Kopala B
Maternal-Child Health Nursing, Niehoff School of Nursing, Loyola University Chicago, IL 60626.
J Prof Nurs. 1994 Jul-Aug;10(4):236-43. doi: 10.1016/8755-7223(94)90025-6.
Nurse educators face conflicting obligations to nursing students, patients, and agencies/institutions that require weighing and prioritizing values and choosing a course of action. Several hypotheses are explored about judgements commonly made in the pediatric clinical setting. These judgements are whether to permit a student to perform a procedure for the first time, make a potentially dangerous mistake, or provide patient care despite limited knowledge and skills. The hypotheses address the ranking of values of safety and student learning, the differences in value hierarchies of nurse educators and practicing nurses, and the use of patients as a means to an end--the education of nursing students. Although patients can be viewed as experiencing some actual or potential loss because students are learning while providing care, a concern is whether the patient "suffers greatly" or is "deprived of essentials." Case analyses suggest that for nurse educators: client safety appears to be the primary value, student learning takes precedence over the fullest achievement of most nursing practice values, the values hierarchy differs somewhat from that of the practicing nurse, and important nursing practice values may appear to be compromised to secure appropriate learning experiences for the student.
护士教育工作者在面对护理专业学生、患者以及机构/院校时，面临着相互冲突的责任，这就需要权衡价值观并确定优先次序，进而选择行动方案。本文探讨了一些关于儿科临床环境中常见判断的假设。这些判断包括是否允许学生首次进行某项操作、是否会犯潜在的危险错误，或者在知识和技能有限的情况下是否提供患者护理。这些假设涉及安全和学生学习的价值排序、护士教育工作者和执业护士价值等级的差异，以及将患者作为实现目的（即护理专业学生的教育）的手段。尽管由于学生在提供护理时进行学习，患者可能会被视为遭受一些实际的或潜在的损失，但一个问题是患者是否“遭受极大痛苦”或被“剥夺了必需品”。案例分析表明，对于护士教育工作者来说：患者安全似乎是首要价值，学生学习优先于大多数护理实践价值的充分实现，价值等级与执业护士的有所不同，并且为确保学生获得适当的学习体验，重要的护理实践价值可能会显得受到了损害。
