STRESS MANAGEMENT PERFORMED BY THE LEVEL III NURSING STUDENTS OF NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY WITH

REGARDS TO THEIR CLINICAL DUTIES: BASIS FOR A PROPOSED EFFECTIVE QUALITY NURSING CARE

An Undergraduate Thesis Presented to the Faculty of the College of Nursing Nueva Ecija University of Science and Technology

In Partial Fulfillment of the Requirements for the Subject Research I

1

By:

Danica Paula Bianca D. Castillo Mark Anthony S. Castillo Gerly P. Carrasco Jayson A. Cardenas Alona Joy G. Mandia

April 2009

APPROVAL SHEET This thesis entitled “Stress Management Performed by the Level III Nursing Students of Nueva Ecija University of Science and Technology with regards to a Proposed Effective Quality their Clinical Duties: Basis for Nursing Care” prepared and
2

submitted by Danica Paula Bianca D. Castillo, Mark Anthony S. Castillo, Gerly P. Carrasco, Jayson A. Cardenas and Alona Joy G. Mandia in partial fulfillment of the requirements for the degree of Bachelor of Science in Nursing has been examined for oral examination.

ZENAIDA A. VILLARIAZA Ph.D Adviser

Accepted

and

approved

in

partial

fulfillment

of

the

requirements for the degree of Bachelor of Science in Nursing.

EPPIE D.C. BUGARIN RM, RN, MAN Dean, College of Nursing

STRESS MANAGEMENT PERFORMED BY THE LEVEL III NURSING STUDENTS OF NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY WITH REGARDS TO THEIR CLINICAL DUTIES: BASIS FOR A PROPOSED EFFECTIVE QUALITY NURSING CARE THESIS ABSTRACT
3

This study is all about the “Stress Management Performed by the Level III Nursing Students with Regards to their Clinical Duties: Basis for a Proposed Effective Quality Nursing Care”. The descriptive method of research was utilized and the

questionnaire serves as the principal data gathering instrument. There are 267 respondents who fill up the survey questionnaire. The results of the questionnaire were tabulated and interpreted from which the findings and conclusion were drawn. Summary of the findings The following are the summary of findings of the study

based from all the data presented, analyzed and interpreted in chapter IV. 1. Majority of the respondents are in 19 years of age. 2. Majority of the respondents are female. 3. The researchers stressors used sixteen (16) items to enumerate by the level III the

different

encountered

nursing

students with regards to their clinical duties namely: Doing bedside care to the patient with weighted mean equivalent to 3.60 was interpreted as “Often”; Finishing charting on time with weighted mean equivalent to 3.89 was interpreted as “Often”; Handling too many patients with weighted mean equivalent to 3.67 was interpreted as “Often”; Preparation and submission of
4

requirements interpreted

with as

weighted

mean

equivalent with

to

3.67 cases

was with

“Often”;

Patients

serious

weighted mean equivalent to 3.62 was interpreted as “Often”; Lack of hospital facilities and equipments with weighted mean equivalent to 3.43 was interpreted as “Often”; with the patients as with Relationship was

weighted mean equivalent to 2.94

interpreted with

“Sometimes”; Relationship with the co-students mean equivalent with to the 3.01 was interpreted Instructor as with

weighted

“Sometimes”;

Relationship

Clinical

weighted mean equivalent to 2.97 was interpreted as “Sometimes”; Relationship with the staff nurse with weighted mean equivalent to 3.01 was interpreted as “Sometimes”; Relationship with the physicians with weighted mean equivalent to 2.79 was interpreted as “Sometimes”; Relationship with the patient’s family,

relatives and visitors with weighted mean equivalent to 2.99 was interpreted as “Sometimes”; Recognition of some evident changes

concerning patient’s symptoms with weighted mean equivalent to 3.29 was interpreted as “Sometimes”; Mixed cases of patients due to lack of rooms with weighted mean equivalent to 3.31 was

interpreted as “Sometimes”; Unfamiliar healthcare setting in the hospital with weighted mean equivalent to 3.21 was interpreted as “Sometimes”; And lastly wrong procedure performed to the

patients with a weighted mean equivalent to 3.01 was interpreted

5

as “Sometimes” also with the total average mean of 3.28 was interpreted as “Sometimes”. 4. The researchers used thirty (30) items to determine the

different stress management performed by the respondents with regards to their clinical duties namely: Thinking positive and being confident in whatever you do with weighted mean equivalent to 4.23 was interpreted as “Always”; Taking time to rest and relax with weighted mean equivalent to 3.78 was interpreted as “Often”; Spending time with your love ones with weighted mean equivalent to 3.84 was interpreted as “Often”; Praying to God with weighted mean equivalent movies and to 4.66 was on interpreted television as with

“Always”;

Watching

programs

weighted mean equivalent to 3.71 was interpreted as “Often”; Daydreaming with weighted mean equivalent to 2.98 was and

interpreted as “Sometimes”; Listening to music, singing,

dancing with weighted mean equivalent to 3.73 were interpreted as “Often”; Enjoying pleasurable activities with weighted mean equivalent to 3.31 was interpreted as “Sometimes”; Knowing your limits and stick to them with weighted mean equivalent to 3.85 was interpreted as “Often”; Engaging into sports with weighted mean equivalent to 3.31 was interpreted as “Sometimes”; Simply stay at the corner of your room and crying with weighted mean equivalent favorite to foods 2.27 was interpreted mean as “Seldom”; Eating to 3.88 your was
6

with

weighted

equivalent

interpreted as “Often”; Using the internet and playing online games with weighted mean equivalent to 3.89 was interpreted as “Often”; friends, Calling etc... or texting your family members, to relatives, 3.90 was

with

weighted

mean

equivalent

interpreted as “Often”; Making yourself busy by doing household chores with weighted mean equivalent to 3.28 was interpreted as “Sometimes”; Ignoring the problem with weighted mean equivalent to 3.33 was interpreted as “Sometimes”; Getting angry and having mood swings with weighted mean equivalent to 2.86 was

interpreted as “Sometimes”; Laughing at it with weighted mean equivalent assistance to to 3.79 the was interpreted as “Often”; with Asking for mean

Clinical

Instructor

weighted

equivalent to 3.67 was interpreted as “Often”; Verbalization of feelings to fellow students with weighted mean equivalent to 3.64 was interpreted as “Often” ;Reasoning out or answering back with weighted mean Taking equivalent it as a to 3.29 were with interpreted weighted as

“Sometimes”;

challenge

mean

equivalent to 3.86 was interpreted as “Often”; Limiting your contact to the source of stress with weighted mean equivalent to 3.42 was interpreted to 2.67 as was “Often”; Cursing as with weighted mean

equivalent

interpreted

“Sometimes”;

Drinking

alcoholic beverages and smoking with weighted mean equivalent to 2.18 was interpreted as “Seldom”; Taking medication as a

reliever with weighted mean equivalent to 2.42 was interpreted
7

as

“Seldom”;

Doing

physical

exercise

with

weighted

mean

equivalent to 3.09 was interpreted as “Sometimes”; Accepting the reality that sometimes it merely happens with weighted mean

equivalent to 3.81 was interpreted as “Often”; Sleeping with weighted mean equivalent to 3.75 was interpreted as “Often”; Managing your time better with weighted mean equivalent to 3.99 was interpreted as “Often”; With the total average mean of 3.48 was interpreted as “Often”. Conclusions: Based on the findings of the study, the researchers arrived at the following conclusions: 1. That the on level time” III as nursing the students consider “Finishing they have

charting

greatest

stressors

encountered with regards to their clinical duties and the least one is the relationship with the physicians. Meanwhile, the rest of the stressors show that they can also affect the respondents somehow. 2. That the level III nursing students consider praying to God and thinking positive as the number one stress management they usually performed when they feel stress. While simply staying at the corner of the room and crying followed by drinking alcoholic beverages and smoking does not play much role.

