NEW YORK NURSE: May 2011
Q.: How should students’ concerns about witnessed incidents of substandard care be addressed by clinical faculty?
Promoting best practices can be a challenge for clinical nursing faculty and students. Schools of nursing depend on limited clinical sites; students and faculty often are considered guests in their clinical setting and are often not welcome to challenge the status quo. Students are sometimes exposed to and learn through negative experience.
Here are some of the guiding principles and resources that support safe practice.
Ethical behavior requires courage to confront colleagues who are behaving inappropriately or unsafely. In order to teach students about this, engaging them about the realities of care settings while acknowledging shortcomings and supports within nursing is essential.
The Code of Ethics provides a framework for values of care, respect, trust and collaboration to guide nurses in everyday practice. (Olson, 2010, p.83).
The “Just Culture” concept encourages nurses to report mistakes to identify and eliminate system failures beyond their control. When applied to nursing, it creates a personal sense of responsibility and accountability for system improvement and patient care delivery, creating a workplace culture supportive of quality and safety (American Nurses Association, 2010).
The New York State Education Department's Office of the Professions (OP) investigates and prosecutes professional misconduct in all professions except medicine. Professional misconduct is the failure of a licensed professional to meet expected standards of practice.
Benner, Sutphen, Leonard & Day, 2010, propose recommendations to address staff and work systems to reduce the stress of nursing staff. Strengthening relationships among students and staff nurses within the clinical setting will reinforce the depth and breadth of the clinical component, and strengthen the evidence for best practices in clinical education (MacIntyre, Murray, Teel & Karshmer, 2009, p.447). Inviting experienced staff nurses to work with faculty will help integrate students into the patient care team in support of collaboration.
Nurse educators are charged with improving their teaching practice and embracing the Quality and Safety Education for Nurses (QSEN) initiative to better prepare nurses for the practice environment (Brown, Feller & Benedict, 2010). We remind the nursing community to honor the moral and ethical implications of good nursing practice.
This is a sample of the questions NYSNA’s experts answer each day. The advice given is specific for the situation described and may not be applicable generally. If you have questions about your own work setting, it is recommended that you contact your NYSNA nursing representative or the Education, Practice, and Research Program, 11 Cornell Road, Latham, New York 12110-1499 or call 800-724-NYRN, ext. 282.