Undergraduate students' perspectives on pursuing a career in mental health nursing following practicum experience.
attitudes to mental illness
mental health nursing
nursing education
nursing students
nursing workforce
Journal
Journal of clinical nursing
ISSN: 1365-2702
Titre abrégé: J Clin Nurs
Pays: England
ID NLM: 9207302
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
received:
17
07
2019
revised:
29
08
2019
accepted:
24
09
2019
pubmed:
16
10
2019
medline:
4
3
2020
entrez:
16
10
2019
Statut:
ppublish
Résumé
The purpose of this study was to explore how undergraduate students perceive and make decisions regarding mental health nursing as a career following completion of an inpatient mental health practicum. Among nursing students, mental health is consistently perceived as the least desirable nursing career path. However, evidence to explain why this is the case remains limited, with a lack of research exploring students' experiences of mental health settings and how these experiences influence their perceptions of a mental health nursing career. This knowledge gap limits strategies to support nurses' selection of mental health nursing as a career path, contributing to a global shortage of mental health nurses. This study used a qualitative narrative inquiry design. In-depth interviews (N = 15) were conducted with undergraduate nursing students to explore their experiences of mental health practicums. Participants had all completed a 6-week practicum in inpatient mental health settings in urban hospitals. Reporting follows COREQ guidelines. Nursing students' decisions to not choose a career in mental health nursing were influenced by negative practicum experiences, including the institutional environments of the inpatient mental health settings and witnessing of harmful nursing practices. These factors were identified as barriers to pursuing a career in mental health nursing. However, students expressed desire to continue to work with clients with mental health challenges and aimed to pursue nursing careers that preserve this opportunity in different healthcare settings. These findings expand upon existing literature that frequently positions nursing students as "uninterested" in mental health nursing and offers insights that can contribute to addressing global mental health nursing shortages. This study highlights the need for mental health nurses, nursing leaders, and educators to recognise and respond to students' difficult experiences in the inpatient mental health setting during practicums.
Sections du résumé
AIMS AND OBJECTIVES
OBJECTIVE
The purpose of this study was to explore how undergraduate students perceive and make decisions regarding mental health nursing as a career following completion of an inpatient mental health practicum.
BACKGROUND
BACKGROUND
Among nursing students, mental health is consistently perceived as the least desirable nursing career path. However, evidence to explain why this is the case remains limited, with a lack of research exploring students' experiences of mental health settings and how these experiences influence their perceptions of a mental health nursing career. This knowledge gap limits strategies to support nurses' selection of mental health nursing as a career path, contributing to a global shortage of mental health nurses.
DESIGN
METHODS
This study used a qualitative narrative inquiry design.
METHODS
METHODS
In-depth interviews (N = 15) were conducted with undergraduate nursing students to explore their experiences of mental health practicums. Participants had all completed a 6-week practicum in inpatient mental health settings in urban hospitals. Reporting follows COREQ guidelines.
RESULTS
RESULTS
Nursing students' decisions to not choose a career in mental health nursing were influenced by negative practicum experiences, including the institutional environments of the inpatient mental health settings and witnessing of harmful nursing practices. These factors were identified as barriers to pursuing a career in mental health nursing. However, students expressed desire to continue to work with clients with mental health challenges and aimed to pursue nursing careers that preserve this opportunity in different healthcare settings.
CONCLUSIONS
CONCLUSIONS
These findings expand upon existing literature that frequently positions nursing students as "uninterested" in mental health nursing and offers insights that can contribute to addressing global mental health nursing shortages.
RELEVANCE TO CLINICAL PRACTICE
CONCLUSIONS
This study highlights the need for mental health nurses, nursing leaders, and educators to recognise and respond to students' difficult experiences in the inpatient mental health setting during practicums.
Types de publication
Journal Article
Langues
eng
Pagination
163-171Subventions
Organisme : Katherine McMillan Director's Discretionary Fund
Organisme : Social Sciences and Humanities Research Council of Canada
Organisme : Canada Research Chair in Gender, Equity and Community Engagement
Organisme : Michael Smith Foundation for Health Scholar Award
Informations de copyright
© 2019 John Wiley & Sons Ltd.
Références
Alexander, V., Ellis, H., & Barrett, B. (2016). Medical-surgical nurses' perceptions of psychiatric patients: A review of the literature with clinical and practice applications. Archives of Psychiatric Nursing, 30, 262-270. https://doi.org/10.1016/j.apnu.2015.06.018
Beer, M. D. (2007). History of psychopathology, psychiatric treatment and the psychiatric profession. Current Opinion in Psychiatry, 20, 599-604. https://doi.org/10.1097/YCO.0b013e3282f0ddda
Bennett, J., & Stennett, R. (2015). Attitudes towards mental illness of nursing students in a Baccalaureate programme in Jamaica: A questionnaire survey. Journal of Psychiatric and Mental Health Nursing, 22, 599-605. https://doi.org/10.1111/jpm.12234
Bowers, L., James, K., Quirk, A., Simpson, A., Stewart, D., & Hodsoll, J. (2015). Reducing conflict and containment rates on acute psychiatric wards: The Safewards cluster randomised controlled trial. International Journal of Nursing Studies, 52(9), 1412-1422. https://doi.org/10.1016/j.ijnurstu.2015.05.001
Clandinin, D. J., & Connelly, F. M. (2000). Narrative inquiry: Experience and story in qualitative research. San Francisco, CA: Jossey-Bass Inc.
