Adjusting to Remote Education: A Q&A with Assistant Dean Louise Fleming

Louise Fleming, PhD, MSN-Ed, RN, is the School of Nursing’s Assistant Dean for Undergraduate Programs & Division, overseeing the ABSN and BSN programs. Skilled nursing is essential to saving lives during the COVID-19 pandemic, and Fleming says it’s no surprise that the school’s ever-nimble nursing faculty, staff and students mobilized so quickly around what the virus’ spread could mean for nurses, the field of nursing, and the lives nurses pledge to protect.

How has this epidemic impacted the School of Nursing?

We’re nurses, so we sensed early on that this was going to have an incredible impact worldwide. During our first meeting, faculty and administration agreed it was important to prioritize our goals, and that our first priority was getting the two legacy cohorts in our programs to graduate on time this May. These future nurses have worked hard and prepared, and we wanted these seniors to graduate and go where they’re needed.

What changes needed to happen to get there?

We needed a plan for what to do if students were removed from clinical situations or if the University decided to go remote – both of which eventually did happen. Before those decisions were made, we already had an incredible team figuring this out – Our Dean, assistant deans, course directors, undergraduate faculty, our compliance team, staff. Carol Durham had begun thinking about how we could convert clinicals into simulation so students could complete their requirements.

The North Carolina Board of Nursing requires 120 focused client care experience hours, and in our very robust curriculum, students get 192. Our ABSN students had already met this, and our BSN students were currently doing this. We shifted focus to allow our students to pick up shifts over spring break, and we’ll allow the remainder of hours come through simulation.

We made these elaborate plans and waited for the calls. We were incredibly prepared.

What was the response like across the school?

Our undergraduate faculty truly rose to occasion. There are bumps – our students are worried about school and their families, financially. So, we’re prepared, but we’re feeling the effects emotionally. Everyone is working around the clock, and the news is good: we’re going to graduate almost 200 new nurses into the workforce this June, and we’re proud of that.

What makes nurses so inherently prepared for a time like this?

Even if the public hasn’t noticed it before now, we are always putting our lives on the line. We have patients that can be combative, we’re in uncertain conditions, we face illnesses that haven’t been identified, and we don’t always know what we’re exposed to. I was an ICU nurse, so this is personal for me. My generation of nurses was working in the HIV epidemic, where we were gowning up and double gloving, and we had so many unknowns. Though some may just now realize it, nurses have been essential leaders in health care crises since the beginning of time. From Florence Nightingale to now, nurses have been through it all.

Nurses are continually voted ‘most trusted profession’ in an annual Gallup poll. Does this reaffirm that?

There’s a reason why nurses are the most trusted profession, and we’re watching it unfold in front of the world right now. These instances in life aren’t going to happen often. I applaud all of my colleagues who are in the trenches right now, and those of us who are not, I know we all feel we should be. That’s hard for me right now. I need to serve this school right now and help us get our students into the workforce where they are so needed right now. But I do feel that pull to just jump in there and do what I’m trained to do.

Our administration and leadership at this school meet two-to-three times a day. It feels like we’re going to war. To see this level of collaboration has been truly amazing. Nurses are superheroes – all of us here, all of us out there.

The School of Nursing is responding so fully to COVID-19. What are some uncertainties that remain?

I find the lack of PPE to be horrific. PPE is such an important part of your training, and it gives you that safety that helps you keep your mind on nursing. You always have those nagging worries – will I bring this home? But, you and your patient are protected. I can’t imagine being asked to go into situations like this without PPE. It also scares me to see people congregate against the orders to socially distance. It’s hurtful, and personal, to nurses who are fighting this and putting their lives at risk to see people ignore the best practices about stopping the spread.

The spirit of nursing is to get the job done and help the people who are vulnerable. I’ve never seen a time quite like this as a nurse. For our students, I think it’s certainly a frightening time but also rewarding to be able to feel pride that this is their chosen profession, and for others in the public to see nursing for what it has always been. That’s reaffirming.