Careers in Nursing and as an Anesthesiology Assistant
Nursing, Dr. Poff
Hello I’m Dr. Poff from the College of Nursing and we’re here to share with you information
about our discipline, give you some ideas about options that you may have. I’m going to share a
little bit about the history of nursing, the educational process of nursing, and some of the history
of the education process. Our mission in the College of Nursing is healthcare transforming lives,
creating the nursing leaders of tomorrow, and the research that improves health. We are located
on the Northwest side of campus if you haven’t visited us yet. We’ve got a beautiful building
with 75,000 square feet, we’ve got a state of the art simulation center, we’ve got state of the art
classrooms, we’ve got bio behavioral lab for research. So it’s an incredibly dynamic place and I
encourage all of you to stop by and check us out.
Slide 1 [01:07]
So according to the American Nurses Association, nursing is the protection, promotion,
and optimization of health and abilities. It’s the prevention of illness and injury. It’s the
alleviation of suffering through the diagnosis and treatment of human response and it’s advocacy
in the care of individuals, families, communities, and populations. So you can see this definition
includes quite a bit of information. We are promoting health, so when we look at the concept of
health we’re looking at someone’s health; they’re physiology, their psychology, their family
relationships, and their culture. So we define health very broadly and we learn about health from
all of those perspectives. We’re interested in the prevention of illness and injury so we do treat
people who have disease processes and we help to manage their help but we’re always thinking
about preventing the disease process and if they do develop the disease process, how to help
them live with it. We work with the alleviation of suffering through the diagnosis and treatment
of the human response. So as nurses, we are aware of a human’s experience, their development,
their goals, their responsibilities, we study their experiences of their health and with that
information we are diagnosis or identifying how we can assist and guide them through their
health condition. So that’s an essential part of what we do as nurses and how we’re educated.
And because of all of that wonderful knowledge and experience we have, we’re advocates. And
we advocate for communities, families, individuals, and populations. So when you think of
nursing, a lot of people think about clinical roles and we work directly with them in the hospital
settings, we’re with them for 8 or 12 hours and we’re communicating their health status to the
rest of the team on a very regular basis. We’re advocating for their needs, we make
recommendations or referrals. But in addition to that, nurses advocate on health policy levels.
We have people working in very high levels of health administration and leadership to be able to
advocate for the needs of people based on that grounded experience of our disciplinary
perspective.
Slide 2 [03:32]
We have a very rich history. So when you get into the history of nursing, you’re looking at a
profession that is really an ancient tradition. Health care has always taken place. There’s always
been care of the sick that’s often been done by families at the bedside. And then there was some
organization of that in the military and religious orders. So I think that people who love and
fought for what they love, thought about what they could do to help people when they were sick.
So military and religious orders would provide care to the ill. And then in 1860, Florence
Nightengale was really a revolutionary in modernizing nursing. She was a British woman from a
wealthy family who really went against her families’ desires for her life to study to be a nurse.
She systematically observed the patient she was caring for in the Crimean War and those
observations were sort of the foundation for modern nursing. And she advocated for nurses to be
educated in both theory and practice. United States Nursing developed in 1872. We had our first
3 schools of nursing in New York, New England, and Boston. And in 1923 there was the
Goldmark Report which stated what the content of nursing education should be. And in 1924
Yale opened its first nursing school that had its own budget and its’ own department. In 1934
there was a doctorate degree for nursing at New York University. A PhD is the highest academic
degree amongst disciplines. And then in 1965, the American Nursing Association issued a
position paper advocating the BSN degree as the minimum education preparation for nursing
practice. We do still have other options for nursing education. But we’re moving it, and there is a
mandate to move it into the Baccalaureate preparation. In 2010, the Institute of Medicine of has
made a statement about nursing saying that nurses should practices to the full extent of their level
and training, nurses should receive higher levels of education and training through an improved
education system that promotes seamless academic progression. Nurses should be partners with
physicians and other health professionals in redesigning the United States’ Healthcare system.
And nursing is an affective workforce for planning and policy making. So that’s coming from
our disciplinary peer in medicine. The Institute of Medicine is making statements about nursing.
And nursing education programs are responding to that need so we are constantly revising and
improving our systems to help our students become life-long learnings and advance in their
medical options
Slide 3 [06:42]
Now I want to share a little bit about nursing roles
VIDEO
What is it? It’s you. Ok Emma I know it’s now your favorite but it’s time for your medicine, ok?
One, two, three. Emma Emma bo Bemma banana fanna fo femma, fi fo fo femma, emma. How
do you feel sweetie? Good. You did a really good job, ok?
END VIDEO
So that’s a great example, it gives you a picture of a male, whose not typically association with
nursing, but we have a large number of males coming into the discipline. And you see the nurse
looks like he’s doing something very simple there. But actually requires a lot of knowledge in
terms of that child’s developmental needs, he’s aware of the diagnosis, he’s aware of her
medication regimen, he’s aware of her needs during her hospital stay, and he’s part of her
professional team, but he didn’t just go in and give her the drug, he did it in a way that was
engaging and connecting with the patient. And it was a nice example of how we’re educated to
provide care. You can see here that nursing has many roles. We work in acute care settings,
ambulatory outpatient clinic settings and health departments, we work with pediatric and
geriatric patients so patients across the life span. And then nursing also has scopes and standards
of practice for the discipline, but there are also scopes and standards of practice with different
specialties. So if you go into nursing for your undergraduate degree, you get an exposure to a
variety of areas of the lifespan of health delivery, but you can specialize and there’s a scope and
standard and there’s certification so you can be recognized as an expert in different areas of
nursing. We’ve got some examples here of corrections nursing, so that’s forensics,
cardiovascular nursing, nursing informatics, hospice and palliative care, and addictions nursing.
