Auburn University College of Nursing prepared to celebrate National Nurses Week May 6-12

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For the first time ever, the Auburn University College of Nursing will celebrate National Nurses Week as a college.

Since its inception in 1979, nursing at Auburn has been a school. The university Board of Trustees agreed in February to reclassify nursing as a college. The School of Forestry and Wildlife Sciences and the Harrison School of Pharmacy were also renamed as colleges.

This year’s National Nurses Week is celebrated between May 6, National Nurses Day, and May 12, the birthday of Florence Nightingale, the founder of modern nursing.

The primary reasoning for the new classification is to signify growth. Auburn nursing moved into a new 89,000-square-foot building only five years ago because it had vastly outgrown Miller Hall. Back then, Miller could only accommodate faculty and administrative offices and limited skills and simulations labs. Classes were held across campus.

The new nursing building on the southwest corner of South Donahue Drive and Lem Morrison Drive houses offices, labs and classroom space, but it was designed to adjust for continued growth in faculty, students and programming.

Welcoming growth

Auburn nursing has been doing its part to address the national nursing shortage for decades.

With more classroom and faculty space in the nursing building, Auburn has been able to add additional faculty and enroll more students, with the hope of preparing more nurses for the workforce.

The college now has nearly 40 full-time faculty members and one part-time faculty member, including an associate dean for research, who is committed to increasing scholarship and research in the college. Three tenure-track faculty positions, each with a research focus, were added last year.

As nursing moved into its new home in 2017, the college was able to admit more students—110 to 115 twice a year—to its baccalaureate degree program. The COVID-19 pandemic, unfortunately, curbed the growth, forcing the college to admit approximately 100 students twice a year.

The dip was temporary, however, as the college now is back to pre-pandemic enrollment numbers.

Just five years ago, nursing offered two degrees: the traditional four-year bachelor’s degree and a joint master’s degree with the nursing school at Auburn University at Montgomery.

Since then, Auburn nursing has added an online RN-to-BSN program, aimed at assisting registered nurses, or RNs, who have an associate degree but want to further their education with a Bachelor of Science in nursing, or BSN. In 2020, the college created a concurrent RN-to-BSN, allowing students who completed Auburn’s prerequisites and started an associate degree program to concurrently take online baccalaureate courses and complete the BSN one semester after completing the associate degree.

The RN-to-BSN program has grown from five students in 2018 to more than 60 currently.

Auburn and AUM stopped administering the joint master’s program in 2017, allowing each campus to offer separate degree programs. For Auburn, this has meant offering a master’s program, with nurse practitioner and nurse educator tracks, as well as certificate programs for nurse practitioner and nurse educator. These options are administered via distance education.

Auburn has also added a Doctor of Nursing Practice, or DNP, which many consider a national solution for the long-standing need for enough well-qualified advanced practice clinicians, executives and clinical faculty.

In April, Auburn’s Board of Trustees authorized the college to create a new Doctor of Philosophy program. The new degree will support the increasing demand for professional nurses and nurse educators and address the health care needs across the State of Alabama and beyond by providing the advanced education and clinical experiences necessary to develop more strategic patient and population-centered care.

Unforeseen challenges

The COVID-19 pandemic impeded nursing’s growth because health care facilities limited or prohibited student placements for clinical experiences. The number of available clinical sites was lessening before the pandemic because of higher demand. More nursing programs with more students were seeking practice locations.

These circumstances meant Auburn would rely more on its state-of-the-art EAGLES Center. EAGLES stands for Engaging Active Group Learning Environments in Simulation.

The EAGLES Center is a simulation suite and a major component of the new building. It includes seven individual rooms designed to represent inpatient care areas, such as intensive care, labor and delivery, medical-surgical and pediatrics, and one community room representing a patient’s home.

Each room has an observation window, audio/visual capture and access to a central medication and supply rooms, as well as control booths.

“Simulation-based experiences are designed to achieve specific course objectives and program outcomes while allowing students to practice making real-time decisions in a controlled environment without the risk of harm to a patient,” said Caralise Hunt, associate dean for academic affairs and the St. Francis-Emory Healthcare Professor.

