Readiness for Nursing Practice Among New Graduate Nurses During Pandemic

#1

The COVID-19 pandemic resulted in unprecedented changes to prelicensure nursing education. In March 2020, nursing
programs across the United States (US) had to quickly transition from in-person classes, simulations, and clinical
experiences to offering comparable remote learning experiences. During the Fall 2020 semester, many programs had to
continue offering didactic classes online. For those that were able to hold some in-person classes and/or simulations,
modifications were often needed to adhere to social distancing and room capacity requirements. For clinical learning,
the number of hours were often reduced (National Council of State Boards of Nursing, 2020; North Carolina Area Health
Education Centers [NC AHEC], 2021). As the Spring 2021 semester began, a surge in COVID-19 cases occurred, and many
schools continued to experience limitations to in-person learning. While there was disruption of in-person learning for
the final weeks of the May 2020 graduates' education, it is the May 2021 graduates who experienced a much larger loss
of in-person learning. It is not known how this will impact their transition-to-practice (TTP) following graduation.

Paraphrase:

The COVID-19 pandemic has caused tremendous changes in pre-licensure in teaching nursing. At Walk 2020, nursing
programs in the United States (US) had to move quickly from face-to-face classes, reenactments, and clinical encounters
to those that facilitate equally broad learning encounters. In the midst of the Drop 2020 semester, many programs had
to continue promoting their educational courses online. Where in-person classes and retreats could be held, they often
had to be adjusted to accommodate social relocation and space capacity requirements. Time for clinical study is
regularly shortened (National Chamber of State Sheets of Nursing, 2020; North Carolina Region Wellbeing Instruction
Centers [NC AHEC], 2021). As the 2021 spring semester began, COVID-19 cases surged, continuing to hinder in-person
learning in many schools. In-person learning was interrupted in the final week of his May 2020 graduate training, but it
was his May 2021 graduate who had much greater misfortune with in-person learning. It is unclear how this will affect
post-graduation transfer to practice (TTP).

Powers, K., Montegrico, J., Pate, K., & Pagel, J. (2021). Nurse faculty perceptions of readiness for practice among new
nurses graduating during the pandemic. Journal of Professional Nursing, 37(6), 1132-1139. Retrieved from
https://doi.org/10.1016/j.profnurs.2021.09.003

#2

The current state of alarm due to the COVID-19 pandemic has led to the urgent change in the education of nursing
students from traditional to distance learning. The objective of this study was to discover the learning experiences and
the expectations about the changes in education, in light of the abrupt change from face-to-face to e-learning education,
of nursing students enrolled in the Bachelor’s and Master’s degree of two public Spanish universities during the first
month of confinement due to the COVID-19 pandemic. Qualitative study was conducted during the first month of the
state of alarm in Spain (from 25 March–20 April 2020). Semi-structured interviews were given to students enrolled in
every academic year of the Nursing Degree, and nurses who were enrolled in the Master’s programs at two public
universities. A maximum variation sampling was performed, and an inductive thematic analysis was conducted. The
study was reported according with COREQ checklist. Thirty-two students aged from 18 to 50 years old participated in the
study. The interviews lasted from 17 to 51 min. Six major themes were defined: (1) practicing care; (2) uncertainty; (3)
time; (4) teaching methodologies; (5) context of confinement and added difficulties; (6) face-to-face win. The imposition
of e-learning sets limitations for older students, those who live in rural areas, with work and family responsibilities and
with limited electronic resources. Online education goes beyond a continuation of the face-to-face classes. Work should
be done about this for the next academic year as we face an uncertain future in the short-term control of COVID-19.

Paraphrase:
The current state of alert due to the COVID-19 pandemic has prompted urgent changes Nursing student education from
traditional learning to distance learning. The purpose of this study was to pursue an undergraduate and postgraduate
degree in nursing from her two public universities in Spain, and to find a way to improve her learning experience and
teaching in the face of the abrupt switch from face-to-face to e-learning teaching. It was to identify expectations for
change. The first month of stay-at-home due to the COVID-19 pandemic. A qualitative investigation was conducted
during her first month of alert in Spain (25 March to her 20 April 2020). Semi-structured interviews were conducted with
a student enrolled in each grade of nursing and a nurse enrolled in her master's program at two public universities.
Maximum variation sampling was performed and inductive thematic analysis was performed. This study was reported
according to the COREQ checklist. His 32 students aged 18 to his 50s participated in this study. The interview he lasted
from 17 minutes to 51 minutes. Six main themes have been defined. (1) Nursing practice. (2) Uncertainty. (3 times; (4)
pedagogy; (5) confined situations and additional difficulties; (6) face-to-face victories and limited electronic resource
constraints. Online education goes beyond the continuation of face-to-face classes. This will need to be tackled next
academic year as we face an uncertain future in the near future in the fight against COVID-19.

Morcillo, A., Costa, C., García, J., & Martínez M. (2020, July 21). Experiences of Nursing Students during the Abrupt
Change from Face-to-Face to e-Learning Education during the First Month of Confinement Due to COVID-19 in Spain
retrieved from https://www.mdpi.com/1660-4601/17/15/5519/pdf

#3

The fight against coronavirus disease of 2019 (COVID-19) remains ongoing in Saudi Arabia and around the world. To
date, there are more than 41.5 million confirmed cases globally and more than 340,000 confirmed cases in Saudi Arabia
(1). The COVID-19 pandemic has immensely affected all aspects of society (2). At present, a vaccine and medicine against
COVID-19 have yet to be developed, and the prevention and control of this disease are the major challenges that every
country faces.

Since the outbreak of the disease, different governments around the world have been implementing measures to
contain and prevent the transmission of COVID-19. The World Health Organization published COVID-19 guidelines and
protocols, which were adopted by the ministries of health of different countries (3). These protocols include information
on signs and symptoms and prevention of and protective measures against COVID-19. The Centers for Disease Control
and Prevention reiterated that everyone should protect themselves and others to prevent the spread of the disease;
such protection includes proper hand hygiene, proper distancing, use of mask, proper etiquette when coughing and
sneezing, and isolation and decontamination of surfaces (4). The success of the measures implemented is based on the
people's adherence to prevention controls, which is largely influenced by knowledge, perception, and preventive
behavior against COVID-19 (5). In the US, 47% of the surveyed population are willing to engage in preventive behavior
(e.g., hand hygiene by using soap, water, and disinfectants, such as hand sanitizers) (6). However, adapting these
preventive and control behavior requires adequate knowledge, right perception, and positive attitudes, as proposed by
the Knowledge–Attitudes–Behavior (KAB) model (7, 8).

