Aims: To examine the level of resilience and burnout among British nurses during the second wave of the COVID‐19 pandemic and the influence of personal, social and organisational factors on nurses' resilience and burnout. Background: Nurses experienced excessive workload and emotional demands over a prolonged period during the COVID‐19 pandemic which may have led to exhaustion. Little research has examined the correlation between the pandemic variables, nurses' resilience and burnout during the second wave of the COVID‐19 pandemic. Design: This study utilised a descriptive, cross‐sectional research design. Methods: A cross‐sectional and self‐report survey involved 111 staff nurses, who completed a self‐administrated questionnaire between January and April 2021. A STORBE checklist was used to report the study results. Findings: The study found that nurses experienced a high level of burnout and low to moderate levels of resilience. The study revealed significant negative relationships between the level of burnout and perceived organisational support and nurses' resilience. The impact of the COVID‐19 pandemic on nurses' social roles and their worries about patient safety were positively correlated with burnout. The perceived organisational support, the impact of the COVID‐19 pandemic on nurses' social roles and the level of resilience were significant factors for burnout. Conclusions: Nurses experienced a high level of burnout during the second wave of the COVID‐19 pandemic, which may be influenced by how they felt their organisations supported them. Nurses' feelings that the pandemic affected their social roles were associated with increasing their burnout. Relevance to Clinical Practice: Strategies should be developed to address staff burnout and resilience. Nurse managers and educators should play leadership roles in creating professional training to include competencies and psychological preparedness for disasters and to implement strategies to increase the organisational commitments to staff safety and well‐being.

Aims: The aim of this study was to investigate nursing students' clinical decision‐making by using high‐fidelity simulation of a deteriorated patient scenario.Design: A convergent parallel mixed methods research design was used consisting of quantitative and qualitative data collection.Methods: Twenty‐three students completed the Health Science Reasoning Test before and after the simulation between October 2015 and June 2016. They were presented with a simulated scenario and asked to ‘think aloud’ during and after the simulation. The students were audio‐video recorded and observations were collected by the researcher.Results: There was a significant moderate increase in the ‘deduction’ and ‘analysis’ sub‐scale scores and overall test score, suggestive of improved analytical decision‐making processes through the simulation experience. Think‐aloud and observation data identified that students predominantly applied ‘forward’ reasoning during the simulated ‘patient's’ deterioration, focusing mainly on cue acquisition. ‘Backward’ reasoning with a focus on cue interpretation was most prominent in the debriefing data, in line with the survey outcomes. Accurate cue interpretation of critical, key cues appeared more useful than the total number of cues in solving the main clinical case problem.Conclusion: Students learn different clinical decision‐making skills during the simulation compared to what they learn from debriefing. Using observation and think‐aloud methods have significant benefits for researchers seeking to optimize the evaluation of the clinical decision‐making process.

Introduction: The integration of high-fidelity simulation (HFS) in nursing education has increased, but its effect on students’ clinical decision-making skills and their ability to transfer these skills to clinical practice remains unclear. Aim: This qualitative study aimed to explore nursing students’ perceptions of simulation's role in developing decision-making skills for clinical practice. Methods: Twenty-three self-selected final-year nursing students participated in an HFS exercise in 2016. They engaged in “think-aloud” activities during the simulation, reviewed videos of their performance, and attended a structured debriefing session. Four to six weeks later, face-to-face semistructured interviews were conducted to gather their views on the application of learning from simulation into practice. Thematic analysis was used to analyze the interview data. Results: Four themes emerged from the analysis: “enhancing clinical decision-making skills,” “recognition of the types of clinical decision-making,” “recognition of cognitive biases,” and “transferability and integrating theory into practice.” Simulation improved student self-awareness, decision-making skills, and recognition of cognitive biases applied in practice. Overall, students found that the simulation improved their ability to apply theoretical knowledge gained through simulation to practice. The students’ perception of the authenticity of activities in relation to real-world scenarios played a crucial role in enhancing the transferability and application of acquired knowledge from simulation to clinical practice. Conclusion: The findings provide valuable insights into how simulation optimizes learning and decision-making skills, ultimately promoting effective care in clinical settings.

