Student nurses' experiences of caring for patients in pain.
Poor pain assessment contributes to inadequate pain relief. Studies in the United States have shown that while student nurses become more sensitive to psychological distress during training, they become less sensitive to pain. However, a recent study by the authors in the United Kingdom found that while inferences of psychological distress increased there was no change in inferences of pain over the common foundation programme. This study set out to explore their experiences of caring for patients in pain during the first 18 months of their training in order to understand how these experiences might affect their sensitivity to patient's pain. Interviews with 15 students following their common foundation programme showed that they experienced a wide range of strong emotions when caring for patients in pain. Their relatively junior status in the wards seemed to place them in difficult positions and provided them with little support. Theories of desensitisation, cognitive dissonance and acculturation have been proposed to explain decreasing sensitivity to pain. The lack of a significant change in students' inferences of pain and the analysis of their interviews suggest that their experiences are more varied than these theories suggest. The students experiences echo those found in previous studies relating to the socialisation of student nurses and emotional labour (Melia, 1987. Learning and Working. The Occupational Socialization Nurses. Tavistock Publishers, London; Smith, 1992. The Emotional Labour of Nursing. Macmillan, London). These findings have important implications for both nurse education and the mechanisms to support student nurses in clinical practice.
Faculty of Medicine and Health Sciences, University of Nottingham, Queens Medical Centre, NG7 2UH, Nottingham, UK. nick.allcock@nottingham.ac.uk
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D000069:Acculturation; D000223:Adaptation, Psychological; D001291:Attitude of Health Personnel; D003073:Cognitive Dissonance; D004645:Empathy; D006185:Habituation, Psychophysiologic; D006801:Humans; D007389:Internal-External Control; D007400:Interprofessional Relations; D009723:Nurse-Patient Relations; D009730:Nursing Assessment; D015404:Nursing Methodology Research; D010146:Pain / Q000175:diagnosis / Q000451:nursing*; D010147:Pain Measurement; D010344:Patient Advocacy; D011209:Power, Psychological; D012380:Role; D012951:Socialization; D013338:Students, Nursing / Q000523:psychology*; D011795:Surveys and Questionnaires