The KAB model is a vital health education theoretical model that explains the part of knowledge in behavioral changes
and emphasizes that changes in behavior are a product of knowledge and attitudes (7). This model proposes that human
health behavior can be modified through three continuous processes of change, namely, gaining of knowledge,
formation of beliefs, and development of behavior (8, 9). KAB emphasizes that the knowledge of a person can directly
affect attitude and indirectly affect behavior through attitude (8). In the present study, knowledge and information
received by student nurses about COVID-19 may affect their attitudes to it, and attitude may affect their behavior or
actions. Providing students with health information and knowledge through various sources and means is intended to
enhance the health related behavior, attitudes, and practices of student nurses with regard to the prevention and
control of COVID-19. However, the negative perception of COVID-19 information and misinformation can lead to poor
knowledge and practice behavior (10). Thus, the most essential method to stop the spread of the COVID-19 pandemic is
to develop and adopt appropriate preventive behavior, which can be achieved by becoming well-versed in this disease
(11).

However, whether student nurses possess adequate knowledge, positive perceptions, and appropriate preventive
behavior in relation to COVID-19 remains unexplored. Being components of the nursing curriculum, preventive
measures are no longer new to nursing students, but experiencing a pandemic is new to everyone. Thus, the knowledge,
perception, and preventive behavior of nursing students may be affected. This notion has been supported by some
studies on previous health crises brought about by infectious diseases, such as the Middle East Respiratory Syndrome
(MERS)-Cov. For instance, in the study Choi and Kim, student nurses reported low-risk perception of and poor preventive
attitudes toward MERS (12). However, to the best of our knowledge, no research on this issue has been conducted
among student nurses in Saudi Arabia. In crises, such as the current one, student nurses' knowledge, perception, and
preventive behavior should be considered in the planning of effective educational interventions for COVID-19 and in
increasing awareness of the health risks brought about by this disease. Therefore, this research aimed to assess the
perceptions, knowledge, and preventive behavior of nursing students toward the COVID-19.

Paraphrase:

The battle against coronavirus disease 2019 (COVID-19) continues in Saudi Arabia and around the world. To date, there
are over 41.5 million confirmed cases worldwide, with over 340,000 confirmed cases in Saudi Arabia (1). The COVID-19
pandemic has had a profound impact on all aspects of society (2). Currently, no vaccines or therapeutics have been
developed for COVID-19, and prevention and control of the disease are major challenges facing countries.

Since the outbreak of the disease, various governments around the world have taken measures to contain and prevent
transmission of his COVID-19. The World Health Organization has published COVID-19 guidelines and protocols, which
have been adopted by ministries of health in various countries (3). These logs provide information about signs and
symptoms, and preventive and protective measures against COVID-19. The Centers for Disease Control and Prevention
reiterated that everyone should protect themselves and others to prevent the spread of the disease. Such protection
includes proper hand hygiene, social distancing, mask use, proper cough and sneeze etiquette, and isolation and
decontamination of surfaces (4). The success of the measures implemented is based on adherence to preventive
measures by a population that is greatly influenced by knowledge, awareness, and preventive behavior against COVID-
19 (5). In the United States, 47% of the surveyed population are willing to adopt preventive behaviors (e.g., hand
hygiene with soap, water, and antiseptic agents such as hand sanitizers) (6). However, adapting this prevention and
control behavior requires appropriate knowledge, awareness, and positive attitudes, as suggested by the knowledge–
attitude–behavior (KAB) model (7, 8).

The KAB model is an important theoretical model in health education that explains the contribution of knowledge to
behavioral change and emphasizes that behavioral change is a product of knowledge and attitudes (7). This model
proposes that human health behavior can be modified through his three processes of continuous change: cognition,
belief formation, and behavior development (8, 9). KAB emphasizes that a person's knowledge can directly influence
their attitudes and indirectly influence their behavior through their attitudes (8). In the current study, the knowledge
and information nursing students receive about COVID-19 can influence their attitudes about COVID-19, and those
attitudes can influence their actions and behavior. Providing health information and knowledge to students through a
variety of sources and means aims to improve health-related behaviors, attitudes, and practices of nursing students
regarding COVID-19 prevention and control. However, negative perceptions of COVID-19 information and
misinformation can lead to lack of knowledge and practice behavior (10). Therefore, the most important way to stem
the spread of the COVID-19 pandemic is the development and application of appropriate preventive actions, which can
be achieved through familiarization with the disease (11).
However, whether a nursing student has adequate knowledge, positive awareness, and appropriate preventive
behaviors regarding her COVID-19 remains unexplored. As part of the nursing curriculum, preventative measures are no
longer new to nursing students, but experiencing a pandemic is a first for anyone. Therefore, it may affect nursing
students' knowledge, perceptions, and preventive behaviors. This concept is associated with Middle East Respiratory
Syndrome (MERS)-Cov. For example, in a study by Choi and Kim, prospective nurses reported low risk perception and
poor preventive attitudes towards MERS (12). However, to our knowledge, no studies have been conducted on this topic
among prospective nurses in Saudi Arabia. Nursing students' knowledge, awareness, and preventive behaviors should be
considered in raising awareness of health risks. Therefore, this study aimed to assess nursing students' awareness,
knowledge, and preventive behaviors against COVID-19.

Albaqawi, H. M., Alquwez, N., Bajet, J. B., Alabdulaziz, H., Alsolami, F., Tumala, R. B., Alsharari, A. F., Tork, H. M.,
Felemban, E. M., & Cruz, J. P. (2020). Nursing Students' Perceptions, Knowledge, and Preventive Behaviors Toward
COVID-19: A Multi-University Study. Frontiers in Public Health. Retrieved from
https://doi.org/10.3389/fpubh.2020.573390

#4

From the onset of the COronaVIrus Disease 19 (COVID-19) pandemic in March 2020 [1], nursing programmes in Italy
have been exposed to a tremendous stress-test and forced modifications to their well-established educational
processes. Since 1994, Italian undergraduate nursing programmes consist of taught modules within the university and
clinical placements within the National Health Services (NHS) [2]. Specifically, the third and final academic year has been
designed to prepare students to identify nursing care needs and prioritise interventions among critically ill patients and
those cared for in the community (mental health included) and paediatric settings, as well as to ensure patient safety
and evidence-based care [3]. After the theoretical education, around > 550 h of clinical practice in critical care, mental
health, paediatric, general medical, surgical and community care settings are offered according to European Directives
[4], harmonising education across Europe. By law, graduation requirements have also been established as homogenous
across universities, both in methods (examination regarding the competences expected and thesis dissertation) and time
(November, first session; April, second session).

