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      Nursing students’ clinical placement experiences during the Covid-19 pandemic: a phenomenological study

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          Abstract

          Aim

          This study explored the clinical placement experiences of nursing students during the Covid-19 pandemic.

          Background

          The health emergency caused by Covid-19 required a rapid reorganisation of care settings. This reorganisation entailed revisiting the clinical placements settings and learning programs of Italian nursing faculties. Some Italian universities wanted to seize the health emergency as a learning opportunity enabling the nursing student to acquire additional knowledge and skills.

          Design

          We conducted a descriptive qualitative study employing a phenomenological approach. The study population was second and third-year nursing students. The students did their clinical placement in 5 Northern Italy hospitals, mainly in infectious diseases wards, intensive care and sub-intensive care units, emergency department, short-stay surgical units and internal medicine wards. In these departments, the inpatient wards were entirely converted into Covid-19 units. Ethical approval was obtained from the local ethics committee.

          Methods

          Semi-structured, open-ended interviews were conducted in March-April 2021 and analysed following a phenomenological approach.

          Results

          Twenty-one nursing students in their 2 nd and 3 rd academic year participated. Their average age was 24 years. 81% were female and 19% were male. Three main themes were generated: (i) Learning which surpasses technicalities; (ii) Confronting dignity issues; (iii) Feeling treated as an equal in the workspace. Students had to learn how to lower their fear and self-manage the emotional burden to be a caring presence for the patients who were intensely suffering from the disease and isolation. Attending a clinical practice placement in Covid-19 wards led them to focus on human dignity issues: participants realised how dignity was questioned and how they could become patients’ advocates. Students also described that they felt part of the team, with their student role almost fading.

          Conclusions

          This study describes that the most unpredictable public health emergency, such as Covid-19, can provide learning opportunities in the practice environment for nursing students. Students described feeling useful and capitalising on new competencies. Designing educational activities for nursing students concerning pandemic emergencies may be strategic for dealing with similar situations in the future.

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          Most cited references38

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          Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

          Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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            The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study

            Summary Background In the early stages of the outbreak of coronavirus disease 2019 (COVID-19) in Hubei, China, the local health-care system was overwhelmed. Physicians and nurses who had no infectious disease expertise were recruited to provide care to patients with COVID-19. To our knowledge, no studies on their experiences of combating COVID-19 have been published. We aimed to describe the experiences of these health-care providers in the early stages of the outbreak. Methods We did a qualitative study using an empirical phenomenological approach. Nurses and physicians were recruited from five COVID-19-designated hospitals in Hubei province using purposive and snowball sampling. They participated in semi-structured, in-depth interviews by telephone from Feb 10 to Feb 15, 2020. Interviews were transcribed verbatim and analysed using Haase's adaptation of Colaizzi's phenomenological method. Findings We recruited nine nurses and four physicians. Three theme categories emerged from data analysis. The first was “being fully responsible for patients' wellbeing—‘this is my duty’”. Health-care providers volunteered and tried their best to provide care for patients. Nurses had a crucial role in providing intensive care and assisting with activities of daily living. The second category was “challenges of working on COVID-19 wards”. Health-care providers were challenged by working in a totally new context, exhaustion due to heavy workloads and protective gear, the fear of becoming infected and infecting others, feeling powerless to handle patients' conditions, and managing relationships in this stressful situation. The third category was “resilience amid challenges”. Health-care providers identified many sources of social support and used self-management strategies to cope with the situation. They also achieved transcendence from this unique experience. Interpretation The intensive work drained health-care providers physically and emotionally. Health-care providers showed their resilience and the spirit of professional dedication to overcome difficulties. Comprehensive support should be provided to safeguard the wellbeing of health-care providers. Regular and intensive training for all health-care providers is necessary to promote preparedness and efficacy in crisis management. Funding National Key R&D Program of China, Project of Humanities and Social Sciences of the Ministry of Education in China.
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              Implications for COVID-19: a systematic review of nurses’ experiences of working in acute care hospital settings during a respiratory pandemic

              Background Pandemics and epidemics are a public health emergencies that can result in substantial deaths and socio-economic disruption. Nurses play a key role in the public health response to such crises, delivering direct patient care and risk of exposure to the infectious disease. The experience of providing nursing care in this context has the potential to have significant short and long term consequences for individuals, society and the nursing profession. Objectives To synthesize and present the best available evidence on the experiences of nurses working in acute hospital settings during a pandemic. Design This review was conducted using the Joanna Briggs Institute methodology for systematic reviews. Data sources A structured search using CINAHL, MEDLINE, EMBASE, PubMed, Google Scholar, Cochrane Library, MedNar, ProQuest and Index to Theses was conducted. Review methods All studies describing nurses’ experiences were included regardless of methodology. Themes and narrative statements were extracted from included papers using the SUMARI data extraction tool from Joanna Briggs Institute. Results Thirteen qualitative studies were included in the review. The experiences of 348 nurses generated a total of 116 findings, which formed seven categories based on similarity of meaning. Three synthesized findings were generated from the categories: (i) Supportive nursing teams providing quality care; (ii) Acknowledging the physical and emotional impact; and (iii) Responsiveness of systematised organizational reaction. Conclusions Nurses are pivotal to the health care response to infectious disease pandemics and epidemics. This systematic review emphasises that nurses’ require Governments, policy makers and nursing groups to actively engage in supporting nurses, both during and following a pandemic or epidemic. Without this, nurses are likely to experience substantial psychological issues that can lead to burnout and loss from the nursing workforce.
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                Author and article information

                Journal
                Nurse Educ Pract
                Nurse Educ Pract
                Nurse Education in Practice
                Published by Elsevier Ltd.
                1471-5953
                1873-5223
                14 January 2022
                14 January 2022
                : 103297
                Affiliations
                [a ]Department of Translational Medicine, University of Piemonte Orientale, Via P. Solaroli, 17 28100 Novara, Italy
                [b ]Qualitative Research Unit, Azienda USL-IRCCS di Reggio Viale Risorgimento, 80, 42123 Reggio Emilia, Italy
                [c ]School of Nursing, Department of Translational Medicine, University of Piemonte Orientale, Vercelli Hospital, 13100 Vercelli, Italy
                [d ]School of Nursing, Department of Translational Medicine, University of Piemonte Orientale, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
                [e ]School of Nursing, Department of Translational Medicine, University of Piemonte Orientale, Biella Hospital "Nuovo Ospedale degli Infermi"- 13900 Biella, Italy
                [f ]School of Nursing, Department of Translational Medicine, University of Piemonte Orientale, Verbania Hospital 28921 Verbania, Italy
                [g ]School of Nursing, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy
                [h ]Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy
                [i ]Department of Translational Medicine, University of Piemonte Orientale, Direzione delle Professioni Sanitarie - A.O.U. Maggiore della Carità di Novara, Via P. Solaroli, 17, 28100 Novara, Italy
                Author notes
                [* ]Corresponding author.
                Article
                S1471-5953(22)00011-7 103297
                10.1016/j.nepr.2022.103297
                8759293
                35066254
                460b6ad6-9c07-4f38-b2c6-7459ab0db84c
                © 2022 Published by Elsevier Ltd.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 23 August 2021
                : 9 January 2022
                : 12 January 2022
                Categories
                Article

                nursing students,covid-19,clinical placements,student experience,learning,phenomenological approach,qualitative research

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