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Includes numbers to call, and valuable online resources.

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Although nursing is one of the most rewarding careers, it comes with challenges that increase the risk of burnout and raise turnover rates. The psychological demands of a nursing career can be addressed through mental health services.

Nurses must value their mental health and have easy access to these services to lower the risk of depression, anxiety, burnout, and suicide. Nurses have access to hotline services for immediate help and in-person or online/virtual support for ongoing assistance.

Explore different mental health resources for nurses that can help address the profession's unique needs.

Mental Health Hotlines for Nurses

Mental health crisis hotlines offer callers trained, unbiased volunteers and professionals who can help defuse a mental health crisis in a culture that doesn't encourage expressing your vulnerability. You may not be the person in crisis, so it's crucial you identify when it's necessary to call an emergency hotline for help.

Austin, Texas is one city that has expanded its 911 system to include mental health services. In addition to 911, you may access immediate help using the 988 National Suicide Prevention Lifeline, which is a national network that provides free emotional support for people in crisis.

988: The lifeline is available 24/7 and the organization receives ongoing consultation and guidance from national and international experts focused on suicide prevention and crisis response. Text HOME to 741741: Volunteer crisis counselors are available to connect with you via text when you aren't able or willing to speak with someone directly. The trained counselors help you move away from a hot moment whether you're dealing with depression, anxiety, an eating disorder, self-harm, or suicide. Text FRONTLINE to 741741: Free crisis counseling for healthcare professionals to help deal with fear, isolation, anxiety, stress, and other challenging emotions. 1-800-985-5990: The SAMHSA national hotline is dedicated to providing support 24/7 to people who have experienced a natural or human disaster and provides referrals to local crisis support centers for follow-up care. 1-800-662-HELP (4357): This is a free treatment and information referral service provided in English and Spanish for people facing mental health or substance use challenges. They provide referrals to local treatment centers, support groups, and community-based organizations. 1-800-950-6264: The national organization offers a range of resources for healthcare professionals facing symptoms of trauma or stress. Nurses can access the NAMI Helpline available Mon-Fri 10 a.m. to 10 p.m. and a list of confidential support resources. The list includes resources for peer support, building resilience, and family support. 206-459-3020: This is a 24-hour crisis referral service for emergency services personnel and was established with the idea that no first responder should face a crisis alone. They work with a variety of groups to provide support and a safe place to turn for first responders.

Mental Health Resources for Nurses

Nurses have a higher risk of suicide than the general population and one of the key risks is job stress. Unfortunately, despite working in healthcare, the mindset that stigmatizes asking for help still exists.

Working with mental health resources that create an atmosphere of acceptance and empathy can reduce the risk of burnout, depression, and suicide. While there is no foolproof way of preventing suicide, there are ways to reach nurses who are struggling and reduce the risk they will act on these thoughts.

Recommended by The National Center for Crisis Management

The Academy is celebrating its 25th anniversary in 2023. In collaboration with Green Cross Academy of Traumatology and CISM Perspectives, they maintain a list of mental health providers who run support groups for medical providers, including times and contact information.

The organization's mission is to increase awareness, help providers to look beyond physical needs, and establish standards, education, and training for crisis management professionals. They offer certifications in traumatic stress and crisis management specialties.

The organization also helps support the Wounded Warrior Project and St. Jude Children's Research Hospital. Mental health professionals who choose to join the Academy can also volunteer to be deployed to areas in crisis.

Recommended by the American Nurses Association

Cost: Free for nursing professionals

Happy is available as an app to employers and insurers to create frictionless access to mental health services. The organization operates as a proactive, peer-based mental health service to change how the delivery of services is executed. Ultimately, the company hopes to remove barriers that prevent people from receiving adequate services and support.

Thanks to the Well-Being Initiative, they partnered with the American Nurses Association to address the needs of nurses without charge. Nurses only need to download the app to communicate with a mental health professional, call (833) 327-0262, or text their first name and ANA to (858) 367-3001.

Happy claims that some of their greatest successes have been offering mental health support to healthcare professionals who don't always have the energy or time to ask for it.

This online, self-paced course was developed as an interactive means of mental health training for nurses. It includes eight modules of video, text, and assessments. It confers 3.75 continuing education (CE) credits approved by the California Board of Registered Nursing.

