Interventions against bullying of prelicensure students and nursing professionals: An integrative review

The problem of bullying is of such significance, health care accreditation agencies such as The Joint Commission have reiterated that these behaviors compromise on patient safety. Researchers demonstrate that much is known about the existence of bullying behaviors in health care and its detrimental effects on the profession of nursing. Leaders in health care and nursing education are beginning to tackle this issue. Guided by the methodology of Whittemore and Knafl, the purpose of this integrative review was to analyze literature discussing the interventions against bullying directed towards prelicensure nursing students and professionals.     

Workplace violence experienced by nursing students: A UK survey

AimsTo appreciate the nature and scope of workplace violence amongst a sample of the UK nursing student population during clinical placement and to recommend strategies universities can implement to successfully manage the impact.BackgroundWorkplace violence is defined as a violent act(s) directed toward workers and can include physical, psychological or verbal behaviour. It is prevalent in nursing and causes victims work-based stress that can affect not only the individual but also the quality of care. Similar negative experiences amongst students can have a direct impact on the development of future professional skills.DesignThis study employed a cross-sectional survey design. Questions were uploaded in the format of a commercial internet survey provider (SurveyMonkey.com) and distributed across a sample of nursing schools in the UK. The survey was voluntary and employed a validated tool to assess workplace violence and was based on a similar study in Australia. The number of respondents was 657. This paper reports on the quantitative results.FindingsNearly half of the students (42.18%) indicated they had experienced bullying/harassment in the past year while on clinical placement. One-third (30.4%) had witnessed bullying/harassment of other students and 19.6% of incidents involved a qualified nurse. The unwanted behaviours made some students consider leaving nursing (19.8%). Some respondents said the standard of patient care (12.3%) and their work with others (25.9%) were negatively affected.ConclusionsWorkplace violence can influence nursing students' attitude toward the profession and their level of satisfaction with the work. Whilst it was reassuring to note that the majority of the participants knew where/how to report, only one fifth had actively reported an episode of bullying/harassment. Current students are the nurses and leaders of the future and have a key role in shaping the culture of generations to come. Universities and clinical providers need to work together to reduce the incidence and impact of workplace violence in order to improve the culture of practice.     

The effect of a course in nursing ethics on the relationship between ethical choice and ethical action in baccalaureate nursing students

This study examined the effect of an ethics course on the variables of ethical choice and ethical action in baccalaureate nursing students. Data were collected from 17 students who were enrolled in a three-credit elective course in ethics and from 20 students who were matched for placement in the curriculum but who were not enrolled in the ethics course. The ethics course consisted of study of the major ethical principles and theories as well as guided ethical case analysis with emphasis on the role and responsibilities of the nurse. Ethical choice and ethical action were measured by Ketefian's Judgment About Nursing Decisions. The variables of moral choice and moral action were positively correlated r = .87 (p less than .001) in the students who were enrolled in the ethics course and they were negatively correlated at r = -.32 (p .34) in the students who were not enrolled in the ethics course. Overall scores of the two groups on both column A (Ethical Choice) and column B (Ethical Action) were not significantly different. The total scores of the ethics group were higher. The results of this study lend support to the inclusion of a course in ethics in nursing curricula. Continued research into this area should continue to be a high priority.     

Social barriers experienced by female Saudi nursing students while studying nursing: A phenomenological study

Saudi Arabia has a shortage of Saudi nurses in the workforce, particularly with limited numbers of local female nurses. Social factors may influence views towards the discipline of nursing thus influencing interest of local females choosing to undetake nursing studies. The aim of this paper is to explore the lived experiences of Saudi female nursing students regarding the social barriers encountered related to studying nursing. Hermeneutic phenomenology guided by Van Manen underpinned the study. In-depth, semi-structured interviews were conducted, and data thematically analysed. Eight female nursing students from one university nursing school in Saudi Arabia participated. Two main themes emerged, the first, 'dealing with social factors', describes the range of social issues encountered by students. The second theme, 'social support', describes support needs and strategies used by students as they faced social issues. This study demonstrates that Saudi female nursing students could generally overcome social difficulties they confronted, particularly when they received viable social support to encourage them in their studies. Therefore, it is important to understand the social factors and experiences that may act as barriers to students completing their nursing studies. This can help in the recruitment and retention of nursing students and design of supportive programs to facilitate their studies.     

