Reassessing the concept of emotional labour in student nurse education: role of link lecturers and mentors in a time of change

"It's a Thing": What Nurse Elders Believe Novice Nurses Need to Know About Managing Emotional Labour

BACKGROUND

Emotional labour (EL) can take a significant toll on nurses' mental health and well-being and has serious implications for the retention of nurses in the workforce. Nurse educators have struggled to prepare novices to manage EL or find serviceable resources with which to do so within the body of nursing literature, which is dominated by essentially unhelpful narratives and is absent of the practical, real-world wisdom of elder nurses.

PURPOSE

This exploratory research study illuminated elder nurses' experiential knowledge and beliefs of what is important for novices to learn about EL.

METHODS

Conventional Content Analysis (CCA) of qualitative survey data from 688 nurses with 20+ years of experience.

RESULTS

CCA generated descriptive categories and sub-categories: What the elders themselves learned as student nurses, and their advice to novices in the individual realm, ("It's a Thing," healthy disengagement, supporting mental and physical well-being, reframing self-reproach), team realm (peer support, mentors), and institutional realm (structural barriers to mentors' support of novices, building novices' capacities for self-advocacy, resources to support health and well-being).

CONCLUSIONS

The elders' data confronted and reframed legacy individuated narratives in the literature by supporting and contextualizing nurses' emotional work. Elders advised novices that EL is a reality requiring concrete strategies to manage it throughout their practices. Elders extended their focus for management of EL beyond the individual to include peer support, mentorship, and the structural conditions in which nurses perform their EL, highlighting the need to empower nurses by building their capacity for self-advocacy of their workers' rights.

The link between task-focused care and care beyond technique: A meta-ethnography about the emotional labour in nursing care

OBJECTIVE

To synthesise the available body of qualitative work regarding the experiences of registered nurses and nursing students in managing emotional demands of care.

BACKGROUND

Care is the central part of nursing, and its provision is linked to interaction with patients. Comprehensive care allows emotions to be considered as an essential part of care. However, the emotional commitment that care demands poses a challenge for the nursing staff.

DESIGN

Noblit and Hare's interpretive meta-ethnography, which was written and reviewed for reporting clarity using the eMERGe.

METHODS

A comprehensive systematic search strategy was undertaken in PubMed, CINAHL, Scopus, Web of Science and PsycINFO in January 2020. The search included terms related to the sample population, phenomenon of interest, purpose of the study and type of research. Original or mixed qualitative articles in English, Spanish and Portuguese were included if they addressed the emotional labour experiences of nurses or nursing students.

RESULTS

A line-of-argument synthesis based on the metaphor The link between task-focused care and care beyond technique was developed. Three themes from analogous and refutational translations of findings in the included nine papers emerged: (1) forces to get involved in care; (2) the cost of caring and (3) need to vent.

CONCLUSION

Nursing staff and students managed the emotional demands by adjusting their involvement in care. Care beyond technique is provided by nurses who have strength and motivation in themselves and in the interaction with patients to become emotionally involved in care. Task-focused care avoids emotional exposure to patient suffering due to the personal cost involved. Venting and distancing are required to emotionally reconstruct themselves and to re-engage in care.

RELEVANCE TO CLINICAL PRACTICE

Increased knowledge about these experiences may raise awareness of the emotional demands as part of the care process, to prevent their impact and favour their support.

Online Virtual Nursing Placements: A Case Study on Placement Expansion

Introduction

A need to increase student placements, in a culture that is under unprecedented demand, means that practice providers and partner higher education institutions need to find new and innovative ways to ensure quality learning experiences for students. Virtual placements are just one way of providing student placements, and this study presents a case for this.

Objective

This research aims to explore the student’s experience of virtual blended placements and to consider future sustainability.

Method

This is a qualitative, exploratory study observing the attitudes, thoughts, and feelings of student nurse experiences of online virtual nursing placements. Key cases were identified, and two participants were asked to reflect upon their experiences of the blended virtual learning placement. Student evaluations, and virtual placement day plans, form part of the data collection, and results are presented in a theory building and comparative approach, adopting pattern matching.

