Millions of students across the United States have been sent home from college and ordered to continue their education through virtual learning due to the coronavirus (COVID-19) pandemic. For most students, including students at the University of New Hampshire (UNH), this includes online Zoom classes and discussions through Canvas, but for nursing students with strict requirements such as clinicals and labs, this poses a new challenge.
Transitioning to non-in-person classes is hard for both professors and students, but it is seemingly impossible for nursing students who are participating in clinicals that are at nursing homes and hospitals. Nursing students are required to take multiple clinical courses throughout their college career so they are able to apply their knowledge and skills in a real health care environment. Clinicals are a crucial part to a nursing student because it applies what they learned in the classroom and labs to the professional nursing world.
Each undergraduate nursing program varies in requirements when it comes to clinical and classes. Typically, the recommended ratio required for a nursing student is to take three clinical learning hours for each hour in the classroom. Julie Hammond, a sophomore nursing major at Fitchburg State University in Fitchburg, Massachusetts, now has to take virtual simulation (VSIM) clinicals. Hammond is given a virtual patient, who she is required to assess through the internet and then use Google Meet with her professor to discuss the correct nursing interventions. Once a week, Hammond is required to do three hours on VSIM and must get an 80 percent or above each time.
Hammond feels she is unprepared.
“Nothing compares to actual clinical practice and what it teaches you,” Hammond said. For her first semester of clinicals Hammond said, “this is why I am worried, I would have liked to get the full experience so I feel ready for next year.”
Hammond received an email from the Fitchburg State nursing department secretary that said that “all hospitals are removing unnecessary personnel.” This means no nursing students are allowed in hospitals or nursing homes to decrease the spread of the virus.
Even with the pause on in-person classes, Hammond is on track to getting her nursing degree and completing her clinicals for this semester through VSIM.
Brooke Hart, a sophomore nursing student at UNH, also has to finish her clinical online for this semester. At UNH, nursing students are finishing clinical by having Zoom conferences with their professor online for about seven hours during the time that clinical would normally take place. During the Zoom meeting, students are assigned case studies which include a virtual patient. Throughout the day, students develop nursing care plans and write IPASS reports, which is a handoff to the next nurse in the rotation that is going to be assigned to that patient.
“It has taken a lot of creativity to decide what my assessment findings will be for my patient,” Hart said.
Hart agreed that she feels she is not getting the same experience.
“The online version is more focused on the thought process behind the care instead of physical tasks like, listening to heart and lungs, taking blood glucose, administering injections, and preparing medications,” Hart said. “I feel less prepared for future clinical because there’s no way to simulate the feeling of actually being present in clinical, observing the actions of nurses and getting more comfortable doing tasks involving hands on patients and interacting with the patients in general.”
Since nursing students are no longer allowed in hospitals because of public health advisories, they are unable to complete their clinical rotations. A New York Times article from March 20 by Emma Goldberg discusses how the pandemic might keep nursing students from graduating in California.
“…Yet a growing number of hospitals are discontinuing clinical rotations for the state’s nursing students. The California Board of Registered Nursing requires that 75 percent of a nursing student’s clinical education be completed with patient contact during hospital rotations. Dr. Goldfarb, dean of health sciences at College of Marin, said that if the state did not change that requirement or encourage hospitals to find clinical roles for nursing students, there would be few nursing students graduating in the coming months,” Goldberg writes.
Luckily for nursing students in the state of New Hampshire, the Board of Nursing “relaxed” Nur 101.04, a rule regarding clinical experience, on March 16.
“The rule relaxes the requirement for clinical experience during the course of a declared state of emergency, and allows the 60 hours of clinical experience to be substituted with 60 hours of simulation and lab work during the state of emergency. It also permits LPN [licensed practical nurse] and RN [registered nurse] programs to substitute in person clinical with simulation,” according to an announcement on the Board of Nursing page of the New Hampshire Office of Professional Licensure and Certification website. This rule is in effect for 180 days.