Thriving, not just surviving in school

Introduction

College can be a stressful and overwhelming time for many students. With so many responsibilities and expectations, it can be difficult to stay grounded and focused on what really matters. This is where the ancient philosophy of Stoicism can be incredibly helpful. Stoicism is a practical philosophy that teaches individuals how to live a fulfilling and meaningful life by focusing on what they can control and letting go of what they cannot. In this blog post, I’ll discuss 10 tips for practicing Stoicism as a nurse anesthesia resident.

1. Focus on the present moment

One of the key principles of Stoicism is to focus on the present moment. This means not dwelling on the past or worrying about the future, but instead focusing on the here and now. In the operating room, it can be easy to get overwhelmed by the amount of work you have to do or the pressure to succeed. However, by staying present and focusing on the task at hand, you can reduce anxiety and improve your productivity. Nothing is more important than the patient you are taking care of at the current momemt. Did something adverse happen with the previous patient? Is the next patient’s care particularly challenging? We prepare in advance, mentally and physically, so that we can be in the moment with each and every patient. The person in front of you deserves your best.

2. Practice self-discipline

Another important principle of Stoicism is self-discipline. This means having the ability to control your thoughts and emotions, even in difficult situations. This can be difficult at times. You will work in difficult situations, with difficult people, and in places where it seems like everything is working against you. You have to remember that you cannot control other people, only your reaction to them. You have so much to do with so little time that constantly letting your emotions govern your behavior is self-destructive. Remember tip 1–be in the moment–when your day is done in the operating room and you have prepared for your next day, you still need to study for upcoming tests and assignments. Procrastination writes checks that future you may not be able to cash.

3. Accept what you cannot control

Stoicism teaches that there are some things in life that are outside of our control. This includes things like the weather, other people’s actions, and even some of the circumstances of college life. By accepting what you cannot control and focusing on what you can control, you can reduce stress and anxiety and feel more in control of your own life.

If this sounds familiar, it is because it is a precursor to the serenity prayer.

I do like the stoic version better though. The serenity prayer uses the word accept which means to believe or recognize as valid or correct. The stoics would not necessarily internalize the belief as correct or even recognize it at all. They would simply let it pass. You don’t have to have an opinion on everything. You can simply let things be as they are.

4. Practice gratitude

Gratitude is an important aspect of Stoic philosophy. By focusing on the good things in your life and being thankful for them, you can cultivate a more positive outlook and reduce feelings of stress and anxiety. In college, it can be easy to focus on the negative, whether that be a adverse outcome or not achieving your goal for that day. However, by practicing gratitude, you can shift your focus to the positive and improve your overall well-being. I get to work with a lot of students early on in their training. My first question in our debrief is often, How do you think today went? In the first few days of training, I usually hear how bad the day was because they weren’t successful with intubations. No matter how many things went well that day, their view of the day is colored by the few things that didn’t go as they expected. I’m not saying that you shouldn’t self-reflect on these things, but rather give them the weight they deserve. Being a good CRNA is equal parts being good at your job and knowing your limitations. I doubt you will ever be good at everything, everywhere, all at once. Being honest with yourself and your preceptor, and knowing where you need to improve will help foster the growth mindset that you need to keep improving. In Outliers, by Malcolm Gladwell, he asserts that true expertise requires 10,000 hours of deliberate, correct practice. The exact number is contentious, but we can safely assume that you won’t achieve expertise on one of your first attempts. Focus on what you’ve learned that day and make your goal for each day to be improvement over the last and you will find it easier to practrice gratitude.

5. Embrace challenges

Stoicism teaches that challenges and obstacles are opportunities for growth and learning. In college, you will undoubtedly face many challenges, whether that be a difficult class or a personal setback. However, by embracing these challenges and seeing them as opportunities for growth, you can develop resilience and become a stronger, more capable person. Most people that you will work with in your training want to teach you. From the perspective of the preceptor, there is nothing worse than working with a student that is simply there to check the box that they need checked for graduation. In the military we like to say “Embrace the suck.” Maintain that growth mindset and always look for something that you can learn. Eventually, you will just want to feel like you are “good” at something. You want the easy day and being challenged mentally and physically will start to wear on you. This self-loathing mindset is defeating. Change your goal from having a good day to learning something new. Try adopting the Navy Seal motto of “the only easy day was yesterday.” When you graduate, you kind of get siloed in what you know. You rarely have the time or opportunity to learn from what your colleagues are doing. Don’t miss out on the opportunity in front of you.

