Quality nursing care: An exploration of student nurses' perspectives

The purpose of this qualitative study was to explore and describe the delivery of nursing care from the perspective of associate degree nursing (ADN) students. Actions and interactions attributed to quality care were explored as well as factors that enhance or inhibit the delivery of such care. Moreover, nursing students' perceptions of the significance of patient education as well as how they incorporate teaching into their practice were explored. A total of 26 students from a North Texas college Associate Degree Nursing (ADN) program volunteered to participate in this research study. All students participated in focus group discussions.

The premise for this research was the assumption that insights into students' perceptions can be gained from accounts of their lived experiences. Students provided significant insights into their experiences and the context of their responses was always considered.

Three separate focus groups were held in February 2000 at the hospital clinical facilities. Participants' perceptions of quality care and patient education were obtained through the use of focus groups. HyperResearch was used for data analysis. Qualitative analysis of focus group discussions revealed that quality nursing care was perceived to relate to the degree to which patients' physical, psychosocial, spiritual, emotional, psychological, and educational needs were met. The consequences of quality care were interpreted as therapeutic effectiveness where the therapy provided by nurses was perceived to positively affect patient healing. This was gauged by the patients' psychosocial and physical response to illness, safety, and satisfaction. Quality care was facilitated by the development of positive relationships between students and staff nurses, competent practices, as well as a functional nursing team.

The problem of student nurses' inability to consistently provide quality care to all patients was identified. Insufficient time and nonsupport from nursing staff were perceived to be the major barriers to the delivery of quality care. Dissatisfaction and stress in student nurses was related to this problem. Moreover, concern was expressed that students were not being adequately prepared to successfully transition from the student role to the professional registered nurse (RN) role. Participants in this study recognized that nursing is facing the demand to produce a professional with abilities to function in the contemporary healthcare system. However, the frustration expressed by participants in this study as a result of unkind treatment by nursing colleagues and perceived deficiencies in their education raises serious concerns. Implications for nursing practice, education, and management are discussed, and directions for further research are provided.