New Nursing Students Adjust to New Normal
By Joseph Gaccione
The prerequisites are complete. The pre-nursing track is done. The moment is here for 72 UNLV students to begin their undergraduate nursing path toward their Bachelor of Science in Nursing. But unlike previous cohorts, the Summer 2020 group starts under a temporary new standard during the coronavirus outbreak. Regular academic routines are on hold while UNLV cautiously plans for the transition to face-to-face interactions. For new nursing students, the nature of instruction is flipped, adapting to changes in courses, scheduling, and interacting with classmates.
I spoke with several Level 1 UNLV undergraduate nursing students, all from different backgrounds, about how the experience has been like to start the semester virtually and what drives them to be nurses. I also sat down with the UNLVSON BSN Program Director Angela Silvestri-Elmore (Ph.D., APRN, FNP-BC, CNE) to discuss the transition to remote learning and its impact on educators.
A Lifelong Goal Achieved
Nicholas Dirasian’s first week likely did not look the way he expected when he originally applied for UNLV School of Nursing, but it is the culmination of a lifelong goal: he always wanted to come to UNLV. “My parents would travel here often and when I was a kid, they brought me a UNLV hat back from a trip, and I wanted to come here since.” Dirasian added, “As far as nursing, I wanted to be out here and UNLV just being the school that it is. I think it’s the best program in the area. It seems like it’s always expanding, always getting better. So, it’s incentive to move forward.”
Dirasian moved to Las Vegas five years ago and worked in the valley as an EMT, then as a personal trainer. But he wanted to extend his familiarity of helping people into a career that he could advance in both professionally and academically.
The first week of virtual classes required Dirasian to adapt sooner than later, because he’s more of a paper and pen person. “For me, retention is what I’m trying to adjust to,” Dirasian says. “On paper, I can retain it and understand it and flip back and forth through things. But with the iPad, it’s weird going from slide 29 to slide five, because you have to flip back.” He added, “We listen for three hours looking at a little screen, and when you go to study, you end up grabbing your iPad or computer and go into another screen for another five or six hours”.
One of the obvious, yet toughest drawbacks to virtual learning is the difficulty connecting with classmates. While not impossible, Dirasian says technology can’t simulate that personal interaction. “Most of the time so far, you socialize through a chat box and you see each other, but its muted. [Also], there is a disconnect. You don’t really know when people are answering questions, like you’ll talk over each other. One person unmutes their microphone and that person has their speaking time: there’s no real discussion”. But he says the students can still participate in eight-person group discussions. Despite the technical barriers, Dirasian praises SON faculty for being accommodating and available to meet one-on-one remotely if necessary.
As of now, Dirasian is interested in both pediatrics and mental health nurse practitioner as potential career fields. Though COVID-19 disrupted our normalcy, he says it doesn’t scare him from being a nurse. “You don’t know how it’s going to play out. But at the same time, there will always be things that pop up at unknown times at any given point. Thinking forward, you just got to go into it.”
Finding the Connection
Compared to some other first-year nursing students, Jane Kearns’ first week was less stressful, because she started her classes from her home in North Carolina. “There are these other factors you don't have to consider. I am going to be relocating to Vegas, so I don't have to consider Vegas traffic and the commute time that I would need to get to class, preparing myself for class and other things. In a way, it was almost less overwhelming, because I’m in this home environment where it’s calm. I can reflect on what’s coming as opposed to navigating these other situations and being new to Vegas.”
Kearns says she thought she knew what to expect with the shift to remote learning, but admitted she had to keep adapting during week one. “There was one day where I felt exhausted, because I’ve been using so much mental energy just thinking about this, but then I accepted it and planned a little differently.” She feels it’s been a smooth start to her courses, crediting her professors to designing a curriculum that is close to being in-person, including interacting with her classmates through smaller Zoom groups. “It’s been really great, because we’re slowly getting to know each other that way and communicate or see each other face to face, but in a smaller format. I think that’s been really helpful.”
The path to nursing didn’t come automatic to Kearns. She just made a career change in December 2019 after years of in the food and beverage industry. “I had nursing on a side burner in my life, even in Food and Beverage (F&B). The heart of why I want to be a nurse is very similar to why I was in F&B: the connection to people, to care for their needs. I saw these capabilities in myself.” She added there was not one particular moment that made her want to switch professions. “It felt like this was a time in my life to do it, that certain things just lined up. I was really fulfilled in my career to the level I had achieved and what I had done. That felt complete to me in a way, but there was still this other calling.” Moreover, she wanted something challenging that would allow her to keep growing and learn about different areas of expertise while also giving back to society.
