The challenges of "learning on the go": A qualitative study of final-year Spanish nursing students incorporated to work during the first Covid-19 pandemic

Background: The first wave of the COVID-19 pandemic caused a shortage of qualified nurses in Spain. As a result, the government authorized the hiring of senior students. Objectives: To explore the perspectives of a group of final-year nursing students who were hired on the basis of a relief contract for health professionals during the first COVID-19 outbreak, regarding their learning process and their mixed role as students and novice nurses. Design: A qualitative exploratory study was conducted. Settings: The Nursing Department of the European University of Madrid, and the Red Cross College of Nursing. Participants: Eighteen nursing students were recruited, aged between 18 and 65 years old, enrolled in the fourth year of Nursing Studies and who were hired under a relief contract for health professionals during the pandemic. Methods: Purposive sampling was used. Semi-structured, in-depth interviews were carried out using a question guide. Interviews were conducted in a private video chat room platform. Also, a thematic, inductive analysis was performed. This study was conducted according to the Consolidated Criteria for Reporting Qualitative Research and the Standards for Reporting Qualitative Research. Results: Four specific themes emerged: a) The students' role during the relief contract; b) The learning process during the pandemic; c) Barriers to learning; and d) A unique learning opportunity. The students had an undefined mixed role, which hindered their skills and activities. Learning was self-directed, sometimes through trial and error, and through experiencing critical events. Time constraints and having to learn under pressure were experienced as difficulties for learning. Nevertheless, this was a unique professional learning opportunity. The students learned to be organized and effective, acknowledge their limitations, gain confidence, face their fears, and mature. Conclusions: These results can help inform nurse training programs and improve the organization and incorporation of nurses in health care facilities during the COVID-19 pandemic.