Meaningfully recognizing the extraordinary contributions of nurses is a key element in creating a... more Meaningfully recognizing the extraordinary contributions of nurses is a key element in creating and sustaining healthy work environments. Publically honoring the work of nursing reinforces those actions and behaviors that patients, families, and colleagues truly value. A multi-site research study provided a 360-degree perspective of the impact this type of acknowledgment had on strengthening the nursing workforce at 20 health care organizations who use The DAISY Award to recognize extraordinary nurses. Data analysis of 2,195 DAISY Award nominations from patients, families, and colleagues at 20 hospitals identified 22 behavioral themes associated with extraordinary nursing.
M any employees face operational failures-missing or insufficient supplies, equipment, informatio... more M any employees face operational failures-missing or insufficient supplies, equipment, information, and personnel-that interfere with their workflow and can negatively impact organizational performance. However, employees often devise methods to work around these obstacles that may come with negative side effects. The Dressing Change Game is a 40-minute in-class exercise that enables students to directly experience workarounds as a natural response to operational failures and allows them to see the trade-off between shortterm and longer-term organizational performance that occurs as a result of workarounds. The overarching learning objective is for students to gain an appreciation that optimizing individual-or unit-level performance likely undermines organizational-level performance.
To examine and report burnout, secondary trauma, and compassion satisfaction in acute care nurse ... more To examine and report burnout, secondary trauma, and compassion satisfaction in acute care nurse leaders through a large mixed-methods research study. BACKGROUND: Although nurse leaders are removed from daily patient care activities, the pervasive challenges in the work environment create conditions for professional burnout. Nurse leaders must garner compassion satisfaction from different sources, including peer and staff interactions. METHODS: The Professional Quality of Life scale was given to nurse leaders at 29 hospitals in 1 health system. Sixteen leaders from 2 hospitals participated in qualitative interviews. RESULTS: Six hundred seventy-two nurse leaders from 29 hospitals reported similar levels of burnout across frontline, midlevel, and director-level leadership. Directors demonstrated higher levels of compassion satisfaction and lower levels of work-life balance. Four themes emerged representing areas of professional life that potentiate and alleviate compassion fatigue. CONCLUSIONS: All levels of nurse leaders must address the risk of burnout and can do so through individual and organizational resiliency strategies.
The opinions expressed are those of the respondents and should not be construed as the official p... more The opinions expressed are those of the respondents and should not be construed as the official position of the institution, ENA, or the Journal.
The opinions expressed are those of the respondents and should not be construed as the official p... more The opinions expressed are those of the respondents and should not be construed as the official position of the institution, ENA, or the Journal.
Answer 1: We have not changed our job description for expert nurses who are older than 45 years, ... more Answer 1: We have not changed our job description for expert nurses who are older than 45 years, but we do offer them positions within their job description that are sensitive to their physical challenges. There are a number of strategies we have successfully implemented to reduce the physical burden on our aging nurses. An option for 8 versus 12 hour shifts is given, experienced nurses are often asked to precept new graduate nurses, and our older population is given the option to work as Medical Incident Command Nurses, allowing them to sit at the radio and communicate with EMS staff on destination and plan of care in the field, reducing the physical workload for that shift. All of these roles within the emergency department capitalize on these nurses’ experience. The physical challenges that are accommodated by this division of labor include arthritic joints, chronic back injuries (from years of service to outpatients) and lower fatigue threshold.—Kelly Bernatine, RN, BSN, Emergency Department Nurse Manager, Arrowhead Regional Medical Center, San Bernadino, Calif
Background As caregivers in high-pressure environments, critical care nurses are at risk for burn... more Background As caregivers in high-pressure environments, critical care nurses are at risk for burnout and secondary trauma-components of compassion fatigue. Recent findings have increased understanding of the phenomena, specifically that satisfaction and meaningful recognition may play a role in reducing burnout and raising compassion satisfaction; however, no large multisite studies of compassion fatigue have been conducted. Objectives To examine the effect of meaningful recognition and other predictors on compassion fatigue in a multicenter national sample of critical care nurses. Methods A quantitative, descriptive online survey was completed by 726 intensive care unit nurses in 14 hospitals with an established meaningful recognition program and 410 nurses in 10 hospitals without such a program. Site coordinators at each hospital coordinated distribution of the survey to nurses to assess multiple predictors against outcomes, measured by the Professional Quality of Life Scale. Cross-validation and linear regression modeling were conducted to determine significant predictors of burnout, secondary traumatic stress, and compassion satisfaction. Results Similar levels of burnout, secondary traumatic stress, compassion satisfaction, overall satisfaction, and intent to leave were reported by nurses in hospitals with and without meaningful recognition programs. Meaningful recognition was a significant predictor of decreased burnout and increased compassion satisfaction. Additionally, job satisfaction and job enjoyment were highly predictive of decreased burnout, decreased secondary traumatic stress, and increased compassion satisfaction. Conclusions In addition to acknowledging and valuing nurses' contributions to care, meaningful recognition could reduce burnout and boost compassion satisfaction.
