Saudi Female Nursing Students’ Sense of Belonging in Clinical Settings: A Mixed-Methods Study

Abstract

The objectives of this study were to: (a) explore what sense of belonging in clinical settings means to female Saudi nursing students, (b) identify the factors affecting the students’ sense of belonging, (c) identify the consequences of a sense of belonging in clinical settings from the perspectives of female Saudi nursing students, (d) modify, translate, and test the Belongingness Scale–Clinical Placement Experience (BES–CPE) instrument based on the qualitative views of the participants, (e) develop a valid and reliable tool for use in the Saudi context, (f) determine the validity and reliability of the Arab version of the BES–CPE, and (g) measure and compare the extent to which nursing students experience a sense of belonging in clinical settings. This research used an exploratory mixed-methods approach. For the qualitative phase, there were 16 student participants. For the quantitative phase, there were 273 student participants. The study was conducted at three government universities in Riyadh, Saudi Arabia. The qualitative data were collected via semi-structured interviews. The quantitative data were collected using modified and translated versions of the BES–CPE. The results indicated different personal, clinical, and academic factors influenced female Saudi nursing students’ sense of belonging. The participants reported the following influential factors: distinctive characteristics of Saudi cultural values; lack of preparation; limited English language skills; and their relationship with the nursing staff, nurse educators, other health care providers, and clinical peers. The participants also reported positive consequences of a sense of belonging, such as feeling safe, valued and like a real nurse, as well as a motivation to learn. The study found that 75% of participants preferred to work with Saudi nurses who understood their needs, culture, and language. Almost 40% indicated their limited English language skills negatively affected their sense of belonging. The majority (90%) indicated an association of their sense of belonging with their motivation to learn. Only 15% indicated they liked the nurses they worked with in clinical settings; and only 13% reported feeling welcomed and accepted by the nursing staff all the time. More than 30% of participants indicated making an effort to feel accepted by the nursing staff. Therefore, students must be team members and participate in patient care to become competent nurses who can provide quality and safe care. The lack of belonging, as the students described, decreases their opportunities to learn and leads to different psychosocial problems. Saudi society and families must promote the nursing profession because the country needs national nurses who understand the language and culture of Saudi patients.