Taking Care of Themselves to Take Better Care of Patients

Resiliency Program Aims to Recharge Nurses, Hospital Staff

As a birthing center nurse, Esther Lozano, RN, treasures the experiences she has shared with families welcoming their new little ones into the world at Sentara Martha Jefferson Hospital.

Moments like those shine bright as she reflects on her four years as a registered nurse. On some days, however, she must gather the courage and composure to support families in their darkest hours.

“This past fall I took care of a mother who delivered a baby who had died before she checked into the hospital,” says Lozano, a mom herself. “I asked the mom if she’d mind if we sat together with the baby and paused for a moment. That gave me space to feel what I was feeling right then and there, and not put it in a box for later.”

This type of moment of reflection is one example of a self-care or resiliency technique Lozano draws on to help her cope with the stresses that come with being a nurse.

In fact, she’s become such an advocate of these practices that she and a committee of like-minded Sentara Martha Jefferson team members have introduced the concept as part of a new hospital wide self-care program formally called “Intentional Caring— A Nurturing Tradition.”

Focusing on a resiliency program for care teams not only helps them cope with the stresses of the day, but it also chips away at feelings of burnout and ultimately benefits patients, who are cared for by a more engaged, grounded and fulfilled staff.

Nurturing Care Teams, Decreasing Burnout

Many of us are familiar with self-care practices at home, such as exercise, a healthy diet, relaxation and adequate sleep. Lozano wanted nurses to have self-care opportunities at work as well, which would allow them to take time to regroup and recharge.

The idea of self-care was ignited for Lozano by a fellow nurse, whose friend, Jonathan Bartels, had developed a practice called the “Medical Pause” to use when a patient passes away. The purpose of this pause is to recognize the patient and give the care team 45-60 seconds of silence to process the passing in a nondenominational way.

Bartels’ technique, which has become well known internationally, is one resiliency tool healthcare teams can use to center themselves, so they can be ready to take care of other patients after a difficult situation.

Going from one patient room to another, informing and comforting families going through difficult times, can cause a roller coaster of emotions for caregivers that must be kept in check in order to deliver exceptional, thorough care to all patients.

Lozano, who has attended numerous resiliency conferences, led sessions on the topic and honed various self-care techniques over the past decade, decided to approach Sentara Martha Jefferson leadership and suggest creating a self-care program for nurses. Hospital administrators enthusiastically agreed, in fact asking her to develop the program for all team members—clinical and nonclinical—throughout the hospital.

Allison Crawford, RN, director of surgical services at the hospital, co-chairs the resiliency program committee with Lozano. She was inspired to participate after attending a retreat on resiliency coordinated by the Sentara Martha Jefferson palliative care team.

“We can start our week with our cups full, but each day the level of the cup slowly depletes,” Crawford explains. “When I attended the retreat, I left feeling like my cup was overflowing, and I wanted to share that with others.”

A committee of seven Sentara Martha Jefferson employees met over the course of six months to develop the resiliency program, which was introduced to staff this spring.

One of the goals of the committee is to curb nurse burnout. A 2017 nationwide study by RN Network found that nearly half of the 600 nurses surveyed had considered leaving the field. The strain of losing patients, high-stress environments and long shifts were identified as having contributed significantly to those feelings of burnout.

“At Sentara Martha Jefferson Hospital, we recognize our nurses as the primary contributors to the organization’s success,” says Johnsa Morris, RN, chief nurse executive. “We understand they’re not exempt from the national statistics around the rate of nurse burnout. Nurses frequently have to play tug of war when it comes to making choices between taking a break to assess their own needs, and giving every ounce of energy to meet the needs of others.”

What is Self-Care?

The Intentional Caring plan at Sentara Martha Jefferson will be carried out in two phases. The first, from May through the end of 2019, will consist of practical, easy-to-follow tips and services, including:

• Insightful speakers

• Massages

• Relaxation techniques

• Stretching/movement sessions

The key to making the plan as effective as possible is to reach employees in the areas and units where they work and offer the programs during different shifts. According to Lozano, if nurses and other staff have easy access to these offerings, they will be more likely to attend.

