In-Person Clinical Continue During the Pandemic


Nursing students Rosalie Monkono (left) and Kennedy Johnson (right) receive instruction on swaddling a newborn from professor Jenny Curwen (middle).

It’s an understatement to say that the pandemic has disrupted the normal flow of in-person learning. For students in the Seattle University College of Nursing who are training to be the next generation of health care workers, the education of essential nursing skills is even more pressing. 

There are numerous hands-on skills that nursing students are required to learn—many of which are near-impossible to replicate online. These skills are learned during clinical experiences in hospitals or in the Clinical Performance Lab (CPL) at Swedish Cherry Hill. 

For students in the nursing program, whether they are working in hospitals or in the CPL, there are strict guidelines in place. At health care facilities, in accordance with Centers for Disease Control and Prevention (CDC) and hospital requirements, students use personal protective equipment (PPE) due to the close proximity of students and patients, and the same requirement is adhered to in the CPL. Most facilities require the students to wear face shields in addition to N95 masks.

Jared DeBest, a third-year nursing major in the traditional Bachelor of Science in Nursing cohort, describes the safety measures he goes through when working in person. 

“For in-person clinicals, we are required to be vaccinated against COVID-19 and are highly encouraged to get our booster,” DeBest wrote to The Spectator. “If we test positive for COVID-19, then we are rotated out of clinical until our quarantine period is over. In regards to testing, there is not mandatory testing but we are encouraged to get tested regularly. When we go to the CPL, we are asked to fill out the Safe Start Health Check and wear a mask at all times.”

Dean of the College of Nursing Kristen Swanson reports that online went into effect mid-March of 2020. Three months later, students started to return to hospital-based clinical rotations. However, despite clinicals remaining in person, there are still some virtual hospital-based clinical rotations for various circumstances. 

“We have been pretty much continuously interspersing virtual clinicals with in-person,” Dean Swanson said. “For example, [in] some facilities such as long-term care facilities or any residential settings such as a psychiatric hospital or nursing home, there could be outbreaks of COVID-19 where our students are temporarily asked to stay away. Hence, there may be one group of students who were not able to be in clinical [in-person] and end up having to do it virtually … So the answer goes from we had, at one point every undergraduate student in our school [doing] virtual clinical, to now we can have anywhere from one student to one group of eight to an entire class of 72 doing virtual simulated clinicals depending on what circumstances unfold.”

One of the students affected by this change in format at the start of the pandemic in 2020 was Elise Reinholtz, a third-year nursing student. At the time, she was doing her geriatric clinical rotation which was converted into a “virtual simulation.” 

“Virtual simulation felt like a video game for the most part and I found it difficult to apply theory concepts into clinical practice,” Reinholtz wrote in a statement to The Spectator. 

Reinholtz is completing her mental health rotation at Swedish Ballard, recalling the first day as “nerve-racking.” She explained that she is never exposed to known COVID-19 positive patients while working in the hospital and feels safe being fully vaccinated and boostered. 

“I was super excited to finally be working in a hospital and practicing nursing skills,” Reinholtz wrote. “Every nurse that I’ve worked with so far has been so helpful and eager to teach me.”

Third-year Nursing student Grace Lohrding shared that her only in-person clinical was for mental health, an experience that helped “solidify that nursing is in fact the career [she] feel[s] suits [her] the best.” 

“I currently work as a nurse technician at Harborview Medical Center and honestly there are times I feel scared,” Lohrding wrote in a statement to The Spectator. “There are COVID-19 patients on every floor and that can be very intimidating, but they deserve the same care as all the other patients. I trust my vaccine and the PPE so I am not very scared, but it can be nerve-racking.” 

Despite most clinicals being offered in person during the pandemic, there have been online alternatives that DeBest has taken part in. DeBest compares his experiences of participating in taking clinicals online versus in a hospital.

“Both in-person clinicals and online clinicals provide a meaningful education,” DeBest wrote. “Personally, I prefer the in-person clinicals because you are immersed into the nursing role, interacting with real patients and observing and participating in critical thinking. While the online clinicals don’t provide the same experience, they are a great supplemental resource. It is a safe, risk-free environment where we can practice our skills and training in a variety of situations that may not appear frequently in the real world.”

The availability of online learning for the College of Nursing helped students when Seattle U announced that classes would remain virtual for the month of January. No significant adjustments had to be implemented with theory classes, which were already online. Students returned to clinicals in sites that were prepared to accept them and the CPL updated its PPE to match current CDC guidelines.

Dean Swanson reports that there have been “well over 8,000 visits of people in the Clinical Performance Lab without a known transmission of COVID-19.” She states that there have been “a lot of nuanced decisions” to keep everyone safe, but so far, all students have graduated on time. 

“I want to say how proud I am of the faculty, staff and students in the College of Nursing,” Dean Swanson said. “They have been brave through this whole process. They’ve been vocal when they had concerns. We have worked through differences and I couldn’t be more proud of my college and more grateful to Seattle U for working with us to enable students and faculty to do the work we need to do and yet help provide the guidelines that keep everyone safe.”

For nursing students, it has been challenging in and out of hospitals. But the pandemic and real-life experience of working in a hospital has given them a renewed sense of purpose in their future profession.