EFFECTS OF MENTORING PROGRAM ON STRESS LEVELS OF NURSING

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Effectsof Mentoring Program on Stress Levels of Nursing Students in ClinicalPractice

Abstract

Purpose:Thepurpose of the study is to determine the role of mentoring inmitigating clinical practice stress among nursing students.

Theoreticalframework:Mentoring programs exposed the student to clinical experiences andthus mitigate the clinical practice related stress.

Background:Clinicalpracticeis an important aspect of a nursing education training and education.However, the exposure to the clinical experience is associated withhigh levels of stress among nursing students. Mentoring programs aresome of the most important strategies that can be used to mitigatethe stressful impact of clinical practice among nursing students.

Method:Aquasi experiment method will be used on the project. A subject of 60students will be used in the study where half of them will bementored by a senior nursing student or experienced nurse while theother half will not be mentored. The perceived stress scale will beused in data collection.

Conclusion:Mentoring programs has been proposed to be an effective measure incombating clinical practice related stress. This study will establishthe effectiveness of these programs.

Nursingtraining programs have incorporated classroom learning as well asclinical practice in community health centers hospitals and clinics.Clinical practice is one of the most important learning environmentsfor the nursing student. This is because the student nurse getsexposed to the realities of the profession, apply the theories andpractice decision making and problem solving skills (Kathleen, 2014).Despite the power of the clinical environment in learning, there aretraumatizing events that are likely to result into stress. Clinicalpractice and the associated experiences is a major source of anxietyamong students in the nursing program. Although students are wellprepared for clinical practice through psychological and professionaltraining, it may not adequately shield the students from theresultant stress. Nonetheless, the exposure is essential indeveloping nursing professionals with expertise and who caneffectively and safely take care of the sick in clinical settings. The high levels of stress as a result of exposure to clinicalexperience have a direct impact on the performance of as a studentand a nurse (Marilyn, 2014). In some cases, the resultant stress mayhave an impact on the retention rate in the nursing program. This isbecause some students have left the nursing profession as a result ofstress associated with clinical practice. There is a need forstrategies that will reduce or eliminate the stress associated withclinical practice. One of these strategies has been the provision ofpsychological and professional support to the young nurses throughmentorship programs (Dennison, 2010).

Purpose

Themain purpose of this study is to accentuate the significance ofclinical practice related stress on nursing student to nursingeducators and training institutions. The project will inspireevidence based approaches towards clinical setting education toassist student better deal with the experiences. This study aims atestablishing the effectiveness of peer mentoring among student nursesin clinical practice. The study will look at the different aspects ofa mentoring program which includes the effectiveness and advantagesof the program where the mentor is a senior student and when thementor is an experienced professional nurse.

Theoreticalframework

Accordingto Gibbons (2010), anxiety and the resultant stress after exposure toclinical practice can have adverse effects on the wellbeing of thenursing student. Instead of being a learning experience, the clinicalpractice can be a bad experience to the student nurse. While thestressors in the clinical settings are well known and documented, howto assist the student nurse in preparing and dealing with theclinical practice experience is an important aspect of the nursingeducation. Studies suggest that mentoring programs have the abilityto prepare the student for the clinical experiences and thus caneffectively mitigate clinical practice related stress.

ResearchQuestion

Thisstudy seeks to answer some of the related pertinent questions whichincludes

  • How does nursing student perceive stress in the clinical setting before clinical practice?

  • How does the student perception about the clinical practice after clinical experience?

  • What is the evidence based interventions that can be used to mitigate clinical practice related stress among student nurses?

  • What are the effects of mentoring programs on the perception of stress and stress levels after clinical practice?

  • What evidence support peer mentoring programs in mitigating clinical practice related stress among nursing students?

LiteratureReview

Studieshave revealed high levels of stress among student nurses duringclinical practices. This has been considered to be among the mostimportant issues in nursing education today. There are many proposalsthat have been proposed as effective strategies in reducing oreliminating clinical practice related stress among student nurses.Nonetheless, evaluation of the application of these strategies innursing is very essential. Stress associated with traumatizing eventis an inevitable aspect of everyday’s life. It has been establishedthat while there are some positive aspects of stress on humans, suchas increased performance in some tasks, the natural responses by thebody to counter the effects of stress or the unresolved stressors hasdetrimental effects. Individuals experiencing stress are likely tomake errors in judgment, have negative thoughts and negatively affecttheir overall performance. More importantly, stress is likely to havea negative impact on the individual’s general health increasingsusceptibility to illnesses and diseases (Dorsey &amp Baker, 2004).Although there is a huge information gap on clinical related stressamong nursing students, recent studies indicate that clinicalpractice related nursing among nursing students is related to thestudent’s health as well as career. The level of traumatizingevents the student is exposed to as well as how well the resultantstress, among other factors, is managed will determine whether thestudent nurse will thrive in the nursing profession or will leave theprofession all together (Melincavage, 2011). According to Gibbon(2010), clinical practice stress among student nurses is associatedwith emotional problems and declining personal achievements. Cases ofnurses being unable to make decisions or think clearly due to theeffects of clinical practice related stress has been reported amongstudent nurses (Sheu &amp Hwang, 2002). Therefore, high levels ofstress among young nurses in clinical practice threaten thefoundation of the nursing profession.