8

3.

The

result in

of

the

study

stands

benefit

to

the

nursing The

practice

rendering

effective

quality

nursing

care.

identification of the possible cause and effect of stressors on the level III nursing students will provide them adequate

academic and clinical knowledge on stress. This study will serve as a guide to them on how to manage their stress with regards to their clinical duties. This will also provide information to the Clinical Instructors, healthcare team in the hospital, and

school administrators on how they can help the students upon dealing competent with stress in properly different in order for area students and to to be

enough

clinical

render

quality and effective nursing care to the patients. Recommendations: After the conclusions were drawn, the researchers of the study hereby recommended that: 1. The students must develop not only their nursing skills but

also their ability on handling problems. 2. 3. The students must learn how to rest and relax. The students also need to develop their good working

relationship to others especially with the patients to avoid pro 4. Proper utilization of coping mechanism will help the

9

nursing students to manage their stress and be competent enough in different clinical area. blems that lead to create stressor. 5. The Clinical Instructors must support their students all

the time to establish a harmonious and professional relationship with them and guide them in rendering quality nursing care to the patient. 6. Doctors and Clinical Instructors as well as the staff

nurses should be invited at times as a resource person during ward class and case presentation to give them a sense of

recognition thereby improving good working relationship in the clinical area. 7. The proper approach and continuous support of the staff

nurse and other healthcare provider must be present to help the students cope and deal with the possible problems that they

might encounter in the clinical area. 8. Discussion for the most practical adaptation to prevent the

existence of excessive amount of stress in the individual should be conducted and if found to be already existed, the most

possible activities should be given to decrease the strength of stressors that could affect on physiological, psychological and behavioral make up of the individual.
10

9.

The college of nursing should conduct seminar workshops and that will further develop the student ability and

trainings

capacity to cope up with stress. 10. The future junior nursing students must be properly

equipped with enough knowledge in nursing for them to become confident. Hence, improper coping with stress will be lessened and prevented. 11. Conducting frame another should study be using more to variable arrive and at a bigger more

sample

considered

comprehensive and meaningful conclusion.

ACKNOWLEDGMENT This work is an outcome of the writers’ struggles and

hardships for the completion of their college degree. This is to
11

express the writers’ grateful appreciation to all the people whose assistance helped them accomplish this study: Sincerest and profound gratitude is extended to their

professor Zenaida A. Villariaza Ph. D. for her all out support and for her unselfish dedication as an educator, persistence and encouragement; To Mrs. Maura Usita their critic, for providing direction in writing the study and for painstakingly editing their

manuscript; To the librarians of the Nueva Ecija University of Science and Technology and Wesleyan University of the Philippines, for their assistance and benevolent response on the researchers’

request to avail the rich resources in their library; To the students who serve as their respondents, for their willingness and cooperation during the conduct of this research; To all their esteemed friends, brothers and sisters, for their prayers and moments they have shared with the researchers which are worthy to treasure and cherish; To patience their and most loving parents, and for their love and care, aspirations to give the

undying

support

researchers a brighter future; and
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Most

and

foremost,

the

researchers

offer

praises

and

thanksgiving to our Almighty God, for lavishly equipping the researchers skills. The Researchers with divine support and guidance, knowledge, and

DEDICATION

13

With heartily

love

and

sincerity, to the

this people

humble whose

piece

of

work

is is

dedicated

contribution

significant in making this study a reality. To our mentors, for the great effort they have exerted in molding us to become well rounded and competent students of this institution. To our families, friends and fellow students, for their cooperation for the completion of this work and for their moral support which inspired us in making things possible and in

pursuing our ambition. Above all, to Almighty God who continually showers His

infinite wisdom, blessings, and skills to the researchers.

Danica Mark Gerly Jayson Alona TABLE OF CONTENTS
14

CONTENTS TITLE PAGE APPROVAL SHEET THESIS ABSTRACT ACKNOWLEDGEMENT DEDICATION TABLE OF CONTENTS LIST OF TABLES LIST OF FIGURES CHAPTER I: PROBLEM AND ITS SETTINGS

PAGE i ii iii xi xiii xiv xvi xvi

Introduction …………………………………………………………………………………………………………1 Statement of the Problem …………………………………………………………………………5 Scope and Delimitation ………………………………………………………………………………6 Significance of the Study ………………………………………………………………………7 Definition of Terms ………………………………………………………………………………………9 CHAPTER II: THEORETICAL ORIENTATION AND REVIEW OF RELATED LITERATURES AND STUDIES

Theoretical Orientation ……………………………………………………………………………11 Conceptual Framework ……………………………………………………………………………………12

Research Paradigm ……………………………………………………………………………………………13 Foreign Literature …………………………………………………………………………………………14 Local Literature ………………………………………………………………………………………………18 Foreign Studies …………………………………………………………………………………………………19 Local Studies ………………………………………………………………………………………………………20 Justification of the Studies ……………………………………………………………21
15

CHAPTER III: RESEARCH METHODOLOGY Method of Research …………………………………………………………………………………………22 Research Instruments ……………………………………………………………………………………23 Sources of Data …………………………………………………………………………………………………24 Statistical Treatment of Data ……………………………………………………………24 CHAPTER IV: PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA

Interpretation of the Study …………………………………………………………………27 CHAPTER V: SUMMARY, CONCLUSIONS AND RECOMMENDATIONS Summary Findings ………………………………………………………………………………………………36 Conclusions ……………………………………………………………………………………………………………40 Recommendations …………………………………………………………………………………………………41 BIBLIOGRAPHY

APPENDICES

A. Sample Letter to the Dean B. Sample Letter to the Level III Coordinator C. Sample Letter to the Respondents D. Sample Questionnaires E. Table Presentations CURRICULUM VITAE

16

TABLE
1.1 1.2

2 3 1

LIST OF TABLES TITLE Distribution of Respondents According to Age Distribution of Respondents According to Gender Stressors of Level III Nursing Students Stress Management Performed By the Level III Nursing Students FIGURE Research Paradigm

PAGE 27 28 29 31 13

CHAPTER I THE PROBLEM AND ITS SETTING

17

Introduction Throughout its distinguished history, nursing has had a

significant effect on people’s lives. As rapid change continuous to transform the profession of nursing and healthcare delivery system broader with which it is to indicately influence linked, human nurses embrace Today,

opportunities

well-being.

nurses bring knowledge, leadership, spirit, and vital expertise to expanding roles and that rewards. all is afford However, increase nursing fervent participation, continuous and to

responsibility, evolve,

underlying

time-honored,

profound

commitment to caring. This profession requires academic and clinical training.

