1. Allen, Electra

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Our traditional prelicensure nursing students are part of Generation Z (born 1995-2015). According to a growing body of literature, Generation Z tends to be less resilient, less mentally tough, and suffers from higher levels of anxiety and depression (Elmore & McPeak, 2019; Twenge, 2017). The COVID-19 pandemic compounded the implications of these pressing challenges. Conversely, this generation also is described as "more redemptive," seeking dignity and respect for everyone (Elmore & McPeak, 2019, p. 30). Such values align beautifully with a biblical worldview that sees inherent worth in all people as humans made in the image of God (Genesis 1:27). Imagine the impact these future nurses will have when educators support them to build character, perseverance, and grit!

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Unpublished data found that nursing students struggle with grief, loss, and moral distress in the clinical setting. Three out of four reported anxiety and nearly half reported feelings of depression. Distress levels rose as students progressed in the program and spent more time in the clinical setting (Fasold et al., 2019). Educators can assist students with processing distress and help them develop coping strategies that build resilience and spiritual strength.


The following spiritual and self-care strategies can be incorporated to support students throughout clinical rotations, conferences, and classroom discussions:


1. Allow a time of quiet or prayer at the start of the shift/conference.


2. Have students take turns leading a devotions or a time of intention.


3. Pair students and allow time for them to meet, discuss challenges, and provide spiritual care for each other throughout the shift.


4. Start the postconference with student reflections. Allow students to gather thoughts in writing; consider using pocket notebooks to record ongoing reflections.


* Provide prompts, then a time to share:


* "I was [surprised]/[angry]/[sad]/[happy] when. . ."


* "I saw growth in myself by the way I. . ." "How have you grown during this time?" (Allows students to identify progress beyond grades.)


* "I felt uncomfortable. . ." or "I felt more comfortable this week when. . ."


* What did you see that was not therapeutic? Why do you think it was done that way?


* "I was inspired when I saw a peer. . ."


5. Let students debrief about their shift and if they encountered challenges or situations that made them uncomfortable.


6. Facilitate nonjudgmental discussions about personal bias, quality of life, abuse, substance use, fetal demise, and so forth. Even if not all students share, they will appreciate safe space and knowing such topics can be discussed.


7. Take a "pulse check" and ask students to share, or share results anonymously. "How many of you are experiencing grief? loss? anxiety? depression? moral distress? compassion fatigue?" Students will recognize they are not alone in their experiences.


8. Discuss utilization and effectiveness of tools and resources for support and self-care.


9. Have everyone (including the instructor) share plans for self-care, framing it as a priority and providing a chance for accountability.




Elmore T., McPeak A. (2019). Generation Z unfiltered: Facing nine hidden challenges of the most anxious population. Poet Gardener. [Context Link]


Fasold B., Klahr S., Kobayashi A. (2019, April). The perception and utilization of Biola's spiritual support resources for nursing students [Poster presentation]. Celebration of Scholarship & Research, La Mirada, CA, United States.[Context Link]


Twenge J. M. (2017). iGen: Why today's super-connected kids are growing up less rebellious, more tolerant, less happy-and completely unprepared for adulthood-and what that means for the rest of us. Atria Books. [Context Link]