A CONVERSATION WITH SCHOOL OF NURSING DEAN JANE GEORGES
Jane Georges, PhD, became the fourth dean of the Hahn School of Nursing and Health Science in July 2018. She spoke with USD Magazine in mid-April 2020 for a wide-ranging conversation that included her thoughts about the future of nursing education in the wake of COVID-19 and the ways that the nursing community is rising to meet the challenges of the pandemic.
Q: How are you? Is it challenging for you to work remotely? Personally, I find it sort of lonely.
A: I am finding that to be true as well. I miss hearing people laugh. It’s funny how you don’t know what you miss until it’s gone. But we try to stay close to our faculty and our students. We’re doing fine, I think.
Q: How are you and how your students and faculty are adjusting?
A: The thing that makes our school really unique is that we are a graduate school of nursing and we take great pride in that. Our students — whether they’re in our master’s entry program in nursing (MEPN) program, doctor of nursing practice (DNP) or PhD programs — are here to get a graduate degree.
One thing that makes us unique at USD is that we have about 450 students, and the vast majority of them are working nursing professionals. What has become very clear to all of us in the past few weeks is that our students are working on the front lines, right now, saving lives in San Diego. They’re working in critical care settings, they’re working in community health settings, and what has really given me a lot of pride in our students is that they’re doing this work so very unselfishly.
This is a time when enormous stresses are being put on everyone. They’re continuing their studies remotely in our school while doing some extremely demanding and actually heroic jobs.
Q: I saw the video of first-year DNP student Elena Johns. Has she left for New York yet?
A: Yes, she felt a real need to go to New York personally and offer her help to those nurses. That kind of unselfishness is really congruent with what our school is about. We like to say that our school of nursing is like no other. And one reason is that our emphasis is on excellence in nursing education. And another reason is our open emphasis on compassion and caring.
In Elena’s case, we don’t just talk about it, we live that way. I’m so proud that she is actually representative of the working nursing professionals that come to us for a higher degree. It’s not about them. It’s about their patients, it’s about compassion and it’s about doing the right thing.
Q: I understand that you’re personally affected by COVID-19 because you have a family member that you’re unable to visit?
A: Yes. My older sister is disabled and in an assisted living facility, and as a result of this crisis, I can no longer see her in person. I have not seen a dearly loved family member in some weeks now, and I feel that. It makes me understand now, even more than I did before, the role that nurses play in being there for patients. Everybody needs that human presence, and in a time when family can’t be there, nurses play that role of being there to show human kindness so that folks are not alone on their healthcare journey.
Nurses, throughout the U.S., are doing creative and wonderful things. Using Zoom or whatever they can to connect families and patients. But more than anything, at this point, the critical care setting is more like a war zone, where there may not be time for that. But nurses can give that assurance to families that ‘Your loved one is not alone and will not be alone in this whole experience.’
Nurses are the only profession who are with the patient 24 hours a day. Physicians come in, make an assessment, write their orders and leave. We’re there with that patient for 8 or 12 hours at a time, all day, every day. And that makes the scope of nursing very different. We have to have those interpersonal skills, which are really essential for human beings to heal and get better. Even at the end of life, when we know the outcome will not be good, to be there with them, and have a nursing presence alongside of them, is very powerful.
Q: Have you spoken with any nursing alumni — perhaps administrators at local hospitals — about how things are going for them?
A: The data are preliminary but I’m very happy to say that self-isolation seems to be flattening the curve. We’ve been very fortunate in San Diego; it’s a tribute to our administrators here that they were paying attention to this and they took actions early on. My hope and my prayer for all of San Diego at this point is that we won’t be seeing the tragedy which we could have been seeing. That’s a tribute to all our health care professionals, including our county public health officials. However, it really is too early to say for sure.
Q: The question that everybody has is: When? When can we go back to normal life? People just want to be back to normal.
A: That’s natural for all of us as humans. We’re going through an unprecedented experience. Nobody has a crystal ball. The good news — and I think we need to focus on the positive — is that Californians, by and large, are doing a really great job of flattening the curve. They really stepped up and, at great personal sacrifice, are stopping the spread of this terrible virus. With that said, I think we look to the Centers for Disease Control and Prevention (CDC) and their scientists to help us understand what that kind of return to normal is going to look like.
It’s important that we all take a deep breath and look at the facts. The very positive fact today is that the curve is definitely flattening in California. As we find out more about the physiology of having this virus, what it looks like when one recovers and what it looks like in terms of antibodies, we’ll have more answers to that.
Q: Knowing that we don’t have all the data, if you were to hazard a guess, would you think we’d be back on campus for the fall semester?
A: I can’t say one way or another. Of course, President Harris and the leadership team are responsible for making those decisions. Because this is unprecedented, it’s very difficult even for those of us who are trained in epidemiology to have a sense of when it will be OK to go back.
There are a lot of terms being thrown around like ‘herd immunity.’ I don’t know what that looks like in the real world, and neither do the physicians and scientists that I’ve spoken to. I think the coming months are going to give us a much better picture of what life is going to look like.
Q: For nursing in particular, there’s practical experience needed to earn graduate degrees. How does that work with remote learning?
A: Clinical experience is actually the heart and soul of nursing education at every level. We’re very lucky that we have the wonderful Dickinson Family Simulation Center at our school, which is able to simulate all kinds of outcomes, both in primary care and acute care.
Associate Dean for Advanced Practice Programs Karen Macauley has worked very hard to make sure that doctor of nursing practice students are involved in telehealth for their clinical experiences this semester. Telehealth is the wave of the future; it’s the ability of a primary care clinician to assess and diagnose a patient using technological means such as Zoom or other apps that are available.
In a way, this crisis has provided us with an opportunity to jump right in and get our students involved with telehealth and giving care in that way. We know that it’s not possible right now for our pre-licensure students to be in clinical settings, and we’re making other adjustments to our curriculum to ensure that their education is not interrupted.
We are slightly adjusting our curriculum so that theory courses, such as the pre-licensure program headed by Associate Dean Kathy Marsh, can perhaps be preloaded and conducted via remote learning. Then, hopefully, clinical experiences can be opened up later this year.
We’re doing our best to be sure that nursing education is not interrupted. We’re also working to make sure that the experiences students have in our simulation center, which is really incredible, can be conducted in a remote fashion. We’re being as creative as we can so that we can continue to graduate nurses who can immediately give a lot of much-needed care in our community.
Q: Are you concerned about the possibility of medical professionals starting to fall ill themselves?
A: It’s possible. One scenario that everyone is looking at — the American Association of Colleges of Nursing is aware that this may happen — is that should the American nursing workforce become inadequate, the AACN has asked us to be prepared to step in as nurse faculty and for our students to give care. We are ready and willing to do that. But at this point, I don’t foresee our American nursing workforce being overwhelmed. I think we’re going to be OK.
Q: What are your thoughts about the shortage of masks and Personal Protective Equipment (PPE)? Is this something you or your colleagues are concerned about?
A: Nurses throughout the U.S. are concerned about this. We’ve done our part in our school by donating a large portion of the PPE that we have for training purposes to local clinical settings and our clinical partners. We’ve also been working with faculty in the Shiley-Marcos School of Engineering; they are able to make plastic face shields using a 3-D computer. Although it’s a slow process, we’ve been able to funnel those face shields to our clinical partners.
Q: Thank you so much, Dean Georges. I really appreciate your taking the time to speak to our readers out of your busy day. — Julene Snyder