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Negotiating the education and practice disjuncture in nursing clinical placements : nursing faculty’s perspectives

University of British Columbia

This qualitative research project is an exploration of how nursing faculty make meaning of their experiences in the disjuncture between what is taught about best practice and what is found in many clinical practice sites. Nursing faculty members teach best practices, but when they take students into practice arenas, the students do not necessarily see those best practices. Instead, they may see caregivers substituting “supposed efficiencies” for best practice. As guests in a hospital, faculty members have no clear-cut entry point to make changes. As both nurses and educators, they face quandaries in places where practice is inadequate; they may want to remove their students but because they are nurses, feel ethically obligated to stay and to attempt to change practice. As educators, they must role model competent nursing care yet may be in a setting where structural conditions create a situation in which nurses are unable to provide best practice. The nursing faculty’s role creates a unique liminal place at the practice-education interface that is challenging and uncomfortable. Constructivism/interpretivism and critical theory inform this study. The main theorist is Dorothy Smith (1992, 2005, 2006). Smith’s critical theory perspective brings into view power relations that organize, but are often invisible to, the everyday activities of nurse faculty in clinical settings. Twenty-four clinical nurse faculty members from post-secondary institutions were interviewed. The main themes arising from these interviews were conflicts, dual consciousness, being a guest and maintaining placements. Analysis of these themes found that faculty members engage in a complex set of negotiations to address disjunctures as they seek to meet the needs of students, patients and staff. The complexity of the navigation is reflective of how faculty and staff nurses are embedded in a nest of social relations with other caregivers, administrators, patients and their families under conditions of neoliberalism. A neoliberal corporate ideology that has infused the health care system has made it difficult for nurses to provide care as they are taught. These uncomfortable moments can become teachable moments not only about “good practice” but also about advocacy for change in structural conditions that constrain “good practice.”

Text

2014-02-14

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/46015

Educational Leadership and Policy

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/