M any employees face operational failures-missing or insufficient supplies, equipment, informatio... more M any employees face operational failures-missing or insufficient supplies, equipment, information, and personnel-that interfere with their workflow and can negatively impact organizational performance. However, employees often devise methods to work around these obstacles that may come with negative side effects. The Dressing Change Game is a 40-minute in-class exercise that enables students to directly experience workarounds as a natural response to operational failures and allows them to see the trade-off between shortterm and longer-term organizational performance that occurs as a result of workarounds. The overarching learning objective is for students to gain an appreciation that optimizing individual-or unit-level performance likely undermines organizational-level performance.
It's working day in and day out for years and years; you forget what impact you make on people yo... more It's working day in and day out for years and years; you forget what impact you make on people you work with and the patients-it's special to be recognized.-Staff Nurse, Children's Hospital Los Angeles One Family's Story: Why Nurses Are Extraordinary When the American Association of Critical-Care Nurses (AACN) published AACN Standards for Establishing and Sustaining Healthy Work Environments in 2005, Standard 5 was Meaningful Recognition: Nurses must be recognized and must recognize others for the value each brings to the work of the organization. 1 At the time, The DAISY (an acronym for Diseases Attacking the Immune System) Foundation was just starting. Our family had created this not-for-profit organization to express our gratitude to nurses for the extraordinary compassion and skill they bring to patients and families every day. Although we were not aware of AACN's and the nursing profession's evidence-based understanding of the importance of a formal recognition process in ensuring an environment conducive to patient and staff safety and nurse retention and recruitment, the lives of our family were forever changed by extraordinary nurses. Thirteen years ago, our 33-year-old son, Patrick, was unexpectedly hospitalized for 8 weeks with the autoimmune disease idiopathic thrombocytopenia purpura. During Patrick's hospitalization, the nurses who cared for him and us truly practiced patient-and family-centered care. To our family, the excellent clinical skill nurses applied to Patrick was not surprising; after all, we expected he would be well cared for in a hospital setting. What we did not expect was the humanity Patrick's nurses brought to his bedside and to our hearts: the way they touched Patrick and the way they talked to him, even when he was fully sedated and being treated with mechanical ventilation. The way they explained his condition and treatment to us, ensuring that every question was answered, no matter how many times the same question may have been asked. The way they understood the dynamics of our family and knew how to approach, comfort, and encourage each member. The way they treated Patrick not as a dreadfully sick patient but as a vibrant young man whom they expected would return to a healthy, fulfilling life. Finally, when Patrick became increasingly ill, and
Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association, Jan 17, 2015
The opinions expressed are those of the respondents and should not be construed as the official p... more The opinions expressed are those of the respondents and should not be construed as the official position of the institution, ENA, or the Journal.
