Nursing during a pandemic

Come graduation, some IU School of Nursing students will be trading in their caps and gowns for scrubs and masks a little sooner than they thought. 

That’s because under Indiana Gov. Eric Holcomb’s executive order made on March 30, the IU School of Nursing is allowing students to obtain temporary nursing licenses to help combat the COVID-19 pandemic. This is an optional choice for students who have completed all of the program requirements and had their certificate of completion signed and submitted by the nursing school dean. 

These licenses will last 90 days and may be renewed in 30-day increments. 

When the health emergency ceases, those with temporary licenses will be required to take the National Council Licensure Examination (NCLEX), a nationwide examination to obtain a nursing license in the United States 

“If students choose to…they can have a temporary registered nurse license and function within the scope of practice and function as a registered nurse immediately,” said Debbie DeMeester, Interim Associate Dean for Undergraduate Programs at Indiana University School of Nursing.

Q & A with Interim Associate Dean for Undergraduate Programs at Indiana University School of Nursing

Normally, IU nursing seniors would graduate in early May and take the NCLEX in late May or early June. After passing  the exam, the students would obtain their nursing license and be able to practice as a registered nurse.

As a result of the Centers for Disease Control and Prevention’s social distancing rules to limit the spread of COVID-19, NCLEX testing centers have been directly affected. 

Instead of rows of newly graduated nursing students sitting side-by-side in cubicles taking the exam, a March 25 order limited testing centers to only 60 students at a time taking the exam. 

“They want to keep the students six feet apart,” said DeMeester “Now, someone will sit at a cubicle and there are several empty bays and another cubicle where someone is sitting. So, you can imagine what that’s done to capacity.” 

In response to these changes, the format of the exam has also been altered. 

Before COVID-19, the NCLEX consisted of a minimum of 75 questions and a maximum of 265 questions, with six hours to complete it. Now, the minimum number of test questions were reduced to 60 while the maximum dropped to 130.  The maximum testing time changed to four hours but “the difficulty level and passing standard has not changed” according to the National Council of State Boards of Nursing. 

“Some individuals are feeling very positive about that [and are thinking],  ‘I only have to sit through 265 questions.’ Some of them are feeling very happy that it’s not going to be as long,”   DeMeester said. “Others are [thinking], ‘Oh no! I have fewer questions to prove myself.’ So I think that’s caused some mixed emotions among the nursing graduates.”

There is a concern that delaying the exam would make a nursing graduate forget critical information and be out of practice with certain medical terms and procedures. However, Morgan Orton, an IU nursing student who will graduate in May isn’t worried about postponing the NCLEX. 

“I don’t see why I shouldn’t be able to start sooner when honestly, you’re learning a lot of things hands-on and when you’re at work,” she said. 

Orton will begin her full-time job in May, working as a nurse on the bone marrow transplant floor at Indiana University Health Hospital in Indianapolis. 

“I actually was lucky and got a unit that I was interested in,” she said. 

The activities that temporary license holders will be able to perform varies between positions at the hospital. 

“They still will have a registered nurse resource,” DeMeester said. “They are not going to be turned loose.” 

For Orton, completing orientation will be the first step in her new role. 

“I still have a 12-week orientation,” Orton said. “Three months is minimum. So by the time I take my NCLEX, I’ll be off of orientation and then I can function as a nurse on my own.”

In this uncertain time, being optimistic, especially as a future health care worker, is key. 

“It is nice to know that in this time of unknown, at least I have a job and I’m secure and safe in that aspect,” Orton said. 

Q & A with IU nursing senior, Morgan Orton.