To quickly expand the nursing workforce in Texas, Gov. Greg Abbott this weekend announced he is waiving regulations and allowing students in their final year of nursing school to meet clinical training requirements using simulated experience rather than in-person contact with patients.
Faculty at the medical branch were working over spring break to switch classes from in-person to online, said Deborah Jones, professor and dean of the School of Nursing.
“During this time, the COVID-19 emergency escalated and clinical facilities were no longer able to accommodate our students,” Jones said. “So we decided to cancel all direct clinical care experiences and implement curricula that allows students to complete the remainder of their clinicals via a variety of virtual simulated learning.”
Most nursing students graduating from the medical branch in May had already completed more than 50 percent of their clinical training through direct patient care, Jones said, but students coming up on their final semester this summer will be affected by the governor’s relaxation of regulations.
Before the governor’s order, the requirement was that at least half of clinical training had to be on actual patients with less than 50 percent simulated. For now, simulated experience can comprise more than half the clinical requirement.
Students at Galveston College, in addition to actual clinical learning with patients, had throughout nursing school worked with a high fidelity mannequin that can express a full range of symptoms, said Donna Carlin, director of nursing at the college.
“The type of virtual simulation they’re doing now is at home, an online simulation where they’re assigned patients, have to look up their meds then simulate taking vital signs, just as they would in the hospital, and doing a full assessment by clicking on different parts of the body,” Carlin said.
Kyle Hendrix, a final-year nursing student at the college, hopes to go into a critical care field and was disappointed when the clinical training phase at the medical branch’s intensive care units, scheduled for the past five weeks, was canceled because of the demands of the virus on the hospital.
“We think these changes are going to enable us to start working right away, though we don’t know exactly what that means, whether we’ll be working as an aide or a registered nurse,” Hendrix said.
“I want to be at the forefront of what’s going on,” he said. “But not everybody does. I have a 4-year-old child and have had to think about what sort of risk I’d be putting him at if I worked at an emergency room, for example, in the face of the virus every day.”
Diane Blair, a 46-year-old fourth-year nursing student at the medical branch, worked for 20 years in health care administration before studying to be a nurse. Many changes are happening because of the coronavirus crisis that alter both the nature of nursing training and the nature of health care in our country, she said.
“We’ve heard that the national licensure board is making an option to place us under temporary licensure until we can get our actual board examinations done,” Blair said.
She and other students have been working as volunteers with the Houston public health department, assessing patients by phone, something she would never have done if not for the rising need, she said.
“It’s been an opportunity to contribute to the public health domain,” Blair said. “Our system is patient-oriented, focused on an individual patient’s acute condition and treatment. This has brought us to a realization that at this moment it’s all about community health.
The convergence or bridging of these two aspects of health care is something she’s never seen before, Blair said.
The medical branch’s nursing school, with its extensive number of experts in viral epidemics and public health threats like the Ebola virus, has prepared her class well, Blair said.
“I want to say that we’re kind of made for this,” Blair said. “We’re ready to go.”