There are large disparities in mental healthcare across races and ethnicities in the U.S. Many factors contribute to the poor mental health outcomes of minority populations. Such as:

• Inaccessible mental healthcare services
• Transportation issues, difficulty finding childcare/taking time off work
• Lacking health insurance coverage
• Cultural stigma regarding mental healthcare
• The lack of Black, Indigenous, and people of color (BIPOC) healthcare professionals
• Racism, bias, and discrimination in healthcare
• Language barriers

Nurses have the first-hand experience needed to advocate for their patients, colleagues, and themselves. They can influence change in their workplace, communities, Nursing organizations, educational institutions, and with policymakers.

Legislators are the experts in drafting laws and regulations, but they often rely on subject matter experts to inform them on changes that must be made. When it comes to healthcare policies, Nurses are those experts. 

Nurses are the largest workforce group in the healthcare industry and the most trusted.

Year after year for 20 straight years, Nurses have led Gallup's annual ranking of professions for having high honesty and ethics.

Here are some ways Nurses can influence change in healthcare policy.

In The Community

On a local level, Nurses can provide fact-based perspectives at town halls and city council meetings, as well as on school boards and in public health departments. They can also run for public office.

Not only can Nurses translate scientific jargon but they can also help raise awareness about what is factual and what is false. They have an important voice in determining public health measures such as mask mandates and stay-at-home orders. 

At Work

Nurse leaders can advocate for their patients and fellow staff at their facility by shedding light on Nursing policies such as patient care standards, safe staffing levels, new technologies, and staff well-being."

Nationally

Many Nurses join National Nursing Organizations which usually have state chapters or societies. These organizations offer a variety of ways Nurses can help them influence national healthcare policies such as writing letters to legislators, campaigning for public support, and organizing events/fundraisers.

By joining these organizations, Nurses can use their collective voice to influence change.

For example, the Oncology Nursing Society (ONS) hosts an Annual Capitol Hill Days event where Nurses from across the nation come together to hear presentations from society leaders and special congressional guests.

These organizations also offer mentoring programs. Nurses can mentor less experienced Nurses about lobbying policymakers, public speaking, campaigning, and fundraising.

Nurses are essential advocates for healthcare policy and their influence is needed at all levels - nationally, locally, and in their place of work.

Times have been challenging for Nurses. Many of you are feeling down and in search of inspiration. A small dose of encouragement can go a long way, so we compiled a collection of inspirational, motivational, and some humorous quotes to lift you up.

1. “Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest accomplishment, or the smallest act of caring, all of which have the potential to turn a life around.” – Leo Buscaglia

2. "Most of the important things in the world have been accomplished by people who have kept on trying when there seemed to be no hope at all." – Dale Carnegie

3. “We may encounter many defeats but we must not be defeated.” —Maya Angelou

4. “As a nurse, we have the opportunity to heal the heart, mind, soul and body of our patients, their families and ourselves. They may forget your name, but they will never forget how you made them feel.” — Maya Angelou

5. "Once a nurse, always a nurse. No matter where you go or what you do, you can never truly get out of nursing. It’s like the Mafia… you know too much." – Deb Gaudlin, RN

6. “America’s nurses are the beating heart of our medical system.” — Barack Obama

7. “Nurses are the heart of healthcare.” — Donna Wilk Cardillo

15. “Knowing is better than wondering, waking is better than sleeping, and even the biggest failure, even the worse, beats the hell out of never trying.” — Grey’s Anatomy

16. “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has.” – Margaret Mead

19. “Who inspires me to be a nurse? Every nurse who doesn’t turn their back on nursing students, or graduate nurses, every nurse who acknowledges it’s okay and simply human to make foolish mistakes, every nurse who takes a moment of their time to help when you’re scared, and every nurse who remembers what it’s like to be a beginner.” – Anonymous Nurse

20. "Nurses are there when the last breath is taken, and nurses are there when the first breath is taken. Although it is more enjoyable to celebrate the birth, it is just as important to comfort in death." – Christine Bell

21. “Kindness can transform someone’s dark moment with a blaze of light. You’ll never know how much your caring matters. Make a difference for another today.” ― Amy Leigh Mercree

As we start the new year, we take a look at trends we expect to see in the Nursing field. Many health experts agree staffing has been and will continue to be the top healthcare issue.