Results

Three themes emerged from the narratives, supported by student evaluations and day plans. Students reviewed the placement positively in that they were able to achieve their required practice proficiencies. Second, they discussed the way in which the virtual days were facilitated and that building relationships with professionals and peers while on placement was of high importance.

Conclusion

This case study presents a novel and unique student experience within a 0–19 community nursing service, which through 3 days of practice placement supported by two virtually taught days, students were able to reach their practice proficiencies. This virtual placement model offers a unique way to reduce the pressures on frontline staff and enriches the students’ experiences.

The Emotional Intelligence of Japanese Mental Health Nurses

The aim of this study was to measure emotional intelligence in nurses in Japan, and to elucidate the characteristics of mental health nurses. Anonymous, self-administered questionnaires were distributed to 206 nurses working in three psychiatric hospitals and two internal medicine hospitals in Japan. The number of participants included in the analysis was 159 (valid response rate, 77.2%), of which 87 were mental health nurses. Emotional intelligence was measured using the Japanese version of the Wong and Law Emotional Intelligence Scale. In the analysis, the emotional intelligence of mental health nurses and internal medicine nurses was compared using a t-test. The results of a t-test comparing emotional intelligence scale scores between the mental health nurses and internal medicine nurses showed that the total mean score and Self-Emotions Appraisal score were significantly lower in mental health nurses than in internal medicine nurses. The self-awareness of mental health nurses was significantly lower than that of nurses in other fields (P < 0.001, Cohen’s d: 0.65). The results of this study provide a basis for future research on the emotional intelligence of nurses in Japan. Development of an emotional intelligence scale based on the characteristics of Japanese nurses will be important regarding nurses’ assessment of their own emotions and the emotions of others. The kinds of people nurses are involved with and the content of their support for others also need to be clarified.

Is spirituality an important variable as the predictor of emotional labour for nursing students?

In the present study, the purpose was to examine nursing students' spirituality and their sociodemographic and professional characteristics as the predictor of emotional labour. In the study, the descriptive cross-sectional and relational research design was used. The study was carried out with 167 2nd, 3rd and 4th grade students from the School of Health at a state university located in Southeast of Turkey. For the analysis of the data, descriptive statistics, correlations and stepwise multilinear regression analysis were used. The results revealed that spirituality (β = 0.198), the average academic achievement score ranging between 80 and 100 (β = 0.152), perception of the school atmosphere to be "poor" (β = -0.367) and "average" (β = -0.269, p = .048) and a) increasing one's motivation by doing his or her job (Yes) (β = 0.154) and c) being in a peaceful environment (Yes) (β = 0.188) for psychological relaxation were found to be important predictors for the sub-dimension of in-depth behaviours of the nurses (p < .05). For the sub-dimension of superficial behaviour, perception of the school atmosphere to be "poor" (β = -0.204) was a statistically significant predictor (p < .05). As for the intimate behaviour, spirituality (β = 0.254), c) being in a peaceful environment (Yes) for psychological relaxation (β = 0.241) and gender (being female) (β = 0.230) were statistically significant predictors (p < .05). In order for nursing instructors and nurses to manage the nursing students' emotional labour process well, an appropriate educational and clinic environment should be established. Also, strategies considering nursing students' spiritual values and development should be developed.

The influence of role models in undergraduate nurse education

AIMS AND OBJECTIVES

To explore the concept of role modelling in undergraduate nurse education and its effect on the personal and professional development of student nurses.

BACKGROUND

Effective educative strategies are important for student nurses, who have to cope with learning in both clinical and university settings. Given the contemporary issues facing nurse education and practice in the United Kingdom (UK), it is timely and important to undertake pedagogical research into the concept of role modelling as an effective educative method.

DESIGN

A descriptive narrative approach.

METHODS

Unstructured interviews were conducted with 14 current/recently discontinued students from Adult and Mental Health branches of nursing degree programmes in the north-west region of England, United Kingdom (UK). Data were thematically analysed.