So those are just a few examples in which you can specialize within your undergraduate degree,
or the bachelor’s degree. But core to that, you are a life-long learner and by nature,
interdisciplinary. You work with a health care team and we establish leadership capacity in our
management of patients individually and in our advocacy roles. So you get all of that in your
education in the process of becoming a nurse. So a lot of people want to know how much am I
going to make. Well, nurses actually do quite well.
Slide 4 [09:21]
We have approximately 3.1 million nurses practicing in the United States. The good news
for you is the median age is 46 and more than 50% are near retirement, so we need nurses to
come into the healthcare system. This graph is basically showing you the supply of nurses until
2020 and the demand is going up so there’s going to always be a need for nurses. And the
median salary of a nurse in Florida is $64,000 a year. So those are the awesome opportunities
you have with a Bachelor’s degree in nursing. To specialize, to make good money, to be in
demand, but that’s not all. You can continue on.
Slide 5 VIDEO ONE [10:10]
There are advanced education options clinically. The Master’s Level Nurse Practitioner.
Nurse Practitioner graduates have the knowledge, skills, and abilities necessary for independent
clinical practice. NP core competencies are acquired through mentored patient care experiences
with an emphasis on independent and interprofessional practice. And the different roles within
advance practice nursing are a certified nurse practitioner, a certified nurse midwife who helps
people through pregnancy and delivery, and certified nurse anesthetist and certified nurse
specialist. And we also have advanced clinical roles at the doctoral level which I’ll talk about in
a little bit. So what do advance practice nurses do? I’ll show you another little clip from the
American Association of Nurse Practitioners
VIDEO
Nurse Practitioners are leading the charge for providing quality healthcare for America.
With advanced degrees in primary, acute, and specialty care, nurse practitioners are at the
forefront of our healthcare future. NP’s lead the way in diagnosing, ordering and evaluating tests,
prescribing, treating, and educating patients nation-wide. I’m one of the millions that choose
nurse practitioners as my primary care provider. Nurse Practitioners are patient-centered,
accessible, and high quality health care.
END VIDEO
So advanced practice education builds on our incompetency. But we learn patient care at
the bedside, working with the interprofessional team, and then we grow in our autonomous
decision making for patients
Slide 6 VIDEO ONE [11:48]
And we’re educationally prepared to assume responsibility and accountability for assessment,
diagnosis, and management of a patient health status including prescription of pharmacologic
and non-pharmacologic interventions. SO we work with medications to prevent and manage
disease processes and we also are educated to do a lot of behavioral counseling as well as
referrals for non-pharmacological interventions
Slide 7 VIDEO ONE [12:24]
So nurse practitioners…this is 2013 data, we’ve actually grown in numbers since then.
We have 171, 000 nurse practitioners. Certified Nurse Midwives about 13,000, Certified
Registered Nurse Anesthetist who provide care for patients during surgery and provided pain
management and anesthesia, 47,000. 87.2% of Nurse Practitioners are prepared in primary care
and 84.9% of Nurse Practitioners see patients and are reimbursed by Medicare and Medicaid.
And then 44.8% of Nurse Practitioners hold hospital privileges. And then this gives you some
information about some different areas of practice that Nurse practitioners Provide Care in.
Acute Care where they’re managing patients in the hospital setting, adult and family
Practitioners care for patients frequently in the ambulatory care setting as well as primary care
and gerontology. Oncology, working with cancer management. Pediatric primary care. We have
psychiatric/mental health Nurse Practitioners who work in a role where they’re providing
psycho- pharmacologic agents for patients who have psychiatric conditions as well as educating
to providing therapy and counseling and women’s health nurse practitioners provide care for
women specifically.
Slide 8 VIDEO ONE [13:40]
Vital statistics in terms of income-we have CRNA’s who tend to make about $159,000,
CNMs-$90,000, CNS, or those that work within clinical research roles in institutions usually
make about $67,000, CNPs- $96,000. And again this is 2013 data so it’s gone up a little bit since
last year. So not only can you become a bachelor’s prepared nurse, become certified in a
specialty, make a good living, go on to become a nurse practitioner, grow in your skills and
diagnostics, diagnostic reasoning, and autonomy with patient management, make more money.
We also have the doctoral level of education. We have two doctoral degree options. The Doctor
of Philosophy is the PhD degree and it represents the highest level of formal education for a
career in research and the scholarship in discovery. PhD graduates develop the science of the
profession, the steward the profession and educate the next generation of nurses. It defines the
discipline’s uniqueness and maintains professional integrity. In the academic setting the PhD is
the highest level you can obtain within a discipline. So within the university, there are PhD
degrees available to many disciplines, but nursing has a PhD and has had one since the 1920’s.
The DNP option. The Master’s preparation is a very intensive preparation and it does have
people have an understanding of scholarship as well as clinical practice. And there was a
recognition from other disciplines that the number of credit hours that a nurse was taking to get a
master’s degree was equivalent to a doctoral degree. And nursing, in accord with other clinical
disciplines such as medicine, pharmacy, psychology, physical therapy, audiologoy, those are all
disciplines that have clinical doctors. And so nursing has developed this clinical doctorate
option. And it’s also a terminal degree in the discipline and offers an alternative to a research
focused degree. So instead of new knowledge development, the DNP involves nurses who are
implemented the sciences developed by PhD prepared researchers. And they often work with
health outcomes, quality improvement, and health care delivery. There are clinical residencies in
specialty areas of practice in addition to the master’s level education in addition to policies and
health care leadership policy improvement. So this gives you an example of some leadership
roles in nursing.
