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‡ Nursing gained recognition in the 19th century
with the activities of Florence Nightingale.
Many nurses have specialties like psychiatry,
critical care and other areas of specialization.
Nurse-practitioners, clinical nurse specialists,
nurse-anesthetists, and nurse-midwives
undertake tasks traditionally performed by
physicians.

‡ Among Asian countries, the Philippines has the

highest quality of nursing education with over
190 educational institutions accredited by the
Commission on Higher Education that offer
nursing courses.
For the past many years, the Filipino nurses have
become a much sought-after healthcare
worker in Asia, the Middle East, Europe, North
America and Africa establishing a popular
figure in major hospitals, nursing homes, and
other healthcare institutions in the United
Kingdom, United States of America, Ireland,
Kingdom of Saudi Arabia, united Arab
Emirates, Kuwait, Singapore, Malaysia and
others.
phe decision to work abroad as a nurse requires
intense consideration. While motivation is
important, preparedness and determination are
essential.

In this complex and competitive world, a nurse·s

performance is very much affected by stress.
Research has shown that stress creates a variety
of effects and consequences which can either
increase or decrease one·s level of
performance.
‡ phis study holds to the
assumption that for various
reasons, stressors and coping
mechanisms are very
important determinants of
work performance, moreover,
the determinants of post-
reaction performances like
personal attitudes and
preferences that affect
interpersonal relationship.
&&$'"(#)* +,-../

Nursing profession has been

increasingly characterized by
occupational stress. It is a
phenomenon where the individual is
exposed to a range of external
environmental demands which
need his response.
phe relevance of the study lies on
the fact that its purpose is to
bring together the implications
of understanding _
__
_, 
 
the lives of Filipino
nurses abroad and how they
h
 with them. Specifically, it
aims to provide a basis for the
development of a p

pl  
  
p

 for nurses who are
seeking employment abroad.
Y
  


phis study aims to determine the stressors and

coping mechanisms of nursing graduates of
Sacred Heart College, Lucena City Batch 2005-
2009 working Overseas. Specifically, it aims to
answer the following sub-problems:

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

their
1.1. Age
1.2. Gender
1.3. Marital status
1.4. Area of Assignment
1.5. Country of Employment
2. What are the stressors
experienced by the
respondents classified as
2.1. Physical
2.2. Psychological
2.3. Professional

3. What are the effects of the

stressors in the job
performance as assessed by
the Nurse- respondents?
4. Is there a significant difference in the stressors
experienced by the respondents when they are
grouped according to their demographic profile?

5. What are the coping mechanisms used by the

respondents?

6. What is the implication of the study for the

improvement of the performance of
the nurses who are working overseas?
O
  
With the foregoing sub-problems, it
is hypothesized in this study that:

phere is no significant difference in

the stressors experienced by the
Filipino nurses working overseas
when they are grouped according
to:
‡ age
‡ gender
‡ marital status
‡ area of assignment
‡ country of employment
a

 
‡ Evans (2001) and Cohen (1986)

‡ Anderson (1991) and pyler and

Cushway (1995)

‡ Shinn and colleagues (1984)

 a
  

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Signif'&)"&0# #%$+
phe study will have significant value
to the following:

‡ Nursing Graduates
‡ Nursing Institutions
‡ Clinical Instructors and Hospital
Administrators
‡ Nursing Organizations
‡ Concerned Government
Agencies
‡ Future Researchers
Y  
   

  Y

phis study focuses on finding out the

different stressors and coping
mechanisms of nursing graduates of
Sacred Heart College Batch 2005-09
working overseas.
÷

  
phe operational definitions of the
following terms used in this research
are provided in order to clarify each
term.
‡ 
  It is the exhaustion of one·s
strength due to overwork.
‡ a 
 
 It is a strategy
which can be cognitive, emotional
or behavioral used to manage and
reduce stress and its effects.
‡ ÷  It is an intense, continuous
and repeated stress.
‡  It is a moderate level of
stress.
‡ M 
 
 It refers to the quantity and quality of job
rendered .
‡
  Y  Physical signs of stress which includes
fatigue, changes in sleeping and eating, lack of energy,
loss of interest in sex.
‡
 
  


  It is a program that
covers subjects which will benefit concerned agencies and
the nurses who are going to work abroad. It includes
training of registered nurses planning to work abroad
tailored to meet their needs in preparation to their new
challenges and responsibilities.
‡
 
 Y  It is the work related source of stress
which includes loss of commitment, meaning and integrity.
‡
    Y  It is the emotional and
psychological source of stress which includes irritability,
hypersensitivity, frustration, negative outlook and forgetting
‡ Y  It is the sources of stress which are classified as to
Physical, Psychological and Professional Stressors.
‡ !   It is the amount of work apportioned to a person
 a"#
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‡ the challenges of working and living
in another country with a different
culture
‡ by higher salaries
‡ a better standard of living
‡ by higher salaries and a better
standard of living
 %1611"1'' '#'1
‡ fulfilling certain aspects of the medical regimen delegated to them by
physicians
‡ assessing and intervening within areas of expertise, such as with pain
management and providing comfort, and teaching patients and their
families
‡ liable for maintaining a safe and patient-centered care environment
and routinely intervene when non-nursing support services are not
available or are inadequate to maintain a clean environment
‡ ensure that patients receive adequate nourishment
‡ important functions associated with patient safety, quality of care, and
patient outcomes is providing surveillance for early detection of
adverse events, complications, and medical errors.

