Faculty of Health & Life Sciences, University Of Northumbria, Newcastle, Coach Lane Campus, Benton, Newcastle upon Tyne NE7 7XA, United Kingdom of Great Britain and Northern Ireland.
Faculty of Health & Life Sciences, University Of Northumbria, Newcastle, Coach Lane Campus, Benton, Newcastle upon Tyne NE7 7XA, United Kingdom of Great Britain and Northern Ireland.
Nurse Educ Today. 2019 Jun;77:1-5. doi: 10.1016/j.nedt.2019.02.015. Epub 2019 Feb 27.
Following the investigation into the Mid Staffordshire Hospital (United Kingdom) and the subsequent Francis reports (2013 and 2015), all healthcare staff, including students, are called upon to raise concerns if they are concerned about patient safety. Despite this advice, it is evident that some individuals are reluctant to do so and the reasons for this are not always well understood.
This research study provides an insight into the factors that influence student nurses to speak up or remain silent when witnessing sub-optimal care.
An interpretive phenomenological study using the principles of hermeneutics. The study took place in one university in the North of England and the sample consisted of twelve adult nursing students.
Following ethical approval and informed consent, each participant took part in individual semi-structured interviews over a three-year period. Data was transcribed and analysed using 'Framework for Applied Policy Research'.
Four key themes were identified: context of exposure, fear of punitive action, team culture and hierarchy. On the one hand, students recognised there was a professional obligation bestowed upon them to raise concerns if they witnessed sub-optimal practice, however, their willingness to do so was influenced by intrinsic and extrinsic factors. Students have to navigate their moral compass, taking cognisance of their own social identity and the identity of the organisations in which they are placed.
在对英国米德尔塞克斯医院(Mid Staffordshire Hospital)进行调查以及随后的弗朗西斯报告(2013 年和 2015 年)之后,所有医护人员,包括学生,都被要求在关注患者安全方面提出关切。尽管有此建议,但显然有些人不愿意这样做,而且其原因并不总是被很好地理解。
本研究旨在深入了解影响护生在目睹护理质量不佳时发表意见或保持沉默的因素。
采用解释现象学研究方法,遵循解释学原则。该研究在英格兰北部的一所大学进行,样本由十二名成人护理专业学生组成。
在获得伦理批准和知情同意后,每位参与者在三年内参加了个人半结构化访谈。使用“政策研究应用框架”对数据进行转录和分析。
确定了四个关键主题:暴露背景、害怕受到惩罚、团队文化和等级制度。一方面,学生们认识到,如果他们目睹了护理质量不佳的情况,他们有专业义务提出关切,但他们这样做的意愿受到内在和外在因素的影响。学生们必须在自己的道德指南针指引下,考虑到自己的社会身份和所处组织的身份。