The Pulse Spring 2023 NCSBN: How has the COVID-19 Pandemic Impacted the US’s Ongoing Nursing Shortage?
Food, Fun, and Flowers for Free? Low and No-Cost Activities in Portland Outstanding Students: Our Recent Nominees for Student of the Month
“The Chicken and the Egg:” The Narrowing Bottleneck Among Nurse Educators
Image © 2014 Jonathan Ley
Contents
Page 3 - 2023 Holidays and Breaks
Page 5 - COVID-19 News - The State of the Nursing Shortage
Page 7 - Activities - Free (And Nearly Free) Things to Do in Portland Page 9 - Psychiatric Nursing - The Success of the New 988 Mental Health Line
Page 12 - Student of the Month Winners
Page 14 - Nursing Employment Oppurtunity
Page 15 - Staffing Shortages - The Nurse Educator Bottleneck
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Holidays & Breaks - 2023
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Campus will be Closed
May 29th for Memorial Day!
We will Also be Closed
June 16th for Juneteenth!
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NCSBN Research Projects Significant Nursing Workforce Shortages
Image © Francine Orr
CHICAGO – Today, NCSBN unveiled its research, titled “Examining the Impact of the COVID-19 Pandemic on Burnout & Stress Among U.S. Nurses,” in a panel titled “Nursing at the Crossroads: A Call to Action” in Washing- ton, D.C. at the National Press Club at 9:30 am EST. For the first time, the research findings reveal how the nursing workforce was impacted by the pandemic and how many left the workforce in this period, and forecast how many nurses in the U.S. have an intent to leave the work- force. The research also examined the personal and pro- fessional characteristics of nurses experiencing heightened workplace burnout and stress due to the COVID-19 pan- demic.
The study is considered to be the most comprehensive and only research in existence, uncover- ing the alarming data points which have far reaching implications for the health care system at large and for patient populations. The research was gathered as part of a biennial nursing work- force study conducted by NCSBN and the National Forum of State Nursing Workforce Centers. Key findings include: • Approximately 100,000 registered nurses (RNs) left the workforce during the COVID-19 pan- demic in the past two years due to stress, burnout and retirements. • Another 610,388 RNs reported an “intent to leave” the workforce by 2027 due to stress, burn- out and retirement. • 188,962 additional RNs younger than 40 years old reported similar intentions. • Altogether, about one-fifth of RNs nationally are projected to leave the health care workforce. • 62% of the sample reported an increase in their workload during the pandemic. • A quarter to half of nurses reported feeling emotionally drained (50.8%), used up (56.4%), fatigued (49.7%), burned out (45.1%), or at the end of the rope (29.4%) “a few times a week” or “every day.” • These issues were most pronounced with nurses with 10 or fewer years of experience, driving an overall 3.3% decline in the U.S. nursing workforce in the past two years. • Licensed practical/vocational nurses, who generally work in long-term care settings caring for the most vulnerable populations, have seen their ranks decline by 33,811 since the beginning of the pandemic. This trend continues. 5
Research also suggested that nurses’ workloads and unprecedented levels of burnout during the COVID-19 pandemic played key roles in accelerating these workforce trends and threatening the future of the U.S. nursing workforce, particularly for younger, less experienced RNs. Further, high levels of turnover were seen with the potential for even further declines in a post-pandemic nursing workplace as disruptions in prelicensure nursing programs have also raised concerns about the supply and clinical preparedness of new nurse graduates. Early career data for new entrants into the profession suggest decreased practice and assessment proficiency. Coupled with large declines among nursing support staff, NCSBN calls for significant action to foster a more resilient and safe U.S. nursing workforce moving forward. “The data is clear: the future of nursing and of the U.S. health care ecosystem is at an urgent crossroads,” said Maryann Alexander, PhD, RN, FAAN, NCSBN Chief Officer of Nursing Reg- ulation. “The pandemic has stressed nurses to leave the workforce and has expedited an intent to leave in the near future, which will become a greater crisis and threaten patient populations if solutions are not enacted immediately. There is an urgent opportunity today for health care systems, policymakers, regulators and academic leaders to coalesce and enact solutions that will spur positive systemic evolution to address these challenges and maximize patient protection in care into the future.” The research findings and