Pulse of health care

Even with the pandemic, those training for the profession are more determined than ever

Nursing educators describe nurses as resilient, resourceful, patient, flexible and caring.

Nurses are tasked with assessing a situation, then doing the best with what they have to care for a patient.

Skills and knowledge can be taught in a classroom setting but are often learned through experience.

The COVID-19 pandemic has challenged nursing school stu

dents as they train for their careers. These future nurses spent the past school year attending their classes and clinicals in ways they never expected.

The silver lining of facing this often challenging situation is they learned how to be flexible and to quickly adapt to new situations.

“Nursing education has always been about real world learning, and the students and faculty alike have been challenged to respond to continuously changing circumstances, most of which they have no control over,” said Dr. Deborah Greenawald, associate professor of nursing and nursing department chair at Alvernia University. “I believe it’s taught them resilience. It’s stretched all of us in terms of patience and understanding.”

Greenawald likened the situation to how much performance standards in an ideal setting are raised when in a crisis.

“In crisis mode the rules change a little bit,” she said. “Sometimes you do things differently than what you’ve been taught in the classroom. Some days we just have to say to ourselves and to each other, it is what it is. Was everybody safe in this situation? Did you accomplish the goals? Did you meet the basic tenets of the plan of care? Can you defend what you did in terms of evidence?

“It might not always be perfect, but using resources that are available to us in present circumstances we’ve met those goals for the day.”

Being in a pandemic did not change the standards nursing students and the programs have to meet. Educators had the same goals for their students this school year as they have in prior years.

“We want to graduate competent nurses for this community and just grow this community,” said Dr. Stacia Visgarda, associate dean of health professions at Reading Area Community College. “We still have to meet outcomes whether during a pandemic or outside of a pandemic.”

In some ways, meeting those outcomes and graduating competent future nurses was even more important because of the pandemic.

“We’ve all in nursing education have been trying to figure out how we continue to supply the need in our community of health care workers,” said Dr. Michelle Wallace, director of nursing programs at RACC. “The public needs to understand the impact (of the pandemic on) bedside, front-line health care workers and how we as the educators need to provide fresh, ready to go, hitthe-ground-running, welleducated, knowledgeable health care workers to be able to help our tired frontline workers.”

Heeding the call

Just as the standards that need to be met have not changed, the desire to pursue nursing has not changed for the students.

“It hasn’t made me want to be a nurse any less,” said Jessica Visbisky, 22, of Leesport, a senior nursing student at Alvernia. “I think it’s actually made that want and desire to be a nurse even more. I’ve really seen what we’re doing and how much of an impact it is making. It’s such an important job for somebody that can handle it.”

Visbisky made the decision to pursue nursing during her junior year of high school.

“I wanted to do nursing when my dad had a heart attack,” she said. “I saw how much influence the nurses had on his care and how big a difference they can make on a patient’s outlook medically.”

Reading Hospital School of Health Sciences’ thirdyear nursing school student Makayla Umbenhauer, 21, of Pottsville fell in love with nursing after her first year of nursing school.

“This pandemic has had an impact on my decision,” Umbenhauer said.

“Thoughts like ‘Do I really want to be thrown into a pandemic as a new nurse?’ and ‘Is this the right choice for me?’ have crossed my mind multiple times.

“This past year has not really changed my vision of nursing. This is what we are meant to do. We are the individuals that people trust the most, and we chose this career path because we wanted to help individuals.”

The pandemic has also not changed the decision to become a nurse for Shanice Mitchell, 21, of Blandon, a soon-to-be third-year nursing student at Reading Hospital School of Health Sciences.

Nursing is a starting point for Mitchell, who plans to become a certified registered nurse anesthetist.

“This past year has been a roller coaster,” Mitchell said. “Thankfully the pandemic has not influenced my decision in any way. When the pandemic hit, I knew situations would be rough, but in the medical field, you must expect the unexpected.”

For Joseph Iannozzi, 20, of Royersford, Montgomery County, a junior nursing student at Alvernia, deciding to pursue a career in nursing was natural.

“My aunt is a nurse, and a family friend is a nurse as well,” he said. “I grew up taking care of my mom. She has bad migraines. I was always babysitting, so I was always taking care of peo

ple.”

Iannozzi believes in some ways the experience of learning to be a nurse during a pandemic has helped better prepare him and his peers for their future.

“I feel like when we come out of this, we’ll be more well-rounded nurses,” he said. “We had to problemsolve and get hit with this huge thing out of nowhere. There’s a lot of change we had to deal with.

“I feel like we can help a lot of people in the future with our knowledge that we’re learning now.”

Burnout, other concerns

Learning to be a nurse during a pandemic has brought to light concerns

the students did not think about as much before 2020.

Seeing the affects the pandemic has had on current nurses and health care workers — whether firsthand or through media images — has made Visbisky more aware of the possibility of burnout.

“We’ve seen the nurses this year and last year experiencing more burnout quicker than ever with the pandemic,” she said. “I see it at my job, and I see it at clinical, nurses are just exhausted from the high number of patients and the level of care they’re requiring. It’s just not what they’re used to. That’s something that I’m very concerned about for going into my job in the middle of a pandemic.”

Burnout and how to avoid it is a topic that Dr. Debbie Rahn, director of Reading Hospital School of Health Sciences, believes will become part of the program

going forward.

“One of the things I think we need to add to our curriculum is that resiliency piece and self-care piece,” she said. “We don’t teach people about how you provide self-care. You are going to see difficult things, and it’s important that you take care of yourself.”

