Experiences and perceptions of Turkish nursing students during their first clinical placement in intensive care units: a qualitative study

Abstract

Background: Clinical practice in the ICU is critical in shaping nursing students' professional development and enhancing their understanding of patient care. Aim: This study examined the feelings, thoughts and experiential reflections of nursing students during their initial exposure to the intensive care unit (ICU), focusing on their perspectives on the first and last day of clinical practice. Study Design: The study employed a phenomenological design and was conducted in a province in north-eastern Turkey. Data were collected from 13 nursing students who participated in ICU clinical practice for the first time as part of the Internal Medicine Nursing course during the 2023–2024 academic year. Findings: Three main themes emerged from students' accounts of their first-day experiences in the ICU: ‘negative emotions’, ‘positive emotions’ and ‘areas for improvement’. Participants commonly described the intensive care experience as physically exhausting, emotionally overwhelming, and, at times, shocking and frightening. Additionally, students acknowledged that the ICU accurately reflects the nursing profession but described the overall atmosphere as cold. They also mentioned that the critical nature of the ICU could make it a frightening experience. Although ICUs were perceived as professionally fulfilling environments, participants noted that improvements are needed in several areas, including increasing the number of visitors allowed, enhancing physical conditions and addressing nurse staffing shortages. At the end of the 14-week clinical practice, students' final evaluations of the ICU revealed two main themes: ‘increase in professional experience’ and ‘positive emotions’. Conclusions: The findings indicate that the negative emotions experienced by nursing students at the beginning of their ICU practice were replaced by positive emotions by the end of the clinical training. The results provide a valuable resource for developing supportive strategies to enhance nursing students' adaptation to ICU clinical practice. Relevance to Clinical Practice: Our findings show that the effectiveness of clinical practice in the ICU on students significantly contributes to the nursing profession by transforming negative emotions such as anxiety experienced in the first days into professional development and awareness over time.