The Learning Experience

of a student nurse,
a critical analysis.

Prepared By:

Azores, Mae Ann A.

BSN 3D2-6

Submitted To:

Mr. Dennis Ubenia

Eng5A- Instructor
 My learning throughout the first year has been helped by an unerring optimism in the
value of nursing, and an appreciation that each and every daily interaction augments my
experience. This enthusiasm, however, has caused an inhibitory effect on my self-directed
researching, and created conflict in some placement areas. While developing my role as a nurse,
my activities as a person at home and beyond have diminished, as I attempt to adjust to the
demands of both domains (Spouse 2003:109). I resent distracting influences, and frequently
domestic pressures restrain my desired pace to accumulate factual knowledge. As described by
Palmer et al. (1994:40), my learning can oscillate between two extremes, “all or nothing”.
Spouse (2003) depicts the student nurses’ need to develop multi-tasking skills emotionally,
mentally and physically as they are caught between the cultures of clinical areas, peer-driven
University life and home. The conflicts arising from these settings create a disharmony, which I
believe for some, may undermine nursing as a career choice.

The competence of a future nurse is evaluated by evidence-based documents, instructors,

mentors assignment and examination results and is based on a continuum of regular assessments.
The learning experience of a student nurse remarkably influences own practice in clinical areas,
as well as the performance level of the student in academic matters.

