Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
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Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : October | Volume : 16 | Issue : 10 | Page : LC25 - LC28 Full Version

Experience of Nursing Interns during COVID-19 in Taif University, Saudi Arabia: A Qualitative Study


Published: October 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/57699.17041
Ahmed S Alkarani

1. Associate Professor, Department of Nursing, Taif University, Taif, Saudi Arabia.

Correspondence Address :
Dr. Ahmed S Alkarani,
Faculty, Department of Nursing, Taif University,
Taif, Makkah, Saudi Arabia.
E-mail: asakg@live.com

Abstract

Introduction: Coronavirus Disease-2019 (COVID-19) has affected nursing staff and students mentally and physically due to their role in the frontline fighting the virus. However, data on the effect of COVID-19 on nursing students are limited and there have been no studies about Saudi nursing intern experience during this crisis.

Aim: To explore the impact of COVID-19 pandemic on nursing students during their interns at hospitals and how they dealt with the COVID-19 pandemic.

Materials and Methods: A qualitative descriptive study was done where 12 interviews were conducted among nursing student at the Nursing Department in the College of Applied Medical Science at Taif University, Taif, Saudi Arabia. The study was conducted from January 01 to April 10, 2021. The descriptive method was used to collect, understand, organise and represent in depth data. All the nursing student participants were interns and started their intern programmes during the COVID-19 pandemic. All interviews were auto-recorded, transcribed and analysed using a thematic method.

Results: The four themes which emerged from findings were: student plans during COVID-19; students’ perspectives of the nursing profession; intern students’ mental states; and hospital roles.

Conclusion: While the virus may negatively affect the experience of nursing intern students, the support of the media and society towards nursing staff during the pandemic has encouraged them significantly. So this study recommended that nursing stakeholders collaborate with the media to create greater interaction and embrace the nursing profession for younger generations.

Keywords

Infection disease, Nursing, Qualitative research, Staff-student relationships

COVID-19 is a virus which emerged from Wuhan, China in December 2019 and quickly spread to the rest of the world (1). In March 2020, the World Health Organisation (WHO) announced it as a worldwide pandemic. Since then, COVID-19 has affected people living around the globe in many different ways. As a health crisis, nurses and medical workers have been the most affected professional since they played a major role in fighting the COVID-19 virus and providing daily healthcare services (2). As a result of the growth in COVID-19 cases, some countries around the world faced nursing and healthcare workers shortages in medical centres. Therefore, nursing students were mobilised in hospitals and medical centres during the lockdown (3). Nursing intern programme is a hospital practice one year after graduation for nursing students. It is designed to provide them with necessary training and to develop medical professionalism when dealing with patients and colleagues (4). For the kingdom of Saudi Arabia, The Saudi Ministry of Health published an urgent report during the early stages of the country’s lockdown caused by COVID-19 pandemic. It called for healthcare affairs directors around the country to allow and encourage all hospitals and health centres to continue all training programmes for nursing students in coordination with their universities. The report stated the importance of training and qualifying health workers in order to enhance their ability to face any emergency cases and health crisis. The report highlighted that all students must be trained in environments where all the necessary and preventive measures had been applied for their safety (5). In addition, the Saudi Commission for Health Specialties released a statement in May 2020 urging Saudi universities to mitigate nursing shortages in medical facilities by signing up all nursing students who had already finished their clinical training and were willing to start their intern period to the six-month nursing temporary service realised by them. The programme will help link signed students to the nearest medical facility needing more nurses in practice (6).

The purpose of this study was to investigate the experience of Taif University nursing students as interns during the COVID-19 pandemic. The main objective was to explore the impact of COVID-19 pandemic on nursing students from the students’ perspective.

Material and Methods

This was a qualitative descriptive study conducted at the Nursing Department in the College of Applied Medical Science at Taif University from January 01 to April 10, 2021. The descriptive design was used to collect, understand, organise and represent in depth data (7). All the nursing student participants whowere interns at the Nursing Department in the College of Applied Medical Science at Taif University and started their intern programmes during the COVID-19 pandemic. Taif University Research Ethics Committee, Saudi Arabia, reviewed and approved this study under the code (42-0075).

