Elsevier

Nurse Education Today

Volume 24, Issue 7, October 2004, Pages 511-520
Nurse Education Today

Keeping afloat: student nurses’ experiences following assignment referral

https://doi.org/10.1016/j.nedt.2004.06.004Get rights and content

Summary

The retention of nursing students is an ongoing problem, both within the United Kingdom (UK) and internationally. While there is a plethora of literature relating to student attrition, there is an absence of evidence in relation to the experiences of those students who are struggling to meet the demands of nursing programmes. Using an inductive sociological enquiry based approach, this study sought to examine the experiences of student nurses after referral on the first attempt of a summative assessment. Nursing students who had failed an assignment (n = 20) were invited to participate. Data was collected using focus groups, with the emergent themes collapsed into a concise format using thematic content analysis. Four key themes were identified: desire to succeed; acceptance of personal failure; recognition of personal attributes required for success; and responsibility for personal success and failure. Students remained on the programme, despite struggling with financial and personal difficulties, because the desire to become a qualified nurse outweighed transient hardships. This paper will illustrate the benefits of understanding the students’ experiences, in order to ensure the support students receive is appropriate to their needs. Understanding the support strategies as perceived by the students may prevent further wastage from nursing programmes.

Introduction

Although there are a plethora of studies, which explore the common reasons why student nurses leave prior to completing nursing programmes (Glossop, 2001; Richardson, 2000; White et al., 1999; Hughes, 1998), there does not appear to be any evidence relating to the strategies that support those who ‘stay the distance’. If nurse educators are to build upon good practice in supporting students they must understand these supportive strategies, because capturing the how and why students are successful may assist in combating attrition. These concepts formulated the basis of this study, which centred upon questioning why some students who are developing well in clinical practice but failing in academic work go on to complete the course and become successful practitioners, while others are lost to the nursing profession. The aim of this paper is to examine the experiences of a group of students after referral on the first attempt of a summative assessment in order to identify potential strategies that could be adopted to support academically weak students, through the application of inductive sociological enquiry based approach (Bailey, 1997).

Section snippets

Literature review

In order to contextualise issues relating to student progression, attrition, education and student status, and student support will be discussed.

Attrition

During the last 15 years, nurse education within the UK has undergone major reforms, firstly with the introduction of Project 2000 (UKCC, 1986), which has recently been superseded by the introduction of the Making a Difference (DoH, 1999) programme. The overall aim of these modernization programmes have been twofold; namely to improve the professional standing of nurses within the UK, and to improve the retention of student nurses. Although it is too early to consider the impact Making a

Education and student status

Concerns relating to the ‘status’ of nursing students, within the UK, were identified as early as the 1940s (Wood, 1947). The Briggs Report (HMSO, 1972) and the more recently established United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC, 1986), have highlighted the repetitive nature of the work of nursing apprentices and the lack of learning opportunities in practice. However, students did not become supernumerary to the National Health Service (NHS) staffing

Student support

Briggs, 1972 identified the importance of nurturing students and suggested that in clinical practice one registered practitioner should support an individual student. This has been difficult to achieve with the increasing demand for student practice placements and the decreasing number of qualified practitioners. Macleod Clark (1998) identified adequate support as a significant factor that contributed directly to the retention of student nurses. Furthermore, she suggested that the problems of

Methodology

A desire to explore the emic perspectives of students who stay on their course following assignment referral, the paucity of research related to the phenomena, and a genuine wish to understand the students’ feelings and attitudes, validated the choice of methodology (Flemming, 1998); an inductive sociological enquiry based approach. Focus groups were used in order to reveal the student’s own perspectives and facilitate naturalistic expression.

Sample

An adequate and appropriate sample determines the quality of the research generated (Morse, 1991). Therefore, a purposeful sample (Ziebland and Wright, 1997) containing participants, who had experienced assignment referral and were willing to share personal insight with the focus groups was obtained. The participants were conveniently sampled from cohorts that were easily accessible on the days the research data was collected. The total number of participants (n = 20) were assigned to two groups

Results and discussion

The categories that emerged from the data could be linked, after much discussion and reworking, into four key themes (Fig. 2):

  • Desire to succeed

  • Acceptance of personal failure

  • Recognition of personal attributes that are required for success

  • Responsibility for both personal success and failure

Conclusions

From the outset the purpose of this study was to try and understand the students’ experiences of the positive and negative aspects that are related to their academic assignments throughout their studentship. The literature review identified the complexities that surround nursing and nurse education including legislation and societal change along with the demographic and epidemiological picture of today (DoH, 1999; UKCC, 1999). Attrition from nursing programmes is a multi-faceted problem and

Recommendations

Recommendations from this study include:

  • Providing a range of academic support mechanisms, which are transparent and foster student participation such as; generic support led by a designated student support lecturer, ‘buddying’ with a more senior student, study skills groups.

  • More explicit development of time management skills.

  • The provision of realistic financial advice.

  • Review, as a matter of urgency, student finances, which will reflect the nursing student profile for example students’ who have

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