Multiple faculty developed the learning materials, which are free to nurses. At the conclusion of the course, nurses will be able to identify the physiological changes associated with stress, anxiety, and burnout, access ways to self-identify those changes, and implement strategies to avoid burnout.

Cost: Free version for individual nurses, but you may get more specific resources if your employer signed up as an organization leader

This online app measures and tracks your mental health by asking a 5-minute set of weekly questions that empower nurses to identify changes in their mental health and seek help early.

Users can access a list of vetted crisis counseling agencies and wellness tools, which enables them to speak to a mental health counselor, get support by text, or receive support for opioid dependence. Within the app, users also have access to search engines that help find free or reduced-cost services in their local area.

Heroes health, originally developed by the University of North Carolina Chapel Hill, has transitioned to Marvin Online Teletherapy, which is continuing to offer free personalized outreach for mental health services.

Cost: Free resources and additional support if you become a Schwartz Center healthcare member

The Schwartz Center for Compassionate Healthcare maintains a list of resources to support mental health and well-being for healthcare workers. These resources address preventing and managing stress as well as resources that are specific to the COVID pandemic. Included are ways to deal with workplace violence, resources for healthcare leaders, and guides for families of healthcare workers.

This is a volunteer-led initiative that was created in response to the COVID pandemic. The group does not offer licensed mental health services and recommends nurses who are in crisis should seek care immediately. The online, videoconference service was created for nurses to develop greater resilience and reduce stress.

They offer no-cost, confidential groups for nurses to interact at a variety of times and days throughout the week. The groups run for about one hour and are facilitated by 1-2 persons; typically between 4-12 nurses participate.

Group activities blend mindfulness practices, emotional skill building, and sharing/processing. The facilitators are experienced volunteers that come from different backgrounds, including not-for-profits, social work, and mental health.

Cost: Free resources and most CEs are between $8-$15 depending on whether you're a member

The association focuses on holistic self-care strategies for nurses to overcome the psychological and physical effects of stress. They offer tools for self-reflection, self-care, and dealing with stress.

Nurses may also earn contact hours through peer-reviewed programs that are online, self-paced home study courses or at live events. A unique three-session program prepares nurses to take the American Holistic Nurses Certification Corporation examination.

In addition to these resources, the association provides holistic practice and self-care modality tool kits for nurses, some of which also include contact hours.

This one-page program is offered by the Center for Patient Safety and focuses on developing a culture of self-care for staff. It includes exercises to address breathing, meditation, stress relief, and yoga. Their mission is to reduce preventable harm by helping nurses and leadership strengthen safety culture and build the necessary skills in healthcare staff.

Assessing and Maintaining Your Mental Health as a Nurse

The American Nurses Association recognizes a long list of risk factors that contribute to the higher risk of suicide in the nursing profession. These include exposure to repeated trauma, inadequate self-care, feeling unsupported, workplace violence, incivility, and bullying.

Nursing care is intimately connected to a nurse's mental health. It is vital to support mental health resources for nurses and more mental health days for nurses since nurses must often function at the highest possible level. Stressors can lead to a host of mental health challenges, including depression as a nurse, anxiety, and burnout.

When mental health is diminished, the quality of care usually suffers. Nurses should look out for signs in themselves and their colleagues that indicate they may require additional support and treatment. These include:

Physical Symptoms

Emotional and Cognitive Symptoms

Social Impacts
Page last reviewed April 9, 2023

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Mental Health Resources For Nurses - NurseJournal

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Nurses must value their mental health to lower their risk of burnout and depression. Check out these programs that are focused on care for nurses and healthcare providers.

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ATI gives tips for coping with stress include:

Put your needs first - work on self-care.

Create a routine - have balance.

Spend Time with friends and family.

Journal before bed.

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Tips for Coping with Stress During Nursing School – ATI Nursing Blog

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Quality of Life - Healthy Nurse, Healthy Nation™ (healthynursehealthynation.org)

The blog engages in how to have a healthy "work - life balance." It also looks at what to look for if you don't have that balance:

exhaustion

do not want to go to work

depressed

experience burnout

The article concludes of way to seek help if needed

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Quality of Life - Healthy Nurse, Healthy Nation™ (healthynursehealthynation.org)

Learn the benefits of being thankful

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This is from the University of North Dakota

This looks at the causes of stress, and how nurses feel stressed in the workplace. It also gives informative information on how to cope with stress.