proposed solutions were presented in a panel discussion today at the National Press Club in Washington, D.C. Panelists included: • Antonia Villarruel, Dean of Nursing at University of Pennsylvania • Gay Landstrom, Senior Vice President and Chief Nursing Officer at Trinity Health System • Congresswoman Lisa Blunt Rochester, U.S. Representative of Delaware • Robyn Begley, CEO of the American Organization for Nursing Leadership and CNO/Sr. VP for the American Hospital Association • Rayna M. Letourneau, Board of Directors, National Forum for State Workforce Centers A recording of the panel discussion is available on ncsbn.org. (https://www.ncsbn.org/video/ nursing-at-the-crossroads) To request interviews with NCSBN or view the entire research, please contact Email Linkncsbn@reputationpartners.com or visit ncsbn.org. Research Methodology: The study examines a subset of the 2022 National Nursing Workforce Study for analysis. Re- ported trends represent population-based estimates. There were 29,472 registered nurses (in- cluding advanced registered nurses [APRN]) and 24,061 licensed practical nurses/vocational nurses across 45 states included. 6
Free (And Nearly Free) Things to do in Portland
Via Travel Portland
If you’re new to Sumner College, there is a chance that you’re new to the Portland area as well. Starting over in a new city can be difficult, especially when it comes to finding affordable ways to spend your free time. Luckily, Portland offers a ton of no and low-cost activities to fill those few precious moments away from your textbooks! Monthly Gallery Walks First Thursday, in the Pearl District and downtown,
has been going strong since 1986. On the first Thursday of each month, galleries and businesses, including the Pacific Northwest College of Art, debut new exhibitions, stay open late, and throw a soiree, complete with free wine and snacks and great people- watching. Of course, it’s also serious business for local galleries like the Elizabeth Leach Gallery, one of the celebration’s pioneers. First Thursday Last Thursday During Northeast Alberta Street’s Last Thursday, the art openings at spaces like the Guardino Gallery set the scene for a boisterous street fair that attracts inde- pendent artists and performers, from local bands to troupes of acrobats. Held year-round, the event is
Cost: Free
biggest from May through September, when the street is closed to traffic during the festivities.
Crystal Springs Rhododendron Garden Cost: $5 If you’ve visited Portland before, you’ve likely ad- mired the thousands of blooms at the International Rose Test Garden. Perhaps you’ve even wandered the rows of rose buses at Peninsula Park. Now it’s time to round out your floral explorations with a visit to Southeast Portland’s lush Crystal Springs Rhododendron Garden. Crystal Springs was founded in 1950 as a rhododendron test garden. Today, the park boasts more than 2,500 rhododendrons, azaleas, and other plants spread across 9.5 acres. One of Port- land’s best bird-watching spots, the garden is home to nearly 100 types of birds and other 7
wildlife. Settle in on a bench by Crystal Lake and enjoy the sight of dozens of ducks and geese. Listen for the trills and squawks of scrub jays, red-winged blackbirds, song sparrows, and many other bird species. However, feeding the birds is prohibited, so leave the bread crumbs at home! Rhdodendrons typically bloom from late Febru- ary through July, and peak in late April to early May. But thanks to the park’s many other plants, animals, and water features, you can enjoy Crystal Springs all year. The park features a numner of benches and ADA-accessible paths, allowing folks of all ages and abilities to enjoy the grounds.
On Mondays, the Admission fee is waived, so you can enjoy the garden for free!
Portland Saturday Market Cost: Free
Combining the vibes of an art show, a live street concert and an open-air bazaar, Portland Saturday Market has been a beloved Rose City tradition since 1974. In fact, the market is considered the largest continually operating arts-and-crafts fair in the United States, drawing up to 750,000 visi- tors during its annual season. On any given Saturday from the beginning of March to Christmas Eve, shoppers can wend their way through the rows of tents of this large out- door market featuring local makers, artisans, and chefs. A full sensory experience, the sights and sounds will have shoppers and on-lookers tapping their heels to bluegrass pickers and jazz trios with weekly sets of local musicians performing for market-goers and passersby in Tom McCall Wa- terfront Park.
Even though attendance is free, you’ll want to bring your wallet for the delicious food and local businesses! With such a variety of goods, the Saturday Market is naturally a great place to score gifts and souvenirs any time of year!
