Using simulation to prepare neophyte nursing students to deliver intimate patient care

"This is part of the body" - Student nurses' de-sexualisation of intimate care for patients

BACKGROUND

Effective intimate care can significantly impact the clinical outcomes of patients. However, conducting intimate care, which involves exposing and touching sexually sensitive areas of the body, presents challenges and anxieties for student nurses, particularly when providing care for patients of the opposite sex.

OBJECTIVES

This study aims to identify the challenges and struggles encountered by student nurses when providing intimate care for patients of the opposite sex, as well as to explore the coping strategies employed by the students.

DESIGN

A constructivist grounded theory research approach.

SETTINGS

The study was conducted in Macau, a Special Administrative Region of China.

PARTICIPANTS

Twenty-six student nurses across various stages of their education, and three clinical mentors.

METHODS

Purposive and theoretical sampling techniques were utilized to recruit participants. Semi-structured interviews were conducted. The data analysis was in line with the principles of constructivist grounded theory research.

RESULTS

A two-stage adaptation model was established, demonstrating a dynamic pathway of student nurses toward intimate care. The first stage 'gendered confinement in intimate care' was characterized by student nurses' negative feelings and lack of nurse-patient interactions; the second stage 'emancipation to gendered confinement' was characterized by the development of constructive therapeutic nurse-patient relationships. The successful transfer was achieved through students' reconstructing the meaning of intimate care and nursing profession in three interplayed types: objectification of patients' body, moral authority of nursing care, and legitimisation of nursing profession. While the transfer process involved the students' intentional efforts to de-sexualize intimate care, clinical mentors facilitated the process.

CONCLUSION

Student nurses' adaption to intimate care is a dynamic process which enhances the construction of the nursing professional identity. Support from nursing educators can facilitate student nurses' coping with intimate care-related challenges.

Adapting the use of Mask Ed simulation in nursing programmes during the COVID- 19 pandemic

The onset of the COVID-19 pandemic toppled education delivery worldwide. Nursing education was no exception. The pandemic required nurse educators to quickly shift from face-to-face learning environments to remote and more virtual interactions. Educators were compelled to create and employ strategies to support nursing learners as they assimilated critical and complex knowledge, and skills from their homes, instead of classrooms and simulation laboratories. One modality of simulation which maintained engagement and connection with learners in the online environment was Mask-Ed™ Simulation. This paper presents a snapshot of Mask-Ed™ simulation activities across four higher education institutions globally during the COVID-19 pandemic.

Journey less travelled: Female nursing students' experiences in providing intimate care in two nursing education institutions in Gauteng province, South Africa

Background

Intimate care is not facilitated in South African nursing education and training. Nursing students encounter it for the first time in clinical practice, where they see and touch the naked bodies of patients. The societal segregation of gender roles has led to the feminisation of the nursing profession, suggesting that women are more caring and maternal and that intimate care implementation comes more easily to them than to their male counterparts.

Aim

This study explored female nursing students' experiences of intimate care for diverse patients.

Setting

The study was conducted in two nursing education institutions in Gauteng province, South Africa.

Methods

Descriptive phenomenology was used to describe the lived experiences of participants. Seventeen female nursing students were purposively sampled. Data were collected using semi-structured interviews and analysed using Moustakas' (1994) eight steps.

Results

Four themes emerged: intimate care comprehension, preparedness for providing intimate care, reactions in providing intimate care and coping mechanisms when providing intimate care to diverse patients.

Conclusion

Intimate care forms a basis on which nursing students prioritise the physical needs of patients by providing care that exposes their bodies and requires touch. The students were taught to provide care with respect, maintaining patient autonomy and nursing professionalism. Unfortunately, age and gender barriers create feelings of discomfort and embarrassment. More needs to be done to support and empower nursing students in providing intimate care to diverse patients competently, confidently and comfortably.

Contribution

Understanding the experiences of participants in providing intimate care to diverse patients will assist nurse educators in intimate care facilitation and support. The female nursing students will be empowered and trained to execute intimate care in a manner that is culturally, religiously and ethically acceptable.

Nursing Students’ Satisfaction and Self-Confidence Levels After Their Simulation Experience

Background

Nursing students should be well prepared before going to clinical setting as they provide direct care to patient. Simulation gives the learners the opportunity to be active learners who practice, train, and give a reflection on a specific experience.

Objective

To obtain an understanding of the human patient simulation experience and nursing students’ perceptions of satisfaction and self-confidence.

Method

Cross-sectional, descriptive design was undertaken. Using purposive sampling, 273 nursing students were enrolled in basic adult nursing courses at levels four and five at female nursing college at King Saud University, Riyadh, Saudi Arabia. A questionnaire was used to measure the demographic characteristics, simulation design characteristics, and simulation educational practice context. Student Satisfaction and Self-confidence in Learning Scale was used to measure students’ satisfaction and self-confidence. Bivariate analyses were utilized where needed and multiple linear regression analysis was performed to find the relationship between variables.

Results

The current study revealed overall, nursing students were satisfied and self-confident after their human patient simulation experience. A relationship was observed between demographic characteristics, simulation design characteristics, and simulation educational practice context with students’ satisfaction and self-confidence.

Conclusion

Simulation is an effective teaching strategy that prepares nursing students for real clinical practice. Findings provided policymakers with information on nursing students’ current levels of satisfaction and self-confidence that can lead to developing future policies.

Mask-Ed (KRS Simulation) an approach to deliver intimate care for neophyte nursing students: the creator's experience

Nurses deliver intimate care to patients in a variety of ways, especially when attending to showering, bathing, toileting and managing chronic or surgical wounds located in body regions such as the genitalia or breasts. Neophyte undergraduate nursing students can experience fear and anxiety at the thought of carrying out this level of care; hence, there is a need for preparation prior to undertaking clinical placements when students encounter real patients. The preparation should begin in the laboratory context of their tertiary educational settings. Traditionally, task trainers and manikins have been used to demonstrate and practise this care in such environments. However, the realism of experiencing true human responses, by both the patient and student, can be lost through these modalities. In recent years, a simulation approach, Mask-Ed, has enabled intimate care to be taught to students in a university setting in Australia where the laboratory context provides a safety net. Mask-Ed involves the informed educator wearing highly realistic silicone props that include torsos, faces and hands. Having donned the props, the educator then transforms into another person. The newly created person has a backstory designed to enable the educator to become a platform for teaching and to coach students through the clinical experience. The following discussion explains the background to Mask-Ed and the underlying framework that is used to implement the technique to teach intimate care. Mask-Ed is considered one of the most realistic approaches to simulation and is used in healthcare facilities and tertiary educational institutions globally.