Concluding words

Despite the limitations reported above, this study has identified stress and stressors in the clinical environment as perceived by fourth-year student nurses and newly qualified nurses. The fundamental aim of this study was to explore and compare stress between two groups within a clinical environment who are on both sides of the transition from student to qualified nurse at a time when nurse education in Ireland has changed dramatically. The numerical data support the qualitative data which add to an existing body of knowledge on stress in the clinical environment and inform the relevant stakeholders in nurse education including hospital managers, nursing institutions, An Bord Altranais, nursing colleagues and nursing students where and how stress and stressors exist in the clinical environment. While findings from this study have echoed previous findings and identified similar stressors in both groups, this study has revealed differences in stressors perceived by both groups and provided insights into the perceptions of fourth-year student nurses that are relatively new given the recent introduction of the degree programme in Ireland. This needs further examination in order to facilitate the development of the graduate nurse, nurse education and nursing practice in the future. Findings may go a long way in alleviating stress and ensuring harmony within the workplace, retention valued nursing staff, which will transcend into the provision of quality care to the patient. The future of nursing depends on the nurses within. To value those people is to value the profession, to steer it forward in the provision of quality care to the people that

Reference list

Abbot, P. and Sapsford, R. 1999 Research Methods for Nurses and the Caring Professions (2nd edition) London: Open University Press.

Aggleton, P. and Chalmers, H. 2000 Nursing Models and Nursing Practice (2nd edition) London: Macmillan Press Ltd.

Alderman, C. 1999 Practice makes Perfect, Nursing Standard, 13 (38), pp.16-17.

Amos, D. 2001 An evaluation of staff nurses role transition, Nursing Standard, 16(3), pp.36-41.

An Bord Altranais 1994 The Future of Nurse Education and Training in Ireland Dublin: An Bord Altranais.

An Bord Altranais 1997 Continuing Professional Education for Nurses in Ireland: A framework Dublin: An Bord Altranais.

An Bord Altranais 2000a Requirements and standards for nurse registration education programme (2nd edition) Dublin: An Bord Altranais.

An Bord Altranais 2000b The Scope of Nursing and Midwifery Practice Framework Dublin: An Bord Altranais.

An Bord Altranais 2000c The code of professional conduct for each nurse and midwife Dublin: An Bord Altranais.

An Bord Altranais 2003 Guidelines on the key points that may be considered when developing a quality clinical learning environment Dublin: An Bord Altranais.

An Bord Altranais 2005 Requirements and standards for nurse registration education programme (3rd edition) Dublin: An Bord Altranais.

An Bord Altranais 2007a Register statistics 2007 Number of Newly Registered Qualifications (online) Available from http://www.nursingboard.ie/en/ statistics_article. (Accessed 12 Aug 2008).

An Bord Altranais 2007b Guidance to nurses and midwives regarding ethical conduct of nursing and midwifery research Dublin: An Bord Altranais.

An Bord Altranais 2008a Nursing/Midwifery - A Career for You (3rd edition) Dublin: An Bord Altranais.

An Bord Altranais 2008b An Bord Altranais News; Publication of the Irish Nursing Board, 20(4),p. 3.

Andrews, G., Brodie, D., Andrews, J., Wong, J. and Thomas, B. 2005 Place(ment) matters: Students’ clinical experiences of their preferences for first employers, International Nursing Review, 52(2), pp.142-153.

Arnold, J., Cooper, C. and Robertson, I. 1998 Work Psychology - Understanding Human Behaviour in the workplace (3rd edition) London: Pearson Education Ltd.

Atkinson, R. 1993 Introduction to Psychology New York: Harcourt Brace Jovanavich.

Baldwin, P. 1999 Stress and the nurse, Nursing Standard, 13(16), p.22-24.

Barr, C., Spizmuller, C. and Stuebing, K. 2008 Too Stressed out to participate? Examining the relation between stressors and survey response behaviour, Journal of Occupational Health Psychology, 13(3), pp.232-243.

Barron, D. 2008 Communication issues within medical practice and education, Irish Medical Times, 25(11), p. 10.

Beckett, A., Gilbertson, S. and Greenwood, S. 2007 Doing the Right Thing: Nursing Students, Relational Practice, and Moral Agency, Journal of Nursing Education,

Begat, I., Ellefsen, B. and Severinsson, E. 2005 Nurses' satisfaction with their work environment and the outcomes of clinical nursing supervision on nurses' experiences of well-being – a Norwegian study, Journal of Nursing Management, 13(3), pp. 221- 230.

Begley, C. and Brady, A. 2002 Irish Diploma in Nursing Students’ first clinical allocation: The views of Nurse Managers, Journal of Nursing Management, 10(6), pp.339-347.

