ANGELS IN THE SICKROOM: THE UNTOLD STORIES OF HOSPITAL NURSES

A Research Paper
Presented to the Faculty of Samal Senior High School,
Sitio Pasig, Brgy. Peñaplata, Samal District, Island Garden City of Samal
Davao del Norte, Philippines

In Partial Fulfillment of the Requirements in the subject

Practical Research 1 for the
Academic Year 2022-2023

By:

CAPUYAN, JULLIAN ANGEL A. .

LAZAGA, NICOLE SHANE P.
NOEL, RHENCELLE P.
OBESO, SAINT RYAN S.
SAOYAO, RALPH L.

JUNE 2023
 APPROVAL SHEET

This qualitative study entitled ANGELS IN THE SICKROOM: THE UNTOLD STORIES OF
HOSPITAL NURSES prepared and submitted by Capuyan, Jullian Angel A.,Lazaga, Nicole
Shane P., Noel, Rhencelle P., Obeso, Saint Ryan S., and Saoyao, Ralph L in partial
fulfillment of the requirements for the course Educational Research, is recommended for
approval and acceptance.

MARK JOEL B. DE ASIS, LPT

Research Adviser

PANEL OF EXAMINERS

Approved by the research committee on oral examination with a grade

of ___.

AIZA S. DIOCAMPO, LPT HELEN JANE A. GO, RN. LPT.

Member Member

JENNIFER A. EMBERADOR, MAEd.

Chairperson

Accepted in partial requirements for the subject Practical Research 1.

PERCIVAL C. VILLEGAS
School Principal
June 2023
 Acknowledgment

First of all, we would like to express the grandest of our gratitude to the

God, the Almighty, for bestowing us with His guidance and blessings that have

allowed us to complete this research study.

To our Practical Research 1 Adviser, insert name, for giving us the

chance to allow this research to take place and giving us with an unrivaled

amount of support throughout this research. His actions and wisdom has

greatly influenced our study and allowed us to push our absolute limits.

To whoever it is for he/she has taught us the values and merit of being

a researcher as well as showing us how to properly handle the presentation of

an ideal research study. It was an honor to have received his teachings and we

hope to be in cooperation with him again in the near future. We are thankful for

what he has done not just for us but the rest of the students, especially for his

friendly vibe, approachable manner, and his humorous attitude.

Another factor that we would like to acknowledge is the Research

Environment Partner who offered their respective time to us. It is a helpful

endeavor that allowed us to finish and create our research in time. Their

assistance has been greatly appreciated and we will do our best to make sure

that their efforts are not in vain.

Lastly, we bid the greatest of gratitude to our family and friends with

their never ending supply of love, and support that has allowed us to keep our

composure despite facing numerous adversary. Also to our dear respondents,

who has given us the privilege of imparting their experiences and

understanding to us which has greatly impact our research unlike any other.
 Dedications

I inscribe this research to the God Almighty; he is the fount of my

strength and passion that has allowed me to continue this research. To my

family and friends, that has repeatedly showered me with their everlasting

support and love. To our adviser, Sir Mark Joel B. De Asis, for guiding us and

assisting us every time we seek his wisdom. Without him, this research will not

have come to where it is today. All of these factors have greatly supported me

in this study and I would not be where I am today if they had not been there for

me.

-Rhencelle Noel

I dedicate this study to God, for giving me the blessing of being a part in

this study. To my family and friends that has given me their emotionally and

physical support. They have showed me their unequaled love and support

throughout this research and I am eternally grateful to them.

-Ralph Saoyao

This research is dedicated to our Lord and Saviour, The Almighty God,

for giving us the blessing of allowing us to do this research. To my family, for

always showing their support and love to me. To our teacher, Sir De Asis, for

his wholehearted love and support to us. Lastly to my friends and classmates,

for giving us words of encouragement and aid.

 -Saint Ryan Obeso
I devote this study to my beloved family for their undying support and

love to me. They are my motivations to continue in working on this study. I

would also like to dedicate this study to my friends and classmates for the

words of encouragement that has allowed me to do more. Also to my subject

teacher, Sir Mak for making sure that we can create this research in the best of

our abilities. Lastly, I would like to devote this research to the God Almighty,

without him this research would not have taken place.

-Gel Vincoy Capuyan

I dedicate the completion of this study to my friends, family, to our dear

panelists, to Sir Mak, for all the advice, support and love that you have given to

us. Without your unrivaled love and support to us, this research would not have

been finished. Last and certainly not the least, I would like to express my

gratitude to our Lord Almighty.

-Nicolle Shane Tumadiang Lazaga

 TABLE OF CONTENTS

Tittle Page i
Approval Sheet ii
Acknowledgement iii
Dedication iv
Table of Contents vi
Abstract viii

CHAPTER Page

1 THE PROBLEM

Introduction 1

Purpose of the Study 4

Research Question and Theoretical Lens 4

Significance of the Study 6

Delimitation and Limitations of the Study 6

Definition of Terms 8

Organization of the Study 9

2 REVIEW OF RELATED LITERATURE 11

3 METHODOLOGY 15

Research Design 15

Roles of the Researchers 16

Research Locale 16

Research Participants 16

Data Sources 17
 Data Collection 18

Data Analysis 19

Trustworthiness and Credibility 20

Ethical Considerations 22

4 RESULTS 23

Struggles of Public Hospital Nurses 23

Coping Mechanisms of Nurses in Term of their Struggles 28

5 DISCUSSION AND CONCLUSION 32

What are the struggles of public hospital nurses? 33

What are the coping mechanisms of the said nurses? 33

What are the meanings generated from the study? 33

Meanings Generated 34

Conclusion 34

REFERRENCES 35

APPENDICES
Appendix A – Communication Letters and Consent
Appendix B – Research Undertaking Documents
Appendix C – Research Conduct Documents
Appendix D – Research Files CD
Appendix E – Research Snapshots
Appendix F – Curriculum Vitae
 Abstract