RESULTS

Students valued exposure to positive role models in clinical and university settings and viewed them as beneficial to their learning. Exposure to negative role models occurred, and this provided students with opportunities to consider the type of nurse they aspired to become. In some cases, students' exposure to perceived poor practice had an adverse effect on their learning and led to negative feelings about nursing work. Clinical staff might be perceived as more relevant role models than those in the university setting although there were still opportunities for academic staff to model professional behaviours.

CONCLUSION

The study found that role modelling is an effective way to support learning and led to student satisfaction across both clinical and university settings. The findings support the use of role models in nurse education, and further research about conscious positive modelling of practice is required.

RELEVANCE TO PRACTICE

Exploring the use of role models is important when examining ways in which the quality of nurse education might be developed.

The Interrelationships of Coping Styles and Professional Burnout Among Physiotherapists: A Cross-Sectional Study

Burnout is a pathological syndrome in which emotional exhaustion (EE), depersonalization (DEP), and a reduced sense of personal accomplishment (PA) develop in response to prolonged occupational stress. Those working in the physiotherapy profession appear to be at risk for professional burnout brought on by the specific character of the medical professions, involving continuous contact with patients and associated stress, as well as poor working conditions. However, literature data concerning the scale of professional burnout and its psychosocial correlates remain scarce. The aim of the present study was to assess the scale of professional burnout among physiotherapists and to determine the interrelationships between coping styles and burnout symptoms. The sample consisted of 117 professionally active physiotherapists (90 women and 27 men) aged 21 to 55 years (mean [M] 31.88, standard deviation [SD] = 9.14, responsiveness rate of 80.6%) from randomly selected medical institutions of the Lodz Region. The study was conducted using the Maslach Burnout Inventory (MBI) and Coping Inventory for Stressful Situations (CISS) by Endler and Parker. Demographic and job-related data on the respondents were also collected. Task-oriented coping correlated negatively with DEP, EE, and low PA, in contrast to emotion-oriented coping. No correlation was found between avoidance-oriented coping and burnout symptoms. Similarly, no interactive correlations between coping styles and particular burnout symptoms were confirmed. Coping styles correlate independently with professional burnout, without any mutual correlations. Physiotherapists employing a wider spectrum of task-oriented strategies are slightly more satisfied with their job. The incidence of burnout syndrome in the analyzed group is similar to that observed in other medical professions and requires the adoption of preventive measures.

'It stays with me': the experiences of second- and third-year student nurses when caring for patients with cancer

Little is known about student nurses experiences of nursing patients with cancer in the UK. With the increasing survival of people with cancer and with cancer no longer seen as a terminal illness it is useful to understand student nurses clinical experience when nursing those with cancer. This study takes a phenomenological approach involving three focus group interviews with 20 student nurses from the second and third year of their course in one centre in the UK. All the students had experience of caring for patients with cancer. The key themes emerging from the study were: Communication, Impact on Self, Lack of Support and End-of-Life-Care. Students emphasised the need to have more knowledge and support in relation to cancer care. They describe how they lack communication skills and found it difficult to handle their emotions. A number of students found the whole experience of caring for patients with cancer emotionally distressing and draining and they describe avoiding contact with these patients by using distancing and avoidance strategies. Student nurses need additional support through demystifying cancer, using reflective practice and good mentoring in the clinical area to enable students to feel supported, and develop confidence in their capacity for care for people with cancer.

Exploring home visits in a faith community as a service-learning opportunity

BACKGROUND

Within South Africa the Psychiatric Nursing Science curriculum in undergraduate Baccalaureate nursing education utilizes home visits as a service-learning opportunity. In this context faith communities are currently unexplored with regards to service-learning opportunities. With limited literature available on this topic, the question was raised as to what are these students' and family members' experience of home visits within a faith community.

PURPOSE

To explore and describe nursing students' and family members' experiences of home visits within a faith community.

DESIGN

A qualitative approach was used that was phenomenological, explorative and descriptive and contextual in nature.

SETTING

The research was conducted within a faith community as service learning opportunity for Baccalaureate degree nursing students. This community was situated in a semi-urban area in the North-West Province, South Africa.

PARTICIPANTS

Eighteen (n=18) final year nursing students from different cultural representations, grouped into seven groups conducted home visits at seven (n=7) families.

