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  • Ep24: Stop Burnout in Nursing School- Janice Lanham, MS, RN, CNEcl

Ep24: Stop Burnout in Nursing School- Janice Lanham, MS, RN, CNEcl

colors of care selfcare and prevent burnout

Janice Lanham, MS, RN, CNEcl

As a veteran nurse educator, I know, all too well, about the stressors of nursing school – the volume of chapters to read, meds to learn, exams to take. The intense pressure to perform consistently at a high level ALL THE Time, in class, on exams, in the skills lab for checkoffs, in clinicals can lead to BURNOUT!

 

And then you graduate. The signs of burnout remain consistent and continue to mount. Enter COVID. COVID-19 has had a huge impact on the mental health and well-being of nursing students AND nurses. Over my 20-year career as a nurse educator, I’ve made a conscious choice to teach and support nursing students & new nursing colleagues differently.

 

As a nurse coach, I seek to partner with healthcare organizations in supporting new nurses.

 

Join the Facebook Community supporting NLRNs (Newly Licensed Registered Nurses, 0 – 3 Years Nursing experience) as they transition to practice. Senior nursing students & new grads welcome!  Click here>>> The New Nurse Collective

jlanham@inursecoach.com

Ep24: Stop Burnout in Nursing School- Janice Lanham, MS, RN, CNEcl Highlights

“Burnout doesn’t just happen when Nurses graduate and start working as a Nurse. In my opinion, I think that in Nursing school, we set them up to burn out because of the intensity and the rigor of these Nursing programs.”  ~Janice Lanham

Ah-ha Moments

  • Nurse burnout is a phenomenon, Nurses are leaving the profession within 3 years of graduation
  • While it is imperative that Nursing schools uphold standards of care and enforce critical Nursing knowledge, could the rigor, strictness and strong focus on performance and grades be forming the foundation of burnout?
  • Could a happy medium between scholarly and practice performance and wellbeing reduce burnout? How could that look in Nursing schools?  How could Nursing professors reshape the present system to incorporate more wellbeing practices into curricula?  Could Nurse Coaching be an answer?
  • Nursing schools could focus more on student’s wellness by incorporating more wellbeing practices into curriculum, like journaling, mindfulness and meditation, movement, music, and self-care and other complementary practices
  • The use of present research on Nurse Burnout in combination with research supporting complementary modalities can be used to establish credible ways to support Nursing student and Nursing professors’ wellbeing
  • A 2021 JAMA of Psychiatry study shows that Female Nurses have double the risk of suicide than women in the general public
  • No Nurse can function from an empty cup. Focus on caring for self, and establishing routines of self-care are imperative to prevent burnout, potential risk of suicide and enhance joy, happiness, gratitude, calm, purpose and satisfaction

Resources

National Suicide Prevention Lifeline is 800-273-8255 (call or chat) their website is https://suicidepreventionlifeline.org/

American Nurses Association Healthy Nurse, Healthy Nation

American Nurses Association Nurse Suicide Prevention / Resilience

Rate of Suicide Among Women Nurses Compared With Women in the General Population Before the COVID-19 Global Pandemic

Integrative Nurse Coach Certificate Program

Integrative Health and Wellness Assessment Long Form

Candy Striper

The Wheel of Life

National Academy for Medicine’s Clinician Well-being

Nicole Vienneau email is nicole@bluemonarchhealth.com

Ep24: Stop Burnout in Nursing School- Janice Lanham, MS, RN, CNEcl Transcript

Nicole Vienneau  00:00

Welcome, everyone, to Integrative Nurse Coaches in ACTION! This is Nicole Vienneau, your host, and I’m also a board-certified Integrative Nurse Coach. And I have the absolute pleasure of welcoming our next guest, Janice Lanham. Welcome, Janice.

Janice Lanham  00:18

Hi, Nicole, thank you. I’m excited to be here.

Nicole Vienneau  00:23

I am thrilled that you are here with us and we get to talk about all things that we love so much, Nurse Coaching, and what we’re doing with it in our lives.

So, we always like to take a little trip back in history to understand you a little bit better, and to learn how you discovered Nursing or what brought you into Nursing.

Janice Lanham  00:44

That is a wonderful question, and I’m so excited to talk about it. So, when I was growing up, my mom’s baby sister – her name is Johnnie Mae, she is a Nurse – and I can remember her, when I was a little girl, watching her get ready for work.

And she would put on this crisp white uniform and her Nurse’s cap – that was back in the day when they wore Nursing caps – and my grandparents and I would take her to work; she worked third shift. And I began to wonder like, what does she do?

