The Impact of COVID-19 on Nursing Students
Moving classes online has been hard on UCC nursing students who are parents. Nursing student Nicole Johnston, mother of a 10 year old, has dealt with the challenges of K-12 schooling being shut down, childcare options being limited as well as medical facilities suspending clinical opportunities.
Closure of the K-12 schools meant Johnston was required to teach her own daughter while also trying to handle difficult nursing classes. “Returning to school online as a parent is a balancing act at best. I often am working on schoolwork eight to 10 hours a day,” Johnston says.“Now, my studying is often unfocused and interrupted because I’m having to balance homeschooling my daughter, maintaining the household work, as well as caregiving for my mother-in-law and other family members that have been impacted by the pandemic.”
Creating an environment for test taking has been particularly difficult for Johnston while balancing parenting and work. “Being a student is not deemed as essential, so it’s difficult to find childcare so I can take tests in a quiet and non-distracting environment. There isn’t staffing available to do socially distanced tests on campus, and there isn’t childcare available for nursing students to be able to come take their tests.”
Johnston reached out to school officials about her difficult testing situation and says she was told that they are doing the best they can at this time and are working toward better solutions. “We need some space, time, and more childcare opportunities to ensure successful learning. People need to know how difficult this time is for nursing students,”Johnston says. “Honestly I think that the school should provide childcare at the bare minimum for us to come take midterms and tests. For nursing students who are parents, we need additional support.”
Childcare wasn’t the only struggle nursing students faced. Johnston and the rest of the nursing students as well as their instructors also had to quickly and substantially readjust the clinical portion of their instruction. Clinicals are typically held in the hospital setting and provide hands-on learning. Through clinicals, students are able to apply their learning in real life situations.
“At the point of the governor’s executive orders, all clinicals within the hospital setting were stopped and classes moved to an online format,” Johnston says.
UCC’s Director of Nursing April Mylar explained that the main medical facility used for the clinical portion of UCC nursing students’ instruction, Mercy Medical Center, became unable to offer their site for clinicals. “We would not have had to make any changes to our clinical hours, but we were blocked at our main medical facility due to low patient census [not enough patients] and low PPE,” Mylar said.
In order to preserve personal protective equipment (PPE), Mercy and other medical facilities across the state were only doing emergency surgeries and were lowering the amount of staff members.
“In the normal world, students have clinicals every term. During terms one through three, they do 100 hours of clinicals per term, terms four and five they do 120 hours, and term six they do 180 hours,” Mylar explained. When access to Mercy was shut down, students instead spent more time in the campus Simulation and Skills Center which Mylar says is an on-campus clinical site.
“The Oregon State Board of Nursing said the only way you can replace the face to face direct patient to patient hours with simulation hours was if we had been blocked by the clinical site. So, I had to wait until we were blocked,” Mylar says.“We knew the first year students were blocked on what would’ve been the first week of the term.” She then submitted a plan for the first year students which replaced clinicals at Mercy with additional at-home case work reports and additional hours in the campus Simulation and Skills Center. That plan for the first year students was submitted on March 19 to the Oregon State Board of Nursing and approved on May 20.
Mylar explains that first year students who would’ve had 100 clinical hours did 50 of those hours on campus in its center and 50 at home with case study type assignments.“They technically still have their hours in, but only half were face to face. Basically, we created simulated patients in case studies for that first 50 at home hours. While they were here with us, they had different simulated patients to work through in the center,” Mylar said.
For second year students, Mylar had to work quickly to accommodate their clinical needs. “The first day of clinical for second year students was supposed to be April 6, and I got notification on the 6th that our second year students were blocked. Because of the low census and low PPE, they were asked not to come in. That went through about weeks one through six. By about week seven, they were allowed to do clinicals again just for the second year which gave them 100 direct face to face patient care hours, Mylar says. “It’s no loss in total hours – a mix of at home and face to face will still total 180 hours for second year students,” Mylar says.
Johnston, however, worries about the change in clinicals. “The clinical experience is vital to the transition of integrating didactic work with hands-on learning. Working through clinicals and gaining judgment and experience is vital,” Johnston says. “Missing a whole term of hands-on learning will be detrimental to our work in the field after graduating. I think it will put us behind. We will have some catching up to do on the job.” Johnston also laments that nursing students were receiving nine hours of instruction on campus per week but during spring term were receiving two hours of academic instruction online a week.
Johnston has also raised concern over potential issues with academic integrity with nursing students taking all online classes. “The accountability of academic integrity has been lowered. The nursing program has a responsibility to the community it serves to graduate nurses with a competent base in order to provide the best care for our loved ones. Academic integrity should still be at the forefront. That’s not something to skimp on,” says Johnston.
Johnston has a background in women’s healthcare as a midwife. She then returned to school in 2017. “After spending years in alternative medicine, I decided to transition to working in the medical system because of my desire to create systematic changes, including changes in healthcare equality for women, minorities, and populations without unequal healthcare access,” Johnston says. “I want to be a nurse that spends the time with her patients, providing thorough and complete patient education, respecting autonomy and focusing on pro-active health choices.”
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