I waved goodbye to my group of pediatrics clinical students during my first semester of teaching in February 2020. I was just starting to build my confidence in my teaching skills in the clinical environment. Little did I know, three weeks later the entire country would “shut down” and I would face unprecedented challenges in my roles as a bedside nurse and an adjunct faculty member at the Widener University School of Nursing.
Here we are, two years later, still facing the obstacles that the COVID-19 pandemic has created. As a novice nurse educator, I learned that there were plenty of challenges that I needed to overcome, but there were also some benefits to teaching clinicals during the height of the pandemic. “It’s a blessing and a curse,” I would tell my colleagues, family, and friends.
I returned to teaching in-person clinicals in the fall 2020 semester. The return was particularly challenging because the circumstances of the pandemic interrupted my pediatrics clinical group’s ability to apply what they learned virtually, such as a head-to-toe patient assessment, in the clinical setting. Recognizing that they had never listened to a patient’s heart or lungs before, let alone a pediatric patient, I adjusted my teaching approach to set my students up for success. I offered to let my students listen to my lungs so they could establish what normal sounded like. Afterward, I had them come with me into a patient’s room, and I demonstrated how to systematically conduct a head-to-toe assessment on a pediatric patient. I then accompanied my students to meet their patients, assisted them with completing their assessments, and addressed any questions they had. As the semester progressed, I was able to review policies and work with them through patient care procedures like a sterile central line cap change.
While the circumstances of the pandemic have been less than ideal, I used these new rules to build on my teaching techniques. Even though COVID-19 impacted students’ in-person clinical time, the return to in-person resulted in having groups of four students, as opposed to eight, which allowed me to dedicate more hands-on time with each of my students and their patients. Despite a smaller, more interactive group, the lack of post-conference due to social distancing recommendations presented additional hurdles and required that I incorporate different ways to promote my students’ critical thinking skills. Nevertheless, I was able to spend more one-on-one time talking with my students about their patients’ diagnoses, nursing interventions, and other aspects of nursing care. We also discussed how to prioritize interventions and cluster care.
Being a bedside nurse, nursing student, and nurse educator during the COVID-19 pandemic has been nothing short of a marathon (not that I ever run anyway). While this rollercoaster ride has yet to come to a halt, I have learned so many lessons about how to continue to develop myself as a nurse educator. Through patience, flexibility, and a few mistakes, I have grown into a more passionate faculty member. I truly enjoy watching my students transform each semester as they build their knowledge and confidence in patient care, and I plan to keep doing so in order to continue growing the nursing workforce.
Stephanie Morgan, PhD, RN, FNP-BC, is no stranger to setting up and maintaining COVID-19 vaccination clinics. Thanks to her work with the team of nursing faculty and students, other health care providers, and volunteers that was formed in December 2020 when the vaccine first became available, she has been able to pull together and train teams to work with children, ages 5 to 11 in elementary and middle schools in Del Valle, an underserved community in southeast Austin.
“Depending on the size of the event we need one to two non-clinical check-in individuals, two to four vaccinators, one to two mixers, one observation individual and a clinical lead,” she said. “On the day of the event, we estimate the number of vaccines to be administered and pack vaccine and supplies according to that estimation.”
The team arrives at the event one hour before the start time to set up and prepare the first vials of vaccine. Once they assemble, they conduct a brief with team members so everyone is clear on the plan and can ask questions.
“Likewise, when the vaccine clinic event is over, we debrief to determine what worked well and identify opportunities for improvement next time,” Dr. Morgan said. “At the conclusion, an event report is required to capture a summary that includes the type of vaccine(s) administered, doses given (first, second, immunocompromised or booster) and totals. It also includes doses wasted and if the waste was in a vial or syringe.”
