A Nurse First

The missing element

• Season 4 • Episode 3

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In nursing, it's not just about being clinically smart, but also emotionally intelligent. The COVID-19 pandemic robbed countless nursing students of their clinical experience—and as an NCLEX tutor, Laura Habighorst has seen the impact on her students’ test scores. With the human element being the difference in exceptional patient care, she’s reworked her tutoring plans to add in the valuable lessons she’s learned both as a nurse and as a patient to help combat this missing piece.

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When I made the decision to retire, it was right after the first year of COVID. And I, like a lot of nurses, were like, I can't. It's not that I can't do this anymore. But I was also at a point in my life where I was ready to retire. We had a lake home. The plan was to retire to it, which we did. And so I went ahead and I retired knowing, though, that I was going to continue to stay very active in all of my nursing organizations and continue lecturing and doing that kind of work. Welcome to A Nurse First. This is Laura Habighorst telling her own A Nurse First story. I was looking for educator jobs. And I was specifically looking down in this area here where I lived. I thought, okay, well, maybe I'll just work part time. When now I am a tutor and I work specifically with students who are having difficulty in nursing school or having difficulty or just preparing for their NCLEX exams. has been wonderful for me because now I'm seeing nursing students who are either in the throes of their curriculum or they're getting ready to take state boards or they've taken state boards and they haven't passed. And they're trying to figure out what to do, where do we go. And really, what I've ended up doing now that I'm doing this, in some instances, I've had to go all the way back to the very beginning and just talk about the basic fundamentals of nursing. And not only that, but also teach how to test. Once Laura put together all her tutoring materials, the process was generally straightforward. An introductory call would provide her with an idea of what areas she needed to focus on, and with her game plan in action, her students usually passed the NCLEX with flying colors. But there was a distinct change in early 2023. More and more of her students weren't passing, and she was determined to find out why. One of my students, she broke down crying because she goes, I thought I knew what I was doing. I thought I had everything. She had taken the NCLEX twice and had failed. And she couldn't figure it out. And as her and I talked, she said, I never got to do a clinical. I'm like, what? And she said, I never got to do a clinical. All I could do was simulators. And that kind of made me start asking others of my students about, how much time did you get doing clinical? And all of these students came through COVID. And their responses were, I didn't really get any. Or, well, I had one semester. It was my last semester. I knew right away. I knew what was missing. I knew what they were missing. And it's that human element. I've worked with simulators. And having had that opportunity when I was just starting out in nursing school, I know that's why they had to do that. I understand. COVID and everything else. I understand that. But that human element of touch and looking into somebody's eyes, you learn from those experiences. It's those nonverbal that that's how you learn. That's how you pick up on that gut feeling that something isn't right. I felt so bad that I could not help. The first clinical class that I had, where I realized that that clinical component was missing, I came to the Sigma Circle and asked about how others are dealing with these feelings from some of these students that they are missing something. And I was finding that with the students that I had at that time, because it was like the soul was missing. The soul was missing in their nursing education. And I wanted to know if other people felt the same way. And I wanted to know, is there research being done? Is there any research being done on those students that came through COVID? But I wanted to know what other people's experiences were. And who better for me to reach out to than through SGMA? Who else? Educators and students and people who've been in the profession for a long time. Given what I'm doing now, it is so important for me to stay up on what is going on, what's going on in the research, what are people seeing, because, you know, that's what I have to unload on my students and to help them to understand. I think that there is a high rate of nurses not passing the NCLEX. right now is because the clinical time that they would have gotten, even though people are starting to come back into the hospital, it's still not everywhere that that's happening. In your opinion, how will this lack of clinical experience impact the nursing profession? what can be done to make up for that missing piece? From what I have seen, that piece of caring maybe has been impacted. And that's what I worry about the most right now. And the definition of a nurse, the nurse is to care for your patient. And you care for your patient by listening to them, respecting them, attempting to understand where they are coming from. But I've had the opportunity to reflect and reflect on my own personal nursing career and how it can help others that are coming down the line after me. I want to share this because this is one that I share. with a lot of people. And it does have a religious overtone. The patient that I had, I was working in recovery room. And the patient that I had came in. He was so combative, horribly combative, trying to get out of the bed. He just woke up really, really bad from anesthesia. And the nurse that was taking care of him I was having a really, really hard time because I know she was frustrated. You could see it. And she didn't know what she was going to do with him. So I went ahead and I said, Hey, let me take, I'll take him. You take this next one coming in. She's like, okay, fine. And this guy, he goes, he just kept saying over and over again, don't you see him? Don't you see him? Don't you see him? And I asked, I said, see who? Well, don't you see him at the foot of the bed?" And I'm like, who? He goes, well, Jesus. He's at the foot of the bed. He, I think, thought that he was dying because Jesus was there at the bedside. And I asked him, and this is one of those things that you only do it if you think it's the right patient. And you're not going to get that if you don't have clinical. If you think it's the right patient, I said, well, do you want me to pray the Lord's Prayer with you? Would that help? When we finished it, he had calmed right down. And he said, he's gone. And I had to quickly interpret that he's gone to this gentleman, that he's gone because you're OK right now. and everything's fine. And the nurse who had him at first, she's like, how did you know that that's what he needed? And I just told her, I asked him what was wrong. He saw Jesus at the foot of his bed. He thought he was dying, and he was fighting that. So it was like, OK, acknowledge their fear. Do what you can to negate their fear. to make them better. And that's what I did. Those are the experiences that I would want to share with those nursing students who didn't get that opportunity and to look for those opportunities That sweet, sweet old lady who I had to do my very first dressing change on, who was scared to death, and all I did was reach out and pat her on her shoulder and said, I'm going to do the very best that I can. And if you don't want me to do it, that's okay, and I understand. Those are the things you don't get with a simulator. That forced me to go back to remembering what it was like as a nursing student, what I was learning, what I learned from all of those experiences as a student. So what that meant for me as an instructor was that I had to share those experiences. So I really had to relate that human component, not just from a nursing perspective, but from a patient perspective, to share that with that group of students, to understand that patient perspective, because they didn't get it in their clinical experience. That was very difficult because I wasn't sure how to approach it. But then I got to, as I said, I got to thinking about it. You know, I've been on the patient end. I know what that's like. Why not use my experiences or experiences of people that I know to help teach people who don't get that and didn't get it? And that's what I ended up having to do. I shared one of my personal experiences that was very emotionally draining for me. And they could see it in my face. And they could hear it. They could feel it. That's what they missed. That's what they missed. So I have to give that perspective of being the nurse, the patient, the family, that human element. And I want them to be the best nurse that they can be. And that has to be all around, not only clinically smart, but emotionally smart. But we cannot, cannot forget how important that human element is. Thank you for listening to A Nurse First from Sigma. If you loved this episode, do us a favor and subscribe, rate, and leave us a review. It is very much appreciated. For more information about A Nurse First and Sigma, visit sigmanursing.org. Until next time.