The first COVID-19 new graduate nurses generation: findings from an Italian cross-sectional study

Abstract

Background Nursing education has been disrupted by the onset of the COronaVIrus Disease 19 (COVID-19) pandemic, potentially impacting learning experiences and perceived competencies at the time of graduation. However, the learning experiences of students since the onset of COVID-19, their perceived competences achieved and the employment status one month after graduation, have not been traced to date. Methods A cross sectional online survey measured the individual profile, the learning experience in the last academic year and the perceived competences of the first COVID-19 new nursing graduates in two Italian universities. Details relating to employment status and place of employment (Covid-19 versus non-COVID-19 units) one month after graduation were also collected and the data compared with those reported by a similar cohort of new graduates pre-pandemic in 2018–2019. All those who graduated in November 2020 and attended their third year after the onset of the COVID-19 pandemic were eligible. The online survey included individual, nursing programme and first working experience variables alongside the Nurse Competence Scale (NCS). Descriptive and inferential statistical analyses were performed. Results A total of 323 new graduates participated. In their last academic year, they experienced a single, long clinical placement in non-COVID-19 units. One month after graduation, 54.5% (n = 176) were working in COVID-19 units, 22.9% (n = 74) in non-COVID-19 units and 22.6 (n = 73) were unemployed. There was no statistical difference among groups regarding individual variables and the competences perceived. Fewer new graduates working in COVID-19 units experienced a transition programme compared to those working in non-COVID-19 units (p = 0.053). At the NCS, the first COVID-19 new graduate generation perceived significantly lower competences than the pre-COVID-19 generation in the ‘Helping role’ factor and a significant higher in ‘Ensuring quality’ and ‘Therapeutic interventions’ factors. Conclusions The majority of the first COVID-19 new graduate generation had been employed in COVID-19 units without clinical experience and transition programmes, imposing an ethical debate regarding (a) the role of education in graduating nurses in challenging times with limited clinical placements; and (b) that of nurse managers and directors in ensuring safe transitions for new graduates. Despite the profound clinical placement revision, the first COVID-19 new graduate generation reported competences similar to those of the pre-COVID-19 generation, suggesting that the pandemic may have helped them to optimise the clinical learning process.

Self‐assessed competence of final‐year nursing students

“…If the supervision during the pandemic was limited, this supports the finding that competence was assessed lower. The Italian study(Palese et al, 2022) likewise confirmed the changes in nursing students' perceived competence levels due to the impact of the COVID-19 pandemic. The changes and measures taken in undergraduate education to address the impact of the COVID-19 pandemic may have influenced new graduates' perceptions of their own competence and their employment status after graduation(Palese et al, 2022).The relationship between the attributes of a nursing students' final clinical learning environment with the level of their self-assessed competence was investigated in several multi-country European studies(Kaihlanen et al, 2021;Visiers-Jiménez et al, 2021).…”

“…The Italian study(Palese et al, 2022) likewise confirmed the changes in nursing students' perceived competence levels due to the impact of the COVID-19 pandemic. The changes and measures taken in undergraduate education to address the impact of the COVID-19 pandemic may have influenced new graduates' perceptions of their own competence and their employment status after graduation(Palese et al, 2022).The relationship between the attributes of a nursing students' final clinical learning environment with the level of their self-assessed competence was investigated in several multi-country European studies(Kaihlanen et al, 2021;Visiers-Jiménez et al, 2021). The contribution of the students' perceptions of their final clinical learning environment, good supervisory relationship to a better level of self-assessed competence and to the success of the transition of newly graduated nurses was highlighted(Kaihlanen et al, 2021;Visiers-Jiménez et al, 2021).…”

Prevention from Sharp Injuries in the Hospital Sector: An Italian National Observatory on the Implementation of the Council Directive 2010/32/EU before and during the COVID-19 Pandemic

“…Nonetheless, the Italian National Healthcare System (NHS) was heavily stressed by COVID-19: the price that the NHS had to pay both in terms of the number of positive virus cases and deaths among the HCWs was significant and represented a peculiarity compared to what happened in other countries [ 42 ]. Considering the increase in the intensity of care due to the selective hospitalization of patients with COVID-19 and other emergency medical or surgical conditions in 2020 and 2021 [ 43 ], the low rate of staff turnover (due to the shortage of collaborators) [ 42 ], the consequent pressure to immediately recruit new nursing graduates [ 44 ], as well as residents and even medical students for some roles, the system has shown a good level of resilience and the implementation of occupational accident prevention measures prior to this emergency has certainly helped protect healthcare workers during the pandemic, although other coping strategies may have intervened. A study on organizational resilience processes among HCWs in Switzerland in the first year of the pandemic found that the difficulties in implementing COVID guidelines and protection measures fell in the category of problematic situations associated with the development of new standards, that is, HCWs became used to new ways of working and developed new skills to perform effectively [ 45 ].…”

New graduate registered nurses’ professional competence and the impact of preceptors’ education intervention: a quasi-experimental longitudinal intervention study

“…Expectations that are sometimes unrealistic may cause sense of inadequacy and stress, and this may in turn prevent NGRNs from fully deploying their competences [ 5 , 6 ]. The COVID-19 pandemic has also brought new challenges to NGRNs by decreasing graduating students’ clinical placements opportunities [ 7 , 8 ], which may in turn affect NGRNs’ readiness to enter clinical practice and increase NGRNs’ feelings of fear, fatigue, and self-doubt [ 7 , 9 ].…”

“…Previous studies about NGRNs’ competence have focused on the practice environment, occupational commitment, and empowerment and on NGRNs’ perceptions of self-assessed competence level during their first year after graduation [ 8 , 27 – 33 ]. Competence-related intervention studies [ 36 – 38 ] have focused on more seasoned registered nurses, but studies about interventions aimed at developing NGRNs’ professional competence and preceptors’ role in competence development are lacking.…”