Journal List > J Korean Acad Nurs > v.48(1) > 1003310

Kang, Jeong, and Kong: Threats to Identity: A Grounded Theory Approach on Student Nurses’ Experience of Incivility during Clinical Placement

Abstract

Purpose

This qualitative study aimed to explore the experience of incivility among nursing students.

Methods

Sixteen nursing students who had experienced incivility during their clinical placement were invited for one-on-one interviews until the point of theoretical saturation. The grounded theory approach of Corbin and Strauss was adopted to analyze transcribed interview contents.

Results

Incivility occurred in the context of a hierarchical organizational culture, due to nursing students’ position as outsiders, non-systematic clinical education, and poor nursing work environment. The experience of incivility was identified as “being mistreated as a marginal person,” and nursing students responded to this phenomenon in the following three steps: reality shock, passive action, and submissive acceptance. This process caused students to lose self-esteem and undergo role conflict. Furthermore, nursing students’ experience of incivility could eventually lead to workplace bullying in nurses.

Conclusion

The results of this study suggest that nursing students’ experience of incivility can be a process that threatens their identity. It is necessary to develop educational programs and provide appropriate counseling services so that nursing students can actively cope with the incivility. In addition, institutional plans are needed to ensure safe and supportive clinical learning environments.

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Figure 1.
The process of nursing students’ experience of incivility during clinical placement.
jkan-48-85f1.tif
Table 1.
Relationships among Categories in the Paradigm Model
Subcategories Categories Paradigm element
Being a pain A nuisance Central phenomenon
Invisible students
Indifference
Being unwelcome
Helper Assistant workforce
Miscellaneous work
Dumping their work on students
Verbal abuse Abuse from nurses
Physical threats
Physical assaults
Psychological harassment
Ignorance from patient or family Ignorance from other stakeholders
Ignorance from nurses and other staff
Hierarchical culture of hospital A strict hierarchy Contexts
Lowest priority
No seats for students Outsider  
Forced concessions
Orientation without any clear plans Unsystematic clinical education
Low standard of clinical education
A nurse without educational intention
Unclear evaluation criteria
Poor practice environment
Safety issues
Breaking practice hours
Heavy nursing workload Poor nursing work environment
Bullying culture
Backbiting Interactions with colleagues Intervening conditions
Exchange of information
Nurse's care Care and encouragement
Encouragement from patient and family
Controlling emotions Reality shock stage Action/interaction strategies
Enduring Passive action stage
Reading others’minds
Avoiding
Understanding nurse's position Submissive acceptance stage
Compliance with practice
Repetitive mistake Lowered self-esteem Consequences
Being intimidated
Being skeptical to be a nurse Role conflict
Feeling of doubt
Worrying about passing down to other nurse Promising oneself to be a different nurse
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