community health
Community Health News
By Gina Combs, Community Health Director
Feeling a Little Stressed Lately?
Let’s face it! Stress is a part of our lives; all our lives. Even the most grounded and well-adjusted individuals face stressful situations on an ongoing basis. It is a part of the world we live in. It’s a part of life. Stress forms a negative image in our minds, though not all stress is bad. According to the University of Akron Counseling, Testing and Career Center, “”Good” stress arises from the demands of a pleasurable activity.” Good stress can motivate us. However, the Center also says “”Bad” stress is having a chronic feeling of being overwhelmed, oppressed, and behind in your tasks with little opening for relief.” If left unchecked, stress can complicate many aspects of our lives. So, it is helpful, if not imperative, that we learn how to live with stress.
As future nurses, we not only need to deal with our own stress, but must be able to “coach” our patients through stressful situations, when needed and appropriate. In order for us to care for our patients in the best possible way, we must make sure we are managing our own stress. Students of any age deal with stress often. There is a constant inflow of tasks to be performed by a designated due date and pressure to perform the tasks at a high level of mastery. Learning how to manage stress, as a student, can help enhance our education and make the most out of our learning experiences. It also prepares us for what is yet to come.
This begins our first module on stress. Our goal this month is to tackle “Student Stress” and we are going to do it using the Nursing Process. Please make sure to read the end of this article for some helpful tips and techniques as well as beneficial resources generously given by the Counseling, Testing and Career Center, the Psychology Department Counseling Clinic, and some of our own fellow nursing students, all from the University of Akron in Ohio.
Student Stress – How to Cope
Let’s discuss stress in nursing students. We will begin by using the nursing process. When faced with a problem we follow these steps:
Assessment
Analysis and diagnosis
Planning
Implementation, and
Evaluation.
These steps are outlined and further discussed in the textbook “Professional Nursing – Concepts & Challenges” by Kay Kittrell Chitty and Beth Perry Black.
Let’s assess. Do you feel overwhelmed by your commitments? Do you feel like you should be doing more or less than what you are currently doing? Do you feel that there are situations out of your control affecting you? … Do you think you’re not coping effectively? Do you have imbalance in your life? Maybe you don’t even know that you’re stressed until you have a mini breakdown in front of your instructor or kids at home. Did you answer yes to any of these questions? You’ve just assessed your situation. Assessing or realizing that there is a problem is the first step. As an example, I notice that I tend to get upper respiratory infections after big exams. This is my personal assessment.
Next we need to analyze and diagnose. Remember this is not a medical diagnosis, as we are not physicians. Here, we are using the word diagnose to identify the condition more specifically. We identify what is causing our stress. These are our triggers. Then we identify those triggers and see how the stress has manifested itself in our bodies and behaviors. Below are some clues that stress might be having a negative impact on your life.
Let’s look at the signs and symptoms of stress. According to University of Akron Counseling, Testing and Career Center, stress can manifest itself in a variety of ways. Here is a general breakdown:
Physical symptoms of stress:
Headaches Fatigue
Gastrointestinal problems Inability to focus
Lack of concentration Sexual problems
Sleep disturbances High blood pressure
Sweating palms/shaking hands Anxiety
Heart problems
Behavioral Symptoms of stress:
Irritability Over-eating or under-eating
Harsh treatment of others Increased smoking
Increased alcohol or drug use Isolation from others
Compulsive shopping
As you read through the symptoms above, you may see how these symptoms can cause further problems in your life, and lead to even more stressful situations. For instance, when we are stressed, others may be affected. We might lash out at loved ones, or avoid them all together. We might become ill due to stress, making us less capable of meeting the rigorous demands of student life.
