Posted: December 4, 2018
With busy and somewhat erratic schedules, demanding classes and clinicals, and the pressures of balancing everyday life, nursing school can be a challenge, even for the best of students.
At the University of Kentucky College of Nursing, a movement is afoot to not only teach students, faculty and staff about how to deal with stress and anxiety but also provide tools to do so. The undertaking is part of a larger campus-wide strategic goal to develop “Work-Life Balance.”
In response, the College of Nursing last year approved establishing a Work-Life Engagement Ambassadors Council for faculty, staff and students to meet monthly and develop recommendations and implement projects that would help everyone at the College find healthy ways to deal with the inevitable strain that training to become a health care worker brings.
The most tangible result is the Cultivating Practices for Resilience (CPR) room, which opened October 2017 on the sixth floor of the College of Nursing. Located in a corner of the building with full-length windows that overlook the campus, the CPR room is dedicated to helping alleviate stress and anxiety. Exercise balls, mats and foam rollers are neatly stacked in one area, leaving open space in the middle of the room to practice yoga, tai chi or meditation. A large-screen smart TV on one wall allows visitors to choose instructional videos if a class is not in session. A rocking chair sits near some plants, and a small fountain adds to the relaxing ambiance.
A gift from two private donors with interests in building healthy working and learning environments jumpstarted the project, says Janie Heath, PhD, APRN-BC, FAAN, FNAP, FAANP, dean and Warwick Professor of Nursing. The Office of the Provost also approved the space so that all six health science colleges’ staff, faculty and students were welcome to participate in CPR room activities.
“A healthy work place is critical to our own well-being and also to the well-being of the patients we serve,” says Dr. Heath. “Dr. Debra Anderson, former director of Work-Life Engagement, was instrumental in pioneering this effort in alignment with our strategic goal to foster and maintain a safe and inclusive environment.”
To accommodate everyone’s busy schedules, early riser and lunchtime yoga classes were added in the spring and can also be viewed online for those who aren’t able to leave their office.
Nursing student Nina Loleng, a recent BSN graduate who served on the Work-Life Engagement Ambassadors Council, was a proponent of the mission and provided the artwork and motivational sayings on the CPR room walls.
“Students’ schedules are so packed with classes and clinicals,” says Loleng. “Because our schedules are so varied every day, it’s hard for us to do things like join clubs. This is a nice alternative because it gives us a chance to do something together between classes that is not school related and addresses the stress we are feeling in our lives.”
Another component of cultivating practices for resilience in addition to the CPR room are events and activities aimed at reducing stress, says instructor Dr. Suzanne Pilon, DNP, RN, who is a member of the Work-Life Engagement Ambassadors Council.
Dr. Pilon works with different pet therapy groups—Love on a Leash, Four Paws for Ability, the Wildcat Service Dogs, Chandler Medical Center’s Activity Department—to bring in therapy dogs and cats during stressful times.
“We usually have six to 12 dogs that show up, and our students, staff and faculty have time to visit with them, pet them and receive unconditional love,” Dr. Pilon says. “We do it on the third floor of our building, and people in the Kentucky Clinic can look over through the windows, see what we are doing and come over and take part. It’s been a big success.”
Dr. Pilon says she tries to host a pet therapy event at least once or twice a semester.
“I try to do it during finals week every semester, and other times, too, like at the end of the fiscal year, which can be a stressful time for staff,” she says. “Especially in the stressful times, you need a reminder to take a moment, relax and breathe, and then you can deal with whatever you are dealing with a lot better.”
The Work-Life Engagement Ambassadors Council also sponsored a lavender bag project, where students who were struggling were given a satchel containing motivational verses, lavender oil, lavender tea and chocolate. “It just reminds them that there are people who support them, are thinking of them and want to help them,” she says.
Lee Anne Walmsley, PhD, MSN, RN, assistant professor and interim director of the Work-Life Engagement Ambassadors Council, says cultivating practices for resilience is the first real acknowledgment that it’s necessary to formally incorporate strategies to reduce stress and anxiety at college.
“Before, if you wanted to do any type of relaxation or strategies, even for test anxiety, it was more that you were supposed to refer students to the counseling center,” she says. “It was like there was something wrong, rather than normalizing it and preventing it.
“Now, there’s a new drive in health care to work on improving resilience in students,” she continues. “It’s an acknowledgment we live in a stressful world and that that is just part of our existence, especially in health care.”
Health care education presents a unique challenge because most students who want to pursue a career in the field have been very successful in their previous academic endeavors. What students in the College of Nursing and other health sciences colleges quickly discover is a steep and rather unforgiving learning curve.
As an example, she talks about the checkoffs required in the simulation lab before a student can do anything to a patient. “You fail a competency exam if you miss any particular point,” she says, recalling a student who forgot to introduce herself to the patient and did everything else right, but failed the competency because of that oversight. “The stakes are really high because they have to be. In health care you can’t make a mistake, or somebody suffers.”
For example, Dr. Walmsley says that with nurses taking care of multiple people and giving drugs to multiple people, it’s very easy to walk in and give the wrong drug to the wrong person.
“And that’s been proven over and over and over,” she says. “So, we have system now, and you cannot miss a loop.”
For most students, it can be the first time they have ever failed at anything in their lives, Dr. Walmsley says, and sometimes the fear of failure in itself becomes paralyzing.
Teaching them to deal with that stress and anxiety, as well as other life stressors, is what the Work-Life initiative at the College is all about, she says. “We are promoting— and dedicating faculty and resources to—a formal CPR room where students can go do things like yoga, tai chi and meditation,” she says. “We’re building the program, bringing in different kinds of practitioners; we are trying to create a space where students can go.”
Dr. Walmsley, who also has an EdS in psychology, says they are also raising awareness among faculty that students need support in a positive way rather than thinking when a student is anxious or depressed that the only solution is to send them to the counseling center.
“Absolutely direct them to a health care worker if someone is having a crisis or is showing symptoms of clinical anxiety or depression,” she says. “But just in a general environment where there are high expectations, we are trying to create a culture where people recognize that normal everyday stressors are real to students.”
Dr. Walmsley says her vision is that every nursing student be formally trained in basic relaxation, meditation and enhancing resilience. “Ideally, they would take it in to their patients’ rooms and help them increase their resiliency with some of these basic practices,” she says.
The College also began a new tradition in the spring, a Circle of Remembrance gathering, to recognize and honor those who may have suffered an illness, injury or even a loss of a family or friend, this past academic year. Faculty, staff and students left heart-shaped notes on the Compassionate and Caring Trees.
Loleng says her own resiliency was the result of having support, and she wants to pass that on to others.
“I really love nursing and everything I am learning about,” she says. “But it is so taxing, emotionally as well academically. I have had people around me to help me get through the hard times. I want everyone to have that and a place to go that addresses mental health in an open way. Because in order to take care of others, you have to first take care of yourself.”