METHODS

Comprehensive reflective reporting after the visits, namely that the students participated in a World Café data collection technique and interviews were conducted with family members.

RESULTS

Three main themes emerged: students' initial experiences of feeling overwhelmed but later felt more competent; students' awareness of religious and cultural factors; and students' perception of their role. Two main themes from the family members emerged: experiencing caring and growth.

CONCLUSIONS

There is mutual benefit for nursing students and family members. Students' experiences progress during home visits from feeling overwhelmed and incompetent towards a trusting relationship. Home visits in a faith community seems to be a valuable service learning opportunity, and the emotional competence, as well as spiritual and cultural awareness of nursing students should be facilitated in preparation for such home visits.

A study identifying the difficulties healthcare students have in their role as a healthcare student when they are also an informal carer

There is a growing body of literature concerning the needs of informal carers, however, there is little relating to the needs of carers who are also university students. There are a number of publications concerning the difficulties university studies may cause and in particular the stress that some healthcare students endures when they undertake clinical placements. Being an informal carer has the potential to aggravate any difficulties students may have in the normal course of their studies. The purpose of the study was to explore the experiences and needs of healthcare students who are also informal carers. An electronic survey (February 2010) of 3567 students identified 36 students who are also informal carers. Most were female, pre-registration nursing students, studying full-time and who cared for their physically disabled children, chronically ill parents or terminally ill grandparents. Most respondents spent over 6h a day on informal caring responsibilities. The majority said informal caring had a negative impact on their studies. An in-depth interview study was undertaken (April 2010) with ten students. Data themes identified in the analysis were; descriptions of being an informal carer, impact of caring on studying, sources of support and hidden lives. In the theme 'hidden lives' students highlighted that they did not want university staff to know that they were informal carers as they did not want 'special' treatment. It was theorised that this could be due to the stigmatisation sometimes attached to being a carer. The value of the study was that it was found that more targeted information about student support services is needed, to help students successfully complete their studies. This would be beneficial for universities too as students who leave early without successfully completing their programme have financial implications.

The concept of reflection in nursing: qualitative findings on student and teacher perspectives

BACKGROUND AND AIM

This study sought to increase the understanding of the concept of reflection within nursing. The research focused on the social construction of reflection through a post-registration, palliative care programme in the United Kingdom (UK).

DESIGN AND PARTICIPANTS

An interpretive ethnographic approach was used to study reflection from the perspective of students and teachers, whilst paying attention to local organisational, contextual and cultural issues.

METHODS

Data collection included: observations of teaching and learning interactions, interviews, extracts from programme documentation and student reflective learning contracts (RLCs).

FINDINGS

Findings identified a learning culture committed to reflection as a valuable way of helping nurses make sense of their practice. Similar to Barnett's (1997) concept of 'critical being', students and teachers described reflection as a way of 'being' rather than simply 'thinking' or 'doing', since reflection intertwined propositional, affective and active elements. This process of reflective 'being' was connected with a humanistic approach to nursing, which emphasises the importance of actively using and expressing oneself in order to care for people.

CONCLUSION

This paper contributes empirical knowledge on the meaning of reflection in nursing regarding: teachers' and students' perspectives, reflection as a way to make sense of practice, and reflection as a way of 'being' and its association with humanistic nursing.

Using psychodynamic small group work in nurse education: closing the theory-practice gap?

This paper illustrates the role of psychodynamic small group work in integrating theory and practice for nursing students. Psychodynamic work with individual patients and small staff groups is established in some areas of medical and nursing practice although not widely used in general nursing. Clinical material which was brought to two group supervision sessions by student nurses on clinical placement is presented in this paper and discussed using a psychodynamic perspective. A critical review of psychodynamic small group work and a position paper is presented in this paper to argue that using a psychodynamic approach in nurse education may address the theory-practice gap for student nurses by allowing them to reflect on the emotional issues arising in clinical placements. The paper illustrates how supervision can assist students to integrate theory and practice. It is suggested that reflecting on feelings in small group work with student nurses with a tutor or supervisor who works psychodynamically may help students integrate their theoretical and practical learning. Understanding the theory-practice gap from a psychodynamic perspective may help nurse tutors in their personal tutor work to integrate theoretical and practical learning for students and thereby support students in providing good quality care for their patients.

