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CHAPTER 1

THE PROBLEM AND ITS SCOPE

Introduction

Clinical rotations in different hospitals and health institutions are

integral in honing the student nurses’ knowledge and skills. It gives nursing

students real world experiences describe in textbook and discussed in

classroom settings. In addition, clinical rotations are designed to help nursing

students’ transition from learning about nursing to performing nursing. This

rotation typically occurs after the first year of the traditional classroom

education.

As a student, one faces many challenges and stressors. However,

nursing students are more likely to experience even more stress. A study

shows that one third of nursing students experience stress severe enough to

induce mental health problems such as anxiety and depression (Pyrjmachuk,

2004).

In addition to contending with exams, long hours of studying, work,

family and personal commitments, they also faced the challenges of clinical

practice. Clinical practice has been identified as one of the most anxiety

producing components in nursing programs. Lack of experience, fear of

making mistakes, difficult patients, discomfort at being evaluated by faculty

members, worrying about giving patients the wrong information or

medication and concern about possibly harming patients are just a few of the

stressors for the beginning student nurse ( Shariff and Masuomi, 2005).

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 like marriage, divorce, or death of

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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.

Incorporating practices that can reduce some of the stress associated

with all of the challenges is important, useful and essential to a student’s

well-being. Stress management, self-care management and self-care

practices will help them navigate through nursing school and will also

provide a wonderful foundation for creating a balanced and wholesome life.

The need for stress management techniques for nursing students is

necessary to prevent burnout and also to prevent nurses from leaving the

profession. The stress that student nurses carry can only be of harm to the

profession in the long-term (O’Regan, 2005).

When people are confronted with stress, they have a great number of

choices about how to deal with it. To truly address that stress, they need to

put the distractions away and get focused on their goals, priorities, and

actions.

Problem-focused solving which looks at different approaches and

resolutions.

Emotional detachment is putting a barrier between yourselves and the

other person involved. It can either be positive or negative.

Reference to others or seeking social support represents the coping

strategies young people use when they turn for support to external

resources, such as peers and professionals.

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Next is focusing on the positive or looking at the bright side of life. This

means being able to accept the current situation a person is in and tries to

have a positive outlook on that certain situation however difficult it may

seem.

Another one is tension reduction wherein a person finds and develops

interests and activities that relieve stress. Example of this is engaging in

exercises or hobbies.

There are also designates strategies that hinder coping. One form of

that is through suppressing tension in which the individual attempts to feel

better by engaging in negative behaviors, such as substance abuse. Second

is keeping to oneself—being withdrawn from others, and refuses to

communicate one’s concerns and feelings. Another is engage in wishful

thinking—hoping for the best without taking steps to ensure it. Lastly is

blaming oneself and seeing oneself as responsible for the problem.

The researchers would like to identify the most common coping

mechanisms that are being utilized by the third year and fourth year nursing

students of Bukidnon State University both male and female aging 18 years

old and above who are assigned in the different units of Bukidnon Provincial

Medical Center specifically Medical, Surgical, OB, and Pediatric Ward, OR, DR,

ICU, and ER.

Figure 1 of this study presents the schematic diagram showing the

interplay of the variables. The independent variables are the profile of

respondents, age, year level, gender, civil status and area of assignments.

The dependent variables, on the other hand are the coping mechanisms

consisting of the problem-focused solving, wishful thinking, detachment,

seeking social support, focusing on the positive, self-blaming, tension

reductions, suppressing tension, and keeping to self.

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Independent Variable Dependent

Variable

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Figure 1: Schematic Diagram showing the interplay of Independent

and Dependent Variables

CONCEPTUAL FRAMEWORK

The popularity of the stress concept in science and mass media stems

largely from the work of the endocrinologist, Hans Selye. In his work, Selye,

the father of stress research, developed the theory that stress is a major

cause of disease because chronic stress causes long-term chemical changes.

In the alarm stage, our body recognizes there’s a danger and prepares to

deal with the threat by the fight or flight response. Activation of the HPA axis,

the sympathetic nervous system and the adrenal glands take place. During

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this phase the main stress hormones cortisol, adrenaline, and noradrenaline,

is released to provide instant energy.

The second stage is resistance stage. Our body shifts into this second

phase with the source of stress being possibly resolved. Homeostasis begins

restoring balance and a period of recovery for repair and renewal takes

place. Stress hormone levels may return to normal but the body may have

reduced defenses and adaptive energy left.

The last stage is the exhaustion stage. At this phase, stress has

continued for some time. The body’s ability to resist is lost because its

adaptation energy supply is gone. Often referred to as overload, burnout,

adrenal fatigue, maladaptation or dysfunction – Here is where stress levels

go up and stay up.

On Lazarus’ Theory of Psychological Stress, two concepts are central to

any psychological stress theory: appraisal, i.e., individuals' evaluation of the

significance of what is happening for their well-being, and coping, i.e.,

individuals' efforts in thought and action to manage specific demands (cf.

Lazarus 1993).

Coping is intimately related to the concept of cognitive appraisal and,

hence, to the stress relevant person-environment transactions. Most

approaches in coping research follow Folkman and Lazarus (1980, p. 223),

who define coping as `the cognitive and behavioural efforts made to master,

tolerate, or reduce external and internal demands and conflicts among

them.'

This definition contains the following implications. (a) Coping actions

are not classified according to their effects (e.g., as reality-distorting), but

according to certain characteristics of the coping process. (b) This process

encompasses behavioral as well as cognitive reactions in the individual. (c)

In most cases, coping consists of different single acts andisorganized

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sequentially, forming a coping episode. In this sense, coping is often

characterized by the simultaneous occurrence of different action sequences

and, hence, an interconnection of coping episodes. (d) Coping actions can be

distinguished by their focus on different elements of a stressful encounter (cf.

Lazarus and Folkman1984 ). They can attempt to change the person–

environment realities behind negative emotions or stress (problem-focused

coping). They can also relate to internal elements and try to reduce a

negative emotional state, or change the appraisal of the demanding situation

( emotion-focused coping).

Statement of the Problem

The study aims to determine how the fourth year and third year

student nurses deal with the stress that they encountered on their clinical

rotation.

