Nursing students prepare for the COVID-19 frontlines

In her Louisiana apartment, nursing student Victoria Young listened to YouTube videos of healthy lungs whooshing and sick lungs crackling, practiced a head-to-toe exam on her dog, Eeyore, and used a cup with a lid and straw to learn how to insert catheters. She has had to come up with creative ways to master coursework while locked away from classmates and professors.

The COVID-19 pandemic highlighted the importance of healthcare workers while making it harder to train new nurses. With classes online and hospital hours limited, states relaxed requirements, and colleges redesigned course schedules to help new nurses graduate on time. Meanwhile, nursing students have searched for new ways to learn hands-on skills. The changes have left some with gaps in their training but also with a new appreciation for their role.

Online classes eliminate real-time feedback from professors as students think through patient scenarios. Nursing school is always challenging, but Young said the isolation and time crunch of online learning has demoralized some of her peers. “You’re having to learn it so quickly that some of us just have lost faith in ourselves,” Young said. “Am I supposed to be here? Is this what I’m supposed to do?”

To catch up after last spring’s disrupted schedule, some schools compressed 16-week courses into eight. Two weeks into a course at the University of California, Sacramento, Brook Murray took a midterm that covered a dizzying collection of topics: delirium, managing airways, and cancer care. She may need to take summer courses to graduate on time.

In addition to classwork, students need clinical hours practicing under a licensed nurse’s supervision. States usually require them to fulfill most hours in a hospital, but understaffed facilities loaded with COVID-19 patients have struggled to schedule the time. Many states have allowed schools to use simulations instead. In California, Biola University uses manikins that simulate heartbeats and medical emergencies. But Rachel Van Niekerk, the Christian university’s director of nursing, said, “There’s really no way to recreate in a simulation or a lab the experience of walking into a patient’s room.”

Once in the hospital, students still face restrictions. They’re often not allowed in COVID-19 patient rooms, which can put whole wards off-limits when case counts rise. Murray couldn’t get a clinical spot in a mental health ward, operating room, or wound care unit. To avoid extra COVID-19 exposure risk, her hospital doesn’t let her visit the day before a rotation to learn about her assigned patient. Instead, she arrives 45 minutes before her shift to cram. And Van Niekerk noted the lack of advice from supervising nurses. “The nurses are stretched incredibly thin right now, they’re working extraordinarily long shifts and working extra shifts,” she said. “They’re exhausted, they’re fatigued, they’re not as able or interested to work with students.”

All the changes mean more stress for students. Young said classmates encourage each other through a group chat. In Alberta, Canada, Grace Walton organizes online socials and prays for fellow students. At Biola, faculty spend extra time debriefing students after clinicals to help them process the information and remind them to rely on Christ. “I honestly don’t know how you do this job, this situation, if you don’t believe in the true love of Jesus that’s covering this,” Van Niekerk said.

For many students, the pandemic has shown them the importance of their chosen career. Last spring, Virginia nursing student Erin Green saw videos on social media of exhausted healthcare workers with faces creased from wearing masks. She prayed about whether to continue the program. She said sometimes after clinical rotations, her ears will bleed from her mask, but she’s grateful for the opportunity to serve and pray for patients. “Even if it’s just for a little bit,” she said, “I impact their lives.”