Location of Repository

Being a real nurse; nurses accounts of learning and working in practice

By Karen Ousey


There has been much written regarding nurse education and the socialisation of student nurses in clinical areas in the past (Olesen & Whittaker 1968, Orton, 1981, Melia, 1987, 1997, Ogier, 1989, Castledine, 1995, Bradshaw 2001, Spouse, 2003). The originality of this thesis lies in the discussions and exploration of the concept of Problem Based Learning (PBL) as a teaching and learning strategy and the implementation of the Making a Difference\ud (DoH, 1999a) recommendations in a nursing curriculum. It investigates whether or not these have indeed made a difference to the ability of the students to socialise into their clinical roles and effectively meet their ultimate\ud aim of becoming a ‘real nurse’.\ud \ud The thesis is split into five chapters and employs qualitative research methods to present an ethnographic case study of the experiences of student nurses in clinical placement areas regarding the process of becoming effective student nurses who ultimately develop their knowledge and skills base to become\ud ‘real nurses’. The sample consisted of fifteen (15) students, fifteen (15) student mentors, eight (8) ward managers, one (1) practice development coordinator and one (1) senior nurse responsible for clinical development.\ud Interviewing and observation techniques were used to obtain the data. \ud \ud PBL as a teaching and learning strategy is investigated and discussed, in relation to the students’ ability to develop critical problem solving skills that can be incorporated into their student roles. The disadvantages of PBL are also debated and issues highlighted that may cast doubt that this strategy and the Making a Difference curriculum has actually changed attitudes in the clinical areas towards the capabilities of the student nurse role. \ud \ud Eight major themes arose from the data analysis; learning to be a student, fitting into the clinical team, being professional, being a real nurse, the role of the practice development co-ordinator, effective mentors, developing clinical skills and reflecting in practice. Integral to these were the concepts of\ud professionalism, power, inequalities and culture that were identified as significant underlying issues for the students to recognize when performing and developing into their clinical roles. \ud \ud The data suggest that the new curriculum and PBL have offered some solutions to help overcome the perceived boundaries of professionalism, power, inequalities and culture but by no means provides all the answers.\ud Overall the study has highlighted the importance of clinical skills development and effective delivery of them by students in learning to become a ‘real nurse’. Through their experiences the students have learnt how to overcome\ud boundaries and to fit in with the culture of clinical areas thereby enabling them to learn the role of the student nurse. Furthermore, the newly developed roles of the practice development co-ordinator and established mentor roles are perceived to be invaluable sources of support for the students while in clinical\ud placement area

Topics: RT
OAI identifier: oai:eprints.hud.ac.uk:4686
Downloaded from http://www.salford.ac.uk/

Suggested articles



  1. (2003). (2001a) Bridging theory and practice in the supervisory relationship: a sociocultural perspective.
  2. (2003a) Communication and Language: A Handbook of Theory and Practice. Palgrave Macmillan.
  3. (2003b) Promoting Equality. Challenging discrimination and oppression. Palgrave Macmillan.
  4. (1999). 2nd edition Qualitative Research in Nursing Advancing the Humanistic Imperative.
  5. (2004). A
  6. (1998). A Conceptual Framework for Facilitating Learning in Clinical Practice.
  7. (1993). A deconstruction of caring.
  8. (1988). A Group Approach to Problem Solving.
  9. (1999). A journey to becoming: the student nurse in transition
  10. (1993). A student centred problem-based curriculum: 5 years experience.
  11. (1993). A Vision for the Future: The Nursing, Midwifery and Health Visiting Contribution to Health Care.
  12. (1990). Academic contributions to psychological counselling: In. A philosophy of science for the study of individual cases.
  13. (1997). Advanced Practitioners: the hidden agenda?
  14. (1981). After Virtue. 2nd Edition.
  15. (1975). An Essay Concerning Human Understanding,
  16. (2000). An evaluative study of clinical preceptorship.
