Transcript of interview with Pamela Gale by Margaret Louis, July 10, 1995

An Interview with Pamela Gale An Oral History Conducted by Margaret Louis History of Nursing in Southern Nevada Oral History Project Part of MS-00784 Special Collections and Archives University Libraries University of Nevada, Las Vegas This oral history interview transcript was included in the History of Nursing in Southern Nevada Oral History Project Records (MS-00784). The digital transcript file found in the collection was not compatible with most current computer environments. To facilitate online access, a copy of the transcript was converted to PDF/A by UNLV Special Collections & Archives. Other than the addition of the cover page and this statement, no changes were made to the content of the transcript. +Margaret Louis: In Elko, July 10, 1995, on the Distance Learning Program at UNLV. OK, this is an interview, oral history interview, by Margaret Louis, interviewer, and Pam Gale, R.N. ML: Your name is Pam Gale. Pam Gale: Yes. ML: Is that your first name or your maiden name? pg: My married name. ML: What was your birth name? pg: Pamela Hancock. ML: Who were your parents? pg: Frank and Molly Hancock. ML: What was your mother's maiden name? pg: Molly Knight. ML: Knight? K-N-I...? pg: G-H-T. Um-hum. ML: Would you give us your birthdate? pg: 6/30/48. ML: And, where did you go for your basic nursing? Where did you get your basic nursing education? pg: I got my basic nursing at Northern Arizona University. I graduated in 1976, and that was in Flagstaff, Arizona. ML: And that was an associate's degree? pg: Um-hum. Yes. ML: And, what kind of work experience have you had as a nurse? pg: The first year out of nursing school I worked at Stafford General Hospital, Mount Grand General Hospital, there in Stafford; and I did med-surg and a little bit of OB, and a little bit of Emergency Room. Didn't like Emergency Room. And then I worked in OB when I moved to Arkansas for four years, I did OB, labor and delivery nurse, not nursery. And then, when I moved here, I did labor and delivery, nursery and postpartum. And then I also, um, went into school nursing. ML: When did you go into school nursing? pg: Uhh... I've done it for six years. I just completed my sixth year as school nurse. ML: And that's with... Elko...? pg: Elko Junior High School. ML: ...Junior High School. OK. Why did you enroll in the Distance Education Program? ...nursing education program? pg: Well, it started, um, when the Nevada State Board of Education said, to be a school nurse, you had to have a four year degree. And so we said, "OK, that's fine, we can do that, but you have to make it available for us." And so we went thought the AHEC Department and asked if they could line us up some kind of program that we could work and still go to school here in Elko. So they, I guess, and this is what I understand, they contacted UNR and also UNLV; and UNLV was the one that came through with the program. And made it available to us, so we could work and continue going to school. ML: But you didn't have to leave Elko... pg: Right... ML: ... to get the education? pg: Because none of us could. ML: Why, uh, did you want the bachelor's education, beyond your work situation saying you ought to do this? pg: I don't... I like going to school. I enjoy school work. I enjoy the challenge. I enjoy the mental stimulation that it gives me, and so when they offered this, I know that Pat always said she wanted to get her B.S.N., and that was what she talked about when I worked with her in OB. And I said, "Well, if I ever go to school, it won't be in nursing." [Laughs] And so, I had to eat my words because, when it became available, I've actually really enjoyed it, and signed right up. ML: OK. What changes do you feel took place in you as a student from a distance learning experience? pg: I think it brought a lot of umm... completion, or... What's the word I'm trying to say? It brought a lot of completion to what I had already learned in my Associate's Degree. I know the first year of Nursing was very frustrating because it taught you how to do things, and then the second year Nursing taught you why you did those things. But now, this teaches you the theory and the whole background behind the whole thing, and it just broadened the whole horizon of Nursing, and it brought it all together. ML: OK, so completion. Completion and...? pg: That wasn't the word I meant, it brought it more full circle, as far as why I thought the way I did, and I'm thinking about the theory part of it, because that was something totally new to me, as far as the different nursing theories. I always thought that nursing is nursing, and then you find out the different unitarian, integrated, and those kinds of things. And so it brings you back to who you really are, about how you practice your nursing. And it was very eye-opening, and it brought it full circle for me. Made me... It gave me a lot of basic understanding. Why I do things. ML: <?