Episode 25: What it’s like to be a nursing student in 2020
Episode 25: What it’s like to be a nursing student in 2020
Listen on your favorite appEpisode 25: What it’s like to be a nursing student in 2020
Dan:
Welcome to the show, Andrew and Caeli.
Andrew:
Hi.
Caeli:
Hi.
Dan:
Let's start off and get some intros going here. So Andrew, tell us a little bit about yourself.
Andrew:
I am in a combined ADN and BSN program through Modesto Junior College and California State University Stanislaus, so I'm dually enrolled. My adventure in nursing leadership kind of started on accident. I got nominated to be class rep for my cohort, and went up there and kind of gave a speech that if I got elected to the position, I'd like to start a chapter of the California Nursing Student Association at my school. And so they elected me, and then next thing I knew, I was the president of the California Nursing Student Association. And it's been a wild and crazy ride, but I'm lucky enough to have someone like Caeli to kind of share the leadership responsibilities and the dream with, and so I'm pretty lucky there.
Dan:
That's awesome. And Caeli, what about you?
Caeli:
Hi. So I actually am a nursing new graduate. I graduated from Sonoma State University's pre licensure BSN program in May, and I got my license in July. I'm very similar to Andrew. I started off as a class representative over at Sonoma State University, and then I ended up here as the vice president working with Andrew. It's been really great. CNSA has given myself, and I'm sure Andrew would agree, lots of opportunities to explore things outside of just what we're learning in the classroom and in clinical at nursing school and it's really exciting.
Dan:
I love what you guys are up to. We've chatted a few times now about some of the initiatives that you're working on with the organization. Can you tell me some of the kind of the three top areas where the California Student Nurses Association is really focused on?
Andrew:
Yeah. So this year is totally unprecedented in nursing in general, and that definitely goes for students as well. So I think that the number one issue that we've been focusing on is the response to the COVID-19 pandemic. Our organization was a key player in really working with the thousands of nursing students that spoke up really collectively for the first time in a long time, kind of if ever, from what I'm understanding, and being a voice in legislature. And it was really a driving force in the waiver for the DCA signed by Governor Newsom that allowed the change in the 75% direct care hours requirement down to 50%, so that nursing students who were displaced from clinical were allowed to reduce the time that was required to graduate and move onto the next semester down to 50%, so that we could do online simulations, and then therefore be able to either move on to the next semester or graduate. We've also, Caeli, I don't know if you want to talk about the Black Lives Matter subcommittee.
Caeli:
Yeah. So that was another thing that again was not in the plan for what we were going to do this year, but that plan kind of got thrown out the window mid February anyway. And that is when we started seeing this huge civil rights movement that began early in the summer. We felt that as an organization with our influence and with our connections to healthcare industry, which is a big player in equity and in racial justice, we felt that it was our responsibility to step up and to use our voice to support this movement, to support the furthering of equality, and also to shed light on the disparity that is in our country.
Caeli:
Now we talked a lot about disparities in how people experience policing, but also another hot spot for that is unfortunately healthcare. And healthcare disparities for minorities is huge, and taking a look at those issues and taking action to support the black community and other communities of color.
Dan:
So I love both of those, and it's really important because it ties right back to our professional obligation as nurses. Right? I mean, I think you basically pulled pages from the code of ethics right there, diversity, equity, inclusion in healthcare, advocating for the professional. I mean, you're living the ANA code of ethics, which is really cool. And so let's dive into those a little bit more. So the first initiative, Andrew, that you talked about was having to flip nursing school, or what we know nursing school is, into something different due to COVID. But I'd love to hear your thoughts on: How's nursing school going? I mean, I'm 15 years out, so it's probably very different. I think simulators were still in the closet. My senior project was to bring sim man out of the closet and program him and get him into a code, and that was about as much simulation as we did. So I know it's changed a lot. But I'd love to hear. Kind of what's the current state of nursing school? And then what specifically changed with COVID that kind of shook everything up?
Andrew:
The state of nursing school, it's not uniform right now. It completely depends on where you are at. I know that in my nursing program specifically at Modesto in the Central Valley, we were very fortunate in that we were only displaced from clinical for like a minute. And our fourth semester students were allowed to stay in so that they could finish their preceptorships and graduate. This was not the case in many nursing programs through California. I just a couple weeks ago got my clinical assignment for which hospital I'm going to be working in next semester. And today, I was just talking to someone from San Diego State, who starts on the same day as I do for this semester, and they have no idea if they're going to be in clinical or not, therefore, they have no idea if they're going to be graduating on time or what that's going to look like.
Andrew:
Nursing school has also become very much online, which is interesting because we're kind of in this position where we have to make exceptions for certain things that normally wouldn't meet the gold standard for what the Board of Registered Nursing thinks is acceptable for accreditation. And thanks to the DCA waiver, we have a little bit of leeway. But except for the clinical component, a lot of programs have moved exclusively online. And that includes the simulation part, which is also now being counted for clinicals. So we're dealing with these online simulated, real life, or they're based on real life patient experiences, where we're taking care of a patient. We're completing a full physical assessment on this digital patient, or multiple patients, and put in these situations where it's not as, obviously, as cohesive to learning as being on the floor taking care of a real patient. You can't ever substitute that, but it gets really close. And that's a really positive thing that we're being able to benefit from.
Andrew:
As far as the moving online, that's included a lot of challenges. I think for nursing students and I'm sure from what I've heard from my own faculty, as well as other faculty members, it has been quite the challenge transitioning programs that used to be almost exclusively online, at least for the generic portion, like the med surg portion, that was very much an in class part of nursing school, is now moving online, and what that means for the curriculum component. And so that's been interesting as well. And we're just essentially, it's all an unprecedented experiment, and we are the guinea pigs, and there's really no way around it. So we're all just doing the best we can to employ the F word, flexibility, which is a big thing in nursing school. And I think that we're just doing the best we can.
Dan:
Now you bring up some good points. And one of the things that we've talked about on this podcast before is that crisis breeds innovation. And I think in general, nursing school needed kind of a kick in the pants to upgrade itself a little bit. Caeli, you may be able to talk to that a little bit. But this might be the kick in the pants that actually modernizes some of nursing education. Not that we want to go fully online and not touch people, but some of the online aspects, the different ways of learning, the online simulation, I think all of those set an interesting foundation for content to build off of when in the past, we've had this assumption that clinical experience and being on the floor is the best way to learn.
Dan:
But we look at the data on that, the varying levels of engagement a student nurse has on the floor with a preceptor is really variable, depending on the location of the preceptor and all these other factors. So if we can standardize some of that baseline education and then jump off of it, put nursing students into clinical with a great standardized baseline, it may even be better than what we were doing in the past. But Caeli, I'd love to hear your thoughts on that as recent graduate.
