Application of Orem's Self‐Care Deficit Theory and Standardized Nursing Languages in a Case Study of a Woman with Diabetes

PURPOSE. This paper aims to illustrate the process of theory‐based nursing practice by presenting a case study of a clinical nurse specialist's assessment and care of a woman with type 2 diabetes. DESIGN. Orem's self‐care deficit theory and standardized nursing language, NANDA, NIC (Nursing Interventions Classification), and NOC (Nursing Outcomes Classification), guided assessment and the identification of outcomes and interventions related to the client's management of diabetes. FINDINGS. Theory‐based nursing care and standardized nursing language enhanced the client's ability to self‐manage the chronic illness: diabetes. CONCLUSION. Nursing theory and standardized nursing language enhance communication among nurses and support a client's ability to self‐manage a chronic illness.     

The effects of a nursing smoking cessation intervention on military students in Turkey

Aim: This study aimed to evaluate the effect of a nursing smoking cessation intervention based on the Transtheoretical Model of change on a sample of military students. Methods: The quasi‐experimental and longitudinal designs were used with a sample of 36 smokers from a Turkish air force school of higher education system. Data were collected through face‐to‐face interviews conducted in 1 December 2004–30 June 2005 at pre‐intervention and at each follow‐up. Results: At the end of the programme, the mean scores related to the perceived ‘cons’ of smoking increased significantly (P < 0.05). The students' self‐efficacy mean scores increased significantly (P < 0.01). The students' stages of change before and after the programme were significant (P < 0.01). The mean number of cigarettes smoked per day before the programme was 14.8 (SD = 5.9) and after the programme was 9.6 (SD = 6.4) at the 6‐month follow‐up (P < 0.05). The quit rate was 8.3% at the 6‐month follow‐up. Conclusions: The interventions by the nurses in the smoking cessation programme were effective, resulting in a positive change in attitude and behaviour that would support the students' smoking cessation and the process of cessation.     

A day in the life of older people in a rehabilitation setting: an observational study

Abstract

Purpose: Nurses' contribution during inpatient rehabilitation is well documented. However, despite being the largest professional group in this setting, the specialty of rehabilitation nursing is poorly recognised. This article reports on the first of a four-phase study that aimed to clarify and develop the nursing contribution to inpatient rehabilitation for older persons. The aim of this study was to identify activity patterns and time use during daytime and evenings of older adult patients undergoing inpatient rehabilitation. Methods: Direct observation using behavioural modelling was undertaken of a convenience sample of 37 older people undergoing inpatient rehabilitation in a specialist unit of a large tertiary hospital in New Zealand. The primary outcome was the observation of meaningful activity. Binomial logistic regression was used to study the association between relevant variables. Findings: Meaningful activity was most likely to involve walking without assistance and to occur 08:00 to 14:00?h and 16:00 to 21:00?h during weekdays. Patients were more likely to receive treatment during the weekend. Irrespective of time, registered nurses were the health professionals most often present with patients. Conclusions: There is likely to be unrealised opportunities for registered nurses to support improved rehabilitation outcomes. Registered nurses' involvement in rehabilitation needs to be actively optimised.

• Implications for Rehabilitation

• Nurses' engagement with older adults in rehabilitation settings is likely to be substantial, placing them as key members of the rehabilitation team.

• Nurses make a pivotal contribution to inpatient rehabilitation based on specialised knowledge and skills but this contribution is not well understood.

• Opportunities are likely, at times when allied health professionals are less often present, e.g. evenings and weekends, for registered nurses to more intentionally overlap rehabilitation activities with other care requirements.

     

