Stress on Nursing During the COVID-19 Pandemic, Thesis of Financial Accounting

Download Stress on Nursing During the COVID-19 Pandemic and more Thesis Financial Accounting in PDF only on Docsity! 1 Running head: NURSING PANDEMIC WELLNESS NURS-6053 Stress on Nursing During the COVID-19 Pandemic NURS-6053N-27: Inter professional Organizational & Systems Leadership Abstract This paper discusses the negative effects seen worldwide among nurses and healthcare workers on the frontline during the COVID-19 pandemic. Hospital systems across the world have taken many steps to mitigate these stressors on staff by implementing various strategies that promote staff wellness. While restructuring can be a source of additional anxiety due to fear of change, this reorganization gives Rutland Regional Medical Center the opportunity to expand on existing services to provide additional amenities as well as decrease the need for budget-related job losses. Employing services such as meditation, yoga, and mental health services, the hospital will ensure that employees have the resources necessary to combat the feelings of fear and anxiety thus increasing staff job satisfaction and employee retention. Keywords: coronavirus, COVID-19, SARS-COV-2, pandemic, nursing, staff wellness, mental health, stressor, job satisfaction. The SARS-COV-2 (COVID-19) pandemic is a stressor that is affecting people worldwide, especially frontline healthcare workers. From personal protection equipment (PPE) shortages and loss of employment to the isolative practices for fear of contracting and dying from the virus or potentially exposing loved ones, COVID-19 has caused elevated levels of fear, anxiety, and symptoms consistent with PTSD (Khan et al., 2020). Nurses are among the greatest affected demographics. The virus has created a working environment in need of leadership's attention. It 2 Running head: NURSING PANDEMIC WELLNESS has long been recognized that the workplace adds stressors to an individual’s life, but it has most recently been proven that personal factors are affecting employee job satisfaction and performance as well as leadership teams worldwide are starting to take notice (Jacobs et al., 2018). Staff wellness and job satisfaction will experience a continued decline without an intervention to support nurses and their overall wellbeing. Impact on a Small Rural Community Hospital The COVID-19 pandemic has tested the resources and capabilities of a 144 bed, community hospital based in rural New England – Rutland Regional Medical Center (RRMC). Per Hardt-DiCuccio et al. (2020), leadership's role in pandemic planning should be transparent and accessible to its employees in a way that bolsters confidence in the organization and lessens fear and anxiety surrounding organizational inaction. Through creation of a COVID-19 task force to disseminate the ever-changing pandemic-related information to stakeholders, the organization has kept the staff, stakeholders, and community-at-large abreast of important information regarding incidence rates, resource availability, plans of care and policy changes, as well as news related to vaccines and vaccine availability. This taskforce, headed by hospital executives as well as nurses, physicians, and other interdisciplinary staff has met to discuss staff wellness during these uncertain times. In minutes from a March taskforce meeting (2020a), plans for a surge scenario were discussed and it was decided to transform a local event space into a 100-bed alternate care facility. This would allow the hospital to care for COVID-positive patients on hospital campus and relocate patients that are negative to the new unit, mitigating the risk of exposing those are that not COVID-positive but need treatment. The taskforce utilized outpatient service providers 5 Running head: NURSING PANDEMIC WELLNESS One way that NYU was able to offer extensive interventions while mitigating large cost increases was to utilize current residents and nurses from various departments and redeploy them to medical areas. The redeployment of inpatient psychiatric nurses in a “medic” role on the medical floors was to offer mental health assistance to staff through experienced psychiatric interventions including therapeutic communication. These psychiatric nurses could then also recommend further mental health services if indicated. Benchmarking Against Other Hospital Systems Work from Spray et al. (2020) show that hospitals are offering wellness services to employees and staff in an effort to combat the negative effects of working in healthcare during this pandemic. The authors posit that centralization of information is imperative to employee success during these unprecedented times. Similar to the centralization of Homeland Security to tackle terroristic threats, Rosen (2019) asserts that centralization of information decreases unnecessary redundancies as well as develops a single trusted source from which to gather information. To this aim, RRMC’s taskforce accomplishes this by being a central location tasked with dissemination of information to staff and stakeholders. When looking at NYU Grossman School of Medicine’s Department of Medicine and its affiliated hospitals, Schaye et al. (2020) assert that providing adequate time off to staff is essential to promote decompression. While this is substantially hindered in the event of surge incidence rates when staffing needs to be increased to meet the demands, this is an essential piece to the overall wellness mission. Research from Hardt-DiCuccio et al. (2020), suggests that the researched hospital leadership has successfully combatted some of the negative sequelae of employee pandemic- 6 Running head: NURSING PANDEMIC WELLNESS related stress by implementing increased communication with staff, 24-hour mental health hotlines, and the use of relaxation or meditation spaces. These resources keep employees