Nursing students’ voices in psychiatric hospitals, South Africa: a qualitative study on strategies to mitigate anxiety

Background Psychiatric units are among the most demanding clinical environments. Nursing students often experience stress and anxiety when allocated to these settings. Their expectations are challenged when they realise that the actual clinical environment differs significantly from simulated training, and that theoretical knowledge does not always align with practical application. Aim: This study aimed to explore strategies for mitigating student nurses’ anxiety in psychiatric hospitals in South Africa. Methods This study employed exploratory, descriptive, and contextual designs within a qualitative approach. Thirty level IV and 21 Level III student nurses were purposively sampled and interviewed in six focus groups (1–3 with 10 participants and 4–6 with seven participants each), then thematically analysed using Tesch's eight steps. Measures to ensure trustworthiness and ethical principles were considered. Results Two themes and their corresponding sub-themes were revealed for each theme. Theme 1 was Contributory factors to student nurses’ anxiety. Student nurses experience heightened anxiety due to internal challenges (e.g., lack of confidence, fear of the unknown) and external clinical factors (e.g., unfamiliar environments, negative staff attitudes). This anxiety can negatively affect their learning, communication with patients, and overall clinical performance. Theme 2 was Strategies to mitigate student nurses’ anxiety. Implementing these strategies may reduce anxiety, improve student confidence, and enhance clinical competence. Supportive supervision, adequate orientation, and active involvement in patient care promote a positive learning environment and better preparedness for clinical practice. Conclusions The study demonstrates how stigmas and unfavourable views of mental disorders among nursing students may influence their professional future choices. A further mixed-method approach should be conducted to assess the long-term impact of the interventions.