Challenges Experienced by Nurse Educators in Promoting Acquisition of Clinical Reasoning Skills by the Undergraduate Nursing Students: A Qualitative Exploratory Study

Background: Clinical reasoning is an essential skill for nursing students since it is required to solve difficulties that arise in complex clinical settings. However, teaching and learning clinical reasoning skills is difficult because of its complexity. This study, therefore aimed at exploring the challenges experienced by nurse educators in promoting acquisition of clinical reasoning skills by undergraduate nursing students. Methods: A qualitative exploratory research design was used in this study. The participants were purposively sampled and recruited into the study. Data were collected using semi-structured interview guides. Thematic analysis method was used to analyze the collected data The principles of beneficence, respect of human dignity and justice were observed. Results: The findings have shown that clinical learning environment, lacked material and human resources. The students had no interest to learn the skill. There was also knowledge gap between nurse educators and clinical nurses. Lack of role model was also an issue and limited time exposure. Conclusion: The study revealed that nurse educators encounter various challenges in promoting the acquisition of clinical reasoning skills among undergraduate nursing students. Training institutions and hospitals should periodically revise the curriculum and provide sufficient resources to facilitate effective teaching and learning of clinical reasoning. Nurse educators must also update their knowledge and skills through continuous professional development if they are to transfer the skill effectively.

Advancement of Nursing Education in Psychosocial Oncology Care:Perspectives and Experiences of Nurses

Introduction:The main objective of this study was to fill the gap between the knowledge nurses have about psychosocial care and what they do about cancer patients’needs.It also aimed to devise ways to improve nursing education for nurses who could provide enhanced psychosocial support in such areas.Methods:This qualitative study relied on 18 in-depth interviews with nurses,with a focus on the difference between their understanding of psychosocial care and its application in helping cancer patients.This involved analyzing the transcribed interviews using thematic analysis.Data were collected from February to March 2024.Results:The verbal accounts of 18 participants were analyzed.These include theme 1“holistic approach to cancer care”with the subtheme“navigating resource constraints:”theme 2“nurses well-being and emotional input”with the subtheme“positive impact of psychosocial care:”theme 3“Care for patients’well-being”with subtheme“resourcefulness and resilience in psychosocial care:”theme 4“adapting care and building connections:”theme 5“ideal and reality in psychosocial care”with subtheme“challenges in delivering comprehensive cancer care:”and theme 6“empowering nurses for effective psychosocial care”with subtheme“building a strong foundation for psychosocial care.”Conclusion:From the nurses’perspective,this study indicates a need for more inclusive cancer treatment.Therefore,in addition to physical interventions,emotions and social welfare must also be addressed.Although emotionally invested,health workers may offer assistance along psychosocial lines,thus aiding both patients and caretakers.Although individualized care with personal connections is crucial for effective services,this approach can make it difficult to ensure that all clients receive adequate psychological assistance.Hence,there has been a call to enhance the training to produce nurses who offer high-quality services.This study emphasizes a more holistic approach toward the emotional needs of patients while supporting those responsible for them in their sickness journey.

Experience of humanistic nursing in hemodialysis nursing for patients with diabetic kidney disease

