6 Tips to Help With Final Exam Stress

6 Tips to Help With Final Exam Stress

If the thought of your nursing school final exam schedule has you harried and anxious, it’s time to take a step back and figure out some tricks to help you get through this very stressful time.

1.Get Help

If you don’t understand some of the material you know will be on the final exam, schedule an appointment with your professor or a tutor before your exam presses down on you. Studying for finals is about reviewing the information (and a lot of it!). This isn’t the time to try to learn information on your own that you are assumed to know. Don’t wait until the last minute.

2. Assess What You Need to Do

Don’t panic over things you can’t control. Start your exam preparation by getting organized. Figure out what your exam schedule is, what needs to be done so you can get ready, and what time you have available for studying. Make task lists for each class so you don’t forget anything. If you know what it all looks like, you’ll be more in control.

3. Gather Your Equipment

Equipment isn’t necessarily pens and paper. You need all that (index cards to make flash cards, gum for stress, and a little bit of chocolate!), but take a look at the bigger picture, too. Decide what you need to study best. Can your professor recommend any additional materials to help you study for the specific subject? Do you need any books ordered from the library to help you out? What about online resources you can access to boost your studying?

4. Take Care of Yourself

Pulling an all nighter isn’t going to make things better. It’s going to make you a cranky student who is more prone to falling asleep and forgetting important points. Eat well to keep your energy up, exercise to blow off steam, take the time to relax so you can recharge, and get enough rest. If you stay up too late one night, try to fit in a short nap the next day.

5. Study With Others

Try to meet up with a study group or at least one other student for each class. Just talking about the subject, writing down notes, and revisiting tough points or applications can help you remember the information better. Someone else might have some excellent study tips or resources you might find helpful as well.

6. Get to Work

Don’t jump from subject to subject. Block out several hours and devote that time to one specific class. But don’t study for five hours without a break. That will set you up for overload. Plan a certain amount of study time, fit in a 10-minute break, and then get back to studying. Remove all the things that might normally distract you. Put your phone away, and turn off the TV and radio if they interrupt you. Try not to think of all you have to do. Just start working and checking tasks off your list.

With a little organization and a lot of dedication, studying for finals will be manageable. Good luck!

When Faced with Discrimination, Practice Mindfulness

When Faced with Discrimination, Practice Mindfulness

A patient calls you a racial slur.

A coworker makes a racially charged statement.

A family member makes a racial joke and anticipates you will laugh with them.

How would you respond to such hurtful comments? Do you respond by confronting them verbally? Do you scold them? Or do you contemplate responding to them in a physical manner? All these thoughts may race through your head, running through your synapses. But what is it that is released by your body? An action or a word? Or do you say nothing and keep such pain within? What is the best course of action of the nurse?

One of the highest tenets of nursing is caring. How do you find it within yourself to care for individuals who verbally express racial hatred? Have you ever utilized self-awareness or mindfulness to combat such behavior? This means being aware of yourself, others, and the environment surrounding you. This also translates into one being keenly mindful of their emotions. Although such behavior may cause feelings of anger or sadness, one can begin to understand the cause of emotions and how one’s outer and inner circumstances triggered the emotion and may lead to the amplification of it.

Instead of going along with an overpowering emotion, we need to seek higher ground from which to look upon that feeling. This does not mean flattening our emotions or being emotionally numb. Brooding exploits one’s previous feelings, only illuminating hatred. On the other hand, analyzing the source objectively allows one to take such energy as they run out before us like ‘scouts,’ simply telling us about the world instead of dictating one’s behavior. Instead, you become like an artist who is keenly aware of their emotions yet can share their emotions through their art. Therefore, life becomes a work of art.

Arthur Zajonc, author of Meditation as Contemplative Inquiry: When Knowing Becomes Love, talks about great individuals who learned to practice such self-awareness. He explains of Mandela and the Dalai Lama being able to “carry not only their trials but also the burden of those under their care…with grace and lightness that belies the fullness of their heavy hearts…because they discovered the secret of empathetic knowing and equanimity when confronted with suffering.”

