Primex trainees under stress.

In summary, it seems clear from the data presented in this report that nurses engaged in becoming a family nurse practitioner in the program studied undergo a considerable amount of social, physical, and psychological discomfort. However, the data on the first class trained does suggest that the psychological and to a lesser extent the physical stress students experience during formal training subsides during the preceptorship. Nevertheless, it is out contention that certain stressful periods in training cannot be avoided because of the nature and intensity of the course content as well as the role change necessary for becoming a responsible, dicisive practitioner. Yet, experience with training two classes does suggest that although high stress probably cannot be avoided, at least the length of intense periods can be shortened. In order to accomplish this, it is necessary to have a curriculum which is well-organized, clear in its purpose, and one which provides the opportunity for tension-release, discussion and development of role, and emotional support. Finally, with regard to the perisitence of social stress both during and after training, there appears to be a need to provide continued support to students during their preceptorship in order to assure that role change and development continues. In this regard, periodic continuing education sessions for students seem crucial as do discussions of role with both students and preceptors. As the family nurse practitioner role evolves, it becomes increasingly clear that at times these new health professionals are neither doctors or nurses and at other times they are both. However, nurse practitioners cannot meaningfully sustain their new and somewhat ambiguous role without the mutual cooperation and support of both the medical and nursing establishments in which they practice.