First-Year Nursing Students’ Experiences in the Clinical Area on the First Day of Placement: A Qualitative Study

Abstract

The first day of clinical placement is a critical milestone in nursing education, marking the transition from classroom-based learning to real-world patient nursing care. For first-year nursing students, this initial exposure to the clinical environment is often emotionally intense and plays a significant role in shaping adaptation to clinical practice, professional identity formation, and perceptions of nursing. Understanding these early experiences is essential for strengthening clinical teaching strategies and improving student transition into practice. This study aimed to explore and describe the experiences of first-year nursing students from the University of Kabianga and Great Lakes University of Kisumu during their first day of clinical placement. A qualitative descriptive design informed by descriptive phenomenology was adopted to capture the lived experiences of the students. The study was conducted among 15 first-year nursing students, comprising eight from the University of Kabianga and seven from Great Lakes University of Kisumu. Participants were purposively selected after completing their first clinical placement experience. Data were collected through face-to-face semi-structured interviews guided by open-ended questions. Each interview lasted between 30–45 minutes, was audio-recorded with consent, and transcribed verbatim. Data were analysed using inductive thematic analysis following six-step framework of Braun and Clarke. Data collection continued until saturation was achieved. Trustworthiness was ensured through credibility, dependability, confirmability, and transferability strategies, including member checking, audit trails, and reflexivity. Six themes emerged: mixed emotional reactions, fear of the unknown, reality shock, importance of clinical support, learning through observation, and development of professional identity alongside communication challenges. Students reported excitement, pride, anxiety, and nervousness as they entered the clinical environment for the very first time. These emotions were influenced by uncertainty, unfamiliarity with clinical routines, and perceived lack of competence. A clear gap between theoretical learning and clinical reality was evident, characterized by busy wards, high patient loads, limited resources, and exposure to critically ill patients, leading to reality shock. Despite these challenges, clinical support from instructors, ward nurses, and peers played a key role in reducing anxiety and facilitating adaptation. Observation was the main learning strategy, enabling students to connect theory with practice while gradually building confidence.
The study concludes that the first day of clinical placement is a transformative yet emotionally complex experience that significantly influences early professional development. Strengthening structured orientation, mentorship, and supportive clinical environments is essential to improve student confidence, competence, and transition into clinical practice.