Slide 9 VIDEO ONE [16:42]
This just shows a diversity of different people that are in leadership. I’m going to point
out a few of them. Here, this woman is a nurse in the Center for Medicare/Medicaid services, this
is a group that’s responsible for managing a $180 billion dollar budget. It insures healthcare
coverage for 100 million Americans. It has ten regional offices and over 4,000 employees
nationwide. CMS administers Medicare, provider’s funds and guidance to all states for the
Medicaid and children’s health insurance. And now with the passage of the Affordable Care Act
in March of 2010, CMS is responsible for implementing insurance reforms in the exchange
programs. Linda Aikens, here, she’s is the director for the Center of Outcomes and Health Policy
Research. She has conducted research on the healthcare workforce and the quality of healthcare
in the United States and globally. She’s recognized internationally with 12 Europeans Countries,
China, and South Africa, for her leadership and utilizing performance measures to demonstrate
the relationships between nursing care and patient outcomes. She’s basically shown data that
baccalaureate prepared nurses have patients with less morbidity and mortality and higher patient
satisfaction and outcomes. Courtney Liter is a Dean at UCLA School of nursing. He’s a
professor of nursing, medicine, and public health, and the director at UCLA Patient Safety
Institute and the Assistant Director of the UCLA Health Team. He’s an international expert in
gerontology. His clinical research is based on chronic care issues affecting older adults. He’s
recently served as the lead investigator for Pressure Ulcer Incidents and Prevalence in US
Hospitals. This work is associated with the US government’s decision to stop paying for hospital
acquired pressure sores. So we have patients who are immobile and they have issues with skin
integrity that lead to some pretty severe complications. And so his work is working to prevent
that and minimize those risks. And then Beverly Malone is a former dean who also worked in the
Clinton Presidential Administration. She’s currently the CEO at the NLN, the National League
of Nursing, and one of two national accrediting bodies for schools of nursing. So you can see
that we have leadership roles that are beyond the clinical practice scope and that they are
working at pretty high levels of policy, administration, and research and knowledge
devleopment.
Slide 10 VIDEO TWO[01:47]
(No spoken words)
Slide 11 VIDEO TWO [01:53]
So I’m going to share a little bit now about my experience becoming a nurse practitioner.
I kind of put this in the perspective of where you guys and what your thoughts are about moving
forward. So I want to share a little about my experience. I was in Health Occupations Students of
America in High School. My mom was a nurse. I loved to hear her stories about nursing. It was
just kind of all a part about my identity and who I was. Now I wasn’t completely sure I was
going to be a nurse, but I knew something in healthcare was my goal. I did Health Occupation
Students of America in high school and I just kind of started school knowing, getting into
college, I wanted to get into something in health sciences. I pretty much declared my major in
my freshman year.
Slide 12 VIDEO TWO [02:40]
I went on and got my Bachelor’s degree in nursing from Florida State University and
then my masters here at USF, so I’m a bulls nurse. And then I finished a doctorate at the
University of Central Florida in Orlando.
Slide 13 VIDEO TWO [02:58]
My early career was in rehabilitation nursing so I helped patients who had experience
with strokes or spinal cord injuries and then I moved into women’s health, mother/baby,
postpartum, labor and delivery, and high risk obstetrics, then I moved into the advanced practice
role of women’s health and family practice. And then I transitioned into a faculty role with the
College of Nursing and a research degree.
Slide 13 VIDEO TWO [03:27]
SO early interest was in sciences and humanities, health occupations, I got involved with
and was ready to go, and I think you all are in the Health Sciences Major so I think you all know
who are preparing to have the prerequisites to get into your upper division program and that’s
important because there are strict requirements to get into the program and to eliminate multiple
semesters in school is helpful to have your plan set up to be able to prepare you to get into the
upper division program as soon as possible, as soon as you’re eligible.
Slide 13 VIDEO TWO [03:54]
So microbiology, Physiology, Anatomy, Nutrition. I worked outside of school. I actually
worked as a waitress which was actually pretty good experience in terms of time management,
service, and having to juggle a lot of things at one time, which nurses often have to do in a
clinical setting. But I do think it’s valuable for anyone who’s going into Health Services to get an
opportunity to work in a health care setting to get a sense of what the day to day activities were. I
did volunteer at the rehab hospital because I was thinking about physical therapy, I kind of
observed and realized that I didn’t want to be that focused and specialized and that’s what helped
me to choose nursing. But I do think it’s a good decision if you have the opportunity to be able to
work part time in a health environment because it will help inform your decision and help you to
know what you’re getting in to.
Slide 13 VIDEO TWO [04:54]
And then Nursing School. There were challenges and it was incredibly intense. You’re all
here so you probably have that character and personality to want to be in this intense program
because anything in Health Sciences is challenging. It is very different than an arts and science
major. You’re up early for clinical, 8-12 hour days, high levels of responsibility, in
Fundamentals of Nursing Class the professor stood up and said this it he only undergraduate
major in which you can kill somebody. It scared me to death. But you have to have a little bit of
a health fear because you do have a significant amount of responsibility in terms of the kinds of
experience that you get. You do have mentors, you do have guides, I don’t want to say you’re
completely on your own, but certainly you are working with people who are in vulnerable
situations and you need to have a certain level of responsibility to be able to manage that.
Slide 13 VIDEO TWO [05:50]
But the opportunities are incredibly character-building. There is a professional identity
associated with being a nurse. I knew that when I finished the degree I was going to be able to sit
for licensure and I was part of a profession, and I expressed it early that it’s a profession that has
a long history and a very solid identity. You get very close to your classmates. We have teams at
the USF College of Nursing, so even though we’re a big school and a big college, you can get to
know a small group of people and you’ll go through experiences together, so you’ll make very
close and lifelong friends. And then I had the opportunity to learn about health care delivery on
rotations from birth to death. It was just, it’s an incredible education. You’re not just getting it
theoretically. Well, you do get theory, you think about it, but you’re actually in the field and
dealing with people in all stages of life. I knew I wanted to get an advanced degree so I was
planning on becoming a nurse practitioner. I love labor and delivery and I loved actually really
liked aging and hospice. So it was interesting I loved the beginning of life and the end of life. I
always liked the idea of helping someone move through a transition or the idea of helping
someone who was sick wasn’t so exciting to me. But in thinking about it I wanted to help the
person get better. And so that was sort of my interest initially in rehabilitation nursing.
