NURSING EDUCATION

SEMINAR ON CONCEPT OF FACULTY SUPERVISOR POSITION IN NURSING (DUAL ROLE)

PRESENTED BY ARUN.JV

CENTRAL OBJECTIVE: By the end of the seminar the group gain knowledge regarding faculty supervisor position,appreciate its importance in nursing and effectively use this method in their future practice. SPECIFIC OBJECTIVES: At the end of the seminar the group will; recognize the concept of faculty supervisor dual role explain clinical supervision describe qualities of a good supervisor explain job description of nursing supervisor identify the role of nursing faculty explain the role of faculty supervisor describe the collaboration between nursing education and service explain models of collaboration between education and service identify collaboration of nursing education and service in India explain strategies for clinical nurses considering a dual role

INTRODUCTION
"sarve bhavantu sukhinah,

sarve shantu niramayah, sarve bhandrani pashyanthu maa kaschiddu khabhagabhavet."

This literally means: (Let all be happy, Let all be free from diseases, Let all see the auspicious things, Let nobody suffer from grief.)
Applying this to our profession

The budding nurses should be so prepared that they make clients free of diseases,remove their sorrows and provide happiness and hope to them.

Nursing education prepares nurses to practice in a variety of settings. The impact of modernization, globalization and liberalization on the society has brought tremendous changes in general and nursing education. The significant trends in modern education are creativity, changes in teaching - learning process and advanced educational technology. The current trends in nursing education are numerous. The scientific and technological advances in medicine along with social changes have resulted in emergence of new diseases and the development of specialities and super specialities. Advanced nurse practice enables nurses to practice in new roles such as nurse practitioners and clinical nurse specialists. Nursing profession ensures a promising career in India with job opportunities abroad. Large number of private nursing educational institutions have been set up, which require faculty with postgraduate education. In developed countries, great emphasis is given on preparing individuals with critical thinking and problem solving skills. Faculty need to be role models especially in the aspect of caring in nursing. The concept of faculty supervisor position(dual role) in nursing has evolved since a decade.But the practice has not been implemented in a wide range.Only very few institutions are practicing it today.The main reason for the emergence of dual role is the shortage of nursing faculty and clinical nurses.Its been widely seen in the Indian setting that highly

competent faculty members are confined only to academic aspects only thus ignoring their clinical competencies.So it has been suggested in that the faculty of an educational institution in nursing has to work as a supervisor in the parent hospital or affiliated hospital. SUPERVISION Concepts of supervision have changed in recent years.Today there is more democracy in supervision.Educators think of supervision either as guidance or working together for common goals.Supervision of graduate staff nurses differs from that of student nurses in one aspect. Supervision of the student has two goals,the development of the student and the improvement of nursing care.With graduate nurse supervision is focused on the attainment of one goal,the giving of high quality care.A good supervisor is one who has broad professional and cultural interests and vision and enthusiasm for work.As per dual role supervision can be of student nurses as faculty or the supervision of staff nurses as ward in charge. QUALITIES OF A GOOD SUPERVISOR 1.First and most important,a supervisor must have something to give which is greater than that which is possessed by the individual whom he/she is supervising. 2.A good supervisor inspires confidence by his ability and his high expectation. 3.A good supervisor has enthusiasm for nursing and a consuming interest in patients and their care. 4.A good supervisor is approachable. 5.A good supervisor is also a good leader. 6.A good supervisor is fair: Treats each individual impartially but with accordance of his own special interests. 7.A supervisor should have infinite patience and hope. 8.A good supervisor is able to look at himself objectively: To try to put himself in the other persons place and see how he will be affected by his own actions. NURSING SUPERVISOR JOB DESCRIPTION

