Nursing students fear graduation delay, urge hospitals to let them fill shortages

Nursing students across the Bay Area and beyond are worried that they won’t be able to graduate and join the fight against the novel coronavirus because hospitals have been reluctant to accept students during the crisis.

By law nursing students must complete 75 percent of their clinical experience with direct patient care in an acute care setting in order to be licensed. But with hospitals facing a shortage of personal protective equipment and worried about spending time training inexperienced nurses, many have canceled the rotations.

Sarah Joseph, a second-year nursing student at the College of Marin, said that she has already completed 632 hours of direct patient care but her final preceptorship, 144 hours in a labor and delivery department in San Francisco, was cancelled and she doesn’t know how she’s going to complete those hours.

If she can’t, she won’t be able to graduate as scheduled in May. And she is far from alone: most of her 41 classmates have had their clinical rotations canceled as well.

Sharon Goldfarb, dean of health sciences at the College of Marin, said:

“My students have come too far and worked too hard to not be able to complete weeks before the semester is over.”

Furthermore, if this class isn’t able to graduate on time, the school won’t be able to take on a new crop of students in the fall, compounding the problem, Goldfarb said.

As many as 12,000 nursing students across California may not be able to graduate this semester, said Joanne Spetz, associate director of research at the Healthforce Center at the University of California at San Francisco.

Noting that California usually has a very well-balanced supply and demand for nurses, Spetz said:

“But having a whole cohort not be able to graduate, that takes some time to recover from at a time that we can’t afford to lose them given increased hospital needs.”

Depending on the spread of the coronavirus, the healthcare system could be stretched to its breaking point in the coming months.

Shortages of personal protective gear are already happening, with the U.S. Centers for Disease Control and Prevention even recommending that healthcare professionals use bandanas or scarves if masks aren’t available. Healthcare systems around the world have faced shortages of staff and equipment as the virus quickly spread and healthcare workers were exposed or became sick.

Unless hospitals change their mind about allowing students to complete their clinical experience, the state will need to relax its restrictions around direct patient care.

Goldfarb and the College of Marin students have been advocating for the state Board of Registered Nursing, a section of the Department of Consumer Affairs, to allow students to complete their requirements with simulations, which Goldfarb said is just as effective as direct patient care.

A petition on Change.org calling for the board to soften its restrictions had more than 52,000 signatures as of Friday morning. The board did not return a request for comment.

Spetz said that some states have also discussed allowing medical students in the late stages of their training to practice early on an emergency basis to scale up hospitals.

She said:

“There’s a lot that they’re trained to do already.”

Spetz added:

“We don’t want unqualified hands on deck, but anyone who’s possibly qualified let’s get them out there.”

Goldfarb said there is a false notion that nursing students are a burden and at least one hospital, Marin General Hospital, has started taking nursing students back after recognizing that they could be a big help at this critical time.

Joseph, a nursing student at College of Marin, said that while she understands concerns that inexperienced nursing students might not be ready to directly treat patients suffering from COVID-19, there are many roles that they still could do.

Joseph said:

“What we are asking for is to be able to help in this crisis in any way possible.”

She said that there are roles in comforting patients and providing information that more experienced nurses won’t have time to do as hospitals approach capacity and experienced staff have to devote all their energy to the coronavirus.

She said:

“There are then roles that they are abandoning that as a new graduate nurse we are confident that we could help fulfill.”

Lindsey Murnin, another second-year student at College of Marin, said that she feels like she could be a resource for strained hospitals and is eager to help. Her next clinical rotation was scheduled to begin Monday at a Kaiser intensive care unit, but was one of the first to be canceled.

Murnin said:

“I’ve been going to school since I was a kid and becoming a nurse has been a lifelong career dream for me.”