BSNs learn the Covid-19 vaccine routine—and pick up some clinical pediatric experience
Across town, Amayrany Maya-Mora, BSN, RN, and public health nurse at the School of Nursing’s Children’s Wellness Clinic (CWC), begins her day by checking the clinic’s refrigerator and freezer temperatures to ensure that all vaccines are maintained in the proper storage conditions. She then checks in with the front office staff to see if any children are waiting to receive vaccines during the morning walk-in clinic.
“During our daily walk-in clinic at CWC, which runs from 8 to 9 a.m., we usually serve around five to seven children,” Maya-Mora said. “I follow this up by entering vaccine data into Immtrac, the state vaccine registry, order vaccines and supplies, and prepare for any upcoming vaccine events.”
The CWC staff spent a lot of time prior to the Centers for Disease Control and Prevention authorization of the Pfizer and BioNTech SE COVID-19 vaccine for use in children 5 to 11 years old. Once the authorization was given in October 2021, the UT Austin School of Nursing was primed to begin providing it at both the CWC and the Family Wellness Clinic in addition to the area schools.
“Although the basic foundation for providing vaccinations at CWC was already in place, we still needed to provide more specific training,” Maya-Mora said. “We already give vaccines to children, but the COVID vaccine is different in its storage and reconstitution. Plus, we knew training would help boost the confidence of outside volunteers and nursing students. Vaccinating young children can be stressful if not done properly.”
“It’s important to be honest with children.”
Fortunately, Eduardo Chavez, PhD, RN, and a clinical assistant professor at the School of Nursing, had created a power-point training outlining creative ways to help volunteers feel confident and create a more relaxed atmosphere for children getting vaccinated. The slide show demonstrated how to safely hold pediatric patients, addressed appropriate needle lengths and provided communication techniques on how to talk honestly to children. “It’s important to be honest with children,” Maya-Mora added.
In addition, the team provided information to parents and others in the community.
“We made available information about studies and trials regarding the risk of side effects and what types of side effects they might expect,” Maya-Mora said. “There has been a great response, and parents have been very excited about our being able to partner with the Del Valle Independent School District and offer vaccines at their children’s schools. Unlike the CWC, not all pediatric clinics around the Austin area offer the vaccine, so we also provide Saturday clinics at Dailey Middle School and at the Opportunity Center at Del Valle High School. These walk-in clinics will be open through January from 9 a.m. to 2 p.m. It’s very important for parents to remember it’s a two-shot process.”
“Because the School of Nursing was prepared to administer vaccines as soon as they arrived, Del Valle ISD was the first Travis County school district to offer vaccinations in their schools with both doses available before the end of the year,” Dr. Morgan said. “That will amount to an average of 70 vaccinations given at each of the nine elementary schools in Del Valle. Parents who take advantage of these free clinics in their own communities can now relax, knowing that their kids — and their schools — are safer. Vaccinating children is an art, but with training, encouragement, and teamwork, we can increase the number of vaccinators and ensure that children are able to receive the COVID vaccine.”
From the NICU to the OR, five exemplary representatives of nursing excellence received the 2021 National Magnet Nurse of the Year® Awards at the 2021 ANCC National Magnet Conference® and the ANCC Pathway to Excellence Conference® in Atlanta.
The awards recognize the outstanding contributions of clinical nurses in each of the five Magnet® Model components: Transformational Leadership; Structural Empowerment; Exemplary Professional Practice; New Knowledge, Innovations, and Improvements; and Empirical Outcomes. Congratulations to this year’s recipients!
A clinical nurse in the neonatal intensive care unit (NICU) at Miami Valley Hospital in Dayton OH, Tracy Morrison has spent the last 22 years transforming the depth and breadth of clinical bedside nursing. Through autonomous practice and consultation, she and her colleagues have developed, evaluated, and shared best practices that reduce newborn mortality and morbidity associated with early birth. Morrison has forged interdisciplinary relationships not only at the local level, but also nationally and internationally, to improve quality outcomes in NICUs everywhere. In addition, she provides high-quality simulation education to new and experienced NICU nurses to prepare them to care for the most challenging and complex cases. Morrison fosters a culture of excellence and inspires others to follow her example to elevate bedside nursing and make a difference.
