Laura F Lewis1, Lauren Jarvis2. 1. University of Vermont, USA. Electronic address: laura.lewis@uvm.edu. 2. MedStar Georgetown University Hospital, USA.
Abstract
BACKGROUND: With the US facing an opioid epidemic, undergraduate nursing students are increasingly encountering patients with opioid use disorder in the clinical setting. Yet, nursing curriculums have not adapted to meet this need. Previous research indicates students are exposed to negative messages that might influence their views about patients with opioid use disorder. OBJECTIVES: The purpose of this study was to examine nursing students' experiences encountering patients with opioid use disorder in the clinical setting, their attitudes about their encounters, and their perceptions of their educational preparedness to care for this population. METHOD: Purposive sampling was used to identify participants. Semi-structured interviews were conducted until saturation. Krippendorff's method for qualitative content analysis was used to cluster units within the data to identify emergent themes. PARTICIPANTS: Eleven senior nursing students from a public university in New England participated. RESULTS: Analysis revealed six themes, including: navigating ethical dilemmas, gaining comfort with time and experience, avoiding the "elephant in the room," learning from real-world scenarios, witnessing discriminatory care, and recognizing bias and stigma. CONCLUSIONS: Students were most likely to experience bias and internal conflict in maternity clinical rotations. Education should include practical communication strategies to reduce avoidance behaviors among nursing students as well as techniques to manage difficult situations and reduce moral distress. Nurses must be mindful of their power to influence students and should model non-judgmental language and behavior. Students ultimately expressed a desire to provide informed and empathetic care.
BACKGROUND: With the US facing an opioid epidemic, undergraduate nursing students are increasingly encountering patients with opioid use disorder in the clinical setting. Yet, nursing curriculums have not adapted to meet this need. Previous research indicates students are exposed to negative messages that might influence their views about patients with opioid use disorder. OBJECTIVES: The purpose of this study was to examine nursing students' experiences encountering patients with opioid use disorder in the clinical setting, their attitudes about their encounters, and their perceptions of their educational preparedness to care for this population. METHOD: Purposive sampling was used to identify participants. Semi-structured interviews were conducted until saturation. Krippendorff's method for qualitative content analysis was used to cluster units within the data to identify emergent themes. PARTICIPANTS: Eleven senior nursing students from a public university in New England participated. RESULTS: Analysis revealed six themes, including: navigating ethical dilemmas, gaining comfort with time and experience, avoiding the "elephant in the room," learning from real-world scenarios, witnessing discriminatory care, and recognizing bias and stigma. CONCLUSIONS: Students were most likely to experience bias and internal conflict in maternity clinical rotations. Education should include practical communication strategies to reduce avoidance behaviors among nursing students as well as techniques to manage difficult situations and reduce moral distress. Nurses must be mindful of their power to influence students and should model non-judgmental language and behavior. Students ultimately expressed a desire to provide informed and empathetic care.