Date of Award

2011-12-01

Degree Name

PhD Nursing

Dissertation Committee

Dr. Jane M. Georges, Chairperson; Dr. Ann M. Mayo; Dr. Maryanne Garon

Keywords

critical feminism, medication administration, medication errors, nursing, nursing students, phenomenology

Abstract

Medication errors are abounding and the complexity of medication administration creates an environment where health care providers are at risk for making errors. This environment includes nursing students learning medication administration. Coupled with a rigid, protocol-driven pedagogy, nursing students may be placed in a learning experience counterproductive to accuracy. Previous studies have focused on causes and perceptions of medication errors looking for the delineation between safe and unsafe practice. In doing so, past research may have narrowed the path of discovery needed to diminish medication errors. In addition, research regarding the lived experience of nursing students while they are learning medication administration is limited. Two designs were used for this study. First, using a critical feminist perspective, a mid-range theory of nursing lens distortion is proposed regarding the oppression caused by the socially-constructed phenomenon of perfectibility and its distorting influence on the development of a nursing lens. Subsequently, an interpretive phenomenological study was conducted to approach the reality of how nursing practice and practice wisdom is learned during medication administration. A purposive sample of 13 students attending an entry-level masters nursing program was analyzed using the interpretive phenomenological method by Benner. Paradigm cases, thematic analysis, and exemplars were identified from the narrative accounts. Four paradigm cases emerged revealing a student-clinical instructor-staff nurse triad where power relations themes either promoted or inhibited learning medication administration. Exemplars of student feelings, meaning of medication administration, and solutions for improvement further revealed the students' experiences. A portion of the thematic analysis examined a student medication error revealing a destructive learning aftermath. Themes describing the sociopolitical context, including the rights of medication administration, are also examined. Discussion using the mid-range theory of nursing lens distortion and the Perfectibility Model further illustrated the experiences. Exploring such experiences offered insight into educational pedagogies that inhibited and promoted accuracy. The phenomenon of medication errors was exposed in a contemporary context revealing a complexity that requires more than a list of rights, or ineffective preparatory actions when learning medication administration. Opportunities for academia and practice are further explored.

Document Type

Dissertation: Open Access

Department

Nursing

Included in

Nursing Commons

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