Slide 13 VIDEO TWO [07:21]
My first position was in rehabilitation nursing, I was up in Tallahassee when I finished
and then I moved to this area and I worked with Brandon Medical Regional Center and worked
in labor and delivery. I knew I wanted to go to graduate school so I was in clinical practice my
first few years of nursing, I took the GRE and statistics; there were some prerequisites to get into
the master’s program. And of course we have our licensure exam so to become a clinical nurse to
be able to practice you have to pass a national standardized exam. So I passed that before starting
those first couple of roles. So I thought I wanted to be a Certified Nurse Midwife because I loved
birth and loved the idea of it and was working in labor and delivery. But, it was actually my
experience while working in labor and delivery, while I loved what I did, it’s an incredible
phenomenon, there’s nothing like it in the world, it’s an incredible privilege, I realized that
babies aren’t always born during the day, they come at all kinds of hours, and I’m somebody
who likes to sleep at night and be up during the day, so it wasn’t quite the lifestyle that was
something I wanted to take on. But I knew I wanted to continue my education so I went into the
family nurse practitioner program here at USF and the education in the master’s program
prepares you very well to be both a clinician and a scholar. So I had graduate opportunities in
terms of clinical courses.
Slide 13 VIDEO TWO [08:48]
Pathophysiology, pharmacology, advanced health assessment, theory, health populations,
and I did the family NP track. Now I was still a pretty new nurse. I had been working for only
three years and now I was back in school and back in a clinical setting in the Department of
Family Medicine. This was the late 1990’s and in a primary care role you’re establishing a
relationship with a patient over time. They come to see you and they share a lot of details and
information about their life and the 1990’s was the decade of the brain and there was a lot of
drug development for people with depression/anxiety, bipolar and schizophrenia, and some of
those, especially those conditions, particularly anxiety and depression treated with serotonin
uptake inhibitors was taking place is the primary care setting and I really wanted to have more
knowledge of this. In addition to just helping to manage some of the complex dynamics that I
was identifying in the patients who were coming to see me. So I both the mental and family
health track in my master’s program. And I’ve always never strictly worked in mental health but
I’ve always woven that into my practice as a NP. So in addition to the clinical preparation, I was
prepared well with scholarship for theory, research, and processes and I was interested in end of
life so I got the opportunity to do some directed research in hospice at that time. So then I got
certified as a family nurse practitioner after graduation, I did have an opportunity to work in
women’s health and I worked with a group of nurse midwives in my initial role but decided I
wanted to expand my horizons and worked with the department of Family Medicine here at USF
and worked as a clinician as an NP and we were in an academic medical setting so I worked with
patients as an NP and was able to have a lot of autonomy in my practice, worked with nursing
students, we had College of Pharmacy, Physical Therapy-well…not physical therapy at the time,
Public Health, so I worked with a multidisciplinary team in that role. I was assessing,
diagnosing, and prescribing, I had firsthand knowledge about our national health priorities,
cardiovascular disease, cancer, risk prevention, and I ‘ve been able to help people live over time
with their diabetes, high cholesterol, some chronic pain conditions, so I’ve had an opportunity to
work with patients with a variety of health conditions, and basically in addition to my diagnostic
reasoning…when you become an NP you start with the nursing approaching, you’re working
with the interdisciplinary team, you rely a lot on the decisions of the physician, and then you
move into this role where you need to make the decisions for the patients, you need to make the
diagnostic call, you need to know which drug to order, you need to know what test to prescribe
and so you really shift to more of the medical model of thinking. And this takes up a certain
amount of your considerations when you’re learning that, but as I grew in my experience as an
NP, the nursing really starts to come out. Once you start a master, that challenging new role, the
therapeutic use of self, diagnosing the human response, understand how a person is living with a
condition really started really to come into play. And then my education as a mental health
clinician helped me to better communicate with patients and so the process that you go through
in terms of your internal development as a clinician and it’s a great gift and a great benefit. So
the accomplishments that I would like to share with you in my role development as a nurse
practitioner
Slide 13 VIDEO TWO [12:56]
Is that I’ve developed a deep understanding of health and healing of people across their
lives. I’ve had the opportunity to work with inter professional teams, I’ve had the opportunity to
teach and mentor nurses and undergrate and graduate level as well as medicine, public health,
and pharmacy. I’ve had the opportunity to network with other nurses I’m involved with multiple
professional organizations, I presented my research at multiple conferences. I’ve gotten to travel
to California, Ft. Lauderdale, Phoenix, Indianapolis, New Orleans, and Austin and basically with
my doctoral work be able to develop some creative applications of my experiences to be able to
help improve health care. So thank you for the opportunity, I’m now going to turn it over to
Brittany.
Slide 13 VIDEO TWO [13:49]
Ok well thank you Dr. Poff, and just to sort of reintroduce myself, my name is Britny
Chabalowskui and I am the director of the pre licensure nursing program here at USF. We did
have another instructor that was scheduled to be with us today, Dr. Kathy Katts, however she had
an emergency and was not able to join us. So I’m just going to review a little about her career
because we wanted to give you different examples of where nursing can take you. So Dr. Poff is
a very accomplished advanced practice nurse. She has shared her story and showed where her
career has taken her. Dr. Katts is a great example of where nursing can take you in leadership. So
I’m just going to talk a little about her and again in her absence I hope I do her some justice.
Slide 13 VIDEO TWO [14:32]
She went through a diploma school of nursing. Now, diploma schools of nursing don’t
really exist anymore as far as I understand, that was sort of the old school way of becoming a
nurse. Now our earliest eentry level is an Associates of Sciences which will get your nursing
license. So she was in diploma school nurse and after she received her diploma and registered
nurse license, she went on to get her Bachelor’s degree. And then her bachelor’s degree in
nursing as well. Master’s degree trained in Management at the University of Pennsylvania, and
finally a PhD. So Dr. Katts is one of our instructor’s now, she’s one of our assistant professors.