> pg: Yeah. ML: What about as a person? pg: As a person, too. And it... A lot of the classes like Family, and tertiary and primary, and those kind of classes [pause] actually made me look at my students as a more complete person, rather than just as a student with a headache. Why did they have a headache? Is this something to get out of class? You know, and you try to look at the whole thing. ML: So you probe deeper, you get more information about these people you're taking care of? pg: Yeah. [thinking] And it made you look at them different, rather than just a student, they are a whole, coming from a dysfunctional or a functional family, and why they're responding to me the way that they're responding. It actually made me a lot more patient with them. ML: < ?> pg: Yeah... [agrees] ML: In terms of the Distance Learning, did you have enough contact with your instructors, and how was that contact? pg: The first semester, I don't think it was a very good contact at all. I think Physical Assessment and the theory part was very hard, because our preceptor wasn't teaching us the things that we were supposed to be learning. And I really feel like it wasn't as effective as it could have been. And I really don't know Physical Assessment as well as I should. [pause] And it's simply because we didn't have hands on. Like we should have. ML: <You should have had that?> pg: Yeah... ML: What about some of the other courses, now...? pg: I thought the other courses were fine, in as far as that... Once... The audio was hard because you didn't know who you were talking to. You couldn't see them, and the videotapes that they send up weren't very clear, and the sound was really bad, and, you know, the kids in the room would scoot their chairs, and their papers were rattling. And so you couldn't really hear what was going on, and a lot of times it was real difficult to understand that. And that, once the video came on, and it was a whole new world, and I think that was the ideal thing, to have the video on and the audio, and... ML: Can you expand on that? Why the video makes it so much better? pg: Because you could see facial expressions. You can see actually what they're doing, if they're, you know... Especially like Physical Assessment, if they were talking about a different body part, you knew what you think they were talking about. The people in the room could actually put a face to their voice, and it just made it a lot more personable. And then also, because they could see us, we weren't fooling around as much. ML: [Laughs] There's some people in Distance Learning as a whole, not just nursing, that they believe very strongly that audio is quite sufficient for high level learning. Do you agree or disagree? pg: I disagree totally. ML: Why? pg: I think, and maybe it's just me, it's because when it was just audio, and they couldn't hear us, we were fooling around. We were eating grapes. We were eating snacks. We were... You know, we were listening and trying to learn, but we were also talking amongst ourselves. And sometimes when it would, you know, get a little dry... ML: [Laughs] pg: Can I say that? It's the truth. ML: [Laughs] We could shut it off too, if you... pg: We were goofing around a little bit, but when we knew they could see us, we weren't goofing around. ML: As much... pg: Well, that's true, isn't it? ML: Ahh, so you think it really enhances the learning? pg: Oh, absolutely... ML: Well, I would agree. That Physical Assessment, by audio alone, was a challenge above and beyond the call, I think. But that was what we had at that point in time. [Pause] In what way could your instructor or instructors have enhanced your learning, considering the different type methods, you had just audio, you had the electronic board, and then you had the compressed video? pg: How could it have been made better, during that time? ML: Uh-hum, in each one, if you want to talk to each one, or... pg: Well, I think it would have been OK, as far as the audio on Physical Assessment, if we had had a preceptor, then... I don't think it was fair to her, and I don't think it was fair to us, because Pat, the instructor, liked things done a certain way, but she never told our preceptor how she wanted it done. And I don't think she assumed that she knew it that way, and the preceptor was teaching something different than what Pat was teaching, and so it was really hard, because when Pat came up here, and expected us to know all this stuff, we didn't know it. And I think it would have been better if she had come up herself or trained someone the way she wanted it done, because there's just no way to do that without being shown. And it... ML: Yeah, so <?