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Fostering Wellness in Nursing: Insights From Mental Health Bulletin Boards
No full textThe College of Nursing promotes a wellness culture to address growing mental health challenges among nursing students and professionals (Lipson et al., 2022). Grounded in the 12 dimensions of wellness (Gawlik et al., 2024), these initiatives foster resilience, support healthy lifestyle behaviors, and create a nurturing environment for the nursing community. Mental health and wellness interventions play a crucial role in improving the well-being of college students, including nursing students (Melnyk et al., 2020).This presentation outlines the development and thematic analysis of Mental Health Bulletin Boards (MHBBs), designed to engage nursing students and professionals in self-care and resilience-building practices. MHBBs foster community engagement and mental health support. These efforts align with national nursing organizations and competency-based education (CBE) standards (AACN, 2021), ensuring future nurses are prepared with skills and emotional resilience to meet professional challenges.
MHBBs were implemented in skills/simulation labs frequently visited by undergraduate nursing students. Graduate students, faculty, staff, and community members also contributed. Participants shared self-care practices on sticky notes in response to the prompt, What do you do for your mental health? A total of 339 sticky notes were collected and transcribed into Excel. A thematic analysis followed Braun and Clark’s six-step process (2006). Atlas.ti software was used to code and identify themes. Institutional Review Board approval was granted for this non-human subjects’ research.
The MHBBs identified key self-care practices such as physical activity, connections with friends and family, music, sleep, writing words of encouragement (e.g., You are enough ), and interactions with animals. This presentation offers strategies to integrate these themes into nursing environments, including academic, clinical, and community settings. By fostering a wellness culture, institutions can better equip nursing professionals to meet field demands
From Intra to Interdisciplinary: Growing an Inclusive NICU Wellness Team
No full textNeonatal intensive care unit (NICU) teams care for some of the hospital’s most fragile and sick patients. Larger NICUs frequently care for more acute patients, increasing the risk of burnout among team members.1,2 These NICUs often see a larger volume of patients, presenting challenges to teaming and collaborating effectively as team sizes increase to meet patient care demands.1,2 The AACN Healthy Work Environment (HWE) assessment tool was deployed to nurses in an upstate NY level IV NICU. The lowest-scoring areas were true collaboration, skilled communication, and meaningful recognition. Based on HWE data, the ACE-15 Teamwork and Collaboration survey was distributed to capture the interdisciplinary team’s perceptions of the workplace, and a unit work environment improvement initiative was formed. The unit wellness committee shifted from a nursing-only group to an interdisciplinary committee as part of the unit HWE initiative. The purpose of moving from a nursing-only to an interdisciplinary wellness team was to understand the impact an interdisciplinary team may have on team members feeling valued and respected. This innovative team utilizes evidence-based interventions such as mindfulness techniques, gratitude boards, gratitude rounds, well-being education, and well-being programs, all focusing on fostering resilience, positive teamwork, and collaboration within the workplace.1,2,3,4,5,6 Currently, interventions addressing low-scoring HWE standards are developed and implemented by interdisciplinary HWE workgroups (including the unit wellness team), which contribute toward increasing the percentage of staff who feel valued and respected in the NICU. The unit is reassessed every six months using a shortened version of the ACE-15 survey to gauge progress, and participation in interventions led by the wellness team is tracked
Reshaping Workplace Well-Being: The Journey to Human Connection
No full textAs healthcare continues to evolve in post-Covid environment, nurse leaders face increasing challenges with guiding teams, improving engagement, and promoting overall wellbeing. Increasing work engagement is an important indicator of workforce sustainability and wellbeing (Schaufeli, 2021). Leaders foster a culture of wellbeing, safety, and support for employees in healthcare organizations with a human connection. The purpose was to reengage direct care nurses to implement wellbeing standards and reestablish the human connection among staff by utilizing engaging leadership concepts.
Faced with lack of council engagement, leaders from the Healthy Work Environment Council (HWEC) shifted their leadership style from transitional to engaging to implement wellbeing standards. Leaders identified and recruited members who were passionate about workplace wellbeing. The council utilized a SOAR exercise to harness member ideas and drive actionable changes. Meeting participation increased by 20%, and wellness programs expanded significantly. Staff now lead all initiatives and leaders continue to empower the members to grow and sustain programing.