The impediment to action advances action. What stands in the way, becomes the way. – Marcus Aurelius

6. Don’t take things personally

Another key principle of Stoicism is to not take things personally. This means not letting other people’s actions or words affect your own emotions and well-being. In school, it can be easy to get caught up in drama or to take criticism personally. However, by practicing detachment and not letting these things affect you, you can maintain a sense of inner peace and focus on what really matters. This really goes hand-in-hand with the previous point. If you are always trying to learn something new, you will have a fair amount of failures or times when things don’t go the way that you want them to. The buddhist’s teach that all suffering is caused by attachment. Attaching your self-worth to the opinions of others is one way suffer. I’m not saying that you should listen to your preceptor in a debrief when they provide you feedback. I’m saying that you should separate the concepts of who you are and the actions you take. The more open and receptive to feedback you are, the more willing people will be to give it. You wouldn’t critize a man with no arms on his ability to give a handshake. So, if someone gives you feedback with areas to improve, it means they think you are capable of much more. We are all capable of much more than we think so take this moment to practice gratitude and try not to place others opinions of you higher than your own.

7. Cultivate meaningful relationships

Stoicism teaches that relationships are one of the most important aspects of life. By cultivating meaningful relationships with others, you can develop a sense of community and support that can help you through the difficult times in college. Whether it be through joining a club or organization, volunteering, or simply spending time with friends, building connections with others is an important part of practicing Stoicism. This is especially true for the student-staff relationship. Don’t be afraid to express vulnerability. You shouldn’t develop overly familiar relationships with your staff, but you should be comfortable discussing your struggles with them. We were all students at one point. Feeling comfortable expressing things you are struggling with has multiple positive effects with your preceptor.

1. They are more likely to provide you tips and tricks that might help.
2. They are less likely to be overly critical in your evaluation.
3. They will more closely observe those areas to give you useful feedback.

If you never ask for help, you might not get it. This might seem simple, but just because you are successful at some skill doesn’t mean that it is easy to you. I can’t always tell what is going on in your head and often I can’t see what you see. If a student tells me that they are struggling with a particular skill before the day starts, I will formulate a plan to address that weakness. I often don’t give adverse marks on an evaluation because I take some responsibility for your education.

8. Practice mindfulness

Mindfulness is another important aspect of Stoic philosophy. By being mindful and aware of your thoughts and emotions, you can cultivate a greater sense of self-awareness and control. This really underpins the rest of the points. If you’re not aware of your feelings and emotions, then you surely won’t be able to change them. This becomes easier with time and starts with self reflection. Self-reflection should be a part of your daily routine. Think back upon your day and just sit with what happened. Don’t pass judgement on what happened, just think about it. There is a quote from The Obstacle is the Way by Ryan Holiday that goes “Where the head goes, the body follows. Perception precedes action. Right action follows the right perspective.” You will only find the truth by trying to see things the way that they are, not the way we wish them to be.

9. Take responsibility for your actions

Stoicism teaches that individuals are responsible for their own actions and decisions. As a student, it can be easy to blame others for your mistakes or to make excuses for your behavior. However, by taking responsibility for your actions and decisions, you can develop a greater sense of accountability and control over your own life. After your reflection, remember that you can only control your thoughts and your actions. Almost everything else is out of your control. Therefore, if you want change to happen, it must start from within. Marcus Aurelius’s rule was to blame yourself, or blame no one. Blaming your equipment or others is not useful, primarily because you don’t control those things. The miller blade sucks! The GlideScope died. The nurse was rude to me. The surgeon yelled at me. While these things might be true, they don’t help you and put you into this woe is me spiral that you can’t get out of. Instead try: I should practice more with the miller blade. I should make sure the GlideScope is plugged into an outlet next time. I should understand that other people have their own set of worries and frustrations and I don’t have to let if affect my actions.

10. Remember the bigger picture

Finally, Stoicism teaches that individuals should keep the bigger picture in mind. This means focusing on the things that truly matter in life, such as relationships, personal growth, and making a positive impact on the world. In college, it can be easy to get caught up in the day-to-day grind and lose sight of the bigger picture. However, by keeping your long-term goals in mind and focusing on what really matters, you can lead a more fulfilling and meaningful life. You are learning these skills for a reason. The skills you learn now might end up saving someone’s life one day. Don’t let the little things keep you from being the best that you can be.

Conclusion

Practicing Stoicism in college can be incredibly helpful for staying grounded, focused, and resilient in the face of challenges and setbacks. By focusing on the present moment, practicing self-discipline, accepting what you cannot control, cultivating gratitude, and embracing challenges, you can develop a stronger sense of inner peace and control over your own life. Remember to practice mindfulness, take responsibility for your actions, cultivate meaningful relationships, and keep the bigger picture in mind. By following these 10 tips, you can lead a more fulfilling and meaningful life, both in school and beyond.