Nurses' lived experience of being a preceptor.

Registered nurses' lived experience of preceptorship was studied in this phenomenological study. To illuminate the meaning of registered nurses' experience of being a preceptor for student nurses, individual tape-recorded interviews were conducted with 17 registered nurses. They narrated their experience of being a personal preceptor for student nurses during practical training on a hospital unit, and the interviews transcribed verbatim were analyzed phenomenological-hermeneutically. The analysis revealed two main themes (1) including the student in their daily work and (2) increasing awareness of the process of learning, as well as six other themes, which contributed to a new comprehension of the meaning of being a preceptor. All the themes were related to the ongoing preceptor-preceptee relationship. The preceptors' thinking on past experiences and their ideas of nursing care in the future were present simultaneously. Nurses acting as preceptors were perceived as conscious individuals, demanding a balance of their daily work responsibility with increased awareness of the professional demands of nursing care. Preceptors gained increased awareness of and a desire to fulfill the student nurses' varied learning needs and increased awareness of their own learning process.     

It's like being in another world--patients' lived experience of magnetic resonance imaging

Aim. The aim of this study was to illuminate patients’ lived experience during magnetic resonance imaging. Background. Magnetic resonance imaging has increased in importance since the early 1980s and is today a common useful diagnostic tool. Although magnetic resonance imaging are non‐invasive and considered painless, many patients experience anxiety, sometimes so strong that the scan has to be terminated. Design and methods. The study had an inductive design and a hermeneutic phenomenological methodology was used. Results. The essential theme of going through magnetic resonance imaging was a feeling of being in another world. The strange environment and isolation inside the scanner made the participants’ experiences unusual, with varying degrees of difficulty dealing with it. Being in the other world caused a threat to the participants’ self‐control. There was a relation between threat to self‐control, effort and need for support in the sense that the magnitude of threat to self‐control had an impact on the effort it took to handle the situation and on the need for support, and conversely that the support received could affect the effort and threat to self‐control. Conclusions. The study shows that the information received and the interaction between patients and staff have a significant influence on patients’ lived experiences. Relevance to clinical practice. The individual experience of threat to self‐control requires the need for support to be individualized and care need to be adjusted for each patient.     

Evaluating the impact of a preceptorship course on mental health nursing practice

The crisis in the recruitment of nursing graduates into the mental health nursing field dictates the need for assertive and innovative strategies to promote the positive aspects of this field of nursing. A positive clinical experience has been identified as one of the most important determinants of nursing students' attitudes towards mental health nursing. The Centre for Psychiatric Nursing Research and Practice implemented the course "Preceptorship in Psychiatric Nursing" as a means to increase the skill level within and interest towards the preceptorship role in clinical practice. This paper presents an evaluation of courses conducted between 2000 and 2002. The findings suggest that participants (n = 150) were highly satisfied with the content and delivery of the course, and that it is likely to affect their attitude towards and fulfillment of the preceptorship role.     

The lived experience of a tracheostomy tube change: a phenomenological study

Aim. To investigate the lived experience patients have of a tracheostomy tube change. Background. Few interpretive studies have looked at specific nursing interventions in relation to nursing practice. This study has investigated the lived experience of patients from an intensive care unit that have had a tracheostomy tube change. The tracheostomy is a significant intervention for many patients within critical care. Method. Using a phenomenological approach, guided by the insights of Martin Heidegger and Max van Manen, participants were interviewed with their responses being transcribed into a text. This text has been subject to hermeneutic analysis using the theories of Paul Ricoeur. This hermeneutic approach has required using the text (discourse) as the focus of the interpretation. Findings. The findings of this study imply that the experience of a tracheostomy tube change is more complex than that of simply a physical sensation. There is a need for participants to prepare themselves psychologically, a process that requires not only the trust of nursing staff but also the assessment by the participant that the nursing staff member has a level of competence to perform the task. The need for maintaining communication and the ability to speak were at times more significant for participants than even the risk of other airway complications. Relevance to clinical practice. This study has highlighted the potential for further interpretive studies into some of the more specific aspects of caring for patients that have been or are critically ill. The themes revealed will enable the nurse, required to change a tracheostomy tube, to do so with an improved level of empathy and understanding.     

Coping with uncertainty within the preceptorship experience: the perceptions of nursing students

A substantial amount of time and resources are channelled into supporting clinical practicum in nursing education programmes. Attention is targeted at the most effective models to achieve this aim. The provision of sound support models regardless of specific clinical setting is recognized as integral to student development and transition periods throughout nurses’ careers. Within the mental health setting, this situation is compounded by the negative attitudes nursing students tend to hold towards people experiencing a mental illness. Preceptorship has been widely used both nationally and internationally for clinical practicum. Although this model seems to have been endorsed by virtue of its increasing use, additional examination is necessary to assess efficacy and effectiveness across clinical practicum, including those in mental health settings. In utilizing a grounded theory approach, this study addresses the question: what is the experience of preceptorship for undergraduate nursing students in the mental health setting? The major themes identified include: ‘fear of the unknown’, ‘reconciling difference between general acute health and mental health settings’ and ‘supporting practice’.     