Nurse Shortage

Many factors play into the staffing crisis like the pandemic, retiring Nurses, and high rates of burnout.

Rhonda Thompson, DNP, CNO and SVP of Patient Care Services at Phoenix Children's Hospital told Beckers Hospital Review, "The nursing shortage affecting health systems nationwide will continue to be a challenge in 2022. This has a greater impact than just unfilled positions and scheduling sufficient nurses based on a high patient census. It also means our experienced staff nurses are investing a great deal of time onboarding and training newly licensed nurses, in addition to their own daily bedside care responsibilities. To solve this, it will take collaboration and commitment from our health systems, staff, and academic partners."

According to the U.S. Bureau of Labor Statistics, about 194,500 openings for Registered Nurses are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.

Increase In At-Home Healthcare

The COVID-19 pandemic created a demand for at-home healthcare that continues to grow.

According to Forbes, the Home Care Providers industry is among the fastest growing healthcare industries in the United States. "Industry revenue, according to IBISWorld, has grown at an annualized rate of 2.2% to $96.9 billion over the past five years."

At-home healthcare has many benefits. So much so, last year a bill called the Choose Home Care Act 2021 was presented to Congress. If passed, this would give patients the opportunity to leave the hospital and recover at home with a mix of expanded skilled Nursing, therapy, personal care, telehealth services, and more.

Prioritizing The Well-Being Of Healthcare Workers

The pandemic has pushed an already stressed-out career field to its breaking point. Nurses are facing high rates of burnout and compassion fatigue.

Compassion fatigue is the emotional residue or strain of exposure to working with those suffering from the consequences of traumatic events.

According to J. Maben and J. Bridges (2020), the pandemic has led Nurses to experience the highest level of stress that has ever been recorded compared to other professions.

Healthcare organizations and leaders have the opportunity and the responsibility to support and prioritize their staff's mental and physical well-being.

These healthcare workers have given so much of themselves they have nothing left to give and yet they are still showing up day after day under impossible circumstances. But for how much longer?

Nurses want to feel valued and safe in their work environment. Healthcare organizations must ensure Nurses are equipped with resources and the support they need to provide quality care.

Nursing School Online

The pandemic forced Nursing schools to provide their classes online to avoid the spread of the virus. Many institutions have continued the online learning option for some of their programs.

According to a report from Inside Higher Ed, about 60% of colleges and universities do plan to keep some of their undergraduate programs fully online.

Online schools provide a great opportunity for Nurses who are looking to advance further in their education, but don't have the time to physically attend classes between shifts.

Being a Nurse is challenging, but being a Nurse with Attention Deficit Hyperactivity Disorder (ADHD) can feel almost impossible some days.

According to the CDC, there are three different types of ADHD, depending on which types of symptoms are strongest in the individual:

• Predominantly Inattentive Presentation: It is hard for the individual to organize or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines.

• Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a lot. It is hard to sit still for long (e.g., for a meal or while doing homework). The individual feels restless and has trouble with impulsivity. Someone who is impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.

• Combined Presentation: Symptoms of the above two types are equally present in the person.

If you haven’t been diagnosed with ADHD, but relate to these symptoms, talk to a healthcare provider about what you’re experiencing. You may benefit from some type of therapy or treatment.  

In addition to therapy techniques and/or medication, here are strategies to help manage your ADHD throughout your shift.

Arrive at work a little early. This gives you an opportunity to get the low down on your patients, take notes, and create some kind of schedule for your shift.

Lists are your best friend. Make lists of anything you need to do during your shift and check them off as you go.

If you are frequently losing or misplacing things like your stethoscope, try using tracker tags. Tile Mate Bluetooth trackers are great tags to help you find lost items.

For smaller items like pens, try using retractable holders and attach to your badge or lanyard. Amazon has lots of options.

Sitting down to chart and feel overwhelmed trying to remember everything from your shift? It may not always be possible, but try to do as much of your charting in present time. Your documentation will be more accurate and you'll use less brain power remembering the details and times you did your assessments.

Find a quiet spot to chart. It can be hard to focus and not get distracted by noises and coworkers. Your charting will be more accurate and done faster if you can find a private nook, cubicle or spot behind the Nurse's station.

During Nurse-to-Nurse handoff, details can get lost in reporting. Using a brain sheet can help you stay organized and save time by efficiently sharing the patient's story. Check out these brain sheets by scrubsmag.com.

