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Nursing, medical students return to clinical placements this fall

Two nurse practitioner students share perspectives on hospital work during pandemic
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The Faculty of Medicine building.NATHAN CHING/THE VARSITY
The Faculty of Medicine building.NATHAN CHING/THE VARSITY

While over 90 per cent of U of T undergraduate classes will have remote delivery options this academic year, many graduate students will return to in-person learning — and for some, this learning will happen on the front lines of the pandemic.

Students at the nursing and medicine faculties are preparing for in-person clinical placements this year, where many of them will be working in hospitals with patients who have tested positive for COVID-19.

In-hospital clinical placements

Justin Struss, a second-year student in the Master of Nursing, Nurse Practitioner program, will soon begin his clinical placement with the University Health Network at Toronto General Hospital. Returning to in-person clinical placements doesn’t worry Struss, who currently works at Toronto General as an intensive care nurse.

“I work with COVID-positive patients… all the time so it doesn’t really bother me so much,” he said in an interview with The Varsity. “Most people [in the program] are probably more comfortable with it because they have to work in a hospital environment or with patients; it’s part of their job.”

Struss reported that the Faculty of Nursing has implemented additional safety restrictions for clinical placements. “We’re not allowed to be in any rooms if there’s an aerosol-generating medical procedure happening,” Struss said, adding that outside of his placement, he regularly performs such procedures as a nurse at Toronto General Hospital.

Struss said that although clinical placements are mandatory for nurse practitioners this year, the Faculty of Nursing is flexible in accommodating individual students’ needs. “The faculty is generally pretty good about if you have certain issues or concerns, like if you were an immunocompromised person or something like that. They would generally work with the student on a one-to-one basis to figure out how to move forward and meet your degree requirements.”

Meagan Noble is a Master of Nursing student in the second year of the Nurse Practitioner program who is starting her clinical placement at Toronto General Hospital. She wrote in an email to The Varsity that, like Struss, she is not concerned for her safety. “I am comfortable taking care of immunocompromised patients since it is part of my everyday profession as [a registered nurse],” she wrote.

The Faculty of Medicine is imposing additional restrictions on the types of clinical placements students can do and will be prohibiting students from working or volunteering at long-term care facilities.

Patricia Houston, Vice-Dean Medical Education at the Faculty of Medicine, wrote in an email to The Varsity that students will be accommodated if they have health or safety concerns regarding their clinical placements. “In some cases, it may be appropriate for a student to consider a Leave of Absence,” she added.

The majority of graduate nursing and medical students, however, seem to be comfortable returning to clinical placements. In fact, according to Struss, the Faculty of Nursing is having difficulty finding enough clinical placements for nurse practitioner students.

“They’ve been having trouble… finding individual preceptors for every student who requires a placement,” he said, explaining that hospitals have only recently reopened to student learners, so the number of graduate students enrolling in clinical placements is higher than the number of available placements.

Clinical placements essential for student learning

When asked whether students could opt out of clinical placements this year, Noble stressed that, in her opinion, they were essential to the program. “I don’t think an option without a clinical placement would suffice,” she wrote, adding that “most of us learn more hands on.”

Clinical placements were cancelled on March 16 due to the COVID-19 pandemic, as student learners were no longer allowed in hospitals. Noble feels that her peers’ upcoming fall 2020 placements are even more important because they have already missed their spring placements. “At this point, we are down a placement… If we don’t have the clinical experience with patients, it will effect [sic] us as future Nurse Practitioners,” Noble wrote.

According to Struss, many other graduate students feel the same way Noble does. “The sentiment of the majority of the graduate students was… that having our placements cancelled wasn’t necessary because we’re used to working with these types of patients,” Struss said. “We’re already licensed health professionals.” According to him, many nurse practitioner students agreed that cancelling clinicals “affected [their] education,” though he noted that it was the Toronto Academic Health Sciences Network, not U of T, that made the decision to remove student learners from hospitals.

Even though nurse practitioner students couldn’t attend in-person clinical placements last spring, Struss said that online learning included “digital simulated assessment clinics.” He explained, “We had a simulated patient and we came together as groups to assess them.”

Noble, however, added that she tried to supplement this learning with hands-on experience. “I practiced health assessments on family and friends as appropriate and bought case study books to review on my own,” she wrote. “You had to get creative in order to demonstrate resilience in the pandemic.”

Accommodation during COVID-19

“The [nursing] faculty has been pretty responsive to us,” said Struss. “They very much have stressed that safety is the number one priority.”

Noble agreed, adding, “We have to realize it has been a struggle for them too. They have had to deal with panic from many students and change many policies and procedures which is no easy feat.”

Houston elaborated on this by outlining the steps the Faculty of Medicine is taking to ensure student wellness during this time and drawing attention to the resources available at the Office of Health Professions Student Affairs (OHPSA).

“OHPSA provides confidential individual counselling to students on both the St. George and Mississauga campuses, as well as other supports,” she wrote. “OHPSA works collaboratively with U of T Health & Wellness Centres at both campuses to expedite access to service.”

According to Houston, the Faculty of Medicine recognizes that the future is uncertain, and it is prepared to adapt to accommodate students’ needs. “COVID-19 may pose unique challenges for students and trainees, and the University is committed to providing as much flexibility as possible in the circumstances,” wrote Houston.

The Faculty of Nursing did not respond to The Varsity’s request for comment.


Editor’s note (September 21): An outdated version of this article that does not match the print version was previously uploaded. This article has been updated with the correct text. The Varsity regrets this error.