U. of Nebraska Aims to Break Nursing Students' Stress-Induced 'Bottleneck'

New study to determine whether stress-reduction techniques can remedy nursing students' struggle to graduate.

While stress is no stranger to nurses, it frequently begins long before they start their first job.

Indeed, research indicates that nursing students experience higher stress levels compared to other majors and that these levels are on the rise. The result is a “bottleneck” or struggle to graduate, which has further effect on a dire workforce shortage.

Cathy Tierney, EdD, assistant professor of nursing at the University of Nebraska Medical Center College of Nursing’s Northern Division and her colleagues are looking into this challenge with a two-year study, “Bottleneck Reduction: Use of Simulation and Stress Reduction Apps in BSN Courses to Increase Academic Success.”

The “bottleneck” is not new, Tierney said, and faculty often recognize it.

“If students struggle in the first and second semester, usually by the third and fourth semester, you can tell the difference,” she said.

For nursing students working through their final year of attaining a Bachelor of Science in Nursing (BSN), stress comes from three primary areas, according to a 2022 nursing study:

1. Academic stressors: Exams, anxiety of failure
2. Clinical stressors: Extreme fear of failure, negative reaction to death or patient pain
3. Personal/social stressors: Economic problems, family issues

Additionally, demands of studying, completing didactic and clinical assignments, and doing actual clinicals leave little free time for nursing students, the study says.

Clinical placements may require nursing students to spend considerable time away from campus and the feeling of being responsible for the well-being of patients can be overwhelming—both of which remove nursing students from the normal social developmental activities of their same-age peers, the study says.

Nursing students participating in the “bottleneck” study, which began January 1, are coached on meditation and stress-reduction techniques. They also are working with faculty to develop individualized study plans.

“We’re being proactive to address student stressors and develop a plan for success by making sure students are familiar with the academic resources available,” says Tierney, who has expertise in wellness and self-care.

Tierney completed her Doctor of Education at Bryan College of Health Sciences in 2021 with a dissertation topic on how traditional nursing programs incorporate self-care practices into the student nurse experience. She has extensive experience using complementary modalities to promote self-care and holistic wellness, and has practiced as a certified hypnotherapist and healing touch practitioner.

Additionally, the study includes incorporating simulation into classroom content, which is offered to all students regardless of whether they participate in the study.