From students to nurses under pressure: Nursing students' entry into employment during the first COVID-19 wave

AIMS AND OBJECTIVE

To describe the experiences of nursing students and their mental health as they entered employment during the first wave of the COVID-19 pandemic (May-June 2020).

BACKGROUND

As other healthcare professionals, nursing students who worked during the first COVID-19 wave suffered from dysfunctional mental health symptoms.

DESIGN

Sequential, mixed-method, multicentre study.

METHODS

The study population comprised 92 students in the third and fourth year of the Nursing degree at three Spanish universities, who entered employment during the pandemic. Data were collected between May and June 2020. In the quantitative phase, data were collected using an online questionnaire containing both validated anxiety and stress scales. In the qualitative phase, semi-structured interviews were conducted with 18 participants. A descriptive analysis of the quantitative data and a reflexive thematic analysis of the qualitative data were carried out, and analyses were combined. COREQ checklist was used for reporting.

RESULTS

The combined quantitative and qualitative results were organised into five thematic areas: (1) Interruption of clinical placements, (2) Entering employment on a healthcare assistant contract, (3) Preventing contagion, (4) Adapting to the situation and managing emotions, and (5) Lessons learned.

CONCLUSION

The students had a positive overall experience of entering employment, as they were able to develop their nursing skills. However, they had an emotional impact in form of stress caused by excessive responsibility, academic uncertainty, lack of personal protective equipment and training in its use, and the possibility of spreading disease to their family members.

RELEVANCE TO CLINICAL PRACTICE

In the current context, changes must be made in study programmes to instruct nursing students to be able to cope with extreme clinical situations, such as pandemics. The programmes should include a more extensive coverage of epidemics and pandemics and management of emotional aspects such as resilience.

Case study: School-based care for a girl and her primary caregiver experiencing difficulties in managing diabetes treatment

PURPOSE

To describe the use of the nursing process and standardized nursing language by the school nurse to facilitate the monitoring of the therapeutic regimen of a girl with type 1 diabetes mellitus and her caregiver.

METHODS

Data were collected through clinical reports, observation, and physical examination of the girl and through interviews with her and her caregiver in accordance with Virginia Henderson's conceptual model.

FINDINGS

Clinical reasoning informed the selection of NANDA-I nursing diagnoses. NIC nursing interventions were selected taking into consideration the available scientific evidence related to the care of children with type 1 diabetes mellitus.

CONCLUSIONS

The school nurse is a key figure in improving and supporting the monitoring of the prescribed therapeutic regimen for children with chronic disease.

IMPLICATIONS FOR NURSING PRACTICE

This case demonstrates the importance of adopting a conceptual model to guide the nursing process, as well as showing that standardized nursing languages are suitable for school nursing practice.

The value of human resources: Experience of critical care nurses during the COVID-19 epidemic

The COVID-19 pandemic has caused an unprecedented health crisis. Pressure on the National Health System has created unique demand particularly in certain services and care units like the critical care units.

Objective

To learn about the experience of nurses in caring for people with coronavirus in critical care units.

Method

A qualitative phenomenological study that constitutes the second phase of a mixed methodology project. We conducted interviews with 17 nurses caring for patients affected by COVID-19 in critical care units. The interviews were audio-recorded, transcribed, and analysed using thematic discourse analysis.

Results

This article shows the findings around the theme “the value of human resources” which is nuanced through sub-themes “it's not the beds, it’s the expert staff”, “shouldering the patient's burden”, and suffering because “they have not cared well”.

Discussion

Expert nurses have emerged as leading professionals in the care of the critical patient during the COVID-19 pandemic. This leadership is executed from a profile framed in an inclusive philosophy where wisdom, agility and intuition are the key elements underpinning problem identification and solving in a creative way, while adapting to the needs of the patient and healthcare team as they emerge.

Conclusions

Expert nurses have played an advanced role in the management of care and human resources by exercising effective leadership in the clinical setting. Care has been hampered due to the crisis, which causes nurses moral distress because they have been unable to meet standards of quality and excellence in care.