She puts on this nice, crisp, white uniform, and we drive her to work… It just… I was always intrigued by what she did. And while she would be at work, I would see all these stacks of Nursing books that she had. And I began to pour over these books and look at them and read about it and everything.

And it just was exciting. So, I was like, I think I want to do this. I really think I want to do this. I went to the library, checked out every book I could about Nursing, and I decided at a very young age that I wanted to be a Nurse. And I’m talking about like sixth grade.

So, I started my pathway to becoming a Nurse at sixth grade. And I started volunteering at the hospital, started really engaging with the profession, became a candy striper. I don’t even know if people even know what those are these days, but I was a candy striper. I probably accumulated over 200 hours of volunteer service working as a candy striper. I was all in.

And then my grandmother was diagnosed with Alzheimer’s and I really began to engage with her and helping take care of her. And I realized at that time that it was a calling for me, it really was a calling on my life to be a Nurse. And so, I set on a path in order to be a Nurse.

And even when I run into people that I went to high school with, and they find out that I was a Nurse – I mean, now I’m a Nursing professor – but when they find out that I’m a Nurse – these are people I went to middle and high school with – they’re like, “Oh, yeah, yeah, I knew you were gonna be a Nurse, you always wanted to be a Nurse.”

On Career Day in middle and high school, you’d have to dress up like your profession of choice and I always dressed up like a Nurse. So, nobody was even surprised. They were like, “Yeah, yeah, yeah, we knew you were gonna be a Nurse.”

And my husband tells me it’s really unusual to find someone – he’s a college professor as well – he said it’s unusual to find someone who knows what they want to do so early, and they set on a straight path to get there and they accomplish it. Because oftentimes, even in college, students change their major two or three times. But I decided, in fifth or sixth grade, that was it, and I was on the path to be a Nurse.

Nicole Vienneau  03:43

I love imagining you watching… it was your aunt, right?

Janice Lanham  03:49

Yeah, my mom’s sister.

Nicole Vienneau  03:51

So, watching your aunt with the crisp white uniform and you imagining yourself going to work in the same white uniform, and then candy striping and volunteering. I mean, 200 hours is a lot for a young woman to be committing to this profession. You didn’t even know exactly what you were getting into.

I mean, I just… I’m imagining all of that, of you going, being with patients at such a young age in sixth, seventh, eighth grade and then your high school, middle school people: “Yes, of course Janice definitely became a Nurse!”

Janice Lanham  04:30

Everybody knew it was gonna happen and it did happen. And I was fortunate that my parents – they would take me to that volunteer job, Nicole, like I was getting paid. I would be there and on time. I would do six hours – sometimes it was that. I think that the most you could do, that they encouraged, was four hours.

Because if you did at least four hours, you could get a free lunch. They give you these little vouchers, and you had to at least do a block of four, minimally, to get a free lunch. So, I was gonna definitely do four hours, but sometimes I would do longer than that.

So, I was working this volunteer job like I was getting paid, I was so serious about it. And then once I got older you transition from being a candy striper to a teenage volunteer. That’s like a promotion, to go from a candy striper where you wear this little dress apron type thing with stripes on it and a little cap.

And you could get stripes on your cap, based on the number of hours. You would get one stripe for 100 hours or two red stripes for… so, you know, I was all in for that – a competition. So, I would have my little stripes and my dress.

But then once you become a teenage volunteer, then you’re a little more older and seasoned. That’s kind of like a promotion. So, then you get more like a volunteer lab coat. It was still like a pinkish peppermint type color, but you are a teenage volunteer, so that’s higher than a candy striper.

Nicole Vienneau  06:07

I love this. So great. Because I didn’t even know that you would be promoted as you got older. Well thankfully, right? I mean, shoot. So, but then this comes… a question comes to mind, which is you’re obviously very driven. I mean, to start this at such a young age, to be so committed to it. And then, of course, you go to college, get your Nursing course completed in whatever fashion you did that.

So, tell us a little bit about that and your steps leading to what you’re doing right now.

Janice Lanham  06:44

Okay, so I got my undergraduate degree from Clemson University, which is where I currently teach. So, that is a full circle moment for me, to be back at the institution where it all started and to be able to walk students through what it takes to be successful in this program because it is intense, and I’m sure it is 10 times more intense than when I went through it.

But it is a real moment for me to be back at the institution where it all started for me. Got my Master’s from Clemson University, as well as a critical care clinical Nurse specialist, and worked at a level one trauma center as a critical care clinical Nurse specialist.

