Inspiring Nurse Innovation and Leadership with Lessons from 5B
The COVID-19 pandemic has created unprecedented challenges for colleges, universities and technical schools nationwide, forcing educators to rapidly transition their courses to be taught remotely for their students and create online modules that can act as a substitute for in-person learning.
According to Barbara Cannella, PhD, RNC-OB, APN, Assistant Dean and Clinical Associate Professor at the Rutgers University – New Brunswick School of Nursing, the novel coronavirus has especially presented unique challenges for nursing students, who have now been tasked with completing their clinical classes remotely. Barbara and her team had to work quickly this spring to put together six weeks of virtual clinical experiences so that their students could continue to learn amid the pandemic and graduate on time.
“The clinical component of our courses has always been in-person, so moving to virtual learning required a new perspective,” said Barbara. “We needed to come up with creative methods to provide clinical experiences for our students. Previously, students would meet in the morning for a pre-conference, take care of their patients and then convene later in the day for a post-conference. We’ve been trying to model our virtual clinical experiences in the same manner.”
But even as COVID-19 presented challenges to nursing students and educators, Barbara says it also presents unique opportunities to reach nursing students in different ways and encourage conversations that they might not have had before by looking at how nurses have led in past crises. One of these opportunities was inviting students to draw parallels between nurses on the frontlines of the current COVID-19 pandemic and the AIDS crisis in the 1980s, an inspiring story she learned more about after watching the documentary 5B.
The film 5B, proudly commissioned by Johnson & Johnson, shares the stories of the patients, nurses and healthcare staff who worked in San Francisco General Hospital’s Ward 5B, the first unit dedicated to HIV/AIDS care in America. In the 1980s, when most of the world regarded HIV and AIDS patients with fear and prejudice, it was nurses who defied convention and embraced patients with innovative ways of thinking and compassionate care. Their brave and then-controversial actions revolutionized patient care beyond the AIDS epidemic and has been inspiring nurses and more across generations around the world.
“There was great uncertainty and fear among nurses at the start of the AIDS epidemic. Nurses on the frontlines during that time had to adapt quickly to changes in patient care and the same is occurring now as nurses care for patients with COVID-19,” said Barbara. “During all healthcare crises, nurses are essential to managing patient care effectively and compassionately, which can take a physical and mental toll. The heart of nursing is nurses being able to advocate for patients in their most vulnerable moments, so I believe the film truly portrays nursing at its best.”
This past spring, Barbara worked to incorporate 5B into the School of Nursing’s “Leadership and Management in Nursing” course as a virtual clinical experience. She challenged students to explore the similarities between the HIV/AIDS health crisis depicted in the film and the COVID-19 crisis. She said not only did 5B spotlight what it was like to be a nurse during that time, but also nurses’ leadership roles during times of healthcare crises – both in hospitals and communities.
“The first time I saw 5B I felt incredibly proud to be nurse and knew I wanted my students to see the film,” said Barbara. “The sudden change in the academic environment provided the perfect opportunity. Rather than simply watching the film, objectives were developed to ensure a meaningful clinical experience. The students were asked to reflect on concepts such as leadership, patient advocacy, professionalism, healthcare stigmas and nursing ethics. These are critical lessons that our students could take with them as they began their career on the frontlines.”
“It is truly eerie how certain aspects of the current COVID-19 pandemic have echoed what went on in the 80’s during the AIDS crisis,” said Cassady Leonard, BS, RN, who graduated this May. “I am only 22 years old, so it was definitely surprising to see real footage from Ward 5B and catch a glimpse at what really happened during that crisis. I have always been extremely passionate about LGBTQ+ rights, so the film brought me to tears when it displayed just how many people used the AIDS epidemic as a way to defend their personal stigma around the gay community. I think that at the core, we've seen in both crises how the ‘unknowns’ can really fuel the fires of fear and uncertainty and prompt the spread of misinformation.”
