Thomas Juliet, Jinks Annette, Jack Barbara
Faculty of Health and Social Care, Edge Hill University, UK.
Evidence Based Practice Research Centre, Edge Hill University, UK.
Nurse Educ Today. 2015 Dec;35(12):e4-9. doi: 10.1016/j.nedt.2015.08.022. Epub 2015 Sep 4.
Clinical practice is where student nurses are socialised into a professional role and acquire the distinct behaviour, attitudes and values of the nursing profession. Getting it right at the outset can maximise the development of a professional identity and the transmission of robust value systems.
To explore the impact of the first clinical placement on the professional socialisation of adult undergraduate student nurses in the United Kingdom.
Data of a longitudinal qualitative nature were collected and analysed using grounded theory.
First year student nurses in hospital ward placements comprising a rural District General Hospital and a large inner city Hospital kept daily unstructured diaries for six weeks.
A total of 26 undergraduate adult student nurses were purposefully sampled between 2008 and 2010 before undertaking their initial clinical placement.
Data collection and analysis used grounded theory and the key question asked of the diarists 'tell me what it is like to be a first year nurse on a first placement' was theoretically adjusted during constant comparison and as the theory emerged. Ethical approval and consent was obtained.
The theory of finessing incivility comprises a conceptual framework depicting how student nurses deal with professional incivility during their initial clinical placement and sustain a student identity. Being disillusioned with their role as worker rather than learner yields a sense of 'status dislocation'. Despite needing professional benevolence, they remain altruistic and seek recompense from significant others to negotiate for learning opportunities and relocate their student status.
Despite the stressful transition into clinical practice rather than 'fit in', the student nurses want to belong as learners. His or her own resilience to learn nursing and be a professional student maintains their resolve, their altruism and strengthens their existing values to be benevolent towards an indifferent profession. This behaviour ultimately mirrors the social nature of the practice community.
临床实践是学生护士融入专业角色并习得护理专业独特行为、态度和价值观的场所。从一开始就做好这件事能够最大限度地促进专业身份的发展以及稳健价值体系的传承。
探讨英国本科成年学生护士首次临床实习对其专业社会化的影响。
采用扎根理论收集和分析纵向定性数据。
在一家农村地区综合医院和一家大型市中心医院的病房进行实习的一年级学生护士,连续六周每天撰写非结构化日记。
2008年至2010年期间,在进行首次临床实习之前,共有26名本科成年学生护士被有目的地抽样选取。
数据收集和分析采用扎根理论,在持续比较过程中以及随着理论的出现,对日记记录者提出的关键问题“告诉我作为一名首次实习的一年级护士是什么样的感受”进行了理论调整。获得了伦理批准和同意。
应对不文明行为的理论包含一个概念框架,描述了学生护士在首次临床实习期间如何应对专业上的不文明行为并维持学生身份。对自己作为工作者而非学习者的角色感到失望会产生一种“地位错位”感。尽管需要专业上的善意,但他们仍然保持利他主义,并寻求重要他人的补偿,以争取学习机会并重新定位自己的学生身份。
尽管向临床实践的过渡压力重重,学生护士们并非想“融入”,而是想以学习者的身份归属其中。他们自身学习护理并成为专业学生的韧性维持了他们的决心、利他主义,并强化了他们现有的价值观,使其对冷漠的职业保持善意。这种行为最终反映了实践社区的社会性质。