From lack of self-esteem to lack of proper training, nurses battle with a host of problems of their own in trying to be caregivers to others
Nurses’ competence is based on the knowledge and skill taught to them. Nursing training is a combination of theoretical and practical learning experiences that enable nursing students to acquire the knowledge, skills, and temperament for providing nursing care. Nursing education is composed of two complementary parts: theoretical training and practical training. A large part of nursing education is carried out in clinical environments. In India as well in our J&K, clinical education forms almost half of the formal educational courses in nursing.
The history of nursing is as old as of medical science. However, while medical science has advanced far ahead, the condition of the nursing profession has stayed more or less the same. The reasons for lack of progress in the field, particularly in an era where other countries are making significant advances, lie in the management and, even more deeply, in the professional training. The last couple of years have seen the establishment of various nursing schools in J&K, but a problem which has been there since times immemorial remains unaddressed: the faults picked up during clinical learning. A perpetual cycle has been created of one generation of students teaching themselves by observing the earlier. Almost every student ends up embracing the faults of the previous generation. Once they are into this practical learning, the textbooks become exotic, irrelevant.
Rudeness towards nurses and by nurses in clinics and hospitals affects their spirit, morale, devotion to their job, and effectiveness in that job. It gets in the way of the patient’s health, and it gets in the way of the patient’s healing. Every other patient complains of nurses talking “over” them. Being talked around or ignored is, of course, fundamentally depersonalising, particularly for someone burdened with illness. Yet it still happens as much now as it ever did. Aren’t there nurses who choose – perhaps subconsciously – to be rude? Choose to make someone feel unseen? Because they feel angry or powerless or undervalued? The seeds of inferiority are sown right at the step of entry into the profession and are nourished during the professional upbringing. Nursing students often feel inferior to the medical students during clinical learning. There are a number of reasons responsible for that. Firstly, difference in behaviour towards the two, either by the staff or patients or general society. The nursing students are continually exposed to responses that deepen their inferiority complex, which may explain their rudeness later. Individuals feel that a good way to overcome inferiority is to make others feel inferior. The person becomes arrogant and aggressive in mannerisms. He or she might also try to show off and indulge into too much of self-praise and bragging. The person might also try to bully others to gain a sense of power.
This all begins with inferiority complex, which makes an individual feel worthless and instils a sense of hopelessness. Due to the inferiority complex, normal feelings of incompetence get exaggerated, which makes the individual feel that it is impossible to achieve goals or have certain abilities. These psychological effects vary over time.
Discrimination Against Male Students
Even though equality of men and women in every field and every aspect is being projected, the fact remains that professions are still dominated by stereotypes. Men can be doctors, physicians or surgeons but male nurses have a sort of stigma attached to them. Male nurses face problems which are similar to those that women face when they dare to enter in male-dominated professions. Men who enter the nursing profession are perceived as “feminine”, and this affects their social life and self-esteem. Men are often not welcomed in the fields of obstetrics and gynaecology, and men are usually uncomfortable when examining female patients. This is because they are not taught proper techniques and approaches due to the gender bias in nursing clinical courses. The teaching side is also dominated by women, who find it difficult to teach and train the male students. If nursing could learn to embrace the idea of men as nurses, then male nurses could give better care to their patients.
Deficient Practical Skill
Clinical environment is a suitable context for learning skills needed to care for patients. However, there are some basic health care skills and any deficit in them affects the quality of care. Most of the procedures in a hospital setting are performed by physicians or medical students, even the procedures what are a part of nursing care.
Deficiency in practical skills in caring for patients is a concern for many students in the clinical setting. Students have had difficulties in performing procedures in some situations, due to the lack of necessary skills, and discrimination on the basis of access to the educational tool. They might have some knowledge but it is never easy to put theory into practice. This becomes a part of perpetual cycle in hospital settings, where many health care procedures are kept from nursing students or nurses.
Nursing students encounter various challenges in interaction with instructors, patients, and department personnel. The thought of being ‘just a nurse’ leaves the nursing student stressful and demoralised. Most of the young nurses work in hospitals just to gain experience so as to be able to take up a teaching job. This lowers the standards by draining the good educated nurses out of the hospitals. Despite the recruitments over the years, the ratio of nurses to patients still remains low. Student nurses find it quite difficult to find a role model in a clinical or hospital environment. They don’t feel they actually belong there. This also results in many nursing students unable to develop the communication skills necessary in the clinical environment, whether it is professional communication with the doctor, with fellow nurses, or with patients. Students need to understand the language of the hospital and therefore it is necessary that effective communication skills are taught to students before they enter the clinical environment, with an emphasis on the differences between the clinical environment and the classroom environment.
Therefore, before students enter the clinical environment, it should be ascertained that they are theoretically and practically prepared. In the light of the presence of stress and inferiority complexes in students, it is necessary that they receive counselling on the nursing profession, caregiving, and the hospital environment. Visits to the hospital should be organised for them to get acquainted with the clinical environment before they begin the actual clinical postings.
—The writer is an undergraduate student at IUST. [email protected]