86% of 7,000 participants in last year's program trial applied the strategies they learned to their work or personal life.
A prevention program that reduced burnout in more than 52% of pilot program participants is now available as a permanent benefit to the entire American Nurses Association (ANA) membership.
“It has been over two long years since COVID-19 became part of our lives and the strain on nursing and the profession is profound,” Loressa Cole, DNP, MBA, RN, FAAN, NEA-BC, chief executive officer of ANA, said in announcing the new Burnout Prevention Program benefit.
“Recent data finds 84% of registered nurses are experiencing burnout and only 42% of nurses feel their employer values their mental health,” she said. “ANA wants to help our members by making a great resource easily available.”
Nearly 7,000 ANA members signed up for the program during last summer’s trial, with these results:
52% of members surveyed claimed the program reduced their sense of burnout.
86% applied the strategies they learned to their work or personal life.
90% were satisfied with the Burnout Prevention Program.
95% asked ANA to add it as a permanent member benefit.
The program, developed by SE Healthcare, a healthcare data analytics provider, gives nurses on-demand access to more than 190 “bite-size” videos on real-world challenges faced by nurses, with such topics as Building a Better Day Off; Delegation—What a Revelation; Shared Governance; and Ethical Dilemmas.
The program, available on a mobile app, also includes a continually updated reference library of peer-reviewed, scholarly articles that support evidence-based interventions, Cole said.
“Not only can you create an individualized well-being care plan, but you can also earn up to 22 free continuing education credits,” she said.
“We chose the SE Healthcare program because it uses real-world clinical data by nurses who understand the day-to-day experiences of our members,” said Stephen Fox, ANA’s vice president of membership and constituent relations.
“We were also pleased to see that 86% of nurses said they have actually used a strategy in their work or personal life, which is a tremendous result for any program,” Fox said.
A confidential four-question assessment tool also assists in identifying the nurse’s top stressors that are a result of the work processes or environment, which are analyzed by demographics and location, and supported by a visual data dashboard, according to SE Healthcare.
The tool’s Summary of Findings report can help nurse leaders properly address and lower, or even prevent, burnout in their staff.
The burnout program also includes access to an anonymous survey, which Cole encouraged nurses to take, to “enable us to use the findings to advocate on behalf of nurses and drive change at the national level.”
USC's online program scored high in engagement, faculty credentials, peer assessment, and more, U.S. News & World Report says.
The University of South Carolina’s online masters in nursing program ranks No. 1 among online nursing master’s programs in U.S. News & World Report’s 2023 Best Online Programs, released today.
The No. 2 spot was a three-way tie. Duke and Ohio State University, who previously were No. 5 and No. 1, respectively, tied with the University of Alabama, which previously was No. 11. Saint Xavier University rounds out the Top 5.
The purpose of the Best Online Programs rankings is to measure whether online degree programs’ academic standards are consistent with quality brick-and-mortar programs and properly adapted toward the unique learning of distance education.
U.S. News ranked nursing schools using five categories. The categories, with its weight in the ranking formula were:
● Engagement (30%): Aspiring advanced practice nurses can readily collaborate with fellow students in their classes and clinical settings. Instructors are accessible, responsive, and help students stay enrolled and complete their degrees in a reasonable amount of time.
Factors included graduation rate, best practices, class size, one-year retention rates, and time to degree deadline.
● Faculty credentials and training (20%): Instructors’ academic credentials mirror those of instructors for campus-based programs, and they have the resources to train these instructors to teach distance learners.
Factors included preparedness to teach distance learners, terminal degree faculty, and tenured faculty.
● Peer assessment (20%): A survey of high-ranking academic officials in nursing helps account for intangible factors affecting program quality that statistics do not capture.
Factors included the school’s weighted mean of scores on a 1 to 5 scale as rated by administrators and academics at online master's in nursing degree programs.
