free peer reviewed journals nursing

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Nursing License Map / Resources / Nursing Student and Professional Toolbox / Online Nursing Journals

Free Online Nursing Journals

Nursing journals primarily focus on research and evidence-based information, offering insight to nurses and those looking to become a nurse. They often present, review, communicate and offer critiques about nursing issues, which may support both academic progress and careers of nurses.

Nursing journals can be general to the profession or specific to  nursing specialties , such as oncology nurse or geriatrics nurse. 

Here is a selection of online nursing journals. These free journals may contain some articles that require purchase.

Advanced Emergency Nursing Journal

Description:  This is a peer-reviewed journal for advanced practice clinicians, healthcare professionals, clinical nurse specialists, nurse practitioners, and academic and clinical educators in emergency nursing. Feature articles focus on current content for experienced clinicians and advanced practice nurses in emergency care. 

Website:  Advanced Emergency Nursing Journal

Advances in Neonatal Care

Description:  This journal from the National Association of Neonatal Nurses promotes evidence-based care and improved outcomes for infants and their families. It publishes clinical practice articles and original research, including peer-reviewed editorials. This journal includes detailed teaching and visual aids, such as Research to Practice, Cultivating Clinical Expertise, Family Teaching Toolbox and Online Features. 

Website:  Advances in Neonatal Care

American Journal of Nursing (AJN)

Description:  This highly honored nursing journal is the world’s oldest. Evidence-based and peer reviewed, it is considered the profession’s premier journal. The journal says its mission is to promote excellence in nursing and healthcare through the dissemination of original research and clinical information, adherence to the standards of journalistic integrity and excellence, promotion of nursing perspectives to the healthcare community and the public, and discussion of relevant and controversial professional issues. 

Website:  AJN, American Journal of Nursing

Birth: Issues in Perinatal Care

Description:  This is an interdisciplinary journal publishing original research, meta analysis of existing studies and systematic reviews, along with commissioned commentaries about maternal and newborn public health and perinatal clinical care. The journal says its readers are obstetrics, public health, and neonatology; childbirth educators; lactation counselors; midwives; physicians; doulas; social scientists; epidemiologists; psychologists; and other policymakers and health workers in perinatal care.

Website:  Birth: Issues in Perinatal Care

Clinical Journal of Oncology Nursing

Description:  This is an official journal of the Oncology Nursing Society (ONS). It is intended for practicing nurses specializing in the care of patients with an actual or potential cancer diagnosis. The journal seeks to share evidence-based, clinically relevant content for oncology nurses to use when caring for cancer patients. ONS says the journal is intended to promote the society’s mission, which is to advance quality cancer care and excellence in oncology nursing. 

Website:  Clinical Journal of Oncology Nursing

Clinical Nurse Specialist: The Journal for Advanced Nursing Practice

Description:  This journal says its mission is to foster continued development of the clinical nurse specialist role, to share outcomes and to highlight contributions globally. It is the official journal of the National Association of Clinical Nurse Specialists. 

Website:  Clinical Nurse Specialist: The Journal for Advanced Nursing Practice

Critical Care Nurse

Description:  This bimonthly peer-reviewed journal says it intends to provide critical and acute care nurses with useful, relevant and evidence-based information concerning the bedside care of acutely ill and critically ill patients. It also aims to keep acute and critical care nurses up to date on issues that affect the safety and quality of their practice. 

Website:  Critical Care Nurse

Evidence Based Nursing

Description:  This journal systematically searches a wide range of global healthcare journals and applies criteria for research validity and relevance to best practices in nursing. Content is critically appraised and the most relevant articles are summarised, focusing on the papers’ key findings and implications for nursing practice.

Website:  Evidence Based Nursing

Geriatric Nursing

Description:  This journal is a comprehensive source for clinical information and management advice relating to the care of older adults. Its peer-reviewed articles provide practical advice on care of older adults across the long-term continuum and report the latest developments in the management of acute and chronic disorders. The journal is written specifically for nurses and nurse practitioners who work with older adults in any care setting.

Website:  Geriatric Nursing

Heart & Lung; The Journal of Acute and Critical Care

Description:  This is the official publication of The American Association of Heart Failure Nurses, presenting original, peer-reviewed articles on investigations,techniques, advances and observations related to the care of patients with chronic cardiac or pulmonary disorder and patients with acute and critical illness.

Website:  Heart & Lung; The Journal of Acute and Critical Care

Holistic Nursing Practice

Description:  This bimonthly peer-reviewed journal explores holistic models of nursing practice. Content emphasizes complementary holistic and traditional nursing and healthcare practices. Rather than focusing on disease process and deficit, the holistic approach emphasizes the potential for health and healing in human systems.

Website:  Holistic Nursing Practice

Home Healthcare Now

Description:  This is a professional, contemporary journal serving the educational and communication needs of hospice and home care nurses. It focuses on the interdisciplinary, multidimensional and specialty practice areas of home care nursing. The core of the publication is operational, clinical and educational home care nursing issues.

Website:  Home Healthcare Now

Intensive and Critical Care Nursing

Description:  The mission of this journal is to aid specialist nurses in their care of critically ill patients; to provide an interdisciplinary and international forum for the publication, dissemination and exchange of experience, ideas and research findings; and to develop and enhance the knowledge, attitudes, skills and creative thinking essential to good critical care nursing practice.  

Website:  Intensive and Critical Care Nursing

International Journal of Nursing Practice

Description:  This journal is a fully refereed publication with original scholarly work advancing the international understanding and development of nursing as a profession and academic discipline. It focuses on professional discussion papers and research with a sound theoretical, scientific or philosophical base.

Website:  International Journal of Nursing Practice

International Nursing Review

Description:  This is the official journal of the International Council of Nurses (ICN). It is a quarterly, peer-reviewed journal focusing predominantly on nursing and health policy issues of relevance to nurses. The journal solicits original articles that advance the council’s global mission by representing and advancing the profession of nursing, and shaping health policy.

Website:  International Nursing Review

Journal for Nurse Practitioners

Description:  This nursing journal offers peer-reviewed, high-quality clinical articles, continuing education, original research and departments that help practitioners as providers of primary and acute care across the lifespan. The journal is an official publication of the American Association of Nurse Practitioners and is affiliated with the Australian College of Nurse Practitioners.

Website:  Journal for Nurse Practitioners

Journal of Christian Nursing

Description:  This is a quarterly, peer-reviewed, professional journal that since 1984 has helped nurses integrate faith and nursing practice. Its stated mission is to help nurses, students and educators practice from a Christian, biblically-based perspective. It offers relevant information on clinical topics, research, healthcare missions, nursing education, ethics, spiritual care, faith community nursing, and self-care and personal growth.

