Perceived Stress in Clinical Areas and Emotional Intelligence among Baccalaureate Nursing Students

Nursing is a complex profession requiring professional nurses to interact with a variety of individuals including colleagues, clients and families in high stress environment. Nursing programs strive to prepare students with knowledge and technological skills to practice in multiple settings. Clinical practice is a critical component and the largest part of nursing education, which helps nursing students to enhance their professional knowledge, skills and values (Ralph, Walker & Wimmer, 2009; Moscaritolo, 2009). Students develop an understanding of the patient problems, develop their clinical knowledge, develop problem solving abilities and technological skills as they proceed through various clinical specialties (Amr, El-Gilany, El-Moafee, Salama & Jimenz, 2011). The concepts of stress among nursing and health care students have been widely discussed. It has been reported that these groups experience high levels of perceived stress (Birks, McKendree & Watt, 2009). Perceived stress can be conceptualized as the extent to which a situation in one's life is appraised as stressful and the ability of the person to successfully deal with the personal and environmental challenges (Forushani & Besharat, 2011). Clinical training is demanding and stressful to nursing students, and this is attributed to the demands of the course work, unfamiliar clinical environment, client population, nursing staff, and faculty. In addition, concerns about applied clinical skills in providing quality nursing care, fear of failure and emotions involved in dealing with patients creates additional anxiety in students (Birks et al., 2009; Maville, Kranz & Tucker, 2004; Oermann & Standfest, 1997). Nursing students are expected to be knowledgeable in different areas like client diseases, treatment and medications, investigations and diagnostic tests, also should have skills in communication, patient-nurse interactions and multidisciplinary collaboration (Chen & Hung, 2014). Also, difficulty in balancing study and social activities, heavy course works, time pressures are contributing factors to increased levels of stress.Major sources of stress among undergraduate nursing students also includes examinations, long hours of study, assignments and grades, lack of free time, and lack of social support (Maville et al., 2004). Three types of stressors in nursing students were also identified: academic stressors, clinical stressors, and personal/ social stressors (Martos, Landa & Zafra, 2012). In a comparative and longitudinal study conducted among 1707 nursing students in Albania, Brunei, the Czech Republic, Malta, and Wales, the sufferings of patients, death of a patient, or learning from a dying patient were the most common clinical stressors reported by students (Burnard et al., 2008). In addition, difficulty in balancing home and college demands, time pressure, financial concerns, and stress associated with feeling unprepared for clinical practice, feelings of distance from faculty and staff in clinical areas and feeling incompetent in clinical skills were reported in literatures (Magnussen & Amundson, 2003). Stress is a complex, dynamic process of interaction between a person and his/her life. It can positively or negatively affect individuals by either motivating or hindering academic and clinical achievement and can adversely affect their personal well-being and long term professional capabilities (Ray, 2006; Abhay, Krishnakumar, Paul & Shashidhar, 2011). Studies have shown that 40.2% of nursing students in Egypt and 71.8% of mid-level nursing students in Greece report high levels of perceived stress levels (Amr et al., 2011). By applying Neuman Systems Model to nursing students in clinical learning environment, Moscaritolo (2009) suggested that clinical stress invaded students' normal lines of defense and had resulted in anxiety. A strong positive association of situational stress with increase in errors due to its effect in decision making, concentration and recall (Reeves, 2005) and also with students' capability for problem solving and use of intellectual process have been reported (Shipton, 2002). …