Exploring the involvement of Patients and Care Givers in Student Nurse Education in a Nursing College in India

Abstract

India is the largest democracy in the world, but in contrast to other democracies, notably the UK, the role of patients and care givers in the formal education of student nurses appears to be less clear. The findings of this research demonstrated that despite there being little, or no formal education planned in India, to be delivered by patients and care givers, there is a lot of very useful informal education. A qualitative, case study methodology, was adopted with data collection methods including those of World Café style focus groups, art-based methods, semi structured interviews, and observational questioning. These approaches enabled student nurses across years one to four, in one nursing college, in India, to share their thoughts and reflect on their experiences of direct patient and care giver contact. Data was analysed using an inductive content analysis approach. The resultant overarching meta theme of ‘involvement’ acknowledged during data analysis, signifies not only that there is patient and care giver involvement in student nurse education in the nursing college, but that this is multi-faceted. This encompasses, a ‘tripartite identity’ with a mixed and interchanging role observed in the nurse, patient, and care giver. Education was enhanced by open access to care givers, constantly present in the clinical environment with the patient. The positive impact of this was multi fold, from the provision of assistance to nurses by care givers tending to the physical care of patients, and by enhancing and challenging nurses’ communication skills. This scaffolded the development of student’s emotional skill bases, acquired after reflection on and in situations with care givers, in which students at times felt harassed by care givers and even patients. The outcome, reach, impact, and value of this involvement is apparent by the transformative effect observed on student nurses learning, cultural sensitivity, and social consciousness. The educational philosophy of Paulo Freire underpinned this study, and findings concluded that by harnessing the naturalistic engagement with care givers in practice, student nurses can apply the Freirean pedagogy that states that education is a series of questioning. The findings indicate that it is important for students to recognise and acknowledge that their humanity and transformation is possible, if grounded in the reality of the social, economic, and political circumstances. The use of reflective activities associated with this, may in turn demonstrate how by the application of Freirean principles, students may transform themselves and others. Accordingly, it would be beneficial for student nurses to be tasked with listening to both patient and care givers experiences when they are in practice. This experience could be maximised in educational settings, by the student sharing their experiences with their peers, and reflecting on these.