How COVID-19 Changed Nursing School

Just as universities have been forced to move away from holding in-person classes, so too have nursing schools. As a result, nursing schools have adopted online and hybrid formats for educating nursing students.

The COVID-19 pandemic has disrupted the way people work and live on a very basic level. It is no surprise then, that the education and healthcare industries have also been impacted. More specifically, the COVID-19 pandemic has, according to Kevin Cummings, RN, the Nursing Program Manager at Marymount University, “affected all facets of nursing education.” Just as universities have been forced to move away from holding in-person classes, so too have nursing schools. As a result, nursing schools have adopted online and hybrid formats for educating nursing students.

Keeping Students Safe

Nursing schools have developed a variety of creative learning methods that seek to blend small group in-person learning and online education. These methods, which include using learning pods, virtual clinicals, simulations, and small online group discussions, are designed to limit nursing students’ exposure to the virus while still enabling them to attend labs, clinicals, and in-person classes.

Educating nursing students has never been more important as the pandemic and burnout have further increased an already existent nursing shortage.

How have nursing labs operated during the pandemic?

While labs at some nursing schools were put on hold during the height of the pandemic, most have now resumed. However, students attending labs may still be screened for COVID-19 symptoms. During labs, students may be required to wear appropriate personal protective equipment (PPE) and socially distance. Handwashing is also encouraged before labs. Some nursing schools may also have vaccine requirements.

How have clinicals changed?

Jeanne Carey, RN, the Director of Simulation at Baylor University, explains that even before the pandemic “learning in the traditional clinical setting was becoming more restricted by shorter lengths of stay for hospitalized patients, higher patient acuity, and policies that impose more and more limitations on what students are allowed to do in a hospital setting.”

The pandemic has made it even harder to find clinical placements for nursing students at hospitals. A 2021 cross-sectional study found that only 55% of nursing students were able to continue their clinicals as planned. Many clinical sites were closed entirely during the pandemic’s peak, as hospitals worked to minimize exposure risks and dealt with the increased patient loads caused by COVID-19. While some hospitals have now resumed clinicals for nursing students, the number of accepted students and the hours they’re allowed to be in hospital units has declined.

Nursing students who are fortunate enough to attend school are likely required to be vaccinated, screened, and/or tested for COVID-19, depending on the clinical site.

What changes were made to nursing school requirements?

Because the pandemic shuttered or limited access to clinicals (as well as licensure testing sites), some nursing students’ ability to graduate nursing school and take their licensure tests was delayed. According to NurseJournal, in 2021, up to 14,000 nursing students had to delay their graduation from entry-level nursing programs.

As a result, some state boards of nursing are trying to make it easier for nursing students to enter the workforce by changing education requirements. Some states have suspended or altered the requirements for initial licensure or for license renewal. This response, as NurseJournal explains, was due to the “rising concern that the pipeline of new healthcare workers is halting when the country needs them most.”

Additionally, some states have eased their requirements for clinicals. California governor Gavin Newsom, for example, reduced the required number of onsite clinical hours that nursing students need to graduate. Likewise, Wisconsin allowed students to graduate if they’ve completed 75% of their required clinical hours. Other states like Washington, Delaware, and North Carolina are allowing for flexibility in how nursing school program outcomes are met. In some cases, this flexibility means counting simulation hours toward their total clinical hours, frontloading didactic content, or offering clinical education replacement options, such as serving in telehealth call centers.

Are there any new learning opportunities for nursing students?

Use of simulated learning has become a unique alternative to in-person clinicals and lab offerings for nursing schools. Even before the pandemic, simulations were popular in nursing education programs. A Wolters Kluwer study estimates that 65% of nursing programs have been using virtual simulation since 2017. With the start of the pandemic, certain states have determined that virtual simulation learning is a suitable alternative for developing clinical competencies. As a result, virtual simulation’s popularity has continued to grow.

Virtual simulations are designed “to create meaningful and safe patient scenarios for students [that] they might not have the chance to experience in a traditional clinical placement.” In other words, simulations offer students a controlled environment where they can practice a wide variety of skills without risk of harming real-life patients. Moreover, because simulation learning is virtual, students have the flexibility to choose where and when their learning takes place.

Studies have shown that simulation learning that is followed by a debriefing is not only effective for knowledge acquisition and skill development, but also increases nursing students’ self-confidence. As KT Waxman, the Director of the California Simulation Alliance at HealthImpact, explains: simulations are integral to nursing education because “[w]hen instructors create clinical scenarios over Zoom or show a video of a heart failure, debriefing allows students to grow more confident in their ability to handle those situations.”

Advancements in simulated learning continue to develop, making it clear that this learning format has become integral to nursing education.

What is the outlook for current and future nursing students?

The nursing education and healthcare professions will look very different in a post-pandemic world. The changes nursing schools made in response to the pandemic are likely here to stay, especially when it comes to the use of educational technology and experiential learning opportunities. Furthermore, the pandemic revealed gaps in nursing education that have prompted curriculum changes, particularly in students’ health emergency education and training.

The future of nursing also means grappling with an ever-present nursing shortage – a problem that already existed before Covid-19. The onslaught of the pandemic only exacerbated the need for nurses as workloads increased, nurses infected with the virus had to isolate or quarantine, and nurses struggling with burnout left the profession. Compounding the shortage even more is the fact that new nurses are slower to enter the workforce due to the shuttering of medical board testing sites and social distancing measures.

The impact of this shortage also extends to nursing schools, which have had to turn away applications because of a lack of clinical sites, faculty, and resources caused by the needs of the pandemic. In 2020, more than 80 thousand qualified applicants were refused acceptance to nursing schools, a number that jumped to nearly 92,000 in 2021.

Increased interest in nursing

The good news is that there appears to be an increased interest in nursing as a result of the pandemic. Dr. Deborah Kelly, chair and nurse administrator for the department of nursing at the University of Pennsylvania, explains that “There have been a lot of positive stories about the impact nurses have had during this crisis…I think that the pandemic has inspired people to become nurses.” Kelly might be right, since enrollment in entry-level nursing programs has grown by over 3% since the pandemic began.

Employment opportunities for registered nurses are also projected to grow between now and 2030. According to the U.S. Bureau of Labor Statistics, an estimated 194,500 nursing job openings per year are expected over the next 10 years.

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