AIM: The aim of the study was to gain new insights into the experiences and accounts of adult pre-registration student nurse clinical allocations in hospital settings in the UK. DESIGN: A systematic review and meta-synthesis of the qualitative literature was undertaken. DATA SOURCES: Pertinent papers published from 1990 to 2010 were identified through searches of Cumulative Index for Nursing and Allied Health Literature, Proquest, Medline (PubMed), and the British Nursing Index. Hand and citation searching was also undertaken. REVIEW METHODS: Ten relevant papers were identified for review. Quality checks on the robustness of the studies were undertaken. Data extraction included identifying details of the study's settings, sample details, focus of the study, research design, data collection methods, data analysis approaches and qualitative data themes. RESULTS: Approximately 40 qualitative data themes were identified and were the subject of a meta-synthesis. Five cross-cutting synthesised data themes were identified including: pre-placement anticipation, the realities of the clinical environment, clinical learning and becoming a nurse. Stress and coping was a concurrent topic area and related to all the synthesised themes. CONCLUSIONS: The findings give new insights into the clinical experiences of student nurses of which the stress of learning in clinical environments and the development of emotional resilience is a focal issue. Whilst the majority of students in the UK experience nurturing, caring clinical environments and positive staff relationships, however, some do not. Reports of negative student nurse clinical experiences are shown in this review to have endured through time. Nurse educators should be alert to the possibility that some students may have very negative clinical experiences. The consequences such negative experiences will affect such things as increases to student attrition and the help perpetuate the cycle of negative clinical learning experiences occurring in the future.