Unsafe student nurse behaviours: The perspectives of expert clinical nurse educators

Clinical evaluation of undergraduate nursing students is one of the most challenging aspects of baccalaureate nursing education, especially for novice clinical instructors. Early identification of unsafe student behaviours is necessary to ensure students obtain adequate support and guidance. The degree to which clinical instructors are certain about what is safe and unsafe varies, and greatly influences their decisions about evaluative processes and which patients to assign to students. The purpose of this study was to gain consensus from a panel of sixteen nurse educator experts on particular student nurse behaviours that represent unsafe clinical practices and provide a hierarchy of unsafe behaviours from their perspectives. Using the Delphi technique, a series of four online surveys were administered to the panel: exploratory (open-ended questions), evaluative (responses to Likert statements with level of agreement), reconsidering (revising or confirming), and ranking. Thirty-eight unsafe student behaviours with respect to patients and seventeen unsafe behaviours with respect to others reached 80% or more consensus as being very unsafe. Two themes emerged from a cognitive perspective: the value of honesty and the expectation of knowledge. Two themes emerged from a behaviorist perspective: the value of control and the expectation of scrupulousness and precision. •Deliberate deceitfulness was ranked the most unsafe student behaviour.•Removal of a chest tube without supervision was ranked second most unsafe behaviour.•Lack of expected knowledge was considered to be a “breach of contract”.•Scrupulousness and precision was expected during medication administration.•Scrupulousness and precision was expected in the students' personal lives.