Now, in between that I did work as a staff Nurse, started as a new grad in mom baby high risk OB, then worked in critical care. And that was my niche. So, I’ve been in critical care Nursing ever since and CCRN, I’m certified as a CCRN.

Was certified as a critical care clinical Nurse specialist in advanced practice and worked at a level one trauma center in the ICU with the clinical practice oversight of a neuro trauma ICU, med surg ICU, a pediatric ICU and an intermediate ICU which is kind of like a step down. And I did that for about 10 years prior to coming to my current job.

So, while I was a critical care clinical Nurse specialist, there was an opportunity for me to take on a joint appointment as a faculty at Clemson, and that was a part time role. So, as a full time CNS, one of the roles of the CNS is educator, and I thought it’d be a great opportunity for me to give back, to really look at working with new Nurses and developing student Nurses.

And so I started a joint appointment where I was a CNS and clinical faculty teaching the critical care course at Clemson. And then I had the opportunity to transition to a full time position and that was during the time… I lost my father during that time.

So, after being so, I guess, driven and really doing a whole lot of things, when my father died – he died of cancer – it was a nine month roller coaster and he was diagnosed and then nine months later, he had passed away. So, it really caused me to pause and kind of re-evaluate my life in general.

And working in a level one trauma center is intense, as well. Hospitals never close, so you’re there all times of the day and night, you’re working the third shift, participating in staff meetings, working with new Nurses, it’s a gamut of things and it’s pretty intense and that was back when we had pagers.

I don’t know if people will know what that is but we used to have pagers, and pages would go off all times of the day or night. I didn’t think there could ever be an education emergency but the people were paging me like I was a doctor on call, and I like being needed, but man, it can really wear you out because as I said, hospitals never close and you’re getting paged all times of the day or night.

I was ready to kind of come out of that rat race and really settle down. But I really discovered that my passion was teaching, I really enjoyed teaching. I really liked being in the classroom, I really liked educating new Nurses and teaching them how to be great Nurses – going from good to great.

That was kind of like my little philosophy as an educator when I started out: teaching good Nurses how to be great. And that was when I made that change. It was in 2006, I decided to come to Clemson full time. And that’s where I’ve been ever since; teaching full time at Clemson University.

Nicole Vienneau  10:48

So fascinating to listen to your journey. I just have to point out something. So, I was hearing you talk about being, you know, CCRN, clinical Nurse specialist in a critical care unit, how fast-paced at level one trauma… I mean, come on, some of us don’t know how stressful that can be. We do know, we’ve seen TV shows. I’m just kidding!

But I want to just point out something because… such a driven career, and then your father passed. When you started to speak of your father passing and this re-evaluation – I don’t know if you noticed this, and maybe our listeners would have to rewind – but the birds started singing.

Janice Lanham  11:38

No…

Nicole Vienneau  11:39

I could hear birds singing.

Janice Lanham  11:42

Wow.

Nicole Vienneau  11:43

I know.

Janice Lanham  11:44

I did not hear it.

Nicole Vienneau  11:47

Ah, the birds were singing, which is such a beautiful transition as you’re talking about your transition into finding your calling. And teaching is your calling. But we never really know that until we go through all of the things that we have to go through in our lives. So, thank you for sharing that.

And now I would love to learn a little bit more about how you discovered Nurse Coaching and what’s going on with the Nurse Coaching piece.

Janice Lanham  12:21

Oh, yeah, that’s an exciting story. So, I came to Clemson, I’m all about teaching, and I’m all engaged and everything, and I was serious about my craft and ensuring that students were excellent clinicians, that they knew the content. And I began to notice on my student evaluations, how they were saying “she’s intimidating”.

And I’m like, “I am?” Like, I didn’t realize I came off as intimidating, but critical care Nurses, now we can be just a little bit – I won’t say aggressive because it has such a negative connotation – I’d say we can be assertive, because we want you to know what you know.

And I always felt my students were representation of me. And when you get onto the clinical environment and they say, “Who did you have for critical care?” And they say Janice Lanham, I wanted people to say, “Oh, you really know your stuff, you really know your stuff.”

So, I was probably more drill sergeant like, not intentional and not with negative intent, but because I really wanted my students to be like, on their A game. And so I started noticing my evaluations like, ah, this is… I’m not connecting. I’m not connecting in some kind of way.

So, I decided… and I had a friend of mine sit down, he’s like, “Janice, let me tell you what your problem is.” He said, “You need to be more vulnerable.” I said, “What? Did you say the V word? No, I’m not trying to hear that.”

