Ethnic inequalities during clinical placement: a qualitative study of student nurses' experiences within the London National Health Service
Ethnic inequalities during clinical placement: a qualitative study of student nurses' experiences within the London National Health Service
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临床实习期间的种族不平等：对伦敦国家卫生服务中心实习护士经历的定性研究
DOI：
10.1101/2023.02.13.23285608
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Walker C
中科院分区：
文献类型：
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作者：
Walker C
目的了解在英国国家卫生服务（NHS）医院实习的护士实习经历在少数民族和英国白人群体中的差异。用归纳的方法设计一个定性的主题分析。方法采用主题分析方法对来自21名英国伦敦医院实习护士的半结构化访谈数据进行分析。作为解决保健服务中的不平等和歧视经验研究的一部分，对参与者进行了采访，并询问了他们在临床安置期间的经历。结果确定了五个主题：(1)导师的角色，(2)歧视和不公平待遇，(3)直言不讳，(4)职业发展，(5)不良经历的后果。所有主题都与社会动态和工作环境（称为“病房文化”）相关联，提供了一个使护理学生所经历的虐待正常化的背景。来自少数民族背景的学生报告了种族主义以及文化和/或宗教上的微侵犯。英国白人学生在因种族和民族而受到重视的同时，也因年龄、性别、性别和性取向而受到歧视和不平等。来自英国白人和少数族裔的学生都承认，受到恶劣对待是职业发展的障碍。少数民族学生还指出，高级护理职位中缺乏多元化代表，这阻碍了英国国民保健服务体系的职业发展。这些最初的不平等和歧视的经历很容易塑造学生对他们的职业和护理进步能力的看法。NHS负责确保学生护士的发展机会是平等的，无论其种族如何。影响文化是由其他人延续的，他们将虐待正常化，同时使少数民族学生处于不利地位，使他们感到不受重视。这反过来又影响了NHS内部的员工保留和职业发展。培训评估人员应该意识到临床实习中存在的歧视文化，并努力消除这种文化。
AimTo understand how student nurse experiences on clinical placement, within National Health Service (NHS) hospitals, differ for ethnic minority and White British groups.DesignA qualitative thematic analysis with an inductive approach.MethodsData from semi‐structured interviews with 21 London (United Kingdom) hospital‐based student nurses were examined using thematic analysis. Participants were interviewed as part of the Tackling Inequalities and Discrimination Experiences in Health Services (TIDES) study and asked about their experiences during clinical placement.ResultsFive main themes were identified: (1) Role of mentors, (2) Discrimination and unfair treatment, (3) Speaking up/out, (4) Career progression, and (5) Consequences of adverse experiences. All themes were linked, with the social dynamics and workplace environment (referred to as “ward culture”) providing a context that normalizes mistreatment experienced by nursing students. Students from ethnic minority backgrounds reported racism as well as cultural and/or religious microaggressions. While being valued for their race and ethnicity, White British students also experienced discrimination and inequity due to their age, sex, gender, and sexual orientation. Students from both White British and ethnic minority groups acknowledged that being treated badly was a barrier to career progression. Ethnic minority students also noted the lack of diverse representation within senior nursing positions discouraged career progression within the UK NHS.ConclusionThese initial experiences of inequality and discrimination are liable to shape a student's perspective of their profession and ability to progress within nursing. The NHS is responsible for ensuring that student nurses' developmental opportunities are equal, irrespective of ethnicity.ImpactWard culture is perpetuated by others who normalize mistreatment and concurrently disadvantage ethnic minority students, making them feel unvalued. This in turn impacts both staff retention and career progression within the NHS. Training assessors should be aware of the existing culture of discrimination within clinical placements and work to eradicate it.