Points of tension: a qualitative descriptive study of significant events that influence undergraduate nursing students' sense of belonging

Abstract

Introduction: Soon-to-be graduate nurses who choose to begin their career in rural hospital settings face not only the challenge of learning to do rural nursing, but also how to navigate the complex personal and professional relationships that characterize the close knit community of rural hospital teams. Since every encounter with registered nurses and other members of the team is contextually mediated, the challenge for students, preceptors, other professional staff members, and nurse educators is to develop a supportive clinical environment that fosters students' sense of belonging. The objective of this study was to describe events that influence undergraduate nursing students' sense of belonging during a rural hospital preceptorship, and to explore their meaning.

Methods: Using the clinical incident technique, a purposive sample of fourth year nursing students completing a rural hospital-based preceptorship in southern Alberta and British Columbia, Canada was used. Individual in-person and telephone interviews as well as written accounts were analyzed. Inductive and comparative analysis was used to uncover the themes 'points of tension' and 'minimizing the differences'.

Results: The clinical environment that includes everyone who interacts with the student has the potential to positively or negatively influence students' sense of belonging. Tension developed when students' expectations of their preceptor, nurses, and other professional team members did not coincide with the reality of the everyday clinical environment. Only when the differences between themselves and the registered nurses they worked with on daily basis were minimized did the participants in this study feel as if they belonged to the community of professional nurses.

Conclusion: Nurse Educators need to carefully assess not only students' knowledge of rural nursing practice, but also students' expectations of themselves, their preceptor, other professional staff members, and the overall clinical environment. As such, students need to develop social awareness and facility. Preparation also extends to everyone in the clinical setting who is involved in the students' experience so that they learn not only what students know but how to interact with them. In this way the clinical environment is supportive of students' learning and transition to the graduate nurse role.