As Virginia鈥檚 vaccine rollout spreads into the Shenandoah Valley, 草莓社区 students are participating at both ends of the needle: both giving and getting the shot.

And in some cases, they’ve giving the shot to fellow students and EMU employees. According to an informal count kept by EMU Health Services, 110 students and 135 employees have received the full course of vaccines as of April 14. These numbers are based on copies of vaccination cards provided to Health Services (through covidhotline@emu.edu).

Senior nursing students in Professor Kate Clark鈥檚 community health course and associated clinical rotation this semester have been giving vaccines and aiding with processing at clinics up and down the Shenandoah Valley: in Lexington, at Augusta Health in Fishersville, the Rockingham County Fairgrounds, and Sentara RMH, the city jail and city community center in Harrisonburg. A recent afternoon saw a small group among the volunteer nurses, physicians, and other health professionals staffing a clinic in the convocation center at James Madison University.

While other rotations like shadowing in the emergency department and the ICU unit may be more exciting, Natalie Stoltzfus has enjoyed the hands-on work and the chance to contribute in an historic public health effort. 

鈥淭hese have been my favorite clinicals,鈥� says Stoltzfus, who will work at Penn State Hospital Hershey after graduation. 鈥淥nce you get the routine down, it鈥檚 pretty simple. Six hours goes by fast.鈥�

According to Clark, EMU鈥檚 smaller program and long relationship with the local district of the Virginia Department of Health has contributed to unique opportunities to work small and large clinics and to interact with many different populations, including healthcare professionals, incarcerated individuals and senior citizens. [Read about spring 2020 clinical experiences and how the Class of 2020 nursing graduates finished their semester.]

Nursing students provide Q & A at campus info sessions

The knowledge students have gained as vaccinators and in the public health context has also benefited their fellow students and campus community. In mid-March, EMU Director of Health Services Irene Kniss contacted the nursing department about hosting a Q & A session.

鈥淲e knew students had lots of questions and a need for information related to the vaccines,鈥� Kniss said. 鈥淲e encourage everyone to educate themselves and our nursing students and professors could be an important and trusted resource in that process.鈥�

On Wednesday, April 7, students in the community health nursing class, with Clark and nursing instructor Lisa Burkholder, hosted a virtual information session about COVID vaccines. Questions from the attendees ranged from possible health impacts of the vaccines, the testing process and efficacy of each type of vaccine, and the biotechnology that has been developed.

In recent weeks, Kniss, along with other area health officials, has been in near-daily communication with VDH representatives for updates about the status of vaccines arriving in the Valley. An application to host an on-campus clinic had been made in January.

EMU students now eligible for the vaccine

On April 9, students were emailed about opportunities to sign up at several local clinics hosted by the Virginia Department of Health within the Central Shenandoah Health District. The campus鈥檚 COVID Response Team has provided transportation if needed.

鈥淕etting the covid vaccine is an act of care for the entire community,鈥� Kniss said, adding that the more fully vaccinated the population is, the more vulnerable populations will be protected and  鈥渢he sooner we can move towards sharing spaces and seeing faces again.鈥� 

Students (and faculty and staff as well) sharing a copy of their vaccination card will no longer need to fill out the daily symptom tracker, one of several measures instituted this year to help track individual and community health.

While some universities are requiring proof of vaccination in the fall, EMU officials are still collecting information and exploring options. 

We have amazing dedicated faculty and a dynamic leader who brought us all together to put together a game plan that works. And students who trusted us and were ready to go with what we proposed. Everyone pitched in. EMU nursing shines in moments like this.

-Professor Kate Clark

Nursing majors at 草莓社区 can expect the spring semester of their senior year to be challenging, exhausting and hectic 鈥� with required clinical hours, difficult coursework, and demanding oral finals being just part of the equation. Seniors also take Kaplan tests and three 8-hour days of review as prep for the NCLEX-RN board exam.

The 2020 spring semester provided all of this and more in a dizzying acceleration caused by a historic global pandemic that would eventually end face-to-face classes and restrict access to clinical sites and  for these 17 students preparing to enter the healthcare profession 鈥� and the frontlines of COVID-19 鈥� in just a few short months. 

Melody Cash, EMU鈥檚 nursing department chair with more than 30 years experience in the nursing profession, simply shook her head when asked if she had ever experienced anything like the COVID-19 pandemic:

I鈥檝e never experienced anything like this before. This is truly an extraordinary time. We鈥檙e already in a nursing shortage and this is exacerbating it. We are doing everything we can to get these students to graduate on time and enter the workforce. 

Everything was changing so fast. We went from face-to-face classes and some normalcy to constant evaluation of students in clinical placements. Eventually we temporarily suspended online classes for seniors and focused entirely on meeting requirements for our Level 3 students who were closest to graduation. 

For clinical rotations, the 17 seniors are divided into three groups. Some were at a regional jail with plans to continue at a local pediatric practice and the Harrisonburg Free Clinic, while the third group was just about to start at Sentara RMH. 

The faculty were meeting hour to hour, staying 12 hours ahead of the students as we were making decisions.

I鈥檝e been so impressed with the professionalism of the students. We often see this in our seniors, but this time was a little earlier than normal. They start to click into that professional nurse role. 

At the same time as nursing students expressed steadfast resolve and professionalism, the sheer scope of the crisis was overwhelming.

Student: ‘Nursing is educating’

Senior Aaron Gusler said nothing in his education had prepared him to enter a healthcare crisis at this level. 鈥淚 don’t even think that health professionals with years of experience are really ready for what’s to come, simply because this is so unprecedented,鈥� he said.