Website:  Journal of Christian Nursing

Journal of Clinical Nursing

Description:  This is a peer reviewed, international scientific journal that seeks to promote the development and exchange of knowledge relevant to nursing practice. The primary aim is to promote a high standard of clinically related scholarship supporting and advancing the practice and discipline of nursing. 

Website:  Journal of Clinical Nursing

Journal of Emergency Nursing

Description:  This official journal of the Emergency Nurses Association (ENA) focuses on the dissemination of peer-reviewed, high-quality manuscripts relevant to all areas of emergency nursing practice across the lifespan. Its content includes integrative or systematic literature reviews, clinical topics, research and initiatives to improve emergency nurse practice.

Website:  Journal of Emergency Nursing

Journal of Psychiatric and Mental Health Nursing

Description:  This is an international journal which publishes scholarly papers and research that advance the development of practice, policy, research and education in all aspects of mental health nursing. The journal publishes rigorously conducted research, essays and debates, literature reviews, and consumer practitioner narratives.

Website:  Journal of Psychiatric and Mental Health Nursing

Nursing & Health Sciences

Description:  This is a leading international journal focused on the global exchange of knowledge in nursing and health science. It also is intended to advance research and practice across health disciplines. The journal provides a forum for original research along with scholarly and systematic reviews focused on health science, clinical practice and education from around the world.

Website:  Nursing & Health Sciences

Public Health Nursing

Description:  This journal publishes program evaluations, empirical research reports and case reports focused on populations at risk across the lifespan. It also prints articles related to developments in practice; methodological innovations; education of public health nurses; theory development; legal, ethical, and public policy issues in public health; and the history of public health nursing throughout the world.

Website:  Public Health Nursing

Information on this page was last updated in June 2021.

Today’s Nursing Shortage: Workforce Considerations

Overview and Summary: Today’s Nursing Shortage: Workforce Considerations

The 6 new articles in the new OJIN topic, Today’s Nursing Shortage: Workforce Considerations , present contemporary aspects of the nursing shortage and actual and potential factors of concern.

ANA members  have the first opportunity to access the most recent OJIN topic.  LOGIN is required . When each new topic is posted, the previous topic becomes available to all viewers. This topic will be available after September 30, 2024 .

The Contingent Nursing Workforce during COVID-19: Implications for Policy and Administration

Addressing the shortage of academic nurse educators: enlisting public and business sectors as advoca, members get more from ojin.

ANA members have the first opportunity to access the most recent OJIN topic.

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83. Contemporary Perspectives on Poverty

82. Nurses’ Impact on Firearm Safety

81. Virtual Opportunities for Nurses

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Factors associated with working during the covid-19 pandemic and intent to stay at current nursing p, supporting healthy nurse-to-nurse relationships as experienced nurses transition to new clinical spe, distressed but not deterred: nurses reveal solutions to the nursing shortage in the aftermath of a p, registered nurses leaving the profession in the first two years.

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I am writing in response to the article titled, “In Service to Others: APRNs as Serving Leaders During the COVID-19 Pandemic”... Continue reading

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Current issue, july 2024 - volume 27 - 3.

Research made simple

Evidence for nurse education, commentaries.

• Maternal inequality: scoping the threats and reflecting on our opportunities to affect positive change (31 May, 2024) Free Elizabeth Bailey , Lizzie Ette
• Enhancing collaboration through interprofessional learning (13 June, 2024) Michael J Tatterton , Claire Bethell
• Evaluating women’s experiences of labour pain: beyond a generic pain scale (6 December, 2023) Tanya Capper , Bridget Ferguson
• Discrimination during childbirth among black birthing people predicts postpartum care utilisation (12 December, 2023) Sonia Minooee
• Experiencing perinatal mental health difficulties as a non-birthing mother in a female same-sex couple: a wider reflection on heteronormative cis-gendered care in maternity services (23 November, 2023) Alessio Gubello
• Individuals with autism are at a higher associated risk of developing cardiometabolic diseases (26 December, 2023) Joe Davis
• Looking after people with mental health and/or substance misuse problems in emergency departments is not easy (14 November, 2023) Andrew Molodynski
• Primary care identification of mental health issues in adults with learning disabilities requires screening measures, practitioner training, collaboration and raising awareness in this population (8 November, 2023) Meenakshi Shukla
• Prehospital transfusion in paediatric trauma can improve patient outcomes: further research and collaboration is needed to increase availability and appropriate application (8 November, 2023) Kelly Nwankiti
• Influence of the COVID-19 pandemic on early child development: exploring individual variations, nursery daycare quality and parental depression (7 November, 2023) Cindy-Lee Dennis , Gerry Giesbrecht , Nicole Letourneau
• Children with prolonged fever are more likely to harbour serious bacterial infections (10 November, 2023) Aneesh Basheer
• Shared decision-making instead of physician-led end-of-life decision-making for children with life-limiting conditions (23 November, 2023) Seyed Qasem Mousavi , Salman Barasteh
• Understanding the association between COVID-19 and new-onset diabetes in children, including diabetic ketoacidosis (DKA) (4 October, 2023) Marion Waite , Katie Hards
• Adult nursing: Holistic care is a key research priority for chronic musculoskeletal pain: findings from an evidence and gap map (15 November, 2023) Dawn V Ernstzen
• Adult nursing: Patients with diabetes mellitus are more likely to present without typical chest pain during a myocardial infarction (28 September, 2023) Tasmira Mohib , Tanvir C Turin
• Adult nursing: Cessation of driving has important psychosocial implications for people living with young-onset dementia and their families (11 October, 2023) Samantha M Loi
• Adult nursing: Emerging evidence for nurse-led interventions in patients with systemic lupus erythematosus and systemic sclerosis (31 October, 2023) Anne-Marie Tetsche Sweeney , Mwidimi Ndosi
• Adult nursing: Enhancing arthroplasty rehabilitation: mobile application-based programs are acceptable and potentially feasible (16 November, 2023) Shayan Bahadori
• Adult nursing: Improving delirium detection with the 3D-CAM: a path towards enhanced patient outcomes (22 September, 2023) Hui-Chen (Rita) Chang
• Study findings suggest the benefit of immediate debriefing for nurses in inpatient acute mental health following seclusion room interventions to reflect on practice and improve patient care (13 September, 2023) Michelle C Danda
• Impact of the internet on everyday life: experiences of a clinical sample of adolescents with problematic internet use (3 August, 2023) Alessio Gori , Eleonora Topino
• Managing multimorbidity in midlife may reduce the risk of developing dementia as we age (16 November, 2023) Valentina Spedale , Paolo Mazzola
• To treat suicidality and impulsivity in bipolar disorders, inclusive, effective and evidence-based psychological interventions should be developed (10 November, 2023) Akhtar Ebrahimi Ghassemi
• Qualitative study of forensic psychiatric nurses’ experiences of delayed decisions on involuntary treatment (9 November, 2023) Etienne Paradis-Gagné
• Video is an invaluable tool for attaining psychomotor skills in nursing (13 October, 2023) Rasoul Tabari-Khomeiran
• Minority ethnic student nurses cannot see themselves in senior roles and why it matters! (19 October, 2023) Irtiza Qureshi , Emma Wilson
• Positive attitude does not automatically lead to increased genetic and genomic literacy (14 November, 2023) Arja Halkoaho , Mari Laaksonen
• Alignment of intrinsic and extrinsic motivators are required to encourage nurse educators to remain in academia (14 November, 2023) Rob Allison
• Rigorous simulation design grounded in best practice reduces learner anxiety (4 October, 2023) Jennifer Dale-Tam
• What matters the most to the older person is pain care provision that is cost-effective (9 January, 2024) Joanne Harmon
• Putting insomnia to bed: nurse-led insomnia therapy is effective in primary care (4 January, 2024) Christopher Gordon
• Use of technologies by nursing improves adherence to hypertension treatment (23 November, 2023) Ana Luiza Lima Sousa
• Navigating the complexities of family resilience in cancer care: unearthing key determinants (13 December, 2023) Abdulqadir J Nashwan
• Unmet needs for terminally ill patients without cancer receiving specialist palliative care (6 December, 2023) Wei-Min Chu