Student perceptions of support in practice

This paper reports on a funded research project exploring perceptions and experiences of pre-registration nursing students of support in practice in one Higher Education Institution in England. The study used a mixed method approach with samples of new students (within the first six months) and finishing students (within the last three months). Students reported that the most important areas they needed support with were clinical skills, placement situations, documentation and personal issues. The mentor qualities that were valued were personal attributes, being facilitative and being knowledgeable; newly qualified mentors and experienced students were seen as being the most supportive. Students saw their own responsibilities as learning and gaining skills, being professional and caring for patients. The finishing students also felt that accountability and teaching were part of their role. Reported challenges encompassed personal issues, including work-life balance and finances, dealing with elements such as patient death and uncertainties in new situations. The best aspects of practice emerged as being involved in patient care, feeling part of a team and experiencing positive support from mentors. The findings explicated the multi-faceted nature of student support in practice that need to be taken into account when putting support frameworks in place.

Mentoring overseas nurses: barriers to effective and non-discriminatory mentoring practices

In this article it is argued that there are barriers to effective and non-discriminatory practice when mentoring overseas nurses within the National Health Service (NHS) and the care home sector. These include a lack of awareness about how cultural differences affect mentoring and learning for overseas nurses during their period of supervised practice prior to registration with the UK Nursing and Midwifery Council. These barriers may demonstrate a lack of effective teaching of ethical practice in the context of cultural diversity in health care. This argument is supported by empirical data from a national study. Interviews were undertaken with 93 overseas nurses and 24 national and 13 local managers and mentors from six research sites involving UK health care employers in the NHS and independent sectors in different regions of the UK. The data collected showed that overseas nurses are discriminated against in their learning by poor mentoring practices; equally, from these data, it appears that mentors are ill-equipped by existing mentor preparation programmes to mentor overseas-trained nurses from culturally diverse backgrounds. Recommendations are made for improving mentoring programmes to address mentors' ability to facilitate learning in a culturally diverse workplace and thereby improve overseas nurses' experiences of their supervised practice.

Where do nurses go for help? A qualitative study of coping with death and dying

As end-of-life care becomes a more prominent issue in health care, it is important to address the experience from the caregivers' perspective. In order to cope with the stressful experience of caring for a dying patient, nurses need programmes that both help them develop coping strategies and prepare them for caring for dying patients as well as resources to help them cope with the experience once it has happened. Because little is known about the coping habits of nurses facing the death of a patient, research is needed that examines their coping responses to develop more effective resources. This research examines the resources that nurses use when coping with the death of a patient. The results of this research indicate that communication with patients and their families, as well as coworkers, is an integral part of that process.

The source of display rules and their effects on primary health care professionals' well-being

Employees' perceptions of the emotional requirements of their work role are considered a necessary antecedent of emotion work. The impact of these requirements on the emotions employees display, their well-being, and their clients' satisfaction has been explored in previous research. Emotional requirements have been characterized as organizationally-based expectations (e.g., Brotheridge & Lee, 2003), formal and informal organizational rules (e.g., Cropanzano, Weiss & Elias, 2004), occupational norms (e.g., Rafaeli & Sutton, 1987; Smith & Kleinman, 1989) and job-based demands (Brotheridge & Lee, 2002). Although all these definitions assume some kind of shared source for perceptions of emotional requirements, it remains unclear to what extent these different sources contribute and to what extent the requirements are shared by different units, teams and individuals in the organization. The present study analyses the perception of emotional requirements from a survey of ninety-seven Primary Health Care teams composed of general practitioners, nurses and administrative staff (N = 1057). The relative contribution of different sources of variance (team, organizational, and occupational) to perceived emotional requirements and the effects on employees' job satisfaction and well being are examined. Results confirm the relevance of the source and show the contribution of emotional demands to prediction of emotional exhaustion and job satisfaction levels.

