Nursing in the Time of Pandemic

As the COVID-19 outbreak hits home, local nurses and nursing students enter uncharted territory

For the second time in less than a year, local nurses and nursing students have found themselves on the front lines of a critical moment in El Paso’s history.

On Aug. 3, 2019, many worked tirelessly following a mass shooting at an El Paso Walmart. A few months after, a novel coronavirus began to sweep across the nation and slowly crept its way into the El Paso area. Today, nurses all around the city – dressed head-to-toe in the best personal protective equipment (PPE) they can get – face a battle against COVID-19 with uncertainty of when it will be contained.

Stephanie Woods, Ph.D., M.S.N.

Stephanie Woods, Ph.D., M.S.N.

“In a pandemic, you’re attacking an enemy that could approach you from any angle,” said Stephanie Woods, Ph.D., R.N., dean of the Gayle Greve Hunt School of Nursing at Texas Tech University Health Sciences Center El Paso. “Nurses and nursing students are learning on the job, they’re trying to figure out how to protect themselves and others. Right now, they’re doing what they always do, which is a little bit like acting as a traffic cop – you’re looking in four directions at once and trying to decide how to keep the flow going.”

Nurses are integral to the work of preventing the spread of COVID-19, as well as caring for those infected, Woods said. They are studying the pandemic in real time, adjusting practices as they learn more about the virus.

“It’s rather dumbfounding to think of what the folks on the front lines are facing right now,” Woods said. “This is an evolving pandemic – I am constantly on the Centers for Disease Control and Prevention’s website ensuring that guidelines have not changed and looking at new information that is coming out every day.”

Add to this the practice of setting up tents outside of hospitals to triage patients who may be infected with the virus. As the number of COVID-19 cases continues to climb, with nearly 200 in El Paso County so far, local hospitals are taking precautionary measures and creating new ways to screen patients safely and efficiently.

“It’s a brave new world,” Woods said.

Facing the Pandemic

Locally, nurses in the emergency room have been preparing for the pandemic to land on their doorsteps since the beginning. While treating patients is priority, educating them is also a part of the process.

“One of the things that the COVID-19 pandemic has taught me is just how much trust and faith the public puts in us as health care providers,” said Amanda Vega, an ER registered nurse and graduate of the Hunt School of Nursing. “I participate in providing a lot of education to my patients and their families, but it has become more apparent how valuable my word is to the public and it is not a duty that I take lightly.”

Like other health care workers across the nation, Vega’s new reality means she must be extra cautious not only at work, but when going back home after long days of caring for patients. This means being even more intentional about disinfecting tools that travel from work to home and keeping her distance from friends and loved ones.

“As an ER nurse, I am unintentionally exposed to many different viruses and bacteria on a daily basis and am therefore at higher risk to my friends and family,” Vega said. “Luckily for me, my closest friends and family are very supportive and check in with me almost daily to make sure I am doing okay.”

As the COVID-19 outbreak surges on, her message to the community is that the work of health care professionals never stops.

“Emergency department doors never close,” Vega said. “Despite the pandemic, other emergencies do happen and we are happy to see you and treat you. Heart attacks, strokes and other emergent medical conditions require swift intervention and we will always be there to take care of all the scary things that happen on a daily basis.”

Efforts in Education  

For students attending the Hunt School of Nursing, distance learning is how they have continued their education after a week-long spring break. While the school of nursing has educated many of its students online for years, Woods hopes this experience will help with the future of telehealth.

“Telehealth is tailor-made for this kind of situation,” Woods said. “One of my strategic goals is to teach nurses and nursing students how to use this technology without losing that face-to-face experience that we have always valued. Telehealth encounters can still demonstrate competence and care.”

The challenge, Woods said, is getting students who are further along in their nursing education into their clinical rotations.

“The faculty and I are working diligently to keep the students in clinical experiences,” she said. “That opportunity changes minute by minute; but what better time for us to help them grow and learn than during a global pandemic?”

Currently, most clinical sites are still open to Hunt School of Nursing students; however, several precautionary measures have been put into place by leadership teams at TTUHSC El Paso and local hospitals to keep students and all health care workers safe.

Karina Rodarte, a student enrolled in the school’s Accelerated Bachelor of Science in Nursing program, gained first-hand experience of working in hospitals during a pandemic as she trained in clinical rotations.

“I was able to take care of a patient and assess them – it was a very interesting experience that few will have as a student, and I’m very fortunate to have gained this experience,” Rodarte said.

An Accelerated Path to the Workforce

Because West Texas already suffers from a critical lack of nurses – with a projected shortage of 5,162 registered nurses by 2030, according to the Texas Center for Nursing Workforce Studies – the COVID-19 outbreak sheds a light on the importance of nursing education and efforts to get students into the workforce as soon as possible.

The Gayle Greve Hunt School of Nursing Class of 2021 received their white coats during a ceremony on Jan. 17, 2020.

The Gayle Greve Hunt School of Nursing Class of 2021 received their white coats during a ceremony on Jan. 17, 2020.

On March 21, Texas Gov. Greg Abbott announced he would waive several regulations to help meet the state’s growing need for nurses in response to the COVID-19 pandemic. This includes temporary permit extensions to practice for graduate nurses who have yet to take their licensing exams and allowing students in their final year of nursing school to meet clinical objectives by exceeding the 50% limit on simulated experiences.

“The intent here is that we would remove any artificial barriers that prevent graduates from immediately going out into practice rather than being hung up on regulations that really aren’t working for us right now,” Woods said. “We need as many nurses in the workforce as we can provide.”

Following Gov. Abbott’s announcement, Woods and Hunt School of Nursing faculty members are in the process of outlining plans that will help the school’s graduate nurses obtain a temporary permit sooner. The governor’s granted waiver will allow nursing graduates to practice for up to six months, under the supervision of a licensed nurse, until they can take their licensing exams.

Woods praises her faculty and staff, who have worked tirelessly to take the school’s coursework online. “They have worked diligently to help students cope with tremendous changes and uncertainty,” she said. Faculty are currently seeking high-quality simulation education in a time of social-distancing and shelter-in-place orders from the City of El Paso.

“We are figuring out how to simulate a patient encounter online so the students can still have a very good learning experience,” Woods said. “If we are going to graduate them earlier than anticipated, they will be well-prepared and competent. It’s an amazing opportunity, but we must be careful in our choices.”

Student response, she said, has been selfless and overwhelming.

“When you ask students why they want to be a nurse, most of them will tell you that it’s because they want to help people,” she said. “I’m just so proud of them. Right now, there’s great confusion, but they are still wanting to be in the fray. They just want to be of any help for our community that needs them.”

As TTUHSC El Paso continues to educate future generations of nurses, community help goes a long way. The importance of scholarships and emergency funding for the unexpected is critical so students at the Hunt School of Nursing can complete their degrees on time.

Right now, many students at the Hunt School of Nursing are experiencing financial hardship due to their inability, or a family member’s inability, to work part-time in the service industry. The last thing leaders at TTUHSC El Paso want their students to face is the worry of making ends meet while serving families in local hospitals.

“I don’t know of any better investment in any community than investing in nursing students,” Woods said. “It’s an investment that will have a lasting impact.”

While the U.S. continues to fight the COVID-19 outbreak, there are still many unknowns; however, when we look back on this moment in history, health care workers will be known as the soldiers who stood on the front lines.

“I’ve always thought it was a beautiful hero or heroine story to talk about health care in the time of crisis,” Woods said. “Health care workers go about their business as usual, taking care of patients while minimizing thoughts of themselves. If these noble people are going to go in and care for these patients, it’s up to us to do everything in our power to keep them protected.”