1

ENVERGAUNIVERSITYBURNOUT PHENOMENON AS ASSESSED BY SELECTED LEVEL IV NURSING STUDENTS OF MANUEL S. ENVERGA UNIVERSITY FOUNDATION AND ITS PERCEIVED EFFECTS ON ACADEMIC AND CLINICAL PERFORMANCE

An Undergraduate Thesis Proposal Presented to the Faculty of College Of Nursing and allied Health Sciences, Manuel S. Enverga University Foundation Lucena City

In Partial Fulfillment of the Requirements for the Degree Bachelor of Science in Nursing

Group III-A Almeyda, Cris Ian V. Basila, Kayla H. Go, Marc Mel Mattheus N. Ocier, Marjorie

2

ENVERGAUNIVERSITYAPPROVAL SHEET This thesis Entitled Burnout Phenomenon As Assessed By Selected Level IV Nursing Students Of Manuel S. Enverga University Foundation And Their perceived Effect On Academic Performance And Clinical Performance Prepared and submitted by group 3 In partial fulfillment of the requirements for the Degree in Bachelor of Science by Nursing has been examined and is Recommended for acceptance and approval for thesis.

Mr. Mc Duffie Joshua E. Sy RN,MSN Adviser

Approved by the committee on oral examination with grade of ___________________________

____________________________ Chairman

______________ Members

____________ Members

Accepted and approved in partial fulfillment for Bachelor of Science in Nursing

_____________________________ Dean

3

ENVERGAUNIVERSITYDedication:

To our beloved Parents for their full support.

To our Group for the cooperation, kindness and understanding.

The Faculty of Department of Nursing For their guidance and support . To our friends, for always being there, for giving the love And care that we will treasure forever.

In the memory of Franz Sigrid L. Enero

Above all, Lord Jesus for never failing to answer the researchers prayers For giving strength, patience, and wisdom in The completion of this study

4

ENVERGAUNIVERSITYACKNOWLEDGEMENT We wish to express our deepest gratitude to the following persons who have shared their time and knowledge in making this special paper: To our parents, for their encouragement and support financially, emotionally and spiritually; To all the faculty members of the Department of Bachelor of Science in Nursing for their encouragement to express and develop our skills and knowledge regarding our chosen field; To our thesis adviser, Mr. McDuffie Joshua Sy RN, MSN, for his guidance, time for critiquing the manuscript and advices that served as a great help in accomplishing this paper; To our Dean, Ms. Corazon Valdeavilla RN, MSN, for giving us information about the subject nursing research and assisting us in conducting the research; To Ms. Rizza Rosales, for her assistance and expertise in statistical computation To all respondents, we really appreciate their cooperation for we cannot accomplish these papers without them, and above all To our Almighty God, for giving us strength, courage and knowledge in making all these things possible.

The Researchers

5

ENVERGAUNIVERSITYTHESIS ABSTRACT This study focused on the Burn-out phenomenon and its perceived effect on the academic and clinical performance of the level IV nursing students of Manuel S. Enverga University Foundation. Hopefully, this studys result could provide benefits to all concerned, the studys respondents were drawn from the 3 sections in level IV namely: section A, B and C. The researchers decided to use this group of respondents because of the fact that the researchers are also level IV nursing students in this University. The study made use of the descriptive method of research since it determine the characteristic of burnout and its effect in the performance of the level IV nursing students. The data gathered were statistically treated by using frequency count, percentage and ranking to get the descriptive informational background of the respondents. The weighted mean were computed to get the result of the different indicators of the study. These were qualified by providing certain intervals to make interpretation more specific.

6

ENVERGAUNIVERSITYCHAPTER 1 Background of the Study Nursing like any other profession has its primary role, to aim of contributing to the countrys progress through providing quality healthcare service to its citizen. Therefore nurses serve as instrument in attaining this goal, they functions as nurturer, comforter, and provider of direct care and promotes comfort of client activities shows concerns for client welfare and acceptance of the client as a person. The nursing profession has many aspects that can cause stress, and nurses must take action to reduce and manage their stress effectively. Stress is the body's instinctive reaction to an environmental change like meeting a sudden deadline. The problem with long-term stress is that your body never gets to unwind Berry (2007).

As with all other arts nursing demands certain skills and attitude like devotion, perception, understanding, training, and hard working among others. If nursing is such, it is a nurses goal to provide care to as many as possible without compromising quality. Just as with any work place they are suspected to give it all they have got Casserley et .al, (2008). Stress contributes to significant morbidity. Providing tools to manage underlying stress and may empower nursing student to make lifestyle change. Nurses simply build competency while performing their role and as part of it they encountered lots of problem dealing with their role like working overload.

7

ENVERGAUNIVERSITYStress is simply a fact of nature -- forces from the outside world affecting the individual. The individual responds to stress in ways that affect the individual as well as their environment. Hence, all living creatures are in a constant interchange with their surroundings (the ecosystem), both physically and behaviorally. This interplay of forces, or energy, is of course present in the relationships between all matter in the universe, whether it is living (animate) or not living (inanimate). However, there are critical differences in how different living creatures relate to their environment. Because of the overabundance of stress in our modern lives, we usually think of stress as a negative experience, but from a biological point of view, stress can be a neutral, negative, or positive experience There are many causes of stress in nursing, such as understaffing of shifts, patient deaths, long hours, difficult patients, paperwork and deadlines. Conflicts with other health care professionals such as a disagreement over patient treatment can also increase the stress level. In addition to dealing with a stressful occupation, nurses also have to deal with everyday stressors like having a baby or buying a house.

A study made by Bech,et.al (2007) comparing the stress levels of various professional students found that nursing students experience higher levels of stress than medical, social work and pharmacy students. Students face many challenges and stressors. However, as a nursing student they are likely to experience even burnoout than their friends and colleagues enrolled in other programs. Another study made by Pryjmachuk, (2007) showed that one third of nursing students experience stress severe enough to induce mental health problems such as anxiety and depression. In addition exams, grades,

8

ENVERGAUNIVERSITYlong hours of studying, work, family and other personal commitments are also faced with the challenges. 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 a patient are just a few of the stressors for the beginning student nurse. Symptoms will differ from nurse to nurse, but might include anxiety, depression, fatigue, confusion, high blood pressure, insomnia, headaches, relationship problems, increased or decreased weight, constipation or diarrhea, upset stomach, shortness of breath, irritability, back pain and stiff neck. Effects of stress in the nursing profession can also lead to increased absenteeism. Long-term exposure to occupational stress can cause job burnout. Signs of burnout can include being unable to reasonably balance work and personal time, increased irritability with patients and co-workers, and feeling no satisfaction from your job. According to Patrick,. (2007) burnout is a psychological term for the experienced of long term exhaustion and diminished interest. The most well studied measurement of burnout in the literature is made by Maslach and her colleague Jackson is the Burnout Inventory first identified the construct Burnout in the 2005s and developed a measure that weigh the effect of emotional exhaustion and reduce sense of personal accomplishment. This indicator has become the standard tool for measuring burnout in research on the syndrome. The Maslach Burnout Inventory uses a three dimensional

9

ENVERGAUNIVERSITYdescription of exhaustion, cynicism and inefficacy. Some researches and practitioners have argued for an exhaustion only model that sees that symptom as the hallmark of burnout.

It recognizes the warning signs of impending burnout in themselves; remember that it will only get worse if you leave it alone. But if you take steps to get your life back into balance, you can prevent burnout from becoming a full-blown breakdown. Sometimes its too late to prevent burnout youre already past the breaking point. If thats the case, its important to take your burnout very seriously. Trying to push through the exhaustion and continue as you have been will only cause further emotional and physical damage.

Burnout brings with it many losses, which can often go unrecognized. Unrecognized losses trap a lot of your energy. It takes a tremendous amount of emotional control to keep it from feeling the pain of these losses. When it recognize these losses and allow itself to grieve them, they release that trapped energy and open his or her self to healing. Luban (2010)

Caring for others is a vital part of nursing but sometimes the demands of that care can be crushing a student can become emotionally or physically exhausted sometimes to the point where she can no longer continue working a phenomenon called nursing burnout. The phenomenon of nursing burnout is not a new one nursing has always been a stressful profession but recent developments have brought nursing burnout into the spotlight.

