Impressions of nursing before exposure to the field

The impact of prior care experience on nursing students' compassionate values and behaviours: A mixed methods study

BACKGROUND

Compassion is critical to the provision of high-quality healthcare and is foregrounded internationally as an issue of contemporary concern. Paid care experience prior to nurse training has been suggested as a potential means of improving compassion, which has been characterised by the values and behaviours of care, compassion, competence, communication, courage, and commitment. There is however a dearth of evidence to support the effectiveness of prior care experience as a means of improving compassion in nursing.

OBJECTIVE

To explore the impact of paid prior care experience on the values and behaviours of pre-registration nursing students indicated as characterising compassionate care.

DESIGN

Longitudinal mixed methods design employing a modified concurrent triangulation strategy, comprising two work packages. Work package 1 was qualitative, and work package 2 adopted a concurrent embedded strategy with a dominant quantitative component. Research is reported in accordance with the Good Reporting of a Mixed Methods Study framework.

SETTING(S)

Three United Kingdom universities.

PARTICIPANTS

Pre-registration nursing students attending one of three universities, and individuals who had previously participated in a Health Education England paid prior care experience pilot. Participant numbers at time point 1 were questionnaires n = 220, telephone interviews n = 10, and focus groups n = 8.

METHODS

Work package 1 consisted of longitudinal semi-structured telephone interviews. Work package 2 comprised validated online questionnaires measuring emotional intelligence, compassion satisfaction and fatigue, resilience, psychological empowerment, and career commitment (as proxies of compassionate values and behaviours), and focus groups. Qualitative data were thematically analysed. Quantitative data were analysed via Analysis of Variance in SPSS v 26.

RESULTS

Qualitative findings suggest that prior care experience has both positive and negative effects on students' compassionate values and behaviours, however positive effects do not extend to qualification. No statistically significant differences were found in any of the quantitative outcome measures between participants with and without paid prior care experience. A statistically significant increase in compassion fatigue was identified in both groups of participants post-qualification. Paid prior care experience did not prevent participants from experiencing reality shock on becoming a student or on qualification.

CONCLUSIONS

There is insufficient evidence of longitudinal beneficial impact to recommend paid prior care experience as an effective intervention to foster nursing students' compassionate values and behaviours. These findings do not support mandating a period of paid care experience as a prerequisite for entry into nurse education.

REGISTRATION

N/A. Tweetable abstract Insufficient evidence of longitudinal beneficial impact to recommend prior care experience as an effective intervention to foster nursing student compassion @PriorCareExp @Sarah_F_R.

Hesitancy among Iranian nursing students regarding future career trajectory: a qualitative analysis

BACKGROUND

The shortage of skilled nurses is a major concern for health systems worldwide. This may be partly due to the hesitancy of some nurses to enter or remain in the nursing career. This shortage consequently reduces the quality of standard patient care, increases patients' length of stay in a hospital, increases medical costs, and results in patients' dissatisfaction. This study aimed to explore hesitancy among senior undergraduate nursing students to pursue a career in nursing.

METHODS

This qualitative study adopted a thematic analysis approach. The population comprised senior undergraduate nursing students at Isfahan University of Medical Sciences, Iran, who indicated that they were hesitant to pursue a career in nursing. The study sampling was performed from May 2021 till February 2022 and continued until data saturation. Twenty-four interviews were conducted with the selected students. The attributes related to hesitancy among senior undergraduate nursing students to pursue a career in nursing were extracted as themes and sub-themes.

RESULTS

Four themes were identified: academic idiosyncrasies, individual characteristics, poor nursing market regulations (sub-themes: nursing as a tough and intense career, and unfavorable employment contracts), and the peculiarities of the workplace (sub-themes: conflict within work environment, and barriers to professional nursing practice).

CONCLUSIONS

The findings of this study showed that senior undergraduate nursing students weigh their future career options from various academic, personal, professional, and work environment dimensions. The findings provide new insights for decision makers to design and implement innovative strategies to promote retention in nursing careers. We recommend to provide academic counseling for all students and applicants of nursing before they enter the nursing education. Furthermore, we suggest to improve study and work environments, and to implement incentive programs to enhance enthusiasm of nursing students for pursuing a nursing career.

Barriers and facilitators to enrolling in nursing programs as perceived by male students: a qualitative study in the United Arab Emirates

OBJECTIVES

Despite the cultural challenges and stigma associated with nursing in the United Arab Emirates, there has been an increase in male nursing students. It is therefore important to understand barriers and facilitators that influence their decision to choose nursing education.

