Story by Nicole Johansson

Thanks to local hospitals and healthcare providers, the coronavirus pandemic will not stand between School of Nursing students and their 2020 diplomas. 

The fifth and final semester of nursing school is designed around students working in healthcare settings to complete clinical hours required for graduation—75 percent of which must take place in a direct patient care setting. However, in mid-March, hospitals began conserving personal protective equipment due to COVID-19 and, for safety, nursing students statewide were restricted from patient care rotations.

With thousands of graduating students’ pending degrees on the line, the California Association of Colleges of Nursing appealed to Governor Gavin Newsom, the Department of Consumer Affairs, and the Board of Registered Nursing to loosen the direct patient care requirements. The National Council of State Boards of Nursing supported the appeal, noting scientific evidence indicates that students can do up to 50 percent of their clinical coursework via simulated methods without affecting educational outcomes.

“Our students have worked so hard to get where they are right now, and the School of Nursing, Univerity administrators, and our community partners are all committed to making sure they could progress,” said Karin Lightfoot, director of Chico State’s School of Nursing. “This is important for our students, as well as for the health and safety of our communities.”

With support from more than 20 state legislators, an order was made to reduce the requirement so that only 50 percent of clinical hours need to be in a direct patient care setting, and faculty were given flexibility to identify clinical hour substitutes that would provide a comparable learning experience in simulation.

Lightfoot had already been working with Dawn Winter, director of education at Enloe Medical Center, to find local solutions. Together, they identified a unique learning opportunity for students to work in Enloe’s Incident Command Center.

“Throughout nursing school, they teach us about how to be resilient and flexible, but you don’t really realize what that means until you’re in this type of situation,” said Jasmine Taylor, a fifth-semester nursing student. “Working shifts in the command center allowed us to see that RNs have a lot of power. It’s mostly the nurses who are making big decisions.”

Jasmine Taylor assembles face shields at a desk.
Graduating nursing student Jasmine Taylor assembles face shields for Enloe Hospital. The need for personal protective equipment has been critical in recent weeks, and the nursing students are helping ensure the supply does not fall short.

Since March 30, she and her classmates have been completing their remaining clinical hours at Enloe’s command center, on tasks such as assembling face shields delivered to the hospital via a joint effort of Chico State and Idea Fab Labs. It’s been an invaluable learning opportunity, they said. 

“Working in the command center allowed us to see how Enloe came together as a team and to observe how they prepare for COVID patients,” said fifth-semester student Amy Peet. “There is a misconception about nurses that they follow doctors around and take orders. Nurses today are an extra set of eyes for doctors—they make decisions, and build trust and relationships with patients and families.” 

Peet just completed her clinical hour requirements and is returning to her hometown of Santa Cruz. After graduation, she hopes to work in an acute care hospital.

Oroville Hospital also opened up to Chico State’s fifth-semester nursing students, allowing them to continue their preceptorships at its Outpatient Rehabilitation Center and, more recently, at the main hospital. Students in limited numbers have also returned to some patient care areas at Enloe, including medical and surgical units, neurology, oncology, and postpartum in the Mother & Baby Care Center.  

“We’ve seen how much our community partners care about our nursing students, and we’ve built great relationships. Conversations have started about new ways we can support our students,” Lightfoot said. “We will apply what we’ve learned, and we’ll be a better School of Nursing on the other side.”

Faculty members have identified additional visual, online resources and telehealth options that they will continue to use in the future for teaching, including piloting an electronic health record program, Lightfoot said. 

Additionally, the California State University Office of the Chancellor purchased a product called iHuman for distance learning on all campuses. iHuman allows students to experience safe, repeatable, fully graded clinical patient encounters on their devices anywhere at any time. 

It will be a different graduation this year, without an in-person Commencement or the Pinning Ceremony, which many nursing students consider a rite of passage. But, many said, working through a pandemic has been an experience all its own for the Class of 2020. 

“You learn different things through difficult and stressful situations,” Lightfoot said. “Our students who worked during the Camp Fire and now those who’ve worked through COVID-19 will be better nurses because of these experiences.”

Two nursing students assemble face masks at a desk.
Nursing students Amy Peet, left, and Jasmine Taylor are both on track to graduate and follow their dream careers, thanks to the change in state requirements and partnership with local hospitals.

Taylor, who is from Los Angeles, wouldn’t have had enough clinical hours to complete her degree if it weren’t for this partnership with Enloe. Building off a previous preceptorship experience in labor and delivery at Oroville Hospital, she is looking forward to graduating and becoming a midwife.

“I’m the first person to go to college in my family,” she said. “I am so grateful I’ve been able to finish my last semester strong.” 

Nicole Johansson is a Butte County resident who has worked as a marketing communications professional for the last 23 years. She is passionate about contributing as a writer and communicator to make our community a better place.