Abstract
BackgroundDespite increasing shortages of highly educated community nurses, far too few nursing students choose community care. This means that a strong societal problem is emerging that desperately needs resolution. ObjectivesTo acquire a solid understanding of the causes for the low popularity of community care by exploring first-year baccalaureate nursing students' perceptions of community care, their placement preferences, and the assumptions underlying these preferences. DesignA quantitative cross-sectional design. SettingsSix universities of applied sciences in the Netherlands. ParticipantsNursing students in the first semester of their 4-year programme (n=1058). MethodsData were collected in September–December 2014. The students completed the ‘Scale on Community Care Perceptions’ (SCOPE), consisting of demographic data and three subscales measuring the affective component of community care perception, perceptions of a placement and a profession in community care, and students' current placement preferences. Descriptive statistics were used. ResultsFor a practice placement, 71.2% of first-year students prefer the general hospital and 5.4% community care, whereas 23.4% opt for another healthcare area. Students consider opportunities for advancement and enjoyable relationships with patients as most important for choosing a placement. Community care is perceived as a ‘low-status-field’ with many elderly patients, where students expect to find little variety in caregiving and few opportunities for advancement. Students' perceptions of the field are at odds with things they believe to be important for their placement. ConclusionDue to misconceptions, students perceive community care as offering them few challenges. Strategies to positively influence students' perceptions of community nursing are urgently required to halt the dissonance between students' preference for the hospital and society's need for highly educated community nurses.
Highlights
The international shift in healthcare from intramural to extramural is associated with aging populations and an increase in chronic diseases and multimorbidity; both global phenomena (Afshar et al, 2015; WHO, 2008)
To reflect the current shift in healthcare delivery, one such challenge is to ensure that nursing students receive appropriate theoretical programme-content and placement experiences
The key aim of this study was to explore the causes for the low popularity of community care in first-year baccalaureate nursing students
Summary
The international shift in healthcare from intramural to extramural is associated with aging populations and an increase in chronic diseases and multimorbidity; both global phenomena (Afshar et al, 2015; WHO, 2008). To reflect the current shift in healthcare delivery, one such challenge is to ensure that nursing students receive appropriate theoretical programme-content and placement experiences Both general profiles for baccalaureate nursing education (AACN, 2008; NMC, 2010) and those in the Netherlands (Lambregts et al, 2014) increasingly contain elements of community care. Baccalaureate nursing students' career choices, are not in line with the labour market problem (Fenush and Hupcey, 2008; McCann et al, 2010) They mostly prefer to work in the hospital (Kloster et al, 2007; McCann et al, 2010), and do not see community care, the generalist home-based care, as an attractive line of work (Bloemendaal et al, 2015; Fenush and Hupcey, 2008; McCann et al, 2010; Norman, 2015). Strategies to positively influence students' perceptions of community nursing are urgently required to halt the dissonance between students' preference for the hospital and society's need for highly educated community nurses
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