Nursing Education Concept by Grayce M Sills

Who is Grayce M Sills,Professional Introduction,Interest in Teaching,Preparation for Teaching,Training  For Teaching,Development as A Teacher,Comfortable As A Teacher,Challenges,Embarrassing Moment,Rewarding Aspects,Least Rewarding Aspects,Maintaining Excellence,Advice for Teachers.

Who is Grayce M Sills

    Dr. Grayce M. Sills is Professor Emeritus at the College of Nursing. The Ohio State University. She holds a diploma in nursing from Rockland State Hospital, a BSN from the University of Dayton, and MS and PhD degrees from The Ohio State University.

    She has served as past president of the American Psychiatric Nurses Association and the American Nurses Foundation, and editor of the Journal of the American Psychiatric Nurses Association. 

    She was elected a Fellow of the American Academy of Nursing and served 8 years as a member of its Governing Council. Dr. Sills is a founding editor of the Journal of the American Psychiatric Nurses Association.

    Dr. Sills has numerous scholarly publications. Her recognition and achievements include The Ohio State University's Distinguished Service Award and Distinguished Teacher Award, an honorary Doctor of Science degree from Indiana University, Nurse of the Year by the American Psychiatric Nurses Association, a Living Legend of the American Academy of Nursing, and the Hildegard Peplau Award from the American Nurses Association for contributions to psychiatric nursing

Professional Introduction

    Dr. Grayce Sills's dedication to nursing and the development of the practice of psychiatric nursing is best demonstrated by her belief that her greatest achievement is her work with graduate students. 

    She holds that the content to be taught is derived from the student's clinical experiences and that the teacher is a consultant with the student in the learning situation.

Interest in Teaching

     SHE first became interested in teaching when she was a freshman in high school. She grew up in a very small town and was sent from the high school over to the elementary school as a substitute teacher because they did not have regular substitute teachers. 

    She had the little people in class, enjoyed it, and thought this is really neat. At that time, she does not think it crystallized that she wanted to be a teacher, although that experience certainly helped frame a later decision.

Preparation for Teaching

    After graduating from the diploma program at Rockland State Hospital, she received a New York State Mental Health Department tuition waiver to go to Teachers College (TC) at Columbia University to complete her degree. 

    At TC, they thought she was a whiz-kid since she already had 2 years of college before Nursing School. She had a diploma in nursing under her belt and hit TC at the time when they were closing their baccalaureate program and beginning to offer master's programs. 

    Mildred Montag was her advisor, and she said, “Well, you know, you are kind of an exception and we could start you in the master's program with Hildegard Peplau even though you don't have a bachelor's.” 

    So then she was working on a bachelor's and a master's which had to be interrupted after a year and a half when she returned to Ohio to help her sister and her family. She fully intended to return to TC but never did. 

    During that year and a half, the administrators at Rockland State Hospital said that since she had 2 years of college she could now teach. So, she started teaching. She taught history of nursing, drugs and solutions, and several other courses that were divided up into small bits. 

    She just did it without much guidance or assistance or help. She had one course in teaching at TC. It was taught by a fine professor of music by the name of James Marsell. He was more of a philosopher than an educator. 

    Perhaps one of the best things that happened to her was that she did not finish at TC. What she mean by that is that she didn't get caught up in that era (early 1950s) when there was not much content in nursing and so an over-focus on education. 

    It was thought that nursing education was having all the objectives in order, and studying students instead of nursing practice. She did not get caught up in that thinking. When it looked like it was possible, she moved to acquire the master's. 

    At that time, there were two people at Ohio State teaching in the only graduate program in psychiatric nursing in Ohio at the time. They were not eager to have her as a student in their program. They knew she came out of an interpersonal orientation and they came out of a psychoanalytic orientation. 

    While we were friends, it was mutually determined that it was not a good idea for her to do her graduate study with them. We decided that what might work was a graduate program in sociology, a master's in sociology where she could focus on medical sociology. 

    If she were studying organizational sociology, she could study hospitals. If she were studying deviance, she could study mental illness. It was a matter of goodness of fit at Ohio State. 

    At that time the psychology department was very experimental and very “rat oriented” while the sociology department had a broader orientation, they even had a family counseling program. So, it was a more favorable environment, for her work. 

    She had a superb group of faculty-a group of university faculty who were, at that point in their careers, coming to be nationally known, and were just about to become internationally known. 

    They were very accessible to students. All during her graduate study she went to the VA hospital in Lexington, Kentucky, as a consultant, and worked with the staff on developing their clinical skills in one-on-one groups. 

    So, she kept her identity as a nurse alive during that period and never expected to think like a sociologist. But, to her surprise, she began to think like a sociologist. She think she still have a more sociological view of nursing, than a “nurselogical” view of nursing.

Training  For Teaching

    And so it was a blessing that she did not finish at Teachers College and also a blessing that she had the opportunity to begin a relationship with Hilda Peplau. She had life long mentoring from her. More important, she learned a teaching method. 