METHODS

This qualitative study used purposive sampling to recruit 30 male undergraduate students. Semi-structured interviews were conducted and data were analyzed with thematic analysis.

RESULTS

Ten themes were identified that described barriers and facilitators to choosing nursing programs as perceived by male students. Four themes reflected barriers and six themes were identified that encompassed facilitators to choosing nursing programs.

CONCLUSIONS

For international audiences, our findings could be helpful in enhancing both the recruitment and educational opportunities for male nursing students. Male students may be inspired to pursue the nursing profession by the presence of men in the profession and favorable male role models. Effort is needed to recruit male role models in nursing schools.

The impact of care experience prior to commencing pre-registration nurse education and training: A scoping review

OBJECTIVES

Compassion in nursing and interventions to support it are of international relevance and concern. Prior care experience as a prerequisite for entry into pre-registration nurse education is suggested as a means of improving compassion. The impact of prior care experience has not been comprehensively reviewed, therefore the potential effectiveness of prior care experience as a means of improving compassion is unknown. The scoping review question was 'What is known about the impact of care experience prior to commencing pre-registration nurse education and training?' The primary objective was to scope and synthesise existing literature relating to the topic and ascertain key themes pertaining to impact. A secondary objective was to appraise literature, to contextualise findings and assess the state and stage of knowledge and research in the area.

DESIGN

The review was guided by Arksey and O'Malley's methodological framework and is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews Checklist.

DATA SOURCES

Health sciences databases CINAHL, Medline and PubMed.

METHODS

Databases were searched in February 2019, updated August 2021. Data (study characteristics, findings, methodological observations) were extracted from papers meeting inclusion criteria (including peer-reviewed empirical papers with English language, electronic full-text available) and findings thematically analysed.

RESULTS

Forty-five papers from 14 countries were included. The majority (64.4 %) were published in Europe (31.1 % in the United Kingdom) between 2010 and 2021 (69 %), 60 % from 2013. Four qualitative themes (compassionate care, commitment, competence and communication) describe the impact of prior care experience, which was variable.

CONCLUSIONS

Evidence to support the effectiveness of prior care experience as a prerequisite for entry into nurse education to improve compassion, is inconsistent and insufficient. The literature displays methodological limitations and conclusions should be interpreted in light of these caveats. Recommendations are made for future research, to improve quality and comparability.

Listening to the minority: A qualitative study exploring male students' perceptions of the nursing profession and reasons for choosing nursing as a career

INTRODUCTION

Nursing is a rapidly growing profession that has traditionally been dominated by women. Research has highlighted various challenges associated with increasing the number of male nurses, such as cultural challenges and stigma related to nursing. The United Arab Emirates (UAE) has experienced an increase in male students enrolling in nursing programs. To ensure this is sustainable, it is important to understand how male students perceive nursing and clarify factors that influence their decision to choose nursing as a career.

OBJECTIVES

To explore male nursing students' perspectives of the nursing profession and understand why they chose nursing as a career.

METHODS

Participants in this qualitative analysis were 30 male students that were selected using purposive sampling. Semi-structured interviews were used to collect data about participants' experiences. We used a qualitative content analysis to guide the data analysis.

RESULTS

Three main themes were identified that described male students' perspectives of and reasons for choosing nursing: (1) perceptions of nurses and nursing profession; (2) individuals as facilitators or role models in choosing the nursing profession; and (3) barriers to choosing the nursing profession.

DISCUSSION AND CONCLUSION

Our results regarding barriers and facilitators for male students in choosing to study nursing may be useful to help improve the recruitment of and learning opportunities for male nursing students. Highlighting the male presence in the nursing profession and positive male role models may encourage males to enter the profession. Therefore, understanding the experiences of male nursing students in choosing nursing as a career has important implications for nursing practice and education.

Perspective and Experience of Male Nursing Students in 3-year Vocational College During Their Clinical Practicum: A Qualitative Study in Shanghai, China

Background

With the expansion of nursing enrollment, more and more male students are joining the nursing program. Nevertheless, the number of male nurses who actually stay in clinical work in China continues to be low. Clinical practicum is a critical period during which nursing students transform to the role of registered nurses. However, few studies have researched the perspective and experience during clinical practicum among male nursing students in 3-year vocational colleges in China.