  17. (2001). An Introduction to Theory and Reasoning in Nursing.
  18. (1995). Analysing Social Settings: A Guide to Qualitative Observation and Analysis. 3rd edition.
  19. (1971). Analyzing social settings.
  20. (2003). Angel, handmaiden, battleaxe or whore? A study which examines changes in newly recruited student nurses’ attitudes to gender and nursing stereotypes.
  21. (1968). Asylums: Essays on the Social Situation of Patients and Other Inmates.
  22. (1983). Auditing Naturalistic Inquires: The Development and Application of a Model. Unpublished PhD doctoral dissertation.
  23. (1998). Basics of Qualitative Research. Grounded Theory Procedures and Techniques. 2nd edition.
  24. (1990). Basics of Qualitative Research. Grounded Theory Procedures and Techniques. New York:
  25. (2003). Basics of Qualitative Research. Techniques and procedures for developing grounded theory. New York:
  26. (1991). Becoming a registered nurse – the students’ perspective. A longitudinal qualitative analysis of the emergent views of a cohort of student nurses during their three year training for registration. Unpublished PhD thesis,
  27. (2001). Building Theories from Case Study Research.
  28. (1991). Calman Report- Hospital Doctors: Training for the Future.
  29. (2002). Caring as a slave morality: Nietzschean themes in nursing ethics.
  30. (1981). Caring: An essential human need.
  31. (1997). Caring: Gender Sensitive Ethics.
  32. (1997). Caring: Nurses, Women and Ethics.
  33. (2004). Case studies: A research strategy appropriate for palliative care? Palliative Medicine 18: 677-Ward-Schofield J
  34. (1984). Case study research:
  35. (1994). Case Study Research: Design and Methods. 2nd Edition. Thousand Oaks.
  36. (1999). Central Council for Nursing, Midwifery and Health Visiting
  37. (1961). Centre and periphery in The Logic of Personal Knowledge: Essays presented to Michael Polanyi., Routledge & Kegan Paul,
  38. (1989). Changing Times, Changing Paradigm (1): The Macarthur Experience. Nursing Education Today,
  39. (1971). Class, Codes and Control.
  40. (1991). Clinical Teaching in Nursing Chapman and Hall, London Whyte W F
  41. (1998). Communities of Practice: Learning, meaning and identity.
  42. (1990). Concepts of caring and caring as a concept.
  43. (1993). Conflicts in Care: Medicine and Nursing.
  44. (2001). Council for Nursing, Midwifery and Health Visiting
  45. (1981). Criteria for assessing the trustworthiness of naturalistic inquires.
  46. (1999). Critical to Success. Audit Commission.
  47. (1988). Demarcation in medical practice; the extended role of the nurse.
  48. (1989). Designing Qualitative Research.
  49. (1994). Developing Professional Knowledge and Competence. Routledge Falmer.
  50. (1978). Differentiation between social groups:
  51. (1977). Discipline and Punish. The Birth of the Prison.
  52. (1997). Discursive Psychology. In: Critical Psychology An Introduction. PP 285-298. Editors: Fox D, Prilleltensky I. Sage Publications.
  53. (1968). Economy and Society.
  54. (1999). Educational implications of multiskilled health carers.
  55. (1996). Educational Research: An introduction. White Plains,
  56. (1981). Effective evaluation: Improving the usefulness of evaluation results through responsive and naturalistic approaches.
  57. (1986). Effective Teambuilding. London: Pan
  58. (1982). Emergent Paradigms: How new? How necessary? In: E. Guba (Ed) The paradigm dialogue.
  59. (2000). Emotional Growth and Learning.
  60. (1999). Enhancing the quality of case studies in health services research.
  61. (1980). Entering Medicine: The Dynamics of Transition,
  62. (2005). Ethical issues in qualitative health research In: Holloway I (ed): Qualitative Research in Health Care.
  63. (1995). Ethical issues in qualitative studies.
