Stress Management Is Key During Nursing School

Maureen E. Davis, MSN, RN, BC
Clinical Instructor in Holistic Adult Health
School of Nursing at the University of Texas at Austin

One important thing that I always tell my students is to take care of themselves. If they cannot take care of themselves, how will they be able to take care of the clients they encounter throughout their nursing career? Nursing is the one profession with the most "dropouts." Nurses change careers because of high stress levels or "burnout," which is synonymous with total exhaustion.

Nursing school is very stressful. Students experience increased tension prior to their clinical rotations or their written examinations, especially their finals. The major sources of stress experienced are interpersonal relationships and performance demands. Nursing school is very demanding with its paperwork and skill performance. Multiple stressors combine and result in cumulative stress. Research shows that catastrophic life events correlate more highly with subsequent illness than joyful life events.

Nursing students need to assess their stress levels and determine what will decrease their tension. Important ways to reduce stress include avoiding change, blocking time, becoming skilled in time management, and setting goals. To avoid change, we need to try to keep the same routines. I always tell students to eat before a clinical rotation or an examination. Even if they have no time, just taking one minute to place a tablespoon of peanut butter in their mouths will give them some protein and energy to perform better.

The second important point is taking time. Take time to address important goals. For a student, setting aside a block of time to study before an examination or setting aside time to complete a client database for a clinical rotation are important. Cramming for the examination or staying up all night to complete a client database will increase anxiety, frustration, and chances for failure. Scheduling fun time is also important. You need to leave the hospital or the nursing school environment behind at times and enjoy something that will bring happiness into your life. This will make it easier to come back to the school or the hospital. Go out, explore creation, and enjoy the sunset, or go home and enjoy your family or a special relationship.

Spiritual resources also help the student nurse to adapt to stress. I enjoy singing with my church choir. We always have a special concert before the Christmas Eve service, when all of the choir members dress up in their finery and sing beautiful Christmas music. The choir members support me spiritually and emotionally in many projects that I have completed. My friends were my walking and running mates during the 2002 Relay for Life in Austin, for which I was the chair. In 2003, they helped me plan the Luminaria ceremony [explain what this is?] and participated again during the Relay for Life.

The third way to reduce stress levels is time management. Establishing goals and having the time available to accomplish those goals are important. Tasks can be reduced into smaller parts. Tasks not related to school can be delegated to other family members or delayed in favor of more important tasks. Avoid waiting too long to begin a task. This will only increase anxiety and tension. Schedule activities-this will increase positive tensions and promote growth. Forget those all-nighters! Get control over the situation. Make time in your schedule for studying and sleeping at night, and eat during the day. I carry many small snacks such as nuts, cheese, and vegetables (little carrots and tomatoes), which I can eat throughout the day when I know I will not be able to sit down for a meal. You can place snacks in plastic bags the night before a clinical rotation or a long school day.

Exercise is a wonderful stress reducer. I have made that the priority in my own life. Schedule 30 minutes of vigorous exercise three times per week, and you will increase your strength and stamina, which are needed in nursing school. I cannot stress enough the importance of taking care of yourself. My family has been a great support to me physically and emotionally. Although my family members live far away, we are close. We call one another often, plan family reunions, and take vacations together. These are very special and joyful times of my life.

Create a strong social support network. Friends and family can provide encouragement and emotional support. Create a relationship with someone who can be your mentor, someone who will not only encourage and support you but also give advice about your nursing career and guidance to achieve your goals in nursing school, advice that you will fall back on throughout your nursing career. I have had many incredible mentors throughout my nursing career. I would not be where I am today, a clinical instructor of holistic adult health, without these mentors. Visit your teachers, and ask for feedback about how you are performing. Teachers can help with developing your clinical assessment skills. Use your health resources at school. Visit the skills laboratory to gain competence in your nursing skills. Visit your coordinator of learning enhancement to discuss test taking strategies or help establish goals to reduce stress. Establish supportive relationships with your fellow students. You can help each other to deal with stress, encourage each other, and provide emotional support during those stressful times in nursing school.

Do plan ahead for the holiday overload of stress. Make room in your calendar for those important people in your life. Turn down requests and people who make demands on your life. Get plenty of rest and sleep during the holidays, and take care of yourself.