BACKGROUND Diabetic kidney disease(DKD)is a prevalent complication of diabetes that often requires hemodialysis for treatment.In the field of nursing,there is a growing recognition of the importance of humanistic care,which focuses on the holistic needs of patients,including their emotional,psychological,and social well-being.However,the application of humanistic nursing in the context of hemodialysis for DKD patients remains relatively unexplored.AIM To explore the experience of humanistic nursing in hemodialysis nursing for DKD patients.METHODS Ninety-six DKD patients treated with hemodialysis from March 2020 to June 2022 were included in the study and divided into the control cluster(48 cases)and the study cluster(48 cases)according to different nursing methods;the control cluster was given routine nursing and the study cluster was given humanized nursing.The variances of negative emotion mark,blood glucose,renal function,the incidence of complications,life mark and nursing satisfaction before and after nur-sing were contrasted between the two clusters.RESULTS No significant difference in negative emotion markers between the two clusters were observed before nursing(P>0.05),and the negative emotion markers of the two clusters decreased after nursing.The Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale markers were lower in the study cluster than the control cluster.The healing rate of patients in the study cluster was significantly higher than the control cluster(97.92%vs 85.42%,P<0.05).Blood glucose parameters were not significantly different between the groups prior to nursing(P>0.05).However,after nursing,blood urea nitrogen and serum creatinine(SCr)levels in the study cluster were lower than those in the control cluster(P<0.05).The incidence rate of complications was significantly lower in the study group compared to the control cluster(6.25%vs 20.83%,P<0.05).There was no significant difference in the life markers between the two clusters before nursing.While the life markers increased after nursing for both groups,the 36-item health scale markers in the study cluster were higher than those within the control cluster(P<0.05).Finally,the nursing satisfaction rate was 93.75% in the study cluster,compared to 75% in the control cluster(P<0.05).CONCLUSION In hemodialysis for DKD patients,the implementation of humanistic nursing achieved ideal results,effectively reducing patients’psychological negative emotion markers so that they can actively cooperate with the diagnosis and nursing,facilitate the control of blood glucose and the maintenance of residual renal function,reduce the occurrence of complications,and finally enhance the life quality and nursing satisfaction of patients.It is worthy of being widely popularized and applied.

Preceptors'experiences in guiding nursing students to use research findings and to implement evidence-based practice

Objective:Evidence-based practices(EBPs)have been taught to students by identifying the best evidence/evidence from research results.However,the experiences of Indonesian nurse preceptors in helping students implement research findings have not been explored thoroughly.This study aimed to explore Indonesian nurse preceptors in guiding nursing students to use research findings.Methods:This study used interpretive phenomenology analysis that involves 9 nurse preceptors from hospitals in West Kalimantan,Indonesia.Semi-structured in-depth interviews were recorded and then transcribed verbatim.Results:Three themes were generated during the analysis:“types of student supervision,”“issues during supervision,”and“the need for research literacy and supervision.”Conclusions:Nurse preceptors need support to supervise the nursing students to use research findings.In addition to upgrading nursing skills,nurse preceptors must receive training in research and its utilization.Developing an appropriate strategy to assist students in using research findings will enhance the promotion of evidence-based nursing practices on a daily basis.

Nursing Experience of Early Application of Nasoenteric Tube for Enteral Nutrition in Critically Ill ICU Patients

Objective:To investigate the effective nursing measures of early application of nasoenteric tube for enteral nutrition in critically ill patients in ICU,and to summarize the nursing experience.Methods:The study was carried out in June 2023–November 2023.62 samples of ICU critically ill patients were selected,all of whom used enteral nutrition by mesenteric tube and were grouped into an observation group(n=31)and a control group(n=31)by using the numerical table randomization method.The patients in the control group were basic nursing interventions,and the patients in the observation group were comprehensive quality care,comparing the nutritional indexes,complication rates,and nursing satisfaction between the two groups.Results:All nutritional indicators of the observation group were higher than those of the control group after nursing intervention(P<0.05);the complication rate of the observation group was lower than that of the control group(P<0.05);the nursing satisfaction of the observation group was higher than that of the control group(P<0.05).Conclusion:Comprehensive quality nursing care during the early application of a gastroenteric tube for enteral nutrition in critically ill patients in the ICU can improve nutritional indexes,reduce the incidence of complications and improve nursing satisfaction.

Effectiveness of Comprehensive Nursing Management in Enhancing Blood Donation Outcomes and Donor Experience: A Comparative Study

Objective:To assess the management effect of comprehensive nursing management on blood donation services in blood stations.Methods:Sixty-four individuals who donated blood at a blood station between September 2021 and September 2023 were selected and randomly assigned into two groups of 32 each.The first group received comprehensive nursing management,while the second group received routine nursing management.Blood donation indexes and observational indexes such as adverse reactions were compared between the groups.Results:The total blood donation volume and qualified blood donation volume were higher in the first group than in the second group.The amount of discarded blood and the rate of blood discards were lower in the first group compared to the second group(P<0.05).Additionally,the adverse reaction rate in the first group was lower,the blood donation comfort scores were higher,the psychological state scores were lower,and the quality of care scores were higher than those in the second group(P<0.05).Conclusion:Comprehensive nursing management can improve the efficiency of blood donation,reduce the rate of blood discards,decrease the incidence of adverse reactions,alleviate negative psychological states of blood donors,and enhance both the comfort level of blood donation and the quality of care provided.

