Mindfulness Meditation for Nursing Students

“The faculty of voluntarily bringing back a wandering attention, over and over again, is the very root of judgment, character, and will . An education which should improve this faculty would be the education par excellence. But it is easier to define this ideal than to give practical directions for bringing it about.”–William James (1890)

Developing the capacity of “bringing a wandering attention back, over and over again” can be a formidable – and ultimately rewarding – challenge. As applied to nursing education, harnessing the wandering minds of our nursing students in order to increase their attention to the task at hand is a goal worth pursuing. An increased level of attention should yield an increased level of student performance, whether it be presenting in class, administering medications at the clinical site, or taking exams. Unfortunately, this proposition is not as simple as it seems. Assisting nursing students in developing their ability to concentrate is more difficult than ever.

A University Nursing Professor’s Observation
The stimuli competing for the college student’s attention has grown considerably in recent years. Prensky recalls how those born before 1990 were somehow able to manage their daily routines without using email, social networking, text messages or other interactive technologies.1 Today’s nursing students live in a world that is quite different. Their cell phones and tablets continually summon their minds to another place with an urgency that is puzzling to many of their elders. Nursing instructors and support staff have witnessed the allure that this electronic commerce has on nursing students, as it collides with academic demands that can tolerate little or no distraction in the classroom, lab, or clinical floor. Even when the cell phones and tablets are powered down, have they left in their wake a student brain that has been conditioned to divert its attention to another unrelated mental realm at any given instant? The students’ ability to focus intently for prolonged periods of time on one thought, idea, or task is not as robust as it formerly was, and indeed must now be to achieve academic success. What is to be our response as nursing educators?Nursing students in classroom

A University Nursing Advisor’s Observation
Anxiety envelopes many nursing students. Like their colleagues in other majors, they (or their families) have made a significant financial investment in tuition, and the need to graduate is imperative. However, nursing students seem to have a significant amount of pressure that other students may not be facing on a daily basis. Having to learn how to provide quality health care to a variety of patients whose lives depend on the student nurse, coupled with the added pressure of having to pass a licensure exam at the end of their curriculum just might create some extra anxiety, particularly test anxiety, for a college nursing student. What can we do to help our students work through their anxiety, particularly their test anxiety, in a meaningful way?

A Collaborative Effort to Alleviate Student Anxiety and Improve Mental Focus
The divergent questions independently posed by the Nursing Professor and the Nursing Advisor actually reflect the same larger issue: How to get nursing students to eliminate distracting impulses, thoughts, and feelings to focus their attention more effectively. This common goal eventually led to the productive collaboration of these two colleagues. Realizing that many of the students who were struggling with test anxiety were at that time on academic probation, the Nursing Advisor decided to consult with the Nursing Professor – a member of the University’s Psychiatric Nursing faculty. In response, the Nursing Professor was able to share her own concerns relating to the often tenuous concentration level of students, as well as her own initial success in promoting mental focus through Mindfulness Meditation. As a result of that discussion, the Nursing Advisor decided to channel interested students through a Mindfulness Meditation introduction, facilitated by the Nursing Professor (who is a trained Mindfulness Meditation instructor).

Mindfulness Meditation as a Remedy
Are you mindful or is your mind full?The illustration above cleverly captures the human state of mind compared to that of our canine friends. At any given moment, ours can be cluttered with distractions, while theirs is fixed on the present. Unlike nursing students, our fortunate furry friends will never be subject to the immediate gratification demanded by cell phones, nor will they experience the burden of classroom/clinical performance, and the difficult exams whose passage is the key that will open the door to a nursing career. So, it is of little surprise that the dog can achieve the desired mental focus that often eludes humans. And yet, the single-mindedness of the dog is still within human reach through Mindfulness Meditation. The simple practices offered through Mindfulness Meditation can represent an effective antidote to the wandering mind.

What exactly is Mindfulness Meditation? The definition of Mindfulness “is being present in the moment, on purpose, without judgment.” The practitioner of Mindfulness Meditation pays close attention to the “here and now,” effectively filtering out all other input that could lead to distraction. There are many research studies being done that point to the benefits of using Mindfulness Meditation to help rein in the wandering mind, and two of these are worth noting here:

In an online study published on March 28, 2013 in Journal of Psychological Science, the measure of cognitive performance before and after mindfulness training sessions on college students revealed a 16 percentile-point increase in scores on the Graduate Record Exam (GRE) among students who learned Mindfulness Meditation as a means of focusing on the present moment in order to ignore interrupting thoughts.3

Recently, researchers have reported improvement in sustained attention and working memory measures in novice meditators who underwent MBSR training relative to a comparison group who did not undergo the training.