> pg: Be one, teach one, and that thing, and we never saw it, so we were making it up as we went along, and trying to gather it out of the books and the information that she sent, but you still don't... You can write all the reports that you want to write out of that stuff, and unless you know what you're doing, you don't know what you're doing. ML: How was it with the electronic board, did you take that class? I think that was a family class, or maybe it was a group class, one of the two? pg: Yeah, but I don't think it was real effective. ML: OK, what... pg: Because it didn't work half the time. They could get theirs to work, but we never could get ours to work so we couldn't send anything back. And I think maybe it was because we really weren't trained in it, we were just expected to know how to run it. And nobody ever trained us. So we were in there, just fooling around with that equipment, not really knowing what we were doing. ML: Uhh... Yeah, that equipment was more difficult to use. How about the compressed video? pg: Now, what's compressed video? ML: That's the one you've been talking about that you can see and hear at the same time. pg: Like the on-line...? ML: Right. pg: That was good, because, umm... You felt like you were more in a classroom. Because the teacher was there. She would include both classes, both students down there and the students up here. ML: How was it... Could you talk about having students at both ends, versus ah, the instructor just having students at the distance end? pg: It's a lot easier just have the teacher and not the other students. The reason being was, you couldn't focus that camera well enough on the instructor, and then, the way the table was situated, you couldn't see a lot of the students anyway. And it was very surprising to me, when I went down to graduation, I didn't know really what these people looked like, because they were never real clear, and it was real surprising to see what they really looked like. ML: Oh... That's who you are! pg: That's the way it was, but, umm... having the teacher alone with just our class was the ideal thing, because you didn't... When they would get to talking, they would all talk at once, and you'd just lose them. ML: You couldn't get... interruption? pg: Hmm-um. ML: That's the piece that we need, the eye contact. We need the fully open mike, and that's a problem. That's a problem last semester. We only had the open mikes at this end... pg: They had to pushed, and see they moved us into another room, rather than the room we were in originally. ML: So the open mikes really do, from the student point of view, make a difference? pg: Oh, yuh. Um-hm. ML: Do you feel you needed to increase, or did you decrease your effort when you took the distance classes, as, compared to other courses? You know, when you have the uh, faculty right in the room? pg: I think it was about the same. I um, liked school work, so I liked report writing and I liked doing those kinds of things. So, it really... I mean, I work that way anyway. I don't procrastinate. I don't put things off till the end. I've never done that. And my daughter did that, and it used to drive me crazy. I said, you know, what if the computer breaks down the night before and you can't put this off till the last minute? So I, that, that was probably the same as I always was. ML: So, the preparation, the time that you put into the course was comparable? I mean the learning process, or the immediate fact that you didn't have a faculty in the classroom or easy access, didn't make a difference? pg: Matter of fact, it was easier for this class, because when I first went through my associate's degree, I had three little kids, so the only time I could study was late at night. Where this time I could come home from work and just get into it. ML: So, that was a help? pg: Yeah. Uh, so I don't think... What I'm saying is that I don't think that having a teacher here, had anything to do with... ML: Could you share with other nurses how they might prepare themselves for a distance learning course or program? pg: [pause] I don't know... ML: What kind of things would they... is there anything you suggest they could do that they might not do or not be, have had experience uh, from a regular classroom? pg: I don't think there would be a difference. The only thing you could say is get your prerequisites out of the way, but that would be with either Distance Learning or not Distance Learning, so I don't think there would be any preparation at all. I mean, it's really the same. ML: OK. All right. Uh, what problems, if any did you have with things other than the instruction, such as registration, on-site arrangements, getting references. Anything else...? pg: Registration was fine, except the $20 health service fee. I had to write a letter every semester saying, take these off of the Social Security numbers that I just kept in on my computer, and send them this letter... And I don't know who's doing it now [Laughs], but they were real good about always taking it off, but you had to write a letter, every semester... And the other thing was, um... ML: On-site arrangements here, getting references, articles...? pg: That all was kind of hard. It was time consuming because, usually you had to go and get in on the Syn-all <?