Chief Nurse Builds a Kinder World Within the Walls of Northside Hospital Forsyth

The Kindness Initiative has changed the culture as it’s expanded throughout the Northside Hospital System.

Carolyn Booker, DNP, RN, NEA-BC, chief nursing officer of Northside Hospital Forsyth, in Cumming, Georgia, was troubled how violence was making its way into places she considered to be sacred and safe: schools, churches, and hospitals.

Kindness, she thought, could be an antidote, so in 2018 she began exploring the possibility and ultimately developed The Kindness Initiative, which has caught on and rippled through all of Northside’s campuses.

HealthLeaders spoke with Booker about how The Kindness Initiative was developed, why it has taken off like wildfire, and how it has changed the health system’s culture.

This transcript has been lightly edited for brevity and clarity.

HealthLeaders: How did The Kindness Initiative originate?

Carolyn Booker: What I began to see in the media was that there did not seem to be any protection against violence. That level of negativity happening out in the world was making its way into the hospital setting, and I wanted to figure out a way to address that. I began to look at the whole concept of kindness, just a Google search, and saw the effects of being kind and then I got the idea to do something.

The definition of kindness I like to use is the one that points to the fact that it's when you do something for someone just to make them feel better, with no expectation of anything in return. This was around the holidays, and we had gotten this huge basket of candy at the hospital. I took that basket and went over to labor and delivery, sat it at the nurses’ station, and said, “Guys, this is for you.” The reaction that came from that unexpected act just gave me a buzz.

I did more research and found an organization called kindness.org, which promotes kindness, and found they had these kindness toolkits. Our Kindness Initiative got started because of this thought about how we could possibly take kindness and make it the norm within the hospital setting.

Carolyn Booker, DNP, RN, NEA-BC, chief nursing officer of Northside Hospital Forsyth

HL: How did The Kindness Initiative begin to spread throughout the hospital?

Booker: I have a series of meetings with employees, and I began to bring this Kindness Initiative into the work environment and started talking through it and sharing YouTube videos of acts of kindness that people were demonstrating for others. The impact of it—people seeing that versus all this negativity—was extremely huge.

I got the idea to do the Kindness Challenge in November 2018, which was spurred by kindness.org, in which we would challenge employees to log acts of kindness. These acts could be in their community, in their home, or it could be at work, and they had to log and submit 12 acts of kindness, because we were counting them up. The goal was to have 10,000 acts of kindness by May 11.

When a person submitted their 12 acts of kindness, we would give them a T-shirt, and that component turned out to be almost like cultural iconography. It was a gray T-shirt that had white lettering and black lettering on it with a red heart and it said, “You have a choice. Choose kindness. I did.” We had to order three times to keep up with the acts that were being submitted.

By May 11, we had more than 11,000 acts of kindness that we had logged in terms of our employees, and those things were not necessarily huge things because we wanted any act of kindness—acknowledging one another, making eye contact, speaking to each other, and seeing each other because that's something that's important as well. The whole environment was positively charged because of this particular activity.

HL: Why do you think it took off and spread so quickly?

Booker: Because it came out of leadership. Every month, we had the Patient Care Council, and a part of that meeting would involve leaders going out to the different units and talking to staff, asking them about their work experience. And then we would ask them, “If there was someone here that you could recognize who would that be?” Then, the leaders would go and find that person and share what their colleague had said about them.

Again, the kindness made a huge difference. It was the talk of the organization at that time. It was very powerful, and we went on to take kindness and just interweave it into everything.

HL: How has The Kindness Initiative changed the culture at Northside?

Booker: This initiative is now a part of the Northside Hospital system. It is not just here at Northside Forsyth; it is across the system. We have a systemwide team—the Kindness Through Communication team—that meets every week to work on ways to embed kindness into the organization’s culture.

Northside has engaged an organization that has created a program called Excellence in Action for peer and leader recognition. This system is similar to Facebook, but it's an internal Facebook, so there is a livestream of this recognition on our intranet.

Another thing we've done as an organization is that all our service standards contain kind elements, which includes supporting co-workers, the ways in which we demonstrate kindness toward our patients, and ways we can be fiscally responsible and kind to our work environment.

HL: What has data shown about The Kindness Initiative?

Booker: It’s like anything else; you wax and you wane. Our patient experience scores reflect the fact that patients recognize when staff members are kind. The other thing that happens when you have kindness that resounds within the organization is that you have very good scores from the standpoint of your externally reported metrics.

HL: And those scores have gone up; is that what you're saying?

Booker: They go up, they go down, then they go back up, because of the fact that it's reflective of life.

HL: How can other nurse leaders begin to implement something like The Kindness Initiative in their hospital?

Booker: Look at the literature because it’s proliferative. Dignity Health on the West Coast is a hospital system that is doing a phenomenal job with kindness, along with the University of California, Davis. They do a phenomenal amount of research on the effects of kindness and the effects of mindfulness, because those things go together.

While it has not translated itself to the masses in the ways that a lot of other things have gone viral, I would expect that, with concentrated effort, we could get there.