Students in Health Care Begin Caring for Each Other

This op-ed appeared in the Courier-Journal on July 21, 2017 and the Lexington Herald-Leader on August 7, 2017.

Something frightening is happening to our health care students and providers.

​​​​​​In "A Roadmap to Decreasing Clinician Burnout"published in Hospitals and Health Networks, authors Ronald A. Paulus, M.D. and David R. Strand reported that more than 50 percent of nurses are emotionally exhausted and 25 percent are clinically depressed.

In "Breaking the Culture of Silence on Physician Suicide" The National Academy of Medicine found that about 400 physicians take their lives each year, that physicians are more than twice as likely to take their own lives than non-physicians, and that female physicians are three times more likely than male physicians.

These alarming numbers are also present within our health care student populations. The American College of Health Association's 2015 annual report found that 17 percent of college students are depressed, 50 percent of college students who seek mental health counseling have been seen before, 34 percent of college students are on mental health medication(s), and 25 percent of college students have self-injured.

Our students here at the University of Kentucky College of Nursing realized they and some of their classmates were struggling.

To understand what was going on, they conducted a survey of 160 UK nursing sophomores in the nursing program.

The sophomore year of nursing school is a critical and busy time for nursing students when clinical rotations begin. Their survey results showed 27 percent of sophomore students were taking a medication for a mental health disorder and 30 percent reported dealing with a mental health condition.

When ranking the degree of stress, they felt during nursing school, most students reported levels of eight and nine on a 1 to 10 scale. The survey also showed that few were taking advantage of on-campus mental health resources, which UK is investing heavily in to support our students.

In response, our students organized Student Mentors Advocating for Student Health(SMASH) on the premise that peer-to-peer support and faculty involvement can help dissolve the stigma of mental health disorders and encourage nursing students to seek help for mental health issues.

The students have partnered with College of Nursing faculty members to promote a healthy school-life balance and create a college culture where students can address the emotional and mental burden of a nursing education and career.

So much uncertainty exists about the future of our health care systems and how they will continue to meet the growing demands of our patients. Nonetheless, we can look to these students who are finding creative ways to support each other and overcome the challenges of their profession.

In that light, I hope all of our health care providers will do something meaningful to better care for ourselves. 

For more than two decades, research has shown the value of resiliency practices to reduce stress. Activities such as mind-body practices and interventions promote increased awareness through focused attention in the present moment, decrease harmful neuro-immunological reactions and improve cardiovascular function and quality of life. Other resiliency practices and recommendations include:

• Get adequate sleep – recommend 7 to 8 hours
• Eat healthily - recommend well-balanced meals with whole foods, fruits and vegetables
• Drink plenty of water – recommend 64 ounces (8 glasses of 8 ounces of water)
• Exercise – recommend at least 30 minutes 5 days a week
• Practice being more fully present and attentive in as many moments as possible
• Nourish heart and soul – recommend frequent spiritual and/or family and friends engagement/activities
• Schedule “me time” each day – recommend at least 30 minutes each day meditate / yoga / reflect silently or in writing or listening to music or while exercising
• Keep a gratitude journal – recommend documenting 3 things grateful for or went well in your day
• Avoid ruminating about negative situations – recommend see glass as half full not half empty

Although our primary obligation is to those we serve, we also have an obligation to address our own self-care, such as cultivating resiliency practices, so that we can be more fully present, more focused, more empathetic and less emotionally exhausted.  This is not only good for growing and sustaining the health care workforce but the health of those we serve – our students, patients, families, communities and health systems. 

Janie Heath,PhD, APRN-BC, FAAN, is Dean and Warwick Professor of Nursing at the University of Kentucky College of Nursing.