  64. (2006). Ethical Issues in Social Research.
  65. (1996). Ethics and midwifery.
  66. (2001). Ethnography after Post-Modernism in Atkinson P et al (eds) Handbook of Ethnography.
  67. (1994). Ethnography and participant observation.
  68. (2000). Ethnography in Nursing Research. Thousand Oaks.
  69. (1995). Ethnography: Principles in Practice. 2nd edition.
  70. (1991). Executive
  71. (1938). Experience and Education.
  72. (1962). Exton-Smith A N
  73. (1993). Feminist epistemologies.
  74. (2004). Flexible education for new nursing roles: reflections on two approaches.
  75. (1983). Freedom to learn for the 80’s.
  76. (1985). From ethnography to theory: a programme and paradigm in the sociology of education,
  77. (1984). From Novice to Expert. Excellence and Power in Clinical Nursing Practice. Prentice Hall Health.
  78. (1982). From Ritual to Theatre.
  79. (1979). From Student to Nurse: A Longitudinal Study of Socialization.
  80. (2001). Fundamentals of Educational Research. 2nd edition. The Falmer Press Teacher’s Library. Routledge Falmer,
  81. (1996). Gender and the Professional Predicament in Nursing.
  82. (1997). Gray M A
  83. (2002). Grounded Theory http://az.essortment.com/groundedtheory_rmnf.htm Accessed 01/04/07 Davies E
  84. (1994). Grounded theory methodology: an overview.
  85. (1980). Grounded theory methodology: Its uses and processes.
  86. (1998). Grounded theory: issues for research in nursing.
  87. (1986). Grounded theory: The method. In
  88. Health (2004a) The NHS Improvement Plan: putting people at the heart of public services. Cm 6268. The Stationery Office.
  89. Health (2004b) Choosing Health: making healthy choices easier. The Stationery Office.
  90. (2000). Health Psychology for Health Care Professionals. 3rd Edition. Churchill Livingstone.
  91. (2002). in Using Experience for Learning. Eds: Boud
  92. (1992). Inside Nursing. A Critical Ethnography of Clinical Nursing Practice.
  93. (1997). Interpreting Qualitative Data. Methods for analysing Talk, Text and Interaction.
  94. (2005). Interviewing In: Holloway I (ed): Qualitative Research in Health Care.
  95. (1998). Introducing single case study research design: an overview.
  96. (2007). Introduction to Grounded Theory.
  97. (1993). Investigator as stranger.
  98. (1993). Is care a virtue for health care professionals?
  99. (2000). Is the complexity of care a paradox?
  100. (2000). Is there a place for ‘care’ within nursing?
  101. (1984). It’s Great to Have Someone to Talk To”: ‘Ethics and Politics of Interviewing Women’
  102. (1992). Leadership Roles and Management Functions in Nursing: Theory and Application.
  103. (1987). Learning and Working. The Occupational Socialisation of Nurses.
  104. (1997). Learning and Working. The Occupational Socialization of Nurses.
  105. (1993). Liberal education and vocational preparation. In: Barrow R and White P (eds) Beyond Liberal Education: Essays
  106. (1987). Lifelong learning and its relevance to nursing.
  107. (1962). Linguistic codes, hesitation phenomena and intelligence.
  108. (1986). Linking Data. Sage,
  109. (1999). Making a Difference: Strengthening the nursing, midwifery and health visiting contribution to health and health care,
  110. (1996). Making Sense of Qualitative Data.
  111. (1978). Mead’s social psychology. In:
  112. (1990). Mentorship – is it a case of the emperors new clothes or a rose by another name?
  113. (1999). Mentorship in nursing: a literature review.
  114. (1991). Methodological orthodoxy in qualitative nursing research: analysis of the issues.
  115. (1994). Methods, Sex and Madness.
  116. (1983). Mixing qualitative and quantitative methods: tri- angulation in action.
  117. (1993). Morton-Cooper A & Palmer A
  118. (1999). Narrative based medicine: why study narrative?