HWEC surveyed the staff on the impact of wellness programs. Survey results revealed that 99% of staff felt valued and saw improved wellbeing from the wellness programs. Organizational turnover rates for nurses decreased by 3.26% and vacancy rates fell by 0.5% (MLH, 2024). Press Ganey scores for “Likely to recommend” increased to 79.45% and “Friendliness of nurses” to 88.09% both above national benchmarks (Press Ganey, 2024). Results demonstrated the positive impact of member engagement and the council\u27s adaptability to provide meaningful programs to the frontline employees. Engaging staff that have a passion for workplace wellbeing creates an environment where their interests and skills can thrive.
Engaging leaders are essential for positive outcomes among teams. By altering their leadership style and improving relationships with members, enhanced engagement and increased productivity were achieved. HWEC leaders reestablished the human connection by empowering staff to feel autonomous and valued as they implemented wellbeing standards. Leaders effectively provided tailored programming to meet the psychological needs of staff. This unique programming fosters a supportive workplace culture and reestablishes a human connection that takes staff from merely surviving the post-pandemic era to thriving in this new healthcare environment
Putting People First: Nurse Leaders\u27 Role in Prioritizing a Culture of Workforce Wellbeing
No full textLeadership should prioritize the deliberate cultivation of healthy work environments to mitigate burnout. Nurses\u27 lack of workplace well-being has been well-documented for decades, with significant exposure during the COVID-19 pandemic. These conditions can lead to poor mental health, as exhibited by feelings of stress, anxiety, depression, and physiological symptoms, which can ultimately contribute to burnout.The literature suggests that nurse leaders are responsible for adopting and implementing healthy work environments that build, nurture, and sustain a positive, healthy culture. Leaders who cultivate a safe and supportive workplace and contribute to staff well-being will likely experience improved staff retention, increased productivity, enhanced interpersonal relationships, and improved patient outcomes.Nurse leaders can prevent nurse burnout by introducing a person-centered approach that focuses on prioritizing the holistic needs of staff members. Evidence-based practices such as The American Association of Critical Care Nurses (AACN) six essential standards, the American Nurses Association (ANA) Healthy Nurse, Healthy Nation initiative, and the International Nurse Coach Association’s Theory of Integrative Nurse Coaching (TINC) model are examples of the shift that needs to be promoted in healthcare. These methods can be implemented through various approaches, such as offering trauma-informed peer support debriefing services, engaging in relationship-building activities, utilizing integrative therapies, providing meaningful recognition of excellence, offering robust educational opportunities, allowing for flexible work schedules, encouraging time off, and supporting boundaries
Mixed Methods Triangulation: Applying Just Culture Principles in Nurses\u27 Transition to Practice
No full textThe transition from nursing student to registered nurse is fraught with challenges, including stress, knowledge gaps, miscommunication, and insufficient constructive feedback, which can cause uncertainty for new graduate nurses (NGNs). Although Just Culture principles are taught in nursing education, they are often difficult to apply in practice. The gap between theoretical knowledge and practical application can result in hesitation when reporting errors, communicating effectively with the healthcare team, or participating in quality improvement initiatives. This disconnect underscores the need for more robust support systems and education that bridge the transition from student to practicing nurse. This study aims to triangulate quantitative and qualitative data in a mixed-methods approach to examine perceptions of Just Culture during the NGN transition to practice and assess changes in these perceptions from student to NGN. Data on NGNs\u27 transition to practice were collected using the Just Culture Assessment Tool and the Just Culture Assessment Tool for Nursing Education. Virtual interviews were conducted, and responses were analyzed using Colaizzi’s methodology. Five key themes emerged from the analysis: communication, error reporting, quality improvement, fear, and fairness and balance. While both students and NGNs report an understanding of Just Culture, challenges persist due to institutional and societal norms. Despite the foundational knowledge acquired during their education, NGNs often find themselves navigating environments where the practical application of Just Culture is hindered by established practices and attitudes. This disconnect between understanding and application highlights the need for ongoing support, mentorship, and systemic change to align organizational cultures with the principles of Just Culture, ensuring that NGNs feel empowered to report errors, contribute to quality improvement, and prioritize patient safety without fear of blame or retribution
Education, Evaluation, and Impact of a Delegation Learning Session in the Care Pair Model
