Student Nurses Undertaking Acute Hospital Paid Placements during COVID-19: Rationale for Opting-In? A Qualitative Inquiry
- What led your decision to opt into a voluntary paid clinical placement during this emergency period arising from the COVID-19 pandemic?
- What impact has the removal of supernumerary status had on your supervision and support in practice?
- Sufficient in-patient hospital capacity to manage increased acute need;
- Health and social care systems coped with demands placed on frontline health and care workers;
- Access to intensive care units and resources, e.g., continuous positive air pressure (CPAP) and ventilation;
- The provision of personal protective equipment (PPE).
“the nature of the programme for undergraduate nursing students so that they can opt to undertake their final six months of their programme as a clinical placement”.
“the students are being trained at the simulation suite at the [University] campus in the city centre. This is believed to be the only such facility in the north west to assist in preparing nurses and other frontline health and social care staff for the outbreak at a time of exceptional demand” .
1.1. International Concern and Response
- Mitigating virus spread by introducing social distancing, PPE and infection prevention control measures;
- Initiating institutional responses in education delivery, e.g., the move towards e-learning, information technology equipment and support;
- Online learning to enhance digital literacy;
1.2. Policy and Guidance
1.3. Student and Staff Experience
1.4. Clinical Practice and Learning Environment
2. Materials and Methods
2.1. Research Design/Setting
- Plan the change to be tested or implemented,
- Do, carry out the change,
- Study, based on measurable outcomes, collect data and reflect on the impact of change,
- Act, change cycle or full implementation of the PDSA cycle.
- Focused directly on organisational strengths, rather than weaknesses,
- Explored underlying values, beliefs, assumptions of people and existing rituals, ceremonies of the teams, wards, and organisation,
- Mirrored the qualitative inquiry phases, through “discovery”, what is working well?, “envision”, what would they like to see happening more of the time?, “co-create”, how to achieve the vison?
2.2. Data Collection
2.3. Recruitment and Sample
2.4. Ethical Issues and Consent
2.5. Data Analysis
3.2. Themes from Initial Statements
3.2.1. A Sense of Duty by Wanting to Help during an Emergency Pandemic
“I believe I have come into nursing to help individuals at risk and who are sick. I don’t believe it would be right to opt out now when the NHS’ need is so high, and I could help”.(P13)
3.2.2. Opting-In or Out
3.2.3. Learning Opportunity and Experience
3.2.4. Financial Incentive
3.2.5. Role Clarification
3.2.6. Professional Practice
4.1. Global vs. Individual Responsiveness
4.2. Safeguarding and Protecting Professional Practice through Reward and Recognition
4.3. Workforce Optimisation through Appropriate Skill Acquisition
4.4. Enhancing Quality of Clinical Learning Experience and Environment
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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|1. Transcript analysis/marking||1. Note taking |
2. Listening to recording
3. Heading detection
4. Transcript preparation
5. Colour coding the focus-group interviews
|2. Deriving primary and sub-categories||6. Establishment of the primary and sub-categories |
7. Coding of the primary and sub-categories
|3. Confirming the primary and sub-categories||8. Finalisation of the primary and sub-categories|
9. Alignment of the data
10. Data saturation
|4. Verification of primary and sub-categories||12. Preparing the data for writing up |
13. Writing up
14. Test for validity
15. Linking the findings to the literature review
|Participant No||Initial Statement||Condensed Meaning||Basic Theme||Organization Theme||Global Theme|
|1||I believe it is my duty as a student nurse||It is my duty as a student nurse||Duty |