>, and they had to or send off for it, so you had at least a two week lag time before you got your articles in, so you kind of had to know what you were doing, before you went in there and ordered it, because you were down to the crunch by the time your articles got in. Uh, so that was not... ML: Uh, did you find that most of them came in good qual... You know, in good quality when they did come? pg: Oh, yeah. Oh, yeah. And the librarians were wonderful about getting them, and calling you when they were in. I mean, there was a good system that way. It's just that they weren't immediately available. ML: Yeah. Did you try to do anything through Grateful Med <?> or where you actually got on-line and had them send you the article right away from the on-line search? pg: I never did that. ML: You used mainly the Syn-all <?> at the community college, right? pg: I didn't have my modem at that time. ML: OK. Uh... pg: And I didn't know how to download stuff. [Laughs] ML: OK. Uh, what were the attitudes toward Distance Learning? Faculty, students, nurses any other group? pg: I thought it was always real positive. A lot of the nurses in the community could see what we were doing and were asking questions, and wanted to be involved with it, and kept saying, "Well, are they going to continue this? Are they going to continue this?" Because after they saw our success, then they were very favorable about doing it themselves. ML: How about in the school district? pg: The school district was wonderful. Um, a lot of times I would leave a little bit early, to get over there, and they had no problems with that. In fact, when I took... uh, it wasn't Distance Learning, but when I took the counseling class, it was right in the middle of the afternoon, and they let me go three times a week for an hour and a half. You know, and they'd never say anything, and they encouraged it. I know Marcia was a lot in favor of this, and would encourage anyone of us who wanted to be a part of this program to try to do as much as we could. ML: So you got support, you feel, from your work environment? pg: Oh, yeah. They were very supportive. ML: Uh, what about ah, just other nurses, not nursing in the school district? pg: Yeah. Like the community nurses and some of the hospital nurses would ask how it was going, and they were aware of it. I know that, when they first came, and I think Dr. Witt came down, they had that big meeting, and there were about thirty of us in this room that were interested in this, and those kind of watched those of us who joined... You know, started taking the classes, and they were kind of asking questions about how we were doing, and was it hard, and some of the things that we were learning. ML: Did they believe that you could do it in the distance mode? pg: Oh, yeah... Oh, yeah. ML: ... any question about that? pg: Oh, no, it was just a really good opportunity. I think everything about it was favorable. ML: Uh, did you have an orientation to Distance Learning? pg: No. ML: So would you recommend one? pg: Yeah... ML: And, if so, what would you recommend be included? pg: I would recommend... especially equipment, rather than just hand them a microphone and say, "Push on this button when you want to talk." There's a lot of things to... to the equipment. And even knowing who to call when the equipment would go down, and we moved so much from different rooms and different equipment, and really, you're just handed these things and told "Do it this way," and you really don't know what you're doing. So, I think the equipment would need to be permanent, would need to be all in one room, and you would need a definite orientation on everything, including the phone number on who to call when it doesn't work, and don't push the encript button. ML: [Laughs] Apparently the encript cut you off. pg: I did that once. ML: [Laughs] Oh well, that's how you learn. Ah, do you think it would have worked better if you'd have had a technician in the room? [pause] Do you need a technician... pg: I didn't think you need a technician. I think you need one available, but I don't think... I think he would sit there and be bored to death. And, I don't think I would... I think it would have stymied some responses to have him in the room. ML: OK. So what you're saying is, as long as you have someone to pick up the phone and say, hey, we've got a problem...? pg: If we really get into a problem, but most of us, as nurses are pretty mechanical anyway. I mean, you're running all these other kinds of machinery at work, the I-vacs <?