Violence experienced by undergraduate nursing students during clinical placements: An online survey at a Scottish University

AimTo assess the prevalence of violence and experiences of violence during clinical placements, among nursing students at a Higher Education Institution (HEI) in Scotland.DesignCross-sectional survey, using an opt-in online questionnaire.ParticipantsAll 950 undergraduate nursing students aged 18 + years were eligible.MethodsThe survey, with 24 open and closed format questions, was advertised over a 6-week period via the students’ virual learning platform. Potential participants were provided with study information before giving (electronic) informed consent. The questionnaire used was adapted from two other surveys and piloted prior to administration. Open-ended questions were fully transcribed and categorised and data analysed using SPSS.ResultsThere were 138 completed questionnaires (approx. 15% response rate); respondents were mainly female (92%). 77% had experienced verbal violence directed at them while on placement, most commonly swearing, shouting and insults. 70% of respondents had experienced physical violence, most commonly hitting, grabbing, kicking and spitting. By the fourth year of study, all 10 students who responded (out of 17 enrolled) had experienced violence. In general, patients (with a mental illness) were perceived to be the most likely perpetrators. The five most commonly reported feelings by respondents during the incident were: anxious (65), understanding (58), vulnerable (54), unsafe (50) and scared (45) and those after the incident were understanding (70), anxious (59), guilty (37), vulnerable (36), incompetent (34). 55 (47.8%) respondents felt supported during this ‘significant’ incident, 23 (20.0%) were unsure and 28 (24.3%) did not feel supported. There was a trend towards younger respondents and those with fewer years of care experience experiencing more violence.ConclusionThis study indicates that there is a high prevalence of violence experienced by student nurses that can have significant emotional consequences. There is scope to provide more training and support for them to deal with frequent incidents of violence.     

Exploring the meaning of critical incident stress experienced by undergraduate nursing students: A hermeneutic study

AimTo better understand the meaning of clinical related critical incident stress experienced by undergraduate nursing students.BackgroundUndergraduate nursing students who engage in learning in the clinical practice setting may experience critical incidents.DesignGadamer’s philosophical hermeneutics (1960/2013) was used to explore the meaning of clinical related critical incident stress experienced by undergraduate nursing students.MethodsA purposive sample was used to recruit 11 students who were enrolled in a Canadian university baccalaureate nursing program. Data collection involved conducting semi-structured interviews over 10 months in 2020–2021. The interviews were recorded and transcribed verbatim and the data were analyzed using the interpretive method of hermeneutics.ResultsFindings from this research revealed that the student-teacher relationship was influenced by students’ experiences of critical incident stress. Students’ navigating uncertainty and the need to maintain the optic of perfection had a potential impact on the response to critical incidents.ConclusionThis study highlighted that critical incident stress may lead to distress associated with students’ altered perception of nursing as a discipline and profession as well as created opportunity for new insights and possibilities.     

护生遭受欺凌行为现状及影响因素分析

目的了解护生遭受欺凌行为的现状及影响因素,为欺凌行为的识别、评估、干预提供依据。方法采取便利抽样的方法,以湖北省、江苏省及山西省4所高校的360名在校学生为研究对象,评估其受欺凌状态、气质类型、心理状态及家庭情况。结果 91%的学生遭受过校园欺凌,遭受欺凌行为总分的四分位数分别为22.00、27.00和33.00;多元逐步回归分析结果显示:学生目前的心理状态、好友数量、与父母的关系、性别、性格特点、成绩排名为受欺凌的预测变量。结论我国护生遭受欺凌行为的发生率较高,但是严重程度处于轻度水平,应从学生的个体因素、家庭关系及心理状态三个方面预防和干预校园欺凌行为的产生,探索校园欺凌行为的预防机制。     

Doing the right thing: nursing students, relational practice, and moral agency

Registered nurses and nurse educators are often unaware of how nursing students experience the nursing profession. In the current practice climate of increased workloads, reduced funding, and higher patient acuity, nurse educators are likely to hear from colleagues how unprepared newly qualified nurses are for the needs of practice. It is difficult for many nursing students to see value in their practice because they become preoccupied with their perceived lack of knowledge and technical skills. Nurses and nurse educators should be aware of how this brands new graduates and informs their sense of developing professional identity. Despite their feelings of deficit in terms of skills and knowledge, it is clear that many nursing students are, in fact, effectively negotiating relational ethics. This article presents a collaborative account of the important relational work being undertaken by one group of nursing students in New Zealand.     

An ethical analysis of double bind conflicts as experienced by care workers feeding severely demented patients

When patients with incurable dementia diseases no longer take food or fluid voluntarily, the care workers experience distress and anxiety. Thirty-nine care workers were interviewed about their thoughts, feelings and attitudes towards feeding severely demented patients. A phenomenological approach was used and the interviews were developed, attention paid to Bateson's double bind theory, Kohlberg's theory of moral development and ethical theories. Ethical theories, principles and rules, containing messages at different logical levels and the lack of empirical knowledge of the demented patients' inner world, led to the care worker's difficult double bind situations. To solve the conflicts the care workers need insight in all aspects of the problem. In order to understand all the components in a double bind situation it is important to redefine it from outside.     

