Student nurse non-attendance in relation to academic performance and progression.

BACKGROUND: High levels of non-attendance are reported in nurse education programmes even though literal interpretation of UK national guidelines implies mandatory student attendance is a requirement for all elements of pre-registration undergraduate programmes. OBJECTIVES: To examine relationships between undergraduate student nurse non-attendance, academic performance and progression. DESIGN: A quantitative study using audit approaches was undertaken. PARTICIPANTS: The records of 1347 undergraduate student nurses who had studied at a university in the north west of England were analysed. METHODS: Following data coding and input into an SPSS database descriptive and chi-square analyses were conducted to explore the associations between non-attendance rates and age, sex, entry qualifications, year of study and degree classification. RESULTS: The characteristics of the sample were that the majority were female, aged under 21years and had 'A' level entry qualifications. Significant chi-square associations were found in regard of age at entry and entry qualifications with degree classification. Significant chi-square associations were also identified between degree classification and non-attendance across all three years of the programme. CONCLUSIONS: The findings that non-attendance is positively associated with degree outcome across all the three years of study are in keeping with the findings of several studies. Many of these findings will help inform future student attendance policies where the study was conducted and are insightful for other national and international institutions that offer nurse education programmes.

Issues concerning recruitment, retention and attrition of student nurses in the 1950/60s: a comparative study.

AIM: To investigate student nurse recruitment and attrition in the 1950' and 1960s and undertake comparisons to modern day concerns. The study was set in one hospital in the U.K. BACKGROUND: In the period studied nursing was unpopular as a profession and there were difficulties surrounding recruitment. Attrition rates were high. METHOD: Documentary analysis of 641 training records dating 1955 to 1968 was undertaken. Attrition rates, reasons for non-completion and employment following successful completion were determined. RESULTS: Most recruits were young, unmarried, females and had overseas addresses. The majority (n = 88) had prior nursing experience. Over 69% (n = 443) successfully completed their training. Attrition rates were over 30% (n = 198), the main reason being academic failure. Following completion over 40% (n = 183) undertook midwifery training (n = 183) or secured a staff nurse post (n = 153). CONCLUSIONS: Issues relating to recruitment, retention and attrition in the 1950s and 1960s put into context present day issues. Recent attrition rates from pre-registration nurse education have fallen, nevertheless some of the issues of yesteryear remain problematic. In the present study significant numbers of entrants left due to domestic and ill-health problems resonates with many modern day studies. Also failure to complete due to academic shortcomings continues to be a concern.

A context analysis of student training records dating from the 1950/1960s: what were desirable and undesirable student nurse characteristics?

AIM: The aim of this study is to identify what were desirable and undesirable student nurse characteristics in the 1950/1960s and relate them to those who had successfully completed the programme and gained State Registration and those who had not. A further aim was to undertake comparisons with modern day values of what are viewed as desirable traits in nurses. BACKGROUND: In the 1950/1960s student nurses were hospital employees. Nurse training was based in hospital training schools and coordinated by sister tutors. Learning about nursing largely took place in clinical settings where there was limited supervision of student nurses by qualified nurses. DESIGN: Content analysis approaches were used whereby positive and negative comments related to successful and unsuccessful completers were identified. METHODS: Data were extracted from individual training records relating to 641 student nurses. The records dated from 1955 to 1968. Clinical and training school reports were summarized by senior hospital figures such as the hospital matron. These reports were the focus of the analysis. FINDINGS: Desirable student nurse traits identified in the analysis were being a 'nice person', who is kind, compassionate and attentive to patients, conscientious, bright and intelligent. Other values such as being hard-working, reliable and punctual reflect that the students studied were primarily employees. Amenable to discipline and unquestioningly obeying a doctor's order also were part of the conventions of the time. Most negative comments related to the unsuccessful completers. CONCLUSIONS: New insights into what was viewed as desirable and undesirable nursing characteristics in the 1950/1960s are identified. These insights have national and international relevance.

Why do students fail to disclose health problems?