Furthermore, nurses often have to deal with anxious families and

sometimes with doctors who may not respect them.
(Aiken et al., 2002).
 )&#1
‡ Demographic considerations in the labor force are
particularly important especially in the light of the nursing
shortage, both here and abroad ( Buchan 2002).
‡ phe nursing staff ratio is known to be a factor in quality of
care (Buerhaus et al., 2002; Steinbrook, 2002).
‡ phere is concern about issues of staff quality in a
marketplace where high demand has driven salaries up,
schools of nursing being set up quickly to deal with the
student waiting list here and abroad (Wickett and
McCutcheon, 2002).
‡ Some note factors in the work environments (Needleman,
2004). phese variables play potential roles as stressors in
the patient care settings.

 can be described as a dynamic and
reciprocal relationship between the
person and the environment.

For over a decade, the nursing profession

has been increasingly characterized by
occupational stress, job turnover, and
job dissatisfaction
(Hawley, 1992)

It is a fact that nurses employed in hospitals

abroad are exposed to greatly different
cultural backgrounds. phus, a critical
factor in stress levels is how a nurse
values a particular stressor based on
his/her cultural orientation
‡ ´Staff burnout is a critical problem for
the human service professions: It is
debilitating to workers, costly to
agencies, and detrimental to clientsµ
(Shinn, Rosario, Morch, & Chestnut,
1984).

‡ Nursing is one of the most stressful

professions, with a great degree of
job stress.

It is a fact that nurses employed in

hospitals abroad are exposed to
greatly different cultural
backgrounds. phus, a critical factor in
stress levels is how a nurse values a
particular stressor based on his/her
cultural orientation
M1#11
is a psychological syndrome in response to chronic
exposure to emotional and interpersonal
stressors on the job (Maslach, Schaufeli, & Leiter,
2001).

‡ Physical markers of stress, which can occur

without coanscious awareness of environment
demands (Cohen, Kessler & Gordon, 1995).

‡ Feelings of stress develop from various events,

such as work overload, criticism, negligent co-
workers, uncooperative patients, and lack of
support from supervisors (Motowidlo,
Manning, & Packard, 1986).
phe national hospital
average turnover rate
A moderate level of stress or "Eustress"
is an important motivating factor
and is considered normal and
necessary. If stress is intense,
continuous, and repeated, it
becomes a negative phenomenon
or "Distress," which can lead to
physical illness and psychological
disorders (Kane, 2009)

Job stressors cause nurses to ´perform

less effectively on tasks which call
for tolerance for frustration, clerical
accuracy, and the ability to avoid
perceptual distractions«they also
become less sensitive to othersµ with
decreased altruistic tendencies
(Cohen, 1980).
‡ All nurses have to do shift work or attend emergencies at night.
phe stress of shift work can also aggravate health conditions and
lead to heart disease or digestive disorders (Pratibha, 2009)

‡ Fatigue can lead to error, injury, and carelessness. Long hours are
a source of depression, low morale, and low motivation.

‡ Shift workers are on the job in the evening or on weekends and

they sleep during the day. Hence, they often miss out on social or
family activities.

‡ phese stressors in the work environment can interfere with very

complex cognitive tasks and are more likely to adversely affect
performance if the stressors are prolonged or of high intensity
(Cohen et al., 1986; Evans, 2001).


‡ Is mainly a state of mind, it causes
many psychological problems. It is as
detrimental to mental health as it is to
physical health.

‡ After an extended period of time,

stress can cause behavioral problems.

‡ phus, they should be diagnosed

carefully and addressed effectively
as the other more visible effects.
RN workforce by 2020 (Buerhaus,
Staiger, & Auerbach, 2000)
‡ phe health care work environment as a
source of overwork and stress has been
implicated in the nursing shortage
( Institute of Medicine [IOM], 2003).
Because stress-related illness contributes to
rising health care costs and disability
(Bruhn, Chesney, & Slacido, 1995)

‡ phe reports from nurses in North America

also indicate that the nurse manager
position has been cut and that the chief
nursing officer level of management has
been eliminated in a number of hospitals.

‡ phe added responsibility given to nurses

might also be due to a low amount of
nurses working in the hospitals. Aiken and
associates (2002)
‡ Chronic stress decreases motivation. It can lead to
increased absenteeism and increased turnover and
attrition rates. phus, it is mandatory for healthcare
organizations to address this issue urgently.

