Master of Arts (Counselling & Guidance)

Stress is something which can be considered as intrinsic to nursing. High workloads and dealing with death and dying are stressful events in nurses’ life. In addition extreme pressure due to insufficient time and resources to complete the given nursing task and organizational factors within the hospital contribute to major stress among nurses. Hence, nursing is an emotionally demanding job and interactive stress ultimately contributes to stress among nurses. This study investigates the impact of group counselling program on nursing students' levels of stress and anxiety during their first clinical attachment. Group counselling as an intervention was introduced to relief the stress for the student nurses during their first clinical attachment in the hospital.

Basically a quasi-experiment was conducted to test the effectiveness of the pre counseling session in helping first year students to reduce their stress and meet the requirements of clinical attachment. Hence, quasi experimental design was adopted for posttest in this current research. Before going for their clinical attachment, all the student nurses were given a survey questionnaire which is the “Perceived Stress Scale to measure the student’s stress level and ultimately the types of stressors.

A total of 134 students participated in the research. They were divided into two groups randomly. The control group of students did not receive any counselling. Thus, students from the experimental group received group counselling. The students in the experimental group were provided with pre counseling intervention. Hence, the group counselling program was given to 67 participants from the experimental group. A counselor facilitated the group counselling with the student nurses and discussed with them about the difficulties they may face in their first clinical attachment and provided coping strategies for them to use in their clinical attachment. During the last week of their clinical attachment, using the same survey questionnaire a post-test was administrated to all participants.

After the clinical attachment, a semi-structured interview was conducted for the participants from the experimental group. As qualitative data, their responses were recorded and used to explain and evaluate the intervention provided.

The group counselling program before clinical attachment focused on what is the possible stressor first year student nurses encountered before going for clinical attachment. The post clinical attachment group counselling was conducted to find out what is the major stressor or stressful incidents students encountered were provided counselling respectively for effective coping. The setting was in Ngee Ann Polytechnic in Singapore.

Based on the “Perceived Stress Scale” to measure the student’s stress level and ultimately the types of stressors and data analysis was performed for each of the sub-scales of Nursing Student Experiences of “ Clinical Practice Scale”, the pre-test score was used as a covariate. ANCOVA was performed to compare the post-test scores obtained from the experimental group and control group.

Participants from the Experimental group who attended group counselling showed that they were able to manage stress effectively and found the group counselling to be indeed effective and positive. Students also found that pre group counselling have prepared them psychologically before clinical attachment and post group counselling had been an avenue to ventilate and cope without going into burnout stage. Therefore, the group counselling introduced for the first year student nurses had been very significant in helping to reduce stress before clinical attachment and after clinical attachment. Results indicated that experimental group student nurses were able to maintain the stress level while the control group had a significant increase in the stress level over the 2-week period of clinical training. Additionally, students in the experimental group receiving group counselling were less anxious and less stressful at post counselling. Students in the control group who did not receive the pre and post counselling experience showed higher level of stress than the control group.

The conclusion is that group counselling as an intervention can reduce stress level for nursing students if administered routinely before and after clinical attachment.