When COVID-19 restricted in-person instruction at Auburn, nursing faculty quickly pivoted. Videos of simulated patient-care scenarios were produced for faculty to facilitate small-group clinical learning. As students watched the recordings, faculty facilitated discussions about the next best step and potential consequences.

“This delivery format allowed students to continue making real-time decisions about patient care,” said Hunt.

COVID-19 restrictions are lifting as the endemic lessens, but many hospitals continue to limit the size of clinical groups. Pre-COVID-19, Auburn could send eight students per group, but now are allowed to send only four to six students per group. Nursing faculty continue to locate additional sites, but it is challenging.

Hunt said the clinical environment ideally provides students with a wide range of experiences, including practicing skills, exercising clinical judgment and interacting with patients, families and a health care team. However, the environment is unpredictable, and learning is episodic.

In the last decade, high-fidelity simulation has emerged as a leading strategy to ensure clinical education needs are met while posing no risk to patients. Hunt said simulation-based experiences allow faculty to ensure that all students receive hands-on experience with specific clinical scenarios they may encounter in the real world, without the risk of harming a human patient.

Simulation has and will continue to be an essential part of nursing education at Auburn.

New equipment

Auburn nursing used this year’s Tiger Giving Day to enhance its simulation equipment. Faculty sought to raise $123,000, its most ambitious goal to date, to purchase two birthing simulators and three medication dispensing systems. The college exceeded its goal and hopes to receive the new equipment later this year.

With fewer clinical sites, opportunities for nursing students to experience specialty areas such as labor and delivery are limited. The addition of two birthing simulators will replicate that experience and allow nursing faculty to run multiple scenarios at one time, doubling the number of students who can attend each session.

Faculty will integrate the new medical dispensing systems into simulation experiences, allowing students to practice administering medications and create a foundation of safe patient care.

Hunt called a medication dispensing system “an essential component” in training nursing students for everyday clinical practice. Medication safety procedures are critical to patient safety and care.

“Integration of the medication dispensing system into simulation-based experiences will allow students hands-on practice administering medications to build a foundation of safe patient care,” said Meghan Jones, associate clinical professor and EAGLES Center director.

Also, the college intends to add virtual reality, or VR, equipment this year. Associate Clinical Professor Tiffani Chidume said utilization of VR can serve as an additional layer of practice and repetition for essential psychomotor skills and procedures taught at Auburn. Psychomotor skills in nursing include taking blood pressure and inserting an intravenous line.

“Additional practice for psychomotor skills using VR can help ‘bridge the gap’ between the current allotted lab time and clinical experiences,” she said.

The plan is to have open practice lab times with the VR equipment, allowing students structured practice to develop skill proficiency and mitigate the decay of fundamental skills.

“Creating the most realistic student experiences is our ultimate goal in simulation and skills,” said Chidume. “The benefits extend beyond skill mastery, improved communication and increased interdisciplinary teamwork, as these interactions occur in a safe and replicable environment. This leads to reduced clinical errors and greatly improves patient safety for both acute care and community health needs.”

Adjusting strategies

The pandemic also brought telehealth to the forefront. When patients were unable to visit a health care provider, providers used telephone or video capabilities to provide virtual care to patients.

Auburn’s undergraduate nursing students participate in mental health telehealth simulations with nursing students at Southern Union State Community College.

“This experience prepares our students to communicate in a simulated environment to assess and identify community resources to assist the person dealing with mental health issues,” explained Hunt.

Master’s students in the primary care nurse practitioner courses are introduced to telehealth in multiple modalities. Simulation exercises introduce these students to both video chat and telephone telehealth encounters.

“This provides real-world experience of emerging health care technologies and delivery modalities,” said Rachael Sweeney, assistant clinical professor and nurse practitioner coordinator.

Interprofessional education has always been a major component of Auburn nursing, but it has gotten more prominent in recent years. Hunt called interprofessional collaboration “crucial for optimal patient outcomes.”

“Health care professions are seeing the importance of these collaborations and increasingly including them as a requirement of professional health care programs,” she added.