Begley, C. and White, P. 2003 Irish Nursing Student’s changing self-esteem and fear of negative evaluation during their pre-registration programme, Journal of Advanced Nursing, 42(4), pp.390-401.

Begley, C. and Glacken, M. 2004 Irish Nursing students’ changing levels of assertiveness during their pre-registration programme, Nurse Education Today, 24(7), pp.501-510.

Benner, P. 1984 From Novice to Expert: Excellence and Power in Clinical Nursing Practice New York: Addison Wesley.

Benner, P. and Wrubel, J. 1989 The Primacy of caring: Stress and coping in health and illness Wokingham: Addison Wesley.

Bick, C. 2000 Please Help! I’m newly qualified, Nursing Standard, 14(16), pp.44-47.

Boxer, E. and Kludge, B. 2000 Essential skills for beginning registered nurses, Nurse Education Today, 20(4), pp.327-335.

Boyatzis, R. 1998 Transforming qualitative information – Thematic analysis and code development London: Sage publications.

Brady, A., Byrne, G., Horan, P., Griffiths, C. and Begley, C. 2007 Measuring the workload of community nurses in Ireland - A review of workload measurement

Brockhopp, D. and Hastings-Tolsma, M. 2003 Fundamentals of Nursing Research (3rd edition) London: Jones & Bartlett Ltd.

Brown, H. and Edelmann, R. 2000 Project 2000: A study of expected and experienced stressors and support reported by students and qualified nurses, Journal of Advanced Nursing, 31 (4), pp.857-864.

Bryman, A. 2004 Social Research Methods (2nd edition) Oxford: University Press.

Buchan, J. 1994 Nursing Shortage and human resource planning, International Journal of Nursing Studies, 31(5), pp.460-470.

Buchanan, D and Huczynski, A. 2004 Organisational behaviour - An introductory text (5th edition) London: Pearson Education Limited.

Burns, N. and Grove, S. 2005 The Practice of Nursing Research Conduct, Critique and Utilization (5th edition) Missouri: Elsevier Saunders.

Butterhurst, N. and Thom, N. 2001 Clinical Supervision and support for nurses: An evaluation study, Journal of Advanced Nursing, 33(2), p.216-224.

Carlisle, C., Luker, K., Davies, C., Stillwell, J. and Wilson, R. 1999 Skills competency in nurse education: nurse managers' perceptions of diploma level preparation, Journal of Advanced Nursing, 29(5) p. 1256-1264.

Carter, D. 2000 Quantitative research in Mc Cormack, D. (ed) 2000 The Research Process in Nursing (4th edition) Oxford: Blackwell Science Ltd, pp. 166-174.

Chang, E., Bidewell, J., Huntington, A., Daly, J., Johnston, A., Wilson, H., Lambert, V. and Lambert, C. 2006 A Survey of role stress and health in Australian and New Zealand hospital nurses, International Journal of Nursing Studies, 44(8), pp.1354- 1362.

Charnley, E. 1999 Occupational stress in the newly qualified staff nurse, Nursing Standard, 13(29), p.33-36.

Cheng, Y., Kawachi, I., Coakley, E., Schwartz, J. and Colditz, G. 2000 Association between psychosocial work characteristics and health functioning in American women: prospective study, British Medical Journal, 320, pp.1432-1436.

Chmiel, N. 2000 Introduction to work and organizational psychology - A European Perspective Oxford: Blackwell Publishing.

Clark, T. and Holmes, S. 2007 Fit for Practice? An exploration of the development of newly qualified nurses using focus groups, International Journal of Nursing Studies, 44(7), pp.1210-1220.

Clegg, A. 2001 Occupational Stress in Nursing: A review of the literature, Journal of Nursing Management, 9(2), pp.101-106.

Clifford, C. 1997 Nursing and Healthcare Research: A skills based introduction (2nd edition), Wilshire: Prentice Hall Nursing Services.

Cohen, S., Kamrarck, T. and Mermelstein, R. 1983 A global measure of perceived stress, Journal of health and social behavior, 24(4), pp.385-396.

Cole, F., Slocumb, E and Mastry, J. 1999 A Measure of critical care nurses’ post-code stress, Journal of Advanced Nursing, 34(3), pp. 281-288.

Colley, S. 2003 Nursing theory: Its importance to practice, Nursing Standard, 17(46), pp.33-37.

Condell, S., Elliott, N. and Nolan, L. 2001 Perceptions of the clinical learning environment: A supernumerary survey, All Ireland Journal of Nursing and Midwifery, 1(4), pp.148-151.

