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The penalty for excellence

Looking into the mental cost of a health major

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Photo illustration by Sarah Rogers

Megan Brown knew in high school she wanted to study diagnostic medical sonography. She also knew the program only accepted 10 students.

The senior diagnostic medical sonography major said she remembered the sea of faces during Welcome Week, keeping a tally in her head of almost 100 students who said they were going to major in sonography.

“You’re like, ‘oh my gosh, I have to beat all these people to get into this program,’” Brown said. “So it’s always been stressful since day one.”

According to the International Nursing Review, stress affects almost every profession. However, levels of stress are higher, and there are more sources of stress among health professionals, especially nurses, with negative consequences for their health.

The study found that the most common sources of stress are clinical environment concerning learning, academic stress, the degree of stress among nursing students and stress because of interpersonal relationships.

Stress is felt and dealt with differently for every person, and some people are able to cope with stress more effectively than others. However, there is a consistent relationship between students in health professions majors and unaddressed stress.

Arguably, this connection is because of the intense nature of most health majors: higher grade standards, long hours in hospitals on top of study hours and the constant fear of being kicked out of their programs for a multitude of reasons, including multiple absences to clinicals and failure to pass a class.

Brown said she has dealt with anxiety and depression her entire life, but she didn’t realize what it was until her symptoms were heightened by the stress of her major.

“There was a time when I felt like I couldn’t handle it anymore,” Brown said. “I had to go to the doctor and do something about it and just admit that I had something going on. I’m on medication now, so everything is great.”

Since getting help, Brown said is still stressed, but she’s not having panic attacks every day like she once was.

Brown said she hopes once she graduates and gets on a more normal schedule she will be able to wean herself off the medication.

Brown said her professors are always willing to listen and help, but can sometimes forget what it was like to be a student.

“There is life outside of these four walls of a classroom and clinicals,” Brown said. “We get home from clinicals and we worked an 8.5-hour day. We do 40 hours a week, that’s a full-time job. They leave their job and they go home and do whatever they want with their family. We leave the classroom and clinical and we have our own personal issues to deal with, let alone the stress of school.”

Brown said she goes to clinicals, comes home and goes to bed. She said she wakes up the next day and starts it all over again.

“It sucks while you’re in it, but once you graduate it’s all going to disappear,” Brown said. “All that extra stress of having an assignment done or getting written up for something. There are still a lot of positives if you’re passionate enough about it.”

Instructor of Nursing Robin Smith said there is “very much an open-door policy.”

“We work closely with our students,” Smith said. “When we see a student is struggling with an exam we tell them to please come talk to us to review their exam. We review what’s going, and talk about different ways of studying, different ways of test taking. We talk about test anxiety and we talk about how to overcome that.”

Smith said she knows many students have full-time jobs and families on top of their studies, and said time management is vital for their success.

“It is a balancing act trying to do it all,” Smith said. “You have to schedule time to study, which is what we talk about. You have to make sure you have time to study, time for yourself and for self-care. You have to be at the clinical time, and you have to come prepared for clinical. Then you have to sleep, and you have to work.”

Smith said if she could change anything about the health professions majors, she would change the perception on mental health.

“We are in the process of bringing more self-care concepts and increasing the students’ perception of the need for self-care,” Smith said. They tend to be so giving and so other-oriented and they think, ‘I’ll take care of myself tomorrow, I’ll sleep tomorrow,’ and they’ve got to sleep today.”

Smith said she has watched too many nurses go through burnout.

“If you know anything about PTSD, there is a type of PTSD where the individual themselves is not directly affected, but they’re affected by the stress of the others, taking on that burden of others,” Smith said. “If you experience too much of that, you start withholding yourself. When you start withholding yourself, you start losing that connection and you become more robotic, and that’s not nursing.”

Smith said she has had students who have dropped out the program because of stress.

“It hasn’t been solely nursing school stress,” Smith said. “They have come in with more stress, or they come in with a preexisting condition. I teach mental health and preexisting conditions happen. What we encourage is first, when you see the stress rising, we encourage them to go to the counseling center because we have an excellent, well-staffed counseling center. Sometimes I walk students there to make sure they get an appointment sooner rather than later because the counseling center is busy, and our courses are so short.”

If students are unable to manage their stress levels and receive lower than a 75 percent in a course, they must reapply to be in the nursing program the following year. If a student fails a class again, they are out of the program for good.

“The reacceptance rate is very high,” Smith said. “I can’t think of any case where a student was not successful reapplying and was not readmitted. We need them to be looking at what in their life can change so they can be successful.”

Katie Stead said when she gets stressed she feels physically sick.

“I’m always tired when I’m stressed,” the junior nursing major said. “It’s just exhausting. I get really nervous and negative about things, and I’m normally a really positive person. I feel like if I was more confident about things, I would have felt better, and I would have done better, but being so nervous, I would second guess myself and question it, and I wouldn’t do as well on the test.”

Stead said she feels the rigor of the program is understandable.

“USI has the number one nursing program in Indiana,” Stead said. “We have that because of how good it is, how strict we are, how much importance they put on our test grades, and how much we know. I feel like to an extent, sometimes it’s a little extreme and I don’t necessarily think it’s healthy for all the students, but they are only trying to prepare us to pass our NCLEX at the end, and after going through everything, if you can make it through USI nursing program you can pass your NCLEX.”

Stead said nurses learn so much about how stress negatively affects the body.

“They teach you that, and they know we’re all very stressed, and they know we’re all trying to get through this program,” Stead said. “I think the focus on our mental health needs to be focused on a little more because you can’t acknowledge that stress is really bad for the body but then say, ‘sorry we’re making you really stressed, but you have to be like this in order to be a nurse.’”

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The penalty for excellence