With the onset of the first COVID-19 wave [1], nursing education in the classroom was interrupted and transformed into
online synchronous teaching. On the side of clinical learning, despite several national laws [5] recommending that
clinical placements would have to be continued, Health Care Trusts imposed the interruption of clinical rotations to all
health care students, mainly due to the lack of personal protective equipment and to prevent units’ overcrowding [6]. As
a consequence, more than 50,000 nursing students were left at home; initiatives were suddenly implemented by nursing
faculties and clinical training were re-established in a number of regions, while not in others [7]. Clinical placement
priority was given to third year students because they were better equipped and also to enable them to graduate sooner
to address the dramatic shortage in the NHS. However, as a consequence of the health service transformation, several
units devoted to nursing education were disrupted: the number of available clinical placements was reduced, and the
majority of health care facilities denied students access to COVID-19 areas. To minimise cross contamination the
universities introduced a series of changes to clinical placements. These placements were limited to one or two long
experiences (> 8 weeks) in non-Covid-19 areas with a small number of students in each area[5]. By law [8], universities
have been allowed to compensate for the lack of opportunities in real-world settings by offering distance learning for
clinical modules. No more than 40% of the time devoted to clinical rotations were allowed to be delivered online, and
small groups of students to promote their active participation (e.g. debating clinical scenarios) were involved. At
graduation, the first COVID-19 new graduate generation was recruited immediately to face the pandemic.

The changes undertaken in the patterns of nursing education on a large scale, and in that of the first employment
experience, are unprecedented. Nursing education has been re-designed mainly around student safety and infectious
disease control principles; by implementing urgent responses mixing online and limited clinical exposure in contexts
undergoing dramatic changes in their mission (e.g. changing from medical to COVID-19 patients), in staffing (e.g. high
turn-over) and in the patients cared for, given that several surgical procedures and other programmed activities were
suspended or delayed [9, 10]. Moreover, no assessments have been performed on the quality of clinical environments to
maximise the clinical competences achieved [11, 12]; also, new clinical tutors have been appointed without any training
[13], and the continuity of the clinical experience has not always been ensured, due to the continuous changes in the
mission of units and episodes of isolation or quarantine [14]. Furthermore, only limited transition programmes have
been offered [15] to help new graduates to enter their first working environments using supervision and peer support in
good clinical settings [16].

The main features of the clinical experiences attended by post-COVID-19 third-year students and their employment
status and placement one month after graduation have been not documented to date; similarly, no data on perceived
competences possessed by the first COVID-19 new graduate generation have been traced to date. Specifically, some
individual variables, or learning experiences during the COVID-19 pandemic, and competences perceived are assumed to
differ according to the employment status and placement of new graduates one month after graduation: for example,
being employed in a COVID-19 unit may have decreased the perception of competences, given the absence of learning
opportunities in these settings as compared to those working in non-COVID-19 units or still unemployed. Therefore, we
undertook an exploratory study investigating the last year of clinical education up to graduation and one month after
among the first COVID-19 new graduate generation. Specifically, the primary aim was to detect any differences at the
individual and nursing programme levels and between the competences perceived among new graduates according to
their working status (in COVID-19 units, in non-COVID-19 units and unemployed) one month after graduation. The
secondary aim was to compare the perceived competences of the first COVID-19 new graduate generation with those
reported by the pre-COVID-19 generation.

Paraphrase:

Since the outbreak of the coronavirus disease 19 (COVID-19) pandemic in March 2020 [1], nursing programs in Italy have
been subjected to enormous stress tests, forcing changes to established educational processes. Since 1994,
undergraduate nursing programs in Italy consist of educational modules within universities and clinical practicums
within the National Health Service (NHS) [2]. In particular, the third and final year of the study will allow students to
assess need for care, prioritize interventions for critically ill patients and those cared for in community (including mental
health) and pediatric settings, designed to keep patients safe and ready for evidence. Base care [3]. After theoretical
training, approximately 550 hours of clinical practicum in the areas of intensive care, mental health, pediatrics, general
medicine, surgery and ambulatory care are provided according to European guidelines [4], harmonizing training across
Europe. In addition, regarding the requirements for obtaining a degree, the method (expected proficiency test and
thesis examination) and the timing (1st in November, 2nd in April) are standardized among universities.

Due to the outbreak of the first wave of COVID-19 [1], classroom nursing education was interrupted and replaced with
online synchronous instruction. In terms of clinical learning, despite several national laws [5] recommending that clinical
internships must continue, medical trusts are obliged to do so mainly due to a lack of personal protective equipment and
all of medical students are suspended from clinical rotations. Prevent overcrowding of units [6]. As a result, over 50,000
nursing students were left home. The initiative was suddenly carried out by nursing departments and reintroduced
clinical teaching in some regions, but not in others [7]. Third-years were prioritized in clinical placements because they
are well-equipped and can graduate early to cope with the dramatic shortage in the NHS. However, as a result of the
transformation of health care, several units devoted to nursing education were disrupted. The number of clinical
internships available has decreased and the majority of health care facilities have denied students access to her COVID-
19 area. To minimize cross-contamination, the university has introduced many changes in clinical practice. These
internships were limited to one or two long experiences (>8 weeks) in non-Covid-19 regions, with a small number of
students in each region [5]. Universities were permitted by law to make up for the lack of hands-on opportunities by
offering distance learning courses in clinical modules [8]. We allowed no more than 40% of the time spent on clinical
rotations to be done online and included small groups of students to encourage active participation (e.g., discussion of
clinical scenarios). After graduating, the first new generation of her COVID-19 graduates were quickly recruited to help
combat the pandemic.

The changes undertaken in the patterns of nursing education on a large scale, and in that of the first employment
experience, are unprecedented. Nursing education has been re-designed mainly around student safety and infectious
disease control principles; by implementing urgent responses mixing online and limited clinical exposure in contexts
undergoing dramatic changes in their mission (e.g. changing from medical to COVID-19 patients), in staffing (e.g. high
turnover) and in the patients cared for, given that several surgical procedures and other programmed activities were
suspended or delayed [9, 10]. Moreover, no assessments have been performed on the quality of clinical environments to
maximize the clinical competencies achieved [11, 12]; also, new clinical tutors have been appointed without any training
[13], and the continuity of the clinical experience has not always been ensured, due to the continuous changes in the
mission of units and episodes of isolation or quarantine [14]. Furthermore, only limited transition programs have been
offered [15] to help new graduates to enter their first working environments using supervision and peer support in good
clinical settings [16].

The main features of the clinical experiences attended by post-COVID-19 third-year students and their employment
status and placement one month after graduation have been not documented to date; similarly, no data on perceived
competencies possessed by the first COVID-19 new graduate generation have been traced to date. In particular, some
individual variables or abilities perceived as learning experiences during the COVID-19 pandemic are thought to vary
according to the employment status and placement of new graduates one month after graduation. For example,
employment in COVID-19 units has a lower perception of skills compared to those working in non-COVID-19 units and
those who are still unemployed, due to the lack of learning opportunities in these settings. There is a possibility that
Therefore, we conducted an exploratory study among the first new generation of COVID-19 graduates to investigate her
final year of clinical training until graduation and her one month post-clinical training. did. Specifically, the primary aim
was to identify differences at the individual and nursing program levels, and perceived competencies of recent
graduates, in terms of work status (COVID-19 units, non-COVID-19 units, and unemployed). month after graduation. A
secondary aim was to compare the perceived competence of the first new generation of COVID-19 graduates with that
of pre-COVID-19 generations.

