1.1 Introduction
Everyone thinks that taking up Bachelor Science of Nursing as a course needs a lot of patience and hard work. Students must take it seriously because time, effort and money are really at stake. If you are not decisive enough or hasty, it would be better to stop and don’t pursue it at all. Everyone has a dream, if you don’t have something to hold on to reach your goal, you should think not only once or twice.
What differs of taking BS Nursing as a course from the other courses is that it demands a lot of patience and effort. Enlisted below, are the top difficulties that a student may encounter while pursuing this endeavor.
Financial predicaments. We are not only talking about tuition fee that ranges twenty to forty five thousand pesos, but also the allowance needed for a student to survive a day that includes transportation, meals, photocopy for hand outs, books and other supplies and paraphernalias.
Time. Clashing of schedules can’t be avoided. When it comes to performing Related Learning Experience outside the Manila Central University, some professors are conducting examinations or quizzes on the schedule given to different groups because not all students could make it, so there should be a clear agreement from the professor and students when it comes to schedule.
Punctuality. It is not really a difficulty but a major concern. If a student could only wake up early to avoid traffic or any unreliable excuses, maybe the percentage for make-up duties of students will be low or eradicated.
Grading system. The grading system of Bachelor Science of Nursing is tremendously different from the other courses. Its passing rate is expected to be seventy five percent unlike the others which is fifty percent. The pressure rises here but the advantage of it is that students are forced to excel and strive harder in order to meet its criteria to pass which prepares them in local board examination.
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Teaching styles competencies. Everyone can teach but not all can be good at this. A professor wh is really an expert in his field sometimes have a higher expectation from the students. He tends to speak fast when discussing without realizing that students couldn’t understand what he was saying so most of the student just rely on notes, memorizing but not understanding or put it on their hearts that’s why most of the students fail when it comes to analytical type of examination especially when it comes to multiple choice because of confusion.
Students have different personalities and uniqueness to perform strategies in order to cope with these difficulties that they could encounter that’s why in spite of the predicaments stated above, huge number of graduates is still expected. Some may give up and fail, some fails but still chose to stand up.
Statement of the Problem
This research study was undertaken to determine the difficulties encountered in nursing course and the stress coping mechanisms of selected junior nursing students of Manila Central University.
Specifically, this study sought to answer the following questions:
1. What are the difficulties that selected junior students encounter in the nursing course?
2. What are the stress coping mechanisms of selected junior students of Manila Central University?
3. What are the most common coping strategies used by the selected junior nursing students of MCU?
Research Objectives
This study aims to reveal the difficulties encountered in the nursing course and the stress coping strategies employed by selected junior nursing students who are currently studying in MCU-CC.
In particular, this study seeks:
To enumerate the difficulties encountered in the nursing course by selected junior nursing students of MCU.
To reveal the stress coping strategies they use to deal with the difficulties.
To determine the most common stress-coping strategies used.
Hypothesis/es
This study will aim to explore the lived experiences of a nursing junior student about the difficulties that they encountered in the nursing course and the stress coping mechanisms that they do.
The research questions that will be addressed in this study guided the development of the following hypothesis:
Significance of the Study
This study will serve as a guiding tool for student nurses whenever they encounter difficulties or problems which bring them stress. It will enlighten them about stress coping strategies which they can use. The researchers believe that through this project study and being student nurses themselves, it will be a great help if we could describe and enumerate thoroughly the difficulties encountered in the nursing course and the stress coping mechanisms in a specific pattern so that our fellow selected Junior Nursing Students of MCU will have additional knowledge on the most common ways of coping in different situations encountered in our daily lives as student nurses. We are aware that every student has their own way of coping in every difficult situation. We just want to ‘dig in’ more deeply.
As we all know, being a nurse is a very hard job. It is very stressful. And knowing that not all people have the same personalities and attributes, every person has their own way of relaxing or unwinding. We would like to study further the ways of our fellow students on their stress coping mechanisms.
And to sum it up, the researchers would enumerate different situations/difficulties a nurse or a student nurse may encounter in the classroom and in hospital duty.
