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The prevention and appropriate professional response to children at risk of or experiencing child abuse and neglect has been identified as a national priority within the United Kingdom. Nurses (adult field) are likely to come into contact with children during their professional career and need to have the skills to detect and refer children who they suspect are suffering or at risk of suffering significant harm. However, there remains a dearth of evidence examining how nursing students (adult field) are prepared and supported and what their experiences are when they encounter child abuse or neglect in the clinical area. Therefore, the intentions of this study were: Research aim: To explore the experiences of student nurses (adult field) when they encounter what they perceive to be child abuse or neglect during their first community placement. Research questions: · How do student nurses (adult field) interpret, respond and learn from their experiences of encountering perceived child abuse or neglect during their first community placement? · How well are student nurses (adult field) prepared for encountering abuse and neglect? · How can they be better supported? Hermeneutic phenomenology was employed to guide the research design and processes, including data collection and analysis. The data were collected using narrative-style in-depth interviews from a purposeful self-selected sample of nine first-year nursing students (adult field) who perceived they had encountered child abuse or neglect during a community placement. Ethical approval was gained from the University ethics committee. Mezirow’s theory of transformational learning was used as a framework for analysis. Three overarching themes were identified: 1) Encountering disorienting events, 2) Reflecting on responses, assumptions and pre-conceptions and finally 3) An expanded worldview. The first theme reflected the student nurses’ initial thoughts as they encountered actual or perceived situations involving child abuse or neglect as well as deprivation. The second theme encompassed the student nurses’ initial feelings and responses to the experiences they encountered. This included feelings such as shock, anger, frustration and fear. Finally, the third theme outlined how the students reflect upon their practice experience, developing professional and personal insights. This is conceptualised as a transformational learning episode. The students’ journeys were idiosyncratic with variations in educational growth and transformation. The findings of this study suggest that student nurses (adult field) who encountered perceived child abuse or neglect during their first community placement felt unprepared for these encounters and would have welcomed the opportunity to reflect on their experiences when they returned to university. This has implications for the BSc Nursing studies (adult field) in considering the preparation and support of student nurses before, during and after their first community placement.

Background - UK healthcare has adopted various improvement strategies from business including using satisfaction surveys. However, the way patients form and express judgements of quality care can be more complex than customer purchases. Research in adult patient satisfaction has found capturing patient opinion challenging; however, adult service- user views continue to underpin quality care guidance across healthcare. Development of knowledge to include parental views of quality care is important to inform future guidance specific to children’s services. Methods - This study aimed to examine how parents determined the quality of care provided when their child was hospitalised, factors influencing perceptions of care and whether these judgements changed over time. Using a grounded theory approach, data were collected through a series of in-depth interviews (22) with nine parents following their child’s hospitalisation. Findings - The substantive grounded theory - Parenting in an alien hospital world: on guard and on behalf offers new perspectives on the complex psychosocial processes underlying parents’ quality judgements. When their child was hospitalised parents landed in an ‘alien’ world but continued to try 'to parent' (protect and advocate) their child. Parents' experiences were characterised by landing; moving from being' new parents' to 'old hands'; searching for and judging the 'clues' and facing dilemmas of how best to respond to professionals. Parents were found to use an escalating level of signals to prompt health professionals to respond to their queries and concerns Parents' personal lens altered through their transitional journey and this, together with their perception of professionals' power impacted on their chosen responses to professionals and their quality judgements. Parents held two views of care quality: ‘at the time’ and a final ‘on balance’ view. The final view recognised their own heightened emotions and reflected their current transition. Conclusions - Ultimately parents judge hospital care as high quality when they perceived health professionals acted as their allies in their parenting roles as protectors and advocates for their child in the alien hospital world. Health professionals could improve parents' experiences and quality judgements of care by early recognition and response to their 'signalling' and by explicitly acting as parental allies.