Tuesday, May 24

Even with COVID-19, it is crucial nursing students get enough hands-on training


Nursing students need crucial hours of in-person training now more than ever, but increasing the percentage of online instruction won't help with that. (Daily Bruin file photo)


This post was updated May 5 at 12:22 a.m.

Health care equipment is not the only necessity in short-supply when there is a shortage of training opportunities for nursing students as well.

The recent move to online learning has affected every department at UCLA, but for students in the UCLA School of Nursing and the David Geffen School of Medicine, these changes could make the difference between an effective future nurse and an unqualified student.

In-person clinical hours, usually in abundance for students in these programs, have been hard to come by now that the California Board of Registered Nursing has decreased the number of clinical hours students are required to perform from 75% to 50%.

While this change is meant to help students continue their graduation requirements despite difficulty placing them in in-person clinics, loosening required person-to-person hours doesn’t address the lack of in-person opportunities for certain classes, and may produce less capable health care workers. An opt-in program for current nursing students eager for an opportunity on the front lines will not only provide better experiences but also help supplement the currently understaffed hospital workforce.

On the surface, more online hours seems to give greater leniency to students whose universities haven’t had much luck placing them in hospitals. However, this flexibility can only take students so far when any number of hours still must be completed in-person.

Valerie Espinosa, a third-year nursing student, experienced an issue with her geriatrics class because of the coronavirus.

“(For) my geriatrics course, … I finished my 15 hours online but, unfortunately, the other 15 we cannot do in person because geriatrics are a vulnerable population,” Espinosa said. “So from my understanding, we are going to receive an incomplete, and we are going to do the in-person clinical hours we require fall quarter.”

This change to the training requirements will only delay and disadvantage students like Espinosa, and depending on how long this pandemic lasts could impact their ability to graduate. And there’s no guarantee hospitals will be ready to have students around vulnerable patient groups by fall quarter.

And if clinical hours get cut back further, the standard of education could fall with them. According to a study performed by the National Council of State Boards of Nursing did not find that an online curriculum could entirely replace more traditional in-person hours.

Yue Ming Huang, an adjunct associate professor in the UCLA anesthesiology and perioperative medicine department, doesn’t think virtual simulations should completely replace the more traditional methods for training future doctors and nurses.

“So you can start off with the conceptual learning where there’s lectures and discussions and that’s all cognitive knowledge-based, but that’s very beginning level,” Huang said. “Everyone understands what to do, but how do they actually show that they know how to put that knowledge into actual practice?”

For people who are going into the medical field, general knowledge application is paramount. It’s not just important to know how to diagnose a patient from afar, but it’s essential these health care professionals know how to apply their knowledge to save a patient’s life.

And applying that knowledge over the computer isn’t nearly the same as doing so in person.

According to Huang, online clinical classes make use of drop-down menus to provide students with potential options. But people want to know their doctor or nurse is capable without a word bank before they arrive at the hospital.

Unfortunately, doctors and nurses working through school during this pandemic may not be as well trained in hands-on work as previous classes. In addition to more time online, some nursing students are having trouble being placed in training for the roles they’ll want in the future.

“Students aren’t in their preferred units all the time,” said Dr. Mary Ann Shinnick, the director of the simulation and skills lab at the UCLA School of Nursing. “For instance, the students who are getting ready to graduate, some of them actually would’ve normally gone into ICUs and of course that couldn’t happen.”

As advanced as these clinical simulations are, no amount of online training can prepare a student for working in an intensive care unit as well as hands-on experience can.

Obviously, we are in the middle of a pandemic, and putting students close to people with COVID-19 against their wishes would be irresponsible. No matter how beneficial in-person training may be, student safety comes first and putting students on the front lines without their consent would be unfair.

However, these aren’t just any students. These future nurses might want the opportunity to help during a time of crisis in the health care system – and ultimately, they worked their way to nursing school and should have access to the resources they signed up for if they want to opt-in.

Students are getting in-person hours in lower-risk departments, but that training won’t help them if they’re planning to work with vulnerable patients. Future doctors and nurses need a mix of hands-on experience and virtual training and it’s crucial now that they receive it.

It might seem dangerous to allow someone to opt-in to clinical work in the middle of a pandemic.

But it’s unfair not to give these students the option, and the understaffed health care system could certainly use the extra help.


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