At a time of heightened demand for nurses, students are finding COVID restrictions have kept them from amassing the hospital training hours they need to get certified — prompting education officials to scramble for a cure.

CUNY’s Lehman College in The Bronx is among schools that have worked with the state Education Department to reduce the number of clinical hours needed to graduate, replacing in-person work with online simulations of tending to patients in need of care. 

That comes as a relief to nursing student Susynne McElrone, who has been concerned she won’t graduate as planned in January because hospitals have been reluctant to allow on-site training required for graduation and the state certification exam. 

Beyond her personal prospects, McElrone also worried the restrictions would disrupt the pipeline of nurses entering the profession, exacerbating a shortage as the city’s health care workforce is on guard for a new spike in coronavirus cases.  

“There may be a blip of months without new nurses,” she warned.

Her concerns have been heightened as a group of her fellow students assigned to do their training hours at a Bronx hospital learned in mid-September that they have to quarantine for two weeks after potential exposure on a floor where they’d worked. They went back to the site Sept. 30, she said.

The possibility that cascading shutdowns could cut off new nurses from needed training is not just an issue for New York City, said Diane Mancino, executive director of the National Student Nurses’ Association. 

“The places that usually allow clinical experience by the students — direct patient care and so forth — have either cut back the number of students that they can take, or they have eliminated the clinical completely,” Mancino said. “Many are saying that they’ll pick up again in the spring semester.” 

She added that restrictions will disrupt the nursing pipeline, but the degree to which it will is “yet to be determined because we don’t know how many will be able to graduate.”

‘Nurses Are Resilient’

Selena Gilles, a clinical assistant professor at NYU Rory Meyers College of Nursing, said the pandemic abruptly altered nursing education around the United States. But, she noted: “Nurses are resilient. They can adapt.”

“It wasn’t just about conducting virtual lectures via Zoom or whatever platform different schools are using, but also trying to figure out how do we replace clinical hours?” Gilles added.  

Now with nursing programs having less access to hospitals than before the pandemic, a new concern is how they will provide enough hands-on experience for nursing students to become ready, Gilles said.  

New York State Education Department officials said their Professional Education Review Office is currently working with nursing programs statewide to determine if flexibility is warranted for them.  

At Lehman, instead of requiring 180 clinical hours to graduate, students now only need 120, said Catherine Alicia Georges, chair of Lehman’s nursing department, following an application and review with the state. 

A drive-through coronavirus testing site at Lehman College in the North Bronx, July 14, 2020. Credit: Ben Fractenberg/THE CITY

“We have to be explicit in the reasoning for why the reduction in hours, and they gave it to us,” Georges said. 

Those adjustments were made possible because the New York State Education Department’s Board of Regents adopted regulations at its April meeting to grant flexibility to educational institutions with nursing programs. 

“Our quality has not decreased,” Georges said of the new requirement and online- simulation curriculum, which includes exercises in interviewing patients about their conditions.  

“We’ve got some of the most dedicated men and women I have known in my entire professional life who are working with these students,” she added. “They go way above — way above what anybody pays, way above — because they’re concerned about the next generation of nurses.”

Financial Burdens

That next generation includes McElrone and her current classmates — a group of 23 students in an accelerated, 15-month nursing program. 

When the program began in June 2019, the students expected to graduate in September 2020. But as COVID restrictions put most medical facilities off limits, they couldn’t take their most important course, Nursing Synthesis, which required 12 hours a week of work in a local hospital. 

The would-be nurses needed to wait until this fall semester to return to hospitals to take their important on-site course, which pushed back their graduation a semester. 

It’s been financially difficult for many of those students, since they have laid out tuition funds for two semesters as part-time students, which is more than they would have paid for only one as full-time students.

“I’m paying for an extra semester,” McElrone said. “I’m paying for four months of rent, you know, and I expected to be working.”

Now, McElrone’s class is promised six hours per week inside a hospital, she said. 

McElrone said that even this fall, her class had difficulty getting in their clinical hours. For the first four weeks of the semester, they didn’t receive any time inside a hospital. 

But in the past two weeks, her class received all their promised hours, she said. McElrone is cautiously optimistic her group will graduate by the end of the fall semester. 

However, she added, “if there’s an uptick in cases across the city again, it’s possible that our critical would be cancelled.” 

“Until the fat lady sings, she doesn’t sing,” she said. “So I’m hopeful, but cautious. I don’t want to be disappointed.”