DOI QR코드

DOI QR Code

Threats to Identity: A Grounded Theory Approach on Student Nurses' Experience of Incivility during Clinical Placement

정체성 위협: 임상실습 중 간호대학생의 무례함 경험에 관한 근거이론적 접근

  • Received : 2017.08.08
  • Accepted : 2018.02.09
  • Published : 2018.02.28

Abstract

Purpose: This qualitative study aimed to explore the experience of incivility among nursing students. Methods: Sixteen nursing students who had experienced incivility during their clinical placement were invited for one-on-one interviews until the point of theoretical saturation. The grounded theory approach of Corbin and Strauss was adopted to analyze transcribed interview contents. Results: Incivility occurred in the context of a hierarchical organizational culture, due to nursing students' position as outsiders, non-systematic clinical education, and poor nursing work environment. The experience of incivility was identified as "being mistreated as a marginal person," and nursing students responded to this phenomenon in the following three steps: reality shock, passive action, and submissive acceptance. This process caused students to lose self-esteem and undergo role conflict. Furthermore, nursing students' experience of incivility could eventually lead to workplace bullying in nurses. Conclusion: The results of this study suggest that nursing students' experience of incivility can be a process that threatens their identity. It is necessary to develop educational programs and provide appropriate counseling services so that nursing students can actively cope with the incivility. In addition, institutional plans are needed to ensure safe and supportive clinical learning environments.

Keywords

References

  1. Korea Nurses Association. Resources; statistics of educational institution [Internet]. Seoul: Author; c2017 [cited 2017 Oct 20]. Available from: http://www.koreanurse.or.kr/resources/statistics.php.
  2. Vallant S, Neville S. The relationship between student nurse and nurse clinician: Impact on student learning. Nursing Praxis in New Zealand. 2006;22(3):23-33.
  3. Wallace L, Bourke MP, Tormoehlen LJ, Poe-Greskamp MV. Perceptions of clinical stress in Baccalaureate nursing students. International Journal of Nursing Education Scholarship. 2015;12(1). https://doi.org/10.1515/ijnes-2014-0056
  4. Anthony M, Yastik J, MacDonald DA, Marshall KA. Development and validation of a tool to measure incivility in clinical nursing education. Journal of Professional Nursing. 2014;30(1):48-55. https://doi.org/10.1016/j.profnurs.2012.12.011
  5. Babenko-Mould Y, Laschinger HK. Effects of incivility in clinical practice settings on nursing student burnout. International Journal of Nursing Education Scholarship. 2014;11(1):145-154. https://doi.org/10.1515/ijnes-2014-0023
  6. Clarke CM, Kane DJ, Rajacich DL, Lafreniere KD. Bullying in undergraduate clinical nursing education. Journal of Nursing Education. 2012;51(5):269-276. https://doi.org/10.3928/01484834-20120409-01
  7. Rad M, Ildarabadi EH, Moharreri F, Karimi Moonaghi H. Causes of incivility in Iranian nursing students: A qualitative study. International Journal of Community Based Nursing and Midwifery. 2016;4(1):47-56.
  8. National Institute of Korean Language. The Korean standard dictionary [Internet]. Seoul: Author; c2017 [cited 2017 Oct 18]. Available from: http://stdweb2.korean.go.kr/main.jsp.
  9. Anthony M, Yastik J. Nursing students'experiences with incivility in clinical education. Journal of Nursing Education. 2011;50(3):140-144. https://doi.org/10.3928/01484834-20110131-04
  10. Tecza BM, Boots BK, Clay PM, Kirkman KS, Mains BC, Newton EE, et al. Development of an instrument to measure civil and uncivil behaviors in the hospital clinical environment: Implications for nurse leaders. Journal of Nursing Administration. 2015;45(7-8):391-397. https://doi.org/10.1097/NNA.0000000000000220
  11. Hunt C, Marini ZA. Incivility in the practice environment: A perspective from clinical nursing teachers. Nurse Education in Practice. 2012;12(6):366-370. https://doi.org/10.1016/j.nepr.2012.05.001
  12. Longo J. Horizontal violence among nursing students. Archives of Psychiatric Nursing. 2007;21(3):177-178. https://doi.org/10.1016/j.apnu.2007.02.005
  13. Einarsen S, Hoel H, Notelaers G. Measuring exposure to bullying and harassment at work: Validity, factor structure and psychometric properties of the Negative Acts Questionnaire-Revised. Work and Stress. 2009;23(1):24-44. https://doi.org/10.1080/02678370902815673
  14. Felblinger DM. Incivility and bullying in the workplace and nurses' shame responses. Journal of Obstetric, Gynecologic, & Neonatal Nursing. 2008;37(2):234-242. https://doi.org/10.1111/j.1552-6909.2008.00227.x
  15. Celik SS, Bayraktar N. A study of nursing student abuse in Turkey. Journal of Nursing Education. 2004;43(7):330-336.
  16. Lasiter S, Marchiondo L, Marchiondo K. Student narratives of faculty incivility. Nursing Outlook. 2012;60(3):121-126. https://doi.org/10.1016/j.outlook.2011.06.001
  17. Thomas J, Jinks A, Jack B. Finessing incivility: The professional socialisation experiences of student nurses' first clinical placement, a grounded theory. Nurse Education Today. 2015;35(12):e4-e9. https://doi.org/10.1016/j.nedt.2015.08.022
  18. Ibrahim SA, Qalawa SA. Factors affecting nursing students' incivility: As perceived by students and faculty staff. Nurse Education Today. 2016;36:118-123. https://doi.org/10.1016/j.nedt.2015.08.014
  19. Rad M, Karimi Moonaghi H. Strategies for managing nursing students' incivility as experienced by nursing educators: A qualitative study. Journal of Caring Sciences. 2016;5(1):23-32. https://doi.org/10.15171/jcs.2016.003
  20. Hyun MS, De Gagne JC, Park J, Kang HS. Incivility experiences of nursing students in South Korea. Nursing Ethics. Forthcoming 2016 Dec 21. https://doi.org/10.1177/0969733016684546
  21. Jo SO, Oh JA. Validity and reliability of the Korean version of a tool to measure uncivil behavior in clinical nursing education. Journal of Korean Academic Society of Nursing Education. 2016;22(4):537-548. https://doi.org/10.5977/jkasne.2016.22.4.537
  22. Corbin J, Strauss A. Basics of qualitative research: Techniques and procedures for developing grounded theory. 4th ed. Thousand Oaks (CA): Sage; 2015. p. 1-310.
  23. Guba EG, Lincoln YS. Effective evaluation: Improving the usefulness of evaluation results through responsive and naturalistic approaches. San Francisco (CA): Jossey-Bass Publishers; 1981. p. 103-127.
  24. Thomas SP, Burk R. Junior nursing students' experiences of vertical violence during clinical rotations. Nursing Outlook. 2009;57(4):226-231. https://doi.org/10.1016/j.outlook.2008.08.004
  25. Randle J. Bullying in the nursing profession. Journal of Advanced Nursing. 2003;43(4):395-401. https://doi.org/10.1046/j.1365-2648.2003.02728.x
  26. Kang J, Yun S. A grounded theory approach on nurses'experience with workplace bullying. Journal of Korean Academy of Nursing. 2016;46(2):226-237. https://doi.org/10.4040/jkan.2016.46.2.226
  27. Luparell S. Incivility in nursing: The connection between academia and clinical settings. Critical Care Nurse. 2011;31(2):92-95. https://doi.org/10.4037/ccn2011171
  28. Curtis J, Bowen I, Reid A. You have no credibility: Nursing students' experiences of horizontal violence. Nurse Education in Practice. 2007;7(3):156-163. https://doi.org/10.1016/j.nepr.2006.06.002
  29. International Council of Nurses. Fact sheet: Violence: A world-wide epidemic [Internet]. Geneva: International Council of Nurses; c2009 [cited 2017 Jul 10]. Available from: http://www.icn.ch/images/stories/documents/publications/fact_sheets/19k_FS-Violence.pdf.
  30. Rad M, Mirhaghi A, Shomoossi N. Self-assertiveness interfacing incivility in student nurses: Possible outcomes. Nurse Education Today. 2015;35(10):e6. https://doi.org/10.1016/j.nedt.2015.07.016

