Supporting the emergent nursing workforce in the wake of the COVID-19 pandemic.

COVID‐19 has had a swift and significant impact on nurses and nursing students across the globe due to both the extensive and rapid added demands on the nursing workforce, and the actions taken to flatten the curve (Fowler & Wholeben 2020). In order to attempt to contain the pandemic, imposed quarantine was used as a strategy in many countries. Imposed quarantine is an unfamiliar experience that can lead to isolation from friends and family and separation from usual activities (Usher et al. 2020). Isolation and separation from usual contacts and activities can cause people to feel unsafe and anxious and threaten an individual’s sense of connectedness.

The quarantine or isolation strategies imposed due to outbreaks of COVID‐19 led to the closure of schools and universities globally, and to altered modes of educational delivery (Ion et al. 2021). As a result of COVID‐19‐related restrictions, faculty were required to rapidly respond to undertake risk assessment and modify learning and teaching activities to ensure that student learning was as safe and as effective as possible during periods of restriction (Ion et al. 2021). These changes persisted for considerable periods of time and were a source of stress for students (Lee, 2020a, 2020b) and faculty, who in some countries were actively assisting to meet the service needs of the pandemic (Hayter & Jackson 2020). Aside from the obvious educational issues, attending classes and other on and off campus‐related activities represent important ways of coping for many students, as well as being a means of staying connected with classmates, friends, and teachers (Garbrah et al. 2020).

The global pandemic resulted in the loss of these previously taken‐for‐granted activities and outlets and have had ramifications for nursing students. For many nursing students, the isolation resulted in the cancellation or the (indefinite) postponement of classes and clinical placement activities, loss of part‐time jobs, or working or attending clinical placements in hospitals where they were required to care for infectious people, and/or risk exposure to infected patients and staff (Cao et al. 2020). Students have been isolated from normal social, emotional, and cultural support systems for extended periods of time, making them vulnerable to loneliness, stress, and mental health distress (Andrew 2020). In their study of third year baccalaureate nursing students, Heilferty et al. (2021) reported students experiencing dislocation and disorientation, loss in various forms, and mental fatigue resulting in physical and academic deterioration arising from pandemic‐related restrictions and issues.

However, there is rather less known about the longer term outcomes and effects of such outbreaks on students and their psychological distress. Even without a pandemic, anxiety is prevalent among nursing students (Savitsky et al. 2020) and nursing school is recognized as a ‘high stake, stressful environment, and the opportunity to be re‐traumatized is high’ (Fowler & Wholeben 2020). It is likely that the effects of COVID‐19 restrictions and the resultant disruption to student education has exacerbated the stressors of nursing school. Andrew (2020) drew attention to the need to particularly support international nursing students during COVID‐19 restrictions, pointing out that international students may be particularly isolated, and so more vulnerable to the negative effects of social isolation.

Nursing students have had to navigate those same issues associated with self‐care and decisions around vaccination as people in the broader communities (Alshehry et al. 2022) and have also faced additional stressors. Andrew (2020) highlights issues such as financial stress, reduced opportunities to make friends and develop support networks, inability to draw on usual support networks and the ensuing anxiety, loneliness and isolation and frames these as a ‘perfect storm of unrelenting stress’, which can have severe consequences for student mental health. In a study of undergraduate engineering and natural science students during the pandemic, Elmer et al. (2020) reported worsening levels of stress, anxiety, loneliness, and depressive symptoms, and found that social and physical isolation, reduced interaction, and social support were linked with adverse mental health patterns. These authors also found gender differences with female students experiencing poorer trajectories, even when controlling for various stressors.

The nature of nurse education means that delays in one part of the student learning trajectory can have considerable ramifications for progression. As a result of COVID‐19 disruptions many students have missed (or have had postponed) some aspects of their nurse education, including classroom, and clinical learning activities. Missed nursing education has been associated with deleterious and stressful outcomes for students and faculty (Palese et al. 2020) and this can mean delayed graduation, with the flow‐on effects of that, to students individually as well as to the profession more collectively.

The cumulative effects of the COVID‐19 pandemic on nurse education and on the new graduate workforce is not fully elucidated yet and will only become apparent over the coming years. However, the transition period from student to registered nurse is already known to be a period of challenge and stress in which graduates need considerable support (Pascale Blakey & Jackson 2016; Su et al. 2021). Currently and for the next few years, it is important to recognize that newly graduated nurses have had their education disrupted by the COVID‐19 pandemic, and that the disruptions continued for considerable periods of time.

It is important to recognize that nursing students of all years have experienced stress and uncertainty during the COVID‐19 pandemic (Drach‐Zahavy et al. 2022). Students and new graduate nurses are the future of our profession, and we all have a role to play in fostering a supportive environment for students and new graduates. In the aftermath of the COVID‐19 pandemic, there is a need to examine, recognize, and mitigate for the effects of the educational disruption and provide additional support for learning and positive, healthy socialization into nursing as may be needed.