Delaney, K. R. (2017). Psychiatric mental health nursing advanced practice workforce: Capacity to address shortages of mental health professionals. Psychiatric Services, 68(9), 952-954. https://doi.org/10.1176/appi.ps.201600405
Galvin, J., Suominen, E., Morgan, C., O'Connell, E. J., & Smith, A. P. (2015). Mental health nursing students' experiences of stress during training: A thematic analysis of qualitative interviews. Journal of Psychiatric and Mental Health Nursing, 22, 773-783. https://doi.org/10.1111/jpm.12273
Ganzer, C. A., & Zauderer, C. (2013). Structured learning and self-reflection: Strategies to decrease anxiety in the psychiatric mental health clinical nursing experience. Nursing Education Perspectives, 34(4), 244-247. https://doi.org/10.1097/00024776-201307000-00007
Goffman, E. (1961). On the characteristics of total institutions. In Asylums: Essays on the social situation of mental patients and other inmates (pp. 1-124). New York, NY: Anchor Books.
Gough, K., & Happell, B. (2009). Undergraduate nursing students' attitude to mental health nursing: A cluster analysis approach. Journal of Clinical Nursing, 18, 3155-3164. https://doi.org/10.1111/j.1365-2702.2008.02764.x
Happell, B., & Gaskin, C. J. (2012). The attitudes of undergraduate nursing students towards mental health nursing: A systematic review. Journal of Clinical Nursing, 22, 148-158. https://doi.org/10.1111/jocn.12022
Happell, B., Platania-Phung, C., Harris, S., & Bradshaw, J. (2014). It's the anxiety: Facilitators and inhibitors to nursing students' career interests in mental health nursing. Issues in Mental Health Nursing, 35, 50-57. https://doi.org/10.3109/01612840.2013.837123
Hartigan-Rogers, J. A., Cobbett, S. L., Amirault, M. A., & Muise-Davis, M. E. (2007). Nursing graduates' perceptions of their undergraduate clinical placement. International Journal of Nursing Scholarship, 4(1), Article 9. https://doi.org/10.2202/1548-923X.1276
Hastings, T., Kroposki, M., & Williams, G. (2017). Can completing a mental health nursing course change students' attitudes? Issues in Mental Health Nursing, 38(5), 449-454. https://doi.org/10.1080/01612840.2017.1278810
Henderson, S., Happell, B., & Martin, T. (2007). So what is so good about clinical experience? A mental health nursing perspective. Nurse Education in Practice, 7, 164-172. https://doi.org/10.1016/j.nepr.2006.06.003
Hoekstra, H. J., van Miejel, B. B., & van der Hooft-Leemans, T. G. (2010). A nursing career in mental health care: Choices and motives of nursing students. Nurse Education Today, 30, 4-8. https://doi.org/10.1016/j.nedt.2009.05.018
Hunter, L., Weber, T., Shattell, M., & Harris, B. A. (2015). Nursing students' attitudes about psychiatric mental health nursing. Issues in Mental Health Nursing, 36, 29-34. https://doi.org/10.3109/01612840.2014.935901
Innes, K., Morphet, J., O'Brien, A., & Munro, I. (2013). Caring for the mental illness patient in emergency departments - An exploration of the issues from a healthcare provider perspective. Journal of Clinical Nursing, 23, 2003-2011. https://doi.org/10.1111/jocn.12437
Jansen, R., & Venter, I. (2015). Psychiatric nursing: An unpopular choice. Journal of Psychiatric and Mental Health Nursing, 22, 142-148. https://doi.org/10.1111/jpm.12138
Kontio, R., Joffe, G., Putkonen, H., Kuosmanen, L., Kane, K., Holi, M., & Välimäki, M. (2011). Seclusion and restraint in psychiatry: Patients' experiences and practical suggestions on how to improve practices and use alternatives. Perspectives in Psychiatric Care, 48(1), 16-24. https://doi.org/10.1111/j.1744-6163.2010.00301.x
Larsen, I. B., & Terkelsen, T. B. (2014). Coercion in a locked psychiatric ward: Perspectives of patients and staff. Nursing Ethics, 21(4), 426-436. https://doi.org/10.1177/0969733013503601
Markström, U., Gyllensten, A. L., Bejerholm, U., Björkman, T., Brunt, D., Hansson, L., … Eklund, M. (2009). Attitudes towards mental illness among health care students at Swedish universities: A follow-up study after completed clinical placement. Nurse Education Today, 29, 660-665. https://doi.org/10.1016/j.nedt.2009.02.006
Muir-Cochrane, E., O'Kane, D., & Oster, C. (2018). Fear and blame in mental health nurses' accounts of restrictive practices: Implications for the elimination of seclusion and restraint. International Journal of Mental Health Nursing, 27(5), 1511-1521. https://doi.org/10.1111/inm.12451