Caeli:
Yeah. So like I said, I graduated in May, so the second half of my last semester was crunch time, pretty much. And this was definitely the biggest shift in my nursing education. Let's be honest, it was not the first. My nursing class had the very unique joy of in our time in nursing school, we had two wild fire evacuations in different years. We had the PG and E rolling power outages. And then we capped it all off with a pandemic, so our nursing school experience was very much the crash course in flexibility.
Dan:
And crisis nursing.
Caeli:
It was pretty much just crisis the whole way. But I definitely agree that I think it is time for nursing school to take a look at itself and be really intentional with how it's using its time, if that makes sense. The model that my school used, it was two days a week, we have lectures. And then two days a week, we have clinical. And like you said, depending on which nurse you were with, we were with a different nurse every day because it wasn't preceptorship, it was clinicals, so it was just whoever would take you. And so I can definitely say that there are people within my own cohort that had vastly different experiences of nursing school from one another, just based on how things went.
Caeli:
So I would love to see a little bit more standardization, a little bit more intention with lesson planning, and especially moving from class to class. That was a big thing for me personally. I don't know if there are others who have this experience, where one teacher was like, "Oh, I'm not going to cover this in this class because you'll learn it next semester." And then we get to next semester, and the teacher's like, "Okay. Well, you learned this in the last class, so I'm not going to cover it. Let's move on to the next one." We were all like, "Wait. What? Did we miss something? Where was that supposed to be?" So I think that was the biggest thing, everyone, every educator was kind of in their own little bubble of their specialty or their lecture, and there wasn't a whole lot of cohesion across the program.
Dan:
Yeah. That's a good point. I was on the curriculum team for the Kaiser Permanente School of Medicine, which just opened on Monday. And that was one of the gripes of medical school and my experience at nursing school too was, yeah, you'll learn that next semester, and then they never talked to that next semester faculty, and so there were gaps in what you should've known and what you were supposed to do. And one of things we did with the med school was we actually spiraled the curriculum, which means every single faculty member was intentionally building upon the other, which was very different model that I think what healthcare education does now.
Dan:
And I was just thinking as you were talking, my OB clinicals were literally me staring at a fetal monitor at the nurses' station and never going into a room. I don't know, Andrew. I don't know if that's a male nurse experience, or the hospital I was at, or what-
Andrew:
That was [inaudible 00:11:28] you. I ran in there. I wanted to learn hands on.
Dan:
I think I actually got to see one birth. And then I ended up failing that test, the OB test in that class, just because I couldn't relate all the things together without seeing it together. So definitely we have challenges, and I think there's new learning science. So I'm interested. Did you guys use any outside tools to help with your nursing education? There's platforms like Khan Academy, Osmosis is another one. And nursing.com is another one where they've built kind of custom content around nursing school that's maybe a little bit more digestible, maybe a little bit more relevant than some things you're getting in class. I wonder if you guys use that tool. Andrew, do you want to start?
Andrew:
Sure. So until COVID-19, for my program, which is a pretty, it tends to be a little bit more old school in its philosophies. The only thing that we used was ATI, and that was just for skills. We would go through the different skills before going into skills lab, and then before seeing it demonstrated by instructors on mannequins. Other than that, we did standardized predictor testing. We did standardized predictor testing through Kaplan, and that was pretty much the only online component until more recently, we've moved to the i-Human software, which is the simulated experience that I was talking about earlier.
Dan:
Caeli, what tools did you use?
Caeli:
I was an Osmosis gal. I watched Osmosis videos a lot. I also watched Cathy Parks, who is a nurse who's on YouTube. And she made YouTube videos going through the content to study for ATI tests. But then I think ATI got mad and told her to cease and desist. So now she does more general nursing.
Dan:
Quote, unquote.
Caeli:
Videos, not specifically about the ATI content. What I liked both about Cathy and about Osmosis is that it really, it was very digestible. You could watch the five or seven minute video, and then take a break or do whatever you want, and it just really focused in on the specific topic and went through it. And with Osmosis, there was visuals, which was nice because then you got the visual and the audio at the same time. And it just really felt more like someone was sitting there explaining it to you, as opposed to when there's a lecture, and it's all the students in a room trying to get through however many slides before it's the end of the class.
Dan:
Right, the good old, got to finish all 55 slides before you can leave kind of thing. Yeah. Well, and that just brings up the point, there's just better ways to teach. And there's more science on learning that may not mesh with the ways we've done it in the past. You remember about 10% of what you're lectured to, but if you engage with that content, and you revisit it every day, you can retain up to 80%, 90% of it. So I think that's that upgrade that we need with the education system. But you're both about to enter the workforce. So Caeli, you just passed the NCLEX, super duper congratulations on that one. And Andrew, you have a semester left, and you're going to be joining. And so what are you feeling about the workforce? How is the job search going, Caeli? What are you seeing out there as you begin to find your first role as a registered nurse?
Caeli:
I have no basis of comparison. You know this is the only time I've ever been a new grad nurse, so I don't know what it's been like in past years and how much is the pandemic layering on top. But it's difficult, for sure. Some of the ways that the pandemic specifically is affecting it is a lot of hospitals are on hiring freezes. And I think because the hospitals don't necessarily know how the situation is developing, I mean, none of us really do, there's not a whole lot of communication. One of the prime examples, an experience I had just a couple weeks ago was a very big health system, Kaiser Southern California opened new grad programs at five different locations, I believe. Opened the applications, and of course, it's Kaiser, everyone rushed in to apply.
Caeli:
And about a week later, they canceled all of the positions because they had gone back on a hiring freeze in response to what I'm assuming was the spike. So that's what I'm running into a lot is these hiring freezes, and then of course the hospitals that are still hiring new grads become much more competitive because in what I'm assuming past years, the potential workforce, I should say, was spread out among these different opportunities. There are fewer, and so now everyone's trying to go into these specific hospitals. It's not a fun time, but-
Dan:
It's fun and stressful. Right? It's like the opportunity to do something great and be at somewhere you want to be is pulling you. And then the logistics of applying and hoping and waiting and communication is dragging you backwards.
Caeli:
Yeah. I really wish that new grad nursing jobs worked the same way that the Common app did in college. When everyone was applying, you could just go into the Common app and fill out one application and it sent it off to all the different schools. I really wish it was like that because now I'm just stalking job boards like a creepy little hermit and just being like, "Where, where, where's the job?"
