From Student to Vaccinator: How Nursing and Medical Students Tackled COVID-19

Students Jillian Macchia (left) and Brianna O’Sullivan (right) before and after putting on their personal protective equipement for their shifts.

At the start of 2020, university students never thought they’d experience a global pandemic before graduating. Going from regular clinical hours to now vaccinating their community members, nursing and medical students are tasked with helping with the battle against COVID-19 and its spread by administering the vaccines and treating patients.

Going to college during a global pandemic has proven to be no easy feat. Many college students in New York were forced to return home last March believing the sudden outbreak would last a couple weeks, in most cases given an extra week extension of their spring breaks. In other parts of the country, students were notified that the remainder of their spring semester would be held online, leaving the graduating class with little time to process and bid farewell to the last of their on-campus experiences.

For students in the medical field, where hands-on experiences were necessary, many grew concerned about the status of their program. In this rare occasion, clinicals, labs and simulations were halted for months — like at no time before. Even more rare, students were put on the frontline helping save the lives of hundreds, if not thousands, in the battle against COVID-19.

Students made their mark as part of a historic medical corp.

Hospitals around the world grew overcrowded while growing more understaffed. Healthcare workers were working around the clock with some not having gone home for extended periods. The Centers for Disease Control and Prevention lists mitigation strategies to help offer options for staffing shortages. They said healthcare facilities must:Understand their staffing needs and the minimum number of staff needed to provide a safe work environment and safe patient care.”

The CDC said hospitals must “be in communication with local healthcare coalitions, federal, state, and local public health partners (e.g., public health emergency preparedness and response staff) to identify additional HCP (e.g., hiring additional HCP, recruiting retired HCP, using students or volunteers), when needed.”

In the call for help, hundreds of medical students were given the opportunity to graduate early in order to immediately join the frontlines. At Albert Einstein College of Medicine in the Bronx, New York, over 100 medical students graduated a month early in April 2020 during one of the worst global outbreaks. In New York University Grossman School of Medicine, 69 out of 122 volunteered to graduate earlier. Now, a year later, current students are now enrolled to help vaccinate their community.

Mitchell Veith, a third year medical student at the Albert Einstein College of Medicine, has been involved with the Einstein student response which started back in March 2020. The group came forward with volunteerism at the beginning of the pandemic to address the needs such as PPE and food for frontline workers. Veith joined in January when vaccines started to become available. He helps volunteers coordinate hours and shifts, such as to vaccinate or navigate in the clinic- in one of their Outpatient centers in the Montefiore healthcare system, as well as helping with an initiative to put a help desk in another one of their clinic locations so that patients can ask more questions about the vaccine and further address vaccine hesitancy in their community.

Veith explained how communication got impacted and how it opened up between students and their administration. More honest conversations were held that probably wouldn’t have felt the same if the pandemic didn’t occur. He believes the school and Montefiore healthcare system in general did a good job with the vaccination efforts and rising to the big task in the Bronx community which ranks 62 out of the 62 NYS counties in many health outcomes, expectancies and issues.

Janet Galiczewski, clinical professor and director of the accelerated and basic baccalaureate nursing program at Stony Brook University, is a bedside critical care nurse at the Long Island Jewish Medical Center. She worked through the pandemic in the hospital’s Intensive Care Unit. Having been a nurse for 33 years, she said she didn’t feel afraid. Working for Northwell Health, New York state’s largest healthcare provider and private employer, Galiczewski said she knew she’d have everything — the personal protective equipment … she needed.

Dr. Janet Galiczewski (left) and SBU alumni Christina Legotti (right) working in the COVID ICU at Northwell LIJ. Photo courtesy of Stony Brook University School of Nursing.

As of last December Northwell had treated over 101,000 COVID-19 patients. Out of those patients, 16,000 were hospitalized — meaning Northwell treated more patients than any hospital system in the country. Rather than fearing for herself, Galiczewski feared for her family. She moved her family during Spring Break last March down to stay in Florida while she returned to Long Island alone. She spent the next 3 months in isolation working 50–60 hours a week.

