We’ve seen the statistics showing that nurses and future nurses need mental well-being more than ever.
With healthcare staffing shortages all over the country, healthcare facilities and consumers cannot afford to lose more nurses. At the root of it is that nursing is an incredibly stressful profession, with 63% of nurses reporting significant workplace stress, 70% saying they put the safety and well-being of the patient above their own, and 31% reporting a workload assignment higher than which they felt comfortable (American Nurses Association, 2021).
In addition, 29% of nurses reported feeling sad, down, or depressed for two weeks before the pandemic, with an increase to 34% during the pandemic (American Nurses Association, 2021).
So how do educators ensure future nurses don’t enter the workforce without the skills to cope with the demands of the job? Modeling support for students in nursing school is the start for future nurses to learn resilience through the challenges of school so that they can manage the stress throughout their nursing career.
Nursing school is a demanding career path and one of the most challenging programs. Students enter the field from diverse backgrounds and often with many personal struggles – from academic challenges, medical conditions, strenuous family responsibilities, mental health challenges, and even prior traumas.
In addition, many students worked through the pandemic assisting nurses who were helping to save lives while experiencing high levels of stress and depression.
When faculty understand and agree that nursing students are experiencing stress and mental health issues, this is the time to provide support and model how to endure these challenges for long-term success. To give students the instruction they need to care for patients holistically, Chamberlain University established the Chamberlain CARE® model.
Educating Students on Mental Health
My career goal has been to combat the stigma of mental illness. The Chamberlain CARE® model has further inspired me to support students through nursing school to become strong and compassionate nurses. As a faculty of mental health nursing, it is crucial to educate students on mental health because every patient and family member they meet will likely experience some form of anxiety.
When patients and families come in, they often deal with a long list of emotions – from apprehension about a diagnosis, severity of the condition, recommended treatment, long-term implications, and even future medical bills. When experiencing this anxiety, the patients and families may display uncharacteristic behaviors as they try to cope with an unpredictable and stressful situation.
It is important to remember the feelings of fear and anxiety people have when seeking healthcare services, as these can be their most vulnerable moments. As nurses, we are in hospitals routinely and become comfortable with the environment. However, we are generally not the ones dealing with an illness or injury and facing uncertainties. Therefore, all nurses must interact with patients compassionately and without judgment.
When teaching mental health, we connect the students to a true understanding of the individual in crisis to develop greater compassion and empathy. We are in a unique position because there is greater subjectivity involved. Diagnosing and treating mental illness involves creating trust with the patient so they feel comfortable disclosing their deepest thoughts, fears, and feelings.
As educators, our role is to provide delicate guidance to help connect the students’ emotions to the reality of the patient’s trauma and life horrors. Without this connection, the students will more likely display stigmatizing behavior that prevents patients from seeking and complying with treatment.
Mental illness is a critical issue, and stigma infects societal attitudes. Many need mental health services but never seek treatment due to that stigma. As a result, some patients can accept their diagnosis, while others grapple with the idea of being seen from a vulnerable and stigmatized perspective. In healthcare, everyone is perceived as caring and compassionate, but empathy toward those with mental health issues is lacking.
This prevents follow-through on appropriate treatment and services and exacerbates the mental health issues, potentially leading to further development of mental illness diagnoses. Interventions to combat stigma are critical to the stability of these individuals and society.
Everyone Has Bias
If we confront the preconceptions nursing students may have, we can help reduce the stigma toward individuals with mental illness throughout all areas of healthcare. The first point to recognize is that everyone has bias.
We all have certain beliefs about people or groups formed throughout childhood and other experiences. Some biases we have are not even rational. Some thoughts jump into our heads, but then we may even realize that we do not believe or support those thoughts. The most important part is acknowledging that we have these thoughts. Without acknowledgment, we allow our behaviors to support those biases. For example, common biases toward mental illness are that these individuals are more aggressive or do not take care of themselves. If a nurse has these thoughts about a patient and does not acknowledge them, that nurse is likely to judge and stigmatize.
Deconstructing the Stigma
Before delving into mental illness diagnoses, we have a class discussion about stigma. We discuss what it is, where it comes from, and how it impacts everyone involved. We examine cases of some of the worst traumatic experiences and how the surviving individuals will struggle for the rest of their lives no matter the other circumstances of their lives. From that understanding, we can recognize that any one of us is a moment away from the potential of a similar life-changing tragedy.
