Will 'compassion fatigue' and surge in COVID-19 cases discourage aspiring nursing students?

As the number of COVID-19 hospitalizations increased and healthcare workers beyond overwhelmed by patients, as well as experiencing a severe shortage in staffing, Houston nursing school educators say they are seeing a mix of students either stepping up to the task or changing careers. 

MORE: Lone Star College nursing students tapped to help out with Houston-area hospitals burdened with COVID surge

In Lone Star College, for example, a new program initiated by Congresswoman Sheila Jackson Lee and the State Department of Health in August will help first-and second-year nursing students at getting jobs at local hospitals, like Ben Taub, LBJ, and UMMC.

According to college officials, these jobs will strictly deal with non-COVID-19 patients. In that capacity, the more experienced staff can handle the influx of patients coming in with severe coronavirus symptoms, while patients not arriving for COVID-19 related issues may still get treatment. 

RELATED: Houston man shot 6 times, a week later still waiting for surgery at hospital overwhelmed by COVID-19

"These students we're not sending them over as students, they're actually being hired as employees into the hospital," said Mario Castillo, the Chief Operating Officer, and General Counsel at Lone Star College Systems. "I'd say it's closer to taking temperatures, sitting there, and making sure that the monitors are okay. Then, when something happens, calling somebody with a lot more experience to come manage it."

Ashley Cook, a second-year LSC nursing student told FOX 26 back in August she's up for the challenge. 

"We've been sitting behind our computers for about a year now reading our textbooks, watching the news, and seeing all of the horrible things that have been going on," she said. "There has been a lot of talk of why can't we go help, why can't we go and put our hands in the fire too, and you know, bring something to the table." 

RELATED: Former Houston-area nurses say they could help with shortage if there weren't mandatory vaccine policies

How are nurses faring after school during the pandemic?

For ICU nurses like Alvin John, who began his career during the start of the COVID-19 pandemic, says despite the intense training he and fellow classmates went through, nothing could have prepared them for the coronavirus. 

"It was kind of crazy to say that as a new graduate nurse, I was on the same level as the season veteran nurses with this disease because it was brand new, no one knew how to deal with it," he said. "No one knew the right ways to deal with it. And it was kind of us working together to figure something out."

Through conversations with friends still in nursing school, Alvin notes current education procedures have also changed in the short time since he’s been out of school.

"What I've heard from a lot of nursing students is they're not getting the type of practicum that I did because of COVID," Alvin explains. "A lot of hospitals aren't letting nursing students even come into hospitals and do the clinical hours that they need. A lot of nursing schools are opting in to simulations on the computers, as opposed to hands-on care with patients. And that's concerning for us as nurses already because you get in these new co-workers that are coming in with no patient experience." 

How have nursing schools and educators adjusted during the pandemic?

According to Dr. Lucindra Campbell-Law, divisional Dean of Graduate Programs at the Carol and Odis Peavy School of Nursing for the University of St. Thomas, while the pandemic did change some things, their nursing program was a bit better prepared. 

"Most of the education was done to face in the classroom and so that challenge for a lot of educators, not so much for our graduate program, pretty much for the undergraduate, we had to pivot at warp speed, if you will, and move all of our courses online," she explained. "And even before COVID-19, our graduate nursing program already had in place a hybrid model, which meant that we had courses being delivered and a combination of face-to-face on-site and virtual platforms are fully online. 

"So we were a little prepared," Dr. Campbell-Law continued. "But I can tell you that we jumped in and we did what we had to do."

She adds there has not been so much a change in the undergraduate admissions to nursing school but has seen a change with their graduate nursing program. 

"Undergraduate enrollment is pretty much remained steady even with the increases in our accelerated Undergraduate Program. Now our graduate program experienced a decrease, not much dropping out," Dr. Campbell-Law said. "Keep in mind, these are people who are already in the work, practicing nurses, and most of them were in leadership positions and that means that they had to respond to the many demands that COVID placed on them."

ACROSS THE U.S.: New Bay Area nursing programs hope to fill void as veteran nurses face COVID-19 burnout

Virtual learning versus hands-on experiences

Elsy John, who serves in one of those professional roles as a nursing manager at a hospital outpatient clinic and is a visiting professor with Chamberlain College of Nursing, says, however, that students may not be able to fully grasp patient care without hands-on experience. 