connected with each other during a time that demands isolationist practices. Strategies for Looking Ahead RRMC has a duty to its staff to use its resources in ways to support its employees. RRMC needs to continue to offer staff the use of mental health services through inpatient psychiatric service providers. This is a low-cost, high-impact intervention that has the additional benefit of creating employment areas and enhancing the capacities of current staff in a time of potential layoffs. This service can be further delineated by making smaller, focused groups per specialty to impact specific units with unit-wide debriefing sessions to coach staff on coping techniques as well as skillsets and techniques that promote self-affirmation during times of crisis. Similar to Hardt-DiCuccio et al.’s researched hospital system, RRMC can make use of the existing meditation room on campus to host meditation and yoga groups both in-person as well as via remote online sessions. Creating an interactive webpage dedicated to staff wellness is another strategy to keep staff informed of all services offered to them. This can be done by linking to the hospital’s existing intranet homepage and itemizing all services provided as well as scheduling abilities for mental health sessions and additional resources. To combat the stress placed on staff with families, the hospitals social work department can create a guide for discussing the pandemic with children as well as assisting families with communication about anxieties and fears. Competing Needs in Staff Wellness Implementation 7 Running head: NURSING PANDEMIC WELLNESS Competing needs are present in every decision needing to be made across all disciplines, healthcare is no exception. With the case of wellness programs for healthcare workers, budgetary concerns are a leading cause of hesitancy for leadership. The need for competent, experienced nursing staff also competes with the staff’s need for personal time away from the organization to decompress. Budgetary Concerns vs. Cost of Wellness Programs The sizeable initial costs for implementing staff wellness programs can be a main deterrent for leadership. Jones, Molitor, and Reif (2019) estimate that the staff wellness program industry generates roughly $8 billion annually at an average cost of $693 per employee. While larger healthcare systems can risk the initial monetary outlay for a potential future ROI, smaller systems or independent hospitals may be leery of spending such large amounts of money upfront for a project whose success can be difficult to quantify. It can be extrapolated that, in the case of RRMC, with roughly 1,700 employees, a $693 per employee cost would amount to roughly $600,000 annually assuming only a 50% employee engagement in the program. Richardson (2017) discusses the monetary effects of Pepsi Co’s disease and lifestyle management program for employees and shows a 29% decrease in hospital admissions. This correlated to an average savings of $136 per month in healthcare savings per member proving that there can be savings to be made above the initial cost of employee wellness programs. Schaefer et al. (2015), however, propose that the implementation of various staff wellness programs and their budgetary feasibility depends on the size of the staff being offered these interventions. The authors suggest that the larger the staff and the higher the engagement, the more feasible the project will be. 10 Running head: NURSING PANDEMIC WELLNESS It is through this office that employees are screened for exposure risks as well as fitted for PPE and provided with immunizations as well as prophylaxis after an exposure. These measures ensure that the staff are working in a culture that values safety. By providing the EWH, RRMC allows nurses and staff to work toward meeting provision 5. The EWH not only allows for emotional growth as an individual, but also promotes self-care and well-being. The nurse’s obligation to self and well-being is paramount in order to provide safe and effective care to patients, especially in such a stressful and demanding time when most things are uncertain. Provision 6 is met by this intervention through its employment of beneficence. While a staff wellness strategy is not necessary or legally obligated on leadership’s part, it is morally obligated. Such an intervention is how leadership can provide a healthy work environment for staff and mitigate harm through stressful working environments without support for staff. The EWH embodies provision 6.3 as it provides support to colleagues to handle difficult situations and topics. Through this intervention, the leadership team is committing to not only a safe work environment for its staff, but also to improved patient care to be provided by that staff as the staff will be more engaged and less stressed and fatigued (Jacobs et al., 2018). Conclusion The pandemic has created an unprecedented level of stress, fear, and anxiety among nurses. Employing wellness strategies to mitigate stress surrounding the pandemic is a necessity in order to increase job satisfaction as well as increase long-term employee retention. It is leadership’s responsibility to utilize available resources to foster staff wellness and assist with these hardships felt by nurses within the organization and community. Through examination of other health systems as well as relevant literature, interventions have been identified and can be 11 Running head: NURSING PANDEMIC WELLNESS utilized in the rural, community-based setting. Using RRMC’s already existing resources through various departments, such as inpatient psychiatry and social work, can have a big impact on wellness among the nursing staff with little upfront costs. References American Nurses Association (ANA). (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD. Author. 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