Dr. Denise Abdoo is an international leader and mentor in the field of child abuse prevention. As a multilingual Certified Pediatric Nurse Practitioner (NP) on the Children’s Hospital of Colorado Child Protection Team, she has improved the identification and treatment of sexually exploited and assaulted children not only in Colorado but around the world. Her contributions to policy work and systems change are unprecedented. She built Colorado’s only pediatric Sexual Assault Nurse Examiner program and recruited, educated, and mentored nurses for this specialized practice across the Mountain West region. Over five years, the program grew from treating 13 patients to treating 70. In addition, Dr. Abdoo developed web-based education to optimize opportunities for and mentorship of SANE-credentialed nurses at CHCO, CU College of Nursing, and in the community. She and her research team also validated a tool used in the pediatric emergency department (ED) to better screen high-risk adolescents for sexual exploitation. *Sponsored by PALL Corporation
Jennifer Moran, MS, RN, APRN-Rx, ACNP-BC, SCRN, CNRN.
Exemplary Professional Practice*: Jennifer Moran, MS, RN, APRN-Rx, ACNP-BC, SCRN, CNRN
Jennifer Moran is the lead advanced practice registered nurse for the neuroscience acute care NP team and a stroke coordinator at The Queens Medical Center in Honolulu, HI. In collaboration with the hospital’s intensivists, she initiated round-the-clock neurocritical acute care NP coverage, which has significantly reduced door-to-needle time (the time between arrival at the hospital and the start of treatment) for stroke patients. Her initiatives also include integration of a virtual neurological consultation in the West Oahu ED, with a charge nurse identified as Stroke Code Leader, and a dedicated bed for stroke patients in the Punchbowl ED. Through Moran’s leadership, The Queen’s Medical Center was the first and only hospital system in Hawai’i to achieve Comprehensive Stroke Center certification from The Joint Commission, meeting rigorous standards for high-quality, lifesaving stroke care. *Sponsored by EBSCO Health
Christine Wetzel, DNP, MSN, RNC-NIC, IBCLC.
New Knowledge, Innovations, and Improvements: Christine Wetzel, DNP, MSN, RNC-NIC, IBCLC
A clinical nurse at the Carle Foundation Hospital NICU in Urbana, IL, Dr. Christine Wetzel designs and conducts research, evaluates nursing practices, and develops innovative tools that have improved the care of newborns in NICUs across the country. She led the creation of the NICU’s first evidence-based nursing risk awareness instrument for necrotizing enterocolitis (NEC), a potentially deadly abdominal infection that can impact premature babies. The tool, later known as eNEC, increases early detection and fills a practice gap in neonatal nursing. Throughout her 28-year nursing career, Dr. Wetzel has been a passionate advocate of the importance of breast milk. She recently introduced the Evaluation of Mother’s Own Milk (eMOM) guide to help mothers and nurses assess breast milk production during the first month of a preterm infant’s life.
Ellen Harvey, DNP, RN, ACNS-BC, CCRN, TCRN, FCCM.
Empirical Outcomes: Ellen Harvey, DNP, RN, ACNS-BC, CCRN, TCRN, FCCM
Dr. Ellen Harvey is an advanced practice surgical nurse at Carilion Roanoke Memorial Hospital in Roanoke, VA, where she focuses on improving and advancing care for neurotrauma patients. When she noticed current EVD-related practice varied from evidence-based neuroscience guidelines could be contributing to higher infection rates among patients with external ventricular drains (EVD), Dr. Harvey assembled and led an interdisciplinary task force to create a new, evidence-based bundle of care. It includes use of strict asepsis, minimization of line manipulations, equipment standardization, and formal nursing education and competency validation. The result was an immediate and sustained drop in EVD infection rates from 24.7/1000 EVD device days to zero. In addition, this nurse-led, infection-free culture of safety is projected to save the hospital more than $700,000 in the first year alone.
