NP program changes due to COVID-19, transitioning work settings

[CanadianNurse90s]

Hello,

I am an RN and part-time student currently working on obtaining my Masters degree and NP in Primary Health Care Diploma. I have completed all the Masters degree course requirements. This would be my last year completing the NP diploma aspect of the program.

Due to the COVID-19 pandemic,  big changes were made to the NP Program for the Fall 2020 term (and probably the Winter term, depending on how the pandemic develops in terms of second wave, if a vaccine becomes available, placement availability etc). The university was not able to offer us placements for the Fall, as well as in-person labs (only a couple of in person labs when absolutely necessary). Seminars would also be online only. The university assured us that they would be doing everything they can to make sure we would acquire all the skills and competency necessary for entry to practice. They also said over email that we would be getting placements for the Winter term. However, when I spoke with the person in charge of the program, she said that depending on the pandemic and placement availability, there could be a possibility that we would not have in person placements for the Winter term. For the Fall term, they have arranged to substitute clinical hours with Shadow Health. She said that if placements are not possible for the Winter term, they would find other ways and look into other options to meet program requirements. (Also, another concern of mine is the fact that currently, in primary care practices, most health care visits are being done over the telephone. So if we did have placement in the Winter term, most of our patients visits might be over the telephone and not in person.)

Despite this, I have many concerns as I believe that clinical hours as well as labs are imperative to skill and competency development, especially when taking on the role of an NP. I cannot fathom the idea of becoming an NP without having seen patients in person. Any nurse can say that simulation is different from in person experience! 

Why this concerns me so much is that I have worked in the primary care setting for my entire career as a nurse. I also briefly worked in continued complex care for 8 months. Because of this, I am worried that, compared to other nurses going into the program having worked in many different nursing fields and having worked in acute care settings, I feel that I don't have as much experience as they have in terms of assessment skills and such. I also struggle with self-confidence as a nurse and this comes from having been bullied by my preceptor and placement facilatator during my consolidation placement during undergrad that left me feeling completely inadequate and defeated right before entering the work field. This made me stray away from working in a hospital as I felt that I was not good enough. This being said, my main goal going into my nursing undergrad degree was always to become a primary care NP. 

All that to say that I decided to take a LOA from the program for two reasons. Firstly, I have been going thru a rough patch recently in terms of mental health (changes in my life, and reoccurrence of depression). I did not have any motivation and energy this Summer to prepare for the fall term even thought I did have time to do it as I was working part time. As the start date of classes approached, I felt increasingly guilty that I had not taken advantage of that time and felt that I should not have been so lazy. I started feeling dread at the thought of starting the program and failing. (I understand that these feeling are related to my depression.) Secondly, I was uncomfortable with the idea of not having any placements and labs and the repercussions that this may have on my competency and skill development as an NP.

Due to the course sequence of the program offered by my university, I will need to wait until next September (Fall 2021) to start up my program again. 

Now that I have a year off, I will be focusing on my health and think it would be a good opportunity to look into getting different nursing experience. (I currently work part time in a primary care setting so I do have extra time.) I am looking for feedback from other nurses having worked in the primary care setting and how to transition into a different nursing setting. I know it would be difficult to go from primary care to working on a floor at the hospital. I was wondering if LTC would be a good transition option. I am also thinking of working in COVID-19 relief in assessment and testing centres as there are job opportunities at the moment. 

For RN's in NP programs across the country, have you experienced similar changes in the program? What are your thoughts and concerns?

Thank you in advance for your feedback!