Many employees face operational failures—missing or insufficient supplies, equipment, information... more Many employees face operational failures—missing or insufficient supplies, equipment, information, and personnel—that interfere with their workflow and can negatively impact organizational performance. However, employees often devise methods to work around these obstacles that may come with negative side effects. The Dressing Change Game is a 40-minute in-class exercise that enables students to directly experience workarounds as a natural response to operational failures and allows them to see the trade-off between short-term and longer-term organizational performance that occurs as a result of workarounds. The overarching learning objective is for students to gain an appreciation that optimizing individual- or unit-level performance likely undermines organizational-level performance. Teaching Note: Interested Instructors please see the Instructor Materials page for access to the restricted materials. To maintain the integrity and usefulness of cases published in ITE, unapproved dis...
Amazing care delivery happens in neonatal intensive care units (NICUs) around the globe, 24/7. As... more Amazing care delivery happens in neonatal intensive care units (NICUs) around the globe, 24/7. As you are reading this abstract, thousands of acts involving extraordinary nursing have occurred in NICUs (babies have been held by their parents for the first time, parents have been comforted and given hope for their child’s future, a few extra milliliters of a tube feeding were tolerated, and children were successfully weaned off ventilators). Behind each of these amazing acts are nurses who come together not only to deliver clinical excellence but also to create a NICU culture that turns fear and uncertainty into hope and optimism. Derived from the collective behaviors of staff, the culture of a NICU can also be influenced and shaped by recognizing the contributions nurses make every day. Research involving The DAISY Award (an acronym for “diseases attacking the immune system”), which recognizes nurses in a meaningful way for their extraordinary contributions, found that this type of ...
Community hospital, stand-alone facility, rural facility, or academic medical center—ED nurses wo... more Community hospital, stand-alone facility, rural facility, or academic medical center—ED nurses working in different settings all rely heavily on stretchers. We might even go so far as to claim that the stretcher is the ED nurse’s best friend, for without these 4-wheeled metal objects our practice would be much different, as “pushing around” patients in beds would greatly decrease the life span of our backs. With such a heavy reliance on these 4-wheeled friends, Audra Ford, MSN, RN, CEN, Director of the Emergency Department at Marshall Medical Center North in Guntersville, AL, reached out to ED nurse colleagues across the United States to ascertain how others were cleaning and disinfecting their stretchers. The feedback ranged from using a variety of commercial products, wipes, and even vinegar (yes, there was an issue with the smell) to clean stretchers. This array of “cleaning tips” led us to contact 2 ENA Corporate Sponsors, Stryker Medical (Kalamazoo, MI) and Hill-Rom (Batesville, IN), for their recommendations and expertise regarding how to properly clean, disinfect, and care for stretchers. At Stryker Medical, Don Payerle, Vice President and General Manager of Patient Handling and EMS, and Kevin Patmore, Chief Engineer, were happy to share a few pointers regarding stretcher cleaning. They began, “Most important to stretcher cleaning and disinfecting is ensuring that blood and/or other bacteria-transferring fluids are removed—and, of course, getting rid of those dust bunnies [that get caught in the casters] helps keep the stretcher in good condition.” Although each stretcher comes with an operation manual detailing proper cleaning and disinfecting, these booklets often reside in the facilities management or ED administrative offices and may not
This month is dedicated to the men and women who every day keep us safe and enable us to do what ... more This month is dedicated to the men and women who every day keep us safe and enable us to do what we do. We reached out to emergency nurse leaders and asked them to share with us their thoughts on how their experience in the military affected their leadership and how being an emergency nurse affected their military career. We offer our heartfelt thanks to these nurses and to all our brothers and sisters currently serving in the armed forces and the veterans and heroes who have served before. Thank you for building our road to freedom and being the wind beneath our wings! The moon gives you light, And the bugles and the drums give you music; And my heart, O my soldiers, my veterans, My heart gives you love. –Walt Whitman
Meaningfully recognizing the extraordinary contributions of nurses is a key element in creating a... more Meaningfully recognizing the extraordinary contributions of nurses is a key element in creating and sustaining healthy work environments. Publically honoring the work of nursing reinforces those actions and behaviors that patients, families, and colleagues truly value. A multi-site research study provided a 360-degree perspective of the impact this type of acknowledgment had on strengthening the nursing workforce at 20 health care organizations who use The DAISY Award to recognize extraordinary nurses. Data analysis of 2,195 DAISY Award nominations from patients, families, and colleagues at 20 hospitals identified 22 behavioral themes associated with extraordinary nursing.
