About midway through the lockdowns that states imposed last spring to slow the spread of coronavirus, the American Nurses Association surveyed 32,000 nurses nationwide on the front lines of the pandemic.
Nine out of 10 said they feared going to work for lack of protective equipment, a quarter of them said they had been forced to create their own surgical masks and more than two-thirds said they were working without the necessary nurse staffing.
“Nurses don’t feel safe and are concerned about spreading the disease to their patients and family members and becoming infected themselves. This is leading to extraordinary stress and exhaustion among nurses and other health care professionals,” Ernest Grant, ANA president, said in a report on the survey.
As daunting as the circumstance might appear across the country, they have not affected northeast Indiana’s nursing talent pipeline when it comes to college enrollment in programs that prepare students for the occupation.
This is important because even before the pandemic hit, hospitals and other area health care providers were at the point of getting creative in their recruiting to attract enough nurses.
“Indiana’s nursing shortage persists as does the need for more nurses across the United States,” Nadeena Frye, Trine University’s nursing director, said in an email.
“While there is no recent data indicating the current pandemic has negatively impacted the number of people pursuing a nursing career, a 2017 article in the Journal of Nursing Regulation projected that one million RNs will retire by 2030,” she said.
“With such a large number of experienced nurses expected to leave the profession, it is crucial that those currently in the workforce are prepared to fill those leadership roles and we continue to see a significant number of people enter nursing.”
Trine is starting a program for registered nurses with 2-year associate degrees who want to upgrade their academic credentials to 4-year bachelor’s degrees.
The university was preparing to launch its RN-BSN program later this month, and Frey said enrollment numbers were not final on Aug. 18 when this report was written. Because it takes place completely online, its delivery will not require any pandemic adjustments.
“Nurses have always been courageous. Courage enables nurses to do the right thing for the patients they care for, to advocate for them, and to have the personal strength and vision to innovate and embrace new ways of working,” she said.
“A commitment to patients, communities, and populations is a cornerstone of what nurses do.”
Students in the area’s major nursing programs at Indiana University Fort Wayne, University of Saint Francis and the Fort Wayne campus of Ivy Tech Community College have shown stout hearts, and enrollments have held steady.
IU Fort Wayne had 623 students in its nursing program last year. This year, that figure was up by three students by the first week of August, with 78 starting it the same number that started last year. The program has 39 faculty.
“Since the 1700s, nurses have served on the frontlines of health care including wars, as well as epidemics,” Christopher Coleman, a professor and associate dean for the university’s School of Nursing, said in an email.
“Courage and compassion are in the DNA of the nursing profession,” he said. “Whether at the bedside in the hospital or in the home, nursing remains the #1 trusted health profession as indicated by a Gallop poll 18 years in a row now to restore individuals back to optimal health.”
To comply with COVID-19 guidelines issued by the Centers for Disease Control, the school decided to minimize student, faculty, and staff density in the building where nursing education takes place. It did this partly by reducing the number of face-to-face courses on campus, Coleman said.
“This fall, we will only teach two laboratory courses face-to-face with a minimum group of students who will be required to wear masks while on campus, and to follow social distancing guidelines designed to minimize COVID-19 exposure,” he said.
“Additionally, when on campus, faculty and staff are required to wear masks and to socially distance according to the CDC/University guidelines,” he said.
“Because it is essential for students in the healthcare professions to have a hands-on, face-to-face experience, our students will participate in face-to-face clinical experiences.”
The National League for Nursing came out with a recommendation in March that health care providers limit student direct care of known or suspected COVID-19 cases until better epidemiologic data are available. None of the Fort Wayne programs will have clinical student nurses treating COVID-19 patients.
More local nursing education opportunities are in the works.
The IU School of Nursing in Fort Wayne plans to launch an accelerated bachelor’s in nursing program for students with bachelor’s degrees in other fields who want to complete a bachelor’s in nursing degree over 12 months, Coleman said.