Growing together: a qualitative study of leading nurse scholars in Thailand

TURALE S., KLUNKLIN A. & CHONTAWAN R. (2010) Growing together: a qualitative study of leading nurse scholars in Thailand. International Nursing Review 57 , 202–210 Background: Asia‐Pacific nursing education and research is growing but little is known about the nature and development of nursing scholarship in the region. Aim: This qualitative study explored the perspectives of 14 leading Thai scholars about the development, facilitators and barriers relating to Thailand's nursing scholarship. Method: In‐depth interviews were digitally recorded, and data were subjected to content analysis. Findings: Five themes arose: (1) growing together, (2) visionary leadership, (3) external support to grow nurse scholars, (4) developing nursing through research, and (5) barriers to scholarship. A history of visionary nursing leadership was revealed, underpinned by leaders' values of growing nursing together. Resource sharing among universities, and a significant number of scholarships for study abroad were major facilitators of scholarship growth. Barriers to scholarship included high teaching loads, especially for newly graduated faculty; a low rate of research publications; not enough mentorship for research and changes to teaching practice; and a wide range of different agencies providing courses for entry to practice. Conclusions: Scholarship development in Thailand is a role model for a number of South‐East Asian countries, with inclusiveness and collaboration to facilitate the growth of nursing education inside and outside of the country as a hallmark of its character. However, against a backdrop of nursing shortages, Thai scholars are challenged, in the future, to produce meaningful research outcomes, including publications of studies; to collaborate with other health professionals; change practices to overcome high teaching loads; and provide the much needed mentorship for young scholars.     

Organizing pain control and rehabilitation service in a cancer centre

Summary

A unique programme of rehabilitation and pain control has been created within the Istituto Nazionale per lo Studio e la Cura dei Tumori in Milan. Rehabilitation of mastectomy, amputee and ostomy patients has been very active and, particularly in this last group, a good rehabilitative outcome may be observed. Pain evaluation was one of the main problems. The treatment modalities have been refined in order to obtain the maximum pain relief with the minimum trauma possible. These treatments are based on a closely monitored analgesic drug administration and on percutaneous thermocontrolled lesions. The growing needs of the Cancer Institution have brought to about 30000 the number of treatments performed by the Service during the last year. Nevertheless, enormous efforts are necessary to break the barrier of indifference to this problem that still persists In the oncologic field.

Zusammenfassung

Ein einzigartiges Rehabilitations- und Schmerzkontrollprogramm wurde im Instituto Nazionale per lo Studio e la Cura dei Tumori in Mailand geschaffen. Rehabilitation von Patienten nach Mastektomie, Amputation und Ostomie war äusserst haufig. Besonders die letzte Gruppe konnte die besten Rehabilitations resultate erzielen. Schmerzbewertung war eines der Hauptprobleme, welche in Angriff genommen wurde. Die Behandlungsmodalitäten sind verfeinert worden, um die optimale Schmerzlinderung mit dem mindestmöglichen Trauma zu erreichen. Diese Behandlung basiert auf einem exakten Überwachungssystem der Analgetika-Dosierung und auf perkutane thermo-kontrollierte Läsionen. Die wachsenden Bedürfnisse des Krebsinstitutes steigerten die Anzahl der vom Dienst ausgeführten Behandlungen im vorigen Jahr auf 30,000. Dennoch sind enorme Anstrengungen nötig, um das grosse Hindernis der Indifferenz gegenüber diesem Problem innerhalb der Onkologie wegzuräumen.

Résumé

Un programme unique de rééducation et de contrôle de la douleur s'est créé au sein de l'Instituto Nazionale per lo Studio e la Cura dei Tumori de Milan. La rééducation des patients ayant subi une mammectomie, une amputation ou une ostéotomie a été très active et, en particulier chez ce dernier groupe de patients, on a pu observer les meilleurs résultats. L'évaluation de la douleur était l'un des problèmes principaux à résoudre. Les modalités de traitement ont été améliorées de manière à obtenir le soulagement optimal de la douleur avec le moins de traumatisme possible. Ces traitements sont basés sur l'administration étroitement contrôlée d'un médicament analgésique et sur le contrôle thermique percutané des lésions. Les besoins croissants de l'Institut ont porté à 30000 le nombre des traitements donnés par le Service au cours de la dernière année. Néanmoins, des efforts énormes sont encore nécessaires pour briser la barrière d'indifférence face à ce problème qui persiste encore de nos jours dans le domaine de l'oncologie.     

Vocational rehabilitation acceptance in the USA: Controlling for education,type of major disability,severity of disability and socioeconomic status

Summary

Nursing the cancer patient has been an unpopular task but advancement in treatment and in the understanding of the needs of the patient with malignant disease calls for a reassessment of the nursing role, especially as far as rehabilitation is concerned. The nurse is often the major source of information for the patient and the relatives, and is in an excellent position to help these people to adjust to the disease and its consequences. The nurse is responsible for providing much of the treatment, which can be unpleasant, and can encourage the patient to accept this and also to accept the need for physical activity. The nurse can encourage social rehabilitation, a role that is enhanced by domiciliary care.