"I'm also a hands-on person, so I do believe students have to go to the hospital and use whatever they learned in the classroom at the hospital," John explained. "So when we switched it to online, it was so difficult for them to keep up with the change. And it was so hard for me, as well, as an educator to turn online, because some stuff you cannot teach them online because it's a personal experience you learn from at the hospital."

Alvin echoed a similar sentiment saying the in-person experience is something he personally benefited from.

"That's how I learned everything in nursing school," he explained. "I mean, you could read a book all you want, and you can know as much as you need to, but until you're in front of a patient that's declining, or a patient that's going towards a certain, you know, an outcome that you're trying to prevent, or you're trying to keep a patient medically stable, that's right in front of you, that's way different than a computer." 

He adds that especially working in ICUs, it’s impossible to really explain the gravity of patient care and the intense work nurses like him have to do. 

"You can get as much practice as you want behind the screen, but really, I think nursing, in general, is hands-on care," Alvin said. "We're with the patients for 12 hours at a time. No one else is there, especially right now during COVID. Even family members aren’t allowed to be in the rooms, obviously, so you are the lifeline."

MORE: COVID patients overflowing into free-standing ERs as local hospitals are stretched thin

"And you're literally sometimes the last person that that patient sees," he continued. "You have to know many things, not just patient care, but just how to be an empathetic human being, you know, and you don't get empathy by working on the computer."

With the influx of COVID-19 patients, the majority of whom are unvaccinated, at Houston hospitals, empathy is just another thing health care providers are struggling with and getting burned out by. 

RELATED: Houston-area nurses experiencing 'compassion fatigue' amid spike in hospitalizations, staff shortages

Opting out of nursing school because of the pandemic

For college students like Ashley John, Alvin’s sister, the added stress from COVID-19 is all the more reason for her to choose a different career path when she was initially planning to go into nursing. 

"Seeing my brother, and how he had to deal with the COVID crisis and seeing all the pressure that was put on him, you know, in nursing school. It kind of just made me second guess it," she said. "I was nervous...being somebody who had to make that decision, you know, going into college during COVID. I think that had a huge part to play in why I decided to switch my career path."

Certainly, Alvin does not blame his sister for her decision, as a career in nursing is not for everybody but says it wouldn’t change his mind, personally, if he was in her position.

 "A lot of my coworkers, even, we talk about this all the time, it's like, man, if we knew [the pandemic] was happening, who knows, you know? But at the end of the day, I think I'm good where I'm at," he said. "So I would probably do it again, even knowing that COVID-19 is happening."

RELATED: 100K more COVID-19 deaths in US by December, projection model predicts

The future for nursing students

Dr. Campbell-Law says it’s not uncommon for them to hear from students who question if nursing is not their calling in life and as educators, they try to be supportive.

"We understand that nursing is an art and a science. But is this what I'm called to do. And so they get a sense of is, you know, and, and some of them will say, you know, is this really what I want to do?" Dr. Campbell-Law said. "And some of them will say, you know, I'm not so sure. But it's a good time before they actually get out in practice to decide if this is something they really want to do, or they're best suited for another profession." 


And of course, while ICU nurses like Alvin admit work has become more strenuous, it’s something he genuinely enjoys.

"I personally think I'm pretty good at my job," Alvin explained. "I got into this [career] because I'm a people person; I love helping people. And, you know, sometimes it's as little as easing anxiety for patients... if you have to sit down and have a conversation with them, just for 30 seconds or a minute, they feel 10 times better. And that could be the difference in the making."  

Not to mention, the belief in the COVID-19 pandemic ending any day now is something he looks forward to each day. 

"I think that's just what's driving me to go into work and kind of get people to get on board with what we're trying to do here," Alvin added. "I know a lot of people are fatigued, but I mean, health care professionals are twice as fatigued, if not more, with this disease."

Some hospitals in Houston have been experiencing a plateau with COVID-19 patients, but remain high. And with Labor Day weekend, local hospitals are bracing themselves for potential gatherings.

RELATED: Some Houston hospitals reaching plateau with COVID-19 patients, but worry about Labor Day gatherings

Still, that message of hope is something Alvin also wants to share with aspiring nurses and those still in school. 

"Keep your head up, really keep your head up, fight through, learn what you got to learn," he concluded. "And at the end of the day, you're going to be here, doing what you love, which is hopefully taking care of people. And we're going to be in a better spot as a global civilization."