In Texas, Pennsylvania, Tennessee, and many other states, nursing students are saying, “Would you please roll up your sleeve?”
U Tennessee nursing students prepare Covid-19 vaccine doses.
Being a nursing student during a pandemic may be lacking in some respects, but at schools of nursing around the United States, students are helping to save lives and play an historic role. Some are keenly aware of their position. In Philadelphia, PA, Alondra Torregrossa, a nursing junior at Temple University’s College of Public Health, helped vaccinate 250 health workers at the Temple U Hospital as members of the media looked on. She said, “To be there as a student nurse felt like being a part of history,” but added, with a nurse’s passion for accuracy, that “I wasn’t too nervous, because I had a recently done flu shot clinic on the Health Sciences Campus.”
At Temple’s nursing program—like many others—students leapt at the chance to take part and gain more in-person experience with patients. Undergrad program director Joelle Hargraves remarked, “The opportunity for nursing students to participate was priceless. They eagerly volunteered to be part of an interprofessional team and witnessed how nurse leaders formulated and implemented a seamless plan for immunizing essential health care providers.”
“Despite the hospital being inundated with COVID-19 cases, the vaccination clinic is a glimmer of hope.”
The University of Connecticut School of Nursing called upon their students as well, and during the first two weeks of January they administered jabs to UConn Health staff and monitored them for adverse reactions. 20 students pitched in, but Dean Deborah Chyun said, “We initially had 85 undergraduate and graduate students express interest in volunteering, as well as a handful of faculty. Due to scheduling, not all were able to participate, but that level of caring speaks volumes about our students.”
In normal conditions, students rarely provide vaccinations even during clinicals, but Covid jab duty is now offers a precious opportunity to practice nursing. For example, “There was one occasion where an individual felt dizzy post-vaccination and required further evaluation,” says Amanda Moreau, a clinical coordinator and instructor with the U Conn School of Nursing. “The student played a crucial role in identifying that the individual did not feel well and initiated the proper protocol to call for additional medical assistance…”
After helping give shots to 200 U Connecticut Health workers, needle-wielding student Rebekah Gerber reflected, “It was easy to get lost in the procedure in the moment, but as I reflect back, I realize that these vaccines will save so many lives. It is an honor to have played a very small role in distributing the vaccines.”
Nursing students at University of Tennessee administered 400 shots in a single day. “They had the chance to talk with patients, answer questions they might have about the vaccine itself or side-effects, and even deal with some folks who might be nervous about getting the injection,” according to Victoria Niederhauser, the UT College of Nursing Dean.
A U Conn nursing student remarked on the experience, “I was often asked to take pictures of individuals receiving their vaccines so they could document their participation in this historic experience and encourage others to receive their vaccines as well. Overall, the environment was positive and uplifting. Despite the hospital being inundated with COVID-19 cases, the vaccination clinic is a glimmer of hope.”
Since March, COVID-19 has been affecting our lives in ways we couldn’t have imagined just one year ago. Between quarantines, wearing masks, using hand sanitizer, and the like, our lives have been completely changed. Imagine what it’s like to attend nursing school during COVID-19 right now.
Mikayla Shkedy, a first-year nursing student at NYU in the Nursing Accelerated BSN program, answered our questions about what it’s like and how she’s faring.
Attending nursing school during COVID-19 is so different from any other time in recent history. Explain to readers what this is like. Are all your classes virtual? Do you have to meet at certain times? Or do you log into your classwork whenever you want to?
I have didactic lectures over Zoom twice a week; I have a clinical every other week, and simulation labs, which are essentially practicing medicine on mannequins. Because of COVID-19, clinicals are the same, but simulations are cut in half: the first half goes in for half an hour, and then the second class goes in. We watch a lot of videos. We also do online virtual assessments, which I don’t love. But it’s cool that we can actually listen to hearts and lungs virtually and interact with virtual patients.
We meet on Thursdays and Fridays in person, but Mondays and Wednesdays are synchronous classes over Zoom. We do have many assignments. We have to log in addition to attending, and all lectures are recorded for review.
