Graduate Nursing Students and Stress

The purpose of this investigation was to determine the effectiveness of a stress management program (SMP). The research question was: What effect does a SMP have on the stress response of full time graduate nursing students? A secondary purpose was to determine personal and professional stressors experienced by graduate nursing students and their coping strategies. The SMP consisted of eight weekly one-hour sessions of demonstration and practice of the relaxation response, imagery, and diaphragmatic breathing. Caffeine intake was also reduced. The subjects were 30 female graduate nursing students between the ages of 25-43. They were randomly assigned to an experimental and a control group. Data collection consisted of weekly Palmar Sweat Prints (PSP), blood pressure measurements, and a Weekly SelfReport (WSR), designed to monitor adherence to the SMP by the experimental group and perceived stress and coping strategies of both groups. The ?-State Anxiety Questionnaire and Rahe's Recent Life Changes Questionnaire (RRLQ) utilized a pre-/post-test design. Three of the four indicators demonstrated no significant differences in the stress response. The PSP indicated a significant difference (.05). RRLQ suggested no significant differences in the lives of the subjects of both groups. The WSR showed significantly more professionally generated stressors than personally generated stressors. The control group reported significantly less strategies for coping with stress than the experimental group. Although the SMP was not practiced as suggested, its presence in one's cognitive repertoire significantly affects stress response and coping. Implications of this study are numerous. Increased awareness of stressors in student's lives and simple, innovative approaches by nursing faculty will diminish stress. We are becoming more aware of the impact of stress on human life and its universality as part of the human experience (Laughlin, 1956). Stress is essentially that same struggle of our minds and bodies to respond to and adapt to change (Jasmine and Hill, 1981). Many life events, particularly those that disrupt everyday routines, cause stress. Significant events of ordinary life such as death, a birth, or a change in jobs can create tremendous stress (Goleman, 1976). Stages in the developmental process from the first day of school through puberty, graduation, employment, marriage, and retirement are strongly associated with considerable stress. Family relationships are a major cause of stress. It is within the family that one is mostly likely to be battered verbally, emotionally, and physically. The relationship between spouses is the main source of stress, with parent-child relationships following closely behind (Wallace, 1978). Modern technology and industrialization have unprecedential transactions between the individual and the environment (Rouhani and Hospital, 1978). Human limitations and needs have tended to be neglected or over-ruled by profit motivation. Technological innovations have been directed toward maximizing the effectiveness of human production rather than improvement in the quality of human life (Frankenheauser, 1979). The hectic pace of industrial life with its concomitant crowding, rushing, and pressures is not directly to blame for the stress. We are the victims of our reactions to it (Goleman, 1976). In 1956 Selye described the effects of stress and defined stress as "the non-specific response of the body to any demands made upon it." He concluded that although the stressor may change, the physiological response appears to remain the same. (Selye, 1956). He outlined this response, which he termed the General Adaption Syndrome, as beginning with the alarm reaction, moving into the stage of resistance, and finally into stage of exhaustion (Selye, 1969). If exposure to the stressor is continued, the body attempts to regain its homeostasis which has become imbalanced. The resulting physiological signs such as increasing heart rate, blood pressure, respiratory rate, muscle tenseness, and digestive tract spasticity indicate the body's efforts to eliminate the stressor.