Home News and Features ‘The Pipeline’: CVMC’s Nurse Trainees Learning Under Pandemic Pressure

‘The Pipeline’: CVMC’s Nurse Trainees Learning Under Pandemic Pressure

Emily McCall recently went through Central Vermont Medical Center’s Pathways Program, completing training as a licensed nursing assistant. Photo by John Lazenby.
Emily McCall, a licensed nursing assistant at Central Vermont Medical Center, arrived at work one morning in March 2019 unaware that her life and her career were about to be upended — and that it would be a good thing.

The agent of that transformation was the hospital’s Pathways Program. Informally, employees and administrators call it the “pipeline,” because, as a work-study program that trains and educates staff members to advance their medical careers, it provides a pipeline of new, urgently needed personnel to fill vacant nursing positions. Nursing shortages were a problem for hospitals before the COVID-19 pandemic erupted; they have only worsened, caused not only by an elevated need for healthcare workers as patient volumes exploded, but also by burnout, as nurses, doctors, and technicians reached their limit and retired or took work elsewhere.

On that morning in 2019, Emily McCall, now 28, had worked at the hospital for about five years. She grew up in Braintree, playing with friends in the park by the village’s famous floating bridge. She graduated from the Randolph Technical Career Center in 2011, and by age 19 found herself working at a restaurant and starting a family. But her sister, Elizabeth Davidson, implored her to return to the Tech Center as an adult student, for training as a licensed nursing assistant (LNA), as she (Elizabeth) had done.

Healthcare was a family tradition. Elizabeth now works at Green Mountain Family Practice, a Central Vermont Medical Center affiliate, but the connection goes back a couple of generations.

“My mom was a medical transcriptionist in radiology,” says Emily, and though Emily wasn’t aware of it until later, her grandmother had once worked as a nurse’s aide. “Taking care of people has always been a family thing.”

It had been a tough slog getting through the LNA program, commuting to Randolph from Rochester, where she and her husband and sons lived at the time. But it paid off, with steady employment in work she felt was valuable at the hospital in Berlin.

In 2019 she had heard about the hospital’s new Licensed Practical Nurse (LPN) Pathways Program, but hadn’t considered it. “When it started it was only open to Woodridge RNAs,” she explains, meaning restorative nursing assistants at the adjacent rehabilitation and nursing home. “I’ve spent the majority of my career in pediatrics, so I didn’t qualify.

“But something changed, and I came into work on a Monday morning after the email had gone out, and I had three or four copies of it on my desk that my coworkers had printed out, and they’d all highlighted stuff and said, ‘Do it! Do it! Do it!’”

It was daunting, but she recognized the opportunity the Pathways Program represented. 

“I mean, I’m a full-time mom, a full-time employee, I’m a homeowner, I’m a wife … I have a lot going on. So finances and time; that was kind of my barrier [in terms of advancing her training and career]. So when this program opened up and they said ‘We’re going to pay you, you’re going to work and learn while you work, and we’re going to have some weekend class time …’ I couldn’t believe it!”

The LPN Pathways Program took just under two years. For classroom and laboratory components, the hospital teams up with the Community College of Vermont and Vermont Technical College. The first year focused on nursing prerequisites: human growth and development, anatomy and physiology, and nutrition. With her specialty in pediatrics, Emily also traveled for training to the birthing-simulation lab at Gifford Medical Center in Randolph.

“That first part of the year everything was great,” she recalls. “The first two prerequisites were finished, and I loved being back in school.

“And then it was about February 2020 when the pandemic hit. There was this huge shift because we’d been doing all our classes in person and going to CCV so we could use their lab there. Suddenly it was like everything stopped. We started doing all our classes online, and that’s hard when you’re learning about the body and all its functions. It was a huge challenge getting through that.”

But summer arrived, and with it a two-month break from course work.

 “Then came August [2020],” says Emily, “and it was go time, the LPN year. And let me tell you it was the hardest year of my life! You go into it thinking, ‘Okay, I’m going to have class time on Friday, Saturday, and Sunday, and I’ll have my clinicals early on those mornings’ — clinicals are when you’re thrown into all the activities on the floor, so we’d go to the hospital and have our teachers with us teaching how to care for the patients in real time. 

“But because of the pandemic it’s a lot different from traditional clinicals — all your PPE, personal protective equipment, and N95 masks the entire time. That was a struggle at first, but it became the norm. A lot of the clinicals were changed, just to work around the pandemic background.”

COVID-19, she says, was a constant for the LPN students, and an added stress, whether they were working in their specialties (Emily continued in pediatrics, where she had specialized as a nursing assistant) or anywhere in the hospital. And the work was rigorous. 

“The LPN year was straight eleven months, no breaks to speak of. Very, very accelerated. Clinicals on the weekends, school after the clinicals, and all the while everything is changing around you, so you’re adjusting as you go.”

It would have been a challenge under any circumstances. Adding the COVID-19 pandemic intensified it, for the obstacles presented in daily nursing routines and the shifting understanding and protocols to contend with the disease. Patients’ tensions, too, are elevated in this atmosphere, so interactions sometimes can be fraught. Add to that the concerns the LPN candidates had for their families when they returned home after potential exposures at the hospital, and their degrees — which they received in July 2021 — were well earned. 

There were 13 graduates in Emily’s LPN pipeline class. That means there were a dozen personal stories similar to hers: local people (Emily McCall and her family now live in Brookfield) gaining enhanced skills that will benefit themselves and their families, their neighbors in the community, and the hospital that serves them all. 

There will soon be a Pathways Program for the next step — training LPNs to become RNs (registered nurses) — and Emily is considering signing up, after a breather. For now, she’s content to have finished her arduous two years of service, study, and training. Doing so under the stresses of a global pandemic added to the challenges, but trial by fire can have its benefits.

“There were days when I just … I couldn’t see the light at the end of the tunnel. And I was scared; and at work we were learning all this new information, learning about how to better care for our patients, and it all came around full circle. It was constantly evolving, and I feel, personally — this is just my opinion — I feel like the folks that went to school during the pandemic are going to be some of the best nurses in the world. I truly, truly believe that.”