Why is nursing school so stressful? It certainly seems like nursing students tend to have more hectic schedules than our classmates from other specialities. At least, this is the impression many of us get after browsing a student nurses’ forum.
Our degrees (and future careers) combine theoretical knowledge with a lot of physical labor. As a result, we often have double the struggles and three times the opportunities for exhaustion. Often, nursing students reach their final semester already burnt out, and many go on to leave their profession due to the high-stress environment. Can this be avoided? Yes, it can: with a holistic approach that combines time management, self-care, and self-kindness. We will have to be mindful and use solid stress-management techniques throughout our careers, and we definitely need to start learning and applying this in nursing school.
The Components of Nursing School Anxiety
Usually, the ingredients that make a stressed nursing student are:
- The large number of objective tests that our courses included (with the infamous “Select all that apply” questions)
- If you are pursuing an accelerated program, you may also have shortened terms and summer classes, which directly cut into your recharge time
- Having to allocate extra time for clinical rotations, which come with additional homework
- Dealing with the occasional unsupportive staff nurse during clinicals who is out to “eat their young”
- The physical exhaustion and muscle soreness that often follow a long hospital shift
- The hospital exposure to people who have been subjected to violence, abuse, or unfairness
- The current uncertainty about nursing during a pandemic, with surge periods in specific areas
Combined, these factors would make for an exciting epidemiology project. According to various studies, approximately half of nursing students are at least “moderately stressed,” and roughly one third develop symptoms of depression.
Are We Making Our Nursing School Struggles Worse?
If we are to be perfectly honest – yes. While academically taxing, some of our coping habits could be making it harder to stay on top of everything.
Inefficient study habits and cramming
For me, this was particularly evident during the end-of-term period. I came from a humanities background, where most final exams were composed of open-ended, essay-based questions. This gave me enough freedom to learn a few basic concepts and then argue my case convincingly into an A.
Naturally, when the time came to memorize the possible signs for phlebitis or figure out how to prioritize care for an imaginary patient, these strategies just weren’t enough.
All healthcare professions, but nursing in particular, are often perceived as a selfless calling.
Behind the clapping sessions and the congratulations for our “heroes in scrubs” lies the assumption that we should be ready to work past the point of exhaustion.
Both nursing and medical students often fall victim to this myth and feel guilty saying “no.” Some nursing instructors perpetuate this myth: if they had to overwork themselves when they were students, then so do you. Shift supervisors are quick to congratulate the students who jump on errands or who are “troopers.”
Being committed to your work is one thing, but you need to be healthy and relatively well-rested to do it well.
Unhealthy “pick me ups.”
This is the point where “nursing school is hard” can become “nursing school is killing me”. To cope with an overly full plate, many of us resort to the holy trinity of unhealthy habits: caffeine, snacks, and overnight study sessions.
In many ways, this makes sense: if you have a paper due tomorrow and an exam in two days, cooking or sleeping fall to the wayside. Instead, you will grab whatever fast food is nearby and wash it down with a Red Bull. If you are lucky, your body will feel the consequences of this after your final exam – but every once in a while, it may happen while you still have a couple of exams to go.
8 Tips for the Stressed Nursing Student
Preventing nursing school anxiety and fatigue is much easier when you set up your schedule correctly from the start of term. Let’s take a look at some of the strategies you can implement that will keep you sane and healthy until it’s time for your last final exam.
1. Set up a day for “ongoing revision” once a week
And perhaps more importantly, put it on your calendar!
Naturally, this doesn’t need to be an entire day, and there’s no need to sit down and get it all done at once.
Still, you should set a few hours every week to review the materials covered just during this week. Ideally, you should re-read them and write down your summaries at the end of the session.
Every three weeks, allocate an extra hour to go through your previous week’s summaries. This will make you go over the older material regularly and create a simplified form of the “spaced repetition technique.”
2. End your sessions with a quick quiz
Every time you finish reviewing a topic, check what you have learned with a small quiz. This can be a brief 10-question multiple-choice quiz using any of the free question banks available online.