According to Cassady, who also served as President of the Rutgers Nursing Student Association during her senior year, the film also did a fantastic job at showing the importance and power of the nurse managers and nurse leadership. “One of the most important things during times of crisis is to have organized, goal-oriented leadership. The nurses in Ward 5B were organized and professional, but also remained consistently compassionate towards the patients and extremely supportive of their staff. That’s what nursing leadership is.”
While watching the film, students were asked to examine the factors that influence the delivery of patient care and the importance of effective nurse leadership. Students were also asked to take on the role of a nurse manager and explore what they would do in certain scenarios, such as how they would handle the issue of staff not being able to come to work due to childcare issues or how they would respond to any staff hesitant to care for patients showing symptoms of a respiratory infection. Twenty-six clinical groups from the Rutgers University New Brunswick and Newark campuses participated in this virtual clinical experience and both the student and faculty feedback was overwhelmingly positive.
“The fact that nurses were the drivers of the much-needed change during the AIDS crisis was not what I expected,” said Richard Truche, a second-degree student in his last semester at the Rutgers University – New Brunswick School of Nursing who worked in New York City during the 1980s. “Watching the film brought back a scary and emotional time. It was powerful to watch nurses overcoming their fear to touch patients, hold their hand, brush their hair or stroke their arm. The film showed how important it is that nurses always see their patient through two lenses: the patient with a medical condition and the patient experiencing fear, anxiety and stress caused by the uncertainty of their health condition. To be a nurse is to see both and understand that sometimes the most important care a nurse can provide is to help the patient express and deal with the emotional turmoil that comes with their illness.”
According to Dean Cannella, it’s too soon to tell how the COVID-19 pandemic will affect nursing education nationally. She also thinks it’s too early to know the full mental, emotional and physical impact this pandemic will have on the nursing profession. “Nursing has never been more visible than it is now,” said Barbara. “Whether we see a wave of nurses entering or leaving the profession is a question without an answer. But throughout this pandemic, nurses have been portrayed in such a favorable, heroic way that I think if anyone was considering becoming a nurse, they are going to feel more motivated to join the profession.”
Without a doubt, Barbara says she will continue use the documentary in her courses, whether the courses are in-person or remotely delivered. She said the film 5B provides an opportunity for students to recognize how nurses, despite overwhelming challenges, have the ability to lead change and the film’s visual representation of the power of nursing leaves students with a sense of pride in their chosen profession.
“Pursuing nursing is a lifelong dream that, for me, feels like a calling,” said Rich, who after a career working in corporate America decided to pursue a second career in nursing where he felt he could be closer to people. “The nurses in 5B saw the lack of care provided to men with AIDS as a tragedy and refused to helplessly stand by. It was gratifying to see how unstoppable nurses who are dedicated and creative can be and how nurses can be a force for good in difficult times. I look forward to opportunities to care for people who are suffering and help them through their most difficult moments, hoping that they suffer less because I was their nurse.”
“In the beginning, I wanted to pursue nursing because I am very caring, and I felt that this was the best profession to help people,” said Yaa Agyeman-Kagya, a recent graduate who was a student in one of the clinical groups. “However, after graduating and witnessing how COVID-19 has affected Black and Hispanic communities the most, it showed me how severe the health disparities are for minority and vulnerable populations. This made me realize that I want to help make the necessary changes in the system, so that all populations can receive high quality care.”
“One quote from the film really struck a chord with me – ‘We made a difference in the way that they died, and we made a difference in the way that those who loved them were held.’ This, to me, was heartbreakingly beautiful and is such a testament to who nurses are, not just what they do,” said Cassady. “My goal in being a nurse is to go above and beyond for the people that I care for, and this documentary really showcased the true meaning of that.”
The film 5B was proudly commissioned by Johnson & Johnson as part of its longstanding commitment to the support of nurses at the frontlines of patient care. Through the development of advanced therapies and together with our partners, Johnson & Johnson is also deeply committed to the treatment and prevention of HIV and AIDS. Learn more about the film 5B at 5bfilm.com.