She applied to UNLV School of Nursing for its status and her love of Las Vegas, both recreationally and affordable standard of living. For now, Kearns is eyeing fields like Med-Surg, OR and ICU, but she’s open to other tracks. For now, she embraces her online courses by concentrating on her education as if she were in a physical classroom. “In class [and at home], you have tangible distractions. Even though we’re online, I’m training myself to be present to the instructor and eliminating those distractions".
Never Too Late to Make a Change
Like Kearns, Hannah Wetherill arrives at UNLVSON via a non-traditional path. She decided to become a nurse after periods as a social worker and fiction novelist. Her experience in child protective services and home therapy helped steer her toward a different way to take care of people. “Those are very taxing jobs. Nursing allows me to step back to help with very specific issues; being able to target what’s wrong and solve the problem, which is a little different than social work, which had more global things to keep your eyes on". She read up on emerging careers and figured nursing would be a good, stable next step. Once she started her pre-requisite courses, she fell in love with the material.
Wetherill admits there was some apprehension to start her nursing courses once the coronavirus outbreak escalated. “I have elderly family members who are immunocompromised. Knowing I’m intentionally going into a place where I could be exposed definitely makes me feel a little trepidation.” She added, “At the same time, I believe that sometimes we’re called to be brave and courageous.” She went on to say she believes COVID-19 will motivate nursing students differently, from a choice of profession to a choice of calling.
The semester started off well for Wetherill. Living in the West Las Vegas valley, remote learning means avoiding the long commute to campus and worrying about parking. When it comes to interacting with her new classmates, Wetherill says the group texts and social media make up for not being in-person and keeps everyone linked, which she argues has been more beneficial now than in her previous classes. “Being a nontraditional student, an older student, I can’t say I connected with my fellow students the same way I do on this app. I feel I have more communication with my fellow cohort, being able to throw out a question, whereas usually when you’re face to face, you don’t have a lot of time.”
Eventually, Wetherill would like to pursue a career in neurology. She’s fascinated with neuroscience and how the brain-body connection works. What pushed her to switch careers as a non-traditional student is her curiosity and what your options are when you want to make a change, regardless of age. “It’s about taking risks. You have one life. For me, I wrote some books and then I was done. I didn’t want to do that anymore. So, what else do I want to experience?” Wetherill added, “You get to a point where you have your kids, marriage, you have whatever your goals were. Do you stop? For me, I’m going to learn, I’m going to grow, evolve, and try something different.”
The transition to virtual learning was equally challenging for school faculty as it was for students, particularly nursing educators who rely on those in-person labs and clinical simulations to better instruct young nurses. On top of the technical challenges, SON faculty and staff had to alter the normal class schedule. Lecture courses are front loaded for the first seven weeks to teach theory and nursing skills, while the last eight weeks will be clinical competency and high-fidelity simulation classes at the Clinical Simulation Center of Las Vegas to focus on students’ proficiency in replicated real-life scenarios.
For Dr. Angela Silvestri-Elmore, UNLVSON BSN Program Director, the new semester is going well, considering all the necessary changes. “We did our best to try and anticipate what might be some of the anxieties the students are dealing with. We’re being flexible in terms of what our students’ needs are, and we continue to be very proactive with students reaching out.”
She also says it was better to plan for the summer after having to transition abruptly once the pandemic grew back in March, though it took some time to get used to the new normal. “When we were asked to transition to remote instruction, especially for clinical, that was hard for me to wrap my brain around,” she says. “I thought, ‘What do you mean we’re going to teach nursing students from a distance? What we would teach them in patient care, interacting with a real patient, how can we do that remotely?’ It takes a conscious thought process to move away from that mindset and to use our skills as educators to help our students learn in this new format.”
Although she personally feels more settled now, Dr. Silvestri-Elmore acknowledges it probably doesn’t feel that way for every faculty member and student. “For the first seven weeks, our theory instructors are working hard for long hours, and they are making a lot of changes and accommodations they may not be used to. On the other hand, our instructors who are mostly in clinical now have a few things they have to do in the first half, but it won’t be until the second half where they feel the pressure the other educators are feeling right now. The students seem like they are holding up, although I know there are different stressors right now. Faculty have been mindful and open to accommodating individual circumstances to promote success.”
Even though the summer semester just started, Silvestri-Elmore says they are already planning different scenarios for the fall semester, but each plan is under constant assessment, because of the rapid changes from COVID-19; it’s difficult for faculty to make decisions too far in advance. For now, Silvestri-Elmore says they will work around the barriers surrounding in-person collaborations, so the students get the education they need. “There are a lot of technological advances now where we can make sure when they graduate as a generalist RN, they have the knowledge, skills, and abilities to be a safe practicing nurse.”