Issue Information

• Table of Contents (PDF)
• Front Cover
• Editorial Board (PDF)

• ABOUT US About the Journal About the Publisher Editorial Board FAQs Journal Metrics --> Open Access Policy Open Url Guidelines
• ETHICAL GUIDELINES Allegations from Whistleblowers Conflict of Interest Fabricating and Stating False Information Plagiarism Prevention Post Publication Discussions and Corrections Publishing Ethics Research Misconduct
• FOR EDITORS & REVIEWERS Editorial Management Editorial Policies Ensuring Content Integrity Ethical Guidelines for New Editors Guest Editor Guidelines Peer Review Workflow Publication Process Guidelines for Peer Reviewers
• FOR AUTHORS Archiving Policies Article Processing Charges Author Benefits Authorship Bentham Manuscript Processing System Institutional Membership Instructions for Authors Manuscript Transfer Facility Special Fee Waivers and Discounts

The Effectiveness of eHealth Interventions-based Self-care on Health-related Quality of Life for Patients with Heart Failure

• Reda Mohamed El-Sayed Ramadan, Atallah Alenezi, Nehal Abd Elazim Youssef Abd ELmeguid, Eman Sobhy Elsaid Hussein

Corrigendum to DONAPP: A Centralized Platform for Bridging the Gap between Donors and Recipients

• Shilpi Singh
• Saurabh Sambhav
• Vinayakumar Ravi
• Apurva Arya
• Tahani Jaser Alahmadi
• Prabhishek Singh
• Manoj Diwakar

Premenstrual Dysphoric Disorder: Knowledge, Attitude and Practice Among Egyptian Females: Results of Surveying Two Centers in the Delta Region

• Eman Ibrahim Abd Elrehim
• Ahmed Yousef
• Mohamed Bendary
• Rania El-Kurdy
• Aisha Ghanem Abd El Lateef
• Rasha Ezzat Elsayed
• Ayman Al Hosainey Abd Almaksoud
• Ayman Hamdan-Mansour

DONAPP: A Centralized Platform for Bridging the Gap between Donors and Recipients

Exploration of multicultural student education on ethical issues in an australian undergraduate nursing curriculum.

• Angela Dawn Sheedy

ISSN (Online): 1874-4346

Volume: 18, 2024.

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AIMS AND SCOPE

The Open Nursing Journal is an open access journal, that publishes research articles, reviews/mini-reviews, letters and guest edited thematic issues in all areas of nursing.

The Open Nursing Journal a peer-reviewed journal, is an important and reliable source of current information on developments in the field. Emphasis is placed on publishing quality papers, making them freely available to researchers worldwide.

We welcome papers related to nursing and midwifery, with specific relevance to health care practice, policy and research. We publish under the following themes:

• Nursing and Midwifery practice
• Research methodology
• Evidence based practice
• New role in practice
• Systematic reviews
• Case studies
• Ethical and professional issues
• Management in health care
• Sustainability in health and health care provision

All authors should make clear how the implications of their paper for nursing, midwifery and health care practice. They should also clearly identify the ‘take home message’ from their paper.

ABOUT THE EDITOR

Dean whitehead.

Affiliation:

Institute of Health and Wellbeing Federation University Australia Ballarat Australia

Editor's Choice

The Effectiveness of Care Bundles Including the Braden Scale for Preventing Hospital Acquired Pressure Ulcers in Older Adults Hospitalized in ICUs: A Systematic Review

Volume: 15 (2021): 74

Natalie A. Floyd, Karen A. Dominguez-Cancino, Linda G. Butler, Oriana Rivera-Lozada, Juan M. Leyva-Moral and Patrick A. Palmieri

Night-time Noise Levels and Patients’ Sleep Experiences in a Medical Assessment Unit in Northern England

Volume: 14 (2020): 80

Felicity Astin, John Stephenson, Jonathan Wakefield, Ben Evans, Priyanka Rob, Garside Joanna and Emma Harris

Revisiting The Meaning of A Good Nurse

Volume: 13 (2019): 75

Go-Un Kim, Eunyoung Jung, Mikyeong Cho, Soo Y. Han, Mira Jang, Mikyung Lee, Sumi Lee, Yujin Suh, Hye Y. Yun, Sue Kim and Mi So Shim

m-Health in the Surgical Context: Prospecting, Review and Analysis of Mobile Applications

Volume: 13 (2019): 18

Alvaro F. L. de Sousa, Lucas L. Bim, Guilherme Schneider, Paula R. de Souza Hermann, Denise de Andrade and Inês Fronteira

Evaluating Pictures of Nature and Soft Music on Anxiety and Well-Being During Elective Surgery

Volume: 12 (2018): 58

Elinor Nielsen, Ingrid Wåhlin and Gunilla Hollman Frisman

Shared Decision-Making for Nursing Practice: An Integrative Review

Volume: 12 (2018): 1

Marie Truglio-Londrigan and Jason T. Slyer

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Press Release

Bentham is proud to announce collaboration with elsevier, three bentham open journals receive impact factors, the nursing journal directory indexes bentham journal, the open public health journal, advertisement.

Online Journal of Nursing Informatics

Powered by the HIMSS Foundation and the HIMSS Nursing Informatics Community, the Online Journal of Nursing Informatics is a free, international, peer-reviewed publication that is published three times a year and supports all functional areas of nursing informatics. The journal was launched in 1996, with readership spanning over 49 countries.

Current Issue

View the most recent issue of the Online Journal of Nursing Informatics (OJNI) : Volume 26, Number 3 (Spring 2023) .

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License .

