The moral courage of nursing students who complete advance directives with homeless persons

Abstract

Our results cannot be generalized, but portions of our approach are likely to be transferable to similar social contexts. For example, because homeless persons are misunderstood and marginalized throughout the United States, our design for training nursing students to provide this service is also likely to be useful across the United States. Internationally, however, it is not yet known whether our participants' fears and the challenge they faced are also experienced by those who assist homeless persons or members of other vulnerable populations in documenting healthcare wishes.

Student courage: An essential for today's health education

“…Study findings revealed that students' preceding fears included acting inappropriate in front of the patient and fear of discussing dying and death with a homeless person. 10 However, it was found that after interaction with homeless persons, none of the preconceived fears occurred; rather, they concluded students needed more courage in anticipation of such events. 10 Having moral courage as a nurse is a valuable characteristic, not only for patient safety but also because of its recently established correspondence with preventing moral distress.…”

“…10 However, it was found that after interaction with homeless persons, none of the preconceived fears occurred; rather, they concluded students needed more courage in anticipation of such events. 10 Having moral courage as a nurse is a valuable characteristic, not only for patient safety but also because of its recently established correspondence with preventing moral distress. 11 Moral distress occurs when a person knows the right action to take, but cannot take the correct action due to constraints (internal and external).…”

“…Practicing student courage while in school could lead over time to active moral courage when new graduates enter the profession. Nash, Mixer, McArthur, and Mendola conducted a study with the intended outcome of instilling courage into nursing students by completing advance directives with homeless persons. Study findings revealed that students’ preceding fears included acting inappropriate in front of the patient and fear of discussing dying and death with a homeless person .…”

“…Nash, Mixer, McArthur, and Mendola conducted a study with the intended outcome of instilling courage into nursing students by completing advance directives with homeless persons. Study findings revealed that students’ preceding fears included acting inappropriate in front of the patient and fear of discussing dying and death with a homeless person . However, it was found that after interaction with homeless persons, none of the preconceived fears occurred; rather, they concluded students needed more courage in anticipation of such events …”

Challenges to discussing palliative care with people experiencing homelessness: a qualitative study

“…In previous research, nursing students described anxiety around discussing death and dying with this group, yet completion of the advance directive with this group was rated as less challenging than anticipated. 47 People experiencing homelessness have been willing to talk about end-of-life care wishes 24 and complete advance directives 48 in previous research, particularly when one to one support is provided. 19 35–37 In this research, avoidance and denial of these issues was apparent.…”