Problem: This research poses the problem that academic adversity may be encountered in nursing students across three levels of nursing education, affecting retention. Because this adversity takes many forms, it is often difficult for nurse-educators to identify students who are at risk for academic adversity and subsequent failure. Identification of students facing academic adversity is the first step toward retention. An additional problem is that effective behaviors used by recent graduates of nursing programs in overcoming academic adversity have not been identified. There is a need for faculty to be able to identify ways that graduates overcome these adversities. Nursing faculty may not always be mindful of behaviors that graduates perceive as being most effective in assisting students in overcoming academic adversity. Nurse-educators must know what is most effective in assisting students in overcoming academic adversity.

Method: This study was a qualitative narrative inquiry using multiple case studies. Purposely selected graduates from three levels of nursing education from four schools were interviewed using semi-structured interviews. Verbatim transcriptions were used to write stories from each interview. Validation was requested through emails to each student, ensuring that the transcript and story were true to the meaning of the conversation. Themes were determined by placement of direct quotations into charts, with prevalent themes identified through coding of quotations. These coded quotations were used for answering the research questions.

Results: Students in all levels of nursing education encountered academic adversity that fell into the categories of families and relationships, physical and emotional illness, legal involvement, financial hardship, and academics. In many cases a cascade of challenges occurred as one event triggered another, forcing students to deal simultaneously with multiple and varied problems. Methods used by nursing students in overcoming adversity followed two separate avenues, intertwined to facilitate each graduate's ability to overcome adversity. One avenue came from an internal, personal strength, beginning with the recognition of the problem, and ending with resolution and academic success gained from resilience, persistence, a strong internal locus of control, and a strong sense of self-efficacy. The second avenue arose from external help. Faculty recognition began the process of the resolution of academic adversity. Assistance that was grounded in altruistic behaviors of caring and compassion was most meaningful. Care, concern, knowing, presence, and empathy were the foundation for meaningful communication. Graduates wanted to be treated fairly but not differently from other students. When there were academic issues, they appreciated practical help with time management, test-taking, and study skills.

Conclusions: There is a nursing shortage in the United States that is predicted to worsen in the next 20 years. One way of overcoming this shortage is by responding to the nontraditional student in ways that will help each one overcome academic adversity and reach the goal of successfully completing the chosen program of study.