When you think of being successful in college, you know lots of hard work, hours of studying, and a dedicated commitment will pay off. But if you’re heading into nursing school this fall, there’s also another essential, piece of the puzzle that will help your college years go as smoothly as possible.
What else can you do to help you make the most of your time in nursing school? Get a team together—one filled with other students you can rely on, professors who can teach you, advisors who can guide you, and college services offices filled with information.
While many students enter college thinking this will happen naturally, planning for the right kind of team is almost a strategic business move. You aren’t going to pick your friendships and associations with an eye on getting ahead, but knowing where to go for help and developing relationships with people on campus will always help you.
Friendships Are Your Foundation
Good friends will be a life saver when you are in college. Not only will they be right in the trenches with you and understand what you’re going through, but they’re also a steady source of sage advice, on-target observations, and, hopefully, some comic relief. Friends aren’t all good for the same thing all the time. You might find you develop friends to study with, friends to blow off steam with, others who help you reach your fitness goals, and others who’ll binge-watch Netflix with you the day after your last final.
Professors Motivate You
Some professors will make you pull your hair out and others will push you to make yourself better. Reach out to your favorite professors to cultivate a good relationship. They will help you when you are struggling with a class, offer you career advice, and will serve as references when you are seeking internships, externships, or a job.
Academic Advising Introduces You to the Possibilities
The most successful students are the ones who seek out help. You may have never needed a tutor or needed extra help in a class, but nursing school is a whole new situation. You aren’t expected to know everything, and keeping up the intense pace of nursing school is difficult—even for the best students. Get to know your school’s academic advising office and staff. Ask them for help with classes, difficult professors, or time management. They are an important part of your team and the sooner you develop a relationship with them, the more likely you are to avoid pitfalls like burnout, poor grades, or procrastination.
Health Services Watches Out for You
If you have any kind of chronic medical condition—from diabetes to depression —college is not the time to manage it all on your own. Health services will help you with getting medication, finding outside providers, and checking in to keep your health on a steady course. When you get to campus, start getting acquainted with the people and routines of the health services center. If you ever need to take any time off for medical reasons, they will be a big help with the process. The first time you see them shouldn’t be an emergency.
Career Services Takes You to the Next Level
All nurses have an end goal of a career in nursing, but that final career will look different for so many students. Career services will help you figure out how to narrow down your best career path, but they will also help you take steps to get there faster. Start early to get a resume in order, explore career options, and even develop a plan of outside experiences (volunteer work, summer jobs, internship or externship opportunities) that can help you get there.
Nursing school is a step toward independence and your career, and surrounding yourself with people who can help you will make your experience that much better and more successful.
“ Once you know yourself, in this living stillness, there is nothing in this world that is greater than you”
One of the elements of discovery is “stillness”… I am sure you are thinking, ” What does that really mean? As healthcare professional, how can I incorporate STILLNESS into my life when I have been trained to move and move fast because it is the difference between life and death?”
Guess what, IT IS POSSIBLE! Let’s break this down a little bit more.
Many people see the word “stillness” and automatically think it means to have no movement which is true to a certain point, but from the perspective of discovery, “stillness” is the state of being or being one with yourself. Not thinking about the kids, what you have to cook for dinner, the bills you need to pay, but can’t… the job you dread, the co-worker or friend that gets on your nerves, etc. I mean you DO NOT think about any of that, just simply BE!! In the state of being is where we really and truly get to “know thyself” and not what everyone else tells us about ourselves. In stillness we allow the voice of the holy spirit, which is our GPS navigation system, to guide us through the streets called life. In stillness we learn to quiet the mind and not allow anything that is going on around us affect us. So when you are in a state of stillness, it doesn’t mean that things are not going on around you, it means that they are not going on within you. Let me make it a little clearer for you, you can be at work on a 35 bed med-surg unit with 10 physicians and 3 respiratory therapist on the unit, family all over the place, a supervisor who is screaming at staff, and a co-worker who scrolling through her social media timelines chilling while you have 10 outstanding task and not let ANY, I mean ANY of it affect you internally. The key is to create an intention of stillness which can be achieved by having some intentionality about how you are carrying yourself in a given moment and focus on what is within your control.