10

ENVERGAUNIVERSITYStatement of the Problem This study will deal burnout phenomenon as assessed by selected level IV nursing students of Manuel S. Enverga University Foundation and its perceived effects on academic and clinical performance on the perception of burnout in nursing students and the situational and personal factors which contribute to this phenomenon and its perceived effect on the academic and clinical performance. This study will aim to improve the quality of nursing care by maintaining positive attitude among nursing students toward themselves and their studies. Specifically it seeks answers to the following questions: 1. What is the demographic profile of selected level IV nursing students in terms of: 1.1 Age 1.2 Gender 2. What are the characteristics of Burnout phenomenon as assessed by level IV nursing students in terms of: 2.1 Emotional Exhaustion 2.2 Depersonalization 2.3 Reduce Personal Accomplishment 3. What are the effects of burnout phenomenon as perceived by the selected level IV nursing students in relation to their: 3.1 Academic performance 3.2 Clinical performance 4. What are the suggested measures to prevent burnout?

11

ENVERGAUNIVERSITYTheoretical Framework Maslach (2005) has conducted research in a number of areas within social and health psychology. The research interests are focused in two major areas: (a) burnout and job stress, and (b) individualization and social influence. An important cross-cutting theme in my recent work is health psychology (and to a lesser extent, gender roles). Her basic approach to research has always been a more broad-based one that integrates both personality and situational variables. She have also been committed using several different research paradigm is my work. Finally, She tried to promote cross-national research on burnout and individuation, either by myself or by others. Current work is focusing on the development of a conceptual model of the burnout process which articulates the key relationships between personal social and contextual variables. Here she is developing an approach to assessing the interaction between person and situation variable and workplace She have also involves in several longitudinal assessments of burnout and engagement, which are providing opportunities to test both new research hypothesis and new processes for intervention. Conceptual Framework The concept of burnout is important because it provides a way of understanding a person as a unified being who respond in totality-mind and body, to a variety of changes that may take place in daily life ( Selye 2006). Student nurses can experience this stress as well. Student nurses have long hours between attending classes, assignments, studying, clinical hours and the assignments that go along with clinicals. There never seems to be enough time in the day.

12

ENVERGAUNIVERSITYConceptual Paradigm:Input

Process Analysis of the characteristic of burnout as assessed by selected nursing students in terms of: Emotional exhaustion,

Outcome

Proposed burnout management for nursing students.

Identification of the demographic profile of the selected level IV nursing student of MSEUF in terms of: Age, Gender

Depersonalization, Reduced personal Accomplishment Analysis of the effect of burnout as perceived by selected nursing students in terms of: Clinical performance, academic performance Analysis of the significant relationship between the demographic profile and the characteristic of burnout Identification of suggested measure to prevent burnout

Figure 1: Burnout phenomenon identification as assessed by selected level IV nursing students and its perceived effect. The assumption enumerated here about nursing students burnout and their perceived effect on clinical and academic performance are neither prescriptive nor

13

ENVERGAUNIVERSITYabsolute. They constitute the belief based on some background knowledge obtained from reading, studies, practices and experiences on some particular areas. Significance of the Study There is a general discussion on burn out which is significant in the title. State that burnout is focusing on the development of conceptual model of burnout process, which articulates the key relationship between personal, social, and contextual variable. Maslach (2006) The students: The result of this study will serve as additional information to create awareness to students. Findings in this study will help them provide positive insights regarding burnout. This will also assist future nurses in their effective and efficient performance in their respective field as they will sooner become part of the growing medical and health workers. To identify behavior of burnout students isolate the situation or personal factors which contribute to this phenomenon and design evaluate strategies to control or remove those stress producing situations. For the faculty and Clinical Instructors: They may use the result of the study as a reference for designing therapeutic environment and activities for nursing students which may enhance the students physical, psychological, and social well-being necessary for better performance.

14

ENVERGAUNIVERSITYThe study is also a relevant contribution to the body of knowledge and will benefit those who would like to conduct a study similar to this to conduct a study similar to this topic. Likewise this study will be highly significant for those researching for this particular topic, particularly allied medicine majors and to nursing students even more. Scope and Limitation of theStudy This study will investigate the burnout phenomenon as assessed by selected level IV nursing student and its relation to academic and clinical performance. This study is limited to MSEUF main nursing students in Lucena City. Definition of Term To facilitate better understanding of the study the following term are as operationally and contextually define: (Defined properly) Academic performance - refers to how students deal with their studies and how they cope with or accomplish different tasks given to them by their teachers. Burnout - refers to over emotional, exhaustion, depersonalization and reduced personal accomplishment produce by stress dealing with the relationship of human being and phenomenon. Clinical Performance- refers to how students deal with their studies and how they cope with or accomplish different tasks given to them by their Clinical instructor.

15

ENVERGAUNIVERSITY Depersonalization - Refers to detached and dehumanized response of the students. Level IV nursing students- are the students in Manuel S. Enverga University Foundation that will help us to identify their perception to burnout. Reduce Personal, Accomplishment - refers to the feeling of student nurse that he/she is a failure Emotional exhaustion -It describes a feeling of being emotionally overextended and exhausted by one's work. It is manifested by both physical fatigue and a sense of feeling psychologically and emotionally "drained". Stress are the thing that students have when there are very pressured or to many things to do.

16

ENVERGAUNIVERSITYCHAPTER II Related Literature This chapter presents the different literature and studies contribute to the effects of burnout and to review the causes of these stressors. Stress and burnout are major factors that nurses have to deal with often while in their environment. It is defined as the body's way of responding to any kind of demand.That is created when a person react to particular events. It's the body's way of rising to a challenge and preparing to meet a tough situation with focus, strength, stamina, and heightened alertness. It can be caused by both good and bad experiences. Lyness (2010) According to Womble (2001) stress is related to both external and internal factors. External factors include the physical environment, including studies, relationships with others, at home, and all the situations, challenges and difficulties. Internal factors determine their body's ability to respond to, and deal with, the external stress-inducing factors. Internal factors which influence the ability to handle stress include their nutritional status, overall health and fitness levels, emotional well-being, and the amount of sleep and rest they get.By themselves these constraints may have no effect at all on a student, but when combined, a student could perceive them as stressful, and the stress factors could have a dramatic effect on a students academic performance. A person who is experiencing stress is overwhelmed by their studies and feels that they are powerless or unable to cope up with studies or the clinical situation they are in.

17

ENVERGAUNIVERSITYstress is inescapable while certain level of stress can help personal growth. Most individual feels overwhelmed at time by the less productive form of stress. In addition of the later author, risk factors for stress related illness are a mix of personal, interpersonal, and social variable. These factors include lack or lost of social support network. People who are dependent like students and children or who are socially disadvantaged because of race, gender, educational level are at greater risk of developing stress-related illnesses.Kozier (2004) According to Selye(2009) there are two types of stress eustress and distress. Eustress is healthy. Distress can be harmful Eustress enhances function. It helps emotionally, mentally or physically. They can experience positive stress when they go through strength training or when they take on a challenging assignment at school or in clinical area. Distress defined experience a lot of stress and they cannot cope well with it, they experience distress, the kind of stress that most of them already know about. Distress can lead to anxiety, withdrawal, depression, and even to physical problems if it not handled well and continues for a long time. Burnout appears common among U.S. medical students and may increase by year of schooling. Despite the notion that burnout is primarily linked to workrelated stress, personal life events also demonstrated a strong relationship to professional burnout. The authors findings suggest both personal and curricular factors are related to burnout among medical students. Efforts to decrease burnout must address both of these elements. Shanafelt (2006)

18

ENVERGAUNIVERSITYAs a student they face many challenges and stressors. However, as a nursing student they are likely to experience stress and even more burnout than their friends and colleagues enrolled in other programs. A research comparing the stress levels of various professional students found that nursing students experience higher levels of stress than other medical, social work and pharmacy students. Even more poignant, another research showed that one third of nursing students experience stress severe enough to induce mental health problems such as anxiety and depression and leads to burnout. In addition to contending with exams, grades, long hours of studying, work, family and other personal commitments they are also faced with 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 a patient are just a few of the stressors for the beginning student nurse. Sharif &Masoumi (2005).

Maslach (2009) define burnoutas results from prolonged and chronic emotional and interpersonal stressors on the job. It occurs when the physical and emotional stress of nursing gets to be too much.

