Nursing school moves quickly to upskill nurses in trying times

The COVID-19 pandemic has brought about many changes to modern life. And although the virus’ sweep across the globe has been shocking and swift, this generation has been uniquely placed to deal with daily tasks that may have been arduous were it not for technology.

Food deliveries have kept us fed and safe from the crowds, while also keeping businesses afloat and keeping many people in jobs. The internet, streaming services and other devices have kept us socially engaged and entertained.

Offices around the globe have migrated to a work from home set up, while students have been able to learn from home.

Australia, by and large, has avoided the high COVID-19 numbers we have seen elsewhere, but what the pandemic has shown us is the need for the healthcare system to be agile like other areas of life, and upskilling nurses quickly has been key to coronavirus readiness in hospitals around Australia.

To that end, the university of Melbourne, in partnership with and funded by Safer Care Victoria, has developed an online course dubbed Critical Care Essentials, which looks to supports nurses’ development of essential foundational knowledge to plan, monitor and evaluate nursing interventions for the critically ill COVID-19 patient.

The course was developed in just two weeks by the School of Health Sciences’ Nursing Department and could point to the future of nurse professional development.

“We're in a situation where we simply didn't have, and don't have the number of intensive care nurses that we would have required that would mandate a one-to-one ratio to match the ventilated patient,” says course coordinator and University of Melbourne lecturer, Nick Bridge.

“And so in order for that to happen, the health services were scrambling to try and come up with a way to literally educate their nursing staff about some of the really important principles, concepts and care strategies to care for the intubated mechanically ventilated patient in intensive care.”

After a conversation with senior nurses at The Royal Melbourne Hospital, Bridge and his colleagues set about designing an online course that they would be able to roll out quickly and free of charge to nurses nationwide. The team of eight people put together a syllabus that would normally take six months of planning.

Although the course was designed with the urgent need for nurses due to COVID-19 in mind, according to Bridge, 80 per cent of the course relates to standard practice for caring for ventilator patients in intensive care, so the course will be valuable for nurses in the future. The other 20 per cent applies to COVID-19 specific practices learnt by professionals over the very short period we have been dealing with the virus.

“The course directly relates to the COVID-19 recommendations from a variety of sources around the world and in particular from the Australian Critical Care Society,” says Bridge.

“But what we did was apply the guidelines to the standards of care or to the care practises and a good example would be, this has never happened before in managing intensive care patients where you would literally have to clamp an endotracheal tube and clamp a ventilator circuit before you disconnected them. It's never had to happen. And that's to stop aerosolization if you're going to disconnect tubing.

"And so whilst disconnecting tubing and suctioning and those sorts of things under normal procedures in caring for ventilator patients, you would never go ahead and do something as simple as that, but as critical as that, because not only are you preventing the disease from spreading, you're actually protecting the health care workers.

“It was really important to have novice health care workers in the intensive care setting protect not only themselves, but all of the people around them."

Bridge believes that even though Australia hasn’t had the need to mobilise the healthcare system like other nations, this does not mean we never will, and the ability to mobilise large number of nurses is key to planning for the post-coronavirus future.

“I think the nursing workforce itself was very open to quickly adapting to what was possibly going to be needed. And that was widespread. There were very few people who were declining redeployment or anything like that," says Bridge.

"Nurses in the main are very agile because of the changing nature of healthcare over the last few years. That's for sure. It’s rapid turnaround, it's high acuity and nurses have got to work fast.

"I think organisations move a little bit slower, but I think this has really highlighted how to go about planning for what could have been a national disaster. Luckily we've had nothing happen here like happened in the US and other countries, where we've been able to put in a lot of planning and preparation. And this program was just a very small part of that, because most of the work was really going on within the health services themselves.”

The course currently has over two-and-a-half thousand nurses enrolled and Bridge says that's a massive number of nurses who could potentially be redeployed to look after COVID-19 patients in the acute setting.

Nurses take 10 self-paced modules which provide online active learning with self-assessment focused on the care of the patient with acute respiratory failure and sepsis. The course is scaffolded by a series of interactive case studies and problem-solving activities. Emphasis is given to critical elements of practice to highlight application of relevant clinical practice guidelines. 

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