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

The Nursing field offers many Nursing specialties to choose from depending on your interests and skills. And, there are plenty of opportunities to get the necessary training to move on to a different specialty.

The stress of the pandemic has increased Nurses' interest in positions beyond the hospital setting. 

Some of those opportunities include:

Nurse Educator

Nurse Educators don’t work in a traditional hospital or medical facility. They teach in universities, technical schools, and hospital-based Nursing programs. They can also work as administrators, consultants, or independent contractors.

Forensic Nurse

According to ForensicNurses.org, Forensic Nurses provide specialized care for patients who are experiencing acute and long-term health consequences associated with victimization or violence, and/or have unmet evidentiary needs relative to having been victimized or accused of victimization. In addition, Forensic Nurses provide consultation and testimony for civil and criminal proceedings relative to Nursing practice, care given, and opinions rendered regarding findings.

Many Forensic Nurses work in hospitals but they also work in community anti-violence programs, coroner’s and medical examiners offices, corrections institutions, and psychiatric facilities.

Health Policy Nurse

A Health Policy Nurse (HPN) plays an active role in forming and communicating public health policies with the goal of improving the overall well-being of society. With a strong background of hands-on Nursing expertise, HPNs are able to aid and act as policy makers within our government and healthcare systems, according to Johnson & Johnson Nursing.

Flight Nurse

Flight Nurses provide care onboard medical helicopters, airplanes, or jets often used in emergency situations to get patients to the best hospital as quickly as possible.

Flight Nurses also transfer patients between facilities. Patients might need to be moved to obtain lifesaving treatment unavailable at the original facility or to relocate to another part of the country. They also communicate with medical professionals at the receiving facility, to ensure all case notes and patient files get to the right person.

Nurse Writer

Nurse writers educate readers on healthcare topics through their personal knowledge and experience.

According to RegisteredNursing.org, they can freelance for medical journals, guides, and other health-related publications (newspapers, magazines, websites, etc.) that require accumulated knowledge, education, experience, and objectivity. Nurses can also write academic papers, write grants for hospitals or programs, coordinate programs, or assist the Communications Department in hospitals or other organizations.

Camp Nurse

Camp Nurses typically serve children or teens, in a camp environment. This can include summer camps or other camps that last from days to weeks to even months at a time, but are usually temporary.

Depending on the size of the camp, Nurses could be required to work alone or as part of a team, making critical decisions on patient care. They may also be required to obtain and keep records on allergies, medical histories, and medications of all camp participants.

Dialysis Nurse

Dialysis Nurses work with patients suffering from kidney diseases and illnesses. They administer dialysis to patients at dialysis centers, nursing homes, or at the patient's home.

Yacht Nurse

As a Nurse/Stewardess, you will be expected to maintain the on-board medical ward and Nursing station. This includes overseeing stock inventory, ordering supplies, and recording inventories. Depending on the yacht owner's health, you may be required for certain medical duties.

Although long working hours are required, the benefits are amazing with salaries often higher than other Nursing positions. Yachting is not for the faint-hearted though and you must have a sense of adventure and an urge to travel.

A Nursing career isn't always a straight path. You have the opportunity to work in a variety of different environments and grow your skills and knowledge. Take a chance and use that degree to explore your options. Discover what Nursing path fulfills and challenges you.

Even before the pandemic, healthcare providers experienced burnout and other negative mental health issues. Now more than ever, it is critical health systems take steps to support their staff's well-being.

Recently, more healthcare organizations have started to hire Chief Wellness Officers (CWO), as a strategy to address burnout, mental health, and compassion fatigue.

Jonathan Ripp MD, MPH, Chief Wellness Officer at the Icahn School of Medicine at Mount Sinai, said there were only a handful of Chief Wellness Officer positions when he was appointed to the role in May 2018. “There has been at least a dozen more who have been named in the past year, and several more places that are looking to create the position,” said Dr. Ripp. “I would not be surprised if, 10 years from now, it's commonplace for most large organizations to have a Chief Wellness Officer or equivalent, taking this challenge on, and doing so in a way that is effective.”

The ultimate goal of this role is to aid system-wide changes that enable staff to practice in a culture that prioritizes and promotes mental health and well-being.

The CWO is responsible for measuring well-being across their organization. Then, they create and implement wellness programs that address the current environment causing burnout and stress.

The hiring of a CWO is not a remedy all on its own. The CWO works in collaboration with other leaders and staff to prioritize well-being and would ultimately lower costs and improve patient care.

According to Beckers Hospital Review, burnout and depression result in major costs to health systems due to an increase in medical errors, reduced quality of care, and turnover. Research has found that for every dollar invested in wellness, hospitals can see a $3 to $6 return on investment.

Medical Schools are also following the hiring trend.

Holder said, "Mental and emotional wellness is essential to complete health. We simply cannot ignore this fact. I view my role as another way to serve the students, faculty and physicians in Brown’s medical school, and aid them in not just meeting their immediate self-care needs but also creating and developing plans that can help them learn more about how to take care of themselves in a way that's sustainable for a profession that demands a lot."