● Services and technologies (20%): Programs that incorporate diverse online learning technologies allow greater flexibility for students to take classes from a distance. Strong support structures provide learning assistance, career guidance, and financial aid resources.
Factors included student indebtedness, support services, and technological infrastructure.
● Student excellence (10%): Student bodies entering with proven aptitudes, ambitions, and accomplishments can handle the demands of rigorous coursework.
Factors included acceptance rates, experience, and undergraduate GPA.
Flexible scheduling and new care models can help provide nurses the work-life balance they demand.
Getting creative with staffing and offering flexible scheduling to nurses are among the strategies that acute-care hospitals can adopt to keep the nurses they have and attract new ones, says a health system executive.
"Double shifts, erratic and inconsistent scheduling, and menial tasks are contributing factors that have led to a sense of imbalance and job dissatisfaction among nurses,” Bayless says. “This situation has worsened mainly due to COVID-19's ongoing impact on healthcare workers."
Bayless spoke with HealthLeaders about how flexible scheduling and new care models can help solve those contributing factors.
This transcript has been lightly edited for brevity and clarity.
HealthLeaders: What care models are being adopted to help with nurse retention?
Jill Bayless: Healthcare has eased into mostly an RN-driven staff model in hospitals and as COVID drove a lot of nurses out of hospitals, many retired, and a lot of them went traveling. It made hospitals look at different ways to take care of patients.
Hospitals within our systems are doing different models. One of them is what we call the dyad model, where you have a care team of an RN and certified nurse's aide or a PCT [patient care technician]—someone who is not licensed—working together. We’re using those models right now in some of our long-term acute-care facilities.
At our acute-care hospitals, we had to start looking at how we could still take good care of all these patients without having the RNs we had in the past. We call that the triad model. Some people who are senior careerists like myself used to call that the team model, which can be a variety of mixtures of staff. Generally, it is an experienced RN, and then inexperienced RNs or LPNs or LVNs—depending on what state you are in they are called different things—and then a PCT or certified nurse’s aide.
Some of our facilities were doing this before COVID because they couldn’t get enough RNs in their rural communities, but a lot of our larger hospitals that had shifted to all-RN staffing are, as they have an RN vacancy, asking, “Do we really need an RN for that? Can we use a very green, brand-new RN or could we use a seasoned LPN?”
Others are adding a respiratory therapist to that team so there’s a team of three people—two RNs and a respiratory therapist—taking care of sick patients. A lot of ICU patients are ventilated and require skills related to mechanical ventilation or CPAP machines and a respiratory therapist can do that. Respiratory therapy personnel are also very experienced in dealing one-on-one with patients.
HL: How do these care models benefit nurses?
Bayless: They know they are supported by someone who has more experience than they do. During COVID, brand-new RNs were coming out of school with very little hands-on experience and being put in situations where maybe they had the didactic knowledge, but none of the practical experience, so this model allows for those new RNs to learn under someone who is very seasoned and experienced.
That also allows for that charge RN to not be doing what I'm going to call mundane tasks—that doesn’t mean they aren’t important, but they’re things like doing blood sugar, taking linens, and helping patients to the bathroom. A certified nurse's aide or a PCT can do that.
It does involve the charge RN going around and meeting every patient at least twice a shift and then more often if they have something more critical going on, so they would still be assisting that LPN or new grad RN and assessing that patient and helping them understand the care needs or whatever that diagnosis is.
HL: When nurse leaders are considering changes, how should they best effectively adopt a new care model into their organization?
Bayliss: I don't know that this is the best way, but I can tell you how we are doing it here. We've engaged all of our CNOs, and our focus is to have a triad model or a dyad model, depending on what kind of hospital they are.
It really has to be driven by the CNO at the local level, along with the director of the unit where that change is being implemented, and you have to get input from your staff on that. The director of the unit and the CNO will talk about anticipated changes with their unit and listen to staff and hear their ideas about how it could work best there.