So early in her career sh
Slide 13 VIDEO TWO [15:19]
So early in her career she worked in the ICU-the medical surgical and intensive care
units. She was a very, pivotal, staff management person, a TGH, she went on to become the
assistant director or nursing, she was in that role for a while. So that’s a pretty impressive role to
be directing all of nursing at Tampa General Hospital. So she’s had really a fabulous career.
Slide 13 VIDEO TWO [15:45]
She went on to become Chief Nursing Officer, Vice President of Nursing and eventually
assistant professor with us. So she had also held some leadership roles outside of the clinical
setting. So she was on some nursing boards. Department of Health, so she served on the
department of health in New Jersey. That’s a very important role for nurses. We do not just
impact indiviudals or families, but the community as a whole. And regional national and I want
to talk about her international impact and conferences that she had or was involved in.
Slide 13 VIDEO THREE [00:00]
She helped to develop and deliver senior specialty elective. When you leave nursing
school you are trained as a generalist nurse, but there are many specializations that you can get
into. It’s very difficult to get into that sometimes because your nursing school is going to prepare
you to be a generalist. So Dr. Katts was instrumental in developing these training modules that
would allow brand new graduates to have this special set of skills. So that would allow them to
go into the operation room for example or the lab where they put stints into hearts. So she was
instrumental in that. Magnet certifications for hospitals or health care provider agencies are a big
deal. It really means that it’s great to work here, our patients are satisfied, they have great
outcomes and it’s a very hard certification to attain. Dr. Katts was instrumental in getting that
certification for Tampa General. She alkso was instrumental in putting together the United States
Air Force Nurse Transition Program. There were only a couple of sites in the country that do
that. These are new air force nurses that are getting ready to deploy. We put them through a very
intensive clinical training program. We do part of that here at USF, so we do their skills refresher
and simulation here, but they do their clinical training at Tampa General.
Slide 13 VIDEO THREE [01:31]
Again these are some of the senior electives that Dr. Katts worked with. So working with
oncology or perioperatively, or working in the operating room).
Slide 13 VIDEO THREE [01:37]
OK so there’s Dr. Katts, that’s what she looks like. So this was their international Magnet
consultation. So in addition to working on Magnet status here, she worked with a board of
leaders that actually got magnet status for a hospital in Moscow, Russia. And again another
pictures for the United States Airforce Transition Program which is a fabulous program.
Slide 13 VIDEO THREE [02:07]
Ok St. Petersburg. That’s where she went. But they worked together, they went over, the
TGA leadership including Dr. Katts went over into Russia and helped them to build their
infastrucutre and helped them attain the first even international Magnet status that had ever been
awarded. So that was a really big deal and just speaking with her and hearing her speak about it,
it was a very monumental role and piece of her career that she is very proud of.
Slide 13 VIDEO THREE [02:35]
Again, she planned for three years and worked with that medical center over there to
receive that Magnet certification. Really very impressive
Slide 13 VIDEO THREE [02:45]
Again with the collaboration with the US Air Force there are only three sites in the
country, of which we are one. We do have air force educators. We have two fabulous Air Force
Colonels that help us with this program and one of them joined when she was in her late 40’s and
early 50’s because it was right after 9/11 and her son also joined. Her son signed up so she said
I’m going to sign up with you. So she is a fantastic fabulous lady and she’s a Colonel now in the
Air Force and she helps us run this program here at USF.
Slide 13 VIDEO THREE [03:20]
Here are the first graduates of the Air Force Transition Program. And again it’s a ten
week program. We do some of that training here at USF in the College of Nursing and the
Clinical Hours and done at Tampa General.
Slide 13 VIDEO THREE [03:32]
So Practice and leadership. Strong leadership on the part of nurses, physicians, and others
will be required to devise respond to all of the changes that are going on right now in our
healthcare delivery system, especially now. We have so many changes coming down the pink.
So having a strong voice as a leader in nursing in very, very important, however as Dr. Poff said
as well, we do work in an interdisciplinary practice so we rely on everyone and everyone’s a part
of the team. I personally think we’re the best part of the team, but that’s just me. Ok so those are
two very illustrious careers that I just told you about-Dr. Poff in advanced practice and Dr. Katts
in leadership did some really great things, so I’m going to give you my story which is maybe a
little less traditional than I think the other two. So here’s the first one, this is not me, ok? I still
gross my parents out when I talk to them about my day I work. My dad’s a pilot and my mom’s
an event planner. Nobody knows where this gene came from in me where I wanted to go and do
this touching people kind of thing. So I had kind of a bumpy road getting here and I think…I
wanted to share that with you guys because you’re in this course and you’re starting out here
thinking where is this path going to lead you, and frankly I didn’t know at the time. I knew I had
a very strong interest in sciences like anatomy and physiology. Originally I thought I’m going to
medical school, that’s what I want to do. And I’m going to be a doctor and I’m going to have a
fancy car and a nice big house. So I thought what do I need to do to get there. I did my first
degree in cellular and molecular biology, loved it, science geek at heart. I started to notice some
things about the people who were next to me in lab, like they couldn’t’ make eye contact,
couldn’t make conversation, there were some types of personality flaws in my lab partners I’m
just going to say that…I’ll just say it. I just thought well I’m not really sure how you’re going o
walk into somebody’s hospital room and deliver bad news or have a therapeutic conversation
with them. You know, we’re working on a project together and you’re…you know…starting at
your feet. So I started thinking maybe I’m not in the right place and maybe needed to start
thinking about something else. And then I started thinking about four more years in medical
school, 4-7 years in residency, tons of student loans, let’s see, they will call you in the middle of
the night incessantly, and so I thought maybe this isn’t the right path for me. But you know and I
loved the science stuff but I certainly didn’t want to do this with a pipette for the rest of my life,
ok? That’s a whole nother carpal tunnel syndrome. So then I thought let me look into PA
school, maybe I want to be a Physician Assistant, maybe that’s what I want to do. So I started
looking at schools that were nearby, and at that time none of the PA schools would accept you
unless you had 2,000 direct patient contact hours. So I thought well how am I going to get that,
what’s the fastest way? So I was already volunteering as a firefighter so I went on to get my
paramedic certification. And I loved it, I had such a graet time, itw as like the most fun anyone is
allowed to have within the law. And I was so excited because I was taking care of patients which
is exactly what I wanted to do. At this point I was kind of like well I think I want to do this but
all I’ve done is watch TV shows, documentaries, and done really well in all of my science
courses, btu what if somebody throws up on me? What if I see something really gross and I pass
out? How do I know this is really something that I want to do? And that’s actually how I ended
up in the fire department. I thought let me just dip my toes into the pool and make sure that I can
do this. And it was cool, it was good, I still don’t’ like throwing up, I don’t think anyone is really
going to like that, but I did get rid of my sympathetic puking. So I thought that was a good step,
OK people don’t like it when you puke back on them, but that only happens once or twice. But I
wanted to do more, I was having such a great time going to people’s homes, going to scenes,
scooping them up, you know fast-paced like making a big difference. But I get to the hospital
and I had to turn in over. I was only able to do this much. I was like what are you doing in there?