This study aims to identify the challenges and the coping mechanisms
of hospital nurses. The question that has been identified by the researchers
focuses on uncovering the lived experiences that a struggling nurse has to go
through. Among these questions are identifying their struggles or
hardships, coping mechanisms, and the meanings generated from the
results of the study. To make sure that the details of the research can be
precise and clear, the researchers will use the study of Phenomenology while
having a Purposive Sampling, this is make certain that the study is more
focused on experiences while making sure that the respondents that were
chosen matches the ideal co-defendant of the researchers. The analysts have
also used theories to further support this data. These theories are the
“Transition Shock” and “Keeping on track”, these theories have allowed
the examiner‟s research to be elevated. Based form the gathered data, the
themes emerged upon doing Thematic Analysis as to the Challenges
encountered by Hospital Nurses are Struggles in Salary
Insufficiency and Co-workers, Misunderstandings with Doctors and
Patients, Interaction and Trust and Problems dealing with Patients. For
the Coping Mechanisms of their struggles, the themes emerged are
Motivations in Aid and Passion, Family Motivations, Actively Attending
Routines and also Prayer and Positivity. The researchers have found out
that these themes postulates to having quite an impact to the nurses. As
conclusion, as according to the study of Zamanian (2016), nurses face a lot of
difficulties in their workplace and being a nurse is more than meets the eye.
The true value of being a nurse is not determined by your knowledge about
different illnesses and its cure. It is about having the will and passion to take
care of someone.

Keywords:

Hospital Nurses, Struggles, Coping Mechanisms and Phenomenology

 CHAPTER 1

INTRODUCTION

In the researcher‟s view, a nurse is the true epitome of caring,

understanding, and nonjudgmental and has a strong capability of guiding their

patients in a better mindset. In the world of medicine, nurses are known for

being physically and emotionally durable, however, there are few occasions

where the capabilities and mindsets of nurses are tested and pushed to its

absolute limits. These obstacles often bring the true hardship and struggle that

nurses feel. A nurse is defined as the perfect balance of physical and mental

warfare that can simultaneously perform numerous tasks and take care of their

patients at the same time (Oxford University 2012). Nursing originates from the

Latin word “nutrire” and “nutrix” which means “to nourish”. It is said to have

th
existed in the mid-19 century as a form of assistance to wealthy British.

However, in our modern time, the treatment of Nurses is becoming poorer and

along with this treatment are extreme struggles that Nurses feel both

emotionally and physically. The hardships of Nurses are often seen as a one

dimensional-concern that many people considered as a simple problem that

doesn‟t need the full attention and concern of the community. However, based

on the researches of Kelly Gooch(2015) Nurses play an integral role in the

health care industry, providing the care to patients and filling leadership roles

at hospitals, health systems and other organization, but being a nurse is not

without its challenges. It‟s a demanding profession that requires a lot of

dedication and commitment as well as having strong mental and physical

abilities. The

existence of nursing is often regarded by critics and experts as a step forward

towards the improvement of medical industry.

Despite having a patient‟s life as a center in the world of medicine,

nurses who partake in the said process also find these kind of moment as

emotionally draining for the simple reason that they often guilt and sadness

whenever they are held responsible for the death of a patient and having

multiple tasks without having a time to catch their own breath. As stated by

Doctor Philip Nitschke, “Both as a doctor and as a human, we doctors can see

the struggles of nurses and all of the hard work and efforts that nurses do in

their respective tasks, it‟s just that not too many people truly appreciate their

efforts and the community just often think of them as glorified puppet of the

higher-ups”. It is a phrase that many nurses see as a truthful representation in

the life of an aspiring health staff. Nurses in the Philippines also see this as

both emotionally and morally correct as they also feel the physical and

emotional struggle whenever the pressure is becoming heavier for them. As

presented by the Manila Doctors Hospital, “Emotional breakdown and/or

damage are a common thing in the world of medication especially when it

comes to doctors and staff who partake in life-changing surgeries and

procedures”. Mindanao is considered as one of the more frequent part of the

Philippines who is reported to have many cases of struggling nurses.

According to the survey of ResearchGate, “From 2011- 2013 there has been a

raised in a number of reports and media stories regarding decreased

compassion, there are over 15 countries with this reported experience which
includes countries like the Philippines”. This signifies that the physical and

emotional struggles of nurses in Luzon, Visayas, and Mindanao are going

more and more frequent as time goes by. On the other hand, this also means

that many nurses in the Mindanao are somehow more emotionally sensitive

compared to the rest. This claim was proven to be accurate based on the

survey that the Univox Community conducted. As declared by their survey in

2013, “5 out of 10 nurses and doctors in Mindanao has already experienced

emotional breakdowns, and depression after participating in life-risking

activities such as transplants, surgeries and other extra task that forces their

body to use more energy than what they can handle, Many of these said

nurses have stated that they often feel the need of questioning their career

paths whenever they get reminded with all of the struggles”. Some of these

struggles are immense pressure from peers, workplace violence, short staffing,

long working hours, harassment, bullying and more. As a clear generalization,

the struggle of nurses in the Philippines has consistently showed itself to be a

big problem that has already affected the majority of the nursing industry.

