Management and  Awareness

Stress Management Project



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Five-Minute Stress Management Techniques Any Nursing Student Can Teach

Esther Beck, Ann Marie Collins, MSN, RN, APRN-BC, Aghaneen Zoma,
Robin Bissonette, Jill Brown, Bobbie Anne Gonzales, Nicole Lake, AnnMarie Owen
Wayne State University, College of Nursing


A university sponsored Alcohol Awareness and Risk Screening Day provided the opportunity for a group of nursing students to teach stress management and relaxation techniques to their campus classmates.  Concepts included: touch, massage therapy, sleep, hygiene, exercise, stretching, nutrition, and deep breathing techniques. The nursing students developed and distributed pamphlets that gave a brief overview of the stress management techniques and Internet links to additional resources.  They also provided information that illustrated the effects of alcohol on the lives of college students and offered anonymous screening for risk of alcohol abuse developed by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Sixty campus students were screened and given information about campus resources for help and support.  Participating campus students overwhelmingly reported appreciation for the information, instruction, and screening.

The Task Force on College Drinking was commissioned by the National Institute on Alcohol Abuse and Alcoholism (NIAAA, 2002) and reported the findings in A Call to Action: Changing the Culture of Drinking at U.S. Colleges. The report cited 1400 student deaths and 500,000 unintentional injuries due to alcohol over a three-year period.  Alcohol was also associated with students drinking and driving, lowered academic performance, and health and legal problems (NIAAA, 2002).

College students experience stress from many sources including parental expectations, competition for grades, relationships, concern about sexually transmitted diseases, and career choices (University of Florida, 2003). Many students carry additional responsibilities such as part- and full-time jobs and the parenting of children. The use of alcohol and drugs is an indicator of stress and considered a dangerous form of coping (Villanova University, 2005).  Social anxiety also has been implicated as a risk factor related to heavy or problem drinking in college students (Repich, 2004).

Nursing students can serve as ideal peer teachers in assisting their campus classmates to learn about behaviors and techniques for stress management.  As college students themselves, nursing students also experience stress and are at risk for problem drinking (Coleman, Honeycutt, Ogden, McMillan, O’Sullivan, Light, et al., 1997).  In contrast to their campus classmates, nursing students learn in their courses about the dangerous physical and psychological effects of problem alcohol use.  They also learn about the effects of stress and the importance of teaching health promotion techniques of stress management to their patients and clients (Pender, Murdaugh, & Parsons, 2002).

The campus stress management teaching project was developed by seven student nurses and their instructor at a large urban, mid-western university. The project was conducted during the annual campus wide alcohol Awareness and Risk Screening Day sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA, 2002) and the national Healthy Campus Initiative (American College Health Association, 2000).

Teaching about Stress and Coping

Teaching stress management serves both as a means for health protection and health promotion. Pender and colleagues (2002) described health protection as a means of reducing health problems by active protection against “pathologic stressors.”  They defined health promotion activities as focusing on “high level health and well-being” (p. 34).  Persons experiencing stress may engage in poor health practices as a way to cope.  These practices may include smoking, drinking alcohol, poor eating habits, poor exercise, and sleep loss (Cohen, Kessler, & Gordon, 1997).  Schaffer and Yucha (2004) reported that relaxation techniques might help to strengthen healthy coping, lower fatigue, and improve sleep. The goal is to help clients protect themselves against the negative effects of stress and aim for a higher level of health and well-being.  Pender, Murdaugh, and Parsons (2002) recommend three types of interventions for stress management:  minimizing the number of stressful situations; increasing the capacity to resist stress; and counter-conditioning to reduce the physiological effects resulting from stress.

In the nursing curriculum, students learn to teach health promotion activities, including stress management, to their patients across clinical settings.  As students themselves, they are exposed to the same academic and personal stresses experienced by their classmates.   They are in an ideal situation to use the stress management training from their clinical courses for self- and peer- teaching with other students.

Stress Management and Alcohol Awareness and Risk Screening

Seven student nurses and their clinical instructor participated with other campus groups in an annual Alcohol Awareness and Risk Screening Day. The screening day was sponsored by the university Healthy Campus 2010 initiative (American College Health Association, 2000). The Alcohol Awareness and Risk Screening Day is consistent with the goals of  the NIAAA and Healthy People 2010 (US Department of Health and Human Services, USDHHS, 2000).  Healthy People 2010 and Healthy Campus 2010 initiatives both have established the goal to increase the number of college students receiving information on alcohol and drug abuse prevention from 19% to 55% by 2010. The Alcohol Awareness and Risk Screening Day provided an opportunity for the student nurses to engage in a mental health promotion activity as part of their Psychiatric/Mental Health Nursing course.

The nursing students began the project by interviewing the director of the campus Counseling and Psychological Services.  She reported that both residential and commuting students were experiencing stress related to academic, financial, and personal demands in their lives. She expressed concern that the high levels of stress placed the students at greater risk for alcohol and other drug abuse.  She told the nursing students about plans for an upcoming campus wide Alcohol Awareness and Risk screening Day and invited them to volunteer to participate as screeners.  The director agreed that the students could use this opportunity to share health promotion teaching of stress management techniques with alcohol information and risk screening.

