Some of the key factors that may lead to poor academic performance of a nursing student are stress and a lack of coping mechanisms to deal with that stress. Moral distress is also a factor and occurs when a person feels unable to do the right thing due to constraints imposed by an institution. In nursing education, moral distress is associated with incivility, cheating, plagiarism and bullying.
Nursing students are particularly prone to stress. Their stress stems from the amount of material to learn, lack of free time, lack of feedback from instructors and difficult relationships with faculty. In addition, nursing students often experience a great fear of making mistakes because they perform procedures that could harm their patients if mishandled. Consequently, they sometimes feel inadequate when dealing with patients who are extremely ill. These types of stressors lead to poor academic performance in addition to depression and health problems. Some nursing students drop out of school due to stress.
Moral distress in nursing schools affects student learning adversely. When students perceive academic dishonesty on the part of faculty or other students, including the failure to deal with students who cheat or plagiarize and a willingness to promote students who have not learned the necessary material, students become dissatisfied with the learning experience. These bad experiences often transfer to their academic and professional practice of nursing.