UNLV nursing student Acacia Herndon poses for a photo outside Centennial Hills Hospital Thursday, Jan. 27, 2022, where she will be working as a nurse apprentice while finishing up her degree.
Tuesday, Feb. 1, 2022 | 2 a.m.
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UNLV nursing student Acacia Herndon doesn’t graduate until June, but she’s already getting a jump on her career and providing some much-needed assistance at Centennial Hills Hospital during the stressful COVID-19 pandemic.
Herndon answered the call from state health officials for advanced students to help relieve staffing shortages at Las Vegas area hospitals, including Centennial Hills. The highly transmissible omicron variant of COVID-19 is not only crowding the valley’s hospitals, it’s also sidelining many healthcare workers.
In her capacity as a nurse apprentice, Herndon is able to do routine but crucial tasks like insert feeding tubes through patients’ noses, start intravenous fluids and insert urinary catheters. She’s excited for the hands-on experience.
“They are really wanting you to become an independent nurse,” she said of her new co-workers.
At Centennial Hills, Herndon will float between departments doing entry-level tasks to free up certified nurses whose expert skills are in critical demand — especially on the COVID ward.
Intensive care beds statewide have been at least 90% occupied with patients suffering from all maladies for the better part of January — and projections by the Nevada Hospital Association show that the peak might not have yet hit Southern Nevada. Officials say full ICU capacity could hit here around mid-February. By then, about three-quarters of those ICU patients could have COVID.
This comes as hospital staffing has hovered at “crisis” levels in Southern Nevada for four weeks running, according to the hospital association. The group doesn’t put a number on “crisis” but generally defines it as “conditions that limit the ability to provide adequate patient care.”
The designation prompted Gov. Steve Sisolak to appeal for more hands on deck — whether through the state’s Battle Born Medical Corps, a volunteer program launched during the pandemic, or through the nurse apprentice program.
Registered nurse Cyndi Johnson, nursing leader for HCA’s Far West Division, said HCA’s three Las Vegas hospitals — Sunrise Hospital and Medical Center, Mountain View Hospital and Southern Hills Hospital — typically had about 20 apprentices between them at any given time before the pandemic.
They now have about 100, and Johnson said she would take on “as many that will come.”
Cathy Dinauer, executive director of the Nevada State Board of Nursing, said the apprentice program had been around for more than 20 years. All nurse apprentices are nursing students, but not all nursing students are apprentices. They become “apprentices” upon being hired by a facility. Although they are paid hospital employees, apprentice nurses can only do what they’ve already been taught, as verified by their schools.
At HCA, Johnson said, students must have completed their second semester of nursing school.
“It’s not an on-the-job training,” Dinauer said. “They can only perform those skills that they have been deemed competent to do in their program.”
Apprentice nurses, acting independently, can help patients with hygiene and grooming, change bandages, remove stitches and staples, start IV fluids and insert and remove catheters, among other tasks. With direct supervision from a licensed nurse, they can give medications.
Currently, the HCA and Valley Health System chains, representing nine Las Vegas-area medical centers combined, and Southern Nevada Adult Mental Health Services hire apprentice nurses. Hospitals in northern and rural Nevada also accept apprentices. There are about 100 open apprentice positions statewide, with the capacity to add another 150, the governor’s office says. (Separately, there are about 1,900 nurses enrolled in the State Emergency Registry of Volunteers-Nevada, which includes the Battle Born Medical Corps.)
Angela Silvestri-Elmore, a UNLV nursing professor and family nurse practitioner, said not all nurses are instructors like her and may not be so sure about supervising apprentices. But students are an underutilized group, she said.
“How do we start thinking about nursing students as resources versus as a burden due to the learning needs that they have?” she said.
With some practical skills under their belts and a natural desire to help, nursing students are ideal, she said.
“These are people that have some level of background and experience in nursing and in health care, and as of now people are being asked to volunteer that have no background,” Silvestri-Elmore said.
Brian Oxhall, dean of Henderson’s Roseman University College of Nursing, said students have responded eagerly to the increased promotion of the apprentice option. It augments the 696 hours of school-organized clinical rotations that Roseman students need to graduate.
Field training teaches students to read people, detect nuance, and see how diseases can present differently, he said.
“There’s an art to nursing,” Oxhall said. “It’s a practice.”
Herndon, who is doing short clinicals in maternity and obstetrics, psychiatry and gerontology this spring, said her apprenticeship at Centennial Hills would give her deeper training.
People are under a trusted nurse’s care when they’re at their most vulnerable, she said, and it’s an honor to serve them.
“I can guarantee, we are all eager to be an apprentice if we can,” she said.