The clinical duties that the nursing students have to undergo are an integral part of the course. Related Learning Experiences (RLE) is required in the nursing curriculum. The RLE training is necessary to all nursing students in order that their clinical exposure becomes an in-depth experience, meaningful and early appreciated when they are in actual hospital situation. Any

nursing student who does not undergo sufficient clinical duties maybe considered ill prepared to undergo further hospital

training and may fail miserably in the major nursing course. Every nursing student needs to be given sufficient duties in the different hospital wards/ areas as well as in the
18

different types of hospital services in order to broaden his/her learning experiences while undergoing his or her RLE program. It is in this respect where the clinical duties plays a vital role in the development of proper skills, attitudes, and behavior among nursing students so that when they graduate, take the

board examination and become professional nurses in the future their conducts and work ethics will be greatly influenced by what they have experienced during clinical duties. As the nursing profession continuously emerges, there is always a question on how a healthcare provider renders service to humanity. Many things that someone is experiencing can give rise to what kind of nurse he/she could be. As these nursing students undergo clinical duties, they will meet some kinds of stressors that produce discomfort and irritation conducive to stress that if not given and proper their attention future may affect their

learning

experiences

professional

practice

because stress interferes

with learning. It is in this context

that the study is focused to help the nursing students identify some stressors during their clinical duties and to recommend possible solutions on how to manage this stress most importantly. Stress is our body’s response to changes in our life. Since life involves constant change (ranging from changing locations from home to work each morning to adapting to major life changes
19

like marriage, divorce, or death of a love one), there is no avoiding stress. This is why our goal isn’t to eliminate all stress, but to get rid of unnecessary stress, and effectively manage the rest. Some common causes of stress that many nurses are experiencing are increasing the severity of clients’

illnesses, adjusting to various work shifts, being expected to assume responsibilities for which one is not prepared, and

inadequate support from supervisors and peers. There are different types of stress that range from

Eustress, which is a positive and exciting form of stress, to Chronic Stress, which has been linked to many serious health issues, and is the type of negative stress most often mentioned in the news. While we want to manage or eliminate the negative types of stress, we also want to keep positive forms of stress in our lives to help us remain vital and alive. Stress affects us in different ways, not all of which are negative. In fact, the stress of an exciting life can actually serve as a good motivator and keep things interesting. However, when stress levels get too intense, people will experience its negative effect. Some of it are headaches, irritability and

‘fuzzy thinking’. These effects are evident that we’re under too much stress. However, not everybody who is under stress will experience these specific symptoms.
20

We all feel overwhelmed from time to time; that is normal. It is virtually impossible to eliminate times when events

conspire and the body’s stress response is triggered, but there are ways that we can quickly reverse our body’s reaction to stress, like buffering the damage to our health and keeping our thinking clear so we can more deal effectively with what’s going on in the moment. It may seem that there is nothing we can do about our stress level. However, we have a lot more control than we might think. In fact, the simple realization that we are in control of our life is the foundation of stress management.

Managing stress is all about taking charge of our thoughts, our emotions, our schedule, our environment, and our problems. The ultimate goal is a balanced life, with time for work,

relationships, relaxation, and fun – plus the resilience to hold on under pressure and to meet challenges head on. There are many ways to manage unhealthy stress in our life. The key to stress reduction is identifying strategies that work for us. As we begin to understand more about how stress affects us, we will develop our own ideas to help relieve the tension. Because each person is unique, some of these stress

management strategies will be more helpful for you than others, and some will be new skills that require practice to be
21

effective. Think about learning to ride a bicycle. There was a time when this was a new skill and felt very unnatural and awkward. You probably needed help at first but with some

coaching, practice, and stress management, cycling or any other skill, becomes easier and more effective. Statement of the Problem This study was conducted to analyze the “Stress management performed University by of the level III and nursing Technology students with of Nueva to Ecija their

Science

Regards

Clinical Duties: Basis for a Proposed Effective Quality Nursing Care”. Specifically, questions: 1. How may the profile of the level III nursing students of Nueva Ecija University of Science and Technology be described in terms of the following:
1.1 age 1.2 gender

this

study

aims

to

answer

the

following

2. What are the different stressors encountered by the level III nursing students of Nueva Ecija University of Science and Technology with regards to their clinical duties?
22

3. What are the different stress management performed by the respondents with regards to their clinical duties? 4. What are the implications of this study to nursing practice in rendering effective quality nursing care? Scope and Delimitation This study was entitled “Stress Management Performed by the Level III Nursing Students of Nueva Ecija University of Science and Technology with regards to their Clinical Duties: Basis for a Proposed Effective Quality Nursing Care”. The primary focus of this study was directed toward the different stress management that the third year nursing students usually utilized and performed to alleviate their stress and to render effective quality nursing care to their patients. The data however were limited from those gathered from the nursing students as from Nueva Ecija of the University study of Science the and

Technology

respondents

during

second

semester of school year 2008-2009. Significance of the Study The researchers believe in the merits of the study

especially to the following:

23

the

researchers,

conducting

this

kind

of

study

brought

a

learning experience for them. It handed them the pulse of the major level III nursing students when it comes to stress

management they performed with regards to their clinical duties, which was hardly known without survey. the nursing students, who may acquire greater insights of the stressors, problems and challenges they may encounter all

throughout their clinical performances which is part of their chosen career. This knowledge will give them better and wider perspective about their profession and aid them in enhancing their coping abilities and self-confidence. the Clinical Instructors, the findings may provide them

understanding why nursing students behave like they do. This study will also provide them hints of what remedial measures they need to institute to lessen the learning difficulties of their students while undergoing clinical exposure. Further, it will eventually help them to build a better relationship with the students, promote educational growth, and improve human and public relations with the identified clinical area of operation. the school administrators and faculty, who may help to work out solutions and course of action that will improve the students’ performance and to lessen their burden in their clinical duties while on the learning process. It also gives them the chance to
24

improve the quality of nursing education for the benefit of the students and the institution as well. the parents, this study will gives insights to the parents about the stressors encountered by their siblings and to prepare them nor strengthen them by means of giving emotional and moral

supports in ways that may help them how to face and manage their stress during their clinical duties. The patients, who are the recipients of the healthcare service given by the nursing students. the future researchers, this study can serve as reference

material to those students who will conduct exactly the same or related studies.

Definition of Terms To convey clearly the meaning of the words used in this study, the researchers defined the terms used operationally, as follows: Clinical Area. This pertains to the hospital setting wherein the nursing students apply and practice what they have learned in terms of rendering or applying nursing care and focusing on the holistic being of the patient.
25

Clinical

Instructors.

These

refer

to

persons

who

impart

knowledge to the students. Clinical students Duties. in These refer to the exposure of the nursing hospital wards/areas as well as in

different

different types of hospital services in order to broaden his/her learning experiences while undergoing the Related Learning

Experience program. Coping. This refers to the adaptation to stress events. Management. This refers to the act or art of managing the whole system of care and treatment of a sick individual. Nursing Students. These refer to the students enrolled in the College of Nursing in Nueva Ecija University of Science and

Technology. Nueva Ecija University of Science and Technology. This is a

state university that provides advanced instructional training in arts, science and technology, education and other related fields. It also leads the leader to attain perfection at a level that will enable him to pursue higher education of gainful

occupation. Related exposure, Learning which Experience. the This pertains to the clinical is
26

nursing students have to undergo. It

required to all nursing students in order for them to have an in

– depth and meaningful experience and easily appreciated when they are already in actual hospital situation. Stressors. This pertains to the factors affecting the

performances of the nursing students.

