Ethical challenges during the COVID-19 pandemic: Perspectives of nursing students

Reinforcement during the COVID-19 pandemic: Perception of nursing students and impact on intention to drop-out of nursing education

Background

Although the COVID-19 pandemic's impact on students has already been studied, its impact on nursing students' perception of their training and their conception of their future profession is unknown.

Aims

To describe nursing students' perception of their involvement in reinforcement during the COVID-19 pandemic and the impact of working as reinforcement staff during the COVID-19 pandemic on nursing students.

Design

Cross-sectional, comparative case/non-case study.

Setting

nurse training institutions in France.

Participants

"Cases" defined as nursing students who worked as reinforcement staff during the COVID-19 pandemic; "non-cases" defined as people who were in final year of nursing studies in 2018-2019 or 2019-2020 and so did not work as reinforcement staff during their nursing studies.

Methods

questionnaire about representations of the nursing profession, role of the nurse in society, previous thinking of dropping out of nursing education.

Results

534 subjects included (310 cases; 214 non-cases). Cases reported feeling useful (38.6%) or very useful (25.7%) as reinforcement workers, while 91.5% concurred that nurses had an important role in the management of COVID-19 patients. Cases more frequently reported that the nursing profession is one where you save lives (61.5% vs 52.5%, p = 0.05). The desire to work as a nurse for a whole life had been more frequently expressed by cases (45.3% vs 34.8%, p = 0.05). Nursing education drop-out has been considered by 63.4% of subjects, without difference between "cases" and "non-cases" (p = 0.63). Subjects who considered dropping out of nursing education were younger (p = 0.01) and less often prone to think that the nursing profession was a profession personally rewarding (p = 0.01) and a life-saving profession (p = 0.03).

Conclusion

The majority of nursing students reported feeling useful during the pandemic, and underlined the importance of the nurse's role in management of COVID-19 patients. Participation in reinforcement staff during the pandemic had no influence on dropping out of nursing education.

Description and Analysis of Research on Death and Dying during the COVID-19 Pandemic, Published in Nursing Journals Indexed in SCOPUS

AIM

To offer an overall picture of the research published regarding the different aspects of death and dying during the COVID-19 pandemic in journals covering the field of nursing in the Scopus database.

DESIGN

bibliometric analysis.

METHODS

The metadata obtained were exported from Scopus for subsequent analysis through Bibliometrix. Using the VOSviewer co-word analysis function, the conceptual and thematic structure of the publications was identified.

RESULTS

A total of 119 papers were retrieved, with the participation of 527 authors. The publications were found in 71 journals covering the nursing area. The main lines of research revolved around the keywords "palliative care" and "end-of-life care" in regard to the ethical, psychological, and organizational challenges faced by the health professionals who cared for these patients.

CONCLUSION

The results obtained offer a range of data and images that characterize the scientific production published on this topic, coming to the conclusion that, due to the multifaceted and multidisciplinary approach to the experience of death, care, and accompaniment in the dying process, bibliometric maps improve the comprehensive understanding of the semantic and conceptual structure of this field of research. This study was retrospectively registered with the OSF Registries on the 14 March 2024.

Ethical dilemmas faced by healthcare teachers during the COVID-19 pandemic

BACKGROUND

Previous studies have shown that the rapid transition to emergency remote teaching due to the COVID-19 pandemic was challenging for healthcare teachers in many ways. This sudden change made them face ethical dilemmas that challenged their values and ethical competence.

RESEARCH AIM

This study aimed to explore and gain a deeper understanding of the ethical dilemmas healthcare teachers faced during the COVID-19 pandemic.

RESEARCH DESIGN

This was an inductive qualitative study using a hermeneutic approach. Semi-structured interviews were conducted and analysed thematically.

PARTICIPANTS AND RESEARCH CONTEXT

Healthcare teachers (n = 20) from eight universities and universities of applied sciences in the Nordic and Baltic countries participated.

ETHICAL CONSIDERATIONS

This study was based on the research ethics of the Norwegian National Research Ethics Committee for Medicine and Health Sciences and approved by the Norwegian Agency for Shared Services in Education and Research.

FINDINGS

Healthcare teachers faced several ethical dilemmas due to restrictions during the COVID-19 pandemic. The analysis revealed three main themes: How should I deal with students' ill-being, and what can I as a teacher do?; What can I demand from myself and my students, what is good teaching?; How do I manage the heavy workload and everyone's needs, and who gets my time?

CONCLUSIONS

This study highlights the importance of healthcare teachers' continuous need for pedagogic and didactic education, especially considering new technology and ethical issues. During the pandemic, the ethical consequences of remote teaching became evident. Ethical values and ethical dilemmas should be addressed in healthcare education programmes at different levels, especially in teacher education programmes. In the coming years, remote teaching will grow. Therefore, we need more research on this issue from an ethical perspective on its possible consequences for students and healthcare teachers.