Inclusion criteria: Students from nursing department at Taif University, who had finished their academic years and started their intern at hospitals were included in the study.

Exclusion criteria: Students who were not in intern at hospitals were excluded from the study.

The researcher conducted a meeting with the clinical affairs to propose the research objectives and the procedure of data collection. After their approval they agreed to contact all intern students through the university system, inviting them to participate along with the information and consent forms. Twelve students replied, eight females and four males, agreed to participate in in-depth semistructured interviews.

All students were recommended by the clinical affair at college of applied medical science, Taif University. The data was collected through individual semistructured interviews with the participants. Open-ended questions were asked during the interviews to allow the students to share their full experience. The interviews questions such as “How did the COVID-19 affect your decision to start training?”, “What are the challenges and difficulties you faced during COVID-19?”, “To what extent have you been able to get support from your co-workers and nurses in the hospital?”, “What are the factors that affected your performance positively, and what are the factors that affected your performance negatively?”. Interviews were done in the Arabic language according to students’ preference. All interviews was done through using Blackboard at Taif University website due the social distancing rules in the country and was approved by author and participants. Ten interviews were enough to achieve saturation and identified all themes, however, this study added two more interviews to ensure the data saturations.

All the participants received an information sheet and signed the consent form. All of them understood their right to skip questions, stop recording and to stop the interview at any time. They were also aware that their contribution would be published in anonymised form.

The interviews were in the Arabic language as requested by the students and lasted for 30–60 minutes. Each interview was recorded in Arabic and transcribed and analysed in English using thematic analysis.

Rigour

The study credibility, transferability, dependability and reproducibility were confirmed. For example, ensured that all genders were included and that all participants had the chance to experience an internship during the pandemic. Participants were given the entire period for expression in order to achieve data saturation. In addition, researcher may add additional questions if clarification is required. Also, researcher may repeat the participant’s answers to emphasise meanings. All interviews were conducted by the same researcher following the interview schedules. The data analysis was conducted by researcher, and they agreed on the finding’s themes.

Results

The total participants in this study were 12 Saudi nursing students from Taif University, Saudi Arabia. Their ages were between 22 and 24 years of age. Participants started their internship beginning months as shown in (Table/Fig 1). From the results, four themes were identified: Student plans during COVID-19; students’ perspectives of the Profession; intern student’s mental state and hospital roles.

Theme 1: Student interns’ plans during COVID-19

Without doubt, the COVID-19 pandemic affected the internships of nursing students at Taif University, Saudi Arabia, although the degree of impact on the students differed according to their starting time and the stage of COVID-19. At the start of the country’s lockdown period, the Ministry of Health chose some hospitals to be limited for corona virus cases and did not accept nursing students. Moreover, the hospitals introduced new rules and regulations during this crisis before accepting nursing students. All these things affected the training of nursing students, as some of them stopped for a while, some were transferred to another place, and some of them reduced their training period in some nursing places, as indicated below:

‘I started before COVID-19, when the virus appeared in Saudi Arabia. My plans were messed up. First, we were ordered to stay home for two months. Second, my plan contained specific departments that were removed because of COVID-19. Those departments were closed for isolation. Lastly, I had to reduce my time in certain departments in order to be able to catch up on the remaining departments because of the missing two months. It is causing me a lot of stress’ (Participant 4).

‘COVID-19 affected my training experience because we were afraid of the unknown. Some hospitals were closed for COVID-19 isolation, which created pressure on the hospitals that remained open as more patients joined the open hospitals as well as more intern students’ (Participant 7).

‘Some students chose to be trained in hospitals outside the city of Taif. Due to COVID-19, their requests were rejected, and they had to train in Taif, which increased the demand. Before COVID-19, we asked to be trained in one hospital, but due to COVID-19 we were asked to split into two groups. The first group would be training in a hospital and the second group in a medical centre to minimise crowding. After two months, groups would have to switch with the others to equalise the experience’ (Participant 3).

