For the Love of the Game

Story by Sue Valerian | Photography By Roger Mastroianni

Nina Cepeda was uncertain about attending Case Western Reserve University before her recruiting visit to campus. A talented tennis player from suburban Cincinnati, she was admittedly shy, timid and a bit of a "nerd." She wondered if she'd fit in.

Soon, Cepeda saw a group of students playing a Nintendo game in the dorm room of the student tennis player who hosted her during her visit, and the encounter put her at ease.

"I saw a lot of people playing the game and I was like, 'Yo, I want to play this game, to,'" she said with a smile. The players gladly invited her to join in.

"People here are so warm and welcoming and it got me out of my shell," she added.

That warmth and support - that feeling of fitting in - has been key for Cepeda and other student-athletes successfully competing in varsity athletics while majoring in nursing at Frances Payne Bolton School of Nursing at Case Western Reserve, one of the nation's top nursing schools.

For any collegiate student-athlete at the University, combining sports and studies is a challenge. For nursing students, who must complete 1,300+ hours in a clinical setting in addition to their classroom work, the challenge is even greater. In the 2017-2018 school year, more than 20 nursing students competed in a varsity sport, including tennis, football, basketball, swimming, track, softball, soccer, and volleyball. For this elite group, managing their time and workload was a key concern , and nursing school leaders recognized the need to provide extra support to make it management for these students to succeed.

A Move Toward More Support

Amy Bieda, PhD, APRN, PHP-BC, NNP-BC, assistant professor, has been director of the Bachelor of Nursing Science (BSN) program at the School of Nursing for three years. During that time, she saw how time-crunched an overwhelmed student-athletes were in the nursing school. Often, they would drop out of sports or nursing - or suffer lots of anxiety trying to do both.

The experience of one stellar athlete in particular, softball player Annie Wennerberg, prompted Bieda to institute some changes, including a full-time student-athlete advisor, to make navigating nursing and athletics more manageable.

Wennerberg, a standout pitcher/outfielder holds the record for career wins and career home runs for the Spartans. She faced missing much of her senior softball season because of the conflicts between her practices and games and her required 280 clinical hours of preceptorship during her final spring semester.

To complete these hours, senior nursing majors are required to work one-on-one with full-time, professional nurses at local hospitals following them during their regular shifts for an entire semester. For some, that means back-to-back 12-hour shifts over several days, working at night and on weekends. Coupled with classwork, daily sports practice and travel to weekend competitions, it can be a lot to navigate for even the most seasoned students-athletes, including Wennerberg.

"That was really the tipping point," says Maryjo Prince-Paul, PhD, APRN, ACHPN, FPCN, associate professor and the new academic athletic advisor to undergraduate nursing students.

Prince-Paul knows personally about the pressures of balancing collegiate academics and sports. Her daughter is a Division I softball player and her son is a soon-to-be Division I basketball player.

"I've come to really understand and appreciate how challenging it is to balance these worlds," she said.

So after she and Wennerberg spoke, Prince-Paul set out to find a solution to keep the senior playing softball and completing her nursing requirements.

"She was really the one to get the ball rolling," Wennerberg says of Prince-Paul.

Prince-Paul was able to set the softball player up with two nurses, instead of the usual one, to follow during her clinical hours. This allowed enough flexibility in her schedule to play softball.

After that, Bieda realized that with a dedicated advisor to student-athletes in the nursing school, others could be helped in a similar way.

No. 1 Challenge: Time Management

What makes nursing particularly difficult to manage as a student-athlete is its rigorous clinical components, which requires students to spend hundreds of hours gaining hands-on experience alongside a professional nurse at a hospital.

"There are many hard parts of being a student athlete," says tennis player Cepeda, "but No. 1 is time management."

One of Prince-Paul's first goals was to create a sense of community among the student-athletes and let them know she was there to support them - and encourage them to support each other.

Senior football player Gage Blair says he is grateful for all the help he's received from everyone at the University: coaches, teammates, staff, advisors, and classmates.

"So many people went out of their way to make this work for me," he says.

Blair came to Case Western Reserve from nearby St. Edward's High School in Cleveland. He dreamed of playing at a Division I Ivy League School but was told that even at 6-foot-1 and 280 pounds, he was "too small" to play as an offensive lineman.

"It was that moment that I knew I really had to focus on my academics," he says. "But I had played football since fourth grade, and I just couldn't give that up."

It came down to choosing between John Hopkins and Case Western Reserve. He chose Case Western Reserve, he says, because he fell in love with the people - coaches, players and classmates - and cherished the "blue-collar, hardworking feel" of the team that he had grown up with in Northeast Ohio.

He didn't start off in nursing. Originally, he was a biology premed major. But after the first semester, he knew he needed a change. "I wasn't happy," he says.

He talked to his mom and uncle, both nurses. They persuaded him nursing would be a good fit for him. He made the switch. Because he missed the first semester in nursing, which includes clinical work, he had to complete his required clinical time during the summer.

"It was tough but I enjoyed every minute of it," he says.