There’s no one-size-fits-all, and there never is in healthcare. Staffing, size of the unit, makeup of the unit, experience of the staff on all levels—all that has to be taken into consideration.
HL: How can flexible staffing create a more satisfied and engaged workforce?
Bayliss: Generally, what we see now is that staff are scheduled three 12-hour shifts, so for a single mother who has a daycare that’s open only 10 hours a day, they can't work those 12-hour shifts, or they have to find some interim solution that will allow for that child to be cared for in the hours outside of that daycare’s opening. Some facilities are looking at whether they can offer eight-hour shifts in addition to three 12-hour shifts to staff, and then someone to work all weekends, which is an old model, called the Baylor Model.
Other ways are hiring tele-nurses to help with things like admissions and discharges and medication reconciliation, all of which are time-consuming for the nurse on the unit. Nurses who can't do long shifts can work within a tele-nursing position.
I implemented “mother’s hours” some years ago to fill voids during the busiest time of day. We had busy times from about nine in the morning until about 2:30 in the afternoon and a lot of mothers with children in school were able to fill those positions because they could come in after they got their child on the school bus or dropped them off at school, and then they got off in time to be at home or to pick that child up.
Some facilities are doing a seasonal nurse schedule. Typically, in ICUs and intermediate care units, their busiest times of the year are September or October through about April or May. Based on the volumes of the unit, some facilities are offering seasonal work schedules where nurses could work about nine months, get full benefits, get full pay, but then be off in the summertime or whatever months are not as busy for those units. It still gives the staff that flexibility of having them when the volumes are hot, but not having them when they're not needed.
Those are all ideas, but what works in one market may not work in another market. You have to look at things that give some relief to that staff on the unit.
The Children’s Healthcare of Atlanta rooming-in program helps nurses to know 'we're not sending babies home into unsafe environments.'
An innovative rooming-in program for families of infants with critical congenital heart disease (CCHD) provided greater peace of mind not only for families, but for nurses as well, in preparing the infants for discharge, a new study reveals.
Children’s Healthcare of Atlanta’s pediatric cardiac acute care unit developed the program in 2019 so nurses could help the infant’s mother or caregiver learn and get comfortable with specific skills required for their complex care—safe medication administration, feeding regimens, respiratory management, wound care, and recognizing early signs and symptoms of worsening issues.
Indeed, taking home an infant with CCHD can be overwhelming for parents; research suggests that caregivers of children with CCHD experience higher levels of distress than do parents of healthy children, according to the study.
Many parents have said they were emotionally, physically, and educationally unprepared for discharge and felt fear and worry about the ability to properly care for their ill infant, the study says.
Rooming-in is designed to allow the mother to remain with their infant for 24 hours prior to discharge, as they learn a large amount of information in a short time and practice those unfamiliar skills under nurses’ guidance.
Findings, published in the American Journal of Critical Care (AJCC), included increased confidence in parents or caregivers, which translated to feelings of greater nurse confidence and satisfaction.
“It gives us more confidence,” one study participant wrote. “It gives us a sense of peace of mind, satisfaction to know that “OK, I feel good about that child going home; that mom really gets it!”
“[Rooming-in] builds [caregivers’] confidence; it also helps [nurses] to know that we’re not sending babies home into unsafe environments,” another study participant wrote.
“Nurses must feel confident and competent in their ability to provide training and education to caregivers of infants with medically complex conditions,” Shackleford said.
“The quality of discharge education and care coordination are important elements for a successful transition to home, and participants pointed to how this program improved both family and nursing outcomes,” she said.
An unexpected outcome of the rooming-in program was improved organization of the discharge process, notably between nurses and the discharge coordinator, paving the way for a smooth transition home, the study says.
Participants also identified ways to improving the rooming-in program, such as developing a more consistent way to measure caregivers’ abilities, beyond simply passing or failing specific skills tests, and customizing the program so each family receives the training that matches their needs.
