March 18, 2025
Attendee Q&A (Answers provided by speaker Jennifer Walker, RN, MSN, NPD-BC, GERO-BC, NE-BC)
We were honored to host so many engaged professionals for our March 18, 2025 webinar, Addressing the Nursing Shortage Through Technology & Innovation. We received excellent questions from attendees—so many, in fact, that we didn’t have time to answer them all during the live session. Below, our speaker, Jennifer Walker, RN, MSN, NPD-BC, GERO-BC, NE-BC, shares thoughtful responses to the remaining questions submitted by participants. We hope you find these insights helpful as you continue to navigate today’s evolving healthcare workforce challenges.
Question: Why are facilities not accepting student nurses for clinical experience?
Answer: There is a high demand for a finite number of units available to accommodate students, making availability competitive. In many areas, there are multiple nursing schools, ADN programs, RN programs, and APRN programs. Hospitals have only a certain set of units where students can practice. In my situation, I had to take students on off shifts and weekends, etc. The problem with that is not much happens on night shifts, therefore students on night shifts do not get as many experiences as they would on day shifts.
Furthering the situation is the ongoing nursing shortage. As nursing students progress in their education, they eventually get to where they are paired with a mentor from the hospital to work longer hours and take on more responsibility. In master’s degree programs, this is the sole clinical rotation. With few available preceptors to train students, clinical placement is very difficult. Also, state boards of nursing and accrediting bodies set strict guidelines on student-to-preceptor ratios and clinical hours, limiting flexibility. Additionally, some hospitals may not meet educational institution requirements for clinical training.
Back when I was in nursing school, hospitals had “less sick” patients, which were good for students and teaching. In today’s healthcare environment, hospitals are caring for more critically ill patients, making it difficult for students to practice hands-on skills without compromising patient safety. When hospitals agree to allow students to do clinical rotations, the hospital assumes legal responsibility for students, increasing liability risks. Some institutions limit student access to high-risk areas to minimize potential legal issues. Furthermore, hospitals often prioritize their own nurse residency programs and graduate nurse training over undergraduate clinical placements. Hospitals may also not receive adequate compensation for hosting students, leading to a reluctance to participate in clinical education programs.
Question: What are hospitals doing to bring nurses back to clinical bedside roles who left many years ago for non-clinical RN roles? Reverse burnout in non-clinical roles has me thinking about returning to bedside. Would be great if there was a pathway back considering all the new tech.
Answer: Great question! In my past experiences, I’ve encountered a lot of nurses with active licenses who wanted to return to the bedside role but didn’t quite know where to start. There are many RN return to work programs throughout the country that typically provide guided mentorship at the end of the program. Another good way to remain up-to-date is through Continuing Nursing Education (CNE). While completing CEs to renew your RN license, choose course topics to upskill yourself. CareeSmart has a variety of topics available, and we are currently working on developing a series of courses to hone bedside nursing skills. It may also be helpful to locate a hospital that is willing to allow you to shadow with a mentor.
Question: I’m curious if states allowed nursing students to graduate early during COVID-19?
Answer: I know the COVID-19 pandemic is one reason we are facing a dip in new nurses. However, nursing schools were quick to respond to the limitations for clinical rotations during the pandemic. That was really one of the kickstarts for VR clinical simulation being integrated into nursing school programs. But, to answer your question, I am not 100% sure if they allowed early graduation. To be licensed, they still had to pass NCLEX, and that would be difficult, in my opinion, with an early graduation.
I did some additional research to answer your question, and this is what I found.
During the COVID-19 pandemic, some nursing schools allowed early graduation for students in their final semesters to help address the critical nursing shortage. Many nursing schools allowed students to graduate early if they had completed most of their coursework and clinical requirements. Some states granted emergency waivers allowing students to bypass certain non-essential requirements or complete clinical hours in alternative ways.
Since hospitals limited student access during the pandemic, some nursing boards permitted virtual simulations and case studies to count toward required clinical hours. Some schools replaced in-person clinicals with telehealth experiences or observational experiences.
Many states issued temporary or emergency nursing licenses to allow early graduates to begin working immediately before passing the NCLEX. These temporary licenses were often valid for 6-12 months, requiring nurses to take and pass the NCLEX within that period.
Hospitals facing staff shortages hired early graduates directly, sometimes placing them in accelerated orientation or nurse residency programs to support their transition. The National Council of State Boards of Nursing (NCSBN) and various state nursing boards made temporary adjustments to licensing requirements. Some schools shifted to competency-based assessments rather than strict hour-based requirements.
References:
EPIC Travel Staffing. (2020). https://epictravelstaffing.com/travel-nursing/emergency-licensing/
NCSL. (2020). https://www.ncsl.org/labor-and-employment/covid-19-occupational-licensing-during-public-emergencies
US World News Report. (2020). https://www.usnews.com/education/best-graduate-schools/top-nursing-schools/articles/how-coronavirus-is-affecting-nursing-school-admissions
Vermont Biz. (2020). https://vermontbiz.com/news/2020/april/09/uvm-nursing-students-graduate-early-help-during-pandemic
Question: Are remote nurses fully remote or do they sometimes work bedside as well at the same facility/hospital? I’m wondering if there have been studies done that look at, for example, full time RNs who would do 2 12-hour bedside shifts a week and 1 12-hour remote shift, to decrease the physical burden of bedside nursing and provide an at-home option 1x week, but keep the same pool of RNs who work a combination of bedside and remote. If fully remote nurses, I wonder how this factors into the finances of a hospital, hiring additional staff like this? Perhaps studies will show that there is less turnover and that is where the savings are?
Answer: I would think it depends on the employer, the nurse’s contract, and personal preference. Nurses who do telenursing can either work strictly in a telehealth role or balance it with bedside shifts. Some nurses exclusively work as telenurses, meaning they provide remote patient care, triage, education, and support without bedside responsibilities. These roles are often in insurance companies, telehealth startups, hospitals with virtual care programs, and nurse advice lines.
Some nurses split their time between telehealth and at the bedside. This is probably more common in hospitals that have both in-person and virtual nursing teams, where a nurse may rotate between remote patient monitoring and direct care. I would think some PRN or part-time nurses use telehealth as a supplemental job. Some states do have specific licensure or practice guidelines for telehealth.
If you’re looking to bring this training to your organization or explore custom learning solutions, I’d love to connect.
Here’s a snippet of the webinar. Stay tuned for our next one in June!