An emotive subject: insights from social, voluntary and healthcare professionals into the feelings of family carers for people with mental health problems

Caring for people with mental health problems can generate a whole range of positive and negative emotions, including fear, disbelief, guilt and chaos as well as a sense of purpose, pride and achievement. This paper explores the emotions of family carers from the perspectives of social, voluntary and healthcare professionals. Sixty-five participants were interviewed, the sample included directors, managers and senior staff from social, voluntary and healthcare organisations. Participants were encouraged to talk in detail about their understanding of the emotions of family carers. Findings highlight a rich understanding of the broad spectrum of carer emotions and the huge emotional adjustments that are often involved. Diagnosis was seen to be imbued with negative emotions, such as fear, anger and denial. However, feelings of hopelessness and desolation were often counterbalanced by feelings of hope, satisfaction and the emotional rewards of caring for a loved one. Participants noted a clear lack of emotional support for family carers, with accompanying feelings of marginalisation, particularly during transitions and especially involving young carers as well as ethnic minorities. By way of contrast, carer support groups were suggested by professionals to be a holistic, effective and economical way of meeting carers' emotional needs. This paper explores the challenge of family carer emotions from the perspective of managers and practitioners and draws out implications for research, policy and practice.

Judgements about mentoring relationships in nurse education

Much has been written about the use of portfolios and mentoring in the clinical assessment of nursing students in the United Kingdom. Research reports have focused on difficulties in using portfolios, mentoring relationships and mentor preparation. The aim of this study was to deepen understanding of how mentors actually make judgements about students' clinical competence. Qualitative data were gathered in 2006 using a critical incident technique in interviews with a convenience sample of students and mentors from two different geographical regions in the UK. Thematic analysis generally confirmed previous findings regarding the qualities of a good student and resource issues in mentoring. 'Good mentoring' depended on students building a relationship with their mentors, and undertaking a great deal of 'emotional labour' to convince mentors that they were 'good students' in terms of attitudes as well as clinical competence. It seems clear that much of the burden of creating effective mentoring relationships falls on students. At the same time, many issues identified in previous research do not appear to have been tackled, including appropriate mentor preparation and support, the format of portfolios and competency statements, and ensuring that enough time is available for mentoring and student supervision.

Plugging a hole and lightening the burden: a process evaluation of a practice education team

AIM

To investigate the perceptions of clinical and senior managers about the role of practice educators (PEs) employed in one acute hospital in the UK.

BACKGROUND

Producing nurses who are fit for practice, purpose and academic award is a key issue for nurse education partnership providers in the UK. Various new models for practice learning support structures and new roles within health care institutions have been established. To sustain funding and policy support for these models, there is a need for evaluation research.

DESIGN

A process evaluation methodology was employed to determine the current value of a practice education team and to provide information to guide future direction.

METHODS

Data were collected through semi-structured telephone interviews using a previously designed schedule. All senior nurse managers (n = 5) and a purposive sample of Clinical Managers (n = 13) who had personal experience of and perceptions about the role of PEs provided the data. Interview notes were transcribed, coded and a thematic framework devised to present the results.

RESULTS

A number of key themes emerged including: qualities needed for being a successful practice educator; visibility and presence of PEs; providing a link with the university; 'plugging a hole' in supporting learning needs; providing relief to practitioners in dealing with 'the burden of students;' alleviating the 'plight of students;' and effects on student attrition.

CONCLUSIONS

Findings provided evidence for the continued funding of the practice educator role with improvements to be made in dealing with stakeholder expectations and outcomes.

RELEVANCE TO CLINICAL PRACTICE

In the UK, there still remain concerns about the fitness for practice of newly Registered Nurses, prompting a recent national consultation by the professional regulating body. Despite fiscal pressures, recommendations for further strengthening of all systems that will support the quality of practice learning may continue to sustain practice learning support roles.

Lamentation and loss: expressions of caring by contemporary surgical nurses

AIM

This paper is a report of a phenomenological study of caring from the perspective of nurses working on surgical wards.

BACKGROUND

While care and caring are complex foundational nursing concepts which have received considerable and ongoing attention from theorists, researchers and clinicians, there has been little research into caring on surgical units.

