Aksoy YE, Koçak V. Psychological effects of nurses and midwives due to COVID-19 outbreak: the case of Turkey. Arch Psychiatr Nurs. 2020; 34:(5)427-433

Andersen KG, Rambaut A, Lipkin WI, Holmes EC, Garry RF. The proximal origin of SARS-CoV-2. Nat Med. 2020; 26:(4)450-452

Cai Z, Cui Q, Liu Z Nurses endured high risks of psychological problems under the epidemic of COVID-19 in a longitudinal study in Wuhan China. J Psychiatr Res. 2020; 132-137

Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. 1951; 16:(3)297-334

d’Aquin V. Reflections of a COVID-19 Graduate Nurse Student. J Nurse Pract. 2020; 16:(8)

de Souza J, da Silva PC, Hoffmeister E, de Negr I, da Costa B, de Figueirado C. Workplace stress in nursing workers from an emergency hospital:Job Stress Scale analysis. Rev Lat Am Enfermagem. 2011; 19:(5)1122-1131

Dyrbye LN, Massie FS, Eacker A Relationship between burnout and professional conduct and attitudes among US medical students. JAMA. 2010; 304:(11)1173-1180

Department of Health and Social Care. What the Coronavirus Bill will do. 2020. (accessed 23 November 2020)

Eaton L. Health workforce burn-out. Bull World Health Organ. 2019; 97:(9)585-586

Eaves JL, Payne N. Resilience, stress and burnout in student midwives.: Nurse Educ Today; 2019

Epstein EG, Haizlip J, Liaschenko J, Zhao D, Bennett R, Marshall MF. Moral distress, mattering, and secondary traumatic stress in provider burnout: a call for moral community. AACN Adv Crit Care. 2020; 31:(2)146-157

Gibson E, Duke G, Alfred D. Exploring the Relationships Among Moral Distress, Moral Courage, and Moral Resilience in Undergraduate Nursing Students. J Nurs Educ. 2020; 59:(7)392-395

Gillespie M, Melby V. Burnout among nursing staff in accident and emergency and acute medicine: a comparative study. J Clin Nurs. 2003; 12:(6)842-851

Gökçen C, Zengin S, Oktay MM, Alpak Burnout G. Job satisfaction and depression in the healthcare personnel who work in the emergency department. Anatolian Journal of Psychiatry. 2013; 14:122-128

Health Education England. HEE COVID-19 student data collections to support paid placement deployment. 2020. (accessed 23 November 2021)

Henrich NJ, Dodek PM, Gladstone E Consequences of moral distress in the intensive care unit: a qualitative study. Am J Crit Care. 2017; 26:(4)e48-e57

Hu D, King Y, Li W Frontline nurses’ burnout, anxiety, depression and fear statuses anf their associated factors during the COVID-19 outbreak in Wuhan, China:A large scale cross-sectional study. EClinical Medicine. 2020; 24:(100424)

Lachman VD. Moral resilience: managing and preventing moral distress and moral residue. Medsurg Nurs. 2016; 25:(2)121-124

Leigh J, Bolton M, Cain K, Harrison N, Bolton NY, Ratcliffe S. Student experiences of nursing on the front line during the COVID-19 pandemic. Br J Nurs. 2020; 29:(13)788-789

Maslach C, Schaufeli WB, Leiter MP. Job Burnout. Annu Rev Psychol. 2001; 52:(1)397-422

Maslach C, Leiter MP, Schaufeli W. Measuring burnout. In: Cartwright S, Cooper CL (eds). Oxford: Oxford University Press; 2008

Morley G, Ives J, Bradbury-Jones C, Irvine F. What is ‘moral distress’? A narrative synthesis of the literature. Nurs Ethics. 2019; 26:(3)646-662

Nelson B, Kaminsky DB. COVID-19’s crushing mental health toll on health care workers. Cancer Cytopathol. 2020; 128:(9)597-598

Nursing and Midwifery Council. Joint statement on expanding the midwifery workforce in the Covid-19 outbreak. 2020. (accessed 23 November 2021)

Pauly BM, Varcoe C, Storch J. Framing the issues: moral distress in health care. HEC Forum. 2012; 24:(1)1-11

Dos Santos LM. How does COVID-19 pandemic influence the sense of belonging and decision-making process of nursing students: the study of nursing students’ experiences. Int J Environ Res Public Health. 2020; 17:(15)

Schooley B, Hikmet N, Tarcan M, Yorgancioglu G. Comparing burnout across emergency physicians, nurses, technicians, and health information technicians working for the same organization. Medicine (Baltimore). 2016; 95:(10)

Fighting the odds—BAME doctors at greater risk from COVID-19. 2020. (accessed 23 November 2021)

Tubbert SJ. Resiliency in emergency nurses. J Emerg Nurs. 2016; 42:(1)47-52

Turale S, Meechamnan C, Kunaviktikul W. Challenging times: ethics, nursing and the COVID-19 pandemic. Int Nurs Rev. 2020; 67:(2)164-167

The Courage of Compassion: Supporting nurses and midwives to deliver high quality care. 2020. (accessed 23 november 2021)

Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet. 2020; 395:(10223)470-473

Yelland A, Winter C, Draycott T, Fox R. Midwifery staffing: variation and mismatch in demand and capacity. Br J Midwifery. 2013; 21:(8)579-589

Zolala S, Almasi-Hashiani A, Akrami F. Severity and frequency of moral distress among midwives working in birth centers. Nurs Ethics. 2019; 26:(7-8)2364-2372

The psychological effects of working in the NHS during a pandemic on final-year students: part 1

09 December 2021
Volume 30 · Issue 22


Resilience in nursing and midwifery involves being able to manage ethically adverse situations without suffering moral distress and is key to mental wellbeing, staff retention and patient safety. The aim of this research was to ask what the psychological effects were for nursing and midwifery students who had been deployed to work in the NHS during the COVID-19 pandemic. This study looked at the incidence of burnout in a small cohort of nursing and midwifery students who were employed as band 4 aspirant nurses and midwives in acute NHS trusts in the south of England. The findings suggested that student midwives reported higher levels of emotional exhaustion and depersonalisation than student nurses but overall, both cohorts of students reported moderate levels of burnout. Part 2 will present the lived experience of deployment as described by students.

In response to the need to increase staffing and to boost resilience in the NHS during the COVID-19 pandemic, the Nursing and Midwifery Council (NMC), Health and Care Professions Council (HCPC) and Approved Educational Institutions (AEIs) were tasked by Health Education England (HEE) with modifying their courses for final year students in nursing, midwifery and allied health professions (NMC, 2020). The students were given a choice of continuing with their studies and delaying their clinical practice until August 2020 or to be deployed and work in the NHS. The third-year student nurses and midwives who chose to be deployed were then accelerated into clinical placements that offered a band 4 salary and temporary registration, thereby boosting staffing throughout the NHS (HEE, 2020). These students were then placed in NHS trusts near their home and this was managed by HEE supporting the AEIs and the local NHS trusts (HEE, 2020). The expectation was that students would complete their academic work as well as working 30 hours a week as paid employees in the NHS. Deploying students into the workforce was the NMC’s response to the Coronavirus Bill published on 17 March 2020 (Department of Health and Social Care (DHSC), 2020), later passing into law as the Coronavirus Act 2020.

Register now to continue reading

Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • Unlimited access to the latest news, blogs and video content