UTMB School of Nursing

A new telehealth certificate program being developed at UTMB School of Nursing aims to improve care for patients in rural areas, where there are often not enough health care professionals to meet the communities' needs.

Innovations in Healthcare Delivery in Rural and Underserved Communities: A Stackable Telehealth Certificate has been funded by the Texas Higher Education Coordinating Board (THECB) through the Accelerating Credentials of Purpose and Value Grant Program. Dr. Kristen Starnes-Ott, director, and Dr. Jacquelyn Svoboda, co-director, are working on course development with plans to launch in January 2023.

The shortage of trained health care professionals in rural areas was a problem prior to COVID-19, but as Dr. Starnes-Ott says, The COVID-19 pandemic only exacerbated this problem and highlighted the inadequacies of our current healthcare system to reach the most vulnerable communities in need.

According to the Texas Rural Health Association and Rural Health Hub, there are 64 counties in the state without a hospital, 25 counties without a physician, and 75% of counties are designated as Health Professional Shortage Areas (HPSA). For telehealth to be a widely adopted solution across Texas, providers need resources, education, and support to eliminate barriers and successfully implement telehealth tools into modern healthcare practice, Dr. Starnes-Ott says.

She points out that many health care institutions shifted to a telehealth model as an emergency measure when the pandemic began, but much was done without training. With proper preparation, training, and implementation, she says, telehealth has great potential to help patients receive needed care in areas with a shortage of health care providers.

The SON's program will consist of a three-semester (12 months), nine-credit certificate offering evidence-based techniques in telehealth patient presentation, telehealth etiquette, and telehealth coordination. It will utilize the four Ps of telehealth: planning, preparing, providing, and performance evaluation.

These foundational pillars will guide the development and implementation of the program, which will include synchronous and asynchronous online sessions, as well as modular engagement with standardized patient encounters to provide collaborative, competency-based practicum opportunities. The University of Texas Virtual Health Network, which supports UT System campuses in leveraging technology to improve health care, is a consortium partner in the program.

Individuals from all health care disciplines who have direct patient care roles and a minimum of a bachelor's degree are encouraged to apply. Preference will be placed on applicants from rural health providers in Texas.

The SON is also partnering with Texas Area Health Education Centers (AHEC) East, which links 100 East Texas counties and more than 18 million people to community health workforce development, health opportunities, and resources. Through this partnership, the SON may identify and market to potential applicants that are interested in starting or enhancing their telehealth programs in rural areas and clinics.

The program directors anticipate admitting 20 students this Fall to begin the program in January.

Upon completion of the program, students will earn a certificate. Credits earned may then be applied toward a graduate degree. However, the program is also designed to be beneficial on its own, equipping healthcare providers with tools to better meet rural communities' healthcare needs.

If the student completes the entire certificate offering, the offering will culminate in a 'toolkit' for the student to start a telehealth program in a patient care clinic, Dr. Starnes-Ott said.

Dr. Svoboda says, By utilizing innovative strategies and platforms, students will strengthen their confidence and their ability to apply telehealth in clinical practice settings.

Applications for the program will open this Fall. Visit the SON's Certificates page to learn more.

UTMB School of Nursing is extremely proud of our alumni who are working hard on the front lines against COVID-19. Loan Do, who graduated from our BSN program in Spring 2019, recently shared her experience working in one of the areas hardest hit by COVID-19, New York City. We are thankful to Loan for her commitment and dedication to serving patients, and for allowing us to share her impactful story.

On a Saturday afternoon in March, I took a huge leap of faith by making the decision to go fight as a front-line nurse in the city that needed my help the most during this pandemic. New York City was being hit hard by the Coronavirus with deaths rising every day. The health care system was overwhelmed and overworked as the patients were flooding into the emergency department and intensive care units.

Before this travel assignment, I was an ICU nurse in the Texas Medical Center with 8 months of critical care experience. Making the decision to go to New York wasn't hard, because I knew I was called to do this. I knew that this experience was going to help make a difference, even if it was a small one. Doing this was important to me because I knew that this city needed my help and my sacrifice. My first week in NYC was one of the toughest weeks I have ever experienced while being a nurse. I came home every night with a heavy heart and most days, it felt as if doing my best wasn't ever going to be enough. It was getting harder to see the light at the end of the tunnel. Was this ever going to get better? When will this pandemic end? How many people have to lose their lives to this deadly virus?

