Nursing Research

Running head: NURSING RESEARCH 1
Nursing Research
Student’s Name
Institution of Learning
Nursing Research
The study conducted provides relevant perspectives and theories on civility, the
occurrence, and impacts of stressors among the nursing students. Different strategies have been
proposed to reduce stress levels and support the students in addressing mental pressures resulting
from academic demands. Mentorship is one of the methods outlined in the study, and this is
effective since it motivates students in different areas of life and increases self-esteem. Exercise
and social activities have been outlined as part of the strategies of reducing incivility.
The student's civility plays a significant role in ensuring that the nursing students manage
different academic challenges and stressors (Alzayyat & AlGamal, 2014). In a case where
students fail to manage different challenges, incivility occurs. This is a situation where students
are unable to conduct themselves as required. It affects academic performance and patients care
during clinic practice. Academic incivility weakens different teaching and learning activities; it
influences negatively impacts the learning environment leading to poor academic performances
(Milesky, et al., 2015).
Nursing students often encounter mental distress due to the challenging coursework
which requires much attention and commitment (Clark et al., 2014). The stress experienced in
the clinical setting during the coursework practice has also contributed to high levels of stress
(Labrague, 2014). Exposure to emergency cases in the clinical environment causes mental
disorders to some student. The situation, therefore, could result in poor attitudes to the
coursework and depression in a case where a student might not endure different incidences that
are handled in the nursing environment.
Personal issues have contributed to incivility cases among students. For instance, some
of them find a difficult time addressing the financial issues during academic programs. Most of
the students fail to manage such kind of stressors. Therefore, the situation leads to increased
levels of incivility among most of the faculty-students and student-student relationships (Clark et
al., 2014)
The effect of stress involves physical illness, poor communication, mental disorder,
burnout, and poor student performance (Babenko-Mould & Laschinger, 2014). Students tend to
cope with the effects in different ways. Some of the students decide to cope with the situation
positively while others deal negatively. For instance, the students who cope with stress levels
positively would address the problems through communication, seeking to counsel and managing
academic workloads by planning on time. The students who would mitigate the issues negatively
would often avoid the problems. Avoidance as one of the methods to reduce the stress levels,
drug abuse, and procrastination is often shared among this group of students (Milesky et al.,
2015). Therefore, effective strategies should be established to address the psychological well-
being of the nursing students.
The incivility problem contributes to different challenges regarding academic
competitiveness. It leads to stressful learning environments (Labrague, 2014). Therefore, the
relationship between stress, coping and incivility have been outlined as the key issues that
require effective strategies to reduce its academic and personal impact. The relationship among
most of the faculty students is also affected due to poor attitude and student depression. The
physical illness affects students due to high-stress levels that expose an individual to
The study aimed at determining changes on overall civility as a result of stress-reducing
activities that were conducted weekly. Furthermore, it should examine and analyze the top
stressors among nursing students. It should also focus on how different strategies would improve
civility in the nursing program. The stress reducing activities in the study positively impacted on
the number of civility and incivility cases. This was determined through analyzing the perception
of nursing students in coping with stress. The variables determined involved the number of hours
that were spent in implementing stress-reducing strategies. The number and the level of student
class played a critical role since it ensured that the maximum number of responses was collected
during the study. Quality of student relationship was to be determined through the hypotheses
hence access to different factors that contribute to stressors at faculty-student and student-student
Study Design
The study design involved surveys and questionnaires. A pilot test was conducted on the
survey on students that were not in nursing school. The content validity was determined
readability and the logical flow (Clark et al., 2014). Civility quality of relationship and stress
were analyzed individually for relevant quantitative measures. This was significant since it
would ensure that the variances that could result from the study would be accounted. Items that
could result in biases were analyzed, which included gender, ethnicity and the year of the nursing
program. The 6-point Likert scale was used. Qualitative measures are based on verbal and textual
responses from the participants (Milesky et al., 2015).
The formulation of the experiment was set based on the years of study of students. The
intensity of the problem was then determined using different responses from the students. An
increase or decrease in civility would determine effective methods of addressing the problem.
The size of the problem was determined by carrying out the study longitudinally hence
determining various factors affecting the group. The study was further set to determine student's
perspectives on the strategies of addressing incivility.
