The COVID-19 pandemic highlights how our chronic shortage of skilled nurses is a critical stressor on our health care system.
In particular, COVID-19 is now ubiquitous in nursing homes. It is extremely contagious and has a very high mortality rate in this population.
In many ways, nursing homes are like cruise ships. They become incubators of contagious disease, having all of the conditions which create the perfect storm for transmission of disease.
Nursing homes care for fragile elderly with multiple chronic diseases who share rooms and bathrooms and are in close contact with others. They function with a bare minimum of registered nurses whose expertise is not in acute care or prevention and control of highly infectious disease. They have limited access to PPE, personal protective equipment, and work in multiple facilities.
To prevent spread of disease it is important to isolate COVID-19 patients in separate facilities. They should not remain in the nursing home where they will inevitably transmit the disease to others. As a preventive measure, all patients should be in separate rooms.
This will require more options for long-term care facilities and for the ability to keep patients in the home with supportive services.
The MA Responds, Medical Reserve Corps put out an unusual request for coverage in nursing homes: “Although historically unconventional when looking at MA MRC response efforts, providing medical personnel to support healthcare facilities is a need that arisen as a result of this pandemic.”
The call has been for our retired nurses to return to practice. However, they are in the high-risk population for COVID-19.
Perhaps the call should be to our new graduate nurses, filled with energy and enthusiasm to be part of the solution.
Currently there is a plan to allow early graduation for senior medical students.
A similar plan would be advisable for our last-semester senior nursing students.
Currently, hospitals will not permit students for clinical practice, so waiting another month will make little difference in their final preparation.
As part of our pandemic response, these new graduates should be allowed to be hired immediately and function in the role of GN, graduate nurse.
This was the case when I was a new graduate in the 1970s. New graduates worked as GNs under the supervision of a registered nurse. They functioned with the same responsibilities as an RN until they received their nursing board results. When they passed, they were registered nurses, RNs. They put a black stripe on their caps and got a small raise; if they did not pass, they functioned in the role of nurse’s aide until they passed the Nursing Board of Registration Tests or “boards.”
This emergency action would put new nurses in the field immediately rather than delaying their entry until passing the boards months down the road. These GNs would relieve our seasoned nurses to function in more critical roles by increasing the numbers of skilled nurses available for nursing homes, home care and hospitals.
I urge the governor, in collaboration with schools of nursing and the state Board of Nursing Registration, to permit the immediate graduation of our last semester senior nursing students to function in the role of GN.
More nursing power is necessary to fight this pandemic.
Nurses save lives.
Barbara A. Poremba, is a professor emeritus at Salem State University and director of the Friends of the United States Cadet Nurses WWII. She can be reached at firstname.lastname@example.org.