Palese, A., Brugnolli, A., Achil, I. et al. The first COVID-19 new graduate nurses generation: findings from an Italian cross-
sectional study. BMC Nurs 21, 101 (2022). Retrieved from https://doi.org/10.1186/s12912-022-00885-3

#5

The Corona Virus Disease -19 pandemic over the world has raised public concern and fear. The high rate of transmission
and the risk of death causes threats world. Many health workers (nurses) have become victims and died from
contracting this disease. This condition causes anxiety and unpreparedness of health workers to work. The purpose of
this study was to identify factors related to the level of readiness of new Diploma III Nursing graduates in East Java to
work in the Covid 19 Pandemic Situation. The research method is cross sectional. The research data were taken using a
questionnaire to 110 new graduates of Diploma III level nurses from 20 universities in East Java. The research variables
include independent variables: achievement, competence, physical condition, interest and mental readiness. The
dependent variable: Readiness to work. Data analysis was performed using Pearson's correlation test with  = 0.05. The
results showed that achievement, physical condition, interest and mental readiness were related to the readiness of
graduates to work in health services. Based on the research results, it is suggested to universities to strengthen the
quality of learning experiences, especially the implementation of clinical and laboratory practices to strengthen the
readiness of graduates.
Paraphrase:

The global pandemic of the new coronavirus infection is giving people anxiety and fear. The high infection rate and risk
of death pose a threat worldwide. Many medical workers (nurses) became victims and died of the disease. This
condition creates anxiety and unpreparedness for healthcare workers in the workplace. The aim of this study was to
identify the factors associated with the level of readiness of her Diploma III nursing graduates from East Java to work in
the Covid-19 pandemic situation. The research method is cross-cutting. Research data were collected using a
questionnaire to his 110 recent graduates of nursing at Diploma III level from his 20 universities in East Java. Study
variables include independent variables such as achievement, ability, physical condition, interests, and mental readiness.
Dependent variable: Willingness to work. Data analysis was performed using Pearson's correlation test with  = 0.05.
Results showed that academic performance, physical condition, interests, and mental preparation were associated with
graduates' willingness to work in the medical field. Based on research, universities are encouraged to enhance the
quality of the learning experience, especially the implementation of clinical and laboratory practices, in order to enhance
the readiness of graduates.

Tamsuri, A. (2021, May). Readiness of New Graduates of Nursing to Work in Health Care Facilities in The Emergency
Period of Covid 19 Pandemic Retrieved from https://sjik.org/index.php/sjik/article/download/664/480/

#6

In the case of the COVID-19 pandemic, which hit Connecticut by force during the weekend of March 7–8, 2020, past
action predicted future success. The Council (2020b) is charged with collecting and disseminating information on current
issues and concerns that affect nursing education, nursing practice, and health care in Connecticut. The Council is
comprised of nursing education leaders from all 21 nursing programs across the state encompassing LPN, RN, and
Advanced Practice educational levels. The Council generally meets monthly, but historically has more frequently to
address urgent issues. The Council regularly share resources and strategies employed across their respective
organizations to address best practice and the needs of students and faculty. This collaborative approach by the Council
created a strong foundation for nursing education during the COVID-19 pandemic.

However, situations like a pandemic put even the most competent of educators to the test. The virus was novel in a
number of ways. Clearly, the viral properties presented like no prior virus. From an educator perspective, the
widespread effects that had resulted from the viral spread in China and Europe presented many challenges and foretold
a difficult situation for nursing education and the profession. The Council needed to act swiftly to identify the potential
challenges and use collective experience and wisdom to strategize through the pandemic.

Despite the novel nature of the pandemic, there was precedent. The Council had gathered together through the Ebola
outbreak in 2014. When the first Ebola patient was admitted to a Connecticut hospital in 2014, the Council mobilized
through conference calls and email communications to assess the impact of Ebola on clinical educational experiences.
Knowing that hospitals, long-term care facilities, and other clinical partners would prioritize preparedness assessment
and be concerned about risk of student exposure, the Council strategized alternative clinical education. At that time, the
Council worked together to develop communication templates for faculty and students using evidence-based practice
guidelines. Finally, members collectively reached out to their connections from other professional nursing associations
to share availability of conferences, meetings, webinars, and guidelines. The information gathered from the Council was
organized and uploaded onto the CLN website for easy access. Successful outcomes from the group's collaboration were
shared through publication.

The Ebola outbreak did not pose the same level of public health concern regarding availability of PPE or the closure of
clinical sites to students as did COVID-19. With the Ebola outbreak as precedent, the Council did what they do best
communicate. Members quickly mobilized concerted efforts through twice-weekly “huddle” conference calls and email
communications. In addition, the Council established a repository site of information and resources from each school. As
an initial priority, immediate safety concerns were addressed for nursing students and faculty. The Council quickly
shifted to develop strategies in anticipation of campus closures and clinical assignment revisions or cancellations as
hospitals and staff assessed their preparedness. Sample alternative clinical experiences formulated during the Ebola
outbreak were expanded upon. At a time when the state needed nurses the most, traditional educational methods were
all but eliminated forcing the Council to identify best practice and evidence-based strategies necessary to maintain
academic continuity despite the disruption in nursing education.

Frequent conference calls and emails worked well during the Ebola outbreak; however, the early conference calls to
address the COVID-19 pandemic were erratic and difficult to navigate given the number of concerns voiced. Some
concerns were similar across schools; others were specific to a particular school or college. Time was limited and it was
essential to operationalize these meetings in the most efficient manner. Agendas were set and the dialogue controlled.
Although issues were raised during the meeting, it was clear that further work would be needed to resolve them. As a
result, the Council organized six work groups to address the myriad of issues brought about by COVID-19 to continue
educating nursing students and ensure a robust nursing workforce for the state.

Of note, parallels exist between the Council's and international nursing education leaders’’ approach to the COVID-19
pandemic (Agu et al., 2021,; Ion et al., 2021). Nursing education leaders from Australia, New Zealand, Singapore,
Canada, and the United Kingdom have shared themes that align with the Council's experience: (1) the need to be flexible
and adaptable, (2) responsive, multifaceted and varying communication, (3) decision-making that prioritizes student and
faculty safety while assisting students to complete their nursing programs in a timely fashion, and (4) plan for the future
by developing strong partnerships. Like the Council, international nursing education leaders addressed significant
challenges, responded to sizable logistical difficulties, and made determinations under considerable and ongoing strain.