“Wellness and self-care is more important than ever before. These next few years will be critical for health care workers as we address the mental and physical burdens from COVID-19,” said George Washington University's Chief Wellness Officer, Lorenzo Norris, MD.

Hopefully this position sticks around, even after the pandemic passes, because burnout and mental health have been issues in the healthcare field all along.

Healthcare organizations must ensure Nurses are equipped with resources and the support they need to provide quality care. Hospitals must invest in initiatives that attract and keep Nurses, such as:

• Developing An Employee First Culture

Dr. Linda Shell, DNP, MA, BSN, DNS-CT, Chief Learning Officer suggests Nurse leaders cultivate an “Employee First Culture” approach in their facilities.

“An Employee First Culture is built on the concept that employees are the best asset of any company, and they need to be encouraged and appreciated,” says Dr. Shell. “When appreciation goes up in an organization, quality tends to go up. I really believe that for us as Nurses, the more we can do to create a positive work environment and develop our leadership skills, the more opportunities we are going to have to improve the quality of care that we provide every day for patients, as well as the residents that we serve.”

• Staff Recognition Programs

"A person who feels appreciated will always do more than what is expected." This quote has been scientifically proven to be factual. 

According to research, giving thanks can have important implications for encouraging actions that promote cooperation.

Whether it be a hand written note, or a brief one on one meeting, managers should take the time to recognize the hard work Nurses are putting in.

Recognizing Nurses on their birthdays and work anniversaries is a simple way for organizations to show appreciation for their staff.

Celebrating Nurses with a themed party or gift bags is another way to give thanks.

According to Nursing Management, realistically, quarterly recognition will suffice for larger units; however, if you have a small unit, monthly recognition is recommended.

• Mental Health Resources

Many Nurses are experiencing severe, adverse mental health effects as a result of the pandemic, and a lot of them are considering leaving the profession entirely.

Organizations must support employee self-care by establishing evidence-based preventive strategies, providing mental health resources, and demonstrating that leadership supports and prioritizes mental health and well-being.

Some health systems are hiring a Chief Wellness Officer (CWO) to support their wellness initiatives.

Dr. Maureen “Mo” Leffler, the first enterprise-wide CWO at Nemours Children’s Health said, “The goal of the Chief Wellness Officer is to promote professional well-being, which is characterized by having everything in place in both the individual and in the system, so those two things work together optimally. When we do that, we can provide the highest quality of care, the safest care, the best care. We can derive meaning in the work we’re doing.”

• Tuition Assistance Programs

Tuition reimbursement is becoming a popular way for hospitals to attract and retain quality Nurses, especially in areas where demand is high. 

These programs are designed to help Nurses continue their education by relieving some of their financial stress.

• Good Communication

Routine unit or individual staff meetings should be held to discuss any issues or concerns. Nurses want to feel heard. So it's important management truly listens to what they have to say and then set up action plans and follow up.  

• Flexible Work Hours

According to a recent McKinsey survey, Nurses that experienced more flexibility in hours and scheduling during the pandemic were highly interested in retaining that flexibility going forward. For Nurses who indicated plans to stay in their current direct patient care role, flexibility in hours and shifts was an influential factor.

Bottom line, health systems must prove to their Nurses that they are Valued, Appreciated, Heard, and Supported if they want to keep them. There are thousands of Nursing opportunities out there and you must work to retain the Nurses you have. This is just as important as recruiting Nurses.

It's no secret Nursing is a stressful and physically demanding career. High stress levels can affect your health and well-being. However, there are ways to manage your stress. Consider some of these techniques.

Try keeping a journal, or note times when you don't feel your best and jot down what might be contributing to that feeling. For example, if you're running low on energy it could be from lack of proper sleep or nutritional foods in your diet. 

Some breathing techniques developed to reduce stress include:

• 4-7-8 technique: Breathe in for four seconds with the nose, hold for seven, and breathe out for eight through the mouth.
• Belly breathing: Place one hand on the belly and one on the chest, feeling the belly move and the chest remain still while breathing in through the nose and out through the mouth.
• Breath focus: Use a picture or phrase to aid in relaxation, such as picturing the air as calmness.
• Equal time: Count the breaths in equal time, such as five seconds, for inhaling and exhaling.
• Modified lion’s breath: Breathe in through the nose, and out through a wide open mouth with a “ha” sound.
• Progressive muscle relaxation: Tense and relax muscle groups in succession while breathing in and out.

Calm the mind. Mediation goes hand in hand with deep breathing. One of the biggest barriers to meditation is that people don’t know where to begin. Start with small goals like 2 minutes every day for a week, then increase your time slowly from there. 

Find a quiet space, get comfortable, then set your timer. Focus on your breathing or chosen mantra. A mantra is a word, phrase, or sound repeated it in your mind continuously. 

Thoughts will float in and out of your mind. Acknowledge them then let them go. The goal of meditation is to keep your focus on one thing. 

