Remember When We Were Nursing Students
Submitted by Maureen Kroning, RN EdD
I remember, as most nurses can, their days in nursing school, feeling anxious and scared going to clinical rotations to take care of real living patients and not just the mannequins in the lab. Most us can also recall how the floor nurses treated us as students engrossed in our clinical rotations. There were nurses who made a positive impression on us and unfortunately there were nurses who did not make a positive impression. Terms such as “Incivility”, “Bullying”, “Vertical Violence” and “Internal Violence” have become too familiar in today’s nursing literature. As an Associate Professor of Nursing, it is a shame to have to include such terms in nursing lectures and worse of all trying to explain reasons this may be happening among nurses and just may happen to them as nursing students. According to Luparell (2011) “Because today’s student are tomorrow’s colleagues, conversations regarding incivility and bullying should include specific aspects of nursing academia and the preparation of new nurses” (p. 92).
As a Clinical Placement Coordinator, in a BSN program, it is my role to place senior students with a preceptor in an acute care hospital setting. The preceptor has to be a BSN prepared nurse, with preferably 5 years medical/surgical experience. When selecting a preceptor, it is essential to find an RN who enjoys teaching and mentoring students. According to research “mentoring nursing students is a complex and skilled activity, requiring educational preparation, support and recognition” (Atkins, 2008). Nurses who enjoy teaching and mentoring have an invested interest to show the students what nursing care is all about through their eyes. If the preceptor is one who is unhappy in her role as a nurse and does not enjoy teaching then the student’s reflection of what nursing care is all about can be tainted.
Research shows that nursing students have experienced vertical violence while in clinical training. According to Thomas & Burk (2009) vertical violence is a term used to describe abusive behavior RNs direct towards student nurses. Vertical violence in nursing has been recognized more in nursing literature and the reason may be directly related to the increased demands on nurses in the healthcare setting. In a research study that included 346 nursing students and 275 nurses findings included that: nurses reported assault or harassment from external violence or violence from patients, relatives or friends whereas nursing students reported internal violence that of colleagues, staff and others such as doctors, teachers and supervisors (Magnavita & Heponiemi, 2011). As a nursing educator, there is the need to analyze and understand this critical phenomenon and look for ways we can help nurses cope with the increased demands they are facing so that they can mentor our future nurses and illustrate a positive image of nursing.
Nurses today are responsible for a vast array of assessments that require rigorous documentation demands from advanced technological charting systems all geared at capturing all aspects of the patient’s plan of care within the healthcare setting. Much of the patient assessments are geared at documenting care that can be billed for patient reimbursement of services. Nursing has become a complex science in which patient care feels as though it is no longer at the forefront and often the end result is what can be found on the electronic documentation for that seems to be the measurement of what the nurse has proven to of completed during her shift. Perhaps, vertical violence or internal violence is really a symptom of a bigger picture, a picture of nurses having a hard time coping with the increased stressors and taking out these stressors on others, others much more vulnerable. But, what are we, as nurses, doing to our image of nursing, the image we give to our nursing students who look up to us and what about the image of the nurse we would want caring for ourselves, our loved ones and our friends? Most of us, want the image of nursing to be a good one, to be one that is caring, compassionate and knowledgeable and most times that is what I see from nurses caring for patients but there times that this is not the case.
The majority of nursing students are excited about starting their clinical rotations. As RNs we need to preserve the student’s excitement and not substitute that with a fear and dread of working as a RN alongside of a nurse who exhibits any form of incivility or bullying. Registered Nurses who work alongside student nurses need to recall the days that they were students and recall wanting guidance and acceptance from the nurses already practicing in the profession. Nurses are known for their caring and compassion but it should not only be used for patient care but for everyone that the nurse comes in contact with. Caring and compassion need to be attributes nurses have regardless of who they interact with, it needs to be an innate part of who we are as a profession, as a vocation. Nursing students are our future nurses who may one day be providing care for us at our bedside so let’s teach them what kind of nurse we would want.
- Atkins, S. (2008). Registered nurses’ experiences of mentoring undergraduate nursing students. Journal of Advanced Nursing. 21(5). 10006-1015.
- Luparell,S.(2011). Incivility in Nursing: The Connection Between Academia and Clinical Settings. 31(2) 92-95.
- Magnavita,N.& Heponiemi (2011). Workplace Violence Against Nursing Students and Nurses: An Italian Experience. Journal of Nursing Scholarship. 43(2) 203-210.
- Thomas, S. & Burk, R. (2009). Junior nursing students experiences of vertical violence during clinical rotations. Nursing Outlook. 57(4). 226-231.