But he said, “You need to be more vulnerable to your students. You’re very professional. You’re the consummate professional, but you need to show them that you are human.” And he’s a preacher too, by the way, so maybe he was counseling me, I don’t know. But anyway, I said, “Hmm, okay.”

So, I started to open up a little bit more to my students. Tell them who I am, talk about my family – similar to what I’m doing here – talk about why I went into Nursing. And I felt like I was able to connect more with my students when I became more vulnerable. And so I flipped my teaching paradigm on its head, and I started looking at ways to engage students in this age group, these college age students.

What can I do to motivate and really help students be comfortable when they’re with me in the classroom, especially when they’re with me in clinical? Because I found that students do not perform well if they are afraid in clinical. They are more prone to make errors and miss things if they are so afraid and so nervous that they can’t think clearly.

And so, I’m in a big football school and my football, my coaching model is Dabo Swinney. Hey, Dabo! Listen, all in! I’m all in, Dabo!

And I began to notice how he motivated players. And we also have a national championship football team, I’ve got to put that out there. I started noticing how he was able to motivate these guys to perform at a very high level on the field.

Psychologically, these kids are all the same age. I hate to call them kids, because they’re adults, but they’re in the same age group. And I’m like, if he can motivate this age group of young men to perform at a high level, I could do the same thing in Nursing using a coaching model of sorts.

So, I went to the literature, and I found some articles on using coaching skills in clinical or being a clinical coach. And I really flipped my teaching paradigm on its head. So, instead of me being the sage on the stage, I became more of a facilitator in the classroom and in the clinical environment.

I became more of a coach and implemented what I call a “no fail” policy. And what I told my students is, when you have me in clinical, you’re gonna have room to learn, nobody in my clinical will fail. If you fail, I fail, and I’m not gonna fail you. So, I really started using coaching strategies and techniques from Dabo Swinney’s book, and I call them my “all in” teaching philosophy.

And the first day of clinical orientation, I would talk to them about my “all in” coaching philosophy for clinical, and the first bullet was: no fail, everybody passes. And when I would talk about that, I could see the students take like a deep breath like, really? No fail?

Right, if you’re not performing at a level that I think you need to be, then we’re gonna sit down, and we’re going to develop a performance development plan, we’re going to sit down and put together a development plan for improvement, and then we’re going to reevaluate your performance at the end of every week. You’re going to get immediate feedback and you will know where you stand with me at the end of every clinical day.

And that’s different in Nursing, because when I came to Nursing school, whether you were passing or not was a secret, it was a secret that the instructor didn’t really tell you at that time how you did, how you can improve, and what you can do to do better, and collaborate with you in a coaching manner.

It was: I’m not gonna tell you ’til midterm. And then you go in there at midterm, and they say, “You know, you’re failing.” And then you’re like, “Oh, my God,” and then they’re like, “Well, if you don’t do this, this and this, you’re gonna fail this quarter.”

And that’s how Nursing has been historically, that we have not typically coached our students to be successful as students and as clinicians. We kind of write down side notes about how badly they’re doing with the mistakes they make, you know, or if they don’t pull the curtain, that’s unsatisfactory. If you get too unsatisfactory, you’re out the program, you fail clinical. It’s been such an extreme way of teaching students.

And so, nobody fails. And once that was off the table, my students… their success in the classroom soared, and more importantly, their success in clinical. And they perform better when failure is off the table.

And when, or if they would do things in clinical that maybe they could have done a little bit better, I would have them finish up with the patient, I would meet them at a private area on the unit and I say, “Tell me how you think you did.” And they would always know what they could have done better.

I don’t like to say what they did wrong, because I try not to use those kinds of words like wrong, fail, those kinds of things. Tell me how you think you could have done that better. And they always know. So, I don’t understand why we used to evaluate students in a way where we would kind of make a side note over here about what they did wrong. They typically know.

And then I would give them feedback. I also had them journal about their experiences in clinical so that they could understand, to help them process their clinical data, what they saw and what they experienced.

And then we would sit down and the evaluation wasn’t any evaluation of sorts, their midterm evaluation was more of a conversation about how they can develop in order to meet the clinical objectives that they would need in order to be successful in the course.

So that, in a nutshell, started me kind of looking at coaching. And I used to also, just for my clinical group, publish – I called it the Janice’s Playbook. It was like a little one page newsletter. I would give an overview of clinical that week, I would talk about things you can do to improve, how to manage your time, things that I noticed that I felt like they needed to brush up on, I would publish this Janice’s Playbook.

