Baptism by Fire: Nursing Students Prepare for an Unseen Challenge

The COVID-19 pandemic has swept across the United States, with the respect of nurses skyrocketing in every facet. A current nurse describes the turmoil, two students try to virtually learn, while another student takes on the frontlines: what does this mean for them?

You walk through the sliding doors at 7 p.m. and pick up the scrubs the hospital began to wash for you. The calmness felt in the parking lot does not carry over inside, and the chaotic 12-hour night shift you’ve already worked twice that week begins once again. You already have on your face mask and you tie your hair back in a bandana to keep it out of your face. You haven’t even walked into a patient’s room yet.

You begin rotation: N95 respirator mask, check. Another surgical mask, check. A face shield, check. You slide on a pair of gloves, your gown and another pair of gloves. You put on booties over your shoes and turn the door handle – “you’re a nurse, you can do it,” you remind yourself.

Lauren Mansfield, Intensive Care Unit RN at Hudson Valley Hospital in Westchester, decided to become a nurse because she enjoys learning new things while caring for people who are sick. However, she’s had to make adjustments to her her normal routine in the wake of the current global pandemic.

“Myself and my co-workers are working extra shifts just to help, because we need to right now,” Mansfield said. “The progressive care unit has nurses that aren’t trained in the vents and the drips that we use.” 

Mansfield says that only once in her two years of working in the unit has she had all 12 rooms in the ICU full. Once the rooms were full, patients began to spill into units that lacked necessary equipment usually needed for critical care. 

Mansfield, along with other ICU personnel, must oversee nurses who are simply not comfortable with the course of treatment for COVID-19, forcing them to take on extra patients to ensure the best possible care.

“These poor nurses have been thrown into critical care nursing overnight, and it’s terrifying for them,” she continued. “Some have transitioned well, some are struggling and some are afraid.”

Nurses who are unfamiliar with hospital practices during this pandemic are being pushed into understanding. Nursing students, on the other hand, are being asked to step up into roles that are otherwise foreign to their normal practices.

What does it mean to become a nurse?

Samantha Bruno, third-year nursing student at Adelphi University in Long Island, NY, wears her scrubs given to her by Cortlandt Healthcare.
Samantha Bruno, third-year nursing student at Adelphi University in Long Island, NY, wears her scrubs given to her by Cortlandt Healthcare.

Samantha Bruno, third-year nursing student at Adelphi University in Long Island, is a prospective nurse who has transitioned from her coursework to helping others in the best way she can. For Bruno, Cortlandt Healthcare, a nursing home and rehabilitation center, was the best place to start.

Bruno began as an administrative clerk, assisting with the creation of COVID-19 policy and infection control binders, completing FaceTime calls with patients’ families to connect with them when they cannot visit, teaching hygiene to residents and passing out supplies as needed.

Since Cortlandt Healthcare was aware of Bruno’s upcoming graduation with a Bachelor’s of Science in nursing this December, they asked if she would be willing to transition to a nursing assistant, due to high demand.

“This was about three weeks ago when COVID-19 first hit the facility and the virus was spreading its wrath,” Bruno said. “Since starting, other staff members in the building have gotten sick, creating even more of a demand for the help.”

Bruno is exposing herself to a virus of unknown strength, while receiving no college credit to show for it. With risky work like this, she at least is receiving patient care hours that are required for her physician’s assistant program acceptance.

Ashley Valentino wears her surgical mask along with her Western Connecticut State University scrubs, which she would be wearing for her hospital rotations prior to COVID-19.

“I want to become a nurse because I have a strong passion to help people.”

Ashley Valentino, third-year nursing student at Western Connecticut State University. 

Valentino noted she’s always had a nurse’s intuition. Growing up, she was there when someone got hurt holding BandAids, and her dad consistently told her she would become a doctor. After attending the New Visions Program at BOCES in Westchester, where she shadowed doctors and nurses at Hudson Valley Hospital, she solidified her decision.

Jobs in healthcare, which often times require constantly tending to people, can be selfless jobs. A global pandemic however, seems to be the something that snaps us awake and forces us to understand the need for people like Mansfield, Bruno and Valentino.

How can nurses’ lives be made easier as they save ours?

The American Nurses Association began a fund for healthcare workers on the frontlines of the pandemic to “enable the public to support and thank nurses.” This fund’s mission is to provide them with financial assistance, help with their mental health in the present and the future, and resources containing vital safety information.

Although this allocation of money will hopefully assist nurses with the current public health crisis, their student debt is insurmountable and they are currently putting their lives at risk to save others, without saving a penny.

Elizabeth May, a writer for The Intercept and a fourth-year psychiatry resident in New York City, says that basically every person who is admitted for COVID-19 “will be cared for by a team of professionals who, theoretically, have over $1 million in combined student debt.” 

Constantly, with nurses on the frontline of this health crisis, the question of what can be done to help is on the minds of those in other industries. More than half of nurses graduate with $40,000 to $150,000 in student debt.

Bruno kneels down holding her stethoscope. She has a personalized ID tag on it saying “It’s a beautiful day to save lives,” from ABC’s Grey’s Anatomy.
Bruno kneels down holding her stethoscope. She has a personalized ID tag on it saying “It’s a beautiful day to save lives,” from ABC’s Grey’s Anatomy.

On May 5, Rep. Carolyn Maloney, D-N.Y., introduced the Student Loan Forgiveness for Frontline Health Workers Act, which would absolve all federal and private student loans for healthcare professionals who are working closely with COVID-19. 