The following is Nursing Supervisor Job Description with details about education, skills, experience and duties. A Nursing Supervisor leads a team of registered nurses, nurse aids and trainee nurses. They

ensure that there is adequate nursing staff during all the shifts. It is also their responsibility to make sure that nurses are properly educated and trained to handle different diseases and illnesses. They organize and monitor nursing staff and nursing procedures. The nursing department functions under their guidance adhering to the hospital policies and principles. The Nursing Supervisor position combines both nursing skills and managerial abilities. Nursing Supervisors Job Duties: A Nursing Supervisor may work in corporate hospitals or nursing homes. Usually, they work in big hospitals or healthcare units where a group of nurses serve. They play a leadership role guiding nurses. Their duties are to: 1) Take care of patients, sometimes just like any other registered nurse. 2) See to it that patients are getting the best care from the nurses. 3) Get the nursing station organized. 4) Hire adequately qualified and trained nurses. 5) Assign shifts and job responsibilities to various nurses. 6) Monitor them and make sure that they are adhering to the hospitals guidelines. 7) Give in-service training to nurses. 8) Resolve any issues with the nursing staff. 9) Ensure that medicines and other essentials are always in full stock and readily available for use. 10) Minimize wastage. 11) Meet and appraise higher ups about the functioning, issues and developments with the nursing department. 12) Suggest improvements in nursing care.

Nursing Supervisor Knowledge and Skills: 1) Should be caring with thorough knowledge of nursing practice. 2) Good knowledge of more than one branch of nursing and specialized knowledge in one branch is essential. 3) Good at emergency care. 4) Leadership abilities and the ability to lead through demonstrations and actions. 5) Always alert during the shift. 6) Attend to patients whenever there is need and help nurses when they cannot cope with a particular patient or situation. 7) Good computer skills.

Nursing Supervisor Educational Qualification and Experience: 1) A masters degree in nursing and certification is essential for a Nursing Supervisors position.. 2) Ideal to begin their careers as registered nurses and experience as a registered nurse in large hospitals.
NURSING FACULTY

The teaching staff and members of the administrative staff having academic rank in school or college of nursing. Clinical faculty members are essential for the success of nursing students. It is impossible to learn nursing without effective clinical experiences provided in an environment that provides support and respect for students while they learn the art and science of nursing.

PRIMARY ORGANIZATIONAL RELATIONSHIP Nursing faculty members are responsible to the Principal and management authorities and also to the affiliated University. JOB SUMMARY Provides students with instruction of the highest standards, evaluate student progress, assist in preparation of syllabi, assist in activities furthering the work of the institution, communicate necessary information to students, provide academic advice to students as needed and serve on standing and ad hoc committees as needed. EDUCATION

A masters degree in nursing and certification or a basic degree or post basic degree in Nursing.
RESPONSIBILITIES Provide competent instruction in the clinical and theoretical areas of nursing. Maintain high standards and promote excellence in education. Participate in and contribute to the team-teaching of classroom and clinical courses and model team-enhancing behavior for students. Serve as a role model for students in professional interaction with other health workers and with clinical facilities. Promote positive and productive relationships with service area hospitals and community Assist the Coordinator of Nursing in scheduling and confirming use of clinical sites. Assist the coordinator of nursing in scheduling curriculum content and classroom scheduling. Maintain relationships with clinical sites and professional peers that support the reputation of the College and the Practical Nursing Program

Continue as competent faculty in nursing by seeking new knowledge,improving nursing skills,and updating professional competencies. Maintain attendance records for classes taught.

Evaluate the progress of students in all classes according to institutional, divisional, departmental, and individual criteria. Prepare or assist in the preparation of materials such as those used in academic administration when requested, including course syllabi, program outlines, articulation, and catalog materials. Participate in scheduled in-service activities. Promote student development through enrichment and mentoring experiences. Serve as academic advisors and mentors. Become familiar with institutional policies and procedures as outlined in the College Catalog, and the Faculty Handbook and follow such policies and procedures. Perform any other professional duties as assigned by the authorities.

CONCEPT OF FACULTY SUPERVISOR According to National League for Nursing(NLN),the main competency of faculty role is described as Creating an environment in classroom,laboratory and clinical setting that facilitates student learning and an achievement of desiered cognitive,affective and psychomotor outcomes. A clinical nurse is one who is practicing in the clinical instituition such as hospital.So a faculty supervisor is a nurse who is employed by an academic instituition to teach nursing and who works in the parent or affiliated hospital supervising students and staff in a particular area on a regular basis.She/he will be accountable to all the activities performed by students and staff and also regarding the proceedings of the ward.

