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Challenges experienced by nursing students

CLINICAL PRACTICE AT REGIONAL HEALTH TRAINING CENTRE IN NAMIBIA

Paulus Tangeni Egodhi | Master's Degree in Public Health and Nutrition | Part 2/2

3. Data analysis and results Data analysis entails categorizing, ordering manipulating, and summarizing the data, and describing them in meaningful terms (Brink et al, 2013) and therefore themes and sub themes were obtained by means of data analysis. The researcher follow the following steps during the focus group data analysis. Data were analysed by qualitative content analysis, after each focus group discussion, debriefing done immediately after each focus group discussion with the researcher assistant listening to the audio record and transcribing, and notes were taken about the process, non-verbal communication and gestures of the participates. Then three levels of coding were selected for coding of data. Level 1 coding, the researcher and his assistant examined the data line by line and made codes from the language of the participants. Level 2 coding, the researcher compared the coded data and categories were created after clustering the coded data resulted from condensing the level coding. Level 3 coding, a central theme was derived from the categories that emerged during coding. The participants consist of thirty nursing students in their third year of study, aged from 20 to 28 years. 18 (60%) were female between the age of 20–27 years of age and 12 (40%) were male between the age of 21–28 years of age. After qualitative analysis of the focus group discussion on the challenges experienced by the nursing students in clinical practice the main the five themes emerges: (See Table 1)

4. Discussion The study revealed that there are challenges experienced by the nursing students in clinical settings. This challenges negatively affects their clinical learning, lack of equipment, supplies, and shortages of nursing staff, lack of supervisions are among the top challenges in public health facilities in Kavango region. There are some similarities between the findings of this study and other reported studies in southern African countries such as Botswana and Malawi, and this confirmed that some of the challenges experienced by nursing students at RHTC is not only unique to our facility but general in nursing education.

THEMES
3.1.1 Initial clinical practice experience
3.1.2 Clinical supervision
3.3.3 Theory and practice gap
3.3.4 Insufficient recourses and equipment’s
3.3.5 Lack of respect and understanding

SUB-THEMES
3.3.1.1 Good and exciting learning experience
3.1.2.1 Insufficient clinical supervision
3.3.2.2 Inadequate prop

4.1 Initial clinical practice experience From Marian University (2013) one student wrote in a blog about her first clinical experience that it was a nerve wrecking, she indicated that to do vital signs and listening through stethoscope was not so difficult and she also specified that she met some nurses in practical area that are very kind and easy to work with, but some have poor communication skills. In the journal of clinical nursing (2014) indicated that nursing students with some knowledge of the work place normally adapt better and they don’t experience anxious much as the first timers. Hughes et al, (2013) stated that allocating students from different levels to work together encourage peer group support and learning. Paring student with one who have previous experience decreases the anxiety and discomfort from the learner at the same time provides opportunity to the more experienced student to compare and contrast the clinical settings.

4.2 Clinical supervision The students mostly mentioned that they were left alone without proper orientation and expected to carry out some procedures supposed to be done by qualified health professional, thewere left without anyone to supervise them especially at clinics and health centres. The literature advocates that clinical nurse supervisors should demonstrate role model to students by mentoring to facilitate nursing learning. Clinical instructor take a role of supervising and not only evaluating nursing students in clinical practice.

4.3 The theory and practice gap The literature indicated that there is indeed a gap between theory and practice (Akram et al., 2018) identified that, there is quite evidence that gap’s phenomenon does exist and has its strengths as well as are that can be improved. Scully (2010), suggested that teaching methods and the responsibility of the student underpin the development of competency in nursing and it play a role in bridging the theory and practice gap. Developing a sustainable approaches to enhance clinical learning environment experience for nursing students is an international concern, (Newton et al., 2012).

4.4 Inadequate recours- es and equipments Conducive environment and adequate recourses at clinical practice, have direct influence on the student learning and determine their opinion if the particular clinical area is appropriate for their clinical practice and teaching (Chaun, Barnett. 2012).

4.5 Lack of respect and understanding Lack of communication and understanding between nurse educator and the nursing students it affects negatively the clinical learning and make clinical practice less effective. (Chaun, Barnett 2012). In nursing profession a special level of knowledge, skills, and personal characteristics are the most necessity to prepare them to enter into working environment in different time intervals (Magnussen, Amundson. 2003)

