The Covid Clinical Experience

I recently asked my Thriving Nursing Students Facebook group what it’s been like going to clinicals during a pandemic. I received so many wonderful and heartfelt responses and want to thank everyone who took the time to reply. Experiences ranged from schools canceling in-person clinical altogether to others only assigning students to COVID patients. And, of course, there is a lot of in-between with many students going through hybrid clinical rotations that are part real-life and part simulation.

I’ve pulled the most impactful responses from that survey and compiled them for you here. Maybe you’re a new student wondering what clinicals will be like, or perhaps you’re a frustrated current student who wants to see that you’re not alone. Whatever you’re feeling or going through, I want you to know I’m here for you.

For more context and discussion around these topics, listen to episode 177 of the Straight A Nursing podcast when it goes live this Thursday, October 28, 2021.

How has Covid impacted how you feel about clinical?

• I feel frustrated. The first semester we had all virtual clinical and it was awful. I felt like I got no hands-on experience. In second semester, we got to do in-person clinical about seven times, for three hours each. It was way better than first semester, but I still felt really behind and lacking in a lot of areas. This semester is half virtual and half in person. I’m just worried I’m going to be an awful nurse because I’ve had little clinical experience.
• I dread clinicals now.
• I’m not scared of going to clinical, but it has made me very angry about the limitations it has put on our clinical experiences.
• The nurses are more stressed, have high patient loads, and don’t have the time or desire to precept.
• I’m scared of contracting this even with the use of masks and PPE. I still enjoy clinical and respect nurses, but this is still a little scary as a student.
• It has made me more aware of therapeutic communication and touch since patients can’t see my facial expressions under my mask. I was apprehensive about having in-person clinical at first and worried about bringing COVID home to my family. But in reality, I feel very safe at the hospital.
• I feel for the nurses, mainly. I am glad we are able to go, but I wish we could do more to help. I feel like we are an added burden at times. Other times, I can tell they are especially thankful for extra hands and don’t want to ruin the profession for us. Tensions in the hospitals are just extra heightened and it’s obvious.
• I feel like we have missed out on a lot. We do not get to do a pediatric rotation and it significantly shortened our mother/baby rotation. On top of that, most of our hospitals will not permit students to follow their patients should they need a procedure or surgery.
• I feel unprepared with nursing skills such as IVs, catheters, trach care, etc. We just have not had the opportunities and exposure. The main focus has been patient care and medication administration.
• COVID has not changed how I feel about clinical. I am studying to be a nurse, typically the people I will be taking care of will be sick. I feel it is part of the profession I am getting into.
• I still enjoy clinical and don’t feel like I’ve missed out on tons. Unfortunately, there have been some areas/floors of the hospital we haven’t been able to go to and we haven’t had as many clinical hours so that has made me feel like I’m going to be less prepared as a nurse. Also when the nurses are burnt out, they are less eager to have students and being a student is already hard enough because you know that the nurses don’t want you there, and so this has decreased my enthusiasm for clinical.
• Even with COVID, clinical is still my favorite portion of my nursing school journey!
• It makes me love the in-person clinicals. I hate online or campus simulation because it’s not the same. But at the same time, I’m worried I’ll be judged as a new grad because I haven’t had a chance to do the basics in person yet.

How has Covid impacted your enthusiasm for nursing?

• I am not as excited to be a nurse as I was. Everyone is burnt out and you can just feel it.
• It’s made me think about nursing more. It’s confirmed my choice, honestly. I want to be on the frontlines taking care of these people.
• Yes, it has been made glaringly obvious that hospital administration doesn’t care about their nurses. Understaffed and overworked, nurses are quitting because they can’t get fair pay. But the same hospitals will pay travelers double to do less work.
• Yes. The ever-changing expectation of nurses and workload that is being placed on them makes me nervous going into that work environment. I have long-time nurse friends that are struggling to stay in the field.
• It’s honestly greatly diminished it. Not because of taking care of patients who need the help, but all the talk of terrible staffing, limiting pay for staff nurses, high patient ratios, tons of horror stories of unsafe practices because of limited resources. It’s scaring the bajesus out of me.
• I’m a little scared of what I’m going to be facing as a nurse when I get out of school.
• I’ve always wanted to be a nurse, but when the pandemic started I really believe it solidified my decision. When we were in lockdown, I watched the news and all I could think was “I should be helping.” Never once did I question my career goals. I think recently the main discussion I’ve been exposed to is the “shortage” of nurses and how nurses deserve better pay and general support. This is disheartening, but not something I was unaware of, and it gives me some hope that change is coming.
• I’m still enthusiastic, but I am also cautious and carefully watching how the hospitals are treating and handling their employees during this time.
• I wish I was further in my program so I could get out there and help the nurses who are struggling and getting burnt out, along with being there for patients who are scared and unable to see their family. If anything, it has just solidified why I wanted to get into nursing.
• Seeing how burnt out nurses are right now has me absolutely terrified that I’m going to be burnt out as soon as I start working. Since I’m so passionate about nursing, I don’t want to become jaded and burnt out, and I am afraid of what the learning environment will be like as a new grad when all the nurses around you are fed up. It seems like it will be hard to learn from them when their focus and attitudes are not positive. This really scares me.
• If anything it has persuaded me to work harder so I can do my part as a future nurse and help my community.
• It has greatly decreased my enthusiasm for nursing. I am so disgusted with hospitals’ lack of care for nurses and other frontline workers and don’t see how that will change.
• It makes me nervous, mostly about burnout. I see endless stories about mistreatment, understaffed floors, not enough PPE, and pizza parties to placate the issues. It makes me worry that I won’t ever get a chance to enjoy it. I see my instructors coming in and quitting their floor jobs to become teachers and wonder why…what is going on that after 28 years, you take that pay cut and tell us students you needed a break from floor nursing. Will I like it?
• My best friend is an ICU RN, and she has been working on the COVID units. Therefore, hearing her stories and seeing her being so exhausted and mentally drained is scary. I know she loves her job, but it’s terrifying to think that I could be in her situation in the future.
• I am more determined than ever to get my BSN and start working. I know morale is low and there is a nursing shortage. I am hopeful that as new grads we can provide some relief to those who have been working the frontlines with COVID patients.
• If anything I’m more enthusiastic for nursing.

