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The worst days of the COVID pandemic may be well behind us; still, nurses continue to experience high levels of psychological distress according to a survey fielded in November as part of the American Nurses Foundation (the Foundation) Pulse on the Nation’s Nurses Survey Series  that found 84% of respondents say they were stressed or dealing with burnout.

To help address nurse burnout, the Foundation and the United Health Foundation announced in December a three-year, $3.1 million partnership to fight nurse burnout with a Stress & Burnout Prevention Pilot program. According to a press release, the program is designed to transform organizational culture, remove the stigma we are taught to associate with seeking mental health support, and offer nurses a new burnout prevention model to help them use mental health resources earlier and more effectively.

Peer Support at the Core

Peer support notes that Allison Nordberg, Foundation program director, is at the program’s core. In a past survey, two-thirds of respondents, Nordberg says, “Their coworker or peer would be supportive of them, and so we saw that as an opportunity to leverage what we already know within the nursing space, of the connections amongst peers. And at the same time, we also see that there’s still a gap in understanding what resources are available.”

The Stress & Burnout Prevention Pilot program grew out of the Well-Being Initiative created by the Foundation at the start of the pandemic, says Nordberg. “The goal of that was to get mental health and well-being resources into the hands of nurses, those resources that are created by nurses for nurses that could be used quickly and that were all available for free. And we’ve had hundreds of thousands of nurses use one of those resources over time,” she says. However, she notes, there was a realization “that there was going to be a need to do larger work around that structural, organizational cultural rebuilding.”

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The pilot, notes Nordberg, also aligns with some of the recommendations from a Nurse Staffing Think Tank. For example, addressing burnout, moral distress, and compassion fatigue were identified as barriers to nurse retention.

Stress Continuum 

According to Nordberg, the concept of a stress continuum played a big role in the program’s approach to burnout. This color-coded schema ranks stress using a range from Ready (Green) to Ill (Red). The program wanted to use this concept “to serve as that foundational point for building a larger program that we could implement and bring about that work to address culture and organizational change,” according to Nordberg.

Serving Younger Nurses and Nurses of Color

One particular focus of the program involves meeting the needs of Millennial and Generation Z nurses and nurses of color. “One of the things we know is that for younger nurses in particular, often they don’t know anything other than they came into the profession in the pandemic,” says Nordberg. “So that’s the context that they know. The survey results show that they have higher burnout levels and are less emotionally healthy than their older counterparts. The good news is that they are more likely to have sought professional mental health support, but they still recognize the stigma around it.”

“Nurses of color have echoed similar survey findings of high rates of stress and burnout, and then we also have seen that experiences of racism amongst particularly nurses of color do negatively impact their well-being.”

Phased Rollout

The Foundation will pilot the program in four healthcare organizations. This first year of the pilot program, notes Nordberg, focuses on support of the pilot sites. After that, the program will have a soft rollout to a broader national audience in years two and three. “We see this as a multi-phase body of work,” says Nordberg. 

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The interventions are not intended to be prescriptive, says Nordberg. Instead, they are “intended to be adapted based on the culture of the unit that’s participating, the person who’s championing the work at their unit level.” The goal is to “take their learnings back and then begin to incorporate that into their organization in their unit.” The specific tools in the program might include online tools and low-tech interventions such as posting a paper copy of the stress continuum in a break room.

“What’s most important is that nurses use the intervention and the tools they’re getting. And we want those tools to be best fit for what their needs are.”

Louis Pilla
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