The caring values of student nurses, and their development during educational programmes

Background: Following the Francis Reports, and austerity cuts, frontline NHS healthcare professionals have faced criticism for perceived lack of compassion. Nurses’ recruitment and education now increasingly emphasise caring values. Education programmes comprise university teaching and practice placements, including experiential learning to develop clinical skills, competencies, and reflexive abilities, yet it is unclear how to develop caring values. ‘Caring’ is conceptually complex, encompassing ‘caring for’ – direct bodywork, and ‘caring about’ – desiring to help. Most negative incidents concern ‘caring for’ tasks.

Objectives: To explore newly-recruited, pre-registration student nurses’ caring values; to understand whether/how these changed during education; to ascertain students’ readiness for caring work post-registration.

Methods: Focus-groups (n=10) with nursing students, placement mentors and lecturers at two UK universities, analysed thematically. For context, online surveys measured students’ caring values (n=514).

Results: Student nurses held what they perceived to be common values around caring, intending to operationalise these before and after qualifying. The vast majority felt welcomed to most placements, but most had 1+ negative placement. Although quantitative measurements of students’ caring values did not change significantly during education, their expectations changed, and caring values became more sophisticated, particularly: learning how to care for patients when they had limited time; and observing poor caring practice. Some placements did not give students scope to complete their educational assessments. In response, some students undertook self-directed learning (which they also used when mentors were busy), and some mentors helped link students with other hospital departments and nursing-homes. Students greatly appreciated this, asserting that they would mentor future students positively.

Conclusions: Students held values which are highly-appropriate for nursing, and endeavoured not to reproduce negative experiences. Staff should be aware that they can model caring or uncaring values. Educational reforms conflate ‘caring about’ and ’caring for’ values; students’ ‘caring about’ values motivated them in what could be extremely challenging conditions.