>, the, whatever you've got going. And if we had had orientation on, you, know if this problem, you do this, and this and that, we could have figured it out. And we did, many times. But I don't think the technician needs to be in the room. I think that's... ML: A redundancy, or...? pg: Yeah. ML: Uh... What were your feelings about returning to school? pg: I was excited to do it. Like I said, I liked school. I liked the challenge. My husband was very supportive of it, and he was behind me all the way. He always said he wanted to marry a nurse before I became one. So he was... And it was a real easy transition for me, because most... all of my children were, where gone. ML: So it was the easier degree, for you, in the process, than...? pg: Oh, sure. Yeah. ML: Did you have any problems in returning to school from... Well, you said your spouse was very supportive? Other family, work, any other areas that... that you had to work out? pg: I didn't have any problems with any support. They were all very supportive. Everyone was. My parents were... real excited about it, and my kids thought that was great, because they were all in school. And you know, we'd complain to each other, we have this test coming up, and we're so nervous... ML: [Laughs] pg: You know, we'd get on e-mail when I got the modem, and would talk about the different things we were learning and stuff. And then my son Jason, who is in electrical engineering, when I went through algebra, I'd call him and say, "Jason, I can't do this." And so, he'd do it for me over the phone, and they were all very supportive. And they were real proud of me for doing it. Were real supportive. Went to all the graduation things, and... ML: Good. What did it do to your relationships, particularly with your children? You were all in school at the same time... pg: Oh, it was wonderful! What a fun thing! Because you can empathize more, of what they're going through. And the struggles that they have. And the report writing, and all of that things. And you... I got a real appreciation for computers, and learned a lot on how to use them and word processors. I mean, the whole thing was an all round education, and not just in nursing. ML: Ah, what kind of thoughts do you have, say, about computers? Say, if a student's going to start the course now... What are your thoughts about computers and their use. pg: I don't know if I could do it without a computer. [Laughs] Everyone should have a computer. ML: Ah, would you recommend a modem, too, or... pg: Yeah... ML: Just a computer to do the word processing? pg: I think a word processing unit, basically, but I think if I had had the fax modem, I could have done a lot more with faxing stuff, to UNLV. I think that would be a good tool, but I don't think it's and absolute necessary. ML: Speeds up the turn around time? pg: Oh, yeah. We fax stuff all over the city a lot of times. ML: Beats driving across town? pg: Yeah, it does! ML: And they have the stuff right away. If you put it in the mail, you don't know how long it's going to take. pg: I've really enjoyed it. ML: Uh, how was the learning for you compared to an on campus course? Uh, you took several courses here for your bachelor's, essentially at the same time you were doing your distance learning. Can you give any comments about comparing the two modes for learning? pg: I think they're basically both the same. The instructors, for the most part, were accessible to us. The distance learning instructors, and we could call them and leave a message on their answering machine, and we always got called back. And I don't think there was a lot of difference. I think it was basically the same. ML: Would you have any recommendations to improve that contact time? Or did it work, uh... pg: I thought it worked... ML: ... that you got the office phone and could leave a message? pg: I thought it was fine... ML: Uh...? pg: With the exception of one that I won't go into right now. ML: Is there anything that you think should be changed with the distance program? [pause] You've been finished now for about six months or a little better, so you've had a little time to kind of step back and think about it... pg: I think the only thing I would change was... the orientation to the equipment and having the equipment stay the same. We went through so many different forms of equipment that you would just learn one, and then they would stick you somewhere else and it would move over here. And then they would add this thing, and... It was constantly changing, and I think that was real hard, because... ML: You're never going to be a dinosaur? pg: No. [Laughs] No, it just changed all the time, and I think, if they had state of the art equipment at the beginning, and it stayed with the group, they need to learn it. ML: Well... pg: But, I don't know how that could happen. Everything changes. I mean, technology is... grows incredibly fast. ML: And nursing changes. It can't always stay the same. pg: No. Everything's totally changed. ML: So maybe... maybe the challenge that you had with the equipment... pg: It was a good thing. ML: [Laughs] It prepared you for some of the nursing challenges? pg: But I totally liked the program, and I was very proud to be a part of it. And they made us feel a part of it, in that... ML: How did that work? What did they do that helped