Unlicensed nursing students will be able to help the state’s health care professionals fight the effects of the coronavirus, but that change doesn’t help thousands of nursing students who could be delayed from graduating.
The California Board of Registered Nursing released guidelines on Tuesday that will allow the state’s nursing students to join the new California Health Corps initiative based on their level of education. The Health Corps was launched Monday by Gov. Gavin Newsom to recruit unlicensed medical students and health care professionals to fight the pandemic. Newsom said Tuesday that more than 25,000 health care professionals had registered for the corps.
“The Board of Registered Nursing advises health care providers and the public that nursing students can be deployed to assist in health care facilities today,” said Loretta Melby, acting executive officer for the nursing board. “These students will not be violating the Nursing Practice Act by providing services without a license.”
But many nursing students and instructors said they want the nursing board to waive some of its requirements for graduation. They are asking for the nursing board to change its policy on clinical rotations that are needed for the students to graduate on time. Without this change, up to 14,000 nursing students could be delayed from graduating and getting into the workforce just when the state needs them.
The nursing board may still decide to make the change so nursing students can complete required hands-on training in a virtual setting since they have not been able to work inside hospitals due to the coronavirus outbreak.
Clinical rotations are typically done in hospitals with students shadowing nurses and doctors as they care for patients. Students complete the rotations, which are required for graduation and licensing, by training in different departments of health care facilities like an emergency room or pediatrics. The state requires nursing students to have at least 75 percent of these clinical rotations with patients, but the COVID-19 crisis has suspended those activities.
The American Association of Medical Colleges recommended suspending clinical rotations because hospitals are dealing with a national shortage of personal protective equipment and it would give health care facilities time to decide how to best use students during the crisis.
“The Health Corps program may be a reasonable solution to approach the pandemic, but it has yet to address how completion of my program will be achieved if at all,” said Lisa Rients, a nursing student, nearing graduation in May from West Coast University in Anaheim. “The fact that we are able to perform and carry out clinical duties as a member of the Health Corps program, but not as a student for completion of a degree is confusing to me.”
One solution offered by nursing instructors and students across the state would be lowering the percentage of clinical rotations conducted with patients from 75 percent to 50 percent. Students would complete the other 50 percent of their clinical practice through what are called “virtual simulations,” which recreates the health care situations and incidents online, especially since many campuses have moved their in-person instruction online. Current regulations allow 25 percent of clinical rotations to be completed with simulations.
When asked about the prospect of waivers on March 30, Veronica Harms, a spokeswoman with the state consumer affairs department, which oversees the nursing board, said, “We are looking at all of our options to expand and grow the health care workforce during the pandemic.”
Sharon Goldfarb, dean of health sciences at the College of Marin in Kentfield north of San Francisco and president of the northern division of the California Organization of Associate Degree Nursing, said the nursing board is not acting quickly enough to solve the immediate problem facing nursing students, which is delayed graduations and the stringent clinical rotation requirements.
“Yes, my students are registering for the Health Corps but it doesn’t count towards the clinicals and they do not graduate,” she said. “I’m feeling very discouraged.”
Rients said many nursing students like herself also have jobs tied to their ability to pass the licensure exam this spring.
“Many of us have jobs lined up already contingent on our timely passing of the (licensure exam),” she said. “So, I feel it is unjustified to allow us to work or volunteer with the Health Corps, but not allow us to continue on our own personal path of employment.”
Last academic term, Rients completed the Medical Surgical III Advanced course with a 4.0-grade point average, she said. According to the guidelines from the nursing board, with that level of education, Rients can perform similar duties as a registered nurse such as collecting patient data or performing respiratory therapy treatments but she would have to do it as a nursing student and not as a licensed nurse.
“It’s evident that student nurses at this point in their educational journey are proficient in collecting, analyzing, implementing and coordinating care of patients,” she said. “The (guidelines) speak to the fact that this last set of clinical rotation hours in nursing school could be easily waived or modified in order to produce new graduate nurses prepared to sit for the licensing exam.”