Finish working on one patient before moving on to the next. Avoid running back and forth between patients (unless it's an emergency). Instead of visiting one patient multiple times within an hour, cluster your care and get everything done at once. Do your assessments, administer medications, make necessary calls, and document while you're still in the room.

Set an alarm to help you move on to another task. Some people with ADHD tend to hyper focus on one task and end up losing track of time.

Remember your treatment plan. Schedule a routine time to take your medications so they last the duration of your shift or set an alarm to remind yourself to take your medications if you need to take another dose during your shift. 

Outside of work, support groups are a great outlet to connect with others who have similar experiences. These groups often meet regularly to share concerns and achievements, to exchange information and strategies, and to talk with experts.

The National Resource Center on ADHD, a program of Children and Adults with Attention Deficit Hyperactivity Disorder (CHADD®), supported by the Centers for Disease Control and Prevention (CDC), has information and many resources. You can reach this center online or by phone at 1-866-200-8098.

Creating a workplace with a strong Diverse, Equitable and Inclusive culture is not only the right thing, it’s also crucial for your retention and improving patient care.

A study from Press Ganey shows health systems with strong Diversity, Equity, and Inclusion (DEI) values have less risk of staff potentially leaving the organization.

The study also found:

• Healthcare organizations had twice as many employees at risk of leaving if the workforce perceived diversity and equity weren’t prioritized versus work forces that do.  
  
  
• The risk of leaving within 3 years is more than 4 times higher for healthcare workers who believe their organization doesn’t value employees from different backgrounds versus workers who do.  
  
  
• If offered another job, healthcare workers are 4 ½ times more likely to leave an organization if they believe different backgrounds aren’t valued, or if the organization isn’t committed to workforce diversity, versus workers who do.   
  
  
• Perceptions of diversity & equity are a bigger indicator of intent to stay with an organization among security personnel, nurses and physicians than other ancillary staff. 

Having a strong DEI culture allows employees to be comfortable and confident in who they are. This allows them to focus on providing the best patient care possible.

Research shows, 77% of employees and 80% of leaders who are disabled chose not to share their disability in their workplace. For LGBTQ workers, 46% are closeted at their place of work. And across all diverse characteristics, 75% of employees feel the need to mask their differences or downplay them during work.

Employees masking or hiding aspects of themselves during shifts affects their confidence, motivation, feelings of safety and hinders their job performance.

It’s important for healthcare workers to have mentors they can look up to throughout their careers. A lack of diversity can make it difficult for minority healthcare workers to find role models they identify with. This can impact their professional growth and their ability to provide optimal patient care.

A strong DEI culture isn’t something that can be achieved overnight. It requires a leadership who is dedicated to promoting cultural awareness and inclusion. It requires staff who are willing to take the time to learn about and understand each other. It also means being willing to identify and address biases.

Working in a healthcare setting can be a high-stress environment. Especially during a time of crisis, many healthcare workers face burnout, worry, anxiety, and grief. Here are some ideas for improving hospital staff's morale.

Mental Health Support

Healthcare workers understand the importance of self-care and mental health. It may be a good idea to offer mental health PTO days so they have an opportunity to see to their own wellness needs. Offering counseling or therapy, virtually or on-site, is another great way to help staff cope and manage stress.

Physical Health Programs

Mental health is important, but so is physical health. Working in the healthcare field can take a serious toll on the body. Offering a physical wellness program with coaching, virtual yoga, cardio classes, massage therapy, etc. is an outlet for staff to blow off steam and feel better.

Not Your Average Break Room

Put some love into the design of the break room. This is a place for staff to escape and recharge. Help fuel your employees by offering snacks and beverages. Replace old metal chairs with something a little more comfortable and switch the cold white lighting for some lamps and accent lights. Plants and calming scenic art are other good touches.

Communication

One of the simplest ways to boost staff morale is through open communication. In any career, employees want to feel they have a voice and their concerns are heard. Find ways to maintain an open-door policy and make sure staff members have the opportunity to share their thoughts.

Celebrations

Celebrate holidays, birthdays, and milestones. Recognition is a huge morale booster. Hanging decorations, planning a potluck or simply having staff sign a card for someone are fun ways to improve moods!

