With the nurse shortage dogging healthcare employers nationwide, another state has joined the ranks of those permitting nursing schools to add more simulation training experiences to their curricula. Such measures could play a part in helping get workers out into the field, but more solutions are needed, according to a long-term care nurse leader.
Under legislation signed this week by Gov. Kathy Hochul (D), nursing students in New York state will be able to complete up to one-third of their clinical training through simulation experiences, up from a quarter. The state is among 31 others that currently use some form of this training, Hochul’s office said.
Keeping the pipeline moving
The idea is to keep the workforce pipeline moving by preventing a wait for the limited supply of student clinical placements necessary before licensure. Stakeholders said expanded use of simulation training will also allow nursing programs to grow, adding more clinical training to meet demand.
Simulation training for future nurses tests clinical and critical thinking skills in a classroom or lab setting rather than a healthcare setting. It became a pandemic stop-gap for many states as schools suspended their in-person training due to COVID-19-related restrictions, threatening to delay graduations. California, for example, temporarily allowed students to receive 50% of their clinical training in certain areas (geriatrics and medical-surgical classes) via simulation.
Replacing lost staff
“I give New York state credit for doing this,” said Shari Carson, RN, BSN, LNHA, regional clinical coordinator of Ciena Healthcare in Michigan and vice president of The National Association of Directors of Nursing Administration of Long-Term Care. There are not enough nurses graduating to replace those that will soon be lost to retirement, let alone those lost to attrition during the pandemic, she said.
In fact, New York’s post-pandemic clinician workforce crisis looks bleak. It will be short an estimated 40,000 licensed nurse employees by 2030. “[E]xpanding simulated training will help clear the logjam, address the shortage and ensure high quality care for millions of New Yorkers,” Hochul’s office said.
Bigger investments needed
Yet, simulation training is only “a partial solution” to the problem of building back the workforce, Carson said. Much bigger investments are needed to attract nurses where they are most needed, she added.
For example, student loan forgiveness programs could work to entice nurses to work in underserved areas such as long-term care and rural care, just as they do for physicians, she said.
Meanwhile, training in a simulated scenario can help boost critical thinking skills, Carson said. The National Council of State Boards of Nursing has found that up to 50% simulation can be effectively substituted for traditional clinical experience. And the learning experience has become more realistic as technological features improve. But there are some skills that nurses in training need to learn hands-on, she said. Intubations can be a different experience in each patient, for example. And when a patient goes into cardiopulmonary arrest, “you need to learn how to respond, how to be part of a team and do CPR.”
Up to speed for LTC
During the pandemic, Carson’s home state of Michigan temporarily allowed simulation for much of its pre-licensure nurses’ training, she noted. As newly licensed nurses moved into jobs, Carson and her peers in the field quickly recognized that orientation programs would need to be expanded and enhanced to be sure the new hires were up to speed.
When it comes to long-term care staffing, if simulation training is geared more towards specialty clinical areas, such as medical-surgical, psychiatric and skilled nursing, it could be helpful, she noted. “We could then teach them what they need to know,” she said.
Related articles:
As behavioral health demands grow, new federal center offers free SNF training
LTC staff to receive free behavioral health training in new federal program
CNAs reduce stress, improve skills with self-compassion training in nursing home study