METHOD

A convenience sample of ten nurses working on surgical units in a public teaching hospital in Canada was interviewed using van Manen's phenomenological approach. Data were collected during 2001 using semi-structured interviews.

FINDINGS

The major theme of lamentation and loss was identified from the data. Participants revealed a dichotomous tension between what caring should be and what actually occurs. This tension was pervasive and generated lament - an expression of grief and mourning for the loss of caring. The essential structures supporting this theme included lack of time, lack of caring support, tasking, increased acuity, lack of continuity of care, emotional divestment and not caring for each other. Loss and sadness were articulated and participants lamented and grieved about the loss of care in contemporary practice.

CONCLUSION

The forces and influences described by participants undermined caring in the new practice milieu. If this is a glimpse of the future, then the values of the nursing profession may be under siege. Caring as the central core, the essence or unifying concept of nursing may be subject to marginalization in contemporary practice.

Student nurses as peer-mentors: Collegiality in practice

Mentoring is promoted as a key strategy for supporting nursing students and new practitioners in clinical settings. However, mentoring is also a complex process, requiring the development of bounded and purposeful relationships underpinned by knowledge, experience and opportunities for reflection. This paper reports the findings of an evaluation by second-year nursing student mentors and first-year mentee students of a short peer-mentoring programme. The main objective of the programme was to support students making the transition to the university and nursing. At a more focused professional level, the programme also provided the opportunity for students to be a mentor or to be mentored, as a learning precursor to being mentored in the clinical setting. The programme provided rich learning opportunities for the development of the qualities and skills required for mentoring roles and was a vehicle for encouraging collegial interaction and learning. The students' evaluation of the programme also demonstrated that formal mentoring programmes require considerable organisational investment and ongoing commitment in educational and clinical settings. Mentors and mentees require time for face-to-face meetings and discussion, effective and on-going communication channels, and adequate role preparation.

RN as gatekeeper: student understanding of the RN buddy role in clinical practice experience

Students may be informally buddied with registered nurses (RNs), during their clinical experience. This paper describes one component of a larger phenomenographic study that explored the qualitatively different ways students understand the RN buddy role during clinical experience and the implications of this understanding for student learning. The perception of the RN as gatekeeper was an unexpected finding and is the focus of this report. Phenomenography is a field of descriptive research concerned with the variation in ways people experience and understand similar phenomena. This approach was used to identify the variation in experience and understanding of students with buddy RNs. Individual semi-structured interviews were conducted with a purposive sample of 24 students from one university in Queensland, Australia. The two variations in understanding of the role discussed in this paper are: understanding as an expectation, and RN as gatekeeper: gatekeeping as access. The research highlights that the various ways RNs promote or block access for students influence the quality of the learning experience. Formal recognition of the complexity of the RN role is essential to ensure RNs have adequate preparation for their role with students.

A phenomenographic study of registered nurses’ understanding of their role in student learning—An Australian perspective

BACKGROUND

Students may be 'buddied' with registered nurses during their clinical experience since the designated clinical facilitator cannot be available for each student at all times. Little is known about the way registered nurses understand this informal role.

OBJECTIVES

The rationale for this study was to gain an insight of the variation of understanding registered nurses have of their role with students, and explored the qualitatively different ways registered nurses perceive their role with students on clinical experience and the implications of this understanding for student learning.

DESIGN

A phenomenographic approach was used to identify the variation of understanding and meaning of the role of the registered nurse with students on clinical practice from the perspective of the registered nurse. Phenomenography is a field of descriptive research concerned with the variation in ways people experience and understand similar phenomena.

SETTINGS AND PARTICIPANTS

A purposive sample of 30 registered nurses from 15 public and private hospitals in central and south eastern Queensland, Australia.

METHODS

Individual semi-structured interviews from a final sample of 28 interviews were analysed to identify Categories of Description.

RESULTS

Eight variations of understanding registered nurses have of their informal role with students were identified. The registered nurses' understanding varies from a focus that is 'student-centred', to 'completion of workload-centred', to 'registered nurse control', to a preference for no contact with students. As a consequence some students may have positive learning experiences while others will have limited learning opportunities.

