|Nursing students in California are in jeopardy of not graduating / Photo by Tyler Olson via Shutterstock|
An estimated 10,000 nursing students in California are in jeopardy of not graduating, which means they will not be able to help treat and evaluate patients in hospitals. Their workforce is supposedly desperately needed as hospitals are now facing a nursing shortage amid the Covid-19 pandemic.
The call for flexibility in education model in nursing schools amid a pandemic
The California state rules provide that nursing students should spend a considerable part (75%) of their clinical education in hospitals but they are now barred from completing it because of the lockdown orders. In a report published by news provider KTLA 5, 10,000 nursing students in California set to graduate in the coming months will find it difficult to earn their license unless the state will loosen its rules. This is why California nursing schools called for flexibility to allow these nursing students to get their license.
California-based West Coast University nursing student Ryane Panasewicz, 27, said that she went through a 19-month training program. The end of her school days is near, but her training has come to a halt. Panasewicz added that keeping graduating nursing students out of the healthcare system in the state during this time will only make the problems worse, referring to the pandemic. The threat of the virus has caused hospitals to prohibit students on-site to finish the required clinical hours.
Together with her classmate, they co-authored a petition to lift the limitations on nursing students and shared this with the school’s Facebook page. They were skeptical at first as to how their petition would be received by the school and nursing community at large but it gained support fast. The petition calls on the Governor of California Gavin Newsom to temporarily change the education model to 50/50, which means 50% clinical education and 50% simulation.
Panasewicz said that other states follow that 50/50 education model in nursing schools so they believe that it would also be a great thing to implement in their state so they can continue their education. The West Coast University’s dean of the nursing program Robyn Nelson has also sent a letter to the governor on behalf of nursing programs in California, calling for the flexibility of the education model during the pandemic.
|The threat of the virus has caused hospitals to prohibit students on-site to finish the required clinical hours. / Photo by Savanevich Viktar via Shutterstock|
The need for healthcare workers
College of Marin in Northern California’s dean of health sciences Sharon Goldfarb also said that the 75% clinical coursework that has to be done face-to-face is “an outdated policy” that was written many years ago. The dean said that they should be “practical about what do students need” or the state needs. “We have this global pandemic, and the board is continuing to stick to antiquated regulations,” opined California Association of Colleges of Nursing's president Scott R. Ziehm.
In another US state, Wisconsin, 3,000 nursing students are also scheduled to graduate this year and join the healthcare workforce but their graduation remains uncertain as well. University of Wisconsin-Eau Claire’s dean of the College of Nursing and Health Sciences Linda Young said that the situation would be “devastating to Wisconsin” as they are already short of nurses. Delaying the graduation of the 3,000 nursing students in Wisconsin would put the healthcare system further behind.
The nurse-to-patient ratio is one of the most important topics in the field of nursing. A balanced nurse-to-patient ratio can lead to positive outcomes. When nurses have fewer patients to care for at one time, it means higher levels of job satisfaction. As the number of patients in a nurse’s care increases, it decreases the quality of patient care as well. In California, the required minimum nurse-to-patient ratios in the critical unit are 1:2 or fewer at all times. The RN-to-patient staffing ratios, by type of care, is detailed as follows: Neo-natal Intensive Care (1:2), Operating Room (1:1), Post-anesthesia Recovery (1:2), Labor and Delivery (1:2), Antepartum (1:4), Postpartum couplets (1:4), Postpartum women only (1:6), Pediatrics (1:4), Emergency Room (1:4), ICU Patients in the ER (1:2), Trauma Patients in the ER (1:1), Step Down, Initial (1:4), Telemetry, Initial (1:5), Medical/Surgical, Initial (1:6), Other Specialty Care, Initial (1:5), Other Specialty Care, 2008 (1:4), Psychiatric (1:6).
Studies show that appropriate nurse staffing helps enhance patient satisfaction, reduce medication errors, hospital readmissions, length of stay, and patient mortality, improve safety outcomes by reducing healthcare-associated infections (HAIs) and incident of falls, prevent nurse fatigue, and reduce patient care costs through avoidance of unplanned readmissions.
In Wisconsin, it is estimated that the state will need about 10,000 new nursing graduates to keep up with the demand but considering the pandemic, the number would probably increase. Nursing students and schools in Wisconsin have also sought a waiver from the Board of Nursing to allow them to accumulate clinical hours through added simulated experiences instead of in person. A petition has also been launched, urging the state nursing board to take action. Nursing board exams in the state have also been temporarily suspended and will be resumed in a limited capacity.
Nursing graduates: statistics
Many OECD counties have taken steps in the past years to expand the number of nursing students by increasing investment in nursing education, recognizing that many in the nursing workforce are approaching their retirement. In the latest available record, countries with high nursing graduates per 100,000 inhabitants are Switzerland (101), Korea (100), Australia (85), Norway (80), Slovenia (75), Iceland (74), Finland (69), Belgium (63), Hungary (62), United States (62), Germany (54), Netherlands (53), Japan (53), Canada (52), Denmark (44), New Zealand (43), France (41), and Austria (34).
In South Korea, 75 newly commissioned nurses are scheduled to head to Daegu city, which is now recognized as the epicenter of the virus in their country. The Korean Yonhap News Agency shared that the recent nursing graduates are headed to work in the Covid-19 epicenter where many nurses have already quit, citing personal reasons and overwork.
As there is a disruption in the present educational process, not just in nursing schools, licensing agencies and accreditors in the US are still trying to figure out how they can respond to the situation. There is a need for solutions too, such as deepening the simulation experiences, if the call for flexibility in education is granted.