So, I typically… I really aligned it with football, because I’m a real big football fan, college and NFL. And so I really aligned my coaching model with sports, mainly football. And the other thing, Nicole, that I wanted to talk about is, like, I would see Dabo, like, he’d be yelling, screaming at people when they’d mess up, he’d get mad at them. But he also would love on them, as well.

Now, I’m not yelling and screaming at my Nursing students, but what I would tell them is you got to be coachable, I said, and I’m going to coach you in a way that is respectful. But when I come into the clinical unit, I may not be smiling, I may not be mama-bear, tapping you on the shoulder and hugging you and everything because that ain’t me, I said, but it doesn’t mean that I don’t care about your success in this class.

So, when we come on this floor, game on. I have my game face on – that’s not a face of, I’m here to kind of stick it to you and find out what you’re going to do wrong. That is my game face. Like, this is game day. So, during the week, I would build up: okay, it’s about to be game day, you know, this is clinical, it’s game day – to remind them of that.

And then, so coming back around to my evaluations, Nicole, my student evaluations flipped. They soared. They would say things about me that I didn’t even realize how much value they got out of the clinical and how sympathetic I was. I went from being intimidating to being sympathetic, empathetic, caring.

They also said I keep it 100 and I keep it real, because that’s part of my personality. That meant if they do something that they need to improve on, I’m going to tell them. No secrets. There was a transparency and authenticity about it, as I’ve changed my whole teaching model, to help students improve.

So, that is kind of the undergirding of how I started coaching. It all started before I even knew what a Nurse Coach was. And then, when I came across the program, I’m like, “Oh! This is like a thing!” Like, I’ve been using a football coach to measure and model my coaching style off of, and we have our own theoretical Nurse Coach framework, and models that I can use as an underpinning of my clinical teaching philosophy or my classroom teaching philosophy.

And it just really opened up doors for me. And what I learned from our program in INCA is that some of the things I was doing wasn’t even coaching yet. I thought I was a real coach but what INCA taught me is how to truly be a Nurse Coach. And that program really validated for me, kind of, sort of, what I’d been doing, but it tied it all back around to Nursing.

And that was such a meaningful experience in order for me to go through that program. So, during COVID, I decided, okay, COVID is really taxing everybody, I said, but I’m going to use this time that I’m on lockdown to improve, to develop personally and professionally. So, I took the Nurse Coach certification program.

I also became a meditation teacher with the Chopra Center and took a health class with Chopra, and took another wellbeing program after I did INCA. And I did that just to add tools to my toolbox. INCA was my foundation, though, and I don’t think that the other classes that I took, and the other certificate programs, would have helped me as much as INCA.

So, it gave me the foundation, and everything else I use I add as tools to my toolbox to help really strengthen my program for Nurse Coaching. And so, you asked… that’s a lot to get around to what I’m currently doing with Nurse Coaching.

So, at Clemson, I’m an academic coach for our students. And like I said, I thought I was really coaching students until I took the INCA program, and then I realized I was like… I could do a lot more. I really have theories and frameworks now to undergird my practice as I coach our Nursing students.

So, even as an academic coach at Clemson, I saw that, yes, students need help with grades, study techniques, time management, those kinds of things, prioritization. But when they were coming to meet with me as an academic coach, there were other things that were on their minds, things that were personal, burnout – even Nursing students experience burnout, and so that’s kind of my thing.

Burnout doesn’t just happen when Nurses graduate and start working as a Nurse. In my opinion, I think that in Nursing school, we set them up to burn out because of the intensity and the rigor of these Nursing programs. And it’s so competitive. It is challenging for students to get all this work done and to be all that they can be without a struggle.

I realized that there is a support that undergraduate Nursing students need before they become Nurses. Nurse burnout is a phenomenon, it is a syndrome. Most new Nurses leave their jobs within the first one to three years. If they’re leaving their jobs that early, then burnout can’t be happening at year one, right?

It’s probably building, they probably have risk factors that are beginning to form and shape, that predispose them to burnout once they graduate. And I feel like we may be contributing to that, as Nursing schools, that we are accelerating that and we are contributing to this burnout.

And we don’t even know it, because all we care about are the grades, are you coming to class, attendance, are you in clinical, and we don’t really sit down and engage with our students on a level that where we find out about their wellbeing.

I am putting together – even though I already have 25% of my time at Clemson dedicated to being an academic coach, and my department chair supports that – I was ecstatic that she allowed me the 25% of my workload to even engage as an academic coach at Clemson – but I am transitioning that role.