NEED FOR COLLABORATION BETWEEN EDUCATION AND SERVICE Considerable progress has been made in nursing and midwifery over the past several decades, especially in the area of education. Countries have either developed new, or strengthened and re-oriented the existing nursing educational programmes in order to ensure that the graduates have the essential competence to make effective contributions in improving peoples health and quality of life. As a result nursing education has made rapid qualitative advances. However, the expected comparable improvements in the quality of nursing service have not taken place as rapidly. The gap between nursing practice and education has its historical roots in the separation of nursing schools from the control of hospitals to which they were attached. At the time

when schools of nursing were operated by hospitals, it was students who largely staffed the wards and learned the practice of nursing under the guidance of the nursing staff. However, under the then prevailing circumstances, service needs often took precedence over students learning needs. The creation of separate institutions for nursing education with independent administrative structures, budget and staff was therefore considered necessary in order to provide an effective educational environment towards enhancing students learning experiences and laying the foundation for further educational development. While separation was beneficial in advancing education, it has also had adverse effects. Under the divided system, the nurse educators are no longer the practicing nurses in the wards. As a result, they are no longer directly involved in the delivery of nursing services nor are they responsible for quality of care provided in the clinical settings used for students learning. The practicing nurses have little opportunity to share their practical knowledge with students and no longer share the responsibility for ensuring relevance of the training that the students receive. As the gap between education and practice has widened, there are now significant differences between what is taught in the classroom and what is practiced in the service settings. Most nursing leaders also assert that something has been lost with the move from hospital- based schools of nursing to the collegiate setting. The familiar observation that graduate nurses can theorize but not catheterize reflects the concern that graduate nurses often lack practical skills despite their significant knowledge of nursing process and theory. Nursing educators know that development of technical expertise in the modern hospital is possible only through on-the-job exposure to the latest equipment and medical interventions.Colleges of nursing have tried to bridge this gap using state-of-the-art simulation laboratories, supervised clinical experiences in the hospital, and internships. However, the competing demands of the classroom and the job site frequently result in a less than optimal allocation of time to learn technical skills and frustration on the part of the nursing student who tries to be both technically and academically expert. The hospital industry has also recognized the need to support a graduate nurse with additional training. As a result, graduate nurses are required to attend an orientation to the hospital and have additional supervised practice before they can function independently in the hospital. The cost of orienting a new nursing graduate is significant, particularly with high levels of nursing turnover (Reiter, Li.n. Young, &Adamson, 2007). The challenge to nursing education is how to combine theoretical knowledge with sufficient technical training to assure a competent performance by a professional nurse in the hospital

setting. Clearly, a partnership between nursing educators and hospital nursing personnel is essential to meet this challenge.

MODELS OF COLLABORATION BETWEEN EDUCATION AND SERVICE

The nursing literature presents several collaborative models that have emerged between educational institutions and clinical agencies as a means to integrate education, practice and research initiatives (Boswell & Cannon, 2005; McKenna & Roberts, 1998; Acorn, 1990), as well as, providing a vehicle by which the theory -clinical practice gap is bridged and best practice outcomes are achieved (Gerrish & Clayton, 2004; Gaskill et al., 2003). Clinical school of nursing model (1995)

The concept of a Clinical School of Nursing is one that encompasses the highest level of academic and clinical nursing,research and education. This was the concept of visionary nurses from both La Trobe and The Alfred Clinical School of Nursing University. This occurred within a context of a long history of collaboration and cooperation between these two institutions going back many years and culminating in the establishment of the Clinical School in February, 1995. The development of the Clinical School offers benefits to both hospital and university. It brings academic staff to the hospital, with opportunities for exchange of ideas with clinical nurses with increased opportunities for clinical nursing research. Many educational openings for expert clinical nurses to become involved with the universitys academic program were evolved. The move to the concept of the clinical school is founded on recognition of the fundamental importance of the close and continuing link between the theory and practice of nursing at all levels.