There are already numerous reports of nurses going in numerous struggles

whenever they get emotionally and physically exhausted. The fact that nurses

are often seen as “second-fiddle” seems to make it worse as they have no one

to share their griefs and sadness which often leads them in horrible conditions

such as self-harm, self-blame, and worst case scenario, suicide. As the

struggle of nurses continues to exist, nurses who feel emotional and physical

distress and trauma will continue to move forward. It is only a matter of time

before the community and the media takes notice of the dire situation that

waits.
 Purpose of the Study

The overall purpose of this research is to identify if nurses who chose

this kind of path in their life truly feels any emotional and/or physical struggles.

The analyzer also wants to know the coping mechanism that the nurse uses in

order to deal with this problem. Furthermore, the researcher wants to know if

the nurse themselves considers this struggle as a dire issue. Lastly, the

researcher wants to know the overall perspective of nurses on their physical

and emotional struggles.

Research Questions

These questions mainly focus on the physical and emotional hardship that

nurses feels whenever they feel exhausted and drained.

 What are the struggles of public hospital nurses?

 What are the coping mechanisms of the said nurses?

 What are the meanings generated from the study?

Theoretical Lens

These theories mainly focus on conveying the struggles that runs in a

nurse not only in terms of mentally but also physically. These theories will
support the researcher‟s research on highlighting the considered struggles of

nurses.

The Transition Shock Theory by Duchscher, J.E.B.(2009) states that,

new and experienced nurses and staffs are usually connected with different

problems and obstacles that are often presented to them whenever their

burden and strain are too great for them. It postulates that this issue is usually

presented when a nurse is engaged in a broad range and scope of physical,

emotional, developmental, and sociocultural changes that are expressions of

and mitigating factors within the experience of transition. This issue is

completely normal for everyone but its intensity and impact on nurses and

other staffs are intense and sometimes harmful to them. This issue can be

resolved when proper time-off and relaxing is applied to those who experience

it. Some of these issues are the following; Non-stop panic attack, Depression

from too much stress, Doubt in their ability, Confusion on which is right and

wrong, etc. Unfortunately, since nurses are often treated as “glorified puppets”,

this kind of treatment is often hard to apply as a form of solution for these kinds

of issues. This theory also states that it is a crucial topic that needs to be

solved as soon as possible as these forms of struggles could impact the

performance of nurses which could lead on multiple major mistakes or

mishaps.

The “Keeping on track” theory that has been theorized by Renolen, A.,

Hoye, S., Hjalmhult, E., Danbolt, L.J., & Kirkevold, M. (2018) is an emerged

explanatory theory about the process of how nurses handle their main
concern: the risk of losing their own work flow. These three strategies are

usually used by nurses when attempting to integrate evidence-based practices

into their daily work: “task juggling”, “pausing for considering” and “struggling

along with quality improvement”. This theory contributes to the body of

knowledge regarding the clinical nurses‟ experiences with evidence-based

practice. The nurses seeks to minimize work flow interruptions to avoid

decreasing the quality of patient care provided, and evidence-based practices

were seen as a consideration that was outside of their usual work duties.

Scope and Delimitation

This study focuses on knowing struggles that runs in nurses whenever

they feel overwhelmed. The researchers are expected to be prepared for any

situations and adjustments in order to achieve the goal of our research paper.

This study will take place in multiple hospitals in Panabo, Davao, Tagum and

other hospitals who have records of this kind of cases. We will also include

other nurses who have experienced similar kind of problem in their lives. This

study is expected to happen in the month of November-January in year 2020.

Significance of the Study

The significance of our study is that it is an eye-opener to the rest of world on

how the hardship of nurses is more than just a minor inconvenience.

Its significance on the following areas:

Its impact on students is that, this research serves as a constant reminder that

being a nurse and/or a doctor is more than meets the eye. It shows those

students who aspire in becoming a part of the medication world that having a

strong mental attitude and positive outlook on things is just as crucial as being

knowledgeable to different illnesses and its cure. This research also has its

significance in community, due to the fact that this research shows just how

emotional pain and torment these nurses feel every day. The community often

thinks of nurses as nothing more but followers of doctors. However, that is

simply not the case, this research will prove and show the true worth of being a

nurse and how nurses contain themselves when they are in desperate

situation. Another benefit of this study is to those who will experience research

in the days to come, the advantage of this study to future researchers is that it

serves as a symbol on how topics that are not the most well-known can impact

your overall life and career as a researcher. This also shows that the world of

medicine is a topic that is constantly filled with countless facts, ideas, and

cases. It is only a matter of courage on whether a researcher is ready to step

up and take the risk. The most important of all, this study also has a crucial

benefit to those who are nurses. Its benefit on nurses is that this research can

open their minds and make them realize the fact that what their experiencing is

an issue that needs to be resolved immediately..

Definition of Terms

“Angels in the Sickroom” – it is a figurative language which refers to the

nurses

Coping Mechanism – the ways how Hospital Nurses overcome difficulties

Hospital Nurses – these are nurses who practiced their profession in the

hospitals and not hired as private nurses.

Phenomenology – the research design speaks about the lived experience of

people.

Struggles- It is the hardships or obstacles that the nurses have experiences in

Hospital.

Organization of the Study

To show the entirety of this research‟s structure and foundation, the

researchers have carefully arranged these following contents by its own

chapter.

Chapter 1 this chapter shows the background of the study and provides its

different factual data that will then support the researcher‟s purpose along with

the different questions that the researcher‟s will use as the foundation for

Chapter 4 and 5. Also, this chapter consists of different theories and ideas that

have a clear connection to the researcher‟s idea and purpose.

Chapter 2 this is the chapter where the RRL (Review of Related Literature) is

located. This chapter consists of different facts that are carefully arranged to

further strengthen the researcher‟s ideas. Along with this chapter are the

different citations, articles, records, data and other information that can be

found throughout reliable sites in the web.

Chapter 3 is the methodology of this said research. This chapter will show the

procedures and and steps that the researchers will use to seek out their ideal
respondents. This chapter will also identify the type of study that will be used

such as Case Study, Phenomenology, etc.