Objectives

To explore the perspective and experience of Chinese male nursing students during clinical practicum in the third year. One of the main objectives is to provide implications for future nursing education and to help male nursing students for better adaptation to clinical roles.

Methods

The qualitative study used a purposive sampling method and collected data through in-depth, semi-structured interviews. The participants were 20 male students from a 3-year vocational college in Shanghai. They completed the basic nursing course in college and underwent a clinical practicum in the 3rd level hospitals in China between July 2020 and March 2021. A Seven-stage Colaizzi process was used for data analysis.

Results

Three themes were revealed through content analysis: opportunities and challenges brought by gender factors in hospital humanistic environment, gaining experience and growth during clinical practicum, and future career planning.

Conclusions

The presented findings further our understanding of the perspective and experience of male nursing students during clinical practicum. It is very important and necessary for providing implications for future nursing education. At the same time, effective support from society, such as social unions, mass media, government, can help better address male nursing students' needs and complete the role transform of registered nurses.

'Do nurses really do that'? An exploratory mixed methods study of Students' willingness to lead

BACKGROUND

Health care needs are changing, requiring nurses to assume leadership roles and engage in political activism to impact health system transformation. Nursing education socializes students to the profession, as this is where they begin to develop their professional identity. For these reasons' educators must begin to explore student perceptions of the role of the registered nurse given the emphasis on leadership and health care transformation and question if students want to assume these roles.

OBJECTIVES

To identify first- and fourth-year baccalaureate nursing student perceptions of the role of the nurse and analyze their willingness to participate in roles that embody leadership and political action.

DESIGN

An exploratory mixed method design.

SETTING

Two western Canadian four-year baccalaureate nursing programs.

PARTICIPANTS

First- and fourth-year students.

METHODS

This study utilized a survey to collect demographic data and broad student perceptions of the registered nurse role and career aspirations. Focus groups followed with a sub-set of participants to further explore student opinions about the role of nurses.

RESULTS

Similar perceptions and views of nursing exist among cohorts (first- and fourth-year students) and between Baccalaureate programs. Students continue to choose nursing as a career for altruistic reasons. Validation of their role is in the form of personal affirmation of a job well done from their patients. While there is acknowledgement among first- and fourth- year students that nurses should be leaders and influence the overall health care system, student responses indicated that the 'other guy' should do it, not them.

CONCLUSIONS

The results identify the need to develop and implement strategies to prepare future nurses who are interested and willing to participate in a career based on leadership, political action, and healthcare transformation.

Academic burnout and professional self-concept of nursing students: A cross-sectional study

BACKGROUND

Nursing students' academic burnout affects their learning behaviour and academic performance, which ultimately affect whether they will become a qualified nurse. However, little is known about the academic burnout of nursing students, or about its relationship with professional self-concept.

OBJECTIVES

The purpose of this study was (1) to assess the academic burnout of nursing students and (2) to evaluate the impact of professional self-concept on academic burnout among nursing students.

DESIGN

A cross-sectional survey.

SETTINGS

The survey was carried out at a 3-year vocational medical college and a 4-year undergraduate medical college in Anhui province, which is located in east-central China.

PARTICIPANTS

From March to May 2018, a total of 1139 full-time nursing students were investigated by convenient sampling, and 1083 valid questionnaires were recovered in this study.

METHODS

Basic information of students were collected. The Academic Burnout Scale (ABS) and the Nurses' Self-Concept Instrument (NSCI) were used to evaluate students' academic burnout and professional self-concept.

RESULTS

The average of the overall score of the Academic Burnout Scale was 2.77 ± 0.53, which closed to the median of the scale (median = 3). Whether class leader students or not has significant influence on influence students' academic burnout. Nursing students' professional self-concept had negative effect on their academic burnout.

CONCLUSIONS

Nursing students' academic burnout level was close to the median on the Academic Burnout Scale, and improper behaviour was most severe. Positive professional self-concept can reduce the level of academic burnout. It is meaningful for nursing educators to take measures to decrease nursing students' academic burnout and enhance their professional self-concept.

Transitioning to university as a nursing student: Thematic analysis of written reflections

BACKGROUND

The international literature has largely conceptualised transition to university as a process of adjustment to both the social and the academic demands of university life. Several factors influence this process including: student, parent and university staff expectations; student preparedness; and student belongingness. Moreover, some student groups (groups well-represented in nursing) appear to have particular difficulty in successfully transitioning to university life.

