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Mary Armstrong uses C-N Experience to do “The Next Thing”

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Working in Wake Forest Baptist Medical Center’s Pediatric Intensive Care Unit has deepened Mary Armstrong’s appreciation for C-N’s academic rigor. The 2012 graduate remembers someone asking about extra credit possibilities.  “Mrs. (Sue) McBee asked, ‘Now, would you want a nurse who got through school on extra credit poster boards to take care of you?’ That made me understand the kind of nurse I wanted to be.”

Professional Care – Working in Wake Forest Baptist Medical Center’s Pediatric Intensive Care Unit has deepened Mary Armstrong’s appreciation for C-N’s academic rigor. The 2012 graduate remembers someone asking about extra credit possibilities. “Mrs. (Sue) McBee asked, ‘Now, would you want a nurse who got through school on extra credit poster boards to take care of you?’ That made me understand the kind of nurse I wanted to be.”

(Jan. 14, 2014) –The young patient’s mother did not grasp what the nurse was trying to explain.

But, she smiled anyway, and she nodded. A lot.

That told the nurse, Mary Armstrong ’12, the mom did not understand what “tracheostomy” meant. Mary needed her to know what would be done, the rationale behind it and prospects for the child’s recovery. But the steady nodding meant the mother was confused and that translator-phones can do only so much.

Mary had learned a great deal as a Carson-Newman nursing major, but knowing the mother was bluffing in order to be polite did not come from a class. She had learned that vital nugget as a student worker for the Center for Global Education while studying nursing.

She had learned it driving international students to Walmart for their weekly shopping trips, having seen many who would feign comprehension to avoid embarrassment.

What Mary experienced with her C-N friends was exactly what she was seeing with the Korean woman whose child was under her care in the Pediatric Intensive Care Unit (PICU) of Wake Forest Baptist Medical Center. Her undergraduate nursing education helped her solve the communication problem.

She took the quest home that night. “I searched all over the Internet and finally found a pediatric tracheostomy education (pamphlet) in Korean, and it had a corresponding English translation.”

The mom’s eyes “lit up” when she saw the illustrated brochure and words she could read. Then Mary saw the comfort afforded when a parent can make an informed decision.

“Going above and beyond for your patients is what I learned at Carson-Newman,” smiled Mary.

That his former student did “the next thing” is no surprise to Dr. Gregory Casalenuovo.

“Mary was able to articulate and apply what she was learning in the clinical setting,” said her advisor and assistant professor of Nursing. “She was very caring and understanding of her patients and their families. She worked very well with her fellow students, faculty and staff at the hospital when I had her in clinicals.”

Casalenuovo recalled her strong academic record, her commitment to learning and her desire to be a nurse.

There are five departmental awards for which C-N undergraduate nursing majors are eligible – Mary received four. They cover the gamut. Seniors select the Leadership Award, the faculty chooses the Outstanding Graduate, the Highest Academic Standing Award is GPA and the Sigma Theta Tau Rho Mu Chapter Award is an overall honor presented to a member of the group.

“I was absolutely blown away by the honors, but I don’t feel like it was anything I did to deserve the awards,” Mary noted. “I have been blessed by God to have professors who pushed me to learn to be the best nurse possible.”

Having been hired shortly before commencement, she went to work at Wake Forest University’s teaching hospital. Within three weeks of graduation, she was working shifts and interacting with physicians and their entourages on rounds. It could have been excruciating for one who is “soft-spoken,” but she had already forded that stream.

“That was something that was very much encouraged throughout my (C-N) clinicals. If something needed to be told to the doctor, instead of going and telling our professor who would then go tell the doctor, you would go to the professor and (he or she) would say, ‘Well, there’s the doctor… Go and tell them...” which was one of the most terrifying things ever,” she admitted.

Hands-on experience, the essence of C-N clinical study, includes “96 hours of critical care preceptorship – direct patient care,” said Casalenuovo. The rest of that particular course is spent on campus learning necessary skills and preparing to work in a real setting. Determining student success includes the evaluation of the preceptor, the professional nurse-educator who has worked closely with the student.

In his campus office looking over her file, Casalenuovo nodded as he read a preceptor's notes about his former student. The final passage was an overall assessment. “Mary is an excellent student and will be as a nurse also,” he recited. “She is always willing to learn more and do more, both of which are great qualities in a nurse.”

Since beginning her career, Mary has earned designations both as a certified pediatric nurse and critical care registered nurse, as well as recently completing her first term as a Duke University graduate student. In August, she was appointed site coordinator for the Medical Center's Virtual PICU operation. The online partnership collects patient data and treatment notes from 120 units across the world, thereby offering doctors, nurses and researchers a treasure trove of information.

In that role, Mary spends much of her rotation schedule collecting, sharing and examining information that is making a difference in pediatric nursing. “It’s so interesting to see the big picture of patients, to be able to organize our care in more effective ways for better outcomes for our patients. Once we implement something, we can see if it has improved or not.”

Her notion that undergraduate nursing programs are pretty much the same lasted only until she began working. “Once I started orientation, I realized that I was leagues ahead in textbook knowledge. I breezed through orientation classes and tests. When I actually started working with patients, I realized that C-N taught me something very important for real-world nursing – critical thinking.”

Her ultimate goal – teaching pediatric nursing – drives her to obtain practical experience, research skills and advanced study. She says her appreciation has only grown for C-N and for who helped provide aid, including the Hannah Pedersen and Lowe-Scott Scholarship Awards.

“Everyone knows college is expensive, but, when you add nursing insurance, uniforms, stethoscopes, penlights, 30 pounds of textbooks, and shoes comfortable enough to stand in 12 hours, the cost can be overwhelming,” Mary explained. “Without scholarships, I may well have missed out on meaningful friendships with professors and students.”

Casalenuovo says Mary passes what he shares with seniors as being his ultimate test.

“I tell them, ‘I’m preparing you to take care of me; when I wake up and open my eyes, if I see you standing at my bedside, I want to have confidence,’” he chuckled. When the chuckling stopped, his smile remained; “And that’s exactly what I would have with Mary.”

Mark Brown, University Relations

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