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Nursing Students Learn to Handle Stress and to Prioritize in a Complex Context During Workplace Learning in Acute Internal Medicine Care – An Ethnographic Study

Authors Hägg-Martinell A, Hult H, Henriksson P, Kiessling A

Received 10 September 2019

Accepted for publication 3 December 2019

Published 13 January 2020 Volume 2020:11 Pages 21—30


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Anwarul Azim Majumder

Ann Hägg-Martinell, 1, 2 Håkan Hult, 3 Peter Henriksson, 2 Anna Kiessling 2

1Department of Health Sciences, The Swedish Red Cross University College, Huddinge, Sweden; 2Department of Clinical Sciences Danderyd Hospital, Karolinska Institutet, Stockholm; 3Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden

Correspondence: Ann Hägg-Martinell
Department of Clinical Sciences Danderyd Hospital, Karolinska Institutet, 182 88, Stockholm SE-141 21, Sweden
Tel +46 70 755 59 15

Introduction: A common focus in many studies, in the short-term perspective, is to evaluate students’ workplace learning and its outcome. However, the outcome can be perceived differently depending on when it was evaluated. The aim of this study was to explore student nurses’ learning activities in an acute internal medicine unit and the nurses perceived learning outcome in a long-term perspective.
Material and Methods: Repetitive ethnographic observations were performed in an internal medicine care unit at a teaching hospital in Sweden between 2011 and 2013. Four student nurses and supervisors were repetitively observed. Two years later retrospective interviews were performed with four nurses who had performed workplace learning, as students, in this unit during the observation period. An inductive comparative analysis involving all interviews and observational data was applied.
Results: Three themes were identified: To handle shifting situations – illustrating how student nurses learnt to adapt to shifting situations, to manage stress, to create structure and space for learning and to deal with hierarchies; To build relationships – illustrating how student nurses learnt to collaborate and to interact with patients; To act independently – illustrating how student nurses trained to act independently in the unit, took responsibility, and prioritized in this complex context.
Conclusion: Learning activities in a complex acute medical unit setting were characterized by a high workload and frequent stressful situations, and a demand on students to interact, to take responsibility, and to prioritize. To learn in such a stressful context, have in a long-term perspective, a potential to develop students’ embodied understanding of and in practice, making them more prepared to work and independently apply their nursing expertise in similar contexts as graduated nurses.

Keywords: students nursing, nursing education research, clinical clerkship, ethnography

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