Readiness for practice in undergraduate nursing students during the COVID-19 pandemic: a cross-sectional study.

Background: The Coronavirus disease 2019 (COVID-19) pandemic negatively impacted nursing students' opportunity to gain experience through clinical placement, potentially threatening their readiness for practice and their clinical competence. The aim of this study was to explore whether and to what extent the third-year undergraduate nursing students perceived that their readiness for practice was impacted by changes to clinical placement and classroom learning implemented in response to the COVID-19 pandemic. Study design: Cross-sectional study. Methods: The study was conducted in a university of North-western Italy that provides nursing education across five sites. All sites stopped in-person classroom learning at the beginning of March 2020, but each site was free to decide whether to continue in-person clinical placement based on the local epidemiological situation. All 228 third-year nursing students who completed their degree by June 2020 were invited to participate. Data were collected via online questionnaire, which included the question "What impact do you think that COVID-19 safety measures employed by your nursing programme had on your readiness for practice?" Answers were given on a 5-point Likert scale (none, minimal, moderate, major, and severe). Explanatory variables were collected at the individual, nursing programme, and university site levels. Results: A total of 126 (response rate 55.3%) nursing students completed the questionnaire. Overall, 84 (66.7%) perceived that COVID-19 safety measures had a moderate to severe impact on their readiness for practice. These students often had lower grade point averages (p=0.037) and received no clinical placement during the pandemic (72.6% vs 90.5% of students who reported no or minimal impact, p=0.022). Average duration of third-year clinical placement was also lower among these students, though it was not statistically significant. No differences emerged at the university site level. Conclusions: Despite important advances in technology-based educational activities, clinical placement remains the best educational strategy to allow nursing students to feel prepared to work effectively during a pandemic.

Nursing student plans for the future after graduation: a multicentre study.

BACKGROUND: When modelling the nursing workforce, estimations of the numbers and characteristics of new graduates over the forecast period are assumed on the basis of previous generations; however, new graduates may have different plans for their future than those documented previously in different socio-economical contexts. AIMS: To explore (a) nursing student plans after graduation and factors influencing their plans, and (b) factors associated with the intention to emigrate. METHODS: A survey questionnaire was developed and distributed to students attending their final third year of nursing education in seven universities in Italy in 2015. Nine hundred and twenty-three (90.4%) students participated. FINDINGS: Four different plans after graduation emerged: about two-thirds reported an intention to look for a nursing job in Italy; the remaining reported (a) an intention to emigrate, looking for a nursing job abroad, (b) an intention to search for a nursing job in both Italy and abroad, and (c) while a few an intention to continue nursing education in Italy. Having previous experience abroad, the need to grow and be satisfied, trusting the target country and a desire to increase knowledge encouraged an intention to emigrate, whereas the desire to stay in a comfortable environment and nurture personal relationships prevented the desire to migrate. CONCLUSION: Nursing students may have different plans after graduation, and this should be considered when modelling the nursing workforce of the future. IMPLICATIONS FOR NURSING/HEALTH POLICY: Policymakers should be aware of different plans after graduation to guide healthcare human resource strategies. Knowing these trajectories allows policymakers to estimate the appropriate nursing workforce, and also to act at both macro- and meso-levels, on work environments and opportunities for professional development, according to the different levels of expectations.

Incidence and severity of oral mucositis in patients undergoing haematopoietic SCT--results of a multicentre study.

Oral mucositis (OM) is a common side effect experienced during haematopoietic SCT (HSCT), and it can have a significant impact on the quality of life of patients. A descriptive nurse-led study was undertaken in 19-member centres of the Italian national transplant group (GITMO) evaluating incidence, severity and duration of OM in patients undergoing HSCT. Data from 1841 patients between 2002 and 2006 was analyzed. Initial medical history and oral cavity assessment was performed. Assessment was repeated on the day of transplant, then daily, using the WHO (World Health Organisation) oral toxicity scale. A total of 71% of the patients evaluated developed mucositis and 21.6% developed severe mucositis. Duration of OM in most cases lasted for 10-14 days and resolved along with marrow reconstitution. Oral mucostitis is a frequent side effect in patients undergoing HSCT. The onset of severe mucositis seems to be related to the conditioning regimen used. This database provides a descriptive overview of the incidence and severity of mucositis and has encouraged participating centres to adopt routine evaluation and measurement of the oral cavity. The assessment tools are still used in some centres, providing a basis for further collaborative research projects.

