Towards a Transactional Understanding of Stress and Coping Among Nursing Students: A qualitative interview study

Introduction: Nursing students experience stress arising from demanding academic requirements and emotionally challenging clinical placements, which may affect wellbeing, learning, and programme retention. This study explored perceptions of stress, its impacts, and coping experiences within undergraduate nursing education among nursing students and educators in New Zealand. Methods: A qualitative descriptive study was conducted with six undergraduate nursing students and six nurse educators at a New Zealand university. Data were collected through semi-structured interviews and analysed using inductive reflexive thematic analysis, with interpretation informed by the Transactional Model of Stress and Coping. Results: Three themes were identified: stress from multiple sources, stress shaping wellbeing and learning, and navigating stress through appraisal and coping. Stress arose from academic, clinical, personal, and social demands and affected academic engagement, health, and relationships. Participants described varied responses to stress, including different appraisals of challenging situations and coping strategies such as peer support, self-care, and use of institutional resources. Conclusion: Stress in nursing education reflects a dynamic interaction between individual appraisal, coping resources, and educational and interpersonal contexts. Although findings are limited to one institution, they highlight the importance of accessible, flexible, and culturally responsive support and of addressing modifiable educational stressors alongside strengthening students' coping resources.