Novice nurses knowledge and skill performance in high crisis situations during the COVID-19 pandemic

Background: The Covid-19 pandemic caused over 38,900 deaths in the state of Ohio with a cumulative hospitalization (March 2020-July 2022) of approximately 119,500. The pandemic propelled novice nurses to quickly demonstrate knowledge and skills of high crisis patient care, such as Advance Life Support (ALS) events. This forced organizations to rapidly deploy educational interventions to support the novice nurse's delivery of high-quality emergent patient care delivery. The literature supports simulation to improve the novice nurses' self-confidence yet, the literature remains unclear regarding how simulation enhances knowledge and skill performance, especially during a pandemic. Methods: Using an experimental randomized controlled, longitudinal, pre-test, post-test design, this study examined the effects of adding an on-line Advance Life Support (ALS) patient scenario module to the current ALS program when exploring participant training experience, knowledge, and skill of the required ALS concepts (initiating cardiopulmonary resuscitation, ECG rhythm recognition, pharmacology, and team communication) during high crisis patient care situations. A convenience sample (N=27) of novice nurses who are employed at a Mid-Western health system were randomly assigned to control and intervention groups. Both groups completed a demographic questionnaire followed by participation in a video-taped, ALS high fidelity simulation and debrief for evaluation of baseline knowledge and skill performance at baseline and at three months. Between the simulations (1 month) the intervention group received the same written clinical update as the control group, plus an independent on-line patient scenario of ALS concepts. Qualitative descriptors of the novice nurse's experience of participating in high crisis simulations were explored. Results: Nine participants completed this study. Quantitative descriptive statistics for trends noted, at baseline, both the control and intervention groups scored low (Control 25% n=4;Intervention 67% n=5) for the skills of "Initiating high quality CPR).". Post intervention, the control group missed CPR resuming in less than 10 seconds after defibrillating at 150-200 joules. When assessing the participants practice areas the control group had 3 of the 4 participants in the ICU and 1 in the Progressive Care units. This missed skill item could be contributed to the oversaturation of codes, coupled with the mental exhaustion form the pandemic, could lead to missed care even during practiced repetitive skills. Quantitative data trends for knowledge and skill coupled with the participant attrition rate of 67% (n=18) led to the exploration of the experience of novice nurses participating in ALS cardiac arrest training during a pandemic. Three qualitative descriptors emerged by examining the transcripts from the simulation debriefs for all simulations: team collaboration, mental distress, and increased confidence to incorporate new skills. Conclusions: On-line independent patient scenarios provided reinforcement of ALS knowledge and skill concepts. Critical knowledge and skill team communication principles may not be reinforced when providing patient care. Simulation debriefs allow the novice nurses to apply fundamental concepts in a safe learning environment. Novice nurses need scaffolding of knowledge to grow and maintain their knowledge, skill, and confidence. Future education experiences should be designed to allow for frequent dosing of simulations with structured debriefs. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The impact of the COVID-19 pandemic on the perioperative transition to specialty practice program.

AIM: To understand how the COVID-19 pandemic impacted nurse educators' and novice nurses' experience with the perioperative transition to specialty practice program. DESIGN: A qualitative descriptive study. METHODS: Semi-structured interviews were conducted with five perioperative nurse educators and five perioperative transition to specialty practice program participants from a major metropolitan health service in Melbourne. Data were collected between April and July 2021. Interviews were audio-recorded and transcribed verbatim, and data were analysed using reflexive thematic analysis. RESULTS: Five themes were identified. The value of the perioperative transition to specialty practice program in supporting novice nurses was recognized in the theme 'Nurturing our novices'. Widespread changes to clinical practice were demonstrated in the theme 'Every day is different', including changes to elective surgery, redeployment of staff and the transmission risk of COVID-19. 'The perils and joys of online learning' revealed both challenges and benefits of transitioning theoretical education from face-to-face to online delivery. 'Roller coaster of emotions' represented the heightened emotions participants experienced due to the COVID-19 pandemic. 'Looking back to move forward' encompassed participants' reflections on the year, considering the challenges, adaptive strategies and the future of perioperative nursing education. CONCLUSION: The perioperative transition to specialty practice program was significantly impacted by the COVID-19 pandemic. Participants needed to adapt to rapid and frequent changes, which contributed to feelings of emotional distress, affected consolidation of clinical learning and reduced engagement with theoretical education. IMPACT: Perioperative nurses should acknowledge that opportunities for learning were decreased for transition to specialty practice program participants during the pandemic. Ongoing support and education should be provided, to nurture the future generation of perioperative nurses.

Burnout and impostor phenomenon in nursing and newly licensed registered nurses: A scoping review.

