STRESS MANAGEMENT
Stre Stress ss is a well well-k -kno nown wn and and iden identi tifi fied ed prob proble lem m with within in the the nurs nursin ing g profession. Stress occurs when one is faced with events or encounters that they perceive perceive as an endange endangermen rmentt to their their physica physicall or psychol psychologi ogical cal well well being. being. Additionally stress levels will increase when controllability and predictability in a situation decrease. (McGowan, 2001) Stress is intrinsic to nursing and a highly demanding job with poor support, rapidly changing circumstances, shortage of resources and staff, and dealing with death and dying all contribute (Chang et al., 2005). Nursing is emotionally demanding and this interactive stress contributes to the daily stress of nurses (Mann (Mann and Cowburn Cowburn,, 2005). 2005). Environ Environmen mental tal factors factors compou compound nd these these intrinsi intrinsic c factors and these include difficult patients and their families, relationships with physicians and low institutional commitment to nursing (Chang et al., 2005). Stress has been identified as a 20th century disease and has been viewed as a comp comple lex x and and dyna dynam mic tran transa sact ctio ion n betwe etween en indi indivi vidu dual als s and and thei their r enviro environm nmen ents ts (Kelly (Kelly & Evan Evans, s, 2004 2004). ). Stres Stressor sors s can be broad broadly ly defin defined ed as situations or events that have the potential to affect health outcomes. Stress can be rega regarde rded d as a psych psycholo ologic gical al threat threat,, in which which the indiv individ idual ual perce perceive ives s a situation as a potential threat (Day & Livingstone 2004). A student student may face many challenge challenges s and stressors stressors.. Howeve However, r, nursing nursing students are likely to experience even more stress than others enrolled in other programs. programs. A study comparing comparing the stress levels of various professional professional students found that nursing students experience higher levels of stress than medical, social social work and pharmac pharmacy y student students.(B s.(Beck, eck, et al.,1997 al.,1997)) Even more more poignant poignant,, another another study showed showed that “one third” third” of nursing nursing student students s experie experience nce stress seve severe re enou enough gh to indu induce ce ment mental al heal health th prob proble lems ms such such as anxi anxiet ety y and and depression. (Pryjmachuk, 2004) In addit addition ion to cont contend ending ing with with exami examinat natio ions, ns, grades grades,, long long hours hours of studying, work, family and other personal commitments you are also faced with the challenges of clinical practice. Clinical practice has been identified as one of the the most most anxi anxiet ety y prod produc ucin ing g com compone ponent nts s in nursi ursing ng prog progra ram ms. Lack Lack of experien experience, ce, fear of making making mistakes, mistakes, difficul difficultt patients patients,, discomfo discomfort rt at being being evalua evaluated ted by facult faculty y memb members ers,, worry worrying ing about about givin giving g patie patients nts the wron wrong g information information or medication and concern concern about possibly harming harming a patient are just a few of the stressors for the beginning student nurse. (Sharif & Masoumi, 2005). Stress Stress amon among g nursin nursing g stude students nts is a para paramo mount unt conce concern rn of nursi nursing ng educators because high stress levels often lead to decreased learning and higher drop-out rates. Moderate to high levels of stress have been found to have a negative effect on learning and impaired judgment. (Patel, Sudduth & Jakopac 2005) College students are prone to stress due to the transitional nature of college life. High levels of stress are believed to affect students' health and acad academ emic ic func functi tion ons. s. If the the stre stress ss is not not deal dealtt with with effe effect ctiv ivel ely, y, feel feelin ings gs of loneline loneliness, ss, nervous nervousness ness,, sleeples sleeplessnes sness s and worrying worrying may result. result. Effecti Effective ve coping strategies facilitate the return to a balanced state, reducing the negative effects of stress. (Seyedfatemi N., N., Tafreshi M. & Hagani H., H. , 2007) Nursing Nursing students students have the same same academi academic c stressor stressors s as other other college college students, such as midterm and final examinations, research papers and other assignments (Kelly & Evans, 2004). In addition, nursing students experience a clinical component, which is highly stressful. Students have a large amount of preparatory work before their clinical assignments. They often must travel long distances to clinical sites and use highly technical equipment (Mahat, 1998) In addition, they must perform procedures that can cause serious harm to their patients, thus enhancing their fear of making mistakes. (Shriver, 2000)
In college and university students, some stress is motivating, whereas too high a level interferes with teaching (Kelly & Evans, 2004). Excessive stress can be harmful to a student's academic performance and students who perceive their stress levels as very high may often become depressed. This depression can lead to other mental health problems, such as excessive drinking or indiscriminate use of other substances (Robin & Walton, 2002). Thus, academic stressors cover the whole area of learning and achieving, as well as adjusting to a new environment, in which a great deal of content must be assimilated in a seemingly inadequate period of time (Kariv & Heiman, 2005). Moreover, excessive stress may lead a student to drop out of college (Shields N. 2001). Student perception of high stress levels can lead to poor academic performance, depression, attrition and serious health problems. Methods to reduce student stress often include effective time management, social support, positive reappraisal, and engagement in leisure pursuits (Misra R, McKean M, 2000). The cause of stress for nurses has found to be related to the nature of the profession. Included in these stressors are an intense work environment with extended work hours, weekends, night and holidays. According to Ruggiero (2003) stress could be related to variables of shift work, which is both physically and mentally taxing. This study also found varying