Paraphrase:

When the COVID-19 pandemic swept through Connecticut on the weekend of March 7-8, 2020, past actions predicted
future success. The Council (2020b) is charged with collecting and disseminating information on current issues and
concerns affecting nursing education, practice, and healthcare delivery in Connecticut. The Council is made up of nursing
education leaders from all 21 nursing programs in the state. This includes LPN, RN and advanced practice level
education. Board meetings typically meet monthly, but in the past pressing issues had to be dealt with more frequently.
Councils regularly exchange resources and strategies used in their respective organizations to address best practices and
the needs of students, faculty and staff. This collaborative council approach has created a strong foundation for nursing
education during the COVID-19 pandemic.

But in a situation like a pandemic, even the most competent educators are put to the test. This virus was novel in many
ways. The characteristics of the virus were clearly different from previous viruses. From an educational perspective, the
widespread impact of the virus spreading in China and Europe presented many challenges and predicted a difficult
situation for nursing education and the profession. The Council needed to act quickly to identify potential challenges and
use collective experience and wisdom to strategically manage the pandemic.

Despite the novel nature of the pandemic, there were precedents. The Council met during the 2014 Ebola outbreak.
When the first Ebola patient was admitted to a Connecticut hospital in 2014, the council came together through
conference calls and email communications to assess the impact of Ebola on the clinical education experience. Knowing
that hospitals, long-term care facilities, and other clinical partners prioritize the assessment of readiness and are
concerned about the risk of student exposure, the Council developed strategies for alternative clinical education. At that
time, the Council worked together to develop communication templates for teachers and students using evidence-based
practice guidelines. Finally, members collectively contacted liaison officers from other professional nursing associations
to share conferences, conferences, webinars, and the availability of guidelines. and uploaded to the CLN website for
easy access. Successful results of group collaboration were shared through publications.

The Ebola outbreak has not had the public health concerns of COVID-19 regarding the availability of PPE or the closure
of student clinical facilities. Using the Ebola outbreak as a precedent, the Board has done its best to communicate.
Members quickly mobilized a coordinated effort through twice-weekly “huddle” conference calls and email
communications. Additionally, the council has launched a website with information and resources from each school.
Immediate safety concerns of nursing students and teachers were addressed as a top priority. The council moved quickly
to develop strategies in anticipation of campus closures and changes or cancellations of clinical assignments while
hospitals and staff assessed their readiness. An exemplary alternative clinical experience developed during the Ebola
outbreak has been extended. At a time when the state needed nurses the most, traditional teaching methods were
largely obsolete, so Congress decided to focus on the best practices and evidence needed to maintain academic
continuity despite the turmoil in nursing education.

Frequent conference calls and emails were effective during the Ebola outbreak. However, early conference calls
addressing the COVID-19 pandemic were unpredictable and difficult to navigate given the number of concerns raised.
Some concerns were similar across schools. Others were specific to particular schools and colleges. Time was limited and
it was important to conduct these meetings as efficiently as possible. An agenda was set and the dialogue proceeded.
Issues were raised during the meeting, but it was clear that further work was needed to resolve them. As a result, the
council organized six working groups to address the myriad issues created by COVID-19 in order to continue educating
nursing students and ensure a strong workforce in the state. .

In particular, there are parallels between the Council's approach and that of international leaders in nursing education to
her COVID-19 pandemic (Agu et al., 2021; Ion et al., 2021). Nursing education leaders from Australia, New Zealand,
Singapore, Canada and the UK have shared themes consistent with the Council's experience. (4) making decisions that
prioritize student and faculty safety while helping students complete their nursing programs on time; and (4) planning
for the future by building strong partnerships. is. Like the Council, international leaders in nursing education have faced
enormous challenges, responded to significant logistical difficulties, and made decisions under great and sustained
tension.

Beauvais A, Kazer M, Rebeschi LM, Baker R, Lupinacci JH. (2021, December 08). Educating Nursing
Students Through the Pandemic: The Essentials of Collaboration. Retrieved from
https://journals.sagepub.com/doi/full/10.1177/23779608211062678

Pros and Cons of the Implementation of Full Capacity of Face to Face Classes During the State of Health Emergency

#1

During the first half of 2020, the world was challenged by the coronavirus pandemic on an unprecedented scale. In
response, many people adopted the practice of social distancing, and schools suspended classes and activities. Medical
students were devoid of opportunities to enter hospital premises because of tightened infection control measures.
Educators adopted innovative measures to maintain learning opportunities for students who stayed at home [1,2,3].
Some of these measures, including online lectures or webinars, were in place before the COVID-19 outbreak [4]. Others
were hastily put into place during the pandemic. Given its user-friendly design, online peer-to-peer platforms became
extremely popular. Lectures, tutorials, skills demonstrations, and even bedside teaching for medical students can be
conducted via this type of platform [5, 6]. For example, at the University of Hong Kong Li Ka Shing Faculty of Medicine
offered a FF PBL tutorial using online peer-to-peer platform software. To many, such adaptations served as a lifeline to
continue medical education during the coronavirus outbreak. It was also envisaged that some of these educational
adaptations would persist after the pandemic. How effective these adaptations have been and how they compare with
the conventional teaching method should be evaluated. A study on surgical skills teaching reported that using Web-
based DL was well-received by undergraduate students [6]. The aim of this study was to evaluate the proficiencies in five
key areas of students who took PBL tutorials by DL, an adaptation during the COVID-19 pandemic, and to compare them
with the proficiency levels of students who learned via the conventional FF method.

Paraphrase

During the first half of 2020, the world was challenged by the coronavirus pandemic on an unprecedented scale. In
response, many people adopted the practice of social distancing, and schools suspended classes and activities. Medical
students were devoid of opportunities to enter hospital premises because of tightened infection control measures.
Educators adopted innovative measures to maintain learning opportunities for students who stayed at home [1,2,3].
Some of these measures, including online lectures or webinars, were in place before the COVID-19 outbreak [4]. Others
were hastily put into place during the pandemic. Given its user-friendly design, online peer-to-peer platforms became
extremely popular. Lectures, tutorials, skills demonstrations, and even bedside teaching for medical students can be
conducted via this type of platform [5, 6]. For example, at the University of Hong Kong Li Ka Shing Faculty of Medicine
offered a FF PBL tutorial using online peer-to-peer platform software. To many, such adaptations served as a lifeline to
continue medical education during the coronavirus outbreak. It was also envisaged that some of these educational
adaptations would persist after the pandemic. How effective these adaptations have been and how they compare with
the conventional teaching method should be evaluated. A study on surgical skills teaching reported that using Web-
based DL was well-received by undergraduate students [6]. The aim of this study was to evaluate the proficiencies in five
key areas of students who took PBL tutorials by DL, an adaptation during the COVID-19 pandemic, and to compare them
with the proficiency levels of students who learned via the conventional FF method.