CHAPTER II THEORETICAL ORIENTATION AND REVIEW OF RELATED LITERATURE AND STUDIES

This

chapter

presents

the

theoretical

orientation

and

review of related literature and studies by the researchers that are relevant to the present investigation. Theoretical Orientation
According to Richard Lazarus and Susan Folkman(1984) stress could be thought of as resulting from an “imbalance between demands and 27

resources”

or

as

occurring

when

“pressure

exceeds

one's

perceived

ability to cope”. Stress management was developed and premised on the idea that stress is not a direct response to a stressor but rather one's resources and ability to cope mediate the stress response and are amenable to change, thus allowing stress to be controllable.

In

order

to

develop

an

effective

stress

management

programme it is first necessary to identify the factors that are central to a person controlling his/her stress, and to identify the intervention methods which effectively target these factors. Lazarus and Folkman's interpretation of stress focuses on the transaction between people and their external environment (known as the Transactional Model). The model conceptualizes stress as a result of how a stressor is appraised stressor-stress link by proposing that if stressors are perceived as positive or

challenging rather than a threat, and if the stressed person is confident that he/she possesses adequate rather than deficient coping strategies, stress may not necessarily follow the

presence of a potential stressor. The model proposes that stress can be reduced by helping stressed people change their

perceptions of stressors, providing them with strategies to help them cope and improving their confide Stress is a condition in which the person responds in the normal balanced state. Most of the concerns and and in worries cases, are out commonly of repetitive, to ongoing, actual
28

extreme

most

proportion

the

situation. Some of these things are relationships, work, health or family’s health and finances. Because of these worries, the person experiences very high level of stress on regular basis. Conceptual Framework
Research paradigm is shown on Figure 1. This included the input, the process, and the output. The input contains the profile of the level III nursing students of Nueva Ecija University of Science and Technology, the different stressors they encountered, and the

different stress management they performed to alleviate their stress. In the process, questionnaires were distributed and observations were • conducted to gather pertinent information from the respondents. It “STRESS MANAGEMENT Students’ • Distribution of also included the analysis and evaluation of the gathered data and Profile Questionnaire PERFORMED BY THE information from the respondents using statistical treatment such as • Observation LEVEL III NURSING The different frequency count, percentage, average mean, weighted means, and • Analysis and stressors STUDENTS OF NUEVA evaluation using analysis. by encountered ECIJA UNIVERSITY OF statistical the level III treatment the stress AND nursing The output was consist of the findings about SCIENCE 1.Frequency students management of performed by the respondents. TECHNOLOGY WITH Count Nueva Ecija REGARDS TO THEIR 2. Percentages Research Paradigm University of 3. Average Mean CLINICAL DUTIES: Science and Input Process Output Technology with 4. Weighted Mean BASIS FOR A regards to PROPOSED EFFECTIVE their clinical duties. • The stress management performed to by the respondents alleviate their stress 29 different QUALITY CARE” NURSING

30

Figure 1

Research paradigm used in this study is illustrated in Figure 1. It shows the steps adopted by the researchers in order to come up with the output of the study. It best describes the idea of the procedural design used by the researchers. Foreign Literature Stress is a feeling that is created when we react to particular events. It is the body's way of rising to a challenge and preparing to meet a tough situation with focus, strength, stamina, and heightened alertness.

The events that provoke stress are called stressors, and they cover a whole range of situations everything from outright physical danger to making a class presentation or taking a semester's worth of your toughest subject.

The human body responds to stressors by activating the nervous system and specific hormones. The hypothalamus signals the adrenal glands to produce more of the hormones adrenaline and cortisol and release them into the bloodstream. These hormones speed up heart rate, breathing rate, blood pressure, and metabolism. Blood vessels open wider to let more blood flow to large muscle groups, putting our 31

muscles on alert. Pupils dilate to improve vision. The liver releases some of its stored glucose to increase the body's energy. Moreover, sweat is produced to cool the body. All of these physical changes prepare a person to react quickly and effectively to handle the

pressure of the moment.

This natural reaction is known as the stress response. Working properly, the body's stress response enhances a person's ability to perform well under pressure. However, the stress response can also cause problems when it overreacts or fails to turn off and reset itself properly.( Wikipedia, 2008. "Stress (biological)"

http://en.wikipedia.org/wiki/Stress_(medicine))

Rebecca J. Frey(2009) said that stress in humans results from interactions between persons and their environment that are perceived as straining or exceeding their adaptive capacities and threatening their stress well-being. responses The element of perception in indicates that as human as

reflect

differences

personality,

well

differences in physical strength or general health. Risk factors for stress-related illnesses are a mix of personal, interpersonal, and social variables. These factors include lack or loss of control over one's physical environment, and lack or loss of social support networks. People who are dependent on others (e.g., children or the elderly) or who are socially disadvantaged (because of race, gender, educational level, or similar factors) are at greater risk of developing stress-related illnesses. Other risk factors 32

include feelings of helplessness, hopelessness, extreme fear or anger, and cynicism or distrust of others.

Selye explained that stress is non specific response of the body to pay demand made upon it under ordinary circumstances, the body’s reaction to specific stimulus anticipate because of its repetitive pattern. Therefore, a person experiences pain. When the body is warm, it perspires and when it is used the body shivers. All human exhibits uniform response to stimulus because of homeostasis. When response is erotic and does not uniform to the usual reaction the body expected is said to from be the in application of the of

stimulus,

stress.(“The

Nature

Stress” http://www.icnr.com/articles/thenatureofstress.html) Walter Cannon(2009) in the meantime said that the human body reacts either positively or negatively to a stress factor producing two kinds of possible reaction. When the human body tries to flee from stress situation, negative reaction is

exhibited. Positive reaction comes about when the body makes the principle of homeostasis apply the body to overcome stressful situation which is known as adaptation or coping. He advocated that while the concepts of stress is an absolute fact, its

presence and intensity reception are all relative in accordance with the physical and psychological make up of the individual. All people therefore, experience stress but the way stress is
33

present and is handled by each individual is unique for each other. A little difficulty is hardly felt by another.
By understanding, we can more easily identify stress factors and their effects on who need or seek healthcare. Each individual is

experiencing stress, in her own particular manner. How the individual adopt or fails to adopt depend on several factors: personality and conditional make past experiences dealing with stress. It is important to remember that stress syndrome can be both positive and negative. Any change or alteration in the balance of life can create stress. We are all unique individual, we respond

differently to various stressors. Thus, it neither does nor matter. Whether, it is positive or negative light or severe. What matter is how we developed adoptive mechanism to cope with these stressors and can be translated as the ability to withstand stress and create a life experiences that do not work against you. The implication of stress theory is by being able to withstand stress and by coping with it. Diluting it when occurs and eliminating it, you can actually affect your life. You are not programmed for premature aging. The fact is you control your own health. The quote of the journal of American Medical Association says, “Nature did not intend to grow old and ill, we were designed to die young in old age but free of disease”.