Chapter 4 presents the result of the interview that has taken place. This

chapter will show the transcription and translation of the useful information and

data that were gathered by the researchers that can potentially support the

researcher‟s objective.

Chapter 5 is the conclusion and discussion of the study that has taken place.

The researchers will comprehend the data that were gathered and answer the

research questions according to their observations and results of their study.

CHAPTER 2

REVIEW OF RELATED LITERATURE

Practicing the world of medicine is difficult, challenging work, immense

pressure from different angles such as responsibilities and conscience, but

despise all of it, nurses and doctors share the tendency to extract more pain

and suffering from their work than is necessary. Many years of observing and

treating nurses and other members of helping professions, have shown that

this need to suffer usually results from efforts to deal with unconscious stress

and efforts towards their job.

Nurse as a Calling

One of the most famous incidents of a nurse handling such immense

struggle and hardship was Sana Goldberg who is a practical nurse that has

authored books that states the struggles and pains of nurses. According to

Goldberg (2010), being a nurse is not just a job but instead is a calling. The
struggles of these said nurses are brutal and continuous for the simple reason

that the longer you endure it the more obvious it becomes.

Mistreatment

As stated by Dellasega, C.A.(2009)“A lot of nurses are often targets of

mistreatment and other form of harassment from fellow nurses and higher-ups

that holds their status as a registered-nurse”. The emotional and physical

distress of nurses was so frequent and numerous that it is now considered as a

natural thing to experience in hospitals. Unfortunately, this difficulty seems to

continue as time progress, the only way of handling this said problem is

through means of personal-healing and relaxing. Many of these problems and

issue are usually found from doctors or nurses that are exposed to too much

work and pressure from their own work. This claim was proven accurate

according to Kelly Gooch(2015) who reported that there are 6 common

reasons why nurses are struggling: compensation, violence in their own work

place, short staffing, long working hours, workplace hazards, and pressure

from dealing with so much responsibilities. New nurses are a prime example of

this kind of struggling experiences as their initial professional adjustment in

terms of feelings of anxiety, insecurity, inadequacy, and instability it produces

is often surprising and unexpected for them.

Health Disorders

Based from the study of Zamanian (2016), nurses experienced a lot of

difficulties and one of those is with regard to their health. Sleep disorders are

the cause of morbidity and mortality and can decrease functional

capacity and quality of life. Nurses, especially those working irregular or

night shifts are at risk for developing sleep disorders. The present study
aims to determine the relationship between sleep quality and health-

related quality of life (HRQOL) as well as quantitative and subjective

aspects of sleep quality in nurses.

Mannerisms as result to Stress and Tiresome

Among these emotional and physical struggles are the strange

mannerism and gestures that nurses and doctors often possess whether it is
hidden or well-known. These are often sited when nurses and staffs are tired

and are looking for a way to personally cope with the issue. In a study,

approximately 15% of the nurse/doctor-patient interactions were labeled as

“difficult”. This difficulty often happens because of the constant unfocused

gestures that nurses and doctors often show despite having many years of

experience in the world of medicine. According to Ranjan, P., Kumari, A., &

Chakrawarty, A.(2015), some of the mannerisms are: patting shoulder,

crossing fingers, wiping sweat constantly, holding hands, nodding and many

more. As noted by the American Nurses Association (2013), “this etiquette

solely relies on the mood of the doctors and nurses which makes it harder to

approach. Considering how nurses and doctors are not the most „sharing‟, this

makes the situation even more complicated than it already is.

These perspectives and views of experts and doctors prove the

existence of this psychological struggle that nurses has to deal with. It plays

with their mind as they continuously struggle in finding any answer to the

problem that revolves around their mental and physical health. The fact that

this issue is basically shrugged off by the public eye seems to only add the nail

in the coffin. Many experience and inexperience nurses falls down because of

the non-stop emotional damage and pressure that they feel whenever they

think of the numerous responsibilities, treatment and pressure that they have to
face constantly. As the previous researches has shown, nurses tries to simply

ignore it and keep it for themselves without realizing the fact that they have

become prone to numerous form of harm such as stress, depression, and

many more. Throughout the years these claims that circles around their life are

proven to be accurate, Despite knowing it‟s extreme

consequences and punishment that nurses has to go through, these well-

versed nurses still continues to do their role and tasks in the hospital while

knowing that sooner or later their struggles might begin to play with their

consciousness once again and cause them more harm than good.

For some experts, it is completely unsurprising, because in their

perspective, the struggles and hardships that nurses feel is completely normal

for it is a so called “test” to those who have what it takes to truly become a

nurse. However, in the perspective nurses, it is indeed surprising, not because

of the fact that they have to deal with this struggling difficulty, but because of

the fact that despite being tired both emotionally and physically, they still see it

as a form of a noble act about enduring all of it and making sure that the health

and well-being of their own patient is much more valuable than theirs.
 CHAPTER 3

METHODOLOGY

This section will discuss procedure that is used in this study. This

include research methods and design, roles of the researcher, informants of

the study, the method of data collection, data analysis, trustworthiness and

credibility, and its ethical consideration.

Research Design

Phenomenology is a theoretical study that focuses on identifying the

lived experience within a specific number of groups. It is commonly used to

clear and notify how the community sees and grasp a certain form of

phenomena. An example of Phenomenology is studying different materials

such as the study of the green flash that happens just after sunset or before

sunrise. A Phenomenology is here defined as “A philosophic attitude and

research approach. Its primary position is that the most basic human truths are

accessible only through inner subjectivity, and that the person is integral to the

environment. This paper discusses the theoretical perspectives related to

phenomenology, and includes a discussion of the methods adopted in

phenomenological research.”(Flood,A. (2010).Understanding phenomenology.

