Nursing students' experiences in mental health practicums : a narrative inquiry

Mental health challenges are one of the leading global health concerns, yet health care for people experiencing these health issues is severely lacking, in both accessibility and quality. Nurses are uniquely positioned to provide direct care to this population, however nurses’ attitudes towards individuals with mental health challenges are frequently characterized by stigma and misconceptions. Mental health practicums within nursing school are a key venue for student learning, development, and experience in working with this population, yet research demonstrates that students frequently hold negative attitudes toward mental health nursing as a career path and do not feel adequately prepared to work with individuals with mental health challenges in any health care setting. To address gaps in understandings of these issues, this qualitative study explored students’ experiences within mental health practicums through a narrative inquiry approach. Individual interviews were conducted with 15 nursing students following their practicum experiences. Findings describe the narrative of resistance within the students’ practicums that emerged from participant stories of their experiences. The students identified this practicum as fundamentally different from others, and as such, their pre-engagement included particular preparation strategies to maintain their emotional well-being through the practicum, and critical engagement with societal stereotypes around mental health. Within the practicum, the students’ recognized the ways in which nursing care of patients was characterized by power relations, enacted through disengagement and unsafe and unethical practices. Participants enacted resistance through connecting with patients, enacting ways of knowing that contrasted with dominant nursing practices, and drawing on their student role to justify their resistance. Informing participants’ enactment of resistance, narratives spoke to the complex interplay of empowerment and disempowerment in the setting, shaping their experiences in the practicum and expectations of future nursing practice. Study implications include theoretical contributions to the concept of resistance within nursing education. Additionally, this study supports the need for increased educator support for students in advance of, and during, their mental health practicums; findings further speak to the need for systemic changes in the practice environment to support safe and effective patient care.Applied Science, Faculty ofNursing, School ofGraduat