Content area
Aim
This study was planned to determine nursing students’ injury experiences in their practice areas and their solutions-related suggestions.
BackgroundClinical training accidents can physically and mentally harm students, potentially affecting their development and careers. Understanding their injury experiences and solutions can help improve this area.
DesignThis descriptive qualitative study used face-to-face semi-structured interviews and content analysis.
MethodsThe data of the study were collected from 15 nursing students who attended a nursing faculty in Türkiye and experienced an occupational accident with a semi-structured interview form between September 2023 and October 2024. The study was reported using the COREQ checklist.
ResultsThe data were categorized under four main themes: (1) Factors Leading to Injury – lack of experience, lack of attention (distraction due to clinical workload) and not using protective equipment; (2) Post-Injury Experiences – negative emotions (fear, regret), loss of motivation, changes in clinical success and stigmatization by peers (being mocked or excluded by classmates); (3) Support Needs – support to access health services (institutional gaps), psychological support and peer support; (4) Recommendations – pre-clinical orientation, mentorship by experienced nurses (lack of mentorship) and being able to access protective equipment.
ConclusionNursing students with limited clinical experience experienced significant challenges in performing interventions on patients, making them more susceptible to occupational accidents. These incidents not only affected them individually but also had academic and social consequences. Addressing these issues through enhanced clinical training and a stronger emphasis on safety protocols is essential to minimize the risk of such accidents.
Today, improving the quality of health services is directly related to the improvement of healthcare professionals’ competencies. Therefore, in nursing education, the aim is to ensure that students learn not only theoretical knowledge but also gain clinical skills and practice in real-life conditions ( Leaver et al., 2021; Almarwani and Alzahrani, 2023). However, clinical practices, which are an essential component of nursing education, expose students to numerous occupational hazards ( Şahinoğlu et al., 2023). Nursing students complete most of their education in clinical settings under the supervision of instructors. Nevertheless, they are more vulnerable to occupational accidents due to several factors, including inexperience with needles and sharps, distraction, patient restlessness, excessive fatigue, rushing and a tendency to assume greater responsibility ( Mishra et al., 2021; Xu et al., 2022). Occupational accidents are one of the most critical issues in professional life. Occupational accidents that occur due to lack of adequate safety measures in the work environment, individual inadequacies, incorrect attitudes and device or equipment malfunctions can lead to consequences ranging from minor injuries to death ( Menteşe and Karaca, 2021).
During their clinical training in hospitals and other healthcare institutions, nursing students are not only frequently exposed to sharps injuries ( Datar et al., 2022; Xu et al., 2022), but also encounter biological, chemical, ergonomic and physical risks. These exposures make them vulnerable to various occupational accidents, including infections and contact with hazardous chemical substances ( Eyi and Eyi, 2020). The National Institute for Occupational Safety and Health (NIOSH), a division of the U.S.-based Centers for Disease Control and Prevention (CDC), has reported universal precautions to be taken to prevent occupational accidents and to protect employees ( NIOSH, 2017). While these guidelines provide valuable recommendations, it is important to note that occupational safety regulations may differ across countries. In Türkiye, occupational health and safety (OHS) in workplaces is regulated by Law No. 6331, which came into force in 2012 and determines the duties, authorities, responsibilities, rights and obligations of both employers and employees to ensure a safe working environment ( Ministry of Labor and Social Security, 2012). In line with this regulation, students participating in clinical practice in hospitals are required to complete a 16-hour OHS training before starting practice. After completing the training, students are required to submit their certificates to the hospital's education department, comply with safety protocols and contribute to the maintenance of a safe clinical environment ( Ministry of Labor and Social Security, 2013). This requirement emphasizes the importance placed on safety awareness and preparation among healthcare students and ultimately contributes to a safer clinical environment. Chen and Zhang (2021) conducted a systematic review and meta-analysis to examine the prevalence of needlestick injuries among nursing interns, the causes of these injuries and the psychological reactions that occur afterwards. In their study, they found that between 6 % and 51 % of nursing students worldwide were exposed to sharps injuries and highlighted the importance of implementing preventive strategies to mitigate the adverse outcomes of such accidents ( Chen and Zhang, 2021).
