COVID-19 Sparks Massive Online Retraining Programme for Nurses
Generation, a youth employment non-profit along with its coalition partners organized an impressive online training programme for frontline healthcare professionals to care for COVID patients.
With each new disease comes a new battle plan, and that’s the motivation behind Generation’s new upskilling programme. In the fight against COVID-19, the most important defence is information.
The four-hour online COVID training programme offers practical, demonstration-based, and immediately-applicable training in the areas of infection, prevention and control in COVID-19 hospitals. It covers the use of Personal Protective Equipment (PPE) as well as personal care for medical staff. First launched in Italy, the epicentre of Europe’s outbreak, the programme has trained over 30,000 nurses across India in just its first few weeks.
Highly-trained nurses are key to winning the fight against COVID
Arunesh Singh, CEO of Generation India, points out that healthcare professionals who have been working in the industry for decades haven't had any personal experience with a pandemic that they can draw on now.
"It is the first time that as a country, we are trying to contain the contagion. Other infections like Ebola haven't been active in India. We have experienced diseases like Dengue and Chikungunya, but they were not so contagious. While the healthcare worker is trained for PPE in their course, they have never used them in the workplaces. The nurses needed to be upskilled. The government of India tried to do it through IGOT, AIIMS and our training programme," he explains.
Singh adds that if there are a hundred nurses in a hospital, only 5-10 per cent are usually deployed in the ICU. "You still have to train 90 per cent of the nurses, because only a few have experience of working in an ICU. While the country was struggling due to the shortage of healthcare workers, readiness was also not there."
Replicating the success in Italy
Singh explains that Generation India is a skills-based initiative. "We train youth into meaningful jobs. We were looking at how we can contribute to the COVID pandemic. Therefore, we redirected our resources to create this online upskilling model. Our first success was in Italy. Every time we replicated in other countries, we tried to understand the pain points. So, we did a diagnostic with 12 hospitals in India and understood the skill gaps for nurses. Based on that, we created the module for nurses, very specific to India."
Key partnerships
The next step was a coalition with like-minded partners like Columbia Asia Hospital, who offered the medical content; ABP news’ crews; and UNESCO, who supported the launch and rolled out the course. Hosmac India Limited—a comprehensive healthcare solutionprovider formedical facilities as well as doctor-entrepreneurs— is the industry partner for the programme. The training has been accredited by the Trained Nurses Association of India (TNAI).
The next step was a coalition with like-minded partners like Columbia Asia Hospital, who offered the medical content; ABP news’ crews, Learnet Skills Ltd. and UNESCO, who supported the launch and rolled out the course. Hosmac India Pvt Ltd —a comprehensive healthcare solution provider for medical facilities as well as doctor-entrepreneurs— is the industry partner for the programme. The training has been accredited by the Trained Nurses Association of India (TNAI).
Nursing India to better Health
Sucharita Sharma, Assistant Nursing Director of Medica Hospital in Odisha, admits that it has been a steep learning curve. "COVID has led to the training of people from all backgrounds to offer enhanced care. As it was an online course, it also provided flexibility to learn at our convenience," she adds.
So, what could have been done to mitigate the gaps in healthcare education and what can be further done in future planning?
"We will have to ensure the continuous learning of nurses—some [facilities] do it, but the majority don't invest in training these frontline healthcare workers. In Italy, nurses were keen to do this course because there is a Continuous Medical Education programme there, and nurses would get a credit. Whereas in India, there is no central body which gives you course credits. TNAI offers credit for the course, but you have to go through them. If you want to keep your healthcare system updated, there should be some credit system; otherwise, there is no incentive for nurses to do such courses," explains Arunesh Singh.
The TNAI has vetted this programme and is also the certification partner. The association also helps in the dissemination of this course to over a lakh of nurses registered with them across India, by adding it to their online portal.
Dr. Roy K George, National President of the TNAI and Principal at the Baby Memorial College of Nursing, says the pandemic has taught him that these kinds of new infections can emerge at any time. "Earlier, the healthcare industry used to think that we have managed to control diseases with our advancement in technology and inventions. But it was just a myth.
"Infectious diseases were not given enough priority earlier by healthcare facilities. The focus was on new super specialities. Even though it was part of the curriculum, there wasn't great emphasis, as much as is there now. The priorities have shifted now due to the current pandemic. Even though India had its fair share of infectious diseases, most of them have been under control, and nurses were operating in a comparatively safer zone. But these days, everyone has to be careful about infections which have a cyclical pattern.
"Earlier, healthcare workers were worried about hospital-borne infections. But now, the concern is about the infection which can come from outside. None of the doctors and nurses have seen a pandemic before. We have studied about the pandemic, but none had witnessed one.
“We have used experts to vet the [nurse upskilling] course to ensure all the essential aspects of COVID management are included. Another important aspect was the duration of the course, and we didn't want it to be more than four hours. Otherwise, nurses won't do it. We also wanted to ensure that it's easily comprehensible. Senior teaching members of TNAI staff have also taken the course," Dr. George explains.
Col Binu Sharma, Senior Vice President of Nursing Services at Columbia Asia seconds his views.
"India has a robust nursing curriculum and has upgrades every few years. But conditions like H1N1, Zika and Ebola can't be found in Indian nursing textbooks. There are specific precautions you need to take, which we hadn't come across in other disease management. Our syllabus is more knowledge oriented. Students often don't manage patients independently, and they come only to assist senior nurses. No nurse or student knew how to handle a COVID patient. Even [senior staff] learnt infection prevention measures in the last six months," says Sharma.
The training programme's module about screening and triaging patients for COVID-19 was the key selling point of the training programme, she notes. "It is crucial because right at the entry point, you need to segregate patients and send them to various departments based on their care needs. It adds so much value because they are protecting other patients, too. It takes a lot of time to train nurses on the ground. It doesn't happen in 24 hours or even in a month. It takes two or three months. Over the last three months, there have been a lot of training initiatives, and this has improved [nurses’] confidence.”
Reactive rather than proactive?
To some, the upskilling programme might seem a little late in coming, particularly regarding critical care management. The slow movement of anti-COVID operations in India has been, for many, cause for concern. The same cannot be said for Generation India’s CEO, however. According to Arunesh Singh, “We have a brilliant National Disaster Management System, which is one of the finest in the world. So, India is learning. As things pick up, we will do a better job. A country that has eradicated Polio can also handle situations like this."