Oh I want to help out with that, can I do that? And my guys would have to put me back on the
ambulance like we need to go back to the house, it is time. So I just wanted to do more. And
when I was in there, when I was in the hospital, I was starting to get a good feel for who did what
and I got a good feel for who is really running the show, and that’s the nurse. So I said that’s the
job that I want to do so I started looking into nursing because unlike medical school or even PA
school where you have to say I’m going to be X kind of doctor and I’m going to board in this,
I’m going to do my residency in this…like speak now or forever hold your peace you never get
to change. And for nursing I was like so I can be a school nurse one day and then go work in
labor and delivery the next day? Ok cool sign me up. Or I can go on and get my advanced
practice degree and I can independently or I can see patients in a clinic or I can go teach. So I
really saw that as the place where my opportunities would be boundless. So I saw this as the next
opportunity for me. So I already had a bachelor’s degree so I signed up for an accelerated
nursing program. Also the reason I didn’t become a paramedic was because I married one, so
you know, shift work and that’s not a fun way to live life so I was like I don’t want to do this
anymore. I do remind him quite frequently that I did his job for free for a very long time. He just
says that was my dumb fault so that’s ok. So accelerated nursing program-my next stop. It was
intense, it was a lot of fun, I think Dr. Poff eluded and I’ve been out of nursing school for a long
time now…I remember my first day of clinical, I remember my first day of class, I remember a
lot of stuff from nursing school. So those things really get etched into your memory or your
psyche, your soul, whatever. It’s a very, very intense process. Becoming a nurse was very
exciting, but there was definitely a lot to learn. It wasn’t just about the sciences. It was about
how to talk to people. How do I interview a person and get them to trust me? How do I build that
relationship? How do I teach somebody? Ok so now I know all of these 50 cent words but now
I’ve got to go teach someone with a fifth grade education about their diabetes. So there was
definitely a whole lot more to this process than understanding what a gram negative bacterium
was. I loved it, it was awesome. So when I graduated my first job was in a medical surgical unit.
I worked in a teeny hospital in Western Maryland. So typically here like in the big city, your
floors will specialize in something like neuro or orthopedic injury and surgery. We didn’t’
specialize in anything. We did everything that came down the pipe. So it was a great experience.
So I had surgical patients, I had chronically ill patients, I had morbidly obese patients, I had
orthopedic patients. It was a fantastic experience and I loved it, but I really wanted to get back to
my roots becaseu I’m just a blood and guts girl like from way back. So I’m like the grosser the
better, so brains, guts, arms chopped off, I’m your girl, that’s me. OK babies being delivered, not
me. So that’s why I’m glad we have nurses like Dr. Poff-like that is way out of my wheelhouse.
So I ended up back in the emergency and trauma department, back to my first love. And I had a
blast there. I just loved learning everything new and anytime a new procedure came our or a new
medicine came out I was like let me learn that; let me teach everyone else about it. I started a
trauma committed there where we reviewed all of our trauma patients and asked questions like
what could we have done better? Where did they go? What happened to them? And this was just
when I was just a baby nurse right out of the gate. But what I really found was that when new
nurses or students were coming in, that’s when I would have the best time. Because my
coworkers kind of were like eye rolling because they didn’t’ really want to hear about the latest
and greatest of whatever we’re doing. But I was like oh a student nurse, come here! I’ll show
you, let’s go talk to this patient! Do you want to see a wound? Put your finger in there! No it’s ok
I’ll ask him, it’s alright, it’s ok. That’s where I really found my passion, that’s what I love to do.