DEI ranks sixth in HR priorities, falling one level in each of the past two years, according to the HR research firm.
DEI reached a high of fourth place in McLean & Company’s 2021 trends report—considerably up from eighth place the prior year—an apparent result of conversations and actions surrounding equity and social justice.
Lower rankings indicate that organizations “were failing to maintain momentum on their DEI work,” according to the new report which surveyed 1,075 business professionals.
“DEI is too important to let slip—other than being the right thing to do,” Grace Ewles, McLean’s manager of HR Research & Advisory Services, said in an online presentation about the report.
Despite indications that DEI is closely related to key organizational outcomes, only one-third of organizations have a formal DEI strategy, with that percentage remaining stagnant—37%—for the past three years, the report says. About 35% have an informal strategy, while 28 have no strategy.
Compared to organizations with no strategy, organizations with a DEI strategy are:
1.4 times more likely to report high overall organizational performance
1.8 times more likely to be high performing at social and environmental sustainability
2.4 times more likely to be high performing at DEI
The top barrier to DEI progress is dedicated time for DEI work (59%), survey respondents said. Those with DEI initiatives focus primarily on efforts related to diversity, equity, and inclusion, such as fostering a culture of belonging, increasing diversity, and embedding inclusion into workplace practices and behaviors.
Others take a more expansive approach, with DEI advising on organizational culture, corporate social responsibility, and employee well-being, the report says, noting, “This breadth of scope may result in blurred functional boundaries and limited time and capacity for DEI teams to dedicate to DEI work.”
Other barriers are:
Resources and funding (43%)
Creating a unified strategy (38%)
Lack of data (34%)
Lack of leadership support (29%)
“It is time to move beyond foundational awareness and toward active ownership. Competency-based training offers an opportunity to help leaders actively demonstrate and reinforce DEI practices in their day-to-day work,” the report concluded about DEI.
“However, training is only one component of a broader DEI strategy—DEI must be embedded throughout organizational programs and policies to ensure uptake and accountability.”
University's expanded program will double its number of nursing students.
The Mayo Clinic is partnering with a Florida university to expand a 12-month accelerated nursing program to help fill the need for more nurses in the United States.
The Jacksonville University and Mayo Clinic 12-month Second Degree BSN Program within the Keigwin School of Nursing offers qualified individuals who have already earned a bachelor’s degree an accelerated path to earn a Bachelor of Science in Nursing in one year.
The partnership part of a growing trend in which hospitals and health systems team up with colleges to boost the U.S. nursing workforce, which is critically understaffed.
The university’s Dedicated Education Unit (DEU) model will allow for flexible clinical scheduling, socialization to the role of the nurse, and the opportunity to create relationships with Mayo Clinic staff, according to the university.
"We're building on the highly successful ABSN programs already offered within the nationally recognized Keigwin School of Nursing with a longtime, world-class partner in healthcare, the Mayo Clinic," said Tim Cost, university president. "Jacksonville University and its preeminent nursing faculty are proud to educate students alongside skilled nurses in the most esteemed hospital in the state of Florida.”
Jacksonville University first launched its 12-month ABSN program in 2021 in partnership with provider Baptist Health and last year announced the program’s expansion to its Palm Coast location with the help of clinical partners such as Flagler Hospital.
The addition of the Mayo Clinic partnership now offers students three pathways into the program, providing flexibility for those looking to make a career change into nursing.
"Nurses are the heartbeat of Mayo Clinic and a critical part of the quality care that we provide to our patients," said Kent Thielen, MD, CEO, Mayo Clinic in Florida.
"Educating and training the nurses of tomorrow is a top priority across all of healthcare,” he said, “and we look forward to partnering with JU on this accelerated nursing program."
Mensik Kennedy brings more than 25 years of nursing experience to the ANA presidency and has given more than a decade of service to ANA as a committee treasurer and board of directors member. She also is a member of the Oregon Nurses Association.
