Nursing Education in Pandemic Mode

The nursing profession shines bright during health crises: student nurses working in facilities during the pandemic can reduce strain on full-time nurses. At the outset of the pandemic, our School, as part of the Nursing Education Council British Columbia, worked with other Schools of Nursing in the province to communicate with the Ministry of Advanced Education, Skills and Training, the Public Health Officer (PHO), and the Ministry of Health. Their goal, early on, was to confirm the importance of maintaining the education of nursing students. They were successful in demonstrating that student nurses ought to be treated as essential, front-line workers and allowed to continue their work of learning and practicing. UBC student nurses continued their studies even while the rest of the province was in lockdown, including the classrooms of other health care programs on campus. Elsie Tan, Professor of Teaching and Associate Director Undergraduate Program, explains the process that was set in place to allow students to return to their lessons both online and in face-to-face learning contexts.

Blended Learning

The School’s executive, faculty, and staff developed and presented plans for approval by UBC Administration, Faculty of Applied Science, and the health authorities. In a very short span of time, the Bachelor of Science in Nursing (BSN) program adapted to deliver a focussed and levelled learning experience in preparation for students to complete their nursing studies.

Students engaged in intensive online classes for six weeks, delivered synchronously and asynchronously. Students then focused strictly on their clinical learning for the next seven weeks in health care settings. Under usual circumstances, the clinical instructors would have received a full-day orientation to their clinical instructor role in person. Under pandemic constraints, they received their orientation virtually. This adapted learning environment required students, faculty, and staff to exercise flexibility and patience, and ease of adaptability.

Lab Learning

The essential learning most challenging to coordinate was the lab learning. This laboratory learning was adapted to a mixed or hybrid approach consisting of online and face-to-face learning. The school houses highly specialized equipment for lab learning on the third floor of the UBC Hospital, which at the time, was no longer accessible to the public. Therefore, special permissions had to be obtained and highly detailed protocols had to be put in place to accommodate all the new restrictions. Cathryn Jackson is both an Associate Professor of Teaching at the school, and the Clinical Skills and Simulation Lab Coordinator. She collaborated with the planning team to provide the rationale needed to bring nursing students on site at the height of the pandemic. UBC and Applied Science Executive, UBC Hospital, and Vancouver Coastal Health approved the plan.

Logistics

In accordance with the PHO requirement for small groups and physical distancing the lab plan included:

1. Limiting the number of people on site to 23 students plus faculty/facilitators.
2. Staggered start times limited the amount of contact between people in halls and elevators.
   1. A face mask was provided at the hospital entrance;
   2. Each student was screened for self-assessment of symptoms and temperature;
   3. Students changed out of street clothes before entering the lab.
3. The screeners wore personal protective equipment (PPE); the cleaners (in PPE) disinfected rooms and equipment at the end of the lab day following BC’s Centre for Disease Control guidelines.
4. The lab team changed the way they taught and worked with students in the lab. Students had to work independently instead of in teams, in work spaces reconfigured appropriately.
5. The delivery of lab learning required a coordinated team approach. The lab staff ordered supplies, organized the lab set-up, and at the end of the day, sanitized and organized for the next day’s group of students.
6. The plans considered space for breaks, change rooms, bathrooms etc. Some areas were designated off-limits while other areas were repurposed, such as using classrooms for changing rooms.
7. Each lab room has a sink where students and faculty practiced appropriate hygiene.

Conclusions

From these initial modifications to the program, the School learned that: it can still deliver quality education virtually; we learn and adapt quickly and in the moment; and virtual learning can be challenging for some students competing for access to technology in the household and reliable internet connections. Most importantly, virtual learning requires a different mind-set and planning. The goal is to continue to produce a steady stream of excellent trained new graduates ready to step into the practice environment.