In January 2022, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced $103 million in awards to improve the retention of healthcare workers and help respond to the nation’s critical staffing needs by reducing burnout and promoting mental health and wellness among the healthcare workforce (HHS press release: https://www.hhs.gov/about/news/2021/07/16/hhs-announces-103-million-arp-funding-to-address-health-workforce-burnout.html). During conversations with nurses, nursing leaders and nursing school deans on this legislation, we heard the following:
- We do not need more resiliency training programs and resiliency research for healthcare workers. These dollars should be awarded to those seeking out innovative ways to reduce workflow burden, creating new models of care and focused policy efforts to eliminate workplace violence. These are a few of the top areas causing burnout in healthcare. We do not need more training. We need help fixing a very broken system from pre-hospital to long-term care. (senior director, DNP, RN NEA-BC)
- We do not need more lip service; we need healthcare organizations to take action and not put the burden on nurse leaders to train their staff to be more resilient. (emergency room director, MSN, RN-BC, CEN)
- The staffing problem is not temporary; it will take years to solve. We must stop blaming people for being burned out and stop telling them to be more resilient. That language blames the individuals. The blame lies with the work environment. Burnout is a work-related injury; focus on improving the environment that delivers the injury. (CNO, DNP, RN, FAAN)
COVID continues to test already strained healthcare organizations. The healthcare industry was experiencing record levels of burnout prior to the pandemic, so we are now experiencing generational turnover and burnout. Vacancy rates continue to skyrocket, causing the employees who are staying to take on higher workloads and additional overtime. In the beginning of COVID, nurse case managers transitioned to the bedside, and in some cases, they still have not returned to their pre-COVID roles and responsibilities. Despite brief periods of relief, the continued stress brought on by the pandemic has caused immeasurable damage to the healthcare industry. Most healthcare leaders want to provide support to their nursing staff, but often, logistical challenges make it difficult to provide the support that is needed. In this article, we will explore a “full service” wellness coaching program that some organizations are using to support their nursing teams.
“Burnout is triggered by extended workplace stress which is not managed effectively” (Ross, 2020). Burnout due to extended workplace stress is prevalent among nurses as they experience extended work hours across multiple shifts and have intense work environments. In the National Institute of Health article “The Exacerbation of Burnout During COVID-19: A Major Concern for Nurse Safety,” nurses reported that only 5% of healthcare organizations were assisting staff with burnout. Organizations must continue to take action to prevent nurses from leaving the industry altogether.
FULL-SERVICE NURSE WELLNESS
Wellness coaching for nurses and healthcare employees is not a new concept, but most programs do not provide “full service” support. Department leaders carry most of the logistical burden without the resources to execute the plan. Employees are asked to come in early, repurpose their lunch schedule or stay after their shift to participate in wellness sessions. If employees participate in wellness sessions during their shift, departments are forced to carry higher patient loads while their teammates are away from the department, which causes more burnout. To overcome these challenges, organizations are turning to partners that provide full-service nurse wellness support (i.e., nurse wellness coaches and relief nurses). This type of program differentiates itself from other programs by eliminating the two biggest obstacles facing most wellness initiatives, staffing and logistics.
The “full service” nurse wellness team consists of one to two wellness coaches and two to three relief nurses who care for patients while full-time and part-time nurses participate in wellness sessions. All wellness coaches are certified mental health nurse practitioners and conduct two rounds of one-on-one coaching sessions over a 12-week period. The “full service” nurse wellness program includes strategies to support department employee engagement and retention efforts.
The program typically runs 8-12 weeks and consists of three stages:
Stage 1: Needs Assessment. In the first two weeks, nurse wellness coaches gain a deeper understanding of the overall needs of the department by working alongside nurses in the departments that will be participating in the program. Building the program around the specific needs of the nurses creates the greatest benefit for the nurses participating in the program. Nurse wellness coaches develop department-specific schedules to conduct individual wellness sessions. Department-specific plans include communications templates for leaders, scheduling analysis and finding a physical space within the facility to conduct the wellness sessions.
Stage 2: Coaching Sessions. Relief nurses are onboarded during the second stage of the program and work in the departments participating in the program. After relief nurses are onboarded, wellness coaches conduct as many as 90 one-on-one sessions each over the course of the 12-week program. Full-time and part-time nurses are encouraged to participate in at least two sessions and receive a customized plan.
Stage 3: Build and Present Engagement and Retention Plans. During the final stage, nurse wellness coaches work with department leaders to build department-specific engagement and retention plans. All recommendations are evidence-based and address the specific needs of the nurses working in the departments participating in the program.
The objective of the “full service” nurse wellness program is to help organizations take action to support their nurses during stressful times. Addressing burnout is a monumental task. We all play a part in supporting nurses and creating a healthy workplace environment. Despite facing unprecedented challenges, leaders who act are seeing positive results. We encourage you to keep up the good fight and make nurse wellness a priority, not a burden.
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Ross, J. (2020). The Exacerbation of Burnout During COVID-19: A Major Concern for Nurse Safety. Journal Of Perianesthesia Nursing, 35(4), 439-440. https://doi.org/10.1016/j.jopan.2020.04.001.
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