Students who experience an occupational accident may face challenges such as physical pain, stress, anxiety and loss of self-confidence after the incident they have experienced ( Hambridge et al., 2021). During this process, students' motivation to continue their education may decrease, their career goals in the health field may be questioned and their social relationships may be negatively impacted. These negative experiences may also hinder students' professional development and diminish their capacity to manage occupational risks in their future professional lives ( Türen et al., 2022; dos Santos et al., 2017). In their study, Hambridge et al. (2021) reported that exposure of nursing students to sharps injuries caused them to experience serious psychological problems such as fear, anxiety, depression and post-traumatic stress disorder ( Hambridge et al., 2021). Similarly, in a study conducted with medical students where the psychological effects of sharps injuries were investigated, these injuries caused students to experience anxiety, stress, depression and post-traumatic stress disorder ( Hambridge, 2022). The results of the systematic review conducted by Hambridge (2022) and the study where Hambridge et al. (2024) investigated exposures to sharps injuries in health students also revealed that students needed psychological support after occupational accidents ( Hambridge, 2022; Hambridge et al., 2024). In this context, understanding the challenges encountered by nursing students after occupational accidents and identifying appropriate support mechanisms are critical both for safeguarding their psychological well-being and for promoting occupational health and safety.
The review of the literature indicates that few descriptive studies have explored the challenges experienced by nursing students following occupational accidents and their related support needs ( Eyi and Eyi, 2020; Chen and Zhang, 2021; Hambridge et al., 2021; Mishra et al., 2021; Datar et al., 2022; Elisa et al., 2023; Huzaifa et al., 2024). When the existing studies conducted in Türkiye are examined, it is seen that there is a gap in research on the challenges and support needs of nursing students who have experienced occupational accidents. Studies conducted in recent years have mostly focused on issues such as nursing students' awareness levels ( Hoşten and Eren, 2021), attitudes towards safe use of sharps ( Karabela et al., 2020), knowledge level ( Menteşe and Karaca, 2021; Demir and Yolcu, 2024; Topçu and Ardahan, 2024) and perceptions of occupational risk, including influencing factors and their relationship with occupational accidents ( Palloş et al., 2024). However, there is no study in the Turkish literature on the difficulties encountered by nursing students after occupational accidents and the support mechanisms they need. This situation reveals that there is a significant research gap in the relevant field. It is thought that an in-depth examination of physical and psychosocial challenges encountered by students can provide guidance both in terms of developing effective interventions for these students and improving their educational processes. Thus, in this qualitative study, we aimed to understand the individual and environmental challenges experienced by nursing students who had an occupational accident, particularly focusing on their emotional responses, perceived level of preparedness and the types of support they needed during and after the incident. We also explored how nurses and academic staff could have contributed to their recovery and professional development following such experiences.
2 Methods2.1 Study design and sample
The present study has a descriptive qualitative design. Qualitative descriptive studies are aimed at exploring and understanding a phenomenon, a process, or the perspectives and worldviews of the participants ( Polit and Beck, 2022). This approach was selected to explore the experiences of nursing students who were involved in occupational accidents. Qualitative descriptive design allows participants to describe how they experience the examined phenomenon ( Creswell and Báez, 2021). The present study was conducted with nursing students who had an occupational accident during their clinical practice at the Faculty of Nursing of a university between September 2023 and October 2024. The inclusion criteria were; being a nursing student at Ege University, having at least 1 month of clinical practice experience and having experienced and reported an occupational accident during clinical practice. The purposive sampling method was used in the sampling of the study. The data collection process was conducted based on the principles of meaningful data saturation as outlined by Creswell and Báez (2021). It was completed once no new information emerged and the data obtained from participants began to repeat. While the data were being collected, data analysis was also started at the same time. During the data collection process, 42 students who met the inclusion criteria were contacted. Data saturation was reached at the 12th student. However, the study was completed with 15 students after three more interviews were held.
2.2 Data collectionData were collected through face-to-face, in-depth interviews using a semi-structured interview form and all interviews were audio recorded with the participants’ informed consent. The semi-structured interview form included open-ended questions asked to clarify the experiences of students who had an occupational accident during clinical practice. After receiving expert opinions from two professors specialized in nursing to determine the clarity and competence of the questions, two pilot interviews were conducted with two participants included in the sample and the questions were finalized ( Table 1). Then, the pilot interviews were evaluated to confirm the clarity and appropriateness of the content of the questions and to determine possible needs to revise the questions. After the evaluations, it was decided that the interview questions were appropriate. Therefore, the pilot interviews were included in the analysis. The participants were informed about the purpose of the study and were notified that the interviews would be audio recorded. Then the time and place of the interviews were planned with the students who accepted to be interviewed. The interviews were conducted by the first author, who has experience in qualitative research, in a well-lit room in the Faculty of Nursing where the interview would not be interrupted. The interviews lasted a maximum of 47 minutes and a minimum of 25 minutes. Probing questions were used throughout the interviews to encourage participants to elaborate on their responses, clarify ambiguous points and provide richer descriptions of their experiences. The interviews continued until the point of saturation, where the data began to repeat and no new information was received. Each participant was interviewed once.