Nurse researcher 17(2)). Simply put, Phenomenology is a study that uses first-

hand experience and comprehensions as its source of information and data.

As the researcher‟s purpose is to fully uncover and understand the emotions of

doctors from different hospitals, the advantageous use of qualitative research

in the researcher‟s topic is the preferred strategy in approaching the complex

subject. As it allows the researchers to approach

both the respondents and the subject‟s view in a broader perspective that can

help the researchers in solidifying their purpose. Since qualitative research is a

method of obtaining information without the use of numerical data. This type of

research refers to ideas, conception, ideogram, attribute and definition of

things rather than estimation and calculation.

Role of the Researchers

As a group of student that wishes to fully explore the world of

medicine and the struggles of nurses, the researchers has identified the

significance and capability that this topic holds for the community. It shows the

amount of possibility that can be uncovered when the subject of medication

and struggles of different staff members is used towards a certain topic. These

procedures will identify the advantages and benefits that this study holds.

Research Locale

The study was initiated at the Maryknoll College of Panabo

Incorporated as form of assessment for the PR1 (Practical Research 1)

subject, however, the proceedings like data gathering, identification of

participants was from the municipality of Carmen, Davao del Norte. The said
respondents are currently assigned in a public hospital in Gaviola/District

Hospital and Carmen District.

Research Participants

The respondents of this research are nurses from different hospitals

and places. This study is generally about identifying the struggles of nurses

whenever they are physically and mentally exhausted. The sampling that is

used in this research is Purposive Sampling and the number of respondents

is 2 to make sure that the gathered data is as authentic and accurate as

possible. According to Creswell, J. W. (1998), Glaser, B. G. & Strauss, A. L.

(1967), these recommendations can help a researcher estimate how many

participants they will need, but ultimately, the required number of participants

should depend on when saturation is reached. Which means that as long as

the researchers have reached their desired results, then the number of

respondents does not hold an enormous impact as long the respondents are

more than 1.

Table of the Distribution of Participants

Hospital Expertise Gender Total Sample

Population Population

Nurse Nurse 1 F 30 1

Nurse Nurse F 11 1

Reliever

Data Sources
 The researchers have scoped numerous articles, data, and sources to

initiate the research. The fount of the research is gathered through means of

interview and other procedures that involve direct interactivity. The

researchers also gathered data from reliable sources on the internet to

strengthen and support the effectiveness of the research.

Data Collection

Data Collection is a study that requires that researchers to gather useful

data and information from their respective respondents. These data are usually

gathered through means of using instruments and different materials such as

questionnaire (Pittman, 2017).

The researchers has identified the needed information and sets out to

approach the respondents that have the knowledge and had provided us with

first-hand experiences and data that had greatly help the researcher‟s

research. Purposive sampling is the technique that was used in identifying and

picking the researcher‟s ideal respondents. Purposive sampling is described

as a selection of sampling units within the population with the most information

on the characteristic interest (Guarte, Jacqueline M., and Erniel B. Barrios

2009). This form of sampling has allowed the researchers to easily identify

their desired subject and had enabled them to make the research‟s point and

purpose clearer and more precise.

Through means of purposive sampling techniques, the respondents were

identified and carefully picked. A letter of permission to conduct this study and

survey towards the participants has been sent to the respondents, with an

appeal of allowing the researchers to continue their survey and observations

on the respective respondents. The said survey was done through means of
video recording and/or audio recording as long as the respondents are in

unison with this request.

This form of data is to be viewed as the survey on the respondents take

place.

Interview- This is the most important part of the study as it allows the

researchers to fully identify the data that the researchers seek from the

respondents. This interview/survey was finished by the use of different tools

such as cellphones. This part had also been done in a face-to-face manner to

make sure that gathered data is as authentic and reliable as possible.

Interview is a conversation with a purpose. It is a form of method where useful

information is obtained though means of face-to-face interaction between the

interviewer and the interviewee. The interview should be planned and should

start with some interest of the interviewee (Bingham, W.V., & Moore, B.V.

(2010).

Data Analysis

Data Analysis is the most complex and mysterious of all the phrases of

a qualitative research, and the one that receives the least thoughtful discussion

in the literature. Thematic Analysis was used in this study because the

researchers identify emerging themes based from the answers of the

participants during the data gathering. For neophyte nurse researchers, many

of the data collection strategies involved in a qualitative project may feel

familiar and comfortable. As it is the process of applying logical approach to

describe and examine a data (Thorne, S. 2008). If quantitative research offers

a more statistical and mathematical procedure on handling a research, the

 researchers instead focused on a more interactive and opinionated approach

on the respondents. The researchers has considered the basis and motif on

why nurses often feel struggles and pressure. The data that were gathered

was carefully monitored and was given a more qualitative approach rather than

a quantitative approach. The taken data has answered the questions and

provided the researchers with the information that they needed.

Trustworthiness and Credibility

This area of trustworthiness and credibility talks about the authenticity

and reliability of the information that the researchers have gathered from their

surveys with the respondents. It is an important factor that determines if your

research is either beneficial or simply fabricated.

Trustworthiness and Credibility is about making specific

recommendations about the integrity of the researchers and the data, the

balance between participant meaning and researcher interpretation, and clear

communication and application of the findings should identify ways in which

these issues are difficult to negotiate within and across different qualitative

approaches (Williams, E.N., & Morrow, S.L. 2009). In the qualitative approach,

the value of your research and data is often questioned if it is authentic or

made-up. To prove the authenticity and accuracy of the researcher‟s data, the

researchers has create an edited and unedited version of the surveys;

however, due to some privacy issues with the respondents, showing the

unedited version will require the full cooperation and permission of the

respondents to make sure that both parties are in full agreement.