BACKGROUND: At the university where this study took place, pre-qualifying healthcare students had previously been enrolled on programmes and were found to have pre-existing and ongoing health problems, which caused difficulties for some students during clinical placements. AIM: To develop a web-based information zone dealing with students' concerns about fitness-to-practise issues. METHOD: A three-stage study involving an online student survey, in-depth student interviews and development of a university web-based information zone was carried out. RESULTS: The web zone's content is based on key areas of importance identified by students who participated in the study. CONCLUSION: Early indications show that prospective and current students regularly use the web zone, demonstrated by the number of site hits.

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.

Resilience to care: a systematic review and meta-synthesis of the qualitative literature concerning the experiences of student nurses in adult hospital settings in the UK.

AIM: The aim of the study was to gain new insights into the experiences and accounts of adult pre-registration student nurse clinical allocations in hospital settings in the UK. DESIGN: A systematic review and meta-synthesis of the qualitative literature was undertaken. DATA SOURCES: Pertinent papers published from 1990 to 2010 were identified through searches of Cumulative Index for Nursing and Allied Health Literature, Proquest, Medline (PubMed), and the British Nursing Index. Hand and citation searching was also undertaken. REVIEW METHODS: Ten relevant papers were identified for review. Quality checks on the robustness of the studies were undertaken. Data extraction included identifying details of the study's settings, sample details, focus of the study, research design, data collection methods, data analysis approaches and qualitative data themes. RESULTS: Approximately 40 qualitative data themes were identified and were the subject of a meta-synthesis. Five cross-cutting synthesised data themes were identified including: pre-placement anticipation, the realities of the clinical environment, clinical learning and becoming a nurse. Stress and coping was a concurrent topic area and related to all the synthesised themes. CONCLUSIONS: The findings give new insights into the clinical experiences of student nurses of which the stress of learning in clinical environments and the development of emotional resilience is a focal issue. Whilst the majority of students in the UK experience nurturing, caring clinical environments and positive staff relationships, however, some do not. Reports of negative student nurse clinical experiences are shown in this review to have endured through time. Nurse educators should be alert to the possibility that some students may have very negative clinical experiences. The consequences such negative experiences will affect such things as increases to student attrition and the help perpetuate the cycle of negative clinical learning experiences occurring in the future.

Consensus and diversity: an action research study designed to analyse the roles of a group of mental health consultant nurses.

AIM: The purpose of this action research study was to enable a group of mental health consultant nurses in the UK to map the scope and dimensions of their roles. This initial benchmarking exercise is a precursor to the development of plans for role improvement and evaluation. BACKGROUND: There is a growing body of literature that addresses advanced nursing practice roles. There is, however, no international agreement on what constitutes an advanced practice role. A few countries have addressed the statutory requirements governing such roles. Consultant nurses' roles in the UK are relatively new innovations that aim to enhance care. However, only a few investigations have evaluated the dimensions and impact of these roles. METHODS: The study was framed by use of action research as a form of self-reflective enquiry. Initial data were generated through use of four focus group discussions, which were held with a group of consultant nurses employed predominately at a mental health National Health Service Trust. Five structured confirmatory questionnaires developed from the focus group data were also administered. FINDINGS: Analysis of the focus group data gave five themes, 71 categories and 271 items that were used to inform development of the questionnaires. Responses to the questionnaire showed that 61% (n = 166) of the items had non-consensus responses. It was found there was most consensus relating to leadership theme with 63% (n = 19) items having consensus responses. Least agreement was found in the education theme where there was <15% (n = 5) agreement to individual items. CONCLUSIONS: The study demonstrated complexity and variety in how the consultant nurses' roles in the UK are being developed. RELEVANCE TO CLINICAL PRACTICE: The potential for consultant nurse roles to enhance patient care is tremendous. This study provides initial indicators, which the practitioners involved, can use to plot future developments and changes to their roles.

Methodological considerations of undertaking research with clinical mentors in the UK: a critical review of the literature.

