Considerations and Implications for Education

Conscious decision making and a sense of achievement having gained a place on a BSc Nursing programme emerged as significant for students from this study, supported in the literature (Du Bois-Reymond :1998 Keane 2011a). The complexity of the application process perhaps distracts the focus of prospective students from their choice of programme, especially significant considering the professional nature of nursing programmes. Early information and engagement with prospective students before accepting a place would appear to be a benefit, particularly surrounding structures and requirements of the programme and placements. Dialogue will support prospective students in making arrangements to prepare themselves, make logistical arrangements and manage family commitments. This could be facilitated through more meaningful engagement between nurse educators and the more centralised support and admissions services.

Students from the underrepresented groups may benefit from preparing for and beginning their programme in a more specific and planned way. This could allow a period of adjustment, perhaps taking the first steps more gradually rather than trying

Conscious decision making and a sense of achievement, when a place on the BSc Nursing programme was secured, emerged as significant for students from this study. This was supported in the literature considered in the discussion (Du Bois-Reymond 1998: Keane 2011a). Initially, prospective students may focus exclusively on the complex application process and may not consider the demands of the chosen programme, particularly in relation to practice placements. Early information and engagement with prospective students before accepting a place would appear to be of benefit, particularly surrounding structures and requirements of the programme and placements. Communicating early with those considering entry to nurse education may help in their personal preparation and help with management of family commitments. This could be facilitated through more meaningful engagement between nurse educators and the centralised support and admissions services.

Students from the underrepresented groups may benefit from preparing for and beginning their programme in a more specific and planned way. This could allow a greater period of adjustment, perhaps taking the first steps more gradually rather than trying to process everything in a short time.

The findings from this study support further deliberation around the positioning of the first clinical placement. Currently, students are findings their way around an education environment when after eight weeks, they now have to prepare and face another change, namely clinical placement. This further challenges them to orientate and readjust to the world of clinical practice. This study is timely and will help contribute to the discussion surrounding the national curricular review. This review will incorporate the Nursing and Midwifery Board of Ireland requirements and standards for pre-registration nurse education, with particular relevance to the positioning and length of clinical placements.

It could be suggested that perhaps there is more that unites than divides the underrepresented student experience with that of the traditional student body. However, the stories shared by students in this study illustrate how difficult it can be for students from the underrepresented groups to complete their studies. Students descriptions in this study of balancing and surviving to manage family, finances, and part-time work is supported by Irish and Australian research, which recommend

greater flexibility in planning and timetabling programmes (O’Brien et al 2009: Carolan-Olah et al 2013).

The importance of belongingness during clinical placement emerged as important for students from the critical first placement right throughout the programme. Students were challenged to understand and adapt to the clinical learning environment. This reinforces the work of Levett-Jones et al (2008, 2009a and 2009b) which has application for the broader nursing student population.

Throughout the findings and developed in chapter 5, students identified the value of individualised support. Examples of support strategies have been identified by Andrew et al (2011), Buultjens and Robinson (2011) and Ross et al (2014). Such examples could be considered for use within nurse education, tailored to the individual institution and the Irish context. A balance needs to be explored between offering individual support, whilst remaining mindful of a delicate balance towards empowering students to be self-caring. Students need to be enabled to perform at the level expected for eligibility for registration, meeting the requirements to be caring, knowledgeable and safe practitioners. This is critical given that it is expected that graduates ‘acquire the skills of critical analysis, problem-solving, decision-making, reflective skills and abilities essential to the art and science of nursing’ (An Bord Altranais 2005 pg12).

The personal growth and development interwoven through the students’ descriptions of their experience is suggested to have a likeness to the attributes described in the literature related to emotional intelligence (Goleman 1998). The intensity of practice shift patterns interfaced with family arrangements and the final academic demands heighten pressure on students. It would seem that students would benefit from enhanced support at this time. Providing opportunities for students’ to develop self- caring practices will in turn enable them to become caring, compassionate nurses to meet the heath care needs of the future. Strategies such as guided reflection offer students opportunities to grow and develop. Guided reflection as suggested by Johns, (2013) opens up a personal space for the practitioner to stand back from the drama of

appropriate as the Irish government, embark on a substantive curricular review of undergraduate nurse education. While this could help all students, it is particularly relevant for those in the underrepresented groups for whom the experience is magnified and intensified.