Using a Nature-Based Mindfulness Intervention to Improve Mental Health in Nurse Anesthesia Students: A Pilot Study

Resident registered nurse anesthetists (RRNAs) face high levels of depression, anxiety, and stress (DAS) due to the academic, clinical, and financial demands of graduate anesthesia education. Nature-based mindfulness, which integrates nature exposure with mindfulness practices, has shown promise in reducing psychological distress but remains underexplored among RRNAs. This single-arm pilot, pre-/posttest study evaluated the effectiveness of a nature-based mindfulness intervention (NBMI) on DAS in a cohort of third-year RRNAs in the southeastern United States. The 8-week intervention included guided nature walks, box breathing exercises, and gratitude journaling. Depression, anxiety, and stress were measured pre- and postintervention using DASS-21. Focus groups explored participants' experiences postintervention. Quantitative analysis revealed a statistically significant reduction in anxiety levels (P = .039). Stress and depression scores decreased but did not reach statistical significance. Qualitative findings reflected improved mental clarity, emotional well-being, and peer connection. Findings suggest that NBMI is an effective, feasible, low-cost strategy to enhance well-being in RRNAs. Larger, randomized studies are warranted to examine the broader applicability of NBMI in nurse anesthesia education.