The experience of transition from nursing students to newly graduated registered nurses in Singapore

Objectives:To investigate the experience of newly graduated registered nurses(NGRNs)in Singapore following their initial 6-12 months of transition from nursing student to registered nurse.Methods:This mixed-methods study consisted of two phases.In the first phase,data were collected via the administration of the online survey to 30 NGRNs.The questionnaire contained 42 items of the fourpoint Likert scale survey.In the second phase,a focus group interview was conducted with 5 NGRNs to gather complementary information regarding the major findings from the first phase.Results:The survey revealed despite most NGRNs(80%)in this study expressed overall satisfied with their transition,the item score was(2.97±0.61)out of 4,the majority(83.3%)also perceived their transition to professional practice being stressful,the item score was(3.07±0.74)out of 4.Three themes emerged from the interview,'personal transition experience','professional transition experience',and'organizational transition experience',which are entwined to construct overall NGRNs'transition experiences.Conclusions:This study reaffirms the theory-practice gap phenomenon.This signifies the need for closer collaboration between educational,healthcare industry and regulatory stakeholders to examine and address factors that influence their transition experience to better support them for workforce readiness.

Relationship of Clinical Nursing Competence to Nursing Occupational Experience in Hospice/Palliative Care Nurses in Japan

Aim: The purpose of this research is to examine the relationship between the clinical nursing competence and nursing occupational experience in hospice/palliative care nurses (HPN) in Japan. Methods: A mail survey using an anonymous self-administered questionnaire was conducted on clinical nursing competence regarding communication, care and prediction of worsening of symptoms with the authors’ previous research as a framework. The subjects were nurses working in hospice/palliative care units in Japan, and the period of survey was January to February, 2014. Results: In this study, the relationship between the clinical nursing competence and nursing occupational experience of HPNs in hospice/palliative care which was clarified in the authors’ previous research was examined. The results showed that the amount of clinical nursing experience as a nurse was related to clinical nursing competence in the care of end-of-life patients and worsening of symptoms. The abundance of specialized nursing experience was also related to clinical nursing competence in communication in addition to care and prediction of worsening of symptoms. Training experience was also shown to be effective for hospice/palliative care. Conclusion: From these results, clinical nursing competence of HPNs in care of end-of-life patients and prediction of worsening of symptoms are possibly learned through the accumulation of clinical nursing experience as a nurse. However, HPN’s clinical nursing competence in communication was suggested to be developed through nursing practice in hospice/palliative care.

An Ethical Practice Intervention Program for Pediatric Nurses with Varied Nursing Experience

Aim: This study aimed to elucidate experience-related differences in the impact of an intervention program promoting ethical nursing practices among pediatric nurses with 0 - 5 years’ experience in varying settings. Methods: The pediatric nursing care model, defining 24 elements of pediatric nursing practice, was developed to educate nurses with pediatric nursing experience only, as well as those with experience in other settings, on ethical nursing practices toward pediatric patients and their families. Participants’ level of knowledge and frequency of application of these practices were assessed before, directly after and two months after the intervention, with a final follow-up three months post-intervention. Results: Results showed that among those who have experience in nursing areas other than pediatrics, the frequency of practicing items related to children’s rights and dignity significantly increased (p Conclusions: Participants showed an increased awareness of issues related to ethical pediatric nursing practice for patients’ and their parents.

