Title : A stress survey in nurse anaesthetist students
Abstract:
Introduction: Nurse Anaesthetist students have to deal with stressful situation during 1-year training program. Usually, students with mild to moderate stress could possibly succeed their goals. However, anyone with severe stress might develop a vicious trouble resulting in poor outcomes or psychological problems. The previous studies revealed that learning difficulty, personal relationship and responsibility in different situation, had terrible effects on most students. As a result, investigators would like to study the stress-related factors in nurse students during their learning program.
Material and Method: After IRB approval, the trial has been registered by ClinicalTrials.gov NCT03094338. A prospective survey was performed in 30 nurse anaesthetist students and verified its causes and effects. All volunteered participants responded to the well-validated research tools 3 times at 2-month interval; at the beginning, during 6 months and at the end of training. It comprised 80-question Siriraj Anaesthesia Related Stress Test (SAST) and 60-question Suanprung Psychological Stress Test (SPST).
Continuous data were presented as mean and standard deviation. Gender within the groups was compared by Chi-square test. Comparisons of all associated factors between groups were performed by Kolmogorov-Smirnov Two-Sample test and t-test independent. Correlation between groups was determined by Spearman’s rho and Pearson’s. Statistical significance was defined as p-value less than 0.05 with a 95% confidence interval.
Results: Nurse Students expressed peri-operatively worries as mild, moderate and severe stress = 27%, 33% and 30% respectively.
Pre-operatively, they worried about the patients’ physical status, emergency cases, choice of anaesthesia, patient with irritable airway and malignant hyperthermia. Intraoperatively, their stress was on massive bleeding, no/low urine output, high airway pressure, displacement of endotracheal tube and air/amniotic/fat embolism. Postoperatively, they concerned on cardiac arrest and panaphylactic/anaphylactoidreaction.
The susceptibility to stress showed no correlation with gender, experience, working data and patient safety issue; however, it was significantly related to sources of stress like personal ones, primarily financial. Their vulnerable periods were pre- and intraoperative period, mainly night duties.
Discussion: Nurse Anaesthetist students were more susceptible to stress at the beginning of school term. This might be possible for they spend only one year in training and work under doctors’ supervision, resulting in lack of confidence, knowledge and experience in patient management. In addition, their cognitive ability might not be as sharp as before, probably because of less work responsibility. Therefore, nurses felt bad about the perception of their competency, thus limiting their self-esteem and eventually undercutting their immune power. So, when under pressure, they failed to ease job stress and displayed anxiety and regression; very few tried to correct this by revising such problems. Nurses expressed considerable uncertainties during night shifts, probably because of intense responsibility and a lack of sleep, compounded by deficiency in experience and knowledge.
Conclusions: Sixty-three per cent of nurse students had moderate to severe stress peri-operatively. Their psychological distress was observed as impairment of cognitive and immune functions.
Audience Take Away:
• Nurse anaesthetist students had to deal with stressful situation at the beginning of school term.
• They worked under doctors’ supervision, resulting in lack of confidence, knowledge and experience in patient management. As a result, nurses expressed considerable worries during night shifts.
• Their psychological distress was about the perception of their competency, thus limiting their self-esteem and eventually undercutting their immune power