Mensik Kennedy’s career has focused more on management and leadership than clinical work—a preference she realized during her undergraduate nursing program, she told American Nurse Journal, ANA’s official journal.
“When I was pursuing my MBA, a lot of my classmates weren’t nurses and hadn’t provided patient care but had ideas about fixing the healthcare system. This made me reflect on how I, as a nurse, was going to dig down into the values of nursing and move the profession and healthcare forward from a leadership and management perspective,” she told American Nurse Journal.
As she takes ANA’s reins, Mensik Kennedy spoke with HealthLeaders about plans for her two-year term.
This transcript has been lightly edited for brevity and clarity.
HealthLeaders: With all the challenges that nursing is experiencing right now, what is the one thing that most needs tending?
Jennifer Mensik Kennedy: There are a lot of challenges, but the most pressing challenge is safe staffing. This has been an issue well beyond COVID. COVID exacerbated it and shined a light on some of these issues, but this has been going on for some time. We need to focus on solving this one because it has a lot of impact on patient safety. This has an impact for nurses staying in the workforce. So, looking at safe staffing is of the highest, highest importance.
HL: The reasons nurses leave an organization are the same ones that have been around for decades: burnout, a stressful work environment, and inadequate staffing, as you just mentioned. How do you plan to address these stressors so that nursing can finally achieve healthy staffing levels?
Mensik Kennedy: We have a couple of things that we're doing at the American Nurses Association. The ANA joins in leading part of the national nurse staffing thinking where we have brought together a diverse group of frontline leaders, nurse leaders, and other key stakeholders and have published a set of priorities and recommendations, which we're going to continue.
But we're really looking at what we can continue to do from a long-term perspective. That includes working with Congress and healthcare organizations to improve the work environment and to work to retain and attract nurses. We need to look at antiquated pay structures; we do know that hospitals might not have the money coming out of the pandemic, so we need to adjust the Medicare Wage Index.
We need to look at imposing restrictions on mandatory overtime. We also need to look at funding the national healthcare workforce commission, which was authorized under the Affordable Care Act. This was something that was passed years ago that Congress hasn't funded. We could have had a decade of information under our belts nationally, to look at what's going on, but that commission has yet to be funded.
We need to fund some of these things and take meaningful action together. This isn't something that nurses can solve on their own, but we can partner with everyone to make these changes.
HL: Some 92% of Black respondents to a study last January by the National Commission to Address Racism in Nursing personally experienced racism in the workplace from their leaders. Leaders generally set the tone in their organizations, so how do you and ANA plan to address this?
Mensik Kennedy: President Grant started this work with the National Commission to Address Racism in Nursing, and I'm going to be fully involved in continuing this work and moving this into the operational phase of helping leaders learn about structural and systematic racism that might exist in the organization. It may be one thing for all of us to say, “Go take an educational module on implicit bias and understand that implicit bias exists,” but it's another thing to be able to take those classes and then look at your own policies in an organization—how you hire—from a different perspective and then remove those barriers.
For instance, a hospital or an organization might require acute-care experience, but the individual did not have acute-care experience and that was a barrier for them coming to work in an organization. So, part of this is to look at the cultures and the diverse experiences of individuals when they hire into an organization.
From a management and leadership perspective, one of those key points is looking at what they might have always thought would be a good idea, but really is a barrier to the diverse workforce that we need to match our patients.
HL: Specializing is on the rise right now in nurse education, both in terms of specialties offered and the number of nurses specializing. What effect will that have on nursing in general?
Mensik Kennedy: I always tell everyone there is something for everyone in nursing. A lot of people tend to say, “I don't want to be a nurse because I'm going to have to look at blood.” But because our technology and healthcare have advanced and we have all these new places and settings and modalities of treatment, nurses do need to be specialized in order to provide the care at those levels for different patients in all different settings.