Problems-Based Learning during COVID-19 Pandemic: Experiences by Nursing Students

Introduction: Problems-based learning (PBL) methodology seeks challenges in the daily life context, where students protagonise their own learning using new technologies as the ideal means to find updated and adequate information, for its processing and dissemination towards a better active and participative role. The aim was to analyze the usefulness and importance of PBL, as a strategy of significant learning in daily experiences of nursing students during the COVID-19 pandemic. Method: The study was qualitative and phenomenological, with 15 informant students of the Module “Attention to addictions in the health area” aged 20 - 25 years, enrolled in the sixth semester of nursing from a public university. Data were collected through oral testimonies, texts, and semi-structured interviews of relevant aspects to them in their everyday life facing the COVID-19 pandemic, telling their experiences. Students signed an informed consent, and the qualitative analysis followed De Souza Minayo. Results: Four categories emerged: Category 1. Students’ experiences along pandemic;1.1, Positive experiences;1.2, Negative experiences. Category 2. Students’ knowledge and abilities for self-care along pandemic. Category 3. Abilities to promote problem solving. Category 4. Impact and usefulness of PBL in students’ experiences for health education;4.1, Positive impact of PBL;4.2 Negative impact of PBL. Conclusion: PBL is very useful for significant learning. It opens knowledge, developing skills to face, support, debate, evaluate and make decisions;it does incorporate critical thinking and problem solving. PBL does encourage collaborative work.

An iterative approach to enhance the clinical learning experience in Macao nursing education

Objective: The aim of this study was to reduce or eliminate the stressors to enhance nursing students' clinical learning experience through implementation of an iterative approach that developed a personalised response to student stress.Methods: A prospective cohort research design was applied to collect data from a sample of undergraduate nursing students across the four study years.An iterative approach was employed to improve students' learning experience and the Stressors in Nursing Students Scale-Chinese Version (SINS-CN) was used to measure student stress.Key problems encountered by students were identified,refined and the responding solutions were worked out and implemented among this group of students through their first year to fourth year.Results: The overall SINS-CN mean score (2.17-2.82) of students was declined to a moderate level.Conclusions: Having implemented iterative approach to address factors that led to stressful environments encountered by the nursing students,the overall stress score and each sub-dimension score decreased significantly.Therefore,it is recommended that this approach could be adopted by other colleagues in the nursing arena around the world.

Difficulties Experienced in Trauma Nursing Practice by Expert Emergency Nurses in Japan

The objective of this study was to determine the difficulties experienced in trauma nursing practice by expert emergency nurses in Japan. Ten nurses who worked at emergency and critical care centers in Japan were directly involved in nursing patients were selected by purposive sampling and underwent semi-structured interviews regarding the difficulties they experienced in trauma nursing. The nurses were specialists in critical care nursing or were certified emergency nurses. The interview responses were analyzed by the qualitative descriptive method. The following six categories of difficulties associated with the direct care of trauma patients and their family members encountered in trauma nursing practice were identified: [Initial handling of highly urgent trauma patients], [Understanding and observing the condition of patients who are in the treatment stage], [Judging when to transition to end-stage care for patients difficult to save], [Mitigating suffering and expanding safe activities of daily living for trauma patients], [Transitional care with a long-term perspective for trauma patients], and [Relationships with the family members of patients who died]. Three categories of difficulties related to the role of the expert nurse in trauma nursing practice were identified: [Person-to-person coordination and cooperation for a trauma patient], [Playing an educational role for the nursing staff], and [Pursuing expertise in trauma nursing and gaining empirical knowledge]. The findings suggested a need to establish systems for training and consultative support and opportunities to create meaning by reflecting on fulfillment and nursing practice.