What has been the biggest challenge with clinicals during a pandemic?

• Not getting into the hospital with enough time to look at charts thoroughly. I feel unprepared because we have such strict in/out times due to Covid.
• Some instructors are great and understand technology. Others are great at nursing and great at education, but stink with online teaching. “We can’t hear you. You’re still on mute.” “Are we supposed to be seeing something? Because it’s just a blank screen.” Frustrating for both sides.
• The biggest challenge was trying to decrease my anxiety enough to do well at clinicals because I was nervous about COVID.
• Not being able to practice skills in the classroom before being expected to know them in the hospital. But mostly, the hesitance of nurses/hospitals to allow us into rooms to practice on real patients.
• We almost weren’t allowed to attend clinical because of the pandemic. Once we did get to clinical though, the nurses did not seem interested at all in us being there.
• My OB and Psych clinicals were canceled, and the M/S floors are limited, so I do not feel prepared at all and I’m forgetting basic skills and how to interact with patients.
• Not having clinicals. I feel like I am lacking a lot of hands-on experience.
• Having adequate and enthusiastic preceptors.
• So far, it’s been not being able to take care of COVID + patients. There were many times that my nurse would have five patients but I could only care for two or three.
• Mostly managing all the changes that have happened in my program. We got pushed back a semester, went to fully online, then to hybrid with only clinicals being conducted in person (I only know most of my cohort from behind a screen). I used to get really stressed and anxious with all the changes and uncertainty, but I’ve learned how to cope with it and change my mentality so I don’t get as overwhelmed as I did in the beginning.
• Impersonal interactions and being constantly worried I’ll be burnt out by the time I finish.
• Keeping clinical sites, having schedules change at the last minute and being expected to drop everything with less than 24 hrs notice.
• Seeing how burnt out the nurses are and the fear that I won’t get a good learning experience because of the frustration on their part (both now and as a new grad).

Is there anything you’d like to add that conveys the experience of being a nursing student during a pandemic?

• There’s a meme that has a nurse leaning over talking to a patient saying “Don’t worry, I’ve seen this done online once.”
• Being able to stay strong during tough situations.
• The nursing students that are witnessing the toll COVID is taking on healthcare workers and are still pursuing this career path will result in us having a completely different outlook on our futures. I think this generation of nursing students is going to be very persevering.
• I think our cohorts honestly deserve more recognition for committing to this field at such a dangerous time. It isn’t hypothetical now, it’s real, it’s stressful, it’s scary, and we came in anyway to help people. I don’t feel like that gets seen. Clinicals are more emotionally draining because of the stress than they otherwise would be–we don’t need the “weed out” mentality that nurses and instructors sometimes bring. We’ve been weeded.
• Nursing school during a pandemic has been so hard. Initially there was more grace towards us, but now that it’s sticking around there is very little wiggle room. This is one of the hardest things I’ve ever done.
• It was very eye-opening. Not only about patient care, but also about the politics in the hospital.
• It’s just hard right now and I feel like a lot of us aren’t going to be very confident in our nursing skills because we have had little experience.
• We have been forced to learn and practice skills through videos and on stuffed animals with little lab and clinical time. I am concerned for our future patients!
• Honestly, even though it has been difficult I think it’s still so worth it! I am so excited to become a nurse and even though I’m afraid of being burnt out, I know that I am adding to the workforce and taking some of the load off of the nurses that are already out there. So, I’m trying to go into it with a positive mindset that I can make a difference. As a fresh RN coming into the field, we can come in and change the existing standards and be a force of change for the profession. So overall, while I have had a few negative experiences, I would say 90% of them have been positive and I would do this whole thing all over again through a pandemic 🙂
• We are seeing the negative sides of nursing much more quickly. I’ve had classmates quit after seeing how nurses are treated by administration. My cohort was lucky to have all their clinical days in person. Working with people cannot be adequately replicated with a simulation.
• Nursing is hard and doing it during a pandemic is definitely extra! It has made me more determined to do well and finish, but it has also taught me how important adaptation is. If one way doesn’t work then try another way. Adaptation is an essential nursing skill!!
• The nurses are very tired and worn out… many nurses have worked overtime/picked up extra shifts, so sometimes they may not seem to have a good attitude…be nice and understanding to your nurses! They’ll usually try to help you, but realize that they also have a “lot on their plates.”
• You learn to be very flexible. I think we all have a plan or idea of how we expect things to go. I’ve heard more times than I can count how hard nursing school is, but mix that with a pandemic and a vaccine-hesitant population and it feels near impossible. I’m so grateful to my cohort and the support of my professors for going through it with me.
• It’s hard. The hospitals are struggling to keep nurses, but on the other hand, they are hesitant to let students in for clinical because of the intermingling and potentials for exposure.
• You feel stuck and that you are not prepared. The constant thought of imposter syndrome is even more prevalent since you don’t get to do everything students would get to do pre-pandemic.