CONCLUSIONS

The research highlights the varied ways registered nurses understand their role with students that may promote or impede the quality of student learning and development to meet professional competency standards. Formal recognition of the complexity of the registered nurse role by health care agencies and tertiary education providers is essential to ensure registered nurses have adequate preparation for their role with students.

Perinatal grief and emotional labour: a study of nurses’ experiences in gynae wards

Death through pregnancy loss is a tragedy which touches nursing staff as well as parents. Exposed to the intense emotions of parents, nurses must simultaneously manage their own emotions. This paper explores how nurses, through the use of personal narratives, develop and construct meanings around the professionally defined, but personally experienced, event of pregnancy loss. The methodology was based on in-depth interviews with fourteen nurses working in gynaecological units in Northern Ireland. The author, through the exploration of the nurse's perspective, concludes that emotion can be conceived of as a valid resource for professionals when integrated into a nurse's matrix of professional understandings. In addition, the study also demonstrates that value should be attached to emotional work which may not be fully visible, particularly for nurses working in gynaecological units. The emotional needs of nurses need to be fully acknowledged through recognition of the importance of managed emotion in the construction of professional knowledge. There is, therefore, strong justification for supporting the recognition of the importance of emotion in the development of nurse education policies and in valuing aspects of nursing practice that may have been marginalized.

Workplace stress in nursing: a literature review

BACKGROUND

Stress perception is highly subjective, and so the complexity of nursing practice may result in variation between nurses in their identification of sources of stress, especially when the workplace and roles of nurses are changing, as is currently occurring in the United Kingdom health service. This could have implications for measures being introduced to address problems of stress in nursing.

AIMS

To identify nurses' perceptions of workplace stress, consider the potential effectiveness of initiatives to reduce distress, and identify directions for future research.

METHOD

A literature search from January 1985 to April 2003 was conducted using the key words nursing, stress, distress, stress management, job satisfaction, staff turnover and coping to identify research on sources of stress in adult and child care nursing. Recent (post-1997) United Kingdom Department of Health documents and literature about the views of practitioners was also consulted.

FINDINGS

Workload, leadership/management style, professional conflict and emotional cost of caring have been the main sources of distress for nurses for many years, but there is disagreement as to the magnitude of their impact. Lack of reward and shiftworking may also now be displacing some of the other issues in order of ranking. Organizational interventions are targeted at most but not all of these sources, and their effectiveness is likely to be limited, at least in the short to medium term. Individuals must be supported better, but this is hindered by lack of understanding of how sources of stress vary between different practice areas, lack of predictive power of assessment tools, and a lack of understanding of how personal and workplace factors interact.

CONCLUSIONS

Stress intervention measures should focus on stress prevention for individuals as well as tackling organizational issues. Achieving this will require further comparative studies, and new tools to evaluate the intensity of individual distress.

Transition experiences of qualified nurses moving into hospice nursing

BACKGROUND

Over a short period of time a number of nurses had joined the staff at a hospice. Many of these nurses were palliative care novices, and thus their transition into hospice nursing constituted a move both to a new workplace and a new clinical specialism.

AIM

The aim of the study was to gain a deeper understanding of the experiences of qualified nurses making the transition into hospice nursing in order to support future nurses in this transition.

METHOD

A constructivist approach was used; data were collected through semi-structured interviews with four new nurses, three mentors and four team leaders. Data were analysed using a constant comparative method.

FINDINGS

Five major themes were identified: expectations, personal and professional development, professional respect, mentorship and support. Nurses came to the hospice with individual expectations, some of which were realized. All identified areas of personal and professional development. Whilst it was acknowledged that new nurses brought transferable skills, there was consensus that they needed to develop palliative care knowledge and skills. Professional respect was demonstrated by the degree of acceptance or questioning of new nurses by established staff. New nurses experienced a variety of emotional responses to hospice nursing. Mentorship enhanced the transition experience and strong support was also gained from each other.

CONCLUSIONS

New nurses need individual support during their transition into hospice nursing in response to their own expectations, experiences and learning needs. Mentors need preparation and support in their role in order to maximize their positive influence on transitions.