Educators' perceptions of their experiences of transnational education in nursing: A grounded theory study.

AIM: The study aim was to explore educators' perceptions of their experiences of participating in transnational education in nursing. BACKGROUND: In an increasingly globalised world, involvement with the delivery of transnational education has become commonplace across the international higher education sector. In recent years, transnational education within the academic discipline of nursing has developed at pace, evolving in response to a global need to invest in nurse education, address nursing shortages and strengthen nursing leadership. However, despite acknowledgement that transnational education is a complex activity that needs to be more fully understood, research specifically exploring transnational education in nursing is scarce, as previous studies predominantly focus on other academic disciplines. The study addresses this knowledge gap, advancing understanding of transnational education in the context of nursing. DESIGN: The study was positioned within the interpretivist paradigm and underpinned by a constructivist grounded theory methodological design, acknowledging the prior knowledge and experience of the research team in relation to phenomenon under investigation. METHODS: Ethical approval was obtained before the study commenced, ensuring adherence to key ethical principles. The study was conducted during May to August 2020, in a university in the North of England that provides undergraduate and postgraduate nurse education in the United Kingdom and transnational context. Participants were recruited via e mail and invited to complete a brief questionnaire, informing a preliminary theoretical sampling strategy. Ten educators with experience of transnational education across a diverse range of international locations participated in individual, semi-structured, online interviews that were recorded and transcribed verbatim. Data were analysed using initial and focused coding, constant comparison, theoretical memos and diagrams. FINDINGS: The findings uncovered three overarching data categories, each of which were crucial to supporting effective transnational education in nursing. Prepare- involved developing an understanding of the context of healthcare and education, being supported and collaborating with transnational partners. Perform- involved recognising language and cultural influences, adapting to the environment and implementing responsive educational pedagogies. Progress- involved recognition of personal development at individual level and valuing the benefits at organisational level. CONCLUSIONS: Although transnational education in nursing can be challenging and complex, it can offer worthwhile advantages for all stakeholders. However, effective transnational education in nursing is dependent on strategies which prepare educators appropriately and enable them to perform effectively, thereby promoting successful outcomes at individual, organisational and transnational partner level and facilitating advancement in future potential collaborative activity.

Compassion in nursing: exploring the perceptions of students and academics.

BACKGROUND: Compassion is integral to effective nursing practice, yet there is limited empirical research exploring this concept, particularly from a professional perspective. Aim To advance understanding of compassion from a professional perspective, specifically through the perceptions of students and academics from the fields of adult, child, learning disability and mental health nursing. METHOD: A constructivist grounded theory study was undertaken, and a theoretical sampling strategy was used to guide the selection of appropriate participants. A total of 12 nursing students and eight nurse academics were interviewed to explore their perceptions of compassion in nursing between January and August 2018. The interview transcripts were analysed using grounded theory techniques. FINDINGS: Four categories were identified from the interview data: character for compassion, competence for compassion, culture for compassion, and connections for compassion. These categories were interlinked, with each having the potential to influence the implementation of humanising approaches to care, which participants perceived to be fundamental to compassion. CONCLUSION: Compassion is a complex concept that can be influenced by biological, psychological and socio-contextual factors. Further consideration of these factors is required to support nurses to facilitate compassion through humanising approaches to care. The findings of this study advance the existing evidence to inform future policy, practice, education and research.

Reflections on developing a conceptual framework to support a constructivist grounded theory study on compassion in nursing.

BACKGROUND: Developing a conceptual framework to underpin the design of qualitative research is often regarded as integral in enhancing its trustworthiness. However, this can often present a challenge to the novice researcher. AIM: To discuss the approach taken to develop the conceptual framework underpinning a constructivist grounded theory doctoral research study. DISCUSSION: Drawing on a clear and accessible approach can help researchers to develop a conceptual framework to underpin qualitative research. A recognised example of such an approach requires the researcher to address three main elements: personal interest, topical research and the theoretical framework. Constructing a conceptual framework to underpin qualitative research can afford it structure and lay the foundations to support trustworthiness. Conceptual frameworks are often developed through a dynamic and iterative process that evolves throughout the research process. CONCLUSION: Using an accessible and unambiguous approach to support the development of a conceptual framework can benefit novice researchers and minimise the challenges they may encounter. One such approach guides researchers to clarify a personal interest in the topic, undertake a topical review of the literature informing the area of investigation and articulate the theoretical perspectives that influence their worldview. IMPLICATIONS FOR PRACTICE: The discussion presented in this paper offers a valuable contribution to help novice researchers to construct conceptual frameworks.

A constructivist grounded theory study to explore compassion through the perceptions of individuals who have experienced nursing care.

