Written by Kayden Heckaman, DSU Student Intern
During this time of uncertainty, those in the medical profession have been pushed to their limits as the COVID-19 pandemic continues to impact the nation and the world. Not only has this atmosphere changed the way medical professionals work, but it has also changed how those looking to enter the profession study. The brightest rays of hope shine on these students. This semester, nursing students from Dickinson State University (DSU) will be completing their clinicals and these challenges have certainly not kept them from persevering.
During clinicals, which are supervised interactions with patients, students perform different tasks to practice and demonstrate the knowledge they have gained. For those in their first year in the nursing program, clinicals cover basic knowledge of nursing. These students perform simulations with a high-fidelity or medium-fidelity simulator on campus. Using these simulators, students are able to learn how to care for and communicate with a patient and to identify interventions in order to improve patients’ well-being. First-year students also do a long-term care rotation and a hospital rotation, often shadowing physicians in order to learn. With the long-term care rotations, they deal with assessments and medication administration. Students will follow a patient through the perioperative setting, the time in surgery from admission to recovery, which includes day surgery, inter-operation, and post-operation. Students do a health assessment workshop at the hospital as well.
Second-years, like first-years, do a long-term care rotation. They also do postpartum work, which is caring for a mother after childbirth, and a medical/surgical rotation. Third-year students do hospital rotations in acute care, or short-term treatment, along with other tasks. As for seniors, they complete internships in medical facilities in places like Bismarck and Hettinger, North Dakota.
Students are encouraged to be around their assigned patient or resident as much as they can. Usually, when students first start their clinicals, they are assigned a patient and have time to do some research. As the student gains experience, the amount of time they receive to research lessens because they should have acquired knowledge and experience with disease processes. When they are more experienced, they care for and will administer medications to their patients, provide interventions to their patients, and interact with the health care team.
Before the pandemic, students would go in the evening before their clinical session to review a patient’s chart, introduce themselves and complete required paperwork. The day of the clinical, they would immediately start to take care of their patient. This would include a pre-conference so the student would know what their tasks were for the day and the care they would be giving their patients. However, since the COVID-19 pandemic, how clinicals are carried out has changed. Now students are unable to go in the night before to look over a patient’s chart. The DSU nursing faculty has worked to provide students with all the patient data they need to know, all while maintaining Health Insurance Portability and Accountability Act (HIPAA) regulations and keeping students’ exposure to residents and patients to a minimum. Students now only work directly with the patient on the day of the clinical.
Some of the facilities that have welcomed students in the past have not allowed students back this spring to keep the risk of spreading infections low. Most locations that are allowing students to come in and complete their clinicals are requiring them to have a COVID-19 screening completed before they can enter the premises. Most are also requiring students to wear N-95 respirator masks, devices which are designed to have a close facial fit and effective filtration of airborne particles.
“Initially, we decided we would not risk exposing students to COVID-19 in the fall,” said Teresa Bren, assistant professor of nursing at DSU, “but as we started to maneuver through this environment, we really kind of came to terms that this is what we are training them to do.”
One student that has learned to adapt to changes in policy and interaction in this environment is Heather Fahy, a junior in the nursing program at DSU. At the beginning of the pandemic, Fahy was preparing for her clinical capstone, which would have included two 12-hour weekend shifts in Hettinger. However, because of the COVID-19 pandemic, she was unable to work these shifts and was initially concerned for what this would mean for her studies.
For the spring 2021 semester, though, Fahy is back in the health care environment and glad for it, even though there have been some challenges for her. She has done her best to navigate these challenges, which include having to care for COVID-19-positive patients and using personal protective equipment (PPE). PPE has presented Fahy some challenges in creating relationships with her patients, but she has learned to adapt and learned other ways of communicating. Nurses are known for their warmth, kindness, and smiles, and Fahy has becomes an expert in smiling with her eyes! She had to learn to how to explain patients’ concerns to them during this anxiety-inducing time and how to be open with them. Also, with the pandemic taking its toll on those working in health care, Fahy has developed some self-care skills to help keep her from burning out.
Even with the changes in the landscape of the health care industry, DSU students have risen to the challenge during their clinicals to provide the best care to their patients. The pandemic has shown the dedication of those in the nursing profession and their ability to overcome challenges – a situation that, for most, has solidified their choice of career.