If you use Lecturio, you will also have a convenient way to track your progress. It’s always extra-satisfying to see the results of your labor.
3. Use the Pomodoro Technique
The Pomodoro technique is a very basic yet highly efficient way to ensure you can stay attentive and committed while performing any task. Simply divide your time into 25-minute slots (or “Pomodoros”), with 5-minute breaks in between. Why? Because, on average, 25 minutes is what your brain can handle without becoming overly taxed or causing your thoughts to wander.
During each “Pomodoro,” eliminate all distractions and study. You can use your small breaks to check your phone’s notifications or get a quick snack – as long as you are back on track as soon as the next Pomodoro starts.
After 4 “Pomodoros,” give yourself a longer 15- to 20-minute break. Use these for a quick relaxation or guided meditation session.
4. Give yourself a caffeine limit
In a perfect world, we would not need the help of any magical drinks to get through the morning. The world does seem just nicer after a fresh cup of coffee, but there is a point in which you will hit diminishing returns. With caffeine, this usually presents itself as feeling too jumpy to sit still or focus on anything.
This amount is highly personal, so it will be up to you to figure out your sweet spot. Just make sure you don’t exceed it.
For me, this turned out to be at three cups a day rather than five. Now, I make two pots of coffee: one regular and one decaf. Then, I alternate between them.
5. Schedule some outdoor exercise
This may sound counterintuitive when your ankles are aching after a long shift or when time feels scarce and precious. Should you really spend an hour jogging around the neighborhood or stretching in the park?
The answer is a resolute yes. There are benefits from exercise that go beyond the simple “moving and burning calories.” The hospital floor’s artificial lights can quickly mess with your circadian cycle. Conversely, cardiovascular activity and exposure to green spaces will help you stave off depression and could help you concentrate better.
6. Account for your clinical days when setting your deadlines
Although this may sound kind of obvious, it is a mistake that we all fall into eventually: we look at our calendar and our to-do list, and everything just seems so far away. That group project is still ten days away, which is more than enough time to figure out a 20-minute PowerPoint presentation.
Except four of those ten days don’t count because you will have clinicals and be too tired to do anything afterwards. And out of the other six days, two are out of the question because the other group members have a shift or lecture. One of them is wasted on research – and suddenly, ten days becomes three.
7. Reach out to your classmates
Explaining your frustrations to people outside of healthcare can be challenging: they don’t understand hospital slang and don’t appreciate the emotional labor involved.
But we all need to vent. And you know who else is going through the same nursing school struggles? Your classmates. Reach out to them and message them, or offer them coffee and a muffin. Chances are they are dying to talk to someone too.
8. Set up a bedtime alarm
Rotating schedules and tight deadlines can make it tempting to simply keep going and push through until you finish everything on your checklist. However, a sleep-deprived brain is less efficient at any task.
Many of us haven’t had a strict bedtime since we were kids. But if there was ever a time to bring it back, it may be now. This is especially critical if you notice any of the following symptoms of a sleep-deprived brain:
- Increased forgetfulness
- Growing easily frustrated
- Clumsiness or lack of dexterity
- Inability to concentrate
If any of these happen, it’s time to set aside a weekend to catch up on sleep. Then, set up a bedtime that allows you to get at least seven hours of full sleep, plus half an hour to actually fall asleep.
What to do When Things Get Bad?
So far, we have mostly covered strategies to deal with regular levels of nursing student stress. However, sometimes things go beyond what we can manage with self-care tips. Our lives are not limited to nursing school, or you may be significantly affected by a gruesome case you meet at the hospital. Other times, negative thoughts go a step further and begin interfering with simple activities.
When this happens, you should reach out for help. Your school’s Student Services unit probably offers some sort of counselling. If they don’t (or you would rather not involve your school), try:
- The National Alliance on Mental Illness Guide on Mental Health for Nursing Students
- The Crisis Text Line, available 24/7 via SMS (text HOME to 741741), WhatsApp or Facebook Messages
Protecting our mental health is often our own responsibility. Healing it should not be. There is professional help out there!