CEO and co-founder Edward Shin, MD caught up with Amy Pettit, DNP, RN, NE-BC, CSSBB, Chief Nursing Officer, Schneck Medical Center, and Rick Roche, Chief People Officer of Grady Health, and the three discussed the current state of nursing. The panel session, hosted by the Beryl Institute, discussed the pandemic’s impact on nurse burnout, as well as how nurse satisfaction impacts the patient experience.
Burnout Isn’t a New Problem
Even before the pandemic, burnout in nursing was a problem–– over one quarter of nurses were reporting severe burnout. However, that has recently jumped to over 60%. Pettit’s doctoral thesis sought to address the pervasive problem. Based on her findings, Schneck implemented a system that constantly monitors the working environment for staff. She says, “We make sure that what we provide for our nurses allows for autonomy and allows the nurses to be involved in decision making practices.”
The result? “We find that nurses become more engaged in the work environment and involved in the care that they’re providing.” In turn, these increase patient satisfaction scores.
According to Pettit, “My work was really taking a look at if we improve the working environment of the nurse, could we therefore improve patient satisfaction scores in the emergency department setting? And that is exactly what we saw when we were able to make sure that nurses have that autonomy and improve their work environment.”
Roche’s position aligns with the HR side of Grady, and he explains that the nurse experience begins during the hiring process. According to Roche, “We use two mantras: one is we hire and retain only people who are great colleagues, and great at customer service but not perfect at it. With that, we’re going to enhance the patient satisfaction and patient safety metrics and financial metrics etc. So for us our focus is great service and great colleagues.” By focusing on the nurses’ experiences, he says that a lot of the burden is taken away from them, and put on higher ups.
Strategies to cope with COVID burnout
Pettit expresses that, at the beginning of the pandemic, her hospital was battling with too many unknowns. That included how the virus spread and how to treat it. She and other C-suite members were front and center, easily accessible for their overworked frontline staff who also had to provide comfort for patients who could not be with their families. She says, “These patients were critically ill or even dying, and we had to come up with innovative ways to make sure that families still felt present and a part of the patient’s care.”
Schneck found creative ways to help the nurses through the healing process, including placing the names of recently deceased patients on a remembrance tree. Pettit explains that ultimately, “The only way that you really work through something like this is if you do it as a team and as a group because it really does take everyone.” Prior to the pandemic, a RISE program was implemented, and that group support has helped boost morale and coping.
Roche says that Grady took care of the mental health of their staff, offering therapy services and webinars for them to express their challenges. The hospital has also given almost $2 million in $1,500 increments which went towards helping staff meet the unique needs of their families. The goal was to give employees an avenue to seek some sort of extra support, whether they needed support with childcare or for a spouse being out of work.
Many organizations are trying to figure out what works best. Roche says, “There is about 100 years of research to suggest that the better you treat your employees, the better they’ll treat your customers, and I believe that pretty strongly, which is why we’re putting those things in place on the employee side, to ensure everybody’s a great colleague, and they’re great at customer service and at everything that we do for patients.”
Roche explains that staff needs a way to provide real-time confidential feedback. While there are quite a few methods for collecting data, he says that he isn’t a fan of massive project surveys. “If we think we have higher than the expected turnover in a particular area, and we’re not quite sure why, we want to be able to very quickly assess that from employees in a confidential way and get real time feedback.” This prompt feedback allows them to put together a plan of action that won’t take six months to implement, and in turn, can affect the organization’s customer service, and ultimately, the bottom line.
According to Roche, “There’s no one way to help the employees with [burnout]. It really needs to be approached in a variety of different ways. Again, to make sure that, even in a pandemic, you can do everything to ensure the employees have a favorable work experience.”
Surveys have given Pettit’s team insight into environmental changes that could boost productivity. She says, “We have implemented a quiet sleep room again. This is all based on best practice, so that nurses can take a moment and step away from the bedside or the work setting, the unit setting. We put furniture in there and we made it quiet and added music.” Other changes include adjustments to scheduling practices and shifts.
“We ask the nurses to come on board and help us create those innovative solutions in order to increase their satisfaction,“ Pettit explains. “When the nurse is happy, that correlates to patient satisfaction because they’re happy to be there and are happy to be taking care of their patients.”