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The Impact of Stress

While most American businesses focus on increasing profit, few realize that the annual cost of workplace stress is nearly $300 billion.

Stress in the Workplace

Stress causes 1 million workers to miss work each day. What's more, surveys indicate 64% of U.S. workers are ready to quit their job due to stress, and 54% say work stress negatively affects their home lives. The long-term health effects can include depression and death. The financial impact of depression treatment and health care costs are in the billions.

Both men and women typically handle stress by either consuming more caffeine, smoking or exercising more frequently. Unfortunately, studies show 34% of workers don't feel comfortable reporting stress because they think it will either be viewed as indifference, weakness or could affect their promotion opportunities.

From an employer perspective, studies indicate companies spend roughly 75% of a worker's annual salary covering lost productivity or replacing workers. In health care, the annual cost of nurse burnout is $9 billion for hospitals and $14 billion for the health care system overall.

Stress Among Nurses

A 2018 survey of over 900 nurses found that 91% of nurses felt their hospitals were understaffed. 62% polled felt regularly burned out and believed the nursing shortage negatively impacted care quality. 54% said their workload negatively impacted their work, while 49% had considered leaving nursing in the past two years.

Bullying and Harassment

Nearly 40% of nurses have experienced bullying or harassment in the workplace from other nurses, patients, physicians or administrators. Only 29% of nurses feel respected by administrators.

Sources of Nurse Stress

There are several factors that drive stress among nurses. These include overtime work, heavy workload, poor work-life balance and fear of infecting family and loved ones during a pandemic.

10 Tips on Stress Management for Nurses

Nurses and leaders share responsibility in managing workplace stress and ensuring nurses receive the care they need.

How Nurses Can Manage Stress in the Workplace

One way nurses can lower stress is to use aromatherapy with substances like lavender oil. Another key tactic is to eat healthy, which can involve limiting caffeine, nicotine and processed foods to boost the immune system. Staying hydrated can also be important. A good rule of thumb is to drink half of your body weight in ounces before a 12-hour shift.

Additionally, engaging in recreational activities such as working on puzzles or playing games can help reset the mind. It can also be vital to take 10 minutes out of the day to meditate in order to refocus and adjust perspective. Finally, getting a full night's sleep or sneaking in a mid-shift nap on the night shift can improve concentration and reduce impulsivity.

How Health Care Managers and Administrators Can Support Nurses

Health care managers and administrators can provide the type of support nurses need by promoting a positive work culture through team outings and team-building activities. They can also keep the nurses' break room stocked with nutritious food, such as nuts and fruit. Additionally, they can automate repetitive tasks, such as entering medical information or reminder calls to reduce nurses' workload. Finally, they can take steps to foster resilience in nurses, such as engaging nurses in open dialogue regarding the exchange of ideas or the teaching of new skills.

How Resilience and Technology Can Reduce Nurse Stress and Burnout

Health care leaders should seek to build resilience among their staff members to help reduce stress and prevent burnout. Technology can also play a critical role in improving processes, increasing efficiency, and lightening nurses' workloads.

The Importance of Building Resilience

According to the Joint Commission, resilience involves fostering resources to combat workplace challenges. Building resilience in health care workers can help increase employee retention, reduce staff turnover and performance problems and increase patient satisfaction.

Nurse leaders should also know the factors that contribute to building resilience. These include feeling valued professionally; team, colleague and organizational support; the use of debriefings; and empowerment.

How Technology Can Relieve Nurse Stress

There are several technological advances in health care that can make nurses' jobs less stressful. These include the use of artificial intelligence (AI) for administrative and repetitive tasks, utilizing predictive and prescriptive analytics and improved use of electronic health records (EHR)

