임상실습에서 학생들이 경험하는 간호과정 적용문제

The Problems for Application of Nursing Process in Clinical Experience of Nursing Students

Nursing process is an essential part for nursing practice. Nursing faculty members must focus on the clinical application for students and try to identify the possible problems that students might face in the fields. The purpose of this study is to examine the actual condition of nursing process education in curricula and to investigate the response of students in clinical experience of nursing process. From 462 students in the 6 associate programs(ADN) and the 6 baccalaureate programs (BSN) data was collected by questionnaire. The results were as followed. 1. Seven programs (58.3%) opened the nursing process in mainly sophomore (BSN) or freshman(ADN). If not opened, the nursing process was taught at the major subjects(espcially fundamental nursing or adult nursing). 2. All Students responded they we supposed to use nursing process in preparing the case report. The majority(94.6%) used NANDA lists for nursing diagnosis and 55.7% of subjects consulted the Korean terms by KNA when translating. The tutors for nursing process in clinical settings were the professor in charge of the subject (68.6) or clinical instructors (48.1%) , assistants(34%). 3. The problems in clinical application that students experienced consisted of 17 items and the mean was 2.27. The biggest problem was 'the lack of the model for RN of applying the nursing process in clinical settings'(2.97). Next the big problem was 'the lack of the competency for implementing the established nursing plans'(2.69). All items were significantly different according to the level of educational programs(ADN or BSN). ADN students had more problems in applying the each step of nursing process and BSN students perceived the NANDA as a guidance of nursing diagnosis and the inconsistency of advices from several instructors or practicum to be mere problematic. 4. The mean of merits after application of nursing process was relatively fair (2.82). The best merit was 'they can identify nursing problems more exactly'(3.07). The second high merit was 'they can study the rational of nursing action' (3.03). BSN than ADN and the subjects of second year than of one year in clinical experience perceived the use of nursing process to be better. Based on this results we need to enforce the application of nursing diagnosis in the class. The use of sample cases can be the efficient method. Students can identify the possible health problems for patient from the cases in imaginary world and discuss them each other. Also we can use the discussion session after practice every other day or as needed. All this is on the good interaction between tutor and student. We must consider to have enough time for student to seize the essence of the nursing process.