Lebanese Student’s Experience of Benefits of High Fidelity Simulation in Nursing Education: A Qualitative Approach

Background: Simulation is perceived as an important part to the nursing clinical educational experience since it can offer a safe learning environment for the students’ clinical practice. Objective: The purpose of this study was to explore the Lebanese student’s experience of benefits of high fidelity simulation in nursing education. Design: A qualitative study using open-ended questionnaire. Setting: This study was implemented at private university in Lebanon between January and April 2015. Participants: A purposive sample was sought from those who have a simulated experience. Methods: Qualitative data were collected via interviews and analysed using a thematic approach. Findings: Four major themes were identified: “Bridging Theory to Clinical Practice”, “Developing Critical Thinking and Decision-making”, “Practicing Safely Leads to Enhancing Confidence”, “Teamwork Spirit and students’ motivation to earn and practice more”. Conclusion: Simulation was found to be an acceptable learning strategy for novice nursing students. The use of simulations is a useful and effective learning strategy. Students with a higher positive attitude towards the simulation experience displayed better learning outcomes. Thus, the integration of simulation into the learning experience of nursing students will bridge the gap between theory and practice;enhance their critical thinking and motivation aptitudes along with traditional clinical practice by sparing them a safe milieu.

Working experiences of nursing aides in nursing homes:A qualitative study

Objective:To examine how nursing aides in nursing homes perceived their caring work.Methods:Twenty-four nursing aides from one public and one private nursing home in Fuzhou,Fujian Province,China were selected and interviewed in focus groups.Phenomenological analysis was performed.Results:Two themes(positive and negative working experiences)and six sub-themes were drawn:companionship,happiness,trust,achievement,hard work,and grievance.Conclusion:A reasonable work arrangement,positive psychological intervention,and the strengthening of professional,medical and social supports are recommended to improve the work quality and satisfaction of nursing aides in elderly homes.

Nursing Students’ Experience with Information Literacy Skill

This study examined the searching skills and extent of usage of electronic databases by Nursing, Midwifery and Public Health Nursing students in the University of Health and Allied Science (UHAS). The focus was on forty (40) level 300 students drawn from a universe of two hundred and forty six (246) of the School of Public Health (SPH). The study used quantitative method approach and the survey instruments were questionnaire, interview and observation. The data collected were analyzed and classified into the following themes: usefulness, extent of use, determinants of use of e-databases, searching skills, and main drawbacks of learning information literacy skills (ILS). Although all the respondents strongly agreed that e-databases are indispensable for academic and professional practice, findings revealed that majority of them have low quality of searching skills and that accounts for the sparse use of the e-databases. This positive association is proven by Pearson’s chi square test (0.000). The study also established that students’ attitude, academic loads and methodology of teaching were the challenges hindering the acquisition of ILS of students. As a consequence, the study recommends that Academic librarians should intensify their education on e-databases, the development of research guides and encourages stronger collaboration with faculty members in the teaching of ILS so that student nurses would be more adept in searching for information to enhanced scholarship and professional practice.

Nurses' families' experiences of involvement in nursing errors: A qualitative study

Background: The most important and irreversible consequence of medical errors is the human impact caused by unintended actions.In a few studies,the significant impact of this error on the private life of healthcare staff have been mentioned,but the problems of the involved nurses' families had been ignored,as of now.Aims: This study aimed to explain the nurses' families' experiences of involvement in nursing errors.Methods: This is a qualitative study using conventional content analysis with 20 semi-structured interviews conducted with nurses and family members of nurses involved in medical errors,done through purposeful sampling and willingness to participate in the study.Results: The results of the data analysis consisted of five main categories including disruption in family functioning,the crisis of fear,oppression,damage,and neglect,along with 15 subcategories.Conclusion: Considering the effects of nursing errors on the families of nurses involved in the error,such as disruption of family functioning,the family of nurses involved in the error should also be considered and paid attention to.These families are abandoned and the need to promote the culture of supporting the family is tangible.

Nursing undergraduates’experiences of a simulation-centred educational program in hospice care in Macao:A qualitative research

Objectives:The study aimed to explore the experiences of nursing undergraduates participating in a simulation-centred educational program in hospice care in Macao,China.Methods:This descriptive qualitative study was based on the data collected through semi-structured individual interviews.Seventeen nursing undergraduates in Macao,China who attended the simulation-centred program in hospice care participated in this qualitative from November to December 2020.This program included three parts:introduction to hospice care(2 h),management of terminal symptoms(10 h),and hospice situation simulations(6 h).The interview data were analyzed using qualitative content analysis.Results:This study revealed two themes and six sub-themes.Theme 1 was developing competencies in caring for dying patients and their families,which included four subcategories of sensitivity to patients’needs,knowledge of hospice care,skills of symptom control and comfort supply,and communication skills.Theme 2 was improving the ability to self-care and support colleagues,which included two subcategories of reflection on life and death and sharing and supporting among colleagues.Conclusion:This program improved the competency of nursing undergraduates in hospice care and participants’learning experience was good.