In addition Senior (2006) said that burnout is a problem that's both physical and existential, an untidy conglomeration of external symptoms and personal frustrations.

19

ENVERGAUNIVERSITYAge may be more related to reactions to stress and the absence of disease rather than to a person's chronological age healthy aging is a good bet if stress can be moderated along with adopting an active, healthy lifestyleMcEwen (2006).

De Lange (2006)said that age typical of burnout is popularly assumed to be middle age but young age has been regarded as the most consistent demographic predictor for burnout, but previous research has confounded age with academic and clinical experience, and levels of burnout have therefore been assumed to depend on early or late stage career.

The concept of Burnout as a psychological syndrome that develops in response to chronic emotional and interpersonal academic and clinical stressors. The three defining components of this syndrome are: (a) exhaustion, (b) depersonalization and (c) a sense of inefficacy and reduced accomplishment. Burnout impairs both personal and social functioning. While some students may quit their studies as a result of burnout, others will stay on, but will only do the bare minimum rather than their very best. This decline in the quality of academic, clinical and in both physical and psychological health can be costly not just for the individual student, but for everyone affected by that personAcorin(2009).

Coedes& Dougherty, (2007) defined that emotional exhaustion refers to the characteristic that individual experience that they seem lack of energy and feeling that their emotional energy is used up. This feeling can be come from that they feel frustration and tension in their academic and clinical area, so they appear compassion fatigue that they feel that their emotional and psychologically cannot continue their responsibilities.

20

ENVERGAUNIVERSITYDepersonalization is characterized that display a detached and an emotional callousness and cynical attitude toward their classmate, clients or people surrounding in them. When people under the state of depersonalization, they may use some derogatory word when communication with other people. They may withdrawal to communicate with other people around them. other symptoms of students includes (1) Continuous or recurring feelings that their an outside observer of their thoughts, their body (2) Numbing of senses or responses to the world around them, (3) Feeling like a robot or feeling like their living in a dream or in a movie, (4) Awareness that their sense of detachment is only a feeling, and not reality. While episodes of depersonalization may last only a short time, some students with depersonalization disorder have episodes that last hours, days, weeks or even months at a time. In some students these episodes turn into ongoing feelings of depersonalization that may periodically get better or worse. When people appear reduce personal accomplishment, the characteristic is they would have a tendency to evaluate oneself negatively, they would not appreciate themselves even though they have contribution at something and even have a decline on feeling competence and successful achievement in their work and interaction with people around them. Mifflin (2009) Defined reduce personal accomplishment as a condition or feeling of being displeased, unsatisfied or discontent. He also stated that some symptoms among students in their academic performance include discontent, boredom, displeasure disappointment,Headache, Increased use of drugs or alcohol. In addition Angier (2006) cited the causes of decrease in personal accomplishment in students are (1). Poor concentration, (2) Lack of confidence and self-esteem

21

ENVERGAUNIVERSITY(3).Relationship problems at home and school (4).Poor time-keeping, and frequent absences (5).Negative and threatening behavior, anger. According to Polifroni (2007) Burnout is viewed in three phases. Phase one of burnout is the stress arousal phase, this happens when the students experiences anxiety, insomnia, forgetfulness, inability to concentrate, feeling of being overwhelmed, frustration, sadness and new physical symptoms, such as headache. The second phase is the energy conservation, in this phase the student starts to call in sick to school, or he/she maybe chronically late getting to school. Deadlines are not met, a cynical or resentful attitude develops and persistent sense of fatigue persuades both the students personal and social life. If the signs of this phase are not addressed, the symptoms become chronic, leading to a sense of isolation and overwhelming exhaustion. This isolation and exhaustion are the last phase of burnout when students finally fail to perform their task. Student burnout isnt just dissatisfaction, It can change the body aswell. This leads to students who are tending the sick while they themselves are ill, which accelerates the rate of burnout. High stress can affect the emotions, leading to conditions such as depression and anxiety. It can even lead to physical ailments, such as high blood pressure and muscle pain, stress also weakens the immune systems, and burnout can also lead to drug or alcohol addiction. In addition he review some studies of nursing burnout found that a lack of good coping strategies for dealing with stress put nursing student at higher risk of burnout. Poor organization and holistic management can also lead to feelings of hopelessness. Roberts (2005) burnout is not an event but the end point in a process of 'burning down'. They work in challenging and turbulent environments, in which the only certainty is

22

ENVERGAUNIVERSITYthat there will be constant change. Stressors add up over time and across the compartments of our lives. A sense of control over what is happening may be critical. If they learn to respond adaptively, they are increasingly able to be effective and enhance their capacity and confidence. Managing their stress as a student can be a little less daunting if they have someone to talk it over with. Voicing their concerns to a friend will deflate some of that built up stress. Whether they talk about a specific stress causing event or talk about stressing-out in general, they will feel better. The added benefit is that by opening up to a friend, they may help them out also. They are probably feeling stressed too. It may even be able to help each other de-stress by doing something fun together. When demands (internal and external) persistently outweigh resources (internal and external), an individual becomes unbalanced. A sustained or progressive disequilibrium eventually leads to burnout. Burn-out is not the result of stress but of mismanaged stress.

According to Firth and Cozens (2006) prevention in burnout begins with recognition and understanding. The thing in managing burn-out is to take responsibility for own experience of stress and then make a commitment to change. They must ensure that their needs are met in order to have something to give to their patients and colleagues. However, there is no consensus on what measures to take. There are no simple or universal solutions. The important thing is to take up the challenge and gradually consider whatthey need and how to tailor 'stress-busting' strategies to their particular situation.

23

ENVERGAUNIVERSITYRelated Studies Escritor (2010) on the study entitled Stress-related experiences and coping mechanism of 3rd year and 4th year nursing students of Southern Luzon State University revealed that students experience academic stress at predictable times each semester with greatest sources of academic stress, resulting from taking and studying for exams, grade competition and large amount of content to master in a small amount of time. This study was to identify the stress of 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. The findings of the study of Ella (2007) entitled Causes of stress in relation to academic achievement of nursing students revealed that among the different stressors, the academic factors particularly the classroom stressors greatly affected the academic performance of nursing students. In addition being aware of the reactions, the students used different management strategies to cope with stress. Asking help from others and by praying are the most common strategies used by nursing students to cope up with their stress. However the causes and effect of stress were unique to every person. Duquette (2006) nursing students face the same sources of stress as students in many other fields. They must learn detailed material and how to apply it in real-life situations. They must study for long hours and take frequent exams. Stress can impair concentration and affect sleep patterns, according to Help Guide. Those who are experiencing high amounts of stress in their lifestyle need to always be aware of the idea of burnout potentially looming in the future. While the term burnout is often thrown around

24

ENVERGAUNIVERSITYin discussions of stress. This can affect a nursing student's performance and caused them to get lower grades. The academic impact might compound the anxiety. Aranilla (2006) conducted a research study entitled about the stress encountered in the ward by BSN III students in the college of allied medicine of Southern Luzon Polytechnic College now known as Southern Luzon State University. Her study determined that heavy workload in the ward is the most common stressor encountered by the respondents although, there were still other stressors encountered. It was mentioned that the respondents were aware that stressors strike when they felt nervous and tensed. In addition she discussed the leading ways to overcome stressors are keeping perspective and looking for positive use of relaxation techniques and humor in which they strongly agree. Stress for the respondents means anything that makes them feel bad, worried, angry and frustrated. They encountered these stressors in their environment especially in the dormitory which causes them to have emotional distress. To overcome these stressors, they looked perceptively and positively to find some relaxation techniques. Based on the study of Salteras (2006) entitled stresses encountered by the selected nursing students batch 2004-2005 revealed that stress means something that makes a person feel worried or uncomfortable. The common stressors are the noisy or over crowded places, while the least is the peers influence. The leading effect of stressors is emotional distress and the least is the digestive disorder. A study by Hogrefe & Huber (2009) entitled School-Burnout Inventory (SBI) Reliability and Validity introduced a new concept of school burnout together with an instrument for measuring it. The results showed, overall, that the correlated three-factor