|3||The duty I have for patients will be continuous and|
I have decided to participate in this role as a nurse
|The duty I have for patients will be continuous I have decided to participate in this role as a nurse||Duty||Duty||Duty|
|9||I felt it was the right thing to do||I felt it was the right thing to do.||Right thing to do||Duty||Duty|
|13||I don’t believe it would be right to opt out now when the NHS’s need is so high, and I could help.||I don’t believe it would be right to opt out now when the NHS’s need is so high||Not right to opt out now||Duty||Duty|
|14||The reason I wanted to become a nurse was to help people, and that part of that responsibility meant volunteering to help when it was needed most.||I wanted to become a nurse to help people|
part of that responsibility meant volunteering to help when it was needed most
|Responsibility to help when needed||Duty||Duty|
|Emergency treatment, e.g., A&E||3||17.6|
|Orthopaedics and trauma||1||5.9|
|Head and neck cancer ward. Currently designated to deal with suspected Covid-19 cases||1||5.9|
|How Did You Decide to Go Into This Paid Placement?||Previously Worked in This Area?||Total|
|Yes, in a Previous Placement|
|Yes, Prior to My Degree |
|I asked for this placement, and it is an area in which I would like to work||1 (5.9)||0 (0)||1 (5.9)||2 (11.8)||4 (23.5)|
|I asked for this placement, but it is NOT and area in which I would like to work||0 (0)||0 (0)||2 (11.8)||0 (0)||2 (11.8)|
|I was offered this placement, and it is an area in which I would like to work||2 (11.8)||0 (0)||2 (11.8)||0 (0)||4 (23.5)|
|I was offered this placement, but it is NOT an area in which I would like to work||1 (5.9)||0 (0)||1 (5.9)||0 (0)||2 (11.8)|
|I was not offered a choice of where I was placed, but it is an area in which I would like to work||1 (5.9)||1 (5.9)||2 (11.8)||0 (0)||4 (23.5)|
|My initial choice had no more capacity, I was offered this and it’s not being terrible so far||0 (0)||0 (0)||1 (5.9)||0 (0)||1 (5.9)|
|TOTAL||5 (29.4)||1 (5.9)||9 (52.9)||2 (11.8)||17 (100)|
|1||Sense of duty||Workforce and skill mix|
|2||Opting-in or out|
|3||Learning opportunity and experience||Programme completion|
|5||Role clarification||Supernumerary status|
|6||Professional practice||Real world learning environment|
Becoming a nurse
|Themes from Literature Review||Primary Themes from Thematic Analysis||Sub Themes from the Thematic Analysis||Consolidated Theme|
|International concern and response||Opting-in or out||Global vs. individual responsiveness|
|Policy and guidance||Professional practice |
|Real world learning environment|
Becoming a nurse
|Safeguarding and protecting professional practice through reward and recognition|
|Student and staff experience||Sense of duty |
|Workforce and skill mix|
|Workforce optimisation through appropriate skill acquisition|
|Clinical practice and learning environment||Learning opportunity and experience||Programme completion||Enhancing quality of clinical learning experience and environment|
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McSherry, R.; Eost-Telling, C.; Stevens, D.; Bailey, J.; Crompton, R.; Taylor, L.; Kingston, P.; Simpson, A. Student Nurses Undertaking Acute Hospital Paid Placements during COVID-19: Rationale for Opting-In? A Qualitative Inquiry. Healthcare 2021, 9, 1001. https://doi.org/10.3390/healthcare9081001
McSherry R, Eost-Telling C, Stevens D, Bailey J, Crompton R, Taylor L, Kingston P, Simpson A. Student Nurses Undertaking Acute Hospital Paid Placements during COVID-19: Rationale for Opting-In? A Qualitative Inquiry. Healthcare. 2021; 9(8):1001. https://doi.org/10.3390/healthcare9081001Chicago/Turabian Style
McSherry, Robert, Charlotte Eost-Telling, Dean Stevens, Jan Bailey, Rhian Crompton, Louise Taylor, Paul Kingston, and Angela Simpson. 2021. "Student Nurses Undertaking Acute Hospital Paid Placements during COVID-19: Rationale for Opting-In? A Qualitative Inquiry" Healthcare 9, no. 8: 1001. https://doi.org/10.3390/healthcare9081001