Experiences of being old and receiving home nursing care. Older South Sami narrations of their experiences—An interview study

The Sami people who are the natives of Scandinavia are not a homogeneous group. They consist of different groups of Sami populations of which the South Sami population are one small group. For the South Sami this means a problem;they have to struggle against a general ignorance about the Sami people and culture, which also may affect received home nursing care. The aim of this study is to describe individual South Sami experiences of being old and receiving home nursing care. A sample of 10 older persons with South Sami background was chosen for this study. Narrative interviews were conducted and qualitative content analysis was used to identify and categorize primary patterns in data. The experience of being an old person with South Sami background who receives home nursing care was understood through the use of the following four themes developed from the informants’ own narratives: “Experience of losses in life”;“Feelings of being less valued”;“Feelings of gratitude”;and “Experience of meaning in daily life as old”. The main finding is that the South Sami population still is exposed to an ongoing subtle colonisation. Therefore, it is important to prepare and teach nurses who work in the South Sami area in cultural care, traditional values and beliefs specific to the South Sami population.

Nursing students’ experiences of caring for dying patients and their families: a systematic review and meta-synthesis

Objective: Nurses play important roles in caring for dying patients and their families. Difficulties students confronted when facing dying patients challenge the quality of nursing education. A better understanding of students' experiences would enhance teachers' ability in helping students. This study aims to describe available evidence about nursing students' experiences when caring for dying patients and their families.Methods: A review of qualitative studies published between 2005 and 2017 was undertaken using the following databases: MEDLINE, CINAHL, ProQuest Central, ScienceDirect, and CNKI. The keywords included were nursing students, experience, care, end-of-life, and dying. Qualitative Assessment and Review Instrument was used to assess the quality of the studies by two independent reviewers. The data from the studies were analyzed by meta-synthesis.Results: Eighteen English and two Chinese studies were selected in this review. Four themes were emerged:(1) Students with dying patients: students did not have enough ability in symptoms control, comfort supply, and therapeutic communication for dying patients.(2) Students with the patients' families: students advocated more caring for patients' families.(3) Students with the surroundings: professional medical staffs, especially the nursing preceptors, were key roles in constructing a supporting system for students.(4) Students with themselves: nursing students underwent various negative feelings and adopted both negative and positive strategies to cope with such feelings;students experienced professional and personal development during the caring for dying patients.Conclusions: Nursing students' abilities in terminal symptom control, comfort supply, and therapeutic communication should be improved by more theoretic learning and simulation practice. The nursing preceptors were key roles in constructing a supporting system for students and helping them to control the negative emotions when facing dying patients.

Nursing Experience of an Elderly Patient with Systemic Disseminated <i>Penicillium marneffei</i>

Elderly patients with systemic disseminated Penicillium marneffei are generally more seriously ill with high mortality. In addition to clear diagnosis and timely treatment, careful nursing throughout the hospitalization is particularly important for the patient’s recovery. Psychological nursing and family emotional support, the treatment of adverse drug reactions, systemic infection wound care, the prevention of pressure sores in long-term bedridden patients, antithrombotic nursing, disinfection isolation and the standard prevention of nosocomial cross infection all play decisive roles in the patient’s prognosis. After one month treatment and medical care, the patient was cured and was discharged from hospital. After discharge, the patient follow-up was carried out up to one year. This patient had completely recovered. In this paper, we report a successful nursing experience of an elderly patient with systemic disseminated Penicillium marneffei. With the summary of nursing key points, it could play a reference in the treatment and rehabilitation of similar patients.