Simulation-based education (SBE) fosters the development of competencies and expands clinical placement capacity. However, the underutilisation of simulation-based education is often attributed to a lack of organisational readiness. To understand organisational readiness for SBE and factors affecting its integration and use in pre-registration nurse education in the UK. A self-report cross-sectional survey was conducted among universities that are members of the Council of Deans of Health (CoDH) and offer pre-registration nursing courses in the UK. Quantitative data were analysed for staff confidence, usage, and organisational readiness for SBE using the Simulation Culture Organisational Readiness Survey (SCORS), while qualitative data explored challenges and benefits of SBE in nurse education. Data were collected between December 2022 and February 2023. Sixty universities completed the survey, resulting in a 69 % response rate. The study found high confidence and usage levels for low-fidelity simulations, while highfidelity, virtual reality, and augmented reality simulations showed lower confidence and utilisation. SCORS scores indicated moderate organisational readiness for SBE in the UK, with 48 % of organisations being highly ready. Significant positive correlations were found between confidence, SCORS scores, and simulation modality usage. Challenges included inadequate resources, staff proficiency, digital skills, and leadership support. The benefits highlighted SBE's role in enhancing clinical skills, interprofessional education, and building capacity for clinical education. Focusing on staff development, particularly in digital and simulation skills, is essential to optimise facilitators' readiness for SBE. Organisational readiness also requires further development in areas such as resource availability and necessitates leadership engagement. Understanding the challenges, developing targeted solutions, and engaging in strategic planning are vital. Addressing these factors would enhance SBE adoption and sustainability, ultimately improving students' clinical competency, preparedness, and clinical placement capacity.

This article discusses the development of professional advocacy in the U.K. nursing and midwifery professions. Initially established in midwifery, the discourse of professional advocacy has gradually shifted from a patient focus to advocating for the professionals in their professional roles. This move is driven by the need to influence the health, well-being, and efficacy of the health professions, thereby positively impacting patient care. The concept of advocacy is thus expanding from advocacy focussing on patients/social groups, to incorporating advocating for health professionals by health professionals. However, it is unclear if literature and evidence is keeping pace with this potential conceptual shift taking place in the practice setting, and it is unclear if past patient-centered conceptualizations of advocacy are relevant to the context of professional-oriented advocacy. This article aims to initiate this discussion specific to the nursing profession.

Background: Traditionally, ward placements have been utilized for nursing students to refine their management skills before registration. Whilst intensive care units (ICUs) offer unique learning opportunities, they are underutilized for student practice, and limited research has examined ICUs as conducive environments for developing management skills. Aim: This qualitative study aimed to explore the experiences of nursing students during their final‐year placement in critical care. Study Design: An inductive methodology was employed to explore the complexities of being a final‐year nursing student in critical care setting. Ten students were recruited between September 2019 and February 2020. Data were collected using individual, face‐to‐face semi‐structured interviews before the Covid‐19 pandemic. Thematic analysis was used to analyse the interview data. Results: Three themes were identified: barriers to learning, empowering transformation and a state of readiness. All the nursing students valued a placement that provided ‘real learning’ experiences and informed their needs and growth. Coaching and constructive feedback provided crucial markers and influenced students' learning performance. As their confidence increased, students became proactive in identifying complex caring activities to test and refine their knowledge and skills. Students visualized themselves working as a registered nurse within the critical care team. Conclusions: With appropriate support and supervision, a critical care placement for final‐year nursing students is a stimulating and transformational experience. Relevance to Clinical Practice: This study highlights the importance of critical care placements for nursing students, aiding their transition to professional practice. Integrating well‐supported placements into nursing curricula enhances decision‐making abilities and readiness for future roles. Critical care nurse educators and managers should focus on developing effective support systems during these placements. By providing tailored support and preparing students for the demands of critical care, these experiences can improve job satisfaction and confidence, which are crucial for staff recruitment and retention in this challenging field.