“We heard you.” This is the message of a wellness initiative launched by UCLA Health nursing that is aimed at reducing work-related stress. The proposal is based on a 2021 research study developed by a team of clinical nurse co-investigators from the Professional Development Council’s Wellness Subcommittee and leaders from the Center for Nursing Excellence who conducted a current-state assessment of UCLA Health caregiver well-being and collected recommendations for interventions using validated assessment tools.
More than 1,200 nursing caregivers shared their voices through the survey, providing recommendations that have been used to drive meaningful organizational change. Validated tools were used to measure compassion satisfaction, compassion fatigue, burnout, secondary traumatic stress, and meaning and joy in work. Caregivers provided detailed responses to open-ended questions about what caused them stress at work and what the organization could do to help.
All members of the study team participated in an extensive review of the qualitative and quantitative data, utilizing this information to develop, implement and advocate for interventions. Top responses identified staffing, schedules and assignments, patient care concerns and work environment as top stressors. Recommendations to manage work-related stress included help with challenging patients and families, offering massage therapy and providing respite and break spaces.
The team surpassed its goal of implementing at least three interventions in 2022. “The study was so powerful because it was driven by a partnership from executive leadership and clinical nurses to capture and hear the voices of all nursing caregivers at UCLA Health,” says Kelley Anderson, MSN-Ed, RN, nursing professional development practitioner with the Center for Nursing Excellence.
Work in progress includes:
- A rotating massage-therapy program across units and shifts;
- Increased rounding with the PaUse cart for just-in-time stress reduction;
- Wellness resource kits for each unit;
- Increased float pool hiring;
- Additional staff to fill functional vacancies related to leaves of absence, sick calls and delays onboarding new staff;
- Creation of a nurse well-being coordinator position;
- Exploring respite spaces and break rooms at Ronald Reagan UCLA Medical Center and UCLA Santa Monica Medical Center; and
- Launch of “A Safer U” initiative focused on promoting a safer, healthier work environment.
The changes are expected to make a meaningful impact, “enabling our nurses to continue to do the work that brings them meaning and joy while making a difference in outcomes for patients, their families and our communities,” says Lee Galuska, PhD, RN, NE-BC, executive director of the Center for Nursing Excellence.
Focus on Relationship-Based Care
“We’re not effective with our patients and families if we’re not taking good care of ourselves” is a mantra at the forefront of the work Anderson does in Relationship-Based Care and Nursing Professional Governance. In 2022, that work was highlighted by:
- A health and wellness page with resources for caregivers developed by the Nurse Wellness and Healthy Work Environment subcommittee;
- A Relax and Reset event, offered through a partnership with Inpatient Integrative Therapy, where nurses and care partners could participate in group meditation, and receive reiki and aromatherapy;
- Unit Practice Council (UPC) Summit professional posters focusing on implementation of unit-based interventions to fight burnout, manage stress and improve staff morale, several of which have been invited to present at national conferences;
- UPC projects focused on improving collegiality through team-building exercises, planning events and employee recognition; and
- Expansion of the Nursing Leadership Fellowship Program to include wellness strategies.
Focus on patient wellness
Nurse well-being and patient wellness go hand-in-hand and the Wellness Bundle Committee continues to identify ways to enhance patients’ hospital visits and improve outcomes. Highlights of these efforts include:
- Sleep carts: Staffed by volunteers at Ronald Reagan UCLA Medical Center, each cart has a sleep-tips card, chamomile tea, eye masks and ear plugs. UCLA Santa Monica Medical Center provides identical items at nurses’ stations;
- Ear buds: These work with the bedside iPads in every room allowing patients to listen to sleep-assistance and music apps;
- Music therapy: For patients who prefer to be lulled to sleep by live music, a music therapist will play guitar and sing. “The patients love it,” says Theresa Kirkpatrick, MSN, RN, CCRN, CPNP, CNS, an advanced-practice manager in the pediatric critical care and pediatric cardiothoracic units at UCLA Mattel Children’s Hospital. “They wish they could have it more often;”
- Mobility: Units compete to see which can mobilize its patients more often and consistently. Kirkpatrick says the friendly competition is intended to help patients heal faster. “The goal is to mobilize more often so their muscles won’t be deconditioned and, hopefully, they’ll get out of the hospital sooner;”
- Upgraded menus: Provide a broader selection of culturally diverse meals that focus on fresh fruits and vegetables from local growers. Pastries and breads are now made on campus;
- Hygiene: Offering culturally appropriate hygiene items including hair products, combs, brushes and lotions make it more likely for patients to ask for a soothing bath or to have their hair shampooed; and
- Oral hygiene: Special toothbrushes and toothpaste are available for patients with sensitive gums.
“The wellness enhancements have been well-received by staff and patients,” Kirkpatrick says. “We’re continuing to expand the program beyond the initial improvements.”