I would like to suggest preparing nursing students through simulation labs, creating similar scenarios and let them learn through PBL

This can be achieved through simulation activity. This gives the students a chance to practice in a non threatening environment. 

My EdD research has considered strategies that develop emotional intelligence (EI) in neophyte adult student nurses. In the quantitative phase a pre and post questionnaire (Multi-Dimensional Fear of Death Scale, Hoelter, 1979) was used to see if interventions with two groups to raise EI had been effective in comparison to a control group. Numbers were low, but results indicate that both a self-help book on raising EI and a spiritual small group work strategy were effective. These were with small groups of 25 students and the interaction with teaching staff was influential. The qualitative phase indicated the importance of the compassion and professionalism of mentors within clinical practice. Almost finished writing up, but not completed or published yet.

By equipping them with knowledge on the subject in lectures and through lab. simulations, I agree also with Professor Ahmad that creating similar scenarios and observing how they respond to different situations is a way of evaluating learning to some extent.

Simulation can be a good option as well as a good theoretical preparation. Very important is to make them discuss in an open way their feellings after simulation and after any traumatic incidents.

It best to teach students through simulation classes and have them as direct observers. Reflective Journals can be the best avenue to assess their learning needs. They can also enhance their  experience during trauma codes as circulating nurses with that we can develop their confidence.

I agree, Brenda.  Students love to hear stories about real live incidents.  They learn a lot from them.  I believe also students need to be warned they can be emotionally distraught after losing a patient or witnessing tragedy.  They need to know it is OK and recommended  for them to seek counseling after such an event. 

Fundamentals. Let them talk about their experiences, what do they think and how do they feel? Thats debriefing

Teaching students about the concept of vicarious traumatisation familiarises them to the possibility of their own vulnerability when exposed to patients traumatic histories or current experiences. Providing opportunities for students to use written reflection logs and have discussion with a supportive clinical teacher can provide a space to validate their responses and facilitate emotional and intellectual processing in a caring, respectful and empathic context. Similarly critical is teaching nurses self care strategies when they are exposed to traumatic mental health situations. There also needs to be an encouragement for nurses to regularly use 'clinical supervision' as a venue for debriefing and to attend to the complex personal, professional and ethical demands made by their work as a nurse.

It might also be helpful to break down the types trauma into categories.  Trauma occurring to the patient is one perspective. Age is a significant factor, potential survival from the trauma another factor, the impact on quality of life on the patient is another.   If someone has the potential to survive from the trauma, it feels positive to be part of the process that assists the person to become well. 

The impact of the trauma will vary according to the student's values and identification with the patient.  There was an incident near where I worked where a mentally ill man stabbed a young girl on the street in the middle of the day.  The child and the mentally ill man were taken to the same hospital.  The hospital administration split the staff so those taking care of the child were not in contact with the man and the reverse.  If a healthcare professional has a young girl near the age of the victim, he or she would be traumatized if asked to care for the man who did the stabbing.   Students need to be aware their own experiences and values will influence the impact on them when traumatic events occur.

I agree with Madelaine Lawrence, divide the traumas in to categories.  pediatric traumas seem to have the the most detrimental effects, followed by innocent bystanders.  Another group to include are those who are injured committing egregious acts such as child molesters or a drink driver who hit and killed another drive.  Lots of conflicting feelings to address before you can provide care.

Student nurses to be prepared prior to the clinical posting. That can create an impact on the clinical performance, but this will help the students to face the reality. The preparation can be done through discussions, experience from the teachers, senior students, staff nurses etc.. even with the help of videos. If any such incidents took place in the ward that should be informed to the clinical supervisor, such instructions and preparation will help the students to face the real situation  

I think that is an important aspect to address. I lost two students after their placement in a palliative care. it really gets to them

I think debriefing is really important when considering any individual dealing with highly emotive and stressful situations at work. This is important when the individual is a student, and even more so when experiencing these situtations for the first time, and at a time of uncertainty in their career path.

From a personal point of view- in the past as a sister in children's ED, caring for children/YP with mental health problems was a part of my job that I enjoyed, had a real interest in and gave my absolute all (to their acute care, safeguarding, emotional support etc.), I found caring for young people with mental health problems quite emotionally draining and it ultimately added to my decision to leave emergency care. I feel I would have really benefited from some supervision/debriefing/support from the senior team. There is a real attitude in student nurses, which I found when helping interview in my final year of training, that one must 'turn off' our feelings and show no emotion when caring for these children/families. This is a really difficult thing to do and may contribute to the feelings of confusion, insecurity and decisions to leave the programme rather than engage in peer or supervisor support. Similarly for qualified staff I feel very strongly that it is something that some areas do very poorly, resulting in stressed and unhappy staff.

Our contribution:

As an educator of nursing students, we make sure to let students know they should report and seek help with their instructors when they are dealing with highly emotional or stressful situations. I also encourage our students to debrief together and seek help from professionals when they feel the need.