Facing the Frontline: Stress and Influencing Factors in Nursing Students During Early Clinical Postings

Abstract

To assess perceived stress and its contributing factors among nursing students during their initial clinical exposure and to determine the association between perceived stress and selected demographic variables. A descriptive study was conducted among 117 undergraduate nursing students at a nursing college in Karnataka, India, using a non-probability purposive sampling technique. Data were collected using a demographic proforma, the 29-item Perceived Stress Scale comprising six domains, and a 10-item Contributing Factors Checklist. The validity of the tools was established through expert review, and reliability was confirmed using the test-retest method, yielding coefficients of r = 0.70 for the stress scale and r = 0.84 for the contributing factors checklist. Descriptive statistics were used to summarize the data, and the Chi-square test was used to determine associations between perceived stress and selected demographic variables. The majority of participants were female (76.06%), aged 18–20 years (96.58%), first-year B.Sc. Nursing students (76.92%), and had four weeks of clinical exposure (68.37%). More than half of the participants (54.7%) reported low stress, while 42.7% reported moderate stress and 2.6% reported high stress. The major sources of stress were patient care (mean 10.58 ± 6.21) and assignments/workload (mean 7.47 ± 4.21). The most frequently reported contributing factors were alterations in social activities (74.3%) and lack of control over relationships (70.9%). Although contact with death and suffering was reported less frequently (42.8%), it produced the highest stress intensity (mean 3.72 ± 1.78). Age showed a significant association with perceived stress ( χ 2 = 8.44, p = 0.015), whereas gender, year of study, duration of clinical exposure, and place of stay showed no significant association. Nursing students experience varying levels of stress during their initial clinical exposure, with patient care, academic workload, social adjustment, and interpersonal factors emerging as important contributors. Targeted interventions focusing on coping skills, emotional preparedness, interpersonal support, and adaptation to the clinical environment may help reduce stress and promote students’ well-being during the transition to clinical practice.