No full textThis study examines the relationship of a structured educational intervention related to registered nurse (RN) delegated practice within the Care Pair Model (CPM) in a medical-surgical unit for its potential to expand the utilization of Nursing Assistants (NAs) in the nursing shortage in health care. CPM employs NAs as complement staff for RNs thus shortening workloads and improving patient care but relies on the RN\u27s ability to communicate clearly and delegate responsibilities. A literature review done identifies that there is a gap in available information about CPM and delegation and thus this study looks at the educational intervention of delegation. Delegation impacts nursing practice related to patient outcomes and extends to the collaboration of colleagues and the workflow. It is meant to facilitate a larger understanding of delegation by optimizing the effectiveness of the work force, especially in this type of new care delivery model. This mixed method study will utilize a pre- and post- design to capture data from the surveys regarding RN delegation and communication skills, nursing dashboard data related to patient outcomes, and the Colleague Pulse Survey examining resource adequacy.Delegation can be empowering for nurses. Nonetheless, this study is needed as there is prevalent lack of delegation confidence and competency observed amongst nurses. Effective delegation is characterized by good communication between both parties; thus, the gap of research related to the CPM signifies the importance of the study. Implementing the educational intervention will incorporate an evidence-based methodology for testing and monitoring interventions.The results of the study will have important implications in nursing education and practice. Therefore, of importance to nursing is the response to care complexities which is supported by expanding what the NA role is through delegation, and this study goes in some way to addressing gaps in knowledge through understanding more about how workforce optimization has an impact on patient care. Findings will allow for more effective training efforts and will guide health systems as they use other innovative care delivery models. This study will provide valuable information on the CPM to aid in the success of delegation and other care delivery models. The outcomes are anticipated to be beneficial to patient care, workforce effectiveness, and RN work satisfaction
mHealth for Nurses\u27 Mental Health
No full textBackground: Post-pandemic surveys show continue to show high rates of exhaustion, burnout, anxiety, and intention to leave the job in hospital nurses. Early-career nurses who experience burnout and exhaustion in the first 1-3 years of their career have a job turnover rate of approximately 46%, and are more prone to physical complaints, insomnia, and cognitive problems 10 years later. Few studies have focused on using mental health mobile apps (mHealth) in the hospital nurse population to help decrease the negative effects of a stressful work environment.Purpose: This randomized controlled trial (RCT) pilot study has three aims: 1. to determine the feasibility and acceptability of using a mindfulness-based mHealth intervention, and the appropriateness of the intervention for the early-career nurse population; 2. to determine if a mindfulness mHealth app can be used as a mediator to buffer the harmful effects of a stressful work environment ; 3. to examine the relationships among the amount time the mHealth app is used and reported anxiety, stress, burnout, job satisfaction, and intent to stay.Methods: A sample of 60 early-career direct-care registered nurses will be recruited from the campus of a mid-west academic teaching facility.Inclusion Criteria: Nurses who have at least one year but less than four years of full-time experience, who own a smartphone capable of running an mHealth MBI.
Exclusion Criteria: regular use of any mindfulness program in the previous three months.
We will use a pragmatic RCT pilot with a two-group, repeated measures design, to compare pretest-posttest and follow-up variable measures.
The study duration is 4 weeks, with surveys conducted at baseline and 4 weeks, with a follow-up at 8 weeks.
The control group will receive an Employee Wellness Resource packet (treatment as usual) and be asked to browse through the packet and participate in any activity they feel would be helpful during the study period.
The intervention group will receive access to the mHealth app Headspace. The “Take 10” introductory Headspace program is an introduction to the content available in the app. Each module takes about ten minutes to complete and delivers content on mindfulness meditation, breath work, body scanning, managing stress, identifying emotions, improving sleep, relaxing, and much more. Participants will be asked to use the app for 10 minutes a day, three days a week while not at work, for 4 weeks.
Results: pending study completio
A New Tool for Evaluating Virtual Nursing in Hospitals: The In-Hospital Telehealth Questionnaire
No full textPurpose/Background: The In-Hospital Telehealth Questionnaire (IHTQ) was developed to address the lack of validated tools for assessing the usability of telehealth and virtual nursing within hospital settings. The IHTQ adapts the Telehealth Usability Questionnaire (TUQ) and incorporates elements from other relevant questionnaires to comprehensively evaluate usability factors like usefulness, ease of use, effectiveness, reliability, and satisfaction. This study is part of a larger research project exploring the integration of virtual nurses and robotics in healthcare.
Methods: The IHTQ was developed following a rigorous scale development process. Items were generated based on a literature review and expert opinions, focusing on key usability factors. Content validity was assessed by experts, and pilot testing was conducted to refine the questionnaire. Data was collected from a diverse sample of participants and analyzed using exploratory factor analysis (EFA) and reliability tests. The scale was further refined based on the analysis, and its psychometric properties were validated.