STUDY AIMS

To explore first year nursing students' experiences of the transition to university; to compare nursing students' experiences with those of other disciplines and identify ways of easing the transition for nursing students.

METHODOLOGY

As part of their coursework, first year nursing students at an English University submitted a 500-word, formative reflection on the transition to university. Anonymised reflections from 161 students were available to the researchers for thematic content analysis; 50 reflections, however, proved sufficient for 'information power'.

RESULTS

Two main themes emerged from the data: (i) 'managing expectations', an overarching theme that permeated most of the reflections; and (ii) 'practical tools and support aids', the practical, concrete actions that either the university took, or the students developed themselves, to ease the transition. Both themes embraced inter-related academic, social and personal domains.

CONCLUSIONS

Nursing students' transition experiences are similar to those of other university students. However, the particular demographics of nursing student cohorts amplifies certain aspects of the transition experience: more students who are likely to struggle with transition but also more students who embrace the developmental aspects of going to university. Transition requires joint enterprise between students and university staff, especially in terms of expectations and the support required to become independent learners. Transitions can be eased by tapping into student resourcefulness and seeing transition as a gradual process that cuts across academic, social and personal dimensions rather than as a short, one-off event.

The role of universities in attracting male students on to pre-registration nursing programmes: An electronic survey of UK higher education institutions

The UK nursing workforce is facing a crisis. More nurses are leaving than entering the profession, and there are tens of thousands of unfilled vacancies. Political factors are having a significant impact on numbers, in particular the decision to withdraw bursaries for nursing undergraduates, and a steep decline in EU nurses registering to work in the UK post-Brexit. Against this backdrop, there is a stark gender imbalance in the workforce, with only around 11% of registered nurses being male. We surveyed UK higher education institutions to try to identify whether the gendered nature of nursing was considered a concern and whether steps were being taken to address it. We sent an electronic survey to every UK university offering undergraduate nurse training validated by the Nursing and Midwifery Council (NMC). With a response rate of 42%, the majority of respondents felt that nursing departments should take much more responsibility to increase the proportion of male nurses entering the nursing profession. More needs to be done to diversify the workforce and make nursing an appealing career choice for men and women.

Peer support systems and professional identity of student nurses undertaking a UK learning disability nursing programme

This practitioner based action research examines the implementation of the peer assisted study scheme (PASS) and individual peer mentoring in a cohort of first year undergraduate nursing students. It arose out of the desire of a small number of students in one UK university to transfer from the learning (intellectual) disabilities nursing field to other fields. The number of learning disabilities nurses is falling in England, and nursing shortages and student nurse retention generally is an international concern. The peer support was evaluated by 21 completed questionnaires. All the students had found the sessions they attended useful. Four themes emerged from the study. Students reported gains in knowledge around academic skills, placements and their chosen field of nursing; students felt more confident as a result of attending the sessions; students felt supported, and the importance of the peer mentor's interpersonal skills was highlighted; and finally students had valued meeting other students in their chosen field. These findings are discussed with reference to relevant literature.

Predicting factors of positive orientation and attitudes towards nursing: A quantitative cross-sectional study

BACKGROUND

Previous studies have identified various reasons for students to choose a career in nursing. Students at the start of their programme hold a great variety of images and perceptions of nursing which can affect their orientation and attitudes towards their future profession.

OBJECTIVES

This paper aims to examine nursing students' orientation and attitudes towards nursing at the beginning of their educational programme, and to explore predictors of positive orientation and attitudes.

DESIGN

The study used a quantitative cross-sectional design.

SETTINGS

A survey was conducted among first-year nursing students at four nursing universities of applied sciences in the Netherlands.

PARTICIPANTS

Questionnaires were administered to all students enrolled in a bachelor of nursing programme (n=1414) at these universities.

METHODS

Respondents completed a survey consisting of: 1) Nursing Orientation Tool, 2) Nursing Attitude Questionnaire, and 3) demographic data such as gender, living status, nursing experience, preliminary training, first-choice programme, and career choice. Kruskal Wallis tests, with post hoc Mann Whitney U tests, were used to compare group scores. Multiple regression was performed to investigate predictors of positive orientation and attitudes towards nursing.