We are seniors, which put us in the tough position of trying to meet the required number of clinical hours while maintaining safety. To try and meet these goals, a small group of students had clinical rescheduled to three consecutive 12-hour days, an attempt to pack in as many hours as possible before the COVID-19 situation got too risky for us. We went through these as scheduled, and had another 36 hours to complete either online or in the hospital…Doing 3 12’s in a row was a great experience for me, as this is the typical workweek for a new nurse.

Senior Joy Driver, also in that group, said the past several weeks have demanded flexibility and patience.

Initially when I thought I was not going to be able to participate in any adult health clinicals, I became fearful because I felt as though I needed to check my assessment and prioritization skills through this experience. These realistic days allowed me to achieve that goal 鈥� The other day a patient in the hospital asked me if I was fearful coming to work because of the COVID pandemic. I said not at all. Those people need care just as much as the next. And we take precautions to protect ourselves so we can continue to care for these individuals. 

I am reminded of stories from the Bible at this time when people feared going near those who were sick and “unclean.” Not only do hospitalized people with COVID need medical attention but also emotional and spiritual support. At this time, they are not allowed visitors, so my intention in sitting down and hearing the patient’s concerns and story has grown. I think the pandemic has also solidified my understanding that an ample part of nursing is educating. In this time of the unknown, some people become frustrated with others who are not abiding by social distancing and other regulations/suggestions. These people should not be reprimanded, but educated. 

 I am so incredibly thankful for my clinical instructor Staci Stoneberger who set aside her agenda to see that our clinical hours were complete, the nurses of 4 East at SRMH, and the rest of the nursing faculty for making adjustments to see us succeed. 

Hotline help

Professor Kate Clark shares Level 3 nursing student teaching responsibilities with colleague Professor Lisa Burkholder. As community clinical sites closed, Clark worked on finding other options for her students. She called the regional Virginia Department of Health, an agency with which EMU has had a 30-year relationship. Several EMU alumni work there.

I have a lot of students in the schools for community clinical hours, and when the schools closed down, that was not an option. So I called Debbie Bundy-Carpenter, the central district manager of Virginia Department of Health, and said, 鈥淚s there something we can do that would actually be helpful for your nurses?鈥� And so she offered this [staffing the VDH regional hotline]. They have to have four staff in here at all times to answer phones. And so if we can fill up two of these chairs, then that’s two nurses who can be doing their other work, including contact investigations for positive cases. So this isn’t like a normal thing we would be doing. It’s a really amazing public health opportunity and it’s the way that students can actually do something helpful, not just for the nurses here but for the general public … And so we’re really happy to be taking advantage of that opportunity and glad that they trust us with it. 

Senior Emily Travis logged several hours at the VDH hotline, calling it 鈥渁n amazing, once-in-a-lifetime opportunity鈥� to help 鈥減eople who are looking to do the right thing and look out for others as well.鈥�

I was definitely eager to get some hours as my other clinical last week didn鈥檛 work out. I feel so lucky … Kate asked me if I wanted to take this full time this week and do every day, eight hours. And I said, absolutely …  I鈥檝e learned so much. I’ll probably never have an opportunity we could do with something like this again during a health crisis …I also sense a lot of people wanting to do the right thing and look out for others as well. It is definitely an interesting time to be a nursing student.

Clinical waiver means more simulation training for faculty

Through the first and second week of March, Clark, Burkholder, Cash and other faculty members met several times a week as information changed. Their major concern, that students get in required clinical hours to graduate, was alleviated by the March 19 announcement from the Virginia Board of Nursing. The director waived certain regulations 鈥渨ith the goal of removing certain regulatory barriers to assist with education, testing, practice and workforce issues.鈥�

The waiver also included an increase in the number of simulation hours to replace the normal clinical hours. While helpful, this required that EMU purchase access to the simulation program for Levels 1 and 2 students, who do not normally have it, and increase training for faculty, not all of whom were previously involved in simulation.

鈥淪ome of our faculty are trained to teach with simulators,鈥� Cash said. 鈥淏ut this move means everyone, even our adjunct nursing faculty, who are full-time practicing professionals. They are all doing this additional training and giving of their own time and energy.鈥�

‘We want to celebrate you’

On Friday, March 27, Clark and Burkholder held an evening meeting to update students as they resumed online coursework and prepared for final group presentations and the rigours of scenario-based oral exams. They also discussed changes to the NCLEX-RN exam,which has been modified in length and time to accommodate fewer test-takers at each time slot.

And they talked about the pinning ceremony that would no longer happen and the commencement celebration that was on hold.

鈥淲e talked to the accelerated program nurses and they brought it up that they want to share their pinning ceremony with you in August,鈥� Burkholder told the students. 鈥淚 know some of you won鈥檛 be around and you may not want to come back to Harrisonburg for that. But you have worked really hard and we want the opportunity to celebrate you.鈥�

Whenever that celebration is held, it will be an opportunity to celebrate not only the persistence and dedication of the Class of 2020 but also how the EMU nursing faculty pulled together and supported them.

鈥淲e hear this all the time, that we鈥檙e a small, close-knit program,鈥� Clark said, 鈥渁nd because of that, we鈥檝e been able to be agile through this whole experience. We have amazing dedicated faculty and a dynamic leader who brought us all together to put together a game plan that works. And students who trusted us and were ready to go with what we proposed. Everyone pitched in. EMU nursing shines in moments like this.鈥