Challenges of Nursing Students during Clinical Practice in Emergency Department: A Case Study

Wawan Febri Ramdani; Dwi Prihatiningsih; Widaryati Widaryati

doi:10.25159/2520-5293/16345

Authors

Wawan Febri Ramdani Universitas 'Aisyiyah Yogyakarta https://orcid.org/0000-0002-4499-5519
Dwi Prihatiningsih Universitas 'Aisyiyah Yogyakarta
Widaryati Widaryati Universitas 'Aisyiyah Yogyakarta

DOI:

https://doi.org/10.25159/2520-5293/16345

Keywords:

Student Adaptation, Emergency Nursing, Skill Development, Emotional Response, Nursing Education

Abstract

Background: Transitioning from theoretical studies to practical scenarios, particularly in the Emergency Department (ED), poses significant challenges for nursing students. These challenges include high time pressure, the complexity of cases, and the urgent nature of situations often encountered. The impact can lead to increased stress levels, a higher workload, and a potential lack of confidence in handling situations that require quick and accurate responses. This study investigated the initial adaptation process of these students, known as Ners, emphasising their environmental adjustment, interpersonal skill enhancement, professional development, and emotional coping strategies.

Method: This qualitative study engaged 25 nursing students in ED rotations from November 2023 to March 2024. It utilised detailed interviews, participatory observation, and document analysis, employing thematic analysis to unearth key themes.

Results: Four central themes emerged: acclimatisation to the clinical environment, dynamics of relationships and interactions, skills and competencies enhancement, and coping with emotional and psychological challenges. Initially challenged, students gradually became accustomed to the ED's demands, enhancing their professional and social skills and developing effective stress management strategies.

Conclusion: The findings highlight the necessity for comprehensive preparation and ongoing support and suggest significant implications for improving nursing education and practices within the ED.

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References

Afaya, A., Bam, V., Azongo, T. B., Afaya, R. A., Yakong, V. N., Kpodo, G. K., Kaba, R. A., Nangsire Zinle, D. A., Tayuu, D. K., Asantewaa, S., and Adatara, P. 2021. "'We are Left with Nothing to Work With'; Challenges of Nurses Working in the Emergency Unit at a Secondary Referral Hospital: A Descriptive Qualitative Study." PLoS ONE 16 (2 February): 1–12. https://doi.org/10.1371/journal.pone.0247062

Ayhan, B. 2020. "Social Cognitive Theory." Consumer Behavior Models, 139–151. https://doi.org/10.4324/9780429491146-7

Bagweneza, V., Anita, C., Nsanzamahoro, I., Mukanoheli, V., Bahaya, F., Niyitegeka, P., Kabanyana, P., Mwiseneza, M. J., Gaterega, T., Kura, A., Twahirwa, C., and Munezero, M. 2021. "Analysis of Clinical Experience Using Kolb’s Experiential Learning Theory: Postgraduate Medical Surgical Nursing Track Students in Selected Sub-Specialties at the University Teaching Hospital of Kigali, Rwanda." Rwanda Journal of Medicine and Health Sciences 4 (3): 430–436. https://doi.org/10.4314/rjmhs.v4i3.13

Bandura, A. 2001. "Social Cognitive Theory of Mass Communication." Media Psychology, 3 (3): 265–299. https://doi.org/10.1207/S1532785XMEP0303_03

Banneheke, H., Nadarajah, V. D., Ramamurthy, S., Sumera, A., Ravindranath, S., Jeevaratnam, K., Efendie, B., Chellamuthu, L., Krishnappa, P., and Peterson, R. 2017. "Student Preparedness Characteristics Important for Clinical Learning: Perspectives of Supervisors from Medicine, Pharmacy and Nursing." BMC Medical Education 17 (1): 130. https://doi.org/10.1186/s12909-017-0966-4

Bardhan, R., Heaton, K., Davis, M., Chen, P., Dickinson, D. A., and Lungu, C. T. 2019. "A Cross Sectional Study Evaluating Psychosocial Job Stress and Health Risk in Emergency Department Nurses." International Journal of Environmental Research and Public Health 16 (18): 3243. https://doi.org/10.3390/ijerph16183243.

