Sources of Stress Among Nursing Students During Clinical Placements: A Malawian Perspective

Background: Nursing is known to be inherently stressful and literature reveals that stress is also evident during pre-registration nursing studies and it can affect student performance. The study did not explore stress, but these are part findings of a larger study which explored the students’ clinical learning experience.

Aim: The aim of the study was to explore undergraduate nursing students’ perceptions of their clinical learning experience.

Design: This was a hermeneutic phenomenological study.

Setting: The study took place at a University Nursing College in Malawi.

Participants: Participants for the study were purposively selected from among third and fourth year undergraduate nursing students.

Methods: Conversational interviews were conducted and a framework developed by modifying Colaizzi’s procedural steps guided the phenomenological analysis.

Results: Findings reveal factors which cause stress among undergraduate nursing students during their clinical placements. The following themes emerged from the study: stress associated with the lecturer/ student interactions; stress associated with clinical practice; stress associated with objective structured clinical examination (OSCE) and stress caused by external stressors. The lecturer is perceived as a major stress inducer and the interaction perceived by students as ‘policing’ which some of the lecturers employ is one of stressors. The main stressors during clinical practice include lack of life saving medication leading to death of a patient, taking care of critically ill patients unsupervised, and fear of contracting infections such as HIV and tuberculosis and death of a patient. Lack of finances for students who lost both parents or for those who are from poor families and or family relationship problems are some of the external source of stress.

Conclusions: The study reveals sources of stress among nursing students and literature reveals that stress is an issue which nurse educators should seriously consider knowing its consequences on students’ learning. Furthermore, literature also reveals that the effectiveness of the interventions to prevent occurrence of stress depend on understanding of the stress phenomenon.