A recent field trip for nursing students at Western Carolina University provided some heartwarming and heartbreaking moments during a day of health care outreach.
The 10 students traveled this month to assist with free dental services in Clarkston, Georgia, a small town within the greater Atlanta metro area that is home to a sizeable community of international refugees and referred to as the “Ellis Island of the South.”
This is where, more often than not, the process of assimilation begins, and the new residents learn to adjust to this melting pot of a country. Over the years, the resettlement program has accepted more than 40,000 displaced persons from some different 50 countries.
“I think one of the moments I will remember forever is the large group of children smiling, running up and hugging or holding hands with me and the other students,” said Rachael Crawford, of Winston-Salem. “The people, both children and adults, showed positivity no matter what their prior circumstances or past trauma had been.”
The WCU group came away with career experience and cultural insights, as well as experiencing some poignant moments during the visit.
“It broke my heart to see kids get excited over getting a toothbrush, a bar of soap, toothpaste, and just other things that I take for granted and do not get excited about,” said Sydney Kinter, of Rutherfordton. “These kids were fighting to get in line to be the first to learn how to properly wash their hands.
“My favorite experience while we were there was when a very cute boy around 4 years old got down on one knee and proposed to me, taking a tire from one of his toy cars,” she said. “At first, I had no idea what he was doing, but when he slipped the tire onto my finger, I knew exactly what he meant. It was honestly the sweetest thing ever.”
Cheryl Clark, an adjunct assistant professor in the School of Nursing, organized the trip through Nurses Christian Fellowship in conjunction with Envision Atlanta, a faith-based mission group. It was a combination of community service and skill-building workshop, the type of activity that the School of Nursing is known for.
“There is so much incorporated into one service visit,” Clark said. “We put together hygiene kits beforehand to distribute to the children when we get there, we help with basics with adults, from filing paperwork – which can be challenging with so many different languages – recording blood pressure, weight and height and general medical assessments, to helping doctor as they process patients.
“Our students were brilliant, getting kids to help translate for parents when they could, showing kindness and going beyond the required procedures to personally reach the person and make them feel cared for,” she said.
Clark expressed appreciation to Lane Perry, executive director of WCU’s Center for Community Engagement and Service Learning, for assistance with transportation arrangements and other logistics. Future trips to the refugee community are scheduled, including several that will include nursing school alumni.
“Getting to experience the culture and being able to provide some health care and conversation with those in the area was very meaningful to me,” said Billy Pilcher, a senior who anticipates graduating in December. “I hope I am able to return in the future to Clarkston, Georgia, and be able to show the individuals there in the community how they are worthy and cared about so much.”
After studying neuroscience and immunohistochemistry at UCLA, Starks apparently realized that she was a definite Type N and decided to become a nurse. Already bursting at the seams with undergraduate degrees, she flew to the East Coast to pursue her studies in nursing. In New York, she went for an accelerated bachelor’s degree program for non-nurses (APNN) at the University of Rochester School of Nursing. Upon graduation, Strong Memorial Hospital snapped her up before she had a chance to go west again and installed her in the adult operating room, where she now works as a skilled vascular surgery nurse and preceptor.
However, Starks does not spend all of her time lollygagging about the OR or burying her nose in a textbook; she wants to effect change and has already created a place for herself among the new generation of upcoming nurse leaders. She is an active member in her local National Black Nurses Association chapter, the Rochester Black Nurses Association (RBNA), a founding member of the local chapter, and the chapter’s first vice president.
But that isn’t all. Stark is paying it forward as the founder and chair of the RBNA mentoring program in partnership with the URSON’s APNN program, where she and other Black nurses mentor nursing students of color. In true Type N fashion, she also manages to make time to participate as a member of the NPA’s Diversity, Equity and Inclusion committee.
