Investigation of Adrenaline, Nor-Adrenaline and Complete Blood Count in Nursing Students with Stress at First Clinical Experience

Abstract

The first clinical experience for nursing students can be stressful. The students expressed feelings of irritability, distress and concern due to reasons such as not being ready for clinical experience, thinking they have inadequate clinical skills, unsupportive health professional staff and clinical learning environment, concerns over patient safety.

Objectives: To identify the level of adrenaline, nor adrenaline and complete blood count among the nursing students before and after their first clinical experiences; to identify the level of stress  among the nursing students before and after their first clinical experiences and to determine association among stress, complete blood count, adrenaline and nor adrenaline hormonal level.

Materials and methods:  A cross-sectional descriptive and quasi-experimental design was designed to investigate the adrenaline, non-adrenaline level, Complete Blood Counts, and their association with stress in nursing students before and after the first clinical experience by using Enzyme Linked Immuno-Sorbent Assay (ELISA) technique and utilizing self-report questionnaire. A non-probability sample (Convenience) of (71) students was taken in present study. The period of the study is from January / 2017 to March / 2017.

Results: The current study was determined that the majority of the age group at age category <=20 by about (84.5%). Regardless of gender, female was more than male (77.5% and 22.5%) respectively. The level of education was mostly at secondary school (97.2%). Additionally, urban was more than rural (78.9% and 21.1%) respectively and the studied group was mostly enough income (54.9%). For marital status, single more than married (94.4%).

Furthermore, the mean and standard deviation of blood tests and hormones level were different before and after the first clinical practice of the nursing students. The statistical results were significant for White blood cells (WBCs), and Hemoglobin (Hb), while highly significant for Lymphocytes (LYM), Mean corpuscular volume (MCV), Red blood cells (RBC), Mean corpuscular hemoglobin (MCH), Mean corpuscular hemoglobin concentration (MCHC), Platelets (PLT), Adrenaline and nor-adrenaline. The levels of all above blood test parameters were slightly decreased except adrenaline and nor adrenaline where increase, however these results were statistically significant. The stress was increased after first clinical practice by about (57.7%). However the statistical result was significant (P-value=0.03%).

Conclusion: The study concluded that the stress state in nursing students was affected by the first clinical experience and increase hormonal level (Adrenaline and nor-adrenaline) and decrease blood cell count when stress increased.