Bringing Better Health to Nurses

Self-care is not optional in the nursing profession. Nurses can only care for patients if they've taken steps to take care for themselves.
Sources American Holistic Nurses Association, Holistic Nursing Self-Care Strategies The American Institute of Stress, 42 Worrying Workplace Stress Statistics Everyday Health, The Ultimate Diet Plan for a Happier, Less-Stressed You HealthcareDive, Burnout Hurts Nurses' Ability to Meet Profession's Demands Healthcare IT News, To Fight Nurse Burnout, EHRs Must Use AI, Reflect RN-Specific Workflows Healthline, 12 Science-Based Benefits of Meditation The Joint Commission, Quick Safety Issue 50; Developing Resilience to Combat Nurse Burnout Medical Xpress, Aromatherapy May Reduce Nurses' Stress, Researcher Suggests Psychology Today, 5 Ways Video Games Can Help With Stress and Mindfulness RN Network, RNetwork 2018 Portrait of a Modern Nurse Survey ScienceDirect, Exploring Nurses' Work-Related Stress In an Acute Care Hospital in KSA Thrive Global, 5 Ways to Manage Stress at Your Healthcare Workplace Psychology Today, 9 Interesting Ways Napping Can Make Your Life Better

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10 Stress Management Tips for Nurses to Reduce Stress

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Explore the stress management tips nurses and health care administrators to lower stress, reduce nurse burnout and improve the quality of care delivery.

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This article from Marquette looks at the importance of self-care for both physical and mental health.

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If you are looking to become a nurse, you've probably been doing a lot of research about programs and schools. Earning a Bachelor of Science in Nursing Degree is a challenge, but one that can be managed with the right program and the right support. Take for instance Marquette University's Direct Entry MSN program for non-nurses.

Our accredited master's in nursing program, which is delivered as a campus-based program in Milwaukee or as an online-based nursing program in Pleasant Prairie, Wisconsin, builds on your existing non-nursing bachelor's degree, making it possible for you to earn an MSN degree in less than 21 months. While the program has its challenges, staff and faculty offer an environment of inclusiveness, one-on-one support, and collaboration to help you cope with nursing school stress and, most importantly, find success. Here are seven stress-relief techniques you can count on during your nursing education.

1. Make Self-Care a Priority

This tip is first for a reason. While it can feel like nursing school is too stressful, it is still important to take care of yourself during this time. After all, if you don't take care of yourself, you won't be able to take care of your schoolwork, or eventually, your patients. The nursing curriculum at Marquette is made up of three main components: online or in-person nursing theory coursework, hands-on skills and simulation labs, and in-hospital clinical rotations. Once you begin the full-time program you will have limited free time outside of your studies, so it's crucial that you have a self-care routine in place to remain both physically and emotionally healthy.

Self-Care for Physical Health

To be your healthiest self, you'll want to incorporate a balanced diet, which can help you maintain optimal energy levels and focus. This means incorporating more nutrient-dense and whole foods like fruits and vegetables, whole grains, nuts, unprocessed proteins, etc. To make this more achievable, try creating meal plans and prepping meals for the week on weekends. Additionally, you can prepare a quick slow-cooker meal in the morning so that it will be ready once you return home in the evening. Making it easier for yourself to eat healthier is the key to staying consistent.

In addition to a healthy diet, moving your body outside of labs and clinical rotations can serve as a healthy release when dealing with the deadlines and workload of a Direct Entry MSN program. Choose physical activities you enjoy such as:

Self-Care for Mental Health

While your physical health is no doubt important, you must also remember to take care of your mental health. This means reducing stress levels and ensuring that you are engaging in activities that bring you joy. Some ways you can take care of your mental health include practicing meditation and mindfulness by using guided meditations. Spending time in nature can also be a great stress reliever. Go for nature walks, being sure that you use all your senses to observe the world around you. Even just taking the time to watch funny cat videos can improve your mental health, as humor can be a great way to clear your mind.

Finally, you need to make sure you get enough sleep. According to the National Heart, Lung, and Blood Institute (NHLBI), sleep deprivation can hinder your decision-making process and slow your reaction times. For example, if you're sleep deprived during clinical rotations, you may find it difficult to quickly compute medication math, assess vitals, or even react to a patient stumbling.

2. Get and Stay Organized

Marquette's curriculum is compressed and moves fast, so you'll need to stay organized to keep up with the rigorous pace. You won't experience any "light" semesters or classes, so you'll want to develop an organizational regimen right away. A planner or calendar can serve as a great resource. Being able to write down and visualize your learning activities on a daily, weekly, and monthly basis will help you stay prepared and keep your stress in check.

Your organizational routine will be important from the beginning of the first semester onward. If you are taking the online coursework option, you're not tied down to a specific classroom or lecture time, you will have the freedom to learn core nursing concepts at a time that works best for you and your schedule. However, you will have plenty of opportunities to interact with faculty during course-specific meetings, office hours and other individualized meetings. you will still be held accountable for all deadlines given by your instructors and in an online environment being organized is key to meeting these deadlines. If you are attending classes in-person, the structure of these classes may make it easier to plan your days, however it is still just as important to stay on top of your schedule.