Foo, Cc., Cheung, B. & Chu, Km. A comparative study regarding distance learning and the conventional face-to-face
approach conducted problem-based learning tutorial during the COVID-19 pandemic. BMC Med Educ 21, 141 (2021).
https://doi.org/10.1186/s12909-021-02575-1

#2
This study shows the results of an autobiographical questionnaire of Spanish university students regarding two different
educational models caused by the COVID-19 pandemic: face-to-face and e-learning. The aim is to discover their
perceptions and opinions about their experiences during the learning process and what they have experienced during this
global emergency and period of home confinement. The sample is made up of 100 students from the Primary Education
Degree programme and the research was carried out through a qualitative study of the questionnaire. The results, divided
into categories of each educational model, show the interpretation that the students make of the current reality and their
own learning process. The most important aspect of the face-to-face learning model, according to 75% of the students, is
direct communication with the teacher, and for 88% of them this model was effective. For the e-learning model, the
flexible schedule, the economic savings and explanatory videos are the relevant ideas that the students express, with
68% stating that it was an effective model. The main conclusion is that the students prefer to continue with the face-to-
face learning process (49%) rather than online teaching (7%) or, failing that, mixed or blended learning (44%), where the
theoretical classes could be online and the practical classes could be face-to-face.

Paraphrase:

This study presents the results of an autobiographical questionnaire of Spanish university students on two different
educational models caused by the COVID-19 pandemic: face-to-face teaching and e-learning. The aim is to find out their
perceptions and opinions of their experiences during the learning process and what they have experienced during this
global emergency and quarantine period. The sample consisted of 100 undergraduate students and the survey was
conducted through a qualitative survey of questionnaires. The categorized results for each educational model show the
student's interpretation of the current reality and the student's own learning process. The most important aspect of the
face-to-face learning model was direct communication with the teacher, according to 75% of students, and 88% of
students found this model to be effective. For the e-learning model, flexible schedules, financial savings, and instructional
videos are relevant ideas raised by students, with 68% saying they are effective models. The main conclusion is that
students prefer face-to-face classes (49%) to online classes (7%) or blended learning (44%).

Dios, M. & Charlo, J. (2021, June 15) Face-to-Face vs. E-Learning Models in the COVID-19 Era: Survey Research in a
Spanish University. Retrieved from https://www.mdpi.com/2227-7102/11/6/293/htm

#3

Schooling is one of the most affected aspects of human life due to coronavirus disease-2019 (COVID-19)
pandemic. Since the rise and threat of the pandemic, many countries around the world have decided to
temporarily close schools that have affected millions of students.1 Consequently, students who are mostly
children have been facing a learning crisis due to the pandemic.2 In a recent correspondence published in this
journal, the authors cited that every country has the responsibility to come up with strategies to reopen schools
in a safe manner.3

In the Philippines, the government’s Department of Education has come up with guidelines to implement
online and modular distance learning delivery of instruction.4 This is to safeguard students from being infected
by the disease. However, plans to conduct the pilot implementation of limited face-to-face delivery in low-risk
areas of COVID-19 transmission for January 2021 have been approved by the president5 but later recalled6 due
to the threat of the new strain of COVID-19. Predicaments are raised whether the country is ready to open its
schools for students to go for face-to-face learning despite having been one of the longest and strictest
lockdowns in the world.

School reopening for face-to-face interactions must be carefully planned to ensure the safety of students as
well as teachers and school staff in a staged fashion especially in following physical distancing.7,8 Planning and
execution of school health protocols during this pandemic must be supported by the truthful data9 being
given by various institutions. Last 11 December 2020, the World Health Organization (WHO) has published a
checklist to support school reopening and the preparation for the possible resurgence of COVID-19.10 WHO
cited that ‘The checklist is aligned with, and builds upon, existing COVID-19-related WHO guidelines and is
structured around protective measures related to: 1) hand hygiene and respiratory etiquette; 2) physical
distancing; 3) use of masks in schools; 4) environmental cleaning and ventilation; and 5) respecting procedures
for isolation of all people with symptoms.’10 The checklist helps policymakers and school officials to enhance
compliance and adherence to public health protocols in the time of the pandemic.10

In conclusion, school health protocols in conducting face-to-face classes must be planned carefully following
national and international guidelines to ensure that students will be safe or at least mitigate the effects of
COVID-19. After all, students’ lives matter as education does to them. That is the responsibility of every
government to ensure its fulfillment.

Paraphrase:

Schooling is one of the most affected aspects of human life due to the 2019 coronavirus disease (COVID-19)
pandemic. Since the rise and threat of the pandemic, many countries around the world have decided to
temporarily close schools, affecting millions of students. The authors said countries have a responsibility to
develop strategies to safely reopen schools: protect students from illness. However, in January 2021, although
plans were approved by the president to conduct a pilot run of limited in-person deliveries in areas with low
risk of COVID-19 transmission, he was 5, and later he was diagnosed with COVID-196. was withdrawn due to
the threat of new strains of Questions have been raised about whether the country is ready to open schools to
students for in-person learning, despite his one of the longest and most stringent lockdowns in the world. The
reopening of schools for face-to-face interactions should be carefully planned to ensure the gradual safety of
students as well as teachers and school staff, especially after physical distancing.7,8 By truthful information
provided by various agencies9. On December 11, 2020, the World Health Organization (WHO) published a
checklist to help schools reopen and prepare for a possible resurgence of COVID-19. The measures are based
on WHO guidelines and consist mainly of safeguards related to 1) hand hygiene and respiratory etiquette. 2)
physical distance. 3) Use of masks in schools. 4) cleaning and ventilating areas; 5) following procedures for
isolating symptomatic persons.”10 The checklist will help policy makers and school officials improve adherence
to and adherence to public health protocols during the pandemic. In summary, when conducting in-person
classes, school health protocols need to be carefully planned according to national and international guidelines
to ensure student safety or at least mitigate the impact of COVID-19. I have. After all, a student's life is just as
important as their education. It is the responsibility of all governments to ensure that they are met.

Sarmiento PJD, Sarmiento CLT, Tolentino RLB. Face-to-face classes during COVID-19: a call for
deliberate and well-planned school health protocols in the Philippine context. J Public Health (Oxf).
(2021, February 08). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7928711/

#4
COVID-19 pandemic forced educational institutions to adopt online methods which were inevitable to
keep continuity of education across all academia after suspension of traditional educational systems.
The aim of this study was to explore the experience of faculty and students of online and face-to-face
learning, and their preference of the mode of learning after the pandemic.
Paraphrase:
The COVID-19 pandemic has forced educational institutions to adopt online methods. This was
inevitable to maintain the continuity of education in all higher education institutions after the shutdown
of the traditional education system. The purpose of this study was to examine teachers' and students'
online and face-to-face teaching experiences and their learning preferences post-pandemic.
Atwa, H., Shehata, M. H., Kumar, A., Jaradat, A., Ahmed, J., & Deifalla, A. (2022). Online, Face-to-Face, or Blended
Learning? Faculty and Medical Students' Perceptions During the COVID-19 Pandemic: A Mixed-Method Study. Frontiers
in Medicine. https://doi.org/10.3389/fmed.2022.791352

#5

Implementing an education response to the COVID-19 pandemic that supports equity, quality and wellbeing should rely
on the capacity of schools and education professionals as well as technological resources available. The engagement of
stakeholders to develop a broadly supported overarching solution may need to be limited to key actors initially and
integrated in later stages, as there is an optimal trade-off between involvement and reactivity. But the policy can
actually be based on schools having leeway to design their own approaches, following the shaping of a national or
regional vision, generic health and educational guidelines, and the provision of support to those in need to manage
inequities. An effective implementation strategy will bring together these dimensions and make them actionable in
terms of timeframes, responsibilities, tools and available resources.