Once during a reception, a reporter pressured the Dalai Lama to comment regarding his opinion of those who had killed monks and nuns and destroyed monasteries during an invasion of Tibet. Instead of speaking out in anger he admitted that the loss of Tibetan autonomy was a tragedy. He then spoke of how the loss and suffering of his kinsmen were painful and should be stopped. He concluded that he would do all within his power to regain the self-rule of his nation. The Dalai Lama describes a contemplative exercise where he pictures the suffering of his people at the hand of Chinese offenders but also sought to look at the viewpoint of these Chinese soldiers as they saw themselves. They felt they were liberating the Tibetans from a religious tyrant. They believed the Tibetans to be ignorant in their belief of a god-king, the Dalai Lama. Therefore, he did not view the soldiers as evil despite their actions being violent and hateful. The Dalai Lama did not respond to the reporter without rage but instead provided a lesson in seeing through to the possibility of good in one’s tormentor.

Likewise, Nelson Mandela, after 20 years of incarceration, did not seek out revenge against those who imprisoned him. Rather, he effaced ethnic strife and Black Nationalism to affirm the humanity in everyone of every color. He did this with the goal of having the white minority have equal opportunity in government, the security, and the rights to land as the oppressed black South African majority. He displayed faith in the whites and blacks of South Africa and did not seek retribution. Rather, he saw the highest in those who oppressed him so that he worked with the government to create laws of inclusion and reconciliation, rather than exclusion and revenge.

Zajonc concludes that “in every situation, there is something worthy of the human being.” The self-aware nurse can acknowledge the negative, but not the negative alone. Therefore, the negative and unjust act is not allowed to blind the nurse who practices self-awareness. That nurse is still able to see the hidden good within each and every individual by upholding the ‘noble dimension’ of the individual who makes a racist comment or act. This is described as displaying faithfulness to the humanity of every individual.

The next time you are confronted with a discriminatory comment or behavior, consider practicing mindfulness. It is an evidence-based practice proven to raise one’s awareness of one’s emotions and sensations in a situation. Experiencing discrimination is associated with increased incidence of depression. However, according to a 2014 study published in Personality and Individual Differences, adults experiencing discrimination who reported high levels of mindfulness had fewer symptoms of depression. Mindfulness is thought to enable individuals to separate experiences from a sense of self-worth.

A decade of research has found mindfulness to be associated with regulation of emotional responses, reduction of anxiety, increased empathy and perspective-taking, and increased gratitude and well-being. As a result, perhaps we can conquer a similar perception to Nelson Mandela and the Dalai Lama. By practicing mindfulness, one can maintain peace of mind and with those who may make unwholesome comments of any nature.

Standing Too Much? 5 Ways to Ease the Aches

Standing Too Much? 5 Ways to Ease the Aches

Do you chuckle every time you hear how bad too much sitting on the job is for your body? The last thing most nurses have to worry about is sitting too much. With packed days, nurses look forward to the few minutes they have to sit down.

But did you know standing too much during your workday isn’t good for you either? You might hate to hear it, but it makes sense. Hours and hours of being upright stresses your legs and back by increasing pressure and overtaxing certain muscles.

What can you do to help counteract all the hours on your feet?

  1. Take Care of Your Whole Body

Standing can make your back hurt, but having a tighter core can help counteract the strain on that area. If your core muscles are tighter, your back will be straighter and more aligned if you make an effort to stand tall. You’ll feel the relief in your lower back. Keep your core tight with Pilates and yoga, or other core-strengthening exercises like planks or good old-fashioned sit ups.

2. Keep It Loose

One of the toughest parts of being on your feet all day is the way it tightens up your whole body. Add in the lifting and pushing you might be doing during the day, and you can really strain parts of your body that are pretty far away from your feet – especially your neck and shoulders. Periodically stretch your muscles throughout the day. You don’t have to do anything obvious. Just a few neck rolls, calf stretches, and lower back loosening stretches can help combat the inevitable strain of standing so many hours.

3. Be Nice to Your Feet

Not many nurses worry about wearing cute shoes for those 12-hour shifts, so paying extra attention to buying shoes that fit your own feet can make a huge difference in how you feel. Shop around (and ask your co-workers!) for shoes that offer enough support and fit your own circumstances. Are you knock-kneed? Do your feet turn out? Do you have high arches or no arches? All of those characteristics will change the support you get from your shoes. Make a good choice and your whole body will thank you.

4. Take a Break

This might not happen very often, but if you can sit down to take a break, do it. If you’ve been on your feet for six hours, sitting down for 10 minutes will do wonders for resting your body. Bonus points if you can manage to put your feet up!