And I have worked together to pull together a proposal where I am looking at being the Nurse Coach, a Nurse Coach for our School of Nursing. And I have asked to be pulled out of the classroom because, you know, teaching somebody and then trying to be their coach might be challenging at best.

I’d like to not have to see students in the classroom and, you know, grading them and then that interfere with their ability to be comfortable with me. So, I’ve asked to come out of the classroom and be the Nurse Coach for the School of Nursing.

There are models across the country that have wellbeing programs for undergraduate Nursing students. The Ohio State University, they have a very strong program for their undergraduate college students, not just Nursing. And so I am looking to create a wellbeing protocol or a protocol for wellness for undergraduate Nursing students in the School of Nursing at Clemson.

Like I said, I’m already an academic / Nurse Coach, I’ve already changed my title at Clemson. But it is not a formalized role, and that is my goal, to formalize the roll to a 50% role where I am engaging with students across our curriculum from first year all the way to senior.

And helping them create a wellbeing plan, being a Nurse Coach, coaching them around issues and challenges that they may feel stuck in, and really using what I have learned in INCA to promote health and well being for undergraduate Nurses and prevent Nurse burnout.

Nicole Vienneau  28:34

Holy moly. And I only say that because I want to back up a little bit. So, first of all, I did hear you say that you’re a big football fan. And in Nursing, we learn a lot of things. You know, as Nurses, we’re learning as we go, we’re learning on the job, we’re learning in our lives, personal lives. And I just really appreciated how you recognized there were areas where you could improve when you were in your relationships with your students.

And so, you looked outside yourself, you looked for role models that you could engage with and connect with and you found your love of football. And you saw that motivation, motivation and the style of being a winner, as far as football is concerned, but taking those tools of coaching in the aspect that you saw in your life.

And I just really appreciate that because that was like your foundation, at first, to just kind of see okay, this coaching model is something that I can use and utilize with my students to make their learning process so much easier and so much more personal instead of the, you know, black and white and this is how we do it in Nursing which, you know, worked for like a minute.

Then we see what you’re talking about towards the end of this with Nurse burnout. I loved, also, how you have a name for the things that you’re doing, like your “no fail” policy or you’re “all in” philosophy for clinicals. And Janice’s playbook was another one that I heard.

And I just really connected with that too, because you’re really calling it something and making it your own. Because then it becomes part of you, and it becomes something that your students can connect with as well. You know, that really is special.

As I listened, I was just like, ah, this is just such a beautiful story of transition. And we hear these stories of transformation in the Integrative Nurse Coach Academy Nurse Coaching program, in many of the programs that we do, and I just was soaking up the story.

And then finally, I mean, there’s a lot of things more I could say, but finally speaking to building on the foundation of the sports coaching, to now use Integrative Nurse Coaching philosophies, theories, adding that to build another, in essence, another foundation to build upon, you know, the life foundation in the sports analogy.

And using all of that to then create your own role at Clemson University, because you see this need for Nursing students to feel really supported. Because I agree with you about this burnout. Burnout doesn’t just happen in a day, this happens over time.

And the way that our Nurse programs are taught are not always from the lens of compassion. And we may feel as Nurses we’re compassionate, but there are things we have to get done. You know, we’re talking about people’s lives here, you know, all of that.

But burnout doesn’t happen in a short term, it happens over a period of time, and starting to implement and understand and coach and teach these strategies to prevent burnout early is very important. And so I want to know more, our listeners want to know more about this and what you see as this vision going forward for helping our Nursing students.

Janice Lanham  32:26

One excellent resource that I have been using is the National Academy for Medicine’s Clinician Well-being – they have a Clinician Well-being initiative, the National Academy of Medicine. It used to be IoM, and IoM has now renamed itself, rebranded, to the National Academy of Medicine.

And the Future of Nursing Report – so, many of us have heard of the Future of Nursing Report. In that report that they have recently revised, where the first report talked about Nurses practice into the full extent of their scope of practice, now they have a wellbeing component within the Future of Nursing Report.

Also, the American Nurses Association, not only do they have resources that also speak to this clinician wellbeing, they also have the Healthy Nurse, Healthy Nation initiative that I have been involved in or a part of with my students at Clemson, because I’m also the faculty advisor for the Student Nurses Association.

We have over 300 active members. And so I’ve engaged them in this Healthy Nurse, Healthy Nation initiative, as well. Now, that was before COVID. Now, when COVID hit, it sent Nursing spiraling, Nurses, healthcare providers, spiraling.