[For a history of nursing care and nurses in Italy: the indications for research on sources and bibliography]. / Per una storia dell'assistenza infermieristica e degli infermieri in Italia: indicazioni per la ricerca delle fonti e della bibliografia.

This is the final article of a series, where main problems and social conditions of italian nurses at the beginning of the century were analyzed, and a thorough (but not exhaustive) list of the main bibliographic sources is presented. Historical research on the recent origins of the nursing profession (beginning of the century) can be very awkward and time consuming because many of the original sources are not very well known, not readily available and scattered in several major and minor libraries and private associations. Knowing what is available and what has already been used for historical research can give a further impulse to the research and enrich the data base and information on readily available sources.

["A nurse fed with pompous words": working conditions and the primary nursing demands at the beginning of the 1900s]. / "Un infermiere pasciuto di rombombanti parole": condizioni di lavoro e prime rivendicazioni infermieristiche all'inizio del novecento.

Working conditions of nursing personnel at the beginning of the century varied widely from hospital to hospital: the number of working hours could range from 10 to 15 hours a day, with up to ten fold variability of (overall low) salary. Social security, holidays and retirement pensions were just dreams. Nurses had no right to proper meals and had to sleep in crowded, noisy and unhygienic rooms: the relationship between these conditions and quality of care was often debated on professional journals and in the Parliament. Unfortunately nursing Leagues were reluctant to go on strike because they did not want to harm patients. Pressures were put on hospital administrators in order to obtain more human living and working conditions for nurses: strike and claims were considered detrimental for the mission of nursing. The claim for a set of rules homogenous all over the country was opposed with the reason that extra money spent for nurses, would have been subtracted from resources available for patients.

[A window on the past: lay nurses and nun nurses in hospital modernization at the start of the 20th century]. / Una finestra sul passato: infermieri laici e suore infermiere nella modernizzazione ospedaliera di inizio novecento.

The presence of nuns in Italian hospitals raised hot debates since the beginning of the century. Though recognised by a large majority as ideal nurses, for the devotion and the amount of time spent working in the hospital, physicians, feminist movements and nursing leagues expressed much criticism against nuns, for several reasons: a. nuns were more liable to the Mother Superior than to the hospital administration, therefore could not be neither controlled nor sanctioned; b. misplaced "religious" behaviors and beliefs (i.e. the body as an occasion of sin; suffering means spiritual salvation) which may threaten proper care for patients; c. nuns could not act as educators or role model for nurses because they were mainly involved in organizational and management activities and not in direct patient care; d. among other problems, the way of dressing, with large hats and long sleeves was a source of transport of microorganisms). Lack of properly educated and trained lay nurses, able to substitute nuns, some improvement in nuns' education, strongly promoted by Pope Pio X and the dissolution of nursing leagues put an end to the fight for the secularization of hospitals.

[A window on the past: are women more adapted to care of the sick?]. / Una finestra sul passato: la donna è più adatta alla cura degli infermi?

The issue of nurse and nursing as feminine concepts and profession was widely debated at the beginning of the century by various professional and political groups and female associations. One of the most accepted positions even among nurses was that women by nature are more patient and kind, therefore born to care for men. Women supported this position because saw in the nursing profession the possibility to have a job and economical independence, but the role of mother and nurse were considered conflicting. Doctors strongly favoured a female nurse, from middle class well educated women but the idea behind this position was to keep separate and subordinate roles. With the first World War, when lack of theoretical knowledge and organization of Italian nurses, especially compared with foreign countries, were evidenced, National Council of Italian Women proposed a nursing curriculum only for female nurses and with very strict requirements. Nurses Federation succeeded in 1920 in opening nursing education to both men and women but, with the advent of fascism, in 1925 a Regio Decreto Legge, with the establishment of Scuole Convitto only for female nurses was definitely approved.

[A window on the past: nurses and education]. / Una finestra sul passato: gli infermieri e la formazione.

The history and the state of the art of the debate on nursing education in the first two decades of 20th century is presented. Improvement of nursing education was a strongly felt need from nurses and physicians: feminist movements were strongly in favour of a limited role of physicians in nursing education. Nurses trade unions (Leghe degli infermieri) supported an improvement of nurses' education as a mean to protect patients rights for a better care. Only a minority of physicians opposed the introduction of the English model of nursing care, with the matron who had the power of organizing the hospital. After the advent of fascism the law of 1929 on institution of Scuole Convitto was approved, and this law hindered the development of a reform of nursing education up to the Seventies.