A district nurse's reflection on pre-registration nursing education: a troubling position

How did student district nurses feel during the COVID-19 pandemic? A qualitative study

BACKGROUND

The COVID-19 pandemic placed a huge strain on healthcare services around the world, including community services. Students also faced substantial disturbance to educational programmes. Student district nurses are usually employed members of staff and can be recalled to the workforce, whereas pre-registration students cannot.

AIMS

This paper explores the feelings and experiences of student district nurses during the first UK national lockdown of the COVID-19 pandemic. An interpretative phenomenological approach was taken.

METHOD

A semi structured 1:1 interview and focus group was held via zoom in July 2020. A total of eight student district nurses, who were all registered adult nurses, took part. Data was analysed using the Braun and Clarke model to identify themes.

RESULTS

The findings related to their experience of being a community adult registered nurse on the frontline, while also being a student district nurse. Three themes were identified from the analysis: anxiety and uncertainty, management of risk and teamwork.

CONCLUSION

This study highlights the contribution that community nurses made in the clinical response to the COVID-19 pandemic. It adds to a paucity of literature available from this clinical setting and specifically from the viewpoint of a student district nurse. There is much written on the strains on hospital care, but it should be remembered that district nursing is the service that never shuts its doors because it has reached capacity. This study found that a lack of communication and uncertainty about their future as students contributed to heightened stress and anxiety. Teamwork and camaraderie are a vital aspect of any team and one that can support resilience in times of heightened stress. A lack of face-to-face interaction can lead to team members feeling isolated. Digital technology can be used to reduce this feeling when possible.

Pre-registration nursing students' perceptions of a district nursing career: a qualitative descriptive study

District nursing vacancies are recognised as high in comparison to many other nursing specialities. The role is often considered as an option for nurses after a period of registration as a nurse, which may be informed by multiple factors. The objectives of the study were to explore barriers to district nurse employment from the perspective of undergraduate nurses. A descriptive qualitative design was employed using focus groups as the method of data collection in accordance with study approval reference no: 21/NAH/006, 30/03/23. Participants were recruited from the current undergraduate nursing programme (n=60). Thematic analysis was chosen as a flexible method of qualitative data analysis. The study produced themes relating to role ambiguity, personal preferences, educational opportunities and recruitment and employer engagement. The experiences provided an insight into the barriers to recruitment of student nurses into district nursing on qualification. Increased engagement from community nurse providers is required to inform the role and incentivise entering this career option. Educational strategies that support community career pathways are required to ensure a balanced view of nursing roles among undergraduates.

Community nurse lecturers' experiences of pre-registration nurse education: a phenomenological study

The aim of this study was to explore the lived experiences of community nurse lecturers in pre-registration nurse education and to gain insight into the nature of community nursing and its profile within pre-registration nursing. A qualitative phenomenological approach explored pre-registration, adult field nurse lecturers' experiences of being community nurses and subsequently their experiences of being community nurse lecturers. Three participants audio recorded answers prompted by three questions that allowed for storytelling and prompted memory recall. The results were analysed, and the themes identified were: community nursing is vastly different to hospital nursing, with a notable heightened sense of accountability, lone working and a recognition of experience needed to be a community nurse. When reflecting on their role as lecturers, research participants recalled responses that informed the second theme: the pre-registration adult nursing curriculum was acute care focused and this was also the expectation of students. Results identified tensions between community nursing and critical care nursing, and a loss of identity to which each of them embraced in different ways.