For the first time, Clarke University assistant nursing professor Kris Tiernan had officials from Dubuque’s hospitals virtually join her class this month to recruit the help of student certified nursing assistants amid rising COVID-19 cases and hospitalizations.

“One of them said it’s kind of like calling them up for duty,” Tiernan said. “They’re asking these students for help because the need is so great.”

In addition to being called upon to gear up in personal protective equipment for CNA shifts, students pursuing health care fields are adjusting to virtual or hybrid classes and, in other cases, losing opportunities to work with patients in person as the pandemic continues.

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Despite the stress, it also has brought along a sense of pride and appreciation for their future career field, one that will particularly offer plenty of post-graduation job opportunities for nursing students. The U.S. Bureau of Labor Statistics estimates that 221,900 new nurses will be needed between 2019 and 2029 to keep up with demand in one of the fastest-growing professions in the country.

“People are really underappreciated in health care,” said Kila Carbine, a junior at Clarke and a nursing student. “Yeah, you’ll always be able to find a job, but all of this (with the pandemic) just makes me appreciate nurses more. People working in the ER have said it’s just been chaos. They’re putting their life on the line.”

WORKING ON THE FRONT LINE

CNAs, who assist nurses with their daily tasks and help take care of patients, are in higher demand as community spread and, therefore, cases of COVID-19 increase, said Christina Schauer, MercyOne Dubuque Medical Center’s director of clinical and professional development. Extra hands are especially needed if multiple hospital staff members have to quarantine.

“We do need nurses throughout the country, but I think what surprised me is that those CNAs are so valuable right now because of their clinical skills,” she said. “For better or worse, the community is never going to need you as badly as they do right now. This is such a great opportunity to create a positive impact.”

Mary Peters, chief nursing officer at UnityPoint Health-Finley Hospital in Dubuque, said the hospital made the decision this summer to not require students to have their CNA certification in favor of increasing Finley’s ability to recruit. Instead, hired CNAs will receive on-the-job training.

She added that previous weekly hour requirements have been waived to accommodate whatever a prospective CNA can offer.

“We’ll take as many hours as they can give us per month,” Peters said. “Whether that’s four hours or 100 hours, we’ll take whatever’s available to us.”

University of Dubuque senior and nursing student Kiana Jaramillo typically works as a CNA when she’s in her hometown of Elkhorn, Wis., on school breaks but was considering starting at a Dubuque hospital.

While the pandemic has created changes in the way that health care professionals do their jobs and uncertainty in what lies ahead, she said she thrives in ever-changing conditions.

“Anywhere in the medical profession, we’re so used to adapting to different things,” she said. “I get bored really easily, so I need that change. When I go into a room, I don’t always know what to expect.”

But working in a hospital during a pandemic is likely to cause stress, which is why Schauer said MercyOne has placed an even stronger focus on taking care of staff emotional needs.

“I get tears in my eyes thinking about my colleagues, thinking about where we were in March to where we are now and all the challenges we’ve overcome,” she said. “We’re strained but not broken.”

NEW APPROACH TO CLINICALS

Figuring out how to conduct clinical credit classes this year has prompted professors to get creative, as many of the typical in-person activities with patients or community members aren’t possible.

At UD, nursing professor Jackie Meyer embraced technology for one mental health nursing clinical class by having students undergo a “Hearing Distressing Voices” simulation. The simulation, with a goal of developing empathy for those with brain health conditions, had students listen to distressing voices through headphones while completing a series of tasks.

Meyer said she was grateful that UD provided the funds for the simulation, adding that familiarizing herself with new kinds of technology to teach classes differently took some getting used to.

“Teaching is just a whole different world,” she said. “There’s just one more layer of preparation with learning new things, and that’s always good, but that’s just one more layer to attend to.”

UD senior and nursing student Edgar Gomez said he is glad new technology has allowed for clinical experiences to continue, though he also noted an adjustment period to get used to a more virtual format.

“It’s a different learning aspect where you really have to manage your time,” he said. “You can’t just pop your head in to ask a question all the time. It was hard at first, but we worked as a team to get over that common hump.”

Tiernan also changed clinical activities due to the pandemic for her Clarke pediatric nursing students, such as not making a trip to Camp Courageous in Monticello, Iowa. She has had students connect virtually with families to offer tutoring and brainstorm ideas to combat isolation, and her students also will put together gift bags for children in need.

She also has been especially grateful this year for Clarke’s simulation lab, in which she had students treat patient dummies to see who was “sickest” and in need of quick care.