Prior to the Alcohol Awareness and Risk Screening Date, the nursing students reviewed information about alcohol abuse and stress (Varcarlolis, 2002). They worked as a group to prepare a pamphlet to use in teaching the campus students about the effects of alcohol abuse on nutrition and stress management techniques. The stress management techniques they chose emphasized two of the modes of stress management interventions suggested by Pender, Murdaugh, and Parsons (2002):  increasing resistance to stress (exercise, nutrition, and sleep hygiene) and counter-conditioning to avoid physiologic arousal resulting from stress (deep breathing, touch massage therapy, stretching, and mental imagery).  Web sites were included in the pamphlet that offered additional information about stress management techniques and nutrition and alcohol abuse.

On the Alcohol Awareness and Risk Screening Day, the students received training in using the anonymous screening tool for alcohol risk, which was developed by the NIAAA. The nursing students were assigned to two campus sites away from the location of the nursing classes so that they would be unlikely to interview students of their acquaintance.  Tables were set up for completing the alcohol screening as well as for displaying information on alcohol and other drugs and the stress management pamphlet they had developed.

5-Minute Stress Management Project

The nursing students screened 60 campus students throughout the day.  Many other campus students did not choose to complete the alcohol screening, but requested information about alcohol and other drugs and the stress management techniques. The nursing students met with the campus students in the halls as they were changing classes, so approximately five minutes were available for the discussion.  After identifying themselves, the nursing students offered information about alcohol and other drugs and an opportunity to complete the alcohol screening forms. They offered the campus students stress management information using the pamphlet they had developed.  They briefly reviewed the information on the pamphlet and encouraged the students to access the web sites that were identified on the pamphlet for more information. The pamphlet included information about touch therapy massage, sleep hygiene, deep breathing, stretching, exercise, visual imagery, and the effects of alcohol on nutrition.  The nursing students also provided information about campus resources for counseling and support.

The students emphasized the effects of exercise on helping to reduce stress. One of the nursing students observed that those campus students who had no risks for alcohol abuse on the alcohol screening form generally tried to exercise 2-3 times a week.

Another nursing student reported that working with the campus students was a positive experience because they asked questions and listened for advice about their health, including nutrition, sleep, and exercise. The instructor was available to answer questions when the students needed support.  One student commented that teaching visual imagery was indeed difficult to do in five minutes. She recommended more time be devoted to offering stress management techniques to campus students because they appeared to like the information.

The nursing students reported that many of the campus students who participated in the Alcohol Awareness and Risk Screening Day expressed appreciation for the information on alcohol and other drugs and the stress management techniques. They also said they wanted to take the information and pamphlets to share with friends and family members.


This article presented information about the relationship of stress and alcohol use by college students.  A campus stress management teaching project developed by seven nursing students and their instructor was presented.  The project involved teaching stress management techniques to campus students during an Alcohol Awareness and Risk Screening Day.  The stress management techniques were outlined in a pamphlet created by the students. Use of the pamphlet made it easy to give information about stress management techniques in a brief 5-minute time frame with campus students. The stress management techniques used by the students in this project and other stress management techniques such as progressive relaxation and time management can be taught in brief 5-minute sessions with the help of pamphlets and other printed information.


American College Health Association (2000). Building Healthy Campus Communities. Retrieved March 20, 2005, from www.acha.org/projects_programs/00081.cfm.


Cohen, S., Kessler, R., & Underwood-Gordon, L.  (1997). Measuring stress. New York: Oxford University  Press. 


Coleman, E., Honeycutt, G., Ogden, B., McMillan, D., O’Sullivan, P., Light, K., &  Wingfield, W. (1997). Assessing substance abuse among health care students and the efficacy of educational interventions. Journal of Professional Nursing, 13 (1), 28-37.

National Institute on Alcohol Abuse and Alcoholism (2002, October). Changing the Culture   of Drinking at U.S. Colleges. Retrieved  February 19, 2005, from  www.niaaa.nih.gov/publications/aa58.htm.

Pender, N., Murdaugh, C., & Parsons, M.A. (2002). Health promotion in nursing practice. Upper Saddle River, NJ: Prentice Hall.


Repich, D. (2004, January). College students use of alcohol as way of coping with social anxiety. Retrieved February 20, 2005, from http://talentdevelop.com/ColStudAlc.html. Schaffer, S. D., & Yucha, C.B. (2004). Relaxation and pain management. American Journal of Nursing, 104 (8), 75-82.


University of Florida. (2003, July). Stress and College Students. Retrieved February 20, 2005, from www.counsel.ufl.edu/selfHelp/studentStress.asp


USDHHS. (2000). Healthy People 2010.Healthy Campus 2010. Retrieved on March 20, 2005,from: http://odophp.osophs.gov.

Varcarolis, E. (2002). Foundations of psychiatric nursing (4th ed.).  Philadelphia: W.B. Saunders Co.

Villanova University Counseling Center. (n.d.). Stress Management. Retrieved February 20, 2005, from www.studentlife.villanova.edu/counselingcenter/psychtopics/stressmanagement.html



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