"I Will Be Here For You": Nursing Students' Perceptions of Being Present for Their Patients

Monday, 30 October 2017

Carol Toliuszis Kostovich, PhD1
Jeanne Van Denack, MSN1
Patricia Bachmeier, MSN2
(1)Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, IL, USA
(2)Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA

Purpose: The purpose of this study was to assess whether pre-licensure nursing students were able to apply concepts of nursing presence taught in theory class to the real-life patient care setting of their clinical courses.

Significance/Rationale: Essential to the delivery of patient-centered care, and consistent with the Institute of Medicine report on the future of nursing, nurse-delivered care should be patient-centered and relationship-based. Nursing presence, defined as the emotional ‘being with’ and physical ‘doing for’ patients, contributes to quality patient care. However, technological advancements coupled with an emerging nursing workforce comprised of a technology-dependent millennial generation could potentially threaten the emotional connection between nurse and patient. Teaching students the importance of being present to their patients can address this challenge. Yet, there are few examples in the literature indicating that this has been done.

Methods and Analysis: Recognizing its importance, we taught students about the phenomenon of nursing presence during a pre-licensure junior level adult health nursing theory course and integrated it into 3 simulation scenarios. On the last day of the semester, students completed a 2-part questionnaire: Part 1 included the Presence of Nursing Scale-RN Version (PONS-RN), a 30-item Likert-type scaled instrument in which participants rated their ability to be present to their patients during their adult health clinical course; Part 2 consisted of a demographic data form and 3 open-ended questions asking about participants’ observations of nursing presence during their clinical rotation. Quantitative analyses included descriptive and correlational statistics. Higher scores on the PONS-RN subscales indicate a higher self-perceived ability to be present to patients. Qualitative analyses were conducted by 3 nurse researchers. Data were first coded independently and then collaboratively. The 2 subscales of the PONS-RN, the 12-item ‘Being With’ subscale and the 18-item ‘Doing For’ subscale, served as the code book to guide the analysis. Patterns and themes were identified in the data.

Results: Surveys were completed by 106 students. Mean scores on both subscales were relatively high. On the PONS-RN ‘Being With’ subscale, scores could potentially range from 12 to 48. In our sample, the mean score was 33.52 (SD=4.02). On the ‘Doing For’ subscale, scores could potentially range from 18 to 72. The mean score of our sample was 63.05 (SD=5.91). There were no statistically significant correlations between demographic variables and either subscale. Students scored the highest on items reflecting their ability to provide emotional comfort, attentively listen, and treat patients as individuals. Lowest scoring items included those that related to providing spiritual care, sharing feelings with patients, and serving as a link to other care providers. Preliminary qualitative data analyses support the quantitative findings.

Conclusions: Pre-licensure nursing students are able to recognize and recount their experiences of nursing presence during an adult health clinical rotation. In this sample of students, relatively high levels of self-perceived nursing presence were identified.

Implications: Teaching pre-licensure nursing students how to be present to patients in their first clinical course can serve as the foundation for building a caring, relationship-based curriculum. This study represents phase 1 of a 3-phase longitudinal study in which students’ perceptions of being present to their patients will also be examined upon completion of the nursing program and 6 months after employment as a registered nurse. Findings from this study will inform potential curricular revisions to ensure the importance of being present to patients is recognized by students as an essential nursing intervention.