Savannah Kolb, registered nurse in the Birmingham area, did not always take time for self-care.
Kolb graduated from Auburn University School of Nursing in May 2018. Since June, she has worked as a labor and delivery nurse.
“I deal with a lot of crazy, pregnant women all the time,” Kolb said. “It’s the most entertaining place I could possibly be.”
Although lively at times, Kolb said the job is taxing. Her first few months on the job, she struggled to find a balance between handling demanding physicians on adrenaline-filled days and enjoying her personal life in her down time.
“The first six months I really didn’t take care of myself,” Kolb said. “I just had enough time to go to work and recover from work.”
On her off days, Kolb was either recuperating from the previous day’s shift or going back to work to take new graduate-education classes and earn certifications necessary to progress in her field.
“I really struggled with things like, ‘Maybe I should’ve majored in something else’ and ‘I don’t know if I want to do this forever.’” Kolb said.
Morgan Yordy, assistant professor at Auburn’s School of Nursing, said the United States is currently experiencing a shortage in the industry that is expected to worsen in coming years.
The United States Bureau of Labor Statistics projected a 15 percent growth in registered-nurse employment from 2016 to 2026, a rate far above the national average.
Despite this outlook, Yordy said an increasing number of nurses are beginning to leave the field within the two-year mark of their hire date.
“The constant changeover is kind of scary,” Yordy said.
One reason for the rapid turnover is the nursing demographic. Yordy said with the national average for male nurses being just 10 percent of the nursing population, the majority of nurses are women, and it’s common for newer nurses to leave the profession to start families.
Another major reason nurses are leaving the job so early in their careers is the stress of the trade and the difficulty managing it, Yordy said.
“The flight attendant says to put the mask on yourself before you take care of the person next to you,” Yordy said. “We don’t hear that. We always want to help other people, and we feel like if we do anything for ourselves, it’s not good.”
Yordy said though nurses are at the forefront of health education, they administer so much care to others, they often forget to take care of themselves.
Stephanie Wood, Auburn pre-nursing academic advisor, said the intensity of the nursing program starts with nursing school hopefuls’ first semesters on Auburn’s campus.
“Nursing students are stress balls,” Wood said. “They’re worried about their grades in their classes. They’re worried about if that’s going to be good enough to get into a competitive major like nursing.”
Wood said when students come into the advising office, advisors ask them to rate their stress on a scale of one to 10 — one being the low extreme and 10 being the high. Advisors want students to be aware of where they are on the scale and how they can utilize resources to help manage their stress.
Wood said it’s important for nursing students to find the decompression activity that helps them the most.
“Find what works for you,” Wood said. “Is it working out? Is it a show? Is it hanging out with friends? Is it turning off your phone? Academics is important but so is getting plugged into the University — so is maintaining your stress.”
As pre-nursing students matriculate into the nursing upper division, the contrast between nursing students and their colleagues in other colleges becomes starker. Yordy said many students are stressed, but nursing students’ stress is different.
“Nursing students are with people, and people’s lives are in their hands,” Yordy said. “They have faculty and nurses working alongside them, but it’s still working with a patient.”
By the time they graduate, nursing students are working 12-hour shifts in local hospitals as a part of mandatory clinicals.
“They have to wake up at 3:30 a.m. to make clinical schedules, and they work 12 hours, so it’s a different lifestyle from their peers,” Yordy said. “It’s hard to compare a nursing student to a student in a different program when they’re up all hours of the night at the hospital.”
Kolb said she first felt the weight of the position while still in nursing school. She was working the night shift at a hospital as a part of the preceptorship program, and though she was always with another nurse, she struggled with anxiety.
“I lost a lot of my hair,” Kolb said. “I have a bald spot from where my hair has still not grown back from how stressed out I was in nursing school.”
After experiencing a few panic attacks, she realized she had to do more to better manage the profession’s intensity.
Now, Kolb relaxes by doing things like exercising on her off days, preparing meals for the week and tackling tasks related to her personal life.
