Nursing students experience anxiety during clinical practicum, which may interfere with their learning in clinical practice and nursing employment after graduation. This study explored: (1) the factors of the difference in anxiety levels between pre- and post-practicum in nursing students; (2) identified their anxiety events in a clinical environment; and (3) the correlation between emotional stability and 5-year nursing professional employment. The study was designed as a mixed method. A longitudinal secondary analysis method and a qualitative approach with open questionnaire were conducted. The emotional stability subscale of Lai’s Personality Inventory and the Beck Anxiety Inventory, as well as open questionnaires were administered. Research data were collected through the purposive sampling of 237 nursing students (mean age was 20.96, SD = 1.29) of 4.2% male and 95.8% female in a central Taiwan hospital in 2013, and the participants were followed up in 2021 to show 70% in clinical service. Most of the nursing students exhibited significantly decreased anxiety levels in the post-practicum period. Compared to nursing students with high emotional stability, those with low emotional stability exhibited higher differences in their anxiety levels between the pre- and post-practicum periods. Low emotional stability is critical in a pre-practicum BAI score. However, the high pre-practicum BAI score would decrease to normal range after enrolling to practicum setting. So, as to their 5-year nursing professional employment after graduation. Teachers foster a positive learning atmosphere that emphasizes the importance of “we are family” to students. Teachers and advisors need to make efforts in leading the low emotional stability nursing students to learn effective coping and adapting strategies in clinical practicum.

Nursing students experience anxiety during clinical practicum, which may interfere with their learning of clinical practice. This study explored the practicum anxiety symptom experience of clinical nursing students. The methodology was a qualitative research design following a grounded theory approach. Research data were gathered via theoretical sampling from 37 female college nursing students practicing in a Central Taiwan hospital and analyzed using the content analysis method. The mean age of the subjects was 20.7 ± 1.35 years old. The practicum-related anxiety symptom experience was made up of core dimensions associated with the nursing clinical practicum, such as bad sleep and fatigue, and covered six themes. Students first encountered anxiety-inducing situations in the clinical setting, and then they began coping through self-adaptation and teachers’ help. In cases of coping failure, students began to have a bad sleep in the night and then felt tired and fatigued all day. These themes became a repeating cycle during the clinical practicum. This conceptual model shows that students experienced bad sleep and fatigue as a result of anxiety symptoms during the clinical practicum. Bad sleep and fatigue are critical anxiety symptoms for nursing students in clinical practice. Nursing teachers should pay attention to bad sleep and fatigue in nursing students and help students to improve their mental and physical health.