Now that we have what stillness means from the perspective of discovery out of the way, I can hear you saying “ Nicole I don’t have time for that”, I have to take care of my family, walk the dogs, manage all the household chores, manage the financial accounts, and I am sure that the list could go on and on but guess what you CAN practice stillness through all of this (I am not telling you what anyone told me but what I know)!! And to be honest if you want to live a life purposefully as a healthcare professional according to Gods’ will then it is a non-negotiable.
So let me share 4 tips that helped me to begin my practice of stillness and make the practice of stillness a ritual in my life.
1. Deep Breath- Yep simply deep breath! I hear you saying “and what is that going to help”? When we take deep breaths it induces the parasympathetic system and slows down your heart rate, which leads to a state of relaxation (use this one when you have trouble going on all around you so that it is not going on in you).
2. Schedule Time to Be- Look lets keep it real we all live busy life’s that pull us in 50 directions and many us live by a Google calendar which tells where to be and when. Well guess what place your “Be Time” on there too. It has been proven that anything we do for 21 days becomes a habit.
3. Get off Social Media- Yep I said it!! Get off Facebook, Instagram, Snapchat, etc. stalking pages and looking at fairytale lives that often don’t exist and practice just “ Being” (I was once guilty of this one, LOL). With the hours we spend on these sites weekly, we can really get to “know thyself” and find our purpose as a healthcare professional.
4. Find a Location that brings you Serenity- Know I know I said the state of being can happen when trouble is all around you which means we can have stillness anywhere but to get to a place where we can do this, we can get practice by doing it in areas where we find peace. So that may be by the water, outdoors with the birds chirping, a certain room in your home, etc. Practicing stillness in a location that brings you peace prepares you to be able to do it anywhere.
These tips are the very tip of the iceberg for practicing stillness because stillness goes much deeper but I wanted to start with building a foundation for you to build upon.
Remember in Psalms 46:10 we were told to “ Be still and know that I am god”.
If there’s one question that I frequently get asked by nursing students, it is how to properly study to pass nursing tests and exams and make it out of nursing school alive. During nursing school I tried different ways to study and it took trial and error for me to finally find what worked best for me. Here are my top study habits to help you get those A’s and tackle nursing school exams.
Best Study Habits:
1. What type of learner are you?
First and foremost, determine what your learning style is. It’s imperative that you’re honest with yourself about the type of learner you are to get the best results from studying. Learning styles typically fall into 3 categories: visual, auditory or tactile/kinesthetic learning. Each learning style retains and processes information differently. So before signing up to be a part of that study group session find out if it works for you. Some students are able to study in only quiet places while others can concentrate around loud noise. Here are two educational websites that offer free learning assessments to help you determine which learning style fits you the best: https://www.how-to-study.com/learning-style-assessment/ and http://www.educationplanner.org/students/self-assessments/learning-styles-quiz.shtml
2. Be organized.
Before you begin studying collect all of your essential tools such as notecards, pens, highlighters, coffee, and wine (just kidding). There’s nothing worse than being in your groove when studying and you realize that you’ve forgotten your favorite pen or highlighter. Have a plan of what you want to study for each session and a realistic expectation of how long it will take to go over the material. Give yourself adequate time to review each subject and include break times for each study session. According to a study recently done by Microsoft the average adult has a concentration span of only 8 seconds. That is less than that of a goldfish! So studying straight for hours without any breaks will not help you retain the information more.
3. Set goals.
You had a goal to get into nursing school and you have a goal to graduate, so why not set goals when studying? If there is a particular topic that is a weak area for you take out your planner and set a goal for when you want to fully master that material. Create a study outline with exact dates, time and even the location for when you will study each material. This will help you avoid having to cram for exams. Your class syllabus should have dates for when exams and texts will take place so don’t wait until you’re two weeks into the class to begin setting your study goals.