I was working at one of the hospitals that was hit the worst, and I could vividly remember the week when the outbreak was peaking. The ICU nurses were taking care of up to 7-10 patients when normally, the nurse to patient ratio is ideally 1:2 in the ICU. Units that were originally outpatient clinics or Med/Surg floors were being converted into makeshift COVID19 ICUs. Within a short amount of time, the world turned into something you would see in a movie... it was pure chaos in the hospitals. The city that never sleeps turned eerie- no one on the streets, all the stores were closed, and Times Square was empty.

I graduated from The University of Texas Medical Branch in Spring 2019. It's ironic how I ended up taking care of critically ill patients at the epicenter of this pandemic, because being an intensive care nurse was not even on my radar whenever I started nursing school. I thank UTMB School of Nursing, along with all the clinical experience it has given me to open my eyes to the world of opportunities. It guided me to do what I'm most passionate about- critical care.

More than ever, I am so proud that I have chosen this profession and that this profession has chosen me. It truly is a beautiful thing when you can say that your career and passion come together. I have to say, it isn't always beautiful and glamorous. There were countless moments where I couldn't hold it together anymore and would fall apart on the bus ride home, in the medication room, or in my hotel room. There were moments where I had to hold it together for patients and their families during the last FaceTime call or during post-mortem care because there were six other patients that still needed my focus, attention, and energy afterwards. I had skin breakdown on my nose from wearing an N-95 mask for over 14 hours each day for 21 days straight and dry cracks that bled on the back of my hands from washing and sanitizing them so often. Despite the challenges, I don't regret this experience one bit, and I would do it all over again.

This experience not only helped me grow as a nurse, but it also humbled me. Saying it has challenged me physically, mentally, and emotionally is an understatement. With that being said, I am inspired and honored to have worked with so many other nurses and essential workers who empowered me. I am uncertain of what the future holds, but I know that it's important to take things one day at a time and eventually, we will realize all this hard work was not in vain. Thank you to all of our health care heroes who continue to fight in the front lines every single day. To all the nurses who selflessly choose to come to work to take care of others during this tough time, don't give up- we're all in this together.

When the call to help at a COVID-19 screening center came to UTMB School of Nursing, our students answered in the spirit of service - exactly as their nursing school training has prepared them.

Dr. Rebeka Watson Campbell, Clinical Capstone course director, saw an excellent opportunity for BSN Capstone students to get involved in an emergency response endeavor. After an application and vetting process, about 50 senior-level students were selected and trained to provide telephone screening services at the call center organized by Harris Health.

Within days, the students were actively involved in prioritizing and scheduling patients for testing according to their reported exposure and symptoms - thus preventing a first-come, first-serve process, and ensuring testing based on need, Dr. Watson Campbell said.

So far, the students have volunteered nearly 800 hours. Their efforts have benefited patients seeking testing, health care institutions administering tests and the students themselves, as they have been able to apply their education in the real world.

It was a great opportunity for us as students to utilize our skills and be able to offer support to the community during a time of crisis, student Sharina Mears said.

Her classmate Leslie Garcia concurred. Most of the patients I spoke to thanked me for guiding them through the COVID-19 assessment, she said. It felt good giving back to the community.

It was great to know that I was able to help people find some answers during this vulnerable time, student Helen Le said.

The opportunity enabled our students to demonstrate their adaptability to the ever-changing health care landscape and gain valuable experience serving in a crisis - experience that will serve them well in their future careers.

Each semester, Capstone students support their community through opportunities like Tall Ships, ARTober Fest and Dickens on the Strand. In the spring, Capstone students worked with UTMB and the Galveston County Health District to conduct two major disaster simulations.

These volunteer opportunities are instrumental in helping to mold our students into professional nurses and integral parts of our community, Dr. Watson Campbell said.

