An exploration into student nurses' perception of patient safety and experience of raising concerns

Fisher, Melanie (2017) An exploration into student nurses' perception of patient safety and experience of raising concerns. Doctoral thesis, Northumbria University.

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Abstract

Background
Patient safety is of paramount importance in healthcare delivery. Following the inquiry into the Mid Staffordshire Health Trust (Francis 2013, 2015), there has been an increasing demand for nurses and other healthcare professionals to be open and candid in a transparent culture where harm and error are minimised. Despite this drive for openness, there is evidence that health care professionals remain reluctant to raise concerns and this includes student nurses as well as registrants. There is however paucity in research focusing upon the underlying factors which prevent student nurses from raising concerns about suboptimal practice. In an attempt to contribute to the discussion, this study will focus upon student nurses.

Aim
The overall aim of this research is to understand student nurses’ perception of what they believe is a patient safety incident in their practice placements and understand the reasons that influence their willingness or reluctance to raise concerns about patient safety.

Findings
Four main themes emerged from analysing the data: the context of patient safety; team culture; hierarchy and fear of retribution.

Analysis and discussion of the data revealed that students were driven to raise concerns as they possessed strong moral and ethical beliefs to uphold patient safety. However, they had an overwhelming desire to fit in with their clinical colleagues and feared retribution and failure if they voiced concerns regarding care. This demonstrated that student nurses were subject to a fluctuating moral compass which was determined by psychological and sociological determinants.

Conclusion
This research study has provided information which contributes to our understanding of student nurses’ beliefs about patient safety. It also helps us to recognise the factors that influence student nurses’ willingness or reluctance to speak up. This is important because with an increased understanding of their experiences and beliefs, we are better informed to broaden our teaching on this topic and develop effective policies to protect student nurses who raise concerns.

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