Since 2020, the COVID-19 pandemic has impacted nurses and the field of nursing profoundly in terms of direct care capabilities, nursing practice issues, and healthcare system operations. Importantly, the pandemic has influenced strongly the professional identity of nurses and nursing education as well as the focus of nursing research. Nurses are the primary human factor affecting care outcomes in formal healthcare systems. However, the challenge of formulating nursing professional identity has increased for nurses and nursing students during the COVID-19 pandemic. Five of the eight articles in this issue of The Journal of Nursing Research address nurse-related professional identity and working environments and innovative simulation training in nursing education, all of which are issues that have been significantly impacted by the pandemic.
Professional identity is a critical issue for nurses because of its close association with issues such as nursing roles, responsibilities, values, and ethical standards, which are unique to the nursing profession. However, during the COVID-19 pandemic, in addition to facing regularly high levels of physical and emotional stress, clinical nurses suffer regularly from moral distress because of conflicts rooted in complex ethical issues related to their professional practice, high levels of acuity, patient deaths, and long working hours (Turale et al., 2020). Furthermore, a high number of frontline nurses were infected during the SARS-CoV-2 epidemic in the early 2020s and, as a result, experienced extended separations from their loved ones and/or died in the line of duty. Nurses need strong moral courage and resilience to work on the frontlines of a pandemic (Turale et al., 2020). Morley et al. (2020) addressed the following three ethical issues that arise during pandemics: (a) the safety of nurses, patients, and families; (b) the allocation of scarce resources; and (c) the changing nature of nurses' relationships with patients and families (Morley et al., 2020). These situations profoundly and negatively impact the professional identity of nurses in general and nursing students in particular.
One study in this issue reports on data showing that nursing students perceive clinical nursing work as "too dangerous to engage in" during the COVID-19 pandemic, with 9.3% expressing intention to leave the nursing profession. How to reconstruct the professional identity of nursing students and nurses is a challenge. One previous qualitative study pointed out that neglect of the professional status of nursing, distrust of nursing knowledge, unprofessional performance, and low professional attraction were the main barriers to fostering professional identity among intensive care nurses and that creating positive professional identity may improve job satisfaction, professional advancement, and durability (Mousazadeh et al., 2019).
Key challenges faced by nursing professionals during the COVID-19 pandemic include preventing staffing shortages and providing psychological and social support to nurses (Chen et al., 2020). Organizations providing positive social support to nurses may help promote their professional identity. Two studies in this issue address the topics of nurse-related job satisfaction, job demand, and organizational support and commitment. In Abadi et al., nurses with lower levels of job satisfaction were shown to have significantly higher psychological and physical job demands. Therefore, enhancing job satisfaction in nurses by creating a balance between job demands, job control, and social support was suggested. In Ekmekc et.al., perceived organizational support was found to change the effect that workload has on affective commitment. It is important to foster a supportive working environment to decrease the impact of workload and work-family interference for nurses normally, and especially during pandemics.
Nursing education has also been dramatically affected by the COVID-19 pandemic (Hsieh et al., 2020). One example is the global trend since 2020 of adopting simulation training in nursing education (Drake et al., 2020). Two studies addressing the use of simulation training in nursing education are included in this issue, with the results supporting that scenario-based simulation training enhances students' preparedness and learning effectiveness and reduces clinical stress.
Nurses and nursing education are the main focuses in this issue. We hope that the findings in these studies stimulate innovative and creative ideas that may be productively applied in nursing research and clinical settings. More studies are necessary to understand and explore the comprehensive impact of the COVID-19 pandemic on nurses and nursing education in order both to take good care of ourselves and to obtain the knowledge and care abilities necessary to relieve the nursing shortage and decrease nursing workloads in clinical settings. The ultimate goal is to maintain and improve quality of care during the pandemic.
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