Cited by

  1. Interventions for coping with bullying need further investigation and should be built into nursing curricula vol.21, pp.3, 2018, https://doi.org/10.1136/eb-2018-102904
  2. “Loving Nursing” and “Taking Responsibility”: Strategies for Transitioning to Practice in Lebanon vol.8, pp.4, 2018, https://doi.org/10.1177/2158244018820376
  3. Differences in the relationship, learning perception and satisfaction of nursing students before and after clinical practice vol.24, pp.4, 2018, https://doi.org/10.9708/jksci.2019.24.04.145
  4. 간호대학생의 임상실습생 권리 인식 경험 vol.25, pp.4, 2019, https://doi.org/10.5977/jkasne.2019.25.4.471
  5. Radiotherapy students’ perceptions of support provided by clinical supervisors vol.19, pp.1, 2018, https://doi.org/10.1017/s1460396919000426
  6. 간호대학생의 임상실습 중 경험하는 무례함의 정도와 스트레스 대처 전략이 간호전문직관 형성에 미치는 영향 vol.10, pp.3, 2020, https://doi.org/10.22156/cs4smb.2020.10.03.104
  7. 간호대학생의 임상실습스트레스와 도덕적 민감성이 임상수행능력에 미치는 영향 vol.26, pp.2, 2018, https://doi.org/10.5977/jkasne.2020.26.2.157
  8. 임상실습 중 태움관찰 경험과 간호전문직관이 간호대학생의 전공몰입에 미치는 영향 vol.10, pp.12, 2018, https://doi.org/10.22156/cs4smb.2020.10.12.049
  9. 간호대학생이 경험한 무례함과 임상실습교육환경이 임상실습스트레스에 미치는 영향 vol.22, pp.2, 2018, https://doi.org/10.5762/kais.2021.22.2.160
  10. 간호대학생의 임상실습 중 폭력경험과 임상학습환경이 직업정체성에 미치는 영향 vol.27, pp.3, 2018, https://doi.org/10.5977/jkasne.2021.27.3.321
  11. Development and Validation of the Nursing Students’ Rights Awareness Scale in Clinical Practice: A Scale Development Study vol.9, pp.10, 2018, https://doi.org/10.3390/healthcare9101323
  12. 간호대학생의 완벽주의 성향과 임상실습현장지도자의 돌봄에 대한 지각이 임상실습 중 경험한 무례함에 미치는 영향 vol.27, pp.4, 2018, https://doi.org/10.5977/jkasne.2021.27.4.436