The lived experience of nurses working with student nurses in the acute care clinical environment

156 Pages·2017·0.77 MB·English

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LSU Doctoral Dissertations Graduate School
2006
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Donna Coffey Hathorn
Louisiana State University and Agricultural and Mechanical College
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Hathorn, Donna Coffey, "The lived experience of nurses working with student nurses in the acute care
clinical environment" (2006). LSU Doctoral Dissertations. 545.
https://digitalcommons.lsu.edu/gradschool_dissertations/545
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THE LIVED EXPERIENCE OF NURSES WORKING
WITH STUDENT NURSES IN THE ACUTE CARE CLINICAL ENVIRONMENT

A Dissertation

Submitted to the Graduate Faculty of the
Louisiana State University and
Agricultural and Mechanical College
In partial fulfillment of the
requirements for the degree of
Doctor of Philosophy

In

The School of Human Resource Education
And Workforce Development

by

Donna Coffey Hathorn
B. S. N. Northwestern State University, 1977
M. S. N. Northwestern State University, 1986
December 2006
©Copyright 2006
Donna Coffey Hathorn
All Rights Reserved

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ACKNOWLEDGEMENTS

I wish to acknowledge the members of the graduate faculty committee, M. Burnett, PhD;
E. Johnson, PhD; G. Johnson, PhD; K. Machtmes, PhD, and T. Page, PhD. I owe special thanks
to the Chairperson of the committee, Dr. Krisanna Machtmes, who was always there for me as an
advocate and advisor. I appreciate the support, guidance, encouragement, mentorship, wisdom,
friendship, and timely humor that Dr. Machtmes provided for me. Dr. Machtmes had faith in my
ability and like all great teachers and leaders inspired me to have faith in myself. This self
awareness and personal enlightenment motivated me to work to my full potential to accomplish
difficult tasks. Like a coach Dr. Machtmes urged me to reach down deep and apply the utmost
rigor to produce a dissertation that I could be proud of. Most importantly, she treated me with
genuine respect and collegiality. I will never forget her acts of kindness and empathy on several
occasions when the going got rough. She and her family, Roland and Ryan, are very precious to
me.
I wish to thank my dear colleague, Kenneth Tillman for being a sounding board, study
partner, carpooler, and friendly competitor throughout the past four years. As in any race, Ken
was like a pace car that kept me from slowing down too much and getting behind. We spent
hours together at the local coffee shop discussing, debating, studying, answering questions, and
encouraging one another to continue on until our goal was reached. I appreciate his patience with
me as I frequently interrupted him to say “let me read this to you.” We never realized what we
were getting into that day when we both agreed to get our Doctor of Philosophy degree together.
I also want to thank his wonderful family for the meals and study time in their home.
Another colleague that I wish to thank is Dr. Jeanie Ricks Harper for her encouragement
and help with qualitative research. Jeanie’s talent as a qualitative researcher was an inspiration to
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me. I also wish to thank my teaching partner Dr. Lorinda Sealey who always altered my work
schedule before I even asked so that I could have time to meet important deadlines regarding my
program of studies. I appreciate the fact that she recognized that it was my turn to work on a
Ph.D. and she offered understanding and encouragement.
I am grateful to my husband Jeff for his willingness to make sacrifices to allow me to
fulfill my academic dream. He tolerated me staying up late nights, being away at the coffee shop
studying, and attending all those night classes. He has always been proud of me and supported
me in my academic endeavors. To my sons Jeffrey, Jared, Jason, Joshua and to C.C. my new
daughter in law, a special thanks for their understanding and patience. I hope that my
achievement will be an inspiration for each of them to reach their full potential and calling in
life.
I acknowledge the members of Holden Baptist Church for all their prayers and
encouragement as I pursued this great academic achievement. They understood how important
this accomplishment was for me and cheered me on to the end. My faith in God helped me to be
strong because I knew this was the right time and the right place. I give ultimate thanks to Jesus
Christ my savior and my Lord!

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TABLE OF CONTENTS

ACKNOWLEDGEMENTS………………………………………………………………………iii

LIST OF TABLES…………………………………………………………………………….....vii

LIST OF FIGURES…….…………..………………………………………………………...…viii
.
ABSTRACT…………………………….……………………………………………..…..…..…ix

CHAPTER
1 INTRODUCTION………………………………………………………………………....1
Problem Statement………………………………………………………………….…......2
Definition of Terms………………………………………………………………………..3
Limitations………………………………………………………………………………....3
Significance of the Study…………………………………………………………………..3