Scope and Delimitations
This study will discuss the different difficulties or problems encountered and the ways of coping of student nurses. The researchers believe that being a registered nurse and being a student nurse has its differences. The researchers would like to focus more on students, knowing that student nurses not only have hospital duties but lecture days as well. The difficulties of registered nurses are more serious in the sense that they have bigger responsibilities that student nurses.
Operational Definition of Terms
Stress – term used to describe the physical, emotional, cognitive, and behavioral responses to events that are appraised as threatening or challenging.
Chapter 2
Review of Related Literature and Studies
2.1 Local Literature
The following is a summary of the difficulties encountered and stress coping mechanisms of nursing students locally:
A nursing student’s life will always be laborious and compelling. Intellectual, physical, and sometimes emotional demands can be encountered in the Nursing discipline. Most Registered Nurses at present had experienced the same predicaments and challenges, in varying degrees, before becoming the great nurses they are today. The prime way on how to deal with the BSN life is to have this realization: It’s never easy to become a nurse. One must pour on a great deal of hard work. Tina (http://nurses.definitelyfilipino.com/index.php/2010/12/a-bsn-students-guide-to-nursing/) is a well organized blog for Filipino Nurses. [1]
In the article stated above, it says that being a nurse is not an easy job. It requires passion, effort, and patience. It’s normal for nurses to have a very stressful routine. But because of individual differences of people, we all have our own ways of dealing with stress, some of us want to eat or maybe meet friends after school or work, sleep. It’s a definitely a fact. We have our own individuality.
2.2 Local Studies
Even at the early beginning of life, stress is being encountered. It appears to be a universal condition which everyone young or old, married or unmarried, Filipino or foreigner, poor or rich, learned or not learned – experiences or develops. In other words, it affects all kinds of people from different walks of life. There are many events in life that can cause stress. It could be generic, physical, chemical, psychological, cultural, ecological or occupational in nature. Simbulan (http://www.jpsimbulan.com/2007/11/19/stress-and-the-working-nurse/) is a site for researches in local nursing and other fields. [2]
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Nurses are not far exempted from facing many stressful things. It has been recognized that the world he lives is a potent source of stress. Nursing is a profession that demands high level of responsibility because it promotes individualized, sensitive, relevant and effective nursing care to patients. Thus, levels of stress are associated with the jobs that are too varied and demanding. Nurses are very much capable of developing a great deal of stress causing either physical or psychological responses in terms of accomplishing the jobs in the hospital settings, as well as in meeting their responsibilities in their respective home because of these hectic activities they have less opportunities for social interaction. Therefore, there is a great for need for studies in order to determine the sources of stressful factors that the behavior of nurses. When a certain individual for example, experiences a stressful situation, that person may try to cope up by making an effort to change the situation into a good one and avoids intolerable situations. Almost all literature claims that work factor produces stress in different levels and that the people vary in their ability to cope with them. In recent years, researcher had begun to investigate costly consequences of occupational stress burnout. Burnout is a state of physical and emotional exhaustion that occurs gradually over a period of time. First described in 1974 by Freudenburger, the “burned-out” are usually professionals who work in people-intensive jobs that are emotionally demanding which is primarily nurses and social workers are likely to be affected. Physical symptoms typically include chronic fatigue and frequent minor illness, such as colds, that resolve slowly. Burned out people spend an overabundance of time at work but are disorganized, easily angered and accomplish little. The most distinguishing characteristic of burnout is the way burned out distance themselves from clients in which distancing is accomplished through depersonalization manner. The burned-out are professionally committed, highly idealistic individuals who over identify in their personal life. Believing their work will make a significant social difference and be financially as well as emotionally rewarding. And these individuals are unprepared for the day to day realities of their jobs that results from suffering stress-related illnesses.