RESULTS

Students in this study sample (n=1244) strongly agreed with statements related to caring, nursing expertise, professional nursing knowledge and the application of this knowledge. Predictors of positive orientation and attitudes towards nursing include having nursing/caring experience, indicating nursing as the first choice for study, preliminary vocational training, and a desire to make a career in nursing.

CONCLUSIONS

Data from this survey suggest a link between personal and environmental characteristics and motivations to select nursing as a career. Understanding which factors predict positive orientation and attitudes towards nursing could offer educators a tool in the recruitment and selection assessment of new students.

Changing negative stereotypes regarding aging in undergraduate nursing students

OBJECTIVE

The aim of this study was to explore the modification of stereotypes and myths regarding aging among third-year nursing students before and after undergoing an Aging Nursing course.

METHOD

A within-subject repeated-measures descriptive study was conducted. The Negative Stereotypes Questionnaire about Aging (CENVE) was used.

RESULTS

The overall prevalence of negative stereotypes was 62.0% pre-intervention (P1) and 12.3% post-intervention (P2) measured; these values were 63.5% (P1) and 9.2% (P2) for the health factor, 43.1% (P1) and 4.9% (P2) for the motivation and social factors and 58.3% (P1) and 3.8% (P2) for the character-personality factor. Paired Student's t tests confirmed that the differences were statistically significant.

CONCLUSIONS

There was a high prevalence of negative stereotypes toward aging among the nursing students, even though they had conducted clinical practice and were in their third year. The course was demonstrated to be effective in modifying these stereotypes. The proper training of future professionals markedly contributes the dispensation of proper care and the eradication of ageism, which remains prevalent in the healthcare system.

Males in Dietetics, What Can Be Learned from the Nursing Profession? A Narrative Review of the Literature

In Canada 95% of dietitians are female despite serving a sex-diverse population. Literature examining why there are so few male dietitians is limited. However, nursing, like dietetics, is female dominated but has a large body of literature examining sex diversity within the profession. Therefore, a narrative literature review was conducted to find articles that examined the following questions: (i) What are the barriers and motivating factors for prospective male nursing students? and (ii) What are the perceived sex-based challenges that male nursing students encounter during their education? A total of 38 articles were included in the final review and the results are presented under the following headings: barriers, motivators, and educational experiences both in the classroom and during clinical rotations. The review outlines the current state of knowledge regarding sex as it relates to nursing and how this information compares with the current dietetics literature. Conclusions and recommendations are drawn about what changes could be made in dietetic education immediately and how further research could provide insight towards reducing the barriers and facilitating easier access to dietetics education for males.

Increasing gender and ethnic diversity in the health care workforce: The case of Arab male nurses in Israel

BACKGROUND

Despite recent attempts at increasing health care workforce diversity, a measure that was found to reduce health disparities, men remain a minority in the traditionally female occupation of nursing. One exception to this observation is the Arab ethnic minority in Israel that includes numerous male nurses.

OBJECTIVE

Determining the percentage of Arab male nurses in the Israeli health care system and understanding how they perceive and negotiate their masculinity.

METHODOLOGY

We used both quantitative and qualitative methodologies. Quantitative statistics were obtained from the 2011 to 2013 Labor Force Survey conducted by the Israel Central Bureau of Statistics and qualitative data derived from 13 semi-structured, in-depth interviews with Arab nurses working in Israeli public hospitals, conducted during 2014.

FINDINGS

Nursing constitutes a prominent employment path for Arab men in Israel and is more prominent as an employment path for Arab men than that for Jewish men. A total of 38.6% of all Arab nurses were men and only 7.5% of Jews and others. Quantitative data thus reveal that men do not constitute a minority among Arab nurses. Similarly, qualitative findings show that Arab male nurses do not manifest marginal masculinity but rather demonstrate many elements of hegemonic masculinity. Arab male nurses distinguish themselves and differentiate their roles from those of female nurses, expressing their motives for choosing the nursing profession in terms of hegemonic gender roles for men in Arab society in Israel.

CONCLUSIONS

Although nursing is a traditionally female occupation, it offers an opportunity for Arab men to demonstrate their masculinity. Arab male nurses choose nursing as a means rather than an end, however, meaning that many of them might not remain in the profession. This observation is significant because of the importance of retaining men from ethnic minorities in nursing, especially in multicultural societies.

