Nursing school can cause a tremendous
amount of stress, which may lead some students
to drop out. Dropout rates for community
colleges can range from 18% to 20%.

Like other people under significant stress, nursing
students commonly experience powerlessness,
isolation, and loss of one’s sense of individuality
and personal responsibility. In 2007, the American
Nurses Association California (ANA/C) passed
a resolution favoring implementation of support
groups within nursing programs to lower stress,
broaden student-body diversity, and reduce dropout
rates.

In the Los Angeles area, after one communitylevel
nursing program implemented weekly support
groups, the school dropout rate fell from 20%
to 5%. Most students attending this college are
from minority groups, promoting the goal of
broadening diversity of the nursing workforce.
Nursing students include many Hispanic-, Filipino-,
Korean-, and African-Americans.

Students in the support groups, who ranged from
age 21 to 52, met weekly in groups of 10 for 90
minutes. They signed consent forms and were reassured
that group discussions would be confidential
and wouldn’t interfere with their school standing.
Both the time allotment and number of students
per session worked efficiently by giving each student
enough time to candidly discuss his or her experiences and feelings without fear of a breach in confidentiality. Students created
closer bonds with each other as they
shared similar concerns, triumphs,
and frustrations. The program also
enhanced both student-teacher and
faculty-faculty relationships.

Group facilitators were licensed
marriage and family therapists or, in
some cases, interns. All facilitators
completed a course in counseling
student healthcare professionals.

They received weekly supervision together
to ensure they’d all follow the same format.
The facilitator’s job was to keep the group on
track by providing a set format for each week. Before
the groups began, agreements were signed
stipulating when and where the groups would begin,
along with contact information, which information
could be shared between school administrators
and students, and confidentiality
agreements.

The program’s success has helped to ensure
even greater success among a larger graduating
class of minority students. The support groups
benefited faculty as well as students. Clinical instructors
found students who’d attended these
groups were less stressed and more confident in
initiating duties. Professional development was
emphasized and students quickly became more
familiar with their new roles. Also,
the groups helped free up more
time for teachers to evaluate students’
skills.

More research is needed to make
support groups a part of nursing
schools’ curricula. Related costs are
minimal. The Los Angeles community
college used grant money to
fund the project director’s salary,
group facilitators, small gifts for
students, and snacks. Students who
participated reported they perceived the group as
a refuge—a comforting, worthwhile forum in
which to debrief each week.
The support groups are ongoing. They begin
when the student’s clinical rotations start—a time
when psychological issues are most ripe—and
continue up to graduation.

Diane Alvy is founder and director of Stop Nursing Shortages, Inc., in Los Angeles, California. The ANA/C General Assembly unanimously passed the resolution she authored favoring support groups in nursing schools. For more information on
how to incorporate support groups within nursing programs, visit www.stopnursingshortages.com. For a copy of the 2007 resolution (“Strategy to Address Stress, Attrition Rates and the Facilitation of a Broader Student Diversity Base as it Relates to Nursing Schools: Incorporate Support Groups in all California Pre-licensure Nursing Programs”) favoring support groups, go to www.anacalifornia.org/resolutions.htm; click on “Members” and then “Resolutions.”