Schafer (2000) defined stress as the “arousal of mind and body in response on the demand made upon them”. The concept of stress is important because it provides a way of understanding
34

the person as a human being who responds in totality (mind, body and spirit) to a variety of changes that takes place in daily life.
Local Literature Accrding to Maraya de Jesus Chebat stress is here to stay. What people must do is to learn more about its nature, sources and

alternatives so that people used the energy positively and work in the best possible way. Orlandi stated, “Your ability to tolerate stressors depends on the number of stressors in your life”. People who can handle stress use their coping mechanism, which is powerful tool to use, to analyze events objectively and observe calmly. Gather information at the state of equilibrium, understanding of what to produce the tension that helps you feel that the stress is alleviated. Miranda specified that the most effective way of managing stress are through relation and exercise which ironically are extremely

aesthetical acts which involved dynamics of the mind and body. People who are always stress survivors stay healthy throughout their lives. They consider stressful situation opportunist for growth. Foreign Studies According to Ann Marriner Tomey et. Al,(2004) Stress is a part of every student's daily life. Leaving home or commuting daily managing, finances, living with roommates, and juggling work, classes, and 35

relationships all contribute to the normal stress of being a student. In addition, it is not uncommon for students to feel stressed and anxious about wasting time, meeting high standards, or being lonely. Stress can also come from exciting or positive events. Falling in love, preparing to study abroad, or buying a car can be just as

stressful as less-happy events. One of the most important things you can do is to recognize when your stress levels are building. The amount of stress that you can tolerate before you become distressed varies with your life situation and your age. A critical first step in coping with stress is taking stock of the stressors in your life. Whenever stress is present, your body reacts. It acts like an alarm system that prepares your body to depend yourself. A little stress is good. It helps you think faster and harder and makes you put that extra bit of effort to meet in the challenge of life. On the other hand, Lether and Woolfolk say that the relaxation is the very valuable stress management technique that can soothe the emotional turmoil and suppress problematic psychological arousal.

While Martin and Lefcourt, suspected humor might be worthwhile coping response. Empirical evidence to that effect has emerged only recent years. For them good humor functions as buffer to lessen the negative impact of stress. Local Studies

36

According to Calderon, people who experience a high level of stress for a long time and who cope poorly with this stress may become irritable, socially withdrawn, and emotionally unstable. They may also have difficulty concentrating and solving problems. Some people under intense and prolonged stress may start to suffer from extreme anxiety, depression or other severe emotional problems. Odrigo G. Ancheta says that, “Stress gives us energy to cope with the demanding activity of life. It is true that stress is a normal constant part of our life because it involves changes, challenges and emotions. Try to imagine life without stress. You would not have any challenges anything to affect your emotions and anything new and

exciting. It gives as energy because it activity involves physically and emotionally. Stress might be considered as a problem because we often bear about stress in a negative light that people may only associate’s bad experiences with stress. How you perceived and handled stressors will determine whether the stress is good or bad for you. A situation that seems extremely stressful to you could leave very calm to somebody. Flores (2000) said that a person who is stressed typically less anxious thoughts and difficulty concentrating or remembering. Stress can also change outward behaviors. Teeth clenching, hand wringing, pacing, nail biting, and heavy breathing are common signs of stress. People also in feel the physically stomach, different cold hands when and they are dry stress. and

Butterflies

feet,

mouth

37

increase heart rate are all physiological effects of stress that we associate with the emotion of anxiety. Justification of the Study The past study discussed in this chapter has given the researcher the concept, theories and principles that pave the way to the ideas of the present study and good starting point for the researcher in

assessing the stressors and the stress management performed by the respondents with regards to their clinical duties. The review has enabled the researchers to have a better

understanding of ideas of different well known writers which resulted to broadening the researchers own thinking in relation to the present study.

CHAPTER III METHODS, PROCEDURES, AND SOURCES OF DATA

38

This

chapter

presents

the

method

of

research

used,

the

instruments, the sources of data and the procedures used in gathering of data which employed by the researchers.

Methods of Research The researchers took into consideration the present factors and current conditions of a group of persons, events or a class in finding facts and data to be interpreted. was This to summary includes this in the

descriptive

method,

which

used

accomplish

study.

Descriptive research is a study in which bodies of data are collected, recorded and analyzed. It is used to answer questions, satisfy

curiosity established a cause and effect relationship. Moreover, descriptive researching is the most popular approach in research. area of It systematically, or factually and accurately describes analysis an and

interest

situation.

Description,

interpretation of conditions that exist are involved. Researchers may also deal with comparison and contrast or the discovery of existing relationship between events or groups. In addition, as this method of research was used in the study it describes systematically the nursing course and stress management

performed by the level III nursing students of Nueva Ecija University of Science and Technology with regards to their clinical duties: Basis for a Proposed Effective Quality Nursing Care. The study describes also its symptoms, management or treatment and situations in which 39

stress may arise in order to obtain a factual and accurate result of the research in which student could avail. Research Instruments The researchers used the questionnaire as the primary tool in gathering data. This was made from created materials and statements that could generate the the desired direction result given when by the correspondents for

followed answering.

correctly

the

researchers

The construction of the questionnaire was preceded by intensive perusal and review insights questions of in related forming on literature, the their which provided the

researchers formulated

questionnaire. readings from

The

researchers books,

based

various

manuals, journal and experiences as nursing students. The questionnaire was first drafted for the approval of their adviser and other members of the faculty who are knowledgeable on the topic. This is composed of 4 problems. Problem no. 1 involves the profile of the level III nursing student of Nueva Ecija University of Science and Technology. Problem no. 2 involves the different stressors encountered by the level III nursing students of Nueva Ecija

University of Science and Technology with regards to their clinical duties. Problem no. 3 is the different stress management performed by the respondents. While, Problem no. 4 is the implication of the study to nursing practice in rendering effective quality nursing care. Then the final draft was reproduced for distribution to the respondents. 40

Sources of Data The researcher used the level III nursing students of Nueva Ecija University of Science and Technology as their respondents who were randomly selected from eleven sections. They were chosen using single random sampling, each number of the population has an equal chance to be included in the sample gathered. (Ymas Jr, et. al. 2006) Their reported. Statistical Treatment of Data After the distribution, collection and completion of distributed questionnaires, the researchers tallied the gathered data and used frequency, percentage, average mean, weighted mean, and interpretation and ranking The following statistical computations were accomplished using the following formula: For the Percentage Computation of the percentage was made using the expression: Percentage (%) = F x 100 N Where: %- Percentage 41 reactions, opinions and suggestions were analyzed and

F- Frequency or number of response to every item or question N- Total number of respondents For the Average Mean Computation of the average mean was made using the expression: AM= F x E (DoR) Where: AM- Average mean F- Frequency used E- Numerical equivalent/ degree of response For the Weighted Mean Computation of the weighted mean was made using the expression: WM=AM N Where: WM- Weighted mean AM- Summation of the degree of response multiply frequency (F x E (DoR)) N- Total number of respondents

42

The researcher used ranking to determine the position of each variable. NUMBER VALUE 4.20-5.00 3.40-4.19 2.60-3.39 1.80-2.59 1.0-1.79 4 3 2 1 E (DoR) 5 INTERPRETATION Always Often Sometimes Seldom Never

Finally, the findings were summarized and compared with each work; conclusions were drawn, and recommendations were formulated.