5. Home Care

Sometimes, you’ll have a week where the only time you sit down is your commute home. Keep relaxing good-for-your-body home care items that are easy to do at home. Chill peppermint foot lotion (or make your own with peppermint essential oil and some of your regular lotion) in the fridge for instantly uplifting relief. Spritz cooling water on your feet and legs (add your favorite essential oils to the bottle if you want) and try to elevate them for a little bit. Use a couple of tennis balls to roll under your feet when you’re sitting down to stretch all the tendons and make your feet feel good. Keep a heating pad at the ready to offer warming relaxation to your neck, shoulders, and lower back.

Nurses can’t avoid lots of standing. And truthfully, the standing and moving you do is probably a lot better than sitting at a desk all day. But that doesn’t mean it always feels good. Take some precautions to care for yourself and to prevent any problems from developing or getting worse (for instance, get any sore veins checked out) because of all that time on your feet. And when you get a chance, treat your body gently to help it recover and refresh.

5 Ways To Stay Sane When Dealing With A Difficult Patient

5 Ways To Stay Sane When Dealing With A Difficult Patient

Working as a nurse at a care center requires skill, patience, kindness, and determination. Most nurses work long hours on their feet all while protecting people’s lives and caring for them when they’re sick.

In many cases, nurses choose their profession because they want to take care of other people, but some patients can make being a nurse very difficult. If you have an angry, whiny, or manipulative patient, use the following tips to make the best of a bad situation and protect yourself and your sanity.

1. Listen Empathetically

Remember that the things you are used to dealing with every single day are new, scary, and unusual for your patients. Remember that they are uncomfortable, in pain, and confused. Take time to empathetically listen to their concerns. Some patients just need to know someone cares about their concerns. Other patients may have valuable information or valid concerns—taking your patients seriously will help you take better care of them and make them feel more respected.

2. Use Professional Body Language

When you’re interacting with a patient, maintain eye contact, use good posture, and avoid unprofessional body language. Rolling your eyes, putting your hands on your hips, and shaking your head may feel justified, but negative body language can make a bad situation worse and make your patient more angry. Remain calm and professional, even when you know you’re in the right.

3. Keep Accurate Records

Meticulous records will help you counter the claims of a manipulative patient and calm down a stressed or frustrated patient. Keeping accurate records is important for the health and safety of the patients, and it will make your job easier.

4. Make Time To Explain What You’re Doing

While your expertise means that you do some of the same things every single day, patients may be feeling scared and confused. Take a little bit of time to explain what you are doing and why. This can help ease your patient’s nerves.

5. Manage Your Own Stress Levels

It is harder to be professional and empathetic when you are stressed out, tired, or hungry. Manage your own stress levels using these tips. For more help managing your stress, take deep breaths when you are angry, go on breaks when you can, listen to music that relaxes you, and talk to friends and colleagues.

Dealing with difficult patients may not be the best part of being a nurse, but you can do hard things, especially when it involves best practices for the benefit of your patient. Use the tips above to make your job a little easier.

Using Spirituality in Health Care

Using Spirituality in Health Care

What is your first reaction to using spirituality in health care? Fear of offending someone, or maybe fear of being recruited to go to worship services? Or, perhaps you would be concerned that a coworker would proselytize and preach to all your patients. In times of legitimate concerns about religious divisions, it is easy to ignore the spirituality and focus on caring for physical health. Yet, in doing so, we are doing a disservice to patients. As nurses, we care for the whole human being, and therefore, we need to wrestle with how to use spirituality in health care.

In discussing spirituality and health care, we need to address four points:

  • What is spirituality and what are spirituality’s effects on health?
  • What are the pitfalls of using spirituality in health care?
  • How do I deal with my own uncomfortableness?
  • How do I integrate spirituality in my daily practice?

Defining Spirituality

Spirituality is such an individualized experience that an exact definition is difficult to formulate. Spirituality does not have to be associated with an organized religion, though for many, spirituality and religion are synonymous. Most definitions say that spirituality is the search for a higher power or a divine purpose in life. This search can be as varied as there are people who have engaged in this search.

Despite this difficulty with an exact definition, we as nurses can know an individual’s spirituality by its effects on the individual’s health. Harold Koegnig at the Duke University Center for Spirituality, Theology, and Health and other researchers have shown that spirituality has three main effects on health. Spirituality can 1) provide meaning to life as a patient copes with illness and suffering; 2) help patients find social support when coping with the effects of illness; and 3) help promote healthy choices and behaviors. Though the studies vary in method and scope, there is a preponderance of evidence that patients who have spirituality are healthier than those who do not have spirituality. In short, it works.

