Nursing students’ attitudes and experiences with mental illness: A cross-sectional study

Almost half (46%) of people will experience a mental health issue in their lifetime and all nurses need mental health knowledge and skills regardless of their area of specialization. Little is known, however, about student attitudes toward people with mental illness on entry to pre-registration nursing programs. The aims were to investigate Australian pre-registration nursing students’ attitudes toward, and prior experience with, people with mental illness on program commencement. This cross-sectional study used the Community Attitudes Toward Mental Illness (CAMI) scale with pre-registration nursing students, and questions on students’ prior experience with mental illness (self, family, friends). There were n = 311 (271 female/40 male) first year, first semester Bachelor of Nursing students at a national Australian university. Students reported prior experience with mental illness with family (49.5%/n = 154) and friends (61.4%/n = 191). Self-reported (36.3% /n = 113) mental illness, particularly anxiety and depression, significantly exceeded national averages. Most students held accepting attitudes toward people with mental illness, except for perceptions of dangerousness. This study provides new findings on nursing student attitudes and experience with people with mental illness on program entry. The high self-reported prevalence of anxiety and depression at program entry indicates a pressing need for early intervention and mental wellbeing strategies for students from commencement of their tertiary education. Fear-reducing education which challenges perceptions of dangerousness in relation to people with mental illness, and supportive mental health clinical placements during their program, may help improve students’ attitudes and reduce fear and mental health stigma.     

Clinical placements in mental health: Are clinicians doing enough for undergraduate nursing students?

There are growing concerns identified in the literature about the lack of quality clinical placements in mental health for undergraduate nursing students. This study outlines an innovative student programme, designed and implemented by clinicians, committed to providing a quality clinical placement for students. The programme was evaluated by the use of an open-ended questionnaire administered to a sample of 10 undergraduate nursing students. Results of this evaluation suggested that the programme was able to provide a positive clinical experience in mental health for nursing students and is worthy of a more controlled investigation.     

Certified nursing assistants’ experiences with self-compassion training in the nursing home setting

Certified nursing assistants (CNAs) in nursing home (NH) settings experience considerable work-related and personal stress. Self-compassion is a personal resource linked to improved stress coping and may be particularly relevant to health care workers. In this study, we explored NH CNA's experiences with self-compassion training based on their narrative replies. Twenty-two CNAs (100% female, mean age 48 years, 82% Black/African American) from 3 mid-sized, non-profit NHs in the Southeast US completed either a standard 8-week, 20 h self-compassion training or a 6-week, 6 h modified version designed for health care providers. Qualitative data analyses from post-training focus group discussions identified four themes pertaining to changes in: (1) stress management, (2) appreciation and support, (3) caregiver role, and (4) connection to others. Findings suggested self-compassion training is feasible and beneficial for the stressors that CNAs experience. In the era of COVID-19 and beyond, self-compassion training is a promising method to improve CNAs' well-being.     

Preceptors’ perceptions of supporting nursing students in prison health services: A qualitative study

BackgroundOur university commenced clinical placements for third-year nursing students in Prison Health Services (PHS) in 2014. Registered nurse preceptors employed in these services facilitated students’ experiential workplace learning, assessed their competence and assisted them to meet course objectives in this challenging environment. To date, no studies have examined preceptors’ experiences of supporting students in the prison health setting.AimThe study aim was to investigate preceptors’ perceptions of supporting nursing students undertaking clinical placements in PHS, in order to inform development of resources and processes.MethodsQualitative data were collected via a focus group and interviews with preceptors (n = 6) working in metropolitan PHS. Data underwent thematic analysis.FindingsParticipants valued the opportunity to support student learning, finding students contributed to the workplace by bringing in new ideas, and conducting beneficial projects. However, preceptors requested better rostering and workload management by their employer. They also wished for more detailed information from the university regarding student orientation and preparation to support student learning. They felt that the employer-provided preceptorship training did not fulfil their needs.DiscussionPreceptors in PHS settings shared many of the support needs of those in other settings, although some challenges were more specific to the setting.ConclusionThis paper makes recommendations on how preceptors in PHS can be better supported to fulfil the role.     

Registered nurses’ experiences supervising international nursing students in the clinical setting

Background

Clinical experience exposes nursing students to the realities of professional practice and opportunities to integrate theory with practice. Increasing multiculturalism in Australia means that approximately 27% of students studying in Australian universities originate from overseas. Yet there is a paucity of literature examining the experiences of Registered Nurses charged with their clinical supervision.

