Finessing Incivility: How student nurses respond to issues concerning their status and learning during practice: A grounded theory.

  • Juliet Thomas

Student thesis: Doctoral Thesis


Background: Interest in understanding the socialisation processes that student nurses are exposed to during clinical practice has endured and is warranted given that first year undergraduates have to adapt and develop intellectually, socially, emotionally and culturally to ensure successful transition and acculturation into higher education. In addition, when first year undergraduates are also student nurses, they must display versatility and tenacity in pursuing a professional identity often in complex, changing and reforming health care and educational environments. In the UK at present the main curricula design consists of equal parts theory and practice and undergraduate student nurses experience clinical placements much sooner than their predecessors. This transitional period has received less investigation and therefore, this study aims to redress this imbalance. Purpose: To explore the impact of initial clinical experiences on the professional socialisation of student nurses. The intention has been to allow the student nurses to ‘tell it as it is’ about their experiences of becoming a nurse, the essence of which could generate a substantive grounded theory. Setting: Two placement areas, consisting of a rural District General Hospital and a large inner city Hospital that reflect diverse socio-economic areas in the north west of England. Method: A classic grounded theory approach (Glaser 1978) was used. The sample consisted of twenty-six (26) student nurses recruited from four (4) intakes over a two year period. Diary keeping was the main data collection method and seven (7) key informants from the first two intakes volunteered to take part in an in-depth interview during the second or third year of their course. Findings: The substantive grounded theory of Finessing Incivility, explains how undergraduate student nurses respond to prevailing concerns regarding their student status, learning opportunities and a lack of professional benevolence during the initial clinical placement. In order to resolve these concerns and relocate their status back to a student from a worker, they maintain values, remain resilient and display and use finesse to broker for learning opportunities and resolve their concerns. The usefulness and originality of the theory is the conceptual explanation it offers of the psychosocial processes that student nurses engage in, and with, during practice that has not been previously noted. Limitations: Although the solicited diary accounts were requested daily, the possibility exists that they were kept less frequently, filled in retrospectively, or not at all (Hyland 1996, Bowling 2002). A larger sample would have negated potential effects of attrition. In addition, and in the absence of participant observation, the accounts are accepted as truthful, although the risk exists that the students exaggerated or distorted their accounts to demonstrate how bad they felt concerning their experiences. Discussion: The theory has yielded insight into the complexities involved in becoming a professional nurse. The theory of ‘finessing incivility’ has implications for nurse educators and other allied health professionals during practice and field exposure. Exploring the experiences of other allied health students with regard to the concepts of finessing and resilience in response to incivility and loss of student status merits further investigation as do the perceptions of mentors involved with student nurses during the initial placement.
Date of Award13 Feb 2013
Original languageEnglish
Awarding Institution
  • Edge Hill University


  • student nurses
  • clinical practice

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