Submissions

We welcome voluntary submissions on a rolling basis. Manuscripts must represent original, unpublished material and represent a functional area of nursing informatics. Letter of inquiries to the OJNI Editorial Team are welcome. Manuscripts undergo a double-blind, peer review process. A decision to publish is based upon the reviews.

The Online Journal of Nursing Informatics is an open-access journal. All content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. 

Explore the Author Submission Guidelines

Explore the Peer Review Process

5/22/2023: We are currently suspending new manuscript submissions.

Current Archives

Volume 26, Number 2 (Fall 2022)

Volume 26, Number 1 (Winter 2022) .

Volume 25, Number 2 (Summer 2021) .

Volume 25, Number 1 (Spring 2021) .

Volume 24, Number 3 (Fall 2020)

Volume 24, Number 2 (Summer 2020)

Volume 24, Number 1, (Winter 2020) .

Volume 23, Number 3, (Fall 2019)

Volume 23, Number 2, (Summer 2019) .

Volume 23, Number 1, (Winter 2019)

Past Editions/Archives

Volumes 1 – Current Archives

Meet the OJNI Editorial Team

Meet the editorial team behind the Online Journal of Nursing Informatics, a volunteer-led effort committed to enhancing nursing informatics knowledge for nurses working in diverse settings.

Call for Peer Reviewers

OJNI is currently seeking experienced peer reviewers to review manuscripts. Get involved and join the OJNI team! 

Peer reviewer qualifications include:

• Previous peer review/publication experience
• Familiar with APA
• Masters level education
• Nursing Informatics expertise

If you are interested please provide a cover letter along with a writing sample to the  Online Journal of Nursing Informatics .

Contact HIMSS Staff

Tammy Kwiatkoski , MBA Director, Clinical Informatics, HIMSS

Cait Michicich, MBA Program Manager, Clinical Informatics, HIMSS

Empowering Nursing Informatics Professionals

The HIMSS Nursing Informatics Committee is helping unite the languages of healthcare, nursing, information and technology into one. #Nurses4HIT

Join Them in Their Mission

Nurses Week 2024

Visit the Nurses Week 2024 website opens in new tab/window , created especially for you and updated throughout the year. This resource includes well-being support, key topics affecting nurses in healthcare, inspirational videos, OnDemand webinar recordings, and current articles .

Nurses make the difference

Open access options.

All of Elsevier’s nursing journals support open access publishing, including our Gold Open Access titles  International Journal of Nursing Studies Advances opens in new tab/window ,  International Journal of Africa Nursing Sciences opens in new tab/window ,  International Journal of Nursing Sciences opens in new tab/window ,  Asia-Pacific Journal of Oncology Nursing opens in new tab/window ,  Asian Nursing Research opens in new tab/window ,  Health Care Transitions opens in new tab/window  and  Measurement and Evaluations in Cancer Care opens in new tab/window . Each journal lists its Open Access details in the guide for authors. All open access articles published by Elsevier have undergone peer review and are immediately and permanently free for everyone to read and download.

Nursing resources

Nursing & midwifery catalog of journals, nursing article collection: diversity, equity & inclusion, open access publishing for nursing, jognn: women’s health manuscript submissions, publishing with elsevier.

Elsevier publishes more than 40 titles across the nursing spectrum, and we have free resources for the thousands of authors, reviewers, and editors that collaborate to make them successful.

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ANA Journals

ANA Enterprise is committed to supporting the more than 5 million registered nurses in the U.S. in reaching their true potential. As part of that commitment, we ensure our members are kept up to date with the latest developments in health and health care; from clinical and practical nursing topics, to helping with career progression, as well as providing the latest news from the ANA Enterprise.

We do this through several journals, made available to all our members and the wider nursing community as a whole:

American Nurse Journal

The official journal of the American Nurses Association (ANA), and rated as a highly valuable benefit of membership by ANA members,  American Nurse Journal is read by 175,000 nursing professionals.

Every edition features peer-reviewed features and articles written to keep nurses abreast of the latest developments in health care, and supply them with the latest information that will enhance patient outcomes. Equally as important, the journal also provides advice and help on dealing with the day-to-day issues nurses can be faced with, such as dealing with workplace fatigue or finding a new position.

READ AMERICAN NURSE JOURNAL

OJIN: The Online Journal of Issues in Nursing

One of the cornerstones of our profession is collaboration. Nurses have always sought to share their experiences and ideas with their peers in order to find new ways of delivering quality health care. OJIN: The Online Journal of Issues in Nursing is the space where they can do just that.

A peer-reviewed, digital-only publication, every month OJIN provides a collection of invited articles written by national and international experts which are then openly discussed by the community. This interactive format encourages a dynamic dialogue, resulting in a comprehensive discussion of the topic. From this, the OJIN community helps build up a shared knowledge base, and even suggests policy implications that can enhance the health of the public.

READ OJIN: THE ONLINE JOURNAL OF ISSUES IN NURSING

The American Nurse

For almost 50 years,  The American Nurse  newspaper was the official member news periodical of the American Nurses Association (ANA). Established in 1968,  The American Nurse  chronicled history as ANA’s work mirrored changes in the profession and society at large. Through its pages,  The American Nurse  helped to inspire, inform, and lead the profession. The November/December 2016 issue was the last issue of  The American Nurse . Beginning in January 2017, news of ANA is included in an expanded section, ANA on the Frontline, in its official journal,  American Nurse . 

The American Nurse  archives and web site at www.theamericannurse.org will remain available as member resources.

READ  THE AMERICAN NURSE  ARCHIVES

Find out more about the publications ANA Enterprise offers and learn how they can help you grow in your profession 

ANA ENTERPRISE PUBLICATIONS

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UpToDate is an evidence-based clinical point-of-care full text resource. Aimed towards students, professionals, and patients, includes the latest information about drugs & diseases. Updated daily, peer-reviewed by expert physicians, and highly reliable. Coverage is extensive, and entries include references. Also includes a number of calculators/assessment tools, scores, scales, and medical equations. Searchable Lexicomp® Drug Interactions, and "What's New" section. 

*When first accessing UpToDate through NMU Library, please create your own account, which will allow access from multiple devices, save/bookmark entries & search history, and track CME/CE/CPD credits.

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Journals, books, and other resources on subjects including nursing, emergency services, nutrition, occupational therapy, physical therapy, optometry, public health, speech-language pathology & audiology, and surgical technology. 1937 to present.

Journal articles covering biomedical research and the clinical sciences including nursing, dentistry, veterinary medicine, pharmacy, allied health, and pre-clinical sciences. Also good coverage of literature in cellular and molecular biology and biochemistry. Formerly known as MEDLINE. Mid 1960's to present.

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Children participate in social media challenges to satisfy their developmental needs. Unfortunately, joining these challenges may subject children to peer pressure, cyber-bullying, and physical dangers. Nurses must be well-versed in social media benefits, risks, and safety to provide appropriate guidance to families and advocate for them and safe social media use.

