Stress among the Nursing Students

 

Mrs. Kalaivani S¹, Dr. Mrs. Karaline Rajkumar²

¹Rani Meyyammai College of Nursing, Annamalai University, Chidambaram, Tamil Nadu

²Principal, Rani Meyyammai College of Nursing, Annamalai University, Chidambaram, Tamil Nadu

 

ABSTRACT:

Stress among the nursing students is acknowledged as one of the most important issues in the modern world. Nursing students are frequently exposed to various stressors which may be directly or indirectly impede their learning and performance. The nature of nursing education faces challenges that may help the nursing students to overcome their stress. Knowledge on student nurse’s stress levels, its sources, and stress responses would serve as an important input in identifying and planning effective interventions and strategies to reduce or prevent stress among student nurses which in turn would facilitate their performance and learning both in academic and clinical area.

 

 

 

INTRODUCTION:

“Brain cells create ideas. Stress kills brain cells. Stress is not a good idea.”                          -Frederick Saunders

 

Stress is seen as a modern society’s illness and it is a growing public health problem, affecting many individuals both physically and psychologically. Everyone feels stressed from time to time in our daily life. It is an inevitable and unavoidable component of life due to increasing complexities, competitiveness in living standards. Everyone experiences stress within the family, business, study, work etc. The World Health Organization has estimated that stress-related disorders will be the leading causes of disability by the year 2020.

 

However, it is problematic when stress becomes overwhelming and a person begins to suffer from its adverse consequences including increased anxiety and depression, multiple somatic complaints without an organic cause, or engaging unhealthy behaviors including smoking, poor dietary habits, and poor sleep habits (Rizzolo D, et al. 2009).

 

The nursing education in India is demanding as far as students’ efforts are concerned. Linn and Zeppa stated that some stress in nursing education is needed for learning. Stress which promotes and facilitates learning is called ‘favorable stress’, and stress which inhibits and suppresses learning is called ‘unfavorable stress’. The same stressors may be perceived differently by everyone, depending on their cultural background, personal traits, experience and coping skills. Nursing education is now recognized as stressful environments that often exerts a negative effect on the academic performance and psychological well-being of the students. Studies from the United Kingdom and India have reported increasing levels of stress among nursing students (Manjunath SM, et al., 2014 and Leodoro JL, 2013).

Nursing students are valuable future human resources. Professional preparation of a nurse is determined by students’ early adjustment and coping to a new college and hospital environment. Early adjustment of trainee students in a new environment will directly or indirectly contribute to provide better patient care at hospital. Undergraduate education is a sensitive period in an individual’s life span. Stress can cause significant negative changes in psychosocial life of nursing students. It can lead to irritation, loss of concentration, difficulty in maintaining interpersonal relationship, insomnia, fatigue, poor academic performance, and marked absenteeism (Kataria RK, 2016).

 

According to Anu Jose MJ nearly 68% of the nursing students had moderate stress, 27% had mild stress and 5% had severe stress.

 

Sources of stress:

Nursing students have higher levels of stress than the students of other disciplines. Nursing students may experience stress both in classroom and clinical learning environment which could be due to the presence of

v  Academics factors.

v  Social factors.

v  Family factors.

v  Emotional factors.

v  Financial factors.

 

Classroom sources:

Language barrier, insufficient theoretical training, frequent examinations and fear of exams, poor grades, more number of assignments, lack of motivation, too much responsibility, peer competition, long study hours during examinations are some of the sources of stress in the class room set up. (Kataria RK, 2016).

 

Clinical sources:

Interpersonal relationship problems with patients and faculty, lack of professional knowledge and skills, unable to learn new psychomotor skills ie. administering injections etc., unclear assignment and submission, unable to provide good nursing care for patients, lack of timely feedback about performance, relationships with other professionals and lack of guidance are the sources of stress arising from the clinical area. (Kataria RK, 2016).

 

Others:

Some of the other sources of stress include rapid changes in society, increasing social demands, romantic interests, economic constraints, adjustment problems and physical health problem of family members, high cost of education, sleeping difficulties, inadequate hostel facilities

Early detection of potential stressors among the nursing students will be helpful to improve the academic performance, quality of life and decrease tension, anxiety, fear, depression and suicidal thoughts (Kataria RK, 2016 and Hamaideh, SH,2011).

 

According to Khater WA. and (et al.) (2014) stated that the most common type of stressors perceived were related to assignment, followed by stress related to patients’ care and stress from nursing staff and teachers among the undergraduate nursing students.  Anu Jose MJ (2015) from his study found out that among the first year students, 35% were under stress due to clinical assignments, in second year 42% were under stress due to theoretical exams, in third year 53% and 54% of the fourth years were under stress due to academic assignments.