25

ENVERGAUNIVERSITYsolution fitted the data best and also gave the best reliability and validity indices. In other words, exhaustion because of school demands, a cynical and detached attitude toward ones school, and feelings of inadequacy as a student. Maslach (2001) burnout in the work context is defined as a syndrome of exhaustion, cynicism or depersonalization, and reduced professional efficacy, exhaustion refers to feelings of strain. Another published study by Noushad (2008) entitled From teacher burnout to student burnout revealed that burnout is a serious academic issue which increases the scope of research in the area of academic and student related stress or burnout. Students stress may be correlated with their socio economic back grounds, familial conditions, teaching styles of teachers, school climate, parental involvement and many other personality characteristics. An intervention program may be developed to reduce increases academic stress to relieve them from severe emotional exhaustion, depersonalization and inefficacy. There is a number of researches in the area of work related burnout, especially on teacher burnout, burnout among nurses, doctors, managers etc. but very few studies were identified on academic burnout of students. Most of the studies on academic burnout concentrate on college students. It should be extended to high school students also. Students who are in the age of adolescence experience severe stress in industrial societies. Moreover the study of Murphy (2008) entitled A comparative study of professional student stress the overall findings of this investigation showed that dental students perceived that they experienced greater levels of stress than medical students in three of the five measured categories. The only category in which medical students

26

ENVERGAUNIVERSITYdemonstrated greater stress levels than dental students was professional identity. A twoway MANOVA is a generalized form of univariate analysis of variance and it is used to determine year in school effects revealed that while medical student stress decreased slightly with each progressive year, dental student stress increased dramatically in the third year, generally coincident with entrance into the clinics. There were no significant gender effects on the gender of the respondent. The published study Killion (2007) entitled Burnout among Healthcare Students stated that healthcare organizations must devise strategies to reduce healthcare students burnout while increasing students work performance. Sadovich (2008) suggests some strategies by management to alleviate burnout including: flexible work arrangements, students growth and learning, cross-training, and change in working conditions. The idea of student growth and learning addresses providing students with challenging projects. The ability to provide cross-training to students to learn a new skill will improve morale. The change in working conditions includes varying work hours, schedules, monetary rewards, and granting students the ability to decide on their own.

27

ENVERGAUNIVERSITYCHAPTER III DESIGN AND METHODOLOGY This chapter presents the methods and procedures used by the researchers in conducting the study. It includes the research design, research locale, sample and sampling procedure, research instrumentation and statistical tools. The study will be conducted by the researchers to determine the burnout phenomenon as assessed to selected nursing student of Manuel S. Enverga University Foundation. Research design The researchers will utilize descriptive survey method, the information will be gathered through the utilization of questionnaire regarding burnout and its perceived effect in the academic and clinical performance of nursing students and suggested measure to prevent this phenomena. This method involves description, and interpretation of data. Research locale The study will be conducted at Manuel S Enverga University Foundation College of Nursing and Allied Health Sciences. The university is located at Ibabang Dupay University village, Lucena City. Starting with only around 60 students in 2002, the College of Nursing and Allied Health Sciences is now one of the biggest academic departments in Enverga University. Within a span of less than five years, the BS Nursing program emerged as the Universitys most popular course, riding high on the crest of insatiable global demand for health workers.

28

ENVERGAUNIVERSITYPopulation sample Using the the respondent of the study will be randomly selected using random sampling. The researcher will select 50 nursing students from level IV at random. The table below shows distribution of respondent. Table 1

Level IV Nursing Statistics Section A B C Number of Students 47 47 23

Selected number of students: 50 50 selected students / 117 level IV students = .43 47 x .43 = 20 47 x .43 = 20 23 x .43 = 10 Total: 50 students

Total number of level IV students 117

Research Instrumentation The tool will be used in gathering data for the respondent is a set of questionnaire checklist. The questionnaire will be divided into three parts. Part I (What is the Demographic profile of the selected nursing students in terms of age, gender, and their perception to burnout) according to the Maslach Burnout Inventory general survey (MBI-GS). The part II (what are the most common burnout manifestation regards to E.E (emotional exhaustion) D (depersonalization) P.A (personal accomplishment). Part III (what are perceived effect of burnout as assessed by the selected nursing student in relation

29

ENVERGAUNIVERSITYto academic and clinical performance). The questionnaire will be answered by the 4 point scale. Data Gathering Procedures The following steps will be undertaken by the researcher to gather the data for the study. First, the researchers present questioner to the adviser and seek for suggestion for the improvement of the instruments, all respondent will be assure of the confidentiality of the data obtain from the feedback obtain the necessary revision was made. A letter requesting permission will be addressed and send to the dean of College of Nursing as soon as permission from the dean will grant the researchers personally ask permission to the selected respondents. Each questionnaire will accompany by a cover letter stating the purpose of the study, the importance of respondents participation, the assurance of confidentiality of responses and a personalized expression of gratitude. The distribution of questionnaire followed by detailed instruction of content in order to avoid misinterpretation was made retrieval of the instrument will personally done by the researcher after a day. Data gathered will tabulate and statistical tools will be applied to answer the sub problem raised in the study.

Statistical treatment of data The following statistical treatments will utilized by the researcher to answer the sub problem raise in the study. The formula will be use to answered the sub problem number I (What is the Demographic profile of the selected nursing students in terms of age,gender and their

30

ENVERGAUNIVERSITYperception to burnout) and sub problem number II (what are the most common burnout manifestation regards to E.E (emotional exhaustion) D (depersonalization) P.A (personal accomplishment) sub problem number III (what are perceived effect of burnout as assessed by the selected nursing student in relation to academic and clinical performance) will resolved with weighted arithmetic men (WAM). This refers to overall average of responses perceptions of the study respondents. It is the sum of its product of the frequency of response the like scale was utilized in this problem to indicate the degree of agreement of respondents. P = f / n x 100 Where: P = percentage F = frequency N = sum of all respondents To evaluate well, the researcher will assign equivalent descriptive rating for the weighted arithmetic mean. The following will be use

Unit Weight 4 3 2 1

Weight mean 3.25 4.00 2.50 3.24 1.75 2.49 1.00 1.74

Verbal interpretation always often sometimes never

Specific sub problem part I,II and III was answered using the first part of questionnaire and response were treated statistically by using formula WAM it is defined as : Formula: WAM = fw/ n

31

ENVERGAUNIVERSITYWhere: WAM = weighted arithmetic mean fw = frequency of responses per unit weight n = total number of respondents

The obtained weighted arithmetic mean was verbally interpreted using the following 4 point scale. Continuum 4 3 2 1 Verbal description Always Often Sometimes Never

32

ENVERGAUNIVERSITYCHAPTER IV PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA

This chapter presents the data gathered through the selected level IV nursing students of Manuel S. Enverga University Foundation and their perceived effects on academic performance and clinical performance presented in the form of tables, figures and graphs to have a clearer understanding of the study.

The information was organized into parts in accordance with the sub-problems. The first part dealt with the profile of the respondents. The second part tackled the characteristics of burnout phenomenon. The third part dealt with the perceived effects of the observable fact of burnout. Likewise, the last part is all about some suggested measures to prevent the phenomenon.

33

ENVERGAUNIVERSITYPart I. Demographic profile of the respondents This part presents the demographic profile of the respondents which includes their sex and age, respectively. SECTION A

Age5%

Adolescent 12-18 Young Adult 18-35

95%

SECTION B

Age5%

Adolescent 12-18 Young Adult 18-35

95%

34

ENVERGAUNIVERSITYSECTION C

Age0%

Adolescent 12-18 Young Adult 18-35

100%

Figures 1, 2 & 3. Distribution of respondents according to age

The figures above show the distribution of respondents according to age. Section A and B have 20 respondents each while Section C has 10. Age is divided into two categories, the adolescent (12-18) and young adulthood (18-35). In Sections A & B, 5% of them are adolescents and 95% belong to young adulthood category. It is obvious because the respondents are Level IV nursing students. Meanwhile, in Section C 100% of the distribution belongs to the young adulthood.

35

ENVERGAUNIVERSITYSECTION A

Gender

35%

Male 65% Female

SECTION B

Gender

35%

Male 65% Female

36

ENVERGAUNIVERSITYSECTION C

Gender10%

Male 90% Female

Figures 4, 5 & 6. Distribution of respondents according to gender

The figures above show the distribution of respondents according to gender. Section A and B have 20 respondents each while Section C has 10. Having 20 respondents in Sections A & B, the distribution for males in both section set forth at 35% while the remaining 65 % are females. Moreover, in Section C who only has 10 respondents, 10% of them are males while 90% are females. Thus, majority of the respondents are females and it dominated the level IV nursing students.