What he quickly came to like about nursing was learning a skill in class and then immediately applying it to a real-life situation with a patient. That instant gratification convinced him nursing was right for him.

"I haven't looked back since," he says.

A Higher Calling

But it hasn't been easy. He had to take classes in the summers and, because of academic conflicts with football practice, he squeezed in weight lifting and film study at odd hours, often by himself or with one of his coaches. "I did not have a lot of free time with clinical, class and football," he explains. "Not to mention weekends with games."

He often spent time on the road doing homework.

"You just had to find the time to study," he says. "Sometimes you're in a hotel room or crammed next to someone on a bus." But he knew how important keeping up with his schoolwork was.

"I'm not just studying to pass the exam, but for when I have a patient, I have the knowledge or understanding of what to do," he says. "When it comes down to it, you have another person's lift in your hands."

Head football coach Greg Debeljak says Blair was one of the best offensive lineman he has coached in his 14 seasons at the University. He said it's interesting that Blair, one of the biggest, strongest and most physical players he's coached, is also so compassionate and nurturing in this role as a nursing student.

"He was one of our most passionate players and is also very passionate about nursing," Debeljak says. "He is proud to be a nursing major and shows that pride often around his teammates, often tending to their injuries or offering advice to them."

It came down to choosing between John Hopkins and Case Western Reserve. He chose Case Western Reserve, he says, because he fell in love with the people - coaches, players and classmates - and cherished the "blue-collar, hardworking feel" of the team that he had grown up with in Northeast Ohio.

Taking Time Out of a Busy Schedule to Get-To-Know Patients

It's easy to spot tennis player Cepeda in class: She's the one with two tennis racquets slung over her shoulder. She totes them around campus because she's always dashing to or from practice. Some days she's up at 6 a.m. for workouts; other days, she's squeezing in her one-to-two hour sessions between classes or late at night, after 9 p.m.

Sophomore year was especially tough for her because of the Medical Surgical (or MedSug) - considered the toughest class for nursing students. It's a nearly three-hour lecture class that requires understanding and memorizing a mountain of information. the class was scheduled at 8 a.m., often after her 6 a.m. tennis practice.

"It takes a strong mentality to keep going," she says, remembering those early-morning classes where she felt so exhausted. The support of her coach and tennis teammates, and her love of nursing, propelled her.

Despite her heavy workload and tight schedule, she worked as a nursing assistant at University Hospitals for a while. Around that time, her grandfather died. The sorrowful experience of her grandfather's death made her thoughtful about what kind of care he would have wanted from a nurse.

"I wanted to treat my patients the way I would want him to be treated," she says.

She remembers one patient in the oncology unit whom she visited daily. After completing her health assessment, the woman looked sad and sighed heavily as Cepeda walked toward the door. Cepeda stopped in the doorway, turned around and asked, "Can I help? Is there something bothering you?"

The woman told her that no one came in to talk to her. Everyone just darted in and out of the room so quickly. The patient's family lived far away and couldn't come see her regularly and she felt lonely. Cepeda listened and promised to come visit her more often.

For the remainder of the patient's stay, Cepeda stopped in, sat down and talked with her. The woman showed her pictures of her dog, whom she missed, and told her about the cruise she and her husband had planned.

"I spent time basically just getting to know her," says Cepeda. "I think a lot of people neglect small gestures like that."

Cepeda describes it as "patient-centered" care, a critical philosophy taught at the School of Nursing. Care for patients is designed to consider their wishes and how they're doing. It's something she'll always be mindful of in her work.

FPB BSN Student Athletes

Communication is Key

Spartan's tennis coach Kirsten Gambrell is not surprised Cepeda connects well with ehr patients. The two of them have communicated often to help each other and the team - as an eight-member squad with two other nursing students, Madeleine Paolucci and Mira Amin.

"It can be challenging," Gambrell says of coordinating Cepeda's academic demands and tennis schedule. "I've learned to become aware of her academic regimen at the beginning of each semester because each semester changes."

Sometimes, Cepeda can't travel to a match with her team and it helps for her coach to know that ahead of time, so she can adjust the lineup. Despite those occasional conflicts, Gambrell marvels at Cepeda's ability to manage two challenging schedules.

"You have to have the time management and desire to be committed to it," Gambrell said. "She really prioritized: nursing and tennis."

This leaves little room for much else, but Cepeda and Blair say they couldn't have imagined college without their beloved sports. Blair beams when he talks about his team's undefeated season (10-0) his senior year and his team's trip to the NCAA playoffs. That's a long way form the 3-7 season they posted when he was a freshman, he says. "So it's really cool the nursing school has taken the initiative to give some recognition to the student-athletes."

Cepeda said it's no so much the recognition, but the support of her teammates that keeps her going.

"It's very easy to get negative about yourself," she says. "I wonder if I had more free time to study, would I have better grades? Would I be more competent in my skills? In the end, it's a matter of staying confident."

Bieda is glad to see the confidence of nursing student-athletes such as Cepeda holding steady - and even growing.

"The word is out among prospective nursing its that you can do both here," Bieda says. "You can major in nursing and play a varsity sport...and that is really wonderful."