This study sought to answer the following inquiries:

1. What is the profile of the respondents in terms of the following:

1.1 Age

1.2 Year level

1.3 Gender

1.4 Civil Status

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1.5 Area of Assignment

2. What are the five most common coping mechanisms that the third year

and fourth year nursing students are using:

2.1 Problem-focused solving

2.2 Wishful Thinking

2.3 Detachment

2.4 Seeking Social Support

2.5 Focusing on the Positive

2.6 Self-blaming

2.7 Tension Reduction

2.8 Suppressing Tension

2.9 Keeping to self

3. Is there a significant difference between the profile of respondents

and their common coping mechanisms?

Significance of the Study

The researchers believe in the merits of this study to the following:

Researchers. This will enable them to determine what coping

mechanisms to manage stress have been utilized by most of the nursing

students of Bukidnon State University and if these have been helping them

cope with the stressors encountered on their clinical duties.

Nursing Students. This will let them acquire knowledge on the

stressors, problems and challenges they will have to overcome all throughout

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their clinical performances which are and will always be part of their chosen

career. This understanding will help them enhance their coping abilities and

self-confidence.

Clinical Instructors. This study will make them determine if their

students are managing stress from clinical rotations effectively. In addition,

they will be able to create measures on how the student nurses will be able

to appreciate their related learning experiences by being able to learn more

and perform procedures with confidence.

College of Nursing and school administrators of Bukidnon State

University. For them to know if the education that was being provided by

the school is enough to produce future nurses who embodied the five Cs:

competence, compassion, caring, commitment and conscience.

Parents.For them to see how their children have been doing in the

hospital. In addition, they can also provide the necessary support that the

student nurses need to be able to work through with all the stressors.

Patients. Who deserve to be rendered with quality service that will

help promote their health, prevent further complications of their disease and

if all these are not possible, aid them in dying with dignity, all the while

maintaining their privacy and confidentiality.

Scope and Limitation of the Study

The study is conducted on third year and fourth year student nurses of

Bukidnon State University. There are 50 respondents, 25 people each from

the two year levels. These students were chosen because they were already

been on duty in a hospital for a longer period of time and the training is more

rigid compared to those in the first year and second year levels whose

competency is still on vital signs taking. In addition, the study has only listed

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the nine most common types of coping mechanisms due to time constraints

in gathering and analyzing the data.

Definition of Terms

Area of Assignment – or Clinical Placement. It provides the opportunity for

students to observe role models, practice, develop their skills and problem-

solving abilities, and reflect on what they see, hear and do.

Clinical Area – This pertains to the hospital setting where in the nursing

students apply and practice what they are learning in terms of rendering or

applying nursing care and focusing on the holistic care of the patient.

Clinical Instructor- a registered nurse who teaches, guides and supervises

the student nurses on their clinical duties.

Clinical duties – These refer to the exposure of the nursing students in

different hospital wards/areas as well as in different types of hospital services

in order to broaden their learning experiences while undergoing the Related

Learning Experience program.

Clinical Rotation - A period in which a nursing student in the clinical part

of his/her education passes through various clinical areas.

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Coping mechanisms- defined as ongoing cognitive and behavioral efforts

to manage specific external and/or internal demands that are appraised as

taxing or exceeding the resources of the person.

Detachment - can mean two different things. In the first meaning, it refers

to an "inability to connect" with others emotionally, as well as a means of

dealing with anxiety by preventing certain situations that trigger it; it is often

described as "emotional numbing". In the second sense, it is a decision to

avoid engaging emotional connections, rather than an inability or difficulty in

doing so, typically for personal, social, or other reasons.

Focusing on the positive - looking on the bright side

Keeping to self - withdrawn from others, refuse to communicate one’s concerns and feelings

Problem-focused solving- looks at different approaches and resolutions.

Related learning Experience – This pertains to the clinical exposure

nursing students have to undergo. It is required to all nursing students in

order for them to have an in-depth and meaningful experience and are easily

appreciated when they are already in actual hospital situation.

Seeking Social Support - share problems, talk to others

Self-blaming - see oneself as responsible for the problem

Suppressing Tension - attempting to feel better by engaging in negative

behaviors, such as substance abuse.

Stress - body's way of responding to any kind of demand. It can be caused

by both good and bad experiences.

Stressor - is anything that is perceived as challenging, threatening or

demanding.

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http://en.wikipedia.org/wiki/Anxiety

http://en.wikipedia.org/wiki/Emotion

Tension reductions- wherein a person finds and develops interests and

activities that relieve stress.

Time management - the act or process of planning and exercising

conscious control over the amount of time spent on specific activities,

especially to increase effectiveness, efficiency or productivity.

Wishful thinking - hoping for the best without taking steps to ensure it

CHAPTER 2

REVIEW OF RELATED STUDIES AND LITERATURE

This chapter presents a review of literature and studies on the coping

mechanisms of nursing students and nurses.

Local Literature

A nursing student’s life will always be laborious and compelling.

Intellectual, physical, and sometimes emotional demands can be

encountered in the Nursing discipline. Most Registered Nurses at present had

experienced the same predicaments and challenges, in varying degrees,

before becoming the great nurses they are today. The prime way on how to

deal with the BSN life is to have this realization: It’s never easy to become a

nurse. One must pour on a great deal of hardwork.

(http://nurses.definitelyfilipino.com/index.php/2010/12/a-bsn-students-guide-

to-nursing/).

In the article stated above, it says that being a nurse is not an easy

job. It requires passion, effort, and patience. It’s normal for nurses to have a

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http://nurses.definitelyfilipino.com/index.php/2010/12/a-bsn-students-guide-to-nursing/


very stressful routine. But because of individual differences of people, we all

have our own ways of dealing with stress, some of us want to eat or maybe

meet friends after school or work, sleep. It’s a definitely a fact. We have our

own individuality.

Local Studies

Even at the early beginning of life, stress is being encountered. It

appears to be a universal condition which everyone young or old, married or

unmarried, Filipino or foreigner, poor or rich, learned or not learned —

experiences or develops. In other words, it affects all kinds of people from

different walks of life. There are many events in life that can cause stress. It

could be generic, physical, chemical, psychological, cultural, ecological or

occupational in nature. (http://www.jpsimbulan.com/2007/11/19/stress-and-

the-working-nurse/)

Nurses are not far exempted from facing many stressful things. It has

been recognized that the world he lives is a potent source of stress. Nursing

is a profession that demands high level of responsibility because it promotes

individualized, sensitive, relevant and effective nursing care to patients.

