orientation and CPR and that’s about it. But we know better. We are educators, facilitators, mentors, consultants, project managers, evaluators and change agents. (Take some time and review the NPD Scope and Standards if you doubt me!) On a recent workday, I did more than orientation.  I did all of these things (and more!):

• Taught 2 software training classes
• Identified regulatory requirements for competencies
• Completed post class paperwork for continuing education (CNE); reviewed a 2-day course and agreed it met the definition of CNE
• Met with project manager for an LMS implementation
• Consulted with a newer team member on a course review
• Developed a survey to evaluate a nurses week event
• Imported a course and post-test into LMS for physicians
• Prepared handouts for a national level presentation I'm giving
• Provided troubleshooting help to a naming convention for some live classes
• Ran a course completion report in response to regulatory visit
• Answered emails and phone calls
• Ate on the go
• Found time for myself to regroup and focus
• Prepared a meeting agenda
• Worked on a shared governance organizational chart
• Tracked my time

The variety and pace can be dizzying and we can find ourselves overwhelmed, frustrated or just plain exhausted.  That’s a lot of activity to juggle. Being able to work in this environment is essential to NPD success.  I have four ideas to help you.

1. Align your work.

You’re doing some things you shouldn’t be, I know you are. You might even enjoy them. But they aren’t part of your scope of practice, or they aren’t aligned with organizational priorities. To manage your workload, sometimes you need to make sure what you are doing is actually important and part of your job.

* Review the Scope & Standards for NPD Practice
* Compare that to your job description
* Start a conversation about what you're doing in relation to both of those

                                * If it is in your control, stop doing what isn't aligned

                                * Demonstrate value by doing things that are aligned with priorities,                                            show people how what you are doing is mission critical

2. Understand your work.

You’re also doing things you have to that you don’t enjoy. I know I do!  They are frustrating and decrease my job satisfaction. Interestingly, I’ve learned that when I don’t like doing something, I amplify its duration and effect. Like when I have to get a teeth cleaning, a 20 minute dental visit turns into a morning of pain, anxiety and discomfort and worries about how will I even be able to work the rest of the day! Of course, the visit goes fine, they are just twice a year, and all of that fuss was for nothing.

I do the same thing at work, I am responsible for helping groups of MDs set-up default settings in our electronic medical record.  I don’t enjoy it, it takes little skill and I really dread doing the sessions. Oh, how I fuss about having to do them! It was a big dissatisfier until I realized that I have to do these just 6 times per year, and each session takes about 30 minutes.  It turns out that this is a minor part of my work encompassing 0.14% of my total yearly work time. Why was I giving it so much energy? I started to focus on the 20% of my work that is delivery of web based content. The 15% that is live education. The 15% that is managing our competency process.  All things I enjoy doing, and they add up to the majority of my work.

Make a list of everything you do. Quantify how much time you spend (in percentages) on each activity during a week. Sort them into “mostly enjoy” and “mostly don’t enjoy” columns. I’ll bet that you end up with <25% of your work in the “don’t enjoy” column. Get a grip and focus on the 75% that you do enjoy! Emphasize the positives and that will get you through the negatives.  If you find that you don’t enjoy most of what you are doing, it’s time to make some serious changes.

3. Adapt and let things go.

You need to adapt to self-imposed stress, deadlines and “I have to…” One of the harder things to learn as an NPD specialist is that not everything must be done RIGHT NOW or BY ME. Don’t be afraid to let something go for today, or for this week and focus your energy elsewhere, or to change priorities regularly. Complete tasks and meet deadlines, but adapt your work style so one small task doesn’t keep you from everything else.  Don’t dwell on small stuff like the background color of the slides you are putting together. I’ve spent hours fussing over stuff like this and that kept me from other more important work!  Also avoid the “I have to do this” trap. We all fall into it sometimes, believing that we are the only ones who can and will do the task. This sucks your energy to one thing at the expense of everything else. Can someone else do this?  Can it wait until tomorrow, or next week?  Identifying and shifting priorities is essential, and to do that, sometimes you have to let go of self-imposed pressure (no one is making you choose a different color blue for those slides) or the need to be the only one who can.

