Student nurses' experiences of preserved dignity in perioperative practice - Part I

Prehospital nursing students' experiences of patient safety culture in emergency medical services-A qualitative study

AIMS AND OBJECTIVES

To describe prehospital nursing students' experiences of patient safety culture in emergency medical services during their internship.

BACKGROUND

Patient safety culture in the emergency medical services is a complex phenomenon including more than organisational policies and practices and professionals' technical skills.

DESIGN

The descriptive qualitative approach used the Sharing Learning from Practice to improve Patient Safety Learning Event Recording Tool, which includes both open-ended and structured questions.

METHODS

Purposeful sampling was used, and data were collected from graduating prehospital nursing students (n = 17) from three Finnish Universities of Applied Sciences. Open-ended questions were reviewed using thematic analysis, and frequencies and percentages were derived from structured questions. COREQ guidelines were used to guide this study.

RESULTS

Four themes were identified during the thematic analysis: environmental and other unexpected factors in emergency medical services, working practices and professionalism in emergency medical services, teamwork in emergency medical services and feelings related to patient safety events in emergency medical services. Patient safety events described by students were seldom reported in the healthcare system or patient files. According to the students, such events were most likely related to communication, checking/verification and/or teamwork.

CONCLUSIONS

This study shows that prehospital nursing students can produce important information about patient safety events and the reasons that contributed to those events. Therefore, emergency medical services organisations and managers should use students' observations to develop a patient safety culture in emergency medical services.

RELEVANCE TO CLINICAL PRACTICE

Understanding how prehospital nursing students have experienced patient safety culture during their internships on ambulances can support educational institutions, together with emergency medical services organisations and managers, to improve policies for students to express patient safety concerns as well as patient safety successes.

"I Felt Alienated in the Operating Room": A Phenomenological Qualitative Study

PURPOSE

To investigate the clinical practice experiences of nursing students in the operating room and to evaluate these experiences in terms of professional socialization.

DESIGN

This study was designed as a qualitative study based on Heidegger's hermeneutic phenomenological approach.

METHODS

The study was conducted with second-year nursing students who attended the operating room (OR) as an observer for 10 hours as part of the Surgical Nursing course. The study data were collected with a semistructured interview form on the day following this restricted and limited experience. This form included items that questioned the students' experiences of how they perceived the clinical experience and how they were ultimately affected. The data were analyzed using van Manen's thematic analysis.

FINDINGS

The study was conducted with nine students, including four males and five females. The ages of the students ranged between 19 and 21 years. Two themes and seven subthemes were determined as a result of the data analysis. The themes of the study were (1) short and difficult experience and (2) very important for professional socialization.

CONCLUSIONS

The study provided important information about nursing students' experiences regarding the effect of OR practice on their professional socialization. It was understood that the students perceived OR practice as a short and difficult experience, felt worthless and alienated, and realized that there was no empathy in the OR. Additionally, they stated that the team members did their job very well and that they felt the importance of being the best. Moreover, they found OR practice important for guiding one's career goals, professional socialization, and gaining a professional identity.

Nursing Students' Experiences Related to Operating Room Practice: A Qualitative Study

PURPOSE

The purpose of this study was to examine the experiences of nursing students concerning operating room (OR) practice.

DESIGN

A qualitative design was used in this study.

METHODS

Data were collected from second-year nursing students using the semistructured interview form including open-ended questions about their OR experiences. Perspectives of phenomenological approach including existentials of lived body, lived relations, lived space, and lived time were used in data analysis.

FINDINGS

The study data regarding experiences of nursing students concerning OR practice were organized under three themes, namely, "OR environment," "emotions," and "career plans after graduation." Nine subthemes emerged: educational experience, teamwork, and communication, excitement, enjoyment, anxiety, fear, different emotions, working as a surgical nurse, and working in departments other than OR.

CONCLUSIONS

In clinical environments, student nurses should be supported by staff and instructors to facilitate learning and create meaningful learning experiences.

The impact of compassionate care education on nurses: A mixed-method systematic review

AIMS

To identify, describe, and summarize evidence from quantitative, qualitative, and mixed-method studies conducted to prepare nurses and nursing students to lead on and/or deliver compassionate care.

DESIGN

Mixed-method systematic review.

DATA SOURCES

CINAHL, Medline, PsychINFO, and SocINDEX (January 2007-February 2018).