Theme 2: Students’ perspectives of the Profession

Most of the interviewees were proud of their participation in training during the COVID-19 period, because the crisis enhanced the importance of nursing as a profession and improved the role of nurses in society. Moreover, this crisis increased nursing students’ responsibilities and their need to work as a team. Despite having the right to start their training or to postpone it, they preferred to start training, as quoted below:

‘When the crisis started in Saudi Arabia, I wanted to postpone my internship because I was scared I might infect my family, but as time went by, I felt more confident about starting my internship. After the pandemic, I felt lucky that I was a nurse and I felt the importance of my role in any health crisis such as COVID-19, although it wasn’t my first choice when I applied to university’ (Participant 3).

‘COVID-19 made me realise the importance of my rule as a nurse. My perspective changed, but so did other people’s. One of the benefits of the virus is that it created more courses online. In my opinion, COVID made people more collaborative and they showed more initiative. I saw a lot of volunteers; I think the crisis has inspired people to work together towards one goal’ (Participant 7).

‘Entering my internship during COVID-19 made me feel that I should be more responsible, although it was hard making the connecting between the theoretical and the practical’ (Participant 5).

Theme 3: Intern students’ mental states

Few of the students hesitated before starting to train in a time of pandemic. The students’ fears were of getting infected, infecting their families and, in the worst scenario, dying. In addition, some of them stated that they regretted entering the nursing field at the beginning of the pandemic, but during the training they felt the fear and the beauty of working in the nursing profession at the same time, as quoted below:

‘This time of training is beautiful but terrifying at the same moment. Beautiful, because it allows you to learn so much and help, and you may never experience a similar situation ever in your life such as a pandemic. Terrifying, because I didn’t know what this disease would do to people when I heard of infections and deaths growing every day’ (Participant 4).

‘Due the crisis, many of my friends were unhappy with the profession and thought they had put themselves at risk. As for me, I felt excited to be lending a hand. At first I feared I might infect my family with the virus, but I was more confident when I returned to my internship as I took my protection procedures very seriously’ (Participant 1).

‘We heard that some nurses in our hospital died because of COVID-19, which had a negative impact on us as nursing students. By observing my teammates during COVID-19, I saw some of them were very confused during training because of the fear. Others were positive and gave their attention to God well’ (Participant 4).

Theme 4: Hospital roles

Given the presence and spread of COVID-19, the Kingdom's government, including the Ministry of Health, put in place a number of rules and regulations aimed at protecting patients and hospitals employees. For example, students were not allowed to enter some hospitals or hospital departments, and all students had to obtain a certificate for the prevention of infectious diseases. Some of these decisions affected students’ training programmes, as quoted below:

I was not allowed to treat COVID-19 patients, unfortunately, because I was an intern student and hadn’t received my infection control course certificate yet, although I was willing to offer my help. You know, COVID-19 has affected my intern experience. I was not allowed to be trained in some departments of the hospital, such as the emergency and intensive care departments, as they were closed for COVID-19 patents (Participant 1).

My working hours as intern changed from am to pm, and this was due to nursing shortage. The hospital contacted our college and asked if students would like to change their working hours to cover the pm shift nursing shortages and we agreed. Also, we had to take an infection control course from the Red Cross to be able to start our internships (Participant 6).

We were not allowed to have direct contact with COVID-19 patients. Because of COVID-19, some departments had nursing shortages as they went to COVID-19 field hospitals. They would use intern students in their advantage and made us take more responsibility than we should. I would not have minded if they had been polite and supportive to us, but they weren’t. Also, they would not give me more credits for it (Participant 4).

Discussion

The main context raised for discussion from the findings are: student interns’ plans during COVID-19; students’ perspectives of the profession; intern students’ mental states; and hospital roles. Present research showed that students started their internships at different stages of the pandemic; some students started one month before COVID-19 emerged in Saudi Arabia, others started in the middle of the pandemic and a few started later. All students were affected by the pandemic, however, the amount of damage varied depending on the period in which they started. Students who started before the pandemic were the most affected because of the changes of laws and legislations while implementing their intern year. This finding was also recorded in the study of Vázquez-Calatayud M et al., the study explained that due to the pressure of the pandemic and the insufficient time to adapt and prepare for the change, nursing students had to transform from students to professionals during the pandemic (8). Furthermore, this transition of nursing students to professionals could result in student not receiving the essential guidance and reflection needed to integrate learning outcomes during their intern (9).