 4. Take control of your time.

You are not an hourly worker, you have some amount of flexibility in your role related to time. One mistake many of us make is letting others take charge of our calendar and our day.  Quantify how you spend your time. Do you know how long certain tasks take?  If not, start trying to figure it out. It’s an activity that pays off big returns! Budget your day and own your schedule. Block time in your calendar for prep work, research, typing minutes, or other tasks. Make an appointment with the CEO of You, YOU. Block that time and keep it as if you were actually meeting with the CEO of your organization. And make sure to schedule time off to restore, regroup, and re-energize. Self-care isn’t a new concept, you know what to do. Now do it!

So there are four quick ideas to help you juggle many hats.

We are all busy and manage a lot of diverse work responsibilities. These ideas have helped me gain control over my work life, increase satisfaction, and decrease frustration. I bet you have more ideas that are helpful.  How do you manage competing priorities? Share them in the comments!

Alternate Careers in the NPD World

Cindy Friis, MEd, BSN, RN-BC, is an Associate Executive Director of Clinical Affairs for the Society of Gastroenterology Nurses and Associates (SGNA)

Have you ever heard the phrase, “Mom knows best?” As a young girl I told my mother, a registered nurse, that I would like to become a special education teacher.  While she entertained the notion, she told me that I was actually going to be a nurse. She said with a nursing degree, I could do anything I wanted and this included teaching.  The idea seemed plausible enough so off to college I went to pursue a degree in nursing.  Upon graduation, I found myself in the medical surgical area caring for more patients than I feel comfortable sharing in the fear that you won’t believe me if I told you. After moving into oncology, an area that I loved, I thought that I might pursue certification in the specialty, but my life’s path did not lead me there.  I later found myself working on the nutrition support team and it was in this area that I began teaching. I taught patients and their families how to care for feeding tubes and provided in-services to staff on new enteral pumps as well as PEG and gastrostomy tube care.  My dream was starting to be realized and I was teaching! 

Moving forward a few years into my career, opportunities presented themselves and I moved into Staff Development. This opened up even more doors for me and I was grateful for the chance to teach other topics and learn more about the specialty. I honed my skills, reached out to those more experienced, and absorbed all I could. My mentors suggested that I look into an organization called NNSDO, for resources and additional guidance. NNSDO proved to be an invaluable resource.  With some experience under my belt, I decided to dig even deeper and learn more. In so doing this, I earned Nursing Professional Development certification through the ANCC and a Master’s degree in Education.

After a few years, the department title of Staff Development evolved into Nursing Professional Development as did my role from Staff Development Specialist to Nursing Professional Development (NPD) Director. After a few years in the NPD Director position in a metropolitan teaching hospital, I found myself on the receiving end of an organizational restructure (AKA unemployed). With two small children at home, I decided to step back a bit and return to work on a part-time basis. I had hoped to find a role in the specialty that I had long since grown to love. A part-time position as the Director of Education for a nursing specialty organization at an Association Management company was posted in a nursing publication. Upon my husband’s encouragement, I applied for the position and was hired. That was over 13 years ago and I haven’t looked back.

My role as the Director of Education for the Society of Gastroenterology Nurses and Associates (SGNA) incorporated many elements of Nursing Professional Development in a very unique environment.  To say that the corporate setting is different than the healthcare setting is an understatement. As nurses, we are trained to adapt and make the best of situations - so I did. Suffice it to say, my earliest set of work colleagues had many concerns about my technical abilities, but I figured it all out with their help. Working with the volunteer members of SGNA offered me the chance to use the skills I had learned in organizational development and behavior during my Master’s program.  I had opportunities to teach, to develop programs, and to provide direction on the educational strategies for a specialty organization.  My role offered me the chance to learn more about association management as well as the specialty of gastroenterology nursing and endoscopy.

As I embark upon my 14^th year at SmithBucklin, the association management corporation that manages SGNA, I still find the work very interesting as the specialty and the association industry continue to evolve. I have a larger role within the organization and work on different projects as well as education.  The role continues to challenge me and I welcome new opportunities to grow. But overall, it is about the people. The privilege to work with our dedicated and talented staff team and our amazing group of committed volunteers is truly the best part of the job.   

So while I haven’t quite ended up where I originally thought I would, I have to say that my mom was right. Nursing has opened up doors that I didn’t even know existed and for that, I am grateful. The next time I speak with mom, I’ll be sure to share that thought with her. 

Cindy and her mother arriving at an airport in the Philippines

The Joy of Lifelong Learning

 

Kari L. Schmidt, MS, RN-BC, ACC is the CEO of Training for Impact® and has extensive experience in professional development and adult education.