4. Less is more.
One of the biggest mistakes you can make when studying in nursing school is using too many books or resources at once. Determine which resources are necessary for each exam and study that content. Professors typically outline which books or resources are appropriate to use for each course so use that as a guide on what to use when studying. If not you may run the risk of studying information that contradicts what you were taught in the classroom. Seek guidance from your professor when choosing to use other resources aside from what is required.
Nursing school is probably one of the most stressful and rewarding things you’ll ever go through in life. Help make things easier for yourself with the four study tactics I listed above to help you prepare for every test and ace those exams. Always remain positive and remember to relax before an exam. You’ve got this!
Stay connected with other nurses just like you! Facebook: Fierce Expression and Instagram: @fierceexpression.
Tears build behind your eyes. Your mind plays over and over how much you want to turn and run, but you can’t. No matter what, you have to keep going because you are strong and people are relying on you. How can you endure it, though, when one part of you wants to scream and one part of you wants to break down and sob? You can do neither, and instead, you hold yourself as taut as a wire over the Grand Canyon.
You are in the elevator on your way up to your unit. Your shift hasn’t started yet, but these feelings are already invading your mind, spreading like tree roots into concrete. It will be worse once you are there, but nurses don’t crack. Nurses don’t break down. They get used to it. Except you can’t get used to it. It is killing you.
You are a nurse with clinical depression, and no one knows—not even you.
Depression is an epidemic in nursing, but no one will talk about it. According to the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative (INQRI), nurses experience clinical depression at twice the rate of the general public. Depression affects 9% of everyday citizens, but 18% of nurses experience symptoms of depression.
If this is such a common occurrence, why don’t nurses talk about it? They are afraid that they will not be trusted with patients and they will not be part of the team. Some of them cannot accept that they need care when they have always been in the caring role. Unfortunately, many nurses just don’t know they have it.
Causes of Nurse Depression
Since depression is so common in nursing, what is causing these men and women to feel this way? The fact that it is ignored is almost inconsequential when you consider the fact that the causes are also ignored. If the causes of this epidemic are not addressed, more nurses will become depressed, patients may be put in danger, and the profession could wind up losing yet another nurse to the stresses of the job.
“Medicine is a profession that doesn’t give much thought to mental illness,” says John M. Grohol, PsyD, the founder, CEO, and editor-in-chief of PsychCentral.com. “It is not within their realm of treatment.” Since medicine is concerned with what it can see, touch, and heal, mental health concerns are often shunted to the side. Nurses not only dismiss the idea of depression in their profession, but they also do it to themselves. This only causes the feelings to multiply.
It also doesn’t help that nursing culture is ruthless by nature.
“Depression is like a cardiac disease: you don’t know you have it. You don’t realize the subtleties,” says Louise Weadock, MPH, RN, the founder and president/CEO of ACCESS Healthcare Services. “Leaders need to create a culture that lifts nurses up. It shouldn’t be a culture in which only the strong survive. Nurses should not be proud of eating their young. Some managers brag, ‘If you can make it on my floor, you can make it anywhere.’”
The culture of survival leads nurses to feeling like they are always under tension—and this can cause anxiety, stress, and depression. Some nurses seem to take great pride in the amount of horrors they have endured, but for those who struggle with depression, living up to this standard and living in the culture only makes them feel like failures.
What are the evidence-based predisposing characteristics of depression, besides culture and neglect? The INQRI study found that certain factors, such as body mass index, job satisfaction, and mental well-being, can lead to clinical depression in nurses.
Furthermore, family problems can exacerbate the stresses a nurse feels, and often nurses feel out of control. They can’t control their shift, their patient load, or even if a patient lives or dies. Helplessness is a feeling that pervades the depressed nurse. When all of these causative factors are coupled with the disruptive cycle of shift work, can depression be far behind?