5. Recommendation This study reveals challenges that nursing students in public health facilities in Kavango east region encounter during clinical practice. The research findings mainly show poor resource clinical setting, if clinical teaching role and airy attitudes which some nurses’ display toward nursing students are not taken care of, then negative attitudes of nursing staff toward patients and clients would not improve. There is a need for concerted efforts by education institution that train nurses and health care providers facilities and to come together in order to improve and harmonize clinical nursing education in Namibia. The research findings in this study support the critical role of clinical learning and the integration of the theory education to practice. If the enhancement of learning in clinical practice has to be realized, the following recommendation the researcher believes should be implemented; • Counselling and debriefing of nursing student should be considered on regular basis to students identified with anxiety during clinical placement. Preclinical orientation conference to prepare nursing students before initial allocation to clinical areas. • Lecturers and clinical instructors should update themselves on the latest practice in the clinical fields by allocated to clinical practice with particular procedures in log book and required hour to fulfil. • Teaching health facilities managements should compelled to provide necessary equipments and make resources available for nursing students to utilize. • Further research to be conducted on how to enhance professional socialization of nursing students and on how best the health educators can assist nursing student in clinical practice to achieve their gaols and potentials. Furthermore, the findings of this study would help nurse educators to come up with strategies and programmes to enhance efficiency in clinical teaching and guide policy makers to develop new structures for management and support nursing students.

Acknowledgements Special thanks to my wife Paulina Tashiya Shingelendu–Egodhi for the love, care encouragement and support throughout my study from the start and my entire family and friends for their unconditional support that I receive in many ways, thanks to you all. The End

REFERENCES.
1. Akram A S, Mohamad Al, & Akram S (2018) Gap between theory and practice in the Nursing education: the role of clinical setting. (PDF) JOJ Nursing and Health Care. Retrieved 24 September 2018. | 2. Brink, HC. & Van Resburg, G (2013) Fundamentals of Research Methodology for Healthcare Professionals. South Africa: Impressum Print Solutions | 3. Burns, N. & Grove, S. K. (2011). Understanding nursing research: Building an evidence- based practice. St. Louis: Sau ders Elsevier. | 4. Chaun O L, & Barnett T (2012 Student tutor and staff perceptions of the clinical learning environment. Nurse Education in practice, 12: 192-96. | 5. Hilla, B. (2012) Fundamentals of research methodology for health professionals. 3rd ed. Cape Town, South Africa: JUTA. | 6. Hughes, S J & Quinn, F M (2013) Quinn’s principles and practice of nurse education 6th ed. Andover: Cengage Learning | 7. Iipinge, S N & Venter E S (2003) Student nurses experience during rural community placement Program in Namibia. Curations. | 8. Jooste, K. (2011). The principles and practices of nursing and health care: Ethos and | 9. Juta, L (2012). Fundamentals of research methodology for healthcare professionals, 3rd edition, UK | 10. Kelly P. (2013) Nursing Leadership & Management. 3rd. Cengage Learning, Houston, Taxes US. | 11. Killam L A, & Heerschap C (2012) Challenges to student learning in the clinical setting. A qualitative descriptive study. Nurse Education, 33: 684-691. | 12. Kindersley L.K. Social teaching Theories 9th ed, Oxford University | 13. Lutz, David. (2014). African Ubuntu Philosophy and Global Management. Journal of Business Ethics. 84. 313- 328. | 14. Macner, C. & McCabe, S. (2008). Understanding Nursing Research: Using research in evidence based practice. Edinburg, UK: Northern-east University Press. | 15. Magnussen L, & Amundson M J. (2003) Undergraduate nursing student experience. Nursing Health Sci.; 5:261–6 | 16. McQuide, P, Kolehmainen-Aitken, R & Foster, N. 2013. Applying workload indicators for staffing need (WISN) method in Namibia: challenges and implications for human resources for health policy. 64 (11): [1-5]. http://www.ncbi.nlm.gov/pmc/articles/PMC (accessed on 11 April 2016). | 17. Mellish, J M, Brink,H & Paton, F (2009). Teaching and Learning the practice of Nursing. 4th ed. Heinemann. | 18. Melnyk B.M & Fineout E. (2015) Evidence-Based Practice in nursing & Healthcare. 3rd edition. Wolter Kluwer. New York. | 19. Ministry of Health and Social Services, Namibia. (2013) Registered nurses job profiles. | 20. Motiagh GF, Karimi M, & Hasanpour M (2012) Iranian nursing students' experiences of nursing. Iranian J Nursing Midwifery Res 17: S107-S114. | 21. Muyenga, M. 2014. Implementation of adolescence friendly health services, Otjozondjupa, Namibia. MPH dissertation. The University of Namibia. Windhoek | 22. Newton J M, Jolly B C, Ockerby & Cross W M (2012) Student centeredness in clinical learning: the influence of the clinical teacher. Blackwell Publishing Ltd. Retrieved 25 September 2018. | 23. Newton JM, Jolly BC, Ockerby CM & Cross WM (2010). A clinical Learning Environment Scale: a factor analysis. Journal Advanced 66, 1370-1481 | 24. Nieswadomy, R. M. (2002).Foundations of nursing research (4th edition). New Jersey: Prentice Hall | 25. Okoronkwo i., Onyia-pat J, Agbo M., Okpala P & Ndu A (2013) Student perception of effective clinical teaching and teacher behaviour. Journal of Nursing. 3, 63 -69. | 26. Polit, D. F. & Beck C.T. (2012). Nursing research generating and assessing evidence for nursing practice. 9th edition. Wolter Kluwer. New York. | 27. Scully N J (2010). The theory–practice gap and skill acquisition: An issue for nursing education. Elsevier Ltd; Australia. | 28. Searle, C H S, & Mogotlane, S, M. 2009. Professional Practice-A Southern African Nursing Perspective. 5th ed. Johannesburg: Heinemann. | 29. The government of the Republic of Namibia. 2014. Nursing Act No 8 of 2014. Windhoek: Government Printer. | 30. Waldock J. (2010) Facilitating student learning in clinical practice: may clinical nurse believe they are ill prepared and poorly supported to supervise students, hpp://www.thefreelibrary.com. Accessed 20 September 2018. | 31. Wilson A. (2014) Are the demands of nurse mentoring underestimated? Nursing Times. http://www.nursing times.net. (Accessed September 2018)