Results: The final IHTQ consists of 14 items across five subscales: Usefulness, Ease of Use and Learnability, Interface Quality, Interaction Quality, and Reliability and Satisfaction. Initial analysis shows exceptional internal consistency, with a Cronbach\u27s alpha of 0.9693. The IHTQ offers a reliable and valid tool to evaluate the usability of in-hospital telehealth and virtual nursing, providing valuable insights for healthcare providers and researchers.
Limitations: The study acknowledges limitations, including the need for further validation in larger and more diverse samples. Future research should also explore the relationship between IHTQ scores and other relevant outcomes, such as patient satisfaction, clinical outcomes, and cost-effectiveness.
Conclusion: The IHTQ represents a valuable contribution to the field of telehealth and virtual nursing research. By providing a reliable and validated instrument, the IHTQ enables healthcare providers and researchers to assess the usability of these technologies within hospital settings and make informed decisions to improve their implementation and effectiveness
Addressing Job Satisfaction in Emergency Services: An Exploratory Study
No full textPurpose: Emergency services professionals (ESPs), like emergency medical technicians, paramedics, and registered nurses, work in stressful, low-resource environments and are vulnerable to work-related burnout (Crowe et al., 2020; Hinderer et al., 2014). While many ESPs are motivated by compassion for others, most ESPs never learn what happened to the patients they cared for (Ntatamala & Adams, 2022; Patterson et al., 2005). Disconnection from patient outcomes may limit compassion satisfaction among ESPs and make it more difficult to actualize their role in patient care and contribute to burnout, which negatively affects patient care (Georgakakos et al., 2022). The purpose of this study is to examine the impact of a novel burnout mitigation method among ESPs: providing follow-up communications regarding outcomes of their patients.
Method: This pilot study aimed to (1) evaluate the feasibility and acceptability of patient follow-up communications among ESPs, and (2) estimate the potential effect size and confidence intervals of follow-up communications on compassion satisfaction and burnout. Participants included emergency medical technicians and paramedics working in the rural Wisconsin, and emergency department nurses working in a Wisconsin critical access hospital. Inclusion criteria included employment for 20 hours per week or greater and willingness to participate in a pre- and post-intervention survey measuring burnout, compassion satisfaction, and feasibility and acceptability of the intervention. Design principles considered while developing this intervention included minimizing efforts required of study participants.
The intervention consists of providing ESPs with weekly patient follow-up communications. Participants will be provided follow-ups for all patients they provided care for and were transported to an emergency department or admitted to an inpatient setting. Follow-up communications contain a summary of the patient’s hospital course and their disposition from the hospital.
Results: Results of this study are ongoing and consist of further evaluation of the feasibility and acceptability of the intervention, an estimate of the effect sizes and confidence intervals of the intervention among ESPs with regards to both burnout and compassion satisfaction, and implementation lessons learned.
Conclusion: This ongoing study will provide preliminary data evaluating a novel intervention to improve compassion satisfaction and reduce burnout among ESPs
Calm the Bone! Transforming Orthopedic Clinics Into Thriving Work Environments With Code Lavender
No full textBACKGROUND: Gibson et al. 1 first used “Code lavender” to describe part of a bereavement program for NICUs. Since then, code lavender evolved initially to caregiver and health care provider support to now mental health well-being for nurses as part of efforts to decrease nursing burn out. 2 Several hospitals have trialed or implemented a variation of a code lavender program; however, the majority of these focus on inpatient staff and the emergency department. 3–5 There is a dearth of literature about using code lavender in outpatient or ambulatory care settings in general. The purpose of this presentation is to discuss a quality improvement initiative using a code lavender kit in a multi-site orthopedic clinic in the western United States.METHODS: The PDSA Cycle was used to guide nurse-driven project implementation. Code lavender kits were distributed to the clinics. There were 30 unique participants who completed 38 surveys.Participants self-reported stress using a 10-point Likert scale, 0 being none and 10 being worst stress possible. Average pre-kit usage stress was reported as 8.57 and average post-kit usage stress was 2.5.NURSING IMPLICATIONS: In moments of high stress and anxiety, clinic nurses can call a code lavender on themselves and step away from their workspace, using the tools of the code lavender kit to decompress and re-center themselves. Similarly, clinic staff may identify other team members who may benefit from a code lavender kit. The kits were designed as a wellness resource tool to support staff well-being during clinic hours to reduce stress, anxiety, and/or burnout. Furthermore, leadership support of this initiative reinforces the importance of staff wellness and its impact on delivering high-quality patient care.
The orthopedic clinic nurses successfully implemented code lavender kits to promote staff wellness within the orthopedic clinic. Although 30 participants have completed the survey, continual encouragement and monitoring are required to promote this wellness resource tool