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Cries for Help Pour into 988 Mental Health Line The impact of the new, government-sponsered crisis line and plans to unveil call centers dedicated to particular communities
HYATTSVILLE, MD. — When Jamieson Brill answers a crisis call from a Spanish speaker on the newly launched national 988 mental health helpline, he rately mentions the word suicide, or “suicidio.” Brill, whose family hails from Puerto Rico, knows that just discussing the term in some Span- ish-speaking cultures is so frowned upon that many callers are too scared to even admit that they’re calling for themselves. “However strong stigma around mental health concerns is in English-speaking cultures, in Span- ish-speaking cultures it is triple that,” said Brill, who helps people navigate mental health crises from a tiny brick building tucked away in Hyattsville, Maryland.
Brill works in one of more than 200 call centers fanned out around the country tasked with answering an uptick in calls day and night from people considering suicide or experiencing a mental health emergency. With bipartisan congressional support and just under $1 billion in federal funds, the 988 mental health helpline has quickly ex- panded its reach in the six months since it launched — with over 2 million calls, texts and chat messages pouring in.
988 Call Center Director Jamieson Brill poses for a photo in front of a desk where work workers take calls around the clock at a facility in Hyattsville, Md., Oct. 7, 2022. (AP Photo/Amanda Seitz)
The number of centers answering calls in Spanish grew from three to seven last year. A pilot line dedicated to LGBTQ youth started taking calls in September. And plans are underway to keep the momentum going, with the federal government adding Spanish language chat and text op- tions later this year and aiming to expand those services to a 24/7 operation for the LGBTQ line. When the around-the-clock service launched last summer, it built on the existing network that staffed the old national lifeline, 1-800-273-8255. The new 988 number is designed to be as easy to remember as 911. It couldn’t have come at a more needed time: Depression rates in U.S. adults, overdose deaths and suicide rates have been on the rise.
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By Amanda Seitz via The Washington Post
“The call volume is, in some instances, well beyond what we anticipated,” said Miriam Del- phin-Rittmon, assistant secretary for mental health and substance use in the Department of Health and Human Services. “It does let us know that people are struggling, people are having a hard time. Where I feel heartened is that people are getting connected to services and supports, as opposed to struggling on their own.” The 988 helpline registered 154,585 more calls, texts and chat messages during November 2022 compared to the old national lifeline in November 2021, according to the latest data available. Texting has been particularly popular, with the Substance Abuse and Mental Health Services Administration noting a 1,227% increase in texts to the line during that same time. The Veterans Crisis Line — callers can press “1” after texting or calling 988 to reach it — has fielded 450,000 calls, texts and chat messages, according to the Department of Veterans Affairs. By the end of the year, the line had handled a nearly 10% increase compared to 2021. Calls show no signs of slowing into this year, with counselors answering 3,869 calls on New Year’s Eve and the first day of 2023 — a 30 percent increase compared to the previous holiday. The Spanish language line saw an increase of 3,800 calls year over year from November 2021 to November 2022.
Meanwhile, some states are considering unveiling their own lines dedicated to certain communities. In November, Washington became the first state to launch a mental health crisis line dedicated to American Indian and Alaska Native people. Call- ers in Washington can reach the line by calling 988 then pressing “4” to be greeted by one of the 13 counselors — all Indigenous people — who staff the phones. Having fellow American Indians answer those calls is crucial, because those familiar with the culture can immediately decode some terms that others cannot, said Rochelle Williams, the tribal
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operations manager for Volunteers of America Western Washington, which oversees the call center. For example, she said, when a caller says that a relative is “bothering me,” that sends up an immediate red flag: The person is likely signaling that they’re the victim of a sexual assault. “Who has a better understanding of native people than native people?” Williams said. “We don’t trust in a lot of government programs. Knowing you’re talking to another Indigenous person is really important.” Williams wants to add chat and text options next. She hopes Washington’s 988 line for Native Americans becomes a model for others. She’s already given presentations in New Mexico, Okla- homa, Montana and in Canada, which is set to launch its own national 988 this year. States are expected to receive more money to fund the line from the $1.7 trillion end-of-the year spending package, which set aside another half-billion dollars for the project. Still, long-term funding for the 988 helpline is in jeopardy in some states, which have yet to figure out a permanent funding plan for it. While the federal government has poured millions of dollars into the project, states are expected to take over the operation and funding of the 988 line — just as they do with 911 emergency call services. So far, fewer than 20 states have passed legislation to permanently fund their 988 line, according to the National Alliance on Mental Health Illness. In Ohio, for example, advocates are pushing for the state legislature to sign off on a 50-cent fee that would be tacked onto cellphone bills, raising roughly $50 million to $55 million every year to operate the line, said Tony Coder of the Ohio Suicide Prevention Foundation.