As it is commonly used, stress is referred as a “burden or load” under which a person survives or cracks. It was also been defined as any internal or external influence that interferes with satisfaction of basic needs or somewhat a thing, which disturb homeostasis. This may be a disturbance in the body homeostasis, general or severe enough to produce a coordinated body response. These responses include renal, respiratory, metabolic, sympathetic and circulatory reactions. A well-known psychologist, Hans Selye, also a world renowned authority defined stress as the non-specific response of the body to any demand made upon it. He coined “stressor” as a factor or agent that produces stress. He further stated that the body’s response to stress is non-specific because it occurs without regard to and very much independently of, the specific stressor; thereby non-specific response to stressor is the essence of stress.
Human beings are viewed as an open system which is constantly reacting to his internal and external environment. There will always be occurrence of influential factors that could cause great response of threats to the constancy and stability of the person. During early 1980’s, psychologists had come up of listing stress and had developed certain scales to be stressed and can prepare for this occurrence. The person must be able to adapt himself and master his coping behaviors satisfactory, in a manner to maintain homeostasis. Walter Cannon pointed out that the purpose of homeostasis is freedom in which it allows the person to reach his potentials as human. Homeostasis is also associated with the person’s state of health, it is believe that when person is healthy, he is said to be in state of equilibrium. Health according to Wolff, is the absence of illness had become entrenched in many peoples’ minds and that the aspects of human holistic view is a very vital consideration not only the physical aspects as an outcome.
In other words, stress deals with how the body could adjust to the demands of life. These demands could either be threat, challenge or change that requires the body to respond, either, on the positive or negative side. Thus when the body is able to adapt to a certain demand and serves as a motivator, it is said to be responding positively. Whereas, when the body fails to adapt, in which there is much effort is released by a stress response, it is turned inward responding negatively and disrupted homeostasis occurs.
In addition, effective coping is necessary in managing stress such that it is an integral part of the stress experience. And in order to do these successfully, an individual must deal with the situation or problem, deal with the feelings, use available support and reduce the psychological arousal of stress by appropriate activities such as relaxation, exercise and others.
Simbulan (http://www.jpsimbulan.com/2007/11/19/stress-and-the-working-nurse/) is a site for researches in local nursing and other fields. [3]
2.3 Foreign Literature
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.
Effectively managing stress is a priority for first-year nursing students. Overall time management for the students will determine their ability to successfully negotiate their way through the remaining years of their program. Including holistic care studies for nursing students have shown to result in the ability to study better, better sleeping habits and general health improvement. Requiring stress management within the nursing curriculum assists nurses with teaching coping techniques to clients and hospital visitors.
An effective nursing program provides ongoing stress management workshops during the academic year. There are unique interpersonal and environmental stressors for nursing students. Stressors specific to nursing college students can be addressed by educational administrators. Administrators can address these with an assigned counseling faculty that supports at-risk students.
Key benefits to learning stress coping techniques as nurses include the promotion of these tools among clients and visitors. They are essential for managing the workload of nurses but can also directly contribute to the care of their clients. Insufficient knowledge about stress coping techniques is the primary barrier to its implementation. Complementary medicine and alternative therapies have proven effective. Implementation of these coping techniques within an academic program better prepares nurses for a professional career.
Academic institutions can institute stress management techniques like massage therapy, meditation, yoga, dance and art therapy activities within their orientation program. Specialized training opportunities can supplement coursework for credit and engage nursing students to develop these opportunities. Including nursing students in developing stress management workshops and activities will extend retention in the nursing program.
For nursing students away from home, creating a support system may fall last in their list of priorities. Providing support within the academic system may involve group and individual counseling as well as direct access to resources. Creating a support system with family and friends is a primary stress reduction technique because having the ability to enjoy time away from nursing and studies supports self-care. Nurses must prioritize their own care amid the other care they are required to provide.
Stress Coping Techniques on Nursing Students | eHow.com http://www.ehow.com/way_5646415_stress-coping-techniques-nursing-students.html#ixzz19t5KsYUX
2.4 Foreign Studies
A study was conducted by Ganga Mahat RN, C, EdD entitled Stress and Coping: Junior Baccalaureate Nursing Students in Clinical Settings (Article first published online: 2 AUG 2007). The purpose of this study was to identify junior baccalaureate nursing students’ perceived stressors and ways of coping during the clinical component of nursing education and the use of coping strategies by students with different ethnic backgrounds. Data were collected from 107 junior nursing students enrolled in the first clinical course. Results revealed students frequently perceived stressors in the clinical setting. The findings also revealed that students utilized two problem-focused coping strategies-problem solving and seeking social support coping strategies-more frequently than two emotion-focused coping strategies-tension reduction and avoidance coping. Additional findings revealed that both Caucasian and African-American students used more problem-focused than emotion-focused coping strategies.