Saudi Arabia Ministry of Health took the decision to stop their internships for two months in order to protect their safety. However, the decision was cancelled two months later, after ensuring that the updated rules and regulations would protect the students’ health. As a result, they had to skip their training in a few departments during those months.

In the early stages of the COVID-19 pandemic, students showed concern about whether they would start their internships during the pandemic or postpone them for a few months. Moreover, Arnetz JE et al., had mentioned that due to the direct contact with the virus, the students feared being infected, and it will restrict their work. Furthermore, it was found that the students had concerns about infecting their families with the virus. These concerns could also impact the family members themselves (10). Likewise, a study was implemented on children of nurses during the pandemic. The children had expressed that they were sacred for their parent’s well-being. Thus, it caused major psychological pressure on the nurses themselves (11). Likewise, it was explored in previous studies such as a cross-sectional design in 2020 with 662 nursing students at three universities in eastern Turkey (12), and high levels of stress among 1715 nurses in Hong Kong (13). In present study, students explained that they were told to not have any direct interactions with COVID-19 patients in order to protect their safety, which was similar to the report of Monforte-Royo C and Coronials FP, which stated that nurse educators most take responsibility for minimising the negative impact of the virus on nursing students (14). Furthermore, a study found that students had felt valued by the professionals during their participation in the pandemic and they further explained that they felt a high level of involvement and collaboration by the healthcare system (15). Consequently, according to Alkarani AS et al., this factor contributes to increase the nurses’ confidence and role in awareness. The study further explained that the acknowledgement and appreciation that nurses received during the pandemic lead to advance nurses’ experience because of the major support from the health professionals (16).

Moreover, according to Shu-Ching CH et al., one of the positive impacts of the pandemic is the increased of research on nurses’ roles and responsibilities during crisis (17). According to Maxton F et al., the rising research on the challenges nurses had to face helped in advancing the technologies and information for nurses and patients (18).

Besides COVID-19 itself, there are many factors caused by the virus that have radically affected the experiences of students, such as hospitals not allowing students to be trained in major departments such as the emergency department due to the need for COVID-19 patient isolation. Most students said that excluding those departments from their plans will not affect their future as a nurse because it involves similar procedures undertaken in other departments. This finding was supported by Mollaoğlu M and Çelik P, who explained that nursing care in all clinical departments is very similar. Only one student reported concerns that she could not train in the paediatric department; her worries involved the importance of training in dealing with children during procedures (19).

Additionally, with all of the challenges faced by the COVID-19 outbreak, students had the chance to deeply understand the occupational status and morals of the profession. Changing hospitals frequently allowed the students to explore different working environments and explore different cases.

Research by Galehdar N et al., stated that patients become attached to the nurses taking care of them, which makes nurses proud of their profession (20). Likewise, current results show that a variety of students have expressed that patients’ prayers and satisfaction after receiving treatments made them proud to be future nurses.

Limitation(s)

Firstly the results of this research represent an intern nursing perspective in only one city in Saudi Arabia; and secondly, this research aims to explore the student experience in the current situation, meaning that the results may change in the future with the crisis and the stakeholder responses.

Conclusion

This study explored the experience of Taif University nursing intern students during the COVID-19 pandemic in Saudi Arabia. Several factors affecting their experiences during the pandemic were highlighted. By reviewing how the nursing profession has been affected by many different diseases in the past few years, nursing education may consider what training nursing students should receive to deal with a health crisis. In addition, present study highlighted the impact of society’s opinion about the nursing profession on nursing stuff and students. Therefore, the study suggests that it is important that nursing stakeholders collaborate with the media to create greater interaction and embrace the nursing profession for younger generations.

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DOI and Others

DOI: 10.7860/JCDR/2022/57699.17041

Date of Submission: May 10, 2022
Date of Peer Review: Jun 21, 2022
Date of Acceptance: Aug 10, 2022
Date of Publishing: Oct 01, 2022

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. No

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: May 11, 2022
• Manual Googling: Aug 05, 2022
• iThenticate Software: Aug 08, 2022 (5%)

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