Health Care Students on the Front Lines

by Abigail Cloutier

On Christmas Day, Cheyton Watkins donned her scrubs and headed to work at Mercy Health St. Elizabeth in Boardman, Ohio — on a COVID-19 floor. On her way out, she grabbed a stack of Christmas cards she made for the 24 patients on her floor after her Christmas Eve shift. As she passed the cards out, nearly every patient shed a tear.


Watkins is a junior nursing student at Youngstown State University. She started working as a personal care assistant in August, 2020. Within months, the medical surgical unit she works in at St. Elizabeth quickly became designated as the COVID-19 overflow unit. By Christmas, Watkin’s basic duties of drawing bloodwork, changing bedsheets and responding to patient requests morphed into monitoring coronavirus patients.


“Those 24 patients, I made a difference in their lives. It reinforced what I’m doing. I know this is what I want to do. Even through a pandemic, it’s really made me understand why I’m doing this,” Watkins said.


Health care students fresh out of college or still in clinical training have never known their field without the pandemic. But students from all health professions, including nursing, dental hygiene and long-term care administration stepped up to the challenge.


Some, like YSU senior dental hygiene student Katie Clement, found she had to throw some of the skills she learned in classes out the window. For example, hygienists stopped using tools like electronic ultrasonic plaque scalers and polishers as a safety precaution due to the potential production of aerosolized bacteria. The hands-on skills associated with tools like manual hand-scales became even more crucial.


“It was a lot more time-consuming, but we still make it work,” Clement said. “We’re really efficient with that, so honestly, it helped us in the long run, because we have those hand skills.”


Besides the obvious stresses of working on the front lines, issues like the interruption of degree requirements are contributing to health care students’ pandemic-related stress in a big way. In the spring 2020 semester, clinical rotations where students get most of their hands-on patient experience moved from in-person to online simulations.


“I’m a visual learner, I like to do things and get comfortable with my patient care. So, when clinicals first went online, it was my first semester actually in a clinical. I was stressed that I wasn’t going to get bad experiences. But I think that’s why I started working at the hospital and that’s made up for a lot of my missing out on clinicals,” Watkins said.


Giovanni Bruno is a senior nursing student at YSU and also works in a cardiovascular ICU at a hospital in Cleveland. Clinicals have since moved back to in-person experiences, but he likened his online clinical experience to a video game.


“I hate to say like, it was almost like a video game treating a patient, but that was kind of the idea,” Bruno said.


According to research published by the National Institute of Health, factors like exposure level, years of experience and personal background, proximity to COVID-19 ‘front lines’ and coping mechanisms were all risk factors in the development of post-traumatic stress symptoms for healthcare workers.


In an analysis of seven studies by the Department of Psychology at the University of Turin, there was between a 7 to 35% increase of trauma-related stress in women, nurses and frontline workers due to unprecedented demands and responsibilities.


“You go into work every single day, and you see the same things every single day… you have to put that face on …” Because this is my job – My job is to take care of these patients and to work help them get through this,” Watkins said.


“I talked to some of the other girls in my nursing program who are still working on a COVID-19 floor… my friend said she thinks she’s going to quit, because she just sees people dying all the time. It takes a toll on your mental health.”


The increase in health care students’ pandemic-related stress has not escaped the notice of those teaching them.


Dr. Nicolette Powe is the public health program director at Youngstown State University. While she’s noticed an increase in awareness of the institutions of public health departments, she noted the face of public health has changed.


“Typically, in the past, if you worked in the WIC [Special Supplemental Nutrition Program for Women, Infants and Children] office, you worked in the WIC office. Now, it’s all hands on deck,” Powe said.


“It doesn’t matter what department you work in, everyone has some newfound role in supporting efforts relating to COVID-19. In theory, in the long-term, that can be a plus because now you have more public health professionals who are more integrated with all facets of public health.”


According to Powe, lack of public health staff and funding is contributing to the burnout of public health students and employees.


“I’m concerned that without new funding sources, and maybe perhaps even a restructure of how public health works – the local and state health departments, they’re not equipped to do the large, massive amount of work that has to be done now. They need additional funding to support these newfound demands and expectations,” Powe said.


Daniel Van Dussen, the program director for Long-Term Care Administration, noted that although students are getting hands-on experience in nursing homes, it comes at a cost.


“They’ve seen residents die from this, so this is very serious, but getting into this field, you’re dealing with the end of life. But the manner and the inability [for families] to see [their] loved one before they’re gone has really impacted them,” Van Dussen said.


According to Van Dussen, the increased demand for long-term care employees puts more strain on existing workers, something he hopes will change after the pandemic.


As more people receive vaccinations and case numbers decrease, students have also seen their stress decrease. Watkins and Bruno have both received their vaccinations, and Watkin’s floor no longer hosts COVID-19 patients.


Despite changes brought about by the pandemic, most healthcare students are on track to graduate on time.


“I’m just really proud of all my classmates and everything they’ve had to do throughout this pandemic, and all the changes we’ve gone through,” Clement said.