What has been easy to handle in terms of schooling and classwork? What have been some challenges that you and other nursing students have faced?
It felt like we were thrown into it. It’s very easy to get overwhelmed by the workload—as well as the sheer quantity of information on each exam. Obviously concepts we’re familiar with from before—like diabetes—were easier to grasp. But now we have to understand them at a much deeper level. We’re expected to understand a lot, which is a little bit jarring right off the bat. But after a few weeks, we got the hang of it, and everything after was reinforcement. It’s cool to see what we’ve learned online come to life on real patients.
Have any of your classes been in person? If not, what have instructors done to work around this?
I have had a few classes in person, but we do rely on a lot of videos and demonstrations of blood pressure, catheter insertion, or medication dispensing.
Do you have study groups? What about class discussions? Explain how this works.
They assign projects, so I have gotten to know my classmates a little over Zoom. We also meet each other in clinical, so there is some social interaction. At the beginning of one of my classes, we go to breakout rooms, so there is some discussion element. Not much though.
What have you enjoyed about nursing school, even though it’s been quite different?
I don’t have much to compare it to as a first year, but I enjoy the simulations. It’s definitely harder to learn online, but I feel that I’m learning the same amount as I’d otherwise be learning. I love the patient interaction. I love going in and speaking and learning about people, and I’m constantly reminded why I want to be a nurse. I also like looking at a patient and understanding the intricacies of what is going on in a body. It makes the hours of work feel worthwhile.
What should nurses keep in mind to have the most success in attending school right now?
It’s hard. And it’s stressful sometimes. But that’s okay. You have to remind yourself what your goal is. Try to see the hard parts as just a path to getting where you need to. If it would be easier, would you really trust yourself to make the important decisions you need to make to get where you want to be? Just look ahead and keep pushing forward.
What would you say to prospective nursing students who may be apprehensive about attending because of the changes in learning? Any words of encouragement?
As someone who struggled over whether to start during the pandemic or to wait a year, I realized that at the end of the day these programs wouldn’t be offered if they didn’t think the education would be the same. Lives are in your hands, and a subpar education would simply not be acceptable.
This is certainly a curveball, but life doesn’t always go as planned. If this is what you want, keep moving forward and don’t let the pandemic get in the way. Also, we don’t know when life will be normal or what normal will be. You’ve got to live, and try to stay safe.
Is there anything else you think is important for our readers to know?
Even though nursing school is hard and scary, I’m grateful to NYU for making this transition as seamless as possible, and I don’t regret any of my decisions to start. Anything you want is hard work. But even when I’m struggling, I know it’s for a goal I love, and I know I’ll be happy with my decision. Especially now, it’s important that these schools are open and doing what they can to prepare the next generation of frontline essential workers.
The key to succeeding as a nurse is to always find ways to learn more, whether you’re a student in clinical rotation or on the floor as an RN, says Dante Hatem, RN, who graduated from the University of Buffalo School of Nursing in 2019. Here are his five tips for making the most of your time in clinicals.
1. Learn How to Document
Documenting is a skill every nurse needs to develop. From writing notes to documenting hourly activities, becoming efficient in nursing school will set you up for success in the field. Documenting is tedious, but it’s necessary because it can save you if you ever have to go to court.
Additionally, I highly recommend not picking up bad habits during clinicals, like copying someone else’s assessments. Doing that could result in errors being copied in a patient record, which could lead to patient care errors and disciplinary action if something bad were to happen to your patient. You need to get familiar with terms like rhonchi and crackles eventually, so you may as well take the time to complete assessments yourself.
Over time, you’ll notice that everything comes back to time management. One of the ways you can improve your time management is by becoming fast on the keyboard while still maintaining accuracy. This will allow you to focus on your patients more, especially in an ICU setting, which is my specialty (I like to think I developed fast fingers). For example, titrating a pressor on a pump may be easy—but documenting the exact time and reason you titrated a critical medication can be time-consuming.
