'Feel the Fear and Do It Anyway': Nursing Students’ Experiences of Confronting Poor Practice

Aim: The two aims of this study were, first, to explore nursing students’ experiences and perspectives of reporting poor care and second, examine the process by which they raised concerns.

Background: The nursing literature is replete with studies which explore nursing students’ experiences of clinical placement. However only a small number explore students experiences of challenging poor care and how this is enacted in the practice setting. Setting and participants: Fourteen nursing students from undergraduate pre-registration nursing programs across three universities, two in the United Kingdom (UK) and one in Australia.

Design and analysis: This paper reports findings from narrative interviews about students’ clinical experiences of reporting poor care. Data were audio recorded, transcribed verbatim and analyzed using a constant comparison approach. Emerging themes were identified, discussed and verified by the researchers.

Results: Four montages from the narratives highlight the overarching themes: bullying, patient advocacy, lack of empathy and poor care. They demonstrate how, driven by an ethical imperative, students speak up when they witness poor care despite the difficulties of doing so: in some cases, the students in this study were prepared to continue speaking out even when initial concerns were dismissed.

Conclusion: Both practice and university teams have a responsibility to support students’ development as ethical and courageous practitioners, able to recognize when care falls below an acceptable standard.