Dan:
Yep. Well, let's continue that conversation outside the podcast because we have some ideas on how we might support that in the future, and we might need you as a subject matter expert. Andrew, still in nursing school, looking ahead to the very near future. What's top of mind for you as you finish out nursing school and search for your first role?
Andrew:
There's a new trend being seen right now in nursing education, where you have these RN to BSN programs. Right? And they're now, especially in California, we're seeing more and more of dual enrollment, which is the program I'm in right now, where I'm taking my ADN classes at the same time as my BSN classes. And essentially, I'm going to be finishing with my BSN in the same amount of time that it would've taken me at the same schools to do the standard pre licensure BSN track for a lot less money. So I actually, at the time I got into nursing school, was accepted into both the ADN and the sequential enrollment program, which is what I ended up taking because there was no way I was feasibly going to be able to afford the BSN directly without taking out a substantial amount of loans that I don't even know that I would've qualified for. So it was kind of like, "Yes, this is great."
Andrew:
I got into this program. However, now that I'm approaching my last semester of the ADN program, one of the big things is, well, for that last year, I'll be working as an RN when I'm only paying the university price because for right now, all the university classes are covered. They're paid for in the program I'm in. So now that it's time for me to start looking for nurse jobs, I don't qualify for a lot of residencies because a lot of them are, especially in California, they are only accepting BSN applications. Or at least that's what they say on their websites. Right?
Andrew:
And so then what a lot of the graduating class ahead of me, which is only the first graduating class in the program that I'm in of the sequential enrollment program, is that some of them did apply to the jobs that were BSN minimum. And they were granted interviews, and a couple of them were given positions because some of the hiring managers have leeway in that, I guess, policy, making process of who they can and cannot hire. So a lot of us are unsure as to what the standard is for that. And a lot of us don't qualify for these positions because we're technically ... We still have eight to 12 months after we graduate with our ADN and get our license that we still have to finish that last year of the BSN program. So we don't qualify for a lot of these residency positions.
Andrew:
But here's the double, the catch-22. Right? So the nursing residency positions almost across the board are like, "Must have 12 months or less of experience in order to apply," so by the time we finish the BSN program, that's exactly 12 months of experience. We also can't qualify for the residency. And if the whole point is to obtain magnet status, we're already helping you meet that requirement because we've signed a contract stating that once we finish the ADN program, we can't just back out and say, "No, we're an RN now. We're not going to finish the BSN." No, we have to finish the BSN. And we have a lot of experience that we bring to the table, especially in I think the community college setting. You get a lot of people that are going into nursing as their second career, or going for their second degree.
Andrew:
We have people in my class that have degrees from UC Berkeley, Cal Poly, and from whole bunch of different places. And they're on their second career. And we have a lot of experience we could bring to the table in these positions, and we just were not given the same opportunity as people that were able to afford the four year BSN track.
Dan:
Yeah. You bring up a good point there. And I think it's unclear for the healthcare systems as well. I think people have cited this 80% of their nursing workforce needs to have a bachelor's degree as a magnet requirement. And it's not an official magnet requirement. It's kind of an unspoken magnet requirement. And it keeps staying in this pending status like, "Well, it might be a requirement next year, so you might as well plan for it." But it's never really been instituted, and so every health system is like, "Well, if I want to go for magnet, I can only hire BSN. That's our thing."
Dan:
And I think you're right. There are other situations where there's even more experience with ADNs, especially in the second degree program students. Or similar to your situation, where you're on the track to get your bachelor's within 12 months of graduation, so it's already happening. Why not pull you in and engage you? Right? And then you have it, and it's done and it's over. You don't even have to convince you to do it. It's already happening. And we kind of gloss over that requirement. It's kind of silly.
Andrew:
It is. And I think that the only difference is it really kind of boils down to what program you can afford to go into. If I had known that this was the way it was going to be, if I would have gone with the program I'm in, although there are a lot of great benefits to the program, there are a lot of really great residencies that I wish I could apply for that I just can't.
Dan:
Well, you should still do it, and then let me know how I can help you.
Andrew:
I'll keep you in the loop.
Dan:
Don't be afraid of applying and being that one diamond in the rough too. So Caeli, as a new grad, what do you wish nurse leaders knew about new graduates and how they're searching for jobs, or what they're looking for, or what support they would need to find their first role as a nurse?
Caeli:
I think the biggest thing that I want nurse leaders to know is not to discount the new grads. We're scrappy. I feel like I'm always sort of explaining. People are asking, "Oh, well, wouldn't they want to hire all the nurses, all the help they can get?" And I'm always sort of explaining like, "Well, they're kind of hesitant to hire new grads because residencies take time and resources." And I completely understand. When you're in a global pandemic, you don't want to be taking any resources away from patient care. But I think, yeah, we're new. We're still finding our feet. We may be a little slower at first, but we're scrappy. We've been through a lot. Nursing students, especially in California the last few years, we've been through a lot. And we have learned from that. We've learned to adapt. We've learned to be resilient. And we're ready. We're eager, so take the chance on us. I think that we will really surprise y'all in a real good way.
Dan:
I agree. I think new nurses are the catalyst for change and innovation within health systems. You bring the best evidence, the latest skills. And I think organizations that aren't planning for a newer generation of nurses in their system are going to lose out pretty quickly when people decide they're going to retire. And at some point, some of these big health systems have up to 50% of their workforce is eligible for retirement or early retirement, and that could all hit at once. And they won't have anyone trained and ready to fill those needs as they come up. So I agree with you, I think take a chance on the new grads. It's an amazing population of people to bring into your system.
Dan:
So switching gears a little bit, kind of wrapping up. I know you guys talked about your work with diversity in nursing and the social unrest and Black Lives Matter. I'd love to hear how your organization is thinking about that and what specifically you're doing to advocate for that movement.
Andrew:
So one of the big things that we're going to be talking about here at our next board meeting is the California Assembly Bill 890, which is the nurse practitioners scope of practice legislation that would essentially allow nurse practitioners to practice autonomously without supervision of the physician. And I think that this really meets a lot of needs in nursing for providing care to underrepresented populations or underserved populations, who experience a lot of barriers to healthcare, especially in primary care, which is what a lot of nursing students, I would say almost half, want to eventually go into nursing practice and have that desire to break down those walls that are barriers to healthcare.
Andrew:
And I think that's our next big step. It's nice that this is kind of going into the end of our terms, this is the last kind of big thing that we're going to do because not only is it such a historic thing to take a position on for the history of nursing in California, but it really answers a need of a lot of the issues we've seen across the board, not just within diversity in nursing and meeting the needs of marginalized patient populations, but also meeting needs for COVID-19 and patients that don't have access to healthcare for all kinds of reasons.
