Annual CNO Roundtable - National Nurses Week 2017

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Annual CNO Roundtable - National Nurses Week 2017

Chief Nursing Officers on balance, self-care and the importance of a supportive nursing team

By Aaron Severson
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There’s no nursing equivalent of the old proverb, “Physician, heal thyself,” but there probably should be. Although every nurse knows the value of adequate self-care, putting the ideal into practice is often easier said than done, contributing to physical and emotional burnout.

As part of our celebration of National Nurses Week 2017, whose theme is “Nursing: The Balance of Mind, Body and Spirit,” Working Nurse decided to focus our annual CNO round table on the ways nurses can revitalize themselves. As the Redland Community Hospital’s motto says, “If you are empty, you have nothing left to give.”

Here’s what our distinguished panel of chief nursing officers had to say about the challenges of seeking balance — and what their organizations are doing to help.

 

Suzie Reinsvold RN, MSN Chief Nursing Officer/Chief Operating Officer Martin Luther King, Jr. Community Hospital, Los Angeles

First, tell us a few things that are going on at your hospital of which you’re especially proud.

MLKCH is relatively new, but already we have a team of very bright nurses and leaders. Because we are still new, we’re putting innovative technologies in place right from the beginning rather than having to build on or modify legacy systems. That’s something we want to continue.

What do you think are impediments to nurses achieving mind/body/spirit balance?

Nurses are by nature givers, but because the needs of our patients are so great and complex, it’s not uncommon for nurses to experience both physical and compassion fatigue. We can guard against both by engaging in self-care activities and by learning to recognize when it’s time to take a break. That break may be something as simple as taking a few days off or giving each other permission to “take care.”

What policies does your hospital have to support nurses mentally, physically and spiritually?

For mental support, we offer training and education programs, plus tuition reimbursement. For physical support, our cafeteria has the healthiest food in town. We also have a morning running club and offer discounted gym memberships. As for spiritual support, we have the peace of mind and comfort that comes from knowing our work is meaningful to the community we serve. Please share with us how you create balance for yourself.

Are there any self-care lessons you’ve learned that you wish you’d known at the beginning of your career?

Early in my career, I worked in critical care and took care of a lot of trauma patients. The emotional impact can be consuming because the injuries can be so horrific and patients sometimes don’t survive. I let that get to me and almost burned out. I learned that I have to make time for me, to spend time laughing with family and friends. If I could pass anything on to new nurses, I’d tell them, “Balance your work with your life.”

 

Karen A. Grimley RN, Ph.D., MBA, FACHE Assistant Dean/Chief Nursing Executive UCLA Health, Los Angeles

First, tell us a few things that are going on at your hospital of which you’re especially proud.

I am especially proud of our nurses — their commitment to our profession and patients is palpable. Several examples include our patient satisfaction scores, which hover around the 90th percentile; receiving the National Patient Safety Foundation DAISY Award; and Magnet recognition — for the third time for Ronald Reagan UCLA Medical Center and the very first time for UCLA Medical Center, Santa Monica. I could go on, but it all comes down to the people, our staff, making a difference at UCLA Health and for our community.

What do you think are impediments to nurses achieving mind/body/spirit balance?

Walt Kelly’s classic comic strip character Pogo said it best: “We have met the enemy and he is us.” This is probably the No. 1 barrier to nurses achieving work-life balance: So many of us focus on others that we seldom put ourselves or our needs first.

What programs or policies does your hospital have to support nurses mentally, physically and spiritually?

We are fortunate to have generous benefits and a number of initiatives and programs that allow us to pursue balance, including a mindfulness program; a zero-tolerance policy on bullying and harassment; and new policies and services to support the “second victims” of traumatic events. However, we must give ourselves permission to participate wholeheartedly.

How do you create balance for yourself?

I am not a good role model, but I have learned that I am the only one who can make work-life balance happen for me. I have set boundaries: I schedule time off, time away and actual vacations. I also make time on the weekends for kids, spa treatments and tennis.

 

Rhonda R. Foster RN, Ed.D., MPH, M.S., NEA-BC Interim Sr. VP, Chief Nursing and Patient Services Officer City of Hope, Duarte

Tell us a few things that are going on at your hospital of which you’re especially proud.