2.3 Data analysisThe content analysis method was used to analyze the interview data. The data were analyzed by the first and second authors who are experienced in qualitative research independently of each other based on the steps described by Erlingsson and Brysiewicz to be used as a guide in the analysis process ( Erlingsson and Brysiewicz, 2017). Before data analysis, all the interviews were transcribed verbatim. The interviews were listened to repeatedly to define the nature of the experience, and the transcripts were read repeatedly. In the first step, the text was divided into meaningful small units by remaining faithful to the nature of the experience. In this step, it is especially important to preserve the core meaning. In the next step, a code list was created from meaningful units and the code lists of both researchers who analyzed the data were compared. The subsequent steps of the analysis continued using the code list that was agreed on. In the category creation step of the analysis, similar and different codes were brought together and grouped to create categories. The categories were named according to the meaning they contained. In the next step, two or more categories were brought together to create themes that explained the experience. Then, the researchers came together, discussed the themes and reached a consensus on four themes that explained the phenomenon. In cases where there was a disagreement in theme development, the first and second authors engaged in discussions and re-examined the collected data to reach a consensus. The themes were constructed based on participant statements and supported with direct quotations.
2.4 RigorRigor and reflexivity are fundamental elements in qualitative research design ( Creswell and Báez, 2021; Terry and Hayfield, 2021). The researchers met regularly to discuss reflexivity, critically examine their attitudes, assumptions and biases and avoid early or inaccurate interpretations of data. During this process, they considered how their roles and personal backgrounds (e.g., education, culture, socioeconomic status) might influence the study's findings and maintained this awareness by keeping reflective field notes ( Creswell and Báez, 2021). The following four essential criteria were used to ensure the rigor of the data in the study: credibility, transferability, dependability and confirmability ( Houghton et al., 2013; Colorafi and Evans, 2016). All the researchers received training on qualitative research and had previously conducted qualitative research. The first and second author held a master’s degree, while the third, fourth and fifth author had a doctoral degree. The second author is male and the other authors are female. They were also experienced in occupational accidents and experiences of nursing students. Students included in the study sample had different experiences and the interviews were continued until no new information was obtained. The interviews were conducted by the same researcher in accordance with the semi-structured interview form. Data analysis was conducted on the code list agreed on by the first and second researchers. To support the findings, direct quotations from participants were presented under each identified theme ( Houghton et al., 2013; Colorafi and Evans, 2016). Kappa analysis was used to compare the reliability levels of the themes among the coders created after data collection. Although statistical measures such as Cohen’s Kappa are not commonly used in qualitative research, the analysis was conducted to demonstrate the consistency between coders and to enhance the credibility of the coding process. This metric was used only to supplement the consensus process, not to validate theme generation. In the present study, the agreement value between the coders was 0.88, indicating that the level of agreement was acceptable ( Polit and Beck, 2022).
2.5 Ethical statementWritten permission was obtained from the institution where the study was to be conducted, and ethical approval was obtained from the Non-Interventional Research Ethics Committee of XXX University (Decision no: 24–4.1T/34 Decision date: 25.04.2024). Before the interviews, the participants were informed about the purpose and procedures of the study and then their written informed consent was obtained. The participants were informed that participation in the study was voluntary and that they could withdraw from the study at any time. The participants were also informed that their pseudonyms, not their names, would be used in the transcripts, data analysis and study report to ensure anonymity of the data and that all the data obtained from them would be kept confidential.
3 ResultsIn this section, the sociodemographic characteristics of the participants and the qualitative findings are presented.
3.1 Participants’ sociodemographic characteristicsThe socio-demographic characteristics of the students who experienced an occupational accident during clinical practice are presented in Table 2.
The participants were between the ages of 21 and 28 years. Their mean age was 22.8 (SD1.6) years. Of the participants 9 were women, 11 were fourth year students, 4 were third year students, 10 had previous occupational accident experience, all had previously received training on Occupational Health and Safety (OHS), 9 used protective equipment at the time of their occupational accident and 11 were exposed to sharps injuries.
3.2 Qualitative findingsIn the study, four main themes were identified concerning the experiences of the participating students who experienced an occupational accident during clinical practice: factors contributing to injuries, post-injury experiences, support needs and recommendations ( Fig. 1).
3.2.1 Theme 1. Factors leading to injuryThe students who experienced occupational accidents identified the following factors as contributing to the incidents: lack of experience, lack of attention and not using protective equipment:
Lack of experience: Participants described lack of experience as a contributing factor to occupational accidents. They noted that performing clinical procedures they had never carried out before or had practiced only a few times made them feel nervous, thereby increasing the risk of occupational accidents. “When I first performed an intervention, my hands shook. My hands couldn’t stop shaking.” (Participant 2)
Another participant noted that their perception of lacking experience increased their level of excitement, which ultimately contributed to the occurrence of an occupational accident. This was expressed as follows: “I was excited to give an injection to a real person for the first time. When people get excited, they can make mistakes. I made a mistake and stuck the needle in my hand…” (Participant 7)
Lack of attention: The participants reported that occupational accidents occurred as a result of momentary distractions during clinical practice. They stated that the busy nature of the clinical environment, combined with their lack of experience, contributed to these distractions and increased the risk of occupational accidents.