Zusammenfassung

Die Pflege der Krebskranken war schon immer eine anspruchsvolle Aufgabe. Aber der Fortschritt in der Behandlung und das wachsende Verständnis für die Bedürfnisse der Patienten mit bösartiger Erkrankung verlangt eine Neueinschätzung der Rolle des Pflegepersonals, insbesondere in Bezug auf die Rehabilitation. Die Pflegeschwester ist oft die Hauptinformationsquelle für den Patienten und die Verwandten. Sie nimmt daher gewissermassen eine Schlüsselposition ein, wenn es darum geht, eine Anpassung beider an die Krankheit und deren Konsequenzen zu ermöglichen. Die Schwester hat die Pflicht, einen Grossteil der unangenehmen Behandlung zu realisieren. So hat sie die Möglichkeit, den Patienten zu ermutigen, diese zu akzeptieren und darüberhinaus die Notwendigkeit körperlicher Aktivität einzusehen. Das Pflegepersonal ist auch in der Lage, zur sozialen Rehabilitation anzuregen, eine Rolle, die erst richtig in der häuslichen Pflege zur Geltung kommt.

Résumé

Soigner les patients souffrant d'un cancer est une taˇche difficile et exigeante. Les progrès réalisés dans le traitement et la compréhension des besoins des patients atteints de maladies malignes justifient une nouvelle appréciation du rôle du personnel soignant, en particulier en ce qui concerne la rééducation. Le personnel soignant est le plus souvent la source principale d'information pour le patient ainsi que pour sa famille et occupe une position primordiale pour leur permiettre de s'adapter à la maladie et à ses conséquences. Le personnel soignant est chargé d'assumer la plus grande partie du traitement, ce qui n'est pas toujours agréable; par son attitude il peut motiver le patient à l'accepter et à accepter également le besoin d'activité physique. Le personnel soignant peut encourager la rééducation sociale du patient, un rôle qui prend de plus en plus d'importance graˇce aux soins à domicile.     

Searching for collaboration in international nursing partnerships: a literature review

GEORGE E.K. & MEADOWS‐OLIVER M. (2013) Searching for collaboration in international nursing partnerships: a literature review. International Nursing Review 60 , 31–36 Background: Nurses from low‐income countries (LICs) face extreme nursing shortages, faculty shortages and a lack of professional development opportunities. Nurses from high‐income countries (HICs) can leverage their wealth of resources to collaborate with nursing colleagues in LICs to expand clinical, education and research capacity. In turn, nurses from HICs gain stronger competency in the care they provide, improved communication skills and an increased understanding of global health issues. Aim: The purpose of this literature review is to identify international nursing clinical, education and research partnerships among nurses from LICs and HICs and to analyse the degree of collaboration involved in each partnership using DeSantis' counterpart concept. Methods: We conducted a systematic review of international nursing partnerships in the scientific literature from January 2001 to July 2012. A total of nine articles met inclusion criteria for analysis. Findings: All of the articles discuss lessons learnt in building international nursing partnerships among nurses from HICs and LICs. However, the articles failed to meet the criteria set forth by DeSantis' counterpart concept to achieve fully collaborative nursing partnerships. Conclusions: International nursing partnerships require more foresight and planning to create partnerships in which the benefits derived by nurses from LICs equal those of their colleagues from HICs. By striving for such collaboration, international nursing partnerships can help build nursing clinical, education and research capacity in LICs.     

Undergraduate nursing students' attitudes towards organ donation: a survey in an Italian university

ZAMPIERON A., CORSO M. & FRIGO A.C. (2010) Undergraduate nursing students' attitudes towards organ donation: a survey in an Italian university. International Nursing Review 57 , 370–376 Aims: To examine undergraduate nursing students' attitudes towards organ donation and to determine whether or not attitudes were related to the students' education and training. Background: Nurses' knowledge and personal opinion can influence patient's willingness to donate organs or to hold an organ donor card. It is unclear how Italy's future nurses view organ donation. Methods: The study's source population consisted of third‐year undergraduate nursing students enrolled in seven nursing schools from an Italian university during 2008. Respondents completed self‐administered quantitative questionnaire with 61 questions, including the Organ Donation Attitude Scale. Findings: Of the 378 students contacted, 183 (48%) completed all survey questions; 140 were females (76.5%) and the mean age of students was 25. The median score of students' attitude scores towards organ donation was 151 (the attitude is positive when the score is higher than 161). No significant correlations were found to exist between organ‐donation attitude and sex, age, clinical practice in hospitals with a transplant unit, nursing care to patients waiting for a transplant or dialysis patients. Only 16% of the students had previously signed a donor card consenting to their own organ donation. The study revealed that doubts about transplantable organs still exist within the student body. Conclusions: This study highlighted that students' awareness of organ donation was not adequate and that attitude levels were lower than in other countries. If these future workers would receive adequate training, they could promote organ donation to the general public and to other hospital personnel.     

