An analysis of senior nursing students’ immediate responses to distressed patients

Abstract

The purpose of this study was to determine whether the effectiveness of senior nursing students' immediate responses to patients is influenced by type of distress presented by patients or by type of student degree programme. Forty-four ADN and 31 BSN seniors from four schools agreed to participate. Subjects viewed two videotaped simulations of 'patients' complaining of pain and two of 'patients' manifesting emotional distress. Content validity of simulations was established through nurse experts. After each tape, subjects answered four research questions based on Orlando's nursing process concept. The fourth question asked what subjects would say initially to 'the patient'. The data revealed eight response categories which were scored according to their congruence with Orlando's concepts. Independent categorization of responses yielded a 0.92 inter-related reliability; t-tests indicated that type of distress was related to response effectiveness (P less than 0.01) but type of degree was not (P greater than 0.01). The presumed emphasis on communication and psychosocial foundations in BSN curricula may not translate into more effective exploratory skills in these students. These skills are a key component of the complex assessment skills which enable nurses to 'diagnose human responses' to health problems. Orlando's model is recommended for teaching BSN students to conceptualize the interactional process and its goals.

Nursing student–patient relationship: a review of the literature from 1984 to 1998

“…Stimuli (for example, slides, audiotapes, videotapes or written case studies) were sometimes applied prior to the participant’s answering the questionnaire (Devellis et al . 1984, Brettell 1987, Davis & Jameton 1987, Haggerty 1987). In quasi‐experimental and experimental studies, different methods of instruction were studied to evaluate their effectiveness (see, for example, Rickelman et al .…”

“…The difficulties some students have in distinguishing a patient’s need for psychosocial intervention can result from the anxiety some students experience in interpersonal situations (Davis & Kurtz 1991). In social situations, such as meeting new patients and responding to a patient’s emotional distress, students seem to be less able to function than when performing role‐related activities or responding to a patient’s physical discomfort, for example, pain (McKinstry 1985, Haggerty 1987). Students’ empathy levels are reported to be influenced by their general competence and attentive listening skills, and they seem to have an effect on client care, when, for example, reducing a client’s anxiety (Rogers 1986, Wheeler et al .…”

Nurse‐Expressed Empathy, Patient Outcomes, and Development of a Middle‐Range Theory

“…Orlando's model has been used as a framework for studies in nursing administration (Schmieding, 1990a(Schmieding, , 1990b and nursing education. Haggerty (1987) studied nursing students' responses to distressed patients. Furthermore, discussions of the application of Orlando's conceptual model to practice (Gillis, 1976), education (Haggerty, 1985(Haggerty, , 1987, and administration (Schmieding, 1984) exist in the literature.…”

“…Haggerty (1987) studied nursing students' responses to distressed patients. Furthermore, discussions of the application of Orlando's conceptual model to practice (Gillis, 1976), education (Haggerty, 1985(Haggerty, , 1987, and administration (Schmieding, 1984) exist in the literature. No literature was found that documented an attempt to use the model as a conceptual basis for a communication study specifically about empathy.…”