Validity and Credibility- The importance of the concepts of reliability and

validity in research findings was a modest distinction between qualitative and

quantitative researchers involving their definitions of research and reliability and

validity (Lewis, J. 2009)

After the interview has concluded, the only modification that was done is the

voice and the censoring of the physical appearance and sensitive information of the

respective respondents; this is to make sure that the privacy of the respondents and

any sensitive information are well protected and hidden. An audio recording of the

said survey was done as well, however, adjustment on the voice and censoring of

sensitive information is the only modification that the researchers had created. Once

again, the researchers have provide an edited and unedited versions of the said

survey, however, the unedited version has not been shown to anyone unless given

full permission by the respondents. The location for the study has taken place in a

local park in a secluded area; however, any adjustment that the respondent asks

regarding the venue has been heard and discussed thoroughly. To make sure that

the respondents feels at ease, the researchers opened the survey by having a simple

and friendly conversation to set the mood and make sure that the respondents feels

comfortable.

The credibility of a researcher‟s study will decide if the researcher works for a

purpose or simply works for the sake of selfishness and arrogance (Bastes-Brkljac, N.

2009). To sump it up, The honesty and worthiness of a researchers study is fully

dependent if the researchers themselves are willing to do it, nevertheless, the forging

of a sensitive data to match your desired outcome is an act that both tarnishes your

study and your role as a researcher.

 Ethical Considerations

In every study, researchers are required to report on the ethical considerations

of their research. Most readers determine if the study was approved by a review

board and if there was participant consent. The researchers should understand these

two important issues, but they also should be aware of other ethical considerations

when reviewing a research article (Connelly, L. M. 2014). As the researchers send the

letter of permission of the nurses, the researchers made sure that any conditions from

the side of nurses and the facility will be listened and discussed. The researchers and

the respondents also discussed the process on how the survey will take place. This is

to make sure that any misunderstanding will be avoided. Any confidential information

about the nurse, the hospital and other sensitive information has been censored, this

is to make certain that the privacy and sensibility of the hospital and the staffs are well

monitored. The use of nicknames in order to cover the names of the respondents has

been suggested by the researchers; however, it is fully dependent on the respondents

if they approve of using nicknames. After conducting the survey, the researchers had

shown the respondents the resulting video and audio recording and asked them if

they have any request regarding the modification of the data. The researchers had

also told the respondents the importance of their participation and its impact in both

the community and the world of medicine. After all of the process has been

concluded, the respondents had sign a letter that proves the authenticity and reliability

of the study that the researchers gathered.

 Chapter 4

RESULTS

This chapter is about the transcription and translation of the data

that were gathered from the interview. These documentations are translated

into English for conventional reasons, however, the original report were still

secured to prove the credibility and authenticity of the research.

This table represents the collected data from the responses of the

informants in different stages that occurred in the data collection. The

contents in the table were carefully analyzed and were arranged properly to

match the researcher‟s ideal subject matter.

The entirety of the gathered data was fully translated and transcribed

to make sure that all the aspects of the gathered data are revealed clearly

and precisely.

Table 1

Struggles of Public Hospital Nurses

Saturated data from the Emerging Themes

Participants

Nurse 1: Ang sturggles jud nga

among gina-again kay ang gamay
nga salary, overwork, and ang pag
deal namo sa among mga katrabah
(The struggles that nurses
experiences are the small salary, Struggles in Salary Insufficiency
overwork and co-workers.
Nurse 2: Ang biggest struggle jud
nako kay ang pakikipag-deal sa mga and Co-workers
doctors og ang gamay nga salary.
(The biggest struggles for me are the
doctors and the small salary.)Ang
akong pinaka-dili jud malimtan as a
nurse kay katong time nga ning
stand-up ko atong doctor nga nag
manage sa amoa para lang dili niya I
discharge ang among duha ka
pasyente. (My most unforgettable
experience as a nurse was the time
that I had to stand up to the doctor
who managed us, so that he won’t
discharge two of our suffering
patients.)

Nurse 1: Ang pinaka dili jud nako

malimtan kay ang katong naa pako sa
Saudi kay naka handle og kanang
pasyente nga kanang biskan gibuhat
nagud nimo ang tanan kay ikaw ra
gihapon ang dut-on or kanang ikaw ra
gihapon ang pasanginlan. (My most
unforgettable experience in being a
nurse is when I was still in Saudi and
I have to deal with a patient that still
puts the blame on me despite the fact
that I did my absolute best.)
Misunderstandings with
Doctors/Patients
Nurse 2: Ang akong pinaka-dili jud
malimtan as a nurse kay katong time
nga ning stand-up ko atong doctor
nga nag manage sa amoa para lang
dili niya I discharge ang among duha
ka pasyente. (My most unforgettable
experience as a nurse was the time
that I had to stand up to the doctor
who managed us, so that he won’t
discharge two of our suffering
patients.)
Nurse 1: Ang positive nga side in
being a nurse is that daghan kag ma
ilhan nga mga tao with different
attitudes and lives. (The positive thing
in being a nurse is that you get to
meet people all over the world with
different attitudes and different lives.) Interaction and Trust
.
Nurse 2: Ang positive jud nga na
encounter nako kay kanang maka ila-
ila ka og biskan kinsa mga pasyente
with different experiences and stories
and ang kanang feeling nga gi entrust
nila sa imoha ang ilang safety. (The
positive aspect in being a nurse is
that you get to interact with different
people with different stories and
experiences to tell. The other positive
thing in being a nurse is the fact that
they entrust their well-being and
safety in your care.)
Nurse 1: Ang pinaka lisod jud nga
experience sa akoa kay ang pag deal
sa mga pasyente nga dili gina
appericiate ang imong efforts and ang
fact nga gina blame gihapon ka nila
biskan gibuat na nimo tanan. (The
hardest thing in being a nurse is the
fact that there are patients out there
that doesn’t appreciate your hardwork Dealing with Patients
and efforts while continuing to blame
you despite giving it your all.)