Participants believed that the high-paced nature of the clinical environment and the pressure of performing multiple tasks for the first time could divert students’ attention and increase the likelihood of occupational accidents: “When I am in an environment that I am not used to and I am new, my attention gets distracted when the workload is high. You have to do many things at the same time. When this happens, an occupational accident becomes inevitable.” (Participant 5)
Protective equipment: The participants stated that lack of protective equipment or not using it led to occupational accidents, that they could not always find the protective equipment they needed in the clinical environment and that they did not use protective equipment even if it was available in the clinical environment: “There are gloves in the clinic, but we cannot always access all the other protective equipment. I was wearing gloves, but the patient’s blood splashed on my skin where there were no gloves…” (Participant 11)
Another student stated that they experienced an occupational accident despite using protective equipment, as follows: “I wore gloves as protective equipment, but the needle pierced the glove and stuck into my hand…” (Participant 14)
3.2.2 Theme 2. Post-injury experiencesStudents who experienced an occupational accident shared their post-accident experiences. They reported feelings of emotional distress, decreased motivation, a decline in clinical performance and stigmatization by their peers after the occupational accident:
Negative emotions: The participants stated that after experiencing an occupational accident, they went through a range of complex emotions that were difficult to describe and that they had difficulty coping with negative feelings such as sadness, regret and helplessness following the incident. “After the occupational accident, I regretted rushing so much during the intervention. I wished I hadn’t rushed …” (Participant 3)
Another participant described the sense of helplessness they experienced after the occupational accident as follows: “I didn’t know what to do after the occupational accident, I felt so helpless. I froze for a while.” (Participant 10)
Loss of motivation: The participants reported a decline in motivation following the occupational accident. They stated that their willingness to engage in clinical practice decreased and that they began to refrain from participating in clinical procedures.
Participants believed that, following an occupational accident, students tended to withdraw from the clinical environment both physically and emotionally. They reported a decline in motivation and a sense of disengagement from the learning process. As one participant expressed: “I am a nurse and I stuck a needle in my own hand… I didn't want to do anything in the clinic for a while.” (Participant 8) “I didn’t want to attend clinical practice after the occupational accident. I wasn’t afraid of getting a needle stuck in my hand again, but I didn’t want to do anything.” (Participant 12)
Changes in clinical success: The participants mentioned that there were changes in their clinical success after the occupational accident because they did not want to do work specific to the field they practiced after the accident and that they also lost motivation to work in the clinic. “I started to feel incompetent in the clinic. I became unmotivated towards things that I was very motivated for before. After the occupational accident, my clinical practice grades were also affected negatively.” (Participant 7)
Stigmatization by the peers: The participants who experienced an occupational accident reported that they were stigmatized by their peers. They stated that their friends repeatedly joked about the incident, mocked them and even took over some of the clinical tasks assigned to them.
Participants believed that they were stigmatized by their peers after the occupational accident and that they did not receive adequate support. One participant shared the following experience: “After the occupational accident, my friends at the clinic were constantly making fun of me about the accident, which made me feel very embarrassed…” (Participant 7)
Another participant described the stigmatization they experienced from their peers after the occupational accident as follows: “They constantly made fun of me about this issue… Once, they took away the injection I was going to give to a patient, saying that “you would stick it in yourself.” (Participant 13)
3.2.3 Theme 3. Support needsParticipants who experienced an occupational accident stated that they needed various forms of support afterward, support to access health services, psychological support and peer support:
Support to access health services: Participants stated that they needed support in accessing health services following the occupational accident. They reported not knowing what to do, whom to report the incident to, or which steps to take afterward.