What does clinical depression look like in nurses? All nurses have covered mental health in their schooling and some work on mental health units. It is safe to say that most nurses know the general symptoms of depression, but it is far more subtle than what they were taught. In nurses, the symptoms are nearly buried under a continuously thwarted attempt to hide their feelings.
Guy Winch, PhD, a licensed psychologist and TED speaker, describes the different nuances in sadness and depression on the Squeaky Wheel blog at PsychologyToday.com:
“Sadness is usually triggered by a difficult, hurtful, challenging, or disappointing event, experience, or situation. … [but] when that something changes, when our emotional hurt fades, when we’ve adjusted or gotten over the loss or disappointment, our sadness remits. … Depression is an abnormal emotional state, a mental illness that affects our thinking, emotions, perceptions, and behaviors in pervasive and chronic ways. … Depression does not necessarily require a difficult event or situation, a loss, or a change of circumstance as a trigger. In fact, it often occurs in the absence of any such triggers.”
Nurses often feel this way as well, but other factors and symptoms appear. “Nurses deal with depression by doing more, keep moving, not standing still, not putting their feelings into words,” says Michael Brustein, PsyD. “They power through it.”
Blake LeVine, MSW, founder of BipolarOnline.com, also makes this point about nurse culture and the medical status quo in general: “There is more detachment in medical professionals who are depressed. It is normal to be slightly detached. When a nurse is depressed, they can also become more detached with their family. They are used to being detached, but they can’t bring it home and cry over people [who] are sick. Depressed nurses may cry more over a patient who died. They may get very emotional. Something they used to deal with in the past can get more difficult for them.”
Of course, this need for detachment and getting past the pain can lead to self-medicating. Usually, that takes the form of alcohol or opiates—both downers that can make depression worse.
“All studies show that those with substance abuse problems have depression or anxiety,” states Nikki Martinez, PsyD, LCPC, a verified mental health counselor on BetterHelp.com. “Prescription drug problems are often present, and that becomes their drug of choice. Just take a pill, and the pain is gone. When a nurse is having a bad day, they can’t wait to come home and have a glass of wine.”
In addition to various negative coping mechanisms, nurses exhibit many other symptoms that are obvious to those looking in on the situation. Weadock explains them this way: “Nurses can experience difficulty concentrating, are slow to respond in a crisis, are accident-prone, and have a limited ability to perform mental tasks, such as care mapping, calculating doses, or intervals required for biometric interpretations. They are reclusive with poor interpersonal skills, struggle with time management, and have lower total productivity outcomes than nondepressed workers. They often have a ‘short-fuse,’ leading to explosive outbursts toward patient, family, or coworkers.”
Stigma against Mental Illness
Nurses are usually willing to talk about the problems in the profession, such as short staffing, poor ratios, and lack of managerial support. However, what they are not willing to talk about is depression and mental illness in their ranks. It is arguably nursing’s best kept secret. Eighteen percent of nurses are suffering from some form of clinical depression—and no one will talk about their experiences with it, what to do about it, or what causes it. What is behind this stigma?
Grohol breaks down the problem by focusing on the two parts of stigma: prejudice and discrimination. “There is a great deal of misinformation and misunderstanding of what depression is,” he explains. “Many in the medical profession hold antiquated beliefs about mental illness, such as the condition was brought upon the self. Nurses are taught not to complain about it, and this is why they don’t talk about it.”
Then, nurses must deal with discrimination when they are found out. “Discrimination comes about when people with mental illness see nurses talking about those who have other medical issues, and don’t want things said about them,” Grohol continues. “Nurses would assign a person a label and boil down their personality to one word, and that is insulting and discriminatory.”
A primal aspect comes into this discrimination, as well. Nurses, for lack of a better reference, are a “band of brothers.” If you suspect the nurse beside you can’t handle the pressures, then you tend not to trust them.
