Audrey Tolouian EdD, MSN, BASW, RN-CNE
Clinical Assistant Professor
ACUE Credentialed Educator
School of Nursing, The University of Texas at El Paso, USA

As we all know at this point, the year 2020 has brought a whole new set of challenges to the world. Not only has the COVID-19 virus caused physical issues, it has also caused emotional, financial, and well-being issues. My students have really felt this. As nursing students, they are in a tough place- they are responsible for book learning, but they are also responsible for hands-on clinical skills. With a lack of protective gear, an unknown virus, and a higher than normal level of anxiety, this created an environment that was not suitable for learning.

The students have been at a loss through all of this. I tried as quickly as I could to disseminate information, but that was not enough-the students wanted more. They not only went to full-time school, they were now taking full-time care of their spouses and children, and then they were told they had to become homeschool teachers for themselves and for their children, creating an environment of overwhelming chaos! Somehow, I needed to help them deal with some of the stress, and in doing so, I also helped myself and a few other faculty members as well.

I provided virtual office hours and noticed that the students only needed a space to have a discussion, not always concerning nursing school, but often times talking about their homelives and how stressful life had become- almost overnight. It became clear pretty quick that the students needed to learn how to care for themselves before they could care for others. Using a model of care called Plane Tree, (Plane Tree, 2020) where the patient is the center of the care team, I morphed this concept a bit so that the student would see themselves as the center of the educational team, and learn some skills that would allow the mind to rest, allowing all of the parts- physical, mental, emotional, environmental, and spiritual (American Nurse Association, 2019)- to fall into harmony.

This transformed into weekly meetings with semi-structured activities- where we came together and learned some mindfulness techniques based on Capacitar, a series of “easy-to-use holistic practices drawn both from ancient cultures and current research”  (Cane, 2011). The activities that we did in the virtual classroom, can be easily used in other settings. They are a great way to create a sense of community as well as learn some skills that will help to take the edge off of the underlying anxiety that everyone seems to have these days. The first step is having conversation to gauge what the group is interested in or struggling with and taking it from there. Not working with a group? Don’t worry- they work solo too!

So, to start, the students and I had some conversations about what we do for fun and things that we do to relieve stress. One student stated during one of the discussions that he was an artist, and his mood was reflected in his color choices. This prompted a bit of color usage study and research studies investigation. Since we were in an Evidence Based Research course, I found a few studies that showed that it helped to increase attention on exams if students colored mandalas before studying, and the students performed better (Carsley, 2020). So, I asked my students to pull out their crayons and get to work. Yes, nursing students actually earned a point if they colored their mandala and shared it with the class. And you know what? They loved it! One of the best parts was actually olfactory- many students said that the smell of the crayons brought them right back to their childhoods, when times were less complicated and they were able to have a bit of fun without guilt. Here they were given permission to take a break and have a bit of stress relief and the response was amazingly positive.

To color a mandala, there is no special skill required- actually the most difficult thing is to decide on the one that you would like to color. Once that is decided- grab some crayons, colored pencils, or pens and get started. You can get as involved as you like- What do the colors mean? Should I color with a certain intention? Will I write down positive affirmations as I go? Gençdoğan, et al discuss how mandalas can be used for meditation, to spark creativity, and to create a sense of calm

(2018). The most important thing is to enjoy it, let yourself go, and be in the moment.

“Bring your pet to class day” was the next week. It is incredible how people love being involved with pets in the classroom virtual sessions. There were dogs, cats, and other types of other pets- such as turtles and lizards. It opened up a whole heart-to-heart about how animals help people to stay calm, make them laugh and help them to take their minds off school (Anderson, 2018). The interactions really showed the animals’ personalities, and how special to the students they are. This was a great activity to get the students engaged with each other quickly and it was so much fun to get a screen grab of all the animals in a Zoom session! Feeling that your team has drifted apart due to working virtually? Ask the members to bring their pets to the next

Cooper Nolan, photograph

meeting and watch what happens- Don’t have a pet? You Tube has tons of cat videos- during the pandemic, they have become extremely popular for a reason.