Agreement: the origin of ethical action

The health care setting is an interweaving of human concerns. What is needed in this arena is an ethic--a guidance system centered on, and relevant to, these concerns. Such an ethic must be derived from, and appropriate to, the health care setting and the practice of health care professionals. This is established by the health care professional/patient agreement. This article will describe how a practice-based, symphonological ethic--an ethic based on agreement--can be brought to bear on the adversities faced by nurses and any other health care professional in any setting.     

Attitudes and preferences concerning interprofessional education of first-year students and experienced medical and nursing staff

ABSTRACT

In order to enhance patient outcome and patient safety in healthcare, interprofessional education (IPE) has over the years become a specific area of interest focusing on teaching concepts, research methods, and implementation strategies. To achieve commitment and positive attitudes as part of the institutional readiness towards IPE, the adoption of change management aspects can support its early implementation. This short report presents results of a baseline survey on attitudes and preferences for IPE among first-year students in medicine and nursing, as well as among chief physicians, nurse directors, and administrative directors at the associated university hospital. For the survey, the UWE-IP (University of the West of England Interprofessional Questionnaire) was used along with ten customised questions. Overall, a high degree of approval for IPE was observed in all participants. Furthermore, participants showed positive attitudes in three of the four UWE-IP subscales. However, neutral to negative attitudes were documented in subscale interprofessional interaction.     

Teaching around the cycle: strategies for teaching theory to undergraduate nursing students

A teaching technique applied to teaching nursing theory in an undergraduate nursing program is presented. This technique acknowledges a variety of learning styles to facilitate student learning. Activities highlight the importance of acquiring a variety of knowledge acquisition and information-processing skills required in a profession. Students use critical thinking, communication, group process, and research analysis skills to learn and apply information about theory. The methods and activities have been developed over four years and implemented in small classes of eight students and in classes as large as 140 students with equal success.     

护理本科生专业价值观的现状及影响因素研究

目的研究护理本科生的专业价值观现状并分析其影响因素,为制定提高护理本科生专业价值观水平的教育策略提供依据。方法2008年12月-2009年4月,我们采用Weis设计的“护理专业价值观评价量表”对308名护理本科生的专业价值观水平进行评价,并分析其影响因素。结果护理本科生的专业价值观呈中等水平,其专业价值观水平在有无临床实习经历间、护生入学时对选择护理专业持有不同态度间,护生毕业时对选择从事护理专业持有不同态度间及其父母对子女从事护理专业持有的不同态度之间差异均有统计学意义（P≤0．05）。经回归分析提示,护生对选择和从事护理专业所持的态度是影响其专业价值观水平的主要因素。结论学校的培养模式、护理本科生自身的因素及家庭因素均会影响护理本科生专业价值观的形成和发展。因此,高等护理教育应加强学生专业价值观的培养,有助于未来护理专业的发展。     

Youth bullying: A review of the science and call to action

Recognized as a critical public health problem, youth bullying is reportedly experienced by approximately 20% of today's youths. In the last decade, attention to bullying has increased and the scientific knowledge base relevant for practitioners who treat youths, research their issues, and create policy has expanded. The purpose of this review is to highlight key developments related to the health effects of bullying, interventions aimed at curbing bullying behaviors, the measurement of bullying, and nursing's disciplinary response to this phenomenon. A call to action for nurses involved in caring for youths across settings and roles is offered and strategic actions for nursing professionals are provided.     

The process of seeking stress-care: coping as experienced by senior baccalaureate nursing students in response to appraised clinical stress

High levels of clinical stress experienced by nursing students continue to be identified in the literature. However, much is still unexplored about the coping processes of nursing students in response to appraised clinical stress. A grounded theory methodological approach was used to acquire a substantive theory of the processes through which senior baccalaureate nursing students manage the demands of the clinical person-environment relationships that are appraised as stressful and the emotions they generate. A theoretical sample of 16 volunteer senior generic nursing students from two baccalaureate nursing programs was determined by saturation of the data. Each participant was interviewed twice. The basic social problem experienced by these senior baccalaureate nursing students was the chaos created in their lives while trying to manage the demands of the appraised clinical stress (i.e., the clinical person-environment relationship). The three-stage process of seeking stress- care, including encountering changing self, loss of self, and regaining managed self, helped the students manage this chaos. Each of the stages related to the processes that transpired within the students as they dealt with the chaos created in their life while trying to manage the demands of appraised clinical stress. Implications include the development of the stress-care construct and innovative instructor interventions in the clinical setting.