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Messy boundaries: the lived experience when younger children’s nursing students are required to care for young people

Messy boundaries: the lived experience when younger children’s nursing students are required to care for young people

Shepherd, Jean Mary (2012) Messy boundaries: the lived experience when younger children’s nursing students are required to care for young people. EdD thesis, University of Greenwich.

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It is acknowledged that caring interactions between younger, adolescent student nurses and young adolescent patients could precipitate particular difficulties and concerns for both parties during their journeys toward successful self-identity. The research undertaken identified two key dimensions: that of professional identity of the student nurses and that of illness identity for the young patients. These issues have been critically analysed using the theoretical underpinning of the seminal identity development theorists.

In order to understand the true meaning behind the lived experience of both groups of participants during these caring interactions, a hermeneutic, Heideggerian, phenomenological study was undertaken. In line with this methodology individual, unstructured interviews were undertaken with 11 student nurses (aged between seventeen years five months to eighteen years eleven months) and nine young patients (aged between thirteen years and seven months and eighteen years and one month).

Three main themes emerged from the data: (1) Messy boundaries; (2) Emotional security; (3) Being Younger making a difference. The findings highlight both concerns and benefits brought about by these caring situations. Concerns raised by the students relate to emotional distress, perceived lack of knowledge, confidence and professional identity. Also of concern is dealing with sensitive information disclosed by the young patients. Benefits identified by the students relate to being able to spend quality time with the young patients, being on the same level as them in informal ‘normative’ relationships, relieving their boredom and helping to momentarily distract them from their illness.

Concerns highlighted by the young patients centre around issues of trust and confidence in the students’ professional abilities, the perceived lack of knowledge of the students in relation to their illness, and the students’ lack of understanding of their feelings. In common with the students, the young patients felt that the opportunities afforded them to ‘chill out’, be normal young people, and to be able to forget about the business of getting better, were invaluable. The friendships formed represent crucial therapeutic relationships which were not explicitly recognised by either party.

The research has led to recommendations for improving student nurse education relating to young people/adolescents which it is anticipated will more appropriately meet the needs of the students and the patients. It has also enabled the creation of two models to support the unique engagement of the nurse-patient interaction, particularly in relation to the care of young people with a chronic illness:

i) A Model for Processing Sensitive Information Revealed by Young Patients who may have a Chronic Illness

ii) A Model of Adolescent Care Which Promotes Normalcy

Item Type: Thesis (EdD)
Uncontrolled Keywords: student nurse education, adolescent care, adolescent student nurses, young adolescent patients, identity, professional identity, illness identity,
Subjects: R Medicine > RT Nursing
Pre-2014 Departments: School of Education
School of Education > Department of Professional Learning & Development
Last Modified: 14 Oct 2016 09:22

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