Fear and learning in mental health settings

Health-care students are frequently concerned and anxious about entering the mental health setting for their clinical placement. There are many situations in mental health clinical settings in which the student will witness or become involved in incidents that may challenge existing values, attitudes, ethics and provoke strong emotions in the student. This paper examines clinical critical incidents that have been identified and reflected on by a cohort of second-year student nurses while undertaking their mental health clinical practicum. Data were gathered from 260 critical incident reports and was sorted into three broad categories: (i) student description of incident; (ii) immediate emotional response of the student to the incident; and (iii) student thoughts and feelings' about the incident after the opportunity for structured reflection. The findings demonstrate a wide range of positive, but predominantly, negative experiences. Witnessing psychotic behaviour and incidents involving both actual and threatened violence and verbal abuse dominated the critical incidents with 52% describing one or both of these issues. To illustrate the range of student-identified critical incidents, verbatim examples of student work are included.