Nursing students at Arizona State University are feeling overwhelmed and nervous about their future careers since the switch to virtual clinicals. Hospitals started closing their doors to college students in clinical programs across the country back in March because of the coronavirus.
Judy Karshmer, dean of the ASU Edson School of Nursing, said hospitals had students leave because they were unfamiliar with the treatment of COVID and what it would do to their resources, but the school jumped into action immediately.
“We were able to pivot (to online) very quickly,” Karshmer said. “Our faculty and staff were amazing and started providing simulations that could help the students successfully complete the academic year virtually.”
After the spring 2020 semester finished, the Edson school brought back some students for in-person simulations in July until the hospitals slowly opened up again to a limited number of clinical participants.
Even for graduates who finished their degrees online, they are excelling in their post-grad testing scores and landing jobs, Karshmer said.
“For every graduate that left ASU nursing in the springtime, their board scores are as good, if not better, than the graduates in years before,” Karshmer said. “They are getting jobs and they are walking into clinical studies with confidence based on the fact that they were able to not go home and close the school, but continually learning and successfully graduating.”
Karshmer said that the Edson school has to meet a minimum requirement of an 80% job placement rate for graduates, and that it has exceeded that number every year before. She said that, if anything, this pandemic has highlighted the importance of having enough nurses.
Professor Salina Bednarek, the director of nursing pre-licensure at Edson, said that this kind of success would not have been achievable if it wasn’t for the staff teamwork. She said these educators were invaluable in creating a learning style that was not location dependent, but universal for all students in getting the best nursing experience.
“I think the greatest success out of that was excellence in education that really changed the way we think about nursing,” Bednarek said. “We’ve learned so much in the last nine months that we’ve really positioned ourselves to deliver even better and higher quality education than we originally thought possible via these various modalities.”
Bednarek said that although some virtual clinicals are in process, Edson is still keeping a hybrid approach to the curriculum to ensure the safety of both the staff and students. She said she has also received feedback from nursing students with reports that the content taught in the online classes translated well to real-life hospital experiences.
“It was a really good experience for them to walk into a clinical facility and realize that we had been doing over the course of the spring semester and the fall semester had actually bridged quite well,” Bednarek said. “It allowed them to walk into their clinical facility and be very successful.”
Since the in-person clinical spots are under more restrictions, Bednarek said priority is given to seniors and upcoming graduates, then next in line are term seven students for the pediatric and critical care units, and more recently, term six students for the mental health and obstetrics units.
However, Olivia Carpenter, a term seven nursing student who started the program over the summer, said that she thinks if the opportunity to do in-person clinicals is presented to some, it should be presented to all students because “we all worked really hard to get to this point.”
“Some of us are halfway through nursing school and we haven’t even been to the hospital yet,” Carpenter said. “We did all the same pre-rec classes, had to get the same grades as them to get into the program.”
Carpenter also said she has not received the kind of support she hoped for from her educators. She said there were some good clinical professors who sympathized with the students, but others compared nursing students to medical students, saying that they “don’t have it that bad” since they are not studying to become doctors.
“It almost undermines our feelings. There was also this big orientation for term six students at the beginning of the semester and they were kind of saying that Zoom is the same as in-person and discrediting the concerns students were expressing,” Carpenter said. “It annoyed a lot of the students because their feelings weren’t validated.”
Because she has had no in-person training, Carpenter said that it was disappointing to have to participate in virtual clinicals because she was excited for more hands-on experience. She said although the simulation labs do a “decent job” teaching the appropriate procedures, it would be very different in-person, especially in awkward situations.
“I just feel like we’re lacking in our patient interaction skills right now and clinical thinking skills because that’s where we get that repetition,” Carpenter said. “For example, we learn how to put in a straight catheter on a mannequin, but I’m sure that experience would be totally different if we were doing it on a real person.”
One of Carpenter’s biggest worries is that the online clinical hours will not count in certain hospitals. She said she is aware that Arizona accepts them, but her goal is to move back to California in the near future.
Bailey Scalise, a downtown Banner ICU nurse and ASU alum, said that she is unsure what hospitals plan to do going forward. She said she has a feeling that employers do not have a concrete plan on making a new hiring process to gage how well graduated nursing students honed skills in the middle of a pandemic with virtual clinicals.
“Right now we are in our second surge and we’re already kind of scrambling to just get nurses working, period,” Scalise said. “I just feel like our educators are busy on-boarding travel nurses, new nurses. I don’t even think they’ve thought about that to be quite honest.”
Scalise said that for newly hired nurses, they get at least two to three months of supervised training, depending on the department, but it wouldn’t be a bad thing to adjust that time to make sure they feel more comfortable.
“In any aspect of nursing, it’s already hard enough when you start out as a new nurse, even with the whole schooling experience. I actually got the full nurse experience as much as I could as a student…and I still had a lot to learn,” Scalise said. “So I can imagine it’s even more terrifying for nursing students right now to not even have that in-person, real-life hospital experience.”
Amanda Jackson, term five ASU nursing student, said she does not fear getting a job, but wonders if she will be as good at her job as she wants to be. She said the staff at Edson want everyone to succeed, but it’s hard to teach everything a nurse experiences through a computer.
“You’re just being fed information on top of information and then there’s pre-work and post-work, so it’s just a lot,” Jackson said. “When you’re in school, your mindset is ‘I need to pass,’ so you’re not taking that extra time to think about it and understand it.”
Jackson was one of the few students who had the opportunity to participate in an in-person clinical this semester in the pediatrics unit of Phoenix Children’s Hospital, which she said she really enjoyed because she could see what nursing actually looked like and when to do each task she had learned about previously.
She also said she’s fortunate to have had this experience and feels for others who have not trained in a hospital yet.
“I do know for some students, they haven’t had any and they’re graduating in like eight months… how are you going to go to an interview and be like ‘I have not dealt with a patient before. Please hire me to take care of humans,’” Jackson said. “It’s a daunting thing for sure, but it’s just the reality of nursing right now.”
In Jackson’s case, she’s received more support from her teachers. She said some of the professors feel bad for the students, and explain certain lessons with a disclaimer that what they’re hearing and learning might be different in a true hospital setting.
“The biggest comments we’ve gotten as students is that they’re really proud of us,” Jackson said. “We’re not given a lot of resources but we’re excelling at the highest capacity that we can.”
Contact the reporter at [email protected].
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