France Griggs Sloat
Holding a syringe at arm’s length, Joyce Cruz checks that it contains exactly 100 milligrams of Dilantin, then slips it into the intravenous line strapped to the arm of a man having a seizure in the hospital bed beside her. Cruz, a junior nursing student, comforts the man while waiting for the Dilantin to take effect, checking to make sure his airway is clear and there’s nothing around that can injure him. Finally she places an oxygen mask snugly over his mouth and nose.
“I’m suffocating,” he says. “I can’t breathe.”
Cruz adjusts the mask as the oxygen begins flowing. Finally, he relaxes and begins taking deep breaths. Cruz is relieved—not only that her patient is OK, but also to know that had she made a mistake, even a fatal one, the man would still be alive.
The man is Stan, a high-tech simulated patient more formally known as “Standard Man.” He is just one of the newest teaching tools in the department of nursing—and one of the items that has helped resuscitate the department from near-death status 10 years ago. Nursing is now the University’s second largest undergraduate program behind liberal arts and fourth largest graduate program in terms of enrollment. Along with a $250,000 high-tech simulation hospital room, new leadership, several unique programs and an emphasis on obtaining a complete education and not just nursing skills, the University is now a major player in the effort to upgrade the profession and stem the country’s growing nursing shortage.
“We’re a destination department now,” says Marilyn Gomez, director for nursing student services. “People come to Xavier to go into nursing, where 10 years ago, someone would say they’re having trouble with pre-med, so they’ll go into nursing instead.”
Cruz, 22, echoes that fact. She says her class today is larger now than when she was a freshman. Some of the new students switched their major to nursing, she says, because of the program’s reputation for producing students who pass the state licensure exam, and “hearing from other students like me.” Indeed, enrollment has more than quadrupled in the last 10 years. (See chart on the next page.) In 1996, there were 60 undergraduate students and 12 graduate students. Today there are 225 undergraduates and 158 graduate students. And the freshman class, at 66, is the largest ever.
“It’s absolutely amazing to see the growth in the program,” says University President Michael J. Graham, S.J., during a tour of the simulation lab. “We’re meeting this incredible need in our changing world. This is yet another way for us to do our mission here.”
What’s attracting students to Xavier’s nursing program are three factors: One is the way students are educated. Xavier requires all students to complete the Jesuit core curriculum, and it’s no different for nursing, which phased out an associate degree program in 1997 to focus on the four-year baccalaureate degree. “You don’t finish Xavier or sit for the state exam until you have finished the whole thing,” says department chair Sue Schmidt. “That’s our philosophy at Xavier. We have a lot of integrity.”
Plus, the department teaches its students to take care of the whole patient and not just the symptoms—a philosophy that made Xavier one of only 14 programs in the U.S. to earn the endorsement of the American Holistic Nurses Association. “We stand out as a program that teaches nurses to care for the whole person across their health and life span,” says Schmidt. “It’s part of the Jesuit focus.”
This theme of holistic care is further developed in the new MIDAS program—the master of science in nursing direct entry as second degree program—which allows college graduates with degrees other than nursing to enter the nursing profession. A highlight is that it follows a clinical nurse leader focus—a national movement to address the fragmentation of health care—which teaches nurses how to oversee a patient’s comprehensive care. It’s the only program in the region to do so. “Because so many physicians are specializing, that leaves a void of communication and no one is coordinating all the care,” Schmidt says. “Marcus Welby doesn’t exist anymore. The clinical nurse leader is coordinating the care.”
A second key factor is choice, such as an Hispanic focus for undergraduates. Also, those wanting a master’s degree choose from five concentrations such as school nurse or health care law. And the accelerated MIDAS program, which graduates its first class in May, allows students to earn a master’s degree and a nursing license in five semesters.
And, of course, the third key factor is the high-tech tools, beginning with Stan and the simulation lab.
“This really is state of the art,” says lab director Mary Sizemore. “In a traditional clinical rotation, you may never care for a heart attack, but here we can make sure you get that experience in an environment where you can make mistakes without negatively impacting a patient.”
Last fall, Stan had a heart attack while Cruz was there with her classmates. The students literally jumped on top of him to do chest compressions. Made of synthetic rubber, Stan looks and acts real. His eyes blink, his tongue swells, his teeth fall out if an intubation goes wrong. He has heart and breath sounds, and he can seize on command. For nursing students like Cruz, he’s a blessing.
“Everyone is nervous the first time they treat a patient, but this helps you out,” she says. “You can think of your first patient as being Stan."