3. Don't Be Afraid to Ask Questions

Nursing school will require you to absorb massive amounts of information, making it crucial for you to put aside your pride and ask questions when necessary. Even if you communicate with your professors through an online learning platform, you can still meet with them one-on-one. In fact, your professors want you to reach out if something isn't making sense.

As part of the Direct Entry MSN curriculum, you'll complete a series of labs that teach you how to safely and effectively deliver patient care. These labs will provide you with the equipment and supplies needed to prepare you for your diverse clinical rotations. Just like your didactic professors, your clinical professors will expect you to be upfront and honest about any additional help you may need. Whether you are struggling with a specific skill, piece of equipment or just need extra practice, your professors will gladly schedule time with you during open lab.

Additionally, if you are struggling, we offer tutoring from Marquette Direct Entry MSN graduates at both of our sites. Through this free service, you will have the opportunity to work closely with some of the alumni who have been in your place and engaged with the same curriculum that you are now facing. They can help you to take on course material, prepare for exams, and keep organized in an effective manner. Marquette's Direct Entry MSN tutors are graduates currently working in the nursing field, so the knowledge that they share with you has been proven in clinical environments.

Asking questions early can help prevent nursing school from being so stressful. If you don't understand a concept, it is very important to get the help you need before the curriculum starts to build on that concept and you fall behind.

4. Create Support Systems with Your Peers

The memories you make in nursing school will stay with you for the rest of your career, and most of them will involve the students you meet in your cohort. Coming from all walks of life, the students in your cohort will share your fears and goals for nursing school success. Because Marquette's Direct Entry MSN program often draws students looking for a career change, you will likely have great diversity in your cohort when it comes to life experiences and perspectives, which can enrich everyone's learning experience.

Your peers will hold you accountable for deadlines, help you work through challenging topics and serve as a sounding board when you are feeling stressed. You will provide the same amount of support for them in return.

5. Learn When to Say No

While it is undoubtedly important to maintain relationships and do good deeds during nursing school, it is also important to maintain boundaries. As a prospective nursing student, it likely brings you joy to help others, which is an admirable character trait. However, you are going to be incredibly busy during nursing school and won't have as much free time to take care of others. Learning to set firm boundaries and say no when you need to will help you to reduce your stress levels while in school and beyond. As a caring person, this may sound a bit selfish. But in reality, it is the exact opposite. You must make sure to take care of yourself first so that you can put your all into helping others later.

6. Start a Journal

Journaling is a great stress relieving technique. It allows you to get all your thoughts out on paper, prioritize your worries, and can help you identify negative ways of thinking or certain triggers for your stress. Even if you don't like the idea of keeping a journal, just sitting still and evaluating your thoughts in a mindful way can help you to realize what is stressing you out. And once you can identify your triggers, you can start coming up with ways to either avoid them or reframe your mindset to prevent those things from causing so much stress.

Keeping a journal while you are in nursing school can also end up producing a keepsake for you. Once you've graduated from nursing school, you can look back at your journal entries and see how far you've come. Taking the time to reflect on your accomplishments will foster a sense of confidence in your abilities to overcome obstacles.

7. Remember the End Goal

There's a reason why you're reading this blog post - you want to change careers to become a nurse. Whether you've been called to serve others, have overcome a traumatic life event, or have always been passionate about working in the field of healthcare, there is a reason behind your nursing school search. Before you begin your nursing school education, write down your "why" on a piece of paper (perhaps in your journal) and keep it safe. Whenever you feel the stress of nursing school, you will have this for reference. Reflecting on your why can give you that boost you need to keep going. And remember, Marquette's Direct Entry MSN program can be completed in less than two years, so you've got this!

Ready to Get Started?

Nursing school is challenging, no doubt. It has to be - patients trust nurses with their lives. So while Marquette's Direct Entry MSN program is demanding, these tips for coping with nursing school stress can help you successfully earn your masters of science in nursing (MSN) degree with confidence. Contact an admissions adviser to learn how you can get started today!

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7 Tips for Coping with Nursing School Stress - Marquette

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Struggling with coping with nursing school stress? We have tips to help you relieve some of that stress and enjoy your time in nursing school.