Patients’ involvement in nursing students’ clinical education: A scoping review

BackgroundActual contacts with patients are crucial in developing the skills that students need when working with patients. Patients are accustomed to the presence of students. The concept of learning from patients has emerged recently, shifting the focus from learning from professionals as role models to the relationship between the student and patient.AimWith focus on patients’ perspective in clinical practice placements, this scoping review aims to review and summarize the existing empirical literature regarding patients’ involvement in nursing students’ clinical education.Design and methodA broad search without time limitations was performed in the databases CINAHL, Medline, PsycINFO and ERIC. A manual search was also performed. Only empirical studies describing aspects of patient involvement in nursing education from the patient’s perspective were taken into account. Thirty-two studies published from 1985 to June 2016 met the selection criteria and were analysed using inductive content analysis.ResultsThe perspective of real patients focused on their role in students’ learning and assessment processes. In general, patients appreciated the opportunity to contribute to a student’s learning process and thus enhance the quality of patient care. However, the patients’ approaches varied from active to passive participants, comprising active participants contributing to students’ learning, followers of care and advice, and learning platforms with whom students practiced their skills. Some patients perceived themselves as active participants who facilitated students’ learning by sharing knowledge and experience about their own care and wellbeing as well as assessed students’ performance by providing encouraging feedback.ConclusionThe state and degrees of patient involvement in nursing students’ clinical education were made explicit by the literature reviewed. However, the number of studies examining the involvement of real patients in students’ education in clinical settings is very limited. To understand this untapped resource better and to promote its full realization, recommendations for nursing education and future research are made.     

A time management intervention using simulation to improve nursing students’ preparedness for medication administration in the clinical setting: A quasi-experimental study

Background

Practising skills to competency level in a simulated clinical environment is thought to prepare nursing students for the real world setting. The ability to prioritise and plan nursing care is also essential for effective work performance. There is, however, limited evidence to support that simulated learning improves preparation for clinical practice.

First-year nursing students’ collaboration using peer learning during clinical practice education: An observational study

The purpose of this observational study was to describe the collaboration between first-year nursing students using peer learning during their first clinical practice education. In earlier, predominantly interview studies, peer learning has been described as a model with several positive outcomes. However, no studies on how students act in collaboration in a real-life context have been found. The present study observed sixteen arbitrarily paired nursing students (eight pairs) on three to five occasions per pair, in total 164 h from September 2015 to March 2016. Repeated unstructured observations including informal conversations were used. Using qualitative content analysis, one theme ‘Involuntary collaboration leads to growth in different competencies’ emerged and three categories ‘Practising nursing skills and abilities when working together’, ‘Establishing knowledge by helping each other to understand’ and ‘Sharing thoughts, feelings, and knowledge and put them into words’. In conclusion, nursing students using peer learning were observed practising several competencies, some of them not so easily elicited according to earlier research as organization, nursing leadership, teaching, and supervision.     

Australian nursing students’ clinical experiences in residential aged care: Reports from nurse academics

BackgroundNurses are the largest group of registered healthcare professionals and are fundamental to delivering health and aged care in Australia.AimTo explore how nursing students report clinical experiences when caring for older people as part of a larger study investigating how care of the older person content is included in Australian undergraduate nursing curricula.MethodsA population sample of all Australian nursing schools that offered a Bachelor of Nursing degree (n = 35) in 2019. Nurse academics involved in curriculum development or delivery were recruited. A telephone-assisted survey was used, and qualitative content analysis undertaken.ResultsAll schools of nursing participated in the survey, representing a response rate of 100%. The acute care focus of nursing curricula meant clinical experiences for nursing students related to older person's care commonly occurred in residential aged care facilities in the first year of the degree. Student reports of these experiences varied, with a majority of respondents reporting mixed or negative feedback associated with a lack of preparation and inadequate supervision.ConclusionsThis study highlights the: significance of the timing of nursing students’ clinical placements in residential aged care; the selection of appropriate care homes; and the need for the right clinical teaching staff who can supervise high quality learning experiences for students.     