A critical analysis of undergraduate students' cultural immersion experiences

HARROWING J.N., GREGORY D.M., O'SULLIVAN P.S., LEE B. & DOOLITTLE L. (2012) A critical analysis of undergraduate students' cultural immersion experiences. International Nursing Review Purpose: This paper is concerned with the impact of an international health promotion experience on the understanding of culture among university students. Such immersion experiences are often cited as a strategy to prepare nurses for culturally appropriate practice. We describe students' epistemic movements over time with respect to cultural perspectives prior to, during and after a field study in Malawi. Design: Data were collected at three time points from students in undergraduate nursing (n = 14) and non‐nursing (n = 8) programs at a Canadian university. Two essays narrating participants' understanding of culture were submitted by consenting class members. A subgroup of nine participants (four nursing students, five from other disciplines) completed a third narrative following a subsequent field study course in Malawi. Method: Using narrative analysis, themes and structures in the participants' writing were identified and located within a constructivist or essentialist paradigm of cultural understanding. Findings: Overwhelmingly, students' narratives were initially portrayed and informed by an essentialist understanding of culture. Later narratives demonstrated varying degrees of epistemic movement towards more constructivist viewpoints. Narratives that initially exhibited constructivist characteristics tended to display strengthened convictions in that paradigm. Conclusion: We challenge the claim that an international immersion experience immediately transforms participants into cultural experts; our evidence suggests that students experienced existential growth, but their understanding of culture did not change as a result of their brief stay in a different cultural context. Cultural immersion is a phenomenon that requires more critical analysis and systematic investigation to determine how such experiences contribute to learning about culture among nursing students.     

Nursing students in clinical practice--developing a model for clinical supervision

The aim of this study was to develop a model for clinical supervision to promote the clinical practice of nursing students. The study was implemented in Finland and it was carried out in three phases. Firstly, data were collected by means of a literature review and focus group interviews. Secondly, the data were analysed and described in expert groups, and finally the model itself was evaluated by 23 nursing experts. The data of literature review and focus group interviews consisted of 27 studies and four groups from three organisations: nurses (n = 7), managers (n = 6), teachers (n = 8) and students (n = 6). The data were analysed by qualitative content analysis. The model devolved from the study includes the concepts describing prerequisites, content and influence of clinical supervision. The prerequisites are nursing skills, a holistic view of the nursing curriculum, pedagogical, organisational, development, cooperation and interaction competence and decision-making skills. The content of clinical supervision includes support of professional development, pedagogical competence, research and development activities and collaborative working. Clinical supervision has influence on students’ professional and personal development and conception of the future of nursing profession, students’ preparedness for career planning and the teacher’s and preceptor’s professional development. The model could unify the notions of all parties concerned of the prerequisites, content and influence of clinical supervision. Furthermore, the entire supervision process and its control could be clarified. The model may be utilised in selecting and educating preceptors and evaluating the quality of clinical supervision.     

The effect of a peer-mentoring strategy on student nurse stress reduction in clinical practice

LI H‐C., WANG L. S., LIN Y‐H. & LEE I. (2011) The effect of a peer‐mentoring strategy on student nurse stress reduction in clinical practice. International Nursing Review 58 , 203–210 Background: That nursing students suffer high levels of stress during clinical practice is a common topic in nursing education, but there are some effective strategies for dealing with it. Purpose: The purpose of this study is to examine the effects that a peer mentoring program has on student nurses' stress levels during clinical practice. Methods: A quasi‐experimental design was conducted. Forty‐nine junior level nursing students (n = 17 in the experimental group; n = 32 in the control group) were enrolled in the same medical‐surgical nursing class. Mentors were recruited from students who had received medical‐surgical experience before entering university. A 6‐point perceived Stress Scale for the nursing students' questionnaire was used to evaluate the stress level. Results: Stress from ‘lack of professional knowledge and skills’ was the highest score before clinical practice in the experimental (3.78) and control (3.57) group, and also was the highest score after clinical practice in the control group (3.44). Stress from ‘assignments and workload’ was the highest score after clinical practice in experimental group (3.25). Wilcoxon matched paired signed ranks test revealed that there are no significant differences in stress scores between the two groups. Conclusions/Implications for practice: Study findings reveal that there are various advantages and disadvantages to implementing peer mentoring programs. The clinical teacher needs to provide suitable support and encouragement to the mentor and mentee students during this program. These results might provide information that can be used in improving clinical internship experience for the students.     