End of life care during the COVID-19 pandemic: A qualitative study on the perspectives of nurses and nurse assistants

AIM

To explore nurses' and nurse assistants' experiences of providing end-of-life care during the COVID-19 pandemic in Austria, Germany and Northern Italy.

DESIGN

A qualitative explorative interview study.

METHOD

Data were collected between August and December 2020 and analysed using content analysis. Healthcare professionals (nurses (n = 30), nurse coordinators (n = 6) and nurse assistants (n = 5)) from hospitals (n = 32) and long-term care facilities (n = 9) in Austria, Germany and Northern Italy were interviewed for this study.

RESULTS

Five main categories were identified as follows: (i) end-of-life care involves love and duty, (ii) last wishes and dignity of the patient, (iii) communication with the family, (iv) organizational and religious aspects and (v) personal emotions. Results indicate that more training and guidelines are needed to prepare nurses and nurse assistants for end-of-life care during pandemics.

PUBLIC CONTRIBUTION

This research can help prepare nurses and nurse assistants for end-of-life care in pandemics and will be of value for improving the institutional and government health policies. Furthermore, it can be of value in preparing training for healthcare professionals patient-relatives.

Nursing Students’ Experiences With Patient Death and Palliative and End-of-life Care: A Systematic Review and Meta-synthesis

AIM

To synthesise the experiences of nursing students encountering patient death and caring for patients under palliative care or at end-of-life and their families in clinical settings BACKGROUND: Nurses are pivotal in caring for dying patients and families. It has been reported that nursing students feel unprepared in caring for dying patients and handling patient death. Understanding their experiences would better inform how palliative care education can be improved and how students can be better supported in clinical settings.

DESIGN

A qualitative systematic review and meta-synthesis METHODS: PubMed, Embase, CINAHL, PsycINFO, ProQuest and Google Scholar were searched for peer-reviewed articles and theses/dissertations published between 1 January 2012-25 Feb 2023. Qualitative studies of any design reporting nursing students' experiences of patient death, caring for patients under palliative care, at end-of-life, or with time-limiting diseases in clinical settings in English were included. Study quality was evaluated using the Critical Appraisal Skills Programme tool. Data were synthesised using Sandelowski and Barroso's 2-step framework through a meta-summary using thematic analysis, which were then integrated into meta-syntheses using an event timeline.

RESULTS

The review included 71 studies from 26 countries (n = 1586 nursing students). The meta-summary contained 8 themes and 23 subthemes: (1) Communication experience with patients and families, (2) Satisfaction with care provided to patients and families, (3) Impact of the COVID-19 pandemic on death and dying, (4) Perceptions of death and dying, (5) Impact of death, (6) Nursing education on palliative end-of-life care, (7) Support systems and coping methods, (8) Learning outcomes. The meta-synthesis depicted nursing students' experiences before, during and after encountering dying patients, families and patient death. Suggestions for nursing faculty and clinical staff on how they could equip students with necessary skills and knowledge and support them in clinical settings were also provided.

CONCLUSIONS

While caring for dying patients and families was beneficial to nursing students' learning and professional development, they encountered many challenges. Governments, clinical and academic nursing leaders must prioritise the integration of palliative care content into the curricula across nursing schools in face of increasing palliative and end-of-life care needs in patients. Nursing schools should ensure that students are adequately prepared by designing culturally and socioeconomically relevant curricula, integrating theoretical and experiential learning and offering students a thorough understanding of palliative and end-of-life care. Clinical staff and nursing instructors should support students emotionally and guide them in patient care.

Challenge, fear and pride: nursing students working as nurses in COVID-19 care units

Context and Purpose

Methods

Results

Conclusion

The influence of emotional burnout and resilience on the psychological distress of nursing students during the COVID-19 pandemic

The aim of this study was to measure and analyse the association of emotional burnout and resilience with the psychological distress of students who finished their nursing studies after the peak of the COVID-19 pandemic. The mental health of nursing students was affected during the pandemic, and resilience seems to counteract the negative effects. This is a cross-sectional study. The data (quantitative) were gathered at the beginning of the second term of the academic year 2020/2021. The study was carried out in the Spanish university context. Self-reported measures were gathered using three one-dimensional, valid, and reliable scales: the Psychological Distress Scale (K-10), the Emotional Burnout Scale (EBS), and the short version of the Connor-Davidson Resilience Scale (CD-RISC10). A total of 393 students of different Spanish universities participated in this study. A valid linear regression model was obtained, which allowed verifying that psychological distress is explained, with 37% variance, by emotional burnout and resilience. The total score in emotional burnout has more relevance than the total score in resilience, and the latter has a negative tendency. Facing the factors that generate emotional burnout in students in the academic scope and promoting resilience in them are fundamental aspects that contribute to their psychological well-being. The reflection should be extended to clinical practices. Universities are urged to think about last-year students, their experiences, perceptions, and feelings, to determine how their susceptibility to emotional burnout and psychological distress can be minimized in their future clinical practices. Strategies to promote their resilience should also be studied.