How nursing students develop resilience through self-compassion and self-leadership: a mixed methods study

Background: Nursing students often experience high levels of stress due to various challenges during internships. To manage these challenges, students need to develop strategies, such as self-leadership and self-compassion. While the effectiveness of these factors has been explored, little research has investigated how students use them to remain resilient in adverse circumstances. Objectives: This exploratory mixed-methods study combining qualitative and quantitative research aimed to examine how nursing students apply self-compassion and self-leadership to foster resilience. Qualitative data collected through 15 semi-structured interviews, were analyzed using reflexive thematic analysis. Quantitative data were collected using the Self-Compassion Scale – Short Form, the Abbreviated Self-leadership Questionnaire, and the Vita-16. While the qualitative component focused specifically on resilience, the quantitative component examined vitality as a broader indicator of resilience. Participants were Bachelor of Nursing students in the later stages of their program, enrolled in one of three educational pathways: full-time (primarily students entering from secondary education), dual (students combining study with employment in healthcare) and modular (flexible programs for lateral entrants, often with prior healthcare experience such as vocationally trained nurses or professionals in related fields). All participants had substantial internship experience. Results: The qualitative analysis identified three main themes: (1) connecting with one's inner nurse, (2) being a brave nursing student, and (3) building strength through self-compassion. Students reported learning to apply these strategies amidst high pressure working circumstances. A total of 137 students participated in the quantitative research (87% female; mean age 24, SD = 6.6). Hierarchical regression analyses revealed that self-compassion (B = 0.47, 95% CI [0.34, 0.61], p < .001) and self-leadership (B = 0.66, 95% CI [0.45, 0.87], p < .001) were significant positive predictors of vitality. The final model explained 54.0% of the variance in vitality, whereas sociodemographic characteristics did not contribute significantly. Conclusion: Self-leadership and self-compassion are crucial skills in fostering resilience among nursing students. Educational programs and clinical practices should take initiatives to promote these skills while also taking proactive steps to protect students by creating safe environments.