Career interest, self-efficacy, and perception in undecided and nursing undergraduate students: a quantitative study

Career choice variables of career interest, self-efficacy, and perception were chosen based upon Social Cognitive Career Theory concepts for study between nursing and undecided undergraduate student groups. Components of the Career Search Questionnaire and Perceptions of Professional Nursing instruments were combined and adapted to form the Career Choice Survey for use in this research. This web-based survey totaling 40 questions was sent to 577 undergraduate students with a 12% response rate (N=68). Due to the need to increase nursing recruitment and retention, hypotheses were developed that distinguish if any relationship existed between groups. Findings of this quantitative study resulted in statistically significant results on two of the three variable hypotheses (p=.006 for career interest, p=.002 for self-efficacy, p=.395 for perception), aligning with previous research and provide insight into the change in nursing perception. Overall, scores for each subscale were encouraging to current nurses and expected from undecided students. Implications for practice include increases in accurate nursing portrayal in the media and early career counseling to younger populations. Nurse educators can further research in career choice with focus on continuing education for current nurses and recruitment of young nursing hopefuls.

Gender differences in the academic and clinical performances of undergraduate nursing students: a systematic review

OBJECTIVES

Nursing is often regarded as a female-dominated profession. Many nursing curricula are received by mainly female students. It is uncertain how male students behave in this environment of nursing education in hospitals and universities. This article aimed to review gender differences in the academic and clinical performances of undergraduate nursing students.

DESIGN

A systematic review was assessed and different themes were extracted by inductive approach.

DATA SOURCES

A search strategy was carried out for the period 2006-2011 utilising six computerised databases: Academic Search Premier, CINAHL, ERIC, MEDLINE, ScienceDirect, and the Wiley Online Library.

REVIEW METHODS

Research studies were included and screened by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. All articles in English that met our aim were selected and relevant results were abstracted and thematised.

RESULTS

Fifty-five articles were included. Five themes were generated from the literatures, including the differences of academic, clinical, psychological, nursing profession identity and health concept between male and female nursing students.

CONCLUSIONS

Both genders performed similarly in different aspects. Most studies revealed that the clinical placement satisfaction of male students was similar to that of female, despite the negative experiences the former faced during obstetric placement. Further research is needed to examine the gender differences in studying and make changes in the nursing curricula to accommodate with male students.

Clinical role of the nurse: concept analysis

AIMS AND OBJECTIVES

To identify the attributes of the concept 'clinical role of the nurse' in the literature.

BACKGROUND

The concept of nurses' clinical role is frequently mentioned in literature, but hardly explored in conceptual terms. This has implications for nursing practice and education.

DESIGN

Qualitative and descriptive study, which corresponds to the first phase in the concept development of the qualitative concept analysis method - identification of concept attributes.

METHODS

The critical literature analysis method was used to identify the antecedents, defining attributes and consequences of the nurse's clinical role. A systematic literature search was undertaken in International Literature in Health Sciences, Cumulative Index to Nursing and Allied Health Literature and Latin American and Caribbean Health Sciences.

RESULTS

The clinical role was shown to be a process of complex interaction between nurse and patient, with critical thinking, informed experience and a sense of clinical autonomy as its antecedents. Consequences of nurses' clinical role include transformations in the organisation and process of nursing practice. A theoretical proposal was elaborated for the concept of the clinical role of the nurse, identifying the defining attributes, antecedents and consequences.

CONCLUSIONS

The clinical role of the nurse concept that was developed represents innovative evidence on the theme. Nevertheless, a deeper understanding of nurses' clinical role is needed, as well as refinement of its conceptual components. This study should be integrated into a field research project, designed to illuminate how nurses manifest and articulate the concept in clinical practice.

RELEVANCE TO CLINICAL PRACTICE

Knowledge of clinical role attributes, associated with nursing competencies, can contribute to reflection on the dimensions involved in nursing practice and inform not only teaching and professional practice, but also health policies.

Factors influencing nursing career choices and choice of study program

In advance of a recruitment campaign, Israeli first-year nursing students of all ethnicities were surveyed to elucidate what factors had influenced them to make nursing their career and what sort of training track they preferred. The responses made it clear that different factors influence different groups differently. There were noticeable differences by gender, age, and ethnicity. Overall, training institutions were chosen for their closeness to the student's home but other factors also operated among particular groups, such as institutional prestige and flexible entry criteria. There was a blatant preference for academic, particularly university-sited, programs over diploma programs.