Engaging the clinical nurse in problem-solving at the bedside and shared decision-making in the hospital. Also, our commitment to patients and families, the focus on excellence and our journey to Magnet recognition.

What do you think are impediments to nurses achieving mind/body/spirit balance?

Taking care of others doesn’t end at the end of the shift. Most nurses leave a shift and immediately focus on the next item of the day, whether it’s cooking dinner, shopping, cleaning, taking care of family or preparing for other professional or personal obligations like volunteering. Our minds never stop, which sometimes makes it hard to recognize the importance of balance.

What programs or policies does your hospital have to support nurses mentally, physically and spiritually?

Our nurses support one another with activities outside work. Some of our nursing units have activities such as annual beach trips. Others have created self-care boards. They take time to thank, encourage and comfort each other, such as allowing a nurse time to cry after experiencing the death of a patient. We also offer “Tea for the Soul,” which is a debriefing session for our nursing staff after a difficult situation, and memorial services to honor patients who have passed away during the previous six months.

Please share with us how you create balance for yourself. Are there any self-care lessons you’ve learned that you wish you’d known at the beginning of your career?

I create balance for myself by having a spiritual life. My faith serves as the foundation for everything I do. I also do things just for me, like manicures, facials, pedicures and massages. I’ve realized it’s important to have me time. The lesson I wish I’d known is to be mindful of the experiences you have while you are in them and not be worried about tomorrow, next week or what happened yesterday or last year.

  

Marcia Anderson RN, B.S., CCM, CDMS Chief of Medical Services Inland Empire Health Plan, Rancho Cucamonga

Tell us a few things that are going on at your organization of which you’re especially proud.

Our health plan is embarking on a practice transformation, integrating behavioral and medical care with complex care case management. We are on the forefront of innovative Medicaid plans and are constantly being asked to participate in studies and projects to promote quality care. Also, we are creating pain management and transgender centers of excellence.

What do you think are impediments to nurses achieving mind/body/spirit balance?

There is a lot of pressure in nursing today: more requirements, a broader depth of required clinical acumen and evolving technology. When you are giving so much energy to your career, it is easy to forget to do healthy things for yourself, or to fail to realize when you need help. The great advantage nursing offers is the flexibility of different career choices with varied hours and responsibilities. The trick is to recognize when you need a change!

What programs or policies does your organization have to support nurses mentally, physically and spiritually?

Work-life balance is part of our core as an organization. We strive to keep our employees well, physically and emotionally. We offer some home office work to help balance mind-body-spirit and we also have a strong wellness program. We recently purchased a new property for a gym and daycare center.

Please share with us how you create balance for yourself.

I did not achieve that balance until I was forced to do so. Early in my career, I never viewed working on a weekend or being on call as a burden. I just tried to tread water as fast as I could. I learned when my mother came to live with me that I had to leave work on time to care for her in the evenings. I realized that I still met my deadlines and actually achieved more when I worked a normal schedule — I plan better and prioritize to ensure the job gets done in the hours I actually work.

 

Downapha Britton RN, DN Chief Nursing Officer Coast Plaza Hospital (Avanti Hospitals), Norwalk

Tell us a few things that are going on at your hospital of which you’re especially proud.

I’m so proud that we recently achieved Primary Stroke Center certification. We have an incredible, hardworking team. Together, we’ve accomplished so much and I’m proud to be a part of it.

What do you think are impediments to nurses achieving mind/body/spirit balance?

Today’s nurses are facing dynamic changes in the healthcare industry. Most of us do not like change, especially if things have been working fine for years. The current healthcare system can be very confusing because of the uncertain economic situation, limited availability of resources, constant regulatory changes, low reimbursement for medical services and high healthcare costs.

What programs or policies does your hospital have to support nurses mentally, physically and spiritually?

As a leader, I strive to show staff appreciation with words, understanding and service awards. We also teach and encourage nurses to practice AIDET [Studer Group’s “Acknowledge/ Introduce/ Duration/ Explanation/ Thank You” framework] with coworkers as well as patients. We have a wellness program, Avanti Go, that’s designed to lower health premium costs and assist employees in improving habits, such as smoking cessation, better nutrition and increased exercise. We have onsite classes and a “Tickets at Work” program that offers deep discounts on travel, entertainment and more.