She expects that once the program is up and running, each nursing floor will determine which elements of the program work best for its employees.

As Sentara Martha Jefferson team members become more familiar with the program’s concepts, the second phase of the program will include retreats and educational sessions. Everyone who works at the hospital—not just nurses—will be encouraged to participate, Crawford says.

Resiliency Room

As part of the self-care movement, one floor at Sentara Martha Jefferson has already designed a “resiliency room” for nurses.

The idea came out of a survey on the cardiac/neurology unit, which treats patients with various heart conditions and those who have suffered a stroke.

In their responses to the survey, nurses remarked that their break room was often too noisy an environment in which to unwind, with coworkers frequently opening and closing their locker doors. Patients on the other side of the break room wall often could hear the clamor as well.

So Dana Graves, RN, clinical nurse manager on the floor, looked into how other hospitals had implemented a resiliency room for breaks, and came up with a plan.

To improve the environment, unit members spruced up the existing break room by replacing the furniture and painting the walls a new, soothing shade of green. They also added a coffee bar, battery-powered faux candles and a comfortable couch to enhance the room’s atmosphere. To address the noise issue, the lockers were moved to a different location in the department.

Six months after the opening of the refurbished resiliency room in spring 2018, a survey of the nursing staff found about 85 percent were making use of the space. The top reason given for spending time there was to eat meals, but it was also being used as a quiet place to think and recharge.

“The resiliency room gives our nurses a place to step away and decompress,” Graves says. “Now they have a comfortable environment in which to unwind before they get back to their patients.”

Toward the end of 2019, the hospital will create a similar room for all staff to use as part of the second phase of the self-care program.

Benefits of Self-Care

Wellness initiatives for employees are taking hold at hospitals across the United States, Lozano says.

Programs like the Intentional Caring initiative at Sentara Martha Jefferson help to promote increased staff retention; a healthier, more reliable workforce; and improved staff and patient satisfaction.

Recognition of the daily challenges nurses face also goes a long way toward their well-being, says Morris, who has spent 30 years in the nursing field.

“I think back to when I was a full-time bedside nurse, spending many hours on my feet without an end in sight, wondering if anyone knew what I’d been through on that shift,” Morris says. “I’m so grateful to Esther and Allison for demonstrating the leadership and foresight to move forward and find a solution to help people wind down and regroup during a challenging workday.”

Ultimately, the effects of the resiliency program are aimed at providing better care for Sentara Martha Jefferson patients.

“Having the opportunity to take better care of ourselves,” Lozano says, “allows us to feel more alert and rested, and to know that we are giving our best to those we care for.”

We are Sentara Martha Jefferson Nursing

Join the nursing team at Sentara Martha Jefferson and be a part of cutting-edge care for patients, backed by a supportive, engaged and appreciated team.

Quality patient care, innovation and technology, and patient safety and satisfaction all depend on highly trained and fulfilled nurses who embody the Caring Tradition philosophy at Sentara Martha Jefferson.

“Happy nurses help fulfill our mission to ‘Improve Health Every Day,’” says Johnsa Morris, RN, chief nurse executive.

Through shared governance, nurses are involved in decision-making processes throughout the hospital.

“At Sentara Martha Jefferson, we value our 400 nurses and strive to provide them with continuing education, including scholarships and other funding for professional certifications and research projects,” adds Morris.

Research shows that hospitals with a higher percentage of bachelor-prepared nurses tend to have better patient outcomes. Based on this finding, the Sentara Martha Jefferson leadership team set a goal of having 80 percent of the hospital’s bedside nurses acquire their Bachelor of Science in Nursing degrees by 2020.

Nurses in good standing are eligible for scholarships of up to $20,000—or up to $25,000 for advanced degrees, including master’s and nurse practitioner degrees.

To learn more, visit SentaraCareers.com.

Sentara Recognized as a Best Employer in the U.S.

Sentara Healthcare, the third-largest employer in Virginia, has been recognized as one of America’s Best Employers in 2018 by Forbes. Ranking in the Best Large Employers category, Sentara is No. 177 of 500 companies across 25 industries. Sentara was named alongside only 24 other organizations in the healthcare and social industry group.

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