The strain on health services from the COVID-19 virus has been well documented, with nursing shortages and burnout a consequence of the high infection rate. But the impact of lockdowns and social distancing on student nurses is underreported in comparison. Dr Karen McLaughlin has been at the forefront of this and says the pandemic has introduced new challenges not just to the students, but to educators as well. 

“We all had to be resourceful, but the students have been great in what has been trying times,” Dr McLaughlin says.

Dr McLaughlin is an associate lecturer for the school of Nursing and Midwifery at the University of Newcastle. With over 30 years of clinical nursing and midwifery experience, Dr McLaughlin is just one example of the need to be innovative in the current climate of COVID-19.

For many student nurses, the experience has been stressful and turbulent, with many having to forgo face-to-face learning or even having their clinical placements delayed, leaving them unable to graduate and join the workforce.  

26-year-old Elizabeth Grills knows the challenges better than most, saying the segregation from peers during lockdown is one she’s had to work hard to overcome. Elizabeth is in the second year of her Bachelor of Nursing degree at Charles Sturt University in Bathurst. 

Beginning her degree in February of 2020, Elizabeth enjoyed just a few short weeks of face-to-face learning before her classes were forced to move online. “I vividly remember that I had a gut feeling of something not being right,” Elizabeth says about the week leading up to lockdown. 

“After four weeks we moved to online learning, I remember feeling anxious, I was just beginning to learn the basics,” Elizabeth says. “It was ripped from us, the foundations of nursing.”

Dr McLaughlin says despite all these barriers the willingness from the students is what is most commendable, “It’s not what they signed up for the students, they didn’t want to do an online course. 

It has been quite difficult, as nursing and midwifery is very hands-on,” Dr McLaughlin says.

Dr McLaughlin recalls the uncertainty during the first lockdowns in March of 2020, with many educators facing the stressful task of moving their curriculum online immediately. “At the start of the pandemic we had such little time to get everything online, it was a steep learning curve for myself as I’m not great with technology.” 

Elizabeth says along with the online learning model, she was feeling the pressure and it was compounded by moving from her hometown of Tamworth to begin her degree. “There were definitely thoughts of have I done the right thing,” Elizabeth says. “I moved cities for this, only to be studying at home, I could have stayed in Tamworth.”

Elizabeth, along with the rest of her cohort, would be limited to online learning for the first year of their degree. This left Elizabeth feeling nervous for her first placement at a retirement home in November of 2020. 

“I’m a hands-on learner, so I felt under-prepared walking in (to the retirement home),” Elizabeth said. “I was open when I walked in, that I didn’t feel completely comfortable because of COVID”. Elizabeth says the staff of the retirement home empathised with her situation, and her confidence skyrocketed, “my concerns were just psychological, they understood the situation (and provided help).”

Elizabeth says even with all the challenges, Charles Sturt University provided the best educational experience possible. “We still had face-to-face classes, they were just infrequent.” 

Elizabeth stressed the importance of a strong support network during these times, and says nurses’ mental health is dangerously overlooked, “(Nurses mental health) isn’t talked about enough,” Elizabeth says. “It isn’t as physically demanding as it is psychologically taxing.

“I am sure to be open and talk with my support network, as it can be tough coming home after a big day.”

Despite all this, Elizabeth says the threat of COVID-19 never wavered her commitment to the profession. “I still love it, (the pandemic has) encouraged me more, and seeing the shortage of nurses has made me more determined.”

Lilli Stanton started her nursing education in 2020, beginning with a Certificate III in Assistant in Nursing with Hunter TAFE. Lilli says the online learning experience hasn’t been entirely positive and has affected her ability to complete the course. 

Lilli’s passion for nursing stemmed from an early age, caring for her elderly grandmother during her teenage years. “I’ve grown up helping my nan, I would buy all her medication and take her to her doctor’s appointments.” Lilli says it was the care shown to her grandmother in hospice that made her decision easy, “those nurses went above and beyond for my family and comforted us”.

Lilli says online education for her certificate has been particularly challenging for her.

“(COVID-19) has affected me completing my first year, as the placements I needed to complete for the course had to be pushed back,” Lilli said.

Lockdowns have prevented Lilli from being able to undertake the required 10-week placement to complete her course, leaving her unable to find full-time work in nursing. “I was meant to head out for my 10-week placement in February of this year, but this has been pushed back till April.”

“It’s just stopped me from becoming fully qualified and handing out medications on the wards, full-time work is what I’m really interested in,” Lilly said. 

Lilly’s delayed graduation is just one example of how COVID-19 has prevented the next step of this generation’s healthcare professionals. 

University of Wollongong (UOW) Professor Victoria Traynor told ABC News in August that thousands of their students could have their graduations delayed.

“The health services are under so much pressure that they cannot take the usual large number of second and first-year students,” acting head of nursing at UOW Professor Victoria Traynor said. 

Hospitals are now seen to be prioritising vaccinated third-year nursing students, leaving first and second-year students like Lilli on an extended waiting list. Hospitals have struggled to keep up with the staffing demand during the pandemic, and students looking to complete their placement are seen as an unnecessary risk.

While there is no immediate finishing line in sight, Lilli is happy to play the waiting game for the profession she adores so much. “I have taken a lot of experience from this pandemic. It has built me a stronger nurse dealing with a lot of stress,” Lilly said.

Dr McLaughlin says the online delivery of the course content will also affect the bonds formed between the students.

“We are noticing the first years aren’t as tight as second years, because of the learning from home,” Dr McLaughlin says.

The social distancing restrictions brought on by the pandemic has been the biggest hurdle for the practical classes for Nursing and Midwifery. Dr McLaughlin says the teaching faculty worked hard to provide the best possible experience for the practical classes.

“We are careful with restrictions and we are innovative to work around that.”

The educators of Nursing and Midwifery at UoN were able to proceed with practical classes but with much smaller groups and more frequent class times. 

Echoing Elizabeth Grill’s comments on nurses’ mental health, Dr McLaughlin underlined strategies she uses as an educator to help support the students. “As tutors and lecturers we always make ourselves available to the students,” Dr McLaughlin said. 

“Students encounter a lot of different scenarios (in the pandemic) and it’s important to have a safe place to debrief”.

“We offer something called ‘clinical supervision’ as part of the course, and this gives students time to chat with the teacher about anything.”

Compassion and empathy are often regarded as important traits to be a great nurse/midwife and Dr McLaughlin’s approach to her student’s education is the perfect example. “It’s easy to get stuck on ‘woe is me’, but we need to focus on the positives too,” Dr McLaughlin said, “I ask my students to turn on their cameras in class and tell everyone one thing that made them smile through the week.”