Andrew:
And essentially, it meets our core values as an organization of advocating for the profession and for the advancement of the profession. And I think that nurse practitioners having that autonomy, it makes a huge statement about the nursing profession. And so I'm excited that's the next step that CNSA is taking in not just meeting the needs as far as diversity in nursing and what we were really hoping to accomplish. But it just kind of covers a lot of bases there, so that's kind of where I'm at right now as far as next steps.
Caeli:
And also some step that we already have taken is, you wouldn't think this would be a big thing, but we put out a statement in support of the Black Lives Matter movement. Historically, CNSA had not made sort of political statements of that kind, so that was a big step for our organization. We also are piloting a program where we are going to sponsor seven black nursing students and cover their registration and membership fees for the Black Nurses Association. So seven students, one for each of the chapters that are present here in California. We voted to allocate a financial contribution to one of the organizations that is supporting the black community, whether it be Black Lives Matter itself, or there's also some really great organizations, bail funds, and lots of different things. That's something we are looking at in the future, actually, is screening those organizations. We've voted to allocate the finances and we need to vet the recipients and see where that money is best served.
Caeli:
We also created a Black Lives Matter task force within our own board. And we brought in a non board member, a nursing student, who is very passionate about Black Lives Matter. She's doing some great work with that. So those are some of the things that we are doing. And we are definitely committed to continuing to support this community and this cause in the future. And it'll be a big part of our handoff to the next board when we switch over in October.
Dan:
That's so great to hear. And I'm so excited and in awe of the maturity of your engagement with all of the things, with assembly bills that are changing the future of our practice, and actually upgrading California out of the dark ages, which I think it's one of the states that's been lagging for a long time in regulation related to our practice, which you know. I wish SB bill 1053 I think would've passed and made us a compact state, but that didn't. The next best thing will be if we can get nurse practitioners independent practice. That would actually upgrade us. We can be like the states all around us. And so I'm super excited to hear what happens with all that, and glad you're engaged in that. And that's the future of our profession. You're building it, and I'm just so proud of that.
Dan:
So you mentioned a handoff to the board, but one of things we do on the podcast is also hand off those pearls of information to the listeners. So Andrew, I'm going to call on you first. What is one thing you'd like to hand off to our listeners about CNSA or being a nursing student?
Andrew:
Absolutely. So if you're listening to this, and you're a nurse leader, whether you're a nursing faculty member, or an administrator in a hospital, or in whatever role that you're in, please engage nursing students and new nursing graduates in shared governance, not just because it's a box to check of your requirements to meet whatever standard that may be, or because you have to. Do it because you actually want to listen to what nursing students have to say because I think one of the underlying themes here that Caeli and I are trying to put out there is nursing students and new grad nurses have a lot to contribute. We're not fresh out of high school. We're not totally green. We bring a lot of live experience and knowledge to the table, and maybe that's non nursing related, but maybe that's valuable too.
Andrew:
I think that there's a lot of value in making everyone feel like their ideas are worth hearing. And I am happy to talk more. I could talk about shared governance all day. And if you have any questions, or ideas, or you want to continue that conversation, and if you're listening to this, I'd encourage you to reach out to me because I have lots of ideas. So on that note, I will hand it over to Caeli.
Dan:
Yeah. Yeah. Caeli, what's your handoff? That was great, Andrew. Thanks so much. And shared governance, agreed, is a great place to include all the diverse voices. Caeli, what's your handoff?
Caeli:
My handoff is sort of again what I said earlier about being intentional with the way that nursing school's being taught and what we're teaching in nursing school, and more specifically in light of some of the things that we're having to examine now because of the Black Lives Matter movement. How are nursing schools teaching diversity? I know pretty much every nursing school is going to say, "Cultural competency, cultural humility," whatever word or phrase you want to use. But what does that actually mean? What are you actually teaching your nursing students about the communities that they are going to go on to serve?
Caeli:
I think one of the things that came to my attention, and it was sort of like an oh my gosh moment for me, was in all of our textbooks and all of our lecture slides, whenever we were talking about derm, or rashes, signs of disease that involve skin, or the conjunctiva, whatever, it's white skin. And there's a black medical student who was actually publishing a book, I don't know the name of it off the top of my head, but it is full of photographs of what these diseases look like on black and brown skin. And I've seen some of the pictures. It is wildly different than what we were taught. So what we were taught to look for and recognize as this looks completely different on black skin than white skin. And that's just one example that I've become aware of recently. I'm sure there are many more. So just really taking a look at: What are you teaching? How are you teaching it? And is that going to serve all of the communities that we are going to be caring for?
Dan:
Yeah. So double down on the diversity and walk the walk. Get the different content in there. Yeah, great. Great advice, both you. If people want to learn more about your organization, or just connect with you both in general, where's the best place to find you, Andrew?
Andrew:
I can be found at the following email address, which is P-R-E-S, [email protected]. Or you can visit our website at www.cnsa.org. And Caeli, I don't know if you're the same.
Caeli:
Yeah. You can reach me, at least until October, at [email protected]. And we also have an Instagram for all of you social media gurus out there. It's @cnsaofficial. All in lower caps.
Dan:
What about Tik Tok?
Andrew:
That's in the works. We were just talking about that with our communications committee last night, so we're one step ahead of you.
Dan:
I love it. And then are you both on LinkedIn yet?
Caeli:
Yes.
Dan:
Andrew, I would make a big push just from my personal experience to get on LinkedIn and build your profile. I know it's not super great for staff nurse jobs, but it definitely links you in with some really cool leaders and connections that may help in the near future.
Andrew:
I'll get working on that right away then.
Dan:
Awesome. Well, I really appreciate your time on the show today. Thanks for all the insights from a different perspective that we don't usually hear. And I'm excited to see where you're going and where the organization's going. And we're big fans here at Trusted of all the work that you're doing, so please continue it, and thank you again.
Andrew:
Yeah.
Caeli:
Thank you.
Andrew:
Thank you so much. We appreciate the opportunity to be here.
Description
2020 has been an unprecedented year for all nurses, and nursing students are no exception. The pandemic has prevented many students from meeting their in-person clinical hours, setting off legislative fights in some states and delaying graduation in others.
Our guests Andrew Rohrer and Caeli Matanky are the president and vice president of the California Nursing Students’ Association, respectively. Dan chats with them about the transition from in-person instruction to distance learning, how nursing school is teaching diversity and what it’s like to look for a job as a recent nursing graduate.
