Learning to nurse children: towards a model for nursing students

Background. As undergraduate nursing students approach their paediatric placement, their anticipation ranges from keen expectation to anxious avoidance. This placement has been described as the most stressful in nursing programmes. While various nurse scholars have attempted to describe the practice and the theory of nursing, it has been the challenge of nurse teachers to weave the theory and practice of nursing together for their students. The nature of this learning is, however, still being explored. Aim. This paper reports a study whose aim was to describe, and propose a theoretical understanding of, how nursing students learn to care for children. Method. In this grounded theory study, participants were drawn from four consecutive student groups in their third year of a Bachelor of Nursing programme. Data included participant observation, focus groups and student descriptions, from both personal reflective journals and narratives. The qualitative research paradigm and the interlaced, often simultaneous, roles of researcher and teacher defined the design and implementation of the study. Findings. Data analysis confirmed the complex nature of students' learning to care. The relationships that they established with children and others (families, peers, clinical nurses and lecturers) whom they encountered emerged as key in their learning. The social process that was central to student learning was working out how to connect with a child in their care: puzzling out a connection. Each connection with a child contributed to the next and thus to the student's learning. Each connection also contributed to the student's resources, knowledge and experience base, adding to learning by further equipping the student for the next encounter with a child. Conclusion. The resulting theory contributes towards understanding the complexity of learning to care for children. The relational nature of learning shown in this work can guide the structuring and evaluation of learning environments in child nursing programmes. The context of interpersonal relationships of students when learning to care for children provides evidence for re-examining how nurse teachers facilitate and evaluate student learning in child nursing programmes.