37

ENVERGAUNIVERSITYDemographical Support A study that person who is experiencing stress is overwhelmed by their studies and feels that they are powerless or unable to cope up with studies or the clinical situation they are in. stress is inescapable while certain level of stress can help personal growth. Most individual feels overwhelmed at time by the less productive form of stress. In addition of the later author, risk factors for stress related illness are a mix of personal, interpersonal, and social variable. These factors include lack or lost of social support network. People who are dependent like students and children or who are socially disadvantaged because of race, gender, educational level are at greater risk of developing stress-related illnesses.Kozier (2004)

PART II. SECTION A A. Emotional Exhaustion 1. I feel lack of energy 2. I feel emotionally drained from the school 3. I feel very lazy to attend classes 4. I feel that I didnt take school/ learning seriously. 5. I feel frustrated and get tension in academic and clinical performance B. Depersonalization 1. I feel that my classmate were of no help when I needed help 2. I feel that working directly with people has put too much stress on me 3. 4. I feel like a robot or feeling like their living in a dream or in a movie Weighted Mean 2.35 2.30 2.25 2.25 2.05 Description Sometimes Sometimes Sometimes Sometimes Sometimes Rank 1 2 3.5 3.5 5

2.00 1.95 1.85 1.95

Sometimes Sometimes Sometimes Sometimes

2 3.5 5 3.5

38

ENVERGAUNIVERSITY5. I feel lost of focused in class or outside observer C. Reduced Personal Accomplishment 1. I feel dependent in class 2. I feel unsatisfied to my grades 3. I feel slow learning 4. I feel headache answering exercises 5. I feel lack of confidence and self esteem Legend: 1.0 1.60 1.61 2.40 2.41 3.60 3.61 4.00 Never Sometimes Often Always SECTION B A. Emotional Exhaustion 1. I feel lack of energy 2. I feel emotionally drained from the school 3. I feel very lazy to attend classes 4. I feel that I didnt take school/ learning seriously. 5. I feel frustrated and get tension in academic and clinical performance B. Depersonalization I feel that my classmate were of no help when I needed help 6. I feel that working directly with people has put too much stress on me 7. I feel that working with people all day was really a strain to me 8. I feel like a robot or feeling like their living in a dream or in a movie 9. I feel lost of focused in class or Weighted Mean 2.45 2.25 2.05 1.90 2.05 Description Often Sometimes Sometimes Sometimes Sometimes Rank 1 2 3.5 5 3.5 2.25 Sometimes 1

2.4 2.4 2.10 2.15 2.21

Sometimes Sometimes Sometimes Sometimes Sometimes

1.5 1.5 5 4 3

2.05 1.90 1.90 1.85 2.10

Sometimes Sometimes Sometimes Sometimes Sometimes

2 3.5 3.5 5 1

39

ENVERGAUNIVERSITYoutside observer C. Reduced Personal Accomplishment 1. I feel dependent in class 2. I feel unsatisfied to my grades 3. I feel slow learning 4. I feel headache answering exercises 5. I feel lack of confidence and self esteem 2.00 2.35 1.90 2.05 2.05 Sometimes Sometimes Sometimes Sometimes Sometimes 4 1 5 2.5 2.5

Legend: 1.0 1.60 1.61 2.40 2.41 3.60 3.61 4.00 Never Sometimes Often Always SECTION C A. Emotional Exhaustion 1. I feel lack of energy 2. I feel emotionally drained from the school 3. I feel very lazy to attend classes/absence 4. I feel that I didnt take school/learning seriously. 5. I feel frustrated and get tension in academic and clinical performance B. Depersonalization I feel that my classmate were of no help when I needed help 10. I feel that working directly with people has put too much stress on me 11. I feel that working with people Weighted Mean 2.30 2.40 2.18 1.70 2.30 Description Sometimes Sometimes Sometimes Sometimes Sometimes Rank 2.5 1 4 5 2.5

2.40 2.20

Sometimes Sometimes

1 2

1.90

Sometimes

4.5

40

ENVERGAUNIVERSITYall day was really a strain to me 12. I feel like a robot or feeling like their living in a dream or in a movie 13. I feel lost of focused in class or outside observer C. Reduced Personal Accomplishment 1. I feel dependent in class 2. I feel unsatisfied to my grades 3. I feel slow learning 4. I feel headache answering exercises 5. I feel lack of confidence and self esteem Legend: 1.0 1.60 1.61 2.40 2.41 3.60 3.61 4.00 Never Sometimes Often Always 1.90 Sometimes 4.5

2.1

Sometimes

3

2.40 2.20 2.20 2.60 2.50

Sometimes Sometimes Sometimes Often Often

5 3.5 3.5 1 2

The tables above specifically dealt with the characteristics of burnout phenomenon and the perceptions of the respondents about the occurrence. As agreed by the respondents regarding emotional exhaustion, respondents most agreed effects of this burnout is the lack of energy. As what Farber, B. A. (1998) uttered, researchers and practitioners have argued for an exhaustion model that sees that symptom as the hallmark of burnout. Engagement is characterized by energy, involvement and efficacy, the opposites of exhaustion, cynicism and inefficacy. This proves that the occurrence experience by level IV students made it as rank 1st. However, as assessed by the respondents, most of them also agreed that statement

41

ENVERGAUNIVERSITYno. 4 is not typically its effects to their performance. It is to be assumed that even though they experience slight and considerable occurrence they still take learning and schooling seriously for their future. Meanwhile in the category of depersonalization, most of them agreed that they easily affected by their emotional exhaustion thats why their focus turned out to be none. Statement no. 5 and its rank prove that losing their focus is also a proximate cause that they can no longer see themselves or others as valuable. They no longer see personal needs and their view of life narrows to only seeing in the present time, while their life turns to a series of mechanical functions. For the time being, statements 3 and 4 are those testimonies agreed by the respondents as the least of all perceived characteristics of burnout. The respondents agreed that they are not alike to robots whose functions are in command and routinely. Lastly, the last part appeared in random ranks. The respondents in different sections are presumably experiencing all of the statements under reduced personal accomplishments because of burnout. It turned out that they not always experience as proved by the degree of mean but they often/sometimes experience these perceived characteristics thats why they agreed to the five statements. As proven, it will always depend on case-to-case basis depending on the situations and condition of the respondents. Thus, in all of the statements it was ranked to know the scope of the characteristics as perceived by the level IV students of MSEUF.

Part III.

42

ENVERGAUNIVERSITYSection A A. Academic performance 1. During an examination I frequently get so nervous that I forget facts I really know 2. I feel very panicky when I have to take an exam 3. I feel frequently so tense that my stomach gets upset 4. I feel it very difficult to combine my study and leisure time. 5. I feel usually end up cramming for examinations and requirements. B. Clinical performance 1. I feel lack of experiences 2. I feel fear of making mistakes 3. I feel of disoriented to the area 4. I feel of over work load during rush hour 5. I feel worry in giving medication that I will make harm the patient Legend: 1.0 1.60 1.61 2.40 2.41 3.60 3.61 4.00 Never Sometimes Often Always Weighted Mean 2.42 Description Often Rank 1

2.05 1.95 1.89

Sometimes Sometimes Sometimes

3 4 5

2.21

Sometimes

2

2.05 2.20 1.90 2.15 2.25

Sometimes Sometimes Sometimes Sometimes Sometimes

4 2 5 3 1

Section B

43

ENVERGAUNIVERSITYA. Academic performance 1. During an examination I frequently get so nervous that I forget facts I really know 2. I feel very panicky when I have to take an exam 3. I feel frequently so tense that my stomach gets upset 4. I feel it very difficult to combine my study and leisure time. 5. I feel usually end up cramming for examinations and requirements. B. Clinical performance 6. I feel lack of experiences 7. I feel fear of making mistakes 8. I feel of disoriented to the area 9. I feel of over work load during rush hour 10. I feel worry in giving medication that I will make harm the patient Legend: 1. 0 1.60 1.61 2.40 2.41 3.60 3.61 4.00 Never Sometimes Often Always Weighted Mean 2.35 Description Often Rank 1.5