If you have trouble practicing on your own, there are many guided mediation apps and online videos to help. 

Recharge your batteries. As you know, lack of sleep is a major stress factor. To achieve better sleep, try the deep breathing and meditation exercises mentioned above, right before bed, as well as these suggestions:

• Don't consume caffeine, alcohol, or food for at least 3 hours before bedtime.
• Establish a consistent sleep schedule/routine.
• Avoid electronics for at least 1 hour before bedtime.
• Try rubbing lavender essential oils on your temples or pillowcases. 

Get your blood pumping. Almost any form of exercise or movement can increase your fitness level while decreasing your stress. The most important thing is to pick an activity that you enjoy. Exercise boosts your endorphins and helps release physical tension.

Enjoy A New Hobby. Hobbies are a great way to relieve stress because it shifts your focus on to something that makes you happy. It doesn't have to be time consuming. It could be watching a funny movie/tv series, reading a book, or knitting. 

Seek Help. If the stress is becoming too much for you to handle on you own, it's okay to seek advice or counsel from a loved one or a trusted mental health professional.

Because you are a Nurse, you often care for others without stopping to care for yourself. This ideology needs to change. It's extremely difficult to provide quality care for others when your own mental health is suffering. Be sure to take care of YOU too!

The School Nurse shortage is not a new issue. The pandemic highlighted the importance of having School Nurses. As schools across the nation open back up,
concerns are again rising.

The US Centers for Disease Control and Prevention (CDC) recommends schools have one full-time Nurse for every 750 students.

The latest data from a study, published in the Journal of School Nursing in 2018, found approximately 39% of schools employ full-time Nurses and about 35% employ part-time School Nurses, while 25% do not employ School Nurses.

With out School Nurses, teachers and staff with no medical training would be responsible for providing care such as dispensing medication, managing allergies and asthma, and monitoring blood glucose levels.

Not only are School Nurses responsible for providing care, they also play a vital role in the management of COVID-19 safety protocols and updating staff and parents.

According to a survey from the National Association of School Nurses (NASN), 78% of School Nurses say they took time to review data to see new trends in COVID infections. The survey shows 43% of Nurses spent time updating and developing school health policies and nearly half said they were spending time answering phone calls from parents and the community.  

“I spend most of my day dressed up as a ghostbuster in personal protective equipment,” Rhonda Cranford, a School Nurse at Northside Elementary with 34 years of experience, shared. “I’m answering the phone constantly with questions regarding isolation and quarantine. I spend hours documenting and sending emails. Ninety-five percent of my day is consumed by COVID activities.”  

Many schools have a tight budget and can lack the funding needed to hire a School Nurse.

Laurie G. Combe, NASN President said, “When budgets are tight, administrators make decisions to hire Teachers over Nurses, but what many administrators don’t understand is that having a Nurse on staff can actually save dollars."

A glimmer of hope arose in May when the Biden administration announced the American Rescue Plan. The Plan includes dedicated funding of at least $500 million to hire School Nurses to help schools safely reopen and remain open for in-person instruction.

It’s important to remember there is a Nursing shortage across the country. School districts are competing against healthcare organizations for Nursing applicants where wages in hospitals and other settings tend to pay more.

Between the Delta variant, mask protocols, and vaccine mandates, schools need Nurses now more than ever. 

As the U.S. population becomes more racially and culturally diverse, having a workforce that mirrors the diversity of your community can improve the quality of care offered at your facility.

Ensuring diversity is incorporated in healthcare hiring practices requires understanding and combatting unconscious biases.

Bias is a prejudice in favor of or against one thing, person, or group compared with another usually in a way that’s considered to be unfair.

Unconscious biases are social stereotypes about certain groups of people that individuals form outside their own conscious awareness.

An example of unconscious bias during the hiring process is when you form an opinion about a candidate based solely on first impressions, such as their LinkedIn photo, their first or last name, or their hometown.

There are methods healthcare institutions can use to identify and reduce biases within their hiring process.

• Clearly define what Diversity means to your organization. It is important to understand which groups are underrepresented. Then set measurable goals that work toward building Diversity.
  
  
• Most hiring processes are designed from one perspective (e.g., level, function, identity). When creating your recruitment process, make it a group effort using input from different perspectives and identities. 
   
• Ensure Diversity exists within all levels of your organization, especially Leadership roles. The top healthcare organizations leading the way for Diversity, Equity, Inclusion, and Belonging (DEI&B) usually have a leadership position solely focused on Diversity, such as Chief Diversity Officer or a similar title.
  
  
• Offer awareness programs, training, and unconscious bias resources for staff. It's a great opportunity for everyone involved in the hiring process to understand what hiring prejudices are and how they can influence decision making. This allows people to identify their own biases and actively improve their behavior. 

With leadership support, clear communication both internally and externally about your DEI&B initiatives, awareness resources, and a motivated workforce, you can successfully reduce biases and increase Diversity, Equity, Inclusion, and Belonging within your organization.