  119. (2004). National Standards, Local Action: health and social care standards and planning framework. 2005/06-2007/08. The Stationery Office.
  120. (1985). Naturalistic Inquiry.
  121. (2002). NMC President. NMC News.
  122. (1997). Nurse autonomy as relational.
  123. (1998). Nurses and Doctors at Work. Rethinking Professional Boundaries.
  124. (1970). Nursing and anthropology: Two worlds to blend.
  125. (2002). Nursing and the Division of Labour in Healthcare.
  126. (2003). Nursing Ethics. 4th Edition. Churchill Livingstone.
  127. (1997). Nursing Intimacy.
  128. (1984). Nursing Research the Application of Qualitative Approaches. Croom Helm,
  129. (1999). Nursing Research. Design and Practice.
  130. (1988). Nursing schools: students beacon to professionalism?
  131. (1999). Nursing stereotypes.
  132. (1987). Nursing students’ perspectives of clinical experience.
  133. (1971). Objectivity and subjectivity in educational research. In
  134. (1951). Observational field work methods. In:
  135. (2002). Ogier’s Reading Research How To Make Research More Approachable. 3rd Edition. Baillière Tindall.London.
  136. (1994). On the evaluation of ethnographies. In J.M.Morse (Ed) Critical issues in qualitative research methods. (Pp 187-209). Thousand Oaks,
  137. (1994). Participant observation and informed consent: relationships and tactical decision-making in nursing research.
  138. (1980). Participant Observation.
  139. (1972). Pedagogy of the oppressed. Sheed and Ward. London Freire P
  140. (1998). Perceptions of nursing as a career, among young people in schools and colleges. Department of Health.
  141. (1997). Philosophy for Nursing.
  142. (1984). Planning and developing programs systematically. In: Green et al (eds) Continuing education for the health professions. (pp 162-178) Sage.
  143. (2005). Power A Radical View 2nd Edition Palgrave Macmillan:
  144. (2002). Power: A Philosophical Analysis 2nd Edition
  145. (1982). Power/Knowledge: Selected Interviews and other Writings
  146. (1994). Practice Based Learning: Problem Based Learning applied to medical education. Springfield (IL):
  147. (1995). Problem Based Learning in a Health Services Curriculum.
  148. (2000). Problem Based Learning in Higher Education: Untold Stories.
  149. (2000). Problem Based Learning in Nursing.
  150. (1980). Problem Based Learning, An Approach to Medical Education.
  151. (1997). Problem Based Learning, Part 1: an innovation whose time has come.
  152. (1991). Problem orientated Training Promotes Spontaneous Analogical Transfer. Memory Orientated Training Promotes Memory for Training. Memory and Cognition.
  153. (1997). Problem solving in clinical nursing practice.
  154. (1998). Problem-based learning: preparing post-RN students for community based care.
  155. (1990). Problem-based learning.
  156. (1970). Profession of Medicine. A Study of the Sociology of Applied Knowledge. Dodd, Mead and Company.
  157. (1990). Professional autonomy and client exclusion: a study in ENT clinics. In:
  158. (1957). Professional Ethics and Civic Morals (Translated by Cornelia Brookfield) Routledge and Kegan Paul, London Du Toit D
  159. (1999). Professional nurse autonomy: concept analysis and application to nursing education.
  160. (1993). Professional socialisation of nursing students as an outcome of a senior clinical preceptorship experience.
  161. (1975). Professional socialization as subjective experience: The process of doctrinal conversion among student nurses. In: Cox C, Mead A (Eds) A Sociology of Medical Practice.
  162. (1995). Qualitative Data Analysis. A User Friendly Guide for Social Scientists.
  163. (1990). Qualitative evaluation and research methods (2nd ed.).
  164. (1992). Qualitative Health Research.
  165. (1998). Qualitative Inquiry and Research Design: Choosing Among Five Traditions.