2. Learn to Do a Full Assessment… Thoroughly.
Obviously, you want a really good full-body assessment. But doing an assessment in nursing school in front of a professor on your friend is much different than doing one during clinicals, when you could be caring for a patient who has five different chronic conditions and is in the hospital for an exacerbation of four of them.
Here’s exactly what I do every time I walk into a patient’s room:
First, I’ll tell them my name and ask how he or she is feeling. Immediately, you should be able to assess level of consciousness, their pain, and what they are there for. (If the patient is sedated, it’s a different story.)
Then, I’ll go from head to toe by asking them, while I shine a bright light in their eyes, if they can tell me today’s month and year and why they’re here. This should give you everything you need neurologically (minus the extremities).
Next, I’ll tell them I have to take a listen to them. In nursing school, they want your stethoscope to touch every surface area of the patient’s body (which you should still do in class)—but realistically, there are only five lobes you need to find, plus one spot on the chest to make sure you don’t hear muffled heart sounds or a gallop. Then, listen for bowel sounds in four quadrants and ask when their last bowel movement was and if they are having any belly pain.
Once I’ve listened and remembered what the lungs sound like (which is one of the most important parts of the assessment, in my opinion), I’ll check the radial pulses and ask the patient to grip my fingers, noting any signs of weakness in one hand over the other. Then, I’ll check for edema in the feet while I palpate for a pedal pulse. If I can’t find a pedal, then I’ll move up proximally. While doing this, just ask the patient to dorsiflex and plantarflex against your hands.
Lastly, I ask the patient to roll over and check their sacrum for any pressure injuries because they won’t know if they have one. If they develop an injury, and get an infection without it being documented, you might find yourself in the courthouses years later.
3. Be Eager to Learn
Clinicals are what you make of them. One comment a nurse made to me (that I guess you can take how you want) was that I was “overzealous.” The nurse said it because I was always asking if I can help, even if it was a bed bath with someone else’s patient. The preceptors saw that, and they would come to me first if they needed any blood draws or Foley catheters placed.
In my first clinical rotation, I put in three Foley catheters, which was three more than any other student in my clinical group—and it was because I was eager to learn. During your down time, I recommend reading through histories, physicals and progress notes. This is the best way to learn what the hallmarks are for each disease.
4. Find a Nurse You Click With
When I was in my pediatrics clinical rotation in school, I clicked with one nurse who not only made me love pediatrics, but got me to love showing up to the hospital on a weekend that I wasn’t getting paid for.
I genuinely enjoyed and looked forward to working with this particular nurse. She challenged me in the right ways, whether it was critically thinking or prioritizing tasks. Because of her passionate teaching, I was a very confident nurse coming out of school because I felt like I had the foundations of time management, prioritization, critical thinking and compassion.
Not everyone gets as lucky as I was. But if you just be yourself, there will almost always be another nurse on your clinical unit that will appreciate it and vibe with you, and you’ll then learn to love what nursing is all about.
5. Learn the Foundations
In a way, this brings together all of my tips. By foundations, I mean assessments, time management, prioritization, leadership, communication and compassion. Nothing is more attractive to an interviewer and nurse manager than a nurse who can show these skills early on in an orientation. And during an orientation, your preceptor will know how to bring these out of you (whether in a good or bad way).
Learning these foundations in your clinical rotations is the best place to start. Wondering how you can learn leadership skills in clinicals? You can start by asking your preceptor if you can do everything and let him or her know that you will ask for help when you feel that you need it. You can also learn to delegate tasks if you feel overwhelmed because you are both that patient’s nurse and care leader. This also ties in prioritization because you need to do the tasks that are most critical to the patient. For example, if there’s a mess that needs to be cleaned up while you’re giving D10 to a hypoglycemic patient, that’s something that can be delegated to a tech.
You can also ask to can practice speaking to a doctor to work on communication and to become accustomed to the types of questions he or she will ask. If you don’t know the answer, just be honest and say, “I’m not sure but I will find out.”
