Professional socialisation is necessary to be discussed, to build upon possible theoretical components of what is required to prepare nurses for professional practice, and therefore answer the research questions. Student nurses, whilst undertaking a pre-registration nursing course, have vast demands placed upon them, from learning both the theory and practice elements of the programme, developing care and compassion within their practice, working with patients and multidisciplinary teams, as well as dealing with the stress and demands of the programme itself (Curtis, Horton and Smith, 2012). Professional socialisation has long been discussed within the literature as a legitimate aspect of nursing education (Gray and Smith, 1999; Luker, 1984; Cohen, 1981; Olesen and Whittaker, 1967; Davis, 1966). Olesen and Whittaker (1968) coined the term studentmanship, in which they describe the learning of behaviours and practices which shape students professional role as a nurse. Interestingly Olesen and Whittaker (1968) acknowledge this is an implicit part of professional practice and the education of student nurses, equally they note how important peer relationships upon professional socialisation.
Professional socialisation is a process where an individual gains the knowledge, skills, experience, and professional identity which are characteristics of that profession (Cohen, 1981). This process also includes acquiring values necessary to perform in that role, and it is the emphasis on nurses’ values that is of interest to nurse academics and NHS recruitment teams at present. To
develop a person with limited experience and knowledge into a well-rounded, knowledgeable, and caring professional within three years is undoubtedly a challenge. Professional socialisation, as noted by Cohen (1981), is a key area that occurs within the hidden curriculum in pre-registration nursing. The hidden curriculum is described as implicit values, which underpin the curriculum and which influence students’ learning (Gidman, 2011).
Melia’s (1987) seminal work found that student nurse socialisation occurs through two descriptions of nursing, one in the classroom and one within the practice setting. Due to the disparity between what students experience with the different ideologies, this causes significant confusion for the students, along with a lack of commitment to both versions, and to a career within the profession (Melia, 1987).
The work by Melia (1981) and Luker (1984) highlighted the insight of student nurses within the 1980’s and their experiences of the professional socialisation that takes place, whilst Gray and Smith’s (1999) work explored students within the 1990’s. Yet it should be noted that nursing and healthcare has changed considerably since this time, and as such further current identification into this areas is warranted. Luker’s (1984) work highlighted how professional socialisation and the acquisition of tasks is primary to gaining knowledge for the group that she interviewed. A commonality between these studies is the identification by the students that they learn the behaviours and practices from ward staff. Ultimately this then leads the students to get involved with delivering direct patient care along with the wider team to enable them to feel that they fit in, as fitting in this was deemed to be important to the participants, and their mentors in practice.
Caring behaviour has been suggested to lessen as students move towards the end of the programme (Curtis, Horton and Smith, 2012; Murphy et al, 2009; Mackintosh, 2006). However, these are not new points, as this was noted as long ago as Smith (1992) who described how student nurses commence programmes with enthusiasm, but by the end of the programme they display cynicism and disillusionment. Along with these traits, students also become less focused on the patient and more focused on the illness, along with not demonstrating an emotional side to caring. It could be argued that had these points been taken on board when they were first written, and noted subsequently each time, the professional crisis which has taken place within the past five years, and harm that has occurred to patients that have been noted in reports such asMid Staffordshire report (Francis, 2013), Winterbourne (DH, 2012), and the Keogh (2013) reviews, could have been avoided, or minimised. This is not to say that if these points were taken on board there would never be patient harm, neglect or a lack of care again, but they may be less frequent than they are now. It has been suggested that care diminishes for student nurses towards the end of their programme (Maben, Latter and Macleod Clark, 2007). This then leads to students becoming dissatisfied and disappointed about the profession that they are entering into because the realities of practice pressure hits them (Maben, Latter and Macleod Clark, 2007).
The retention of students and RN within Ireland has been enhanced by effective socialisation whilst students are on the pre-registration programme (Mooney, 2007). New registrants need to have skills to be able to adapt quickly, and should be socialised into the role (Pennbrant et al, 2013). Student nurses currently have many different practice placements throughout their programme.
Therefore, the socialisation and ability to adapt has been overlooked by curriculum managers, and there may be a perception that students are taught this through part of the hidden curriculum, rather than making this a key point in preparing students for coping within today’s clinical world, where change occurs almost continually.
Professional socialisation can assist with the development of skills to provide safe and effective care, in line with the expectations of the public and the NMC (2015, 2010). Professional socialisation can also assist with the development of understanding the role of the nurse (Curtis, 2013), therefore, it is clear that as a component of a student nurses’ education professional socialisation is extremely important. Equally important, is that student nurses are socialised in the correct practices of nursing, and have positive experiences from mentors. As professional socialisation occurs largely within the practice environment, learning through working in practice will now be discussed.