AIMS AND OBJECTIVE: To identify the prevalence and severity of impostor phenomenon and burnout in newly licensed registered nurses, map the current literature on impostor phenomenon in nursing, and identify related factors affecting the new nurse's transition to practice. BACKGROUND: Impostor phenomenon is an internalised intellectual phoniness resulting in persistent self-doubt despite prior success. It can evoke feelings of emotional exhaustion associated with burnout, negatively affecting employee retention. Due to changes in nursing education resulting from COVID-19, self-doubt and uncertainty among new nurses are expected to be heightened, leading to burnout which adversely effects nurse well-being, patient care and retention. DESIGN: The scoping review follows the methodological framework developed by Arksey and O'Malley (2005) and the Reporting Checklist for Scoping Reviews (PRISMA-ScR) guidelines. METHODS: The literature search was conducted utilising PubMed, CINAHL and PsycINFO. Inclusion criteria were studies published between 2011 and 2021, written in English, peer-reviewed, and focused on newly licensed registered nurses. Eighteen articles were reviewed. RESULTS: Studies on impostor phenomenon in nursing are limited to nursing students and clinical nurse specialists. Prevalence of impostor feelings in these populations range from 36% to 75%, and 12.3% to 46% of new nurses report burnout. Impostor feelings arise from role ambiguity, lack of self-compassion, transitions, and minimal clinical experience. Burnout was associated with stress, feeling unprepared, inadequate socialisation, and lack of self-compassion. Overlap in these factors could increase impostor feelings and burnout in new nurses. CONCLUSIONS: Effects of impostor phenomenon and burnout can negatively impact the well-being of the new nurse. Currently, no studies simultaneously examine impostor phenomenon and burnout in new nurses. Further research on the relationship between these phenomena should be conducted. RELEVANCE TO CLINICAL PRACTICE: Understanding the impact of impostor phenomenon and burnout on new nurses could help mitigate challenges they face transitioning into practice.

How Psychological Variables Maybe Correlated with Willingness to Get COVID-19 Vaccine: A Nationwide Cross-Sectional Study of Polish Novice Nurses.

INTRODUCTION: Nurses became the largest medical group exposed to direct contact with the SARS-CoV-2 virus. In this study, we aimed to assess the readiness and motivation for vaccination, as well as the use of sources of information and attitudes toward vaccination depending on the psychological profile. MATERIAL AND METHODS: A cross-sectional online survey study was conducted. The study included 145 novice nurses from 8 medical universities who completed 3-year undergraduate studies. Women constituted 97.2% of the respondents (N = 141). The Generalized Anxiety Disorder 7-Item Scale, General Self-Efficacy Scale, Brief Resilient Coping Scale, and an original questionnaire were used. Variables were analyzed with descriptive statistics methods. A p-value of <0.05 was considered statistically significant. RESULTS: Among the participants, 73.1% had already been vaccinated against COVID-19 (N = 106). The participants were divided into two groups: G1 (N = 98), characterized by a lower level of anxiety with higher self-efficacy and resilient coping, and G2 (N = 47), with a higher level of anxiety with poorer self-efficacy and resilient coping. The analysis of the potential correlation of psychological pattern with the decision to vaccinate was not statistically significant (p = 0.166). CONCLUSION: Psychological variables may be correlating with motivation, attitudes toward vaccination, and the choice of reliable sources of information about vaccination. Our study demonstrates the key role of two psychological variables, self-efficacy and resilient coping, in this context.

Creative Solutions to Assure New Graduate Preparation and On-Boarding

The pandemic has caused nurse leaders to rethink how to best prepare nurses for practice in challenging times. Creative strategies employed by nurse leaders in academia and in community settings can ensure that new graduate nurses are ready for practice. This article discusses ideas for implementation or refocus that are required to meet the needs of the novice nurse and community partners.

Novice nurses' transition to the clinical setting in the COVID-19 pandemic: A phenomenological hermeneutic study.

Background: The COVID-19 pandemic both exposed and increased weaknesses in the healthcare system, so that novice nurses have become a more vulnerable group during this context. Aim: This study sought to illuminate experience of novice nurses in providing care during the COVID-19 pandemic. Method: It consists of a qualitative study conducted with data collected by means of semistructured interviews, audio recorded, transcribed, anonymised, and analysed in the light of the phenomenological hermeneutic approach. Fourteen registered novice nurses from two health areas in northwest of Spain, being twelve women and two men, who experienced the COVID-19 pandemic within their first five years of professional experience, were selected through a non-statistical snowball sampling. Results: After analysing the narratives, we identified four main themes: "Transitioning to a hostile, unknown and uncertain clinical setting from inexperience," "Invisible wounds because of being on the front line," and "Healing to return to the front line." Discussion: The uncertainty of an unknown illness and the lack of support during the COVID-19 pandemic has been affecting novice nurses, impacting their health conditions. At the same time, this context created opportunities for professional development. According to the interviewees, self-care and social support were elements to cope with exhaustion. Conclusion: Our study investigates the experiences of a group barely approached in the literature, highlighting the reality and difficulties of these nurses in transitioning to the clinical setting and providing insights to managerial leaders and educators.