M any employees face operational failures-missing or insufficient supplies, equipment, informatio... more M any employees face operational failures-missing or insufficient supplies, equipment, information, and personnel-that interfere with their workflow and can negatively impact organizational performance. However, employees often devise methods to work around these obstacles that may come with negative side effects. The Dressing Change Game is a 40-minute in-class exercise that enables students to directly experience workarounds as a natural response to operational failures and allows them to see the trade-off between shortterm and longer-term organizational performance that occurs as a result of workarounds. The overarching learning objective is for students to gain an appreciation that optimizing individual-or unit-level performance likely undermines organizational-level performance.
To examine and report burnout, secondary trauma, and compassion satisfaction in acute care nurse ... more To examine and report burnout, secondary trauma, and compassion satisfaction in acute care nurse leaders through a large mixed-methods research study. BACKGROUND: Although nurse leaders are removed from daily patient care activities, the pervasive challenges in the work environment create conditions for professional burnout. Nurse leaders must garner compassion satisfaction from different sources, including peer and staff interactions. METHODS: The Professional Quality of Life scale was given to nurse leaders at 29 hospitals in 1 health system. Sixteen leaders from 2 hospitals participated in qualitative interviews. RESULTS: Six hundred seventy-two nurse leaders from 29 hospitals reported similar levels of burnout across frontline, midlevel, and director-level leadership. Directors demonstrated higher levels of compassion satisfaction and lower levels of work-life balance. Four themes emerged representing areas of professional life that potentiate and alleviate compassion fatigue. CONCLUSIONS: All levels of nurse leaders must address the risk of burnout and can do so through individual and organizational resiliency strategies.
The opinions expressed are those of the respondents and should not be construed as the official p... more The opinions expressed are those of the respondents and should not be construed as the official position of the institution, ENA, or the Journal.
The opinions expressed are those of the respondents and should not be construed as the official p... more The opinions expressed are those of the respondents and should not be construed as the official position of the institution, ENA, or the Journal.
Answer 1: We have not changed our job description for expert nurses who are older than 45 years, ... more Answer 1: We have not changed our job description for expert nurses who are older than 45 years, but we do offer them positions within their job description that are sensitive to their physical challenges. There are a number of strategies we have successfully implemented to reduce the physical burden on our aging nurses. An option for 8 versus 12 hour shifts is given, experienced nurses are often asked to precept new graduate nurses, and our older population is given the option to work as Medical Incident Command Nurses, allowing them to sit at the radio and communicate with EMS staff on destination and plan of care in the field, reducing the physical workload for that shift. All of these roles within the emergency department capitalize on these nurses’ experience. The physical challenges that are accommodated by this division of labor include arthritic joints, chronic back injuries (from years of service to outpatients) and lower fatigue threshold.—Kelly Bernatine, RN, BSN, Emergency Department Nurse Manager, Arrowhead Regional Medical Center, San Bernadino, Calif
Background As caregivers in high-pressure environments, critical care nurses are at risk for burn... more Background As caregivers in high-pressure environments, critical care nurses are at risk for burnout and secondary trauma-components of compassion fatigue. Recent findings have increased understanding of the phenomena, specifically that satisfaction and meaningful recognition may play a role in reducing burnout and raising compassion satisfaction; however, no large multisite studies of compassion fatigue have been conducted. Objectives To examine the effect of meaningful recognition and other predictors on compassion fatigue in a multicenter national sample of critical care nurses. Methods A quantitative, descriptive online survey was completed by 726 intensive care unit nurses in 14 hospitals with an established meaningful recognition program and 410 nurses in 10 hospitals without such a program. Site coordinators at each hospital coordinated distribution of the survey to nurses to assess multiple predictors against outcomes, measured by the Professional Quality of Life Scale. Cross-validation and linear regression modeling were conducted to determine significant predictors of burnout, secondary traumatic stress, and compassion satisfaction. Results Similar levels of burnout, secondary traumatic stress, compassion satisfaction, overall satisfaction, and intent to leave were reported by nurses in hospitals with and without meaningful recognition programs. Meaningful recognition was a significant predictor of decreased burnout and increased compassion satisfaction. Additionally, job satisfaction and job enjoyment were highly predictive of decreased burnout, decreased secondary traumatic stress, and increased compassion satisfaction. Conclusions In addition to acknowledging and valuing nurses' contributions to care, meaningful recognition could reduce burnout and boost compassion satisfaction.
