A descriptive phenomenological study of the lived experiences of preregistration nursing students who use graded assertiveness to speak up for patient safety during work-integrated learning

Abstract

Aim

To describe the lived experiences of preregistration nursing students who used graded assertiveness to speak up for patient safety during work-integrated learning.

Background

Most Australian preregistration nursing programs have introduced graded assertiveness education to on-campus student learning. Graded assertiveness is a communication technique that gradually increases communication intensity to express concerns and focuses on patient safety rather than team members' actions. Previous research has indicated that although provided with the tools to speak up for patient safety, preregistration nursing students often withdrew or stayed silent when facing challenging patient safety situation during work-integrated learning.

Design

A qualitative study using Husserlian descriptive phenomenology.

Methods

Seven preregistration nursing students enrolled in the Bachelor of Nursing Science program at a multicampus university in Queensland, Australia, took part in a semi-structured Zoom® interview. Consistent with Husserlian descriptive phenomenology interviews were transcribed verbatim and analysed using the Colaizzi seven-stage method.

Results

Four themes were gleaned from the data: i) patient safety before self, emphasised that patient safety must be placed above all other considerations, including themselves; ii) being the patient advocate prevents harm, a strong belief among participants that advocating for patient safety helped to ensure safe care; iii) please hear me, participants expressed feeling unheard when raising concerns about patient safety; and iv) speaking up is rewarding, participants described speaking up for patient safety using graded assertiveness during work-integrated learning as personally rewarding.

Conclusions

The four themes uncovered by this study highlighted the value of graded assertiveness to the lived experiences of preregistration nursing students who speak up for patient safety during work-integrated learning. Our findings indicate that these students can effectively use graded assertiveness to promote patient safety, providing valuable insights for future education and practice.