Bodys-Cupak, I., Majda, A., Kurowska, A., Ziarko, E., and Zalewska-Puchała, J. 2021. "Psycho-Social Components Determining the Strategies of Coping with Stress in Undergraduate Polish Nursing Students". BMC Nursing 20 (1): 129. https://doi.org/10.1186/s12912-021-00630-2

Bodys-Cupak, I., Ścisło, L., and Kózka, M. 2022. "Psychosocial Determinants of Stress Perceived among Polish Nursing Students during Their Education in Clinical Practice." International Journal of Environmental Research and Public Health 19 (6). https://doi.org/10.3390/ijerph19063410

Carter, N., Bryant-Lukosius, D., Dicenso, A., Blythe, J., and Neville, A. J. 2014. "The Use of Triangulation in Qualitative Research." Oncology Nursing Forum 41 (5): 545–547. https://doi.org/10.1188/14.ONF.545-547

Castleberry, A., and Nolen, A. 2018. "Thematic Analysis of Qualitative Research Data: Is it as Easy as it Sounds?" Currents in Pharmacy Teaching and Learning 10 (6): 807–815. https://doi.org/10.1016/j.cptl.2018.03.019

Cruz Araújo, A. A., de Godoy, S., Arena Ventura, C. A., Rodolfo Silva, Í., Santos de Almeida, E. W., and Costa Mendes, I. A. 2022. "Reflections on Nursing Students Fear and Anxiety Arising from Clinical Practicums." Investigacion y Educacion En Enfermeria 40 (3). https://doi.org/10.17533/udea.iee.v40n3e13

de Jesus, J. A., and Balsanelli, A. P. 2023. "Relationship between Emergency Nurses’ Professional Competencies and the Nursing Care Product." Revista Latino-Americana de Enfermagem 31. https://doi.org/10.1590/1518-8345.6585.3939

De, S. 2022. "An Analysis of Theory Practice Gap in Nursing." Nursing & Healthcare International Journal 6 (6). https://doi.org/10.23880/nhij-16000276

Dornan, T., Conn, R., Monaghan, H., Kearney, G., Gillespie, H., and Bennett, D. 2019. "Experience Based Learning (ExBL): Clinical Teaching for the Twenty-First Century." Medical Teacher 41 (10): 1098–1105. https://doi.org/10.1080/0142159X.2019.1630730

Fawaz, M., Hamdan- Mansour, A., and Tassi, A. 2018. "Challenges Facing Nursing Education in the Advanced Healthcare Environment." International Journal of Africa Nursing Sciences 9. https://doi.org/10.1016/j.ijans.2018.10.005

Fullard, D. A. 2018. "Teaching the Importance of Developing the Therapeutic Relationship" New Directions in Treatment, Education, and Outreach for Mental Health and Addiction, 281–29. https://doi.org/10.1007/978-3-319-72778-3_19

Ghasemi, M. R., Moonaghi, H. K., and Heydari, A. 2020. "Strategies for Sustaining and Enhancing Nursing Students’ Engagement in Academic and Clinical Settings: A Narrative Review." Korean Journal of Medical Education 32 (2): 103–117. https://doi.org/10.3946/kjme.2020.159

Hassan, J.N., Al-Amarei, H,.M., Eidan, A. 2023. "Self-Perceived Work Stress between Emergency Department Nurses and General Wards Nurses." Kufa Journal for Nursing Sciences 13(2): 222–228. https://doi.org/10.36321/kjns.vi20232.12601

Hertz, U. 2021. "Learning How to Behave: Cognitive Learning Processes Account for Asymmetries in Adaptation to Social Norms." Proceedings of the Royal Society B: Biological Sciences 288 (1952). https://doi.org/10.1098/rspb.2021.0293

Jimenez, C., Martı, P., and Diaz, C. V. 2010. "Stress and Health in Novice and Experienced Nursing Students." Journal of Advanced Nursing 66 (2): 442–55. https://doi.org/10.1111/j.1365-2648.2009.05183.x