Weadock has experienced this. “I don’t think nurse leadership or the workforce sees depressed nurses. When they perceive some sort of injury, then they throw the nurse out of the wolf pack. When you backslide into your disorder, that’s when people don’t know whether to trust you.”
The stigma has become so bad that many depressed nurses fear for their jobs. “Nurses know that admitting a mental health problem puts their job at risk,” says LeVine. “People are scared to admit it. That’s when mistakes happen. Get treated. Nurses feel they have to hide it to protect their jobs, but a nurse that seeks help for depression ends up a better and stronger nurse. Those who seek help have more longevity in their career.”
Psychologically, the prospect of losing everything rewarding about nursing is scary, and LeVine cites that as a reason for keeping quiet. “The hard part of admitting to depression is that nursing is a good paying job and losing it is hard. You are on a big team as a nurse. When you can’t do that anymore, you lose that sense of team. It is hard to give that up. Therapy means you can work on that and possibly avoid leaving the profession.”
One of the most prominent reasons for nurses to keep quiet about their mental health is the stigma associated with an “unhealthy” caregiver. Martinez describes it this way: “Nurses feel they need to be perfect and healthy at all times. It is just not possible when they are doing so much for someone else. Mental health professionals realize that this is a huge problem. Openly talking about it is the only way to break the cycle, but no one talks about it. When they do talk about it, it takes away stigma and shame.”
For these reasons and more, many nurses are living with depression in silence—afraid for their jobs, afraid that they are weak, and ignoring their own health in favor of others. In addition to education, treatment for nurses specifically is important for recovery and retention.
Self-Care and Treatment for Nurses
Nearly all experts agree that education is the primary method to get nurses treated for depression. This means educating management on what to look for, and for nurses to know the symptoms to recognize the condition in themselves and others. Sometimes coworkers can see symptoms far better than a manager can. If the stigma is reduced with education and support, those nurses can get the help they need from a team effort.
Weadock suggests that this reform starts with the manager. “A manager should say, ‘I’m going to put you on the bench and help you get better.’ Assignments should be given out just a dose at a time, because you don’t want to ruin the reputation of a good nurse. The nurse can’t help it when they are feeling depressed. Management needs to lift the RN up by promoting them to other suitable, supportive work environments, and to make reasonable accommodations for nurses whose cyclic phase of depression is negatively affecting their work performance.”
After management has identified a struggling nurse, that nurse should be introduced to treatment and encouraged to keep attending. Many nurses terminate their therapy because they think they don’t need it, they don’t feel they should be sick, or they are afraid someone will think they are weak.
“Seek medical treatment with a professional that understands depression,” LeVine suggests. “Find a therapist who understands a nurse’s career and life. Openly assess your situation. Do you need to take a break? If it is all too much, it is okay to do something else. It is better to admit that you are struggling and seek help. It’s like trying to fit a round peg into a square hole.”
What can nurses do when they are in therapy and still working? According to Martinez, it all comes down to self-care. “Nurses often don’t have good self-care. It can be as simple as starting the day off right, instead of waking at the last minute and rushing around. Start off slowly: have some coffee, do meditation or yoga. Do things at the end of the day, too. Have rules with your family that the first half hour after work is for you when you come home.”
Alejandro Chaoul, PhD, is an assistant professor in the integrative medicine program at the University of Texas MD Anderson Cancer Center. Working for a hospital, he often instructs nurses in how to better handle the stresses of their jobs.
“The motivation for nurses is that they feel like they shouldn’t focus on self, but they can focus on how their own mental health can help patients,” Chaoul explains. “We don’t need an excuse to take care of ourselves. It is an important part of being, not just a nurse. We have forgotten this. Showing how busy we are is the way to go. If you tell someone you are happy, it is almost like a sin.”
Nurses are practical, though. Self-care, therapy, and meditation are great ideas, but how is a depressed nurse supposed to handle the rigors of their fluctuating mood while actually working on the floor? One helpful technique is known as grounding. Grounding can be done anywhere, anytime, cannot usually be seen, and can last as long as you need it.