Nurse 2: Ang pinaka lisod para sa

akoa kay ang co-workers o gang pag
deal sa mga pasyente. (The most
difficult thing for me is dealing with
your own co-workers and patients.)

Struggles in Salary Insufficiency and Co-workers

This part talks about the struggles of low salary and overwork of nurses. It

is believed to be consistent due to the fact that nurses often have the same

struggle that comes back every time. As stated by Kelly Gooch (2015).

Among the struggles of nurses are underpayment, workplace hazards,

overwork, etc. This is to conclude that even though nurses are well versed in

their field, they often experience the same struggles every time which proves

the consistency and repetitive nature of their struggles.

Misunderstandings with Doctors and Patients

This section is about recalling some of the most unforgettable experiences of

nurses. Among these experiences are standing up to their patients and

standing up to those who have a higher position than you. As stated by

Oberle, K., & Hughes, D. (2001). It was concluded that observed differences

between nurse and patients/doctors were a function of the professional role

played by each rather than differences in ethical reasoning or moral

motivation. This is to conclude that the usual interactions of nurses to their

doctors and/or patients are often connected with a strong ethical problem.

Interaction and Trust

Theme 3 is about knowing the positive side of being a nurse. As the interview

has concluded, the apparent benefit of being a nurse is that you get to

interact and gain the trust of the people around you. They get to know the

attitudes and lives of their patients as well as their fellow colleagues.

According to, Laurencelle, F.L., Scanlan, J.M., & Brett, A.L. (2016). The

advantages or benefit of being a nurse is the interactivity and contributing to

your profession which is obtaining the trust and maintaining the care and

assistance to your patients.

Dealing with Patients

This area discusses the difficulties that nurse‟s experience when they are on

duty. There were much difficult experiences that were presented; however,

the difficulty of dealing with their patient is the most frequently showed

answer by the respective respondents. According to Adeb-Saeedi, J.(2002).

Based on the study results it is suggested that whilst it may not be possible to

decrease the demands of the job, the association of nurses to their patients

which has a chance in becoming a negative altercation will still exist.

Improving work conditions and providing greater support to both parties may

assist in decreasing the stress associated with working in the emergency care

environment.

Table 1 is about all the hardships and struggles that nurses has to go though

in their day to day lives. From dealing with their own patients to handling the

authority that their higher-ups poses towards them, these are only some of

the issues and struggles that nurses go through. As stated by Kelly Gooch

(20015), among the problem that nurses experiences are long working hours,

small income and the violence and pressure that is posed by your superiors.

These details along with the facts and data that were gathered in the

researcher‟s RRL (Review of Related Literature) clearly proves the existence

of the struggles that nurses feel.

 Table 2

Coping Mechanisms of Nurses in Term of their Struggles

Nurse 1: Ang motivation nako para

mahimong nurse kay gusto lang jud nako
mag care sa ubang tao and passion lang
jud nako na. (My motivations in being a
nurse are the fact that I want to take care of
people and I consider it as my passion.)

Nurse 2: Ang motivation nako para mapili

ang nurse kay para naa koy ma share nga Motivation in Aid/Passion
knowledge tungkol sa medicine sa akong
pamilya and para makatabang jud ko sa
uban. (My motivation in being a nurse is to
be able to share my knowledge and
expertise about medicines towards my
family and of course to help those who are
in need.)
Nurse 1: Ang biggest sacrifice nako nga
nahimo kay everytime nga dili ko maka
spend og time sakong pamilya tungod sa
akong trabaho. (My biggest sacrifice is the
fact that I can’t spend some time with my
own family due to work.) Family Motivations

Nurse 2: Ang pinaka dako jud nako nga

sakripisyo kay kanang dili ko maka bonding
sakong pamilya tungod sakong trabaho og
tungod kay abroad ko. (My biggest sacrifice
is that I can’t properly bond with my family
because of my work and because I’m an
OFW( Overseas Filipino Worker)).
Nurse 1: Ang daily routines sa nurse kay
dapat active lang jud ka kung mag start
imong shift sa 7:30 then expect na nga
mahuman imong shift around 9:00 without
resting na minsan. (The daily routines of
nurses goes from 7:30 in an average and
usually ends at around 9:00 without resting,
you also need to make sure that you’re
active as well.)
Actively Attending Routines
Nurse 2: Ing-ana pud ang amoa sayo mag
start imong shift then gabii najud na or
worse kadlawon and siyempre most of the
time walay resting ana. (It’s basically the
same as mine, once your shifting or routine
starts at morning then you better be ready
to end your shift at evening or early in the
morning without rest and being active as
well.)
Nurse 1: Para ma-overcome nako akong
mga struggle kay prayer nalang jud and
being optimistic. (My way of overcoming
my struggles is through means of prayer
and just having a positive mental attitude.)

Nurse 2: Akoang pama-agi kay thankful

lang jud ko sa akong mga experiences then Prayer and Positivity
positive lang jud and never give up lang
nga attitude. (I’m just thankful everytime
regardless of my day and overall just be
positive and never give up regardless of
the problem.)