One of the key points to remember is that those without a mental illness diagnosis are not so different from those with a diagnosis. Many patients we help in an inpatient behavioral health setting have a history of trauma, hence the greater insistence on more mainstream trauma-informed care. In the current healthcare environment, it is becoming increasingly common for nurses to experience trauma through violent events and the workplace’s compounding stress.
Impactful Self-Assessment Activity
One of the other activities the class participates in is a self-assessment using the Adverse Childhood Experiences (ACEs) scale. Ten traumatic experience categories are tallied to determine an ACEs score. The range is from zero to 10 in the scoring of traumatic childhood experiences. Once the students confidentially calculate their scores, I have them anonymously enter them into a poll that presents the class scores on the screen for everyone to see.
It is an incredibly impactful experience for the students to see the scores of their classmates. Through discussion, we realize how many students in that class have experienced high levels of trauma, primarily as they reflect on the description of each question. Some realize they are not alone in their traumatic childhoods while also, at times recognizing for the first time that those experiences are not typical for a child to experience.
This has become one of the most important activities I have implemented. It causes the students to recognize that they do not even know their classmates well enough, so how would they be able to understand their patients well enough to justify judging them? As we reflect on the numbers, I emphasize to the students that none deserved any of those traumas, just as none of our patients deserve the traumas that destabilized their mental well-being.
Support is often the most critical factor in overcoming and enduring trauma, mental illness, and life challenges. Throughout the course, there is a continual emphasis on self-care and coping skills for teaching others and as a resource for themselves. We know what nursing today looks like with nurses experiencing stress and trauma. Collectively reducing stigma can strengthen the mental health support and treatment we can provide, which can also help the nursing field. With a non-judgmental approach from healthcare professionals, we can better support each other in our times of need.
The impact of self-realization that my students experience drives me to continue supporting them. And notes from students like Larry Pitts, a senior at Chamberlain’s Addison campus who is finalizing his program, are my inspiration. “In 2020, I wasn’t doing the best in school. I was careless, unfocused, and unmotivated. Once I found my motivation and started doing better in school, Professor Mayo always made it her priority to acknowledge my progress and let me know I was doing a great job! She was a haven because she welcomed everyone to discuss anything without passing any judgment. I am forever thankful for her.”
There’s no doubt about it, nurses — it’s the holidays, and many of us feel pressure in our personal and professional lives. So how do the holidays impact you, your mental and emotional health, spiritual well-being, and professional responsibilities as a nurse?
Working During the Holidays
Many of you employed by hospitals, home health agencies, hospices, and other organizations are likely working during the holidays, perhaps even on your favorite special day. As a result, you may miss special moments with family and friends, even while you do your best to spread cheer among your colleagues, your patients, and their families.
Having to show up for work at 7 am on Christmas Day or New Year’s Day is no fun, and working 11 am-7 pm in the ER on New Year’s Eve is no picnic. However, those who don’t work in milieus requiring us to work holidays may forget how our nurse colleagues are slogging away while we tuck into Christmas dinner and open presents with family.
For Jews who celebrate Hannukah, having eight days makes it easier to be flexible with our celebrations, even though most employers pay no attention to Hannukah in their planning. And for African Americans who celebrate Kwanzaa, it can be challenging to ask for time off for a holiday that few people recognize or understand. Then again, Kwanzaa has multiple nights like Hannukah, which can sometimes make it easier, but only occasionally, depending on your work schedule’s demands and your employer’s sensitivity.
No matter how you slice it, the holidays can be challenging enough without the added stress of working odd hours and missing out on the fun and togetherness that others enjoy so readily.
Nurse Self-Care and the Holidays
Self-care is essential at any time of year — and everyone defines that concept differently — but you need to be extra vigilant during the holiday season. Ask yourself some questions:
What can I do to make my holiday shifts easier?
How can I bring more cheer to my workplace, colleagues, and patients?
Can my family be creative about the timing of special celebrations and meals so that I don’t miss out on my favorite holiday activities? (I’ve heard of nurses having Thanksgiving or Christmas dinner the day before or the day after to accommodate work schedules.)
Are there nice things I can do for myself this time of year? Can I take myself out for a pastry and hot chocolate? Can I spend a few hours in my favorite bookstore?
How can I reward myself after the holidays for a job well done?