Camp Blessing 2019

UTMB School of Nursing (SON) offers a variety of high-impact opportunities that shape the educational experience of our students and inform their nursing practice. For the past 10 years, BSN students, in their pediatrics course, have had the opportunity to fulfill their clinical hours at Camp Blessing, a summer camp for children with physical, developmental or intellectual disabilities. Campers are thrilled to participate in the barrier-free gamut of activities including: horseback riding, canoeing, fishing, ropes course, crafts, sports, water games and more. This summer, 21 BSN students were selected to complete their pediatric nursing clinical rotation at Camp Blessing, supervised by 2 Pediatric nursing faculty.

Students were responsible for the physical, social, psychological, and spiritual needs of their campers throughout the week. They provided continuous care for their campers, assisting with activities of daily living, camp activities, and any necessary medical care. They performed clinical skills such as, medication administration, seizure management, g-tube feedings, and administered injections. Students were challenged in their clinical decision-making skills in a fast paced, non-traditional environment. They also served as a medical/nursing resource to non-medical volunteers in their cabins.

I was a little nervous at first on how to care for children of varying abilities. I wanted to make sure I did everything right, says Milan. After four weeks in her pediatrics course, and attending the required pre-camp preparation sessions, she felt more confident and excited to serve where she was needed. I was grateful that our faculty members, the cabin leaders and camp administrators prepared us well.

We felt really proud to be from UTMB. Everyone there knew that we were nursing students and that we were learning. They taught us the best communication styles, and we provided a valuable perspective from a health care lens. It was a collaborative effort and we felt so grateful to help in any way we could, Milan continued.

Faculty members, Shelly Nalbone, MS, APRN, CPNP and Laura Butler, MS, RN mentored the 21 students during this experience. During the week, our students were able to creatively negotiate controlled choices with their campers and they navigated through numerous challenging experiences with special needs children and teens. Although this is not a traditional hospital based clinical rotation, the students were able to apply clinical knowledge into practice throughout the week and truly live the 'art of nursing'. A non-traditional clinical experience is an excellent opportunity for students to showcase their innate abilities to connect with people and each of them rose to the occasion! All of these skills will serve the students well as they transition into their careers as professional nurses. We are so proud of the knowledge and empathy that these students attained at Camp Blessing.

While only 21 students attended Camp Blessing, their classmates supported their efforts by writing encouraging letters to their classmates, helping to collect donations for the camp, and raised $3,300 for camper scholarships. Camp Blessing is a group effort by the entire cohort, says Bonnie K. Webster MS, RN, BC, the pediatric nursing course coordinator.

The opportunity to serve at Camp Blessing and complete my pediatric clinical here was the primary reason I applied and accepted admissions to UTMB School of Nursing. I heard about this from my peers from Texas A&M who previously graduated from UTMB and this opportunity was a convincing factor for me," Lexie explained. "And the experience was so much more than I imagined. I feel more prepared to work in pediatrics. This was the most empowering and challenging thing I have ever done. Lexie has always wanted to work in pediatrics, but now feels more confident that a career in pediatrics is her calling. I have a better perspective on how to be supportive of the family. The camp did a great job instilling confidence in everyone.

Upon returning from camp, the students presented their evidence-based practice presentations covering topics such as: the use of homeopathic supplements in children with chronic illness, impact of non-medical interventions on children, and the psychological impact of a child who has a special need. The students used their experiences at Camp Blessing to integrate their coursework with their clinical experience to educate their peers on the topics. The entire semester was very inspiring, said Ms. Webster.

The Camp Blessing experience is life changing for not only the campers, but our students as well. This was evident in their evaluation of this clinical experience. Quotes from these evaluations include:

I truly understood what it means to be a patient's advocate because he relied on me for his physical, emotional, and mental needs for the entire week. I observed just how much they can express & how they feel without words.

This pediatric rotation was the most challenging week I had ever experienced. The growth that came from pushing myself and being completely out of my comfort zone is exponential and I plan to use these skills throughout my nursing profession. I would recommend anyone, especially in the nursing field, to spend a week caring holistically for a special needs child, because it creates an awareness inside of you that I think is hard to find elsewhere.

The UTMB School of Nursing will continue to partner with Camp Blessing each summer and we look forward to the opportunity to contribute again next year.