Student experiences of the undergraduate nursing degree

As a recent undergraduate and nurse, currently practicing in mental health, I have recollected my undergraduate training and have specifically identified its deficits, and feel that the current course is in need of some improvements. I believe such changes will benefit the future generations of mental health nurses by preparing and moulding them into confident and knowledgeable practitioners. The most positive aspect of university preparation was the consistency of staff, but more importantly, peers. This allowed for two things: (i) understanding how to work within a team; and (ii) being able to bond with your peers. These characteristics were beneficial in knowing who worked well with who for group work and presentations, as well as our role within that group. Being acquainted with people for a few years, with who we practised communication and counselling skills, allowed us to drop our guard and be somewhat less self-conscious while practicing. This was advantageous in gaining confidence and further developing and/or refining our skills. Having mental health academics with many years' experience behind them was a great resource for learning. Many students felt the academics could provide a diverse range of information on different career options within mental health, and thus, this was useful. Other identified positives included all working towards the specific goal of mental health nursing and always having good psychiatric topics for assignments. The university also encouraged students to obtain their registration in Division 2 nursing in the third year as a way of gaining additional experience that allowed us to compare our practice to the theory we learnt at university. It cannot be stressed enough that there is inadequate clinical placements in mental health. My fellow mental health major students and I completed five clinical placements in general nursing and only two in mental health nursing. It quite simply does not make any sense. Furthermore, the setting for clinical placements is extremely important. Students who went to inpatient units usually reported greater confidence and an increased knowledge base when beginning their graduate year. However, a lot of students did not get the opportunity to be placed in an inpatient unit and felt they were lacking in a lot of skills. Another prominent issue is preceptorship. If we were allocated a nurse who did not appreciate having a student, he or she did not really want to take the time to teach you in detail. This can be even more detrimental to the general nurses who come through, who experience such treatment resulting in them hating their placement and never returning to mental health nursing again. Quality preceptorship can make a placement very enjoyable, academically stimulating, and can positively influence general nursing undergraduates to become mental health nurses. Quality preceptorship is based on the willingness and eagerness of the preceptor to teach the students. Preceptors who are polite, supportive, and take the time to ensure that students' learning needs are addressed and assessed are the kind of preceptors students wish to have. Such quality preceptors result in positive placements. Many other students and I experienced persuasion to work as a general nurse. At university, I can remember sitting in a lecture with a general nursing academic advising 350 or so nursing students to hide their last name when on a mental health placement, implying that it is likely that a patient will track you down with such information. We were also told not to mention the suburb of our home residence or if we even had children. This, I believe, is where a lot of general nursing students develop a fear of mental health nursing. When young and naive students have a respected and experienced nurse telling them such things, why would they believe otherwise? While on many general nursing placements in hospitals, preceptors never really tried to dissuade my chosen career of mental health nursing, but definitely encouraged me to do general nursing for all or part of my graduate year. However, on these placements we had more contact with the registered nurses we worked alongside of each shift. It was here that I was asked questions like ‘Why do you want to do mental health nursing?’, ‘Are you crazy?’, and ‘What's wrong with you?’ These nurses were never understanding of my career choice and persistently told me so. It even went so far that some nurses would neglect to teach me or show me anything on the basis that I was doing mental health nursing and would never need such information or skills, resulting in me being ignored for the rest of my general clinical placement. I eventually learnt not to tell any of the general nurses my career choice until the placement was ending. The lack of mental health-focused subjects at university level was quite obvious and disappointing. This resulted in limited opportunity to learn much other than mental state assessment, risk assessments, and the characteristics of major mental illnesses. The remaining information we learnt on placements or on the job. The current undergraduate course is suitably designed to develop on with the potential of the following changes: incorporating mental health subjects throughout the 3 years, allowing additional information to be taught. Even general nurses can make use of the content, as they will also have to deal with mental health clients in their general careers, and this will better equip them in that role. Extra topics in lectures and tutorials are needed, specifically addressing working with families, working with people who have been abused, and writing nursing notes. Graduates feel unsure of how to deal with and what to do for families and victims of abuse. Many graduates have confided in me that they do not really know how to write nursing notes and have read over previous notes to get ideas from there, leading to the formation of bad habits. This needs to be addressed at the university level prior to the commencement of work. It would also be useful to include practical assessments of mental state examinations. That way, students can relate the theory to practice, and receive feedback on what was done well and where improvement is required. Most essential is the necessity of every mental health student having a clinical placement in an acute inpatient unit with quality preceptorship and support for students on clinical placements. Hopefully, this insight will be a catalyst for change in the development of undergraduate nursing degrees, thus preparing graduates to feel additionally informed and confident for when they commence working in the wondrous world of mental health nursing.