Andrew is currently enrolled in a joint ADN/BSN program between Modesto Jr. College and Cal State Stanislaus. He started the CNSA chapter at his school and ultimately became the president of the entire association. Caeli graduated from Sonoma State’s nursing program this spring and was CNSA’s vice president. Since our conversation, she has since accepted a job on the Cardiac Telemetry Unit at Adventist Health in Rohnert Park, CA. Andrew can be reached at pres (at) cnsa (dot) org and Caeli can be reached at vp (at) cnsa (dot) org.
Links to recommended reading:
https://www.trustedhealth.com/blog/advice-for-new-grad-nurses-2020
https://www.trustedhealth.com/blog/25-things-they-didnt-tell-you-in-nursing-school-but-we-will
Transcript
Dan:
Welcome to the show, Andrew and Caeli.
Andrew:
Hi.
Caeli:
Hi.
Dan:
Let's start off and get some intros going here. So Andrew, tell us a little bit about yourself.
Andrew:
I am in a combined ADN and BSN program through Modesto Junior College and California State University Stanislaus, so I'm dually enrolled. My adventure in nursing leadership kind of started on accident. I got nominated to be class rep for my cohort, and went up there and kind of gave a speech that if I got elected to the position, I'd like to start a chapter of the California Nursing Student Association at my school. And so they elected me, and then next thing I knew, I was the president of the California Nursing Student Association. And it's been a wild and crazy ride, but I'm lucky enough to have someone like Caeli to kind of share the leadership responsibilities and the dream with, and so I'm pretty lucky there.
Dan:
That's awesome. And Caeli, what about you?
Caeli:
Hi. So I actually am a nursing new graduate. I graduated from Sonoma State University's pre licensure BSN program in May, and I got my license in July. I'm very similar to Andrew. I started off as a class representative over at Sonoma State University, and then I ended up here as the vice president working with Andrew. It's been really great. CNSA has given myself, and I'm sure Andrew would agree, lots of opportunities to explore things outside of just what we're learning in the classroom and in clinical at nursing school and it's really exciting.
Dan:
I love what you guys are up to. We've chatted a few times now about some of the initiatives that you're working on with the organization. Can you tell me some of the kind of the three top areas where the California Student Nurses Association is really focused on?
Andrew:
Yeah. So this year is totally unprecedented in nursing in general, and that definitely goes for students as well. So I think that the number one issue that we've been focusing on is the response to the COVID-19 pandemic. Our organization was a key player in really working with the thousands of nursing students that spoke up really collectively for the first time in a long time, kind of if ever, from what I'm understanding, and being a voice in legislature. And it was really a driving force in the waiver for the DCA signed by Governor Newsom that allowed the change in the 75% direct care hours requirement down to 50%, so that nursing students who were displaced from clinical were allowed to reduce the time that was required to graduate and move onto the next semester down to 50%, so that we could do online simulations, and then therefore be able to either move on to the next semester or graduate. We've also, Caeli, I don't know if you want to talk about the Black Lives Matter subcommittee.
Caeli:
Yeah. So that was another thing that again was not in the plan for what we were going to do this year, but that plan kind of got thrown out the window mid February anyway. And that is when we started seeing this huge civil rights movement that began early in the summer. We felt that as an organization with our influence and with our connections to healthcare industry, which is a big player in equity and in racial justice, we felt that it was our responsibility to step up and to use our voice to support this movement, to support the furthering of equality, and also to shed light on the disparity that is in our country.
Caeli:
Now we talked a lot about disparities in how people experience policing, but also another hot spot for that is unfortunately healthcare. And healthcare disparities for minorities is huge, and taking a look at those issues and taking action to support the black community and other communities of color.
Dan:
So I love both of those, and it's really important because it ties right back to our professional obligation as nurses. Right? I mean, I think you basically pulled pages from the code of ethics right there, diversity, equity, inclusion in healthcare, advocating for the professional. I mean, you're living the ANA code of ethics, which is really cool. And so let's dive into those a little bit more. So the first initiative, Andrew, that you talked about was having to flip nursing school, or what we know nursing school is, into something different due to COVID. But I'd love to hear your thoughts on: How's nursing school going? I mean, I'm 15 years out, so it's probably very different. I think simulators were still in the closet. My senior project was to bring sim man out of the closet and program him and get him into a code, and that was about as much simulation as we did. So I know it's changed a lot. But I'd love to hear. Kind of what's the current state of nursing school? And then what specifically changed with COVID that kind of shook everything up?
Andrew:
The state of nursing school, it's not uniform right now. It completely depends on where you are at. I know that in my nursing program specifically at Modesto in the Central Valley, we were very fortunate in that we were only displaced from clinical for like a minute. And our fourth semester students were allowed to stay in so that they could finish their preceptorships and graduate. This was not the case in many nursing programs through California. I just a couple weeks ago got my clinical assignment for which hospital I'm going to be working in next semester. And today, I was just talking to someone from San Diego State, who starts on the same day as I do for this semester, and they have no idea if they're going to be in clinical or not, therefore, they have no idea if they're going to be graduating on time or what that's going to look like.
Andrew:
Nursing school has also become very much online, which is interesting because we're kind of in this position where we have to make exceptions for certain things that normally wouldn't meet the gold standard for what the Board of Registered Nursing thinks is acceptable for accreditation. And thanks to the DCA waiver, we have a little bit of leeway. But except for the clinical component, a lot of programs have moved exclusively online. And that includes the simulation part, which is also now being counted for clinicals. So we're dealing with these online simulated, real life, or they're based on real life patient experiences, where we're taking care of a patient. We're completing a full physical assessment on this digital patient, or multiple patients, and put in these situations where it's not as, obviously, as cohesive to learning as being on the floor taking care of a real patient. You can't ever substitute that, but it gets really close. And that's a really positive thing that we're being able to benefit from.
Andrew:
As far as the moving online, that's included a lot of challenges. I think for nursing students and I'm sure from what I've heard from my own faculty, as well as other faculty members, it has been quite the challenge transitioning programs that used to be almost exclusively online, at least for the generic portion, like the med surg portion, that was very much an in class part of nursing school, is now moving online, and what that means for the curriculum component. And so that's been interesting as well. And we're just essentially, it's all an unprecedented experiment, and we are the guinea pigs, and there's really no way around it. So we're all just doing the best we can to employ the F word, flexibility, which is a big thing in nursing school. And I think that we're just doing the best we can.