2.30 2.20

Sometimes Sometimes

3.5 5

2.30

Sometimes

3.5

2.35

Sometimes

1.5

2.10 2.55 2.00 2.40 2.00

Sometimes Sometimes Sometimes Sometimes Sometimes

3 1 4.5 2 4.5

44

ENVERGAUNIVERSITYSection C C. Academic performance 11. During an examination I frequently get so nervous that I forget facts I really know 12. I feel very panicky when I have to take an exam 13. I feel frequently so tense that my stomach gets upset 14. I feel it very difficult to combine my study and leisure time. 15. I feel usually end up cramming for examinations and requirements. D. Clinical performance 16. I feel lack of experiences 17. I feel fear of making mistakes 18. I feel of disoriented to the area 19. I feel of over work load during rush hour 20. I feel worry in giving medication that I will make harm the patient Weighted Mean 2.40 Description Sometimes Rank 2.5

2.00 2.30 2.40

Sometimes Sometimes Sometimes

5 4 2.5

2.70

Often

1

2.60 2.70 2.50 2.80

Often Often Often Often

3 2 4 1

2.30

Sometimes

5

Legend: 1. 0 1.60 1.61 2.40 2.41 3.60 3.61 4.00 Never Sometimes Often Always

45

ENVERGAUNIVERSITYThe tables above show the effects of the observable fact of burnout. Sections A-C agreed that it really affects their academic and clinical performance. All of their means qualified on the degree of agreement. Thus, it proves that all of the statements that every nursing students are affected of their burnouts in all means. Moreover, on the responses mentioned, statement no. 1 under academic performance ranked 1st as the students got really nervous and they are experiencing mental block out because of burnout. According to Smith (2011), the mental effects are probably because of stress that continues and it began to lose the interest or motivation that led everyone to take on a certain role in the first place. Furthermore, Smith (2011) also stressed that the unhappiness and detachment burnout causes can threaten your job, relationships, and health. And being burned out means feeling empty, devoid of motivation, and beyond caring, thus, people experiencing burnout often dont see any hope of positive change in their situations because excessive stress is like drowning in responsibilities and burnout is being all dried up and while youre usually aware of being under a lot of stress, you dont always notice burnout when it happens. Meanwhile, the statement that got the least rank can be depicted as statements 3 and 4 because their means vary. On the other hand, in terms of clinical performance, every section has different perceived effects. This is to prove that they have different strategies and trainings when it comes to clinical setting. Partly, peers also contributed the burnout or peers help to cope up the burnout. Thats why in any means, the results in clinical setting can be considered high effects for the respondents.

46

ENVERGAUNIVERSITYLastly, the effects are only perceptions and it can be changed by the condition and other external manifestations of burnout. Part IV. Suggested measures in prevention of Burnout as assessed by 4th year nursing students SECTION A YES (F)1. Identification of what stresses you each day 2. Start the day with a relaxing rituals 3. Organize schedule on everyday activities 4. Get plenty of rest, eat right and engage in regular activities 5. Set boundaries by learning to say NO to request on your time. 6. Stop over nurturing other people 7. Take a daily break from technology by stop checking your e-mail, turn off your phone and put away your laptop. 8. Nourish one-self creative side 9. Early identification of the signs and symptoms of stress as contributing to burnout ( anxiety, depression, irritability, headache, insomnia and difficult to concentrate ) 10. Learn how to manage stress

Percentage 90 65 65 85 75 55

NO (F) 2 7 7 3 5 9

Percentage 10 35 35 15 25 45

18 13 13 17 15 11

11

55

9

45

16

80

4

20

18

90

2

10

18

90

2

10

47

ENVERGAUNIVERSITYSECTION B YES (F)1. Identification of what stresses you each day 2. Start the day with a relaxing rituals 3. Organize schedule on everyday activities 4. Get plenty of rest, eat right and engage in regular activities 5. Set boundaries by learning to say NO to request on your time. 6. Stop over nurturing other people 7. Take a daily break from technology by stop checking your e-mail, turn off your phone and put away your laptop. 8. Nourish one-self creative side

Percentage 85 95 85 95 85 85

NO (F) 3 1 3 1 3 3

Percentage 15 5 15 5 15 15

17 19 17 19 17 17

14

70

6

30

19

95

1

5

9. Early identification of the signs and symptoms of stress as contributing to burnout ( anxiety, depression, irritability, headache, insomnia and difficult to concentrate )

19

95

1

5

10. Learn how to manage stress

19

95

1

5

48

ENVERGAUNIVERSITYSECTION C YES (F)1. Identification of what stresses you each day 2. Start the day with a relaxing rituals 3. Organize schedule on everyday activities 4. Get plenty of rest, eat right and engage in regular activities 5. Set boundaries by learning to say NO to request on your time. 6. Stop over nurturing other people 7. Take a daily break from technology by stop checking your e-mail, turn off your phone and put away your laptop. 8. Nourish one-self creative side 9. Early identification of the signs and symptoms of stress as contributing to burnout ( anxiety, depression, irritability, headache, insomnia and difficult to concentrate ) 10. Learn how to manage stress

Percentage 90 80 80 100 90 90

NO (F) 1 2 2 0 1 1

Percentage 10 20 20 10 10

9 8 8 10 9 9

5

50

5

50

9

90

1

10

10

100

0

-

10

100

0

-

Based on the results of the suggested measures assessed by the respondents, they all agreed that the statements can be effective measures to prevent burnout except on statement number 7 wherein they cannot take daily break from technology by checking email, turning off the phone and putting away the laptop probably because of the generation and the condition of the youth. The results attest that technology is one way convenient

49

ENVERGAUNIVERSITYthat bring entertainment and help to the students. Moreover at many times it is the easiest escape of every nursing student from burnout, stress and pressures. Technology at times is for relaxation and setting of mood. Thus, the statements above with their corresponding frequency and percentage suggest upon as preventive measures from burnout as they were above 75%.

50

ENVERGAUNIVERSITYCHAPTER V SUMMARY OF FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS This chapter presents the findings derived from the data gathered, conclusions drawn from the findings, and recommendations given by the researchers. Specifically, this study was designed to answer the following sub-problems:

1

What is the demographic profile of the respondents in terms of: 1.1 Age? 1.2 Gender?

2

What are the characteristics of Burnout phenomenon as assessed by level IV nursing students in terms of: 2.1 Emotional Exhaustion 2.2 Depersonalization 2.3 Reduce Personal Accomplishment

3

What are the effects of burnout phenomenon as perceived by the selected level IV nursing students in relation to their: 3.1 Academic performance 3.2 Clinical performance

4

What are the suggested measures to prevent burnout?

51

ENVERGAUNIVERSITYSummary of Findings Based on the data gathered, the researchers derived the following findings:

1. Demographic Profile of the Respondents Base on the distribution to 20 respondents both section A and B reveals that 35% of nursing students were male and the remaining 65% were female. Moreover, in Section C who only has 10 respondents, 10% of them are males while 90% are females. Thus, majority of the respondents are females and it dominated the level IV nursing students. By age. Sections A & B, 5% of them are adolescents and 95% belong to young adulthood category. Meanwhile, in Section C 100% of the distribution belongs to the young adulthood. Thus the majority of our respondent is young adulthood (18-35) years old 2. Characteristics of Burnout Phenomenon This proves that the occurrence experience by level IV students made it as rank 1st. However, as assessed by the respondents, most of them also agreed that statement no. 4 is not typically its effects to their performance. It is to be assumed that even though they experience slight and considerable occurrence they still take learning and schooling seriously for their future. Meanwhile in the category of depersonalization, most of them agreed that they easily affected by their emotional exhaustion thats why their focus turned out to be none. Statement no. 5 and its rank prove that losing their focus is also a proximate cause that they can no longer see themselves or others as valuable. They no longer see personal needs and their view of life narrows to only seeing in the present time, while their life turns to a

52

ENVERGAUNIVERSITYseries of mechanical functions. For the time being, statements 3 and 4 are those testimonies agreed by the respondents as the least of all perceived characteristics of burnout.The respondents in different sections are presumably experiencing all of the statements under reduced personal accomplishments because of burnout. It turned out that they not always experience as proved by the degree of mean but they often/sometimes experience these perceived characteristics thats why they agreed to the five statements. 3. Effects of Burnout Phenomenon On the responses mentioned, statement no. 1 under academic performance ranked 1st as the students got really nervous and they are experiencing mental block out because of burnout.Meanwhile, the statement that got the least rank can be depicted as statements 3 and 4 because their means vary. As assessed nursing students section A.B.C were sometimes 1.nervous, 2.panic during examinations and 4.experience difficulties in combining studies and leisure time affecting their academic performance. While in clinical area students sometimes experience 16.lack of experience, 20.fear of giving medication, 18.feeling of disoriented to area, 17.fear of making mistakes. Thus our highest weigh is Sometimes. 4. Suggested Measures to Prevent Burnout The suggested measured given were effectively use by the students they were agreed that using prevention control were very helpful to lessened burnout especially in the field nursing. But rather Statement number 7 wherein they cannot take daily break from technology by checking e-mail, turning off the phone and putting away the laptop probably because of the generation and the condition of the youth. Thus, the statements above with

53

ENVERGAUNIVERSITYtheir corresponding frequency and percentage suggest upon as preventive measures from burnout as they were above 75%.