Kojuri, J., and Ashkani Esfahani, S. 2013. "Early Clinical Experience: A Way for Preparing Students for Clinical Setting." Galen Medical Journal 1. https://doi.org/10.31661/gmj.v1i2.15

Lin, E. C.-L., Chen, S.-L., Chao, S.-Y., and Chen, Y.-C. 2013. "Using Standardized Patient with Immediate Feedback and Group Discussion to Teach Interpersonal and Communication Skills to Advanced Practice Nursing Students." Nurse Education Today 33 (6): 677–683. https://doi.org/https://doi.org/10.1016/j.nedt.2012.07.002

Mlambo, M., Silén, C., and McGrath, C. 2021. "Lifelong Learning and Nurses’ Continuing Professional Development, A Metasynthesis of the Literature." BMC Nursing 20 (1): 62. https://doi.org/10.1186/s12912-021-00579-2

Noble, H., and Heale, R. 2019. "Triangulation in Research, with Examples." Evidence-Based Nursing 22 (3): 67–68. https://doi.org/10.1136/ebnurs-2019-103145

Papathanasiou, I. V, Tsaras, K., and Sarafis, P. 2014. "Views and Perceptions of Nursing Students on their Clinical Learning Environment: Teaching and Learning." Nurse Education Today 34 (1): 57–60. https://doi.org/https://doi.org/10.1016/j.nedt.2013.02.007

Podvorica, E., Rrmoku, B., Metaj, A., and Gashi, H. 2020. "Level of Stress at Nurses Working in Emergency Clinic and Central Intensive Care: University Clinical Centre of Kosovo." Open Journal of Emergency Medicine 08 (02): 39–52. https://doi.org/10.4236/ojem.2020.82005

Ramdani, W. F., Alim, S., and Hapsari, E. D. 2023. "Guardians of Safety: Indonesian Nurses and COVID-19 PPE Practices." Journal of Radiology Nursing 42 (4): 515–520. https://doi.org/10.1016/j.jradnu.2023.09.007

Rebeiro, G., Edward, K., Chapman, R., and Evans, A. 2015. "Interpersonal Relationships Between Registered Nurses And Student Nurses in the Clinical Setting—A Systematic Integrative Review." Nurse Education Today 35 (12): 1206–1211. https://doi.org/https://doi.org/10.1016/j.nedt.2015.06.012

Rubio-Navarro, A., García-Capilla, D. J., Torralba-Madrid, M. J., and Rutty, J. 2020. "Decision-Making in an Emergency Department: A Nursing Accountability Model." Nursing Ethics 27 (2): 567–586. https://doi.org/10.1177/0969733019851542

Ryan, F., Coughlan, M., and Cronin, P. 2009. "Interviewing in Qualitative Research: The One-To-One Interview." International Journal of Therapy and Rehabilitation 16 (6): 309–314. https://doi.org/10.12968/ijtr.2009.16.6.42433

Sánchez-Conde, P., Beltrán-Velasco, A. I., and Clemente-Suárez, V. J. 2019. "Influence of Psychological Profile in Autonomic Response of Nursing Students in their First Hospital Clinical Stays." Physiology & Behavior 207, 99–103. https://doi.org/10.1016/j.physbeh.2019.05.008

Siyamti, D. 2023. "Persepsi Stres Mahasiswa DIII Keperawatan Menghadapi Praktik Klinik Kegawatdaruratan." Jurnal Keperawatan Berbudaya Sehat 1 (2).

Wang, A., Lee, C., and Espin, S. 2019. "Undergraduate Nursing Students’ Experiences of Anxiety-Producing Situations in Clinical Practicums: A Descriptive Survey Study." Nurse Education Today. https://doi.org/10.1016/j.nedt.2019.01.016

Zaleski, M. E. 2019. "Emergency Nurse Orientation." Journal of Emergency Nursing 45 (5), 551–555. https://doi.org/10.1016/j.jen.2019.07.008