2.5 Conceptual Framework
2.6 Theoretical Framework
Sister Callista Roy developed the Adaptation Model of Nursing in 1976. This model comprises the four domain concepts of person, health, environment, and nursing and involves a six step nursing process. Andrews & Roy (1991) states that the person can be a representation of an individual or a group of individuals. Roy’s models see the person as “a bio-psychosocial being in constant interaction with a changing environment” (Rambo, 1984). The person is an open, adaptive system who uses coping skills to deal with stressors. Roy sees the environment as “all conditions, circumstances and influences that surround and affect the development and behavior of the person” (Andrews & Roy, 1991). Roy describes stressors as stimuli and uses the term ‘residual stimuli’ to describe those stressors whose influence on the person is not clear (Andrews & Roy). Originally, Roy wrote that health and illness are on a continuum with many different states or degrees possible (Rambo, 1984). More recently, she states that health is the process of being and becoming an integrated and whole person (Andrews & Roy). Roy’s goal of nursing is “the promotion of adaptation in each of the four modes, thereby contributing to the person’s health, quality of life and dying with dignity” (Andrews & Roy). These four modes are physiological, self-concept, role function and interdependence.
Roy employs a six-step nursing process which includes: assessment of behavior, assessment of stimuli, nursing diagnosis, goal setting, intervention and evaluation. In the first step, the person’s behavior in each of the four modes is observed. This behavior is then compared with norms and is deemed either adaptive or ineffective. The second step is concerned with factors that influence behavior. Stimuli are classified as focal, contextual or residual (Rambo, 1984). The nursing diagnosis is the statement of the ineffective behaviors along with the identification of the probable cause. In the fourth step, goal setting is the focus. Goals need to be realistic and attainable and are set in collaboration with the person (Andrews & Roy, 1991). Intervention occurs as the fifth step, and this is when the stimuli are manipulated. It is also called the ‘doing phase’ (Rambo). In the final stage, evaluation takes place. The degree of change as evidenced by change in behavior, is determined. Ineffective behaviors would be reassessed, and the interventions would be revised (Andrews & Roy).
Source: http://en.wikipedia.org/wiki/Adaptation_model_of_nursing
Chapter III
METHODOLOGY
This chapter presents the methods and procedures which were used in the study of the difficulties encountered and the stress coping strategies used by selected junior nursing students of Manila Central University. It describes the nature of the research study, research locale, sources of data, data gathering instruments and procedures, and the statistical techniques which are to be used in the study.
Research Design
The research design to be used is …..
Research Locale
This study will be conducted mainly in Manila Central University. The research will particularly involve selected junior students from the College of Nursing in MCU-Monumento. At least eighty to ninety percent (80%-90%) of the total student population from the third-year students will be investigated.
Sources of Data
Data Gathering Instruments
The questionnaire that will be used …..
Sampling Technique
The sampling technique to be used is ….
Data Gathering Procedure
The schedules of the junior students are to be acquired primarily, to determine the date and time of the survey. Proper coordination with the professors and/or clinical instructors handling the classes of the respondents will be done prior to the administration of the survey questionnaire. Classrooms where the regular classes of the respondents are held will serve as the testing venue for the conduction of the test.
Before the test will start, the respondents will be asked to indicate their student number on the questionnaires. Aside from the general instructions written on the exam, verbal examples will be given to ensure that the respondents would follow the directions correctly. They will be given fifteen to twenty minutes (15-20 minutes) to answer the questionnaire. The proctors will be advised to make sure that all areas of the questionnaire are answered. The papers will be retrieved as soon as the participants have finished answering them.
Validity of Instruments
The questionnaire used is ……
Statistical Techniques
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