Some years ago I undertook a small piece of research for one school of nursing aimed at exploring the reasons why some students don't complete their pre-registration course. One of the outcomes was the introduction of an ‘attrition risk prediction tool’ (Fowler and Norrie, 2009) within the nursing department of the university. While there are no single simple solutions to reducing attrition, the study found four distinct areas that increased stress on nursing students and made them consider resigning and five factors that supported them through some of the ‘normal’ and ongoing stresses of the nursing course.
Factors associated with resigning
Factors supporting completion
Surviving the first few weeks
There are a number of stress points when starting a nursing degree. The orientation to university life and the possible move to a new part of the country, leaving family and friends behind, can be difficult. The small school or college classes are replaced by lecture theatres of one or two hundred students. Libraries are large, course information, timetables and lecture notes have to be accessed through a complex computer system. You miss your friends and family, and money is tight. Surviving the first few weeks is important because these stressors will soon disappear as you learn to adapt to student life. Each student will cope differently but here are a few suggestions.
First, try to avoid retreating to your home town in the first few weeks and work hard at building up new friends and friendship groups. If you are shy, then you will find this difficult but look for opportunities within the smaller seminar groups, in your accommodation or in some of the organised social groups. Try to build a few good friends with students on your course, but explore other opportunities within the university's sports and social activities.
Surviving the first year
The first year of your course is both exciting and stressful. You will have clinical placements with real patients, and assignments, exams and continuous assessment of your clinical and profession development. Some students find the interaction with patients and clinical staff the most difficult, others the assignments and exams most difficult, yet others adapting and maintaining professional behaviour a problem.
If patient interaction is hard, seek help from your clinical mentor; be honest and let them support you as you develop confidence in your clinical skills. If academic work is your weaker point, then again, be honest with your lecturer, seek out the university support groups and specialist tutors and, most importantly, acknowledge your weakness to yourself. If professional behaviour may be your weaker area—and by that I mean attitudes to patients, colleagues, friends; honesty in relationships, academic work and adherence to the law of the land—then try and identify some good nursing role models to learn from and emulate.
All these areas—clinical confidence, academic ability, professional standards—require dedication, hard work and personal sacrifice. They are the essence of good nursing care and practice and, if you acknowledge your weaknesses and work hard to overcome these and develop your skills, you will be able to build strong foundations on which to develop your nursing career.
Surviving the rest of the course
Lack of money, changes in personal circumstances and ongoing clinical work and assignments are the stress factors of years 2 and 3. Survival comes from the solid foundations of support from friends and tutors, enjoyment and satisfaction from patient contact and the self-recognition of your developing skills. As you enter into the final year you will begin to focus on jobs following qualification. That is strong motivation to work hard clinically, academically and professionally because it will put you in a strong position to apply for, and be appointed to, an area of nursing you really enjoy.
Surviving as a nursing student requires honesty, hard work and self-belief. It can be aided by building good foundations of support from friends, which obviously means that at times you will be the friend giving support to others.