The development of observational competence through identification of nursing care patterns in 'The Sickbed', a work of art by Lena Cronqvist

A visual art programme was developed with the aim of improving observational competence through identification of nursing care patterns in 'The Sickbed', a painting by the Swedish artist Lena Cronqvist. Symbols and expressions were interpreted from hypothetical caring situations. Data were collected from student nurses (n=203) at three university colleges of health sciences in Sweden. Study and observation of 'The Sickbed' were reported in writing both individually and on a group basis. The findings suggest that the students observed, as well as described a great many details in 'The Sickbed'. The role of the characters depicted in the painting was easily transferred to imaginary clinical situations. The students improved their observational competence.     

Predictors of hospital nurses' intent to stay: a cross‐sectional questionnaire survey in Shanghai,China

Wang L., Tao H., Ellenbecker C.H. & Liu X.H. (2012) Predictors of hospital nurses' intent to stay: a cross‐sectional questionnaire survey in Shanghai, China. International Nursing Revie Aim: To investigate predictors of hospital nurses' intent to stay in the nursing profession. Methods: A cross‐sectional survey design was adopted. Over 1000 nurses working in hospitals in Shanghai, China, were invited to complete a survey questionnaire between May and October 2009 and 919 nurses responded for an 82% response rate. Findings: Regression models explained 41.3% of variance in nurse intent to stay. Although the proposed model hypothesized 18 predictors of intent to stay, only seven were statistically significant factors of nurse intent to stay: normative commitment, economic costs commitment, age, limited alternatives commitment, praise/recognition, professional advancement opportunities and the hospital classification. Of these, the strongest predictors were normative commitment, economic costs commitment and age, which explained 37.3% of variance in nurse intent to stay. Conclusion: Possible strategies to improve nurses' intent to stay include employment practices that improve the work environment, increased wages and benefits, and greater professional opportunity for nurses' personal growth development and promotion. Healthcare organizations should establish an asserting and nurturing environment for nurses and improve nurses' normative commitment and economic costs commitment. Increased effort should be made to improve nurses' conditions in primary and secondary hospitals where nurses report a lower level of intent to stay in nursing. Study Limitations: Participants came from a limited number of hospitals in Shanghai. A larger sample from different hospitals in Shanghai and other districts in Mainland China could have enhanced the generalizability of the results and increased the power of the study.     

Informal in-hospital care in a rehabilitation setting in Greece: An estimation of the nursing staff required for substituting this care

Purpose. To explore: (a) the type and frequency of care-giving activities provided by family members in the Rehabilitation Setting (RS), (b) opportunities for family members to receive training in care-giving activities, (c) to what extent caregivers feel free to ask the nursing staff for help and (d) to estimate the number of nursing staff required to substitute this care and thus to estimate the money saved by the RS due to the in-hospital informal care.

Method. A convenience sample of 80 family members was selected. A questionnaire was developed to investigate several aspects of informal in-hospital care. Data was analysed using SPSS for Windows (Release 10.1).

Results. Cultural reasons and nursing staff shortage led 78.8% (n = 63) of the sample to provide informal in-hospital care. Oral and facial care (67.5%), help with getting dressed (62.5%), help with feeding (61.25%, n = 49), making patients' beds (57.5%, n = 46) and assistance with transferring patients from one hospital department to another (56.25%, n=45) was provided on a daily basis by the subjects. 48.75%, (n=39) changed sheets 1-2 times per week, while assistance with transfers from bed to wheel-chair and vice-versa (43.75%, n = 35) was provided 3-4 times per week. The estimated total time spent per week by the subjects on care-giving activities was 34,034 minutes that corresponds to a total of 75.6 working days or 15.12 working weeks. In order to substitute this care, the RS would need to hire 17 more assistant nurses, entailing a cost of from e14,450 to e20,060 per month.