Dedicated Education Unit Clinical Teaching Model (DEU) (1999)

In this model a partnership of nurse executives, staff nurses and faculty. This model transforms patient care units into environments of support for nursing students and staff nurses while continuing the critical work of providing quality care to acutely ill adults. Various methods were used to obtain formative data during the implementation of this model in which staff nurses assumed the role of nursing instructors. Results showed high student and nurse satisfaction and a marked increase in clinical capacity that allowed for increased enrollment.

Key Features of the DEU are Uses existing resources Supports the professional development of nurses Potential recruiting and retention tool Allows for the clinical education of increased numbers of students Exclusive use of the clinical unit by School of Nursing Use of staff nurses who want to teach as clinical instructors Preparation of clinical instructors for their teaching role through collaborative staff and faculty development activities Commitment by all to collaborate to build an optimal learning environment.

Research Joint Appointments (Clinical Chair) (2000) A Joint Appointment has been defined by Lantz et al. (1994), as a formalised agreement between two institutions where an individual holds a position in each institution and carries out specific and defined responsibilities.

The goal of this approach is to use the implementation of research findings as a basis for improving critical thinking and clinical decision-making of nurses. In this arrangement the researcher is a faculty member at the educational institution with credibility in conducting research and with an interest in developing a research programme in the clinical setting. The Director of Nursing Research, provides education regarding research and assists with the conduct of research in the practice setting. She/he also lectures or supervises in the educational institution. A formal agreement exists within the two organisations regarding specific responsibilities and the percentage of time allocated between each. Salary and benefits are shared between the two organisations.

The Collaborative Learning Unit (British Columbia) Model, 2005

In the CLU model, students practice and learn on a nursing unit, each following an individual set rotation and choosing their learning assignment (and therefore the Registered Nurse with whom they partner), according to their learning plans. Unlike the traditional one-to-one preceptorship-, an emphasis is placed on student responsibility for self-guiding, and for communicating their learning plan with faculty and clinical nurses (e.g., the approaches to learning and the responsibility they are seeking to assume). All nursing staff members on the Collaborative Learning Unit are involved in this model and, therefore, not only do the students gain a wide

variety of knowledge but the unit also has the ability to provide practice experiences for a larger number of students. Specifically, a Collaborative Learning Unit is a nursing unit where all members of the staff, together with students and faculty, work together to create a positive learning environment and provide high quality nursing care. The Collaborative Approach to Nursing Care (CAN- Care) Model (2006)

The essence of the CAN-Care model is the relationship between the nurse learner (student) and nurse expert (unit-based nurse), within the context of each nursing situation. The learner is responsible and accountable for engaging in the learning process and for taking an active role in establishing a dyadic learning partnership with the nurse expert. Unit-based nurses are experts in the work of nursing care. The work of the faculty is re-conceptualized as the creator of the environment to support learning and professional growth as opposed to the direct teaching of preselected content. In this model, the healthcare organization becomes an active participant in creating learning environments and contributing to the learning activities, as opposed to just being a setting in which college-affiliated faculty appear with students for a teaching encounter. In return, the college becomes an active partner in the professional development and retention of nurses at the practice facility.

COLLABORATION OF NURSING EDUCATION AND SERVICE IN INDIA We have two institutions which are practicing dual role, education & practice: NIMHANS, Bangalore CMC, Vellore. More institutions need to adopt this model. This will help improve the quality of Nursing Education with overall objective of improving the quality of nursing care to the patients and community at large.

Dual role model in NIMHANS

Following the amalgamation of 1974 resulting in NIMHANS, the faculty of the nursing department took up the dual responsibility of providing clinical services as well as conducting teaching programs. In 1975, all the Grade II nursing superintendents working in the hospital were designated tutors to maintain uniformity in the department. Combined workshops were conducted under the guidance of WHO consultant Mrs.Morril to prepare the tutors who came from Grade II Nursing Superintendent cadre for teaching purpose and to make the Lectures and

tutors associated with educational programmes (DPN course& 9-months course in psychiatric nursing) comfortable with clinical supervision. After both groups felt comfortable to assume the dual responsibility, the areas of supervision were designated. The Head of the Department of Nursing was given the responsibility for both the service and the education component of the department. Integration of education with service raised the quality of patient care and also improved the quality of learning experiences for nursing students, under the close supervision of teachers who were also practitioners.

