‘I didn't realise that it would eat my life’: Nursing students’ accounts of clinical placements and the stressors associated with work-integrated learning

Abstract

An ongoing concern for higher education providers is employer feedback suggesting graduates are not ‘work-ready’: they may have knowledge and technical proficiency, but they do not always understand the applied complexities of the workplace. In any Bachelor of Nursing (BN) curriculum, the requirement for students to complete a series of clinical placements over the three (and in some jurisdictions, four) year degree is a dominant feature. Numerous studies attest to the benefits for the three main stakeholders: students, academic institutions and the healthcare provider hosting the placement, including enhanced graduate employability, strengthened personal and professional attributes, and an authentic, real-world learning experience. What has perhaps been less well explored is the issue of the stressors students face, potentially impacting on wellbeing, experience, academic outcomes and commitment to completion. This article focuses on the experiences of stress revealed in a mixed method study of final year BN students prior to graduation, which included an online survey followed by a focus group with participants who had volunteered to ‘unpack’ the aggregated survey data. Layering of multiple stressors, results in students feeling overwhelmed and with diminished capacity to cope. Student stress is multifaceted, often stemming from factors beyond institutional control, however the findings emphasise the importance of accessible, culturally responsive, pastoral and academic support throughout the students’ journey. These findings will resonate with others supporting students through stress, from classroom, through placement, and into the world of work and are applicable to disciplines outside of nursing seeking to optimise work integrated learning.