Studentsare exposed to a wide range of stressors in the clinical learningenvironment. Some of these stressors include the traumatizing eventsassociated with initial experience in clinical practice, therelations between the student and other faculty staff, limitedprofessional experience and knowledge, difficulties in balancingclinical practice demands and academic work and the discrepanciesbetween the nursing theory and practical clinical nursing. Nursingstudents in clinical practice are faced with challenging clinicalsituation every day and always have difficulties handling the big gapbetween what is taught in class and the realities in clinicalpractice. This stress affects the individual both as a student and asa nurse. While it directly affects the ability of the young nurse toprovide adequate care to the patient, the academic success is alsothreatened. The situation is worse when student nurse does notreceive and psychological and moral support from the people aroundthem and is forced to deal with the stressful situation on their own. There are several ways through which stress among nursing studentscan be handled. This includes strategies that reduce anxiety amongstudent during clinical practice. They include peer mentoring, rolemodeling within the profession, increasing the clinical placements,constant counseling and good relationship between students and theclose associates in school or clinical practice (Yucha et al 2009).

Accordingto Li et al (2010), mentoring is one of the most advocated strategiesin dealing with clinical practice related stress among nursingstudents. Mentoring involves pairing a more experienced nurse with aless experienced nurse, possibly a student nurse in clinical practicewithin the faculty or a clinical facility. While the mentor providesemotional, psychological and professional support through counseling,the relation should be mutual where both benefits. The experience andknowledge of the mentor is essential in helping the student nurse indealing with the traumatizing experiences in the clinical practice.The student nurse is also expected to learn from other seniorstudents and medical workers through observation and interaction.Therefore, the mentoring strategy is dependent on the characteristicsof the student nurse, which includes openness and personal initiative(Tourigny &amp Purich, 2005).

Thementoring strategy can be implemented throughout the nursing trainingprogram to increase it effectiveness and ensure that the nursingstudent acquire the maximum benefits (Moscaritolo, 2009). Forexample, some training facilities have established a system where thesenior nursing students provide mentorship to the junior students.This provides a supportive learning environment that exposes directlyor indirectly the young students to the realities in nursingpractice. Also it is also important for the training facility toestablish a mechanism that will facilitate feedback from the mentorsin the clinical setting (Burns &amp Paterson, 2004). According toMoscaritolo (2009), peer monitoring among nursing students promotespractical learning in junior students and greater responsibilityamong senior students. The effectiveness of peer mentoring where thementor is a senior student is based on the fact that theinterventional aspects of peer mentoring such as free communication,humor and closeness between the peer instructor and the young nursereduces anxiety associated with clinical practice experiences.

Accordingto Li et al (2010), in addition to reducing anxiety among theinexperienced student nurses in clinical practice, peer mentoring hasseveral other advantages. Peer mentoring improves self confidence,technical and professional skills, personal growth and promotepractical and cooperative learning and nursing practice. Although theinfluence of peer mentoring has not been widely studies in the past,it has evolved into an important research topic in advanced nursingstudies. As a stated earlier, this has been necessitated by the highnumber of student nurses who have had to deal with stress associatedwith clinical practice. The studies are aimed at establishing themain factors that predisposes student nurses to the stress andstrategies that can avert the problem (Sprengel &amp Job, 2002).

Method

Theresearch method used in the study will involve two groups, theexperimental group and the control group. The study will use thequasi experimental design to answer the research questions. The studywill involve two sets of questionnaires which each subject isrequired to fill before and after the clinical practice. Thepre-clinical practice questionnaires will be distributed to thesubjects, both experimental and control group before exposure to theclinical setting. The experimental group will involve nursingstudents under a mentorship program. The experimental group will alsohave two subgroups, one where the mentor is a senior student in thefaculty, who has been exposed to clinical settings while in thesecond group, the mentor is senior and experienced nursingprofessional within the faculty or the clinical setting. It isassumed that the interaction between the subject and other seniornurses exposes the subject to the experiences in the clinicalsetting. The control group will have no exposure to clinical settingsby not having a mentor.