First timers in clinical rotation engage themselves in the initial stage of familiarizing and
accustoming one’s self to the practice becomes crucial. This is the point when printed theories in
books and hand outs are recalled and reshuffled in the mind in order to carry out the best
intervention suited for a particular situation. It was never easy for the a novice student nurse to
be assigned in the OB ward or in the emergency room without sufficient knowledge about
postpartum care or familiarity with the basic instrument used in minor surgeries. Also,
inadequate and ineffective education influences the manner that one gains necessary principles
and skills needed in actual and assisted delivery cases. This has affected the coping strategies of
the trainees to different problems arising in the clinical settings. In reality, some just performed
as assistants instead of handling actual deliveries—this is also dependent to the hospital
protocols—and some were just given free cases.
This fact has urged others’ curiosity to get a hasty view of the first learning experiences
of the other nursing students who are also in the same level. Some people ought to assess the
level of students’ adjustment with the respect to different conflicts they have encountered so that
appropriate improvements in nursing education programs will be obtained.
The trend to commit oneself to healthcare field has not yet wiped out especially in
nursing profession. Students seem to be devotedly engaging themselves into this line as seen
with continuous enrollment of freshmen students and transferees, may it be influenced by
financial demands, personal preferences, or just by current blooms. The Professional Regulation
Commission reported that the country has an oversupply of 400,000 licensed nurses (Porcalla,
2008). With this fact that there are still thousands of nursing graduates in the country who are
either unemployed or working as call center agents, clerks, salesladies or salesmen,
discouragement in the part of the fresh high school graduates is still invincible. Though many say
that those temporary jobs are just their means of earning money while waiting for the board
examination, individual encounters prove that a significant percentage of those graduates would
just end up working in the same condition; others fortunately have passed the board and served
as volunteer nurses to gain experience during the initial years of the profession; and some might
have dealt with hard life or just settled down rearing families. For so many reasons, nursing
career—for some—terminates there, which should not be.
Why is it that even universities have started to limit accepting nursing enrollees due to
overpopulation of out-of-work nursing graduates, the government's need for ideal healthcare
system is still unmet? The answer would be—it is a matter of competition! In the Filipino
context, it goes, "Matira ang matibay." As with the student admission criteria of one hundred
eleven medical schools in the United States, education programs and requirements filter nursing
students meticulously (Reynolds, W.Scott, P.A.,& Austin W., 2000).
Spouse (2003:42) depicts the student nurses’ need to develop multi-tasking skills
emotionally, mentally, and physically as they are caught between the cultures of clinical areas,
peer driven university life and home. The conflicts arising from these settings create a
disharmony, which Greenwood (2003) believes for some, may undermine nursing as a career
choice. Aside from it, it is not new to hear stories about taking the course with the dictate of the
mother in exchange for the big Dollar sign neither a complaint for expensive matriculations and
a shelf of three-kilogram-books. According to Rep. Satur Ocampo, “Low and inappropriate
budget of DOH for 2009 now pegged at 28.9 billion still does not address the problem of the
exodus of nurses in the country”(Porcalla, 2008). It is one of the major sicknesses of the
country’s healthcare system which puts down the field. But with the growing population and
high expectancies of quality care and competence, nurses should be skillful in integrating
theoretical frameworks, as well as nursing philosophy, into real life situations so that high quality
care can be delivered and optimal health will be met and promoted.
Nursing is an art, an art of caring. Nurses are much involved in lots of health teachings
and interventions; and are expected to portray a variety of roles. Be it as an educator,
communicator, caregiver, counselor, advocate or as a leader, a nurse should possess a well-
defined body of knowledge and expertise in the field especially on actual scenarios (Kozier
et.al.,2008). Student nurses may be perceived as trainees, yet it is far apart from that thought. It
is incorporating oneself to and embracing the vocation of helping and providing care in order for
mastery and dedication to be more likely.
The developmental educative process in nursing is a sophisticated and complex
combination of scientific, logical, humanitarian, communicative, experiences and psychomotor
skills, designed to consolidate abilities to produce “knowledgeable doers” (Greenwood 2003,
Sajiwandani 2000, Slevin 1992, Cheung 1992).
Nursing students at this point of time should be cautious whether they have delivered or
could deliver appropriate care. They have to be very vigilant because they deal with a lot of toxic
things every single day (Tacdol, 2008). It is not anymore in a classroom setting, it is more of real
life situations. When at the area, there is no room for mistakes. No more dummies. No more
trials.
The reflective process enables the students to gain a sense of proportion. While
researched academic study underpins practice, there are frequently qualifications made by
nursing staff about ward performed procedures, stating “real-life” situations employ differing
methods to those taught in the class room. These instances challenge student’s assumptions and
provide impetus for further clinical reflective investigation (Spouse 2003, cited by Greenwood
2003). They also serve to demonstrate the existence of multiple methods of care delivery,
attuning them to motives and perspectives of other practitioners in the healthcare team,
indicating that others have legitimate reasoning (Palmer et.al 1994 cited by Greenwood, 2003)
The performance of students in the clinical area is greatly affected by difficulties they
encounter especially in their first clinical duty. Factors include relationship with clinical
instructors, misunderstandings arising from group works, hospital policies and requirements,
alterations in contingencies when handling patients and so on. As new members of the healthcare
team, adjustment to different stressors seems to be crucial.
It is an undeniable fact that problems with the clinical instructor top all. Many claim that
superiors sometimes do not provide favorable atmosphere for learning. Using negative
reinforcement is one of the examples. Others found this as beneficial since it helps the students
to ask questions, enhances perception, and inhibits recurring of errors. But many negate this
assertion. Embarrassment, comparison to other schools, and stickling behavior of the superior
notably outweigh the benefits it should have made.
Although many have agreed that the student nurses are very effective in delivering their
duties and responsibilities in the clinical areas, there should still be improvement in the learning
scheme of the education provider because there is no room for mistakes in the medical
profession because it deals with a very fragile thing-life- and a single mistake may cause an
enormous damage which is death. The students must be prepared and trained well before their
exposure in the clinical areas so as not to commit error (Babula et.al., 2006).
Group conflicts such as lack of teamwork have something to do in accomplishing case
studies. Hospital policies and protocols may at times become annoying and confusing. Different
shifts and location of clinical duties tend to be the second in the list. Personal moods and
anxieties affect functioning of the whole personality which may result to unproductive planning
and ineffective nursing interventions (Abaravar et.al., 2006). Moreover, unexpected problems
arising when handling patients are to be aided with harmonious interaction between the
instructor and the students while correction and giving of remedies are done (Amania et.al.,
2008).
The identification of these common conflicts that are actually the factors which affect the
level of performance of nursing students in clinical duties extensively bring up good adaptation
behaviors and ease up finding solutions to the mentioned conflicts. Because of the continuous
efforts made by some concerned people behind the nursing education−students, educators, and
also the registered nurses in the profession−, improvements in nursing curriculum has been
made. Though distinction between the old and new curriculum of the program have been clearly
identified, effectiveness of each are still debated and talked about more often. For nursing
education and nursing career does not end in passing all the academic subjects and completion of
the PRC forms, one has to subject himself in difficult situations when nursing judgment becomes
a necessity. As nursing student begins on the path of career, he or she finds new opportunities
unfolding as from within which brighten the path ahead. The kaleidoscope image used on the
cover of the 7th edition of Fundamentals of Nursing by Kozier and Erb is an everchanging piece
of art with its colors, light and form. As it turns, it represents new opportunities for beautiful new
designs. Seeking light and reflections to form new shapes allows one to open one’s mind to all
possibilities a kaleidoscope has to offer (Kozier et.al.,2007). Same with the field of nursing,
there are many areas that a nursing student may have never imagined at the beginning of his or
her journey.
As nursing students open their minds and eyes to these wonderful chances, a good
experience they had gained when they were still first timers would be a pertinent tool and
inspiration in attuning upcoming difficulties and developing passion in the career. These would
let them not to desist from this world of struggles.
Conclusion
A qualified nursing practitioner is a professionally trained integrated member of the
health-care team. This professional education should be life-long, beginning with three years pre-
registration factual knowledge and skill acquisition. As previously described there is a symbiotic
relationship between nursing’s craft and nursing wisdom, and they are required in practice
simultaneously. Despite the apparent impression given by traditional methods of education that
these categories exist seperately, for nursing they are fluidly cohesive, one informing the other,
through reflective analysis (Watts 1992:).
The elements experienced by nursing students during their training are bonded internally
together to authenticate their practice, by unleashing possibilities inherent in the situation
between patient and the therapeutic self (Kirby and Slevin 1992).
The following guidelines are intended to promote improvements in the student’s learning
experience. Qualified staffs that direct pace and direction of study need to encourage students in
imaginative and innovative ways to prepare them for adoption of new concepts and the flood of
changes and that they will need to make in all aspects of their life. Support such as this will guide
them through the vulnerable initial stages of their steep learning curve of level one, as echoed by
the dissonance described in the first paragraph of the essay.

Guidelines

I would like to see better preparation of mentors by lecturer-practitioners within clinical

placements, in order to foster environments of positive, constructively planned activities. From
this, students can gain insight to challenge their assumptions and lay-view of nursing. In this
respect, I would like those in the clinical settings to be encouraging students rather than
attempting to degrade their efforts by dismissing their academic research based interest in the
subject of nursing.

I would like access to professional teaching staff in-college at all times, especially
immediately prior to and post placement. I hope for tutor liaison with mentors more regularly
within the clinical settings, serving to remind mentoring nurses that their duty to support students
is real, and linked with Higher Education Establishments.

I would like to see in-college mentors giving better, basic and consistent guidance while
initially developing the concepts of critical reflective consciousness and the production of an
evidence-base of knowledge thus strengthening the intellectual and practical growth of students.
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