What advice would you give to a new student starting clinicals for the first time?

• Just try to get as much out of it as you can! It’s a privilege to be in person so soak up as much as you can!
• Be willing to do anything and everything to get that hands-on experience. Not everyone is so fortunate. Be willing to be awkward and uncomfortable because it all is at first! It gets easier with each interaction and you’ll be amazed at how much you learn by the last semester!!
• It is the best! A SIM experience cannot compare to having a real patient to care for. Take advantage of being able to do those comfort practices with your clinical patients (lotion, reading, massage) because as you take on more patients as a nurse those things are harder to get to. Enjoy!
• Consider CNA work experience if you have virtual clinical at school. You will have opportunities to see skills and practice basic patient care.
• Always come prepared. Ask questions but also do research. Don’t just ask people because it’s easier.
• Do not be afraid to ask questions, you are not expected to know it all but be mindful of when you ask the questions…….do it when it’s appropriate and your nurse can give their full attention to you. I would also suggest spending time learning the supply rooms, know where the common items are so you can “fetch” these for your nurse quickly.
• Take it one moment at a time, try not to overthink or work yourself up into a worry. You have the skills and knowledge you just need to bump your confidence to match it all!
• Deep breaths. Hydrate and get plenty of sleep night the before. You are there to learn and no one expects you to know everything right out the gate. I’ve found it helps when I introduce myself to my nurse for the day, letting them know what semester I’m in and what skills or tasks I can help them with.
• Make sure you know the policies/rules of your school and of the hospital. If you are not certain what you can and cannot do, clarify with your clinical instructor so that you don’t get yourself in trouble! Be safe and have fun!!!
• I often found myself following around the nurse tech because if my nurse was in a COVID room, I could at least learn from these skilled nurse techs and pick up a few tricks from them. They also always found it helpful to have assistance because they have a busy, difficult job. I learned a whole lot from the techs.
• You are going to be nervous. It is difficult to not let yourself freeze up when you don’t know how to help. REMEMBER TO BREATHE! Seriously! Jump in and take advantage of anything! Even if you can’t help, observe! Make yourself a cheat sheet of V/S, labs, needle gauges, etc, and have it with you.
• Be inquisitive, and jump in head first! Be confident, and curious, and you’ll reap the benefits.
• Interact with as many patients as you can and learn where things are! It’s so helpful when you can run and grab things for a nurse or a patient and be independent. Also, things don’t feel so hard when you’re comfortable working with patients, so the more practice, the better! Offer to take vitals, change linens, get them dressed, help with toileting, and do assessments. I’ve only been a tech for a month now but I know my clinical experience will be so much better this semester because I’m much more comfortable with patients.
• You will never forget your first patient. You will never forget the first time you walked into that room. You’ll feel the jitters and be very consumed with going exactly by the book, but it will be the first step towards your career. It will feel very overwhelming, but after that first clinical, you’ll feel so proud of yourself.
• Volunteer to do anything/everything you can. Be an asset to your preceptor and they will teach you a ton.
• You get what you put into your clinical! If you want to learn, you can learn! If you want to fly under the radar to get over/through things, you can do that too. But if you want to be a good, safe, competent nurse, put in the work, effort, and time.

I hope you’ve enjoyed reading about other students’ experiences and felt less alone as a result, no matter which way you are feeling. For more context and some advice from me, check out Episode 177 of the Straight A Nursing podcast (publishes October 28, 2021). See you there!

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