Publications by Students: aiu.edu/StudentPublication.html

I’m a college student

By Dr. Rosa Hilda Lora M. Advisor at AIU | rosa@aiu.edu

I ’m a College student. Beautiful statement! When I say this expression to you, it’s because I traveled a path: I examined my abilities, I saw myself in what I want to be in my life, I selected the university where I want to make my dream come true and now I must start the necessary activities to arrive to my goal To reach my goal I begin to think that I have to do research to show you that I’m acquiring the knowledge indicated and then apply them in what will be my daily life, either as an entrepreneur in my own company or as an employee in the company which I dream that I’ll work. I look for everything I need to study and it comes now: to start doing it.

What needs to be done to say that I study and even more to learn, to apply what I know? To study: what I have to do is –know how to read and know how to write. Is it that easy? Yes, it’s that easy. I realize that sometimes, or many times, I have to read more than once the document from which I want to extract the knowledge it expresses. How to make this task easier? We have good news for you. Every document has a structure, a way in which it was built; that structure is logical. The logical structure is the division by themes and subthemes.

When it comes to reading, most of the documents are structured: an easily identifiable numbering or presentation appears by integrating alphabetically related letters.In the case of the essays the structure may not appear visually. The structure of a document is the division by themes and sub-themes; there are also the main ideas within the subtopics. The main ideas can be at the beginning, center or end of the document and are identified as follows: what is explained is the main idea; the secondary ideas are the ones that complement. It happens that when reading is not understood because there are concepts within the text that we don’t know its meaning. The situation is resolved by looking for explanations of the concept in a dictionary of the subject matter.

Underlining or marking the logical division, the division by themes and sub-themes and the main ideas we can understand the document that is what is called reading. The documents that are interdisciplinary, which may include mathematics, they need that knowledge independently.

When I read in the way we just explained, my work will be productive and I can write about my object, I can write my assignment applying any of the existing methodologies without having problems because I learned all the elements that my subject has, my object of study and I can present in any of the ways you tell me. The methodologies for a research can be: Holistic Methodology: Explain from any method and consider the application for the benefit of society Quantitative Methodology: Explain from the measurement. Dialectical Methodology: Explain why this is in this way and why the opposite can’t be. Below we exemplify what we have just explained so you can understand how to read in science successfully.

“Fortunately, today it is no longer necessary to insist on the interest offered by the historical study of science, nor is it necessary —after the masterful works of a Duhem, an Emile Meyerson, and those of Cassirer and Brunschvicg— to insist on interest and rich knowledge that this study provides from the philosophical point of view. Indeed, the analysis of the evolution (and revolutions) of scientific ideas —the only story that (along with that of the technique) gives a meaning to the concept of progress, as exalted as detracted— reveals the disputes waged for the human mind with reality; it reveals to us its defeats, its victories; it shows what superhuman effort each step on the path of understanding the real has cost, an effort that sometimes led to a true “mutation” in the human intellect; transformation thanks to which some notions laboriously “invented” by the greatest geniuses become not only accessible, but even easy and obvious to schoolchildren.” (Koyré, 2005. p. I)

