Faculty/Flight Nurse, Andrew Tran, West Coast University

Once COVID-19 hit in March, we switched over to virtual ED software that allows students to triage simulated patients in real time. It also provides in-depth, evolving patient scenarios that allow students to prioritize, delegate and think critically. It even has background noise so that the students have to assess, think and plan while dealing with the chaos of a clinical scenario happening all around them.

We’ve recently had students at clinical sites again for about two terms, with limited but valuable patient interaction. Some fundamentals students have been brought back onto campus for skills validation using mannikins — with PPE and appropriate social distancing.

Through our relationships with community clinics, hospices and other clinical organizations, we also place students in actual telehealth scenarios where they assess and communicate with real patients presenting with problems and multiple comorbidities. This is done via Zoom, with the instructor, patient and student on the call together.

The rest of the students in the clinical group listen in, take notes and then debrief after the patient encounter. In essence, one student is in the “hot seat” with an actual patient and the rest of the class gets to critique their performance.

Are you concerned about the limitations of COVID-19?

Absolutely. Virtual interactions and learning can only take us so far. For instance, nothing can replace the moment when we start our first IV. I worry that many new nurses will lack that kind of experience and the clinical judgment that comes with it.

Some of our hospital partners are extending their new grad nursing programs and incorporating more skills-based learning so that novice nurses can get the mentoring and coaching they need to be successful.

What do you tell students about becoming nurses now?

When students ask me about my experience and the outlook for the future, I try to be honest as well as optimistic. I tell them that this crisis is real, and it’s scary to work with COVID-19.

As a flight nurse, I transport COVID-19 patients on a regular basis, and even seasoned nurses are concerned. I tell students that I have the same genuine fears as they do — I have a 4-month-old baby at home — and that it’s okay to be afraid. I also remind them that if they ever feel uncertain, they need to speak up, because fear often means you have questions that require answers.

Have healthcare and nursing permanently changed?

There will always be evolution and change, and the pandemic is a powerful opportunity for that. Evidence-based practice means we do research, look back at what we’ve seen and then grow and develop from there. However, the core of nursing — care and compassion — will never change, whatever the circumstances.

How is your school approaching the NCLEX in the 21st century?

We have a specialty team of coaches who focus solely on the NCLEX blueprint for the year. We utilize these experts from the very beginning of fundamentals through the end of our programs and beyond. The coaches are not content experts per se, but testing experts.

Our NCLEX coaching program is a service we provide for our students — it’s not a class. We schedule individual students with the coaches to review their past proctored exams and improve their test-taking performance. The coaches track our students for up to six months after graduation to make sure they have the support they need for the exam.

How do you address technology with your students?

Technology is central to 21st century healthcare, but students still have to understand the basics. I’ll often ask them if they’d know what to do if the power suddenly went out or the hospital’s server crashed. We still teach two-step blood pressures, and we make sure students know their med math calculations through and through.

I also joke with students about whether they know how to write a proper verbal telephone order. They have to prove that they can write a legally appropriate order without the use of the EMR. Students need to have facility with computers and EMR software, but we can’t become so reliant on it that we lose sight of the basic skills and knowledge that make us the nurses we are.

Any advice for a nurse interested in becoming a professor?

They need to garner as much clinical experience as they can. It’s hard to go straight to an MSN in nursing education and begin teaching without the benefit of real-world clinical experience.

My advice would be to get that clinical time under your belt, accumulate as much acumen and skill as you can, learn to be the kind of nurse you want your students to grow into being and then bring that to the educational setting.

I also recommend that you be as kind and compassionate to your students as you are to your patients.

What’s next for your career?

I’d like to get my DNP, however, having a baby and a family definitely makes that harder to do right now. It’s very rewarding to see the determination and drive that our students have for becoming skilled and competent nurses. Melding my clinical work as a flight nurse with teaching is a great way to bring it all together, and nothing could be more satisfying than that.

KEITH CARLSON, RN, BSN, CPC, NC-BC, has worked as a nurse since 1996 and has hosted the popular nursing blog Digital Doorway since 2005. He offers expert professional coaching for nurses and nursing students at www.nursekeith.com.

In this Article: Career Advice, Nursing Education