Hathorn, Donna; Krisanna Machtmes,; Ken Tillman,. "The lived experience of nurses working with student nurses in the clinical environment.(Report)." The Qualitative Report. Nova Southeastern University, Inc. 2009. HighBeam Research. 18 Jun. 2013 <http://www.highbeam.com>.
Hathorn, Donna; Krisanna Machtmes,; Ken Tillman,. "The lived experience of nurses working with student nurses in the clinical environment.(Report)." The Qualitative Report. 2009. HighBeam Research. (June 18, 2013). http://www.highbeam.com/doc/1G1-201551637.html
Hathorn, Donna; Krisanna Machtmes,; Ken Tillman,. "The lived experience of nurses working with student nurses in the clinical environment.(Report)." The Qualitative Report. Nova Southeastern University, Inc. 2009. Retrieved June 18, 2013 from HighBeam Research: http://www.highbeam.com/doc/1G1-201551637.html
Addressing the negative attitudes of nurses is important because the problem of resolving the nursing shortage is compounded by the negative effects these negative attitudes have on nursing education. Wells (2003) stated that inability to retain students in nursing programs negatively impacts the supply of registered nurses to meet the demands of the nursing shortage. Research of nursing students revealed that negative attitudes and behaviors of nurses impede learning (Lofmark & Wikblad, 2001) and threaten student progression and retention within nursing programs (Chan, 2002). Furthermore, if student nurses do not identify with the nursing profession, they will eventually leave (Li, 1997). Nurses need to stop eating their young and help prepare a strong, competent workforce for the future. After all, a component of professionalism is to mentor those seeking to enter the profession. The student nurses' socialization into the profession is dependent upon acceptance and approval by staff nurses, who have the greatest influence on the development of the student nurses' professional role (Hardy & Conway, 1988). The purpose of this study was to gain a personal understanding of "what" kinds of attitudes nurses have toward student nurses, and "how" nurses develop negative attitudes toward student nurses.
Researcher's Phenomenological Lens
Moustakas (1994) describes the researcher as an instrument who collects and interprets data about the phenomenon from a particular phenomenological lens. The phenomenological lens informs the reader of the researcher's perspective because interpretation from different researchers may vary. The phenomenological lens in this study is derived from my personal perspective, and is based on experience in teaching clinical nursing courses.
I, Donna have been a nurse educator for 18 years and have worked in three baccalaureate nursing programs within the Southeastern region of the United States. My basic nursing education is a baccalaureate degree, and I have been a licensed nurse for 30 years with practice experience in acute adult care, labor and delivery, postpartum, nursery, and pediatrics. I earned a Master's degree in maternal-child nursing education, and a PhD in human resource education and workforce development with a focus on adult education. My experiences in clinical teaching include maternal-child, perioperative, community, and psychiatric nursing. During my teaching career I have taught clinical courses in various levels of the nursing program from beginning students to graduating seniors. I have also taught clinical nursing courses in various clinical facilities that include private and public, profit and not for profit clinical sites.
After many years of teaching nursing I have dealt with nurses who dislike working with student nurses and display negative attitudes toward student nurses during clinical practice rotations. I have personally experienced the frustration that occurs as a result of nurses who make it difficult for student nurses to participate in direct patient care and meet clinical objectives. Students have complained about certain nursing staff, and stated they did not feel welcomed on the nursing unit. Some of the more common negative behaviors include being overly critical, making rude condescending remarks, refusing to work with students, ignoring students, and not giving patient reports.
My colleagues have also expressed frustration that occurs from dealing with nurses who have negative attitudes toward student nurses. Usually when I encounter a nurse with a negative attitude, I try to manipulate the student patient care assignment in an attempt to avoid the nurse. However, unit staffing and patient census may not permit the avoidance tactic. When avoidance seemed impossible, I confronted the nurse. If that didn't work, I reported the behavior to the nursing supervisor, despite the risk of worsening the problem.
I could not understand why nurses who were so caring to their patients, and who were once students themselves, could be so uncaring to student nurses. Rather than continuing to work with the problem and accepting it, my desire was to eliminate the problem by identifying factors that contribute to negative attitudes.
Nurses' Influence on Nursing Students
Studies of nursing students' perceptions of the clinical environment concluded that there is a need for nurses to welcome the nursing students into the profession (Atack, Comacu, Kenny, LaBelle, & Miller, 2000; Chan, 2002; Cope, Cuthbertson, & Stoddart, 2000; Drennan, 2002; Li, 1997; Lo, 2002; Lofmark & Wikblad, 2001; Seigel & Lucey, 1998; Suen & Chow, 2001). To promote a positive psychosocial learning environment, nurses should offer support, be nurturing, and treat nursing students with dignity and respect. The interactive experiences nursing students have with nurses give the students the opportunity to internalize the role of the nurse as a caregiver.
In a study conducted by Lofmark and Wikblad (2001), facilitating and obstructing factors for learning in clinical practice were identified by students. Facilitating factors included being allowed to take responsibility, being allowed to work independently, having opportunities to practice tasks and receive feedback, collaborating with staff and supervising others, gaining an overview of the setting, and gaining a sense of control. Obstructing behaviors were identified as a lack of a student-supervisor relationship, organizational shortcoming in supervision, and experience of students' own shortcomings. The negative supervisor behaviors were described as taking over, making condescending comments, being irritated or not interested, and not giving feedback or opportunities to reflect. Other supervisor behaviors, which negatively impacted student learning were not knowing the educational objectives and abilities of the students, staff uneasiness from lack of guidelines for nursing care, stress on the ward and lack of time, and not allowing students to take part in patient care activities.
In a study of students perceptions of the effectiveness of mentors by Suen and Chow (2001), roles identified as essential to that of a mentor were befriending, assisting, guiding, advising, and counseling. Scores of the effectiveness of mentors (as perceived by students) improved after the mentors attended workshops and were provided with materials to assist them with their mentoring roles. Also, the students were given the opportunity to meet with the academic staff to improve communication between the clinical setting and the university. Students felt that many mentors did not achieve the befriending role adequately; most students prepared themselves to be part of the team, but found they were treated as guests. Because of the job stress, the students expected the mentors to have a counseling role, but found this role to be weak. Effective mentoring could not be established without sufficient relationship building between mentors and mentees.
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