Fran London
I was thirty-four when I became a student at the University of Rochester School of Nursing. I had earned a Bachelors degree in Physical Anthropology from Brooklyn College, and I was always reading about health and nutrition. It all seemed to be leading me more and more into something involving human health and health care. When my husband was transferred to Rochester, the change was like an invitation. The University of Rochester School of Nursing was best in Rochester and – even then – was regarded as one the top ten in the county.
I took that invitation, and the School of Nursing certainly lived up to its billing. I immediately picked up how well and how completely nursing students are trained and grounded. The commitment to professionalism was meticulous.
But I also learned something at least as important -- that my thoughts, perceptions, and input were welcome and significant. One of the most satisfying things about the University of Rochester experience is that you come to understand and to be able to articulate the value of your calling. That’s what really made the instruction stand out. What they taught best wasn’t in the curriculum – namely, that nursing is important, that nurses have something to say. That nurses really matter.
It was more than a matter of mastering abstract information. We learned that a human being’s life could depend on our ability to understand what we were learning correctly, and how to apply it properly. We learned the importance of really getting it right.
Classes then were generally arranged for the daytime learner and the full-time student who was younger and had no other responsibilities. So at first I bonded mainly with the older students. But eventually I became friends with the younger students too. After a while it didn’t matter that they went to a dorm and I went home. There was a sense at the School that we were all either colleagues or on the way to becoming colleagues.
Was it difficult to maintain a marriage, handle work and study in a new city? It was tough sometimes. It wasn’t all parties -- undergraduate nursing was very demanding, more so than graduate school training. Requirements were high, demands were rigorous, and the amount to actually learn was considerable, both in terms of both content and sophistication. But other students and faculty were supportive. And the training could be fascinating -- it always practical, always geared to developing your ability to apply it well in real situations with patients.
Any profession has levels of sophistication. At first you follow the rules. With time you gain experience. In the end, when you’re an expert, what you’re doing looks intuitive. But the fact is that all that you’ve seen and learned and studied has become so integrated that it’s automatic. You see subtle signs and patterns that let you can anticipate what happens next even before it happens.
Nurses spend more time with people than doctors. As a result they’re well positioned to catch problems early and stop them. So true excellence in nurses and nursing is often invisible. Complications and infections and tragedies don’t happen – one competent nurse somewhere saw it and caught it and stopped it in time. That’s the highest kind of service.
The scope and quality of training the University of Rochester the School of Nursing gave you the ability to reach that point. More and more there are nursing programs that are task-oriented, but that don’t see the big picture. At the University of Rochester School of Nursing, I not only learned, but learned how to apply what I learned with sophistication and expertise.
Is attending the University of Rochester School of Nursing helpful in a career sense? Well, of course. Nowadays employment is a given. The demand for nursing is so strong that it seems like they grab you the moment you’re out the door.
But if you want to get into one of the better graduate schools, or find a choice position, a school with a good reputation is great help. Where you go to school influences the opportunities you’re offered later on. Quality training makes a difference. I’m glad I went to the University of Rochester School of Nursing and not a school of lesser quality.
Best of all, the School and its people will still be with you, however far you go. I’m still in touch with many faculty members from the School. Distance doesn’t mean much anymore, thanks to email. When one of us publishes an article and the other finds it, we pass messages about it almost at once. We’re an increasingly mobile nation, so we run into each other more and more often at conferences. In some ways I feel that I did more than just learn about nursing at the University of Rochester -- I was welcomed into a community of nursing. One that’s always there to support you.
The University of Rochester did a great deal to help shape my subsequent career. I wasn’t entirely sure which direction I wanted to go into at the start. I was lucky to go to a school that exposed me to many sides of nursing early on, sides I didn’t know at the time existed. I had an internship in a cancer center program that introduced me to all aspects of cancer care and nursing, gave me depth exposure to specialty areas. And yet one universal nursing activity ended up being my career: patient and family education .
I now work as the Health Education Specialist at Phoenix Children’s Hospital is to produce the teaching materials that families take home and use. I’ve published several books and many articles on patient education, and I travel and give workshops and presentations on the subject. But I learned it first as an undergraduate.
At the time I didn’t think it was anything remarkable. Patient education was just one of the many things they taught you at the University of Rochester School of Nursing. I assumed that all nurses learned it and that everyone knew it. It seemed obvious to me that, after saving lives, the most important work of nurses is teaching patients self-care skills. When I got out into the world I found not all nurses were as aware of this.
I was lucky. I went to a school that showed me what was possible for me to be as a nurse. A school that grounded me in everything I needed to be able to the best possible care to a patient. A school that helped me find myself as a professional. It led me to what’s been a useful and very happy career. Nursing is a wonderful, deeply satisfying profession to be in. To paraphrase Minnie Minoso, "Nursing has been very, very good to me."
What I began with then is now is becoming a huge emphasis in health care. Functional health literacy is now recognized as a major predictor of health outcomes. Low reading skills and poor health are clearly related. Patient education is our way of helping patients understand how to best take care of themselves. We spend so much money developing new drugs to improve health outcomes. Yet studies show almost half of all patients do not comply with prescribed medication regimens, and 20% of patients never even fill their prescriptions. Without effective and efficient patient education, our advances often are not put into effect. And so are futile.
It takes time to teach patients how to become active participants in maintaining their health care. We need to individualize our treatment plans to meet their needs. To make sure they understand our instructions through teach back and return demonstrations. To make sure they know how to recognize problems and know how to respond. Translating our technical expertise so as to help patients and families apply it to their daily lives, is the essential work of nurses.
I’m pleased to have been able to disseminate research in the field of patient education to clinical professionals of all disciplines, and help them apply it in practice. I love publishing books and articles, and stimulating professional discussions that ultimately move nursing forward. And I never forget where it began: I published my first article in a nursing journal when I was an undergraduate at the University of Rochester School of Nursing.
I learned many things at the School of Nursing. But the most important thing I learned was how to learn. How to solve problems. How to be open. In my book The Laughing Buddha Box, I write about the healing power of humor. I’ve examined research in techniques relating to psychoneuroimmunology involving meditation and visualization. Since nursing addresses the body, mind, and spirit, it’s easy to incorporate these within my professional framework. And in part, this approach is a legacy of my time at the University of Rochester. They showed me how much there was out there to know. They taught me how to find answers for myself. And they gave me the confidence to trust my instincts and my judgment and follow my own path.
The University of Rochester prepared me to be a thinking nurse. A reasoning professional. And when you receive training and encouragement like that, you have the solid foundation that lets you go in any direction you choose.
Fran London is health education specialist at Phoenix Children’s Hospital and has published two books on patient education, including Patient Education in Health and Illness (Lippincott Williams and Wilkins) with S.H. Rankin, K.D. Stallings and F. London, and No Time to Teach? A Nurse’s Guide to Patient and Family Education (Lippincott Williams and Wilkins), which has been translated into and published in Korean and German. Her exposure to integrative therapies and mental health nursing led her to write The Laughing Buddha Box (Chronicle Books).
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