“Quite frankly, lives depend on it,” Coder said. “The need for 988 services is more crucial than ever, simply because of the aftermath and the mental health issues from COVID.”
Source: https://www.washingtonpost.com/politics/call- ers-keep-flooding-988-mental-health-suicide-help- line/2023/01/10/afc040ca-90a5-11ed-90f8-53661ac5d9b9_sto- ry.html
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Students of the Month
Every month, the faculty and staff vote on a student to receive the Student of the Month award. Some of the characteristics we look for are reliability, professionalism, and a positive attitude. The nominated student receives a $500 scholarship and has a placard hung for them in the front lobby. The students listed here were nominated for Student of the Month this past Winter. Con- gratulations to our winners! January - Hamza, LPN
Hamza was taking prerequisites in nursing at Highline Community College before enrolling at Sumner College. He was referred by professional colleagues to consider our program and he has been impressed with the wonderful edu- cation and learning experiences provided. Originally from Uganda, where he was working in environmental restoration, Hamza emigrated to the United States in 2018. He has worked as a caregiver and nursing assistant for the past
4 years in long term care settings. Hamza is also proud to be a hospice volunteer with CHI Franciscan Health. Currently completing his practicum at Life Care Center of McMinnville, he plans on pursuing his BSN and focusing on becoming an Emergency Room nurse. Hamza is an accomplished soccer player, has recently been trying vegan cuisine, and is planning to explore Yellowstone National Park.
February - Kayliegh, MA
Originally from Illinois, Kayleigh moved to Oregon in December. She was inspired to become a medical assistant because she wanted to help others and was unsure of where to start in the medical field, and recognized that becoming an MA would give her the opportunity to decide. Kayleigh is a people person who loves helping others with their conflicts and problems. She thrived with the hands-on labs that are offered at Sumner College, which were her favorite part of the program. When asked to give advice for students starting at Sumner College, Kayleigh emphasized the importance of being patient and not being too hard on yourself. She encourages students to take things one day at a time, and with focus and repe- tition, things start to get easier. Kayleigh devotes most of her time to her studies and work, but enjoys listening to music during her free time. She is a hardworking individual who is sure to make a positive impact in whatever career path she chooses.
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March - Cassandra, RN
Cassandra is an inspiring individual who’s mantra is “be the good you want to see in the world”. Introduced to Sumner College by a former student, Cassandra was inspired to pursue a career in nursing by her daughters. As a parent and former secretary at a local elementary school, she recognized a need for nurses who understand the importance of mental health in pediat- rics, which can be challenging to find. Her long-term career goal is to become
a psychiatric mental health nurse practitioner. Maintaining the demands of nursing school can be difficult, but Cassandra manages with the help of her wonderful husband, daughters, and fellow nursing students. To first term students, Cassandra advises embracing the experience and cohort, being humble and open to learning not just from the material, but from the people around you. Her cohort is very important to her, and she has made lifelong friends because of this experience. In her free time, Cassandra loves working out with her family and friends, and traveling together with them. Her teenagers and husband are all fun and interesting people to be around, and there is never a dull moment with her crew. April - Alexander, LPN With over ten years of experience as a CNA, Alex has always been inspired by the hardworking and patient nurses he worked alongside, which motivated him to pursue a career as a nurse. Alex takes pleasure in caring for people and being a part of their recovery. To balance the demands of school and family life, Alex attributes his success to his supportive wife, who serves as his master scheduler and encourages him to study whenever possible. Additionally, he relies on his fantastic nanny to care for his children while he attends classes or studies. Alex's long-term goal is to become an RN and work at either Randalls or Doernboechers, where he can specialize in working with children. For first-termers, Alex advises them to study when- ever possible, even if it means downloading books on their phone or laptop and studying during routine activities. Outside of his academic and professional goals, Alex enjoys hiking and exploring different parks with his wife and four children.