The subject of this paper is critical review of the reported research approaches used when undertaking clinical mentor research in the UK. The term 'Mentor' is used to denote a clinical practitioner who is responsible for the teaching, assessing and supervision of student nurses undertaking clinical practice. Imperatives such as new quality assurances in the UK are cited as part of the rationale for conducting the review. In these new initiatives, clinical placements are viewed as an integral feature of Higher Education Institution's (HEI) nurse education provision. Within these new quality assurance processes, there is an emphasis on the importance of clinical learning environments and the impact that mentors have on student learning. A critical review of 19 reports that have clinical mentors as their target population was undertaken. Factors such as the subject areas of the studies reviewed, research methodologies, sampling issues, responses rates and ethical considerations were the focus of the critical appraisal. It was found that most studies used postal survey approaches. Methodological weaknesses were found to relate to such things as questionnaire design, sampling and poor response rates. It is concluded that the study gives further insights into the debate about the rigor of nursing research and particularly nurse education research and therefore is of interest not only to nurse education researchers but also to nurse researchers generally.

Issues surrounding professional portfolio development for nurses.

This article discusses issues that underpin professional portfolio development for registered nurses. The findings were informed by a review of the pertinent literature. The literature was obtained by undertaking searches of a number of electronic databases and hand searches of key journals. It was found that portfolio development has been a requirement for re-registration for a number of years. However, there appears to remain confusion and uncertainty among professionals regarding the meaning and implications of portfolio development for nurses. For example, in the review conducted, the terminology used was often found to be confusing and expectations of how a portfolio should look are unclear. Conclusions can be drawn that practitioners may be in a quandary of how to develop and present evidence in what is now a mandatory requirement for re-registration, the maintenance of a professional portfolio.

Angel, handmaiden, battleaxe or whore? A study which examines changes in newly recruited student nurses' attitudes to gender and nursing stereotypes.

This article presents the findings of a comparative study, which investigated the attitudes of two groups of newly recruited student nurses to gender and nursing stereotypes. The 1992 sample (n=100) was a group of student nurses who were in their second day of studies of a Project 2000 type curriculum. The 2002 sample (n=96) were in their second month of studies of a "Fitness for Practice" curriculum [Fitness for Practice (the 'Peach Report'), UKCC, London, 1999]. Data were collected using a questionnaire, which utilised a Likert scale for measurement of attitudes to statements pertaining to gender and nursing stereotypes. The findings reveal significant differences between the characteristics of the two groups of students. For example, the 2002 group were generally older and had more healthcare experience. However, male representation in the sample groups was similar. The overall high scores and implied propensity towards beliefs in gender and nursing stereotypes in the 1992 study was found not to be the case for the 2002 sample. This is particularly true of most statements related to gender stereotypes, nursing as 'feminine', male nurse stereotyping and issues related to nurses' uniform. However, there is less evidence of changes in attitudes towards female nursing stereotypes with indecision being a general feature of both the 1992 and 2002 responses.

A survey of the health needs of hospital staff: implications for health care managers.

Developing strategies to address the health needs of the National Health Services (NHS) workforce are of concern to many health care managers. Focal to the development of such strategies are of being in receipt of baseline information about employees expressed health needs and concerns. This article addresses obtaining such baseline information and presents the findings of a health needs survey of acute hospital staff in a trust in North Wales. The total population of trust employees were surveyed (n = 2300) and a 44% (n = 1021) response rate was achieved. A number of positive findings are given. Included are that the majority of those surveyed stated that their current health status is good, are motivated to improve their health further, do not smoke and their alcohol consumption is within recommended levels. There appears, however, to be a number of areas where trust managers can help its staff improve their health. Included are trust initiatives that focus on weight control and taking more exercise. In addition, there appears to be a reported lack of knowledge and positive health behaviour amongst the male respondents surveyed that would imply the trust needs to be more effective in promoting well man type issues. Finally there appears to be a general lack of pride in working for the trust and a pervasive feeling that the trust does not care about its employees that needs to be addressed. It is concluded that the findings of this survey have implications for management practices in the trust where the survey was conducted and also wider applicability to the management of health care professionals. For example, addressing work-related psychological and physical problems of employees are of importance to all health care managers. This is especially so when considering recruitment and retention issues.