The value of role modelling: Perceptions of undergraduate and diploma nursing (adult) students

Using a grounded theory methodology, this paper demonstrates the value of role modelling in teaching and learning within the clinical area. Views of undergraduate (n = 20) and diploma (n = 22) nursing (adult) students were sought using individual and focus group interviews. Although the importance of role modelling is acknowledged within the literature, there appears to be little written about the value of providing role modelling within the clinical learning environment to facilitate learning for student nurses. Both groups of students stated the importance of having access to a good role model in order that they could observe and practice skills and/or behaviour. ‘Good’ role models were seen to have a tremendous influence on the clinical learning environment and on the development of students’ competence and confidence. Recommendations were made to include discussions on the value of role modelling on enhancing the clinical learning environment within mentor preparation courses. These discussions should emphasise the value of observational learning, the necessity of providing constructive feedback and the need for role models to enable the student to convert observed behaviour/skills into their own behaviour and skills set.     

Evaluation of clinical teaching models for nursing practice

Clinical placements provide opportunities for student nurses to learn experientially. To create a constructive learning environment staff need to be friendly, approachable, available and willing to teach. There must be adequate opportunities for students to develop confidence and competence in clinical skills with a focus on student learning needs rather than service needs of facilities.A popular model for clinical teaching of nursing students is the preceptor model. This model involves a student working under the supervision of individual registered nurses who are part of the clinical staff. This model was failing to meet students’ needs in acute nursing practice areas, largely due to Registered Nurse staff shortages and demanding workloads. The students’ evaluations led to the trial of a ‘cluster’ or group model of eight students, with a clinical facilitator who is paid by the university, in each acute nursing ward.Evaluation of twenty nursing students’ perceptions of their acute nursing practice clinical placements was conducted using a mixed method approach to evaluate the two models of student supervision. Results indicate that the students prefer small groups with the clinical facilitator in one area. Thus evaluation and feedback from students and the perceptions of their clinical placement is essential.     

Concepts of experience and evaluation as educative processes in registered nurse baccalaureate school program

A learning experience for registered nurses in a baccalaureate program consisted of an opportunity for the students to engage in systematically assessing their own learning needs in utilizing the nursing process. While involved in giving individualized nursing care, they continued to evaluate their own clinical competencies and to ‘learn how to learn’ as active participants with their instructors, peers, and clinical personnel.     

基层医院在职护士继续教育对护士护理技能的影响

目的 探讨基层医院在职护士继续教育对护士护理技能的影响.方法 选取2018年4月至2018年6月我院的210名在职护士作为对照组,选取2019年7月至2019年9月我院的340名在职护士作为观察组.对照组未参与继续教育,观察组参与规范化在职护士继续教育.比较两组在职护士的护理质量评分;分析在职护士继续教育效果与护士专业...     

Emotional labour and the clinical settings of nursing care: the perspectives of nurses in East London

Emotions in health organisations tend to remain tacit and in need of clarification. Often, emotions are made invisible in nursing and reduced to part and parcel of ‘women’s work’ in the domestic sphere. Smith (Smith, P. 1992. The Emotional Labour of Nursing, Macmillan, London) applied the notion of emotional labour to the study of student nursing, concluding that further research was required. This means investigating what is often seen as a tacit and uncodified skill. A follow-up qualitative study was conducted over a period of twelve months to re-examine the role of emotional labour and in particular the ways in which emotional labour was orientated to different clinical settings. Data were collected from 16 in-depth and semi-structured interviews with nurses based in East London (United Kingdom). Findings illustrate emotional labour in three different settings (primary care, mental health and children’s oncology). Findings show the different ways in which emotional labour is used and reflected upon by nurses in these three clinical areas. This is important in improving nurse training and best practice as well as helpful in offering an initial synopsis of the culture of care in nursing; investigating several clinical settings of nurses’ emotional labour; looking at changing techniques of patient consultation; and beginning to explore the potential therapeutic value of emotional labour.     

Using innovative models in transition to practice and Master's Entry programs to teach ambulatory and primary care nursing

With advancements in health care and changes in reimbursement that contribute to shorter hospitalizations, health care delivery is increasingly shifting to other settings to include skilled nursing, home care, and outpatient areas. There is a well-documented shortage of hospital-based capacity for clinical placements in California. The need for clinical placements is creating an opportunity to utilize ambulatory care settings as innovative alternative learning experiences for prelicensure nursing students. Care coordination, health coaching, and population health management are examples of skills useful for all RNs that ambulatory care settings offer as learning experiences for nursing students. The skills and knowledge students gain in ambulatory care are valuable for a wide range of employment settings. Additionally, these alternative settings provide faculty other clinical placement options since acute care placements are difficult to secure and sustain. The University of San Francisco (USF), School of Nursing and Health Professions (SONHP) developed two educational models to prepare nurses for complex disease management. One was a post-graduate new RN program that focused on outpatient/ambulatory care, the Transition to Practice Program (TTP). The other was a prelicensure Master's-Entry Master's of Science in Nursing (ME-MSN) program that has an ambulatory and acute care pathway.     

