Battling Compassion Fatigue & Turnover: Implementation of a NICU Relaxation Station Luann R. Jones, DNP, APRN, NNP-BC, NE-BC Arkansas Children s Hospital Neonatal Services Nursing Director Objective Describe how a NICU relaxation station can help battle compassion fatigue & turnover. 1
Compassion Fatigue & Burnout Compassion Fatigue= combination of physical, emotional, & spiritual depletion associated with caring for patients in significant emotional pain and physical distress Burnout= syndrome defined by symptoms: Emotional exhaustion Alienation from job-related activities; disengaged Negative attitude Reduced performance/productivity including reduced ability to recognize errors & reporting of errors Background 104-bed, Level IV NICU with ADC=70 NICU= stressful work environment Stress increased by: Staffing issues created by turnover, high census & high acuity Lots of change (unit expansion, transition to EMR, changes in leadership) How the idea came to life NICU Relaxation Station Approvals Space Funding Massage Chair Other relaxation tools 2
NICU Relaxation Station Overhead Lights On Indirect Lighting Only Process Log sheet kept in the team leader office along with the key to the room Staff must sign in & out Log sheet with disclaimer listing contraindications for use of massage chair 15-30 minutes each session (break time) Outcome Data Opened February 11, 2016 Room utilization 2/11 to 4/6/16 (8 weeks): 179 sessions documented QI Survey of Staff Pre- & Post Outcome Measures RN Turnover Rate Compassion Fatigue Survey Scores 3
Compassion Fatigue Data (Pre-Implementation) Practice Setting N Burnout Compassion Fatigue Scale Compassion Satisfaction Secondary Traumatic Stress Mean (SD) Mean (SD) Mean (SD) Mean (SD) Social Readjustment Scale NICU 36 25.1 (5.7) 39.8 (6.0) 23.7 (6.0) 103.6 (82.0) P QI Survey of staff 3/10/16 thru 4/1/16 Total # 80 responses Primary role in NICU RN 7 Years in current role <1 1-5 5-10 10-20 >20 2 28.5% 2 25% 6.25% Gender female 98.73% Age 21-30 31-40 41-50 > 51 32.5% 22.5% 22.5% 12.5% Used the space Yes 6 No 4 How often Once Twice 3-5 >5 31.25% 35.42% 25% 8.33% Rate stress level before using space (scale 1-5) Rate stress level after using space Rate anxiety level before using space Rate anxiety level after using space QI Survey of staff 3/10/16 thru 4/1/16 8.33% 12.5% 77.08% 2.08% 10.42% 66.67% 22.92% 4.17% 18.75% 33.33% 41.67% 2.08% 20.83% 52.08% 27.08% 4
Do you feel your work performance improved after using space? Did ability to handle additional stress improve? If you have not used the space, why not? Do you plan to use the space in the future? QI Survey of staff 3/10/16 thru 4/1/16 Improved No different Other Yes No Not interested Haven t had the time Other Yes No Maybe 83.33% 14.58% 2.08% 78.72% 21.28% 81.25% 18.75% 62.5% 37.5% Quotes from Staff I have used the station 3 times so far. The massage chair, turning the lights down, & having relaxing music playing has helped me to relax and recharge from a stressful shift & life and be ready to finish my shift with a positive attitude. Quotes from Staff The past few weeks my primary has been in a "loud pod"... You know babies crying monitors going off, etc. Being able to go to this room turn the lights down and have little to no noise is amazing!!! Just what I need to get through the last few hours of my shift! 5
Quotes from Staff It's really nice to have somewhere to go that you can unplug for a few minutes and get away from all of the commotion and noise that seems to dominate the vast majority of the shift on most days. It is so nice to have a private place to stretch after standing/sitting long hours. Thank you for the space! References Braithwaite, M. (2008). Nurse burnout and stress in the NICU. Advances in Neonatal Care. 8(6): 343-347. Engen, D.J., Wahner-Roedler, D.L., Vincent, A., Chon, T.Y., Cha, S. S. Luedtke, C.A., Loehrer, L.L., Dion, L.J., Rodgers, N.J., & Bauer, B. A. (2012). Feasibility and effect of chair massage offered to nurses during work hours on stress-related symptoms: A pilot study. Complementary Therapies in Clinical Practice. 18: 212-215. 6
References Jennings BM. (2008, April). Work stress and burnout among nurses: Role of the work environment and working conditions. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); Chapter 26. Retrieved from: http://www.ncbi.nlm.nih.gov/books/nbk2668/ Romano, J., & Rich, V. (2013, October). Providing workplace renewal opportunities for nurses. American Nurse Today. 8(10). Retrieved from: http://americannursetoday.com/providing-workplacerenewal-opportunities-for-nurses/ References Sabo, B. (2011, January). Reflecting on the concept of compassion fatigue. The Online Journal of Issues in Nursing. 16(1). Retrieved from: http://www.nursingworld.org/mainmenucategories/anamarketplace/ ANAPeriodicals/OJIN/TableofContents/Vol-16-2011/No1-Jan- 2011/Concept-of-Compassion-Fatigue.html Sheppard, K. (2016, January). Compassion fatigue: Are you at risk? American Nurse Today. 11(1). Retrieved from: http://americannursetoday.com/compassion-fatigue/ Thew, J. (2016, February). Nurse renewal rooms benefit patients, too. HealthLeaders Media. Retrieved from http://www.healthleadersmedia.com/nurse-leaders/nurse-renewalrooms-benefit-patients-too?page=2c2 7