Transition: an exploration of student nurse experience in their first practice placement

Nurse education has altered considerably in the past 30 years. The combined demands of a growing population with diverse health needs and an expansion of career opportunities for those traditionally recruited to nursing have made it increasingly difficult to recruit and retain a viable workforce. At the same time pressure to establish nursing as a profession has influenced how the nursing curriculum has been delivered. Schools of nursing are now established in universities and away from clinical control. However, the retention of student nurses has remained an issue for many universities and studies have identified that students are particularly at risk of leaving around the time of their first practice placement. Whilst underlying factors associated with either the student or the practice environment have been identified which may be predictors for attrition at this time, no studies have given detailed consideration to the way students cope with the process of transition from the academic setting to the practice setting. This thesis aims to research and understand how first year student nurses manage the transition into their first practice placement and studies this process through the lens of human, social and identity capital theory. Questionnaires were used to collect the initial data from an entire cohort of first year student nurses. These data were then explored in depth via face to face semi-structured interviews with 20 of these students. The findings show that the transition process is highly complex and stressful for the student. It has been made more difficult by the separation of academic and practice settings. As a result students are expected to adapt rapidly to a strong occupational culture as they enter the practice setting. In order to do this they rely heavily upon building human, social and identity capital. The students who struggle and falter at this time appear to be those who lack the skills or support they require build capital successfully. These findings have significant implications for nurse educators who must consider how a student’s abilities to build and exploit capital can be encouraged within the nursing curriculum