M any employees face operational failures-missing or insufficient supplies, equipment, informatio... more M any employees face operational failures-missing or insufficient supplies, equipment, information, and personnel-that interfere with their workflow and can negatively impact organizational performance. However, employees often devise methods to work around these obstacles that may come with negative side effects. The Dressing Change Game is a 40-minute in-class exercise that enables students to directly experience workarounds as a natural response to operational failures and allows them to see the trade-off between shortterm and longer-term organizational performance that occurs as a result of workarounds. The overarching learning objective is for students to gain an appreciation that optimizing individual-or unit-level performance likely undermines organizational-level performance.
It's working day in and day out for years and years; you forget what impact you make on people yo... more It's working day in and day out for years and years; you forget what impact you make on people you work with and the patients-it's special to be recognized.-Staff Nurse, Children's Hospital Los Angeles One Family's Story: Why Nurses Are Extraordinary When the American Association of Critical-Care Nurses (AACN) published AACN Standards for Establishing and Sustaining Healthy Work Environments in 2005, Standard 5 was Meaningful Recognition: Nurses must be recognized and must recognize others for the value each brings to the work of the organization. 1 At the time, The DAISY (an acronym for Diseases Attacking the Immune System) Foundation was just starting. Our family had created this not-for-profit organization to express our gratitude to nurses for the extraordinary compassion and skill they bring to patients and families every day. Although we were not aware of AACN's and the nursing profession's evidence-based understanding of the importance of a formal recognition process in ensuring an environment conducive to patient and staff safety and nurse retention and recruitment, the lives of our family were forever changed by extraordinary nurses. Thirteen years ago, our 33-year-old son, Patrick, was unexpectedly hospitalized for 8 weeks with the autoimmune disease idiopathic thrombocytopenia purpura. During Patrick's hospitalization, the nurses who cared for him and us truly practiced patient-and family-centered care. To our family, the excellent clinical skill nurses applied to Patrick was not surprising; after all, we expected he would be well cared for in a hospital setting. What we did not expect was the humanity Patrick's nurses brought to his bedside and to our hearts: the way they touched Patrick and the way they talked to him, even when he was fully sedated and being treated with mechanical ventilation. The way they explained his condition and treatment to us, ensuring that every question was answered, no matter how many times the same question may have been asked. The way they understood the dynamics of our family and knew how to approach, comfort, and encourage each member. The way they treated Patrick not as a dreadfully sick patient but as a vibrant young man whom they expected would return to a healthy, fulfilling life. Finally, when Patrick became increasingly ill, and
Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association, Jan 17, 2015
The opinions expressed are those of the respondents and should not be construed as the official p... more The opinions expressed are those of the respondents and should not be construed as the official position of the institution, ENA, or the Journal.
