Surviving first placement: Enrolled nursing students’ perceptions of preparedness for a residential aged care placement

Abstract

Objective: To explore and identify enrolled nursing students’ perceptions of their preparedness when undertaking their first clinical placement in a residential aged care home. Background: Registered training organisations play a key role in recruiting, training, and preparing Enrolled Nurses who form an indispensable part of the nursing workforce required to meet the future health care needs of Australia’s ageing population. Clinical placements are an essential component of these training programs, offering students the opportunity to apply theoretical knowledge and skills into practice. Initial clinical placements can offer valuable professional experience, support skill development, and facilitate students’ socialisation into the profession; however, they may also be distressing and impede learning, contribute to early withdrawal, and influence future career choices, particularly when students are inadequately prepared. Study design and methods: This research used a qualitative descriptive design to identify enrolled nursing students’ perceptions of their preparedness prior to their initial placement. Using convenience sampling, five semi-structured individual virtual interviews were conducted with students enrolled in Stage 1 of a Diploma of Nursing program, following completion of their first clinical placement at a residential aged care home. The study was conducted across two campuses of a registered training organisation in Queensland, Australia, who deliver nationally recognised training in the Vocational Education and Training sector. Data were analysed using thematic analysis. Results: The analysis describes the overall negative placement experience of enrolled nurses who described feeling unprepared for the emotional challenges of the residential aged care setting, which impacted their learning and perceptions of the environment. These were characterised by three themes: (1) navigating the unexpected; (2) missed learning opportunities and (3) a challenging learning environment. Conclusion: The findings of this study echo current concerns about the quality of nursing students’ placement experiences. Being underprepared for placement can impede learning, perpetuate ageism, contribute to program withdrawal, and deter students from pursuing aged care careers once enrolled. This has the potential to ultimately affect the nursing workforce needed to care for the growing ageing population in Australia. Implications for research, policy, and practice: This study identifies opportunities for registered training organisations to refine curriculum design and delivery, particularly for initial placements in residential aged care homes. Recognising enrolled nursing students’ emotional challenges during first placements offers opportunities for better preparation and support. The potential negative impact of that experience must be recognised, valued, and addressed through urgent collaborative action from both training organisations and placement sites. What is already known about the topic: Current research predominantly reports on the perceptions of Registered Nurse students, highlighting both positive and negative placement experiences in residential aged care homes. There is no consensus regarding the timing, duration and suitability of residential aged care homes as the first placement experience and how to best prepare nursing students for the challenges associated with that learning opportunity. What this paper adds: This study explores concerns about enrolled nursing students’ preparedness for placement in residential aged care homes, with the added perspectives of enrolled nurses from the Vocational Education and Training sector (VET). The current VET curriculum lacks specific tools or curriculum design to better prepare enrolled nurses for an emotional and challenging learning environment.