The holidays are a joyful time but also a stressful time for many people. The pandemic has also added an extra layer to the holiday blues. So here are some tips for managing this season's stressors.

According to Psychology.org, common symptoms of the Holiday Blues are:

Symptoms often begin in November and last until the start of the new year.

Triggers of stress vary for each person but many common themes arise this time of year such as finances, family gatherings, isolation and loneliness.

The thought of holiday spending is unquestionably stressful, but with a little planning, you may be able to alleviate some of that stress.

Budget - creating a budget is most important. Understand what you have for resources and then prioritize. For example, make a list of the people you need to buy gifts for, figure out how much money you have to work with, then allocate your resources in order of priority.

Plan and shop early. It's usually a good idea to start buying gifts earlier in the year. When you see that certain item on sale months before the holidays, grab it. It can be overwhelming hunting down limited items and spending a lot in a short amount of time.

Also don't stress about cutting back on pricey gifts. The important people in your life will recognize that, ultimately, it's still the thought that counts.

For many people, the pandemic is adding to the typical holiday stress of navigating how to approach family gatherings.

Discussing family plans in advance is always a good idea. If you're feeling stressed about attendees being vaccinated or not, try keeping the gathering immediate family only and utilize facetime tools to include those who couldn't be there this year.

If traveling to see loved ones is stressing you out, consider inviting them to your home.

Are there family members who are choosing to skip the full-fledged family gathering? Try spending time with them on other days throughout the holiday season or meet for a meal or some other meaningful activity.

Sending greeting cards to your loved ones during this time of year is another great way to let them know you are thinking of them.

People who don't have the opportunity to gather with loved ones this year may be feeling bouts of loneliness and isolation.

Try taking some extra special care of yourself. It may not completely erase feelings of loneliness, but self-care can help you feel better. Whether you take a relaxing bath, read a good book, practice your favorite hobby, or learn something new, doing something for yourself is important during stressful times.

Volunteer – it’s a great way to beat loneliness. Spend time volunteering at local shelters, fundraisers, and even animal shelters. There are plenty of charities that could use an extra hand during this busy season of giving.

In addition to the stress and anxiety caused by the holidays, many people suffer from seasonal affective disorder (SAD).

According to the National Institute of Mental Health (NIMH), SAD is a type of depression that comes and goes with the seasons, typically starting in the late fall and early winter and going away during the spring and summer. People who suffer from SAD typically see the onset of symptoms annually, coinciding with the same time we roll our clocks back.

Treatments are available that can help many people with SAD. They fall into four main categories that may be used alone or in combination:

• Light therapy
• Talk therapy
• Medications
• Vitamin D

Talk to your health care provider about which treatment, or combination of treatments, is best for you. With these tips, hopefully you’ll have a happy and less stressful holiday season!

When it comes to recruitment and retention, creating a supportive environment is key. A great way to provide support is through mentorship programs.

Studies report mentorship programs in retaining and easing the transition to practice for new graduate Nurses, re-entry Nurses, and Nurses new to a specialty area are critical in retention.

Nurse mentorship is described as a synergetic relationship between a beginning Nurse (the mentee) and a Nurse with multiple years of experience (the mentor). Nurse mentorship programs are meant to encourage mutual professional growth between both the mentor and the mentee through a dynamic and supportive relationship.

Nurses at every stage of their career benefit from mentorships. Research shows the career-long roles of the Nurse as both a mentor and a mentee are fundamental to the Nursing profession. Learning from peers can result in significant professional and personal growth.

According to NurseJournal, the goal of mentorship programs is to provide:

• Clinical care support
• Psychological and emotional support
• Academic advice
• Career development
• Nurse leadership opportunities

Mentorship in Nursing has been found to:

• Improve job satisfaction
• Promote professional growth and development
• Decrease turnover
• Increase cost-effectiveness

If your organization doesn't offer a Nurse mentorship program, there are other ways to seek guidance and support.

• Look online. There are many online resources to help you find a good mentor match. You can also search Facebook and LinkedIn for professionals in the same field as you.
• Connect with your co-workers. Is there someone you work with who you look up to or has offered advice and support? They may be willing to mentor you. If they agree, set up times to meet and discuss your career goals or any questions you have.
• Local Nursing chapters. Reach out to local Nursing chapter organizations. They might be willing to recruit volunteer mentors from among their members.