Please share with us how you create balance for yourself.

Maintaining a healthy lifestyle, thinking through your options and making a realistic plan can go a long way in making the best use of your time.

 

Karen T. Descent RN, MSN, CEN Chief Nursing Officer Parkview Community Hospital, Riverside

Tell us a few things that are going on at your hospital of which you’re especially proud.

We are one of only about 400 hospitals in the nation that are designated “baby-friendly.” We are one of Blue Cross and Blue Shield’s designated Blue Distinction Centers for joint replacement and bariatric surgery and we have one of only four Joint Commission certified palliative care programs in California.

What do you think are impediments to nurses achieving mind/body/spirit balance?

I think nurses forget to care for themselves. They give so much of themselves to their patients and families, but don’t take time after work to heal and rejuvenate. At a recent meeting of the Association of California Nurse Leaders, author Laura van Dernoot Lipsky [of the Trauma Stewardship Institute] talked about the need to develop a “mindful presence” and know that presenting our best selves to help others includes taking care of ourselves.

What programs or policies does your hospital have to support nurses mentally, physically and spiritually?

Here at Parkview, there is a real sense of family. We support each other in both the good times and times of crisis and we bond together to form a true sense of community. The executive team is working on exciting new plans to grow this feeling. We recognize that our nurses are our patients’ healing hands and we plan to acknowledge nurses’ achievements while developing ways to care for them.

Please share with us how you create balance for yourself. Are there any self-care lessons you’ve learned that you wish you’d known at the beginning of your career?

My, isn’t hindsight always 20/20? I have four children and a 6-year-old grandson, so balance at the beginning of my career was a juggling act. I learned that no matter how busy work is, I need to leave it at work and focus on my family. My family will ask how my day is, which gets five to 10 minutes when I get home. Then, the focus shifts to where it needs to be: family time. For personal self-care, I indulge in lunch with friends and pedicures twice a month. As nurses, we spend so much time on our feet!

 

Derek Drake, RN, DNP, NE-BC, CNML, CNL Chief Nursing Officer St. Francis Medical Center, Lynwood

Tell us a few things that are going on at your hospital of which you’re especially proud.

Among the things I’m most excited about is the restructuring and reenergizing of our new-graduate program, which will provide foundational knowledge and skills for nursing excellence. I am equally excited about the reintroduction of the DAISY Award Program so we can recognize nurses who go above and beyond for patients and families.

What do you think are impediments to nurses achieving mind/body/spirit balance?

As nurses, we are wired and trained to care for others physically, emotionally and psychologically. We have an inherent tendency to ignore our own needs and put others before us, often at the expense of our own mind/body/spirit balance.

What programs or policies does your hospital have to support nurses?

Our peer diffusing tool provides a process for reviewing incidents and issues to discuss what went well, what needs improvement and how those involved are feeling. It also provides an opportunity for debriefing and allows nurses to share input and receive feedback. We also have a workplace safety/violence prevention committee that assesses policies and practices on an ongoing basis to make recommendations for how we can create a safer workplace for patients and staff.

   

Aries J. Limbaga, RN, DNPc, MBA, CRRN Chief Nursing Officer Rancho Los Amigos National Rehabilitation Center, Downey

Tell us a few things that are going on at your hospital of which you’re especially proud.

We recently started on our Magnet journey. I am so proud of our nurses, who have developed our professional practice model and are leading the way on our shared governance structure. This has made such a positive change in our nurse engagement, patient outcomes and professional practice. For instance, within the last year, our nurse-driven protocols have reduced falls by 50 percent and hospital-acquired pressure ulcers to fewer than one per 1,000 days. Our sepsis protocol has saved more than 200 lives since inception.

What do you think are impediments to nurses achieving mind/body/spirit balance?

We are constantly putting others first. At work, we spend our shifts providing emotional, physical and mental care to our patients. We do the same when we are at home with our families. It is all too easy to forget about ourselves. It may seem to contradict the ethos of our profession, but nurses need to set aside time for themselves and let the mind, body and spirit rejuvenate.