Paraphrase:

Implementing an educational response to the COVID-19 pandemic that promotes equity, quality and well-being must
rely on the competence of schools and educational professionals, as well as available technical resources. Stakeholder
involvement to develop a broad, comprehensive solution may need to be limited initially to key stakeholders and
integrated at a later stage. This is because there is an optimal tradeoff between participation and responsiveness. In
practice, however, schools should be able to afford to develop their own approaches, following national or regional
visions, general health and education policies, and based on providing support to those who need to address injustice.
Policy can be formulated. An effective implementation strategy brings these aspects together and makes them viable in
terms of timeframes, responsibilities, tools, and available resources.

OECD (2020), "Education responses to COVID-19: An implementation strategy toolkit", OECD Education Policy
Perspectives, No. 5, OECD Publishing, Paris, https://doi.org/10.1787/81209b82-en.

#6

During the COVID-19 crisis, countries have implemented a range of measures to curb the educational impact of the
pandemic. In times of emergency, speed in the implementation of responses is key, but evidence of what may work is
limited, and constraints on resources and capacity are binding. A framework providing a coherent implementation
perspective can save time and result in better outcomes. As countries explore ways forward to reopen schools and
design new models of education that expand the borders of the physical schools through technology, this paper
proposes a framework that can help governments structure the implementation strategy of their evolving education
responses to COVID-19. It consists of a set of general recommendations and guiding questions that can inform the
development of mid-term education strategies and, more broadly, help build school systems’ resilience for potential
education emergencies.

Paraphrase:

During the COVID-19 crisis, countries have taken many measures to limit the impact of the pandemic on education. In
emergencies, rapid response is critical, but evidence of what works is limited and resource and capacity constraints are
inevitable. A framework that provides a consistent implementation perspective can save time and yield better results. As
countries seek ways to reopen schools and design new education models that push the boundaries of physical schools
through technology, this white paper will guide governments in implementing his evolving education response to
COVID-19. We propose a framework to help you strategize and structure your It consists of a series of general
recommendations and guiding questions to help develop medium-term educational strategies and, more broadly, the
resilience of school systems to potential educational emergencies. help to build.

Gouëdard, P., B. Pont and R. Viennet (2020), "Education responses to COVID-19: Implementing a way forward", OECD
Education Working Papers, No. 224, OECD Publishing, Paris, https://doi.org/10.1787/8e95f977-en.

Exploring Nurses' Perception of Professional Nursing Practice with Concurrent Entrepreneurial Job/Activities

#1

In Canada, as well as internationally, efficiency-focused organizational restructuring in healthcare has resulted in

stressful job change for nurses, although nurses continue to work in a system that values technology-based, physician-
provided services. Employed nurses have had to participate in organizational activities that undermine their professional
values and goals. Nursing entrepreneurship presents an opportunity to explore nursing’s professional potential in
nursing practice that is uniquely independent. In this study, a focused ethnographic approach was used to explore the
experiences of self-employed nurses, who see themselves as leaders in advancing the profession of nursing and its
contribution to healthcare. Key themes in the findings include the responses of self-employed nurses to health system
change, expanded roles for nurses, the consequences of this non-traditional approach to nursing work and the
possibilities for change that arise from nursing entrepreneurship. This research has implications for healthcare policy,
professional advocacy and nursing education.

Paraphrase:

Efficiency-driven restructuring in healthcare, both in Canada and internationally, has resulted in stressful career
transitions for nurses, even though they are nurses continuing to work in a system that values the value based
on the technology provided by doctor’s service. Staff nurses had to participate in organizational activities.
Undermine their professional values and goals. Care Entrepreneurship presented an opportunity to explore the
professional potential of nursing in nursing practice independent on its own. This study used a focused
ethnographic approach exploring the experiences of self-employed caregivers who see themselves as leaders’
further development of the nursing profession and contribution to healthcare. important issues inside results
include responses of self-employed caregivers to changes in the healthcare system. Expanding the role of
nurses, a consequence of this non-traditional approach care jobs and opportunities for change arising from
care entrepreneurship. This research will benefit health policy, professional advocacy, and nursing education.

Wall, S. (2013). Nursing Entrepreneurship: Motivators, Strategies and Possibilities for Professional Advancement and
Health System Change. Retrieved from https://era.library.ualberta.ca/items/bd716de0-6eb3-4cbb-9476-
b84a3be10625/view/20f9a2c6-24cc-461e-b1ef-ecca4082f524/NL_2013_26_2.pdf

#2

Entrepreneurship is a concept involving developing and managing a business venture in order to gain profit by
taking several risks in the cooperate world. Nurses enjoy the privilege as the singular group of professionals
with the most far-reaching presence at all levels of the health care system. However, the nurse is yet to exploit
the opportunity created by the lack in the health system. Nurses need to get the necessary drive to exploit the
entrepreneurship opportunities available to them. The purpose of this study is to explore the perception of
entrepreneurship among nurses and develop a mid-range theory that explains the meaning and practices of
entrepreneurship among nurses.

Paraphrase:

Entrepreneurship is the concept of developing and managing a business to take multiple risks and generate
profits in a collaborative world. Nursing is privileged to be the single most prevalent profession at all levels of
the health care system. However, caregivers have yet to seize the opportunities created by the shortfalls of the
healthcare system. Nurses need to be empowered to take advantage of available entrepreneurial opportunities.
The purpose of this study is to investigate nurses' perceptions of entrepreneurship, and to construct a medium-
term theory that explains the meaning and practice of nurses' entrepreneurship.