It's exciting because this is one of those areas where we can retain nurses. They have places to go when they want to do something different, and they don't have to leave the profession because there's so many ways they can contribute to improving the health of this country.
“NPs are highly trusted healthcare providers who are at the forefront of diagnosis, research, and treatment. We ensure patients receive access to high-quality care that leads to better health outcomes,” Kapu says.
U.S. News’ top-5 Best Healthcare Jobs looks like this:
1. Nurse Practitioner
Median salary: $111,680
Unemployment rate: 1.2%
Number of jobs: 114,900
2. Physician Assistant
Median salary: $121,530
Unemployment rate: 1.2%
Number of jobs: 38,400
3. Speech-Language Pathologist
Median salary: $79,060
Unemployment rate: 1.7%
Number of jobs: 34,000
4. Physician
Median salary: $208,000
Unemployment rate: 0.3%
Number of jobs: 19,400
5. Registered Nurse
Median salary: $77,600
Unemployment rate: 1.6%
Number of jobs: 195,400
Besides ranking No. 1 in healthcare jobs, NP ranked No. 2 in the top 100 Best Jobs by U.S. News, the global authority in rankings. And though nearly 40% of the best jobs are in healthcare, a technology job—software developer—captured the top spot this year because of the “rising number of products and services that leverage software,” says Janica Ingram, careers editor at U.S. News.
'Jobs in healthcare continue to dominate'
The annual rankings offer a look at the best jobs across 17 categories from sectors such as healthcare, technology, business, social services, education, construction, and media, to help job seekers evaluate the employment landscape with detailed information on training and education requirements, median salary, and job satisfaction.
The ranking takes into account the most important aspects of a job, such as salary, growth potential, and work-life balance.
Rounding out the top five overall jobs are medical and health services manager at No. 3, physician assistant at No. 4, and information security analyst at No. 5.
“It is unsurprising that jobs in healthcare continue to dominate the Best Jobs rankings. This year’s cold and flu season reiterates the ever-present human need for healthcare practitioners,” Ingram says. “The higher-than-average salaries, low unemployment rates, and strong future prospects for many of these roles certainly reflect that.”
Healthcare jobs also continue to rank high among the U.S. News Careers with the Most Job Security ranking, with the industry capturing 13 of that list’s top 20 jobs. Nurse practitioner captured No. 1, while dentist took the No. 3 spot, physician assistant landed at No. 4, and orthodontist came in at No. 5.
To calculate Best Jobs, U.S. News draws data from the U.S. Bureau of Labor Statistics to identify jobs with the greatest hiring demand. Jobs are then scored using seven component measures: 10-year growth volume, 10-year growth percentage, median salary, employment rate, future job prospects, stress level, and work-life balance.
“The ranking of NPs as a top job demonstrates the strength of the profession in serving communities and meeting the skyrocketing demand for healthcare across the nation,” Kapu says. “As more Americans choose an NP, we will continue delivering exceptional care in every healthcare setting.”
“The NP role is more than a job—it’s a calling, and it is an honor,” she says. “I look forward to a new generation of providers heeding that special call to serve and build healthier lives.”
The program, with a goal of increasing healthcare diversity while offering economic mobility, will annually select up to 25 outstanding high school juniors as ASPIRE scholars to participate in an enrichment program, lasting for the remainder of high school.
The enrichment program offers mentorship and exposure to healthcare, the role of nurses, patient safety, and more through a series of interactive and hands-on sessions at the hospital. The first cohort begins in early 2023.
Growing partnerships
The partnership is the latest in which hospitals and health systems are teaming up with high school systems or colleges to boost a thriving and diverse nursing workforce.
The pipeline, begun more than 20 years ago, continues to help with workforce challenges, says Stacey Whiteside, the hospital's director of experience and engagement who leads MC².
ASPIRE students initially will receive lecture-type lessons and hands-on learning in the hospital from HUP nurses and hospital staff. They won’t participate in clinical work with hospital patients, they will be able to observe and assist nurses and other clinicians.