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Pediatric nursing is a fulfilling career, but what happens when a pediatric nurse finally faces the day when they are unsure if they can do the job anymore? The author reflects on caring for a young patient with a brain tumor, and how this experience put him at a crossroads in his nursing career.

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Nursing Research: What It Is and Why It Matters

When people think about medical research, they often think about cutting-edge surgical procedures and revolutionary new medications. As important as those advancements are, another type of research is just as vital: nursing research.

This type of research informs and improves nursing practice. In many cases, it’s focused on improving patient care. Experienced nurses who have advanced nursing degrees and training in research design typically conduct this research.

Nurse research can explore any number of topics, from symptomology to patient diet. However, no matter the focus of a research project, nurse research can improve health care in an impressive number of ways. As experts in their field, nurse researchers can pursue a wide range of unique career advancement opportunities .

Why Nursing Research Matters: Examples of Research in Action

Research drives innovation in every industry. Given that nurses are on the front line of the health care industry, the research they do can be particularly impactful for patient outcomes. 

It Can Improve Patients’ Quality of Life

Patients diagnosed with life-threatening chronic diseases often undergo intense treatments with sometimes debilitating side effects. Nursing research is vital to helping such patients maintain a high quality of life.

For example, a 2018 study led by a nurse scientist explored why cancer patients undergoing chemotherapy frequently experience severe nausea. While the physical toll of chemotherapy contributes to nausea, the study found that patients who have factors such as children to take care of, high psychological stress, and trouble performing day-to-day tasks are often much more likely to experience nausea.

By identifying the root causes of nausea and which patients are more likely to experience it, this research allows health care professionals to develop evidence-based care practices . This can include prescribing anti-nausea medications and connecting patients to mental health professionals.

It’s Central to Making Health Care More Equitabl

A Gallup survey reports that about 38% of Americans put off seeking medical treatment due to costs. Unfortunately, cost is only one factor that prevents people from seeking treatment. Many Americans don’t live close to medical providers that can meet their needs, aren’t educated about health, or encounter discrimination.

As complex as this issue is, the National Institute of Nursing Research (NINR) asserts that the country’s nurse researchers can lead the charge in tackling it. In its strategic plan for 2022 to 2026, the institute highlights the following:

• Nursing has long been one of the most trusted professions in the country.
• Nurses often interact with patients, patients’ families, and communities more frequently than other health care professionals.
• The care that nurses provide must often take environmental and social factors into account.

These traits put nurses in the position to not only research health inequity but also put their research to work in their organizations. To help make that happen, NINR often funds nurse-led research projects focused on equity and social determinants of health. With that kind of backing, the field may become more transformative than ever.

It Can Strengthen the Health Care Workforce

While nursing research can be used to improve patient care, it can also be leveraged to solve issues health care professionals face daily. Research about the state of the health care workforce during the COVID-19 pandemic is a perfect illustration.

In 2022, a team of nurse researchers published a report called Nursing Crisis: Challenges and Opportunities for Our Profession After COVID-19 in the International Journal of Nursing Practice . In it, the authors provided concrete statistics about the following:

• Mental and physical health issues many nurses encountered
• Effects of increased workloads and decreased nurse-to-patient ratios
• How many nurses were planning to leave the profession altogether

As nurses themselves, the authors also offer actionable, evidence-based solutions to these issues, such as streamlining patient documentation systems and implementing employee wellness programs.

However, this type of research isn’t just important to solving workforce issues stemming from specific emergencies, such as the COVID-19 pandemic. By publishing quantifiable data about the challenges they face, nurse researchers empower other nurses and professional nursing organizations to advocate for themselves. This can help employers enact effective policies, support their nursing staff, and draw more talented people into the profession.

Career Opportunities in Nursing Research

Nurse researchers can work in any number of administrative, direct care, and academic roles. However, because nurse research often requires clinical care and data analysis skills, jobs in this field typically require an advanced degree, such as a Master of Science in Nursing (MSN).

While many more nurse research career opportunities exist, here are four career paths nurses with research experience and advanced degrees can explore.

Nurse Researcher

Nurse researchers identify issues related to nursing practice, collect data about them, and conduct research projects designed to inform practice and policy. While they often work in academic medical centers and universities, they can work for any type of health care provider as well as health care advocacy agencies.

In addition to conducting research, these professionals typically provide direct patient care. Many also write papers for peer-reviewed journals and make presentations about their work at conferences.

Clinical Research Nurse

Despite having a similar title to nurse researchers, clinical research nurses have slightly different responsibilities. These professionals are usually in charge of providing care to patients participating in medical research projects, including clinical trials and nursing research initiatives. They also typically collect data about patient progress, coordinate care between different team members, and contribute to academic papers.

Occupational Health Nurse

Also referred to as environmental health nurses, occupational health nurses serve specific communities, such as professionals in a particular industry or people who live in a particular area. They often educate their communities about relevant health risks, advocate for stronger health and safety regulations, and run wellness programs.

To carry out their duties, occupational and environmental health nurses must typically research health trends about the people they serve, including living and working conditions that put them at risk for illness or injury. They can work for private companies and government agencies.

Nurse Educator

Nurse educators prepare new nurses to enter the workforce or train experienced nurses in more advanced techniques. This can include teaching classes and providing on-the-job training. They often work for colleges, universities, and large health care providers.

While their duties don’t always include research, nurse educators must keep up with the health care industry’s needs and new patient care practices. This is so they can provide relevant education themselves and help their organizations design up-to-date curricula.

Make Nursing Research a Part of Your Journey

Conducting and implementing nurse research is a collaborative effort. It takes a team of informed leaders, skilled analysts, and creative educators to create effective, evidence-based policies. Those interested in pursuing nurse research should consider The University of Tulsa’s online MSN program , which can prepare you to fill any one of those roles and more.

All of TU’s MSN students take classes on research and evidence-based practices. However, the program’s specialty tracks allow students to take their studies in multiple research-oriented directions. For instance, if you’re interested in collecting and interpreting clinical data, you can choose the Informatics and Analysis track. If you have a passion for public health policy, the Public Health and Global Vision track includes classes on population health and epidemiology.

Delivered in a flexible online format, this program can be a great option for working nurses and nontraditional students alike. To find out more, read about TU’s admission policies and request more information today.

Recommended Readings

A Nurse Educator’s Role in the Future of Nursing

How Global Health Nursing Supports Population Health

What Can You Do With an MSN?

