title: Mental health nursing students' experiences of stress during training: a thematic analysis of qualitative interviews.
abstract: What is known on the subject? Stress can impact students on mental health nurse training. This can have implications at the individual level (e.g. their own mental health) and at the level of the organization (e.g. sickness absence and attrition). What this paper adds to existing knowledge? We interviewed 12 mental health nursing students regarding the stress they experienced during training. Participants described how the academic demands can at times be unbearable during clinical placements. There were also issues with 'being a student' on some placements, with participants describing negative attitudes towards them from staff. The younger participants reported feeling overwhelmed on their initial placements and described some of the main challenges of mental health work for them. Raising concerns about the quality of care on wards was also described as particularly challenging for the students. What are the implications for practice? This paper can be useful to help training providers support mental health nursing students. Recommendations include reducing academic demands during clinical placements and extending and promoting existing support services beyond normal 9 am-5 pm working hours, even if these services are limited. Younger students could be better supported by being allocated to the more well-resourced placements in the early stages of their training. Raising awareness among staff of the tasks students can and cannot perform can help improve staff/student relations. Finally, students should be educated about the issues around raising concerns on placements to help the government's drive for a more open and transparent National Health Service (NHS).
  
  
  
  BACKGROUND
  Previous studies investigating stress in nursing students focus on general nursing students or adopt quantitative measures.
  
  
  OBJECTIVE
  A qualitative study focusing specifically on mental health nursing students is required.
  
  
  METHODS
  One-to-one interviews were carried out with mental health nursing students (n = 12). Data were thematically analysed.
  
  
  RESULTS
  Participants reported unreasonable demands during clinical blocks, and described how control/support is lowest on placements with staff shortages. Negative attitudes towards students from staff and related issues were also discussed. Younger participants described struggling with mental health work during the early stages of training.
  
  
  CONCLUSIONS
  Training providers should strive to provide adequate support to students to help them manage stress during training. Implications for practice Academic demands should be reasonable during clinical blocks and support services outside normal working hours should be available for students, even if these are limited in scope. Greater consideration to the allocation of placements for younger students in the mental health branch could be helpful. Furthermore, staff on placements should be aware of the tasks students can and cannot perform, to help improve staff/student relations. Educating students on the issues of raising concerns can help the government's drive for a more open and transparent National Health Service (NHS).
authors.affiliation: School of Psychology, Cardiff University, Cardiff, UK.
authors.forename: J
authors.initials: J
authors.lastname: Galvin
authors.affiliation: School of Psychology, Cardiff University, Cardiff, UK.
authors.forename: E
authors.initials: E
authors.lastname: Suominen
authors.affiliation: School of Psychology, Cardiff University, Cardiff, UK.
authors.forename: C
authors.initials: C
authors.lastname: Morgan
authors.affiliation: School of Psychology, Cardiff University, Cardiff, UK.
authors.forename: E-J
authors.initials: EJ
authors.lastname: O'Connell
authors.affiliation: School of Psychology, Cardiff University, Cardiff, UK.
authors.forename: A P
authors.initials: AP
authors.lastname: Smith
mesh_terms: D000328:Adult; D004508:Education, Nursing, Baccalaureate; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D015402:Nursing Education Research; D011568:Psychiatric Nursing / Q000193:education*; D036301:Qualitative Research; D013315:Stress, Psychological / Q000523:psychology*; D013338:Students, Nursing / Q000523:psychology*; D055815:Young Adult
keywords: coping; mental health nursing students; psychiatric nursing students; stress; stressors; support