Adult Student Nurses’ Experiences of Urinary Incontinence in Their First Year of Study: A Longitudinal Phenomenological Exploration

Abstract

Urinary incontinence (UI) is a major health care problem which has significant implications for quality of life within an ageing population. Urinary continence can however, be restored by simple rehabilitative strategies and therefore nurses need to be knowledgeable and proficient in providing quality care for patients with UI. However, there is evidence that there is very limited content related to continence promotion within the current pre-registration nursing curricula and there are no specific modules dedicated to this area of clinical practice. Student nurses are also still expected to learn through doing i.e. delivering hands on care for patients with UI and are supported in practice by a qualified mentor. There is evidence however, that suggests that qualified staff have negative attitudes towards UI but what is not known is if these negative attitudes influence student nurses’ experiences of dealing with UI in clinical practice in their first year of study.
In order to generate a deeper understanding of the lived experiences of adult branch student nurses a longitudinal phenomenological study was adopted to explore their experiences in their first year of study. Thirteen students volunteered to participate and were recruited from 2 United Kingdom (UK) Universities. The students were interviewed on two occasions; once at the beginning of their first year and again at the end of their first year. Data was analysed using phenomenological and hermeneutical approaches including iterative reading and interpretation to identify the themes that emerged from the data.
The findings revealed 3 major themes; Being There, Being Understood and the Influence of Others. Being There, showed that student nurses are perplexed and confused about why loss of bladder function, is not viewed as something that requires assessment and investigation and is predominantly the remit of Healthcare Assistants (HCAs). Being Understood, captured the students’ problems in ‘finding a voice’ to express these concerns regarding this approach to UI care delivery in their desire not to ‘rock the boat’ and to ‘fit in’ with their nursing colleagues who were predominantly the HCAs in this study. The Influence of Others, encapsulates the role of the HCA in influencing the student nurses’ experiences of UI in their first year of study. Student nurses should spend up to 40% of their time in clinical placement supported by a qualified member of staff however, there is considerable evidence in this study that this support is infrequent. Student nurses’ experiences of UI therefore do not appear to be negatively influenced by qualified staff as they are infrequently their role models for this aspect of care in their first year of study. They are however, influenced by HCAs who have no formal training in this area of clinical practice or in supporting students in practice. The findings from this study have implications both for the education of student nurses and for HCAs.

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