Students in the Loras College and Northwest Iowa Community College 3+2 nursing dual degree program, which started in 2019, haven’t reached their clinical stage yet, said Ulrike Schultz, Loras postbaccalaureate premedical program director. Students currently are working on their kinesiology or Spanish bachelor’s degree at Loras before transferring to NICC for their nursing degree.

But this spring, Schultz said, Loras will offer a fundamentals of public health class for the first time to have academic discussions about keeping entire communities safe, a topic especially important in light of the pandemic.

“This epidemic overall has shown us that certain populations suffer more than others, and we need to prepare our future health care providers for that,” she said.

Schultz said she also has encouraged the students interested in health care to take advantage of remote job shadowing opportunities in the absence of in-person ones.

“It’s different — it’s not the real deal,” she said. “But it helps them to some extent to build relationships with health care providers and see what they do on a day-to-day basis.”

FEARS ABOUT PREPAREDNESS

While CNA jobs and health care classes have continued throughout the pandemic, some area students are anxious about the uncertainty that COVID-19 has placed on the rest of their college career.

Clarke junior and nursing student Teri Kauffmann said some clinicals were stopped in the spring when the university closed, and more clinical credits were prioritized in the beginning of the fall semester in case a shutdown occurred again.

“There’s a lot of concern about not getting those opportunities and having them be taken away,” she said. “We don’t know what COVID is going to do.”

Katlyn Giesler, also a Clarke junior and nursing student, said the learning curve of the course materials has been huge.

“There’s concern about having to go in and take care of patients and not feeling fully prepared,” she said.

University of Wisconsin-Platteville biology professor Richard Dhyanchand, who also advises pre-health-care students, said the shift away from in-person patient interaction this year has provided a hurdle for students needing practical experience for graduate school applications.

“We had students that took a gap year for clinical experience, but now, they have to do something different,” he said. “That makes them less competitive for the programs they’re hoping to get into. They set up the opportunities to do that, but now, that’s becoming harder.”

UW-P sophomore biology student Bethany McDonald, who’s on the pre-physician’s assistant path, said the pandemic delayed both her CNA class and certification, which include an exam and clinical experience to complete.

“Making yourself stand out isn’t doable right now. You can’t immerse yourself in an experience because everything is on Zoom now,” she said. “And some people feel they’re not learning as well. It’s kind of scary because I need to know this stuff and retain this stuff.”

For students already in graduate medical schools, however, the changes to classes and training haven’t been as drastic as for undergraduate students.

Maria Leighton, who graduated from UW-P in 2015, is a graduate student at University of Wisconsin School of Medicine and Public Health in Madison and works on rotation at Southwest Health in Platteville. While in-person classes and hospital rotations paused in the spring, she said, the medical school curriculum has bounced back to its usual set schedule.

However, the pandemic has created barriers for health care professionals looking to make connections with patients.

“Since I’m primarily interested in psych, it’s a lot harder now to connect with patients if I’m wearing a mask and a face shield,” Leighton said. “A lot of people with psychiatric conditions are already going through a rough time, and the COVID stuff has exacerbated it.”

‘BEST LEARNING OPPORTUNITY WE CAN GET’

As an adviser, Dhyanchand said he hopes to continue seeing students wanting to explore health care fields. When he was in graduate school, he said, news of the bird flu generated strong interest in medical professions, a trend he hopes the COVID-19 pandemic also will bring about to alleviate some of the health care staff shortages.

“One thing that COVID has done is that it’s made it easier for us to present some of those other opportunities moreso,” he said. “I think the word ‘epidemiologist’ wasn’t a word people really heard of before, but it’s become something more people have heard of in the last eight months.”

While students might continue exploring different health care careers, McDonald said the overall importance of taking care of the public’s general health, no matter the circumstances, has been highlighted even more.

“I feel like in this whole situation, you didn’t know what was going to happen. Nothing like this has happened in my lifetime,” she said. “The ability to adapt is so important in the health care field. This could almost benefit me in the future because we still need to stay on top of things even if they don’t go the way we planned.”

UD senior and nursing student Hannah Sawyer added that the pandemic has presented a learning curve for everyone in health care, from people that have been nurses for 40 years to freshman pre-health-care students. For students specifically, she said this unprecedented time only can better prepare them for future challenges post-graduation.

“This is the best learning experience we can get, getting all this experience,” she said.

However, Meyer said she worries about the well-being of both current and future nurses as the pandemic drags on. While the beginning of the pandemic shed a lot of light on the hard work that nurses were doing, she said people often don’t see all the work that goes into the job until they’re in those shoes.

“It might be something that might motivate people to want to do nursing, but as it drags on and on, there’s a really big risk of people that are in the trenches have the potential to burn out,” she said. “We’re asking a lot of these individuals over a long period of time.”