At the end of this part of ASPIRE, scholars will also have a better understanding of the life of a nurse and the skills and approach required to excel at the job.
Those who graduate from high school, fulfill requirements, and want a career in nursing then can pursue a Bachelor of Science in Nursing (BSN) at La Salle University with financial support from federal grants, a school scholarship, and a scholarship from the ASPIRE Program itself—which is funded by the Howley Foundation and Penn Medicine.
The students will be able to apply for paid positions at HUP where they can practice their skills and gain more relevant experience.
“ASPIRE firmly aligns with Penn Medicine’s and HUP’s goals to offer pipeline opportunities for members of our community to continue cultivating an inclusive workforce and providing outstanding patient care,” said Colleen Mattioni, DNP, MBA, chief nurse executive at HUP.
During their college years, ASPIRE students will receive ongoing support and guidance from advisors, as well as regular check-ins with their peers and instructors from the program.
Health systems must do more than dip a toe into wellness waters; they must appoint a chief wellness officer with the resources to do the job correctly, Melnyk says.
With nurse burnout at about 84%, according to the American Nurses Association, and 64% of nurses planning to leave healthcare one study says, the toll of burnout can seem overwhelming on many levels.
High levels of stress, anxiety, depression, and poor physical health correlated with an increase in self-reported medical errors by critical care nurses (CCN), according to a study co-authored last year by Bernadette Melnyk, PhD, APRN-CNP, chief wellness officer of The Ohio State University and dean of the university’s College of Nursing.
Nearly two-thirds (60.9%) of the CCNs reported having made medical errors in the past five years, according to the study. Occurrence of medical errors was significantly higher among nurses in worse health than those in the better health categories. For example, 67% of the nurses with higher stress scores versus 56.5% of the nurses with no or little stress reported having made medical errors in the past five years.
"These errors are made by very dedicated, caring, committed nurses who are experiencing their own symptoms of depression, anxiety, or poor physical health," Melnyk says. "It’s important that hospitals … equip their clinicians with resilience, because we know that’s a protective factor for their own mental and physical health, as well as their ability to provide optimal care to their patients."
"We’ve got to invest more in our clinicians, because if nurses and doctors are well, the safety and quality of healthcare is going to be better," Melnyk says.
The solution to clinician well-being, says Melnyk, lies with a hospital or health system’s executive leadership. They must take the lead on shifting to a wellness paradigm and appointing a chief wellness officer with a team and resources to do the job correctly, she says.
Some organizations dip a toe into wellness waters, but they don’t go all in, she says. They’ll place wellness under the human resources department, or they’ll go as far as hiring a chief wellness officer, but they won’t provide the needed resources to do the job correctly and effectively.
"That person isn’t going to be able to move the needle that much," Melnyk says. "This is an important component of an organization’s vision and strategic plan, so they’ve got to invest in a leader to spearhead their population’s health and well-being.”
Fix system issues
Though zen rooms, pet therapy, and affirmation boards helped nurses power through the darkest days of the pandemic, they are now experiencing long-term effects of that period, such as burnout, trauma, and depression.
To help nurses and other clinicians toward wellness, healthcare facilities must fix system issues that are known to adversely affect their health and well-being, Melnyk says.
"You can have all these fabulous wellness programs [because] they’re important, but at the same time hospitals have to fix their system issues that we know are causing problems, such as too many bureaucratic tasks that take time from nurses caring for their patients, which brings them joy, and length of shift work," she says. "And all my studies have shown the longer the shift work, the poorer the health outcomes for nurses."
While making systemic changes in healthcare traditionally takes long periods of time, there’s no time to waste in addressing clinician wellness, Melnyk says.
Bernadette Melnyk, PhD, APRN-CNP
Ohio State’s culture of wellness
For more than a decade, Ohio State, home to nearly 68,000 students and almost 50,000 faculty and staff, has prioritized creating and nurturing a wellness culture.