As much as I loved nursing, I love making new nurses. Maybe it’s a little hubristic, I’m like OK
I’m just going to make you in my image, it’s a little inappropriate, but you know out into the
world you go. So I’m not sure how I’ve affected the nursing profession, but you know. So I
started my Master’s Program and didn’t know where it was going to take me. I focused on
Management and Education. So I didn’t go into an advanced practice role. I didn’t’ see that that
was me, that it was something I wanted to do. I know that if I changed my mind I could do that
later. I could add that on as a post master’s certificate if I decided to become an advanced
practice nurse. It wasn’t for me at the time. So this I where I kind of started out. And I started
teaching at the University of Tampa. Really liked working over there, but I had a better
opportunity to work over here so now I’m a bull nurse, that’s just how it works. So as an
Instructor here at the University of South Florida I’ve gotten to do pretty much everything across
the board in nursing education. So I’ve worked in clinical, taught classes, both online and live,
I’ve done simulation which is something I’m really excited about, so we have human patient
simulators, but…I bring my kids in all the time because it really creeps them out…because they
blink and they breathe and they talk to you and so you can do all kinds of bad stuff to our human
patient simulators…so if you kill them it’s ok, we just reset them. So that’s one of the things that
I love the most because it’s a really great fun way to learn. So I did a lot of simulation in our
program. I was eventually promoted to the director of the pre-licensure program and again in
some ways I think this part of the profession has chosen me, but I’m glad to be here and I want to
keep going. I’m currently in PhD school which is…I don’t want to say exciting because you
guys are in school, you know what school is. I don’t’ have to lie to you. But I really feel like I
made the right decision. I don’t ever regret not going to med school, not going to PA school. And
I tell my students all the time. I say you know…I read the admission essays of I want to help
people and I want to make a difference…this job makes a difference, it does. I tell them I’m the
nurse, I’m the hub, I’m the spoke on the wheel, and everyone else is the spoke. They all work for
me, ok? Physicians, PT, Occupational therapy, [pharmacy, respiratory therapy, they all work for
me. I coordinate that patient’s care. I’m at their bedside for twelve hours a day. I am their
advocate, their protector, their voice, I’m the person who takes care of them. I am the one that
knows that they don’t have a car and can’t go get their food at night. I’m the one that knows that
they’re allergic to cats, but if her daughter moves in, they’re bringing the cat with them. Other
providers don’t’ know this about my patient. So I feel like I picked the absolute best career
because I get to do everything. I’ve even told my doctors in the ER that they work for me. They
think that’s ok. Well they called me assertive. I don’t know what that really means but its ok, I
don’t really mind.
Slide 13 VIDEO FOUR [0:00]
Alright well that’s my story. Now what for you guys? I totally sold you on being a nurse.
This is what you need to do next. We have information sessions at the College of Nursing
routinely. So if you check on our website, they will list them there for you. We have fantastic
pre-nursing advisors. They will help you with what prereqs you need, they’ll help you fix your
GPA if it needs fixing, what are the next steps. And if you choose not to come to our college of
nursing, which I don’t know why you’d look anywhere else, you want to make sure they’re
regionally accredited and CCNE or NLN accredited, of course we are all of these things. The
kind of caveat or watch out is that there are some proprietary schools out that that are happy to
take you in, charge you a lot of money, and they’ll give you a degree in nursing and qualify you
to sit for your boards. However, if you want to go on and get your bachelor’s degree or master’s
degree if they are not accredited, those credits do not count. They will not transfer or apply for
further education. So you just gotta really make sure you know what you’re getting into. You
want to target for a bachelor’s degree for a number of reasons that Dr. Poff mentioned. While
that is currently not our entry standard, it is becoming more of the accepted place that we want
our nurses to go. So many of the hospitals here in the area, if you are Associates Prepared, they
want you to get your Bachelor’s degree usually within two or three years of being hired. So if
you start out with a Bachelor’s degree you’re already one step ahead of the game. So, very strong
historical foundation. And also because I know I was back and forth between PA and NP what
do I do, what’s the difference between the two? PA’s were actually established during the
Vietnam War. They were transitioned from our front line medics. They were doing a lot of
procedures that didn’t really fall into category…it didn’t really fall into nursing, it didn’t really
fall into med school, but they were like super, super smart, did a lot of stuff, had a lot of great
experience. So that’s kind of the evolution of the PA role. So that kind of goes back to the
1960’s, that’s when the PA role was started. And nurses had been around since the Crimean War.
So we got them by a lot on the timeline. So that’s our first thing. So a very, very strong
foundation for us. Being a nurse it’s not like...I don’t get doctor’s coffee, I don’t put mints on
pillows…that’s just not what I do. I’m not a waitress, but yes waitressing skills helps. It’s like
hey can I top off your iced tea? Can I get you a little more morphine? It’s a little bit of the same.
But that’s not what I do. I coordinate my patient’s care, I take good care of my patient, and I
know that I make a difference. And that’s where we all start out in general, the bedside. And
that’s where we learn our practice, it’s how we learn our trade. It’s how we learn to treat people
from all walks of life the same. We provide the same care and service to everyone. You learn a
lot about yourself in this career that’s for sure. And the one place you learn a lot about yourself is
probably in nursing school. One of the things you learn is how tough you are, or how tough you
aren’t. I know it’s almost the end of the semester, so I’m out of tissues, but I also have a box of
chocolates in my office. So you can come and take some chocolates, gather yourself, and then
come back. It’s a tough career. I’m not going to lie to you. This is a really tough job. But
anything that is worth doing is hard. It’s just hard. But I love my job because I know at the end
of the day I’ve made a difference. That I held somebody’s hand when they died because nobody
else was there. Or been there at the beginning of life. I know that…that’s important to me. That’s
better than shoving papers around, sharpening pencils. Lots and lots of career options just with
your bachelor’s degree. You can make a full and long career just with your bachelor’s degree. I
don’t’ want to leave you with the impression that you must continue your education, but our
good ones do, ok? Go on to master’s degree and then doctoral level, which we talked about. We
have a lot of nursing students who….this is what I don’t ever want to read on an essay because I
can get a job when I finish. Ok it’s true, but you’re not going to last in your profession. It’s an
upshot for sure. It’s a lot of hard work, but you’re going to get a job because nurses are in huge
demand. Very, very well-respected discipline. People know that we are not waitresses, that we’re
the ones at the bedside making a difference. This career choice ages well. I worked in ER and
trauma unit, I had people take a swing at me, throw stuff at me…I don’t want to be 70 and doing
that. I’m not a good wrestler anyway, but I’m sure when I’m 70 I’ll be an even worse wrestler.
So this is a job where you can transition into…like if you decide I’m getting to old for this. I’m
working at a call center. I’m going to be the nurse on the phone. Take your medicine and then
call your doctor or go to the ER. So there are really so many ways you can take this career into
so many different directions. The best part is you don’t’ have to decide right at the front, you can
change any time you want. It’s not task-focused at all. Opportunities: unlimited. SO I think we
have a few more minutes right? Questions? Yes there are some, but they’re not as formal I guess.