What programs or policies does your hospital have to support nurses mentally, physically and spiritually?

We recently opened a new wellness center that is open to all staff. The center has a pool, fitness equipment and yoga and Pilates classes. It’s a great opportunity for nurses to take care of themselves. It’s also a wonderful way for staff and former patients to interact and socialize. Please share with us how you create balance for yourself. Remember, the work you do is important and has an impact. As a leader, you need to allow yourself time to regenerate and replenish your energy so you can continue to be an effective and valuable team member. Take care of yourself, your family and your friends. Work will always be there.

 

Bobbie McCaffrey RN, M.A., NEA-BC Vice President/Chief Nursing Officer Methodist Hospital of Southern California, Arcadia

Tell us a few things that are going on at your hospital of which you’re especially proud.

Methodist Hospital received the CMS five-star quality rating, the only hospital in L.A. County to receive this honor. For me, it is an honor and a privilege to work in such a high-caliber organization.

What do you think are impediments to nurses achieving mind/body/spirit balance?

Nursing requires focus and engagement, so nurses often put the needs of others before their own and find it difficult to disengage. I once read an article by Kathleen Mullen, RN, Ph.D., that mentioned that nurses can use their knowledge to “nurse the nurse within.” That resonated as a starting place for enhancing work-life balance.

What programs or policies does your hospital have to support nurses mentally, physically and spiritually?

We offer a gym, an employee assistance program, meditation programs, Tea for the Soul, the DAISY Award and pet therapy. Please share with us how you create balance for yourself. I find work to be invigorating! But, I have always been an avid reader and enjoy classic movies and spending time with my husband and our shelter rescue pups.

 

Margaret C. Pfeiffer RN, MSN VP, Patient Care Services and Chief Nursing Officer Good Samaritan Hospital, Los Angeles

First, tell us a few things that are going on at your hospital of which you’re especially proud.

Good Samaritan recently received certification as a Comprehensive Stroke Center. We are one of five hospitals in L.A. County to achieve this status. We knew this was a community need and we as an organization decided to make the investment. We are very proud of the team that worked tirelessly to make it happen.

What do you think are impediments to nurses achieving mind/body/spirit balance?

Nurses come into the profession because they want to give to others. It is not unusual for nurses to focus all their energy on caring for others at the expense of caring for themselves. Work places a lot of demands on nurses: patients’ needs, anxious families, busy physicians and a never-ending stream of documentation. Often, those demands continue after work as nurses deal with the needs of their families.

Are there any self-care lessons you’ve learned that you wish you’d known at the beginning of your career?

It is important for nurses to take a few minutes each day to find a moment of peace.

 

Pattie Soltero Sanchez RN, BSN, MAOM Chief Nursing Officer and Chief Nursing Information Officer Los Angeles County-Harbor/UCLA Medical Center, Torrance

Tell us a few things that are going on at your hospital of which you’re especially proud.

Harbor-UCLA has implemented TeamSTEPPS [the Agency for Healthcare Research and Quality’s Team Strategies & Tools to Enhance Performance & Patient Safety model] in many areas of our hospital. Our physicians and nurses teach these classes side by side, which has improved communication and patient care processes. We are currently on a “lean” journey: Harbor-UCLA is partnering with Toyota to incorporate the Toyota Production System and lean principles into our process improvement activities, which has helped to clarify and refine our nursing units, clinics and workflow.

What do you think are impediments to nurses achieving mind/body/spirit balance?

Busy lives! First, today’s nurses are busy parents. Second, we are also students. More than ever, nurses are going back to school to obtain advanced degrees. However, it is important to remember that different elements of our lives tip the scales to different degrees at different times. As nurses, we have the ability to maintain balance in ways that may seem unbalanced to others. We adapt with each shift and assignment because there are no repeats. Every day is new, variable, emotional and full of surprises.

What programs or policies does your hospital have to support nurses mentally, physically and spiritually?

Our social workers, chaplains and psychiatric providers deploy to our staff in times of crisis, providing mental and spiritual support as needed. Harbor-UCLA also conducts Schwartz Rounds, which provide our nurses with a regular forum to openly, honestly talk about social and emotional issues related to patient care. Our hospital also supports nurses by participating in various recognition standards and by serving meals to working nurses during National Nurses Week.