AIM: To explore compassion from the perceptions of individuals with personal experience of nursing care. BACKGROUND: Although compassion is considered integral to professional nursing, increasing reports of care experiences illustrating a lack of compassion have challenged this. Despite political and professional guidance to reaffirm compassion as an underpinning philosophy of contemporary nursing practice, this provides limited insight into what compassion may involve. Contemporary evidence to inform understanding of compassion predominately arises from the professional perspective. This knowledge gap supported the rationale to explore compassion from the individual perspective. DESIGN: Constructivist grounded theory, underpinned by the theoretical perspectives of symbolic interactionism and social constructionism. METHODS: Data were collected via 11 individual interviews, a focus group discussion and three additional individual interviews during 2013-2015. Initial and focused coding, constant comparative analysis, conceptual mapping, theoretical memos and diagrams supported data analysis until theoretical sufficiency was determined. FINDINGS: Inter-related data categories emerged: Self-Propensity for Compassion, Attributes for Compassion, Socialising for Compassion, Conditions for Compassion; and Humanising for Compassion (core category). CONCLUSION: Compassion is a complex phenomenon, constructed by individuals through their personal experiences of nursing care and life experiences in the social world. In this study, participants perceived that compassion was fundamentally embodied by experiences of a humanising approach to nursing care. These humanising experiences were thought to be influenced by biological, psychological and socio-contextual factors. The study provides additional insight into compassion that requires further investigation with individuals in other care contexts, nurses and healthcare professionals.

Cultivating compassion in nursing: A grounded theory study to explore the perceptions of individuals who have experienced nursing care as patients.

Although compassion is considered integral to nursing, the ongoing reality of this traditional philosophy has been challenged due to emerging patient reports of care experiences reflecting a lack of compassion. Political and professional guidance reaffirms compassion as an enduring philosophy of contemporary nursing practice, but provides limited insight into what compassion involves. To address this knowledge gap, a constructivist grounded theory study was undertaken with eleven participants who had experienced nursing care as patients across a range of contexts, exploring what they perceived compassion to involve. Theoretical sampling supported data collection via eleven interviews, a focus group discussion and three additional interviews. Data was analysed with initial coding, focused coding and conceptual mapping. Key findings highlighted the importance of cultivating compassion, which involved learning about compassion, role modelling for compassion, leadership for compassion, resources for compassion and systems and processes for compassion. These findings contribute to the ongoing professional dialogue surrounding compassion, specifically in relation to recruitment and selection, nurse education curricula, supervision of student nurses, compassionate organisational cultures, staffing levels and the systems and processes that underpin contemporary ways of working.

Exploring compassion: implications for contemporary nursing. Part 1.

The origin of compassion is firmly rooted in religious ideologies. In 19th century Great Britain, Christianity was the prominent religion and scripture advocated that followers should always be compassionate in their deeds and actions. Florence Nightingale was a Christian and translated her ideals into the characterization of the professional nurse. The image of the ministering angel, performing the work of God, was perpetuated for some time. However, as the profession of nursing advanced to develop evidence-based practice, some of the ethos of the compassionate nursing character was seemingly lost in favour of technical skills. This is supported by evidence suggesting that nurses have a decreased affinity with the ethos of altruism. Recent reports have highlighted negative patient experiences which reflect a clear lack of compassionate nursing care. This has led to a variety of documents re-endorsing the concept of compassion as a core and fundamental nursing value. This has raised several issues for nursing practice which require due consideration if the profession is to restore the image of the compassionate nurse, technically skilled and clinically effective, equipped with the appropriate skills, knowledge, values and attitudes to fulfil the pledges to respond to patients with humanity and kindness and to deliver high-quality compassionate care.

Exploring compassion: implications for contemporary nursing. Part 2.

A range of contemporary political and professional literature endorse the principle of compassion in nursing as a core and underpinning philosophy fundamental to the profession. However, despite pledges to ensure that compassion lies at the heart of nursing, the concept has not been clearly defined. It is evident that uncovering the true meaning is complex and challenging owing to its subjective nature. In light of this, several implications must be considered. Effective student nurse recruitment is essential to ensure that the most appropriate individuals are selected. Contemporary marketing campaigns must be implemented, and recruitment strategies developed, which consider specific values and attitudes. Service user involvement in recruitment and selection, curriculum planning and learning and teaching strategies, and post-qualification education, can enhance nurses' understanding of the patient perspective and make headway in embedding compassion as a core nursing value. Additionally, effective role modelling in practice which demonstrates high-quality compassionate nursing care is essential. Nurses must be adequately supported in the clinical environment to facilitate compassionate behaviours and clinical leadership at all levels must uphold political and professional pledges to achieve this. Consideration of these implications for practice is essential to ensure that nurses are able to respond to patients with humanity and kindness, and deliver high-quality, compassionate care to all.

Safeguarding vulnerable adults: the role of the registered nurse.

This article discusses vulnerable patient groups who may be at risk of being abused by family members, carers or practitioners. Different types of abuse, including institutional abuse, and the associated signs and symptoms are described. The article highlights that registered nurses working with adults need to be aware of at-risk groups and understand how to implement measures to protect and safeguard vulnerable individuals at their place of work.