43

CHAPTER IV PRESENTATION, ANALYSIS, AND INTERPRETATION OF DATA

This chapter presents the data gathered in this study which has been carefully presented, analyzed, and interpreted. These data were gathered by the researchers to the two hundred sixty seven (267) junior nursing students enrolled at the College of Nursing, Nueva Ecija University of Science and Technology as of A.Y. 2008-2009. Table 1.1 Distribution of Respondents According to Age

Age 17years 18years 19years 20years 21years 22years 23years TOTAL

old old old old old old old

Frequency 2 67 152 35 6 3 2 267

Percentage 0.75% 25.09% 56.93% 13.11% 2.25% 1.12% 0.75% 100%

Rank 6 2 1 3 4 5 6 27

Table 1.1 presents the data of the respondents in terms of their age. There are 2 or 0.75% of the respondents who are 17 years old which ranked 6; 67 or 25.09% of the respondents who are 18 years old which ranked 2; 152 or 56.93% of the

respondents who are 19 years old which ranked 1; 35 or 13.11% of the respondents who are 20 years old which ranked 3;6 or 2.25%
44

of the respondents who are 21 years old which ranked 4; 3 or 1.12% of the respondents who are 22 years old which ranked 5;2 or 0.75% of the respondents who are 23 years old and above which also ranked 6. The data indicate that the respondents are at the right age to consider them as mature individuals capable of managing

stress. It also shows that majority of the respondents are 19 years old. Table 1.2 Distribution of Respondents According to Gender

Gender Male Female TOTAL

Frequency 114 153 267

Percentage 42.70% 57.30% 100%

Rank 2 1 3

Table 1.2 presents the data of the respondents in terms of their gender. There are 114 or 42.70% of the respondents who are male and 153 or 57.30% of the respondents who are female.

45

This indicates that majority of the students enrolled as nursing students are female.Wherein, they are more capable of adjusting to the stressors resulting to stress management rather than males.

Table 2 Stressors of Level III Nursing Students ITEM 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11 2.12 2.13 2.14 2.15 2.16 STRESSORS Doing bedside care to the patient. Finishing charting on time Handling too many patients Preparation and submission of requirements Patient with serious cases Lack of hospital facilities and equipments Relationship with the patient Relationship with the co-students Relationship with Clinical Instructors Relationship with staff nurses Relationship with the physicians Relationship with patient’s family, relatives, and visitors Recognition of some evident changes concerning patient’s symptoms Mixed cases of patients due to lack of room Unfamiliar healthcare setting in the hospital Wrong procedure performed to the patient TOTAL WEIGHTED MEAN 3.28 WM 3.60 3.89 3.67 3.67 3.62 3.43 2.94 3.01 2.97 3.01 2.79 2.99 3.29 3.31 3.21 3.01 SOMETIMES VERBAL INTERPRETATION OFTEN OFTEN OFTEN OFTEN OFTEN OFTEN SOMETIMES SOMETIMES SOMETIMES SOMETIMES SOMETIMES SOMETIMES SOMETIMES SOMETIMES SOMETIMES SOMETIMES RANK 5 1 2.5 2.5 4 6 15 10.5 14 10.5 16 13 8 7 9 10.5

Table 2.1 presents the different stressors of level III nursing students with regards to their clinical duties. Item 2.1 “Doing bedside care to the patient” got a weighted mean of 3.60, item 2.2 “Finishing charting on time” got a weighted mean of 3.89, item 2.3 “Handling too many patients” got a weighted mean
46

of 3.67, item 2.4 “Preparation and submission of requirements” got a weighted mean of 3.67, item 2.5 “Patient with serious cases” got a weighted mean of 3.62 and item 2.6 “Lack of

hospital facilities and equipments” got a weighted mean of 3.43 and interpreted as “Often”. This indicates that the routine practices in the hospitals is one of the reason for the nursing students to be

stressed.This also indicate that a holistic approach should also maintain in dealing with patients and in treating them as a human being or as a whole with body, mind, and spirit and not just merely a person with a specific disease. With the item 2.7 “Relationship with the patient” got a weighted mean of 2.94, item 2.8 “Relationship with the co-

students” got a weighted mean of 3.01, item 2.9 “Relationship with the Clinical Instructors” got a weighted mean of 2.97, item 2.10 “Relationship wit the staff nurses” got a weighted mean of 3.01, item 2.11 of “Relationship 2.79, item with 2.12 the physicians” got a the

weighted

mean

“Relationship

with

patient’s family, relatives and visitors” got a weighted mean of 2.99, item 2.13 “Recognition of some evident changes concerning patient’s symptoms” got a weighted mean of 3.29, item 2.14

“Mixed cases of patients due to lack of rooms” got a weighted mean of 3.31, item 2.15 “Unfamiliar healthcare setting in the
47

hospital”

got

a

weighted

mean

of

3.21

and

item

2.16

“Wrong

procedure performed to the patient” got a weighted mean of 3.01 and interpreted as “Sometimes”. This indicates that sometimes dealing with the hospital

personnels makes the students feel uncomfortable when they ask questions,expect satisfactory performances from them, and do not trust the students own capabilities that’s why instead of

relying on the staff nurses and even Clinical Instructor they prefer to rely on their own. Thus, resulting in failure to

establish harmonious and good working relationship with them.
Table 3 Stress Management Performed By the Level III Nursing Students

ITEM 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13

STRESSORS Thinking positive and being confident in whatever you do Taking time to rest and relax Spending time with your love ones.(Family, friends or even pets) Praying to God Watching movies and other programs on television Day dreaming Listening to music, singing and dancing Enjoying pleasurable activities. (Playing instrument, reading, drawing, painting, etc.) Knowing your limits and stick to them Engaging into sports Simply stay at the corner of your own room and crying Eating your favorite foods Using the internet (chat,friendster, facebook, etc.) and playing on line games

WM 4.23 3.78 3.84 4.66 3.71 2.98 3.73 3.31 3.85 3.31 2.27 3.88 3.89

VERBAL INTERPRETATION ALWAYS OFTEN OFTEN ALWAYS OFTEN SOMETIMES OFTEN SOMETIMES OFTEN SOMETIMES SELDOM OFTEN OFTEN

RANK 2 12 9 1 15 25 14 20 8 21 29 6 5

48

3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30

Calling and texting your family members, relatives, friends, etc. Making yourself busy by doing household chores Ignoring the problem Getting angry and having mood swings Laughing at it Asking for assistance to the Clinical Instructor Verbalization of feelings to a fellow student Reasoning out or answering back Taking it as a challenge Limiting your contact to the source of stress Cursing Drinking alcoholic beverages and smoking Taking medication as a reliever Doing physical exercises. (Jogging, running, aerobics, etc.) Accepting the reality that sometimes it merely happens Sleeping Managing your time better TOTAL WEIGHTED MEAN 3.48

3.90 3.28 3.33 2.86 3.79 3.67 3.64 3.29 3.86 3.42 2.67 2.18 2.42 3.09 3.81 3.75 3.99 OFTEN

OFTEN SOMETIMES SOMETIMES SOMETIMES OFTEN OFTEN OFTEN SOMETIMES OFTEN OFTEN SOMETIMES SELDOM SELDOM SOMETIMES OFTEN OFTEN OFTEN