    Her doctoral dissertation at TC was on the “Experiential Method of Teaching.” In this method, the content was derived from the clinical experience. This automatically put the teacher in a different relationship with the student. 

    You were collaborators in the process. The student was gathering the data and as a teacher you were helping to analyze, providing references and that kind of thing. It was clear that a teacher needed a broad theoretical background in the field in order to relate to the clinical content that was developed out of clinical practice. 

    This method always seems to have made for a different style of teaching. It was more about being a consultant with students, Hilda always said, “One should never refer to the students as her students.” 

    She would say, “They studied with me.” she tries to incorporate that in her language as well. Student and teacher both learn from the clinical data at the same time. 

    Now presumably, the teacher has more experience, or should have, by definition, a broader range and command of the literature in psychology, psychiatry, and the social sciences to help people interpret the phenomenon that they are dealing with.

Development as A Teacher

    When she returned to Ohio, she was helping with family problems, and decided that she would stay in Ohio for a year before returning to TC. She wanted to work in a state hospital. 

    When she talked to the people in the State Mental Health System they said, “We would like to have you anywhere!” “Anywhere” ended up being at Dayton State Hospital where she took an administrative position that was both clinical and administrative. 

    However, she was distressed because there were somewhere between 90 and 110 nursing students for a 3-month period who lived on the grounds. It was a 12-week experience in psychiatric nursing. She was taken by the fact that none of them ever returned as staff. 

    So, when the faculty in charge of the program left. She said, “She wants to be in charge of the program.” she was piling up years in college, but still had not finished her baccalaureate. 

    At this time in the mid to late 1950s, there was less concern about what academic credential you had. She worked on finishing the baccalaureate part time at the University of Dayton and began to work with the students who came for their psychiatric nursing experience on affiliation.

     She worked with two other people teaching psychiatric nursing to the students. We taught using the clinical data that the students brought from their care of patients. Some days we would focus on anxiety, some days on depression, and some days on hallucinations. 

    We were zooming along just fine until she had a call from one of the home schools that asked her for the course outline and objectives. 

    They were preparing for a State Board visit. We didn't have any! We got busy and someone sat at the back of the room taking notes from the class. After each class we wrote up the objectives and the content. 

    This experience led to her  lifelong aphorism that states, “Never let an objective interfere with learning,” she have seen too many examples of people getting frozen into thinking that “this is what we are to learn” and “we cannot learn anything else. ” 

    sOne must always be open to the possibilities for learning that go beyond the objectives. We got through that first round of having the State Board visit, which was an educational experience for me. 

    Hilda always said that the word education comes from the Greek word 'educe, which is “to be led out of” or “to bring out of.” Her idea was that you educated from the clinical data, the content. 

    She built the content of psychiatric nursing through her work with students at Teachers College. She believes the method is as valid today as it ever was. The actual acquisition of knowledge may be a little easier, because it is more structured than it was in those early years. 

    Hilda often came in the summer and we did some summer workshops together. She kept pushing me, telling her  she needed to work with graduate students, and to do that she need a master's, and probably a PhD. she felt her gentle knuckles in her  ribs while at the same time she was very happy at Dayton enjoying what she was doing. 

    She enjoyed the clinical work and watching the students learn and grow. More importantly, they came back to the hospital and worked with us. The only part of work at Dayton that she did not enjoy was the supervision of the student nurses dormitory. 

    That was not her strength because she is not good at rules and housemother kind of things. That piece of the work was not her favorite.She had a year between the masters and the doctorate, and took a position at Ohio State teaching psychiatric nursing in the undergraduate program in the school of nursing. 

    She thinks that was one of the hardest periods of teaching she ever had. She was teaching in a program that was analytically oriented and she was inter personally oriented. It was really tough trying to keep her viewpoint and her passion about her viewpoint under control so that it was not disruptive to the students or the program. 

    She was not very successful, but she lived through it. She told the director of the school that she did not think it was working because the people who headed the program and she were too far apart. 

    She told her that of the most important experiences in her doctoral program was a course in which two philosophers articulated their different points of view to the students. This did not happen for her in this year of undergraduate teaching; it was most difficult.

Comfortable As A Teacher

     SHE thinks she has always felt comfortable in a classroom. It's never felt unfamiliar. She believes this has to do with the way she teaches. One of her methods is to know as much about the people who are in the room with her as she can, even if it is an audience of 400. 

    She try to find out how many of them are only children, how many of them are from large families, how many are rural, how many are urban, how many of them are diploma graduates, how many of them have “this” kind of degree, how many are married, how many are single. 

    Then, she can use examples, illustrations, and stories that will tie into the experiential background of the people who are in the room. This “knowing” the audience brings a level of comfort. 

    When comfort is absent, and sometimes it is, when she has not been able to make it happen, it is dreadful; but that is a rare occurrence.

Challenges

    Hilda and she did a large week long workshop for nurses in the state of Ohio on interpersonal counseling and working with a group of very difficult patients. She had half of the students and Hilda had the other half. 