So the question was about making transitions besides going into education. So like for me from
going to a medical/surgical floor and then going to the emergency department I had a number of
different certifications that I needed to get. I did go through a training program where I..you
know there are different skill sets on both sides, but I didn’t have to go back to school and get a
degree. Really it was just about applying for the job and talking to the manager and saying I
would be a really good fit because I used to be a paramedic and I’m a super great nurse on the
med/surg floor and I think I would do really well here. So there’s nothing formal about that, it’s
just making that decision. And a lot of those transitions, like if I wanted to go to labor/delivery,
they could take me and train me in those specific skills, but I already have the nursing base…so I
can do that…I can pick up the phone and move to L and D tomorrow if I want. So that’s a pretty
tough one. We have a lot of patients that are in our general, medical, surgical units. Then we
have patients that are in our critical care areas. So the evolution of that is that we have patients at
home now that would have been in our med/surg unit 5 years ago. Patients in our med/surg unit
that would have been in ICU 5 years ago. So I think that the need and the model will be
changing. We’re looking at more of a medical home, but critical care is always in demand.
Med/surg is where most are going to be. Yeah, definitely. And that’s just a different model. We
have to consider that medical home. You know, tele health is the big one now. So we may not
have to have people get on a bus and come in to the doctor’s office. We may just skype with
them. You now, like hold up your wound, let me see it. Show me your pill bottle. Show me how
you take it. Show me how you inject your insulin. So that’s really where I think our model is
moving. Because we just can’t sustain the patient population that we have in the acute care
facility. So I can’t say for sure that this is the kind of nurse you need to be to get a job because
it’s just blowing up all over the place. But the opportunities I think are going to change, just a
little bit. Did that answer your question? Ok going from your associate’s with prereqs to
Bachelor’s degree currently our program is six semesters long. We do enroll once in the summer
and once in the fall. So it’s 5-6 semesters depending on when you enroll. We are currently going
through a curriculum revision that I’m hoping we will launch next year, but I think that those
semesters will stay the same. We’re just realigning things. So about 5-6 semesters for our upper
division students and about 4 semesters for our second degree students. So those are students
who already have a bachelor’s degree. Correct, yes. So four semesters. So the only challenge for
some of my second degree students is if you get your first degree in Art History, you might not
have your micro, and your bio, so you’ll have to obtain those prerequisites before you enter the
program, but once you get in then its four semesters. Now I would probably say if like right now
this is what “m doing and I want to be a nurse just go straight for it. Otherwise I would say you’d
be pretty covered with just a general bio degree because you’re going to get those things that you
need like Micro, A and P, Nutrition, I would say other degrees that we’ve had that have come
in…I would say public health is a good adjunctive learning strategy, health sciences is a good
one. Because you get to pick as you move along, or do you not get to pick? Ok so everything is
covered in health sciences, absolutely. But you guys will do…you will start here and then apply
to the nursing program? Or do you do the whole degree here? Sorry I don’t get to this side of
campus very often. Ok so yeah then obviously health sciences is going to cover all of those
prereqs for you. And it sounds like a pretty good program that you have where you get
everything. I’m sorry we don’t leave our corner of the world very often. We’re in our USF
Health corner. That’s kind of a tough one because you’re like right in between, you’re at the
halfway point. That would be a good one for our advisors because they would be able to look at
your progression so far and it wouldn’t hurt if you got all of your prereqs to throw your hat in the
ring. Now there are other considerations like financial aid, number of credit hours that you take
here. So you know like the whole take 15 get out in 5, whatever you’re supposed to be doing.
Four? Oh. Four. Like I said my little world is all I know. But I think that would be a more
specific question for our advisors so they can actually look at your transcript. Alright so excellent
question. The balance of students we take…we do take more upper division students or
‘traditional’ students than we take of our second degree students. And there are a number of
reasons behind that that have to do with our clinical collaborative partners and so on.
Historically, the GPA for the upper division incoming students, like our traditional students, is
about 3.8. So that’s our average GPA. Our GPA for our second degree students is usually a little
bit lower, like a 3.5 of a 3.6 and something that is because sometimes you go to school when
you’re 18 and you don’t take it as seriously as maybe you should and your first degree doesn’t’
look as impressive as your next degree is going to look. So that’s what happens to that pool of
applicants for us. I will tell you in addition to overall GPA we look at first attempt grades so if it
took you three times to get an A in micro that’s not as good as if you got a B the first time. We
also look at your prerequisite grades and we have you write a personal statement. The personal
statement is pretty heavily weighted. I don’t want anyone to think omg I got a 3.2 or a 3.3 on my
first degree I’ll never get in…absolutely not true. We look at kind of the whole picture. We look
at where you’re coming from, what’s your motivation to be a nurse, what’s your experience, so I
don’t’ anyone to feel like they can’t apply. We’ve taken. 3.0’s. And I know that’s kind of like a
low GPA, but it’s a competitive program. So interesting question and I would say the answer is
that we don’t know yet, ok? To be honest with you, I haven’t seen much impact practice at this
point. Because it’s still rolling out at this point. So much like the roll out and sign up, we don’t
know everything that’s going on. So the way it’s going to impact us is we don’t know yet. I will
tell you that no matter what healthcare looks like, we will always need nurses. So what DR. Poff
was saying is that there is definitely much more focus on prevention and wellness. It’s not our
current medical model. Our current model is treatment of illness. So nurses aren’t trained from
day one in prevention, wellness, education, and all those things. There was a fabulous
documentary that was saying that physicians don’t even get trained in nutrition. And there were
physicians that were interviewed that said I know what to do once you’ve had a stroke, but I do
not know how to tell you to prevent it. That’s what nurses do. That’s what we do. We teach you
how to eat to prevent your diabetes from killing you. We teach you how to take your medicine
we make sure you have an appropriate exercise regimen, so I think the ACA when we look at it
through that lens, it can only pump nurses up and help us. And I think people in general. People
who wait to get sick is kind of lousy, so. Well thank you guys very much I hope to see you over
there.