- Anxiety is a common mental health condition in college students and nursing students, in particular.
- Anxiety in nursing school can harm academic performance. Some common anxiety triggers for nursing students include fear of failing, not living up to expectations, or fear of hurting a patient.
- Nursing students can lower anxiety levels by being prepared, using resources, taking time to relax, and practicing self-care.
Mental health is a growing concern across all college campuses, especially among nursing students. One prepandemic survey of college counseling center directors showed 95% were concerned by the number of students with significant psychological issues. Another literature review of 27 studies found a 34% prevalence of depression in nursing students.
However, with some simple strategies, nursing students can lower their anxiety level and improve their performance. We spoke with two nurses who shared their tips to manage stress and nursing school anxiety.
Tina M. Baxter, MSN, APRN, GNP-BC, has practiced nursing for over 20 years, and Sheila A. Burke, DNP, MSN, MBA, is the national dean of nursing for Pacific College of Health and Science.
7 Tips Nurses Offer for Managing Nursing School Anxiety
Anxiety in nursing school is not uncommon. While considering how nursing students can manage stress, Burke points out that there are usually two types of nursing students. The first is fresh out of high school, and it is their first experience in postsecondary education.
The second type is returning to school to complete a bachelor of science in nursing degree or advanced education. Adult learners typically have challenges like limited time and resources. At the same time, adult learners may also be more motivated and adept at using resources.
It is crucial that nursing students learn self-awareness and self-care to cope with nursing school anxiety. These tools also help registered nurses to identify stress and anxiety in their patients and offer tools that have proven to be successful.
1. Be Prepared
Both Baxter and Burke advise nursing students to be prepared. Baxter focuses on being prepared for the challenging workload you can expect in nursing school. While she also played the clarinet as an undergraduate, she spent the bulk of her study time in the library or her room.
“Many students are not prepared for the amount of work it will take to complete your classwork. Read the syllabus. I repeat, read the syllabus,” Baxter says.
Baxter’s friends who were music majors practiced for eight hours each day, while she practiced for two hours. The bulk of her time was spent away from distractions, in the library or her room, to be prepared for classes and exams.
Burke also stresses having a plan and being prepared for the challenges nursing students encounter in school.
“Nursing school is a journey and having a map (information about what ground you will cover), planning for the resources you will need, and accepting that you may have some detours to achieve your goal will help you feel more confident,” she says.
2. Identify and Use Resources
Most universities, colleges, and nursing schools offer a variety of resources to help students be more successful. Burke stresses the online and on-campus resources that can help lower anxiety levels, such as nursing apps, counseling, and study coaching.
Students are not born knowing how to study effectively. What may have worked in high school may not work with a greater workload in college. Take advantage of the coaching and tutoring the program offers to lower your stress and anxiety in nursing school.
“Identify what works for you and use it. It may be music that inspires you [or] reaching out to a friend who will be encouraging and positive,” Burke says. “It’s also important to be intentional and avoid people or situations that cause stress for you.”
3. Study, Review, and Practice
One proven method of reducing anxiety is to be prepared for classes, labs, and exams. The more you know the information, the less anxiety you’ll experience. Burke advises students to practice, and practice some more.
“The more students study, review, and discuss the material they are learning the better they can grasp it. Things that seem very hard can be broken down into manageable steps,” she says.
4. Recognize It Is Time Limited
Although nursing programs are challenging, they are also self-limited. In other words, you may be going through a rough semester, but a college semester is limited to 15-16 weeks. Not all semesters are as difficult, and the program lasts from 2-4 years.
It’s important to see the light at the end of the tunnel and keep your goals in sight. Burke advises students to realize that their nursing program is just one chapter in their life.
“The anxiety can be managed, and it’s most important to ask for help. Remember you are not in this alone and many people have been able to enter and succeed in these programs,” Burke says.
5. Take Time to Relax
When you are planning your study schedule, it’s important to plan times to relax and bond with your fellow students. Only nursing students can appreciate what other nursing students are experiencing.
Baxter told us that while she doesn’t miss the late night studying and the “awful white aprons with light blue piping that had to be wrinkle-free and kept clean,” she does miss the memories and camaraderie she shared with other nursing students.
“I mean, this is the time to make friends and make memories. Celebrate your wins with each other,” she says.
When Baxter was a student nurse, her class developed the habit of preparing for nursing midterms and finals by having a group study time. After the nursing exams, Baxter and her classmates celebrated wins by meeting at the local restaurant and bonded over pancakes, she says.