Every Nurse can benefit from having or being a mentor. It's crucial that mentor relationships be comfortable and trusting in order to have open communication and establish measurable career goals.

Violence against healthcare workers is more common than most people realize. The environment of a healthcare institution can create high levels of stress for patients, their loved ones, and staff. Fear and illness are major contributors of agitation and aggression from patients.

National Institute for Occupational Safety and Health classifies work place violence (WPV) into four basic types:

• Type I: Involves “criminal intent.” In this type of workplace violence, “individuals with criminal intent have no relationship to the business or its employees.”
• Type II: Involves a customer, client, or patient. In this type, an “individual has a relationship with the business and becomes violent while receiving services.”
• Type III: Violence involves a “worker-on-worker” relationship and includes “employees who attack or threaten another employee.”
• Type IV: Violence involves personal relationships. It includes “individuals who have interpersonal relationships with the intended target but no relationship to the business”

According to the American Nurses Association, 1 out of 4 Nurses is assaulted on the job and only 20% to 60% of Nurses report the incidents. The lack of reporting is a serious barrier to effective research and regulatory or legal action.

Three of the most common reasons for not reporting violent incidents are:

• Fear of retaliation
• Lack of a clear reporting method
• Belief that nothing will be done about it

Studies show that WPV can affect the quality of care and care outcomes, contribute to the development of psychological conditions, and reduce the RN's level of job satisfaction and organizational commitment.

If an attack happens, Nurse.org recommends these suggestions:

• Try to escape - If you can’t escape, yell loud enough to get help.
• Create a barrier - Put something between that person assaulting you and yourself so you might be able to escape. 
• Defend yourself - You can defend yourself. You are allowed to meet the attacker with equal force to get them to stop. Some people don’t know that. 
• Report the incident - Notify your facility of the assault.
• Take a leave of absence - Many people will be nervous to go back to work after an incident. If you are struggling emotionally with the trauma, people need to begin to realize that trauma and anxiety are legitimate reasons to get a leave of absence. Don’t rush back to work if you aren’t ready. 
• Get support and seek help - Surround yourself with people that you trust. Consider getting trauma counseling. 

The World Health Organization (WHO) holds employers accountable for both ensuring the safety of their employees and acting to treat them after an act of violence has occurred.

Hospitals should establish a culture of safety by implementing WPV prevention programs and by showing support of incident reporting. 

The Joint Commission released new and revised requirements addressing workplace violence prevention programs which will be effective on January 1, 2022.

These requirements include hospitals providing de-escalation training, education, and resources at time of hire, annually, and whenever changes occur regarding the WPV prevention program. Also the program should be led by a designated individual and developed by a multidisciplinary team. 

The American Association of Critical-Care Nurses (AACN) urges hospitals to:

• Establish a clear and consistent reporting structure for workplace violence, with easy to understand policies and procedures on how to report violent incidents to law enforcement.
• Encourage employees to press charges against persons who assault healthcare workers, and support staff members who do.
• Provide resources and support programs for employees to help them cope with violent incidents.
• Evaluate staffing and patient classification systems that could increase or reduce the risk of violence.
• Ensure the presence of sufficient security systems, including alarms, emergency response and available security personnel.

Many hospitals have set up personal security and safety protocols in case of an altercation or attack. 

Cox Medical Center in Branson, MO installed a panic button system. The hospital said about 300 to 400 staff will have their own personal panic buttons on their badges. If the button is pushed, it activates a personal tracing system, security is notified and an alert on hospital computers shows the employee's location.

Resources

Training:

Workplace Violence Prevention for Nurses

Podcasts:

Combating Workplace Violence in Health Care by Creating Safer Workplaces

Trauma And Trauma Informed Care

M.O.V.E. to Prevent Workplace Violence

Websites:

victimlaw.org 

Futures Without Violence: Workplace

Workplaces Respond National Resource Center

DOL Workplace Violence Program

Hotlines:

The National Domestic Violence Hotline is 1-800-799-7233, or you can text LOVEIS to 22522 if you cannot speak safely.

Workplace Harassment & Discrimination – Employee Concern Hotline Services: 800-307-5513

Fact Sheet:

Building a Safe Workplace and Community A Framework for Hospital and Health System Leadership

Guide:

End Nurse Abuse Resource Guide