And the American Association of Colleges of Nursing sent out a call to action that all Nursing schools, department chairs, Dean’s, faculty begin to address the issues and challenges impacting student Nurse wellbeing and suicide. Because Nurses have a significantly higher suicide rate than any other profession other than physicians – they also have a very high suicide rate.

And so we’ve got to begin to look at clinician wellbeing, and what COVID has done is exacerbated the challenges that are from Nurse burnout, and just from the stress of the profession, significantly.

And so, what I am looking at doing is when students come into the program first year, creating a wellness inventory, or a comprehensive development plan, personal and professional development plan, to begin to set goals around what they can do to address their wellbeing.

There is a reluctance among students in general in this age group to oftentimes seek out help before they’re drowning. So, this would be a proactive, comprehensive plan to begin to set goals around wellbeing as it relates to Nursing students, but also to help them deal with challenges.

And that’s the other thing that this age groups struggles with is being able to see a challenge, and begin to formulate a plan to cope and manage those challenges before they begin to sink.

And so if we can proactively begin to bring them on board, there are so many tools out there that I’ve learned about, there are burnout inventory tools, assessments, things that you can use to screen risk factors for burnout, for resilience strategies, that you can use to help create resilience strategies around burnout signs and symptoms. Just so much is out there now, and a lot of it came out, I think, because of COVID.

So, we have this undergraduate research program at Clemson called Creative Inquiry. And Creative Inquiry is an undergraduate research program that helps students get engaged with faculty research. And so one of my research interests is Nurse burnout, resilient strategies in undergraduate Nursing student, etc.

And so I’ve been working with a small group, a small team of students, looking at assessing students for burnout and also identifying and developing a wellness or wellbeing protocol to implement in a pilot group of students. And so right now, the students are participating in a literature review, where they’re scoping the literature and compiling everything they can find about clinician wellbeing, about clinician burnout.

We are particularly interested in undergraduate Nursing students in pre-licensure, undergraduate baccalaureate programs, but this would be a tool or a process or approach that could be used for all Nursing students. We’re just piloting it in our baccalaureate program.

And there are a couple of tools we were looking at, there’s a burnout inventory that we’re looking at and another tool… there are lots of tools out there, actually, that measure burnout. And so we’re looking at doing a pretest where we assess burnout, or any factors that students may have, implementing a wellbeing or a wellness protocol or some type of resilience strategy based on what we find in the literature.

And then conducting a post test at assessing if there has been any change in that inventory score once we’ve implemented some type of resilience strategy, which could be meditation, journaling, these are what have been identified in the literature as resilient strategies. Conducting some type of intervention to see if that makes a difference.

Even something like meditation or centering. And these are all tools that I learned about in the INCA program. Also, looking at giving them the INCA wellness assessment, which I thought was a fantastic tool. That was the first tool that I was introduced to like that, that looked at all the different areas: spiritual, environment, personal, all those different areas of life.

I mean, they have things like the wheel of life that’s out, and different things like that, but INCA was the first place that introduced me to a test that could assess different areas. And then engaging with students in a way to help create wellbeing goals around those areas that have been identified in the INCA and the… IWA, I think? We love acronyms, don’t we, in Nursing?

And looking at identifying areas that maybe they want to develop goals around and using that as a foundation to develop a wellness protocol. So, there is some structure to it. I know I’ve probably been talking all in the air about: “oh, this is so great… we’re gonna do this…” but I do have in mind a structure for how I want to lay out this program.

All the other… even the Chopra program, they use the wheel of life, which has the different areas, but it doesn’t have the questions that the IWA program uses. It doesn’t ask questions about certain things, it just has topical. So, what I’m saying is that assessment tool that I have for INCA is the most comprehensive assessment that I have seen that is a real good jumping off point for people, particularly the students that I’m going to be working with, can use to begin to develop goals around.

So, I am looking at using that as a part of this process and as a part of this comprehensive strategy that I am planning to implement in Nursing education at Clemson.

Nicole Vienneau  40:03

Anything in Nursing requires proof, right? Evidence that something should be supported or could be supported. And using all of these different tools before, after, showing how much someone could potentially improve just by simply using these resiliency strategies like journaling or like meditation, really prove that this work is valuable.

You know, the Integrative Health and Wellness assessment, now on version number two, validated and worked on, and so that will be included in the resources here. As well as all of the other amazing resources, Janice, that you’ve shared with us that we will include in the show notes so that people can go to and click on and look at to potentially use within their own facilities or their own self.

