In the third edition of Skyscape’s Fellows Advisory Network nursing newsletter, we explored how faculty members can take care of themselves by growing what you know, learning what you don’t know, and being comfortable saying no.

These same words – “Know, Don’t Know, and No” – can help us care for our students as we help them become strong, confident, capable, and safe nursing professionals.

Know

First, we have to know our students. Can you look around and know the names of the students who sit in your classroom? Can you honestly say that you know a bit about each one of them – how they study, how they perform on tests, how comfortable they are in the clinical setting, how much they have going on in their personal life? Clearly, knowing our students is a cumulative experience – we learn more about them during each class session, and over each semester as they progress. However, even in the earlier of courses, it is important to make a connection. Knowing a student’s name is the first step towards professional personalization. Being mindful of their didactic and clinical performance can help you effectively intervene when necessary if a student is struggling, provide kudos to a student who is excelling, or gently (or firmly) nudge a student in the direction of growth if they are floundering. Knowing a bit of personal information about a student – within the boundaries of professionalism – can also help the student build trust in your teaching and your intention for their success. This can be demonstrated by simply talking to students about what their goals are after graduation, asking what brought them to your college or university, or allowing them to express what made them choose to major in nursing. Evidence shows that we, as human, are wired for connection; taking the time to know your students not only shows you care; it reminds them that we are here to help them achieve their goals, which builds trust in the educational process and the professional relationship between faculty and student.

Don’t Know

Have you ever talked with someone who knew everything? This may have been a family member or friend, or it may have been a fellow faculty member or leader. This is the person who, unfortunately, has nothing new to learn because they have “been there and done that”, no matter where it is, or what you’re referring to in the discussion. Nursing students often feel that faculty members know everything, and granted, we do know a lot about nursing. We are responsible for delivering evidence-based information that is current and relevant to today’s practice…not pulling something out of a filing cabinet from the 1990’s when we prepare to teach. Even when we go to class or clinical as prepared as we feel we can possibly be, there are going to be times when a student asks a question that may stump you. There you are, at the front of the classroom or in the presence of all your students on the clinical floor, with no answer. What are you thinking at that moment? Are you afraid the students will think you are incompetent? Are you concerned that your authority as a faculty member will be diminished if you admit that you don’t know something? Are you scrambling to redirect the conversation so that you don’t have to address the student’s question? Let’s reframe this scenario. What would happen if you simply, openly, and honestly stated, “I don’t know”? What a great learning opportunity this is for students… and how empowering it can be for you as a faculty member… because your next statement can be, “let’s look it up together” as you direct everyone to pull out their smartphone or tablet and seek an evidence-based answer. If it is not convenient to have everyone engage in a search at that moment, consider allowing students to look up the answer before the next class or clinical, and come prepared to discuss the answers to the question. This fosters a sense of inquiry and redirects the students to recognize that nurses must use resources every day to carry out their roles. Use the opportunity of “not knowing” to free yourself from having to have an immediate answer. We care for our students by role-modeling within the learning environment to strengthen students’ abilities to seek information from
credible, current, evidence-based resources
, and we capitalize on this opportunity to remind students that nurses work together to achieve goals as a part of everyday professional practice.

No

Finally, we recognize that sometimes we have to say no for the purposes of the greater good of a student, or in observance of keeping the public safe from harm. A student may miss passing a class by a fraction of a point. Another student may be unsuccessful in the clinical environment. Every faculty member has been on the receiving end of a tearful plea from a student to be granted re-entry into a course or clinical. There are various reasons that faculty may have difficulty saying “no”, but the bottom line is that it is important that we learn how to do so kindly, compassionately, and justly. Students who struggle with passing classes are known to struggle on NCLEX. Students who struggle clinically may compromise patient safety. It is critical that we hold to standards for passing so that we assure that students moving through our programs are safe and prepared for the reality of professional practice. Holding to a standard in the presence of a didactic failure can be done by openly discussing the student’s performance on each required course component. Demonstrate where points were available, and contrast that with how the student performed. Remind the student that sometimes more time is needed to process the material, and direct the student (if eligible) to the process for requesting to retake the class. Allow the student an opportunity to grieve. This demonstrates the essence of nursing – providing a nonjudgmental, compassionate approach in a time of need. It may be more challenging to determine what constitutes a clinical failure. It is important for faculty in a program to agree upon, and collectively use, an evidence-based approach to identifying student behaviors in the clinical setting. Addressing behaviors from the philosophy of a just culture can help the faculty member logically work through the student’s behaviors via an algorithm. This removes subjectivity and feelings from the process of determining whether a student made a human error, if there is a systems problem to which the student was subjected, or if the student behaved recklessly. If it is determined that a student’s behavior was reckless, saying “no” to course continuation or re-entry is the best way we can care for the public, while also caring for that student’s ability to be successful in reaching their academic goals. “No”, depending on the circumstance, can mean “not right now” or it can be absolute, based on your program’s policy for course or program re-entry. Either way, your demeanor in delivering difficult news can demonstrate caring, as long as you remain calm, nonjudgmental, and objective throughout this difficult process.

We have the great privilege, as well as the great accountability, to walk alongside students on their nursing journey. Our roles in caring for students is threefold:

• To 
  
  know
  
   what they are capable of and gently, professionally guide them towards that end point;
• 
  To allow them to recognize that no one knows it all and that saying “I 
  
  don’t know
  ” is ok… but not knowing where to find something, or not asking for help, is not ok; and
  
• 
  
  To say 
  
  no
  
   when safety of the public, or safety of the student, is called into question.
   
  
  

Reflecting on the theme of Skyscape’s Fellows Advisory Network nursing newsletters Editions 3 and 4, “Know, Don’t Know, and No”, consider how adopting this approach into your teaching philosophy may help you guide your students towards success. Earning a nursing degree is a marathon, not a sprint, and exercising this approach can help you care for students by helping them gain the necessary skills to become exceptional nurses in the long run.

Authored by:

Cherie Rebar, 
PhD, MBA, RN, COI

Nicole Heimgartner, 
DNP, RN, COI

Carolyn Gersch, 
PhD, RN, CNE