How to move from normal to now, to the new normal, has been our focus. Likely, no matter what else happens, we will not go back. The bad news is we may not feel as comfortable as we have been in doing whatever it was we did before. The good news is that we will all get to exercise our best thinking and creativity and, in some cases, test new approaches that would likely have had to be approved through multiple committees and regulatory groups under normal circumstances.
On February 25, 2020, I left a statewide meeting on nursing education where we used an innovative approach to secure input from a variety of nurse educators and our service partners. Our focus was on how best to address clinical experiences for our students, from practical nursing through advanced practice nursing students. We had intense discussions and a plan to move the report ahead. We all returned home to our usual responsibilities and practices of commuting, teaching, meeting, and socializing. Little did we know how dramatic the next month would be.
March came and life changed! Campuses shut down; students living on campus were sent home; carefully devised course plans were replaced with evolving and ingenious ideas to ensure no or limited physical contact. Hybrid courses (part on campus, part online) and courses delivered solely on campus were converted to online only. We canceled major learning experiences, and in one short month, our view of our educational programs changed. Even students in programs normally delivered solely online experienced stress. Their work situations changed, and they faced uncertainty about how they would complete their coursework or meet the requirements for graduation and licensure.
Faculty were unable to get off of email, phone calls, or Zoom because everything kept changing. Educators rose to these challenges through careful planning done quickly. Does any of this sound familiar to you?
Nationwide, many schools of nursing moved to online learning - some for the first time. Faculty and administrators devoted a lot of time to how to provide clinical experiences in a safe manner; what substitutes could be possible; how graduating students would be able to complete the program and qualify for the licensure examination; how (and even if) the licensure examination would be available; how COVID-19-intense health care facilities could use the talents of our about-to-be graduates; how faculty could complete courses and research projects; how graduates could be recognized, even though no ceremony would acknowledge the culmination of their studies; and on and on. We quickly learned how to work from home. Webcams were sold out or overpriced. Faculty and staff had to decide what in their offices they had to have for an unknown period of time while sheltering at home and continuing their work expectations.
A new term, Zoom fatigue, emerged due to the numbers of hours many of us engaged in electronic meetings with a different kind of concentration needed to follow online conversations (the term refers to any interactive video, not just Zoom). We all rose to the occasion! Educational programs, as well as private industries, donated personal protective equipment to hospitals so that those in direct care with patients would be safe. We moved educational testing to online options, and we searched for hand sanitizers, masks, and, yes, paper products, which suddenly were in short supply.
Many organizations, including the National League for Nursing, switched from a usual format of preplanned educational conferences to problem-oriented, answers-now approaches available to electronic audiences. How to move from normal to now, to the new normal, has been our focus. Likely, no matter what else happens, we will not go back. The bad news is we may not feel as comfortable as we have been in doing whatever it was we did before. The good news is that we will all get to exercise our best thinking and creativity and, in some cases, test new approaches that would likely have had to be approved through multiple committees and regulatory groups under normal circumstances.
Today, we have the opportunity to turn the pandemic into real gains in health care and education. What if, for example, we rebuilt our public health system and provided some intense practica within that system? What would our graduates be able to do? Or, what if we changed the way we taught mental health and increased the numbers of nurses who could help manage the increasing numbers of people with mental health needs? In addition to the numbers of people in the general population needing such services, consider how dramatically caring for COVID-19 patients has been for health care professionals and other essential workers. Some people have likened the impact in health care to the posttraumatic stress disorder experienced by men and women in military wars.
As each day dawned during the past few months, clinicians went to work with one set of facts and often returned home with a new set of facts. Strategies to convey the latest messages caused mayhem in many situations, including in nursing education. Some students wanted to complete their clinical experiences but were denied access to their clinical agencies, typically due to limited availability of personal protective equipment. Students received multiple updates about what would be possible, what would not, and about how their faculty were there to support them, sometimes with answers such as, "We do not know yet." Clinical experiences that were no longer accessible converted to virtual simulations, electronic conferences, and online testing. In short, we lived in the most intensive example of VUCA (Volatility, Uncertainty, Complexity, and Ambiguity) ever experienced. (I actually think we should add an I to that acronym for Intensity. The intensity of work and our creativity within the time frame surely warrant this change.) Out of all this can come a new normal.
Going forward, suppose we relook at our various practices? We would not want to operate with VUCA and the intensity that we currently have in either service or education, but we likely can change practices to be more facilitative. Have we invested enough in how artificial intelligence can help us in both settings? Have we capitalized on virtual learning and practice sufficiently so that we are better able to respond to crises when they occur? Do we prepare learners to work with telehealth? Have we analyzed what content can be relinquished to allow us to increase our knowledge about public health, mental health, and policy creation and implementation?
If we analyze what we needed in March and what we need on an ongoing basis, we might conclude that strengthening public health and mental health is in order. Changes are greatly needed but not likely to happen in sufficient time to serve our current and emerging needs. So, how do we prepare all of us to be able to assist with public health and mental health demands? One way is to strengthen our policy capability.
Nurses in practice and education have been incredibly inventive in responding to the COVID-19 pandemic. We have been at the forefront of change and ingenuity in responding to the pandemic. We have demonstrated our caring, strength, and sacrifices, and, yes, ingenuity. The public has even more reason to trust us than before. We always find ways to overcome adversity. We need to capitalize on that for the health of our communities and individuals.
Be safe!