Try keeping a journal of any and all symptoms. Next to your list of symptoms, write down any possible causes of your stress. For example, what are some of the “things” that you think of most often in a day? What thoughts keep recurring even when you are involved in another activity? Do these thoughts leave you feeling anxious or upset? What do you feel is causing your stress as a student? Is it a big exam that’s coming up? A paper that’s due? Are you feeling overwhelmed by the shear amount of reading, assignments, quizzes and tests, etc.? Did you do poorly on the last exam, and need to bring your grade up? Do you feel like you have no social life? Are you juggling school with other responsibilities like family, a significant other, or a career? Your list is unique to you, but don’t feel alone. We all get stressed out at times, and what you are experiencing, has most likely been experienced by many others.
Ok, so now we’ve maybe analyzed how we feel and what might be some of the causes that are affecting us. After all, in order to fix something, you need to know what to fix. For the example I gave you previously, when I thought about it, I realized that I was probably getting sick because I went for several days with little sleep and was feeling stressed because I wanted to do well on the exams. I also noticed that my diet was not up to par during this time, because I didn’t want to take the time away from my studies to fix a healthy meal, so I relied on “quick” alternatives. In other words, fast food most of the time, or skipping meals altogether. Then on the day of exam I would sit, tired and stressed in a room full of people with the doors closed. Since Fall and Spring semesters coincide with cold and flu season, and students are in close proximity, several of them coughing and sneezing, those germs abound. I compromised my health by not getting adequate sleep and nutrition, then, unwittingly put myself into a prime situation to get sick. In Fundamentals of Nursing, 8th edition, by Barbara Kozier, MN,RN, Glenora Erb, BSN,RN, Audrey Berman, PhD, RN, AOCN, and Shirlee J. Snyder, EdD, RN, on page 675, “Whether a microorganism causes an infection depends on a number of factors….One of the most important factors is host susceptibility, which is affected by age, heredity, level of stress, nutritional status, current medical therapy, and preexisting disease processes.
The next step is planning. It helps to be creative, but there are many resources to turn to for this, as well. Again, don’t feel alone. These resources come in a variety of forms. Planning might be introducing good habits into your life to help you to organize yourself. Planning can also mean making changes, either eliminating extraneous activities from your schedule or adding a study group to it. It might include trying to eat better. As referenced above, your physical body goes through its own stress if it’s not receiving the proper nutrition. If you are physically not feeling well, then it’s difficult to emotionally feel well. Combined, your physical and emotional states can either prepare you to be successful and feel happy or set you up for failure. These successes or failures can be in any area of your life, but since we are dealing with student stress, we see things like affected GPA, having to retake a class, getting in to the college of your choice, graduating, and preparing yourself for a much desired career. We all have goals, whether general or specific and it is in our nature to want to meet those goals. We will be more effective and successful if we are physically and emotionally prepared to do so. So feel free to integrate the tips and techniques that will be given at the end of this article, into your plan. We will provide links to the resources that supplied them. Pick out a plan that best suits your personality, one that you feel you could commit to. Don’t set yourself up for failure by trying to make to big of a change or too many changes at one time. For me, I know I need to get more sleep, especially before an exam. I know I need to eat healthier all the time, instead of just when I have the time to do it. How can I plan this? Well, to begin with, I might want to try to study at a constant rate throughout the semester rather than putting some tasks off then leaving them to pile up right before it’s time to study for that exam. Maybe I can stock up on fresh fruits and vegetables the week before the exam. I could make sure I have handy, healthy food to eat, like raw carrots, celery, apples, grapes, etc. I could arrange to make dinners ahead of time and freeze them. If you are a student living on campus or on your own, you could accept the occasional invitation to a home cooked meal. You get a healthy meal, and time to socialize with friends and family, which is a much needed break and strengthens the bonds for a supportive and nurturing relationship.
