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[The reference nurse--position on the practice of training and supervision]
Myriam Manson-Clot1, Philippe Pahud, Ronald Müller
1Haute Ecole de la Santé La Source (ci-après HES-ELS).
Abstract:
This qualitative research discusses the nurse known as the reference nurse who is more specifically in charge of the training and supervision, and evaluation of the student nurse who has in-service training in care unit. The research notably describes the practice and position of the Reference Nurse (hereafter RN) in this role. As the aim is to know better the practice of the RN for the training and supervision of student nurses, this is an approach of mutual understanding that every RN is individually interviewed, then that researchers meet them again, this time in groups (by region), which enables among other things, to discuss certain positions which came out of a first analysis of discussions. In this aim, within a university hospital, twenty-four nurses working in internal Medicine, Psychiatry and Surgery, were interviewed by a research team. The context of this research is particular and interesting in several respects. The research was carried out in partnership between two institutions, one institution of university care and one institution of training in nursing care; the research team therefore includes people from both institutions. It is the encounter of two worlds that have a joint function, that is to train nurses, but that also have trend and themes that are specific to them, or even antinomic; all this in a context of educational and organizational changes of the nursing training. The research themes are the activities of training and supervision carried out, the arbitration of their caring and educational practice, the key moments of training and supervision, their objective look at this role, the ideal thing as they would see it. RN described a system which is not much formal, essentially marked out by key moments such as the entry in the care unit of the student, the welcome, exchanges with the student, punctuated with educational assessment and end-of-training assessment. When giving to the patients, RN develop some forms of activities with the student which ensure the work prescribed on behalf of their responsibilities, while trying to adapt themselves and interact with the student as well as with the contextual situation. The student's questions are uses as much to check her knowledge, her understanding of the caring situations, her ability to get organised, to argue as to understand her better in her real-life experience, her self-esteem, to put her well at ease, in confidence to facilitate her apprenticeship. The quality of dialogistic communication is strongly emphasized as necessary to training and supervision. Evaluation is an important part of the supervisory work and reference nurses actually showed a tension between a control position and a confidence position in the practice of the student's follow-up. RN expressed their wish to have specific time to train and supervise the student, would like to increase partnership with schools, and requested some educational support. Their talks brought to light the various skills, as much technical as social, that this role of training and supervision requires, but also the emancipatory impact of these various roles held.
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