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Valuing kindness in mental health.

How do you teach kindness? How do you convince bachelor of nursing students to value kindness as much as scientific knowledge? Is a tertiary setting the right place to foster kindness, empathy and resilience in students?

These are interesting questions for our times--times when dictatorships are on the rise; times when inequality in New Zealand is like nothing we've seen before; and times when students are highly concerned with finding a job at the end of their costly studies. All students want to succeed and, for some, the grade becomes the focus, rather than the "soft skills". These soft skills are generally known as interpersonal skills and are critical for effective social interactions. Soft skills are also the linchpin in hard times.

The World Health Organization says there is no health without mental health, and yet approximately one in six adults in New Zealand experience mental health problems. (1) More and more people are struggling with increasing hardships and fewer opportunities. This means more stress for them and increasing stress on mental health services. Mental health is a hot topic currently, with the government inquiry into mental health and addictions. It is no accident Prime Minister Jacinda Ardern, who spearheaded this inquiry, aims to base her government's philosophy on kindness.

Nurses encounter people in distress in all settings, so it makes sense to deliver mental health courses that emphasise the skills nurses use to help people make sense of, and manage, their most distressing moments. American Israeli sociologist Aaron Antonovsky used a concept called a "sense of coherence", which, put simply, means how people make sense of the world contributes largely to how well they get on in life. (2) Supporting others to find a sense of coherence is a nurse's bread and butter.

Nurses are privileged to be alongside distressed people at any time of the day or night. Seven days a week, 365 days of the year, it's nurses who offer the helping hand, sit and listen, and act as safe receptors for humanity's most extreme suffering. The nursing care patients remember and value is the experience of nurses being with them and helping them make meaning of their situation. When suffering has a witness and an advocate, it becomes that much more bearable, allowing the person to carry on.

Making the course relevant

Teaching skills such as compassion and empathy starts with students themselves. The average age of nursing students at the University of Auckland is around 21, with some coming straight from high school. Given their relatively young age, it is important staff make the mental health course relevant to them. This is what is known as the hidden curriculum in which the learning objectives are not overt. Activities related to the topics allow students to practise and reflect individually and with each other. They are also opportunities for students to consider how they think and feel, and then to consider how others may think and feel.

To understand what makes people tick, watching movies and reading, both fiction and non-fiction, are useful. Doing these quiet, thoughtful activities helps encourage students to think about other people. Being able to imagine other people's motivations and ideas means you are better able to step into their shoes. The ability to do this keeps us close to helpful possibilities and away from unhelpful judgements.

This kind of reflection takes time and is at odds with the digital age. In an era when we are expected to absorb vast amounts of information in a multi-tasking, double-screen, click-bait, tab-switching learning environment, skim reading is the norm. While a very useful skill when used in the right situation, skim reading provides a surface level of understanding, with little time for critical analysis. The ability to critically analyse the structures of power is essential for fostering the social values of empathy and care.

In the undergraduate mental health course I coordinate, I hold three key principles in mind when teaching students. Firstly, modelling, which needs no explanation. Secondly, the learning environment. This involves significant preparation to create diverse teams of up to six students who work together in class for short periods of time on "low-stakes" activities. These activities aim to foster social inclusion and value difference. Once a class is running, there are magic moments when students are involved in co-creating knowledge, and can be seen laughing together and taking care of each other. Valuing diversity is the third thread running throughout the course. This is highlighted overtly and covertly in many ways.

These three key principles are synergistic and serve to prioritise teamwork, knowledge-sharing and valuing others.

Colette Adrian, RN, PGDip, is a professional teaching fellow and course coordinator for mental health, addictions and disability at the University of Auckland's school of nursing.


(1) Antonovsky, A. (1987). The Jossey-Bass social and behavioral science series and the Jossey-Bass health series. Unraveling the mystery of health: How people manage stress and stay well. San Francisco, CA, US: Jossey-Bass.

(2) Mental Health Foundation of New Zealand. (2014). Quick Facts and Stats.
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Title Annotation:editorial
Author:Adrian, Colette
Publication:Kai Tiaki: Nursing New Zealand
Article Type:Column
Geographic Code:8NEWZ
Date:Sep 1, 2018
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