What gratefulness can I feel and express for the abundance and love in my life?
Nurses are a nurturing bunch, and we can often forget to nurture ourselves. Do you work 12-hour shifts, do all the holiday shopping, cook most of the meals, send all the cards, and show up bright and smiling every day, even when you feel run down and overworked?
Sometimes, there’s something that needs to give, and whether you cancel a social engagement, delegate a task to another family member, or turn down an extra shift, you may need to make some choices that put your needs first this holiday season.
The Presence and the Presents
As Ram Dass once said, “be here now.” The holidays are admittedly often about presents, but they’re also about presence.
How can you be more present during this holiday season? How can you be more mindful? You can be present for your patients, expressing compassion for the fact that, unlike you, they don’t get to go home to their families when your shift ends. You can also be present for your colleagues as they struggle with the stress of the holiday season.
Meanwhile, you can also be present to yourself and your feelings; this time of year can be joyous but also a challenge. Remaining mindful of how you feel can help you choose a course that will keep you uplifted, cajole you into scheduling your self-care activities, and relieve you of the sense that you have to do it all. And if you have to work on the holidays, make a plan to do it with great heart, compassion, and a feeling of gratitude for your patients and the ways in which you can serve their greatest good.
Stay present, enjoy the holidays, take care of yourself, make self-care a priority (whatever that means to you), and give yourself a pat on the back for a job well done in 2022.
Minority Nurse is thrilled to welcome Keith Carlson, “Nurse Keith,” a well-known nurse career coach and podcaster of The Nurse Keith Show as a guest columnist. Check back every other Thursday for Keith’s column.
The holiday mood is all around us, but holidays represent hectic medical facilities times for numerous reasons. Some of them are mainly because the staff is working hard and not being home with their loved ones. The overall atmosphere is not good for the patients either since none of them want to spend the holidays in hospitals. That’s not the kind of care they hoped to get this time of year, and they might lash out at medical staff. But in the spirit of the holiday season, here is an overview of things to improve the morale of medical staff.
How to Boost the Medical Staff Morale During Holidays
I’m a registered nurse behind Medicare Login HQ, a portal dedicated to patients who want to find out how to log into different Medicare providers. Unfortunately, being in a love-hate relationship with administration myself on the one hand and taking care of the patients on the other, I too suffer the same fate as all other medical workers – being understaffed, tired, and spread thin when holidays come around. So here’s a list of things we like to do at our hospital that might ease the burden.
Bust Out the Decorations On Time
There is something about holiday decorations that eases the pain of being away from home. This rings true for the patients and staff alike. And also, there isn’t a bleaker sight than an undecorated space during the holidays. So the first step towards cheering up the collective is decorating the area they spend the most time.
Start decorating on time, ask for help and enjoy the team-building activities like placing mistletoes and trimming trees. Here, deck the halls has a different meaning.
The Spirit of Christmas Playlists
We all know what time of the year it is as soon as we hear the Mariah Carey tunes. Unthroned Queen of Christmas and other carols can be easily played in the background and still add to the overall festive time of the year. If the tunes can’t spread across the hallways due to hospital policy, then keeping them in the staff area will improve everyone’s mood.
Organize an Early Celebration
No matter what department you are in, everyone knows how crazy things get during the holidays. It’s best to plan the gathering early and celebrate before the rush so the staff will be rested and enjoy the party. Hosting a celebration during the holidays is usually bad because overworked staff can’t let loose and truly enjoy socializing.
Pick a date, call the entire staff department, and dedicate the time to non-work related activities.
The Gift of Holiday Spirit
It’s hard to assess people’s financial situation, so mandated gift-giving shouldn’t be a part of your holiday festivities—no need to strain the staff’s budget. Instead, you can go back to the roots of the meaning behind the holidays. For example, you could organize a simple card-giving ceremony and a small potluck party.
That should be enough to stir some pleasant conversation and show appreciation between coworkers. And everybody can taste various dishes and maybe even exchange some recipes.
A multicultural staff brings a lot to the table for a holiday party, just like it’s shown that having a multicultural staff increases the facility’s innovation and care level. Good food, and in the wisdom of Sheldon Cooper, offering a hot beverage might soothe all the worries away. Add to that some desserts, and you will have a room full of relaxed staff in no time.
