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Description

Situation:

PICU staff frequently verbalize feelings of moral distress, anxiety, and exhaustion related to repeated exposure to complicated, ethically challenging situations and the intense nature of work in the PICU. Stressors associated with complex long term patient cases, deaths, medical errors, and adverse events are compounded by factors like the pandemic, high patient acuity, and instability of staffing. Collectively, these situations increase the risk of burnout and decreased job satisfaction.

Background:

Research shows that cultivating resiliency practices can improve overall well-being of the individual and lessen burnout and turnover. Though the hospital offers a program (RISE) that promotes resilience, integrated ethics, staff support, and engagement this service was historically under-utilized in the PICU.

Assessment:

The PICU and RISE leadership team met to identify specific PICU needs and develop a multifaceted plan to support staff. That included a survey of PICU staff to assess their knowledge of the RISE program and gain insight into what situations cause the most stress.

Implementation:

After the assessment, the PICU and RISE leaders implemented the following components: re-education on RISE services and the plan for strategies to support staff; implementation of monthly RISE sessions that offer safe spaces to discuss relevant themes or events; staff rounding by RISE and PICU leadership to foster intentional discussions; utilization of trained RISE 1:1 peer supporters following adverse events; resilience education offered to PICU leaders and staff; structured debriefings immediately after codes/deaths; increased dog rounding and acts of appreciation such as food or personalized notes.

Results:

Since implementation, the PICU has offered 30 RISE sessions impacting 194 employees, supported 59 employees through 1:1 peer support, and trained 6 additional employees for peer-to-peer support. In total there has been over 360 staff personal interactions. The 2021 EIE showed the PICU remains in the 60th percentile for employees saying that leaders care and create a trusting and open environment. Also, rounding comments emphasize the staff’s acknowledgment of departmental efforts to support them through difficult times.

Publication Date

2021

Disciplines

Pediatric Nursing

PICU Team Member Innovative Support PlanIntentional caring practices to mitigate moral distress, secondary trauma, andburnout in the Intensive Care Unit.

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