Nursing students will no longer report to their clinical hospital placements beginning March 30. Multiple hospitals canceled their student programs before App State’s department of nursing announced this change March 25, forcing the university and the North Carolina Board of Nursing to adjust regulations for 2020 graduates.

“As far as the seniors are concerned, we did have to discontinue hospital clinical rotations, and we did that effective (March) 30,” said Tyia Dawson, clinical instructor. “We have developed and are continuing to develop some virtual simulations and other assignments for the nursing students to be able to complete in order to get credit for the number of clinical hours that they need for the course.”

App State senior nursing students are normally required to complete 10 shifts of 12 hours of clinical work in a hospital “one-on-one with a preceptor” for their capstone, also referred to as preceptorship, before they can graduate with a Bachelor of Science in Nursing. 

Prior to their capstone, nursing students take a variety of didactic and clinical courses. Didactic classes are the normal classroom settings with an instructor and exams. Clinical courses are hours that must be completed in the hospital assisting patients with a registered nurse’s supervision, but some hours are granted through classroom labs and online modules. 

Once a nursing student obtains their BSN, they can take the National Council Licensure Examination to receive their license and registered nurse status. But, that will look different for current seniors. 

Dawson wrote that App State will allow nursing students to graduate in May who complete their clinical hours through online modules.

“All of the nursing faculty are very dedicated and concerned with ensuring that our students are able to meet the course requirements and for the seniors to be able to graduate at the end of the semester,” Dawson said.

Sarah Thompson is a senior nursing major who said she felt “nervous and stressed” when she found out her clinical placement was ending its student program due to COVID-19. 

Thompson said she chose nursing because she wanted a hands-on job helping people, but she wasn’t sure what that would be until a family member needed medical assistance. 

“We ended up getting a lot of motivation and hope and faith from the nurses, not really so much doctors,” Thompson said. “It’s now been almost four years, and he’s still alive. So, that’s just been a big motivator for me, because now I want to be that advocator and support system for families and patients.”

Thompson will turn her dream into reality after graduation, when she will begin work as a nurse in the emergency department at Novant Health Forsyth Medical Center in Winston-Salem. 

NCBON said in a statement on March 24 it would work to allow recent bachelor and associate nursing students in North Carolina to practice as much as they can upon graduation if they have jobs lined up, despite the closure of the NCLEX testing centers. Julia George, CEO of the Board of Nursing, said the organization will institute a shortened exam and a temporary approval permit for students who need to take the exam. 

“We will defer to program directors of schools of nursing to determine whether individual students have mastered the required competencies (in clinical and classroom work) for program completion,” George said. “The temporary permit will allow the graduate nurse (RN and licensed practical nurse) to practice to their full scope, provided they have RN supervision.”

The student will be allowed to work with the permit if the date they begin their job is before their exam date. A shortened exam will follow Centers for Disease Control and Prevention social distancing guidelines, meaning less students can test at one time. Shortening the exam will allow for all approved nursing students to begin work on time and take the NCLEX as soon as possible.

Thompson said she was thankful she will be able to begin work because she knows how bad the nursing shortage is. The New York Times reported March 30 there were already 200 sick medical workers in New York. 

Faith Baldwin is a senior nursing major who has already accepted a job in the emergency department at Centra Lynchburg General Hospital. She said they are working with patients virtually to complete their clinical hours. 

“It’s obviously very different from being in the hospital and in a clinical setting, but for what we have to work with, it’s pretty good,” Baldwin said. 

Both Baldwin and Thompson’s clinicals were canceled before App State suspended all programs, but the hospitals never gave either student a specific reason for terminating their student programs. 

Baldwin and Thompson said they thought the hospitals made the decision to decrease exposure to COVID-19 and prevent additional outbreaks, to allow registered nurses and doctors to spend their time focusing on their patients, and to save personal protective equipment for the other hospital workers. 

Dawson said these changes were in response to concerns about potential exposure to COVID-19.