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Yoga for Nurses

Reducing stress in the workplace one yoga pose at a time.

Not often do you witness students doing a lotus pose, warrior II or downward-facing dog during a school day at Kent State University's College of Nursing in Ohio. But thanks to an innovative program developed by fashion designer Donna Karan, students have the opportunity to discover the healthy benefits of yoga.

Kent State and Karan's Urban Zen Foundation have teamed on a program focused on nursing wellness and self-care with the goal to address issues facing nurses today, such as burnout and job-related stress. Karan established the foundation to advocate for combining Eastern and alternative healing therapies with Western medicine. In 2009, the foundation launched the Urban Zen Integrative Therapy Program (UZIT) to advance a more holistic approach to healthcare. The UZIT program includes training in yoga, essential oil therapy, Reiki, nutrition and contemplative caregiving.

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Yoga Comes to Kent State

The collaboration started as a pilot project in September 2010. Approximately 30 students in the accelerated nursing program participated in the first 15-week "Care for the Caregiver" program. They met for an in-person class on a monthly basis, taught by a UZIT instructor. Students also participated in weekly webinars and tracked their progress through regular journaling. Thirty BSN students are participating this spring.

The program is embedded in the Introduction to Accelerated Nursing course. In the course, students are introduced to a variety of complementary modalities. The Urban Zen modalities of yoga and aroma therapy are practiced weekly in a 1-hour time block. A 3-hour introduction of Reiki is also part of the Urban Zen presentation.

"As a public institution, we take our public responsibility very seriously," explained David A. Pratt

director of advancement, Kent State University College of Nursing. "At the College of Nursing, we feel we have a fundamental obligation to develop the talents of the nursing students who come through our doors to better prepare them for their future as healthcare providers. By providing them tools to better handle a stressful nursing education, we hope to plant the seeds of self-care they will carry with them throughout their nursing careers. In the end, the ultimate payoff would be for improved patient care/outcomes."

Combating Stress

Nursing professionals face extraordinary stresses and emotional and physical demands in the present healthcare environment. Many of these stresses have long been associated with the profession: extended work hours, giving intense emotional support to others in the face of patients' suffering, competing demands in personal and professional lives, and caring for patients and families coping with pain, loss and trauma. More recently, the problem of nursing shortages and the associated consequences have exacerbated the situation.

As a result of these demands, nurses are at high risk for chronic stress and burnout. Studies reveal the consequences of nurse burnout can be devastating; in addition to contributing to psychological and physical problems, burnout can also result in decreased patient, family and community satisfaction. For nurses, stress and burnout equate to lost time, less productive hours and a premature exit from the profession. Because nurses are identified as healthcare givers, much of their preparation has been focused on others, not on themselves. Mind/body self-care practices can offer an intervention that provides an opportunity for nurses to care for themselves.

"We believe it is important to teach nursing students how to care for themselves physically and mentally so they can have the capacity to care for others," said Tracey Motter , MSN, RN, senior undergraduate program director, Kent State University College of Nursing. "The Urban Zen modalities teach students to focus on ways to care for themselves, develop mindfulness, improve their ability to cope with stress and calm the chaos of the moment. Students can learn and practice these modalities while in school and as they begin to practice in the healthcare environment. Patients are also using and benefiting from these alternative modalities, and nurses need to be aware of the many practices that are helping patients heal and cope with illness."

Students Feel Stress Relief

Program participant Megan Janoch is a sophomore in the accelerated nursing program and has practiced yoga for the past 5 years. "Yoga keeps me in sync with my body. When there is discomfort, I find its location and breathe into it. I no longer fear pain. Yoga allows me to embrace it and control it."

Janoch believes in the benefits for her role as a nurse and for her patients as well. "Yoga has and continues to give me the patience to deal with stressful situations. It is easy to just react to stressors, but yoga emphasizes staying present in the moment, keeping the mind calm so you can critically think your way through problems. I have yet to master such mental peace, but I have noticed more patience within myself. Hospitals are founded on stressful situations of illness. Mindful awareness will help me navigate through the spurts of chaos and focus on what really matters - my patients."

Julie Friese is in her first semester of a  4 semester long accelerated/second degree BSN program.

She currently works as a nursing assistant on a busy ICU stepdown unit, so she has seen and experienced how hectic a nurse's schedule can be.

"I have always admired nurses who are able to seamlessly transition from one task to the next, despite the stressful environment. This ability may be difficult to achieve, so I believe it will be very important to have a technique I can use to find balance amidst the tension," Friese explained. "After learning of the mental and physical health benefits of yoga and meditation, it was obvious to me they would be vital to my success in nursing school and as a practicing nurse to find that balance.

She added the Urban Zen program has been wonderful. "The high level of stress and anxiety that I have is subdued when I tell my brain to solely focus on long, deep breaths. This is because my thoughts are redirected away from the stressful thoughts to the simple act of breathing. I have also used the meditative breathing technique before and during exams to calm myself down, and during class and clinicals to help maintain my concentration. Before a 12-hour clinical day, I make sure to take time to practice yoga in the morning when I'm getting ready for the day. This really helps me to calm my mind and prepare my body for the upcoming day."

Future for the Program

The university is conducting an evaluation of the program by measuring students perceived stress and ability to be mindful at the beginning, the midpoint and the final week of the course. "In my mind, success will be if students understand and appreciate the importance of caring for themselves physically and mentally and becoming open to alternate modalities," added Pratt. "Our goal is to open this program up to all students of the college."

Friese would absolutely recommend this program to other nursing students. "A nurse gives so much, and a lot is expected of him or her on an average day, which can quickly lead to feelings of stress and eventually burnout. We need to take care of ourselves first in order to be able to care for others. The simple techniques of yoga and meditation are easy to learn and provide a safe place to mentally return to when in a stressful environment."

Leslie Feldman is a contributor to ADVANCE.

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