Another fun activity was Tai Chi. The students said that they really enjoyed this- and actually had their family members join in. Let’s all admit- Tai Chi gets a bit of a bad rap, I mean what good can moving in slow motion do, how is that even exercise? it is just going to make me look silly!  Well, there is much more to Tai Chi than those specific movements, it is actually a martial art that helps to improve the mind-body connection and helps with balance (Tong, Chai, Lei, Liu, & Yang, 2018). I always know I need to increase my levels of Tai Chi when I go to the airport and fall over putting my shoes back on after security- really, if I am doing Tai Chi a little bit everyday, I can balance on one foot and get my shoes back on pretty quick- if not, I am that person holding up the line trying to awkwardly tie my shoes. Tai Chi is also noted to improve self-efficacy (Tong, 2018), and this was a huge part of the purpose.

The last day of the session, we did a guided meditation. Amanda from Calming Crow Natural Healing delighted our students with leading them on a beautiful journey through a favorite place while focusing on a ball of white light. This allowed the students to reduce their stress and to connect with their bodies in a way that they are not normally doing (Sharma, 2015). After this activity- the students said they wished that they could have a weekly meditation. There are many apps available now for guided meditations, as well as YouTube videos, and other websites. Take a look and give it a try, just remember, this activity does take a bit of practice- you will not become proficient in the first few attempts. Again, have fun with it and enjoy the experience- pull yourself back into the meditation when your mind starts to wander-it will, I guarantee it- this is normal and will get easier as you practice!


These are just a couple of techniques that can be used to help reduce stress. Just remember, not all activities work for every person. Try a few until you find something that can help you get through this chaotic pandemic. It is definitely worth the adventure!



American Nurses Association. (2019). Nursing: Scope and standards of practice, 3rd ed.

Washington, D.C :Nursesbooks.org


Anderson, D. (2018). The effect of animal-assisted therapy on nursing student anxiety.

University of Kansas, Dissertation. dissertations.umi.com/ku:15802.

Cane, P. (2011). Capacitar: Healing trauma, empowering wellness, a multicultural popular education approach to healing trauma. Capacitar International, Inc. Santa Cruz, Ca.


Cane, P. (2011). Capacitar: Healing trauma, empowering wellness, a multicultural

popular education approach to healing trauma. Capacitar International, Inc.

Santa Cruz, Ca.


Carsley, D. & Heath, N. (2020). Effectiveness of mindfulness-based coloring for

university students’ test anxiety, Journal of American College Health, 68:5, 518-527, DOI: 10.1080/07448481.2019.1583239


Gençdoğan, B., Çetinkaya, S. K., Gümüş, E. (2018). Effects of Coloring Mandalas on

Test Anxiety, Inonu University Journal of the Faculty of Education, 19(1), 221-

  1. DOI: 10.17679/inuefd.415982


Kabat-Zinn, J. (2013). Full catastrophe living: Using the wisdom of your body and mind

            to face stress, pain, and illness (2nd ed.). Random House Publishing Group.

ISBN: 978-0-345-53972-4.


Planetree (2020). How we help. https://planetree.org/how-we-help/


Sharma H. (2015). Meditation: Process and effects. Ayu36(3), 233–237.




Tong, Y., Chai, L., Lei, S., Liu, M., & Yang, L. (2018). Effects of Tai Chi on self-efficacy:

A systematic review. Evidence-based complementary and alternative medicine :

           eCAM2018, 1701372. https://doi.org/10.1155/2018/1701372


Turturro, N., & Drake, J. E. (2020). Does Coloring Reduce Anxiety? Comparing the

Psychological and Psychophysiological Benefits of Coloring Versus

Drawing. Empirical Studies of the Artshttps://doi.org/10.1177/0276237420923290



van der Riet, P., Levett-Jones, T., & Aquino-Russell, C. (2018). The effectiveness of

mindfulness meditation for nurses and nursing students: An integrated literature

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