Academic Stress Among Nursing Students in Medan

. Stress occurs when a stressor stimulates an individual's brain and leads to physical and psychological symptoms. Students must deal with some stressors in their studies that cause a high complexity of problems. Furthermore, in some cases, it leads to some academic stress. This study aims to describe the academic stress of the Nursing Students of the Faculty of Nursing, Universitas Sumatera Utara. This research is a descriptive study with a cross-sectional approach. The population in this study were all undergraduate nursing students, totalling 574 people, with a sample of 85 people using the proportionate stratified random sampling technique. All samples are obtained with the Slovin formula and recruited with the sweepstake technique in every class. Data analysis was conducted to determine the frequency distribution of the variables studied. The results showed that there were 35 students without academic stress (41.2%), 47 students with mild academic stress (55.3%), and three students with moderate academic stress (3.5%). Based on the study results, it is recommended that further researchers need to conduct further exploration of student academic stress in qualitative studies.


Introduction
A student undergoes the process of gaining knowledge and registering in one of the educational institutions, such as a university, diploma institution or high school (Tanner et al., 2009).
Moreover, the transition from high school to university is challenging since the academic situation is different (Patricia Aguilera-Hermida, 2020).In some cases, the class, the assignments, and the lecturers are complicated for students.Thus, it is prevalent for students to experience stress due to their inability to adapt to the university educational program.Stress experienced by students during the study is very likely to occur, making the issues complicated and leading to academic stress (McKenzie et al., 2015).
Academic stress is pressure due to subjective perception of an academic condition.This pressure precipitates responses experienced by students in the form of adverse physical reactions, behaviours, thoughts, and emotions that arise due to school or academic demands (Misra & Castillo, 2004).Based on a preliminary study conducted by researchers on several students of the Faculty of Nursing, Universitas Sumatera Utara/FoN USU, some students said that several factors influenced the academic stress of nursing students.For instance, the hectic lecture schedule from morning to evening, personal matters with the lecturer, the existence of lab skills, nursing practicum, tutorials, practice exams, midterm exams, and end-of-semester exams.The responses expressed by some students such as palms heart beating faster than usual, headaches, stomachaches, difficulty concentrating, and feeling tired.According to some research, these symptoms are part of the response to academic stress.However, no research in FoN USU related to academic stress has yet been conducted.So, needs to conduct such research to describe the academic stress of FoN USU Nursing students.

Research Methods
This cross-sectional study aims to describe the academic stress of the Faculty of Nursing, Universitas Sumatera Utara students.Sample selection was done using a proportionate stratified random sampling technique and obtained 85 nursing students.The sampling technique was conducted with the sweepstake method.The researchers made a list of the entire population's names written on paper.All the names were folded and put in a bottle.Then, shake the bottle and choose 85 papers with the student's name.If the sample is unwilling to participate, the researcher repeats the sampling process until the number of samples matches the number desired by the researcher.All samples came from a different class.Therefore, the researchers conducted data collection in every class with the sweepstake method to identify potential samples and guided the chosen samples to fulfil the instrument.
The instrument used in this research is statements related to student academic stress, which was designed by the researcher based on the study literature.In this case, the researchers study the theory of stress and its impact in terms of physical, mental and social life according to the content of stress (Susan A. Newfiel, Mittie D. Hinz, Donna Scott Tilley, Kathryn L. Sridaromont, 2007).
There are 20 questions with a Likert scale of 0-3.The instrument has been tested for content validity by one of the lecturers of the Faculty of Nursing.It also has been tested on 30 nursing students outside the research sample.Based on the validity and reliability tests, it was stated that the instrument was valid and reliable to use with a value of Cronbach alpha result of 0.837.Therefore, the instrument is feasible to use.The data collection was carried out by explaining the research objectives to prospective respondents.If the respondent's criteria were following the considerations for taking respondents, then the researcher asked about the willingness of prospective respondents to become research subjects.After the students agreed to be the research subjects, the researcher submitted a letter of approval to become respondents.The researcher also asked the students' willingness to answer the questionnaire with the researcher's explanation.The researcher explained how to fill out the questionnaire, and students were allowed to ask questions if there were unclear questions.The data analysis was carried out to find the frequency distribution of the variables studied.This research was conducted after the research proposal had been tested and the researcher obtained approval from the ethics committee of the USU Faculty of Nursing.

Research Results
Based on the results of the study, it was found that the majority of students were the class of 2016, as many as 25 people (29.4%), 60 people lived with parents (70.6%), 45 students were not an organization member (52.9%) and 44 students (51.8%) had a monthly allowance in the range of Rp600,000-Rp1,000,000.Based on the measurement of the student's academic stress level, no severe or very severe level showed.Most of the sample was at a mild academic stress level, with as many as 47 students (55.3%).Further information on the characteristics of respondents is below.

Research Discussion
Based on the study result, the academic stress level among nursing students in the Faculty of Nursing, Universitas Sumatera Utara, was found in the mild category, whereas no severe level was found.According to M. Ranjita & McKean (2000), cademic stress in the normal and mild range occasionally motivates the learning process since the trigger increases students' motivation.
However, mild academic stress also needs to be anticipated with good stress management to prevent more severe stress in the future.In the case of the Faculty of Nursing, Universitas Sumatera Utara, there is a counselling room for students who have academic or non-academic issues.
In addition, there were no significant stressors during the research process since the class schedule was not hectic.Even so, when the data collection process was carried out, there were still classes for the skills lab and practicum.Therefore, there are still three students who experience moderate academic stress.students with a monthly allowance above Rp1,000,000 and students who have below Rp1,000,000.It showed that regardless of the monthly allowance, it depends on how the student manages the monthly expense.

Conclusions and Recommendations
Based on the results of research conducted on 85 respondents, it can be concluded that most students' academic stress was in the mild range of 47 people (55.3%).Based on the sample characteristics, most samples are senior students, mainly students who do not participate in any organization.Also, most students stayed in a dormitory or rented a house.Their allowances mostly range from Rp500,000 to Rp1,000,000.Based on the results of this study, it is expected to be the primary data for further research in the future.

Table 1
Characteristics of Respondents Stallman (2010) (2015)cKenzie et al. (2015)found that almost 50% of students challenge with academic life in higher education.These issues lead to psychological burdens, such as stress, anxiety, sleep deprivation and depression.According toStallman (2010), mild academic stress lasts a few minutes or hours.For example, during class, a presentation, or lab skills exam.This stressor might cause symptoms of difficulty breathing, dry lips, tiredness, excessive sweating, and fear for no apparent reason, but feeling relief when the situation ends.
Nurhidayati et al. (2021)wance owned by students is low when viewed from the nominal.The results of research conducted byNurhidayati et al. (2021)showed no difference in stress between