Teaching Nurses

Caroline Mosca, Assistant Professor of Nursing at The Sage Colleges in the Albany area, has been teaching undergraduate nurses for 11 years, first in an Associates Degree program and then in Sage’s BS of Nursing program. She holds a BA in English, a BS in Nursing and an MS in Nursing Education and is in the process of completing her PhD at CUNY Graduate Center.

Professor Mosca introduces new students to basic nursing theory and also teaches more advanced classes for third and fourth year students, including a senior-level “capstone” program focused on transitioning to professional practice where each student is paired with a hospital or community-based nurse who acts as preceptor for 240 hours of hands-on experience.

NYN: What brought you to nursing?

CM: I was a high school English teacher for seven years, pursuing my Master’s Degree in English. I was halfway through when I decided it was time for a change and switched over to nursing. When I graduated, I was an oncology nurse. But I still had some teacher in me and served as education coordinator on my unit. I went back to school and got a Masters in nursing education and eventually took a faculty position. Nursing education has brought my two passions together.

NYN: What’s the biggest challenge facing today’s nursing students?

CM: The disconnect between academic studies and clinical practice. Clinical practice is much more fast-paced and demanding than the classroom. When new nursing graduates start working, too many leave their jobs within the first year because they are not equipped emotionally to deal with the realities of our over-burdened healthcare system. We lose nurses because we haven’t properly managed their expectations; we throw them into the pool with no life vest and expect them to swim.

This premature attrition exacerbates the nurse shortage. Schools need to find ways to help improve retention in the industry. At Sage, we try to address this through the senior capstone program. We have to find ways to help new nurses maintain the altruism and idealism that led them to the profession while making sure they don’t burn out while they develop the coping skills needed to thrive in a challenging environment.

NYN: How do you teach big picture healthcare issues like climate change?

CM: I try to weave the full range of issues into all my classes, from global to local. For example, whenever the Institute for Medicine comes out with a new report, we’ll discuss it. One of my recent students was drawn to nursing out of concern over human trafficking and focused her research on that topic. We see this type of focused interest particularly in older students or those from other cultures. Many of those from abroad tell me, “I want to go back and help my country.” With the education they receive here, they’ll be able to return home and work in a pretty advanced capacity.

We spend a lot of time in my classes talking about the changes taking place in the healthcare system — things like affordability, access, and community health. Particular focus is put on raising awareness of healthcare disparities; discussions are woven throughout the entire curriculum. We talk about what needs to change in order for nurses to deliver the safest, highest quality patient care.

NYN: What’s the status of the nursing shortage in New York?

CM: There’s still an overall shortage but the degree differs by geography.

NYN: What’s standing in the way of educating more nurses to meet demand?

CM: Demand for nurses is expected to grow with an aging population. For now, nursing schools simply cannot produce enough grads fast enough. At Sage, we’ve doubled our enrollment from ten years ago to its current level of 300 students and we still feel like we can’t keep up. There are three reasons for this. First, as already mentioned, some new nurses don’t make it through their first year of hospital work. Hospitals have to work on improving retention of new nurses.
Second, many of today’s grads aren’t taking the traditional route of beginning their career as a bedside nurse; some are going straight through to earn a higher specialty like nurse practitioner or certified registered nurse anesthetist. NPs and CRNAs are in high demand and sorely needed, so there’s no downside. It’s just that we’re in a predicament where we already can’t produce nurses fast enough and some of those that do come out either leave too soon or aren’t going into the traditional nursing roles.
Finally, even if they wanted to, nursing schools can’t just decide to open their doors to more students because there’s a shortage of nursing faculty. We simply can’t educate more students without more faculty.

NYN: What distinguishes today’s nursing students from those of twenty years ago?

CM: Nursing programs have become more competitive as more students are drawn to the field. It’s tougher to get into a nursing program now and we’re seeing more non-traditional students. The heightened public dialogue about healthcare over the last decade has impacted nursing education; it’s brought a more culturally diverse and qualified pool of students into the mix.

NYN: Any final advice?

CM: If we want our new nurses to change the world, need to talk about how to be an advocate for change. In an industry as big as healthcare, change can happen, but it will be slowly. Young nurses need to be taught how to not become overwhelmed by the day-to-day frustrations that they face on the job. Nursing offers extraordinary rewards if you stick with it. NYSNA sisters and brothers, train your new nurses to advocate for change in their workplace, in their community and in their world!

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