As hospitals bring in traveling nurses and California urges retired medical professionals to volunteer their services amid the coronavirus pandemic, nursing students set to graduate this spring are being told to stay home.
Texas and Virginia in recent days have moved to loosen regulations and allow nursing students to join the workforce, but officials in the Golden State have not. Under normal circumstances, students need to log hundreds of clinical hours at hospitals to graduate and become licensed. But as the virus has swept across the state, hospitals have largely told them to stay home — putting their dreams of helping people on hold.
“If you’re going to make it easier for people who are retired, why can’t you make it easier for people who are about to enter the workforce?” said Zeeshan Mehmood, a senior nursing student at Dominican University in San Rafael. “We’re needed, so I don’t know why we’re sitting at home.”
Hospitals and medical officials have said everyone but absolutely essential employees needs to stay home, including almost all students, for their own safety. But students close to graduating say they can provide valuable care to patients.
Gov. Gavin Newsom has indicated his team is considering the possibility of allowing nursing students to become licensed earlier, but his office did not immediately respond to a request for comment about details. Likewise, the Board of Registered Nursing (BRN), which handles licensing, has not weighed in publicly.
In a letter to the California Nursing Students’ Association, Loretta Melby, acting executive officer of the board, said the board was looking into options and monitoring the situation, but did not have the power to lift regulations.
In a Facebook group that had swelled to nearly 2,000 members by Thursday, nursing students in limbo have banded together to push the state to take action, share what they’re hearing from their schools and lend each other words of encouragement.
The National League for Nursing and the National Council of State Boards of Nursing this week issued a statement in support of the students.
“Our nation faces an increasingly urgent need for more nurses. While the COVID-19 outbreak has forced many educational institutions to send their students home or provide them with online learning, it remains imperative that nursing educators also find ways to help their students graduate on time this spring,” the groups said.
One option, Mehmood said, could be for graduating students to get provisional licenses, be allowed to work and then have those work hours count as the clinical hours typically required to be a full-fledged registered nurse, or RN. Many students, he said, have put in more than enough hours to qualify as nursing assistants, but getting that license also takes time and money and is a different educational path than the one required to become an RN.
Another option students have raised is simulations that would allow them to demonstrate virtually that they are capable of providing quality care.
But in their letter, the BRN board wrote, “As a matter of policy, the BRN considers that time spent in direct patient care better prepares a student for situations the student may face once licensed. A lack of direct patient care may result in graduates not having sufficient educational preparation and opportunities that require requisite knowledge, skills, and abilities needed to safely and competently perform required nursing functions.”
“It’s like we can’t do anything,” Mehmood said. “It’s counterintuitive.”
Schools are continuing classes online for now, and students say professors are trying to keep them on track and updated in a landscape that is constantly shifting.
Some medical schools, too, have canceled clinical rotations for students studying to become doctors. At UCSF, fourth-year medical students are helping at the hospital and third-year students are slated to return next week — although not to work directly with COVID-19 patients, said Hunter Jackson, a third-year student.
“We’re very eager to help out where we can, but we also know the hospital is trying to keep us safe and patients safe,” he said.
Hospitals are also trying to stretch limited personal protective equipment, PPE, like masks and face shields, as far as possible, in some cases asking nurses to reuse masks or wear them for extended periods when they would normally change them.
In an interview with the editor of a medical journal, Stephen Parodi, an infectious disease expert who works at Kaiser, said people are “literally going to hardware stores” to buy materials to make face shields and relying on baby monitors so physicians can virtually examine coronavirus patients without having to don protective gear and enter the room.
“I think it’s incumbent upon all of us to save PPE because the manufacturing shortfall in China is not going to be fixed in the next month,” Parodi said.
Jackson and other medical students at UCSF have launched their own PPE drive while they wait to be allowed back into the hospital, urging individuals and businesses that have masks and other gear to donate them.
“With the wildfires last year and the year before,” he said, “people had masks.”
Still, Jackson acknowledged, “I hope the supply lines become robust enough in the next couple of weeks that we don’t need to be collecting masks from the community.”
Like Mehmood and their fellow nursing and medical students, he’s anxious to get back to work.