The structure of the document Document structure. These are the themes and subthemes: I have a text in which no numbering or division appears but I have to know what it says; I have to read it successfully. Main ideas. They can be at the beginning, center or end of the document. The main idea of this text is at the beginning of the document and is: “The analysis of the evolution (and revolutions) of scientific ideas” The ideas that explain the main idea are as follow: “Concept of progress” “The disputes waged by the human mind with reality” “Superhuman effort on the path of under- standing the real” If I don’t know the meaning of the main idea and those that explain it, I already have a precise way to look for these concepts and take the readings I need and I will always obtain successful results to conclude my research. I can search the dictionary for the names of the people mentioned in the text and I already have my reading done successfully. When I read the way we have just explained, they can tell me to do a job with this or the other method and I’ll be able to do it because I understood the subject I’m reading through a well-done reading. Passing the letters of a document in front my eyes doesn’t give me the knowledge I need and that is why the difficulties to do the university work that I must present. In my research work I will have: the Cover, the Introduction. The theory that I’ll apply, the case to which I want to apply it, what I learned by doing the work and the bibliography that will indicate the scientists on which I relied.

There is another situation to consider in terms of being a university student. Being a College student also leaves me a lifelong commitment. I was able to go to a university because the society in which I live is organized and could have the institutions that allowed me to be a college student. I have a commitment for life because I must contribute to the development of the country where I live because the efforts of my fellow citizens gave me the opportunity to be a College student. I must contribute so that other human beings have, like me, the opportunity to live their lives according to what they think will make them happy. I’m a college student and I have the commitment that others can be. I’m a college student and I have the commitment to teach others to be true college students.
BIBLIOGRAPHY. Koyré, Alexander. (2005). Estudios Galileanos. España: Siglo XXI.

LESSONS LEARNED FROM FINAL THESIS PROJECT: International Relations

By Scott Wilson, PhD | Advisor at AIU

With a solid support system, perseverance, and a little luck, I recently completed my Final Thesis project in International Relations. Along the way I made a few observations that could help other students in their quest to complete their own final thesis research project. Although my own particular thesis project was in the field of International Relations, the lessons learned here may be applicable to other fields as well. Lesson #1: No matter what stage you are in your academic program, keep an updated and on-going list of potential final thesis topics.

Chances are that your academic interests and potential topics for your final thesis will evolve over the course of your academic studies. This is a normal part of the academic process where we discover new things about the world, and about ourselves. Personally, my final research project remotely resembled the topics that were on my early list. However, keeping a list of potential topics almost forces you into looking ahead during your studies. In addition, through the process of elimination, you’re moving closer to your eventual topic! So, whenever a topic enters your mind, write it down in your topics journal! Lesson #2: Let the topic come to you! My list of potential topics evolved; just as easily it was for one topic to join the list another was removed just as easy. Personally, I knew that I wanted to analyze Latin American politics, but I wasn’t quite sure how this would come about.

Would it be Latin America in general? Or, would it involve Colombia or Guatemala, two countries that I had personal connections in? In other words, I was lacking details. Then, I came across an article about a professor who, in the 1990’s, used public opinion surveys in Russia as a means to gauge how legitimate the Russian Government was at the time. There it was; it hit me like a slap in the face; I would use public opinion surveys in Guatemala to determine the strength and legitimacy of the Guatemalan Government! In short, it was only by reading and continually thinking about potential ideas that my topic suddenly became very clear to me.

Lesson #3: Don’t underestimate your own contacts! For the next three months I created a public opinion survey for Guatemalans, and it was a great survey! But, I had a problem... How would I administer this survey; I lived the U.S., after all. My first inquiry was with my professional contacts that I already had in Guatemala, but my contacts were unable to assist me. My second inquiry was with professional public opinion survey companies in Guatemala, but they were unwilling to take on this project as well. So, with nowhere else to turn, I contacted an acquaintance in LinkedIn; a Guatemalan that I communicated once with about four years ago. When asked if he knew of a survey company, he said, yes; his firm does public opinion surveys in Guatemala! So, just like that, the project was back-on! Lesson #4: Expect the unexpected, so be flexible and go with the flow!

My contact with the survey company in Guatemala was a gentleman named Sebastian and via email and WhatsApp we refined my original survey and it came out great! The next stage entailed a visit to Guatemala to finalize the project and conduct pilot tests. When I met Sebastian, though, we had a problem; he was only 18 and this was his first assignment! My initial reaction was to go to my contact and demand a new contact, or simply go with the flow and work with Sebastian. Being that communications between Sebastian and I went well up until that point, I opted to work with Sebastian. In the end, though, I was very pleased with this decision; the outcome was fantastic, and I’m not sure that another professional would have so eagerly incorporated the many revisions that we made as the project unfolded! In closing, I hope that these lessons learned will be useful to you as you embark on your own Final Thesis. Do you have lessons learned from your own Final Thesis that could help your colleagues? If so, please share; we’d love to hear about your experiences as well!
Mailbox: aiumagazine@aiu.edu

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