Sample

Thesample will consists of 60 junior nursing students in the faculty.The experimental will have 30 subjects while the control group willhave 30 subjects. The subject in the experimental group will bepaired with a mentor before exposure to clinical setting. The groupwill further be divided into two where one group will be assigned toa senior student nurse while the other group will be paired with anexperienced nursing profession. The control group was not paired witha mentor. After filling the pre-exposure questionnaires, the studentnurses were assigned to different clinical settings to minimizeinfluence within the group.

Strengthand limitations of the research design

Thequasi experiment design fits this study because randomized studiesare inappropriate in this project. The research design will alsoallow generalization based on the outcome of the study. The design isalso flexible and allows the researcher to manipulate the study tofit the needs and take into consideration the ethical and conditionalfactors involved in the study. However, the main limitation of thisstudy design is the inability to control confounding variable thatmay influence the results. For example, there are individualcharacteristics that will influence the impacts of clinical practiceon the nurse but are not measurable. The lack of randomness may alsoweaken study (DeRue, 2012).

Datacollection

Theperceived stress scale which measures the stress levels among nursingstudents will be used in the data collection. The scale consists oftwenty nine items and 6 stress level rank. In the six point stressranking, 0 (zero) will indicate no stress while 5 (five) willindicate very stressful. The use of perceived stress scale, which isa tested and verified method of data collection will ensure that thedata collected is valid and reliable (Li et al 2010).

Conclusion

Clinicalpractice is an important component of nursing education. However, theresultant stress due to exposure to the clinical settings may have anegative impact on the nursing students. The student needs to be wellprepared for the clinical practice to effectively deal with thechallenge. Mentoring has been proposed to be an effective method ofdealing with stress among nursing student in clinical practice. Thisproject will establish the effectiveness of the monitoring programs.

References

Burns,I., &amp Paterson, I.M. (2005). Clinical practice and placementsupport: supporting learning in practice, NurseEducationinPractice,5, 3-9.

Dennison,S. (2010). Peer mentoring: untapped potential. JournalofNursingEducation,49(6), 340-342.

DeRue,S. (2012). A Quasi Experimental Study of After-Event Reviews.JournalofAppliedPsychology97 (5): 681–689.

Dorsey,L.E. &amp Baker, C.M. (2004) Mentoring undergraduate nursingstudents: assessing the state of the science. NurseEducator,29 (6), 260–265.

Gibbons,C. (2010). Stress, coping and burn-out in nursing students.InternationalJournalofNursingStudies,47, 1299-1309.

Li,H-C., Wang, L.S., Lin, Y-H., &amp Lee, I. (2010). The effect of apeer-mentoring strategy on student nurse stress reduction in clinicalpractice. InternationalNursingReview,58, 203- 210.

Kathleen,G. (2014). Clinicalteachingstrategiesinnursing.New York, NY: Springer Publishing.

Marilyn,H O. (2014). Teachingin nursing and role of the educator: the complete guide to bestpractice in teaching, evaluation, and curriculum development.New York, NY: Springer Publishing Company, LLC.

Melincavage,S.M. (2011). Student nurses’ experiences of anxiety in the clinicalsetting. NursingEducationToday,31, 785-789.

Moscaritolo,L.M. (2009). Interventional strategies to decrease nursing studentanxiety in the clinical learning environment. JournalofNursingEducation,48(1), 17-23.

Sheu, S., Lin, H-S., &amp Hwang, S-L. (2002). Perceived stress andphysio-psycho-social status of nursing students during their initialperiod of clinical practice: the effect of coping behaviors.InternationalJournalof NursingStudies,39, 165-175.

Sprengel,A.D., &amp Job, L. (2004). Reducing student anxiety by usingclinical peer mentoring with beginning nursing students. NurseEducator,29(6), 246-250.

Stuart,C. (2013).Mentoring, learning and assessment in clinical practice: a guide fornurses, midwives and other health professionals,Edinburg : Churchill Livingstone.

Tourigny,L. &amp Pulich, M. (2005). A critical examination of formal andinformal mentoring among nurses. HealthCareManagement,24 (1), 68–76.

Yucha,C., Kowalski, S., &amp Cross, C. (2009). Student stress and academicperformance: home hospital program. JournalofNursingEducation,48(11), 631-637.

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