The Pitfalls

There are pitfalls to spirituality. People have strong attachments to their spiritual beliefs. Even those who profess no spirituality, such as atheists or agnostics, strongly identify with their lack of beliefs in a higher power. Such strongly held beliefs can create defensiveness. A patient can react negatively to a well-meaning health nurse who unknowingly offends the patient. The nurse instinctively reacts defensively. This starts a cycle of poor communication and bad feelings. It does not take many such occurrences to make a nurse shy of discussing, let alone using, spirituality in health care.

Nurses themselves tend to have a strong spiritual background. Why else would we choose such an altruistic profession if it did not involve, at some level, spiritual reasons? When we are faced with a patient who does not have a spirituality, we want to provide comfort. We start to engage in giving advice to such patients. While this may seem helpful, it can come across as superficial to others who do not share our experiences. It builds up a block between the patient and caregiver. Spirituality develops through a lifelong process involving integration of meaningful life experiences. Advice offers a shortcut through this process when we really need to honor the patient’s starting point.

Dealing With Discomfort

A nurse’s uncomfortableness with spirituality in health care has its roots in lack of self-acceptance of our own current level of spirituality. When a nurse believes she should be more spiritual or have a different type of spirituality, the focus is on shame and not on hope. If our own experience of spirituality is shame-based we would naturally hesitate to use spirituality in health care. We really don’t want to do anything that will harm a patient and if our own experience with spirituality is negative we would hesitate to use spirituality in health care. The answer here is to practice the same acceptance toward our own spiritual being as we would give any patient.

Integrating Spirituality

Integrating spirituality into daily practice starts with the assumptions you make about a patient. The current assumption we make is that spirituality is akin to “Don’t ask, don’t tell,” (e.g., spirituality is something best avoided). Whereas, if we assume that a patient has spirituality, then the question becomes not how do we avoid talking about spirituality, but how do we as clinicians use spirituality.

As with any health intervention, we have to start with an assessment. I work in a low-income clinic with a diverse mix of patients. We have meta-conversations with patients about spirituality. A meta-conversation is a conversation about the conversation we are going to have about spirituality. It introduces the topic of spirituality and informs the patient why we are asking about spirituality. It starts out something like this: “Our clinic staff feels that belief in a higher power or divine being is important to health. We know that this can mean different things to different people, and we are not here to tell you what to believe, but we would like to know a little about your spiritual life so that we might find ways your beliefs may help you obtain the health you need. Is it okay if I ask you a few questions about your spirituality?”

We have very few patients turn us down; in fact most want to discuss this. We ask questions about three areas:

  1. Describe for me your beliefs in a higher power. How important are these beliefs to you?
  2. Do you pray? If so, how.
  3. Have you ever used these beliefs to improve your own health? If so, can you give me an example?

We try to speak of these questions in a conversational manner, sharing our own beliefs and experiences as appropriate.

We had a woman who came to the clinic complaining of a headache. She had no access to primary care and little money. We did our assessment, including the questions about spirituality. The woman did have a strong belief system and went to church regularly. Her blood pressure was slightly high and her pulse was rapid. When asked about the cause of her headache, she said that her youngest son had just been murdered by another family member in a dispute over money. She had not only found the body, but she had to clean up the room where the stabbing occurred. How do you respond to such a situation, if not spiritually?

We offered to pray with the woman and her small child that was with her. This involved about five minutes of silence and then an asking for help and assistance for this family. The woman said a few things and then we concluded that part of the visit. After this prayer, the woman said her headache, which had been over her entire head, was much improved except for a muscle in the back of her neck, which was treated with ice and OTC pain relievers.

Making Healthy Decisions a Habit

We also use spirituality in health decision-making. To attain a higher level of health, patients have to make healthy decisions daily and, frequently, several times a day. Weight loss does not occur because of one decision no matter how firmly that decision is made. Weight loss occurs when patients make several decisions each day, at every meal or snack, to not eat too much. Similarly, smoking cessation is really a series of daily decisions to not smoke the next cigarette.

Unhealthy behaviors are largely habitual. Habits are unconscious, immediate decisions that have built-in positive reinforcement. Habits are all around us. The way we dress, the way we get into an automobile, the way we answer and dial our phone. Habits are good. They save time. We don’t have to learn something new each time we want to do something.

