Date of Award


Document Type


Degree Name

Doctor of Nursing Practice (DNP)




Jacqueline Haverkamp, DNP, MBA, RN, FNP-BC

First Committee Member

Rachel Cummings, RN, BIT: Chief Nursing Office


Student Nurses Clinical, Medical Surgical Unit, Mixed-Method, Pilot Study, Critical Access Hospital

Subject Categories

Medicine and Health Sciences | Nursing | Perioperative, Operating Room and Surgical Nursing


This pilot study explored Registered Nurses (RNs) perceptions of the impact of student nurses’ clinical on the workload of medical-surgical RNs in a Critical Access Hospital (CAH). The real-life experience of students in the clinical learning environment has been seen as a valuable part of nursing student education. With the increase in the number and size of nursing programs leading to a shortage of clinical sites, maintaining a positive relationship with clinical sites is extremely important to nursing programs. Previous research has found that nurses often have ambivalent feelings regarding nursing students on their units. Purpose: Explore RNs” perceptions of the impact of student nurses’ clinical on the workload of medical-surgical RNs in a Critical Access Hospital. Background: Nursing programs in rural areas often utilize rural hospitals, many of which are Critical Access Hospitals (CAHs). CAHs have features and challenges that make their nurses’ work environment unique. With a shortage of clinical sites and the challenging work environment of RNs in CAHs, it is vital that nursing programs maintain a good relationship with these nurses. No studies have been reported specific to medical-surgical RNs and students in a CAH. Method: Mixed-method, descriptive, pilot study. The quantitative portion utilized a 38 item, electronic, adapted version of the Nursing Students’ Contributions to Clinical Agencies (NSCCA). The qualitative portion of the study utilized RN interviews, guided by semi-structured open-ended questions. Population: Regularly scheduled, day-shift RNs on a medical-surgical unit of a Critical Access Hospital. Results: RNs perceived the impact of student nurses’ clinical as positive. RNs with less than 10 years of experience viewed students more positive than RNs with more than 10 years of experience. Conclusions: RNs in the CAH perceived student nurses’ presence more favorably than nurses in previous studies in other hospitals types. Although not statistically significant due to the small sample size, the perception of students’ contribution to the clinical agency based on nurses’ years of experience supported previous research.



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