How to Deal With Initial Clinicals Anxiety

NursingApril 13, 2017

If you are interested in a nursing career, or perhaps interested in pursuing your RN to BSN, you will probably encounter clinicals anxiety at some point. If so, rest assured you are not alone. Classroom and learning lab instruction can be stressful enough for student nurses, but the prospect of that first clinical rotation often evokes stage fright even among experienced nurses. The phenomenon is so common, in fact, and poses enough of a challenge to the learning process, that clinical nurse educator Linda M. Moscaritolo published a paper on this very subject in 2009, in the Journal of Nursing Education.

It Is Not Nothing

“High levels of anxiety can affect studentsclinical performance, presenting a clear threat to success in a clinical rotation,” Moscaritolo wrote. Clearly, as an experienced educator, she does not dismiss or even minimize this potential problem. Rather, she recognizes clinicals anxiety as a genuine potential threat to successful learning. Her proposed solutions involve recommendations to clinical nursing faculty and students alike. “It is crucial for clinical nursing faculty to foster a supportive learning environment conducive to undergraduate nursing student learning.”

To that end, she proposes that faculty make efforts to defuse tensions through the appropriate use of humor, through student mentors and peer instructors, and through the use of mindfulness practices by students themselves. Moscaritolo notes that research on the subject has consistently concluded that students in virtually all levels of undergraduate nursing education report heightened anxiety surrounding the clinical rotations components of their educational experience. From fear of committing errors, to fear of botching practical clinical skills, to feelings of a lack of support from nursing personnel, student nurses harbor many misgivings, especially about their initial clinical rotation.

Lighten Up

Humor as a tool to defuse anxiety among stressed students is among the chief recommendations made by this particular educator. She notes that humor can help make learning fun, help relieve anxiety, and boost focus and attention. Of course, she’s not suggesting students turn into comedians. On the contrary, the onus is on educators to alleviate some of the anxiety students are experiencing through the judicious and appropriate use of humor. This need not involve becoming a wannabe standup comic. Rather, it is about “lightening up;” approaching the teaching process with a “lighthearted attitude,” so students can begin to enjoy and embrace the challenges and rewards of the clinical experience.

Mindfulness and Meditation

In addition to the use of mentors and peer instructors, Moscaritolo recommends the implementation of Mindfulness-Based Stress Reduction techniques. These practices are tools individual students can use to minimize anxiety. Often called, simply, mindfulness, these practices help foster awareness, with the purpose of being present in a given moment. Mindfulness recognizes that worries about the future, and dwelling on the past, are both mental expenditures of energy that take away from one’s ability to simply be fully present in the present moment. Practices such as meditation and yoga have long incorporated these strategies, and research demonstrates that they can yield significant, positive results. Indeed, numerous clinical papers have been published examining the potential benefits of mindfulness practices for everything from alleviating “bodily distress,” chronic lower back pain, migraines and many other conditions. As noted in a recent issue of the Journal of Advanced Nursing, a systematic review of mindfulness interventions showed that these practices can “improve nurses' mental health significantly”.

Yoga Means Union of Mind, Body, and Spirit

Ancient practices such as yoga and meditation emphasize emptying the mind of “chatter” and internal dialog, allowing you to simply be present in the moment. As a thought occurs, simply acknowledge it, then send it on its way. Do not focus on it, and do not attach any emotional significance to it. Simply acknowledge it and dismiss it. Eventually, it becomes easier to remain in a state of calm, quiet awareness without any anxiety about things one cannot control. If at all possible, consider enrolling in a yoga class, or engage in this ancient mind/body/spirit unification practice on your own time. Research has consistently shown that yoga is an effective practice for the relief of stress and anxiety.     


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