Many employees face operational failures—missing or insufficient supplies, equipment, information... more Many employees face operational failures—missing or insufficient supplies, equipment, information, and personnel—that interfere with their workflow and can negatively impact organizational performance. However, employees often devise methods to work around these obstacles that may come with negative side effects. The Dressing Change Game is a 40-minute in-class exercise that enables students to directly experience workarounds as a natural response to operational failures and allows them to see the trade-off between short-term and longer-term organizational performance that occurs as a result of workarounds. The overarching learning objective is for students to gain an appreciation that optimizing individual- or unit-level performance likely undermines organizational-level performance. Teaching Note: Interested Instructors please see the Instructor Materials page for access to the restricted materials. To maintain the integrity and usefulness of cases published in ITE, unapproved dis...
Amazing care delivery happens in neonatal intensive care units (NICUs) around the globe, 24/7. As... more Amazing care delivery happens in neonatal intensive care units (NICUs) around the globe, 24/7. As you are reading this abstract, thousands of acts involving extraordinary nursing have occurred in NICUs (babies have been held by their parents for the first time, parents have been comforted and given hope for their child’s future, a few extra milliliters of a tube feeding were tolerated, and children were successfully weaned off ventilators). Behind each of these amazing acts are nurses who come together not only to deliver clinical excellence but also to create a NICU culture that turns fear and uncertainty into hope and optimism. Derived from the collective behaviors of staff, the culture of a NICU can also be influenced and shaped by recognizing the contributions nurses make every day. Research involving The DAISY Award (an acronym for “diseases attacking the immune system”), which recognizes nurses in a meaningful way for their extraordinary contributions, found that this type of ...
Community hospital, stand-alone facility, rural facility, or academic medical center—ED nurses wo... more Community hospital, stand-alone facility, rural facility, or academic medical center—ED nurses working in different settings all rely heavily on stretchers. We might even go so far as to claim that the stretcher is the ED nurse’s best friend, for without these 4-wheeled metal objects our practice would be much different, as “pushing around” patients in beds would greatly decrease the life span of our backs. With such a heavy reliance on these 4-wheeled friends, Audra Ford, MSN, RN, CEN, Director of the Emergency Department at Marshall Medical Center North in Guntersville, AL, reached out to ED nurse colleagues across the United States to ascertain how others were cleaning and disinfecting their stretchers. The feedback ranged from using a variety of commercial products, wipes, and even vinegar (yes, there was an issue with the smell) to clean stretchers. This array of “cleaning tips” led us to contact 2 ENA Corporate Sponsors, Stryker Medical (Kalamazoo, MI) and Hill-Rom (Batesville, IN), for their recommendations and expertise regarding how to properly clean, disinfect, and care for stretchers. At Stryker Medical, Don Payerle, Vice President and General Manager of Patient Handling and EMS, and Kevin Patmore, Chief Engineer, were happy to share a few pointers regarding stretcher cleaning. They began, “Most important to stretcher cleaning and disinfecting is ensuring that blood and/or other bacteria-transferring fluids are removed—and, of course, getting rid of those dust bunnies [that get caught in the casters] helps keep the stretcher in good condition.” Although each stretcher comes with an operation manual detailing proper cleaning and disinfecting, these booklets often reside in the facilities management or ED administrative offices and may not
This month is dedicated to the men and women who every day keep us safe and enable us to do what ... more This month is dedicated to the men and women who every day keep us safe and enable us to do what we do. We reached out to emergency nurse leaders and asked them to share with us their thoughts on how their experience in the military affected their leadership and how being an emergency nurse affected their military career. We offer our heartfelt thanks to these nurses and to all our brothers and sisters currently serving in the armed forces and the veterans and heroes who have served before. Thank you for building our road to freedom and being the wind beneath our wings! The moon gives you light, And the bugles and the drums give you music; And my heart, O my soldiers, my veterans, My heart gives you love. –Walt Whitman
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