2 REVIEW OF THE LITERATURE……………………………………………………......6
Clinical Environment as a Learning Environment…………………………………...…....6
Professional Socialization Attitudes………………………………………..….………...12
Nurses’ Motivation and Incentives to Work with Students……………………………...18
Role Theory and Professional Socialization…………………………………………..…19
Collaboration between Nursing Education and Nursing Service………………………..20
Legal Considerations in Nursing Education……………………………………………..25

3 METHODOLOGY………………………………………………………………….……29
Qualitative Research……………………………………………………….………….…29
Phenomenology and Phenomenological Method………………………………………...30
Phenomenological Processes…………………………………………………………….33
Epoche………………………………………………………………………...…33
Phenomenological Reduction………………………………………….………...34
Imaginative Variation…………………………………………………………....35
Synthesis…………………………………………………………………………35
Data Collection Preparation……………………………………………………………...36
Conceptual Model………………………………………………………………..36
Researcher Role………………………………………………………………….37
Guiding Questions……………………………………………………………….40
Credibility………………………………………………………………………..41
Sampling Strategy……………………………..………………….…......….…....42
Informed Consent, Confidentiality, and Selection Process……………………...44
Pilot Study……………………...………………..………………………………45
Data Collection…………………………………………………………………………..46
Interview Process………………………………………………………………..46
Ethical Dilemmas…………………………………………….………………….47
Organization, Analysis, and Synthesis of Data………………………………………….49
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4 ORGANIZING, ANALYZING, AND SYNTHESIZING DATA ……..……………..…52
Horizonalization…………………………………………………………………….……52
Meaning Units……………………………………………………………………..….….52
Themes…………………………………………………………...………………………79
Thematic Textural-Structural Descriptions…………………………………….………...80
Kate…………………………………………………………………….…………81
Jenny…………………………………………………………………………..….86
Sarah……………………………………………………………………..……….92
Tommy………………………………………………………………………..…..98
Natina…………………………………………………………………………...104
Cindy…………………………………………………………………………….110
Composite Thematic Textural-Structural Descriptions……………………..………….116

5 SUMMARY, OUTCOMES, AND IMPLICATIONS……………………..……………127
Summary………………………………………………………………………………..127
Outcomes……………………………………………………………………………….130
Implications………………………………………………………………...….…….….136

REFERENCES…………………………………………………………………………………140

VITA……………………………………………………………………………………………144

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LIST OF TABLES

1. Themes and descriptions of the lived experience of nurses working with student nurses….80

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LIST OF FIGURES

1. Conceptual Model of the Experiences of Nurses Working with Student Nurses………….38

2. Conceptual model of Kate’s experience of working with student nurses in the acute care
clinical environment…………………………………………………………………….….85

3. Conceptual model of Jenny’s experience of working with student nurses in the acute care
clinical environment………………………………………………………………………..92

4. Conceptual model of Sarah’s experience of working with student nurses in the acute care
clinical environment………………………………………………………………………..98

5. Conceptual model of Tommy’s experience of working with student nurses in the acute
care clinical environment…………………………………………………………………104

6. Conceptual model of Natina’s experience of working with student nurses in the acute care
clinical environment………………………………………………………………………110

7. Conceptual model of Cindy’s experience of working with student nurses in the acute care
clinical environment………………………………………………………………………116

8. Conceptual model of composite experiences of working with student nurses in the acute
care clinical environment…………………………………………………………………126

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ABSTRACT

The purpose of this phenomenological qualitative study was to describe the lived
experience of nurses’ who work with baccalaureate student nurses in the acute care clinical
environment. Because of the nursing shortage nursing education is challenged with equipping a
safe qualified workforce while preventing or reducing student attrition. Students may choose to
leave the profession or receive less than optimal learning experiences when exposed to negative
socialization behaviors of nurses while in the clinical environment. Findings from this study can
be used to foster collaboration between nursing education and nursing service in the
development of positive clinical environments for nurses and nursing students.
The methodology used for data collection was one-time, in-depth semi-structured
informal audio taped interviews of staff nurses who worked with student nurses in an acute
clinical setting. Saturation of the data was determined after six interviews. Data analysis was
conducted according to the modified van Kaam method. The following themes emerged: beliefs
about nursing education, role expectations, communication structure, motivational factors,
deterrent factors, and professional socialization attitudes.
Findings from this study revealed that nursing education and service should establish
more effective communication between staff nurses by providing them with job descriptions and
role expectations while working with students. Staff nurses also need to be informed of the
student’s learning objectives, and competencies. Staff nurses need to be empowered to change
the clinical environment and resolve conflicts that may arise as a result of having students in
their work environment. Most importantly the staff nurses need to be educated about their legal
liability and responsibilities when working with students. Students should also be informed of
their legal responsibility for nursing practice before attending a clinical course.
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