  166. (1997). Qualitative inquiry and research designs: Choosing among five traditions. Thousand Oaks,
  167. (1987). Qualitative Research: A Contemporary Dialogue. Thousand Oaks.
  168. (2002). Qualitative Researching. 2nd Edition. Thousand Oaks.
  169. (2003). Quality in Qualitative Evaluation: A Framework for Assessing Evidence. Government Chief Social Researchers Office,
  170. (1984). Reading nursing: the burden of being different.
  171. (2003). Real World Research. 2nd Edition.
  172. (1985). Reflection – Turning Experience into Learning.
  173. (1996). Regulations and Guidelines for the Approval of Institutions and Programmes.
  174. (1999). Researching Social Life.
  175. (2001). Researching Social Life. 2nd Edition Sage Publications;
  176. (1998). Rethinking Feminist Ethics: Care, Trust and Empathy.
  177. (2004). Safeguarding children and the future of the nursing and midwifery council.
  178. (1993). Sampling: purpose and generality, in: Colquhoun D, Kellehear, A (eds) Health Research in Practice: Political, Ethical and Methodological Issues. Chapman and Hall.
  179. (1998). Scaffolding student learning clinical practice. Nurse Education Today 18, 259-66 Spouse J
  180. (1997). Scaffolding techniques of expert human tutors. In: Hogan
  181. (1988). Social Identifications.
  182. (1957). Social Theory and Social Structure. Glencoe: Free Press Merttens R
  183. (2001). Sociology of Health and Health Care. 2nd Edition. Blackwell Science.
  184. (1971). Sociology of occupations and professions.
  185. (1973). Sociology. Introductory Readings.
  186. (1987). Some aspects of the hidden curriculum. In: Allan
  187. (1994). Specialist and advanced nursing and the scope of practice. In: Hunt G, Wainwright P (eds). Expanding the Role of the Nurse. Blackwell Science.
  188. (2002). Standards for the preparation of teachers of nursing and midwifery London: NMC Nursing and Midwifery Council
  189. (1985). Strategies for theory construction in nursing. Norwalk: Appleton and Lange.
  190. (2000). Student and mentor perceptions of mentoring effectiveness.
  191. (1999). Student carers: learning to manage emotions.
  192. (2001). Student nurses’ perceptions of Project
  193. (1967). Studies in Ethnomethodology. Prentice-Hall Inc. Englewood Cliffs,
  194. (2003). Studying Nursing Using Problem-Based & Enquiry-Based Learning.
  195. (1994). Styles of ethnography. In J.M.Morse (ed) Critical issues in qualitative research methods. (Pp 159-185). Thousand Oaks.
  196. (2006). Successful Qualitative Health Research. A practical introduction.
  197. (1972). The Archaeology of Knowledge.
  198. (1995). The Art of Case Study Research. Thousand Oaks,
  199. (1997). The Body Politic: Health, Family and Society. Unit 11. Open University Literature, In: Social Problems and Social Welfare.
  200. (1986). The Case Study Method in Psychology and Related Disciplines.
  201. (1978). The case study method in social inquiry.
  202. (1994). The challenges for nursing and midwifery in the 21st century (The Heathrow Debate). Department of Health.
  203. (2001). The Changing Shape of Nursing Practice. The role of nurses in the hospital division of labour.
  204. (1949). The Concept of Mind.
  205. (1984). The Constitution of Society: Outline of a Theory of Structuration.
  206. (1967). The discovery of grounded theory: Strategies for qualitative research.
  207. (1979). The Divided School.
  208. (1996). The effective mentor: A model for student-centred learning in clinical practice.
  209. (1986). The emergence of norms competitive decision-making groups.
  210. (1992). The Emotional Labour of Nursing Macmillan.
  211. (2000). The Emotional Labour of Nursing: How Students and Qualified Nurses Learn to Care. A Report on
  212. (2001). The Ethics of Ethnography in P. Atkinson and Hammersley M (eds) Handbook of Ethnography.
