“Feel the fear and do it anyway” … nursing students’ experiences of confronting poor practice

Aim
The two aims of this study were, first, to explore nursing students’ experiences and perspectives of reporting poor care and second, examine the process by which they raised concerns.

Background
The nursing literature is replete with studies which explore nursing students’ experiences of clinical placement. However only a small number explore students experiences of challenging poor care and how this is enacted in the practice setting.

Setting and participants
Fourteen nursing students from undergraduate pre-registration nursing programs across three universities, two in the United Kingdom (UK) and one in Australia.

Design and analysis
This paper reports findings from narrative interviews about students’ clinical experiences of reporting poor care. Data were audio recorded, transcribed verbatim and analyzed using a constant comparison approach. Emerging themes were identified, discussed and verified by the researchers.

Results
Four montages from the narratives highlight the overarching themes: bullying, patient advocacy, lack of empathy and poor care. They demonstrate how, driven by an ethical imperative, students speak up when they witness poor care despite the difficulties of doing so: in some cases, the students in this study were prepared to continue speaking out even when initial concerns were dismissed.

Conclusion
Both practice and university teams have a responsibility to support students’ development as ethical and courageous practitioners, able to recognize when care falls below an acceptable standard.