Thus, levels of stress are associated with the jobs that are too varied and

demanding. Nurses are very much capable of developing a great deal of

stress causing either physical or psychological responses in terms of

accomplishing the jobs in the hospital settings, as well as in meeting their

responsibilities in their respective home because of these hectic activities

they have less opportunities for social interaction. Therefore, there is a great

for need for studies in order to determine the sources of stressful factors that

the behavior of nurses. When a certain individual for example, experiences a

stressful situation, that person may try to cope up by making an effort to

change the situation into a good one and avoids intolerable situations.

Almost all literature claims that work factor produces stress in different levels

and that the people vary in their ability to cope with them. In recent years,

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researcher had begun to investigate costly consequences of occupational

stress burnout. Burnout is a state of physical and emotional exhaustion that

occurs gradually over a period of time. First described in 1974 by

Freudenburger, the “burned-out” are usually professionals who work in

people-intensive jobs that are emotionally demanding which is primarily

nurses and social workers are likely to be affected. Physical symptoms

typically include chronic fatigue and frequent minor illness, such as colds,

that resolve slowly. Burned out people spend an overabundance of time at

work but are disorganized, easily angered and accomplish little. The most

distinguishing characteristic of burnout is the way burned out distance

themselves from clients in which distancing is accomplished through

depersonalization manner. The burned-out are professionally committed,

highly idealistic individuals who over identify in their personal life. Believing

their work will make a significant social difference and be financially as well

as emotionally rewarding. And these individuals are unprepared for the day

to day realities of their jobs that results from suffering stress-related

illnesses.

As it is commonly used, stress is referred as a “burden or load” under

which a person survives or cracks. It was also been defined as any internal or

external influence that interferes with satisfaction of basic needs or

somewhat a thing, which disturb homeostasis. This may be a disturbance in

the body homeostasis, general or severe enough to produce a coordinated

body response. These responses include renal, respiratory, metabolic,

sympathetic and circulatory reactions. A well-known psychologist, Hans

Selye, also a world renowned authority defined stress as the non-specific

response of the body to any demand made upon it. He coined “stressor” as a

factor or agent that produces stress. He further stated that the body’s

response to stress is non-specific because it occurs without regard to and

very much independently of, the specific stressor; thereby non-specific

response to stressor is the essence of stress.

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Human beings are viewed as an open system which is constantly

reacting to his internal and external environment. There will always be

occurrence of influential factors that could cause great response of threats to

the constancy and stability of the person. During early 1980’s, psychologists

had come up of listing stress and had developed certain scales to be

stressed and can prepare for this occurrence. The person must be able to

adapt himself and master his coping behaviors satisfactory, in a manner to

maintain homeostasis. Walter Cannon pointed out that the purpose of

homeostasis is freedom in which it allows the person to reach his potentials

as human. Homeostasis is also associated with the person’s state of health,

it is believe that when person is healthy, he is said to be in state of

equilibrium. Health according to Wolff, is the absence of illness had become

entrenched in many peoples’ minds and that the aspects of human holistic

view is a very vital consideration not only the physical aspects as an

outcome.

In other words, stress deals with how the body could adjust to the

demands of life. These demands could either be threat, challenge or change

that requires the body to respond, either, on the positive or negative side.

Thus when the body is able to adapt to a certain demand and serves as a

motivator, it is said to be responding positively. Whereas, when the body fails

to adapt, in which there is much effort is released by a stress response, it is

turned inward responding negatively and disrupted homeostasis occurs.

In addition, effective coping is necessary in managing stress such that it is an

integral part of the stress experience. And in order to do these successfully,

an individual must deal with the situation or problem, deal with the feelings,

use available support and reduce the psychological arousal of stress by

appropriate activities such as relaxation, exercise and others.

(http://www.jpsimbulan.com/2007/11/19/stress-and-the-working-nurse/)

Foreign Literature

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Nursing is a stressful program to study. Implementing techniques to

cope with stress in a nursing program has an effect on retention and

performance. It has been shown that nursing students perform with less

anxiety when using stress coping techniques such as massage. Increasing

nurses' knowledge about complementary techniques supports retention of

nurses in academic and professional fields.

Effectively managing stress is a priority for first-year nursing students.

Overall time management for the students will determine their ability to

successfully negotiate their way through the remaining years of their

program. Including holistic care studies for nursing students have shown to

result in the ability to study better, better sleeping habits and general health

improvement. Requiring stress management within the nursing curriculum

assists nurses with teaching coping techniques to clients and hospital

visitors.

An effective nursing program provides ongoing stress management

workshops during the academic year. There are unique interpersonal and

environmental stressors for nursing students. Stressors specific to

nursing college students can be addressed by educational administrators.

Administrators can address these with an assigned counseling faculty that

supports at-risk students.

Key benefits to learning stress coping techniques as nurses include the

promotion of these tools among clients and visitors. They are essential for

managing the workload of nurses but can also directly contribute to the care

of their clients. Insufficient knowledge about stress coping techniques is the

primary barrier to its implementation. Complementary medicine and

alternative therapies have proven effective. Implementation of these coping

techniques within an academic program better prepares nurses for a

professional career.

Academic institutions can institute stress management techniques like

massage therapy, meditation, yoga, dance and art therapy activities within

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their orientation program. Specialized training opportunities can supplement

coursework for credit and engage nursing students to develop these

opportunities. Including nursing students in developing stress management

workshops and activities will extend retention in the nursing program.

For nursing students away from home, creating a support system may

fall last in their list of priorities. Providing support within the academic

system may involve group and individual counseling as well as direct access

to resources. Creating a support system with family and friends is a primary

stress reduction technique because having the ability to enjoy time away

from nursing and studies supports self-care. Nurses must prioritize their own

care amid the other care they are required to provide.

(http://www.ehow.com/way_5646415_stress-coping-techniques-nursing-

students.html#ixzz19t5KsYUX)

Foreign Studies

A study was conducted by Ganga Mahat RN, C, EdD entitled Stress and

Coping: Junior Baccalaureate Nursing Students in Clinical Settings (Article

first published online: 2 AUG 2007). The purpose of this study was to identify

junior baccalaureate nursing students’ perceived stressors and ways of

coping during the clinical component of nursing education and the use of

coping strategies by students with different ethnic backgrounds. Data were

collected from 107 junior nursing students enrolled in the first clinical course.