Unhealthy habits are those habits that hurt us over time, but which tend to self-perpetuate until the harm can kill us. No one gets up in the morning and says, “I am going to start smoking today and I will continue to do so until I smoke three packs a day for 10 years and die from emphysema.” Most unhealthy habits are a response to outside triggers that answer a need, even though the answer may only be short-term.

A smoker may smoke to relieve stress. So, when everyone is in a bad mood at work and the workload is increased, the smoker will take a break and grab a few puffs. The smoking does nothing to improve other people’s moods, but it does provide a temporary relief from this type of stress. The relief will make the smoker more likely to smoke the next time work becomes stressful. He is not smoking for the cigarette per se, but to get relief from stress. The same process occurs with over eating, lack of exercise, abuse of alcohol and drugs, and other unhealthy behaviors. This relief is very powerful and is reinforced with habitual thought patterns and physical cravings. Since spirituality is neither physical nor mental, it has the power to break habits.

Spirituality can be applied simply without a degree in theology. For example, we use meditation in our weight loss groups at my clinic. We encourage our participants to take a few moments each morning to sit quietly and think about what they will eat each day. It is that simple. Meditate and then plan a menu. Like all planning, this decreases habitual thinking. The plan puts another mental reference point during the day and the can help reassure someone that they have enough calories when they have stress-related hunger. In our last class there was an average weight loss of 6 pounds over a six-week period.

If you are interested in sharing your own experiences with spirituality in health care or would like to see more information about this subject, please visit Health Spirituality or the Duke University Center for Spiritual, Theology, and Health.

6 Summertime Stress Busters

6 Summertime Stress Busters

Summer is supposed to be the most relaxing season. With warmer weather beckoning and an easier feel to the days, relaxing should be second nature during this time of year.

But for many people, summer can sometimes ramp up stress. Kids are home from school, and you’d like to spend some of their summer vacation making lasting memories with them. Or maybe the intense round of family events, block parties, weddings, baby showers, and trying to fit in vacation time has got your schedule, and you, stretched thin.

And then there’s work. Nurses’ work pressures don’t ease up just because it’s summer. But there are a few simple stress busters you can try right now that will help reduce your frustration levels and offer you some fun, too!

1. Make Bread

This one is weird, but true. The repetitive, steady kneading and pounding needed to turn dough into delicious bread is also a great way to lower your blood pressure. This summer, ditch the bread machine and make bread the old fashioned way.

2. Color

Have you seen the news lately? Adults are snapping up coloring books faster than stores can keep them stocked. With companies gearing some coloring books toward adults with more intricate themes (think mandalas or Celtic patterns), grown ups are finding the meditative benefits of staying within the lines to be incredibly soothing.

3. Use Aromatherapy

For centuries, people have used scents to help influence their moods. Use peppermint to pick you up, lavender to relax you, and green apple to control your appetite. Luckily these scents can all be found at your local health food store in the form of essential oils. Mix a few drops into an unscented lotion or just put a few drops on a cotton ball to bring you instant sensory uplift.

4. Start at the Bottom

Nurses bodies work incredibly hard and one of the areas that suffers most is those poor feet. Your feet take a beating in any given day, so make yourself feel better by treating them well. Keep peppermint foot lotion (found in almost any drugstore or even the supermarket) in the fridge. When you get home, drop onto the nearest couch and slather some on your feet and legs for a soothing and instant pick me up.

5. Listen to Music

Don’t just put music on for background noise. Find music that is uplifting to you and sing along to it. If you don’t want anyone to hear you, blast your music when you’re alone in the car. If it makes you feel good, listen to it and enjoy the boost in your mood!

6. Dine Outside

Whether it’s having coffee on a park bench or grabbing dinner on a restaurant patio, there’s something so soothing and summer like about eating outside. This is one way to enjoy this very fleeting season that doesn’t involve packing, making a side dish to bring, or coordinating relatives.

Summertime is a fun season, but it’s not without stress (no matter what the magazines say!). You’re keeping track of everyone and everything and sometimes the “can’t-go-anywhere” winter weather seems appealing. But the season is so short – use a few stress busters to enjoy it even more.

Just Published!

The Minority Nurse Winter 2017-2018 issue is now available. Read the latest issue of Minority Nurse today.

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