Participants thought that they were unable to receive guidance from the nurses in the clinic after the occupational accident: “When I got a needle stuck in my hand, I didn’t know where to go or which unit to report it to. I panicked. I didn’t know from whom I could get support.” (Participant 2)
Another student expressed their need for support in accessing healthcare services after the occupational accident as follows: “…My hands were contaminated with blood, Was I supposed to report it? To whom should I report it? What path should I follow? I was scared and had a lot of questions in my mind…” (Participant 15)
Psychological support: Participants stated that they needed psychological support following the occupational accident. They reported that this need stemmed from a loss of motivation, negative emotional experiences and stigmatization by their peers. “After the needle stuck in my hand, I had a hard time psychologically, my motivation decreased, I did not want to go to the clinic anymore… I wish I could have received psychological support during this difficult process to get through it.” (Participant 10)
Another participant expressed the psychological impact of occupational accidents and their need for psychological support as follows: A person experiences psychological difficulties after such an accident. If they had supported us, students, in this regard, I could have coped better.” (Participant 15)
Peer support: The participants stated that they needed peer support after the occupational accident they were exposed to. They talked about the importance of not being stigmatized by their friends but getting support from them after the occupational accident.
Participants believed that the lack of social support and stigmatization by peers following the occupational accident made the coping process more difficult: “No matter how careful we are, we can all have an occupational accident. It would have been good for me if my friends supported me after I got stuck in my hand with a needle and my motivation would not have decreased.” (Participant 14)
3.2.4 Theme 4. RecommendationsParticipants who experienced an occupational accident made several suggestions to support their peers in better managing the post-accident process. These included having pre-clinical orientation, being mentored by experienced nurses in the clinic and being able to access protective equipment:
Having pre-clinical orientation: The participating students stated that they should be orientated about the clinic they would be attending before they started clinical practice, because pre-clinical orientation would help them adapt faster and would decrease occupational accidents. “If we were made acquainted with the clinic and if we were given a short orientation on the clinical practice by our responsible instructor before the clinical practice, occupational accidents could be reduced, because we did not know where materials or things that could pose a danger were placed.” (Participant 3)
Being mentored by experienced nurses in the clinic: The participating students suggested that they should be mentored by a nurse working the clinic where they would perform the clinical practice. They said that occupational accidents would decrease if a nurse mentored them. “A nurse in the clinic where we perform the clinical practice can mentor us… In this way, we can adapt to the clinic more quickly and safely and don’t have any occupational accidents.” (Participant 6)
Being able to access protective equipment: The participating students stated that students should be able access protective equipment more easily to reduce occupational accidents. They also stated that they had difficulty in using protective equipment because they did not know where to get it or how to access it. “When an emergency case came, I couldn't put on the human protective equipment because I didn't know where it was. At that moment, I prayed that the patient's blood wouldn't splash on me or my hands…” (Participant 11)
Another participant expressed their recommendation regarding the issue of access to protective equipment as follows: “We should be taught where we can get the materials and how we can access the protective equipment. As students, we sometimes cannot use protective equipment just because we are afraid to ask where the materials are.” (Participant 13)
4 DiscussionAt the end of the present study, which explored the experiences of nursing students who had an occupational accident during clinical practice, four main themes were identified: factors leading to injuries, post-injury experiences, support needs and recommendations.
Nursing students perceived lack of experience, distraction, lack of knowledge and lack of use of personal protective equipment as key factors contributing to occupational accidents. The results of the present study are consistent with previous research involving students who experienced occupational accidents ( Elisa et al., 2023; Min et al., 2023; Huzaifa et al., 2024; Palloş et al., 2024). In a study conducted with 312 student nurses, Mishra et al. (2021) identified behavioral factors as the primary causes of needlestick injuries. They reported that especially students who had not received training on occupational hazards experienced injuries more frequently. Lack of concentration and incorrect practices (e.g. re-capping needles, being hasty) ranked second among problems induced by lack of competence. Additionally, neglect by trained professionals and organizational deficiencies—such as the absence of protocols on needlestick injuries, failure to empty waste bins and inadequate training—were also highlighted ( Mishra et al., 2021). Similarly, in a descriptive and cross-sectional study by Eyi and Eyi (2020), which evaluated nursing students’ occupational health and safety experiences in surgical units, 140 participants most frequently encountered risks such as contact with blood and body fluids (90.7 %), interaction with patients and their relatives (60 %) and sharps injuries (30.7 %). The leading causes of occupational accidents were identified as lack of attention (84.2 %) and a high-intensity work environment (81.4 %). Likewise, Palloş et al. (2024) stated that the leading causes of injuries among students were carelessness, rushing, lack of access to protective equipment and nervousness while performing clinical procedures under the supervision of a faculty member or nurse. In a study involving 415 medical students, nursing students and residents at a university medical center in the United States, the causes of needlestick injuries were investigated. Participants identified lack of assistance, insufficient skills, lack of concentration, burnout and feeling rushed as primary contributing factors. Notably, a significant proportion of participants emphasized lack of concentration as the leading cause of injuries ( Katsevman et al., 2020). Similarly, a qualitative study conducted by Min et al. (2023) with 31 direct care nurses in three acute care hospitals in South Korea aimed to explore needlestick injuries. The findings revealed that inexperience among novice nurses, time pressure, negligence, lack of patient cooperation, understaffing, limited access to safety equipment and inadequate hands-on training were key contributing factors ( Min et al., 2023). Thus, identifying the factors that lead to occupational accidents among students during clinical practice is of great importance if these risks are to be addressed. These incidents can be reduced by providing students with more comprehensive training on occupational health and safety, ensuring its implementation, emphasizing the most common causes of injuries and reinforcing the use of protective equipment prior to clinical placements.
