Student nurses' lived experience of patient safety and raising concerns

Abstract

Following the investigation into the Mid Staffordshire Hospital (United Kingdom) and the subsequent Francis reports (2013 and 2015), all healthcare staff, including students, are called upon to raise concerns if they are concerned about patient safety. Despite this advice, it is evident that some individuals are reluctant to do so and the reasons for this are not always well understood. Study aim: This research study provides an insight into the factors that influence student nurses to speak up or remain silent when witnessing sub-optimal care. Design: An interpretive phenomenological study using the principles of hermeneutics. The study took place in one university in the North of England and the sample consisted of twelve adult nursing students. Methods: Following ethical approval and informed consent, each participant took part in individual semi-structured interviews over a three-year period. Data was transcribed and analysed using 'Framework for Applied Policy Research'. Findings: Four key themes were identified: context of exposure, fear of punitive action, team culture and hierarchy. On the one hand, students recognised there was a professional obligation bestowed upon them to raise concerns if they witnessed sub-optimal practice, however, their willingness to do so was influenced by intrinsic and extrinsic factors. Students have to navigate their moral compass, taking cognisance of their own social identity and the identity of the organisations in which they are placed.

A multi-method exploratory study of health professional students’ experiences with compliance behaviours

“…It is assumed that the issues with negative compliance and the prevailing issues are well documented and understood as negative compliance is becoming more frequently discussed in the literature. However, much of the existing literature covers anecdotal experiences with situations that caused compliance and theoretical suppositions about causes and student experience while lacking causative explanation [24][25][26][27][28][29]. There is a small but emerging body of experimental work on these constructs based in psychological theory [30][31][32][33][34].…”

Conflict, confusion and inconsistencies: Pre‐registration nursing students’ perceptions and experiences of speaking up for patient safety

“…Despite the implementation of large‐scale national and organizational strategies, healthcare professionals continue to be challenged to speak up and keep patients safe (Agency for Healthcare & Quality Research [AHCQR], 2019; Australian Commission on Safety & Quality in HealthCare [ACSQHC], 2019; NHS, 2017). There is strong evidence over the last decade demonstrating that nursing students are perplexed because they frequently encounter situations of unsafe and poor clinical practice (Fisher & Kiernan, 2019; Rees, Monrouxe, & Ajjawi, 2014; Stevanin, Magnusson, Smith, & Pearson, 2014). The circumstances around student speaking up and the consequent impact on students remain relatively under‐explored.…”

A Multi-Method Exploratory Study of Health Professional Students’ Experiences with Compliance Behaviours

“…It is assumed that the issues with negative compliance and the prevailing issues are well documented and understood as negative compliance is becoming more frequently discussed in the literature. However, much of the existing literature covers anecdotal experiences with situations that caused compliance and theoretical suppositions about causes and student experience while lacking causative explanation (Fisher & Kiernan, 2019;Liao, Thomas, & Bell, 2014;Peadon, Hurley, & Hutchinson, 2020;Sur, Schindler, Singh, Angelos, & Langerman, 2016;Voogt et al, 2019;Wray, Yu, & Philbey, 2016). There is a small but emerging body of experimental work on these constructs based in psychological theory (Beran, 2015;Beran, McLaughlin, Al Ansari, & Kassam, 2013;Daly Guris, Duarte, Miller, Schiavi, & Toy, 2019;Kaba, Wishart, et al, 2016;Kuo, Wu, Chen, Chen, & Hu, 2020).…”