Student nurses' lived experience of the sudden death of their patients

This phenomenological study looks at the lived experience of third-year student nurses caring for dying patients in surgical, medical and elderly care units. Informal interviews were tape recorded and interpretive analysis was applied to narrative accounts of the nursing students' experiences. Themes which emerged from the students' narrative accounts included sudden death experience, vulnerability and support. These are evaluated in terms of their meaning for students and the possible implications for clinical care. In addition, the use of students' narratives is also suggested as a valuable learning tool both within clinical and academic frameworks.     

Study on the lived experience of aging

The purpose of the present study was to explore the experiences of aging in adults aged from 40 to 80 years, living in Seoul, Korea, and how these experiences differ according to age. The phenomenological analysis method was used to identify major categories of experience. Five common categories were identified: bodily change; downward spiral of the perspective about aging; acceptance of limitation and boundaries with aging; feelings of nostalgia and hope and; sustaining life through harmony. Results showed that as South Korean adults grew older they began to recognize changes in their bodies. In their 60s, functional changes were explicit and individuals finally admitted that they were getting older. Disease was a part of life, which was inseparable from their daily lives, and death was accepted as a natural event. As South Korean adults grew older, they felt a strong responsibility for their children and tried to live an honest and respectable life. This was a common perception held regarding aging. Thus they pursued a traditional family-oriented life. Even though aging was something that many wished to avoid, it was accepted as part of life. As they experienced the agony of life, they began to accept the realities of living, and wished for their family's happiness and a better future. The present study aimed to increase understanding of the aging experience and to provide a foundation for future research to develop effective health promotion interventions for this population.     

Attempting to accomplish connectedness within the preceptorship experience: the perceptions of mental health nurses

The provision of sound support models for clinical practicum is recognized as integral to the development of nursing students and their transition to registered nurses. In mental health settings, there is the additional issue of positively influencing recruitment rates. Preceptorship has been widely adopted nationally and internationally, however, there is a paucity of research, particularly in mental health settings, to assess its effectiveness. The current study utilized a grounded theory approach to explore the experience of preceptorship for mental health nurses. The findings suggest that mental health nurses seek to accomplish connectedness in the preceptorship relationship. A number of factors inhibit the degree of success in achieving this connectedness, including fear of mental health settings, misconceptions about mental illness and organizational constraints.     

Women's lived experience of breast biopsy: a phenomenological study

This study aimed to explore Irish women's lived experience of breast biopsy with a view to gaining a deeper understanding of their individual experiences and the meanings that it holds for them. A phenomenological approach from a Heideggerian hermeneutical perspective was used. Study participants were eight women aged 22-54 years who had experienced a recent breast biopsy with benign diagnosis. Data were collected using in-depth interviewing. The work of Benner (1994), together with guidelines from Morse & Field (1996) and Burnard (1991) were used to guide the process of data analysis. Themes which emerged from the data were: 'Finding the lump', 'Waiting, not knowing', 'knowing', 'Getting back to normal' and 'Reflections'. Women's feelings of initial distress followed by relief permeate these themes.     

The lived experience of clinical development unit (nursing) leadership in Western Sydney, Australia

BACKGROUND: A network of nine Clinical Development Units (Nursing) (CDU(N)) were recently created in the Western Sydney Area Health Service. These units are designed to develop patient-focused nursing practice through group process and action research, based on principles of transformational leadership. AIMS OF THE STUDY: Although there is documented evidence from Australia and the United Kingdom (UK) that CDUs and Nursing Development Units (NDUs) are very successful in improving both patient and staff satisfaction, there is also growing evidence that the stressors experienced by nurse leaders are threatening the survival of some of these units. This study set out to develop an understanding of the phenomena of Clinical Development Unit (Nursing) leadership when these stressors were likely to impinge. STUDY DESIGN: Hermeneutic phenomenology was employed in order to identify how these experiences changed over time. Two rounds of interviews were conducted: approximately 4--6 months after the launch and, again, 12 months later. FINDINGS: The Clinical Development Unit (Nursing) philosophy provided a framework on which these very motivated leaders began to enhance nursing accountability in their units through reflective practice and participatory governance. While reinforcing many previously published positive and negative aspects of Clinical Development Units and Nursing Development Units, this paper also highlights how the expectations and experiences of these leaders changed over time with unanticipated pressures of work, a high turnover of clinical leaders, a perceived diminution of management support and unrealistic self-expectations. A significant theme that emerged as these stressors began to impinge was the leaders' own need for leadership in order to sustain their confidence and motivation. IMPLICATIONS FOR NURSING: Insights harvested from this study have since been incorporated into a revised leadership preparation programme and support mechanisms for the leaders of eight new Clinical Development Units (Nursing) in the Western Sydney Area Health Service.     