4 23 19 26 11 16 17 22 7 18 27 30 28 24 10 13 3

Table 3.1 presents the stress management performed by the respondents to handle and alleviate their stress. Item 3.1

“Thinking positive and being confident in whatever you do” got a weighted mean of 4.23 and item 3.4 “Praying to God” got a

weighted mean of 4.66 are interpreted as “Always”. This indicates that the rspondents believe that praying is the most and above all the effective and reliable stress

management that they can perform because this can give us a renewed sense of clarity, purpose, and peace that’s why we

should never loose hope because God is always with us. A sincere prayer from the heart can instantly bring soothing comfort and
49

quick stress relief. Prayer reminds us we are not really alone. Prayer can give us an immediate and deep sense of safety, and peace regardless of the external circumstances we face. With the item item 3.2 “Taking time to rest and relax” got a weighted mean of 3.78, item 3.3 “Spending time with your love ones (Family, friends, or even pets)” got a weighted mean of 3.84, item 3.5 “Watching movies and other programs on

television” got a weighted mean of 3.71, item 3.7 “Listening to music, singing, and dancing” got a weighted mean of 3.73, item 3.9 “Knowing your limits and stick to them” got a weighted mean of 3.85, item 3.12 “Eating your favorite foods” got a weighted mean of 3.88, the item 3.13 “Using the internet (chat, face book, friendster, etc.) and playing online games” got a weighted mean of 3.89, item 3.14 which is “Calling and texting your

family members, relatives, friends, etc.” got a weighted mean of 3.90, item 3.18 “Laughing at it” got a weighted mean of 3.79, item 3.19 “Asking for assistance to the Clinical Instructor” got a weighted mean of 3.67, item 3.20 “Verbalization of feelings to fellow student” got a weighted mean of 3.64, item 3.22 “Taking it as a challenge” got a weighted mean of 3.86, item 3.23

“Limiting your contact to the source of stress” got a weighted mean of 3.42, item 3.28 “Accepting the reality that sometimes it merely happens” got a weighted mean of 3.81, item 3.29
50

“Sleeping” got a weighted mean of 3.75 and item 3.30 “Managing your time better” got a weighted mean of 3.99 and interpreted as “Often”. This indicates that it is necessary to alter one’s

attention so that stress will not be the primary of interest. With the item Item 3.6 “Daydreaming” got a weighted mean of 2.98, item 3.8 “Enjoying books pleasurable or magazines, activities drawing, (Playing painting,

instruments,

reading

etc.)” got a weighted mean of 3.31, item 3.10 “Engaging into sports” got a weighted mean of 3.31, item 3.15 “Making oneself busy by doing household chores” got a weighted mean of 3.28, item 3.16 “Ignoring the problem” got a weighted mean of 3.33, item 3.17 “Getting angry and having mood swings” got a weighted mean of 2.86, item 3.21 “Reasoning out or answering back” got a weighted mean of 3.29, item 3.24 “Cursing” got a weighted mean of 2.67 and and item 3.27 “Doing a physical weighted exercise mean of (jogging, 3.09 and

running,

aerobics)”got

interpreted as “Sometimes”. This indicates that the respondents do cursing and

reasoning out just to manage the stress. And lastly, item 3.11 “Simply staying at the corner of your room and crying” got a weighted mean of 2.27, item 3.25
51

“Drinking alcoholic beverages and smoking” got a weighted mean of 2.18 and item 3.26 “Taking medication as a reliever” got a weighted mean of 2.42 This implies and interpreted as “Seldom”. the respondents are mature enough to

that

adjust and manage their stress because instead of staying at the corner of the room and crying for nothing they prefer to do something to work for possible solutions. This implies also that the nursing students believe that drinking alcoholic beverages and smoking is inappropriate management for stress because it might increase the risk for illnesses instead. Implication of the Study The result of the study on the “Stress management performed by the respondents with regards to their clinical duties” stands benefit to the nursing practice. The identification of the

possible cause and effect of stressors on the level III nursing students will provide them adequate academic and clinical

knowledge on stress. This study will serve as a guide to them on how to manage This their stress with regards to their to the and clinical Clinical school

duties.

will

also

provide team in

information the

Instructors,

healthcare

hospital,

administrators on how they can help the students upon dealing with stress properly in order for students to be competent

52

enough

in

different

clinical area and to render quality

and

effective nursing care to the patients.

CHAPTER V SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS

This

presents

the

summary

of

the

study,

formulated

conclusion and recommendations offered. Summary of the findings: This study is all about the “Stress Management Performed by the Level III Nursing Students with Regards to their Clinical Duties: Basis for a Proposed Effective Quality Nursing Care”. The descriptive method of research was utilized and the

questionnaire serves as the principal data gathering instrument. There are 267 respondents who fill up the survey questionnaire. The results of the questionnaire were tabulated and interpreted from which the findings and conclusion were drawn. The following are the summary of findings of the study based from all the data presented, analyzed and interpreted in chapter IV.
53

1. Majority of the respondents are in 19 years of age. 2. Majority of the respondents are female. 3. The researchers stressors used sixteen (16) items to enumerate by the level III the

different

encountered

nursing

students with regards to their clinical duties namely: Doing bedside care to the patient with weighted mean equivalent to 3.60 was interpreted as “Often”; Finishing charting on time with weighted mean equivalent to 3.89 was interpreted as “Often”; Handling too many patients with weighted mean equivalent to 3.67 was interpreted as “Often”; weighted Preparation mean and submission to 3.67 cases of was with

requirements interpreted

with as

equivalent with

“Often”;

Patients

serious

weighted mean equivalent to 3.62 was interpreted as “Often”; Lack of hospital facilities and equipments with weighted mean equivalent to 3.43 was interpreted as “Often”; with the patients as with Relationship was

weighted mean equivalent to 2.94

interpreted with

“Sometimes”; Relationship with the co-students mean equivalent with to the 3.01 was interpreted Instructor as with

weighted

“Sometimes”;

Relationship

Clinical

weighted mean equivalent to 2.97 was interpreted as “Sometimes”; Relationship with the staff nurse with weighted mean equivalent to 3.01 was interpreted as “Sometimes”; Relationship with the physicians with weighted mean equivalent to 2.79 was interpreted
54

as

“Sometimes”;

Relationship

with

the

patient’s

family,

relatives and visitors with weighted mean equivalent to 2.99 was interpreted as “Sometimes”; Recognition of some evident changes

concerning patient’s symptoms with weighted mean equivalent to 3.29 was interpreted as “Sometimes”; Mixed cases of patients due to lack of rooms with weighted mean equivalent to 3.31 was

interpreted as “Sometimes”; Unfamiliar healthcare setting in the hospital with weighted mean equivalent to 3.21 was interpreted as “Sometimes”; And lastly wrong procedure performed to the

patients with a weighted mean equivalent to 3.01 was interpreted as “Sometimes” also with the total average mean of 3.28 was interpreted as “Sometimes”. 4. The researchers used thirty (30) items to determine the

different stress management performed by the respondents with regards to their clinical duties namely: Thinking positive and being confident in whatever you do with weighted mean equivalent to 4.23 was interpreted as “Always”; Taking time to rest and relax with weighted mean equivalent to 3.78 was interpreted as “Often”; Spending time with your love ones with weighted mean equivalent to 3.84 was interpreted as “Often”; Praying to God with weighted mean equivalent movies and to 4.66 was on interpreted television as with