Nursing students in their fourth semester attend an interprofessional education community clinical with students from pharmacy, social work, nutrition and the Edward Via College of Osteopathic Medicine. The interdisciplinary student team plans care for clients with complex needs at clinics, primarily in rural areas.

Hunt said the experience facilitates development of students’ communication and collaboration skills.

These students also participate in two robust interprofessional simulations: a poverty simulation and a disaster simulation.

At the beginning and end of each simulation, students complete a survey.

“Results have consistently shown students’ perceived improvement in confidence, collaboration, communication and teamwork in working within interprofessional teams,” said Hunt.

Another interprofessional experience involves fifth-semester nursing students participating in a virtual simulation with Auburn’s speech language pathology students during which students observe pre-recorded nursing care of a patient requiring nursing and speech and language interventions. Faculty from both programs facilitate collaboration among students throughout the virtual experience.

Around campus and beyond

The animal-assisted therapy program, called Canines Assisting Rehabilitation and Education, or CAREing Paws, in nursing has grown tremendously since its inception in 2010. Associate Clinical Professor Stuart Pope taught eight nursing students in the initial class. Now, the elective course is open to other majors across campus, and it fills to capacity every semester.

Pope used to share his office in Miller Hall with the program’s dogs. In the new building, Miller, CHOA, Daisy and Tucker get their own space across from Pope’s office.

Pope was the only instructor until 2016, when Assistant Professor Morgan Yordy joined the faculty with experience working with animal-assisted therapy teams.

Recently, with more students in the class each semester and fewer clinical sites to visit, Yordy created a simulation experience involving animal-assisted therapy, allowing students to practice visiting patients in hospital and home settings.

During the pandemic, when students couldn’t visit patients in clinical settings, Pope and Yordy went to specifically provide much-needed therapy to clinic staff, who were experiencing high stress and burnout.

“Our dogs have not been able to visit with patients in clinical settings due to COVID-19 restrictions, but we hope to get back to that in the fall,” said Hunt. “They are visiting more places on campus, however, including the colleges of engineering, sciences and mathematics and business, as well as other student events on campus. Their motto is, ‘have dogs, will travel.’”

As a land-grant institution, outreach is fundamental at Auburn. Beyond campus, the College of Nursing currently has 31 projects in rural Alabama. Faculty, staff, undergraduate and graduate students and community partners reach nearly 20,000 individuals each year.

In 2021 alone, nursing connected through screenings, education, vaccinations and community initiatives targeting health disparities and improved access to care to meet the needs of 19,776 individuals.

Next steps

The pandemic positioned health care workers and Auburn nursing alumni on the front lines of the battle against an unknown foe. Auburn students saw this and were not deterred. Like nurses in the field, students learned to adapt.

They adapted and they succeeded. More than 90% of the Class of 2021 had a job at the time of graduation. They also achieved a 97.78% NCLEX pass rate.

The NCLEX, or National Council Licensure Examination for Registered Nurses, is a national exam to determine competency and preparedness to enter nursing practice. All state boards of nursing across the United States use the NCLEX as a requirement for licensure.

Auburn nursing boasts a three-year NCLEX pass rate average of 98.56%, the highest in Alabama for baccalaureate nursing programs.

“Students have many reasons for wanting to be a part of Auburn nursing,” said Hunt, “including the high NCLEX pass rates, a reputation of excellence, the variety of clinical experiences in different specialty areas and locations, faculty and staff who are committed to student success and job placement at graduation.”

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Auburn University is a nationally ranked land grant institution recognized for its commitment to world-class scholarship, interdisciplinary research with an elite, top-tier Carnegie R1 classification, life-changing outreach with Carnegie’s Community Engagement designation and an undergraduate education experience second to none. Auburn is home to more than 30,000 students, and its faculty and research partners collaborate to develop and deliver meaningful scholarship, science and technology-based advancements that meet pressing regional, national and global needs. Auburn’s commitment to active student engagement, professional success and public/private partnership drives a growing reputation for outreach and extension that delivers broad economic, health and societal impact.