degrees of depression in nurses ranging from mild to severe. Finally this study revealed that nurses were indifferent and disconnected to the job by feeling neither satisfied or unsatisfied with the work. Results such as these expose how large a problem stress is for the profession of nursing. Factors of the intense emotional support that is needed for the patient and family is yet another burden of stress placed on nurse. In addition, exposures to pain, suffering and traumatic life events that the nurse experience on a daily basis can contribute to stress (Cohen-Katz, Capuano, Baker, & Shapiro, 2005). These concerns can lead to emotional exhaustion for nurses. Virtually everyone experiences stress. However, in a 2001 survey conducted by the American Nurses Association, it was reported that 70.5% of nurses cited the acute and chronic effects of stress and overwork among their top three health and safety concerns and that 75.8% of surveyed nurses report that unsafe working conditions do, in fact, interfere with their ability to deliver quality care. In a meta analysis of workplace stress in nursing, several major themes were identified as sources of workplace stress for nurses. These were: Workload/inadequate staff cover/time pressure Relationship with other clinical staff Leadership and management style/poor locus of control/poor group cohesion/lack of adequate supervisory support Coping with emotional needs of patients and their families/poor patient diagnosis/death and dying The individual may deal with stress through several methods, including removing the stressor through manipulating the environment, developing specific responses to help deal with the stressor or seeking diversion from the stressor (Robin & Walton, 2002). Nursing is a stressful program to study. Implementing techniques to cope with stress in a nursing program has an effect on retention and performance. It has been shown that nursing students perform with less anxiety when using stress coping techniques such as massage. Increasing nurses' knowledge about complementary techniques supports retention of nurses in academic and professional fields. An effective nursing program provides ongoing stress management workshops during the academic year. Therefore, this seminar is conducted to create awareness among nursing students to manage their stress. Furthermore, nursing student will learn ways on how to manage stress practically. • • •
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References: Books: Chang, E.M., Hancock, K.M., Johnson, A., Daly, J., Jackson, D., (2005). Role stress in nurses: review of related factors and strategies for moving forward. Nurs. Health Sci. 7, 57–65. Mann, S., Cowburn, J., 2005. Emotional labour and stress within mental health nursing. J. Psychiatry. Mental Health Nurs. 12,154–162.
Electronic Sources: American Nurses Association (2001). Holistic Stress Management for Nurses www.ahna.org Last retrieved: January 1, 2011 Beck, et al.,(1997), Pryjmachuk, (2004), Sharif & Masoumi (2005). Stress Management for Nursing Students www.ahna.org (American Holistic Nursing Association) Last retrieved: December 28, 2010 Cohen-Katz, J., Capuano, T., Baker, D. M., & Shapiro, S. (2005). The effects of mindfulness-based stress reduction on nurse stress and burnout, part II Holistic Nursing Practice, 26-35. Retrieved September 27, 2006, from Ovid data base Day A.L., Livingstone H.A (2004). Gender differences in perceptions of stressors and utilization of social support among university students. Canadian Journal of Behavioral Science, 35(2) :73-83. www.biomedcentral.com Last retrieved: December 28, 2010 Evans W., Kelly B.(2004): Pre-registration diploma student nurse stress and coping measures. Nurse Education Today, 24(6) :473-482. www.biomedcentral.com Last retrieved: December 28, 2010 Kariv D, Heiman T (2005) Task-oriented versus emotion-oriented coping strategies: the case of college students. College Student Journal, 39(1) :72-84. www.biomedcentral.com Last retrieved: December 28, 2010 Mahat G (1998) Stress and coping: junior baccalaureate nursing students in clinical settings. Nursing Forum, 33(1):11-19. www.biomedcentral.com Last retrieved: December 28, 2010 McGowan, B. (2001). Self-reported stress and it’s effects on nurses. Nursing Standard, 15(42), 33-38. Retrieved September 28, 2006, from Ovid data base Misra R, McKean M (2000). College students' academic stress and its relation to their anxiety, time management, and leisure satisfaction . American Journal of Health Studies. 16(1):41-51 www.biomedcentral.com
Last retrieved: December 28, 2010 Patel S., Sudduth A. & Jakopac K. (2005). Self-Reported Life Stressors Among Students in Their First Nursing Course. 16 th International Nursing Research Congress. stti.confex.com Last retrieved: December 29, 2010 Robin & Walton L (2002). A Comparison of Perceived Stress Levels and Coping Styles of Junior and Senior Students in Nursing and Social Work Programs. www.biomedcentral.com Last retrieved: December 28, 2010 Ruggiero, J. S. (2003). Health, work variables, and job satisfaction among nurses. JONA, 35(5), 254-263. Retrieved October 3, 2006, from Ovid data base Seyedfatemi N., Tafreshi M. & Hagani H. (2007). Experienced stressors and coping strategies among Iranian nursing students www.biomedcentral.com Last retrieved: December 28, 2010 Shields N. (2001) Stress, active coping, and academic performance among persisting and nonpersisting students . Journal of Applied Biobehavioral Research, 6(2):65-81 www.biomedcentral.com Last retrieved: December 28, 2010 Shriver C.B., Scott-Stiles A (2000). Health habits of nursing versus non-nursing students: a longitudinal study . Journal of Nursing Education. 39(7) :308-314. www.biomedcentral.com Last retrieved: December 28, 2010
Identification of the Problem What are the different factors that cause stress to a nurse or student nurse and how they will be able to manage it? Seminar Objectives: At the end of the Seminar, the participants will be able to: 1. 2. 3. 4. 5.
Define stress and stress management. Identify factors that may contribute to stress Identify different activities to lessen stress. Perform different relaxation exercises. Apply learning that they have acquired during the seminar workshop.
Resource Person The resource speaker for the Seminar on Stress Management is Henrietta Española, MD, FPPA (Fellow, Philippine Psychiatric Association). Target Population •
St. Paul University Iloilo Nursing Students, BSN IV - Regular Track (Angeli Beati Domini 2011)
