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a b s t r a c tBackground: Clinical nursing education is a fundamental component in the pre-registration nursing curriculum and literature reflects its challenges. Aim: The study investigated the clinical learning experience of undergraduate nursing students in Malawi to explore their perceptions of the experience. Design: This was a hermeneutic phenomenological study. Setting: The study took place at a University Nursing College in Malawi. Participants: Participants for the study were purposively selected from among third and fourth year undergraduate nursing students. The sample consisted of 30 participants and their participation was voluntary. Methods: Conversational interviews were conducted to obtain participants' accounts of their experience and a framework developed by modifying Colaizzi's procedural steps guided the phenomenological analysis. In a hermeneutic phenomenological study, interpretation is critical to the process of understanding the phenomenon being investigated. The findings have been interpreted from a perspective of emotions, utilising emotional labour (Hochschild, 1983) as a conceptual framework which guided the interpretive phase. Results: The study findings reveal that the clinical learning experience is suffused with emotions and students appear to engage in management of emotions, which is commonly understood as emotional labour. Emotional labour is evident in students' narrative accounts about their caring encounters, death and dying and caring-learning relationships as they interact with clinical nurses and lecturers during their clinical learning experience. Conclusion: Effective clinical teaching and learning demands the emotional commitment of lecturers. The understanding of emotional labour in all its manifestations will help in the creation of caring clinical learning environments for student nurses in Malawi.

The findings illustrate that nursing students need to work on their emotions to provide compassionate care. This is consistent with the concept of emotional labour and the paper argues that undertaking emotional labour is essential in promoting compassionate care.

This article reports findings of a hermeneutic phenomenological study that explored the clinical learning experience for Malawian undergraduate student nurses. The study revealed issues that touch on both nursing education and practice, but the article mainly reports the practice issues. The findings reveal the emotions that healthcare workers in Malawi encounter as a consequence of practising in resource-poor settings. Furthermore, there is severe nursing shortage in most clinical settings in Malawi, and this adversely affects the performance of nurses because of the excess workload it imposes on them. The results of the study also illustrate loss of professional pride among some of the nurses, and the article argues that such a demeanour is a consequence of burnout. However, despite these problems, the study also reveals that there are some nurses who have maintained their passion to care.

Purpose Stress among nursing students has been widely investigated across the globe, and evidence suggests that nursing programs are stressful. Students from resource constrained contexts, such as Malawi, often find it difficult and over stressing to be socialized into the nursing profession. However, this area has not been adequately investigated in Malawi. The aim of the study was to investigate stress and its coping strategies among nursing students in Malawi. Methods This was a quantitative study which used a descriptive cross-sectional design that included 102 students in years 2, 3 and 4. Data were collected using the adapted standard tools (Perceived Stress Scale and Adaptive Version of the Nurse Stress Scale) to comprehensively measure levels of stress categorised as clinical, academic and external. The brief Cope was used to measure common coping strategies. Independent samples t test and ANOVA were run at 5% level of significance to analyze the data. Results Moderate levels of stress were perceived by this sample. Academic category contributed to more stress than clinical and external sources. Lecturers, clinical teachers and nursing staff were the major contributors of stress among students. Similarly, high levels of stress were found among year 2 and self-sponsored students. In terms of coping strategies, active coping and planning were the common coping strategies. However, substance use was also recorded as a coping strategy. Conclusion The study revealed that although nursing students face various challenges in under-resourced environments, teachers and clinical staff highly contribute towards stress. It was then established that stress among nursing students’ can be contained by initiating stress reduction interventions. There is also need to further investigate the extent of substance use as it suggests that some students have not been able to cope with current stress levels hence resorting to use of substances.