Gallup, “Record High in U.S. Put Off Medical Care Due to Cost in 2022”

International Journal of Nursing Practice, “Nursing Crisis: Challenges and Opportunities for Our Profession After COVID‐19”

Journal of Pain Symptom Management , “Risk Factors Associated With Chemotherapy-Induced Nausea in the Week Prior to the Next Cycle and Impact of Nausea on Quality of Life Outcomes”

Mayo Clinic, Nursing

National Institute of Nursing Research, Scientific Strategy: NINR’s Research Framework

National Institute of Nursing Research, The National Institute of Nursing Research 2022-2026 Strategic Plan

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• Published: 02 September 2024

Evaluation of stress, bio-psycho-social response and coping strategies during the practical training in nursing students: a cross sectional study

• Müjgan Solak   ORCID: orcid.org/0000-0001-6201-3139 1 ,
• Sevcan Topçu   ORCID: orcid.org/0000-0002-6228-1720 2 ,
• Zuhal Emlek Sert   ORCID: orcid.org/0000-0002-2809-5617 2 ,
• Satı Doğan   ORCID: orcid.org/0000-0002-9935-3265 3 &
• Fatma Savan   ORCID: orcid.org/0000-0002-4846-9129 2  

BMC Nursing volume  23 , Article number:  610 ( 2024 ) Cite this article

Metrics details

The aim of the study was to identify stress level, bio-psycho-social response and coping behavior of nursing students during the practical training.

A cross-sectional study was carried out with the 1st, 2nd, 3rd, 4th-year nursing students ( n  = 1181) between September 2018-may 2019. Data was collected using by Socio-Demographic Questionnaire, The Student Nurse Stress Index, The Bio-Psycho-Social Response Scale and Coping Behavior Inventory.

The fourth-grade nursing students’ stress level was found to be statistically significantly higher than of other graders. Nursing students have shown emotional symptoms and social-behavioral symptoms the most. To cope with stress, nursing students used the strategies transference, staying optimistic, problem-solving and avoidance, respectively.

Conclusions

These findings highlight the need to routinely evaluate nursing students for stress, bio-psycho-social response, and coping strategies during practical training. Thus, counseling units can be constituted by the nursing schools, and nursing students who have higher stress levels and inadequate coping strategies benefit from these units.

Peer Review reports

According to Lazarus and Folkman’s transactional theory of stress and coping, stress is a two-way process. Stress is defined as exposure to stimuli (as harmful, threatening, or challenging) that exceed the individual’s coping capacity [ 1 ]. There is a complex transaction between individual subjective reactions to stressors and stressors produced by the environment complex transaction. Transactional theory consists of cognitive appraisal, and coping. After a primary appraisal of the threat or challenge is made, a secondary appraisal process of identifying and selecting available coping options is made. Coping processes produce an outcome, which is reappraised as favorable, unfavorable, or unresolved [ 1 , 2 ].

Stress is accepted as a disease of the 20th century that affects many professions [ 3 ]. Health professionals, especially nurses encounter higher levels of stress and stress factors when their level of exposure to stress and the number of stress-sources are evaluated [ 4 ]. For nurses, stress starts from the beginning of training period and they experience the negative effects of stress on health for many years [ 5 , 6 , 7 ].

Nursing students experience different levels of stress both during their theoretical and practical training [ 8 , 9 ]. Sources of theoretical stress are constantly subjected to examinations, assignments about courses, length of lecture time despite the lack of free times and preparation process before practical evaluations [ 10 , 11 , 12 ]. But sources of practical training stress comprise of the followings; starting to practice for the first-time, clinical evaluations, feeling inadequate in practice, scaring to give patients any harm, caring for patients, relationships with healthcare workers, friends and patients [ 13 , 14 ]. Although nursing students experience stress due to many reasons both in practical and theoretical settings, practical training periods are expressed as periods in which nursing students experience the highest levels of stress [ 15 , 16 ].

Stress can sometimes be a source of motivation, however, high stress can affect coping, self-confidence, concentration, motivation, academic performance [ 9 , 17 ]. In addition, high stress levels may cause students to experience health problems such as hypertension, heart diseases, nutritional disorders, stammering, nausea, vomiting, exhaustion and depression [ 5 , 6 ]. It is stated that nursing students experience higher levels of stress and relevant physical and psychosocial symptoms when compared with the students of other health-related disciplines [ 15 , 18 ].

This situation makes coping strategies crucial for stress management. Coping is defined as constantly changing cognitive and behavioral efforts to manage specific external and/or internal demands that are appraised as taxing or exceeding the resources of the person [ 1 ]. The impact of stress on health depends on the adequacy of coping strategies that play a vital role in managing the stress [ 6 ]. As a strategy to cope with stress, nursing students prefer problem solving the most [ 8 , 11 , 19 ] and avoiding the least [ 5 , 6 , 8 ].

It was found in previous studies that the stress levels of nursing students differed according to classes. It is reported that stress levels are higher in nursing students in the upper grades and the initial clinical practice affects their stress levels [ 20 , 21 , 22 ]. In order to reduce the stress and its negative effects in nursing students, first of all, to determine their stress levels, their responses to stress, coping strategies and the factors affecting their stress levels is very important.

Research questions

What are the stress levels, bio-psycho-social responses, and coping behavior of nursing students during the practical training?

Which variables affect the stress level of nursing students?

A cross-sectional design was used.

Procedure and samples

The study’s population consisted of 1st, 2nd, 3rd, and 4th-year students [ n  = 1181] of nursing school. A cross-sectional study was conducted between September 2018-May 2019.Since it was aimed to reach the entire population, no sample selection method was used. The inclusion criteria for the study were (1) voluntary acceptance of study participation (2) being during the period of practical training. The number of students was 300 for first grade, 309 for second grade, 285 for third grade and 287 for fourth grade. All of the students [ n  = 996] who meet inclusion criteria are included in the study. The response rate of the questionnaires is 84%. ( n  = 996/1181).

Data was collected during the practical training for each grade. The Faculty of Nursing has an integrated education system. The integrated education system is based on holistic learning. It enables the student to see the big picture instead of learning small parts and subject areas are associated according to a subject. The integrated education programme, which includes a structuring from health to disease, is organised to include basic knowledge, attitudes and skills related to the subjects related to care. In the first, second and third years of the integrated education programme, courses are conducted as modules, active education methods are used, and skills training is provided in laboratories and clinics. The fourth year is organised as an internship programme. Practical training starts to in the second term of the first year in the Faculty of Nursing. 1st-year students have practical training consist of 13 h per week for one month in Primary and Secondary Schools. 2nd and 3rd-year students have practical training in Hospitals and Primary Care. The practical training of 2st-year students in the third semester consists of 24 h per week for one month in dermatology, otolaryngology clinics, eye clinics, etc. In the fourth semester, their practical training includes 24 h per week for two months in İnternal Medicine and Surgery clinics. The practical training of 3rd-year students comprises 24 h per week for three months in pediatrics, obstetrics (fifth semester) clinics and psychiatry clinics, primary care (sixth semester). 4th-year students (internship) are in practical training (eight different nursing fields fundamentals of nursing, internal nursing, surgery nursing, pediatric nursing, obstetric and gynecological nursing, psychiatric nursing, public health nursing) during the seventh and eighth semesters. They have practical training 32 h per week each semester.