Our next step is to implement our plan. Put your chosen plan into action. Anticipation is always the hardest thing. We get afraid it won’t work or don’t have the time to try. This is why many of us continue to put things off. Don’t worry it won’t work. If it doesn’t, you’re no worse off than you were before. If it does work, imagine how much better you’re going to feel. If you think you don’t have time, think again. If you find a good plan to help with being a more efficient student, you’ll have saved time, and energy. If the stress has moved into other areas of your life, by eliminating the stress, or managing it better, you can possibly improve the other areas, thereby eliminating that stress, as well. I’m going to put my “sleep and better nutrition” plan into action this semester and see if it helps.
Finally, evaluate. Did it work? If your plan was not as successful as you had hoped, try again. Ask a trusted friend what they would do. Ask a successful student how they best prepare for an exam. If you find you are trying your best and unable to resolve the problems causing you stress, don’t give up. Help is only a phone call away.
I want to wrap this article up by thanking those in my world that helped me to write this article. First, Assistant Professor Wanda Franklin, PhD(c) MS, RN from the University of Akron, Ohio who is also a Professional Role Instructor, and a Community Health Nurse. She is an inspiration and a wonderful and willing mentor. Dr. S. Marc Silling, PhD, Coordinator of Testing and Psychologist at the University of Akron Counseling, Testing and Career Center was kind enough to meet with me, and provided many resources for our students to use including handouts. Dr. Susan I. Harding, Assistant Professor in the Department of Psychology and affiliated with their own Counseling Clinic, was also very helpful by providing pamphlets for me to hand out. Also, I want to thank my committee members: Melissa Hill, Amy Cunningham, Kathy Burke, and Kerrie Blewit for their time and commitment in helping with this project, and for some of their personal strategies they were willing to share.
Resources for you to use
(The counseling centers listed are available at the University of Akron-Please check your institution for similar counseling centers.
Counseling, Testing and Career Center – They have many helpful ways in which to help students with a variety of problems, and offer both private and group sessions. These are listed in their College Survival Kit. Please take a look at it. I was amazed at all the group sessions they had to offer. Just a sample would include “Improving Your Study Skills”, “Overcome Procrastination”, “Reduce Your Test Anxiety”, “Improve Your Memory (300%)”, “A Parent , and Also a Student”, “Coming Out”, “Love Shouldn’t Hurt”, “Interracial Relationships”, “Quit Smoking”…….the list goes on. There are also several sessions about dealing with sexual assault. You can go on line to view all of their sessions and times, or call to make an appointment to join them or to arrange a private session.
The vast majority of these sessions are FREE and your private sessions are CONFIDENTIAL.
Simmons Hall – Room 306
(330) 972-7082
www.uakron.edu/counseling
The University of Akron
Psychology Department Counseling Clinic
They provide vocational and personal counseling to The University of Akron students and individuals from the surrounding communities.
290 E. Buchtel Ave., Rm. 342
(330) 972-6714
Here are some links to sites offering further information on stress that I found very interesting:
www.mayoclinic.com Just enter a search for stress and you’ll have quite a bit to choose from. I liked the ones listed as “Understand your sources of stress” and “Stress symptoms: Effects on your body, feelings and behavior”.
www.clevelandclinic.com Type in stress in their search bar and you will also find many related articles pertaining to stress. Check out this link of theirs: http://www.clevelandclinic.org/health/health-info/docs/1800/1824.asp?index=8133
It is called “Manage Your Stress: Ten Ways to Ease StressAnd lastly, here are a few tips from our very own students from the School of Nursing:Melissa HillSome relaxation tips I have before taking a test!!! Arrive at least 10 minutes before the exam so you can relax and not it's not enough time to panic. Choose a seat that is not distracting, and breath slowly, and deeply. And most important are PEP TALKS!!! When I relax I play with my children! A good game of the tickle monster is really helpful when I need a good achy belly laugh!! Surround myself with positive people!! While I am in the car I drive with the radio off to think to myself and listen to my thoughts!! A bath helps diminish tense muscles. Take a brisk ride on the bike or jog in front of the computer while watching Nursing videos. A good buddy to listen to me vent when I am all steamed up with stress!!! Writing my thoughts down on a paper, starting with goals and methods of ways to achieve them can help. A person can set it up like a nursing diagnosis to get more practice in, then follow with implications and rationale for it!!