ABC says that the debt forgiveness would also limit stress of passing away from coronavirus, as medical professionals’ families would no longer be left responsible to pay off loans. Nurses, in particular, are in debt because they were learning the necessary skills to save people, which is needed now more than ever.

“When nurses are called soldiers and told to fight a war, we should wonder what is being overlooked,” May said. “Speak up, Uncle Sam. Support the troops.”

Are our healthcare workers safe while fighting for Americans?

Registered nurses earn a 86.1 out of 100 for a COVID-19 Risk Score, compared to dental hygienists receiving a 99.7. On May 7, nurses placed white shoes (typically worn by RN’s) on the brick path in front of the White House, protesting for better personal protective equipment and working conditions as they put their lives at risk. On April 27, these nurses read off 44 names in protest, but now that number has doubled with over 80 passing away.

Bruno holds her N95 respirator mask. She is wearing the shoes used in multiple White House protests defending the safety of American nurses.
Bruno holds her N95 respirator mask. She is wearing the shoes used in multiple White House protests defending the safety of American nurses.

Bruno, a new nursing assistant at Cortlandt Healthcare, explains that a majority of the staff at the assisted living facility have been using the same masks for about three weeks. The only way to get a new one is if they break, as Bruno finally replaced hers a few nights ago.

Even with protests surrounding the White House and federal government, states are still begging for more PPE to defend frontline responders. 

The ANA says that nurses may choose not to respond to a call to assist if they are in a high-risk population group, if they feel unsafe due to lacking PPE, not enough support for a nurse’s family or they are uncomfortable with ethical and legal protection during COVID-19. 

Nurses shouldn’t risk their own lives to save others, while working to maintain quality of care, says The Provisions of the Code of Ethics for Nurses with Interpretive Statements. 

“You try not to let anyone pass away in a room alone, and you never know when their last breath will be, even as their condition declines,” Bruno said. “They do not have family, so you do your best in order to ensure they at least had someone to care for them in their last moments.” 

Although not on the front lines, how is this pandemic affecting future nurses?

Ashley Valentino, nursing student from Western Connecticut State University, rolls over at 7:30 a.m. to open up her computer and sign into her Webex class. She grabs a cup of coffee, moves her laptop to her desk and prepares for the lessons of the day. She starts by reviewing assignments that were due before switching over to her other courses. 

A clinical, or a time in a nursing students educational track that allows them to apply skills learned in lab and classroom lessons directly to the hospital environment, is now virtual for students. Valentino signs into Webex for a short 30-minute period, just to go over work given and future deadlines. She watches a video of scenarios in obstetrics, reviews case studies and care plans. She now lacks a vital component of her OB nursing rotation: in-person assessments on a mother and her baby. 

“I have been waiting so long for [it], [and] it really sucks that I don’t have that in person experience working with this different population of patients,” she said.

Valentino and her fellow classmate, Kim Brower, have lost their labor and delivery rotations in the hospital, putting any potential hands-on experience out the window. During this semester’s OB rotation, the pair would have worked with pregnant women and in the neonatal intensive care unit. 

Valentino (back) and Bruno (front) wear their PPE while sitting separate from ongoing foot traffic in Cold Spring, NY. The pair feel isolated from others, especially in their scrubs.
Valentino (back) and Bruno (front) wear their PPE while sitting separate from ongoing foot traffic in Cold Spring, NY. The pair feel isolated from others, especially in their scrubs.

As of March 9, hospital clinical rotations were canceled for students at Western Connecticut in order to stop the spread of the virus. As classes went online, so did most of the experience nursing students would gain. Brower thinks the online clinicals are a waste of time, but her professors are working their hardest to give virtual experience. 

Jennifer Ort, an RN and now an assistant professor of nursing at Western Connecticut, still thinks that virtual clinicals are valuable to her students. She could be incorrect, as an overseeing body on education requirements for nursing programs admits not every student is going to find the same level of education during COVID-19.

“Because of the COVID-19 outbreak that is causing practice facilities to limit or refuse clinical experiences, just when we need more nurses in the pipeline, many nursing programs are struggling to find ways to meet students’ clinical experiences,” the National Council of State Boards of Nursing wrote on April 28.

Aside from academics, the question on every nursing student’s mind is: Did I make the right decision? Brower and Valentino agree that they would have chosen the same path, as this turbulent time is something that will pass. “Being a nurse is my ultimate goal in life and it is very hard for me to change that, even now,” Brower said.

Valentino holds her stethoscope and looks into the sunlight, hoping for brighter days. Valentino graduates from her nursing program in the spring of 2021.
Valentino holds her stethoscope and looks into the sunlight, hoping for brighter days. Valentino graduates from her nursing program in the spring of 2021.

The World Health Organization agrees, as in early January, they designated 2020 as the “Year of the Nurse.” This shows people’s appreciation for nurses, as a Gallup poll says that 85% of the U.S. believe nurses have high levels of honesty and ethics, rating them higher than doctors.

“Without the rigorous work that nurses are doing, and soon to be me, we would not be able to get through hard times like this,” Valentino said. “Healthcare workers are the backbone that is keeping this virus from killing a greater population of Americans.”

Linda Aiken, director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing, says that hospitals that employ more nurses have lower patient mortality rates. The American Association of Colleges of Nursing believes that if a hospital were to increase their nursing staff by ten percent, the rate of patient deaths would decrease by seven percent.

“I personally believe this situation should be very eye-opening to nursing students, as they see you cannot choose when to go to work or when to stay home,” Ort said. “Nurses must work regardless of the illness or disease.”

“After this pandemic, the nursing world will be changed forever and I believe that it will be for the better,” Valentino echoed.

Susanna Granieri

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