Are there any self-care lessons you’ve learned that you wish you’d known at the beginning of your career?

I wish I had learned to better say “maybe” or “let me think about” it. I often feel pressured to make rapid decisions when most times, the task or answer can wait. As a new CNO, I am learning to take a moment to breathe before making a decision on a commitment or project that might make me temporarily unbalanced. I still say “yes” more than I probably should, but I am trying. My other advice: Make family a priority and rest when you need to rest. Take naps!

 

Lauren Spilsbury RN, MSN Vice President, Patient Care Services Redlands Community Hospital

We have many exciting things happening. For example, if you were a preoperative patient, how would you like to be prepped in a pre-warmed bed and provided aromatherapy while watching lovely nature scenes and listening to calming music? Another item our ED is working on is patient experience “Care Cards” that help patients know what is happening to them during their stays and how much longer it could be. This is just the tip of the iceberg — we have a lot going on, including initiatives based on research by our nurses.

What do you think are impediments to nurses achieving mind/body/spirit balance?

Nurses feel they must keep giving in order to meet expectations and forget to take care of themselves in the process. At RCH, we say, “If you are empty, you have nothing left to give.”

What programs or policies does your hospital have to support nurses mentally, physically and spiritually?

We’ve adopted Jean Watson’s Caring Theory principles. Our nurses are encouraged to practice self-care to be able to fully meet the needs of others. We also think teamwork is incredibly important; if you do not have that team working together, it is just too hard. We use many complementary therapies for patients and staff. We maintain a stock of aromatherapy and try hard to minimize visual and noise pollution. We’ve invested in educating staff in therapeutic touch and tapping techniques [also called Emotional Freedom Techniques, or EFT]. Each department has a Serenity Room for staff to use to re-center themselves in order to better care for both themselves and their patients.

Please share with us how you create balance for yourself.

Exercise is my gift to myself. It helps reduce or eliminate stress. I work long hours, so exercise is essential to my ability to cope effectively as a nurse leader. Also, I spend weekends out of doors, since I spend so many hours inside the hospital during the week. I love spending time in nature.

 

Helen Staples-Evans RN, DNP, NE-BC Chief Nursing Officer Loma Linda University Children’s Hospital

Tell us a few things that are going on at your hospital of which you’re especially proud.

We broke ground on our new hospital towers and began our journey to Magnet recognition with the formation of professional governance councils on 100 percent of our units. Since 2013, we have also had a paid, fulltime nursing leadership residency program, which gives baccalaureate-prepared nurses the opportunity to develop leadership and management skills in multiple departments and disciplines over a two-year period. All of our residents have transitioned into leadership positions.

What do you think are impediments to nurses achieving mind/body/spirit balance?

We live in a world of distractions and hurry. Many nurses are trying to balance being a spouse, raising children and caring for elderly parents. Some have also stretched themselves financially by taking on debt. We have to make a conscious choice to slow down, schedule time to exercise, plan time to play and be with our families. Living a life of wholeness is a decision — it doesn’t just happen.

What programs or policies does your hospital have to support nurses mentally, physically and spiritually?

Through our nursing residency program, we offer debriefing groups for new nurses, led by a spiritual care or mental health professional along with a nurse. This has been a helpful forum for discussing issues that can often discourage new employees. When a difficult event occurs on one of the units, chaplains and team members from our employee spiritual care and employee assistance programs form staff support teams, which take healthy snacks to the departmental break room and talk with nurses as they come in for support. Each spring, a day of renewal is offered for all employees. This is an off-campus opportunity to refresh spiritually and emotionally. We also begin each January with a week of renewal, offering a number of spiritual programs on campus and via live streaming. Beyond that, we have a fitness center that all fulltime employees can join free of charge, a host of free educational opportunities for employees and free mental health and spiritual support resources for all staff.

Please share with us how you create balance for yourself.

Exercise is so important. However, I did not realize until later that going to a gym does not work for me. Now, I walk, which gives me time to listen to music, breathe fresh air and think. It’s also important to prioritize family time on your days off. Being involved with your community and faith group is another wonderful way to decompress and nurture lasting relationships. 

This article is from workingnurse.com.

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