Changing Unit Culture and Fostering Well-being of Staff

INTRODUCTION: The key role of healthcare leaders is to create and sustain an environment that optimizes high-quality, safe, and effective patient-centered care. The leader's role is to ensure the best possible physical environment and provide a culture that supports healthcare team members in the stressful work of providing direct care. A positive approach is to empower nurses and other health team members with effective skills and techniques to help them transform stressful situations into more therapeutic scenarios. METHODS: The nursing leadership team decided to test an approach to positive coping and resiliency designed to teach individuals on the oncology unit to recognize their stress symptoms and to use learned skills to counteract the negative impact of stress. Sixty-three participants voluntarily participated in the HeartMath educational class where they were taught techniques that could be used “in the moment” and throughout the day. A champions group was then identified to develop tools that would be used on the oncology unit to keep these techniques at the forefront of the staff's mind throughout each day. Staff members were encouraged to use the tools every day. RESULTS: Staff members were surveyed using the Personal and Organizational Quality Assessment survey pre-intervention, post-intervention, and again at 7 months post-intervention. Results at the 7-month post-intervention showed statistically significant differences for each of the personal indicators (positive outlook, gratitude, motivation, calmness, fatigue, anxiety, depression, anger management, resentfulness, and stress symptoms). The organizational indicators at the 7 month post-intervention all trended in the expected direction, but only statistically significant differences were found in the indicators of goal clarity, productively, communication effectiveness, and time pressure. Other areas of improvement noted were decreased turnover on the oncology unit, improved employee satisfaction scores, and patient satisfaction scores with nursing care. CONCLUSION: Changing unit culture and fostering well-being of staff begins with nursing leadership. Recognizing that nurses and health team members are stressed, we implemented HeartMath as a team approach with staff taking an active role as champions to bring out ideas to keep the techniques at the forefront of everyone's mind everyday. By encouraging use of these tools at work, personal and organizational gains were found that were beneficial for the staff as well as the organization.