Integrative Service-Education approach in CMC Vellore

College of Nursing under Christian Medical College, Vellore, where nurse educators are practicing in the wards or directly involving in the delivery of nursing services. This enables the practicing nurse to share her practical knowledge to the student nurse who is practicing in the concerned wards.

Government of India conducted a pilot study on bridging the gap between education and service in select institutions like one ward of AIIMS. The project was successful, patients and medical personnel appreciated the move but it required financial resources to replicate this process.

Strategies for Clinical Nurses Considering a Dual Role A clinical nurse is a nurse who is practicing in a clinical institution, such as a hospital. A faculty member is a nurse who is employed by an academic institution to teach nursing. If considering a dual role as both a clinical nurse and a faculty member, a critical care nurse will want to acquire a significant amount of information about the nature of a faculty position, the requirements and responsibilities of faculty members, and the day-to-day realities of a dual role. As clinical nurses collect information, they will be comparing their interests and abilities with the varying aspects of the faculty role, deciding whether a dual role is the right role at the right time for them The focus of faculty members is to facilitate the learning of students. Nursing faculty prepare licensed practical nurses (LPNs) and RNs for entry into the practice of nursing. Nursing faculty also teach in graduate programs at the master's and doctoral level, where nurses are prepared as APNs, nurse educators, nursing administrators, nurse researchers, and in other leadership roles. The NLN is an organization that oversees all facets of nursing education in the United States.

A main competency of the faculty role is described by the NLN as "creating an environment in classroom, laboratory and clinical settings that facilitates student learning and the achievement of desired cognitive, affective, and psychomotor outcomes" In past decades, faculty members lectured while students passively listened. However, in the current paradigm of education, faculty do not simply teach information but rather support students' learning. The difference between teaching and supporting learning is an important one that critical care nurses will want to explore as they consider a faculty role. For example, rather than lecture for 2 hours on hemodynamic monitoring, an astute faculty member will engage student in presenting "real-life" case scenarios along with hemodynamic monitor printouts. The faculty and students together will explore possible interpretations and propose decisions based on the data set. Alternately, the "real-life" hemodynamic case scenarios may be available on-line for students and faculty to review and discuss asynchronously. Clinical expertise is a necessary, but not sufficient, criterion for teaching nursing students. Expert critical care nurses may have the clinical knowledge to try a dual role if they are willing to learn the science of teaching and learning. Just as there is evidence required for clinical nursing practice, evidence also guides the teaching practices of faculty members. For example, research suggests that nursing students learn some skills best in simulated contexts. Therefore, faculty must now plan and use computerized patient simulation scenarios and actual simulators, along with branching logic software that may accompany nursing textbooks.

Advantages and disadvantages of dual role Advantages

1. Abundant learning opportunities. 2. Improves clinical competencies. 3. Professional recognition and status. 4. Variety and novelty in work 5. Gets authority both in hospital and educational instituition. Disadvantages 1. Requires atleast agraduate degree and competency in teaching and clinical skills.

2. Requires expert knowledge and skills both in nursing and in education. 3. Have to set firm boundaries on time and energy spent in both roles. 4. Can be overburdened with work;sometimes adversely affecting the teaching process.

Conclusion Many nursing service administrators believe that academic nurse educators, removed from the realities of the employment setting, are preparing students to function in ideal environments that rarely exist in the real and extremely diverse worlds of work.For preparing high quality professionals and to prevent the dilution of practice standards ,the faculty themselves need to be oriented to the actual clinical situations.So dual role is extremely important in nursing. All the models pursue collaboration as a means of developing trust, recognizing the equal value of stakeholders and bringing mutual benefit to both partners in order to promote high quality research, continued professional education and quality health care. BIBLIOGRAPHY Book reference Young E.Young, Paterson L Barbara Teaching Nursing 1st edition Lippincott Williams and wilkins.pp 523 Tomey Marrine Ann Nursing Management and Leadership 5th edition Mosby publishers.pp 201-220 Barrett Jean Ward Management And Teaching1st edition Konark publishers.pp 434-440 Net reference
www.nursesource.org/nurse_educator.html www.americannursetoday.com/article.aspx?id=7832&fid=7770