Ong, H. L., Seow, E., Chua, B. Y., Xie, H., Wang, J., Lau, Y. W., … Subramaniam, M. (2017). Why is psychiatric nursing not the preferred option for nursing students: A cross-sectional study examining pre-nursing and nursing school factors. Nurse Education Today, 52, 95-102. https://doi.org/10.1016/j.nedt.2017.02.014
Paris, M. Jr, & Hoge, M. A. (2010). Burnout in the mental health workforce: A review. The Journal of Behavioral Health Services & Research, 37(4), 519-528. https://doi.org/10.1007/s11414-009-9202-2
Patterson, C., Moxham, L., Brighton, R., Taylor, E., Sumskis, S., Perlman, D., … Hadfield, L. (2016). Nursing students' reflections on the learning experience of a unique mental health clinical placement. Nurse Education Today, 46, 94-98. https://doi.org/10.1016/j.nedt.2016.08.029
Patterson, C., Perlman, D., Taylor, E. K., Moxham, L., Brighton, R., & Rath, J. (2018). Mental health nursing placement: A comparative study of non-traditional and traditional placement. Nurse Education in Practice, 33, 4-9. https://doi.org/10.1016/j.nepr.2018.08.010
Poreddi, V., Thimmaiah, R., Chandra, R., & BadaMath, S. (2013). Bachelor of nursing students' attitude towards people with mental illness and career choices in psychiatric nursing. An Indian perspective. Investigación Y Educación En Enfermería, 33(1), 148-154. https://doi.org/10.17533/udea.iee.v33n1a17
Redknap, R., Twigg, D., Rock, D., & Towell, A. (2015). Nursing practice environment: A strategy for mental health nurse retention? International Journal of Mental Health Nursing, 24(3), 262-271. https://doi.org/10.1111/inm.12126
Reissman, C. K. (2008). Narrative methods for the human sciences. Los Angeles, CA: SAGE Publications Inc.
Shafer, T., Wood, S., & Williams, R. (2011). A survey into student nurses' attitudes toward mental illness: Implications for nurse training. Nurse Education Today, 31, 328-332. https://doi.org/10.1016/j.nedt.2010.06.010
Slemon, A., Bungay, V., Jenkins, E., & Brown, H. (2018). Power and resistance: Nursing students’ experiences in mental health practicums. Advances in Nursing Science, 41(4), 359-376. https://doi.org/10.1097/ANS.0000000000000221
Slemon, A., Jenkins, E., & Bungay, V. (2017). Safety in psychiatric inpatient care: The impact of risk management culture on mental health nursing practice. Nursing Inquiry, 24(4), e12199. https://doi.org/10.1111/nin.12199
Smith, P. M., Spadoni, M. M., & Proper, V. M. (2013). National survey of clinical placement settings across Canada for nursing and other healthcare professions - Who's using what? Nurse Education Today, 33, 1329-1336. https://doi.org/10.1016/j.nedt.2013.02.011
Spence, D., Garrick, H., & McKay, M. (2012). Rebuilding the foundations: Major renovations to the mental health component of an undergraduate nursing curriculum. International Journal of Mental Health Nursing, 21, 409-418. https://doi.org/10.1111/j.1447-0349.2011.00806.x
Stevens, J., Browne, G., & Graham, I. (2013). Career in mental health still an unlikely career choice for nursing graduates: A replicated longitudinal study. International Journal of Mental Health Nursing, 22, 213-230. https://doi.org/10.1111/j.1447-0349.2012.00860.x
Thomas, S., & Bhattycharya, C. (2012). A study to assess the change in attitude and perceived stress of nursing students during their first mental health clinical placement. International Journal of Nursing Education, 4(1), 69-72.
Thongpriwan, V., Leuck, S. E., Powell, R. L., Young, S., Schuler, S. G., & Hughes, R. G. (2015). Undergraduate nursing students' attitudes toward mental health nursing. Nurse Education Today, 35, 948-953. https://doi.org/10.1016/j.nedt.2015.03.011
Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349-357. https://doi.org/10.1093/intqhc/mzm042
Waite, R. (2006). The psychiatric educational experiences of advance beginner RNs. Nurse Education Today, 26(2), 131-138. https://doi.org/10.1016/j.nedt.2005.08.005
Walsh, A. (2015). Are new mental nurses prepared for practice? Mental Health Review Journal, 20(2), 119-130. https://doi.org/10.1108/MHRJ-10-2014-0040
Wojtowicz, B., Hagen, B., & Van Daalen-Smith, C. (2014). No place to turn: Nursing students' experiences of moral distress in mental health settings. International Journal of Mental Health Nursing, 23, 257-264. https://doi.org/10.1111/inm.12043
World Health Organization (2011). Human resources for mental health: Workforce shortages in low- and middle-income countries. Retrieved from http://apps.who.int/iris/bitstream/handle/10665/44508/9789241501019_eng.pdf?sequence=1&isAllowed=y
World Health Organization (2013). Mental health action plan 2013-2020. Retrieved from http://apps.who.int/iris/bitstream/10665/89966/1/9789241506021_eng.pdf?ua=1