Date of Paper/Work


Type of Paper/Work

Systems Change Project

Degree Name

Doctor of Nursing Practice



First Advisor

Susan M. Hageness


This qualitative study aimed to explore the student experience when the QSEN mindfulness module was embedded into the nursing curriculum. Pre and post intervention questionnaires were utilized and included six questions that focused on previous experiences, definitions of mindfulness, impact on nursing practice, and recommendations to faculty for future delivery. Twenty-two pre-licensure nursing students participated in this study. Students valued the module and content, several reported utilization outside the classroom, and many planned for future use especially in times of stress. Based on experience, students felt early integration of the module into the curriculum would be of value and module delivery allowed for ease of access but suggested reinforcement during class times. Future research exploring the most effective delivery of stress management skills, including the use of the QSEN mindfulness module across the spectrum of nursing education, and the impact upon nursing practice, should be explored further.

Students enter nursing school motivated to work in a profession where they provide care to others in need. Often, as they immerse themselves within their nursing studies they soon realize that taking care of others can be stressful and have both short and long-term consequences. Nursing graduates are at particular risk for stress as they transition into their new roles. Studies show that within the first year of a new graduate’s employment, 18% to 50% of nurses change jobs or leave the profession due to an inability to cope with their new role, (Bowles & Candela, 2005; Salt, Cummings, & Profetto-McGrath, 2008; Scott, Engelke, & Swanson,2008). This turnover contributes to significant costs for the healthcare system, has the potential to impact the quality of care received, and effects the overall supply of nurses (Aiken, Clarke, Sloane, Sochalski, & Silber, 2002; Cimiotti, Aiken, Sloane, & Wu, 2012).

Nurse educators (NE) are in key positions to help prepare students with the knowledge and skills necessary for adaptation to their new roles. If the NE can assist students in developing foundational stress management skills that can be reinforced in school and become a basis for lifetime utilization, it is possible that the turnover discussed earlier can be reduced. The challenge for the NE is that the curriculum is already overflowing with required content so that students are prepared to take their state board examination. In addition, the NE is required to confirm student competency at several levels which necessitates a curriculum that is heavily dependent on stress inducing tests, simulations, and clinical experiences. Sadly, the breadth and volume of content covered in nursing curriculum does not allow for the time nor create the optimal environment to build foundational stress management skills; therefore, finding an effective and efficient method to introduce and reinforce the topic of stress management in nursing education is paramount.

In 2005, The Robert Wood Johnson Foundation funded a project which focused on the quality and safety education of nurses (QSEN). This project included the development of education modules for faculty to utilize when educating nurses. The purpose was to enhance the quality and safety of nursing care. Of particular interest is the third module, which relates to the topic of stress management and includes the introduction to mindfulness practice which is utilized to help with stress management. Mindfulness based stress reduction (MBSR) has been studied in many different settings by several disciplines including nursing (Beddoe & Murphy, 2004; Birnie, Speca, & Carlson, 2010; Galantino, Baime, Maguire, Szapary, & Farrar, 2005; Riley & Yearwood, 2012). Review of the literature indicates a gap in research surrounding the utilization of the QSEN module on mindfulness suggesting that further exploration of the use of this module may offer opportunities for the NE to implement stress management techniques into the curriculum with minimal burden.