As we know, part of this process is also working on self, like doing things for ourselves. So, I’ll be… I’m so excited for you to see and hear how things go as you work through this, because there has to be a pioneer to start these programs. And to start this connection that we do as healthcare providers, whatever area we are practicing in, we need support.

And these pioneers like yourself, who are saying yes, I will do this work to show that these strategies are very helpful in preventing, you know, you point out suicide, and I did not know that Nurses were very high at risk for suicides. Doctors, as well, you mentioned.

And, you know, just looking at that and thinking, yes, you’re right, because I have had colleagues, friends that I saw on a daily basis, who did not come back to work because they ended their lives because of the work that we’re doing on a daily basis. This work that you’re doing creates hope for our future of our healthcare providers.

So, what other things would you like to share with us?

Janice Lanham  42:17

I will be sharing all the resources that I mentioned here today. There are several articles out about suicide rates and Nurses, the call to action, resilience tools – I’ll be sharing all of that with you, Nicole, so that you can share it with our listeners, as well.

The only other thing that I just want to share is – that I hadn’t talked about – one thing about the INCA program is when I started the certificate program, I said, okay, okay, I’m gonna take this class, so teach me what I need to know so I can learn everything I need to know and move on through.

And one of the things that I was not anticipating was that the INCA program was gonna help me look at myself. I’m like, nah, no, no, I’m not trying to do nothing personal here, I’m not trying to do no self-care, self eval. Just teach me what I need to know.

And then I started to think: man, you are no different than your students, you know, how they want to… just tell me what I need to know for the test and let’s get up out of here. And that’s kind of how I started that program – very task driven, task oriented, let’s get it done, blah, blah, blah, blah.

And it forced me to sit back and really look at me personally, and how I could personally develop, and habits that I needed to work on, things that I can integrate to improve, because you can’t pour from an empty cup. And I know that is probably said so many times, but like, that’s real talk. That’s real talk.

You cannot pour from an empty cup. And even though I have a lot I want to do, I have a lot I want to focus on, I have a lot I want to accomplish, I have also got to take care of myself. And it is important that I look out for my self-care as well and that I am constantly evaluating my habits.

Am I taking care of myself? What am I doing to improve? But not just improve, it’s not always about improvement, but what am I doing to take care of myself? And I think that comes before we can be effective Nurse Coaches. We have to be able to walk the walk.

If you are a budding Nurse Coach out there and you don’t have a Nurse Coach, you need a Nurse Coach. How can you coach someone or even encourage someone to use you as a Nurse Coach if you don’t have a Nurse Coach yourself? So, it is important that we, as Nurse Coaches, take care of ourselves, and find you a Nurse Coach that can coach you.

And then it’s going to make you so much more effective, as a Nurse Coach, to then go out and talk the talk, talk about how wonderful a Nurse Coach is and how you need my services or get you a Nurse Coach. No, get you a Nurse Coach, and, you know, be the change that you seek.

And I think that is probably the underlying message that I would want to leave this podcast with, is that be the change that you seek. And as you improve yourself, you contribute to the collective, you contribute to the whole of all of us if you are working on ways that you can heal the trauma within. And then you can help others heal their trauma.

Nicole Vienneau  45:56

Thank you for those words of wisdom from your heart. Yeah, we can only go as deep with someone as we have gone within ourselves. Yes, and oh, my goodness, supporting other Nurses who are doing this work as Nurse Coaches is also very important, and supporting Nurses in general. So, thank you for that amazing reminder for all of us, that we all have things that we can work on, and we need a coach to do that.

So, before we tie up our time together, is there anything else on your heart that you’d love to share?

Janice Lanham  46:40

I think I have shared a lot, and I hope I’ve given people some things to think about. And if anybody wants to know, yes, I do have a coach. I have my own Nurse Coach, so… and you can have more than one.

Nicole Vienneau  46:56

Yeah!

Janice Lanham  46:58

To chat around different areas. But I just want to thank you for reaching out and connecting with me and inviting me to be a guest on the podcast today. I’m excited. I can talk, so you definitely reached out to the right one because I can talk. But thank you so much for just being willing to listen and for holding the space for me to have an opportunity to share my love for Nurse Coaching.

Nicole Vienneau  47:27

Thank you so much, Janice. We will look forward to your future success. We’re looking forward to hearing how your program evolves, and how you evolve through this journey, as well. So, thanks for being here.

Janice Lanham  47:41

Thanks, Nicole.

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