*3.7. Nursing School Preparation for a Pandemic*

Each participant expressed both satisfaction and limitations in their nursing education, describing the coursework as sufficient but the application to practice specific to pandemic was missing. Many described feeling unprepared and, at times, powerless as they were required to adhere to standards of care changing rapidly and practices, like reusing PPE and increasing nurse to patient ratios, became commonplace. They recalled learning about pandemics, viruses, and emergency preparedness during their educational program; however, participants were ill equipped to employ related nursing protocols in the context of a large-scale pandemic. This gap was not seen as detrimental to their success because working as a nurse during a pandemic was unknown to all nurses they encountered. Emma describes this imparity:

"I don't think there's anything that could have fully prepared us for the pandemic. I mean, we learned about pandemics. We learned about viruses, you know, we learned all these things, but I don't think there's anything that can prepare you for just being thrown into it."

Marie praised her program for imparting needed information but was aware of the incongruence between didactic education and bedside practice: "I think the reality of nursing school is that not everything is going to copy over directly onto the job, but I think my, I think our school did a good job of doing their best." Cesar noted his colleagues who were experienced nurses reverted to novice nurses when faced with the uncertain challenges of working during a pandemic. He felt that this was evidence that nursing programs cannot fully prepare you:

" ... The veteran nurses on the floor and they're like, yeah, we've kind of seen nothing like this either and they're the people you kind of go to, to ask questions. So, if they didn't know what was going on, and I mean, I don't think there's anything that could have made me more prepared."

Conversely, many believed that aspects of their academic program effectively prepared them to assume the role of the nurse. They noted that clinical experiences were valuable as were post-clinical debriefings, which allowed students to discuss clinical based topics among their peers. Marie believed that hands-on clinical were "the most beneficial" aspect of nursing school, specifically, post-clinical debriefing:

"I found that to be so helpful, whether it's debriefing regarding a task of medication or whole patient experience that we had to deal with that day ... just being able to sit down with a group, a smaller group of people and really just talk about things."

Denise echoed this opinion that sharing experiences after a clinical was important: "I would say that definitely helped because even though I didn't have like an experience, it was nice to hear like other people's experience."

Participants described the ability to manage time effectively, employ flexibility, and put into practice new skills was a result of learning in an accelerated nursing program. The pace of the twelve-month accelerated nursing program assisted them in developing critical thinking and prioritization, skills they utilize in their bedside practice. Emma states "Going through the accelerated program and having to learn to manage all of that and like keep myself on a schedule is really helpful with keeping my two patients on a schedule." Marie compared her experience in an accelerated nursing program to working during a pandemic. She states "I think it prepared us pretty well especially because the program was only a year long. And so, we were forced to kind of put our heads down and grind for a year. And that is kind of what it feels like."