Conclusions. Informal in-hospital care is provided by Greek families in the RS. Nursing care staff shortage combined with cultural factors are the main reasons for this phenomenon. However, it saves the RS and the Greek State money and policy makers should be looking for ways to overcome the nursing shortage.     

The contribution of high‐fidelity simulation to nursing students' confidence and competence: a systematic review

YUAN H.B., WILLIAMS B.A. & FANG J.B. (2011) The contribution of high‐fidelity simulation to nursing students' confidence and competence: a systematic review. International Nursing Review 59 , 26–33 Background: High‐fidelity simulation (HFS) has been proposed as a novel, supplemental teaching‐learning strategy to enhance students' confidence and competence in nursing practice. Aim: To describe available evidence about the effects of HFS on students' confidence and competence within nursing educational programmes. Methods: A review of studies published between 2000 and 2011 was undertaken using the following databases: CINAHL, Proquest, MEDLINE, Science Direct, OVID and Chinese Academic Journal. The concepts of confidence and competence as they related to HFS in nursing education were used for screening the literature. Quantitative studies were assessed for methodological quality. Findings: Eighteen English and six Chinese studies addressed confidence and competence as outcomes of simulation and were retrieved in this review. The results of meta‐analysis indicated a mixed contribution of HFS to confidence and competency with a lack of high‐quality random control trials and large sample sizes. Conclusions: Although qualitative studies presented positive results, there was still insufficient evidence for supporting the notion that students' confidence and competency are enhanced through HFS. More quantitative studies are needed to demonstrate effectiveness. There was a deficit of formal measurement tools available to evaluate HFS. Most research pays no attention to validation of measurements. The increased confidence and competence after simulation may not be realized until the student experiences a real situation like the one in the simulation. More research is needed to examine the transferability of the simulation experience into real situations.     

Where to Start? Introducing Standardized Nursing Languages in Educational Settings

Viewpoint provides a forum for scholarly discussion about the theoretical, philosophical, and practical issues related to nursing language and classification systems. The sometimes controversial views are intended to stimulate readers' comments and perspectives. We welcome brief, informal responses to published viewpoints. If you have a viewpoint you want to submit, or if you want to discuss it beforehand, contact the column editor: judithwilkins@att.net ; 913.631.1089.     

The effects of applying an assessment form based on the health functional patterns on nursing student's attitude and skills in developing the nursing process

ObjectivesComprehensive nursing assessment, as the first step in the nursing process, involves the systematic and constant data gathering to facilitate the development of the patient-specific nursing process. The aim of this study is to determine the effects of applying an assessment form based on the health functional patterns on nursing student's attitude and skills in developing nursing process.MethodsA randomized controlling design was conducted. Of 84 undergraduate nursing students, 42 students were allocated to the intervention or control group. In clinical education, a patient assessment form based on Gordon's functional health patterns was applied to help students in the intervention group to develop nursing process, while the control group received traditional methods. The data were gathered using a demographic information questionnaire, skills in nursing process development checklist, and attitudes towards nursing process questionnaire.ResultsThe average scores for students’ attitude and skills in developing nursing process in the intervention group were greater than those of the control group.ConclusionApplying nursing assessment using the patient assessment form based on Gordon's functional health patterns can improve the students' learning in developing nursing process.     

Pre-registration nursing students' perceptions and experiences of violence in a nursing education institution in South Africa

Violence is a growing problem worldwide in the field of health care and within the nursing profession. A study comprising a survey and focus groups with nursing students, and interviews with nurse educators was conducted to examine nursing students' perceptions and experiences of violence at a nursing education institution in the Western Cape, South Africa. A self-administered questionnaire was distributed to all nursing students. Two hundred and twenty three (n = 223) respondents completed the questionnaire. Focus groups were conducted with purposively sampled student participants and semi-structured interviews with nurse educators. The findings indicated that the nature of the violent incidents experienced by students on campus, especially in the residences, ranged from verbal abuse to violation of students' property and personal space, and could be attributed primarily to substance abuse. Violence among student nurses could negatively affect learning. In a profession in which nurses are exposed to violence in the workplace, it is important that violence in the learning environment is actively prevented and respect of individual rights, tolerance and co-operation are promoted.