‡ phere is urgent need for proactive stress

management, especially preventive strategies.
phere is need for coping techniques like team
building, counseling, learning assertiveness, and
communication skills, which should be taught to all
nurses, even incorporated in their training curriculum
(Pratibha, 2009)
 )#$ #%$'1
E.M. Andal (2006). ´A Pilot Study
Quantifying Filipino Nurses· Perception
of Stressµ

-Historically, many U.S. hospitals have

recruited nurses from the Philippines
to alleviate staffing shortages.
- phe study explored stress levels in
Filipino registered nurses.

- phe result of the study indicates that

inadequate experience, lack of
support, unpredictable staffing and
scheduling and unreasonable
demands from doctors and patients
are occasionally or frequently stressful.

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Moira Attree in her research study
entitled ´ A Critical Analysis of the
Evidence-Base to Nurse Staffing
Policies in Five European
Countriesµ
-phe paper will contribute to the
development of evidence-based
policy and practice by
stimulating critical awareness and
debate about the current
evidence-base to nursing
workforce healthcare policies.
-phe review aimed to identify the
extent to which current evidence
about nurse staffing is
implemented in national
healthcare policies.
Shinn and colleagues (1984) investigated the
effects of coping on psychological strain
and "burnout" produced by job stress in
human service workers
-phe researchers found that these stressors
predicted job dissatisfaction, behavioral
consequences as job performance and
turnover in studies of human service workers,
psychological symptoms and somatic
symptoms.
‡ Callaghan (2001) in his study
entitled ´Factors Related to Stress
and Coping Mechanisms Among
Chinese Nursesµ investigated
factors related to stress and coping
mechanisms among Chinese nurses
in Hong Kong
‡ phe results revealed that nurses
reported lower stress levels than
other workers.
‡ phe respondents' major sources of
stress were related to nursing issues
like too much work, interpersonal
relationships, and dealing with
hospital administration.
‡ phere was a statistically significant
link between the respondents' stress
and sickness levels.
Deanna Stewart. phe study entitled ´ Job Stress,
and Health in Nurses: the Mediating Role of
Experienceµ examined whether or not the
relationship between nurses· job experience
and health is mediated by job stress.
-phe results indicate that nurses who have been
working in a hospital setting longer experience
less job stress than nurses who have been
working for less years.
-pherefore, job stress also appears to mediate the
relationship between work experience and
better health among nurses
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Non-experimental research design,

specifically descriptive-correlation
approach will be utilized in
conducting the study.
Research Locale
phis study will be
conducted involving Sacred
Heart College nursing
graduates working as
nurses in the United States,
Canada, Saudi Arabia,
Dubai, London, Australia,
Japan and other places all
over the world.
 Population and Sample
po date, an estimated number of one hundred nurses who
are alumni of Sacred Heart College, Nursing Department
are working in the different parts of the world. Of this
number, the researcher is aiming for a sample of at least
fifty respondents for her research. phe number is more
than the minimum required number of samples for a
valid representation of the population under study.

phe respondents of the research are Filipino nurses who are

graduates of Sacred Heart College , school years 2005
to 2009. Although they are deployed in different parts of
the globe, internet on-line system will be utilized by the
researcher to reach the prospective respondents for
their responses.
Research
Instrumentation
phe study will use on-line questionnaire
and/or on-line interview method in
obtaining the necessary data and
information to answer the research
problem. phis will be done in order to
facilitate easy collection of data,
thus minimizing time and effort
involved. phe researcher will
formulate guide questions based on
related literature and studies as well
as additional readings for the
respondents to answer.
Statistical preatment
po answer sub-problems no. 1 and no. 2 ,
simple count and percentage
equivalents will be done using the
formula:
Percentage (%) = n / N x 100
Where: n = number of entries per group
N = total number of entries
Sub-problems no. 3 and no. 5 which deal with the
effects of stressors on job performance and the
coping mechanisms respectively will be
answered and computed using the weighted
mean.

Weighted Arithmetic Mean (WAM) will be

computed using the formula:
WM = ƴ(fw)
n
Where: WM = is the value of the scale or the
weighted mean
ƴ(fw)= is the sum of the products of
frequency and weight
n = is the total number of respondents

Weighted means will be interpreted using the

following continuum:

3.10-4.00 =ALWAYS
2.10-3.00 = OFpEN
1.10-2.00 = SELDOM
0.00-1.00 = NEVER
Sub-problem no. 4 which tests if there is significant
difference in the stressors experienced by the Filipino
nurses working overseas when they are grouped
according to categories identified in sub-problem no. 1
will be answered using the Chi-Square pest (X ).
Computations will be done using the formula:

Where: O = observed frequency

E = expected frequency
X2 = chi-square