Fifth-semester nursing student Courtney Space said nursing professors frequently encourage students to take time to do mindless activities that don’t drain their brains.
“Our teachers always tell us to not just go all the time,” Space said. “We had a huge test this past Wednesday, and they said the day before to not study at all — to not overwhelm ourselves.”
Space said faculty members emphasize the importance of exercising in upholding healthy habits.
“They tell us to exercise because that gets blood pumping to your brain, helps with studying and releases endorphins,” Space said.
They also recommend taking breaks outside to break up the day’s strain.
“Most of the time when we’re working in the hospital, we don’t see the light of day,” Space said. “Getting out on days off or even when you’re still in school helps.”
Fourth-semester nursing student Adam Kosan said the advice he has heard the most is to find people nurses can talk to about their days.
“They tell what to look for as signs of burnout and compassion fatigue,” Kosan said. “And what we can do to not be afraid of telling somebody we might be experiencing it.”
The American Institute of Stress defines burnout as “emotional exhaustion and withdrawal associated with increased workload and institutional stress.”
Compassion fatigue differs from burnout in that it specifically deals with “the emotional residue or strain of exposure to working with those suffering from the consequences of traumatic events.”
“It’s a person-by-person thing,” Kosan said. “It’s not like they can give us a medication or a six-step plan to eliminate compassion fatigue.”
Kosan said that male nurses generally tend to avoid sharing feelings in general, particularly work-related ones.
“Now, we’re learning that it is common, and if you start noticing this stuff to just go and talk to somebody about it,” Kosan said.
Space, too, said she has heard that finding people in her life she can communicate with can help with enduring the pressure.
“You’re going to have really crummy days, and you don’t want to carry that burden home with you,” Space said. “That’s one of the worst things you can do.”
Space said a professor of hers once told the class that when she worked as a nurse on the hospital floor, she took her 20-minute commute home after work as time to shift from a work mindset to a home one.
“She found herself, especially in her first year, taking the burden of pain and sadness from the patients home, and she was sad all the time,” Space said. “You have to learn to separate them.”
Kolb has discovered having friends in the field to be one of her best outlets. She said other people in her life care but don’t understand like her nursing peers. Her nurse friends relate to tough situations and are able to share what they did in similar circumstances.
“Even just hearing, ‘Hey, you didn’t deserve that doctor to yell at you.’” Kolb said. “Things like that help.”
Yordy said Auburn is looking into doing more to help nursing students take ownership of their care.
For example, she and other faculty peers are in the process of developing an elective course focused on helping students recognize their responsibilities to themselves.
Another of Yordy’s projects is the center of her research at Auburn — using animal-assisted therapy on the staff side in healthcare.
Daisy, a 2-year-old goldendoodle, has her own office in Auburn’s nursing college. Yordy said students regularly take her with them to study rooms or out for walks. She’s noticed how Daisy brings joy to the students, and she’s now working to quantify that effect.
“Nurses have a stressful time at work,” Yordy said. “We want to see how animals help.”
Yordy worked as a nurse for 17 years, and she said, though mentally draining, nursing is one of the most rewarding careers.
For Kosan, who wants to work in the ER when he graduates, helping people through life-and-death situations makes it worth it.
“It’s getting to help people,” Kosan said. “It’s watching them walk out on the other side OK — knowing that they get to go home to their friends and family because of things we were able to do.”
Kolb enjoys her patient population, educating new mothers on proper infant care and having a healthy baby at the end of the day.
“Some of these young women add me on Facebook, and I get to watch their babies grow up,” Kolb said. “I love that.”
Space appreciates the chance to go above and beyond to make her patients smile on their worst days.
“If I can walk into a patient’s room and make their day even just a little bit better, I get joy and satisfaction out of it,” Space said.
Space said she’s commonly asked how she’s able to constantly pour into people when the job is so mentally taxing.
“Imagine it’s you or your family member lying in that bed — you’re going to want the best care for them,” Space said. “We need to be that nurse for that person.”
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