Coombs, C., Arnold, J., Loan-Clarke, J., Wilkinson, A., Park, J., and Preston, D. 2003 Perceptions of nursing in the NHS, Nursing Standard, 18(5), pp.33-38.

Cooper, C. 1995 Handbook of stress, medicine and health Florida: CRC Press.

Cooper, C. and Locke, E. 2000 Industrial and Organizational Psychology: Linking theory with practice Oxford: Blackwell Publishers Ltd.

Cooper, C. 2004 Handbook of Stress Medicine and Health (2nd edition) Florida: CRC Press.

Corr, M. 2000 Reducing Occupational stress in intensive care, Nursing in Critical Care, 5(2), p.76-81.

Cotrell, S. 2001 Occupational Stress and job satisfaction in mental health nursing: Focused interventions through evidence-based interventions, Journal of Psychiatric and Mental Health Nursing, 8(2), pp.157-164.

Cowen, J. Statistical power analysis for behavioural sciences 1988 (2nd edition) New Jersey: Laurence Erlbaum associates.

Cowman, S. 2001 Nursing Education in Ireland: The end of the beginning and the end envy of others in Europe, Journal of Advanced Nursing, 34(4), pp.419-420.

Creswell, J. 2007 Qualitative inquiry and Research Design - Choosing among five approaches (2nd edition) London: Sage Publications limited.

Crossan, F. 2003 Research philosophy: towards an understanding, Nurse Researcher, 11(1), pp.46-55.

Culiton, G. 2008 Up to 10% of staff absent, Irish Medical Times, 42(33), p.1.

Deary, I., Watson, R. and Hogston, R. 2003 A longitudinal cohort study of burnout and attrition in nursing students, Journal of Advanced Nursing, 43(1), pp.71-81.

Dearmun, A. 2000 Supporting Newly Qualified Staff nurses: The Lecturer Practitioner Contribution, Journal of Nursing Management, 8(3), pp.159-165.

Demerouti, E., Bakker, A., Nachreiner, F. and Schaufeli, W. 2000 A model of Burnout and life satisfaction amongst nurses, Journal of Advanced Nursing, 32(2), pp.454-464.

Denzin, N. 1989 The Research Act, (3rd edition), London: Prentice Hall Ltd in Williamson, G. 2005 Illustrating triangulation in mixed methods nursing research, Nurse researcher,12(4), p.7-17.

Department of Health and Children 2001 Quality and Fairness: A Health System for You Dublin: Department of Health and Children.

Department of Health and Children 2002a The nursing and midwifery resource-Final report of the steering group: towards workforce planning Dublin: Department of Health and Children.

Department of Health and Children DoHC 2002b Action plan for people management in the health service (online). Available from http://www.dohc.ie/publications/ all.html#N (Accessed 26 Aug 2008).

Department of Health and Children 2004 National report - Turnover in Nursing and Midwifery Dublin: Department of Health and Children.

Department of Health and Children 2005a Employment Statistics (online). Available from: http://www.dohc.ie/statistics/ (Accessed 12 April 2007).

Department of Health and Children 2005b Report of the working group to examine the development of appropriate systems to determine nursing and midwifery staffing levels Dublin: Department of Health and Children.

Department of Health and Children 2008 Numbers Employed in the Public Health Service, December 2006 (online). Available from: http://www.dohc.ie/statistics/ key_trends/health_service_employment/table_5_1.html (Accessed 14 August 2008).

Department of Justice, Equality and Law Reform 2003 Data Protection Act (Amendment) Dublin: Stationery Office.

De Raeme, L. 1997 Nursing Research- An Ethical and Legal appraisal London: Bailliere Tindall.

De Vaus, D. 2004 Analysing Social Science Data (2nd edition) London: Sage Publications.

Doran, L. 2007 Forward together, Editorial World of Irish Nursing, 15 (9), p.5.

Downes, M. 2001 Support for student nurse training: A new role as demonstrators, Nursing Times, 97(7), p.39.

Drennan, J. 2002 An evaluation of the role of the Clinical Placement Coordinator in student nurse support in the clinical area, Journal of Advanced Nursing, 40(4), pp. 475-483.

Drenth, P., Thierry, H. and Wolff, C. 1998 Work Psychology: Handbook of Work and Organizational Psychology, Sussex: Psychology Press Ltd.

Dublin Academic Teaching Hospitals and St Luke’s Hospital (DATHs) 2000 Nursing Recruitment and Retention Group Report 2000 Dublin: Dublin Academic Teaching Hospitals.

Dunne, L. 1991 How many nurses do I need? A guide to resource management issues London: Wolfe Publishing Ltd.