The mindfulness of student nurses during interpersonal communication with colleagues and patients in clinical facilities in the Western Cape

Abstract

A great deal of attention has been paid to mindfulness during interventions by healthcare professionals as well as the importance of mindfulness during interpersonal communication. At a Higher Education Institution (HEI), clinical mentors reported that students when placed in clinical practice, lacked interpersonal communication skills during interaction with colleagues and patients. It seems that they exhibited compassion fatigue, which could be linked to them having a lack of mindfulness. The purpose of this study was to investigate the extent (level) of mindfulness of junior and senior students, from which guidelines were developed for them on being mindful during interpersonal communication with colleagues and patients in clinical facilities in the Western Cape. The study departed from the assumption that mindfulness in a human being (student) consists of three dimensions (psychological, physical, and spiritual) adapted the theoretical perspective of Neil Bierbaum (2018), that assumes that three key elements of having deliberate awareness, being non-judgmental and being non-reactive are included in the three dimensions of mindfulness. A quantitative, descriptive study was completed. From the accessible population (N=600), the sample of respondents who took part in the study was junior nurses (1st and 2nd years), and senior nurses (3rd and 4th years) (n=204). A self-report, 6-point Likert scale questionnaire was developed from literature with 49 items. Respondents voluntarily participated in the study and completed the instrument (questionnaire) in around 30 minutes. Pre-testing of the questionnaire indicated no shortcomings in the instrument. Ethical principles on the right to privacy, confidentiality, anonymity; justice, and equality, beneficence, protection and harm, written informed consent, the freedom of choice and withdrawal from the study, were adhered to. Data analysis included descriptive and inference statistics. A factor analysis, followed by a Pearson Chi-square Test (𝑥2), and Cochran-Armitage Trend Test, was performed, to determine significant differences (p < 0.05) between the responses of junior and senior students and their mindfulness during interpersonal communication. The principles of reliability and validity were adhered to during conducting the research. The factor analysis rotated nine factors that included the three dimensions of mindfulness and linked to the elements. Some similarities and differences were found between the responses of the two groups regarding the three dimensions of mindfulness. Responses on most items in the psychological dimension in the element of deliberate awareness, indicated high mean values (𝑥̃ ≥ 4.5), on the ‘somewhat to totally agree’ scale ratings. Juniors were more alike (SD ≤ 0.7) in their mindfulness on pay full attention to the charge sister when she delegates certain duties to me listening to what a patient said without interruption, aware of the thoughts of a patient to be empathetic. Seniors were more alike (SD ≤ 0.7) in their mindfulness on being willing to connect with those who are in distress due to their own personal challenges and more diverse in their mindfulness levels (SD ≥ 1.2) on enjoying routine tasks in the clinical area with their colleagues. In the element of being non-judgemental, seniors were more alike in their mindfulness levels regarding put themselves in the position of other students when struggling to perform procedures and not judging a patient when repeatedly asking the same questions. In the element of non-reactiveness senior students were remarkably diverse in their responses (SD ≥ 1.2) on keep their emotions intact when they were insulted by others, while juniors were diverse in their mindfulness levels on standing back and letting a colleague give feedback on behalf of a group while struggling. The responses in many items addressed in the physiological dimension, indicated that the both the juniors and senior groups were mindful in the element of deliberate awareness, with mean values of ≥ 4.50 (somewhat to fully agree) with normal standard deviations (> than 0.7 and < 1.2). However, in the element of being non-judgemental, seniors and juniors differed in their mindfulness levels. Seniors had a narrow distribution of responses around their mean value, on listening without being judgmental if a new way of performing a procedure was explained (≤ 0.7). Senior respondents found to be more alike in their mindfulness levels (SD 0.65), oppose to their juniors with a normal distribution of responses (SD > 0.70). In the element of deliberate awareness in the spiritual dimension, junior and student respondents obtained mean values of ≥ 4.50 that was interpreted as a positive outcome of mindfulness (somewhat to totally agree on items). Juniors were more similar in their mindfulness levels, strengthening their weaknesses (SD 0.68) than their counterparts with a normal distribution of responses around the standard deviation (SD 0.40). On the other hand, seniors were more similar in their mindfulness levels on being able to change the way they interacted with colleagues during interpersonal communication, by evaluating their own communication techniques (SD 0.65), oppose to the normal distribution of their counterparts (0.82). The responses on the element of being non-judgmental were addressed in the spiritual dimension, and both groups indicated moderate mean values and high standard deviations on being at ease to accept the failures of other students. This was different from the responses of both groups having a high mean value of ≥ 4.50 and low standard deviation (≤ 0.7) on showing compassion for peers by, for instance, advising them when they struggle to hear a blood pressure. In the element of non-reactiveness, high mean values and normal standard deviations were obtained on the responses on doing a task even if students would rather not do it, showing neutrality in a conflict situation between two colleagues arguing without all facts at hand, and tolerance of others’ opinions even if it differs from theirs. It was concluded that student nurses of the different year levels, were reasonably mindful during interpersonal communication with their colleagues and patients. However, there was a slightly negative shift in awareness of seniors on importance fundamental aspects of mindfulness from being juniors. It could have been expected that senior students have had internalised the fundamental elements of mindfulness during interpersonal communication, from them being juniors. Junior and senior students should have a similar conceptualisation of the elements and dimensions of mindfulness during interpersonal communication, which could enhance a person-centred approach during interaction with others in daily clinical practises.