The results of the present study indicate that participants experienced negative emotions, loss of motivation, changes in clinical success and stigmatization by their peers following an occupational accident. The review of previous studies in the literature similarly demonstrated that occupational accidents may lead to various psychological issues—such as fear, nervousness, anxiety, depression and post-traumatic stress disorder—particularly among young individuals and those newly beginning vocational training ( Eyi and Eyi, 2020; Hambridge et al., 2021; Hambridge, 2022; Palloş et al., 2024). In a study conducted with 280 nursing students, Palloş et al. (2024) investigated the frequency of needlestick and sharps injuries, the contributing factors and preventive measures. They reported that fear and nervousness were the most commonly experienced emotions following such injuries. Similarly, in a qualitative study conducted by Hambridge et al. (2021) with twelve nursing students in the United Kingdom, participants who had experienced sharps injuries reported suffering from a range of psychological problems. These issues were found to affect both their professional and personal lives. Peer stigmatization of nursing students who seek psychological support may reflect sociocultural dynamics shaped by hierarchical structures in clinical education and student competition ( Byrnes et al., 2020; Shahaf-Oren et al., 2021; Tawse and Demou, 2022). This form of stigmatization can function as a defense mechanism for coping with psychological challenges. Among students who are highly aware of occupational stigma, such attitudes have been shown to reduce professional commitment and psychological empowerment, thereby hindering help-seeking behaviors ( Chen et al., 2023). Fear of losing credibility, embarrassment, or social exclusion further discourages students from seeking support ( Özdemir et al., 2023; Bamine and Tanaka, 2025). Understanding these complex sociocultural factors is essential for developing policies and educational strategies that encourage help-seeking behavior and reinforce professional commitment. The study by Kang and Cho (2023) investigated the emotional distress experienced by nursing students following clinical errors and presented important findings regarding their coping mechanisms. The study revealed that students employed both passive and active coping strategies to manage their emotional burden, particularly through seeking social support and engaging in self-evaluation. Similarly, Bazrafshan et al. (2025) emphasized that some students tend to conceal incidents, which may negatively affect the learning process. Lazarus and Folkman’s Stress and Coping Model suggests that stress arises when individuals perceive situations as threatening or beyond their control ( Biggs et al., 2017). After a clinical error, students may perceive this situation as a threat to their professional competence or future career. In this context, experiences such as negative emotions, loss of motivation and change in clinical success, as identified in the present study, may be interpreted as outcomes of inadequate coping mechanisms. Passive coping strategies (e.g., avoidance or denial) may, in particular, have a negative impact on students' psychological well-being by increasing feelings of stigmatization by peers. On the other hand, —such as seeking social support and engaging in problem-solving—may assist students in managing this process in a healthier manner. Therefore, creating an educational environment characterized by supportive and open communication is essential for fostering the development of healthier coping strategies. Thus, the results of this study revealed that nursing students who experienced an occupational accident encountered a range of psychosocial difficulties. Supporting these students not only physically, but also psychologically and socially, is of critical importance. Educational institutions can contribute to students in regaining their motivation and maintaining clinical performance by offering psychosocial support programs aimed at reducing the impact of such traumatic experiences.