Patients’ views of nurses’ competence

This study examines, from the patients’ perspective, what is meant by competent nursing and how, with this perspective in mind, patients would view the prospect of assessing the competence of nurses.There is a little empirical research that clarifies professional competence from the patient’s perspective. Nursing curricula in the UK have shifted attention to ‘competencies’ as the outcome of nurse education and, in an era of patient involvement, their views are important to investigate.The study utilises a grounded theory approach. Data were collected in Central Scotland between 2001 and 2003. Twenty-seven patients participated. Data were analysed, in keeping with the grounded theory tradition, utilising the constant comparative method.Patients described the foundation of competent nursing practice as technical care and nursing knowledge. Patients assume that technical care is competent as safe guards are considered to be in place to protect patients. When technical competence is assumed, interpersonal attributes become the most important indicator of the quality of nursing care.The results of this study highlight uncertainty about whether patients feel able to assess the competence of nurses. The results of this study may have implications for nurses internationally when trying to involve patients in the assessment of nurses.     

Patients’ views of nurses’ competence

This study examines, from the patients’ perspective, what is meant by competent nursing and how, with this perspective in mind, patients would view the prospect of assessing the competence of nurses.There is a little empirical research that clarifies professional competence from the patient’s perspective. Nursing curricula in the UK have shifted attention to ‘competencies’ as the outcome of nurse education and, in an era of patient involvement, their views are important to investigate.The study utilises a grounded theory approach. Data were collected in Central Scotland between 2001 and 2003. Twenty-seven patients participated. Data were analysed, in keeping with the grounded theory tradition, utilising the constant comparative method.Patients described the foundation of competent nursing practice as technical care and nursing knowledge. Patients assume that technical care is competent as safe guards are considered to be in place to protect patients. When technical competence is assumed, interpersonal attributes become the most important indicator of the quality of nursing care.The results of this study highlight uncertainty about whether patients feel able to assess the competence of nurses. The results of this study may have implications for nurses internationally when trying to involve patients in the assessment of nurses.     

The experience of new nurses’ early working life: Learning in a hospital care context – An interview study

AimTo explore how nurses during their early working life learn to provide high-quality care in relation to organisational prerequisites in a hospital setting.BackgroundWhen nurses enter employment in contemporary hospital settings, they face multiple learning challenges. Organisational prerequisites that have been identified to affect their ability to learn to provide high-quality care are related to staffing turnovers, large patient groups and a lack of experienced staff to support their learning.DesignQualitative.MethodsThe study was conducted between 2018 and 2019 at a medium-sized hospital in Sweden. Data from interviews with 10 nurses with fewer than two years’ work experience were subjected to qualitative content analysis.ResultsThe results describe the nurses’ learning during their early working life in two categories: Performing tasks in relation to organisational prerequisites and Making use of clinical experiences to grasp the complexity of nursing care. The first theme reflected a learning process that was initially characterised by seeking confirmation and instructions from colleagues of how to act safely and by balancing the demands of time efficiency and sustaining patient safety. The second theme reflected that, after addressing organisational prerequisites, the nurses tried to understand and make use of clinical experiences to grasp the complexity of nursing care by encountering and processing clinical patient situations.ConclusionsThe results of this study revealed that nurses’ learning during early working life seemed to be primarily directed towards handling tasks, with sometimes limited opportunities to grasp the complexity of nursing care. Their learning depended largely on their own initiative and motivation and was strongly influenced by organisational prerequisites. The limited availability of experienced nurse colleagues and lack of time devoted for reflection needs to be dealt with to support nurses’ learning.     

Liberating new talents: an innovative pre-registration community-focused adult nursing programme

The drive for a more community-focused approach to pre-registration nursing education as identified in Modernising Nursing Careers, (Department of Health, 2006a) has continued to gather momentum. The research literature identifies that the community context impacts significantly on care delivery, with student nurses often missing the underlying complexities of working in this context; focusing on the task in hand rather than the broader landscape of care (Carr, 2004). In 2008, a community focused pre-registration adult nursing degree pathway was started at Canterbury Christ Church University (CCCU), to prepare a cohort of 16 nursing students to work in the community and general practice setting at the point of registration. Placement learning has been focused within general practice and community through a hub and spoke approach to enable students to develop a deep understanding of the complexities of care in this setting with particular reference to the management of risk and unpredictability. The pilot is being formally evaluated with a particular emphasis on the meaning and relevance of practice learning within these settings. The emerging data will not only provide evidence to promote the community and general practice agenda within pre-registration curricula, but help to clarify the essential skills and knowledge required to prepare students nurses for working in these settings.     