First year nursing students' viewpoints about compromised clinical safety

OBJECTIVE

Undergraduate nursing students must uphold patient safety as a professional and moral obligation across all clinical learning experiences. This expectation commences at entry into the nursing program. As part of a larger study exploring undergraduate baccalaureate nursing students' understanding of clinical safety, this paper specifically focuses on first year students' viewpoints about unsafe clinical learning situations.

METHODS

Q-methodology was used. Sixty-eight first year nursing students participated in the ranking of 43 statements indicative of unsafe clinical situations and practices. Data was entered into a Q-program for factor analysis.

RESULTS

The results revealed a typology of four discrete viewpoints of unsafe clinical situations for first year students. These viewpoints included an overwhelming sense of inner discomfort, practicing contrary to conventions, lacking in professional integrity and disharmonizing relations. Overall, a consensus viewpoint described exonerating the clinical educator as not being solely responsible for clinical safety.

DISCUSSION

This information may assist students and educators to cooperatively and purposefully construct a clinical learning milieu conducive to safety.

Measuring the qualities of nurses: development and testing of the Qualities of Nurses Scale

AIM

This paper reports on the creation, development and testing of a new instrument to measure qualities of nurses, known as the Qualities of Nurses (QON) scale, applicable to student nurses.

BACKGROUND

High attrition rates within nursing programs and during early postgraduate years are an international phenomena. Mismatches between idealized perceptions of nursing and the realities of education and clinical experiences have been identified as contributing factors.

METHOD

A survey method was used to elicit responses to scale items from 678 first-year nursing students at a large university.

RESULTS

A one-factor 12-item solution explaining 47 percent of variance in the construct was demonstrated.

CONCLUSION

The QON can assist in the initial assessment and ongoing monitoring of changes in students' perceptions of nurses. Using the QON, researchers and educators can identify initial student nurses' perceptions and any changes associated in educational or other events that ultimately could be manipulated to reduce attrition.

Voices From a Minority

In Hong Kong, males constituted only about 10.2% of the nursing workforce in 2010. The learning experiences of male nursing students in Hong Kong during their clinical practicum have rarely been explored. If these students cannot maintain their psychological well-being and psychological health in formal education and clinical placements, then their physical health will also suffer. This ethnographic qualitative study gave male nursing students in Hong Kong a chance to voice their experiences during their clinical practicum. Selected through snowball sampling, 18 male nursing students from a local university participated in individual face-to-face semistructured interviews. The data were processed with content analysis. The findings indicated that male students not only received more support and understanding from male rather than female members of staff but endured a certain amount of oppression while working in female wards. According to the students’ comments on nursing culture, the work climate of male nursing students could be improved by reorganizing the clinical placements and providing extra support to male nursing students.

The nurses' self-concept instrument (NSCI): a comparison of domestic and international student nurses' professional self-concepts from a large Australian University

Professional self-concept is a critical driver of job satisfaction. In Australia, as international nursing enrolments rise, nursing is increasingly characterised by a professional body of international nurses who may differ from domestic Australian nurses in their nursing self-concept. At present, little is known about the extent to which domestic and international students nurses' self-concepts may differ. The present study aimed to elucidate and contrast domestic and international nursing students' self-concepts from one large Australian university. A total of 253 domestic (n=218) and international (n=35) undergraduate nursing students from a large public university in Sydney, Australia completed the Nurses' Self-Concept Instrument (NSCI). Multiple-Indicator-Multiple-Indicator-Cause (MIMIC) modelling was used to assess the effects of student group (domestic and international) on the latent self-concept factors of the NSCI. Domestic and international students' professional self-concepts were similarly high. MIMIC modelling demonstrated that domestic students had a higher patient care self-concept in comparison to international students. Results imply that it may be useful for Australian universities to foster strategies that enhance specific domains of self-concepts (e.g., care) which may be underdeveloped for at least some cultural groups within the international nursing student population compared with domestic nursing students.

Relational dimensions of a positive integration experience for new mental health nurses

This study investigated the key aspects of a successful integration experience into mental health nursing from the perspectives of new nurses working in a psychiatric institution. Analysis of 10 semistructured interviews revealed that the relational atmosphere in which new nurses find themselves is determinant of their satisfaction with their integration experience. Quality relational connections with patients constitute the primary motivation of new nurses in choosing a career in mental health. At the same time, quality relational connections between and among team members sustain such motivation. Conversely, a negative relational atmosphere sets the stage for new nurses to experience disillusionment and despair.