you to feel important? pg: Well, they got to know each of us on an individual basis, and they... I felt like they... they... ML: You mean the faculty... pg: Exactly. The faculty. They knew what my strengths were and what my weaknesses were. They... I mean, the Sigma Theta Tau, I think, was a wonderful thing, because we felt like we were a part of the University, you know, and I even bought a couple of UNLV tee shirts, because that was my alma mater. And... I... It was a good thing, and I think the faculty knew that, and they knew the problems that we were going through, and they knew... Like when Margaret's father died, and when um, Barbara's mother died. And my back problems. And... and they worked with each one of us, through the problems that we had. You know, in real life, you have to deal with these things, and whether you're distance learning or on campus, those things have to be dealt with. And I think all of the instructors were very good about their compassion and their empathy, and working with us with the problems that we had to deal with. ML: Uh, what was the instructor's attitudes about distance learning? pg: I think if they just got used to the equipment, just started talking into it and learned how to use the equipment and learned how to get our feedback that, I think that... I mean, any instructor would be able to do that. And I think nursing, too, because nurses are very adaptive. They are very... subject to change, because nursing changes so quickly, as far as theories, as far as legislation, as far as what you do as a nurse, and as far as your role goes, and because those things change so rapidly, I think anybody could do this distance learning because they are used to change, and they are used to adapting to whatever the situation is. ML: Uh, knowing what you know now, would you get your bachelor's in this mode again? pg: Absolutely. Absolutely; I wouldn't have a hesitation at all. ML: Is there anything you think you missed? pg: Physical assessment. [Laughs] ML: OK. [Laughs] In terms of the technology that we've talked about, can you see any other uses for it and for nursing? [Pause] Have you thought about that at all? pg: I haven't thought about that one, but I'm sure there's an application out there somewhere. I know that in a lot of nursing charting is on computers now, which I think is wonderful, unless the computers are down [Margaret laughs], and then the world comes to a stop. But I think there's a lot of technology that could be utilized in nursing. ML: OK, is there anything else you'd like to add, or anything else you can think of, in terms of distance learning, in terms of being a student in such a scenario? pg: Other than I'm really grateful for the opportunity, and... It did expand my horizons, and it did bring a lot of education that was not available to me before, because when you do live in a rural area, you don't have these opportunities unless something like this comes along, and it's a good thing. I think it's fabulous. ML: Do you think it's worth the money? pg: Absolutely. ML: Would you support paying a higher tuition for uh... being at an off-site campus? pg: Oh, yeah! There's a... I mean, this... I think we paid the same as an on-site student did, and I know that, like Diane Elmo is taking this at Graceland <?>, and she's paying $300 a credit for her nursing classes, and I don't... I think our distance learning program was a lot easier, than um... the way she did it. [Pause] When you do correspondence courses like she's doing, it's self-learning, where here we have teachers who are lecturing, and you're taking notes, and you can ask questions. And at Graceland <?> she went back for a two week period, and did her physical assessment on-site, and that was a good thing for her, but I don't think I could do this course by correspondence. I think there was too many... ML: How much does it... or what impact do you think it has, when you speak about, correspondence, where correspondence versus having a situation where you have other students in the class at the same time? Correspondence, you don't have that student interaction. What impact does that have? pg: Well I think you need that feedback from each other, think you need the support from each other, and I think we were a pretty good group... There was a couple of times that we got annoyed with each other, but I think that goes along with the territory. But, for the most part, everybody was pretty supportive of each other, and we learned from each other. Because each one of us brought to this class different experiences and different levels of understanding of different things, and many, many times we would call on each other and say, "I don't understand what she was saying. Explain this to me." And we were all very supportive and would share notes when one of us couldn't be there, and they videotaped the classes when we couldn't be there for each other, and I feel very close to this group. [Phone rings/pause]