Though the pandemic has highlighted the need for self-care, Rahn said, it is important even in nonpandemic times as nurses have to deal with the residue they take home with them.

“I think that is an important change that we need to really focus on in the future when we educate our nurses,” Rahn said.

Iannozzi’s concerns are looking further ahead on the pandemic’s impact on potential nurses who haven’t yet started nursing school.

“The concerns I have are about the future availability of nurses,” he said. “I don’t know if future nurses would be scared to be a nurse with this pandemic. I don’t know if we’ll see a decrease.”

Rahn is hopeful that will not be the case.

She said she came across some articles recently stating enrollment in nursing programs has increased despite the impact of the pandemic on current nurses and on the ability of nursing programs to be able to recruit students.

“It will be interesting to see what the downstream effects are and what happens with enrollment going forward,” Rahn said. “I expect that it’s going to be a positive influence. I think it’s going to influence people who say, ‘I want to be a part of that,’ ‘I want to help with that.’”

“A great lesson”

Despite, or possibly because of, the challenges graduating and soon-tobe graduating nursing students faced this year with remote learning and restrictions when it came to being in hospitals and other

facilities, educators of the three programs feel their students are prepared to transition from students to nurses.

“We’re ready for this class,” Wallace said. “I think this class will demonstrate the same type of preparedness and competency as they graduate.”

In some areas, they may even be better prepared, educators said.

Being flexible and adapting to changing circumstance quickly; becoming familiar with technology and telehealth; blocking out distractions and focusing on prioritizing the situation in front of them; working as a team and helping one another; patience; a closer focus on personal protective equipment and sterilization; and an awareness of nursing are all skills educators and students believe were emphasized more because of the pandemic.

“I think it did better prepare them in some ways,” Rahn said. “It also showed the role that nursing has in the health care arena and the importance of nursing and nursing leadership in serving in these types of situations.

It was a great lesson that students learned.”

Wallace and Visgarda said the use of technology will help students communicate better with a patient’s support system when that support system cannot be in the room with the patient.

They also highlighted students dealing with distractions at home as the pandemic forced them to complete their coursework while having other household members home because of the pandemic.

“I think that will translate into the health care environment because you have lot of distractions as a nurse,” Wallace said. “You have to figure out how you’re prioritizing, how you’re focusing, that’s not going to be a negative.

I think that my help them in the long run.”

Greenawald said the way students have stepped up and worked together, including interdisciplinary teamwork, has been a hopeful sign for her when she thinks about the class of 2021.

“I’m hopeful for the students who are here now that, having lived through the COVID-19 pandemic and still living through it during their nursing education, they will be different as professional nurses in the future,” Greenawald said. “In good ways in terms of looking to the science, looking to the evidence, not being afraid to ask questions, taking time to educate others to dispel (dis)information and challenge disinformation in a compassionate way.

“That they understand people have questions because they’re afraid, and a lot of times people are afraid because they don’t know the facts. So nurses are in a wonderful place to share information and help people be less afraid. Empower people to make well informed decisions about their health.”

The nursing students agreed with their educators when it comes to their preparedness.

“It’s forced us to think of about 80 different solutions to the same problem,” Visbisky said. “Nurses already have to do that, but even more now. That’s definitely been something that’s going to help us.”

Umbenhauer had similar thoughts.

“I’ve learned that patience is huge in nursing and that a deep breath to relax may be needed every hour,” Umbenhauer said. “Yes, this experience with the pandemic has prepared me more than I thought it would have.”

Iannozzi said he feels more experience came out of the learning during the pandemic that will help better prepare him for his future.

The exact impact of the pandemic on their education will be better known in the years ahead based on how they do on their licensing exams compared to students in prior years and how they adapt to their new jobs as nurses, Rahn said.

Future programs

The educators are also hopeful for the future of their nursing programs.

Even as normalcy returns to society, some of the skills and lessons needed during the pandemic will remain, such as incorporating more telehealth and being innovative in teaching the curriculum. “If anything, it’s really about how do we take lessons that we’ve learned and apply them in a different way and understanding the value here and how we need to look to future growth to be able to meet the needs of our community health care constituents,” Wallace said.

Rahn believes the pandemic put a spotlight on the strengths and weaknesses of health care. She used the example of equitable COVID vaccine distribution and access as one the weaknesses the pandemic highlighted.

Two areas Rahn feels will receive more focus in health care are public health and the ethics involved with how health care works and is delivered.

“A lot of time when you’re thinking about nursing, we think about the individual patient and we’re thinking about the person in front of us and how we help them,” Rahn said. “The pandemic has taught us a lot more about looking at the community. This is an issue that happens to communities.

“We needed to look at how do we protect the community and how do we help the community? We need to look at what we can do as nurses to improve the conditions for the entire community.”

SUBMITTED PHOTO Maternity nurses at Chester County Hospital display handmade signs showing their appreciation for the support they got from the community during the pandemic.

SHEA SINGLEY — MEDIANEWS GROUP Alvernia University nursing students Joseph Iannozzi and Jessica Visbisky feel their experiences learning to be a nurse during the COVID-19pandemic have helped better prepare them for their future in nursing.

SHEA SINGLEY — MEDIANEWS GROUP Alvernia University nursing students Joseph Iannozzi and Jessica Visbisky examine one of the mannequin patients in a classroom in the nursing resource center on campus.