Seven Ways To Cope With Anxiety In Nursing School

Anxiety is one of the most common conditions college students face, and nursing students get it worse than most. The triggers are specific: fear of failing, fear of falling short of expectations, fear of hurting a patient. Left unmanaged, that anxiety drags down your performance. But it responds to a few concrete habits, and the same self-awareness you build managing your own anxiety makes you better at spotting it in patients.

The scale of the problem is well documented. In one prepandemic survey, 95% of college counseling center directors were concerned about the number of students with serious psychological issues. A review of 27 studies found a 34% rate of depression among nursing students.

Two experienced nurses shared what works. Tina M. Baxter, MSN, APRN, GNP-BC, has practiced for more than 20 years. Sheila A. Burke, DNP, MSN, MBA, is national dean of nursing for Pacific College of Health and Science.

Seven ways to manage nursing school anxiety

Burke notes that most nursing students fall into one of two groups. Some come straight from high school, with no experience of college. Others return to finish a BSN or pursue advanced education, juggling limited time and money but often more motivated and better at using resources. Either way, self-awareness and self-care are what carry you through.

1. Be prepared

Both nurses start here. Most students underestimate the workload. "Read the syllabus. I repeat, read the syllabus," Baxter says. As an undergraduate she played clarinet two hours a day while her music-major friends practiced eight, and spent the rest of her time in the library or her room, away from distractions and ready for exams.

Burke frames it as planning. "Nursing school is a journey, and having a map, planning for the resources you'll need, and accepting that you may hit some detours will help you feel more confident," she says.

2. Use your resources

Most schools offer more help than students use: tutoring, study coaching, counseling, nursing apps. What worked in high school often will not scale to a college workload, so take the coaching. Burke also points to managing your environment: lean on friends who are encouraging, and be deliberate about avoiding the people and situations that spike your stress.

3. Study, review, practice

The single most reliable way to lower anxiety is to know the material. "The more students study, review, and discuss what they're learning, the better they grasp it," Burke says. "Things that seem very hard can be broken down into manageable steps."

4. Remember it is time limited

Nursing programs are demanding, but they end. A rough semester is still only 15 or 16 weeks, not every semester is that hard, and the whole program runs two to four years. "The anxiety can be managed, and it's most important to ask for help," Burke says. "You are not in this alone. Many people have entered and succeeded in these programs."

5. Make time to relax

Build downtime and time with classmates into your schedule. Only other nursing students really understand what you are going through. Baxter doesn't miss the late nights or the stiff white aprons, but she misses the camaraderie. Her class prepped for midterms and finals together, then celebrated afterward over pancakes at a local diner. "This is the time to make friends and memories. Celebrate your wins with each other," she says.

6. Practice self-care

Sleep, exercise, and decent food are not extras. "Don't forget to breathe," Baxter says. "Take a few minutes and practice deep breathing. Get plenty of sleep. Eat healthy meals. Get some sunshine." The habits you build now carry into the job, where you will be caring for people on the worst days of their lives.

7. Practice positivity

Decades of research show that what you say to yourself shapes your outlook and your anxiety. Burke recommends three moves: use positive affirmations and picture yourself succeeding, be kind to yourself the way you would to anyone you care about, and act with courage. Courage is not the absence of fear; it is moving forward despite it.

How anxiety and panic attacks hit your education

Anxiety and depression are among the most common conditions students face, and they take a real toll on academics. In the American College Health Association's Spring 2014 assessment, 21.9% of students said anxiety hurt their academic performance and 30% said stress did, while 56.9% reported overwhelming anxiety. The number of students in crisis has climbed over the past decade.

Take it seriously, in yourself and in classmates. Symptoms differ from person to person and can look strange from the outside, so downplaying them is counterproductive. Baxter sees fear as the root of most of it. "The fear of failing, of not living up to expectations. If you fail a test or a class, it's a setback, not the end of the world. You can recover and learn from it," she says. The other common fear is clinical. "What if I make a mistake? What if someone gets hurt? That's where practice comes in. That's why time in the clinical lab matters," she says.

Anxiety also undercuts self-care, and that becomes a loop: the less you care for yourself, the more anxious you get, and the more anxious you get, the less you care for yourself.

Panic attacks are different from general anxiety. Anxiety builds gradually; a panic attack hits suddenly, triggering the body's fight-or-flight response. For some students, nursing school is where they have their first one. The first step is recognizing it for what it is. From there, regular therapy, deep breathing, mindfulness, muscle relaxation, light exercise, and aromatherapy all help. Building a relationship with a therapist gives you tools that hold up across a whole nursing career.

---

Anxiety in nursing school is real, common, and manageable. If yours feels like more than you can handle on your own, that is exactly when to reach for the counseling and support your program offers.