Conclusion: Based from the aforementioned findings, the following conclusion were drawn 1.1 They concluded that most of the nursing students in level IV are on the young adulthood(18-35) years old with the majority gender of female. It shows that the ages of the respondents are right to their level. 1.2 Majority of them are female. 2.1 Because Nursing Students involved in the 4 years intensive program. The students agreed that the characteristic of burnout regarding emotional exhaustion are respondents most agreed effects of this burnout is the lack of energy, feel frustrated or tension, emotionally drained to their academic are not specifically affect their performance. Respondent agreed that lazy and absence affects their performance. 2.2 In the category of depersonalization respondent agreed that they feel lost of focused in class or seems to be an outside observer because of the effects of emotional exhaustions and it affect the performance. The testimonies I feel that working with people all day was really a strain to me Agreed by the respondents as the least of all perceived characteristics of burnout. The respondents agreed that they are not alike to robots whose functions are in command and routinely. 2.3 The respondents in different sections are presumably experiencing all of the statements under reduced personal accomplishments because of burnout the testimonies like; I feel

54

ENVERGAUNIVERSITYdependent in class, I feel unsatisfied to my grades, I feel lack of confidence and selfesteem, I feel headache answering exercises. That they not always experience as proved by the degree of mean as proven it will depend on the condition of respondent on how they handle it literally.

3.1 The perceived effects of burnout out to academic performance of the student is During an examination they frequently get so nervous that they forget facts I really know, as often experience by respondents. They feel it very difficult to combine their study and leisure time, as sometimes experience. They feel frequently so tense that my stomach gets upset, as sometimes. They feel usually end up cramming for examinations and requirements, as sometimes. All this testimonies is experience by the respondent throughout the symptoms of burnout. As proven, it will always depend on case-to-case basis depending on the situations and condition of the respondents. 3.2 In terms of clinical performance, every section has different perceived effects. They feel lack of experiences, as agreed sometimes. They feel fear of making mistakes, as the majority answered sometimes. They feel of disoriented to the area, as often. They feel of over work load during rush hour, as sometimes they feel worry in giving medication that they will make harm the patients, as respondent agreed sometimes. 4 The suggested measured given were effectively use by the students they were agreed that using the preventive measure will help them to improve their academic and clinical performance. Concluded that they recognized the management of burnout.

55

ENVERGAUNIVERSITYRecommendations Based on the foregoing findings and conclusions derived from the study, the following recommendations are hereby presented: To the Students 1. Continuing student development to upgrade the competence of the students 2. Positive attitude should be developed 3. Awareness on the burnout syndrome and its causes and coping with it actively 4. Stressors should be minimize 5. Recognize school organization 6. As a student nurses, perform well in school because the quality of the clinical performance depends on how good a student can be in theoretical bases. 7. Should use the proposed burnout preventive measure. To the Faculty 1. There should exist a harmonious professor-student relationship, should be friendly but within the limit of dignity to be aware of the problem that may greatly affect their students performances. 2. Continue to guide and counsel the student 3. Not to show favoritism in front of the class and not to only show more attention to bright students. To the Researchers 1. Further related studies to be undertaken by those involved in the nursing profession to enrich education. 2. Conduct a research study comparing the level of burnout of the level IV nursing students today and in the future.

56

ENVERGAUNIVERSITY

APPENDIX - A

57

ENVERGAUNIVERSITY

Manuel S. Enverga University Foundation College of Nursing and Allied Health Sciences Lucena City

Dear Respondents: Greetings of Peace! The undersigned, students of College of Nursing and Allied Health Sciences, level IV. Presently conducting a research study entitled Burnout Phenomenon As Assessed By Selected Level IV Nursing Students Of Manuel S. Enverga University Foundation And Their perceived Effect On Academic Performance And Clinical Performance as one of the requirements in Nursing Research. In connection with this, may we request you to be one of our respondents by answering the attached questionnaire? Rests assured that information you will be treated for educational purposes only and with strict confidentiality. Thank you for your time and cooperation Respectfully yours: Cris Ian V. Almeyda Kayla H. Basila Marc Mel Mattheus N. Go Marjorie Ocier, Noted by: Mcduffie Joshua Sy. RN,MSN Thesis Adviser

58

ENVERGAUNIVERSITY

APPENDIX B

59

ENVERGAUNIVERSITY

LETTER FOR VALIDATION September 7, 2011 Maria Anabelle Rejano RN, MSN Clinical Instructor Manuel S. Enverga Univesity Foundation Lucena, City Greetings of Peace! We will be conducting a study entitled, Burnout Phenomenon As Assessed By Selected Level IV Nursing Students Of Manuel S. Enverga University Foundation And Their Perceived Effect On Academic Performance And Clinical Performanceas a requirement for the degree in Bachelor of Science in Nursing. In connection with this, may we beseech for support from you through validation of our tool to be utilized in the said study. We are looking forward for your favorable response. Thank you very much and God Bless! Respectfully yours: Cris Ian V. Almeyda Kayla H Basila Marc Mel Mattheus N. Go Marjorie Ocier, Noted by: Mcduffie Joshua Sy. RN,MSN Thesis Adviser

60

ENVERGAUNIVERSITY

LETTER FOR VALIDATION September 7, 2011 Jennifer Rosales Palacpac RN, MSN Clinical Instructor Manuel S. Enverga Univesity Foundation Lucena, City Greetings of Peace! We will be conducting a study entitled, Burnout Phenomenon As Assessed By Selected Level IV Nursing Students Of Manuel S. Enverga University Foundation And Their Perceived Effect On Academic Performance And Clinical Performanceas a requirement for the degree in Bachelor of Science in Nursing. In connection with this, may we beseech for support from you through validation of our tool to be utilized in the said study. We are looking forward for your favorable response. Thank you very much and God Bless! Respectfully yours: Cris Ian V. Almeyda Kayla H Basila Marc Mel Mattheus N. Go Marjorie Ocier, Noted by: Mcduffie Joshua Sy. RN,MSN Thesis Adviser

61

ENVERGAUNIVERSITY

LETTER FOR VALIDATION September 7, 2011 Dario V. Sumande RN, MAN Clinical Instructor Manuel S. Enverga Univesity Foundation Lucena, City Greetings of Peace! We will be conducting a study entitled, Burnout Phenomenon As Assessed By Selected Level IV Nursing Students Of Manuel S. Enverga University Foundation And Their Perceived Effect On Academic Performance And Clinical Performanceas a requirement for the degree in Bachelor of Science in Nursing. In connection with this, may we beseech for support from you through validation of our tool to be utilized in the said study. We are looking forward for your favorable response. Thank you very much and God Bless! Respectfully yours: Cris Ian V. Almeyda Kayla H Basila Marc Mel Mattheus N. Go Marjorie Ocier, Noted by: Mcduffie Joshua Sy. RN,MSN Thesis Adviser

62

ENVERGAUNIVERSITY

LETTER FOR VALIDATION September 7, 2011 Maria Corazon B. Valdeavilla RN., MSN Dean of College of Nursing and Allied Health Sciences Manuel S. Enverga Univesity Foundation Lucena, City Greetings of Peace! We will be conducting a study entitled, Burnout Phenomenon As Assessed By Selected Level IV Nursing Students Of Manuel S. Enverga University Foundation And Their Perceived Effect On Academic Performance And Clinical Performanceas a requirement for the degree in Bachelor of Science in Nursing. In connection with this, may we beseech for support from you through validation of our tool to be utilized in the said study. We are looking forward for your favorable response. Thank you very much and God Bless! Respectfully yours: Cris Ian V. Almeyda Kayla H Basila Marc Mel Mattheus N. Go Marjorie Ocier, Noted by: Mcduffie Joshua Sy. RN,MSN Thesis Adviser

