San Diego State University’s nursing program, along with others across California, have pulled their students from clinical experiences in hospitals amid the coronavirus pandemic.
While the decision greatly reduces the risk that nursing students will contract and spread COVID-19, the disease caused by the coronavirus, it creates a new set of problems.
The students may not have the clinical hours they need to graduate, which would further exacerbate California’s ongoing nursing shortage. A 2017 report by the American College of Medical Quality estimated that by 2030 the state will have a shortage of more than 140,000 registered nurses.
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At this point, the only way nursing students set to graduate this year will make it into the workforce would be if the state lowered the number of hours it requires them to spend on direct patient care. The most realistic way to make that happen would be an executive order by Gov. Gavin Newsom.
Nursing student organizations and the California State University system have written letters to the governor asking for his help, and students have signed a petition. So far, Newsom hasn't responded, and his spokesman didn't respond to a request for comment for this story.
Caught up in all of this is Sarah Faucheux, a third year nursing student at SDSU. She had been spending two days a week in the hospital, fulfilling her clinical hours, until the coronavirus struck..
"I myself was actually potentially exposed to one of the patients being tested for coronavirus," Faucheux said.
She and another nursing student had to be isolated at home until the patient’s results, which turned out to be negative, came back. But by then hospitals and SDSU decided nursing students should no longer be in hospitals.
This left Faucheux with mixed emotions.
"I wish I could be helping on the front lines right now and I sort of feel guilty that I can't," she said. "Because I feel like that's part of signing up for the job, you're taking care of sick patients and infectious patients, so there's a risk to yourself as well."
The problem is that nursing students can't treat patients on their own, but they still need personal protective equipment and other resources that are in scarce supply right now, said Dr. Phillip Greiner, the nursing director at SDSU.
"In healthcare, nurses are the people who run in and take care of patients, some people might say we should have students doing the same thing," he said. "But remember students are here for education, not exposure. As they graduate, they might put themselves in harm's way, but we can't do that as part of their education."
Greiner said it was the right call to remove students from hospitals. But he does worry about creating a backlog of nursing students who can't graduate.
"Not just this year but in years behind them, they would not be able to progress," he said. "These students need to graduate, enter the workforce, be full [registered nurses] at a time when we need them most."
In some states, including Virginia, governors have made executive orders waiving the hands-on requirements.
Others, including Wisconsin and New Jersey, are going so far as to ask nursing students to start working in hospitals amid staffing shortages.
Greiner said allowing nursing students to temporarily work as registered nurses violates schools' accreditation rules.
Faucheux, the nursing student, said she worries that if clinical requirements were lifted, she wouldn't have the full training experience. But, she thinks lab simulations would be enough.
"Even though I can't talk to patients and interact with patients, I can still work on my critical thinking skills and my clinical decision making skills through these simulations," she said.
Plus, she'd still have next year to do more direct patient care hours — assuming the virus subsides. Still, it's hard for her to be stuck at home instead of working in her chosen field.
"In a perfect world, if more was known about this virus and if more personal protective equipment was available, I feel like this would be a really great learning experience for nursing students," she said. "But I feel like the decision to have us not being clinical is better for the greatest number of people and in terms of minimizing the spread."