Amy Cunningham
Stay organized!! Write all exam, paper, reading, LSRN, etc. due dates in a planner. Make sure to look ahead in your planner to see when things may pile up, such as having several tests in one week. When everything is written out you can plan out when you need to start studying and what things are priorities for that week. I write everything in my planner including what I need to study each day and errands that I need to make time for. This also helps you see when you can take a break to do something fun or relaxing. 2. Try not to get overwhelmed! Take things one week at a time. Look at your planner and find what needs done for that week and make time for it. Be aware about the exam 3 weeks away but don't worry about it when you have a paper due this week. You'll end up worrying about the exam and not do as well on the paper, which will add even more stress to do well on the exam. This is when the planner really helps. You can tell what days you'll have time to work on stuff due later in the week and what things to start on over the weekend when your week is packed full. I also get some relief by knowing how many more days until I get a break. Like on Wed. I get to sleep in so on Tuesday morning I'm thinking "Just get through today and then you can sleep in on Wed!" It may sound silly but it really helps get through the day/week. 3. If you need to study when you get home, then do just that! Don't turn on the TV or computer (unless you need it for studying). Walk in the door and hit the books otherwise you can get so easily distracted with other things. Study first and then you can do other (more fun) things the rest of the evening. You'll enjoy your favorite shows much more when you know you don't have 2 hours of reading to do when it’s over.
Gina Combs
Ok! Here are a few more tips from me.
I try to take care of myself. College is rigorous. I think of it as boot camp for the rest of my life. I need to be in good shape to make it through. I try to eat healthy. That doesn’t mean I can’t have pizza; I just try to eat sensibly most of the time. I try to get enough rest. I know, from experience, that when I’m tired, nothing works as well as it does when I’m rested. I’m more forgetful, more stressed, achy, and I don’t want to do things I like to do.I try to exercise on a regular basis. It really does give me more stamina and energy. It also gives me time to focus on myself and I know I always feel better when I start to see results. It’s not necessarily about weight loss, either. It’s more about toning my muscles and feeling stronger inside. It feels good to take responsibility for my health. Personally, I like Pilates and swimming laps. I also do Range of Motion exercises we learned in Foundations of Nursing LRC. They are a great way to stretch out in the morning and before exercising. Plus, they help me to remember each ROM exercise I will someday use with my patients.I try to maintain balance in my life. I have a husband and three daughters, a house that always needs cleaned, outside commitments, pets, and extended family and friends, and a job, as well as being a student. I notice when I spend too much time on one thing, I feel guilty about neglecting others. It’s not easy, but I try to give everyone and everything a little attention. I try not to put things off. I know when I do procrastinate, things pile up quickly and I feel guilty about not getting around to that “thing” I have to do. Also, it seems that working myself up to doing that “thing” is always worse than just doing it. This goes for studying, laundry, favors, promises, etc.
Here’s a big one. I try to smile and laugh often. There is really nothing that feels better to me than to smile at my kids, or to laugh with a friend. I even smile at people I don’t know. It gives me a boost when they smile back, and hopefully I made them feel better too.
I always try to keep perspective. I currently work in a hospital. Occasionally, patients will readily tell me about their lives and the problems they have had to deal with, in addition to their current problem. Of course I keep it in confidence unless I feel their RN needs to be informed. It really puts my life in perspective. On one hand, some of my problems seem trivial. On the other hand, I feel so blessed to have been their “ear” or “shoulder” that it reminds me of why I’m working so hard in school to become a nurse.
We hope you enjoyed this segment and are now more aware of how stress affects you as a student, and how you might cope more effectively with it. Feel free to access the resources given to get further information on this topic. Use them in good health,
Gina Combs
Community Health Director - ONSA