Lisa Najavits, PhD, describes grounding in her book, Seeking Safety: A Treatment Manual for PTSD and Substance Abuse, as follows: “Grounding is a set of simple strategies to detach from emotional pain (for example, drug cravings, self-harm impulses, anger, sadness). Distraction works by focusing outward on the external world—rather than inward toward the self.”
Najavits breaks it down into three categories: physical, mental, and soothing. A physical grounding exercise would comprise breathing in and out, thinking a soothing word on every exhale. A mental grounding exercise would include describing an everyday procedure, such as passing meds, in as much detail as possible. Finally, soothing grounding might be picturing your loved ones—or actually looking at a picture of them. For each type, there are many types of grounding, and these techniques can be learned through therapy.
Although the reasons for nurse depression are multi-factorial, part of the problem is the stigma. With education and a decrease in the antiquated notions of mental health, these nurses could get help. Registered nurses are leaving the profession in droves. Some of those defections are due to injury, but a large part is likely due to undiagnosed or unacknowledged depression. If nurses hope to keep the profession vital and solve such problems as short staffing and poor ratios, they need more nurses to stay working as nurses. Helping, instead of ostracizing, nurses with depression is exactly what nurses need to help solve other problems that they face.
The beginning of a new year is a common time to reflect on the previous year, and deciding what goals you would like to accomplish in the next 365 days. This is not a time to be shy about the things that you want in your life. Be bold, intentional, and brave when setting goals for yourself. The sky is not the limit; it is simply the view. Although we tend to start out highly motivated and dedicated to the goals that we have set, we have got be honest with ourselves and realize that often that ambition can fade, and nothing gets accomplished! I want to share with you five methods I utilize to keep myself grounded, motivated, and a realizer of my goals.
Find Yourself a GOAL MATE
What is a GOAL MATE? A goal mate is someone that you have a great connection with that supports, motivates, encourages, and enables you to manifest all of your wildest dreams. It does not matter how far-fetched they may seem, your GOAL MATE will not only hold you accountable but encourage you to jump in and get dirty neck first. Whether you succeed or fail at accomplishing a goal they are there to pick you up if you break your neck for real (just kidding), brush you off, and send you on your awesomely merry way to attempt your next goal. Keep in mind, that in order to be a good GOAL MATE, you need to reciprocate the same energy and tenacity that your partner(s) give to you. It’s important to keep each other focused, interested, and motivated.
Make Clear, Objective, and Achievable goals
Be clear and intentional about the goals you are setting. It is also important to be specific. Think about where you want to be with your finances, health, career, and love life. Self-love included. Be realistic with your timeline and remember that there are only 12 months in a year, but that is a valuable time that can be leveraged to generate a better you.
Make a Vision Board or Host a Vision Board Party
This is an annual tradition of mine. Each year I invite my GOAL MATES, friends, neighbors, co-workers over to craft vision boards. This is inexpensive and so much fun. All you need is magazines, scissors, glue, posters, your imaginations, and perhaps some wine!
Set Mall Quarterly Milestones
Hold yourself accountable. Think about where you want your progress to be after 3,6, and 9 months. I like to review my goals monthly. This keeps it relevant in my mind. You should review your goals quarterly at a minimum. Think about what is working for you, and what you can switch up.
Look at It
If you do not see your goals periodically, or place your vision board somewhere that you can see it every day. I have my goals on my vision board, iPhone, iPad, and posted in my locker at work. Don’t forget the plans you have made for yourself. Utilize these tools, go forth, and prosper!
Jazmin Nicole is a military officer, obstetrics nurse, advisory board member of Black Nurses Rock Inc., and the founder/CEO of Jazmin Nicole & Co.
For more posts/blogs like this follow me on twitter (@jazminweb), Instagram (@therealjazminnicole_, and Facebook (Jazmin Nicole and Co.)
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.
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!