Ubochi, N. E., Osuji, J. C., Ubochi, V. N., Ogbonnaya, N. P., Anarado, A., & Iheanacho, P. N. (2021). The drive process
model of entrepreneurship: A grounded theory of nurses’ perception of entrepreneurship in nursing. International
Journal of Africa Nursing Sciences, 15, 100377. https://doi.org/10.1016/j.ijans.2021.100377

#3

The purpose of this exploratory study was to better understand the experiences and challenges of nurse
entrepreneurs. Nurse entrepreneurs (N=44) reported on their transitions from employment to
entrepreneurship, key motivators in the decision to start a business, and the challenges they face as
entrepreneurs in the health care field. Additionally, participants completed the 33-item Mindful Self-Care Scale
– Short, which measured their self-care activities and behaviors in six domains: Physical Care, Supportive
Relationships, Mindful Awareness, Self-compassion/Purpose, Mindful Relaxation, and Supportive Structure.
Nurse entrepreneurs reported higher rates of self-care practices than a norm community sample, and age was
positively correlated with higher rates of self-care practices. Nurse entrepreneurs reported that factors related
to psychological empowerment, such as meaning/purpose, having an impact, need for growth, and getting to
make decisions, were more critical motivators in the decision to start a business than factors associated with
structural empowerment, such as financial gain and job or organizational constraints. Some work/life balance
challenges, such as juggling multiple roles in a business, balancing one’s own needs with those of others, time
management, and addressing both family and business needs, were associated with fewer self-care behaviors.
The biggest challenges to success that were identified, such as implementing a marketing strategy, networking,
and accessing mentorship, were all related to relying on connections with others. The results of this study will
benefit nurse entrepreneurs, potential nurse entrepreneurs, and others in the health care delivery system.

Paraphrase:

The aim of this exploratory study was to better understand the experiences and challenges of caregivers.
Nursing entrepreneurs (N = 44) reported on their transition from employment to entrepreneurship, their
primary motivations for making the decision to start a business, and the challenges they face as healthcare
entrepreneurs. In addition, the participant completed her 33-item Mindful Self-Care Scale-Short. It measures
self-care activities and behaviors in her six domains of personal care, supportive relationships, mindful
awareness, self-compassion/purpose, mindful her relaxation, and supportive her. structure. Nursing
entrepreneurs reported higher rates of self-care practices than the normal community sample, and age was
positively correlated with higher rates of self-care practices. Entrepreneurs in the care industry report factors
related to psychological empowerment, such as financial gain and professional or organizational limitations.
Work-life balance issues such as juggling multiple roles within an organization, balancing your own needs with
the needs of others, managing your time, and attending to family and business needs are all part of self-care
behaviors. was associated with a decline in the greatest identified challenge to success. For example,
implementing marketing strategies, networking, and access to mentoring were all related to relying on
connecting with others. The results of this study will benefit caregivers, prospective caregivers, and others in
the health care system.

Vannucci MJ, Weinstein SM. (2017, September 22). The nurse entrepreneur: empowerment needs,
challenges, and self-care practices. Nursing: Research and Reviews. 2017; 7:57-66
https://doi.org/10.2147/NRR.S98407

#4
Nursing entrepreneurship presents as a viable and innovative approach for nursing practice while contributing to health
system transformation. And yet, in countries such as Canada where universal health care funding has most nurses
working as employees for state funded health service providers, few nurses are self-employed. This qualitative study
acquired the perspectives of eleven practicing Canadian nurse entrepreneurs from across Canada, and six Canadian
nurse leaders with respect to current nursing practice, contexts, and issues that serve to inform and guide the
development of national and provincial/territorial policies that support nursing entrepreneurship. Three categorical
themes were identified: Going alone versus going along; Resistance outside of convention; and, Nursing
entrepreneurship: Outcomes and opportunities. The overall findings highlight a resistance-resilience dialectic for nurse
entrepreneurs, the outcome of which sees them advancing nursing practice and health system reform. Meso and macro
level policy recommendations that aim to support nursing enterprise within Canada are discussed.

Paraphrase:

Entrepreneurship in nursing positions itself as a viable and innovative approach to nursing.

While doing so, we will contribute to the transformation of the healthcare system. Nevertheless, in
countries such as In Canada, most nurses fund universal health care as employees of government-
funded health care providers, but few nurses are self-employed. This qualitative survey captures the
perspectives of 11 practicing Canadian nursing entrepreneurs and 6 Canadian nursing leaders from
across Canada to explore current nursing practice, the landscape, and national and
provincial/territorial nursing I learned about issues that help inform and guide the development of
support strategy entrepreneurship. Three category themes were identified. Unconventional
resistance. Entrepreneurship in Nursing: Results and Opportunities. Overall results highlight a
dialectic of caregiver resistance and resilience A successful entrepreneur who is driving nursing
practice and healthcare reform. Policy recommendations at the meso- and macro-levels aimed at
supporting Canadian care businesses will be discussed.

Smith, B. (2017, August) THE PERSPECTIVES OF CANADIAN NURSE ENTREPRENEURS AND RELATED POLICY
IMPLICATIONS: AN INTERPRETIVE DESCRIPTION STUDY. Retrieved from
https://core.ac.uk/download/pdf/94149313.pdf

#5
Background Entrepreneurship is a concept involving developing and managing a business venture in order to gain profit by
taking several risks in the cooperate world. Nurses enjoy the privilege as the singular professionals with far-reaching presence at
all levels of the health care system, yet she is yet to exploit the opportunity created by the lack in the health system. However,
nurses need to get the necessary drive to exploit the entrepreneurship opportunities available to them. The purpose of this study
is to explore the perception of entrepreneurship among nurses and develop a mid-range theory that explains the meaning and
practices of entrepreneurship among nurses.

Paraphrase:

Background Entrepreneurship is the concept of developing and managing enterprises in order to take various
risks and generate profits in the cooperative world. Nurses enjoy the privilege of being single professionals that
are prevalent at all levels of the health care system, but have yet to seize the opportunities created by the
health system's deficiencies, they need to be motivated to take advantage of the entrepreneurial opportunities
available to them. The purpose of this study is to investigate nurses' perceptions of entrepreneurship and to
construct a medium-term theory that explains the meaning and practice of nurses' entrepreneurship.

Ubochi, Nneka & Joseph, C. & Ubochi, Vincent & Ogbonnaya, Ngozi & Anarado, Agnes & Iheanacho, Peace.
(2021). The drive process model of entrepreneurship: A grounded theory of nurses’ perception of
entrepreneurship in nursing. International Journal of Africa Nursing Sciences. 15. 100377.
10.1016/j.ijans.2021.100377.https://www.researchgate.net/publication/
355836368_The_drive_process_model_of_entrepreneurship_A_grounded_theory_of_nurses'_perception_of_entre
preneurship_in_nursing
#6

Mounting evidence suggests that holding multiple concurrent jobs in public and private (dual practice) is
common among health workers in low- as well as high-income countries. Nurses are world’s largest health
professional workforce and a critical resource for achieving Universal Health Coverage. Nonetheless, little is
known about nurses’ engagement with dual practice.

Paraphrase:

There is growing evidence that dual practice is prevalent among health workers in low-income and high-
income countries. resource. However, little is known about nurses' engagement in dual practice.

Russo, G., Fronteira, I., Jesus, T.S. et al. Understanding nurses’ dual practice: a scoping review of what we know
and what we still need to ask on nurses holding multiple jobs. Hum Resour Health 16, 14 (2018).
https://doi.org/10.1186/s12960-018-0276-x