Abstract
D.Cur.
Nursing is a clinical discipline, strongly anchored in clinical practice. In order to learn
the art and science of Nursing, it should be kept in mind that nursing is a complex and
intrinsic process that entails skills that are highly cognitive. Community Nursing is one
of the clinical disciplines in which clinical guidance takes place. Guidance in
Community Nursing takes place on district health level and is based on the primary
health care approach. With clinical guidance from a community nurse in the community
nursing practice, students are given the opportunity to apply in clinical practice what they have learned in theory. Students learn in the clinical practice by working alongside a
competent, experienced and registered community nurse. They are guided to realise their
full potential, to develop self-confidence in psychomotor skills, as well as the good
values which are an inherent part of nursing. Due to the fact that the clinical learning
environment is dynamic, it is necessary to ensure value-sensitive clinical guidance in the
community nursing practice. This implies that the values of all role players involved in
clinical guidance, namely the students and nurses (the patients during clinical guidance)
should be handled with the necessary sensitivity.
The goal of the study was to explore and describe to what extent value-sensitive clinical
guidance in Community Nursing takes place. As a result of the findings a concept
analysis of the categories identified was done and standards for value-sensitive clinical
guidance in Community Nursing were developed and refined.
For the purposes of this study an explorative, descriptive and contextual design was used.
Interactions taking place between the nurses and students during clinical guidance were
explored for value-`sensitivity by means of video-recordings, participative observation,
diaries, focus-group and semi-structured interviews. The data collected were analysed
and coded by the researcher and the external coder. As a result of the findings in this
research a concept analysis was done of the different categories (identified in phase 1).
The findings were compared with the literature in the concept analysis and similarities
and differences were highlighted. As a result of the concept analysis standards for value
sensitive clinical guidance in Community Nursing were developed, described and refined
after it was presented to experts from academic training institutions and the community
nursing practice.
The four main categories identified were communication, attitudes, respect and clinical
opportunities during clinical guidance. Due to the fact that professional socialisation
mainly takes place in the clinical practice clinical guidance should be well-planned.
Nurses acting as clinical guides should always keep in mind that they are acting as role
models who are in possession of sufficient theoretical and clinical knowledge, and that
they must maintain high nursing care standards. Nurses must approach the clinical
guiding situation with an open and accommodating attitude. Students should be
respected as human beings in order to establish open communication channels whereby
clinical learning in students could be facilitated. Therefore a supportive, non-threatening
clinical practice should be established, so that students will take the liberty to ask
questions and will have the confidence to participate in clinical nursing actions under the
direct supervision of nurses.
The standards for value-sensitive clinical guidance in community nursing are aimed at all
role players involved with clinical guidance. These role players include the service
providers (the nurses, clinical co-coordinators and managers), as well as the academic
training institutions (lecturers and students).