In the present study, nursing students who experienced an occupational accident reported needing support to access health services, psychological support and peer support. These findings are consistent with those of previous studies involving students with similar experiences ( Wada et al., 2007; Naidoo, 2010; Naghavi et al., 2013; Rossouw et al., 2017; Zhang et al., 2021). In China, a study was conducted with the participation of 51,406 nurses to evaluate occupational accidents and psychological support received and to examine the relationship between these two variables. In the study, it is noteworthy that all participants stated that they needed psychological support at different levels. 86.1 % of the participants stated that they needed little or moderate psychological support and 13.9 % stated that they needed very high or extreme psychological support ( Zhang et al., 2021). The findings of Rossouw et al.'s (2017) study revealed that medical students had a significant need for support during clinical rotations. Most students perceived their clinical experiences as highly stressful and reported an average stress level of 8 out of 10, suggesting that the heavy workload and challenges in the clinical environment created considerable emotional burden. A striking finding was that a large portion of students felt that they did not receive adequate support from clinical staff. Only 17.6 % of the participants considered the department where they were placed to be supportive. In contrast, 99.3 % reported receiving substantial support from their personal environment, especially from family and friends ( Rossouw et al., 2017). In their qualitative study on needlestick injuries among nursing students, Naidoo (2010) reported that participants needed support following such incidents, which was reflected in three main themes: “Support from family and friends”, “Support from the staff in service settings” and “Support from the staff at the Higher Education Institution”. Participants emphasized the important role their friends played in supporting them during this process. While some students felt that staff in service settings were indifferent and not sufficiently supportive, clinical supervisors working in these settings provided valuable assistance by guiding students through this challenging experience. Following the supervisors’ support, participants reported feeling safer and better able to cope with the situation ( Naidoo, 2010). Although the support provided by faculty members has a direct impact on students' mental health, open communication and a safe learning environment fostered by hospital staff further strengthen this process ( Van Slambrouck et al., 2021). The policies adopted by institutions can influence outcomes across various areas, from the accessibility of student support services to the flexibility of implementation practices. Therefore, it is critical that all stakeholders act in cooperation. The results of the present study demonstrated that students should be supported not only physically but also psychologically and socially after occupational accidents. While access to health services enables timely and effective responses to physical issues encountered during the recovery process, psychological support can help students cope with the stress and anxiety caused by such accidents. Additionally, peer support can promote emotional solidarity among students who share similar experiences and help them process trauma in a healthier way. These interventions can contribute to improving both the physical and psychosocial well-being of nursing students exposed to occupational accidents and reduce the challenges they may face during their vocational education.
Another finding of the present study is that participants who experienced an occupational accident made several recommendations—based on their own experiences—to help other students cope more effectively with similar situations. These recommendations include the provision of comprehensive orientation training prior to clinical placements, mentoring support from nurses during clinical practice and improved access to protective equipment. The results of this study are consistent with previous research involving students who have experienced occupational accidents ( Rossouw et al., 2017; Eyi and Eyi, 2020; Yıldız et al., 2021). In Rossouw et al.’s (2017) study, students who had experienced an occupational accident made various suggestions—based on their own experiences—for supporting peers who might encounter similar situations. Among them, 32 % emphasized the need for additional training on injury prevention and suggested that such training should be delivered through practical sessions (49 %) or traditional methods (41 %). Students also recommended that medical sharps bins be regularly supplied and properly maintained to prevent occupational accidents. Additionally, they emphasized the importance of facilitating access to safety needles and other protective equipment. Ensuring constant availability of gloves in various sizes and vacuum containers was also identified as critical for maintaining a safe clinical environment. These findings highlight the importance of incorporating student-informed recommendations into institutional policies and underscore the need for educators and administrators to implement practices that enhance safety and reduce stress among students ( Rossouw et al., 2017). In Yıldız et al.’s study (2021), students made various suggestions—based on the experiences of individuals who had experienced an occupational accident—to support peers who may face similar situations. In the same study, 21.8 % of the students emphasized the importance of being informed about whom to report an occupational accident to in the hospital, suggesting that clear guidance should be provided on this issue. Additionally, 20.3 % highlighted the need for a comprehensive orientation program prior to internship, noting its significance for both adaptation to the hospital environment and the establishment of safe working conditions. Furthermore, 18.5 % recommended providing specific training on safe use of certain medical devices, while 15.6 % emphasized the regular and correct use of protective equipment in hospital settings. A further 12.4 % stressed the importance of routine inspections regarding the proper use of personal protective equipment and waste management. Lastly, 11.4 % suggested increasing both the number and scope of occupational health and safety training sessions offered in hospitals ( Yıldız et al., 2021). In a qualitative study conducted by Min et al. (2023) involving 31 direct care nurses from three acute care hospitals in South Korea, participants recommended increasing the availability of safety equipment to prevent needlestick injuries. At the institution where the study was conducted, there is no student-specific regulation for reporting occupational accidents. Instead, students are required to complete an incident form in accordance with the Occupational Health and Safety Law ( Ministry of Labor and Social Security, 2012). However, this process is often ineffective due to students’ unfamiliarity with the procedure or hesitation to report. Therefore, a clear, student-oriented reporting protocol is needed to promote timely and accurate reporting. Although a psychological counseling unit exists, support is only provided on request. Making such support part of institutional policy—by automatically referring students who report incidents to counseling—could help them cope with trauma more effectively. Pre-clinical occupational health and safety training, while legally required, remains largely theoretical ( Ministry of Labor and Social Security, 2013). To better prepare students, these trainings should incorporate case scenarios, simulations and practical exercises ( Vaquero-Álvarez et al., 2020). Finally, partnering with hospitals to improve the accessibility of personal protective equipment and ensuring its systematic provision is essential for enhancing student safety.