‘Things you can't learn from books’: Teaching recovery from a lived experience perspective

Mental health policy in Australia is committed to the development of recovery‐focused services and facilitating consumer participation in all aspects of mental health service delivery. Negative attitudes of mental health professionals have been identified as a major barrier to achieving these goals. Although the education of health professionals has been identified as a major strategy, there is limited evidence to suggest that consumers are actively involved in this education process. The aim of this qualitative study was to evaluate students’ views and opinions at having been taught ‘recovery in mental health nursing’ by a person with a lived experience of significant mental health challenges. In‐depth interviews were held with 12 students. Two main themes were identified: (i) ‘looking through fresh eyes’ – what it means to have a mental illness; and (ii) ‘it's all about the teaching’. The experience was perceived positively; students referred to the impact made on their attitudes and self‐awareness, and their ability to appreciate the impact of mental illness on the individual person. Being taught by a person with lived experience was considered integral to the process. This innovative approach could enhance consumer participation and recovery‐focused care.     

Elderly persons' experiences of living with venous leg ulcer: living in a dialectal relationship between freedom and imprisonment

The aim was to illuminate elderly persons' experiences of living with venous leg ulcer. Fifteen persons 74-89 years of age with active leg ulcer were interviewed. Data were analysed utilizing a phenomenological-hermeneutic approach inspired by Ricoeur. The analysis includes dialectic movement between understanding and explanation of the text as a whole and its parts. In the structural analysis four themes were identified: emotional consequences of altered body image, living a restricted life, achievement of well-being in connection with a painful wound and bandage, and struggle between hope and despair with regard to a lengthy healing process. The comprehensive understanding indicated that the meaning of living with venous leg ulcer can be understood as a dialectal relationship between, on the one hand the feeling of being imprisoned in the body, the bandage and the home, and on the other hand, hope of freedom from a burdensome body. The results indicate that the concept, body of image, is vitally relevant to the caring of elderly people with venous leg ulcer. The study shows the importance of recognizing the persons' perceptions of their leg ulcers and the impact of these perceptions on well-being. Nurses can thereby anticipate problems and provide more sensitive care.     

Lost in the present but confident of the past: experiences of being in a psycho-geriatric unit as narrated by persons with dementia

Aim. To illuminate meanings of being in a psycho‐geriatric unit. Background. There are known risks associated with moving persons with dementia from home to an institution, but little is known about how they experience being in psycho‐geriatric units. Method. Using open‐ended research interviews, six persons with mild to severe dementia were asked to narrate about their experiences in the hospital. The interviews were interpreted using a phenomenological hermeneutical method of analysis. Results. The comprehensive understanding of being in a psycho‐geriatric unit points towards an understanding of being lost in the present but confident of the past. The analysis showed that the participants appeared lost as they could not narrate where they were and why, but that they became confident when narrating about their previous life. The analysis also showed that being in the hospital meant sharing living space with strangers, invasions of private space and establishing new acquaintances. Being in the unit could also mean boredom and devaluation for participants. The interviews were interpreted in the light of narrative theory of identity: persons with dementia narrating about previous life experiences as to make claims of how to be interpreted by others; as persons instead of merely as ‘demented’ patients. Conclusions. Experiences of care narrated by persons with dementia present meaningful and useful information that can provide feedback to inform care practice. Relevance to clinical practice. Experiences of care from persons with dementia provide meaningful information about care and the doing and being of staff. Creating time for conversations with these persons may facilitate well‐being.     

Supervision of the mental health lived experience workforce in Australia: A scoping review

The mental health Lived Experience workforce (also referred to as peer workforce) is growing rapidly internationally and within Australia. Peer workers are increasingly employed within multi- and inter-disciplinary teams, often directly supervised by mental health professionals such as nurses. Professional supervision has been identified as fundamental for implementing a sustainable peer workforce, but significant gaps in the literature remain, in particular, an understanding of appropriate supervision practices. This scoping review synthesized academic and grey literature on Lived Experience supervision in Australia, exploring current thoughts on best practices. Four electronic databases were searched, and grey literature was located via Google Advanced searches, contacting Lived Experience experts and conducting web-based desktop searches of key mental health organization websites. Thematic analysis identified and described key characteristics in relation to how supervision is conceptualized and operationalized. Eight peer-reviewed and 46 grey literature documents describing supervision and supervisory practices were analysed. Of these studies, 26 were Lived Experience-led. Analysis revealed four key themes: (i) defining peer supervision, (ii) variability in understanding the purpose of supervision, (iii) approaches to supervision and the need for choice and flexibility, and (iv) qualities and skills of the supervisor. Additionally, the establishment of a national professional organization for peer workers was highlighted to protect the authenticity of Lived Experience roles and develop an effective workforce. Clearly, a sustainable Lived Experience workforce cannot develop in isolation, and mental health nurses, as important allies in mental healthcare, need to work alongside, plan and advocate for appropriate supervision practices for this emerging workforce.