Guided Imagery for Stress Reduction in Graduate Nurses Transitioning into Practice

Abstract

Research has shown that the transition from graduation to practice is very stressful, resulting in high new graduate RN turnover rates in the first year of employment. The aim of this study was to investigate using guided imagery to reduce stress levels in new graduates as they transition to the role of the professional nurse. This study examined the effect of a guided imagery with background music session on stress in a group of new graduate RNs compared to a control group who listened to the music only. A repeated measures experimental design was used to examine the effect of the intervention/control using objective and subjective measures of stress taken immediately before and after each of the 2 live sessions. Thirty-six nurses, employed in positions requiring an RN license for less than a year completed the study. All but one were in an employer-sponsored nurse residency program. After consent was obtained, participants were randomly assigned to the guided imagery or music-only groups. They then completed a demographic survey, the Short Betts QMI that measured imaging ability, the Perceived Stress Scale (PSS), and Visual Analog Scales (VAS) for feeling stressed, anxious, calm and relaxed. Next their blood pressure and heart rate was measured. Participants then listened to their assigned recording and afterwards had BP and HR measured and completed another PSS and VAS. At the end of 3 weeks of listening at home, participants came back for a follow-up session. Data were analyzed using mixed analysis of variance (ANOVA). A significant difference in diastolic blood pressure was seen over the four time periods, favoring the guided imagery group. Both groups experienced significant improvement over time on the PSS and VAS, however there were no significant differences between the two groups. This study also showed that at baseline, even within a nurse residency program, participants reported moderate stress levels on the PSS and VAS. Consequently, providing tools for stress reduction early in a nurse’s career may be a means to proactively combat workplace stress, especially during transition to the professional RN role.