“Always”;

Watching

programs

weighted mean equivalent to 3.71 was interpreted as “Often”; Daydreaming with weighted mean equivalent to 2.98 was
55

interpreted as “Sometimes”; Listening to music, singing,

and

dancing with weighted mean equivalent to 3.73 were interpreted as “Often”; Enjoying pleasurable activities with weighted mean equivalent to 3.31 was interpreted as “Sometimes”; Knowing your limits and stick to them with weighted mean equivalent to 3.85 was interpreted as “Often”; Engaging into sports with weighted mean equivalent to 3.31 was interpreted as “Sometimes”; Simply stay at the corner of your room and crying with weighted mean equivalent favorite to foods 2.27 was interpreted mean as “Seldom”; Eating to 3.88 your was

with

weighted

equivalent

interpreted as “Often”; Using the internet and playing online games with weighted mean equivalent to 3.89 was interpreted as “Often”; friends, Calling etc... or texting your family members, to relatives, 3.90 was

with

weighted

mean

equivalent

interpreted as “Often”; Making yourself busy by doing household chores with weighted mean equivalent to 3.28 was interpreted as “Sometimes”; Ignoring the problem with weighted mean equivalent to 3.33 was interpreted as “Sometimes”; Getting angry and having mood swings with weighted mean equivalent to 2.86 was

interpreted as “Sometimes”; Laughing at it with weighted mean equivalent assistance to to 3.79 the was interpreted as “Often”; with Asking for mean

Clinical

Instructor

weighted

equivalent to 3.67 was interpreted as “Often”; Verbalization of feelings to fellow students with weighted mean equivalent to
56

3.64 was interpreted as “Often” ;Reasoning out or answering back with weighted mean Taking equivalent it as a to 3.29 were with interpreted weighted as

“Sometimes”;

challenge

mean

equivalent to 3.86 was interpreted as “Often”; Limiting your contact to the source of stress with weighted mean equivalent to 3.42 was interpreted to 2.67 as was “Often”; Cursing as with weighted mean

equivalent

interpreted

“Sometimes”;

Drinking

alcoholic beverages and smoking with weighted mean equivalent to 2.18 was interpreted as “Seldom”; Taking medication as a

reliever with weighted mean equivalent to 2.42 was interpreted as “Seldom”; Doing physical exercise with weighted mean

equivalent to 3.09 was interpreted as “Sometimes”; Accepting the reality that sometimes it merely happens with weighted mean

equivalent to 3.81 was interpreted as “Often”; Sleeping with weighted mean equivalent to 3.75 was interpreted as “Often”; Managing your time better with weighted mean equivalent to 3.99 was interpreted as “Often”; With the total average mean of 3.48 was interpreted as “Often”. Conclusions: Based on the findings of the study, the researchers arrived at the following conclusions: 1. That the on level time” III as nursing the students consider “Finishing they have
57

charting

greatest

stressors

encountered with regards to their clinical duties and the least one is the relationship with the physicians. Meanwhile, the rest of the stressors show that they can also affect the respondents somehow. 2. That the level III nursing students consider praying to God and thinking positive as the number one stress management they usually performed when they feel stress. While simply staying at the corner of the room and crying followed by drinking alcoholic beverages and smoking does not play much role. 3. The result in of the study stands benefit to the nursing The

practice

rendering

effective

quality

nursing

care.

identification of the possible cause and effect of stressors on the level III nursing students will provide them adequate

academic and clinical knowledge on stress. This study will serve as a guide to them on how to manage their stress with regards to their clinical duties. This will also provide information to the Clinical Instructors, healthcare team in the hospital, and

school administrators on how they can help the students upon dealing competent with stress in properly different in order for area students and to to be

enough

clinical

render

quality and effective nursing care to the patients. Recommendations:

58

After the conclusions were drawn, the researchers of the study hereby recommended that: 1. The students must develop not only their nursing skills but

also their ability on handling problems. 2. 3. The students must learn how to rest and relax. The students also need to develop their good working

relationship to others especially with the patients to avoid pro 4. Proper utilization of coping mechanism will help the

nursing students to manage their stress and be competent enough in different clinical area. blems that lead to create stressor. 5. The Clinical Instructors must support their students all

the time to establish a harmonious and professional relationship with them and guide them in rendering quality nursing care to the patient. 6. Doctors and Clinical Instructors as well as the staff

nurses should be invited at times as a resource person during ward class and case presentation to give them a sense of

recognition thereby improving good working relationship in the clinical area.

59

7.

The proper approach and continuous support of the staff

nurse and other healthcare provider must be present to help the students cope and deal with the possible problems that they

might encounter in the clinical area. 8. Discussion for the most practical adaptation to prevent the

existence of excessive amount of stress in the individual should be conducted and if found to be already existed, the most

possible activities should be given to decrease the strength of stressors that could affect on physiological, psychological and behavioral make up of the individual. 9. The college of nursing should conduct seminar workshops and that will further develop the student ability and

trainings

capacity to cope up with stress. 10. The future junior nursing students must be properly

equipped with enough knowledge in nursing for them to become confident. Hence, improper coping with stress will be lessened and prevented. 11. Conducting frame another should study be using more to variable arrive and at a bigger more

sample

considered

comprehensive and meaningful conclusion.

60

BIBLIOGRAPHY Books
• • • •

Deborah Antai-Otong et. Al, Thomson Asian Ed. Psychiatric Nursing Book Ann Marriner Tomey et. Al, Guide to Nursing Leadership and Management 7th Ed. Copy Right 2004 by Mosby, Inc. Barbara Kozier MN, RN, Glenora Erb BSN, RN, Audrey Berman Ph. D., RN, MAN Funadamental of Nurszing 7th Ed. Brunner and Suddart’s Textbook of Medical-Surgical Nursing Volume1 11th Ed. / (Edited by) Suzanne C.Smeltzer…( et al ) Stress (2008). Encyclopedia Britannica. Encyclopedia Britannica 2007 Deluxe Edition. Chicago: Encyclopedia Britannica. "Cannon, Walter Bradford." Encyclopedia Britannica from Encyclopedia Britannica 2007 Deluxe Edition. (2009) Lazarus, R.S., & Folkman, S. (1984). Stress, Appraisal and Coping. New York: Springer. Article

• •

[2009 Article by: Paula Ford-Martin; Rebecca J. Frey, PhD] Website

• • •

Selye, Hans. “The Nature of Stress.” http://www.icnr.com/articles/thenatureofstress.html Wikipedia, 2008. "Stress (biological)" http://en.wikipedia.org/wiki/Stress_(medicine) Wikipedia 2009. "Walter Bradford Cannon." http://en.wikipedia.org/wiki/Walter_Bradford_Cannon en.wikipedia.org/wiki/Stress_management Undergraduate Thesis

• Stress Experiences and Coping Mechanism of Third Year Nursing Students of WUP
61

• Stress Encountered by the Level IV Student Nurses of WUP in conduct of their RLE

62

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