“Facing–Coping–Transformation” Traumatic Experiences to Growth Among Chinese Nursing Students During Clinical Internship: A Qualitative Descriptive Study

Abstract

Clinical internship is a core component in nursing education, during which students are often exposed to high emotional stress and potentially traumatic events. Although the adverse psychological effects of these experiences have been widely recognized, it remains unclear whether and how such traumatic experiences can foster personal and professional growth among Chinese nursing students. This qualitative descriptive study aimed to explore the traumatic experiences of nursing students during an internship conducted at a college in eastern China. Purposive sampling techniques were used to recruit 15 undergraduate nursing students who were engaged in their pre-graduation clinical practicum. Data were collected through in-depth, semi-structured interviews and supplemented by their original drawings. Following each interview, participants were invited to depict their traumatic experiences or reflections using colored pencils on A4 paper, without restrictions on time or artistic skill. The Braun and Clarke topic analysis method was employed. 

Three main themes emerged: 1) confronting painful experiences during practicum, encompassing unprepared exposure to death and suffering, hidden harm within power structures, and activation of personal unfinished business; 2) coping with emotional pain, including emotional labor overload, feelings of empathy but powerlessness, and defensive emotional isolation; and 3) transformation from pain to personal and professional growth, involving pulling strength from supportive resources to develop coping strategies, reshaping personal views on life, nursing, and boundaries, and reaffirmation of professional identity and personal growth. 

This study reveals a unique experience of trauma-to-growth trajectory among nursing students, “Facing–Coping–Transformation.” It identifies the core mechanisms underlying this positive transformation: using internal and external supportive resources as the foundation, internal cognitive restructuring as the core driving force, and reaffirmation of professional values and meaning as a key link, ultimately leading to dual growth in personal maturity and professional advancement. It is suggested that trauma-informed growth experiences be integrated into undergraduate nursing curricula to cultivate such adaptive capacities and transformative skills in clinical practice, with adequate support.