Walking on Eggshells: Addressing Nursing Students' Fear of the Psychiatric Clinical Setting

Abstract

Addressing Nursing Students' Fear of the Psychiatric Clinical Setting N ursing students often express anxiety or apprehension regarding patients who are mentally ill. Based on more than 25 years of psychiatric teaching experience, the current authors have found that most students fear two major situations before starting their psychiatric clinical rotation: (a) handling assaultive patients, and (b) communicating with psychiatric patients. Students ask: "Am I safe? Will I get hurt? Have you had any student get hurt during this rotation?" One student interpreted the fear in one sentence: "I am worried I will not know how to talk or handle a patient who is angry or asking self-harm questions." The authors hope that this interpretation will help nurse educators prepare nursing students so that they will feel ready for this rotation. BACKGROUND The need to care for and treat psychiatric patients is undisputed, based on reports from the World Health Organization (WHO; 2016). In 2015, the National Institute of Mental Health (NIMH; 2017) reported that serious psychiatric illness affects 4% of all U.S. adults. This number accounts for approximately 10 million U.S. adults ages 18 and older. Hunter, Weber, Shattell, and Harris (2014) concurred that students' attitudes toward individuals with psychiatric problems are not consistently positive. Nursing students

Opinions and experiences on the provision of care to people with mental illnesses: a qualitative study with Doctor of Pharmacy graduates after a rotation in psychiatry

“…Regardless of their familiarity with mental illnesses, the first impressions of the PharmD graduates carried a tone of mixed feelings towards the setting and the patients, which slowly changed as they progressed in the rotation and gained valuable insight of psychiatry practice. Similar feelings of apprehension when starting psychiatric rotations have been reported by students from pharmacy and other healthcare programmes [ 22 – 24 ]. Participants in this study described their PharmD psychiatric-rotation experience as unique, eye opening, and insightful.…”

Qualitative interviews with Doctor of Pharmacy Graduates on Care Provision to Patients with Mental Illness after a Psychiatric Rotation

“…Regardless of their familiarity with mental health issues, the rst impressions of the PharmD graduates carried a tone of mixed feelings towards the setting and the patients, which slowly changed as they progressed in the rotation and gained valuable insight of psychiatry practice. Similar feelings of nervousness and apprehension when starting psychiatric rotations have been reported by students from pharmacy and other healthcare programs [20][21][22].…”

Improving mental health education in nursing school

“…36 Nursing students are often apprehensive about caring for patients with psychiatric disorders because they assume these patients are dangerous, incompetent, and impulsive. 37 Education about clinical safety and de-escalation of aggressive or potentially violent behaviors should not be limited to mental health clinical rotations as this content is applicable in any setting.…”