Results revealed students frequently perceived stressors in the clinical

setting. The findings also revealed that students utilized two problem-

focused coping strategies—problem solving and seeking social support

coping strategies—more frequently than two emotion-focused coping

strategies—tension reduction and avoidance coping. Additional findings

revealed that both Caucasian and African-American students used more

problem-focused than emotion-focused coping strategies.

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CHAPTER 3

RESEARCH AND METHODOLOGY

This chapter deals with the methodology and procedures employed in

this study. Discussion includes the research design, research setting,

respondents, sampling procedures, the research instrument, data gathering

procedure and statistical technique.

Research Design

A descriptive design is used by the researchers to gather and interpret

the data. Surveys are conducted to determine the most prevalent strategies

that are being utilized by the student nurses. This will then be analyzed to

determine how they are dealing with their stressors while taking up the

nursing course.

Research Setting

The research was conducted here at the College of Nursing of

Bukidnon State University, Malaybalay City, Bukidnon.

Bukdinon State University is located in the capital town of Malaybalay

City, Bukidnon and is strategically positioned to serve Region X, Region XI

and CARAGA region and other out laying cities and provinces of Mindanao.

Respondents and Sampling Procedures

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The respondents are the third year and fourth year nursing students of

Bukidnon State University. They have more experiences on having their

clinical exposure. In addition, their competency is expected to be higher and

wider than those of the first year and second year nursing students.

Samples will be taken through simple random sampling method.

Research Instrument

The Ways of Coping (Revised) is a 66-item questionnaire containing a

wide range of thoughts and acts that people use to deal with the internal

and/or external demands of specific stressful encounters. The revised Ways

of Coping (Folkman& Lazarus, 1985) differs from the original Ways of Coping

Checklist (Folkman& Lazarus, 1980) in several ways. The response format in

the original version was Yes/No; on the revised version the subject responds

on a 4-point Likert scale (1 - Not Used, 2 - Used Somewhat, 3 - Used Quite a

Bit, 4 - Used a Great Deal).

Redundant and unclear items were deleted or reworded, and several

items, such as prayer, were added. Many investigators have asked if the

Ways of Coping can be used to assess coping styles or traits. The measure is

not designed for this purpose; it is designed as a process measure. It is

possible though to look for consistency (style) across occasions by

administering the measure repeatedly and then doing intraindividual

analyses. Each administration, however, is focused on coping processes in a

particular stressful encounter and not on coping styles or traits. In addition,

the researchers have utilized the student sample Ways of Coping from the

same authors because it is more appropriate for use of nursing students.

Forty-one items were omitted because the study only focuses in nine coping

mechanisms.

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Data Gathering Procedure

The respondents were divided into two groups, the third year and

fourth year nursing students of Bukidnon State University. Both groups are

composed of 25 students randomly chosen. They will be given the same set

of questionnaire. The result will then be computed and analyzed. The coping

mechanisms will then be ranked according to the most commonly utilized up

to the least favored behavior. It will then be analyzed on how it affects the

performance of the nursing students on their clinical duties and studies.

Prior to the distribution of questionnaires to the students, a letter to

the Dean of the College of Nursing was submitted in order for the study to

push through. Upon approval, gathering of data follows.

Statistical Technique

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:

P =

Where:

P= Percentage

F= Frequency

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N= Total Number of Respondents

For the Average Mean

Computation of the average mean was made using the expression:

Ave Mean = F x E

Where:

Ave Mean = Average mean

F= Frequency used

E= Numerical equivalent or the degree of response

For the Weighted Mean

Computation of the weighted mean was made using the expression:

WM=

Where:

WM = Weighted mean

∑ = Summation of the degree of response

N = Total number of respondents

F = Frequency of response

The researchers used ranking to determine the position of each variable.

Number Value E ( Degree of Response) Interpretation3.25 – 4.0 4 Used a great deal2.50 – 3.24 3 Used quite a bit1.75 – 2.49 2 Used somewhat1.0 – 1.74 1 Not used

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Finally, the findings were summarized conclusions were drawn, and

recommendations were formulated.

CHAPTER 4

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 fifty junior nursing students, 25 from the third year

level and 25 from the fourth year level enrolled at the Bukidnon State

University College of Nursing as of school year 2012 – 2013.

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Problem 1: What is the profile of the respondents in terms of age, year

level, gender, civil status and area of assignment?

Table 1.1

Distribution of Respondents According to Age

Age Frequency Percentage Rank18 – 21 39 78% 122 – 25 9 18% 226 – 30 2 4% 3

Total 50 100%

Table 1.1 presents the data of the respondents in terms of their age.

There are 39 or 78% of the respondents who are at ages between 18-21

years old which ranked 1; 9 or 18% of the respondents or 22-25 years old

which ranked 2; 2 or 4% of the respondents who are 19 years old

which ranked 3.

The data indicate that the respondents are at the right age to consider

as mature individuals capable of managing stress. It also shows that majority

of the respondents are between 18-21 years old.

In a study of Age Differences in the Use of Coping Mechanism by

Robert McCrae, it shows that older people coped in much the same way as

younger people and that where they employed different mechanisms, it

appeared to be largely because of the different types of stress they face.

Table 1.2

Distribution of Respondents According to Gender

Gender Frequency Percentage RankMale 7 14% 2

Female 43 86% 1

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Total 50 100%

Table 1.2 presents the data of the respondents in terms of their gender.

There are 7 or 14% of the respondents who are male and 43 or 86% of the

respondents who are female.

An influential study published in the July 2000 issue of Psychological

Review reported that females were more likely to deal with stress by

"tending and befriending" -- that is, nurturing those around them and

reaching out to others.

In women, when cortisol and epinephrine rush through the

bloodstream in a stressful situation, oxytocin comes into play. It is released

from the brain, countering the production of cortisol and epinephrine, and

promoting nurturing and relaxing emotions.

While men also secrete the hormone oxytocin when they're stressed,

it's in much smaller amounts, leaving them on the short end of the stick

when it comes to stress and hormones.

Table 1.3

Distribution of Respondents According to Year Level

Year Level Frequency Percentage RankThird year 25 50% 0.5

Fourth year 25 50% 0.5Total 50 100%

Table 1.3 presents data of respondents in term of their year level.

There are 25 or 50% of the respondents who are third year which rank 0.5;

25 or 50% of the respondents who are fourth year which ranked 0.5.

