SON: Connections - Fall 2003

Headlines | Briefly | From the Deans Desk

Terror Tamed - Nursing Students Enter the
Clinical Arena with Help at Their Side

Nurse practitioner and preceptor Pat Abbott looks on as master's degree student Pat Forg examines a patient in the urgent care clinic at UW Medical Center.

The baby was crying so hard, it seemed impossible to conduct the exam. Younhee Cho, a student in the University of Washington School of Nursing's family nurse practitioner program, could see the parents' anxiety level mounting as the infant's cries escalated. She was about to abandon her efforts when her mentoring physician, Dr. Steve Dassel, entered the room. Within minutes, Dassel had both baby and parents calm and relaxed. "Dr. Dassel smiled at the baby and cradled her while he spoke softly to her parents," remembers Cho. "His ability to calm the baby and the parents was amazing. There's no way to teach in school what I learned from him."

Teaching both the science and the art of nursing is the essence of the UW School of Nursing's preceptor program. Each year, more than 350 physicians and nurse practitioners instruct, guide and mentor students on a quarterly basis. Dedicated preceptors like pediatrician Dassel, who is retiring from practice this year, spend countless hours (in Dassel's case, more than 2,000 since 1995) helping students master critical skills and modeling professional behavior.

"If only you could videotape the little things Dr. Dassel does to put children and their parents at ease," says recent graduate John Cranton. "I watched Dr. Dassel counsel the parents of a young boy who had an occasional stutter. He could have simply told them that stuttering is common and often goes away with time, but he could see how worried they were. Instead, he asked the boy's parents if the stutter was making the child upset or affecting his social life or his learning. When they said no, he told them to watch for any changes in these areas as signals that it might be time to do something." The child's parents were visibly relieved.

Dassel's ability to "take the worry away" while explaining something in simple terms was a valuable lesson to Cranton, who feels fortunate to have a large memory bank of his own "Dr. Dassel videos". For Dassel, working with the students is just plain fun. "The students stimulate me to read and question what I do," he comments. "It's wonderful to watch them develop."

"It's extraordinary to see how the enthusiasm of the nursing students motivates their preceptors," observes Maggie Baker, a clinical instructor and research assistant professor. "Students enter the clinical arena with a lot of questions that need to be answered. They're scared-sometimes terrified, but eager and enthusiastic." Baker watches as UW Medical Center nurse preceptors are inspired and energized by the positive feedback they receive from students. When the students have an 'aha!' moment with their preceptor, it's thrilling for everyone, she says. Baker recalls student Andrea Valdez' 'aha!' moment last winter. "I assigned Andrea to a complex young patient with liver failure. She went to the door of the woman's room and came back to me with eyes as big as saucers and said, 'Do you think I can really do this?'"

According to Baker, Valdez moved past her fears and quickly began relating to the young woman as a person, not as a set of tasks or list of medications. There came a moment when everything clicked and Valdez suddenly realized that she had conquered her anxiety and was really helping to comfort her patient and the patient's family. For Baker, the chance to watch students like Valdez transform from green, scared nursing students to proficient caregivers is "an incredible privilege."

Watching his students develop and learning the lessons they had to teach inspired Dr. Frank Mitchell to serve as a preceptor for 22 years (he recently retired from the program). "Teaching is itself a learning experience," says Mitchell. He remembers one student in particular with a master's in psychology. "She was very knowledgeable about ways to integrate the psychological side of care with the physical," he recalls. Together they developed effective techniques for helping his gerontology patients make lifestyle changes. "Working with the students was a lot of fun," Mitchell states. "They were thorough, asked challenging questions and spent a lot of time with my patients."

Because he discovered ways to help the students without cutting back on the number of patients he was able to see, Mitchell found the time he spent with them to be a profitable investment. One of the best benefits of being a preceptor is getting to work with great nurse practitioners that you can hire later, Mitchell notes. But, he says, nothing beats the enormous satisfaction he got from hearing his students say, "Hey, I feel I'm a lot better now than when I started."

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