HealthApril 25, 2020

Post COVID-19 - Helping students prepare for secondary surge needs

By: Martin Mufich MSN, RN, NHDP-BC, CHSE
Texas A&M University
Clinical Assistant Professor | College of Nursing

As the U.S. and the world react to the COVID-19 pandemic, this is a challenging time in healthcare.  Resources and personnel are stretched to the max and many states are allowing early graduation from nursing programs or relaxing NCLEX restrictions to help more nurses join the workforce during this time of need.

But what happens as things return to normal, or what may indeed be a “new normal?”  Before that occurs, there will be a secondary surge of patients requiring help.  What is a secondary surge?  A secondary surge occurs after a disaster when there is a sudden increase in the need for healthcare for those exposed to the disaster.  When we think of disasters and response, many times we focus on the initial days to weeks after a disaster strikes, when there is an attempt to alleviate the immediate impact of the event.  Few disaster plans include adequate preparation for a secondary surge, which can last weeks to months.

What components of a disaster event could constitute a secondary surge?  A disaster may have affected a vulnerable population such as low-income, chronically ill, physically or mentally disabled, uninsured, and/or ethnic minorities.  There may be a loss of medical infrastructure, such as a hospital or medical centers being destroyed.  Yet another consideration is the type of disaster.  If the disaster was a hurricane and wide-spread flooding occurred, groundwater may become polluted, causing illness and the need for medical care.

How can nursing students and faculty help out when a secondary surge takes place?  They can provide additional staffing and “boots on the ground” when it is most needed.  This being said, issues for nursing faculty and administration to consider include: 

  • Are the nursing students, and faculty for that matter, adequately trained on the tasks being requested?  An example would be a mass immunization event.  Just because students passed their injection checkoff using a pad, doesn’t mean they are ready to actually inject a person.  If it has been months since they had their checkoff, just-in-time training to refresh their knowledge of proper protocol and psychomotor skill should be done

  • Do the tasks requested fit nursing program objectives, and if so, would students enrolled in a particular course derive the most benefit?  Would the activity warrant granting clinical hours for that course?  If students receive “service” or “leadership” credit in their program, this may not be such an issue.  

  • Have the students completed the proper organizational training to facilitate helping?  There are response entities that require a person to complete their training before being allowed to assist.  For example, in the community health course at our college, students who are interested in volunteering must complete Red Cross sheltering training modules, including a background check.  

  • What about students and/or faculty who, for whatever reason, decline to help?  These students need to continue on their program of work, so faculty must be in place to provide this training.

  • Student safety is paramount!  While the idea of trained students at the front lines appeals to some, this is not appropriate.  We have to proactively safeguard both the physical and mental health of our nursing students.  

  • Plan, plan, plan.  Advocate for a committee to establish a protocol for when students and faculty are asked to deploy.  Be sure these plans include memorandums of understanding with the entities that may need your services.

  • While nursing students can be an invaluable resource during a secondary surge, these students can also be just as valuable contributing to the other facets of disaster management: preparedness, mitigation and recovery.  Consider implementing this education in your community health course, weave in each course, or as a standalone disaster nursing elective.

This blog post began with a discussion of the current COVID-19 pandemic.  A secondary surge will most likely occur as sheltering in place orders and social distancing lessen.  What makes this challenge unique is determining when it’s safe for our students to help.