Clinical education during a crisis lived experiences of nursing students in Sweden during the COVID-19 pandemic.

Background: Nursing education entails extensive training across varying settings where nursing students can practice their theoretical knowledge and practical skills for their future profession. Skills in evidence-based practice are pivotal competences for nurses and need to evolve from novice to expert skills. During the COVID-19 pandemic, Sweden had a unique approach to restrictions. The conditions for nursing students to apply their practical skills changed, as the COVID-19 pandemic influenced nursing education. Previous studies lacked focus on the clinical and practical aspects of the nursing education during the COVID-19 pandemic. Such experiences can provide valuable knowledge for nursing education, especially in preparing for future crises as well as understanding the needs of the nurses who were educated during the pandemic. The aim of this study is therefore to highlight the essence and understanding of the experiences of nursing students undertaking nursing education in Sweden during the COVID-19 pandemic.

Methods: A qualitative interview study of nine nursing students recruited through a convenience sample. The data was analyzed through a phenomenological hermeneutic approach, chosen for two of the opportunity to use the researcher's preunderstanding. The result is presented in three main themes; Being disappointed yet accepting the situation, Feelings of uncertainty and the covid-19 pandemic provided new insights, the two latter are further divided into a total of eight subthemes.

Results: The COVID-19 pandemic affected nursing students' experience with clinical learning and contributed to their unique experiences. Compared to students who began their nursing education during the COVID-19 pandemic, those who started before the outbreak faced more significant adjustments in their learning. It was seen as positive for the student's future profession that a great focus was placed on how to prevent the spread of infection. The students experienced loneliness in the lack of support from other students, and fear of infecting or being infected. Furthermore, there was a lack of clinical placement and training hours, leading to worries of not being prepared. Opinions differed between the students on whether the clinical knowledge they acquired during the training was sufficient. Whilst the vast majority wanted more time for practical elements and training, they emphasized that this was not solely caused by the impact of the COVID-19 pandemic but an effect of the design of the education.

Conclusions: The study showed that, through the shared experiences of nursing students who studied during the COVID-19 pandemic, education and the acquisition of clinical skills were affected. The students experienced feelings of loneliness in their isolation and fear of infecting or being infected throughout their education. However, the majority found themselves with a sense of acceptance of the situation, while there were also experiences of pausing the education because of the pandemic. Being a part of the group of nursing students participating in education during the COVID-19 pandemic gave new insights into the nursing profession regarding hygiene routine and hindering factors in communication with patients. Nursing students who have gone through their education during the COVID-19 pandemic have unique experiences such as preparedness of coming pandemics and the importance of reflection surrounding clinical education that are worthy of sharing. These experiences could be helpful when developing nursing education in the future and preparing for possible future crisis situations.