Brain injury rehabilitation settings: a gold mine for student and staff learning

This article explores cognitive, psychomotor, and affective learning relative to the professional development of senior nursing students and staff in a long-term brain injury rehabilitation setting. Valuable opportunities for learning exist in this environment. Nursing students acquire a much different perspective toward caring for patients in rehabilitation settings than in acute care; they also gain tremendous opportunities to strengthen the clinical judgement and psychomotor skills applicable to most clinical work environments following graduation. In addition, they assume professional attitudes toward and interest in caring for long-term brain-injured patients as they work closely with expert rehabilitation nurses. When staff nurses interact with students, they receive reciprocal benefits. Staff nurses profit by refining and broadening the scope of their own practice; they also develop a positive self-image and a feeling of pride in their work. More importantly, staff nurses in a long-term brain injury rehabilitation setting regain the feeling that their daily efforts are really worthwhile.     

Care home nursing: Co-creating curricular content with student nurses

BackgroundMeeting the complex care needs of an ageing population is a global issue and long term care settings, such as care homes, play an essential role. However, there is a crisis in the recruitment of registered nurses within care homes. Higher educational institutions have a critical part to play in addressing the crisis in recruitment in care homes and it is argued that student nurses can have a significant role to play in co-creating curricular content responsive to population need.ObjectiveTo co-create curricular content on care home nursing with student nurses.DesignCo-creation through collaborative enquiry and a three stage thematic analysis.SettingUndergraduate, preregistration nursing programme in a university in the United Kingdom.ParticipantsStudent nurses from Years One to Four undertaking a Bachelor in Nursing with Honours degree.MethodsSix focus groups and two one to one interviews.ResultsFindings revealed predominantly negative attitudes towards care home nursing. Teaching and practice placements appeared to play a minor role in shaping students' attitudes but rather, gave the unspoken message that for the acquisition of necessary knowledge and skills, care homes were less important than other settings. Most students were initially averse to care home nursing as a career choice. During focus groups/interviews, views shifted from seeing care homes as places where you ‘lose clinical skills’ to places where there is ‘a lot of responsibility’, and also a potentially rewarding career choice. From this attitudinal shift, students made suggestions for developing better curricular content and more positive learning opportunities.ConclusionsA co-creative framework can create a space for mutual learning between students and staff about challenges and opportunities for equipping nurses to meet the needs of ageing populations. Student nurses are open to learning about care home nursing as part of their education and keen to have a more positive exposure.     

Practice nurses experiences of mentoring undergraduate nursing students in Australian general practice

Internationally, the delivery of health services has shifted from secondary to primary care, necessitating an exponential growth of the nursing workforce and expansion of the nursing role in general practice. This growth, and the subsequent need to develop this workforce, has created a need to expose undergraduate nurses to general practice nursing as a viable career option. Concurrently, universities are struggling to find sufficient clinical places for their undergraduate students to gain clinical experience. It is logical, therefore, to increase the number of undergraduate nursing student placements in general practice. Through qualitative research methods, this paper seeks to explore the experiences of practice nurses mentoring undergraduate students on clinical placements within the general practice setting. Findings are presented in the following three themes: (1) Promoting Practice Nursing: We really need to get students in, (2) Mentoring future co-workers: Patience and reassurance, and (3) Reciprocity in learning: It's a bit of a two way street, which show the benefits of such placements. Clinical placements in general practice settings can be mutually beneficial in terms of providing quality teaching and learning experiences for students. Conversely, the experience provides an impetus for practice nurses to maintain currency of their clinical skills and knowledge through mentoring student nurses.     

Communication in palliative care: Philosophy, teaching approaches, and evaluation of an educational program for nurses

In this article is presented a post-graduate program in palliative care nursing focusing communication. The teaching plan was inspired by action learning, and the students’ discovery processes necessitated a variety of teaching methods. The program was based on a holistic view of the human being and of inter-human communication. Neuro-motoric stimulation exercises were used to improve the students’ focus of attention, sensory reception, and awareness of their corporeal and intellectual selves. Stimulation of relational skills, the discussion of ethical and difficult questions, and narratives helped students discover relationships between theoretical knowledge and palliative practice, and were used to explain and illustrate topics, and as backgrounds for discussions.During the program the students examined, challenged, and continuously reflected upon their explicit and unconscious praxis theories and their communicative habits. Although very different from educational programs they previously had experienced, this teaching/learning plan and the outcome thereof was positively evaluated. At the end of the year the students found themselves to be more knowledgeable, discerning and self-confident nurses. Even so, some found that they needed more time to digest what they had learned and for new knowledge and philosophies to become internalised.     