6. Practice Self-Care
Self-care is a foundational resource that Burke advises students to use every day. Take the time to get quality sleep, exercise, and make good nutritional choices. These steps help lower your stress level and help you to feel more balanced.
Baxter cautions students to remember that while nursing school anxiety is not uncommon, working with patients at some of the worst times in their life is also stressful. She believes that the self-care strategies you develop in nursing school to lower anxiety can help in the workplace.
“Don’t forget to breathe,” she says. “Take a few minutes and practice deep breathing exercises. Get plenty of sleep. Eat healthy meals. Get some sunshine. Practice self-care. It will help you to be successful in nursing school and set you up for future success as you begin your career in nursing.”
7. Practice Positivity
Burke compares thinking positively to self-management. She noted there are years of research that demonstrate what you say to yourself has a powerful impact on your outlook and a major impact on your anxiety.
Burke recommends taking three intentionally positive steps to reduce your stress and nursing school anxiety. These include:
- Using positive affirmations: What you say and focus on in life will expand. See yourself as being successful.
- Being kind to yourself: Remember that people, pets, and plants all respond to kindness and care, and so will you.
- Having courage: Courage is not the absence of fear; it is taking action despite the fear.
How Anxiety and Panic Attacks Impact Nursing Education
Anxiety and depression are two of the most common mental health issues students face, and they can take a significant toll on academics. The number of students in crisis or needing medical transport to a psychiatric facility has risen in the recent decade.
In the American College Health Association Spring 2014 National College Health Assessment, 21.9% of students reported anxiety affected their academic performance and 30% said stress affected their academics.
Of the students asked, 56.9% felt overwhelming anxiety. One of the most important aspects of treatment is to take anxiety seriously. Since the condition affects people differently, behavior and symptoms can look bizarre to other students. It is counterproductive to downplay the condition and symptoms. Baxter believes that one of the biggest sources of nursing school anxiety is fear.
“The fear of failing, of not living up to expectations. This is why I encourage you to be prepared. If you ‘fail’ a test, a quiz, or class, it is a setback but not the end of the world. You can recover. You can try again and learn from those mistakes,” she says.
Despite the fact that depression and anxiety in nursing school are treatable, many students are reluctant to get help. Nurses and nursing students have an added stress factor not faced by other college students or professionals.
“Another anxiety that students have is, ‘What if I make a mistake in clinical? What if someone gets hurt?’ This is where practice comes into play. That is why spending time in the clinical lab is important,” Baxter explains.
Anxiety can affect school performance and self-care activities. This sets up a vicious circle for the nursing student. The less they take care of themself, the more anxiety they experience. And as anxiety rises, they take care of themself even less.
Panic and anxiety attacks can feel the same. They share similar symptoms, but anxiety usually builds gradually and panic attacks occur suddenly, triggering the body’s fight-or-flight system. Panic attacks in nursing school can be scary.
Some students have found that nursing school is the first time they experience a panic attack. It’s important to use several strategies to manage them. The first is to recognize that you are having or have had a panic attack in nursing school.
Coping with panic attacks in nursing school can look like: seeking regular therapy, deep breathing, mindfulness, muscle relaxation, light exercise, or aromatherapy. Building a relationship with a therapist can give you the tools to cope with anxiety throughout many parts of your nursing career.
Meet Our Contributors
Sheila A. Burke, DNP
heila A. Burke is the national dean of nursing for Pacific College of Health and Science and has held national nursing leadership positions for more than 25 years. The past 15 years her focus has been on leading nursing education programs. Before working with nursing education, Burke was a nurse leader in hospice and palliative care organizations that served diverse populations in Chicago, San Diego, and the Dallas area. She has served as an ANA board member for the Illinois chapter. Burke has designed wellness programs and is trained in reiki, yoga nidra, and mindfulness-based stress reduction.
Tina M. Baxter, MSN, APRN, GNP-BC
Tina M. Baxter is an advanced practice registered nurse and a board certified gerontological nurse practitioner through the American Nurse Credentialing Center. Baxter has been a registered nurse for over 20 years and a nurse practitioner for 14. She is the owner of Baxter Professional Services, LLC, a consulting firm which provides legal nurse consulting services for attorneys and insurance professionals; wellness and chronic disease management coaching; and customized educational and operational resources to healthcare organizations. She is also the founder of The Nurse Shark Academy where she coaches nurses to launch and scale their businesses. Baxter has contributed to Entrepreneur.com, The Minority Nurse, LinkedIn, as well as numerous podcasts.