The Most Important Step – Plan a Holiday Schedule In Advance
There is no such thing as overplanning when it comes to holiday shifts and medical staff schedules. Instead, make contingency plans and contingency plans of contingency plans. There’s a Latin saying, “Malum consilium quod mutari non potest,” – which means: Bad is the plan that cannot change.
Pro tip: plan the shifts well in advance so people can plan their vacation and downtime around them.
Treat Medical Staff with Kindness
Medical staff is the first line of defense. When people are nervous and depressed because they miss quality time with their family, being in a hospital feels like a prison. Some deal with it better than others, and some might lash out at medical staff. The same medical staff that’s already overworked and strained because they, too, are missing their families.
The best advice is: to offer a kind word. No matter how bleak someone might feel, and even if they are lashing out, the best way is to provide a kind word and show that you are there for them. Likewise, enticing medical staff to socialize with patients improves patient care and how your staff feels. After all, we are all just human.
Despite the increased focus on mental health over the pandemic, it’s not always easy to diagnose or recognize depression. When it’s something you are experiencing, it can be even tougher to see the bigger picture.
October 6 is National Depression Screening Day and offers an excellent opportunity to assess your own mental health by taking an online depression screening and learning more about depression. Depression can happen at any time and to any person regardless of their race, ethnicity, social status, income, lifestyle, location, family history, or previous mental health status. Sometimes depression is triggered by an event–a death, a divorce, a diagnosis, a job loss, a trauma. Sometimes depressive symptoms coincide with the changing seasons. Depression can also be brought on by genetics or by hormonal changes in pregnancy, menopause, or puberty. It can be fleeting, lasting less than a year, or it can be something a person manages throughout their lifespan.
Why do people need a depression screening? Because depression can look like a lot of other things. This condition can appear as individual bothersome symptoms that are easy to overlook or brush off. When seen collectively, it becomes more obvious that there’s something more serious going on. A depression screening gives that broader scope and opens the path for treatment options.
Many people recognize some of the more obvious symptoms of depression including feeling sad, having crying spells, or a lack of interest in many things they once loved. But other symptoms of depression are more difficult for people to recognize.
Less obvious symptoms of depression include
irritability and anger
generalized, persistent feelings of fatigue or being tired that are unrelated to amount of sleep
lack of focus
feelings of being unwell like stomach pains, muscle aches, headaches
trouble sleeping or sleeping too much
changes in eating–eating too much or not enough
What do these look like in real life? It can be as simple as noticing you are raising your voice at your kids or your partner. You might find yourself getting unusually frustrated at work when a colleague is late or a patient is challenging. It could be that the daily walks that used to give you energy and a sense of calm, have dropped off your activity list because you just can’t get motivated. Or you seem to have a pounding headache by the time your day ends–on most days. Taken individually, these might not seem to be anything but an unusual blip in life. But when any of these happen repeatedly or happen collectively, it’s a signal that something else is going on.
A depression screening is an excellent tool for nurses to apply to themselves or to patients or loved ones. Nurses can look more into depression assessments to see what kind of assessment is used in particular circumstances in the industry too. But simple depression screenings can help you recognize when you might need help to manage your symptoms.
Depression treatment can include talk therapy and medications for milder cases and more intensive treatments for moderate to severe depression. If you notice that you’re experiencing symptoms of depression or that someone you love or someone you care for is, seeking additional help should be the next step.
Eye health is essential for your overall health and is especially important for nurses. For nurses who wear contact lenses, keeping your eyes in top shape takes some dedicated effort. The Centers for Disease Control and Prevention (CDC) has elevated the importance of contact lens care to create a Contact Lens Health Week which begins this year on August 22.
Contact lens wearers know how much of a benefit the lenses bring, but it’s easy to dismiss some of the basic health guidelines around this convenient alternative to glasses. Nurses, particularly those with long shifts, are especially prone to wearing them for long periods.
Here are a few refreshers on how to keep your eyes healthy while using contact lenses.
Maintain good hygiene
Make sure anything that touches your contact lens is meticulously clean. Wash and thoroughly dry your hands before putting your lenses in or taking them out. Rinse your case regularly with contact lens solution (not water) to help reduce the chances of bacteria contaminating your lenses, and change your case regularly. Follow all instructions for how long to wear the kinds of lenses you have (some are longer-wear hard lenses while others may have daily or two-week lenses). And always remove them before sleeping (this counts if you’re on a plane as well).
