April 28, 2021 Back to Basics: Driving Fulfillment for Frontline Caregivers

Over the past year, I have had the pleasure of speaking with numerous leaders in the healthcare industry. We’ve explored everything from the impact of COVID on frontline workers to diversity, equality, and inclusion (DEI), to caring for caregivers. Last week I had the distinct pleasure of sitting down with Bonnie Barnes, FAAN, Co-Founder, CEO, and Board President at The DAISY Foundation during our latest IPMI Virtual Think Tank (VTT).

Our conversion centered on the shift from employee engagement to the need for employee fulfillment.  Similar to an earlier conversation I had with Dr. Ninfa Saunders, in a COVID world we are seeing the increasing need to consider a more holistic approach to supporting our frontline workers.

In fact, prior to our discussion, we surveyed the VTT participants, who for the most part were CNOs. Here’s what we learned:

  • What are the top three things on your mind as it relates to your work as a healthcare leader? 90% of the respondents listed employee engagement and retention, increasing challenges with staffing, and managing high-stress levels, and how to bring back joy and satisfaction in the workplace for teams.
  • What keeps you up at night? Here we learned that 85% of leaders are concerned with staff well-being. This includes leader burnout, how to effectively care for people, how to lessen the burden on frontline leaders, and how to help create better connections between leaders and their teams.

Here are some highlights from my conversation with Bonnie.

Bonnie, tell us about the stories you’re encountering today, and has that shifted over the past 18 months?

Well CJ, the thing that strikes me as I listened to the responses to your questions is, yes, there is a theme that carries through all of them. It has to do with nurse’s well-being.

Thinking back, we didn’t create a program with an intent to say, “Gee, we really have to elevate nurse’s well-being.” We created a program that was needed to say Thank You. It was really a selfish move on our part, based on our personal experience. But what we’ve seen over the years, and it’s certainly been highlighted in the last year, is that when you shine the light on all the right, and you focus the attention on all the good that’s going on in healthcare every day, it has a huge uplifting impact on nurses. It reminds them why they became nurses.

I think, at this time, when there is so much noise around the pandemic and the tragic aspects of what we’ve all had to live through over the last year and some months. It’s important to be able to remember what it is that makes a nurse, a nurse. It’s all about caring, compassion, the calling that so many nurses have started on this journey to deliver on.

I think the one thing that strikes me is the level of compassion fatigue, which is literally described as a combination of burnout and secondary trauma. The level of compassion fatigue has never been higher for obvious reasons. And it’s higher throughout all levels of nursing.

But what we know from our research that was conducted in intensive care units is that meaningful recognition, like the DAISY Award, like anything that brings these stories out of extraordinary care, reminding nurses why they became nurses, helps to mitigate compassion fatigue, and elevate compassion satisfaction.

And boy, if ever, there was a time that we needed compassion satisfaction to be strong among nurses, it’s now. So, I think that the most important impact that we’re seeing from meaningful recognition is around this notion of reminding nurses why they do what they do and elevating their compassion satisfaction to balance against the horrors of burnout and secondary trauma.

I think this gets back to the theme of today’s conversation – getting back to basics and the need for fulfillment. Today we’re seeing the need to shift our approach to caring for caregivers. It’s about feedback/communication – frequency of communication, timeliness of communication, authenticity, and personalization. They are looking for fulfillment. They chose this path for a reason.

That feedback comes from patients and their families, from their peers, and increasing the relationship with their leadership in a meaningful way. Let’s talk about the fact that many of these caregivers were denied an important aspect of their daily interactions. Families were not allowed to see patients in the hospital. How does that impact the caregiver? How does it impact DAISY?

Well, I have to say we saw a dip in nominations in some of our facilities over the last year or so since the pandemic started. Just as you say, the families weren’t there and in many cases, patients were so sick that they were not writing nominations. A big piece of the feedback nurses needed was missing.

So, we did two things. First, we strongly encouraged members of the care team and nurse’s peers to take the time to write DAISY Award nominations. We encouraged them to stop and look at the extraordinary things that were going on around them and not take them for granted. We asked them to take the time to write them down. The descriptions that we’ve been receiving from co-workers about the extraordinary and compassionate care that nurses are providing have been rich, and robust, and so incredibly moving.

The second thing we did was to reach out to the public for the first time. We’ve never done this before. We decided that we needed to go to the public directly and remind them that it was time to say “thank you” to their nurses. We kicked off a campaign in January with two enormous signs in Times Square. The response was overwhelming and gave the nursing profession incredible visibility. It’s been promoted all over the world in social media and has been sustained on billboards with more than $1 million dollars of free advertising donated to nurses for the DAISY Award.

I think the combination of those two things has helped us sustain the feedback and communication needed. Direct outreach to the public, and, very importantly, reminding coworkers that they needed to take the time to write down what they were seeing. Because there is always a need for meaningful recognition, but never as much as right now. These were the two key actions we took to help sustain those basic needs.

What an incredible campaign. Just as a level set, the basic needs we all refer to within our healthcare teams are as follows: 

  • Safety in the workplace, the ability to feel part of a supportive team, and recognition and satisfaction for providing care.
  • Enabling our teams to feel part of a larger mission. One that is driven by the culture and values of the organization or health system.
  • Personalized interactions that touch something special within each and every person on the team. 

It’s that last one that has become increasingly more prevalent. We need to develop a more systematic way to make recognition and celebration a part of our daily lives – now more than ever. We need to help our teams overcome feeling isolated by carving out time for personal connections. Instead of having “nurse’s week” it should be all year.

You’re singing my song CJ, that’s why our mantra has been the time for meaningful recognition is always. We want to see how many of our partners can sustain what we refer to as the ritual of recognition, and the impact on culture that it’s having. It’s a lot.

I think about what you’re describing in terms of isolation, which breaks my heart. But when these huddles happen, when the teams get together, and a DAISY Award is presented, and the story of what a nurse has done is read aloud, and people get to hear why nurses are making such a difference, and how they’re making a difference with a particular patient or family, all the nominees are being celebrated.

You don’t feel alone when you feel part of that team. I know that’s a very subjective statement. But anything we can do to offset the feeling of isolation and give them a place where they feel supported emotionally – well, that’s a great thing for us to do.


Check back next week to read the second installment in our Bonnie Barnes and The DAISY Foundation blog series.

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