Challenges of Clinical Nursing Training Through Internship Approach: A Qualitative Study

Figures & data

Table 1 The Characteristics of the Nursing Students with Internship Program

Participant(p)	Gender	Age	Education Semester
P1	Male	23	7
P2	Female	22	7
P3	Male	24	7
P4	Female	23	8
P5	Female	23	8
P6	Female	22	8
P7	Female	24	8
P8	Male	23	7

Table 2 Categories and Examples of Quotations

Category	Quotation
Education before internship	I was not satisfied with the previous six semesters [...] We had only seen the suction [as one of the nursing procedures] in the books and it was the first time on internship that we used the suction device [P2] This final [exam] helped us a lot in the internship. If they [teachers] took it at the end of the eighth semester, it would not be useful for us anymore, but the fact that it was on the sixth semester made us to review the basics [P1]
Lack of support	The nurses are afraid to leave the patient to the student independently to manage. Because, if there is a problem for the patient, it is usually the nurse that is responsible for, not the student. I have no money to pay diyat [blood money] [P8]. By the way, I told the students that if we had to say anything or protest now, they would give us a reason. For example we asked [the supervisor] for help, and they replied that the head nurse has his own morals and tastes that he treats you this way [P5].
Planning difficulties	One of the disadvantages of internship is that it takes our time to study for a master’s degree because shifts do not allow us to spend time studying at all [P6]. The medicine was given at 11:30, there was no work in the ward until so we left to rest. The head nurse and other nurses shouted that why did you entered the rest room of staff, the students have no right to rest! [...], but we did all the works of ward [P2]
Interaction to staff	It was very good to be allowed to sit with our supervisor and arrange shifts. I was busy the afternoon and I could not go on Wednesday morning, I easily changed my shifts and it was very good [P1]. They do not let us sit even for a moment; if we do, each of nurses overwhelm us with a lot of work [...] Some nurses and their staff have friendly attitudes, but some do not [P4]
Invisible evaluation	I did not see any reason for getting such low score, but the head nurse gave me a low grade. I asked her about it, and she said I would ask the nurses; but, the nurses were all happy with me. I this she did that not based on my performance. Maybe she did not like me [P4]. Another drawback that I think is very important is that now the G.P.A has an impact on the chance of admittance in an MSc program. Our score has now fallen into the hands of those who have no knowledge of our theoretical and practical knowledge [P5].
Welfare defects	They did not give us a locker to put things on it and there was no place safe to leave our valuable items. There was no special place for students to rest [P1]. Thank God, we did not have night shifts, and we used to have the same nurses’ pavilion when we were along (the morning and evening shifts), but sometimes they would say do not change clothes here. This place is not for you [P2]
Personal identity	When we protested that it was not our duty to take 40 vital signs, the nurse or head nurse told us not to protest, you are a student and you have to do your job, and we had to do it. Well, we do not know if we are colleagues or students after all?!” [P7] The attitude of the staff was better and even the attitude of the coaches was different. The coaches handed their students [other students in lower semesters] over to us and said, “You”re with Mr. So-and-so who are interns. They knew we have more experience” [P8]

Figure 1 Conceptual model of the challenges of the internship program.