It also is submitting plans to launch a master’s degree family nurse practitioner program within a year.
At Ivy Tech’s Fort Wayne campus, the nursing program has a limited enrollment because of the way it is accredited, and demand always exceeds the number of students it can accept. Total enrollment in the program rose to 299 this fall from 291 last fall.
Angela Russ, Ivy Tech’s School of Nursing dean, considers its healthcare specialist feeder program a better measure of interest in nursing. She said in an email the healthcare specialist program saw its enrollment grow 39% to 287 this fall from 206 last fall.
“We have a very competitive nursing program and have been able to allow students to continue progression through our programs. We have three program tracks locally that admit students various times each year and we are at capacity in each program,” she said.
“The School of Nursing developed comprehensive contingency plans to ensure student progression thru our nursing programs during the pandemic while maintaining student and faculty safety,” she said.
“We have approximately 30 nursing faculty who were able to adapt quickly and championed the use of new technology and equipment to assist students through this time of uncertainty.”
Labs, clinicals and classes were transitioned during the second half of Ivy Tech’s spring semester to virtual formats using a variety of resources to meet course learning objectives, Russ said.
Resources included interactive gaming, telehealth simulations, virtual clinical and lab simulations, virtual classroom lectures with interactive activities and break-out rooms, and synchronous debriefing activities, she said. This fall, the students will return to clinical sites with contingency plans in place.
“One of my favorite nursing quotes,” Russ said, “is the following (by Rawsi Williams): ‘To do what nobody else will do, in a way that nobody else can, in spite of all we go through; is to be a nurse.’
“This quote embraces the spirit of nursing,” she said. “Nurses practice courageously every day. The presence or absence of a pandemic does not change this fundamental concept of nursing.”
Well before it declared a global pandemic, the World Health Organization declared 2020 the International Year of the Nurse and the Midwife, Russ said.
“This could not have been a more timely declaration. Ivy Tech faculty and students have demonstrated perseverance and resilience through these times of uncertainty,” she said.
“I anticipate that the knowledge gained from this experience will continue to be incorporated in our program long after the pandemic has passed. We look forward to preparing future nurses that meet the unique health care needs of our communities through excellence in education and evidenced-based practice.”
Without providing enrollment figures, University of Saint Francis officials said their numbers were steady and they expect to see an increase this fall in the number of students seeking a nursing degree. It has 30 faculty for five nursing programs its offers in Fort Wayne.
“All College of Health Sciences programs, including nursing, are preparing for students to return to in-class instruction starting in the fall semester,” its dean, Angie Harrell, said in an email.
“Masks will be worn and social distancing will occur in classrooms. While we know that things can quickly change, instructors are designing their courses in a way that delivery of content can easily be transitioned to an online delivery format in the event classes would need to transition to an online delivery method,” she said.
“COVID-19 has not largely changed how we educate nursing students, rather something like the recent pandemic further supports the commitment faculty have always had in preparing compassionate, caring professionals who respect the unique dignity of each individual.”
USF nursing graduates have been taught to embody the university’s Franciscan values in their work, which includes faithfully caring for the sick regardless of a condition or diagnosis, Harrell said.
“The work of a nurse routinely involves problem-solving and the ability to critically assesses a situation for the best course of action,” she said.
“Our nursing faculty did just that when transitioning the nursing clinical courses from an in-person delivery format to a virtual delivery format. Students participated in virtual case studies and simulations to complement the material being presented online,” she said.
“The need for compassionate and caring nurses, ready to care for the world’s sick is not going to decrease. At USF we are committed to continuing our long-standing legacy of preparing nurses to serve.”
The ANA said in its report nurses were working around the clock in dangerous, distressing circumstances. In return, the association said policy makers must view their protection as a moral and strategic imperative, which relates directly to safeguarding the public.
The survey was taken between March 20 and April 10 to see how nurses were holding up in the face of staffing and medical supply shortages.