The systems psychodynamic role identity of nursing students during their preceptorship

Abstract

Background: Existing research on nursing students' preceptorship experiences focusses mainly on conscious and rational behaviour, evidencing experiences of personal and professional development. This study argues that the exploration of their unconscious experiences could add important information towards an in-depth understanding of their role identity during this experience.

Objective: The research objective was to describe the unconscious role identity of nursing students during their preceptorship from a systems psychodynamic stance.

Design: A qualitative design, a collective case study and hermeneutic phenomenology were utilised as methodologies.

Setting: Set in the School of Nursing of a Canadian University, the research focussed on students in the fourth year Consolidation in Nursing Practice Course.

Participants: The sample included 41 nursing students, 37 females, 22-28 years of age.

Findings: The manifesting themes were high levels of anxiety, defensive structures, boundary and authority matters, and role dynamics. The nursing students experienced high levels and different kinds of anxiety, which they defended against using introjections, projections and regression to their child ego state. They experienced the preceptorship as being in a middle position between past and future as well as between knowing and not knowing. The discussion was presented in relation to the macro (organisational), meso (group), and micro (individual) levels.

Conclusions: Unconsciously, the nursing students experienced difficulty in effectively taking up their professional role. They defended against their discomfort by splitting their experiences into what they introjected and projected. They introjected incompetence in coping with the emotional demands of the role and projected their anger onto authority figures. Their professional role identity got stuck in a de-authorised position where they could survive but not develop their selves in their new role. These experiences inhibited their authenticity and learning ability.

Keywords: Anxiety; Authorisation; Defence mechanisms; Role identity; Systemic functioning; Transformation.