5 ConclusionThis study found that the academic success and clinical motivation of nursing students who experienced an occupational accident declined following the incident and that many felt stigmatized. These findings underscore the importance of providing comprehensive pre-clinical orientation, increased support from clinical nurses and easier access to protective equipment. Nursing education programs should consider developing and implementing structured support mechanisms, including psychological counseling, peer support networks and accessible healthcare services tailored to students’ needs after occupational accidents. Future research could benefit from longitudinal designs that explore the long-term impact of occupational accidents on students’ professional development. Intervention-based studies may help evaluate the effectiveness of support programs, while gender-based analyses could reveal whether male and female students experience occupational challenges differently. Moreover, exploring the perspectives of faculty, clinical mentors and administrators could offer valuable insights into institutional factors that influence students' experiences and support mechanisms ( Fig. 2).
This study has several limitations. First, the retrospective nature of the student interviews may have introduced recall bias, particularly due to social desirability, as students might have underreported errors or concerns. Second, the study was conducted with nursing students from a single university, which may limit the generalizability of the findings to other nursing programs, clinical institutions, or cultural contexts. Nevertheless, the study offers valuable insights for educational programs that share similar curricular structures and clinical training environments.
CRediT authorship contribution statementAycin Ezgi Onel: Writing – review & editing, Writing – original draft, Visualization, Validation, Supervision, Software, Resources, Project administration, Methodology, Investigation, Funding acquisition, Formal analysis, Data curation, Conceptualization. Erkan Unsal: Writing – review & editing, Writing – original draft, Visualization, Validation, Supervision, Software, Resources, Project administration, Methodology, Investigation, Funding acquisition, Formal analysis, Data curation, Conceptualization. Fahriye Vatan: Writing – review & editing, Visualization, Validation, Supervision, Formal analysis. Aysegul Donmez: Writing – review & editing, Visualization, Validation, Supervision, Formal analysis, Conceptualization. Eda Dolgun: Writing – review & editing, Visualization, Validation, Supervision, Formal analysis, Conceptualization.
Ethical approvalThis study was conducted in accordance with the ethical principles specified in the Declaration of Helsinki. An application was made to the Scientific Research and Publication Ethics Committee of the university where the study was conducted and ethics committee approval (Date:25.04.2024 Number:24–4.1 T/34) was obtained. Informed consent was obtained from all participants before inclusion in the study.
Funding sourcesThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Declaration of Competing InterestThe article or parts of it have not been published or submitted for publication elsewhere. We have no conflicts of interest to disclose. All authors have seen and approved the submitted manuscript and all authors abide by the copyright terms and conditions.
AcknowledgementsWe would like to extend our sincere thanks to participants for taking part in this study.
Appendix A Supporting informationSupplementary data associated with this article can be found in the online version at doi:10.1016/j.nepr.2025.104386.
Appendix A Supplementary materialSupplementary material
| How would you describe the emotions you experience when you have an occupational accident?
What do you think you could have prepared yourself better for or what would have preferred to have learned earlier after you had an occupational accident? What kind of support did you need after you had the occupational accident? How could nurses or academics have supported you after you had the occupational accident? |
| | | | | | | | |
| | 24 | Woman | 4 | Yes | Yes | No | Sharps |
| | 28 | Woman | 4 | Yes | Yes | Yes (Gloves) | Sharps |
| | 21 | Woman | 4 | Yes | Yes | Yes (Gloves) | Sharps |
| | 22 | Man | 4 | Yes | Yes | Yes (Gloves) | Sharps |
| | 23 | Woman | 4 | Yes | Yes | Yes (Gloves, mask) | Sharps |
| | 22 | Man | 3 | No | Yes | No | Blood-Body Fluid |
| | 22 | Man | 4 | No | Yes | Yes (Gloves) | Sharps |
| | 23 | Woman | 3 | Yes | Yes | Yes (Gloves) | Sharps |
| | 24 | Man | 4 | No | Yes | No | Sharps |
| | 23 | Woman | 4 | Yes | Yes | Yes (Gloves) | Sharps |
| | 22 | Woman | 4 | No | Yes | Yes (Gloves) | Blood-Body Fluid |
| | 21 | Woman | 3 | Yes | Yes | Yes (Gloves, mask) | Sharps |
| | 22 | Man | 4 | No | Yes | No | Blood-Body Fluid |
| | 22 | Woman | 3 | Yes | Yes | No | Blood-Body Fluid |
| | 23 | Man | 4 | Yes | Yes | No | Sharps |
| | 22.8 ± 1.6 | - | - | - | - | - | - |
| | 1.64 | - | - | - | - | - | - |
©2025. Elsevier Ltd