Its vision is to be the healthiest university and community in the world, and Melnyk is helming that by taking a comprehensive approach to build a culture of wellness for everyone.
"At Ohio State, we take a multicomponent, multistrategy approach to wellness," Melnyk says. "We target evidence-based interventions to middle managers and top supervisors, because if we’re not walking the walk and supporting the folks, it’s not going to happen."
For example, the Wellness Partner Program was created to pair up nurse practitioner (NP) students with RNs at the university’s Wexner Medical Center and travel nurses to serve as wellness support partners. The student coaches listened as nurses expressed their fears or talked about their long, difficult days.
The program taught the student coaches how to help their nurse partners create a wellness plan to help them develop stress-relief activities, build resilience, and work on healthy behaviors.
"It was very successful," Melnyk says. Indeed, in the program evaluation, 98% of participating nurses said that the Wellness Partner Program helped them engage in self-care and wellness, and 94.7% said that it helped them improve their mental and physical health.
Another Ohio State initiative is the Buckeye Wellness Innovators, in which faculty and staff who are invested in wellness volunteer three to four hours a month to develop grassroots plans for their individual units to champion the wellness culture.
The wellness innovators:
Hold virtual dialogue sessions regarding diversity, inclusion, and belonging with small groups of staff.
Encourage team members to designate an out-of-office point of contact to allow and encourage them to truly take time away.
Host voluntary yoga lessons, painting parties, and other social events to build team camaraderie.
Eliminate stigma surrounding mental health by creating a safe space for staff to share concerns.
Organize wellness walks around campus with hydration stations along the way.
Part of Melnyk’s wellness strategy is to annually provide university and hospital leadership—vice presidents, college deans—with their department’s general health data.
"I tell them things such as their folks are doing great on blood pressure and A1C, but there are high levels of stress and depression in their unit," she says. "We then work within the unit in implementing strategies to improve those specific outcomes."
A cumulative productivity net savings of more than $15 million from wellness programming across the university
$3.65 ROI for every dollar invested in wellness
Decreased anxiety, depression, stress, and suicidal intent among students, faculty, and staff
Increased academic performance
Increased levels of healthy lifestyle behaviors
Melnyk’s newest project, courtesy of a grant from the American Foundation for Suicide Prevention, is to digitize her cognitive behavior skills program for nurses to help prevent suicide so that it can reach anybody.
Melnyk took an effective cognitive behavioral therapy training program she had developed nearly 30 years ago for children, teenagers, and young adults that lowered stress, anxiety, and suicidal ideation and created a new version, called MINDBODYSTRONG, for clinicians.
Suicide risk is significantly higher in the nursing population, with female nurses roughly twice as likely to die by suicide than the general female population and 70% more likely than female physicians, according to a 2021 University of Michigan study that examined suicide among physicians and nurses. Data for the study was gathered before the COVID-19 pandemic, which means those numbers likely are even higher now.
"This [wellness] culture, I can’t emphasize enough," Melnyk says. "You’ve got to make it easy and the norm for people to engage in healthy behaviors, and to seek mental health help when they need it.
The right priorities
A workplace that prioritizes building and sustaining workplace wellness cultures has deep and positive outcomes for its largest labor force, Melnyk says.
Nurses who reported having workplaces that supported wellness were three to nine times as likely to have good mental health, good physical health, no/little stress, no burnout, and high professional quality of life, as compared with nurses whose workplaces provided little or no support, according to Melnyk’s study.
"We know mindfulness works. We know cognitive behavior skills building works," Melnyk says.
"It’s complex, but people have got to understand that wellness is an investment; it’s not a nicety," she says. "This is necessary. We’ve got to fix our system issues and create wellness cultures and programming and staffing models we know are going to yield better health and well-being outcomes for nurses."
