Study also highlights mental health challenges nursing students face

While the COVID-19 pandemic has increased stress exponentially and impacted the mental health of many nurses and nursing students, it hasn’t necessarily dampened the desire for nursing students to pursue the profession, according to a University of Rhode Island College of Nursing professor’s recent study.

Assistant Professor Karen Jennings Mathis, along with colleague Dr. Meredith Kells, from the University of Chicago Medicine and Biological Sciences, conducted a survey of URI nursing students in the summer of 2020 asking about their interest in the profession in light of the pandemic, as well as their mental health. Among the 161 respondents, 54.4 percent affirmed their interest in becoming a nurse, while just 14.3 percent indicated that the pandemic led to a reduced interest in a nursing career.

“Overall, it was good news to know students are still interested in pursuing their career, they still speak highly of nurses, and have a love of helping others,” Jennings Mathis said. “There have been enormous challenges for our students. The stress of the pandemic, shifting to online education, not being able to do clinical placements because of COVID restrictions. But despite those stressors, students were still interested in pursuing this career.”

Despite their positive response about pursuing the nursing profession, many expressed feeling overwhelmed and “unsettled about the future.” Respondents cited mental health issues, with 18.7 percent reporting moderate-to-severe anxiety and 19.8 percent reporting moderate-to-severe depression. On a stress scale of 0-100 (0 not stressed, 100 extremely stressed), the respondents’ mean stress score came in at 56.6.

“There is a subset of students struggling with anxiety and depressive symptoms. I don’t want that to be overlooked due to the positivity of the study,” Jennings Mathis said. “One of the main things is the duality of students. Although students were extremely stressed and overwhelmed, and concerned about their academic performance, they were still satisfied with their current and future lives, and still wanted to pursue a career in nursing, and they have a positive outlook on their lives as nurses.”

The survey results suggest a need to prioritize mental health screening, and to improve mental health services, for nurses and nursing students, for career success and the ability to “emotionally manage” any “external stressors” that arise, Jennings Mathis said.

“Close to 20 percent of students expressed depressive or anxiety symptoms,” Jennings Mathis said, noting she has seen similar feelings among her colleagues in the field, originally prompting the study. “Considering this percentage, I think that’s an important factor to take into consideration how we interact with our students. Are we making sure the rigors of our program continue while considering the challenges students may be encountering outside the classroom? The mental health of students in general was already an issue. It was exacerbated by COVID-19. This may have already been a problem, but it kind of exploded.”

Jennings Mathis now plans to expand her survey, conducting it with more students, multiple times throughout their educational careers, to gauge their mental health over time. She plans to look at mental health, substance use, risky behaviors, eating behaviors, and how attitudes and feelings may change over time from their first year to their fourth year. That longitudinal data will help determine any response needed.

“The stress definitely existed for all health care providers. You go into this discipline to help others, but our safety is not guaranteed. That can have a significant impact on an individual’s mental health, on their passion for nursing, their continued commitment to nursing,” Jennings Mathis said. “But there is this passion for caring for others, and that’s something that I think nurses don’t want to give up. At the end of the day, they want to help and promote health. That was a positive out-take of this research. Even after the fact, it continues to be a promising outlook.”