Keep them away from water
It’s easy to forget that you have lenses in when they become such a routine part of your life. But if you’re near any water–such as showering or swimming in a lake, ocean, or pool–your contact lenses should be out. Water holds all kinds of germs that are normally perfectly safe for normal use, but can introduce bacteria that can contaminate your lenses and cause a dangerous infection in your eye.
Protect your eyes
Many contact lenses have UV protection, but that doesn’t mean you’re covered. Wear sunglasses with 100 percent UVA and UVB protection when you’re outside to help your general eye health. The sun’s rays, even on overcast days and even in the watery sun of northern winters, can cause eye damage and hasten conditions including cataracts, macular degeneration, or even cancer.
Take a break
There are all kinds of guidelines around the various contact lenses available today. Be aware of the recommendations for how long you should keep yours in your eyes. If your work schedule means you leave your lenses in for long periods of time, make an effort to wear them less on your days off. Ideally one day a week that’s free of contact lens use can help your eyes, but even taking them out earlier than usual (as soon as you get home) is a healthy choice.
Be ready for a change
If you’re at work or doing something fun and your eyes begin to hurt or bother you in any way (a speck of dirt getting in your eye or allergies can cause real discomfort and irritation), be prepared to remove them and use your prescription glasses. Carry a pair of glasses with you when you leave the house so you aren’t forced to leave in uncomfortable contact lenses or to remove them and leave you with uncorrected vision. Leave a stash of solution and a lens case at work and contact lens-safe rewetting drops in your bag.
Don’t skip appointments
See your contact lens provider regularly. They will check for any vision changes and will notice any other changes in your eye. They also perform a regular assessment to see if your eyes are getting enough of the needed oxygen exchange (if contact lens overuse is your fallback, this might be an issue) that keeps them healthy.
While some tips for contact lens care can seem burdensome, getting an eye infection is not only painful and potentially dangerous, but it’s also disruptive. Being mindful of eye safety while using contact lenses will help keep them healthy.
That advice about timing resonated last month as she prepared to donate a kidney to her mentor, professor and faculty colleague. Professor and biostatistician Vicki Stover Hertzberg, PhD, who directs the school’s Center for Data Science, had been waiting nine months for a transplant after being diagnosed with kidney failure.
The two professors’ personal relationship is only one aspect of their remarkable story.
Both long ago had personal experiences that made them aware of the high need for living kidney transplants and the safety of donation. At the nationally No. 2-ranked School of Nursing, both women work on a research team that studies renal issues and other health problems related to heat exposure in farmworkers and published their findings in March. Both say their life-giving partnership reflects their school’s caring connections.
Chicas was only one of several Emory employees who answered Hertzberg’s call for potential donors in mid-2021. While others matched enough to donate, Chicas was the closest match.
“So much science has gone into it for such a long time, and to be able to use that science to help Dr. Hertzberg be healthier and live longer, it’s awesome. And I get to be a part of it.”
—Roxana Chicas, PhD, RN
“I have no words to express my gratitude for the individuals who came forward including those who ultimately, for one reason or another, could not be a donor,” Hertzberg said before the March 15 transplant surgery. “And for Roxana to do this is just phenomenal. I find it very overwhelming and very humbling.”
Most of us only need one kidney
Chicas’ first job at a pediatric office in Atlanta, when she was 18, exposed her to kidney issues and solutions. She translated for pediatric nephrologist Stephanie M. Jernigan, an associate professor of pediatrics at Emory School of Medicine.
“Children who were born with just one kidney often lived perfectly normal lives,” she says. “Other children who had kidney transplants did very well, even though it’s a very invasive surgery.”
She also learned to see her own intellectual potential.
Having come from El Salvador at age four and undocumented, Chicas had received temporary protective status that allowed her to work for the pediatricians. She helped them communicate with families who only spoke Spanish, and thought she might be smart enough to become a medical assistant so she could help them more. Pediatrician A. Gerald Reisman, MD, urged her to try nursing instead, and at age 28, Chicas enrolled in what is now Perimeter College at Georgia State University.
That educational decision led to Bridges to the Baccalaureate, an Emory program that nurtures minority students in research. With School of Nursing Dean Linda A. McCauley, PhD, RN, FAAN, as her advisor, Chicas got a BSN and went directly into the doctoral program. She joined McCauley’s team working on farmworker health, which felt personal because her mother, Maria Chicas, farmed in El Salvador. Farmworkers are 35 times more likely to die from heat-related illnesses than any other profession, she says.