The methodology involved descriptive methods and repeated measures conducted on the
participants. The methods aimed to determine further the perception of the nursing students on
dealing with incivility and stressors. A longitudinal study was conducted where a group of
participants was analyzed based on the responses they provided.
Surveys were conducted at different times in 2010, 2011 and 2012. The survey aimed the
nursing student at different academic levels. 68 nursing students had n=54, 79.4% response rate
at the beginning of the entry program. The response of the students who were 12 months old into
the program reported n=66, 97% response rate. The course scheduling conflicts had affected the
absence of some of the students during the survey.
The population sample demographics involved four quantitative items that measured the
perception of the nursing students which included the level of civility in the nursing program by
using 6 points Likert scale. The quality of students faculty and student relationship was also
determined using the 6-point Likert scale. The quality of students was determined using a similar
method. Open ended questions were also involved in determining different factors that
contributed to increased levels of incivility and poor student-student relationship.
The data collection tools involved survey and questionnaires. The methods were relevant
to the group of participants since they were familiar with the answering of questions writing and
responding accordingly. The tools were reliable to the group of participants hence enhancing the
process of data collection. Verbal responses are usually acquired through interviews with the
participants (Milesky et al., 2015).
The procedure involved acquiring an approval for the study in the American College
campuses. The participants were identified from the nursing school. Planning and scheduling
activities were conducted based ion the time. A 13-item questionnaire was provided for the
responses of the students. The results were anonymously collected from the questionnaires were
used to collect aggregate data (Clark et al., 2014). The procedures were safe for the participants
since it aimed to address ways of coping with different stressors. The participant's health was not
affected during the process. Psychological impacts of the procedure could be minimal since the
students only answered what they were asked without explaining their psychological views on
the topic.
Ethical Consideration
The practices that were utilized during the study were safe and ethical. The approach to
participant did not violate human rights, and safety was assured before the study was conducted.
The IRB ensures that safety of human subjects was protected (Alzayyat & AlGamal, 2014). IRB
approval played a significant role in ensuring the researchers in the institution were also
protected and those of the institution. The participants were further assured of confidentially with
the information they were going to provide on the questionnaires. For instance, before the
students took the surveys, they were assured that their responses were not going to affect their
Quantitative and qualitative data were analyzed differently. SPSS method was used to
analyze quantitative data. During the survey items were examined using ANOVA method, the
method is a one-way analysis between a group of variances (Clark et al., 2014). The survey
treated the groups independently since different participants were involved and the study was
conducted at different times.
The textual content analysis was used to analyzed narrative responses from the qualitative
research question. The verbal information was organized and ranked according to the research
questions. The textual content should often be confidential and valid, therefore to ensure its
validity external reviewers were involved to ensure that the information provided was relevant
(Alzayyat & AlGamal, 2014).
The results show that 91% of participants were female with an average age of 27.93 and
an SD, 7.97 years during sophomore years. Significance difference was noted in overall levels of
civility among the groups (Clark et al., 2014). It further proved that civility decreased from
sophomore years to senior years. The number of hours spent in stress-reducing activities showed
no difference across the groups. However, faculty student relationship differed significantly
across the group where quality relations decreased from sophomore junior to senior groups.
There was no difference noted in the quality of student-student links across the group.
Implication of the Study
The study has shown a decrease in civility was noted among students (Clark et al., 2014).
Therefore, strategies should aim at reducing incivility among students through different methods
such as providing civility instructions as part of the coursework for every year of study.
Awareness should be created among students where different factors that reduces civility are
outlined. Therefore, students should be provided with various consequences of incivility on the
nursing profession. Civility closely relates to mental wellness of a person. Therefore,
Psychotherapy could be introduced into the school program to ensure that issues related to
mental distress are addressed (Labrague, 2014).
Communication is one of the strategies that could reduce incivility. The students in the
study identified communication as an effective means of addressing creating positive student
relationship hence a positive learning environment (Clark et al., 2014). Students often address
different challenges through communication hence improving the relationship and civility
reduced. It improves quality of the student-student relationship. Problems can be identified and
addressed early when relevant communication exists between students and the faculty members.
It improves social skills and various means of dealing with academic issues.