Motivations in Aid/Passion

This area is all about the motivations of why people choose the profession of

being a nurse. As the result suggest, one of the main driving motivation of

most nurses is to Aid those who are in need and the Passion for taking care

of other people. There are also other factors that may contribute to the

motivation of being nurse, however, Aid and Passion is the usual pick for

aspiring nurse. This claim is proven to be accurate for as according to Toode,

K., Routasalo, P., & Suominen, T. (2011), there are usually five categories of

factors that affects their work motivation, among these factors is (3) personal

characteristics and (4) internal psychological states that often postulates to

selfless acts and helping others.

Family Motivations

Theme 2 is all about identifying the sacrifices that nurses has to do in order to

continue serving others. According to Rebecca Mowat, R.N., & Jarrod Haar,

B.M.S. (2018) one of the most significant is the sacrifices within the family

such as being separated to their loved ones. Along with the data that the

researchers have gathered, it is concluded that one of major thing that a nurse

has to perform is the process of sacrificing their bond with their family.

Actively Attending Routines

This section is about the usual routines of nurses in their work. As the study

suggest, public hospital nurses often has long routines of shifting that is

sometimes considered as an act of overworking without extra payment or

salary to the nurses. As concluded by Caruso, C. C. (2014). Shift work and

long work hours can increase the risk for reduced performance on the job.

Fatigued nurses also endanger others during their commute to and from work.

This section proves that the long routine of nurses often leads to fatigue that

can have a negative result on the nurse.

Prayer and Positivity

This part talks about the procedures of how the said nurses overcome their

struggles. This is to be expected that the usual coping mechanism of nurses

are prayer and positiveness. This is proven to be precise as according to the

study of Raja Lexshimi, R., Tahir, S., Santhna, L. P., & Md Nizam, J. (2007),

the five coping mechanisms adopted by nurses were identified. Prayer

(100%), relaxation (100%), Physical exercises (35.7%), Ventilation and

alacrity of their feelings (60%) and the (35.7%) of nurses who takes rest in
between work. This study concludes that Prayer and Positiveness are the

often coping mechanisms of nurses.

Table 2 is about the motivations and sacrifices that nurse‟s experience. Along

with these experiences are the coping mechanisms and routines that the

nurse often uses to deal with their hardship and struggles. According to Hart,

P.L., Brannan, J.D., & De Chesnay, M. (2014), these kinds of reviews provide

about the concepts of resilience.Becoming aware of contributing factors to the

need for resilience and successful strategies to build the resiliency that cam

help in recruiting and retaining nurses.

Perspective of Nurses in their situation

In their point of view, being a nurse is all about passion and the desire

to selflessly take care of people. As they have said in the interview “If you

don‟t have any passion for taking care of your patients then you‟re not a

nurse”. This simply proves that despite having to experience all of this

struggles and hardships, they still see this not as a job but as passion and

with this passion alone, they are more than confident that they can take down

any struggles that stands in their way

 Chapter 5

DISCUSSION AND CONCLUSION

This chapter talks about the overall discussion and conclusion of the subject

matter that‟s established in the outcome of the said study. Furthermore,

further discussion of this topic has been given full importance and attention to

fully understand the experiences that nurses go through. In short, the

gathered data from the discussion is connected to the researcher‟s question,

purpose and desired answers.

In this lens of study, nurses from different hospitals who have already

experienced the struggles and hardships of this said occupation are the

respondents that were carefully picked by the researchers. In this research

that was conducted, these are the following qualitative questions that were

answered.

 What are the struggles of public hospital nurses?

 What are the coping mechanisms of the said nurses?

 What are the meanings generated from the study?

1. What are the struggles of hospital nurses?

The struggles of public hospital nurses are the interaction and dealing with

their patients, doctors, and co-workers. There are also other factors such as

overwork, and small salaries. Be that as it may, these are struggles that come

across towards anyone that wishes to take the path of being a nurse or being

a part in the medication industry. These struggles are often presented as all

natural and expected, however, its impact on nurses is undeniable.

2. What are the coping mechanisms of the said nurses?

The quintessential way of nurses in order to deal with their struggles is

through means of having a positive mental attitude and prayer. This form of

coping mechanism is especially effective to nurses who are travelling abroad.

It plays a major role in the well-being of nurses as it is their only form of stress

reliever in an industry that‟s filled with pressure and hardships.

3. What are the meanings generated from the study?

To them, struggles and hardships that nurses and/or other staffs experience

is simply a part in being invested in the world of medicine. Being a nurse is

not all about memorizing different illness and its cure; it‟s also about having a

strong physical and mental game that could strengthen your perspective and

outlook in your career despite taking some the most grueling and prolonged

exposure to pressure. All of this experiences that have played with their well-

being is but a proof that their passion and will to continue their career will

always prevail.
3. What are the meanings generated from this study?

The overall meaning of this study is that it seeks to uncover the true

experiences of nurses in their lives. This research seeks to inform the

community that even though this kind of situations are not the biggest of

issues in our society, it is still a circumstance that needs to be inspected and

seek to maintain the well-being and mentality of our dear nurses. After all,

what would become of us if those who care for us are not in their best

shapes? The entirety of this research is all about acquiring the attention of the

community and those who dreams of being a nurse that there are so much

more to this kind of field.

Conclusion

Taking the career path of being a nurse is more than meets the eye, being a

nurse is not just about knowledge and expertise towards your respective field,

it is also about preparing yourself in facing the struggles that nurses has to

experience just to continue their desired career. The entirety of this research

proves that being nurse is all about having the willingness and passion to take

care of someone and allowing them be in good health while experiencing

numerous struggles and problems in their life. All of the results and

information that the researchers have gathered is a verification to the fact that

nurses are truly one of a kind.

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APPENDICES

Appendix A – Communication Letters and Consent

Appendix B – Research Undertaking Documents
Appendix C – Research Conduct Documents
Appendix D – Research Files CD
Appendix E – Research Snapshots
Appendix F – Curriculum Vitae