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Hot Topics in Nursing: It's OK to not be OK

Hot Topics in Nursing: It’s OK to not be OK

New mental health courses teach students self-care to avoid burnout, quitting profession

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The pandemic left nurses across the country physically worn out, emotionally exhausted, and asking themselves if it’s worth it. In a survey by the American Organization for Nursing leadership, 36% of nurse managers admitted they are not emotionally healthy. One out of every two nurses has thought about quitting. That’s why the University of Colorado College of Nursing has made mental health and wellness a top priority.

Just like First Aid can help someone with bleeding, the Mental Health First Aid curriculum is First Aid for nurses. The students learn about spotting signs of depression, anxiety, and substance abuse in coworkers and themselves. They also learn to listen without judgment so the person who is stressed feels respected, accepted, and understood.

CU Nursing also has a group of mental health nurse practitioners who help the students talk about the need to step away and take a break.

Mental health care is now central in a post-pandemic world experiencing more mass shootings and mental illness. According to the World Health Organization (WHO), mental health conditions and substance use disorders have increased 13% in the last decade. Those conditions impact all areas of life, including school and work performance, relationships, and the ability to participate in the community. Two of the most common mental health conditions, depression, and anxiety, cost the global economy US$ 1 trillion each year, according to WHO.

To learn about the new mental health coursework at CU Nursing, we spoke with the Assistant Dean of Undergraduate Program and Specialty Lead Academic Advisor in the Baccalaureate Nursing Program Tammy Spencer, DNP, RN, CNE, ACNS-BC, CCNS.

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Dr. Spencer, what is the goal of the mental health First Aid courses for CU Nursing students?

We need to change the narrative and the culture about mental health. There shouldn’t be any apologies anymore for saying “I need to take a break.” That’s a different shift for healthcare personnel because we always feel like we need to be that rock for people. When you find yourself in the position of wanting to deliver care that is the best possible care, but you’re unable to do that, whether it’s because you don’t have the right personal protection equipment or you’re feeling

burned out, that’s where moral distress kicks in. We know what we should be doing, but we’re not able to do it. That moral distress is one thing that causes people to leave nursing. We’re trying to catch that early so that we graduate students who have those tools in their toolkit to be able to recognize issues in themselves and others and seek resources to help deal with them.

Many hospitals have new graduate transition to practice programs to help support students when it comes to things like seeing their first death or having their first encounter with challenging, complex patients. These transition to practice programs teach them how to handle these situations so new graduate nurses feel supported and confident, which helps them to stay in the nursing profession and prevent burnout.

How can students recognize they or coworkers need help?

We’re teaching students to recognize when something feels off. Maybe they’re not feeling the same connection they normally have with their patients, that they’re not 100% present. In a clinical environment that can take an emotional toll, You have to listen to the voice inside you that says “this is different.” You need to pay attention to disconnection. That's when you need to step back and think, “That's not okay for me, and it's not okay for my patient.” It’s being able to know when you are feeling burned out, being able to recognize those behaviors of burnout, and being able to stop and take a breath, pause, and refill your tank so you can come back to nursing and stay in nursing.

For your coworkers, it’s the ability to say, “Hey, I'm seeing some of these things. I'm worried about you. How can we get you connected to the resources that you need?” So instead of saying, “What's wrong with you?” Saying, “Hey, I've noticed these things. Let's talk and see if you can figure out what you need to get you back into the zone where you're healthy.”

We just need to talk about it. This should not be something we are ashamed of or apologize for. It’s out there more than we know. We have to start talking about how difficult it is. That doesn’t mean you’re weak or you’re not going to be a great nurse. You just need support around you to talk about it. If we can do that, boy, we can keep a lot of people in nursing.

What steps can they take for self-care?

Taking time out, taking a walk, having support around you, and being able to feel okay to say “I'm not okay” in a safe environment. Maybe that’s your unit manager or a good friend. You want to have someone to tell, “I'm not feeling myself.” I think that’s a really important step.

Also, students need to self-reflect. It should be part of your daily routine. Ask what went well about that shift? What didn't go so great about that shift? What could I have done better? What was out of my control that I really couldn't do anything about? I think that's the first step in all of it; be self-reflective all the time, every day, in every way to be the best practitioner that you can be.

Also, figure out your strengths and weaknesses. Nursing is a great profession, but maybe the chaos of urgent care isn’t for you. You can work as a nurse researcher, an instructor, work with children, seniors, veterans, and in multiple other areas. Learn where you will perform your best, and love what you do.

What advice do you give students about getting a job in nursing?

My advice is to find an organization that you feel is the best to support you in the first two years of your career.

You want a culture where somebody has your back when it hasn't been a great day. If you’ve made a mistake or an error, it’s knowing that the organization will support you. Seek an organization that values nurses through nurse-driven committees and also creates a culture where nurses are valued for their expertise and insight.

I think nurses also need to have a voice in policy and leadership, especially in staffing ratios. Also, having a voice in legislation around things like that is really important. Because we do have a voice. We're the biggest provider of healthcare. We need to use that voice.

About Our Expert

TSpenser_ExpertTammy Spencer, DNP, RN, CNE, ACNS-BC, CCNS

Dr. Spencer is the Assistant Dean of Undergraduate Program, Specialty Lead Academic Advisor, Baccalaureate Nursing Program at the University of Colorado College of Nursing.

Dr. Spencer has been a faculty member since completing her master’s degree at the University of Colorado College of Nursing in 1989. She’s a seasoned classroom instructor with a focus on adult Medical-Surgical nursing with a special emphasis on concepts related to caring for the critically ill adult patient.

She serves as the Lead Academic Advisor for the baccalaureate nursing program and is currently serving as the faculty liaison for the University of Colorado Student Nurses Association. She also serves on the University of Colorado Alumni Board and practices as a staff nurse in the Post Anesthesia Care Unit at University Hospital.

Topics: Faculty, Hot Topic