Effects of stress on the performance of nursing Students
Effects of stress on the performance of nursing Students
Background to the Study.
The term stress is broad, and its application is in many disciplines and perspectives. Stress refers to the situation in which an individual has a dynamic interaction with the environment(Shultz2011, p.8). In the process of an individual interacting with the environment, there are limitations and demands as well as opportunities that are related to work that may seem threatening to surpass the skills and resources that are at the disposal of the individual. Therefore, stress may be denoted to be any stimulus, be it psychological or physical, that disturbs the adaptive state of that individual as well as provoking a coping response from the individual(Gomathi,Jasmin, and Baba2017, p.107).
Scholars are increasingly developing interest in research in this area since we live in a world and environments that have many stressful circumstances. The implications of stress in the lives of individuals is a global phenomenon. Stress has become part and parcel of the life of human existence, and it has been feted to be the price that human beings pay to stay alive(Donovan, Doodyand Lyons2013, p.969).
The American Academy of Family Physicians points out that of all the visits that are made to the family doctor, two-third of them are stress-related. This revelation underscores how serious the issue of stress is. It is important to note that stress is inevitable to human beings; however, how individuals react to the stressful stimulus varies from one individual to another. How individuals respond to stressful situations is dependent on their coping capabilities in various life situations(Donovan, Doody, and Lyons, 2013, p.970).
Nursing students are also susceptible to stress due to the transitional nature of life in college. Studies have shown that if the stress levels in the nursing students are high enough, then the stress has the capability of affecting the health and the academic functions of the students. In nursing school, the students are subjected to various stressors, which may include pressure of the nursing curriculum, the angst the succeed, difficulties to integrate into the system, uncertain future, as well as financial and relationship issues. Nursing schools have now been identified as stress hotspots, and this stress has an adverse effect on the academic performance as well as the psychological wellbeing of these students(Gomathi,Jasminand Baba2017, p.107).
Therefore, research in this area is essential since knowing how stress impacts on the performance of the nursing students will go a long way of devising coping mechanisms that will help the student cope with the everchanging environment in the nursing field. In the medical industry, study about stress is vital, since stress has the capacity of impacting on the quality of nurses that nursing schools produce and by extension, the quality of health care. The study will also contribute to the advancement of knowledge in the area of stress on learners, which will go a long way in improving the quality of life of the learners, especially nursing students.
Statement of the Problem
Most of the literature about stress in nursing students, articulate that changes in life, and transition between different stages in life, can make students predisposed to stress. Also, the negative as well as the positive events in the life of the student, like the fear of, or actual failure of examination, problems with peers, getting married of getting a divorce, going to an institution of higher learning can be sources of stress in the lives of the student. According to studies, about one-third of students in nursing school at one time or another may experience stressful situations of weight that may induce mental problems, especially depression. Studies have also shown that the level of stress that nursing students encounter is higher than those experienced by students in medicine, social work, and even pharmacy. The World Health Organization has estimated that in 2020, the leading causes of disability, especially among the students, will be stress-related disorders(Beddoeand Murphy2004, p.305).
It is therefore essential that what is causing this high level of stress among the nursing students be critical isolated so that mitigation measures are developed way in advance to help these students cope with stress early enough before its causes severe damage to the health and academic and professional performance of the nursing students. That stress affects the performance of students is common knowledge, but the extent to which stress contributes to academic failure among nursing students needs further scrutiny, and this is one of the areas that this study will significantly dwell on.
The study will also look at the evolving stressors among college students sense the world around the students of the 21st century has changed significantly, which implies that the types of stressors may have changed also. In summary, the issue of stress among the nursing students needs to be critically investigated to ensure that they are well equipped to cope with it during their time as students, so that the quality of nurses getting out of nursing school, will be those that will contribute positively to the quality of healthcare.
Objectives of the Study
The long-term goal of this research is to come up with updated ways of coping with stress among nursing students. Dealing with stress is key to managing the adverse effects that come with stress, especially among nursing students. The objective of the research will be to provide a comprehensive review of the literature on stressors among nursing students to update them to reflect the current situation. The research will also endeavor to recommend updated coping mechanisms of stress in nursing students. The study has the following specific objectives.
- To provide a comprehensive review of the stressors among nursing students and recommend updated coping mechanisms.
- To review the existing industry practices and studies regarding the management of stress among nursing students.
- To propose and outline the conceptual framework for stress management for nursing students.
Research Questions
This study will seek to answer the following questions:
- What are the current stressors that are causing stress among nursing students?
- To what extent is stress affecting academic performance among the nursing students?
- What can cope mechanisms be proposed in managing stress among nursing students in this century?