After she earns her degree, Starks plans to work as an FNP in primary care. Her passion is caring for those with chronic diseases, especially African American patients. She plans to continue her advocacy for Black patients and students through her continued work in RBNA and other organizations and mentoring programs.
Unlike many students during the pandemic, Starks has been very fortunate with regard to clinicals, and told a reporter that “Luckily, within my program, they didn’t stop us from doing any type of clinical rotation or any type of classes.” In her acceptance speech, the charismatic FNP-to-be graciously thanked everyone who made the award possible and declared her dedication to helping to further NPs’ scope of practice in New York State.
To see an interview with Starks at a local Rochester station, click here. Her acceptance speech is below.
*There are two NPA winners, actually, and we congratulate the Region 7 winner Margaret O’Donnell, DNP, FNP-BC, ANP-BC, FAANP, who will have a post of her own shortly.
Nurse of the Week Kashon Holmes, RN is also our candidate for Father of the Year. Holmes had long dreamt of becoming a nurse. He had done his homework early and was keenly aware that school would require an intense commitment and focus. “I tell people nursing school will not be cheated on,” Holmes told a reporter. “You need to be 100 percent in, or it’s not going to work out.”
Back in 2002, Holmes was ready. Shortly after his first son, Kashon, Jr., was born, Holmes enrolled at Maria College School of Nursing in Albany, NY. However, while the young man was grinding away to prepare for his 2003 final exams, he realized that his calling should perhaps have been midwifery: yes, the stork was on its way to bring another little addition to the Holmes family. So, would he have to settle for being a distracted, part-time parent for the next three years? Having already missed out on some of Kashon, Jr’s first milestones, Holmes just didn’t feel like he could become a good nurse if he was an absent dad. Giving up the nursing program was a painful sacrifice, but he felt there was only one choice. “Knowing that I had to take care of my son and raise him and everything, that wasn’t a hard decision,” he says.
So, for the next 18 years, Holmes worked a variety of jobs, including security guard positions and—when things were especially rough—as a school hall monitor. But it was worth every moment he was able to spend with his sons, Kashon, Jr. and Jashon (both of whom had Dad as the coach of their high school wrestling teams). As the boys grew up, though, and started to graduate from high school, Kashon Holmes, Sr. still “felt a little incomplete.” He had more time on his hands, still yearned to be a nurse, and maybe it would be good for the boys to see Dad knuckling down to study for his Chem Lab tests: “I thought I could be a good example for them in the house, studying every day,” he told his local news station.
The Holmes Men: Kashon Holmes and sons Kashon, Jr. and Jashon at the beach.
In 2017, 18 years after he’d had to withdraw, Holmes once again enrolled at Maria College to work toward his BSN. Then, in early 2020, he realized he’d be a graduate of the Nursing Class of Covid-19. The pandemic began filling New York’s hospitals—and essentially shut down all apparent opportunities for clinical hours. The astonishingly swift development of vaccines for SARS-CoV-2 luckily threw Holmes and his classmates a lifeline to graduation: soon, they were helping to vaccinate Albany and its environs. Kashon, Sr., now a Senior, quickly settled into his clinicals under the aegis of Nicole Pollay, the operations manager for a vaccine site at Hudson Valley Community College. Pollay recalls, “So many of them were nervous because they weren’t sure that they were going to be able to graduate until they were able to obtain those clinical hours.” The students’ gratitude for the opportunity, she said, “still gives me chills.”
Kashon Holmes, Sr. graduated on time in May 2021. The reaction of his youngest son, Jashon, must have made Holmes certain that his 18-year hiatus was worth every moment. “I feel proud of him,” said a teary-eyed Jashon. “He worked his butt off. He always was stressed, and like, he managed to do my wrestling and do school.” What greater tribute could a parent want?
For the full story, Mikhaela Singleton’s “Dreams Don’t Quit”—and an interview with Holmes—visit Albany’s Channel 10 site.