Back to basics—Essential nursing care in the ED: Part One

Emergency nurses are expected to work under pressure to many standards, guidelines and protocols related to patient care, and often in an advanced practice role. These expectations can sometimes take priority over basic nursing care once emergency/resuscitative intervention has occurred. However, posing the question ‘How would I want this patient to be cared for if they were my grandmother/father/child’ sets a benchmark for nursing practice [Fulbrook P, Grealy B. Essential nursing care of the critically ill patient. In: Elliot D, Aitken L, Cheboyer W, editors. ACCCN critical care nursing. Sydney: Elsevier; 2006]. How well patients are cared for has a direct effect on their sense of well-being and their recovery. Effective communication is essential to good nursing care and patient outcomes. The length of stay of the patient in the ED may be extended, and the use of “holding” wards while waiting for investigation results of patients for probable discharge necessitates the ED nurse to consider basic but essential aspects of nursing care that will be discussed. Other essential aspects of care such as psychosocial; including culture, pain management and infection control are beyond the scope of this paper.     

Primary care clinical placements: The views of Australian registered nurse mentors and pre-registration nursing students (part 2)

An increased burden of chronic and complex conditions treated in the community and an aging population have exacerbated the primary care workload. Predicted nursing shortages will place further stressors on this workforce. High quality clinical placements may provide a strategic pathway to introduce and recruit new nurses to this speciality. This paper is Part 2 of a two part series reporting the findings of a mixed methods project. Part 1 reported on the qualitative study and Part 2 reports on the quantitative study. Forty-five pre-registration nursing students from a single Australian tertiary institution and 22 primary care Registered Nurse (RN) mentors who supervised student learning completed an online survey. Students largely regarded their primary care placement positively and felt this to be an appropriate learning opportunity. Most RNs were satisfied with mentoring pre-registration nursing students in their setting. Furthermore, the RNs desire to mentor students and the support of general practitioners (GPs) and consumers were seen as key enablers of pre-registration nursing placements. Findings from this study provide a preliminary impression of primary care clinical placements from the perspective of pre-registration nursing students and registered nurse mentors. Further research should examine whether a broader scope of non-traditional health settings such as non-government organisations, charities, pharmacies, welfare and social services can also provide appropriate learning environments for pre-registration nursing students.     

The lived experiences of general student nurses on their first clinical placement: A phenomenological study

This phenomenological study explores and describes the ‘lived’ experiences of general student nurses on their first clinical placement in an Irish School of Nursing. The research question: ‘What are the experiences of general student nurses on their first clinical placement?’ provided the focus for the study. In-depth interviews were conducted with nine female student nurses and one male student nurse. Data from the interviews were collected, recorded and analysed using Coliazzi’s (1978) framework (Coliazzi, P., 1978 . Psychological research as the phenomenologist views it. In: Valle, R.S., King, M. (Eds.), Existential Phenomenological Alternatives for Psychology, Oxford University Press, New York). Five core themes emerged: self-awareness, confidence, anxiety, facilitation and professional issues. The findings revealed that the standard of preparation for the placement was viewed positively though some aspects of preparation require a critical shift in thinking towards meeting the students’ needs in future curriculum planning. The conclusions of the study indicate that the presence of mutual respect and regard for others had a positive impact on the students’ self-esteem. The acquisition of knowledge led to an increase in confidence levels that subsequently reduced anxiety. This enhanced the learning process that was dependant upon the collaborative support and facilitation in the clinical learning environment. The findings prepare the way for further research that could continue to develop and maximise the educational value and clinical experience for undergraduate nursing students.     

Friendship fosters learning: The importance of friendships in clinical practice

This paper reports on one of the key findings from a recent ethnographic study (Roberts, D., 2007. Friendships and the community of students: peer learning amongst a group of pre-registration student nurses. Unpublished PhD Thesis, University of Salford, UK) and aims to highlight the importance of friendships for student nurses in clinical practice. An interpretive ethnographic approach was taken in order to reveal the student experience during their pre registration programme. Data was collected using ethnographic interviewing (Sorrell, J.M., Redmond, G.M., 1995. Interviews in qualitative nursing research: differing approaches for ethnographic and phenomenological studies. Journal of Advanced Nursing 21, 1117–1122.) and participant observation. Within this paper I argue that student nurses exist on the edge of the community of practice (of the qualified staff) and therefore form their own parallel community where students are all seen as being in the same boat. In particular students use the friendships they develop in clinical practice to enable them to learn; developing an ‘ask anything’ culture where all students are perceived as valuable sources of knowledge. Furthermore, it appears that knowledge is contextually bound and not therefore linked to seniority, or length of time served on the course.