  213. (1993). The five C’s of caring: the lived experiences of student nurses.
  214. (1963). The hospital and its negotiated order In: Worsley P Ed
  215. (1993). The impact of trusts in the management of the NHS.
  216. (1986). The Individual Subject and Scientific Psychology.
  217. (1959). The Logic of Scientific Discovery.
  218. (1983). The managed heart: commercialisation of human feeling.
  219. (1997). The nursing-medical boundary: a negotiated order? Sociology for Health and Illness.
  220. (1970). The order of things.
  221. (1992). The poverty of professionalisation: a critical analysis of strategies for the occupational advancement of nursing.
  222. (1989). The Primacy of Caring: Stress and coping with health and illness.
  223. (2000). The professional socialization of diploma of higher education in nursing students (Project 2000): a longitudinal qualitative study.
  224. (1992). The professionalisation of social work? A case study of three organisational settings.
  225. (2001). The Project
  226. (1994). The Qualitative Research Interview.
  227. (1995). The Racism of Psychology: Time for Change. Harvester Wheatsheaf.
  228. (1983). The Reflective Practitioner. How Professionals Think in Action. Basic Books,
  229. (1998). The relationship of tutor’s content expertise to interventions and perceptions in a PBL medical curriculum.
  230. (1965). The Renaissance foundation in anthropology.
  231. (2004). The role and accountability of senior health care support workers in intensive care units. Intensive and Critical Care Nursing.
  232. (1993). The Scope of Professional Practice.
  233. (1968). The Silent Dialogue: a Study of the Social Psychology of Professional Socialisation.
  234. (1984). The Sociological Eye. Transaction Books. New Brunswick and London.
  235. (1997). The Teacher Practitioner and Mentor In Nursing, Midwifery, Health Visiting and The Social Services. 2nd Edition. Stanley Thornes.
  236. (1997). The theory of human caring: retrospective and prospective.
  237. (2000). The use of reflection in a palliative care programme: a qualitative study of the development of reflective skills over an academic year.
  238. (1978). Theoretical Sensitivity.
  239. (2000). Theory and Practice in Human Services. 2nd Edition.
  240. (1995). Too busy studying to give patient care.
  241. (1996). Towards a model of competence
  242. (1986). Towards Ecological Understanding of Occupational Stress.
  243. (1991). Triangulation in qualitative research: issues of conceptual clarity and purpose
  244. (2001). Understanding Culture: Cultural Studies Order,
  245. (1998). Understanding learning in the professional context: 5 case studies of nurses from a pre-registration degree course. Unpublished PhD Thesis.
  246. (1998). Understanding problem based learning contexts from staff and students’ perspectives. Paper presented at Higher Education Close Up,
  247. (1985). Using grounded theory method in nursing research.
  248. (1994). Validity through triangulation.
  249. (1981). Ward Learning and Climate. A Study of the Role of the Ward Sister in Relation to Student Nurse Learning on the Ward. RCN Research Series.
  250. (1982). Ward Teaching and Learning: Sister and the Learning Environment. London. Royal College of Nursing.
  251. (1984). What do nurses want in a mentor? The Journal of Nursing Administration. October: 42-44 Darling V
  252. (1992). What’s Wrong with Ethnography?
  253. (1997). Who am I? The need for a variety of selves in the field. In
  254. (1995). Who care about care in nursing education?
  255. (1967). Whose side are we on? Social Problems 14 (Winter) 239-Begley C M
  256. (2003). Whyte L A
  257. (1991). Wilkins A L
  258. (1995). Will the nurse practitioner be a mini doctor or a maxi nurse?
  259. (1975). Will, Freedom and Power.
  260. (1992). Witz A
  261. (1989). Working and Learning.
  262. (2004). Working paper 2. Improving the quality of research proposals. www.info.lut.ac.uk/depart,emts/cv/wedc/garnet/actiwp2html accessed 10th

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.