School of Health and Social Care, Faculty of Health and Medical Sciences, University of Surrey, UK.
Nurse Educ Today. 2012 Oct;32(7):790-5. doi: 10.1016/j.nedt.2012.04.012. Epub 2012 May 13.
Compassionate practice is expected of Registered Nurses (RNs) around the world while at the same time remaining a contested concept. Nevertheless, student nurses are expected to enact compassionate practice in order to become RNs. In order for this to happen they require professional socialisation within environments where compassion can flourish. However, there is concern that student nurse socialisation is not enabling compassion to flourish and be maintained upon professional qualification. In order to investigate this further, a glaserian Grounded Theory study was undertaken using in-depth, digitally recorded interviews with student nurses (n=19) at a university in the north of England during 2009 and 2010. Interviews were also undertaken with their nurse teachers (n=5) and data from National Health Service (NHS) patients (n=72,000) and staff (n=290,000) surveys were used to build a contextual picture of the student experience. Within the selected findings presented, analysis of the data indicates that students aspire to the professional ideal of compassionate practice although they have concerns about how compassionate practice might fit within the RN role because of constraints on RN practice. Students feel vulnerable to dissonance between professional ideals and practice reality. They experience uncertainty about their future role and about opportunities to engage in compassionate practice. Students manage their vulnerability and uncertainty by balancing between an intention to uphold professional ideals and challenge constraints, and a realisation they might need to adapt their ideals and conform to constraints. This study demonstrates that socialisation in compassionate practice is compromised by dissonance between professional idealism and practice realism. Realignment between the reality of practice and professional ideals, and fostering student resilience, are required if students are to be successfully socialised in compassionate practice and enabled to retain this professional ideal within the demands of 21st century nursing.
关爱实践是全世界注册护士(RNs)所期望的,同时也是一个有争议的概念。然而,期望护生在成为 RNs 之前实施关爱实践。为了实现这一目标,他们需要在能够培养关爱的环境中进行专业社会化。然而,有人担心护生的社会化并没有使关爱得以蓬勃发展并在专业资格后得以维持。为了进一步调查这一问题,我们采用扎根理论的格拉泽研究方法,对 2009 年至 2010 年期间英格兰北部一所大学的 19 名护生(n=19)进行了深入的、数字化记录的访谈,并对他们的护士教师(n=5)进行了访谈,还使用了来自英国国家医疗服务体系(NHS)患者(n=72000)和工作人员(n=290000)的调查数据,以构建学生体验的背景图景。在所选发现中,数据分析表明,学生渴望成为有爱心的专业实践的理想职业者,尽管他们对如何将关爱的实践融入 RN 角色感到担忧,因为 RN 实践受到限制。学生感到自己在专业理想与实践现实之间存在矛盾。他们对自己的未来角色以及参与关爱的实践机会感到不确定。学生通过在坚持专业理想和挑战限制之间取得平衡,以及意识到他们可能需要调整自己的理想并适应限制,来管理自己的脆弱性和不确定性。本研究表明,关爱的实践社会化受到专业理想主义与实践现实主义之间的不和谐的影响。如果要使学生成功地接受关爱实践的社会化,并在 21 世纪护理的需求下保持这一专业理想,就需要在实践的现实与专业理想之间进行调整,并培养学生的适应力。