Nursing students in Sonoma County volunteer to fight coronavirus

Sonoma State nursing student Alexandra Holbrook signed up right away when Gov. Gavin Newsom this week called for aspiring health care workers like her to join the surge workforce now being mustered in California to treat an influx of coronavirus patients expected soon in hospitals.

Holbrook is among an estimated 14,000 graduating nursing students statewide, including 136 in Sonoma County, who may not be able to get their degrees this year because the pandemic led many hospitals to halt the supervised clinical rotations that students need to graduate.

So at a historic time of need, their ability to enter the workforce may be put on hold. Holbrook was three emergency department shifts away from completing her clinical hours required by the state. Joining the state’s volunteer work force could help her community, but it will not, as the rules currently stand, help her start her career.

“I got into this field to be able to do this type of work. There’s this huge need for it, it’s a pandemic,” Holbrook, 25, said. “I could be helping so much right now, taking relief shifts.”

Although the state has relaxed some rules to allow these students to join the governor’s California Health Corps, they will be assigned to non-nursing roles that for many won’t fulfill the requirements of their programs.

A delay in graduations could have a domino effect, possibly reducing or eliminating slots for incoming students in the fall and adding pressure on an already taxed health care workforce.

Sonoma County emergency officials, too, have said they expect to rely on nursing students as the county prepares for a steady rise in cases, expected to peak in early June.

Nursing programs across the state, including Santa Rosa Junior College and Sonoma State University - which are currently training nearly 400 nursing students - are trying to ensure students aren’t exploited for their labor and prevented from getting necessary skills to start their careers.

“They want the students to put in their time and put in the work but aren’t willing to give them the clinical time, which is disappointing to say the least,” said Mary Ellen Wilkosz, department chair of the SSU’s family nurse practitioner program.

Local nursing program directors said they’re concerned students may be shifted into roles that won’t give them the experience they need to enter the field as registered nurses at a time of serious need.

Sending students to do non-nursing work in environments where there are already not enough masks and other protective gear cannot be done without serious thought, said Katherine Magee, interim associate dean of nursing for SRJC.

“Most of my students have families of their own. They have kids, they take care of older parents,” Magee said. “I have to weigh giving credit for this type of activity against their safety.”

But if they cannot graduate, the college may be forced to downsize its incoming class by half, allowing only 60 students to start in the fall, said Magee,

“That’s the worst-case scenario I’m trying to avoid,” Magee said.

Program directors across the state have been writing letters to state officials and the Board of Registered Nursing, which sets licensing guidelines and accredits nursing schools, asking for a solution to this dilemma.

Nursing schools, like other programs, have transitioned to online instruction. But central to a nurse’s training is direct experience with patients under the supervision of a professional.

The state temporarily loosened some restrictions to help get nursing students into the field and directly working with COVID-19 patients, but the guidelines put nursing students in roles such as nursing assistants, according guidelines published this week by the Board of Registered Nursing.

The state is putting the burden on nursing programs to decide whether the work counts toward their degree.

Regulators “are aware of and sympathetic to the predicament some nursing students are in as well as the need for health care workers during the pandemic,” Veronica Harms, deputy director of communications with the state Department of Consumer Affairs, which oversees the Board of Registered Nursing, said in an email.

“Our goal with these proposed waivers is to get the nursing students out into direct patient care experiences to help,” Harms said, adding that the state is “encouraging the academic institutions that these nursing students are enrolled in to allow them to receive academic credit for their time spent assisting in the care of our COVID-19 patients.”

Newsom issued his executive order Monday creating the California Health Corps to corral a surge workforce. As part of the response effort, the governor temporarily loosened licensing and certification rules to allow retired doctors, nursing students and others to work in clinical settings.

So far, more than 70,000 health care workers have applied. The governor’s order is meant to build a workforce able to care for patients who could fill an estimated 50,000 clinical beds anticipated to meet the peak of the virus’ spread in California, which state models estimated could arrive by the middle of May.

Across California, the number of people known to have COVID-19 surpassed 10,000 Thursday, including nearly 2,000 people hospitalized with the disease, Newsom said during a press conference. Of those, 816 individuals were being treated in intensive care units reserved for the most serious cases.

In early to mid March, many hospitals began shutting down programs that brought in nursing students to work with patients as facilities began sharply limiting any visitors that might bring the virus into care settings.

“We did not make this decision lightly,” Christina Harris, spokeswoman for St. Joseph Health, which runs Santa Rosa Memorial Hospital, Petaluma Valley Hospital and Queen of the Valley Hospital in Napa, said in an email.

But the move made sense as public health officers throughout the Bay Area began ordering people to stay home and closed school campuses and parks. Hospitals took steps to protect patients and staff.

“While we know the value our student nurses bring to our hospital, and understand how important the clinical experience is to the students, the safety of our caregivers, students, patients and visitors is our top priority,” Harris said in an email.

An exception is Mendocino College, where its 24 graduating seniors will be able to complete their clinical hours in care settings less likely to involve coronavirus patients, like heart patients who need telemetry nurses to review data from monitoring equipment to track vitals, according to Peggy Goebel, interim executive dean of nursing.

Goebel said she began anticipating this problem last month and began working out an agreement with Memorial Hospital to get students back into clinical settings with less risk of exposure.

“They’re going to fulfill their hours to be able to graduate and join the workforce, which is a miracle,” Goebel said.

Goebel has served on international missions with U.S. Navy medical ships the Comfort and Mercy, which is docked at the Port of Los Angeles and took its first patient Sunday. She’s also worked as a Red Cross supervisor during major disasters like Hurricane Harvey and volunteered her time during major wildfires that hit Sonoma County in 2017 and 2019.

She knows the value of volunteering your skills during a crisis and, as an educator, she believes it’s essential to get nurses into the workforce without delay.

“If those students don’t graduate, it will be 14,000 nurses that don’t enter the workforce,” Goebel said. “When we need it so desperately.”

You can reach Staff Writer Julie Johnson at 707-521-5220 or julie.johnson@pressdemocrat.com. On Twitter @jjpressdem.