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Hillsboro Medical Center
Apply now to our Nursing Residency Program: Next cohort starting March 2023
Join our Nurse Residency Program and come grow your career with Hillsboro Medical Center! What you can expect from our program: • You will get up to 24 weeks of didactic, hands-on and practicum training • Our program is designed to provide you with the support and guidance you need in a safe, nurturing environment • You will increase confidence in your clinical skills and judgement and enhance your critical thinking • You will refine your time management skills and ability to prioritize • Past graduates of our program have described it as a fun and engaging experience! Our organization offers a unique opportunity to work for a great organization with a tight-knit culture, where you don’t feel like you’re just another number. Hillsboro Medical Center is unique because of the relationships we build and as individuals we are seen and heard. We have deep roots in our community, as well as the advantage of having a strategic & clinical partnership with OHSU. We offer a competitive compensation package and outstanding benefits. Connect with one of our recruiters today! Call us at: Suzy Sapra (503) 681-1857 suzy.sapra@tuality.org Linnea Cornish (503) 681-1792 linnea.cornish@tuality.org
Next cohort starting March 2023 Specialty Training Positions in PCU and ED
© 2022 Tuality Healthcare, doing business as Hillsboro Medical Center, an OHSU partner. OHSU and OHSU Health are registered trademarks of Oregon Health and Science University.
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Oregon Health Care Employers Hamstrung by Staffing Shortage
As an intensive care nurse in a Portland cardio- vascular unit, Jazzy Walker lived through the COVID burnout that’s driven nurses from the industry and exacerbated widespread nursing shortages across Oregon’s healthcare system. She watched as some of her most seasoned col- leagues broke down under the strain of heavy workloads with increasingly sick patients, and she felt team dynamics change as hospitals called in short-term travel nurses to fill staff gaps.
When the stress got to Walker, prompting panic attacks and sleepless nights, she decided to move from bedsides to academia and focus on building the future nursing workforce. Four months into her job as the nurse administrator at Clackamas Community College, Walker is up against the chicken and egg situation impeding Oregon’s higher education institutions from meeting healthcare industry needs. Nurses can’t make as much money teaching as they do helping patients, which makes nurse edu- cators hard to hire. That instructor shortage limits the number of students that nursing programs can enroll, preventing Oregon colleges from graduating enough nurses to meet state workforce needs. Short staffing in both settings means fewer nurse educators are available to train students in hands-on clinical settings, further limiting the number and experience of nursing grads. “It is a very ugly cycle,” Walker said. Oregon’s nursing programs produced the third fewest graduates per-capita of any state in 2020, according to the Oregon Longitudinal Data Collaborative, which analyzes data across Oregon’s education and workforce landscapes. “Most of our schools have programs. It’s a capacity issue,” said Tracy Thompson, policy analyst for nursing education at the Oregon State Board of Nursing. “There’s no faculty to support addi- tional students.” An upcoming report from the collaborative, expected in February, will recommend that the state convene a workgroup to address nursing faculty pay and estabilsh a centralized clinical 15
By Sami Edge via OregonLive
placement system. Nurse educators are also looking to legislators for policy changes that could fix kinks in the workforce pipeline for a critical state industry. “If we can get incentives to clinical partners, and if there’s a way for the state to help fund nurs- ing educator’s salaries and program administrators, that would really help with two of our prob- lems,” Walker said. LIMITED CAPACITY
Oregon has 17 associate degree programs for students who want to become registered nurses, as well as six public and private bachelor’s degree programs and another eight community college programs for licensed practical nurses, who have less schooling than a registered nurse.