This indicates equal of number third year and fourth year respondents.

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Table 1.4

Distribution of Respondents According to Civil Status

Civil Status Frequency Percentage RankSingle 46 92% 1

Married 4 8% 2Total 50 100%

Table 1.4 presents data of respondents in terms of their status. There

are 46 or 92% of respondents who are single which ranked 1; 4 or 8% of the

respondents who are married which ranked 2.

This indicates that majority of the respondents are single and therefore

not yet burdened by responsibilities of managing a family.

Table 1.5

Distribution of Respondents by Area of Assignments

Area of Assignment

Frequency Percentage Rank

Medical 45 90% 1Surgical 40 80% 2.3

OB 38 76% 5ER 32 64% 7OR 40 80% 2.3

Pedia 37 74% 6DR 40 80% 2.3ICU 3 6% 8

Table 1.5 represents the data of the distribution of respondents by area

of assignments. 45 or 90% of the respondents were rotated in the medical

ward which rank 1; 40 or 80 % of respondents were rotated on the surgical

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ward, OR, and DR which rank 2.3; 38 or 76% of respondents were rotated on

OB ward which rank 5; 37 or 74% of respondents were rotated on the Pedia

ward which rank 6; 32 or 64% of respondents were rotated on the ER which

rank 7; And only 3 or 6% of the respondents were rotated on the ICU which

rank 8.

This indicates that the respondents were not distributed equally on

each area of assignments. Studies found that stress level was significantly

higher in junior nurses than in senior nurses. There are also studies reporting

that the longer the nurses had worked in their units the more likely they were

to experience stress, regardless of their seniority (Lee 2003:87).

Problem 2: What are the five most common coping mechanisms that

the third year and fourth year nursing students are using?

Table 1.6

Coping Mechanisms Utilized by the Third Year Nursing Students

Coping Mechanisms WM Verbal Interpretation

PROBLEM-FOCUSED SOLVING1. I go over in my mind what I will say or do. 3.36 Used a great deal2. I know what has to be done, so I am

doubling my efforts to make things work. 3.28 Used a great deal

3. I try not to act too hastily or follow my first hunch in solving a problem.

3.12 Used quite a bit

4. I’m making a plan of actions and following it.

3.36 Used a great deal

5. I try to see things from the other person’s point of view


6. I try to keep my feelings from interfering with my responsibilities too much.


7. I try to analyze the problem in order to understand it better.


Overall average 3.27 Used a great deal

WISHFUL THINKING

26

1. I wish that I can change what is happening or how I feel during our duty.


2. I wish that the situation would go away or somehow be over with it.


3. I daydream or imagine a better time or place than the one I am in.


4. I have fantasies or wishes about how things might turn out.


Overall average 3.06 Used quite a bit

DETACHMENT1. I try to forget the whole thing about our

clinical duty.2 Used somewhat

2. I go on as if nothing is happening. 2.08 Used somewhat3. I accept my situation, since nothing can

be done2.88 Used quite a bit

Overall average 2.32 Used somewhat

SEEKING SOCIAL SUPPORT1. I talk to someone about how I’m feeling

with regards to my mistakes on our duties.


2. I let my feelings out somehow whether I’m feeling happy or frustrated with our duties.

3.16 Used quite a bit l

3. I pray. 3.28 Used a great dealOverall average 3.32 Used a great

dealFOCUSING ON THE POSITIVE l

1. I look for the silver lining, so to speak; try to look on the bright side of things.


Overall average 3.52 Used a great deal

SELF-BLAMING1. I criticize or lecture myself. 3.08 Used quite a bit2. I make a promise to myself that things

will be different next time.3.24 Used quite a bit


SUPPRESSING TENSION1. I got away from our clinical duties for a

while; tried to rest or take a vacation. 2.6 Used quite a bit

2. I try to make myself feel better by eating, drinking, smoking, using drugs or medication, etc.

3 Used quite a bit

27


TENSION REDUCTION1. I jog or exercise. 2.28 Used somewhat

Overall average 2.28 Used somewhat

KEEPING TO SELF1. I try to keep my feelings to my self 2.32 Used somewhat2. I keep others from knowing how bad

things are2.52 Used quite a bit

Overall average2.42 Used somewhat

Table 1.6 presents the coping mechanism used by the third year

nursing students of Bukidnon State University. For the focusing on positive,

got an overall average weighted mean of 3.52 and was interpreted as “used

a great deal”. It ranked number 1 based on the findings presented above.

For seeking social support, it has a weighted mean of 3.32. It was

interpreted as “used a great deal” and it ranked number 2.

For problem focused solving, it has overall average weighted mean of

3.27 and was interpreted as “used as a great deal”. It ranked number 3 in all

the scale of coping mechanism.

For self-blaming, it has overall average weighted mean of 3.16 and was

interpreted as “used quite a bit”. It ranked number 4 in all the scale of

coping mechanism.

For wishful thinking, it has a weighted mean of 3.06. It was interpreted

as “used quite a bit” and it ranked number 5.

For suppressing tension, got a weighted mean of 2.8 and was

interpreted as “used quite a bit”. It ranked number 6 base on the findings.

For keeping to self, it ranked number 7 and got an overall average

weighted mean of 2.42. It was interpreted as “used somewhat”.

28

For detachment, it has a weighted mean of 2.32 and was interpreted

as “used somewhat”. Base on the findings, in ranked number 8 in all the

scale of coping mechanism.

