Shea Sawyer Shares the Full Story Behind the Sawyer Initiative
Often you hear that a few people can’t move a mountain; however, that’s not always true.
Recently I had the opportunity to interview Shea Sawyer for The Full Story Behind the Sawyer Initiative and Nurse Practitioner Education.
Shea, along with a few other Nurse Practitioner advocates moved a great mountain. The Sawyer Initiative was a grassroot movement request to the CCNE (accreditation agency that ensures the quality and integrity of baccalaureate, graduate, and residency programs in nursing) to mandate graduate nursing schools to find clinical sites and preceptors for its students.
Shea is a Nurse Practitioner, veteran of the army, and creator of the Sawyer Initiative. His mission is professional advocacy and he strives to bring change in support for the Nursing profession — to add something without taking something.
Krish: Walk us through how the Sawyer Initiative came about?
Shea: I started school at Walden University in 2012 to become a nurse practitioner. I paid my tuition and completed all my requirements. After I had almost finished the entire degree plan, it was time to start clinical. I was denied 3 clinical sites, delayed 3 semesters, a total of one year. I soon found out my clinical site was denied in part because Walden had stated they did not have the right to do business in Texas. So, to salvage some of my hard work and time, I changed my major to an MSN in Nursing Education. I finished this degree and then applied to UT. At UT I was able to complete my degree as an NP. So I went to school from 2012–2018 to become a nurse practitioner. It took two schools, two graduations, more than twice the debt, and twice the time. I finally passed boards in February 2018. That is the same month I started the Sawyer Initiative.
Ironically during my MSN in Nursing Education, I learned about accreditation, accreditation standards, and the requirements of the school. I realized, like myself, many students at many schools have the same problem, namely no clinical site. So, I knew it was a systemic issue and quickly came to the conclusion that it’s the accreditation standards that are deficient or not enforced. The initiative was straightforward and simple — have the CCNE require schools to be responsible for preparing clinical sites and clinical practice experience.
Krish: This is a huge win for Nurse Practitioners! Has it sparked a newfound passion into student advocacy?
Shea: It more so fuels the fire, but yes, to an extent. I have always been this way. I am a big advocate, fan of the underdog. When I was in RN school at San Antonio College, we had one bad test in my OB class. Everyone in the class failed except for two people. I was one of those 2 people who passed. There were two tests: One test for the morning cohort and one test in the evening. We took the evening test. Now these tests were mirror tests, which means different questions but same difficulty level. I knew the morning class had done really well and our test scores were usually similar. So I knew the test was much more difficult for us. So, after the test, we started class. The entire class was there, worried and afraid of failing and getting kicked out of the program. That was the constant fear of students. The instructor had no idea what I was going to do, but I got permission from the instructor and stood up in front of the entire class of more than 40 people. I remember being really nervous. I explained what I thought and started a petition to have either a second test or a curve. Everyone signed with the exception of one student in the back. I gave the petition to the Dean. I argued the tests were not mirror tests and ours were more difficult. Long story short, the faculty curved the test and pretty much everyone passed.
Krish: Who are the main people that have helped you?
Shea: John Canion, Jeff Powers, and Chris Woods, and also Ian Lane. These guys have made this happen too. There are also other people like Carmen Kosicek and Rachel NP from the Preceptors for Nurse Practitioners group. Just in my area locally as well, Justin Cullers is another person that has helped. Also, the Facebook group administrators who have allowed me to post links, people like Chris Pogue, have also made a big contribution. There are actually many key people and networks. You know, without the awareness and sharing, this could not have happened.
Krish: A lot of people in Nursing don’t believe this will change anything. What’s your response to them?
Shea: I know some people believe that. I have seen their comments and received their emails. I usually respond to those people with a question. I ask those people what they see as the biggest obstacle for change and I listen to get a feel for their position. Then I share with them what I see as the biggest obstacle, which to me is the attitudes of people, namely the idea that nothing can be done. In theory, the power belongs to the masses, not an authority. When a group realizes that, united, it can make a powerful change.
Krish: Do the schools have to listen? Can the schools just do whatever they want and does the CCNE really have to make the schools abide by this?
Shea: The schools must follow the accreditation standards. The CCNE must enforce the standards. This is a federal requirement by the US Department of Education.
Krish: What do the new standards state and when will the standards go into effect?
Shea: The new standards will go into effect January 2019. The new standards state that it is the responsibility of the schools to ensure clinical sites and prepare clinical experiences.
Krish: What is the most important thing that needs to take place in order to make this change happen?
Shea: If students know the standard, demand it from the schools, and file formal complaints when, and if, the school violates this standard. The schools will be forced to change.
Expecting preceptors to work for free creates the preceptor shortage, as preceptors are undervalued and receive no financial incentives
Krish: What’s your vision for NP education moving forward?
Shea: Well, there needs to be a consortium of clinical sites and preceptors — a way to calculate resources available. There needs to be an authority on this matter. Program enrollment needs to be very close to clinical sites available and these clinical placements need to be established in advance.
We also need to use the concept of clinical instructors being over many students like other programs, like RN, CRNA, PA. That’s because traditionally preceptors have been a 1:1 ratio. If you think about that, that’s ridiculous. That means you must have nearly as many preceptors as students. Now that’s an extreme, but you see the point.
There also must be a shift away from the idea that preceptors should pay it forward by working for free. The expectation that preceptors should work for free is unethical. I understand an NP should be altruistic, but not in this regard. Expecting preceptors to work for free creates the preceptor shortage, as preceptors are undervalued and receive no financial incentives. If you want to increase preceptors, pay preceptors.
And who, in theory, is the preceptor even being altruistic to? The school? The for-profit school? Because the school, who should be responsible for compensation, is the one not paying. Students do not benefit from this system, nor do preceptors.
Krish: Given your experience in the past year, what’s something you wish you knew before getting started?
Shea: What I was up against. In 2012, Walden did nothing to inform me of information like, “there is a clinical shortage, ” “many students cannot find placement,” and it can be very difficult to find a preceptor”… that sort of stuff. I would have been okay paying had I known about clinical placement services. I do not think students should have to pay for clinicals, but the service is needed because schools are not being responsible.
Krish: Okay, we made it! Last question — what one piece of advice you have for NP students that are having a tough experience in school? How can they take control and improve a bad situation?
Shea: You must obtain a clinical site. Do whatever it takes, even if that means traveling or paying. Options are not really so much limited, but more so limited by what you’re willing to do. So, do whatever it takes. And if your clinical site is bad, be proactive to get the most out of it. Ask questions, reflect, be inquisitive. That is how learning takes place.
Krish: Where can people find more information or get in touch with you?
Shea: Sawyerinitiative.com
A note to the readers: Nurse Practitioners in Healthcare and in the media are underrepresented. I’ve been an NP advocate for 2 years, and working with NP students and practicing NPs has been an incredible journey and one of the most rewarding experiences of my career.
A special thanks to Shea Sawyer again!
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