RN as gatekeeper: gatekeeping as monitoring and supervision

Jillian D Brammer
Journal of Clinical Nursing 2008, 17 (14): 1868-76

AIMS AND OBJECTIVES: To understand the variation of ways that students understand the informal or buddy registered nurse role during facilitated clinical experience, and to identify the relationship between student learning and student understanding and experience of the registered nurse role during clinical experience.

BACKGROUND: Student clinical experience is an essential aspect of all undergraduate nursing programs. Students expect registered nurses to supervise and support them and to provide learning experiences during clinical placement. Both positive and negative experiences have been reported in the research literature. The quality of the relationship between the registered nurse and the student directly affects the learning outcome for students.

DESIGN: Qualitative research using a phenomenographic approach.

METHODS: Semi-structured individual interviews with 24 students from all three years of an undergraduate nursing program at a metropolitan university in Brisbane, Queensland, Australia, who voluntarily participated in this study. Interviews were conducted at the completion of a recent clinical experience.

RESULTS: While adequate monitoring and supervision is an expectation of students, there is a wide variation in the way registered nurses appear to understand this aspect of student learning. In the category of description, 'registered nurse as gatekeeper: gatekeeping as monitoring and supervision', student conceptions were identified as: registered nurse awareness, registered nurse vigilance, promoting learning/developing learning and growing (as) students. Students identified their experiences and the strategies they used when monitoring and supervision were lacking or limited.

CONCLUSIONS: The findings of this study illuminate the need for recognition of the complexity of the informal registered nurse role with students and highlight the areas that should be addressed to promote quality student learning experiences.

RELEVANCE TO CLINICAL PRACTICE: Registered nurses need adequate preparation for their informal role to support and supervise undergraduate students in clinical placement to ensure the safe development of student competence and confidence for their graduate registered nurse role.

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