Lessons about Boundaries and Reciprocity in Rural-based Preceptorships

Challenges and Opportunities in Rural Nursing Preceptorship: What Multimedia Participant Action Reveals (Défis et possibilités du préceptorat infirmier en milieu rural : ce qu’une participation multimédia révèle)

“…Developing a holistic sense of health, encompassing the community and landscape, was cited repeatedly as a significant outcome by students (Amundson et al, 2008;Charles et al, 2006;Yonge et al, 2013c). At the same time, they alluded to the challenge of serving a rural client base whose community ethos often did not align with professional boundaries and confidentiality (Dowdle-Simons, 2013;Presley, 2013;Yonge et al, 2013cYonge et al, , 2015. The role modeling of their preceptors, especially regarding reciprocal giving, afforded the students an insight into rural caregiving as a constant balance of professional and community values, in which the rigid maintenance of boundaries was neither sustainable nor desirable (Mills et al, 2007;Yonge et al, 2015).…”

“…Some of the most conspicuous challenges in rural preceptorship involve relationships, as informality and boundary crossing are more common in rural communities and health care settings as compared with urban settings. Rural nurses teach students and novice nurses how to negotiate boundaries and reciprocity when dealing with clients (Mills, Francis, & Bonner, 2007;Yonge, Myrick, Ferguson, & Grundy, 2015); however, the relational bond between preceptors and students may also entail boundary crossings, such as personal disclosure, gift exchanges, touching, and post-preceptorship contact (Yonge, 2009). Indeed, the absence of such interpersonal gestures can be detrimental to learning outcomes, as students feel intimidated or obliged to spend time managing the relationship (Pront et al, 2013).…”

“…Rural preceptorships enable nursing students to achieve a holistic grasp of health, community, and landscape (Amundson et al, 2008;Charles et al, 2006;Yonge, Myrick, Ferguson, & Grundy, 2013c), but students may initially struggle with the competing values of community and society (Presley, 2013;Yonge et al, 2013cYonge et al, , 2015, or of nursing theory versus frontline practice (Dowdle-Simons, 2013). Sedgwick and Yonge (2008) found, for example, that students felt most challenged by the psychosocial and psychomotor demands of the rural practice setting, for which their classroom studies had not fully prepared them.…”