Factors that assist undergraduate nursing students to cope with the experience of their first clinical placement

Background: Nursing schools prepare nurses for their future career, therefore academic nursing programs need to be well-developed and structured with both theoretical and practical components to ensure they graduate competent nurses. Clinical placement is an essential component in nursing education that integrates theoretical knowledge with clinical nursing skills which cannot be gained by classroom education alone. The first clinical placement can be an extremely stressful experience for some undergraduate nursing students which may lead to negative consequences for students, the profession, healthcare settings or patients. Objectives: The aim of this study was to identify factors that enable a positive experience of the first clinical placement for first year undergraduate nursing students. This aim was achieved by adopting three research objectives including: identifying factors from the literature that were facilitators or barriers to first clinical placement for first year undergraduate nursing students; identifying a framework in which to explore and discuss how first year undergraduate nursing students coped with their experience of their first clinical placement and identifying coping strategies first year undergraduate nursing students used to overcome any barriers or to prevent negative experience of their first clinical placement. Significance of the study: Results of this research will offer academics in nursing schools further insight regarding coping strategies of nursing students in their first clinical placement, which in turn, will assist in supporting these students to cope with the experience of their first clinical placement, continue with their studies and enter the nursing profession. Method: This study adopted a concurrent mixed method design and was conducted using an online questionnaire that involved both quantitative and qualitative questions. Adaptation and content validity was assessed by piloting the questionnaire in order to ensure that the tool was understandable, relevant and well-designed. The study participants were all first year undergraduate nursing students at a higher education facility in South Australia. There were no ethical considerations or risks associated with this study. Findings: There were fifty-eight first year nursing students of one hundred and fifty-four that responded to the questionnaire. The majority of participants were female, aged less than twenty years old, local students with no previous work experience as healthcare professionals. Most participants had a level of anxiety ranging from moderately to extremely anxious about their first clinical placement due to several reasons. These reasons included being worried about making mistakes that could harm patients, providing direct care and speaking to patients for the first time. Some participants were also worried about being assessed by nursing staff and clinical lecturers, as well as inadvertently breaking the rules of clinical placement institutions. Factors that assisted participants to cope with their anxiety and have a positive experience of the first clinical placement included supportive clinical lecturers and nursing staff, co-operative patients, adequate preparation before the clinical placement, effective communication between nursing schools and clinical institutions, and constructive feedback from nursing staff and clinical lecturers. Participants developed different strategies that assisted them to cope with their first clinical placement, including talking to different people about the experience of the first clinical placement, adopting positive attitudes, asking nursing staff questions, providing help to nursing staff and asking for help if unsure about their competence in their nursing task. Conclusion: There are a range of strategies that can be put into place by the nursing students, clinical lecturers and nursing staff that will enable nursing students to cope well with their first clinical placement and to have a positive experience. The research shows that preparation for the first clinical placement is very important for all concerned. Once on placement, then support and encouragement by clinical lecturers and nursing staff is critical in building the nursing students’ confidence in the new work environment. It is also essential that nursing students are provided with opportunities to reflect and debrief with colleagues and with friends and family about their experiences during their first clinical placement, being mindful of patient confidentiality. This study confirms the findings of other research of the importance of using a range of supportive approaches for nursing students undertaking their first clinical placement to enable them to have a positive experience that will boost their confidence as they commence their career in nursing.Thesis (M. Nurs. Sc.) -- University of Adelaide, School of Nursing, 201