Mindfulness Seminars and Workshops: A Positive Experience for Student Participants
Efforts to address the Nursing Advisor’s need began by offering a Mindfulness Meditation workshop that targeted the most at-risk students as represented by those on academic probation. The first session was offered in the fall semester of 2014 to a maximum capacity attendance and has been offered every semester thereafter. Each workshop is approximately an hour and fifteen minutes long and teaches students the basic principles of Mindfulness Meditation.

Since that time, the Mindfulness concept has been successfully introduced to nursing students in classroom seminars and the more comprehensive workshop forum. Workshops are limited to about twenty students. Participants gather in a quiet space, sit in a circle, and the Mindfulness Meditation teacher presents modalities including imagery, body scan, loving kindness meditation, and relaxing sighs. All are simple tools for nursing students to use in their self-care, especially in the area of anxiety management. Once they ascend into the ranks of Nursing, nursing students can use these same techniques in dealing with anxiety felt by their patients.

Twenty-one nursing students participated in our last workshop. All responded that they see themselves utilizing tools from the workshop to manage stress and anxiety. The body scan, imagery, and stretching seemed to be some of the practices they found most helpful. Taking short mindfulness breaks, focused breathing, or other mindful exercise before exams or class were the activities they mentioned would be most helpful in their academic work.

SEE ALSO: Earn CE: Anxiety Disorders

Mindfulness in Students’ Own Words Here is a sampling of comments from nursing student participants who took part in a Mindfulness workshop or seminar:

“I have been practicing mindfulness body scan several times a week and it is really helping to keep me focused and feeling clear and calm- so thank you once again!”

“I swear to you your mindful meditation has been an absolute lifesaver. During my NCLEX . . . I was getting so frustrated! The deep breaths really calmed me down though and helped me focus when I was feeling so frazzled. I used them in my interview too since I was SO nervous!

“I have been incorporating more mindfulness into my routine now that I take the train to work because I find it to be the perfect time, although not the perfect environment. Again, feel free to share my experience! I hope it can help someone else.”

“I experienced my first patient death. Relaxing sighs were a strong benefit to me in dealing with these reactions and emotions immediately following the patient death. I needed a way to quickly reset and refocus between the patient assignments and found relaxing sighs were really an accessible technique.


“This week I tried to revisit my intention of “letting go” daily. I was successful in visiting it every day, but some days had better outcomes than others. I try to pay attention to the thoughts and feelings that my mind wants to hold on to and how that affects me. I notice that the present feels like the most productive and healthy place to focus my energy on during that time.

“After clinical on Wednesday I started to become overwhelmed by the amount of work that had accumulated in a mere 48 hours of the first full week back to school. I would get anxious and become aware of the physical changes in my body. My breathing increased, my heart rate increased, and I started to get butterflies in my stomach. I immediately thought back to the body scan we did in class and decided to do it. After it was over, I felt a lot better and more relaxed and when it was time for bed and my anxious thoughts started to creep back, I took three deep breaths to let go of tension. It definitely helped so I could sleep better.

The successful completion of a nursing education requires that the student be completely focused in both the classroom and clinical sites. That focus can be impeded by a variety of factors, not the least of which is the constant beckoning of electronic communication and the tendency to be haunted by the anxiety emanating from the intense nursing education process. Mindfulness meditation offers an accessible way to filter out such distraction. Teaching future nurses to strengthen their mental focus to increase scholastic performance today will improve their professional performance tomorrow – an education that the philosopher William James would no doubt approve as “par excellence.”

References
1. Prensky, M. (2001). On the horizon. Bradford, England MBC University Press.

2. Kabat-Zinn, J. (2012) Mindfulness for beginners: reclaiming the present moment and your life. Boulder, Colorado: Sounds True Inc.

3. Mrazek, M. D., Franklin, M. S., Phillips, D. T., Baird, B., & Schooler, J. W. (2013). Mindfulness trainin improves working memory capacity and GRE performance while reducing mind wandering. Psychological Science, May 2013, 24(5) 776-781.

Susan Stabler-Haas is a member of the clinical faculty, College of Nursing, Villanova University, Villanova, Pa. She is also a licensed marriage and family therapist. She is the author of Fast Facts for the Student Nurse (Springer Publishing), and a co-author of Fast Facts for the Clinical Nursing Instructor(Springer Publishing).

Patricia Abdalla is nursing student resource advisor College of Nursing, Villanova University, Villanova, Pa.

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