Data collection tools

Data was collected using by Socio-Demographic Questionnaire, The Student Nurse Stress Index (SNSI), The Bio-Psycho-Social Response Scale (BPSRS) and Coping Behavior Inventory (CBI) Socio-Demographic Questionnaire consists of seven questions such as age, gender, grade, employment status, smoking status, choosing nursing profession willingly and academic status.

The student nurse stress index (SNSI): SNSI that developed by Jones & Johnstone (1999), consisted of 22 items, and four subscales which include academic load, clinical concerns, personal problems, and interface worries [ 23 ]. SNSI is a five-point Likert-type scale ranging from 1 [not stressful] to 5 [extremely stressful]. The Turkish validity and reliability study was conducted by Sarıkoç, Demiralp, Oksuz, Pazar, [ 24 ]. Its Cronbach α coefficient was 0.86. Turkish version of the scale consists of four subscales as personal problems, clinical concerns, interface worries, and academic load. The higher scores obtained from SNSI indicate the high-stress level.

The bio-psycho-social response scale (BPSRS): The BPSRS, developed by Sheu, Lin, Hwang (2002), consist of 21 items and three subscales about symptoms relating to the students’ physical, psychological and social health [ 25 ]. BPSRS five-point Likert-type scale from 0 to 4. Its Cronbach’s alpha coefficient was 0.90. A higher score indicated the presence of more symptoms and poorer physio-psychosocial status [ 25 ]. The Turkish validity and reliability study was conducted by Karaca et al. [ 26 ]. The Cronbach’s alpha coefficient of the Turkish version was found to be 0.91 [ 26 ].

Coping behavior inventory (CBI): The original version of CBI that developed by Sheu, Lin, Hwang, (2002), consists of 19 items and four subscales as avoidance, problem solving, stay optimistic and transference [ 25 ]. The scale is a five-point Likert-type scale from 0 to 4. Its Cronbach’s alpha coefficient was 0.76. A higher score in one factor indicated more frequent use of this type of coping behavior [ 25 ]. The Turkish validity and reliability study was conducted by Karaca et al. (2015) and its Cronbach’s alpha coefficient was 0.69 [ 26 ].

Data analysis

The data were evaluated using the SPSS 21 (Statistical Package for the Social Sciences). Descriptive statistics was used as mean and standard deviation. One way anova test was used to compare scale scores (SNSI, BPSRS, CBI) according to graders. Multiple regression analysis was used to determine the variables (gender, employment status, smoking status, willingness of the choice of the nursing profession, academic achievement status) affecting stress level. For all effects, we used the standard significance level of α = 0.05.

Ethical considerations

This study was approved by Ege University Scientific Research and Publication Ethics Committee (Approval Number: 56/2018). The participants received information about the research objectives and procedures, and their written permission was obtained by means of informed consent form before data collection.

The mean age of nursing students is 21.32 ± 1.57 years. Of the students, 91.9% are females and 26.5% are freshmen, and 5% are working outside the school (Table  1 ).

When nursing students’ total and subscale SNSI mean scores were compared, a statistically significant difference was found between the mean scores of total SNSI and academic loads, interface worries and clinical concerns subscale (Table  2 ). The first grade nursing students’ mean score of academic load subscale was found to be statistically significantly higher than of second and third graders ( p  < 0.05). The third and fourth grade nursing students’ interface worries subscale scores were also statistically significantly higher than of the first and second graders. In the clinical concerns subscale, the second and fourth grade nursing students had significantly higher clinical anxiety than the other graders and the first-year nursing students had lower clinical concerns than other graders. When the total SNSI mean scores were compared, fourth grade nursing students’ stress level was found to be statistically significantly higher than of other graders, and the first grade nursing students’ stress level was statistically lower than of other graders.

It was established that nursing students have shown emotional symptoms and social-behavioral symptoms the most, whereas physical symptoms were shown the least (Table  3 ). When the total and subscale mean scores of BPSRS were compared according to nursing students’ grades, a statistically significant difference was detected in subscales of total BPSRS, emotional symptoms and social behavioral symptoms. In the emotional symptoms subscale, the first year nursing students had less emotional symptoms than other graders. In the social behavioral symptoms subscale, the mean scores of fourth grade nursing students were found to be significantly higher than of other graders. When total BPSRS mean scores were compared, it was observed that the fourth grade students had more bio-psycho-social behavioral symptoms than the first grade students.

It was found that to cope with stress, nursing students used the strategies transference, staying optimistic, problem-solving and avoidance, respectively (Table  4 ). When nursing students’ behaviors related to coping with stress were evaluated according to grades, no statistically significant difference was found between the subscale scores of avoidance, staying optimistic and transference, whereas only the problem-solving subscale was statistically significant. In the problem-solving subscale, the problem-solving skills have increased significantly as the class increased ( F  = 72.63; p  = 0.00).

The relationship between nursing students’ stress level and gender, willingness to choose nursing profession, smoking status, employment status and academic achievement status was evaluated using regression analysis (Table  5 ). The extent to which nursing students’ stress levels were predicted by variables such as gender ( β =-0.22, p  = 0.00), choosing nursing profession willingly ( β =-0.27, p  = 0.00), smoking status ( β  = 0.28, p  = 0.00), employment status ( β  = 0.14, p  = 0.00) and academic achievement status ( β =-0.34, p  = 0.00) was determined by applying linear multiple regression. As a result of this process was detected as R  = 0.84, R2  = 0.70, and 70% of the total variance on stress level was explained by these variables. The stress level was found significantly higher in female students, working students, smokers, those who did not want to choose the nursing profession and those with low academic achievement.

One of the most important stress factors for nursing students is practical training periods especially an initial period of practical training [ 21 ]. It is stated that nursing students experience more stress in clinical practice periods than other periods [ 16 , 21 ]. In the literature, studies investigating the effects of grade on the stress level of nursing students have shown mixed results. Eswi, Radi, Youssri reported that there was no relationship between grade and stress level [ 27 ]. In a study conducted by Shaban, Khater, Akhu-Zaheya, it was found that nursing students were more sensitive to stress due to reasons such as transition to university life, managing their own needs and gaining new social skills, especially during the first years of education. In this study, unlike other studies, the first-year nursing students’ stress level was found lower than of other graders [ 6 ]. Aedh, Elfaki & Mohamed, reported that nursing students who are in the second year of nursing education have experienced higher level of stress than other grades [ 28 ]. In this study, although the second grade was not the highest stress level group, the stress level showed a rapid increase compared to the first grade and the clinical concerns subscale scores were found higher than other grades. Third and fourth grade nursing students’ mean interface worries scores were found high the other grades. Several studies have similarly reported that, nursing students’ stress level was found higher in the last period of nursing education compared to other periods [ 15 , 22 ]. In a qualitative study conducted by Admi et al. (2018) it was found that conflict between professional beliefs and the reality of hospital practice were stressors for final year students [ 19 ]. In the study conducted by Bhat (2021) et al. it was reported that training on invasive procedures (safe catheter etc.) should be standardised in undergraduate education and this should be made part of the annual or biannual compulsory training for healthcare personnel [ 29 ]. Similarly, in this study, the stress level of fourth-grade nursing students was found higher than of other graders, and fourth-grade nursing students’ mean scores of clinical concerns and interface worries were higher than of other graders. The results of our study indicate that the first-grade nursing students had problems adapting to the intensive pace of nursing education and that they experienced stress; accordingly, second-grade nursing students who first-time took to practical training and fourth-grade nursing students who had the longest practical training period also experienced stress due to practical training.