Fitness and relaxation activities improve muscle relaxation and mental pressures.
Therefore, the institutions should introduce it as part of the curriculum (Labrague, 2014) Social
activities would contribute to an improved relationship between the faculty and the students.
Therefore if the nursing school hosts social activities incivility could be reduced.
Mentorship programs should be introduced in the school. It creates positive attitude
among the students and builds self-esteem hence improved civility medication, and mental
imagery would play a key role in ensuring that effective stress management is achieved (Milesky
et al., 2015). The program would ensure that students engage in positive activities during and
after classes.
Poorly managed stress levels lead to an individual being inflexible with poor perception
of learning activities (Clark et al., 2014). Poor and outdated teaching practices have contributed
to incivility. Therefore, the faculty should be updated and informed on relevant teaching methods
and provided with guidelines for handling stress among the students. Furthermore, the mental
disorder could increase leading to students attempting violent activities with other colleagues and
isolate themselves during class work discussions (Alzayyat & AlGamal, 2014).
Students desire for respect should be created among the students. This would create a
culture of learning to respect aspects of learning relationships and career requirement (Clark et
al., 2014). Debates and discussions should be introduced to address different challenges
encountered by the students. Respect should be encouraged by the faculty members so that
students emulate such behavior from the faculty members
Cognitive behavioral techniques should be encouraged to ensure that a student accounts
for his or her actions (Griffin & Clark 2014). Self-reflection assignments should be introduced
for the students to access their behaviors and attitudes toward academics. Students should further
be encouraged to observe the norms for the school. Cognitive rehearsal is an effective means of
addressing incivility. For instance, the use of verbal interaction and interactive instruction would
ensure that students understand the relevant means of handling different problems (Babenko-
Mould & Laschinger, 2014). Furthermore, this would encourage ethical behavior as far as the
nursing career is concerned.
Incivility often contributes to an unethical career during the clinical practice in the
nursing school (Alzayyat & AlGamal, 2014). Such situation could create different perspectives
from their supervisors. The problem should be addressed by guiding students before and during
practical activities to ensure that ethical behavior is encouraged. Close supervision improves
behavioral conducts of the students, hence increasing civility.
Civility has often been associated with right conduct hence ethical practices during and
after the nursing program. The study has summarized different aspects of civility levels among
students from the sophomore years to senior years in the nursing school. During the study, the
participants and institution for study were identified. The study was conducted through different
methods, which involved surveys, interviews, and questionnaires. The methods were relevant to
the group of participants since they were familiar with the concept of answering questions
relating to civility. Confidentiality was assured to the students before the study was conducted
hence enabling students to answer the questions without fear. The result proved hypotheses
where civility decreases across academic years. Students observed civility more at sophomore
years compared to the final years of their studies. Different strategies for dealing with incivility
were provided by the students where students outlined introduction of social activities as one of
the methods that would decrease incivility. The study design involved a 3-year longitudinal study
that determined students independently. Therefore, in result analysis, ANOVA test was used to
analyze the groups of students since the repeated test was not conducted on similar students over
the three years.
Alzayyat, A., & AlGamal, E. (2014). A review of the literature regarding stress among nursing
students during their clinical education. International Nursing Review, 61(3), 406-415.
Babenko-Mould, Y., & Laschinger, H. K. (2014). Effects of incivility in clinical practice settings
on nursing student burnout. International journal of nursing education
scholarship, 11(1), 145-154.
Clark, C. M., Nguyen, D. T., & Barbosa-Leiker, C. (2014). Student perceptions of stress, coping,
relationships, and academic civility: A longitudinal study. Nurse educator, 39(4), 170-
Griffin, M., & Clark, C. M. (2014). Revisiting cognitive rehearsal as an intervention against
incivility and lateral violence in nursing: 10 years later. The Journal of Continuing
Education in Nursing, 45(12), 535-542.
Labrague, L. J. (2014). Stress, stressors, and stress responses of student nurses in a government
nursing school.
Milesky, J. L., Baptiste, D. L., Foronda, C., Dupler, A. E., & Belcher, A. E. (2015). Promoting a
culture of civility in nursing education and practice. Journal of Nursing Education and
Practice, 5(8), 90.

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