Supporting Nursing Students in Learning

Supporting Nursing Students in Learning

Supporting Nursing Students in Learning

Rosemary Taylor

Most nursing students join the profession to help others, yet many recall their introduction to clinical practice as unwelcoming. These experiences can be highly stressful. A supportive environment is a prerequisite for learning. Students are vulnerable and their welcome to the profession from experienced nurses shouldn’t be one of disgust or dismissal. Supporting Nursing Students in Learning

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Nursing students are often targets of the kinds of incivility that can be classified as vertical violence. The majority of these incivilities are “low risk,” as described in Cynthia Clark’s “continuum of incivility,” with eye rolling (“low risk”) just below sarcasm on one end of the spectrum and threatening behaviors and physical assault (“high risk”) on the other. Supporting Nursing Students in Learning

Eye rolling, a seemingly trivial gesture, is in fact a particularly hurtful form of nonverbal aggression. In her book, Creating and Sustaining Civility in Nursing Education, Clark recounts her students’ experiences of eye rolling by nursing faculty or nurses in practice. They described feeling angry at first, wishing they could retaliate. Over time, they avoided the enactor and stopped asking questions. These responses mirror my senior nursing students’ reactions. Although many discounted the experience during class discussion, in an assigned reflection, they shared the profound impact of eye rolling and other low-level incivilities, such as shunning and gossiping, that were directed toward them.

“I remember that I asked her a question and she rolled her eyes. I don’t think she meant it to be as obvious as it was. However, I definitely noticed it. The way the nurse responded to my questions made me feel stupid and question my own knowledge. The most frustrating part was that it made me question my decision to be a nurse. I wondered if I was cut out for nursing. It also made me wonder if there were more nurses out there like this one who would treat me poorly in the future.”

Unfortunately, so-called low-risk incivilities appear to be accepted as a rite of passage. “If they can’t handle a little eye rolling, how can they make it as a nurse?” Yes, we nurses need to prepare students for the difficult realities of the nursing environment, but this preparation should not include a tolerance for abuse. When we dismiss experiences of incivility, we normalize the behavior and are complicit in its perpetuation.

Students want to contribute and should be provided opportunities for meaningful participation in patient care. The future of our profession depends on supporting them in their formation of a professional identity. One of my students shared her experience and suggestions to address the problem:

“It is so important for nurses to have each other for support and encouragement. There are already so many times in my clinical experiences that I have heavily relied on support from other nurses. There needs to be service programs and staff meetings that strictly focus on the issue. I think nurses need to be educated about exactly what vertical and horizontal violence looks like because so many nurses just deal with it on a daily basis without giving it a second thought.”

Other students recommended that instructors work closely with nurses to prepare and support them in having a student. They also suggested that nurses reflect on what it was like to be a student and how they would wish to be treated.

We are all responsible for modeling professionalism and positive communication skills. Our students are our future colleagues. How often have we told them that “every day is a job interview”? Indeed, they are interviewing each of us to determine whether they want to join in the work we do.

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