REVIEW METHODS

Papers were screened by two independent reviewers using an online screening tool and data were extracted using a standardized data extraction table. Parallel-results convergent synthesis was used to synthesize evidence from included qualitative, quantitative, and mixed-method studies. Quality appraisal and risk of bias assessment were conducted.

RESULTS

Fifteen studies were included with three main themes and six sub-themes: (a) programme impact (impact on ward-level and senior nurses and impact on nursing students and educators); (b) programme characteristics (characteristics leading to positive outcomes and characteristics leading to negative outcomes); and (c) programme implementation (implementation barriers and implementation facilitators). Compassionate care education programmes helped enhance nurses' ability to engage in reflective practice, deal with clinical challenges, and gain confidence. The importance of nurturing compassionate care delivery in nursing education was highlighted in the literature. Various nursing-level, patient-level, and organizational barriers to compassionate care delivery were identified.

CONCLUSION

The impact of compassionate care educational programmes on nurses was predominantly positive. Further evaluation of the long-term impact of these programmes on nurses, patients, and organizations is warranted.

IMPACT

Optimal delivery of compassionate care can be achieved by building organizational infrastructures that support nurses from all levels to attend education programmes and lead on compassionate care delivery.

Responsibility for patient care in perioperative practice

AIM

To obtain an understanding of operating theatre nurses' experiences of responsibility for patient care and safety in perioperative practice.

DESIGN

A hermeneutic design were used.

METHOD

Data were collected during 2012 from 15 operating theatre nurses who participated in individual interviews. The text was analyzed by hermeneutical text interpretation.

FINDINGS

The texts revealed two main themes: A formal external responsibility and personal ethical value. Responsibility that the patient was not exposed to risks, protecting the patient's body, systematically planning and organizing work in the surgical team. The personal ethical value meant confirming the patient as a person, caring for the patient and preserving the patient's dignity. A new understanding emerged that the operating theatre nurse always have the patient in mind.

Nurse anaesthetist students' experiences of patient dignity in perioperative practice-a hermeneutic study

Aim

The aim of the study was to describe how nurse anaesthetist students experienced patient dignity in perioperative practice.

Design

A hermeneutical design and the critical incident technique were used to obtain experiences from practice.

Method

In the Autumn of 2015, after participating in a mandatory lecture on ethics, 23 nurse anaesthetist students reported their experiences and interpretation concerning violation and preservation of patients' dignity in the operating theatre. The text, which was a compilation of descriptions of 35 incidents, was analysed by using hermeneutical text interpretation.

Findings

The text revealed three main themes preserving patients' dignity: allocating time to the patient, inviting the patient to participate and shielding the patient's body. Furthermore, three main themes of dignity violation were identified: alienation, backbiting and violation of intimate sphere.

Conclusion

Discussion and reflection based on the personal experience of the students during their practice are ways to strengthen ethical awareness and promote an ethical and dignified caring culture.

What facilitates the delivery of dignified care to older people? A survey of health care professionals

Background

Whilst the past decade has seen a growing emphasis placed upon ensuring dignity in the care of older people this policy objective is not being consistently achieved and there appears a gap between policy and practice. We need to understand how dignified care for older people is understood and delivered by the health and social care workforce and how organisational structures and policies can promote and facilitate, or hinder, the delivery of such care.

Methods

To achieve our objective of understanding the facilitators and to the delivery of dignified care we undertook a survey with health and social care professionals across four NHS Trusts in England. Participants were asked provide free text answers identifying any facilitators/barriers to the provision of dignified care. Survey data was entered into SPSSv15 and analysed using descriptive statistics. These data provided the overall context describing staff attitudes and beliefs about dignity and the provision of dignified care. Qualitative data from the survey were transcribed verbatim and categorised into themes using thematic analysis.

Results

192 respondents were included in the analysis. 79 % of respondents identified factors within their working environment that helped them provide dignified care and 68 % identified barriers to achieving this policy objective. Facilitators and barriers to delivering dignified care were categorised into three domains: ‘organisational level’; ‘ward level’ and ‘individual level’. Within the these levels, respondents reported factors that both supported and hindered dignity in care including ‘time’, ‘staffing levels’, training’,’ ‘ward environment’, ‘staff attitudes’, ‘support’, ‘involving family/carers’, and ‘reflection’.

Conclusion

Facilitators and barriers to the delivery of dignity as perceived by health and social care professionals are multi-faceted and range from practical issues to interpersonal and training needs. Thus interventions to support health and social care professionals in delivering dignified care, need to take a range of issues into account to ensure that older people receive a high standard of care in NHS Trusts.