That is what learning is.  You suddenly understand something you’ve understood all your life, but in a new way.

-- Doris Lessing

This powerful quote has been an inspiration to me for many years.  Lifelong learning is a core value of mine, as I believe it is for all nursing professional development (NPD) specialists.  We are committed to facilitating lifelong learning for others—at many levels and in many roles in our organizations.  We continue to stay current with evidence-based practice, and promote practice-based evidence.  We scan the healthcare environment internally and externally for innovative practices.  Sometimes we discover new knowledge.  Sometimes we find validation for our current practices.

Our commitment to facilitating learning for others sometimes results in prioritizing the development of others over our own development.  Yet, we have the opportunity, and I would suggest obligation, to role model lifelong learning.  As stated in our NPD standards, “Lifelong learning is important to develop and maintain competence and grow personally and professionally,” (ANA & NNSDO, 2010).  Learning occurs formally and informally:  formally through academic courses and continuing education, and informally through self-directed learning activities such as reading, conversations with authors, networking with colleagues, and self-reflection. 

Acquiring the academic degrees stated in our Standards is critical.  Certification in our specialty is vital.  Continuing education evidenced by contact hours is essential.  Acquiring and maintaining the credentials for our NPD specialty is critical—this validates our expertise.  Yet I often hear about the receipt of contact hours as a task, too cumbersome for busy NPD specialists.  The contact hours are not the end goal.  The acquisition of knowledge as evidenced by the contact hours is the goal.

Formal learning occurs in other formats as well.  In recent years, I had the opportunity to complete an executive leadership course, Leadership in Action, through Carroll University.  This program consisted of multiple days of facilitated workshops over six weeks.  In addition to the workshops, several self-assessments, analysis of the assessments, and individualized coaching were part of this program.  The participants included leaders in healthcare, including two physician leaders, as well as non-healthcare leaders in the public and private sector.  What a phenomenal opportunity to learn from seasoned executives who facilitated the program, as well as other participants!  I gained new understandings of my leadership style, and new perspectives to enhance my leadership skills.  Another example of formal learning is a comprehensive and intensive certification in coaching I completed.  This process included classroom learning, experiential learning through being coached, and over 120 hours of supervised coaching of clients.  Am I proud of this accomplishment—absolutely.  However, it is the learning from the process that was the greatest accomplishment.  Those learnings guide my personal self-reflection that is part of my daily life.  In both these examples of formal learning, it was the integration of learning into my practice that was the greatest value, and the greatest joy.

We are bombarded with information every day.  We can prioritize the information we access based on our learning needs. This informal learning is targeted to meet those needs.  I have integrated a structured process for reviewing key web sites and information from key resources.  ANPD provides excellent resources in nursing professional development, and a method for us to track our continuing education though the Professional Development Center (www.anpd.org).  I schedule time on my calendar to review current information, and select key readings from business literature every month, e.g. Harvard Business Review.  I review new posts on the ANCC and ANA websites monthly, including ANA testimony in Congress (http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Federal/Testimony).  The Journal for Nurses in Professional Development (http://journals.lww.com/jnsdonline) is an ANPD member benefit.  Through online searches you can access current NPD best practices from your computer or iPad®.   To augment information in articles published in numerous journals, I often contact authors to discuss their work.  I am always impressed with how generous authors are in sharing their experiences and insights.

Perhaps the learning opportunity that gives me the most joy is learning from other NPD specialists—novice to expert.  Hearing exceptional insights, seeing the enthusiasm, and pausing to appreciate unique settings and roles is intriguing to me.  Thoughts and questions from the novice NPD specialist always remind me of the importance of fresh eyes and questioning the status quo.  Learning from experts provides new perspectives and research that I can share with others.  Recently I was facilitating a regional workshop for nurse and non-nurse educators.  The group included novice to expert educators.  The participants demonstrated such energy for learning, including learning from each other.  I was impressed with the openness of sharing, collaboration, and networking.  They were committed to sharing ideas with each other, and to their personal growth and development.  At one point I paused, and just observed their interactions.  I was truly inspired.

I am also committed to informal learning through self-reflection—what did I learn from a specific experience?  What would I do differently the next time I am in a similar situation?  How did I make a difference with others?  How can I be a resource to others in the future?  Integrating learning into practice is certainly lifelong. 

I believe as NPD specialists we have the opportunity and privilege to learn from every encounter.  Whether it is learning something new or understanding something in a new way, what joy there is in lifelong learning!