 

Signs and Symptoms:

v  Physiological :

Some of the physiological signs and symptoms which includes are

·         A pounding heart, elevated blood pressure, sweaty palms, tightness of chest, aching neck, jaw and back muscles, headache, chest pain, abdominal cramps, nausea, vomiting, prolonged colds, trembling, sleep disturbance, tiredness, itching, easily startled, forgetfulness, breathing difficulty, fatique, dry mouth, bruxism (clenched jaw), restlessness (Potter, P.A., Perry, A.G et al. 2014 and Murray R,2005).

 

v  Psychological:

Some of the psychological signs and symptoms which includes on basis of cognitive, behavioral and emotional are

Ø  Cognitive:

·         Mind racing or going back, not being able to ‘switch off’, a lack of attention, self esteem and confidence plummeting, disorganized thoughts, a diminished sense of meaning in life, a lack of control, negative self statements and negative evaluation, difficulty in making decisions, a loss of perspective, making ‘mountains out of molehills‘, demanding too much of others as well as ourselves, memory problems, distressing dreams.  (Potter, P.A., Perry, A.G et al. 2014 and Murray R, 2005)

Ø  Behavioral:

·         Become withdrawn and not want to socialize, increase intake of alcohol, nicotine or drugs, under eat or over eat, become accident prone and careless, become impatient, aggressive or compulsive – pacing, fidgeting, sweating, blaming, throwing and hitting, work longer hours, no leisure activities, suspiciousness (Potter, P.A., Perry, A.G et al. 2014 and Murray R,2005).

 

Ø  Emotional:

·         Irritable, angry, depressed, jealous, restless, anxious, unreal or hyper alert, unnecessary guilty, panic, mood swings, crying easily, lack of interest, isolated, negative thinking, crying tendencies, worrying (Potter, P.A., Perry, A.G et al. 2014 and Murray R, 2005).

 

How to cope up with stress?

 

 

According to Rajakumari GA. (et al.) (2015) in her study states that meditation-based stress-management practices reduce stress and enhance forgiveness among college undergraduates. Kaur L and Walia I (2008) revealed that laughter therapy had positive effect on reducing the stress level of the nursing students and it is statistically significant.

 

CONCLUSION:

Thus stress is very common in nursing education and it may have an impact on the physio – psycho- social health of the students. knowledge on student nurse’s stress levels, its sources, and stress responses would serve as an important input in identifying and planning effective interventions and strategies to reduce or prevent stress in nursing education and training thus, facilitating their learning both in the academe and clinical setting.

 

REFERENCES:

1.        Leodoro JL. (2013). Stress, stressors, and stress responses of student nurses in a government nursing school. Health Science Journal. 7(4): 424-435.

2.        Rizzolo D, Piinto ZG, Stiskal D and Simpkin S. (2009).Stress management strategies for students: the immediate effects of yoga, humor and reading on stress. Journal of Teaching and Learning, 6(8), 79-88

3.        Kataria RK. (2016). Self esteem, stress and depression in nursing students. Indian Journal of Continuing Nursing Education ,17(1), 30-37

4.        Murray R. (2005). Staff counseling in the health service: a guide for RCN members. Available from www. managingstress.com

5.        Manjunath SM, Nagesh RG, Janardhan S, Ravish KM. (2014). A cross –sectional study on the sources and levels of stress among second year undergraduate medical students. National Journal of Medical Research, 4(4), 314-315

6.        Kalra R, Mutalik N, Vinod A, Moni S, Choudhari S and Bhogale G (2016). Perceived stress and coping profile of undergraduate medical students: A cross sectional study. International Journal of Indian Psychology, 4(1): 56 – 63.

7.        Hamaideh, S.H. (2011). Stressors and reactions to stressors among university students. International Journal of Social Psychiatry, 57 (1), 69–80.

8.        Khater WA, Akhu-Zaheya LM, Shaban IA. (2014). Sources of stress and coping behaviours in clinical practice among baccalaureate nursing students. International Journal of Humanities and Social Science, 4(6): 194-202

9.        Anu Jose MJ. (2015). A Study to assess the level and factors contributing to stress among the nursing student. International Journal of Science and Research, 5(9): 1482-1484

10.     Rajakumari GA, Soli TK and Malathy D. (2015). Meditation lowers stress and supports forgiveness among nursing students: a randomized controlled study. International Journal of Advances in Scientific Research, 1(04): 199-202.

11.     Kaur L and Walia I. (2008). Effect of laughter therapy on level of stress: a study among nursing students. Nursing and Midwifery Research Journal, 4(1): 34-38

12.     Potter, P.A., Perry, A.G., Stockert, P.A. and Hall, A.M. (2014). Fundamentals of nursing. First edition. New Delhi: Reed Elsevier India private ltd. Pp: 705-708.

 

 

 

 

Received on 27.03.2017          Modified on 15.04.2017

Accepted on 01.05.2017          © A&V Publications all right reserved