As a result of the COVID-19 pandemic, a large for-profit Registered Nurse (RN) to Bachelor of Science in Nursing (BSN) Online Degree Completion Option was faced with both student and faculty challenges that required a creative and innovative approach to education. Student persistence is crucial for educating and graduating nurses to meet the demands of an ever-changing health care environment. The program developed and implemented the Care to Persist campaign in 2018 to provide the support needed to encourage student persistence. This campaign evolved and expanded during the pandemic, with initiatives centered around the care model and dedicated to assisting students to persist in an ever-changing environment.
Persistence is defined by Merriam-Webster as the "continuance in a course of action" (https://www.merriam-webster.com/dictionary/persistence). It is measured in the program as an eight-week session-over-session continuance by students. The Care to Persist campaign, began as an initiative designed to positively impact student persistence, evolved and expanded during the pandemic when nursing students were faced with working on the frontlines, caring for COVID-19 patients while also juggling personal and academic responsibilities. University leaders recognized the need to nurture students and provide a caring environment in the virtual classroom to support persistence and academic progression. The campaign proved to be successful for students, faculty, and the university.
The program created a culture of care that included meeting students were they were and identified what they needed to persist from session to session. Care must be grounded in kindness and concern, two universal human values that can be facilitated through interaction and role modeling between nurse educator and nursing student (Watson, 1985). Faculty and academic leaders who model behaviors of care and respect for their nursing students create a culture of care that ultimately impacts integrity, professionalism, and patient care (Gruenwald, 2018). Believing in a student's potential is a humanistic value and is critical in nursing eduation. When students know their instructors recognize their skills and abilities and have faith in their potential, they are able to appreciate their own strengths and use available resources to persist through their educational program and ultimately graduate (Cara et al., 2020).
CARE TO PERSIST CAMPAIGN
As the COVID-19 pandemic emerged during the March 2020 session, it became increasingly evident that students, many of whom were working in the clinical setting, were facing a rapidly evolving crisis. Patient census and acuity levels were rising, and anxiety levels were escalating as the origin, progression, and prognosis of the virus were unknown. Within weeks, the impact of the virus was being felt across the globe as no evidence-based treatment plans were available, personal protective equipment was scarce, and death tolls were rising. To mitigate the virus and slow the spread, the nation began to shut down, thus adding the additional burdens of home-schooling children and families were with financial constraints because of changes in employment.
As the March 2020 session progressed, students became overwhelmed. Faculty reported numerous instances of students falling ill; being required to work excessive hours; and even reporting the loss of loved ones, friends, and coworkers to the virus. The stories being shared by students about their lived experiences were strikingly similar yet personal, as students struggled to grasp the gravity of the pandemic situation while striving to continue their education. In response, a rapid assessment of the situation was conducted and an action plan was developed and implemented aimed at assisting students through this challenging time. It was quickly realized that many initiatives already in place would enable management of the rapidly changing needs of students. These initiatives offered flexibility but also structure needed to succeed academically while simultaneously adapting to rapidly changing and chaotic professional environments (see Supplemental Content for Table 1, available at http://links.lww.com/NEP/A353, which outlines existing initiatives and modifications made during the pandemic).
Faculty employed as health care leaders across the nation faced similar challenges. Recognizing the critical role faculty play in student persistence and success, faculty-focused initiatives were also implemented. These included empowering faculty with the ability to say "yes" when a student reached out requesting additional assistance. For example, faculty were permitted to offer students a three-day late pass when warranted without first seeking approval from program leadership. In addition, discussion posting requirements were reduced and grading deadlines were extended to allow faculty the flexibility needed to manage personal and professional commitments.
By remaining nimble and through constant communication and collaboration with members of the Student Services leadership team, program leaders were able to pivot and adjust persistence iniatives. This allowed the needs of both students and faculty to be met during this time of crisis. As a result, first-term session-to-session persistence rates improved from 81.2 percent in May 2019 (840 of 1,033 students) to 85.2 percent in May 2021 (891 of 1,046 students).
CONCLUSION
The Care to Persist campaign has proven to be a beneficial strategy to care for students and ensure academic progression both before and during the pandemic. Many lessons were learned during this time that included how to best support students and faculty. Some initiatives that were expanded during the pandemic were made permanent in the program, such as the discussion posting requirements for students. Other programs at the university have used the Care to Persist campaign as a model. The initiatives were freely shared, and other programs quickly moved to integrate the model to assist students and faculty.
Feedback about the Care to Persist campaign from students and faculty was positive. Students shared that they appreciated the accommodations, felt supported, and realized they could succeed, despite the situation they faced during the worst moments of the pandemic. Students reported that sharing lived experiences of the pandemic in discussion forums was therapeutic, helping them debrief from the stressors they faced. Faculty shared that they felt empowered to help students as they faced the crisis. The Care to Persist campaign encouraged faculty to say "yes" to students when they were approached with a need or request. Faculty were also thankful for the accommodations shown to them during the pandemic. Like their students, many faculty worked on the frontlines and knew the reality of the pandemic all too well.
The Care to Persist campaign continues at the university and will remain in place to support students and faculty following the pandemic. Individual initiatives within the campaign created the supportive and caring environment needed during this most challenging time. Persistence continues to be monitored by the program, and initiatives will be modified as needed to ensure that support remains in place.
The benefits of the Care to Persist campaign include reinforcement of the values of the university, which include a focus on graduating extraordinary nurses to serve the public. The university reaped a return on investment with the Care to Persist campaign by seeing stable persistence data for students beginning the program, thus driving growth and ensuring superior student outcomes. Students benefited from being able to continue with their education while facing the challenges of the pandemic in a supportive and encouraging environment. The impact of the Care to Persist initiatives on future graduation rates will continue to be monitored, and initiatives will be modified as needed based on the needs of students, faculty, and the university.
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