Dan:
Now you bring up some good points. And one of the things that we've talked about on this podcast before is that crisis breeds innovation. And I think in general, nursing school needed kind of a kick in the pants to upgrade itself a little bit. Caeli, you may be able to talk to that a little bit. But this might be the kick in the pants that actually modernizes some of nursing education. Not that we want to go fully online and not touch people, but some of the online aspects, the different ways of learning, the online simulation, I think all of those set an interesting foundation for content to build off of when in the past, we've had this assumption that clinical experience and being on the floor is the best way to learn.
Dan:
But we look at the data on that, the varying levels of engagement a student nurse has on the floor with a preceptor is really variable, depending on the location of the preceptor and all these other factors. So if we can standardize some of that baseline education and then jump off of it, put nursing students into clinical with a great standardized baseline, it may even be better than what we were doing in the past. But Caeli, I'd love to hear your thoughts on that as recent graduate.
Caeli:
Yeah. So like I said, I graduated in May, so the second half of my last semester was crunch time, pretty much. And this was definitely the biggest shift in my nursing education. Let's be honest, it was not the first. My nursing class had the very unique joy of in our time in nursing school, we had two wild fire evacuations in different years. We had the PG and E rolling power outages. And then we capped it all off with a pandemic, so our nursing school experience was very much the crash course in flexibility.
Dan:
And crisis nursing.
Caeli:
It was pretty much just crisis the whole way. But I definitely agree that I think it is time for nursing school to take a look at itself and be really intentional with how it's using its time, if that makes sense. The model that my school used, it was two days a week, we have lectures. And then two days a week, we have clinical. And like you said, depending on which nurse you were with, we were with a different nurse every day because it wasn't preceptorship, it was clinicals, so it was just whoever would take you. And so I can definitely say that there are people within my own cohort that had vastly different experiences of nursing school from one another, just based on how things went.
Caeli:
So I would love to see a little bit more standardization, a little bit more intention with lesson planning, and especially moving from class to class. That was a big thing for me personally. I don't know if there are others who have this experience, where one teacher was like, "Oh, I'm not going to cover this in this class because you'll learn it next semester." And then we get to next semester, and the teacher's like, "Okay. Well, you learned this in the last class, so I'm not going to cover it. Let's move on to the next one." We were all like, "Wait. What? Did we miss something? Where was that supposed to be?" So I think that was the biggest thing, everyone, every educator was kind of in their own little bubble of their specialty or their lecture, and there wasn't a whole lot of cohesion across the program.
Dan:
Yeah. That's a good point. I was on the curriculum team for the Kaiser Permanente School of Medicine, which just opened on Monday. And that was one of the gripes of medical school and my experience at nursing school too was, yeah, you'll learn that next semester, and then they never talked to that next semester faculty, and so there were gaps in what you should've known and what you were supposed to do. And one of things we did with the med school was we actually spiraled the curriculum, which means every single faculty member was intentionally building upon the other, which was very different model that I think what healthcare education does now.
Dan:
And I was just thinking as you were talking, my OB clinicals were literally me staring at a fetal monitor at the nurses' station and never going into a room. I don't know, Andrew. I don't know if that's a male nurse experience, or the hospital I was at, or what-
Andrew:
That was [inaudible 00:11:28] you. I ran in there. I wanted to learn hands on.
Dan:
I think I actually got to see one birth. And then I ended up failing that test, the OB test in that class, just because I couldn't relate all the things together without seeing it together. So definitely we have challenges, and I think there's new learning science. So I'm interested. Did you guys use any outside tools to help with your nursing education? There's platforms like Khan Academy, Osmosis is another one. And nursing.com is another one where they've built kind of custom content around nursing school that's maybe a little bit more digestible, maybe a little bit more relevant than some things you're getting in class. I wonder if you guys use that tool. Andrew, do you want to start?
Andrew:
Sure. So until COVID-19, for my program, which is a pretty, it tends to be a little bit more old school in its philosophies. The only thing that we used was ATI, and that was just for skills. We would go through the different skills before going into skills lab, and then before seeing it demonstrated by instructors on mannequins. Other than that, we did standardized predictor testing. We did standardized predictor testing through Kaplan, and that was pretty much the only online component until more recently, we've moved to the i-Human software, which is the simulated experience that I was talking about earlier.
Dan:
Caeli, what tools did you use?
Caeli:
I was an Osmosis gal. I watched Osmosis videos a lot. I also watched Cathy Parks, who is a nurse who's on YouTube. And she made YouTube videos going through the content to study for ATI tests. But then I think ATI got mad and told her to cease and desist. So now she does more general nursing.
Dan:
Quote, unquote.
Caeli:
Videos, not specifically about the ATI content. What I liked both about Cathy and about Osmosis is that it really, it was very digestible. You could watch the five or seven minute video, and then take a break or do whatever you want, and it just really focused in on the specific topic and went through it. And with Osmosis, there was visuals, which was nice because then you got the visual and the audio at the same time. And it just really felt more like someone was sitting there explaining it to you, as opposed to when there's a lecture, and it's all the students in a room trying to get through however many slides before it's the end of the class.
Dan:
Right, the good old, got to finish all 55 slides before you can leave kind of thing. Yeah. Well, and that just brings up the point, there's just better ways to teach. And there's more science on learning that may not mesh with the ways we've done it in the past. You remember about 10% of what you're lectured to, but if you engage with that content, and you revisit it every day, you can retain up to 80%, 90% of it. So I think that's that upgrade that we need with the education system. But you're both about to enter the workforce. So Caeli, you just passed the NCLEX, super duper congratulations on that one. And Andrew, you have a semester left, and you're going to be joining. And so what are you feeling about the workforce? How is the job search going, Caeli? What are you seeing out there as you begin to find your first role as a registered nurse?
Caeli:
I have no basis of comparison. You know this is the only time I've ever been a new grad nurse, so I don't know what it's been like in past years and how much is the pandemic layering on top. But it's difficult, for sure. Some of the ways that the pandemic specifically is affecting it is a lot of hospitals are on hiring freezes. And I think because the hospitals don't necessarily know how the situation is developing, I mean, none of us really do, there's not a whole lot of communication. One of the prime examples, an experience I had just a couple weeks ago was a very big health system, Kaiser Southern California opened new grad programs at five different locations, I believe. Opened the applications, and of course, it's Kaiser, everyone rushed in to apply.
Caeli:
And about a week later, they canceled all of the positions because they had gone back on a hiring freeze in response to what I'm assuming was the spike. So that's what I'm running into a lot is these hiring freezes, and then of course the hospitals that are still hiring new grads become much more competitive because in what I'm assuming past years, the potential workforce, I should say, was spread out among these different opportunities. There are fewer, and so now everyone's trying to go into these specific hospitals. It's not a fun time, but-
Dan:
It's fun and stressful. Right? It's like the opportunity to do something great and be at somewhere you want to be is pulling you. And then the logistics of applying and hoping and waiting and communication is dragging you backwards.
