Editor’s note: At the bottom of this story is a three-paragraph sidebar on work being done by Master of Public Health students.
Rising COVID-19 numbers at South Dakota’s major hospitals early this winter provided an opportunity for South Dakota State University respiratory care students to get an early start on their careers.
The program, housed in the College of Pharmacy and Allied Health Professions, offers students an opportunity to earn a two-year associate degree or a four-year bachelor’s degree. The students’ classroom sessions and hands-on clinicals are at Sanford Health and Avera McKennan in Sioux Falls and Monument Health in Rapid City.
Clinicals begin in the students’ second semester.
“It’s pretty much a yearlong interview based on the course,” said Brent Aukerman, who is in the Rapid City program and will graduate in May. He and his classmates were told shortly before Thanksgiving they could apply to work as interns while finishing their degree and help address the severe workforce shortage the 386-bed hospital was facing.
Four of the seven students at the Rapid City site accepted the offer.
Most staff grads of program
Aukerman applied to Monument, was interviewed and obtained a temporary respiratory therapist license from the state. By December, he was working full time—three 12-hour shifts a week. Because students train on equipment in the hospital’s lab and are mentored by the hospital’s registered respiratory therapists, hospital directors have a lot of confidence in the program’s second-year students, according to program director Lacy Patnoe, of Rapid City.
The scenario is in the same in Sioux Falls, where eight of the nine students opted to work as a temporary respiratory therapist.
Patnoe said 65% of the respiratory therapist staff at Monument Health graduated from the respiratory care program, which was transferred from Dakota State University to SDSU July 1, 2020. In Sioux Falls, 85% of the respiratory therapy staff is a program graduate. “They have already offered our students full-time employment when they graduate,” Patnoe said of the hospitals.
The program can accept up to 24 students in the associate program; currently there are 16. The bachelor’s program is designed for working professionals and has seven enrolled.
‘Incredible’ learning experience
Aukerman said when he was caring for patients as a student, he didn’t care for COVID-19 patients. That changed when he became an intern. While his primary responsibility was for patients on the general medical floor, during the course of his shift, he also would care for COVID-19 patients.
“It’s been, from a learning experience, incredible. You can see how differently COVID patients can respond to different treatments and contrast the oxygen demands for one person versus a similar patient. You’re trying to do the things you usually do, but the patient doesn’t always respond as expected,” Aukerman said.
The role of the intern is to take the burden away from the registered respiratory therapist.
Duties include delivery of nebulizer medications and inhalers, observing oxygen titration levels, especially before and after surgeries, and educating patients on chronic obstructive pulmonary disease.
“The experience definitely sets us up for the future,” said Aukerman, who plans to continue at Monument Health and eventually pursue the bachelor’s degree through SDSU.
COVID work challenging & rewarding
Carolina Diaz, a student at the Sioux Falls program, has a similar story to tell. The director of the Sanford respiratory therapy program talked to the class about the valuable experience students would gain if opted to work as an intern during semester break. After being evaluated on their treatment procedures and undergoing four days of orientation, the students were assigned patients, she said.
Diaz did a few four-hour shifts while still in class and then worked two 12-hour and one four-hour shift during Christmas break.
In early November, she was working on the general medical floor. “After that, depending how busy it was, they put us on a COVID unit. By December, it was getting super busy in the COVID unit,” which then occupied three floors, Diaz said.
“Everything I have learned in school has been enhanced … The school has taught me what to do for my patient. If you have any questions, you can ask the registered respiratory therapist. They will help you with everything. They taught me the right way of doing things and what my patient will need,” said Diaz, who is to graduate in May with her associate degree.
She is attending on a Sanford scholarship, which commits her to work three years there to pay the scholarship obligation. Eventually, she will seek a bachelor’s degree.
Working with COVID-19 patients has not been easy physically or emotionally. Wearing an N95 mask, eye protection and full personal protective equipment makes the tasks more difficult to complete. Also, “some days it was hard emotionally. My patient isn’t getting any better and I think ‘What can I do for them?’ I communicate with nurse and make it happen for the patient. That will make me more confident when I graduate in talking to a nurse,” Diaz said.
“While sometimes it was hard to work with COVID patients, other times it was rewarding because the patient improved and was moved to another floor; they had a lower oxygenation need and could be transferred to another floor. I felt good that I did something and the patient got better,” she continued.
Flood of patients unprecedented
Connor Elrod, a registered respiratory therapist at Sanford, earned his associate degree in May 2020, but had been working extensively at Sanford while a student. “I worked probably too much. I worked every weekend, I worked holidays. Being a student employee prepared me for the full-time employment. I tried to work almost full-time hours as a student. There were times I got overtime.
“Schooling translates into the job and vice versa. I ate it up. I worked as much as I possibly could and my grades stayed good,” he said.
Elrod, whose father also is a Sanford respiratory therapist, said his experience as a student helped him adjust to the flood of COVID patients that arrived not long after his schooling days ended. “I couldn’t imagine coming right out of school with no experience.
“When that fall (surge) came around, that was something like we had never seen before. I asked my dad and he said he’s never seen anything like it in his 36 years. It exceeded my expectations. (But it also) jump-started my career tenfold. My first ICU shift I got to do a lot of things you don’t usually do so quickly.
“When it got real bad, when numbers got high, they stopped doing elective surgeries so they would have more rooms for COVID patients. The pulmonary rooms were designated wings or floors for COVID patients and were two to a room. Patients with other health issues went to the med-surg floor. ICU for non-COVID needs was moved over to the Heart Hospital, where there were two critical care floors.”
‘We need respiratory therapists’
By mid-January, COVID-19 cases were dropping again.
“It’s more just normal hours and not as much overtime and extra shifts. Now we’re not having to call in the extra help. It’s definitely gotten better from just a few weeks ago. What used to be called busy will be like a vacation now,” Elrod said.
He added, “For students thinking about pursuing this career, who might be worried about coronavirus, the teachers and hospitals take care of you 100%. It’s a very rewarding career. As long as you’re safe, there is nothing to worry about. I pray that coronavirus doesn’t persuade people away from this career path. We need respiratory therapists.”
Patnoe, the program director, said, “There is a huge workforce shortage in respiratory care ... Hiring student interns has been a huge lifesaver for the hospitals.”
Public health students also involved
Students in the Master of Public Health program, a joint effort between South Dakota State University and the University of South Dakota, also are involved in the COVID-19 effort.
The Community Action Response Epidemiology team was created in collaboration with the state health department and the Great Plains Tribal Chairman’s Health Board to do case investigation and contract tracing for South Dakota tribal communities and the USD community. It is led by Susan Puumala, a senior lecturer at USD in the program.
“It is a great workforce development opportunity for Master of Public Health students, current undergraduate health sciences students and recent graduates,” she said.