“My goal is to do great science that will really improve the working conditions of agricultural workers,” Chicas says. “They are the backbone of this country and the globe. They feed us, and I think we need to value them more and recognize their worth, and they should be treated with dignity and given the same benefits that sometimes we take for granted. Many of them are undocumented and live in poverty, and I hope that I can be a part of a movement to better their lives.”
Heat-related illnesses affect kidney function, and Chicas did a postdoctoral stint in renal (kidney-related) medicine at the Emory School of Medicine. The research team measures indicators of health like core body temperature and kidney function.
“I got lucky, because I could have been working out in the field,” Chicas says. “I’m not there because of sacrifices that my mom made, and many other Latino parents have made and by having a mentor who told me that I can be a professional.”
A mentor in need
Hertzberg became Chicas’ professor and research teammate. From Florida to Mexico to Brazil, Chicas was in direct contact with farmworkers while Hertzberg worked to tell the story of the collected data.
“A wonderful mentor,” Chicas, 39, calls Hertzberg, 67. “She taught me that you can be smart and be strong in your career, and yet still be very kind.”
As the director for the nursing school’s Center for Data Science, Hertzberg is an internationally-recognized expert on “big data” and its impact on health care. She is widely known for her work measuring the social contacts in emergency departments and disease transmission on airplanes.
“Mentoring is what graduate education is all about,” Hertzberg says. “You learn a lot from each other. Part of it is just kind of a natural process because we’re engaged through research activities and part of that is just kind of understanding how the world works and what makes people tick. Roxana is incredibly driven and intrinsically kind, and always keeps me and our team focused on issues that our partner community experiences in ways that we don’t.”
On the farmworker longitudinal study, newer data relates to 25 markers of kidney function disease because of a relatively recent phenomenon called chronic kidney disease of undetermined etiology (CKDu). “Young farmworkers who had been feeling fine or really healthy all of a sudden wake up sick,” Hertzberg says. “Lo and behold, they have kidney failure and need dialysis.”
In late 2020, Hertzberg’s own bloodwork showed acute kidney injury, and when restrictive diet didn’t improve function enough, she was referred for a kidney transplant in mid-2021.
Like Chicas, Hertzberg had learned about the disease long before through a family friend and others. She reached out to her network by email and social media.
“Ideally a living donor is best,” she wrote. “A kidney from a living donor lasts on average 25 years, while a kidney for somebody who is about to have life support turned off is on average 12 years. Obviously, the 25 years is my preference…. the wait for a kidney from the person on life support will take three to seven years.”
“I knew it’s a pretty big surgery, but I was just like, ‘I have an extra kidney. I’m pretty healthy,’” she says. “And I called my mom and asked her what she thought and she was like, well, if that’s what you feel that you’re called to do, then go for it. And I was like, Okay.”
When she found out that there was competition to give a kidney to Hertzberg, Chicas told herself, “If God wants me to be the donor, then I’m going to match. So much science has gone into it for such a long time, and to be able to use that science to help Dr. Hertzberg be healthier and live longer, it’s awesome. And I get to be a part of it.”
Hertzberg even had colleagues clamoring to organize her meal train. This loyalty is partly from working at Emory since 1995, and supporting so many people and projects with her expertise. She served on dissertation committees for Chicas in 2020 and (at the University of Cincinnati) for McCauley in 1988.
Christian Larsen, MD, DPhil, professor of surgery in the Division of Transplantation at Emory and former dean of the Emory School of Medicine, transplanted Hertzberg’s new kidney last month. Larsen and Hertzberg knew each other through their collaborative research. From 2005 to 2010, they teamed-up on a protective immunity project studying aspects of the immune system in kidney transplant patients.
“This is not a road I would have chosen for myself,” Hertzberg says. “So I’m trying my hardest to learn the lessons along the way and to keep being positive. I want to dance at my grandchildren’s weddings, and the oldest one is soon to be five years old.”
Chicas believes that her success, her mentors and her organ donation have proved her favorite quote.
“Mother Teresa said, ‘If you can’t feed 100 people, then feed just one,’” she says. “I’m not a philanthropy. I’m not a billionaire. But I feel like there are certain things that I can do.”