‘I felt compelled to help”: Surge of ex-nurses seeks refresher course at WSU Spokane

A refresher course for nurses has drawn a surge of applicants at Washington State University’s College of Nursing in Spokane.

Susan Rossetti, the college’s professional development director, said the spike includes about 20 applicants since February, with a majority in recent weeks. Normally, she might get material from two or three people a month seeking to refresh skills after letting their nurse licenses lapse.

Rossetti credits the rise to a calling, that many former nurses feel compelled to help because of the current health crisis caused by COVID-19.

“They just keep pouring in,” Rossetti said Wednesday. “One applicant told me she just can’t sleep because she feels like she should be out there.”

About half of the calls and applications are from nurses who are military-retired. The other half are from nurses who let their licenses lapse because they decided to say home with kids or for other personal reasons.

Under state rules, nurses who have let their licenses lapse or become inactive must take a refresher course before they can practice again.

Marcia Hess, 41, worked 10 years as a community nurse with disabled adults. She applied to the program in February after nine years away to raise children. She felt a calling at first because of widespread nurse shortages, but COVID-19 has made her feel even more compelled, she said.

“My motivation in going back into the workforce is to serve the community,” Hess said. “I’m seeing a need and hearing about nurse shortages. Even though it was not at first totally related to the coronavirus, that does make a difference in wanting to reach out and help.”

Rossetti said the program works to ensure that nurses who have stepped away for a time get updated, evidence-based knowledge for a clinical setting. It has a “handful” of students required to take the course to satisfy disciplinary requirements of the state Department of Health.

“Typically, what our program does is it’s for people who have put their license in inactive status because they didn’t want to let their license go,” Rossetti said.

“Some have expired licenses, which means they didn’t fulfill the continuing education that’s required every two years by the state. Those are usually parents – both male and female – who stayed home with kids or for other life events.”

Many of the new applicants live across Washington state, including in the Seattle area and central Washington.

The RN refresher has three parts – an online theory course, a two-day skills review on campus and 160 hours of bedside clinical experience – mandated by state law.

New applicants can start now on the theory, but the state’s coronavirus restrictions are affecting the other two parts of requirements under the state’s “Stay Home, Stay Healthy” order.

For the refresher course, program coordinators have asked the state for a change to allow the college to substitute online simulations for up to half of the in-person clinical hours.

The simulations require exercises with a virtual patient that involve critical-thinking skills, asking patient questions, assessment work and some equipment use, Rossetti said.

“We have asked for half of the required 160 hours of bedside clinical to be allowed to have 80 hours as virtual simulation, if approved, and the other 80 hours would be direct bedside care,” she said.

“I’m hoping to get an answer by the end of this week,” she continued, while adding that DOH is inundated. “Realistically, I don’t know how long it will take. I know they are doing their due diligence.”

Eve Stern, 63, who lives in Lake Stevens, is newly accepted into the program after most recently working as a medical esthetician. Previously, she had a career as a registered nurse in pediatric oncology and then nursing administration.

She described that she felt affected by watching the COVID-19 situation in New York. When a call went out to retired health care professionals, she felt the need to contribute in Washington.

“I did my study in New York and got my BSN from the Columbia University, so many of my former schoolmates have been dramatically affected by the nursing shortage and the situation of COVID in New York,” Stern said.

“I felt compelled to help but couldn’t with where my skills are. It’s been years, so I absolutely need a refresher course. I just have a particular soft spot and interest for the whole geriatrics side of this epidemic. I can give so much more to them in that experience than I could when I was in my 20s.”

Rossetti also circled back to a nationwide nurse shortage for years, and how this surge can bring more back to the profession. Once people complete course requirements that are certified by the college, they can apply to the state to reissue their license.

Prior to February, the program had 30 people in various stages of completing the course, she said. They also are held back from clinical and skills work now until restrictions are lifted. The whole course can take up to a year to complete, and some students might have to get an extension.

For all nursing students, the college suspended clinical experiences in March for safety and to help hospitals and clinics conserve resources. That also frees up staff nurses who mentor students.

Despite current events that are requiring technical solutions, it makes sense to do some clinical experience online, Rossetti said. Studies have shown virtual simulation can be effective to advance skills and critical thinking. For example, certain scenarios have an avatar as the nurse on the screen.

“You go to the beside, ask all the assessment questions, use a stethoscope on the patient. You go through the nursing process, and it will give real-time feedback, like you didn’t ask this question or you didn’t put your stethoscope in this spot,” Rossetti said.

“I am holding my breath for approval, so we can move the applicants forward without compromising the integrity of the WSU refresher program or the RN licensure itself. We are still following the guidelines to make sure nurses are practicing safely.”