For tension reduction, it ranked number 9 and has a weighted mean of

2.28. It was interpreted as “used somewhat”.

Table 1.7

Coping Mechanisms Utilized by Fourth Year Nursing Students

Coping Mechanisms WM Verbal Interpretation

PROBLEM-FOCUSED SOLVING

1. I go over in my mind what I will say or do. 3.56 Used a great deal

2. I know what has to be done, so I am doubling my efforts to make things work.


3. I try not to act too hastily or follow my first hunch in solving a problem.


4. I’m making a plan of actions and following it.3.28 Used a great deal

29

5. I try to see things from the other person’s point of view


6. I try to keep my feelings from interfering with my responsibilities too much.


7. I try to analyze the problem in order to understand it better.


Overall average3.44 Used a great

dealWISHFUL THINKING






3 Used quite a bit



Overall average:3.17 Used quite a bit

DETACHMENT1. I try to forget the whole thing about our

clinical duty.2.2 Used somewhat

2. I go on as if nothing is happening. 2.52 Used quite a bit3. I accept my situation, since nothing can be

done3.12 Used quite a bit

Overall average 2.61 Used quite a bitSEEKING SOCIAL SUPPORT

4. I talk to someone about how I’m feeling with regards to my mistakes on our duties.



1.84 Used somewhat

6. I pray. 3.88 Used a great dealOverall average 3.08 Used quite a bitFOCUSING ON THE POSITIVE




dealSELF-BLAMING

1. I criticize or lecture myself. 3.0 Used quite a bit2. I make a promise to myself that things will

be different next time.3.56 Used a great deal


deal

30

SUPPRESSING TENSION1. I got away from our clinical duties for a

while; tried to rest or take a vacation. 2.12 Used somewhat


2.28 Used somewhat

Overall average 2.2 Used somewhatTENSION REDUCTION

1. I jog or exercise. 2.04 Used somewhatOverall average 2.16 Used somewhatKEEPING TO SELF1. I try to keep my feelings to myself. 2.76 Used quite a bit2. I keep others from knowing how bad things are. 1.76 Used somewhatOverall average 2.26 Used somewhat

Table 1.7 presents the coping mechanisms used by the fourth year nursing students to effectively manage stress.

Problem-focused solving has a weighted mean of 3.44 and is interpreted as being “Used a great deal”. It has the highest weighted mean and is ranked first among the nine coping mechanisms listed.

Focusing on the positive ranked second with a weighted mean of 3.32 and is “used a great deal.”

Self-blaming follows with a weighted mean of 3.28 and is interpreted as being “used a great deal”.

On the fourth rank is Wishful Thinking with a weighted mean of 3.17 and is “used quite a bit.”

Next is Seeking Social Support with a weighted mean of 3.08 and is also ‘used quite a bit.”

Sixth in rank is Detachment with a weighted mean of 2.61 and is interpreted as being “used quite a bit.”

Seventh is Keeping to Self with a weighted mean of 2.26 and is “used somewhat.”

Next is Suppressing Tension with a weighted mean of 2.2 and is “used somewhat.”

31

Lastly is Tension reduction with a weighted mean of 2.04 and is “used somewhat.”

COMPARISON:

The top five coping behaviors of the third year are focusing on the

positive, seeking social support, problem-focusing solving, self-blaming and

wishful thinking.

32

The fourth year nursing students, on the other hand, have the

following coping mechanisms: problem-focused solving, focusing on the

positive, self-blaming, wishful thinking and seeking social support.

This indicates that both the third year and fourth year has the same

coping behaviors, only the ranking of it differs.

Problem-focused solving looks at different approaches and resolutions.

Problem-focused coping is generally found in research to be the most

positive to overall health. This kind of coping is appropriate when there are

elements of a stressful situation that they have actual influence over – that

is, they are changeable. When they apply problem-focused coping to stress

that can’t be changed, they tend to feel frustrated, defeated, or disillusioned.

Problem-focused coping is necessary to help them move through hard times.

Although it is found in research to be the most positive to overall health, it is

extremely unpopular in practice, and very hard to do. Solving problems takes

planning, impartial assessment of needs, and a willingness to act upon

decisions. End result – the actions that will make them healthier in the long

run, become very difficult to take.

Reference to others or seeking social support represents the coping

strategies young people use when they turn for support to external

resources, such as peers and professionals. Knowing how and when to get

help from others and how to get along with others are skills that contribute

to success in life. Such strategies are indicative of emotional intelligence.

This indicates that the respondents are open to others to let their feelings

out. Making contact with others can help reduce feelings of distress. When

there is somebody who is willing to listen it makes them feel better. By

letting out the problems, it helps them ease the heaviness that they carry in

their hearts. It also indicates that the respondents are always praying to give

comfort for their selves. They believed that God is always in there that willing

to listen in terms of difficulties and happiness. That God gives them strength

33

to pursue in their life even the obstacles that they have to face. Praying is

one of their ways to release the stresses they have.

Next is focusing on the positive or looking at the bright side of life. This

means being able to accept the current situation a person is in and tries to

have a positive outlook on that certain situation however difficult it may

seem. This indicates that the respondents are using this ability to stay

positive even in times of difficulty and crisis. It gives them strength and the

ability not to feel despair. Being a positive thinker helps them focus on the

solution rather than waste time and energy on negative emotions. This

means they get themselves back on track faster and start thinking about

what they can do instead of staying in a disempowering state. Rather than

repeating the same negative emotions of irritation, regret and anger in their

head, they now focus on the lessons learned and get into a creative flow in

finding a solution. Through practicing positive thinking, they are creating a

positive reality for their selves. This is because when they focus on positive

things, they will have positive actions. And consistently having positive

actions can only lead to the achievement of desired results.

Wishful thinking is hoping for the best without taking steps to ensure it.

students have been trying to distract themselves to lessen or avoid the

impact of stress, however, wishful thinking does not guarantee that it will

make a person more determined and committed to do well because more

often, they are just contented with daydreaming than taking steps to ensure

it.

Self-blaming is seeing oneself as responsible for the problem. This

indicates that the respondents evaluate themselves so that they well know

what is lacking on them. By assessing themselves they may know more of

who really they are. It well helps them to identify how they react in different

kinds of crisis that they may encounter. It is one way of reminding

34

themselves to improve, do their work or job better next time, what they will

going to do in terms of crisis and how to handle problems base on what they

experience. Criticizing themselves will also be helpful in analyzing on what

are the right things to do.

The remaining coping behaviors are not often used by the respondents.

Emotional detachment is a psychological term that can refer to either a

positive or a negative behavior. When emotional detachment is negative, it

presents as an inability to really connect with other human beings; this

person might remain emotionally unavailable in all relationships, even

though he or she is physically present in the relationship, which can lead to

problems. The second type of detachment, which is a positive psychological

behavior, is the ability to recognize and empathize with other people's

feelings without compromising one's own personal boundaries, emotions, or

sense of self. The second practice is one that can be cultivated and improved

upon, and can be beneficial to relationships, whereas the first is usually

detrimental.

Suppressing tension ranked 6 and the overall interpretation is that it is

“used quite a bit”. This indicates that some respondents relieve stress by

taking a vacation or engaging in eating, drinking liquors, smoking and using

drugs or medications.