    By the second day, there was already some mumbling in the background about some of them having the great Hilda Peplau and some of them having Mrs. Sills. 

    There were some sessions where we had them together and as soon as Hilda got a whiff of the mumbling, she addressed it. 

    She remember her standing in front of the group saying, “Some of you are concerned that you are getting 'less than' with Mrs. Sills than you are with me. Let her assure you, you are getting equal to and more than. When they made Grayce, they broke the mold.” she will never forget it. 

    It was such an affirmation of belief in her potential and capacity. She thinks that is one of the most valuable things that a mentor does is to somehow signify a belief in the potential and capacity of the person. 

    She always gave her gentle nudging about career guidance. The opportunity to work with her side by side and to debrief with her guided her learning of so many basic fundamental concepts. For example: starts with people where they are, take them as far as you can, value everybody's experience. 

    These learnings seeped into every pore. She did all the things that you do initially with a role model mentor. She tried to stand like she stood and tucked her thumb in her skirt belt the way she did. She knew that those weren't the things that did it, but, early on they were the things that gave her some kind of reassurance from time to time. 

    For many years with Peplau, he was senior to junior mentoring. It was only in the last 20 or 25 years of her life that it was much more collegial.

Embarrassing Moment

    It was early on in her time after her PhD. Among other things, Hilda said that she really should learn about family therapy because that's the new, emerging thing. So, she went to the University of New Mexico workshops that she, Shirley Smoyak, and Bill Field were doing. 

    When she returned to Ohio State, she took on a couple who had a baby for family therapy. She had a graduate student ask to go with her to observe. She said yes. We were in the middle of the time with the couple when the wife excused herself and went towards the kitchen. 

    We waited me, the student, and the husband. Five minutes, 10 minutes, 15 minutes, and finally after about 20 minutes the wife returned and said she had called suicide prevention and that now she felt better. 

    Although this was embarrassing at the time, as she look back on it now, it is funny. But she learned from that experience, too.

Rewarding Aspects

 SHE think the most rewarding period is one that she call the “golden era.” It was about a decade in the graduate program at Ohio State where we fashioned a new curriculum. We were able to design it around a different paradigm from traditional nursing. 

    Most importantly we had a group of faculty who believed in it and who shared a common belief and value system. We managed to maintain that for almost a decade and it was a wonderful time. 

    It save was a time when you worked collegiality with your friends and colleagues and looked for the expansive cutting edge. We were working on putting together what it really meant to think about nursing as a holistic healing profession and to have advanced clinical expertise. 

    It was a wonderful time. The students of that era, who came through that program, have gone on to do some remarkable things. 

    They have gone on to positions of leadership She was interviewed for one of those articles that people write about you after a certain age.They asked how they would know a student of mine. 

    She said, “I'm damned if she know. One of her students runs a quilt shop. She says that it's a place where she does therapy with older women who are depressed. These women tell her that she has saved their lives and she teaches them quilting. 

    While quilting in groups she also does therapy. Another one is writing children's books. Another one is writing music for a Women's Barber Shop Quartet, and doing stress reduction workshops for them.”

Least Rewarding Aspects

     SHE doesn’t think there was any teaching experience she ever had that was not rewarding. She always learned from each experience. You learn how to manage difficult situations, how to convert people to your point of view without creating revolution, and how to deal with irrational authority. 

    There were some satisfying happenings in that tough year that she taught between her master’s and her PhD. Some students from that experience will tell you to this day that it was the best thing that ever happened to them. The teaching was vital. The outcomes were good, but it was a tough year.

Maintaining Excellence

    When she hear myself getting irritated with students that is a barometer that tells her she am too far away from practice herself. Being involved in practice gives you the humility you need to work with people who are learning from their practice. 

    By this she means to know how tough it really is. So this constant refreshment and reminder has been part of the key to maintaining excellence. The other key is to read widely and keep adding to your experience. 

    You grab opportunities to increase your experiential base because the broader it is, the more you have to share with students. 

    When she had the opportunity to go on service boards, it was an opportunity to bring something about how agencies and organizations work. This was helpful in guiding students to think through situations in which they might be working and assessing.

Advice for Teachers

     She would tell new teachers to always be open to the new and novel. Ask yourself what you can learn form this situation. Think of teaching as a gift to make a difference. 

    What difference will this course make in the lives of the students? She think new teachers could be helped with a course in acting to help them express their ideas.

    New teachers should keep in mind that they do not own the student and that outcome measures are for the short term. It is the long-term application and verification of what students have studied that makes a difference.

    You are a co-creator with the students of their learning. If your students don't believe your words they are unlikely to believe your “Power Point” presentations. Find a mentor share your struggles.

    Remember that integration/synthesis occurs when experience meets information, transformed to knowledge which can then be used and shared with others. 

    It may occur as the syllabus suggests, but it is also very likely to occur months or years after the exposure to information.rs should keep in mind that they do not own the student and that outcome measures are for the short term. It is the long-term application and verification of what students have studied that makes a difference.