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Managing Stress & Self-Care | APNA

This article stress the importance that every day nurses need to give themselves self-care, and the importance of taking care of your mental health. The article also look at the warning signs of excessive stress form a cognitive, emotional, behavioral and physical aspect.

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The video looked at one important way to destress-exercise.

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#1 TIP -  How to Deal With Stress -  Nursing School Resources | @LevelUpRN

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Importance of Self-Care for Nurses and How to Put a Plan in Place (purdueglobal.edu)

Informative blog from Purdue Global. It defines what self-care is and tells why it is important for nurses.

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Self Care Tip Sheet (apna.org)

A well-informed look at mental health and the importance of scheduling time for self care.

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Taking care of yourself during a work shift

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Taking care of yourself during a work shift

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Treat your body well

Practice Mindfulness

Be kind to yourself

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The American Nurses Association polled over 183,000 nurses for its Healthy Nurse survey and concluded that there is an urgent need to improve nurses' health, particularly in the areas of physical activity, nutrition, rest, safety and quality of life. Additionally, 70% of nurses admitted prioritizing the health, safety and wellness of their patients over their own, while 77% reported a "significant level of risk" for stress in the workplace. Stress is a major contributing factor for registered nurse turnover and it is estimated that 17% of RNs in the US will leave their first job within the first year after graduation. RN turnover leads to poorer patient outcomes as skilled caregivers are lost. Moreover, stress and burnout negatively impact the quality of life among nurses, affecting both their physical and mental health.

The services provided by nurses save lives. We must do all we can to preserve our minds, body and spirits to not only continue our work, but to ensure that we are the best possible versions of ourselves, for ourselves.

Here are five simple ways nurses can practice self-care during a work shift.

1. Start with a plan

As a new nurse, it can be difficult to establish a routine when starting a shift (and an unorganized approach can lead to a disastrous shift). Prioritize your duties. Completing the most crucial tasks first will lend you reassurance and help to decrease work stress and anxiety. Remember to delegate appropriately and go to your colleagues or supervisor early if you need assistance. If you have a colleague that seems to always have things under control, ask them how they manage, as they may be able to give you some insight on how to approach your tasks each shift.

2. Treat your body well

I was well into my career when a colleague pointed out to me how cigarette smokers never missed a break. The simple statement blew my mind. Use your breaks! After reporting your coverage, use each break allocated to you. Go for a walk or take the stairs to get a quick workout in. Use the restroom. Hydrate with something other than coffee or an energy drink. Eat a healthy meal or snack. Put your feet up for a moment. Call a loved one for a quick chat. Focus on doing something that makes your body feel good at that moment.

3. Practice mindfulness

It may seem like a stretch for a nurse to practice mindfulness during a shift, however, it doesn't have to be a long formal process. If I'm feeling particularly overwhelmed, I like to use a popular mindfulness exercise known as S.T.O.P.

Stop. Just take a pause, no matter what you're doing.

Take a breath. Focus solely on your own breathing to bring you back to the current moment.

Observe. Acknowledge what is happening, good or bad, inside you or in your physical environment.

Proceed. After briefly checking in with the present moment, continue with whatever it was you were doing.

4. Learn to say "no, thank you."

Because you're such a great nurse, many people will have many requests for you. Overtime shifts, committees, councils, special projects, precepting and the list goes on. Although I wouldn't recommend you go full Bartleby and prefer not to do anything, I encourage you to practice using your voice to advocate for yourself in the same way you advocate for your patients. It's okay to decline a special request to prioritize yourself. It's okay to turn down overtime (I assure you the facility will not fall apart in your absence). It's okay to not volunteer for projects that don't feed your interests. Politely decline requests that do not align with your self-care and career goals. When you are ready, ask your supervisor how you may be of service, on your terms.

5. Be kind to yourself.

Lastly, always remember to be kind to yourself. Check in with yourself often. Extend yourself the same care and grace that you extend to your patients. Take care of yourself, first.

We need you! We appreciate you!

Wishing you a long and healthy career,
Olivia Cox, DNP '20, AGPCNP-C

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Simple ways nurses can practice self-care during a work shift

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Here are five simple ways nurses can practice self-care during a work shift from Olivia Cox, DNP '20, BS '11, AGPCNP-C.