Significance of the study
The result of this study will be precious to the practitioners in the industry as well as other stakeholder’suniversity deans and parents in developing a better well thought coping mechanisms for stress in nursing students.
Literature Review
Student Stress and Coping Mechanisms
Redhwan et al. (2011) conducted a study on stress on nursing students. The intensity and level of academic workload, all course examinations, poor relationships among nursing students, and the gap in theory practice are most leading stressors that were identified. Stress and emotional imbalances among them were caused by the students being fatigued and are under intense pressure (Redhwan et al. 2011, p.57). The study found out that nursing students adopted short-term coping strategies in an attempt to deal with stress. They focus on their over achievement and determination to perform better whenever stress factors were present, and this assisted them in carrying through there course. The study also found out that student nurses also received support services from a wide range of supporters including but not limited to academic and clinical perspectives, changes in curriculum that emphasizes the need to support nursing students emotionally and developing skills concerning student awareness and developing a model of lecturer practitioner that emphasis educational quality and delivery (Redhwan et al. 2011, p.63).
A study by Baric (2012) explored life events, situations that are stressful, problems, and coping methods among adolescents and nursing students, and the descriptive statistics reveal that breaking up with a girlfriend or boyfriend was the most frequent life effect that causes stress among nursing students. Other most frequent stressors were adjusting to school life, stressful situations that are related to family issues were also identified (Baric 2012, p.46). Methods to cope with these stresses are defined with a few gender differences. Self-control is the most significant coping mechanism that nursing students employ in dealing with stress in the event that they are faced with physiological change psychological changes and being vulnerable to stress To help improve the coping mechanisms, nursing schools should hire a nurse who is specialized in psychiatric- mental health to help schools education systems teach mental health promotions as a way of training nursing students on how to cope with stress. The system also identifies mental ill-health prevention mechanisms, students who are at a higher risk for mental ill-health and provisions in guidance programs for students and consultants for both parents and teachers (Baric 2012, p. 52)
Another study Kravits et al. (2010) investigated gender and developmental influence on stress and coping strategies among adolescents and found out that girls experienced more life events than the boys. The most significant stressors that were reported were life events at senior school for both boys and girls, although girls recorded more scores (Kravits et al. 2010, p.133). The intensification in gender is a phenomenon that accounts for the greater gender disparity in the types of stress factors recorded by both boys and girls. The study further revealed that girls reported more life events that are related to interpersonal and immediate family relationships (Kravits et al. 2010, p.135). Concerning coping mechanisms, the study points out that both boys and girls employed coping strategies in relation to stress by using active distraction methods like physical exercise (Kravits et al. 2010, p.137). It was noted that girls’ use of these techniques declined over time, whereas passive distraction techniques were found to increase over time. On the side of boys, aggression and self-destructive coping mechanisms increased as they aged (Kravits et al. 2010, p.137).
Redhwan et al. (2011) conducted a study on the causes of stress and the coping mechanisms among rural adolescents. The study defined coping as a process that is transactional and cognitive between the environment and an individual. The study further reveals that adolescents in rural schools experience stress related to family, health, school, and transportation (Redhwan et al. 2011, p. 58). The most significant coping strategy reported was being optimistic that things will be better one day. Besides, developing support systems was also found to be the most effective coping strategy when it comes to dealing with stress (Redhwan et al. 2011, p. 59)
The findings of this study donate to limited information about coping with stress among adolescents in rural areas (Redhwan et al. 2011, p. 62). This provides a heavy insight into the health care providers’ understanding of this vulnerable population. The study recommends that clinicians should improve the coping mechanism to be more effective and the general health of the rural adolescent population through proper discussion on the available coping strategies and screening of vulnerability.
Stress and Suicide among Nursing Students
One of the effects of stress among nursing students is emotional and psychological imbalances, which eventually lead to suicide. A study by Sreeramareddy et al. (2007, p. 26)assessed the causes of anxiety and emotional imbalances among nursing students and found out that common stressors were related to psychosocial and academic concerns. Most nursing students, in most cases, opt to get accommodation outside campus, like staying in a hotel or other rental premises. This means that to maintain such an expensive lifestyle requires that they either put pressure on their parents or guardians to pay for their rent or they engage in criminal activities with the aim of raising money to pay their bills. Another cause of stress that was identified is that parents have high expectations for the children’s academic achievement, lack of time, and recreational facilities, a vast academic curriculum that is examinations and tests that have proven to be difficult for most nursing students. In trying to adapt to a stressful situation, most nursing students opt to engage in alcohol and drug abuse and active coping strategies like aggression. When things don’t work out to their expectations, they are depressed, and some of them opt to commit suicide if not well guided. The study suggested that supporters such as psychological counselors should train the students on some of the ways to cope with stress-related effects such as positive reframing, acceptance, active coping mechanisms, proper planning emotional support, and self-distraction. These coping strategies vary with gender, parents ‘occupation, and year of study.