FIRST-YEAR nursing students’ experiences of simulation involving care of older patients. A descriptive and exploratory study

Mastering geriatric nursing skills takes time and its acquisition should start early in undergraduate nursing training. The purpose of this study is to synthesise and evaluate the learning experiences that first-year nursing students had following geriatric patient simulation and practice of clinical patient handover. Qualitative content analysis of survey comments from first-year students (n = 216) at a large university in Norway were performed. Simulation training included systematic patient observation of scenarios based on genuine geriatric cases in nursing homes and practice of clinical patient handover. Content analyses identified four generic categories: (1) ‘embodying theoretical knowledge’; (2) ‘increased awareness about one's self’; (3) ‘understanding that collaboration is needed’; (4) ‘preparing for future work life’. These themes provide evidence for students integrating geriatric theoretical knowledge with clinical skills as a result of simulation. Analysis of learning experiences shows that geriatric scenario simulation and practice of clinical patient handover are valuable instruments before entering clinical training with geriatric patients, even for novice students. The use of genuine simulation cases and instruction on the use of clinical handover instruments are effective in producing conceptual changes that prepare students for their first encounter with complex, real-world geriatric scenarios.     

Impact of the nurse-related information through social media use on undergraduate nursing students’ professional identity in nursing: A mixed-methods study

AimTo understand the impact of nurse-related information, through social media usage on undergraduate nursing students’ professional identity.BackgroundPrevious research has addressed professional knowledge and practice that affect the development of undergraduate nursing students’ professional identities. As an increasingly crucial factor in the internet age, social media needs to be explored in-depth for its influence on the professional identity in nursing.DesignSequential explanatory mixed method was used in this study.MethodsIn this quantitative study, participants (N = 698) completed an e-questionnaire survey between June and July of 2020. The relationship between main variables was analyzed by linear regression using SPSS 20.0. Then, face-to-face semi-structured and audio-recorded interviews were carried out among participants (N = 16) between January and March of 2021.ResultsThe quantitative findings indicated that the mean score of professional identity was 93.07 ± 11.96 in participants. The results of the linear regression showed that the year in school, whether nursing was the first choice, online time per day, frequency of reading official accounts related nursing on WeChat and appraisal of the online nurse-related information and so on explained 49.0 % of the variance in professional identity. Four major themes emerged from the qualitative study: 1) increased concern; 2) few and non-professional information; 3) encouraged by positive information; 4) limited impact of negative information.ConclusionsNurse-related information on social media has the potential to have an impact on undergraduate nursing students’ professional identity. Nursing educators should guide undergraduate nursing students to use social media appropriately and assist them in developing their professional identity with it.     

Nursing degree students’ clinical placement experiences in Australia: A survey design

AimThis study aimed to evaluate Australian nursing students’ views of placements at seven tertiary education institutions with the use of the Placement Evaluation Tool (PET).BackgroundClinical placements are a core element of healthcare education programs around the world (Chuan and Barnett, 2012) with undergraduate nursing students required to complete a prescribed number of hours as part of their degree. The quality of nursing clinical placements varies with a range of positive and negative learning experiences.DesignA survey design was used with a contemporary survey tool– the Placement Evaluation Tool (PET). Using Qualtrics software (Qualtrics, 2005) the on-line survey was distributed to approximately 6265 undergraduate nursing students at six Australian universities and one Technical and Further Education (TAFE) college where Bachelor of Nursing degree students were enrolled. Three Australian States were covered. Sites were selected where a project team member was employed.MethodsA total of 1263 nursing students completed the Placement Evaluation Tool (PET) − 19 items (rated 1–5), one global rating (rated 1–10) − following placement in three Australian States (July 2019−February 2020). Most - 618 (48.9%) completed a placement in acute care with placements positively rated overall.ResultsThe total PET mean score was 78.3% with 29.8% being ‘extremely satisfied’ (10 out of 10 – Item 20). However, 11.0% were dissatisfied with global ratings of four or less, whilst ratings between States differed significantly (p = <0.001). One third of respondents answered a free text statement relating to placement experiences, with significantly more comments from older students (p = <0.001) and from those with ratings in the lower range (p = <0.001). Three core themes emerged: 1. Staff Attitudes to Students, 2. Environment and 3. Lifestyle.ConclusionsWhilst students’ clinical experiences in Australia tend to be positive a minority reported exposure to negative staff attitudes, in unsafe environments, with lifestyle detriments. Further work is required to understand and enhance student experiences.     

The international focus—A neglected curriculum in global undergraduate nursing

International learning in undergraduate global nurse education is recognised for promoting essential cultural competence. This can be addressed both at university; through the increasing use of collaborative technology and in practice, where the impact of international placements has promoted cultural sensitivity and outward student mobility. The authors debate the barriers that impede students’ desire to take up international placements and review initiatives to promote a greater investment in this experience. The complexity and lack of transcultural principles that govern an international placement exchange have been addressed by one initiative to produce a robust pan-European quality audit process for clinical learning environments. In conclusion, the authors call for a greater and evaluated effort to increase global understanding and learning in the context of the COVID-19 response.