Nursing education during pandemic

[JPnAZ]

My daughter is in Block 1 of a community college concurrent enrollment nursing program in AZ. She has one 4 hour Zoom lecture per week, on line clinical simulations, and absolutely no actual in person clinical training opportunities due to the SNFs being shut down due to Covid. Her instructor keeps telling her that she needs to learn to "think like a nurse" and eventually "it will just click". Huh? How does someone learn to do that if you never are able to actually see nurses working, have the opportunity to ask questions, and observe everything that goes into "nurse thinking"?  I am a practicing physician and can't imagine in med school only learning patient care and the nuances can only be developed with in person clinical experiences. No one ever said one day it will just click in and I'll think like a doctor.   My daughter has never worked in any clinical setting. She went from HS to community college to do the pre-reqs and then was accepted into the concurrent enrollment program to get her ADN followed by her BSN. Is it now the standard in nursing education to have such little in person instruction (4 hrs/wk?) and no in person clinical exposure? This is how nurses are now learning? It looks like a self taught nursing on line education program to me. I see her studying, doing NCLEX questions, but she is struggling on tests. I'm trying to figure out how to help her. I don't understand how answering NCLEX questions that have terms, treatments, diseases, etc.. that have never been taught makes sense. Many of the questions might as well be in a foreign language given her current knowledge base. I would be interested to hear other nursing student educational experiences / perspectives as well as educators of nurses regarding these Covid influenced education changes. 

[cameron5575, BSN, RN]

Senior BSN student here. This semester, I'm taking peds/OB and community health. I've had 2 clinical days for pediatrics, no clinical days for OB, and 4 clinical days for community health (doing home health care only). We were supposed to have way more clinical days but schools shut down and hospitals turned away students so this is all we get for this semester. I go on campus for peds/OB simulation once a week, have lecture 2 times a week for ped/OB (pre-recorded PPTs), and once a week for community health (Zoom).

My experience is less than ideal and I do feel as though I've had to teach myself a lot more of the concepts than before COVID hit but, at the same time, I'm grateful that I've gotten in actual clinical days because I am hearing that other programs aren't so fortunate.

[Coco chanel_2]

My daughter is in her first semester of a BSN program. Fundamentals is a struggle for her. I completed a BSN program and anesthesia school some years ago now and we focused more on the facts & A&P. But now they are requiring that you “think like a nurse”. How is that even possible if you’ve never been a nurse. After trying to help my daughter for months now without success I finally realized that I can’t teach her the way I studied. I find the key to studying success is by creating scenarios and then applying the facts but not getting to in-depth into A&P, then adding in a list of what to do and not do. Then we added in any applicable medications along with contraindications, precautions,etc. I do agree with JpnAZ it does feel like an online self taught nursing class. When we applied to our nursing program I expressed a concern about the think like a nurse issue. They assured me that their program is set up to teach this. So far that hasn’t happened. Perhaps it’s because of the modifications due to the pandemic. 

[abz, ADN, BSN]

There is a huge amount of variance from program to program, so it doesn't make much sense to talk about a general "standard of nursing education." It just doesn't exist. I think you largely answered your own question in your post; COVID has resulted in dramatic changes in many areas of life, and nursing school is not exempt. Are the changes for the worse? Certainly they are--online clinical simulations are obviously no substitute for the real thing, and I think most would agree that even if the content of an online lecture is the same as it would be in person, there are downsides to remote learning.

Realistically, though? Nursing school, just like med school, just like many other branches of education, is largely self-taught. Instructors are there to clarify, if they can, and answer questions, if they can, both roles that a quick Google search can fill a majority of the time, these days. While lab time and clinical experiences are valuable, if you ask most nurses, they'll tell you that most of their learning happened on the job. All that said, no one is under any illusions that the current state of things is desirable. Some programs have voluntarily decided to close their doors for the time being. Others have been forced to close by state boards of nursing that are unwilling to compromise on certain requirements for RN licensure that can't realistically be met during the pandemic. Nurses are needed, though, so in many places difficult compromises are being made and standards are being lowered, by necessity, not by choice, to allow students to get through, get licensed, and start working. 

I feel for you and your daughter and everyone else going through this, but your particularly situation isn't unique, nor is it surprising given these unprecedented circumstances. 

Regarding the NCLEX questions, there are some resources--testbanks, basically--that are very useful. The gold standard is UWorld, and Kaplan is also widely used. Beyond that, if I had any advice, it'd be this; get through it. Nursing school is as much about learning to pass the NCLEX as it is about learning to be a nurse (maybe more so, depending on who you ask), and that is more true than ever now. Jump through the hoops, learn the material in whatever way works best for you (or your daughter, in this case, of course). Youtube is really a great source for nursing content, and also for foundational health science like anatomy and physiology, patho, etc. I would be very surprised if the content your daughter is getting through her program is even close to the quality of the stuff that's available on Youtube for free. That's just the way it is now in this brave new world.

Good luck.