63

ENVERGAUNIVERSITYQUESTIONAIRE Direction: Kindly check the box of the correct answer that corresponds to your personal data. Part I. Demographic Profile Students Number: 1.1 Age: 1.2 Gender: Adolescence: 12 to 18 Years Male Young adulthood: 18 to 35

Female

Part II. On the ff. pages are the characteristic of burnout. Using with scale below rate with items according to the degree. Check the column of your choice:1 Never 2 Sometimes 3 Often 4 Always

A. Emotional Exhaustion 1. I feel lack of energy 2. I feel emotionally drained from the school 3. 4. 5. B. 1. 2. 3. 4. 5. C. I feel very lazy to attend classes I feel that I didnt take school/ learning seriously. I feel frustrated and get tension in academic and clinical performance Depersonalization I feel that my classmate were of no help when I needed help I feel that working directly with people has put too much stress on me I feel that working with people all day was really a strain to me I feel like a robot or feeling like their living in a dream or in a movie I feel lost of focused in class or outside observer Reduced Personal Accomplishment

4 3 2 1

1. I feel dependent in class 2. I feel unsatisfied to my grades 3. I feel slow learning 4. I feel headache answering exercises 5. I feel lack of confidence and self esteem

64

ENVERGAUNIVERSITYPart III: The effects on burnout as assessed by 4th year nursing students1 Never 2 Sometimes 2 3 Often 4 Always

A. Academic performance 1. I feel frequently nervous that I forget the facts that I really know during examinations 2. I feel very panicky when I have to take an exam 3. I feel frequently so tense that my stomach gets upset 4. I feel it very difficult to combine my study and leisure time. 5. I feel usually end up cramming for examinations and requirements. B. Clinical performance 1. I feel lack of experiences 2. I feel fear of making mistakes 3. I feel of disoriented to the area 4. I feel of over work load during rush hour 5. I feel worry in giving medication that I will make harm the patient

4 3 2 1

Part IV. Suggested measures in prevention of Burnout as assessed by 4th year nursing students Direction: please put a check (/) if you think this will be a preventive measure. 1. Identification of what stresses you each day 2. Start the day with a relaxing rituals 3. Organize schedule on everyday activities 4. Get plenty of rest, eat right and engage in regular activities 5. Set boundaries by learning to say NO to request on your time. 6. Stop over nurturing other people 7. Take a daily break from technology by stop checking your e-mail, turn off your phone and put away your laptop. 8. Nourish one-self creative side 9. Early identification of the signs and symptoms of stress as contributing to burnout ( anxiety, depression, irritability, headache, insomnia and difficult to concentrate ) 10. Learn how to manage stress THANK YOU VERY MUCH!! YES NO

65

ENVERGAUNIVERSITYBibliography

BOOKS Dwoskin A.G (1997) A scale to assessed teacher burnout (2nd ED) U.K Technomic Pub. Corp Gold Y and Roth P.A (2006) Teacher managing stress and professional burnout: The professional Malta Solution London U.K Rudow B (1999) Stress and Burnout in teaching profession Europe studies issue and research perspective In R. Vandenbergh and A.M Humberman (Eds) Understanding and preventing teachers burnout JOURNALS Browners (2000) Vol. 20 239-253 Teaching in Teacher Education Cheriss C. (1988) Burnout new prof. 12 pages 14-24 Maslach C. and Jackson S.E (1981) 99-113: Journal of Occupation Behavior Scott C. and Dioham S. (2003) no. 10 pages 74-76 Cordes C. & Dougherty T. Academy of Management Review [AMR], p621-659

SOURCES OF ILLUSTRATIONS www.globalhealingcenter.com/gazette/images/stress.jpg www.ehow.com/how_4747839_help-children-deal-stress.html www.positivethinking-for you.com//stress.jpg

66

ENVERGAUNIVERSITYwww.fantantashak.files.wordpress.com/2009/02/Kua-29-prev-stress_450.jpg Mifflin 2009,http://www.salkforum.se/kurs/GK070327.pdf Knight A., RN, MSN 2003,http://nsweb.nursingspectrum.com/Articles/FiredUpCF2003.htm Knight A., RN, MSN &Shepard G.2006,http://nursing-is-not-for-sissies.blogspot.com/ Lyness D. A, PhD 2010,http://kidshealth.org/teen/your_mind/emotions/stress.html# Sharif &Masoumi 2005, http://www.ahna.org/Resources/StressManagement/ForNursingStudents/tabid/1815/Defaul t.aspx Womble L. 2001, http://www.psych.uncc.edu/Womble.pdf

67

ENVERGAUNIVERSITYPROPOSED BURNOUT PREVENTIVE MEASURES FOR NURSING STUDENTS

1. Identify of what stresses you each day. 2. Start the day with a relaxing rituals, Rather jumping out of bed as soon as waking up, spend at least fifteen minutes meditating, writing in journal, doing gentle stretches, or reading something inspirational. 3. Organize schedule on everyday activities 4. Get plenty of rest, eat right and engage in regular activities.It gives energy and resilience to deal with lifes hassles and demands. 5. Set boundaries by learning to say NO to request on your time.Dont over exert yourself 6. Stop over nurturing other people 7. Nourish one-self creative side. Creativity is a powerful antidote to burnout. 8. Early identification of the signs and symptoms of stress as contributing to burnout ( anxiety, depression, irritability, headache, insomnia and difficult to concentrate ) 9. Learn how to manage stress, can help in regaining a persons balance.

68

ENVERGAUNIVERSITYCURRICULUM VITAE

Almeyda, Cris Ian V. #4 Green Heights Subd, Tayabas, City 793-0042/0949-6367-564 Email Add: ian_on7292@yahoo.com

PERSONAL INFORMATION Age Birth Date Civil Status Name of Father Name of Mother : 19 y/o : Febuary 7, 1992 : Single : Romy Almeyda : Necy Almeyda

EDUCATIONAL BACKGROUND Tertiary : Manuel S. Enverga University Foundation Lucena, City Secondary : Saint John Bosco Academy Tayabas, City Elementary : Ibabang School building-II Tayabas, City

69

ENVERGAUNIVERSITYCURRICULUM VITAE

Basila, Kayla H. Brgy. Pansol Lopez, Quezon 0912-6596-514 Email Add: kayla.basila@yahoo.com

PERSONAL INFORMATION Age Birth Date Civil Status Name of Father Name of Mother : 19 y/o : April 22, 1992 : Single : Medel D. Basila : Rowena H. Basila

EDUCATIONAL BACKGROUND Tertiary : Manuel S Enverga University Foundation Lucena, City Secondary : Eastern Tayabas College Lopez, Quezon Elementary : Pansol Elementary School Lopez, Quezon

70

ENVERGAUNIVERSITYCURRICULUM VITAE

Go, Marc Mel Mattheus N. 15 P. Nieva Street Iyam Lucena, City 0908-434-6651 Email Add: marc_go0@yahoo.com

PERSONAL INFORMATION Age Birth Date Civil Status Name of Father Name of Mother : 20 y/o : August 14,1991 : Single : Alec Patrick R. Go : Melody N. Go

EDUCATIONAL BACKGROUND Tertiary : Manuel S Enverga University Foundation Lucena City Secondary : Quezon National High School Lucena City Elementary : Lucena West I Elementary School

71

ENVERGAUNIVERSITYCURRICULUM VITAE Ocier, Marjorie 71-Habito St. Ibabang Iyam Lucena, City 0908-408-3186 Email add: smash2mato@yahoo.com

PERSONAL INFORMATION Age Birth Date Civil Status Name of Father Name of Mother : 20 y/o : March 17, 1991 : Single : Charlie L. Tan : Ma. Eden G. Ocier

EDUCATIONAL BACKGROUND Tertiary : Manuel S Enverga University Foundation Lucena, City Secondary : Quezon National High School Lucena, City Elementary : Sacred Heart College Lucena, City