From an academic perspective, though, she was concerned how nursing students were going to gain their clinical and hands-on experience.

“My one promise to the students was that they were going to graduate on time. The world needed them. The community needed them as nurses.” — Janet Galiczewski

She then took on the role of being a point person for the all student communication and questions. Emails with updates from the university, classes, and coordinators were sent daily, causing commotion and confusion.

“Things were changing minute by minute. I would send an email saying we’d do something at 8 in the morning, and an hour later the whole plan would change,” she said. With students growing frustrated, Galiczewski held virtual sessions called “Fireside Chats” to help update students and answer more questions — in between her shifts in the ICU.

On-site learning, such as clinicals, were suspended from March to May 2020. During the summer, clinicals resumed normally. With special permission from Stony Brook University, nursing students were allowed to resume on-site lab and simulation experiences in small groups, which continued until a surge of coronavirus cases hit during the winter holidays. Regular clinicals were once again suspended except for psychiatric, pediatrics and obstetrics. Although the spring semester didn’t start until February 1, 2021, Stony Brook Medicine asked nursing students to volunteer earlier. Dozens of students started on January 11 to help in the non-Covid floors of the hospital with the supervision of faculty members due to many nurses being diverted to COVID-19 patients.

Nursing students Brianna O’Sullivan, Nina Ramirez, Jillian Macchia and Brennan Bruschini are all Stony Brook Nursing students who’ve been involved in the vaccination efforts at the university. O’Sullivan, a senior nursing student and president of the Stony Brook Student Nursing Association, got registered through the state in January 2021 to administer vaccines and has volunteered to give university faculty, staff and students their doses on-campus and at community points of distribution. Ramirez, a junior nursing student, started off by doing vaccination registration and data before being signed off as a NYS vaccinator in late February. Since then, Ramirez has been working just as a vaccinator. Macchia is a senior in the Accelerated Baccalaureate Program and the communications director of the Stony Brook Nursing Association. Bruschini, another senior in the ABP, is a member of the community health committee.

They all recall where they were last March as the coronavirus started to spread across the country.

“I remember being in the student health center on March 1 and taking a picture of Cuomo announcing the first confirmed case of coronavirus. It just snowballed from there. Two weeks later we didn’t know what was happening after we came back from spring break, and then we just didn’t come back,” Ramirez said. Visiting her partner in Rochester at the time, she remembers getting the email confirming that students weren’t coming back after the break.

“I remember banging on his door in disbelief saying ‘We’re out! They did it! It happened!’ because everyone was speculating.” As a junior now, this is Ramirez’s first academic year in the program. Back then, she was taking general education classes.

“I was so scared that I was starting fall semester online. I was like, I can’t do nursing school online. I can’t learn how to put an IV online.” — Nina Ramirez

Macchia was down in the Outer Banks during her spring break last year when she heard about stores and restaurants starting to close up here. She later found out she wouldn’t be returning to school for the remainder of her senior year during her trip.

For both junior and senior classes, it was mandatory for them to become NYS vaccinators by late March, which consisted of several modules and in-person evaluation before officially being signed off. After that, students have the decision to either keep working or volunteering in the community. Clinical hours are also earned by volunteering.

O’Sullivan recalls giving several patients both their first and second vaccine doses. “For me, I see many different faces everyday that I’m vaccinating, but these people remember you because it’s such a time right now where we’re a part of history and it’s really cool to have that opportunity as a nursing student. It’s a cool aspect of nursing that we wouldn’t have gotten to see before,” she said.

She added that seeing the reactions of those receiving vaccinations, such as the elderly, was very emotional for them. Some would become or be teary eyed. Many were relieved to finally reunite and be with their families after over a year of isolation.

Brianna O’Sullivan at her station in the Stony Brook POD site. Photo courtesy of Brianna O’Sullivan.

Nursing shifts range anywhere from 4 to 12 hours depending if students want to sign up for more hours and a single vaccinator can give out approximately 50 to 200 shots per shift. The students talked on how they’ve worked with different people nearly every shift varying from people on their first day as vaccinators or those who’ve been on the job since vaccination rollouts started. The state provides vaccinators with breakfast, lunch and dinner. If someone’s on the morning shift, they’d attend mandatory brief staff meetings held at 7:15 in the morning to get debriefed by heads of departments such as registration and clinical staff on expected vaccination counts and general building rules and regulations, typically lasting about 15 minutes before workers and volunteers split up to set up their assigned POD stations.

