Changes in the NSG 440 Community Health Clinical

Changes in the NSG 440 Community Health Clinical

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Started
Petition to
Le Moyne Nursing Department

Why this petition matters

Le Moyne Nursing Department,

On January 10th, one week before the semester started, we were told that “Based on the current situation with our community health partners and the pandemic, there was a need to change the method in which we conduct the Community Health clinical.” (Email from Clinical Coordinator). Based on the above email it was assumed that there was a concern for students’ safety regarding COVID while being in a clinical setting, as well as a lack of preceptors to fulfill the semester clinical requirements. The clinical requirements for Nursing 440 are 45 hours.  Instead of being assigned to a preceptor, shadowing that preceptor for 40 hours, and then completing 5 hours’ worth of paperwork and reflections, an alternative clinical assignment was put in place. “The Community Health clinical experience activities will be eight weeks (eight sections) in length and will start in Week #3 and continue into Week #12 during the semester. Students will spend approximately 20-25 hours performing a community assessment and 20-25 hours developing and presenting a clinical population education program. Students should budget at least five hours per week for these activities.” (NSG 440 Syllabus).

We as the nursing class of 2022 understand that this alternative was a last-minute change, but the change is a project that will be much harder to successfully achieve due to the pandemic, and more time-consuming than that of the original clinical experience. COVID has created stress, isolation, and decreased community engagement, and we believe it is unfair that these changes have led to more stress and less flexibility being placed on the students.

This alternative clinical came without objectives and few clear-cut expectations. In the project sections alone, the expected “at least 5 hours a week” for 8 weeks requires 40 out of the 45 hours. The current work allotted in each section will easily take 5 hours and does not account for time spent looking for resources and time spent in attempting to get in contact with people who will be willing to participate. 

Looking at the assignments, if done properly as outlined in the assignment, more than 5 hours will be required for each of the 8 sections. Completing part 1, which has the least amount of work, took many students more than 5 hours to complete, while other students have been unable to complete section 1 due to no response from the RNs they have attempted to contact. This project will also require the students to, in a way, find their own preceptors, which in the past has been a responsibility of the Clinical Coordinator. Requiring students to try and reach out to multiple nurses, multiple agencies, and a family on their own is a large responsibility that has now been placed on the students with little notice. If the Le Moyne Nursing Program struggled to find enough preceptors for the original clinical, why would this struggle not be present when the students try to find nurses and agencies willing to help for clinical placement. 

In addition, when assigned to shadow, the agency RN is able to do their job with minimal interruption. The way this clinical project is, requires those who we are reaching out to, to take time out of their days to address our questions and inquiries about being able to complete a school assignment. These organizations have no incentive to help and are already dealing with their own lack of time and staffing shortages. We as students approaching these agencies have less influence than if the college approached them. It is also concerning that amongst a pandemic, instead of going to one clinical site, we are now being asked to interact with more people and go to more places. We would hope that our safety would be of utmost importance to the nursing program. 

We are also being asked to talk with a family within our community. When a student inquired about the best way to connect with a family in a safe manner, as well as do so in a way that protects HIPPA, the student was told that they could most likely figure it out themselves when that portion came along. We understand the importance of being independent, but as students, we still require instruction, guidelines, and clear expectations from our professors on assignments. There is a difference between promoting independent thought and action and leaving us to our own devices. 

It was also noted that there are portions of the project that state, “This activity is optional, but it is recommended for full credit”. These “optional” activities are not truly optional if they are required for full credit. These activities are also the activities that would require us to enter a clinical setting in which was deemed unsafe amongst the COVID pandemic and was given as a reason for the usual clinical to be canceled.

Our hope is that this project will be adjusted and changed, to only take the 45 hours required for this 1 credit course, to not require us to enter clinical setting that could put us or others at risk, to be provided the resources to complete each section within Canvas, and to have clear and detailed explanations for each portion of the clinical project assignment. 

We believe that these goals can be accomplished by being provided resources and suggestions for contacting the RNs, families, and agencies—as well as help from the clinical coordinator in securing connections and finding who is willing to help us from our chosen community. Detailed explanations specifically about how to go about reaching a family within the community in a safe way that protects ourselves as well as patient information would be very helpful—as this piece of the project is one that causes students the most concern. We believe that there are multiple ways that this project could be adjusted to ensure the project does not exceed the 45 hours. One way would be with the elimination/adjustment of section #4. This section has raised the most concern of personal safety as well as how to go about it. The agencies/RNs cannot give us patient information to connect us with a family and attempting to approach a family within the community ourselves, could potentially be dangerous and/or extremely difficult to do. Barriers that could inhibit us from completing section #4 could be a lack of technology, hesitancy for families to participate due to COVID, unwillingness for families to talk with a stranger who is approaching them as a student, and even if a family is willing to talk, they may not want to share the detailed personal information section #4 is asking the students to collect and then share with many others. The hours required could also be decreased by resources being provided as to where we can find the information needed for each section. Google may have all the answers, but without knowing where to find the information, students can spend hours searching google for the right information. Providing websites would increase the student’s efficiency and allow the time to be spent on the important aspects of this project. One last solution to decrease the time spent would be more detailed expectations and descriptions for each section. We are willing to meet to discuss these requests or other suggestions.

In the last few days, many students have asked questions about how aspects of this project can be accomplished and about resources that can assist us in the process–unfortunately many of these questions have been met with resistance. The repeated theme is that we should be able to independently find the answers. As students we understand that there is value in independently finding the resources, in spending time searching for all the answers, and in completing this project as it currently stands, but not at the price of the limited hours we have left during our heaviest semester. This final semester students are balancing up to 19 credit hours as outlined in our program of study, working part/full time jobs that help us pay for tuition and provide us real world nursing experience, managing all other responsibilities, and trying to keep ourselves afloat.

 

We as students must advocate for ourselves as we have been taught to do for our patients since day one–and we hope to be heard.

 

Thank you. 

 

Sincerely,

 

The Le Moyne Nursing Class of 2022

Signatures of those who agree to the above sentiments.

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