Caeli:
Yeah. I really wish that new grad nursing jobs worked the same way that the Common app did in college. When everyone was applying, you could just go into the Common app and fill out one application and it sent it off to all the different schools. I really wish it was like that because now I'm just stalking job boards like a creepy little hermit and just being like, "Where, where, where's the job?"
Dan:
Yep. Well, let's continue that conversation outside the podcast because we have some ideas on how we might support that in the future, and we might need you as a subject matter expert. Andrew, still in nursing school, looking ahead to the very near future. What's top of mind for you as you finish out nursing school and search for your first role?
Andrew:
There's a new trend being seen right now in nursing education, where you have these RN to BSN programs. Right? And they're now, especially in California, we're seeing more and more of dual enrollment, which is the program I'm in right now, where I'm taking my ADN classes at the same time as my BSN classes. And essentially, I'm going to be finishing with my BSN in the same amount of time that it would've taken me at the same schools to do the standard pre licensure BSN track for a lot less money. So I actually, at the time I got into nursing school, was accepted into both the ADN and the sequential enrollment program, which is what I ended up taking because there was no way I was feasibly going to be able to afford the BSN directly without taking out a substantial amount of loans that I don't even know that I would've qualified for. So it was kind of like, "Yes, this is great."
Andrew:
I got into this program. However, now that I'm approaching my last semester of the ADN program, one of the big things is, well, for that last year, I'll be working as an RN when I'm only paying the university price because for right now, all the university classes are covered. They're paid for in the program I'm in. So now that it's time for me to start looking for nurse jobs, I don't qualify for a lot of residencies because a lot of them are, especially in California, they are only accepting BSN applications. Or at least that's what they say on their websites. Right?
Andrew:
And so then what a lot of the graduating class ahead of me, which is only the first graduating class in the program that I'm in of the sequential enrollment program, is that some of them did apply to the jobs that were BSN minimum. And they were granted interviews, and a couple of them were given positions because some of the hiring managers have leeway in that, I guess, policy, making process of who they can and cannot hire. So a lot of us are unsure as to what the standard is for that. And a lot of us don't qualify for these positions because we're technically ... We still have eight to 12 months after we graduate with our ADN and get our license that we still have to finish that last year of the BSN program. So we don't qualify for a lot of these residency positions.
Andrew:
But here's the double, the catch-22. Right? So the nursing residency positions almost across the board are like, "Must have 12 months or less of experience in order to apply," so by the time we finish the BSN program, that's exactly 12 months of experience. We also can't qualify for the residency. And if the whole point is to obtain magnet status, we're already helping you meet that requirement because we've signed a contract stating that once we finish the ADN program, we can't just back out and say, "No, we're an RN now. We're not going to finish the BSN." No, we have to finish the BSN. And we have a lot of experience that we bring to the table, especially in I think the community college setting. You get a lot of people that are going into nursing as their second career, or going for their second degree.
Andrew:
We have people in my class that have degrees from UC Berkeley, Cal Poly, and from whole bunch of different places. And they're on their second career. And we have a lot of experience we could bring to the table in these positions, and we just were not given the same opportunity as people that were able to afford the four year BSN track.
Dan:
Yeah. You bring up a good point there. And I think it's unclear for the healthcare systems as well. I think people have cited this 80% of their nursing workforce needs to have a bachelor's degree as a magnet requirement. And it's not an official magnet requirement. It's kind of an unspoken magnet requirement. And it keeps staying in this pending status like, "Well, it might be a requirement next year, so you might as well plan for it." But it's never really been instituted, and so every health system is like, "Well, if I want to go for magnet, I can only hire BSN. That's our thing."
Dan:
And I think you're right. There are other situations where there's even more experience with ADNs, especially in the second degree program students. Or similar to your situation, where you're on the track to get your bachelor's within 12 months of graduation, so it's already happening. Why not pull you in and engage you? Right? And then you have it, and it's done and it's over. You don't even have to convince you to do it. It's already happening. And we kind of gloss over that requirement. It's kind of silly.
Andrew:
It is. And I think that the only difference is it really kind of boils down to what program you can afford to go into. If I had known that this was the way it was going to be, if I would have gone with the program I'm in, although there are a lot of great benefits to the program, there are a lot of really great residencies that I wish I could apply for that I just can't.
Dan:
Well, you should still do it, and then let me know how I can help you.
Andrew:
I'll keep you in the loop.
Dan:
Don't be afraid of applying and being that one diamond in the rough too. So Caeli, as a new grad, what do you wish nurse leaders knew about new graduates and how they're searching for jobs, or what they're looking for, or what support they would need to find their first role as a nurse?
Caeli:
I think the biggest thing that I want nurse leaders to know is not to discount the new grads. We're scrappy. I feel like I'm always sort of explaining. People are asking, "Oh, well, wouldn't they want to hire all the nurses, all the help they can get?" And I'm always sort of explaining like, "Well, they're kind of hesitant to hire new grads because residencies take time and resources." And I completely understand. When you're in a global pandemic, you don't want to be taking any resources away from patient care. But I think, yeah, we're new. We're still finding our feet. We may be a little slower at first, but we're scrappy. We've been through a lot. Nursing students, especially in California the last few years, we've been through a lot. And we have learned from that. We've learned to adapt. We've learned to be resilient. And we're ready. We're eager, so take the chance on us. I think that we will really surprise y'all in a real good way.
Dan:
I agree. I think new nurses are the catalyst for change and innovation within health systems. You bring the best evidence, the latest skills. And I think organizations that aren't planning for a newer generation of nurses in their system are going to lose out pretty quickly when people decide they're going to retire. And at some point, some of these big health systems have up to 50% of their workforce is eligible for retirement or early retirement, and that could all hit at once. And they won't have anyone trained and ready to fill those needs as they come up. So I agree with you, I think take a chance on the new grads. It's an amazing population of people to bring into your system.
Dan:
So switching gears a little bit, kind of wrapping up. I know you guys talked about your work with diversity in nursing and the social unrest and Black Lives Matter. I'd love to hear how your organization is thinking about that and what specifically you're doing to advocate for that movement.
Andrew:
So one of the big things that we're going to be talking about here at our next board meeting is the California Assembly Bill 890, which is the nurse practitioners scope of practice legislation that would essentially allow nurse practitioners to practice autonomously without supervision of the physician. And I think that this really meets a lot of needs in nursing for providing care to underrepresented populations or underserved populations, who experience a lot of barriers to healthcare, especially in primary care, which is what a lot of nursing students, I would say almost half, want to eventually go into nursing practice and have that desire to break down those walls that are barriers to healthcare.
