Most Nursing Students Hold a Positive Attitude toward “Internet plus Nursing Service”
The nursing students participating in this survey are from generations that have grown up with the Internet, and who are not only familiar with but have a preference for “Internet plus.” The majority of nursing students expressed support for the implementation of the “Internet plus Nursing Service” project, and they were willing to choose it as their future career choice. These nursing students believed that “Internet plus Nursing Service” could break the limitations of hospital services and extend the nursing service to the family; thereby meeting the patient’s needs for home health care and alleviating the problem of nursing shortages in the hospitals. Moreover, nurses could increase their income by making use of “Internet plus Nursing Service” in their spare time, thereby enhancing their personal value.5–7 However, about one third of nursing students still held a neutral or unsupportive attitude in “Internet plus Nursing Service.” The home and school education they received made them identify with nursing within hospital. Therefore, in their views, medical institutions are important components of their professional safety. Their inherent cognition makes them skeptical about “practice outside the hospital” and their capacities to be qualified for nursing work outside the medical institutions. In addition, nursing students with the experience of community activities or part-time jobs were more willing to accept the concept of “Internet plus Nursing Service,” indicating that school education ought to remain sensitive and concerned about the changes in social development and enhance the cognition of nursing students on “Internet plus Nursing Service.” Furthermore, it should encourage nursing students to actively participate in community activities as well as extracurricular practice activities, and consciously cultivate their professional ethics, attitudes, and style, along with other qualities such as communication skills, cultural sensitivity, interdisciplinary cooperation capacity, responsibility, professional dedication, team awareness, and professional integrity. It should also encourage them to keep good psychological as well as physical qualities and enhance their ability to cope with stress and frustration.8–10
Pay Attention to the Professional Loyalty and Career Planning
About 51 nursing students (10.04%) were unwilling to accept “Internet plus Nursing Service” as their future career choice while 178 (35.04%) responded unclear. Of the latter, the ones who were non-voluntary to choose nursing profession accounted for 66.78%, those who were satisfied with nursing profession accounted for 52.34%, and those who did not want to or were unclear whether they will engage in nursing work after graduation accounted for 47.80%. Their identification degree to nursing profession was not high. They also felt confused about being a clinical nurse in the future. Thus, we should pay attention to the professional loyalty of nursing students firstly prior to investigating whether nursing students could accept “Internet plus Nursing Service.”11 School education should pay attention to the emotions and attitudes of nursing students beginning at enrollment, thereby helping these students make good career choices based on correct understanding of themselves and the relevant environment. Projects such as alumni association and career development forum could help nursing students face their career choices rationally to avoid wasting of human resource.12,13
Strengthen the Nursing Education of Elderly Care and Arouse the Interest of Nursing Students in Elderly Care
The key service focus of “Internet plus Nursing Service” is the elderly or disabled/semi-disabled elderly population. Considering the physiological and psychological specificity of the above population, professional geriatric nurses are urgently needed to meet their health needs.14The survey suggested that nursing students did not master the knowledge and skills required for elderly care sufficiently, and they lacked confidence in caring for the disabled/semi-disabled elderly population. Additionally, they lacked the willingness to engage in elderly care after graduation.
Elderly care education is also limited in the insufficient courses in the school of nursing. Poor practice results in fewer opportunities for nursing students to understand older persons at a close distance.15 Many nursing students pay inadequate attention to the courses in elderly care due to the lack of corresponding professional examinations. Only a minority of undergraduate nursing students are willing to engage in elderly care.16 The related knowledge and skills on elder care are included in the category of registered nurse examination in USA, elderly care practicing certificate is set, nurse’s practice on elderly care is encouraged and student’s study on elderly care course is strengthened in order to promote the development of elderly care.17
The nursing students with experience of elderly care were more willing to engage in elderly care than those without experience of elderly care. Thus, developing an elderly care education program that combines theory, experiment, and practice as a whole into nursing education is needed. A practical training base of elderly care should be built for professional practice experience. The awareness of nursing students on nursing profession, life, and elderly should be strengthened to arouse their responsibility and nursing professional emotions and accurately meet the diversified and differentiated health needs of elderly patients. In a systemic evaluation on medical students’ attitude intervention study towards the elderly.18,19 Samra et al.20 proposed to add empathy building into elderly care courses and encouraged students to have direct contact with the elderly to listen to their stories. Fisher and Walker21made the students feel the situation of their old age through simulation-based teaching, where the elderly were taken as themselves, thereby increasing the students’ awareness of the elderly population and improving their attitudes towards older persons.
Safety and Salary of “Internet plus Nursing Service” Key issues for Nursing Students
This survey showed that safety concern was the main reason to block students from accepting “Internet plus Nursing Service” as their career choice. The personal safety issue in the case of going to an unfamiliar environment to provide home nursing services is one part of the safety concern mentioned above. “Nobody knows what kind of person the patients and families behind the door belong to. It’s full of unknown and risks.” The nursing students were also worried about the medical security for themselves and patients in the case of providing out-of-hospital care service for high-risk population such as the elderly or disabled people. Any nursing procedure is not absolutely smooth and safe. Medical teams and equipment support could act as strong backing in a hospital if it encounters a tricky problem. However, how to deal with the possible thorny problem when provide out-of-hospital nursing service?” Nursing Students were interested in the added income from “Internet plus Nursing Service,” and they regarded it as a crucial problem due to that it fully reflected the personal value of nurse and met the requirement for high income. The majority of nursing students believed that “the nursing work was very hard. If the salary obtained was not satisfactory after spending the rest time in part-time job, the participation enthusiasm of nurses would be affected.”
The government should pay attention to the concerns of nursing students and reinforce the service procedure and salary managements of “Internet plus Nursing Service.” School education should also strengthen the practice of safety education for nursing students and training for professional knowledge and skills to enhance their abilities to withstand risks.22,23