‘My mentor kicked a dying woman's bed…’ Analysing UK nursing students’ ‘most memorable’ professionalism dilemmas

Rees, Charlotte E.; Monrouxe, Lynn V.; McDonald, Laura A.

doi:10.1111/jan.12457

Cited by 69 publications

(79 citation statements)

References 37 publications

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“…Issues related to suboptimal patient care, hierarchy, respect, mistreatment were identified and were in accordance with previous studies [3, 12, 23, 24]. …”

Section: Discussionsupporting

confidence: 84%

(How) do medical students regulate their emotions?

2016

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BackgroundMedical training can be a challenging and emotionally intense period for medical students. However the emotions experienced by medical students in the face of challenging situations and the emotion regulation strategies they use remains relatively unexplored. The aim of the present study was to explore the emotions elicited by memorable incidents reported by medical students and the associated emotion regulation strategies.MethodsPeer interviewing was used to collect medical students’ memorable incidents. Medical students at both preclinical and clinical stage of medical school were eligible to participate. In total 104 medical students provided memorable incidents. Only 54 narratives included references to emotions and emotion regulation and thus were further analyzed.ResultsThe narratives of 47 clinical and 7 preclinical students were further analyzed for their references to emotions and emotion regulation strategies. Forty seven out of 54 incidents described a negative incident associated with negative emotions. The most frequently mentioned emotion was shock and surprise followed by feelings of embarrassment, sadness, anger and tension or anxiety. The most frequent reaction was inaction often associated with emotion regulation strategies such as distraction, focusing on a task, suppression of emotions and reappraisal. When students witnessed mistreatment or disrespect exhibited towards patients, the regulation strategy used involved focusing and comforting the patient.ConclusionsThe present study sheds light on the strategies medical students use to deal with intense negative emotions. The vast majority reported inaction in the face of a challenging situation and the use of more subtle strategies to deal with the emotional impact of the incident.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0832-9) contains supplementary material, which is available to authorized users.

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“…Issues related to suboptimal patient care, hierarchy, respect, mistreatment were identified and were in accordance with previous studies [3, 12, 23, 24]. …”

Section: Discussionsupporting

confidence: 84%

(How) do medical students regulate their emotions?

2016

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“…Thus, nursing students experience morally distressing situations and they witness circumstances of care and behavior that are morally inappropriate in the academic environment, disrespect to the subjects and their rights, incompatible with their values, principles and personal standards learned during their academic training, possibly experiencing moral distress (MD). Studies on MD in nursing students have been prominent in the international (1,(3)(4)(5)(6)(7) and national (8)(9)(10) fields. In this context, students may face difficulties to resist disciplinary mechanisms of power, which aim to form docile bodies with maxims of obedience and submission to norms and hierarchy (11) .…”

Section: Introductionmentioning

confidence: 99%

Nursing students facing moral distress: strategies of resistance

et al. 2018

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Objective: To understand the resistance strategies adopted by undergraduate students in nursing, faced with situations of moral distress (MD). Method: Qualitative research, developed in three universities in the south of Brazil, two federal and one private, with 21 undergraduate students in nursing from December 2015 to February 2016; the data was submitted to the discursive textual analysis and Foucauldian theoretical reference. Results: Students resisting demonstrate a sense of self-preservation and moral empowerment. Moreover, non-resistance initiatives are related to the fear of possible sanctions. Thus, by resisting or not, students may experience both positive and negative repercussions. Final considerations: By resisting, students aim to defend what they believe to be right, demonstrating their moral empowerment in the face of their moral distress. However, the exercise of disciplinary power seems to contribute to their moral fragilization, making it diffi cult to implement resistance strategies. Descriptors: Nursing Students; Nursing Education; Power; Moral; Ethics. RESUMO Objetivo: Compreender as estratégias de resistência adotadas pelos estudantes de graduação em enfermagem, diante de situações de sofrimento moral (SM). Método: Pesquisa qualitativa, desenvolvida em três universidades do sul do Brasil, duas federais e uma privada, com 21 estudantes de graduação em enfermagem, entre dezembro de 2015 e fevereiro de 2016; os dados foram submetidos à análise textual discursiva e referencial teórico foucaultiano. Resultados: Os estudantes ao resistirem demonstram um senso de autopreservação e fortalecimento moral. Ainda, ações de não resistência relacionam-se ao medo de possíveis sanções. Assim, ao resistir ou não, os estudantes podem vivenciar repercussões tanto positivas como negativas. Considerações fi nais: Ao resistir, os estudantes visam defender o que acreditam ser o correto, demonstrando seu fortalecimento moral diante do sofrimento moral. No entanto, o exercício do poder disciplinar parece contribuir para sua fragilização moral, difi cultando a implementação de estratégias de resistência. Descritores: Estudantes de Enfermagem; Educação em Enfermagem; Poder; Moral; Ética. RESUMEN Objetivo: Comprender las estrategias de resistencia adoptadas por los estudiantes de graduación en enfermería, ante situaciones de sufrimiento moral (SM). Método: La investigación cualitativa, desarrollada en tres universidades del sur de Brasil, dos públicas y una privada, con 21 estudiantes de graduación en enfermería, entre diciembre de 2015 y febrero de 2016; los datos fueron sometidos al análisis textual discursivo y referencial teórico foucaultiano. Resultados: Los estudiantes al resistir demuestran un sentido de autopreservación y fortalecimiento moral. Aún, acciones de no resistencia se relacionan con el temor de posibles sanciones. Así, al resistir, o no, los estudiantes pueden experimentar repercusiones tanto positivas como negativas. Consideraciones fi nales: Al resistir, los estudiantes pretenden defende...

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“…, Rees et al . ), the UK and Australia (Levett‐Jones & Lathlean ), the UK and Japan (Bradbury‐Jones et al . ) and Israel (Mansbach et al .…”

Section: Introductionmentioning

confidence: 99%

Accounting for actions and omissions: a discourse analysis of student nurse accounts of responding to instances of poor care

Ion

Smith

Moir

et al. 2016

Journal of Advanced Nursing

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‘My mentor kicked a dying woman's bed…’ Analysing UK nursing students’ ‘most memorable’ professionalism dilemmas

Abstract: Findings extend previous research with nursing and medical students. Nurse educators should help students construct emotionally coherent narratives to make sense of their experiences, actions and identities and to better prepare them for future professionalism dilemmas.

Cited by 69 publications

References 37 publications

(How) do medical students regulate their emotions?

(How) do medical students regulate their emotions?

Nursing students facing moral distress: strategies of resistance

Accounting for actions and omissions: a discourse analysis of student nurse accounts of responding to instances of poor care

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