It’s not learning as usual in the age of COVID-19, and Union College nursing students in Elysia Ockenga’s mental health class discovered that sometimes a change in plans can bring unexpected blessings — and benefit the student provider just as much as the patient.
The class at the Seventh-day Adventist school in Lincoln, Nebraska, United States, focuses on mental health, including the importance of communication between health-care providers and patients.
“Therapeutic communication is the way we ask questions, have empathy and care about patients,” Ockenga said. Usually, students are paired with patients at Lincoln’s Regional Center to help them hone their therapeutic communication skills, but the coronavirus put an end to in-person patient visits.
Still, students had to complete clinical hours. “We needed to find a way for students to establish a relationship with patients,” she explained. Virtual simulations allowed students to make decisions for virtual patients. But they didn’t allow for as much communication that is needed when establishing rapport and building a relationship with a patient.
The struggles with COVID-19 provided inspiration. Worldwide, individuals who are older or more vulnerable to illness are self-isolating, putting them at risk of loneliness and anxiety. Ockenga reached out to neighboring College View Church and Union Manor, Union College’s HUD-funded retirement apartments, asking for volunteers who were willing to meet by phone with a nursing student once a week for four weeks.
Junior nursing major Isaiah Delarmente was paired with a resident who was immunosuppressed and sheltering in place. Over the four-week clinical, they built a friendship. Instead of the required 15- to 30-minute phone calls, the two often spoke for an hour.
While the forum was different, it still allowed for learning and growth. “It was different than being in a hospital, because over the phone, you can't see nonverbal communication,” Delarmente said. “I had to listen to her tone of voice and ask more clarifying questions. It was a good experience because, in the nursing field, you never know what you’ll have thrown at you. We weren’t expecting COVID-19 to shut down classes, but this ended up being positive. It taught me that it’s fundamental to get out of my comfort zone and build relationships with my patients.”
Delarmente said his last phone call with his patient proved that relationship. “As we were wrapping up, she wished me luck and prayed for me. That was really meaningful.”
This innovative clinical proved to Delarmente that, even during a pandemic, Union’s nursing program is preparing him for his future career. “They’ve given me new experiences. I’ve learned that not everything is going to go my way; COVID-19 took a lot of personal interaction away. But sometimes you just have to do things by yourself, like study and put in the work. I learned that I can do that and succeed.”
Senior nursing major Amanda Harland was nervous about the mental health class from the start. “It’s different from other nursing classes,” she said. “It’s not a class where we give medications and do a head-to-toe assessment. Mental illness is different from medical illness, so it’s not a quick fix.” She was scared she wouldn’t get the communication right or would say the wrong thing. But she said Ockenga showed her she could do it.
Then COVID-19 changed the direction of clinicals, and in-person meetings were out. “I thought getting to know someone over the phone would be awkward,” Harland said. Again, she was pleasantly surprised. “My patient talked a lot about leaning on Christ. It was empowering for me, and I learned how to look at life through her perspective,” she said. “I was apprehensive, but this was a blessing for me. It's one of the best things that’s happened in my nursing education.”
Like Delarmente, Harland found she was able to practice therapeutic communication without relying on visual clues. “I like to look at people when I’m talking to them so I can see how they react to things I ask, but I was surprised at how successful our phone calls were and how gracious my patient was. She wanted me to learn.”
Like most Union students, Harland moved back home when live classes were canceled. Her family was also personally affected by the coronavirus, making it hard for her to focus. “Online learning was a challenge, but our teachers were there for us and helped us get through it.”
Harland said the patient she was connected with also helped. “She’d lost her husband earlier this year, and we talked a lot about coping and how God has a plan for everyone. I found comfort in that. It’s easy to get sucked into the things that are happening in the world and lose sight of what’s important. My patient strengthened my faith and gave me peace.”
Harland hopes future nursing students will get the chance to experience this project, even if COVID-19 isn't a factor. “Reaching out to community members like we did to check on them, being there, and telling someone ‘I’m here to listen’ is something that can change lives and perspectives. It's a great learning experience.”
During their clinical phone calls, students got a chance to practice professional and therapeutic communication. But Ockenga said she didn't anticipate the more substantial learning the students would get.
“These individuals have experienced life and were able to share with our students that we all have difficult times and ways to cope,” she said. “They found a connection — the older individuals appreciated a voice on the phone, someone to listen to their stories and spend time with. The students found a relationship in which an older person cares about them and appreciates that they are spending time with them. It speaks to what our college is about — community and connection — and these students exemplify that. I’m so proud of them.”