Narrativizing Nursing Students’ Experiences With Medical Errors During Clinicals

Abstract

The ways providers story their mistake experiences help to explain how providers understand medical errors and how they communicate about those errors. Communication scholars have slowly begun to explore the communicative nature of medical error experiences, with communication research becoming more abundant over the past few years. Missing from this discussion is how students in health professions, in this case nursing students, tell medical errors narratives and how the stories help them determine how to respond to mistakes. In this article, we explore how nursing students narrativize their medical errors experiences during clinicals. Qualitative interviews were conducted with 68 nursing students. The interviews were transcribed and resulted in a total of 1,261 single-spaced pages of data. We found that nursing students told three different narratives: (a) the "save the day" narrative, (b) the "silence" narrative, and (c) the "not always right" narrative. Finally, we discuss the implications of these narratives and their impact on nursing education.

Nursing students’ experiences of patient safety incidents and reporting: A scoping review

“…[34,35] Offering suggestions for communicating mistakes may also prove beneficial. [64] Faculty can provide students with safe learning spaces through the use of simulation scenarios in laboratory environments to practise prior to real-life clinical placements. [60,65] Simulation for safe medication administration and incident reporting may be helpful in reinforcing these skills.…”

“…[71] While further research is required in this regard, specific strategies could enhance communication, so students feel comfortable and confident in expressing safety concerns and disclosing. [35,64] 4.3 Implications for research With the development of educational strategies, best practices, and through the recognition of existing barriers, students could be better positioned to practise patient safety principles. [17,20,45] Exploring the relationship between patient safety education, and the type or setting of educational intervention, could be helpful in developing optimal strategies.…”

“…[37] Furthermore, examining the communication patterns between students involved in PSIs and their educators or staff nurses could identify communication gaps. [33,47,64] Perspectives from educators and health professionals could provide a more comprehensive understanding of student involvement in PSIs and reporting. Additional insights could enhance understanding of the socialization process between students and preceptors [47] and inform the nature of supervision necessary for the individual student learning needs.…”

The space to make mistakes: allocating responsibility and accountability for nursing student-committed medication errors

“…Student nurses have been found to be particularly likely to believe that errors can be avoided by working hard and that those who commit errors should be punished (Cox et al, 2009). They have also expressed an acceptance that mistakes are inevitable while, at the same time, they struggle with their inability to be perfect (Noland & Carmack, 2015a). Many faculty members also still hold a belief that individual vigilance is all that is required and, if a medication error occurs, then the student is at fault and his/her academic record should be impacted (Barnsteiner & Disch, 2012;Disch et al, 2017;Zieber & Williams, 2015).…”

“…Student nurses have been reported as readily taking on blame from both self and others for errors in which they were involvedeven when the level of blame accepted was disproportionate to their actual contribution to the error (Noland, 2014). Students were also very likely to readily adopt the notion that they must have been in the wrong if an error occurred (Noland, 2014;Noland & Carmack, 2015a;Zieber & Williams, 2015).…”