McAllister (2008, p. 4) conducted a study on stress among caregivers and found out that nursing students experienced a traumatic brain injury. The study noted that many patients recorded behavioral, emotional, physical, and cognitive problems following traumatic brain injury. Thus, they require continued care for a relatively long period of time, and most of this was provided by inexperienced caregivers, including spouses, other close family members, and parents. The role of this kind of care is related to a wide range of effects, including suicide, which is a result of poor physical health, depression, anxiety, and poor quality of life.
A study by Pulido, Augusto, and Lopez (2012, p.15), point out that nursing students not only encounter academic-related stress, but they also experience anxiety during work training. One of the areas of research on the stress that is gaining traction is the issue of stress at work, especially on the sources of stress or stressor and how they interact and become the beginning of stress. Review of literature, especially in the workplace, also indicates that research on the state of health in the workplace is evolving from focusing on the prevention of physical hazards to concentrate on a global approach of health at the workplace. The issue of the psychological wellbeing of workers, especially at the workplace, is becoming increasingly important. Therefore, problems emerging like stress at the workplace has started to elicit a lot of interest.
Literature indicates that the main effects of stress on individuals, especially the students, can be classified into psychological, physical as well as behavioral disorders. These effects, by extension, can be associated with organizational issues levels like the diminishing of the quality of work by individuals, truancy or absenteeism, and even decreased productivity. Several reports on the safety of the workplace indicate that the issue of stress has become a significant concern for almost every organization.Smith et al. (2001, p.64), further discovered that absenteeism conflict and accidents at school and in the hospital experienced by nursing students could be traced to the high-stress levels that these students experience. The reports, however, indicate that the stress levels are higher among health care professionals, especially the nurses.Many of the health problems that nurses encounter can be traced back to have originated from stress (Demerit et al. 2000; Hampel & Caputi 2001; Lim et al. 2010).Benavente and Costa (2018, p135), seem to agree that among the students and professionals, the health care professionals are the ones experiencing the highest levels of stress when a comparative analysis is done. Among the health care professionals and students also, it has been found that nursing students and professionals experience the highest levels of stress.
An investigation by Sawatzky (2001, p.45), postulate that stress as a psychological factor significantly affects the performance of the nursing students. This has elicited a lot of interest in research, which aims at determining the level and sources of stress in the area of training of nurses. Pryjmachuk and Richards (2007, p.18), outline that among the nursing students, stressors that affect these students can be categorized into academic, clinical, and personal. Academic stressors entail fear of failure in the academic endeavors of the students, for instance, in evaluation. Clinical stressors include the fear of making mistakes, especially when handling of the actual patients, while the personal stressors include personal problems like finance and relationship issues. These stressors have a significant adverse effect on the performance of the nursing students, both academically and in the nursing practice (Demeuroti, Bakker, Nachreiner, and Schaufeli2000, p. 454)
A review of literature by Benavente and Costa (2018, p.65) indicates that exposure to stress by nursing students prompts then to develop coping strategies to adapt and survive, especially in the turbulent academic world. Benavente and Costa (2018, p.66) point out that stress studies are gaining popularity since stress is a predisposing and trigger factor of many of the health problems that students face. The academic schedule, the teaching and learning process, and the experience requirements of nursing students may be threatening and challenging to some students, which may render them stressed.
A study by Donkor (2013, p.65) indicates that of particular concern to many researchers is the effects of stress among health care professionals and, more specifically, nurses. This study concluded that, is a significantly stressful profession, by its very nature. This sentiment seems to be supported by Harris (2001, p.14), who observed that in everyday life of a nurse, he is always confronted with grief, suffering, death, among other frightening situations. These situations increase the intensities of the stress that these healthcare professionals and students face, and therefore the studies on stress among health care professionals have been of great interest to many researchers.
Smith et al. (2001, p.63) point out that the most common setback in the workplace as well as in class is stress. The majority of health care workers, as well as students, often experience high intensities of stress. The high utilization of health care services by healthcare workers can be traced to the rise in stress levels among health care workers, especially the nurses. Donkor concludes that the reason why studies on stress are of particular focus, especially in the health care sector is that, the cornerstone of a nation’s health care and the nurses are the faces of health care in any country. The nurses serve as role models for the health care sector on any nation, and therefore there is adequate justification for further study of the effects of stress on the performance of nursing students.
References
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