Missed nursing care as experienced by undergraduate nursing students
A qualitative study
Abstract
Abstract. Background: In clinical settings where missed nursing care prevails, nursing students’ instructions, supervision and the joint reflection on clinical practice with mentors are also affected and nursing students become involved in dealing with missed nursing care. Aim: To explore the experience of missed nursing care in clinical placements, its meaning for nursing students, and actions they considered or took. Methods: Qualitative study based on a content analysis of nursing students’ written reports. Nursing students in three universities in Germany with experience of at least one clinical practice placement were invited to participate. Online, they answered three open questions concerning missed nursing care focusing on: (1) experiences of the phenomenon, (2) its meaning and (3) actions that had been considered or taken when dealing with missed nursing care. A content analysis was performed. Results: The recruitment criteria were met by 69 nursing students. Four main themes and 20 sub-themes were identified. The reports covered all forms of missed nursing care. Becoming involved led to intrapersonal conflicts and, feelings of powerlessness but also to learning opportunities. It challenged professional and ethical standards. Students identified a broad spectrum of actions to answer the challenge. Conclusion: Dealing with missed nursing care creates opportunities and challenges for nursing students. To build up a well-trained and sustainable nursing workforce, learning environments for nursing students must reflect the challenges and counteract deficits.
Zusammenfassung. Hintergrund: In klinischen Settings, in denen unterlassene Pflege vorkommt, sind auch die Anleitung und die Supervision der Pflegestudierenden sowie die von Mentor_innen begleitete Reflexion der klinischen Praxis betroffen und die Studierenden sind auch in den Umgang mit unterlassener Pflege einbezogen. Ziel: Exploration der Erfahrungen mit unterlassener Pflege in klinischen Einsatzbereichen, deren Bedeutung für die Pflegestudierenden sowie Maßnahmen, welche in Erwägung gezogen oder umgesetzt wurden. Methoden: Qualitative Studie basierend auf einer Inhaltsanalyse schriftlicher Berichte. Studierende von drei deutschen Hochschulen in Deutschland, die Erfahrung in mindestens einem klinischen Einsatzbereich hatten, wurden zur Teilnahme eingeladen. Online beantworteten sie drei offene Fragen zu unterlassener Pflege: (1) Erfahrungen mit dem Phänomen, (2) seine Bedeutung und (3) Maßnahmen, die im Umgang mit unterlassener Pflege erwogen oder ergriffen wurden. Es wurde eine Inhaltsanalyse durchgeführt. Ergebnisse: 69 Studierende konnten einbezogen werden. Es wurden vier Hauptthemen und 20 Unterthemen identifiziert. Die Berichte umfassten alle Formen unterlassener Pflege. Mit unterlassener Pflege konfrontiert zu werden, führte zu intrapersonellen Konflikten und Gefühlen der Ohnmacht, aber auch zu Lernchancen. Es forderte professionelle und ethische Standards heraus. Die Befragten identifizierten ein breites Spektrum an Handlungen, um auf die Herausforderung zu reagieren. Schlussfolgerung: Der Umgang mit unterlassener Pflege birgt Chancen und Herausforderungen. Um gut ausgebildete Fachkräfte nachhaltig zur Verfügung zu stellen, müssen Lernumgebungen Herausforderungen reflektieren und Defiziten entgegenwirken.
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