The purpose of this study was to examine the stressful nature of the clinical experience of nursing students within the context of Lazarus' theory of cognitive appraisal of stress. The students' evaluative response of their initial medical-surgical clinical experience as a threat or a challenge was determined along with the hypothesized mediating variables of psychological hardiness and social support.

Two hundred and forty-six female nursing students from seven different colleges and universities in Pennsylvania completed a hardiness measure, the Norbeck Social Support Questionnaire (NSSQ), and a Clinical Stress Questionnaire (CSQ). After psychometric evaluation of the CSQ, the data were analyzed by Pearson Correlation Coefficients and Multivariate Analysis of Variance (MANOVA). Multiple regression equations were used to determine predictor variables for threat and challenge.

As was hypothesized, hardiness was positively related to the evaluation of challenge and negatively related to the evaluation of threat in an initial clinical nursing situation. The hypothesis that social support would be positively related to the evaluation of challenge was supported using only a work-related measure of social support. It was not supported using the total functional support score provided by the NSSQ. Although significant, the correlations supporting these hypotheses were low. The hypothesis that social support would be negatively related to the evaluation of threat was not supported.

The hypothesis that those with high levels of hardiness and social support would be more challenged and less threatened than those with low levels was not supported. The buffering effect of social support and clinical stress on the evaluation of threat and challenge was not supported.

Additional data about the students' description of the stresses, threats, and challenges in a medical-surgical setting were obtained from open-ended questions. Despite the fact that the students' comments focused more on the negative aspects of stress, the students were significantly more challenged than threatened in the clinical setting. Frequent participation in religious activities was associated with a significantly higher appraisal of challenge and was positively correlated with the total functional support score and its component measures. The results of this study have implications for nurse educators.