In several studies found that nursing students experienced higher levels of stress, physical and psychological symptoms than the students in other health disciplines [ 6 , 30 ]. Chen & Hung reported that nursing students demonstrated physical symptoms toward stress mostly, and social-behavioral symptoms the least [ 8 ]. In the study carried out by Kassem & Abdou, when the bio-psycho-social responses experienced by nursing students were evaluated, it was found that emotional symptoms were the most common and social-behavioral symptoms were the least [ 11 ]. In another study conducted by Durmuş & Gerçek with nursing students, it that bio-psycho-social responses were found to be occurred mostly in fourth grade students [ 31 ]. In all classes, the most often emotional symptoms were observed in nursing students followed by social behavior symptoms and physical symptoms respectively [ 31 ]. The present study showed that nursing students demonstrated emotional symptoms and social-behavioral symptoms the most, whereas physical symptoms were demonstrated the least, and these results were consistent with results from most of previous similar studies. It was found that fourth-grade nursing students experienced more Bio-Psycho-Social Responses than freshmen and emotional symptoms were higher in second, third and fourth grade nursing students and social behavioral symptoms were higher in fourth-grade nursing students. This difference may be explained by the fact that because fourth-grade nursing students’ stress levels were higher than of other graders, they showed more Bio-Psycho-Social Responses.

Durmuş & Gerçek found that first, and the third-year nursing students have usually used strategies for coping with stress such as stay optimistic and avoidance, respectively [ 31 ]. Also, the same study showed that second and fourth-year nursing students have used problem-solving most [ 31 ]. Many studies found that nursing students have generally used problem solving as a coping strategy [ 5 , 8 , 11 , 19 , 32 ] and the avoidance at least [ 5 , 6 , 8 ]. Sheu, Lin, Hwang reported that using effective ways of coping with the problem will facilitate returning to stable status by allowing reduction of negative consequences of stress [ 25 ]. The present study showed that nursing students most often used transference and least avoidance strategies to cope with stress, and as the students’ grade levels increased, also the level of using problem-solving skills increased. This situation indicates that the problem-solving competencies involving in nursing education are being provided to the students. The fourth grade of nursing students who has highest practical-training hours possess problem-solving skills more than other grades because of the positive effects of the practical applications encountered in a large number of complicated situations on the problem-solving skills of the nursing students.

In the present study, when the interaction between nursing students’ stress level and gender, working status, smoking status, willingness to choose nursing profession and academic achievement status was evaluated, it was found that female students, employees, smokers, those that have chosen nursing profession unwillingly, and those with low academic achievement had significantly higher stress levels. It was reported in different studies that academic success [11,20,], gender [ 20 , 21 , 33 ] have affected students’ stress levels and also their working hours outside of nursing education have affected their stress level [ 11 ]. Although it is important for all students to reduce stressors and to provide support for the use of coping mechanisms; especially female students, employees, smokers, those that choose the nursing profession unwillingly, and those with poor academic achievement should be supported more.

Limitations

This study has some limitations. Unlike other nursing schools in our country, this research was carried out in a nursing school where an integrated education system was applied. The findings could be specific to this college of nursing. Therefore, the generalizability of results may be limited. Besides, the small number of male students is another limitation of the study. SNSI, BPSRS, and CBI are a self-reported questionnaire. This can lead to social desirability bias in respondents.

Reccommendations

It is recommended that long-term studies be conducted to understand the long-term effects of stress experienced during nursing education and to develop sustainable support mechanisms. Support mechanisms may decrease stress levels and their negative effects on nursing students and can promote nursing students’ well-being and academic success, especially during practical training. Exploring what is nursing students of stress levels and coping strategies during education, can inform post-graduation preventive strategies. Also, evaluating the current stress levels and coping strategies in different nursing education programs is crucial for identifying gaps and areas for improvement. Interventional and qualitative studies are crucial to providing concrete recommendations for educational institutions and policymakers to address stress among nursing students.

According to results of the present study, the stress levels of fourth-grade nursing students were higher than of other graders and causes of stress varied as regards grades. The higher level of stress in the senior nursing students that have the maximum responsibilities and stay times of practical training and the bio-psycho-social responses given by students associated depending on this stress indicate that those clinical practices are one of the main sources of stress for nursing students. Due to the nature of nursing education and nursing practices, students use their problem solving skills as a coping strategy. However, the presence of stress-related emotional and social-behavioral symptoms in nursing students indicates that they cannot cope with stress sufficiently. Internship, which is the preparation period for the transition to professional life for nursing, is the period in which nursing students experience the most stress. Students’ learning to cope with stress in this period will enable them to use these strategies in their professional lives. Nursing schools can consider this period as an opportunity period to reduce and cope with stress, which is one of the important risk factors for nurses.

To develop stress management and the stress-coping mechanism of nursing students, it was recommended that courses or counseling units should be available, nursing educators should support students in the clinical areas, receive regular feedback from the students about practical training, and cooperate with clinical nurses to increase nursing students’ clinical compliance. Also, in particular, female students, working students, smokers, those that have chosen nursing profession unwillingly, and those with low academic achievement should be encouraged to receive individualized or group support for stress management and in coping with stress.

Data availability

The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request.

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M. S Conception and design, data acquisition, data analysis and interpretation, writing, give final approvals. S. T Conception and design, data acquisition, data analysis, writing, give final approvals. Z. E. S Data acquisition, data interpretation, give final approvals. S. D Data acquisition, data analysis, give final approvals. F. S Conception, writing, give final approvals.

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Solak, M., Topçu, S., Sert, Z.E. et al. Evaluation of stress, bio-psycho-social response and coping strategies during the practical training in nursing students: a cross sectional study. BMC Nurs 23 , 610 (2024). https://doi.org/10.1186/s12912-024-02265-5

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Received : 30 June 2024

Accepted : 14 August 2024

Published : 02 September 2024

DOI : https://doi.org/10.1186/s12912-024-02265-5

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