Original ArticleAn Interpretive Study of Nursing Students' Experiences of Caring for Suicidal Persons
Section snippets
Literature Review
The research on teaching undergraduate nursing students about suicide is sparse. The few studies that do exist describe students' knowledge and attitudes about suicide and their skills in providing suicidal care. To determine knowledge and attitudes about suicide, Kawanishi et al. (2006) administered a questionnaire to groups of nursing students, psychiatric nurses, and social workers. They compared the findings between these groups with a group of medical students who had previously completed
Research Design
The investigators used phenomenology (Heidegger, 1927/1962) and hermeneutics as the research design (Gadamer, 1960/1989). Phenomenology permitted an “unfolding, explicating, and laying out” of students' experiences (Caputo, 1987, p. 53) of caring for suicidal persons. Consistent with Heideggerian phenomenology, the researchers assumed that students' experiences would include expressions about what concerned them most (Heidegger, 1927/1962, p.83). Hermeneutics provided an approach through which
Sample
Following institutional review board approval, the investigators recruited 12 senior, baccalaureate nursing students to participate in the study. The students recruited were in a class of 24 students who had completed a 7-week long psychiatric/mental health nursing course as part of their nursing curriculum at a private midwestern university. At the time of the study, the school of nursing within the university enrolled 88 nursing students each academic year. The students completed the clinical
Data Collection
Data were collected using unstructured, audio-taped interviews. All of the interviews were face-to-face and were conducted in a private location at a mutually agreed upon time. The investigators began each interview with the following open-ended question: “You have just completed your psychiatric/mental health nursing course. During the clinical rotation you learned how to assess a patient for suicidal ideation. Can you tell me about a particular time when you were assessing a patient for
Data Analysis
The investigators analyzed the data using Benner, 1985, Benner, 1994) and Diekelmann and Ironside's (1998) approaches to phenomenological and hermeneutical data analysis. They began the data analysis by reading each transcript numerous times. This repeated reading of the transcripts permitted a comprehensive understanding of the data (Benner, 1994). They then coded the data by excerpting exemplars, which were strong instances of participants' experiences of caring for suicidal persons (Benner,
Rigor
The investigators maintained rigor by adhering to Madison's (1988) principles for evaluating interpretive research. Madison developed these principles from Gadamer's philosophical works. He contended that the principles are similar to ethical norms whereby the investigator(s) uses them to maintain “good judgment” when interpreting texts (p. 30). The principles included appropriateness, coherence, comprehensiveness, agreement, suggestiveness, and potential. They ensured appropriateness by
Findings
Three themes emerged from the data analysis. Each theme presents a distinct but important understanding of participants' experiences of caring for suicidal persons.
Discussion
Findings of this study indicate that, when participants read documentation about suicidal persons' mental status and behavior, they experienced initial fears about interacting with them. These fears disrupted their perceived ability to provide nursing care for suicidal persons. These findings closely align with a plethora of literature indicating that nursing students commonly fear those with mental health problems and that these fears can impede their ability to care for these individuals (
Educational Implications
The study themes provide understandings about nursing students' care of suicidal persons. Educational implications that align with these themes are summarized in Table 1. In regard to patient documentation, nurse educators need to remind students that documentation facilitates communication about a suicidal person's status, needs, and progress. Nonetheless, they need to acknowledge and discuss with students the fear they can experience when reading records of suicidal persons and how this fear
Limitations and Future Research
A limitation of this study was that it was a single site, qualitative study with a homogenous sample. The study design limited the investigator's abilities to quantify how students' completion of the mental health course influenced their care of suicidal persons. In addition, the open-ended interview limited asking specific questions about how other sources of students' experiences (e.g., students' personal experiences of suicide within their own family, their perceptions of suicide, etc.) may
Conclusion
Nurses interact with suicidal persons on a regular basis in various health care settings. Their reports about lacking competencies in caring for suicidal persons raise serious concerns that highlight the imperative need to address the preparation of nursing students in caring for this population of patients. This study provides a step toward understanding pedagogies that can improve how nursing students learn to care for suicidal persons across health care settings in ways that contribute to
Acknowledgments
The authors wish to thank Viterbo University for funding this study. They also wish to thank Elizabeth Harrison and Jennifer Hedrick-Erickson for their thoughtful review of this article.
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