Andrew:
And I think that's our next big step. It's nice that this is kind of going into the end of our terms, this is the last kind of big thing that we're going to do because not only is it such a historic thing to take a position on for the history of nursing in California, but it really answers a need of a lot of the issues we've seen across the board, not just within diversity in nursing and meeting the needs of marginalized patient populations, but also meeting needs for COVID-19 and patients that don't have access to healthcare for all kinds of reasons.
Andrew:
And essentially, it meets our core values as an organization of advocating for the profession and for the advancement of the profession. And I think that nurse practitioners having that autonomy, it makes a huge statement about the nursing profession. And so I'm excited that's the next step that CNSA is taking in not just meeting the needs as far as diversity in nursing and what we were really hoping to accomplish. But it just kind of covers a lot of bases there, so that's kind of where I'm at right now as far as next steps.
Caeli:
And also some step that we already have taken is, you wouldn't think this would be a big thing, but we put out a statement in support of the Black Lives Matter movement. Historically, CNSA had not made sort of political statements of that kind, so that was a big step for our organization. We also are piloting a program where we are going to sponsor seven black nursing students and cover their registration and membership fees for the Black Nurses Association. So seven students, one for each of the chapters that are present here in California. We voted to allocate a financial contribution to one of the organizations that is supporting the black community, whether it be Black Lives Matter itself, or there's also some really great organizations, bail funds, and lots of different things. That's something we are looking at in the future, actually, is screening those organizations. We've voted to allocate the finances and we need to vet the recipients and see where that money is best served.
Caeli:
We also created a Black Lives Matter task force within our own board. And we brought in a non board member, a nursing student, who is very passionate about Black Lives Matter. She's doing some great work with that. So those are some of the things that we are doing. And we are definitely committed to continuing to support this community and this cause in the future. And it'll be a big part of our handoff to the next board when we switch over in October.
Dan:
That's so great to hear. And I'm so excited and in awe of the maturity of your engagement with all of the things, with assembly bills that are changing the future of our practice, and actually upgrading California out of the dark ages, which I think it's one of the states that's been lagging for a long time in regulation related to our practice, which you know. I wish SB bill 1053 I think would've passed and made us a compact state, but that didn't. The next best thing will be if we can get nurse practitioners independent practice. That would actually upgrade us. We can be like the states all around us. And so I'm super excited to hear what happens with all that, and glad you're engaged in that. And that's the future of our profession. You're building it, and I'm just so proud of that.
Dan:
So you mentioned a handoff to the board, but one of things we do on the podcast is also hand off those pearls of information to the listeners. So Andrew, I'm going to call on you first. What is one thing you'd like to hand off to our listeners about CNSA or being a nursing student?
Andrew:
Absolutely. So if you're listening to this, and you're a nurse leader, whether you're a nursing faculty member, or an administrator in a hospital, or in whatever role that you're in, please engage nursing students and new nursing graduates in shared governance, not just because it's a box to check of your requirements to meet whatever standard that may be, or because you have to. Do it because you actually want to listen to what nursing students have to say because I think one of the underlying themes here that Caeli and I are trying to put out there is nursing students and new grad nurses have a lot to contribute. We're not fresh out of high school. We're not totally green. We bring a lot of live experience and knowledge to the table, and maybe that's non nursing related, but maybe that's valuable too.
Andrew:
I think that there's a lot of value in making everyone feel like their ideas are worth hearing. And I am happy to talk more. I could talk about shared governance all day. And if you have any questions, or ideas, or you want to continue that conversation, and if you're listening to this, I'd encourage you to reach out to me because I have lots of ideas. So on that note, I will hand it over to Caeli.
Dan:
Yeah. Yeah. Caeli, what's your handoff? That was great, Andrew. Thanks so much. And shared governance, agreed, is a great place to include all the diverse voices. Caeli, what's your handoff?
Caeli:
My handoff is sort of again what I said earlier about being intentional with the way that nursing school's being taught and what we're teaching in nursing school, and more specifically in light of some of the things that we're having to examine now because of the Black Lives Matter movement. How are nursing schools teaching diversity? I know pretty much every nursing school is going to say, "Cultural competency, cultural humility," whatever word or phrase you want to use. But what does that actually mean? What are you actually teaching your nursing students about the communities that they are going to go on to serve?
Caeli:
I think one of the things that came to my attention, and it was sort of like an oh my gosh moment for me, was in all of our textbooks and all of our lecture slides, whenever we were talking about derm, or rashes, signs of disease that involve skin, or the conjunctiva, whatever, it's white skin. And there's a black medical student who was actually publishing a book, I don't know the name of it off the top of my head, but it is full of photographs of what these diseases look like on black and brown skin. And I've seen some of the pictures. It is wildly different than what we were taught. So what we were taught to look for and recognize as this looks completely different on black skin than white skin. And that's just one example that I've become aware of recently. I'm sure there are many more. So just really taking a look at: What are you teaching? How are you teaching it? And is that going to serve all of the communities that we are going to be caring for?
Dan:
Yeah. So double down on the diversity and walk the walk. Get the different content in there. Yeah, great. Great advice, both you. If people want to learn more about your organization, or just connect with you both in general, where's the best place to find you, Andrew?
Andrew:
I can be found at the following email address, which is P-R-E-S, [email protected]. Or you can visit our website at www.cnsa.org. And Caeli, I don't know if you're the same.
Caeli:
Yeah. You can reach me, at least until October, at [email protected]. And we also have an Instagram for all of you social media gurus out there. It's @cnsaofficial. All in lower caps.
Dan:
What about Tik Tok?
Andrew:
That's in the works. We were just talking about that with our communications committee last night, so we're one step ahead of you.
Dan:
I love it. And then are you both on LinkedIn yet?
Caeli:
Yes.
Dan:
Andrew, I would make a big push just from my personal experience to get on LinkedIn and build your profile. I know it's not super great for staff nurse jobs, but it definitely links you in with some really cool leaders and connections that may help in the near future.
Andrew:
I'll get working on that right away then.
Dan:
Awesome. Well, I really appreciate your time on the show today. Thanks for all the insights from a different perspective that we don't usually hear. And I'm excited to see where you're going and where the organization's going. And we're big fans here at Trusted of all the work that you're doing, so please continue it, and thank you again.
Andrew:
Yeah.
Caeli:
Thank you.
Andrew:
Thank you so much. We appreciate the opportunity to be here.