When nurses help nurses by creating special programs, it's a personal mission to make work life better for all of their colleagues. Let's take a look at some programs that are succeeding in this endeavor.
Amy Castillo, BSN, RN-BC, clinical nurse and healthcare safety advocate at UCLA Health in Los Angeles, California, saw the toll that violence was taking on her colleagues and knew something had to change.
"I remember when one of my nursing colleagues was punched in the face by a patient," Castillo said.
"The assault was unprovoked and made me realize we needed to do more to ensure staff safety."
According to the American Hospital Association, violence against hospital employees has increased since the pandemic.
Looking for a way to alert her colleagues to a potential high-risk situation before they enter a patient's room, Castillo designed The Gray Dot, a symbol placed discreetly outside of the patient's room, notifying staff that a patient may be aggressive or violent. Castillo introduced The Gray Dot initiative in 2021 as part of a pilot program, offered in conjunction with Crisis Prevention Intervention Training (CPIT). The color gray was chosen to coincide with the Hospital Emergency Code — Code Gray — that notifies staff of a combative or violent person in the hospital.
For her efforts to improve safety, Castillo was one of 10 UCLA nurses chosen to receive this year's Simms-Mann Foundation's Off the Chart: Rewarding Nursing Greatness awards. Thirty nurses at three medical centers in Southern California were chosen to receive the honor, which includes a $10,000 gift from the foundation. Nurses were selected based on "a bias toward action; a capacity for self-direction; originality and creative instincts; courageous and bold thinking; and the potential to achieve even more."
Castillo said The Gray Dot program combined with the CPIT training have resulted in fewer workplace violence incidents.
In addition, nursing staff achieved a 70% completion rate with the CPIT training and learned how to identify patients who may pose a safety risk and to de-escalate tense encounters. "In 2020, we had 27 safety events and one workplace injury," she noted. "In 2021, we had six safety events and no workplace injuries." Castillo said The Gray Dot program will be implemented systemwide at UCLA Health by the end of 2023.
Program sparks collaboration
At Community Health Network in Indianapolis, Indiana, Betsy Wisehart, MSN, RN, CNML, works with a new generation of nurses through the Students Prepared for a Remarkable Kickoff/Career (SPARK) program. Wisehart, who's co-founder and manager of the program, said SPARK creates opportunities for nursing students by allowing them to work as paid senior patient care technicians at Community Health Network.
"We started with 20 students and now have 81," Wisehart said. "We draw from 12 different nursing schools and currently have more applicants than positions."
Launched two and a half years ago, SPARK provides student nurses with mentorship from experienced nurses, valuable hands-on experience, and a pathway to hiring into a new grad program after they finish nursing school. Students also are able to work on multiple units — ICUs, PCUs, EDs, and med/surg units — and learn how to care for patients from diverse backgrounds.
SPARK has proven to be an effective recruiting tool for the Community Health Network as well. Wisehart noted the program has an 80% hire rate. To qualify, students must have completed at least one semester/rotation of nursing clinicals and be at least one year and not more than two years away from graduation.
"Our students get to do one-on-one shifts with our nurses and help with tasks such as drawing blood or dressing changes," said Wisehart. "Both our nurses and the nursing students love the program."
Nurses help nurses through stress, trauma
As the associate chief nursing officer at the University of Southern California's Verdugo Hills Hospital, in Glendale, California, Jessica Thomas, CCRN-K, CENP, wanted her nursing staff to know their health and well-being are a priority.
"Nursing can be stressful, especially when a patient dies or a trauma occurs," Thomas said. "I wanted to implement a program that could provide emotional support to nurses and other staff during these difficult times."
Thomas, who began her nursing career at The Cleveland Clinic in 2004, remembered a program called Code Lavender that was developed and launched by the hospital in 2008. She first introduced her own version of the crisis intervention tool in 2013, while working as a nurse manager in the Cardiovascular and Thoracic Medicine Center at Keck Hospital of USC in Los Angeles. When she transferred to the USC Verdugo Hills Hospital in 2015, Thomas launched the program there and uniquely tailored it to the USC staff.
This year, Thomas was named one of the recipients of the Simms-Mann Foundation's Off the Chart: Rewarding Nursing Greatness awards.
"Code Lavender provides a rapid response when an emotionally stressful event occurs in one of our hospital units," Thomas said. "It offers a way for us, as an organization, to provide care to our front-line caregivers."
Thomas said a patient death, a co-worker losing a family member, or a particularly stressful day on a unit, for instance, fit the bill. Any staff member can call a Code Lavender, and after a call is made, a team — Thomas, the director or manager of the Patient Experience Department, and the nursing house supervisor — will reach out to provide emotional support to the affected nurses.
"The team brings a Code Lavender basket to the unit filled with lavender sachets, soothing teas, and chocolates," she said. "One of our social workers or the hospital chaplain will often accompany the team and provide respite to nurses and other staff through tools including meditation, shoulder massages, and breathing exercises."
Thomas said the Verdugo Hills Hospital typically has one to two Code Lavender alerts each week, while the larger Keck Hospital of USC averages five to six a week. Any incident in which staff is suffering from compassion fatigue qualifies.
Thomas said calling for a Code Lavender offers staff the chance to talk about the stressful event, process it, and decompress before returning to work. "We want nurses to know they aren't alone in their feelings and that we're here for them."
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