This article provides the reflections of three University of Salford student nurses. Two have experience of working on the front line during the COVID-19 pandemic. One has now qualified as a registered nurse. The crucial role of students' personal tutors is also presented.
The nursing profession globally is facing unprecedented times due to the coronavirus disease outbreak (COVID-19). The recent experiences of student nurses and newly qualified nurses during the peak of COVID-19 cases and deaths in the UK has drawn into sharp focus the importance of particular aspects of undergraduate nursing programmes. These include developing empowered nurses who are courageous and resilient and who can contribute to the healthcare workforce while continuing with their education, leading to registration with the Nursing and Midwifery Council (NMC) (NMC, 2020).
To ensure that student nurses feel empowered, academic and clinical staff from universities and healthcare organisations must support these nurses, enabling them to find the courage to manage difficult clinical situations and to speak up where necessary (Barchard et al, 2017).
The University of Salford is situated in the heart of Greater Manchester. Having more than 20 000 students, 2000 staff and a global community of over 170 000 alumni, the university has a large School of Health and Society, offering undergraduate and postgraduate nursing programmes that lead to registration with the NMC. When second- and third-year student nurses embarked on their nursing career, at no time did they envisage that they would have to make decisions about joining an NHS frontline that was facing a worldwide pandemic.
Below are reflections from University of Salford nursing students and their personal tutors.
Kerry Cain is a second-year student nurse and mother to four children. Alongside charity work, and setting up her own sewing business, Kerry is also working in an accident and emergency department, supporting the NHS during the pandemic. Kerry decided to opt into a deployed contract, meaning that she has chosen to spend 80% of her hours in a paid clinical placement and the remaining 20% continuing with academic learning, completed online with the support of her personal tutor and other academics.
‘The request for student nurses to work on the front line during the COVID-19 pandemic brings with it many challenges … especially for those only part way through their degree’
Kerry said:
‘I wouldn't have it any other way. I thrive off being busy and get great satisfaction helping patients on placement and at work. I think keeping busy is my coping mechanism. I believe that I have seen some of the toughest things I will come across in my career during this pandemic. I have supported people as they died without loved ones and comforted people crying through sadness, fear or pure exhaustion. However, I have also seen the most wonderful acts of humanity, too—from members of the public turning up to the hospital in the night to give us lots of praise and gifts such as food and hand cream—to the nation coming out to clap every week and the overwhelming appreciation from our patients when they come into hospital with the fear that they have the virus.
‘Everything I have witnessed, whether it be good or bad, will influence my future practice as a student and nurse. I will reflect on the things that I have experienced and when I feel drained and defeated through life, work or when I'm struggling with an assignment, these things will remind me that I am strong and that, no matter how tough things get, it will all be worth it for both myself and my patients.’
Sarah Ratcliffe, personal tutor to Kerry, provides her own reflections:
‘The request for student nurses to work on the front line during the COVID-19 period brings with it many challenges for the undergraduate student nurses, especially for those students who are only part way through their nursing degree. From the very start of her programme, Kerry has always expressed a need to want to ‘do the right thing’ demonstrated during class discussions and even putting herself forward for group representative so she could be a strong voice for her peers. It came as no surprise that Kerry demonstrated the same fortitude when choosing to work on the front line. I am mindful that this period will not only challenge Kerry's physical resilience but will also push her emotional limits too. The role of the personal tutor has never been so important as now; students need the pastoral support to reflect on the many challenges that this new role brings but which will no doubt enrich their knowledge and future nursing philosophy.’
Nathan Harrison, a second-year student, helps to run the University of Salford's Nursing Society, supporting fellow students during the pandemic, providing student information and guidance to support their practice and to ensure that they keep safe.
Nathan provides his story:
‘It was a difficult decision to decide to opt in to the extended clinical placement or not. As soon as I heard that a Nightingale Hospital was going to open in Manchester, I knew I certainly wanted to work there. Therefore, I took the decision to work as a clinical support worker. Despite this role being different from my duties as a student nurse, I knew that I would still learn a lot from the people I met there and be able to apply my existing knowledge to working in a field hospital. ‘I first went to the Manchester Central Convention Complex for a Universities and Colleges Admissions Services (UCAS) convention when I was applying for university and I never thought that, years later, I would return to work there in a field hospital. I am proud to have been given the opportunity to work in the NHS Nightingale Hospital North West during the pandemic and to contribute to the efforts being made across the NHS. Alongside my work at the Nightingale, I am completing theory work for university to ensure that I stay on track with my studies.’
Maine Bolton is a newly qualified nurse from the University of Salford who was shortlisted in the Student Nursing Times Awards in the ‘Outstanding Contribution to Student Affairs’ category. Just before the pandemic took hold, Maine moved to Den Helder in the Netherlands, which has a large population of older residents. The number of COVID-19 cases in the Netherlands has reduced and lockdown measures are being scaled back. Maine is not yet able to work as a fully qualified nurse until she passes her Dutch language examination, a requirement for joining the Dutch Healthcare Professionals Register.
Maine said:
‘Being in a different country trying to figure out the healthcare service, language and culture is a steep learning curve, but it is something I have enjoyed learning about so far. I am still on the list as a volunteer and am awaiting a phone call where I can be of some use. Until then I will keep cheering my healthcare friends and colleagues, both here and back home, from the sidelines until I am able to join them. I am so proud of all the student nurses at Salford and I want to wish all my colleagues who are starting work the best of luck! ‘It has certainly been a baptism of fire for us newly qualified nurses who are entering the workforce during a global pandemic, but many are facing that challenge head on to provide excellent care for their patients. It's so amazing to hear the positive stories of communities coming together to support our healthcare and key workers. I have been joining in by clapping here too for both the NHS and the Netherlands' zorgmedewerkers (healthcare workers).’
Natalie Yates Bolton reflects on being a personal tutor to nursing students working on the front line, some of whom have only just qualified:
‘Our ongoing conversations with our students as they continue on their pre-registration journey or as they start their new staff nurse roles has brought into sharp focus some of the aspects of nursing we explored in our personal tutor sessions. These include the 6Cs of nursing, the importance of developing personal resilience, reflections on how as individuals they are able to contribute to effective team working and the importance of paying attention to our own wellbeing. ‘Each of our newly qualified staff nurses have exemplified courage in the way they have stepped straight into the NHS frontline and faced the current challenges that COVID-19 has brought. They have had to draw on the resilience they have developed during their lives to date so they can be the best nurse they can be for the patients they are caring for. ‘As their induction period has become more intense, they have embraced the opportunity to develop new clinical skills so they can contribute optimally to the care provided by their new clinical teams. These new nurses have also shared reflections on how they are using their time at home to ensure their ongoing wellbeing.’
Conclusion
These personal accounts demonstrate the varied experiences of University of Salford students and graduate nurses during this pandemic. They have demonstrated the difficult decisions that student nurses are having to make on the path towards professional NMC registration. The reflections from these nurses and their personal tutors provide insight into their immense personal resilience. Their stories show courage and compassion, demonstrating the juggling of university life with contributing to the NHS workforce.