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All nursing students have seen and likely re-posted the memes – pages and pages of humorous jokes - poking fun at the life of nursing students. Memes that help nursing students get through the rigor of their courses through humor. Then there are the nursing memes – the famous, ‘Who said nursing is hard, I’m 39 and feel great!’ captioned above a picture of a white-haired elderly female. What is the one common theme throughout these memes? Nursing school is hard! So how can we, as instructors, help?

At the peak of COVID-19, I saw a change in my students. They were less eager and excited. Emails frequently included the phrase ‘I’m just not getting it.’ I saw many become discouraged when they could not find a research topic for the course project or had difficulty finding articles to support their chosen topics. I read emails detailing their struggles in online courses and the personal issues confounding these issues such as loss of jobs and uncertainty about the future while balancing clinical courses and nursing courses, life and family.

From this arose the Module 6 discussion board: Happy nurse = healthy nurse. Previously, the module 6 discussion board post had asked students to describe how they cope with stress. However, in the spring of 2019, I realized students needed more. They needed to do more than just talking about stress relief – they needed to DO it!

My approach to discussion boards is different than most in academia. At the beginning of the semester, my students are placed into small groups of 4-5 students. I give them names such as team Yeti or team Quokka, complete with a picture of their team mascot. They take pride in their team’s name early on and closing discussion remarks often include something like #teamquokkarocks! By doing this, students form a solid group of friends to talk to throughout the semester. Each week they are posed a question regarding professional issues in nursing which aligns with the week’s module focus. Initial posts are due on Wednesday and students must respond thoughtfully to each group member by Saturday. The rules are simple: answer the question with at least 100 characters – posts should be thorough, respectful and insightful. No character or reference/citation rules apply for the response; however they must respond to each of their group members and it needs to be substantial, considerate and thoughtful. As the semester progresses, I often see a camaraderie build with students making meeting plans or responding multiple times to their peers – a real conversation! I watch friendships being built as students are encouraged and supported by their peers.

The new and improved module 6 discussion board follows the module lesson which includes three YouTube videos. The first is how to relieve stress with QI Kong and then two videos by Dr. Zubin Damania (ZdoggMD – a former Standford hospitalist) on moral injury and compassion fatigue in nursing. I then provide a few humorous memes and discuss the importance and science behind laughter. After reading and watching the module 6 content, students complete a module 6 discussion board; the instructions read as follows:

1. Create a short video of your stress relief. This could be a video of you with your family or pets, on the water, riding 4-wheelers, at yoga, etc. Use your iPhone/android device - nothing special! Just a short snippet of what you can do to relieve the stress of school, work and life and what you will lean on when you just worked your third 12-hour shift (that RN behind your name will be here before you know it!). Yes - it must be a recording - we are forcing you away from the computer!!!

2. My examples: Africa.MOV (Being with my children - I do fun things each Easter for the kids to get their Easter baskets. This year was an escape room and the final task was to sing Africa by Toto.) and Stress Relief MOV (being outside on the 4-wheeler!)

The modification of this assignment brought some very surprising results! I saw students eagerly posting their de-stress video, proud to display what they love. Reading the response to their group members, I saw students making plans to get together to try each other’s de-stress techniques or students offering suggestions for new places to go or things to do based on their videos. For some, it was a wake-up call to get out more! Students had so much fun with this assignment, making TikTok or Reels with mini videos of what brings them happiness in life. I thoroughly enjoyed watching each video and provided individual comments on every video, as I do with each discussion board post. I wrapped up the week reminding students that they need to care about themselves by having a way to escape from stress. They need to find joy in the little things and remember to spread their joy with others.

The following are a few of the discussion board responses I love the most. These examples show the engagement in this assignment and the friendships and sense of belonging felt throughout the semester.

• “I recently got into meditating. It truly is an art form and something you learn how to do, not just ‘pick up’ at any time. I use Headspace which is an app. I'm not sure if you use it, but I highly recommend it!

• “I give you a lot of credit for your meditation skills. I have tried it a few times but haven't been able to get my mind relaxed enough to stick with it. The closest I've gotten to meditation is deep breathing. I find doing that usually calms me down. I'd like to know how you learned to meditate. Did you take a class, watch a video or learn on your own?”

• “<student name>, once again I find myself wanting to try another one of your meals and now, I am hungry for tacos! I am also starting to learn how to cook so if you have any favorite recipes or helpful tips, please throw them my way! Thanks for sharing, I expect new recipes added to the next discussion post!”

• “I love that a lot of your stress relief tactics include your family. I wish I was able to spend more of my free time with my family. Also, winery trips always do the trick when stressed, maybe sometime after an exam or semester, we could do a cohort winery trip. What workouts do you feel help you the best with destressing? Personally, I like going on outdoor hikes or lifting weights.” 

• “Yes, I would love to do a winery trip, Sarah's vineyard is close by and it's nice! Do you like sweet or dry wines?”

• “That is so exciting that you're going to Vegas. Have you ever been there before? If you haven't, we can talk, and I'll tell you some of my favorite things out there. I've been with my family a few times and then for a girls' trip with my mom and sister!” 

• “Where has been your favorite place to play golf? I once went to visit my friend in Arizona and we went to the waste management golf tournament. I've never seen a golf tournament quite like it! We should get a group together once it gets warmer and go to Top Golf, it would be so much fun!” 

Lastly, a comment from the course evaluation shows the power of engagement in the classroom!

“I love how our discussion board was organized. Every student was free to voice their opinion and give respect to each other. Tracy interacted with students on discussion posts which made it fun because she also tells you what she thinks about a topic.”