Bruschini said “Guidelines and rules change all the time and you might not know that not coming in the morning. It’s a big responsibility on the vaccinator to make sure they have all the current information. You could come in one day and the next day it’s totally different.”

Brennan Bruschini (right) with fellow student peers Olivia Todaro (bottom), Francisco Bisono (left), and Damien Chan (top). Photo courtesy of Brennan Bruschini.

Working in registration and data, students have duties such as setting up the paperwork and laptop. When vaccinating, they made sure they have essentials such as bandages, gauzes, and hand sanitizer.

For the safety of the students, staff, and patients, every staff member is required to have surgical face masks on, not the fabric, as well as a face shield to protect the eyes. Gloves are provided and hand sanitizer is placed at every station. PODs supply PPE to those who don’t have it to ensure everyone’s safety. Social distancing is another mandatory measure taken throughout the entire facility.

Although gloves aren’t mandatory as per CDC guidelines, students try to have at least one on incase bleeding occurs.

Brianna O’Sullivan captures what her vaccine station consists of.

“We’re not allowed to touch a bleeding site without gloves on. We can administer the vaccine without gloves, but if the patient starts bleeding, which happens less than you’d expect- at least for my patients it happens at least 25 percent of the time- then the patient themself has to put the gauze on,” Ramirez said.

When it comes to breaks, Ramirez said how they usually allow an hour break for those working long 12 hour shifts. For shorter shifts they don’t mind small breaks unless there’s a long line, although it’s not required.

When it came to her experience Ramirez said, “Not only are the people getting vaccinated super grateful and super nice, I’ve gotten tiny gifts… but the staff is really appreciative that you’re there.”

Macchia talked more about patients who were afraid of the needles. “Every so often you get a patient who just cannot do needles. I feel for the peds nurses since they’re dealing with kids and screaming… but you don’t really expect that with adults. I had that for the first time recently.”

The patient was older in their 50s or 60s and flinched every time Macchia got close. She explained that also posed a safety risk for her as she could’ve punctured herself and how talking patients down can take a lot of effort.

In the PODs, Bruschini explains that given the unique experience, many people come in being extra critical of the vaccine which results in patients being very critical of the vaccinators.

“It’s kinda like customer service in a way. You have to be very professional, polite and give them the answers they need to make them feel comfortable, but not everyone will,” she said.

Brennan Bruschini during one of her shifts.

For Veith, he did multiple navigator roles in the city such as observing people after they got their shots to doing counseling prior to vaccinations and addressing the patient’s or associate’s questions about the vaccines.

“I think a lot of those questions, especially early on in January or February, myself included there was a lot of apprehension about the vaccines just because they were so new and not many people had gotten them at that point. Being able to talk to people and having that spirit of ‘We’re all in this together’, we’re trusting in how far science can take us at this point. I think that’s something that will stick with me,” he said.

Navigating each of their individual experiences came with a certain amount of sacrifice in order to protect themselves as well as their loved ones. For Ramirez, she hasn’t been able to see her mother, who lives internationally, in a year and a half. “I tried to see her over winter break. Didn’t work. I tried to go over summer. Didn’t work. Spring break is nonexistent so I can’t see my family.”

Bruschini mentioned how she comes from a family of healthcare workers and first responders. It was a part of their jobs and they knew they were at more risk of being exposed. The best they did was look out for each other and offer help if they needed anything.

For Veith, the pandemic has been a reminder to focus more on what he already had, such as his health, getting outside more and spending more time with his dog and his now fiance to which he proposed during the pandemic.

Despite losing out on many experiences, students and staff in the health field have shown resilience and commitment towards their communities and ensuring that the vaccination process goes as smoothly as possible for their patients. Student leaders have shined in communities facing health disparities across New York, providing easier access to those less fortunate.