COVID-19 Changes Nursing Education


Nursing education has seen some changes due to the pandemic

By Debra Wood, RN, contributor

The COVID-19 pandemic has disrupted life in the United States, including nursing education, but nursing programs adjusted to shutdowns and the loss of clinical sites to continue to educate the next generation of nurses. And through it all, students remain dedicated to their planned careers. 

Among students, “there was much more of an outreach to volunteer and help,” said Elaine L. Smith, EdD, MBA, RN, ANEF, dean of the College of Nursing and Public Health at Adelphi University in Garden City, New York. “They wanted to be there.”

Smith was not aware of students who left because of the pandemic conditions. 

“This is what nursing is about, and [students] see it like that,” added Beverly Malone, PhD, RN, FAAN, president and CEO of the National League for Nursing in Washington, D.C.

“More people want to be nurses,” Malone added. “They want to jump right in. That’s amazing.”

Nursing education changes

“The transition from in-person classes to remote or distant learning is a major point,” Smith said. 

Initially, New York was a hot-zone early on in the pandemic, and nursing programs were forced to adapt to keep students learning. Now educators across the country are dealing with similar challenges. 

“With massive influxes of critically ill patients into hospital settings, opportunities for continued student placement at hospitals was severely restricted,” Smith explains. “We had to look for alternative ways of learning.”

At Adelphi, faculty responded immediately. Adelphi changed processes and ways of learning. Faculty members also continued their clinical practices. Lectures moved online as did virtual simulation with high-fidelity manikins to replace portions of the clinical component of the students’ education. 

“Virtual simulation, thank goodness, has allowed students to continue to learn clinical practices but not having access with the patient,” Malone said. “When they do have access with the patient, they are very well prepared.”

Now, rather than a real patient being on the receiving end of a student nurse performing a procedure for the first time, simulation allows the students to perfect their technique on a manikin.   

Once students could return to campus, the lab was set up so students could participate while social distancing. Students practiced clinical procedures, such as inserting foley catheters; delivering babies; caring for children; and managing obstetric and other emergencies. Some of these presented opportunities to experience situations they might never take place during a hospital rotation. 

“They are well prepared for when they go into an actual clinical agency,” Smith said. “The literature is replete with evidence that supports the use of high-fidelity simulation.” 

Faculty at Adelphi ensured all 940 students were competent in on donning and doffing personal protective equipment. Once some hospital clinical openings developed, each student received an N95 mask and face shield to use when going into facilities. 

Another area requiring adjustment was the development of and maintenance of technical skills. Adelphi created “boot camps” in which students could practice for long periods of time at different skill stations with nursing instructors. The college opened the labs seven days per week, with extended weekday hours. 

Most graduate students had jobs and remained working during the pandemic while continuing their studies. For the students, school provided a sense of normalcy and a respite from the high stress of patient care. 

“I kept hearing about the kindness, understanding and support of our faculty,” Smith said. “Showing compassion, flexibility as true values has been important cornerstones of how we managed through this.” 

In response to nursing education changes necessitated by the pandemic, many state departments of education or boards of nursing revised new nurse-education requirements. The National Council of State Board of Nursing has outlined those modifications. 

Malone considered that cooperation between regulators and academia “huge.”

In addition to the technical changes, Malone noted a greater emphasis on diversity and inclusion and the recognition of and conversations about unconscious bias. 

“Even where nurses are doing this heroic work, there is more of an emphasis on differences and that equity is there in the care they are doing,” Malone said. 

Travel nurse education

Travel nurse education trends remain as before. The nurse must complete the continuing education requirements of his or her home state and by other compact states. 

Online learning has been a dominant method of obtaining the necessary courses. The pandemic has increased the available webinars and courses offering continuing education hours. 

Additionally, many schools and colleges of nursing, including Adelphi, offer online RN-to-BSN programs, offering travel nurses to complete a bachelor’s degree while on the road. 

In some areas of the country, such as New York, with many colleges of nursing, hospitals still prefer nurses with a BSN degree, Smith said. Smooth transitions from associate degree programs to RN-to-BSN programs make the higher degree easier to achieve. 

“It offers flexibility to working professionals,” Smith said. “Access to baccalaureate completion is much better than ever.”

Brightness in the COVID darkness

While nursing educational changes have occurred in response to the COVID-19 pandemic, educators remain flexible and are looking at the positive.  

Malone hopes academia learns from this experience and continues some of the pandemic educational practices once COVID-19 has been tamed. 

“What are we going to do after the pandemic,” Malone said. “Are we going back to the old, more restricted ways?”

Students want to be prepared and supportive and caring to the patient. With simulation, it gives students the chance to learn the skills, and when with a patient, they can focus on the interaction, the communication and showing kindness. 

“[Simulation] allows us to bring our very best caring to the patient, and not get distracted with the skills,” Malone said. 

COVID-19 has shown nurses how much better prepared they must be, Malone added. 

“I am proud of our profession, and in this time of crisis, nurses have demonstrated how important nurses are to the health and safety of our people,” Smith said. “And how brave they are and how caring they are and how dedicated and passionate they are about their work.” has thousands of nursing positions across the U.S.

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