20201108-bc-nursing

When the pandemic hit, Kayla Moore, left, and Gabriela Guiellen, right, weren't sure if they would be able to graduate from the registered nursing program at Bakersfield College on time. Dignity Health's Memorial Hospital not only helped them get their hours, but hired them as registered nurses once they were licensed. Lindsey Panick. center, the RN Residency Program Administrator, trains nurses at the hospital.

Kayla Moore was ready to graduate from Bakersfield College's registered nursing program when the coronavirus pandemic hit. She and her classmates just needed crucial clinical hours with patients — just at the time when many hospitals weren't sure whether allowing students in was a good idea.

"It was stressful for our entire class," she recalled. "And this is what we were training for."

Moore had worked for the last six years to become a registered nurse, and the thought of it falling apart just eight weeks before graduation felt "terrifying." Not getting those clinical hours and graduating could set off a cascade of effects: not being able to take the state board exam, not getting a job as a nurse for months or even a year, not being able to pay the bills for her family.

This wasn't just a problem for nursing students. California has a shortage of registered nurses that is especially acute in Kern County, according to Cindy Collier, Bakersfield College's interim director of student health and wellness. In recent years, the college had doubled the capacity of its program to try to address that shortage.

"Then the pandemic hit," she said.

For the incoming class this fall, BC reduced the enrollment spots in the Registered Nursing Program by 20 percent and the Vocational Nursing Program by 50 percent, though Collier says that's still much higher enrollment than a few years ago. The college has also put a greater emphasis on hours in simulation rather than in-person care, thanks to decisions made at the state level to try to help those close to graduating this spring.

Nursing programs and students pleaded with the Board of Registered Nursing to waive requirements for graduation, which required they do the majority of their clinical work with patients instead of in classes and simulations. The board softened but didn't completely waive those requirements. At a time when the American Association of Medical Colleges recommended suspending clinical rotations, that left some nursing students without a sure path to graduation and the ability to take the state board exam.

But not in Kern County.

"Thankfully, our community came together," Moore said. "What Bakersfield did was special."

When nursing students were panicking, Bakersfield College reached out to its partners at Kern Medical and Dignity Health. 

Collier said that nearly 50 students in the class of 2020 needed help getting their clinical hours. She called upon Kern Medical CEO Russell Judd, hoping he would take a few.

He took everyone.

"It was such a great opportunity for students," Collier said.

Toni Smith, chief nursing officer at Kern Medical, said their administrative team considered it crucial for local nursing students to finish their education. One class of nurses that doesn't graduate on time could create a bottleneck for years that would make it difficult for them to hire nurses down the line. And it wasn't just administrators who realized what was at stake. Smith said nurses jumped at the chance to take on the swell of students and show them the ropes.

"Kern Medical prides itself on being an educational organization," Smith said. "Of course, we would do anything we could do to educate nurses."

Some hospitals had been nervous to take on students early in the pandemic because they didn't have enough personal protective equipment, but Smith said that wasn't a problem at Kern Medical. That helped students learn the valuable lessons about how to work in a pandemic that they would be facing once they graduated. 

Students who aspired to work in the intensive care unit or emergency department were assigned nurse preceptors in those areas. Smith said they didn't make a point of having students work with COVID patients, but if there were a chance of exposure to a COVID patient, they were taught how to protect themselves.

"We taught them how to use it properly," Smith said. "As a senior nurse, that’s very important for them to learn."

Some nursing students at Bakersfield College had a head start on their classmates, including Moore and one of her fellow classmates, Gabriela Guiellen. They were already externs at Memorial Hospital well on their way to getting their clinical hours, but they weren't quite done. Guiellen, also worried about taking care of her kids and bills, was nervous about whether she would graduate.

The department heads at Memorial Hospital, where they were already shadowing nurses, assured them that they would be able to continue their externship until they had enough hours to graduate — and they would be paid for those hours, too. They would be kept away from patients in isolation but otherwise they continued to get the hands-on education they need as nurses.

Bakersfield College faculty worked into the summer, one without extra pay, to make sure all the students had finished their clinical hours.

It paid off for both the hospital and the students: Moore and Guiellen have since passed their Board of Registered Nursing exam, got their licenses and just wrapped up their second month on staff as nurses at Memorial Hospital. 

And it's not a moment too soon. Guiellen considers the work she does right now crucial. It's not just about providing health care but also a friendly face, when not every patient is allowed to have visitors because of COVID-19 restrictions.

"It feels special for me to spend extra time with patients and to help them FaceTime with family members," she said.

Guiellen feels like the community supported its nursing students through a critical time in their careers.

"Now we're here for our community," she said.