Keeping to self is being withdrawn from others, and refuses to

communicate one’s concerns and feelings. This indicates that the

respondents are not fond of keeping problems on their own. They let it out by

telling it to others because it is more relieving rather than keeping it by self.

When someone knows what they feel, that person will give comfort to ease

the tension that they felt because of the problems they have. For them

keeping problems by self is less effective in reducing or managing stress.

35

http://www.wisegeek.com/what-are-personal-boundaries.htm

Tension reduction ranked ninth in both year levels. This indicates that

the respondents do not really engage themselves in exercise. They didn’t

give more time in exercise to reduce their stress. It is also means that the

respondents are not fond of using exercise as a way of reducing tension.

Because of busy schedule they tend to forgot to give time in doing physical

activity. Doing exercise will also be helpful to us by strengthening our body

and relaxing our mind, but most of the respondents find another way in

relieving stress rather than engaging in exercise.

Problem 3: Is there a significant difference between the profile of

respondents and their common coping mechanisms?

There is a significant difference between the profile of respondents and

their common coping mechanisms. However, the way they cope with stress

depends on the type of stressors they are facing.

CHAPTER 5

SUMMARY, CONCLUSION AND RECOMMENDATIONS

This presents the summary of the study, formulated

conclusion and recommendations offered.

Summary of the findings

36

This study is all about “Coping Mechanism of the Third year and Fourth

Year Student Nurses of Bukidnon State University”. The descriptive method

of the research was utilized and the questionnaire serves as the principal

data gathering instrument. There are 50 respondents who fill up the survey

questionnaire. The results were tabulated and interpreted.

The following are the summary of the findings of the study based from

all the data presented, analyzed and interpreted.

1. Most of the respondents are in 18-21 years of age

2. Most of the respondents are female.

4. In the data gathered from the questionnaires majority of the

respondents are single.

5. Regarding to the areas of assignments majority of the respondents

were assigned in the medical area.

6. The top five coping behaviors of the third year are focusing on the

positive, seeking social support, problem-focusing solving, self-blaming and

wishful thinking.

The fourth year nursing students, on the other hand, have the

following coping mechanisms: problem-focused solving, focusing on the

positive, self-blaming, wishful thinking and seeking social support.

7. This indicates that both the third year and fourth year has the same

coping behaviors, only the ranking of it differs.

8. There is a significant difference between the profile of respondents

and their coping behaviors.

CONCLUSION

37

Based on the findings of the study, the researchers arrived at the

following conclusions:

1. The five most common coping mechanisms are as follows: Seeking

social support, focusing on the positive, problem-focused solving, self-

blaming and wishful thinking. The first three are considered to be positive

ways of coping. It shows that the third year and fourth year nursing students

are managing stress effectively.

On the other hand, suppressing tension, detachment, keeping to self, and tension reduction are not popularly used.

2. The result of the study stands benefit to the nursing practice in

rendering effective quality nursing care. The identification of the most

common coping strategies of the third year and fourth year students will

provide them adequate academic and clinical knowledge on how to

effectively manage 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 with

stress properly in order for students to be competent enough in different

clinical area and to render quality and effective nursing care to the patients.

RECOMMENDATIONS

After the conclusions were drawn, the researchers of the study hereby

recommended that:

It is recommended that the third year and fourth year respondents of

Bukidnon State University College of Nursing should have monthly stress

management workshop. This is to help them further harness and learn new

positive stress coping mechanism and to let them change their old negative

stress mechanism to new and positive ones.

38

Weekly morning stress exercises should also be implemented because

this type of tension reduction is only used somewhat. Exercise will not only

help the body to improve its endurance to the daily stress that a nursing

student encounters, it will also help the body to stimulate endorphins which

will help in relieving stress that a person is experiencing.

Finally, conducting another study using more variable and

bigger sample frame should be considered to arrive at a more

comprehensive and meaningful conclusion.

BIBLIOGRAPHY

Books

Barbara Kozier MN, RN, GlenoraErb BSN, RN, Audrey Berman Ph. D., RN, MAN

Funadamental of Nurszing 7th Ed.

Deborah Antai-Otonget. Al, Thomson Asian Ed. Psychiatric Nursing Book

Stress (2008).Encyclopedia Britannica.Encyclopedia Britannica 2007

Deluxe Edition. Chicago: Encyclopedia Britannica.

Lazarus, R.S., &Folkman, S. (1984). Stress, Appraisal and Coping. New York:

Springer

39

Stress and Coping Theories by H. W. Krohne

Greenglass, E. Beyond coping: Meeting goals, vision, and challenges.

London: Oxford University Press,

Undergraduate Thesis

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.

Stress and Coping Strategies amongst Registered Nurses Working in a South

African Tertiary Hospital

Factors associated with stress among nursing students

Student Nurses’ Perception of Death and Dying

Nursing Students‟ Learning Experiences in Clinical Settings: Stress, Anxiety

and Coping

Article

A longitudinal study of stress and self-esteem in student nurses by Deborah

Edward, Philip Burnard, Kim Bennett, UnaHebden

Website

http://www.thestressoflife.com/why_men_and_women_handle_stress_.htm

http://my.webmd.com/webmd_today/home/default

http://www.etd.uwc.ac.za

http://www.medind.nic.in

40

http://www.medind.nic.in/

http://www.etd.uwc.ac.za/

http://my.webmd.com/webmd_today/home/default

http://www.thestressoflife.com/why_men_and_women_handle_stress_.htm

http://www.ohiolink.edu

http://www.spectrum.library.concordia.ca

http://www.psych.yorke.ca

http://www.sagepub.com

http://digitalarchive.gsu.edu

http://www.tip.duke.edu

http://www.wisegeek.com

http://www.ukessays.com/essays/nursing/stress-coping-mechanisms-of-

selected-junior-nursing-students-nursing-essay.php

http://nurses.definitelyfilipino.com/index.php/2010/12/a-bsn-students-guide-to-

nursing/

http://www.jpsimbulan.com/2007/11/19/stress-and-the-working-nurse/

http://www.ehow.com/way_5646415_stress-coping-techniques-nursing-

students.html

41

http://www.jpsimbulan.com/2007/11/19/stress-and-the-working-nurse/



http://www.ukessays.com/essays/nursing/stress-coping-mechanisms-of-selected-junior-nursing-students-nursing-essay.php

http://www.ukessays.com/essays/nursing/stress-coping-mechanisms-of-selected-junior-nursing-students-nursing-essay.php

http://www.wisegeek.com/

http://www.tip.duke.edu/

http://digitalarchive.gsu.edu/

http://www.sagepub.com/

http://www.psych.yorke.ca/

http://www.spectrum.library.concordia.ca/

http://www.ohiolink.edu/

APPENDICES

A. RESEARCH INSTRUMENT

I. PROFILE OF THE RESPONDENTS

Name (Optional): ______________________________

Age: 18 – 21 years old 26 – 29 years old

22 – 25 years old 30 – and above

Year level: Third Year Fourth Year

Gender: Male Female

Civil Status: Single Married

Area of Assignment/s:

Medical OB OR DR

Surgical ER Pedia ICU

42

PART II.Please read each item below and indicate, by using the following rating scale, to what extent you used it during/on your clinical duties.

Not Used Used Somewhat Used Quite a Bit Used a Great Deal

1 2 3 4

Coping Behaviors1 2 3 4

PROBLEM-FOCUSED SOLVING

1. I go over in my mind what I will say or do. 2. I know what has to be done, so I am doubling my efforts

to make things work. 3. I try not to act too hastily or follow my first hunch in

solving a problem.4. I’m making a plan of actions and following it.5. I try to see things from the other person’s point of view6. I try to keep my feelings from interfering with my

responsibilities too much. 7. I try to analyze the problem in order to understand it

better.

WISHFUL THINKING





DETACHMENT

1. I try to forget the whole thing about our clinical duty.2. I go on as if nothing is happening. 3. I accept my situation, since nothing can be done

SEEKING SOCIAL SUPPORT

1. I talk to someone about how I’m feeling with regards to my mistakes on our duties.


43

3. I pray.

FOCUSING ON THE POSITIVE


SELF-BLAMING

1. I criticize or lecture myself. 2. I make a promise to myself that things will be different

next time.

SUPPRESSING TENSION

1. I got away from our clinical duties for a while; tried to rest or take a vacation.


TENSION REDUCTION1. I jog or exercise.

KEEPING TO SELF1. I try to keep my feelings to myself.2. I keep others from knowing how bad things are.

44

CURRICULUM VITAE

Name: Gladden Pearl A. Badajos

Age: 20 years old

Sex: Female

Current Address: Zone 7, Barangay 9, Malaybalay City, Bukidnon.

Date of Birth: November 16, 1992

Place of birth: Malaybalay City

Hometown Address: Malaybalay City, Bukidnon.

Educational Background

Elementary: Malaybalay City Central School, 1998-2005

High School: San Isidro College, 2005-2007

Bukidnon National High School, 2007-2009

College: Bukidnon State University, 2009 up to present

Seminars Attended:

Research Forum

45

Psychiatric Nursing: Nurturing the Complex Mind Through Competency-

based Care

Forensic Nursing with I.Net

Nursing practice: coping up with its new trends and challenges through

legal and ethico-moral principles

Transforming novice into competent nurses.

Intrapartum Care

Disaster Triaging and Management

ORNAP

Coping up with Public Speaking fear

Affiliations: College of Nursing Student Body Organization, Public

Information Officer SY: 20011-2012, Bukidnon State University Supreme

Student Council, Senator SY: 2012-2013

46

CURRICULUM VITAE

Name: Florsean Mae A. Sala

Age: 20 years old

Sex: Female

Current Address: Mampaalong St, Malaybalay City, Bukidnon

Date of Birth: September 6, 1992

Place of birth: Placer, Surigaodel Sur

Hometown Address: Legaspi St, Hinatuan, SuigaodelSr


Elementary: Hinatuan South Central, 1998-2005

High School: Hinatuan National Comprehensive High School , 2005-2009

College: Davao Doctor’s College, 2009-2010

Bukidnon State University, 2010 up to present

Seminars Attended:

Global Disaster Preparedness Program

Research Forum

47


based Care





Intrapartum Care


ORNAP

Affiliations:

UNIFIRE member

48

CURRICULUM VITAE

Name: Chrizel Jane F. Panchacala

Age: 20 years old

Sex: Female

Current Address:Mampaalong St, Malaybalay City, Bukidnon

Date of Birth: August 5, 1992

Place of birth: Poblacion, Quezon, Bukidnon

Hometown Address: Poblacion, Quezon, Bukidnon


Elementary: Quezon Central School, 1998-2005

High School: Quezon Institute of Technology, 2005-2009

College: Bukidnon State University, 2009 up to now

Seminars Attended:


Research Forum


based Care


49




Intrapartum Care


ORNAP

Affiliations:

D’ Quezonians member

50

CURRICULUM VITAE

Name: Terence B. Serafin

Age: 32 years old

Sex: Male

Current Address: San Victoria St, Zone 3, Barangay 9, Malaybalay City,

Bukidnon

Date of Birth: November 8, 1979


Hometown Address: San Victoria St, Zone 3, Barangay 9, Malaybalay City,

Bukidnon


Elementary: Bukidnon State College

High School: Bukidnon National High School

College: Bukidnon State University

Seminars Attended:


Forensic Nursing

Affiliations: College of Nursing-Student Body Organization, Appointee

51

CURRICULUM VITAE

Name: Lech Mahonri Abecia

Age: 21 years old

Sex: Male

Current Address: 07-69 Fortich Street Malaybalay City

Date of Birth: October 14, 1991

Place of birth:Malaybalay City

Hometown Address: 07-69 Fortich Street Malaybalay City


Elementary: Malaybalay City Central School



Seminars Attended:


Research Forum


based Care





52

Intrapartum Care


ORNAP

Affiliations:

UNIFIRE member

CURRICULUM VITAE

53

Name: Ivyn Ian Neri

Age: 20 years old

Sex: Male

Current Address: Heights Melendez Subdivision Street, Malaybalay City

Date of Birth: October 29, 1991


Hometown Address: Heights Melendez Subdivision Street, Malaybalay City


Elementary: Malaybalay City Central School



Seminars Attended:


Research Forum


based Care





Intrapartum Care


54

ORNAP

55

chap..doc

Documents

stress severe

avoiding stress

stress management techniques

nursing programs

nursing school

common causes of stress

rid of unnecessary stress

students wellbeing