In 2020, 409 students graduated from practical nursing programs, 606 students from associate degree nursing programs and another 929 students with a bachelor’s degree in nursing, said Ben Tate, director of the Oregon Longitudinal Data Collaborative. Still, the data collaborative estimated that Oregon needed more than 1,000 additional graduates to meet workforce needs that year, according to a draft summary of its upcoming report. Schools have enough applicants to more than double their capacity. Oregon’s nursing schools received more than 6,000 applications in 2020, but accepted less than a quarter of them, the draft summary says. Clackamas Community College sometimes gets more than 300 applicants for an average of 30 open spots, Walker said. “To turn down that many potential nurses is a very hard thing to do,” she said. Jennifer Limones, 36, is in her second year of the Clackamas nursing program and is planning to enter the profession full-time this summer. She spent several years working and taking 16
prerequisite courses before she applied for the associate degree program in nursing, inspired by the impact of nurses who took care of her 4-year-old son when he needed a kidney operation at Randall Children’s Hospital. Limones, who has worked as a medical assistant for 15 years, was accepted to the Clackamas program on her first try. She knows that’s an unusual feat. “There are so many capable and qualified prospective nursing students who are not making the cut and it isn’t for lack of qualifications or ability. These are not incapable or incompetent pros- pects,” Limones said. “There are only so many seats and it really becomes discouraging.” Walker hopes to expand Clackamas’ open seats. In a perfect world, she’d offer 36 spots next fall and work to open 40, maybe 60 in the long-term. But this fall, Clackamas didn’t even have enough teachers for its typical enrollment. The school cut its usual 30 slots down to just 18, Walker said. “Trying to advertise and get nurses at the bedside to come teach with our students is like pull- ing teeth,” Walker said. “They can’t afford financially to take that pay cut, so they’re not going to come on full-time.”
NURSE EDUCATORS MAKE LESS Walker nearly turned down her position at Clackamas when the first offer from the school came in $30,000 lower than what she made nurs- ing full-time. Without picking up extra shifts, Walker could pull in $90,000. With extra shifts she made over $100,000. Full-time faculty at the school make somewhere between $60,000 and $80,000 by comparison, Walker said.
Nursing program administrators around the state are hamstrung by that challenge. Janie Griffin, director of nursing at Columbia Gorge Community College, reminds prospective teachers that they get summers and most weekends off and can take nursing shifts on the side. “When you look at an ad and you see I’m going to make $20,000 less, (nurses say) ‘I’m not even going to apply,’” Griffin said. “I don’t know, how do we catch them and hook them and bring them in and say ‘Give it a try, I think you’ll like it?’” Oregon Health and Science University is working to boost the ranks of nurse educators through its Oregon Nursing Education Academy. The academy aims to train 63 new faculty members and 92 new supervising clinicians with a $4 million federal grant. Nurses accepted to the academy
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will receive scholarships that cover the majority of tuition. Several lawmakers have proposed bills in the 2023 session that would extend income tax credits for rural medical providers to nurse educators. A similar effort died in committee in 2019. FEW CLINICAL SPOTS Nursing students need hands-on practice to finish their schooling, but a lack of faculty and working nurses means there are too few mentors to guide students in clinical settings. The short- age of clinical placements became acute during the COVID-19 pandemic, when many healthcare facilities closed to visitors. Deb Henry, a nursing education and practice specialist at Legacy Health, said the hospital system offered 2,607 clinical spots for nursing undergraduates in fiscal year 2020, then only 468 in 2021. Clinical spots rebounded to 1,110 in 2022 but are still not back to pre-pandemic levels because of staffing shortages. Hospital units that have several nurse openings can’t accommodate as many students, Henry said, and will prioritize onboarding new Legacy hires or traveling nurses before training stu- dents. “We try hard, I try hard, to place these students but there are so many variables involved that it’s difficult,” Henry said. The Oregon State Board of Nursing allows schools to substitute simulated nursing scenarios – like working with high-tech mannequins, case studies or actors – for up to 49% of a student’s clinical hours, Thompson said. Some schools have leaned into that option. The Linfield School of Nursing expanded simulation centers during the pandemic to help meet students’ needs for clinical experience. Spending time alongside professional nurses in real health care settings helps prepare students to work face-to-face with patients, but the hours can be unpredictable, associate dean of nursing Julie Fitzwater said. Simulations let instructors craft the exact experience they want their students to work through, like caring for a mannequin that has given birth and is suffering a post-partum hemorrhage or interacting with an actor simulat- ing a patient in a mental health crisis. “Having both experiences is so important for building their clinical reasoning and clinical judge- ment,” Fitzwater said.
Source: https://www.oregonlive.com/business/2023/01/oregon-health-care-employers-hamstrung-by- staffing-shortage-as-the-state-produces-3rd-fewest-nurses-per-capita.html
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