PowerPoint Presentation · PDF fileNursing and Positive Patient ... Hospitals, nurses, and the social organization of ethics. Chicago: The University of Chicago Press. ... PowerPoint

5/26/2017

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Gratitude for the Human Connection: A Formula for Compassion Satisfaction

Traci Hanlon, MN, RN, CHCM ConsultantCindy Lefton, PhD, RN, CPXP

Bonnie Barnes, FAANMark Barnes, FAAN

Objectives

• Identify the concepts that define the human connection between nurse and patient/family.

• Discuss the impact of gratitude and meaningful recognition on organizations, nurse engagement and the patient/family experience.

©2017 Creative Health Care Management

Today

• Defining the See Me As A Person Framework

• Compassion Fatigue and Compassion Satisfaction

• The Impact of Honoring Extraordinary Compassionate Care – the Evidence

• Special Inspiration


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Presence


Paired Interactions

• Have you had experience with anyone in the state of mind you imagine this man to be in?

• Does a name or descriptor come to mind for this state of mind, this state of being?

• Have you or someone you love been in such a state?



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See me.

Listen to me.

Give me your undivided attention.


Attunement


Connection increases Healing

~

Isolation increases Suffering


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We are neurologically wired for attunement.



Wondering


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Wondering …

A state of mind characterized by curiosity, openness and acceptance.

Wondering happens when we have a devotion to the principle that the patient always has something to teach us, without which we cannot really do our jobs.


Following


Following …

A series of intentional acts of devotion to being led and taught by the patient and family …

Following refers to the practice of listening to, respecting, and acting on what we learn from our patients about who they are and what they need and want.


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Holding


Holding …

A devotion to safeguarding the person in your care …• Clinical competence• Respecting personhood/dignity• Communicating information • Anticipating and preparing for transitions• Being a sturdy and nonjudgmental

presence


My Caregiving Stance for Today


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BREAK

10 MIN

Compassion Fatigue and Compassion Satisfaction:

Impact to CareCindy Lefton, PhD, RN, CPXP

Vice President, Organizational ConsultingPsychological Associates

Patient Experience Manager and Researcher, Emergency Services

Barnes-Jewish Hospital

®Copyright The DAISY Foundation 2017

So, What Exactly Are Compassion Fatigue and Compassion Satisfaction?


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Vulnerability

Uncertainty

Complexity

Ambiguity

Current State of Healthcare



The Nurse’s Experience

“…I have been struggling to keep my heart in my job, wondering if I should leave my job to do something that would be easier, less demanding of my time and energy.”


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Compassion Fatigue

Nuts and Bolts of Compassion Fatigue


Burnout Secondary Trauma

Draining Your Emotional Energy

• Think of an example of Compassion Fatigue that you have you experienced.

• Did it lead you to question yourself as a nurse and/or think about leaving the nursing profession?

• Why?

In groups of two, share with each other. (5 min)


Consequences of Compassion Fatigue

Coetzee & Klopper, 2010; Jenkins & Warren, 2012; Kelly, et al 2015

Emotional Distress

Safety Risks

Workdays Lost

Poor Judgment

Loss of Empathy

Desire to Quit

Apathy


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Professional Quality of Life

Compassion Satisfaction

Compassion Fatigue

BurnoutSecondary

Trauma

®Copyright The DAISY Foundation 2017 ®Copyright The DAISY Foundation 2017




“The ability

to receive gratification

from caregiving”

Simon, Pryce, Roff & Klemmack, 2005 (pg. 6)


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Restoring Your Emotional Energy

• Think about a positive patient care experience which energized you.

• How did it make you feel?

• How did it reinforce your choice to be a nurse?

• Why?



Benefits of Compassion Satisfaction

Perry, 2008; Hooper et al., 2010; Stamm, 2010 , 2012

Patient Satisfaction

Feelings of contribution

Caring

Energized Moments

Retention

Self-esteem


BREAK10 MIN

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The DAISY Foundation

Bonnie Barnes, FAAN

Mark Barnes, FAAN

Co-Founders, The DAISY Foundation

Our Story of GratitudeNovember, 1999

Tena and Pat (and baby Riley)


The “Expected”

Clinical skill


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The “Unexpected”

• Not just what but how

• Kindness, thoughtfulness

▪ Of Pat

▪ And all of us

• Pat as a whole person


Our Awesome Experience• Never rushed

• Our interpreters

• Included us

• Educated us

• Engaged us

• Patient, tender, gentle

Confidence and Trust


There is no hug like a nurse’s hug.


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Pat’s Nurses

Our NursesTruly Patient and Family-Centered Care


The DAISY Foundation

Diseases

Attacking the

Immune

SYstem

Founded November, 1999In memory of J. Patrick Barnes


Gratitude To Nurses

J. Patrick Barnes Grants For Nursing Research and

Evidence-based Practice Projects


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Gratitude Beyond Borders

• Over 2,600 healthcare facilities and colleges of nursing committed to honoring their nurses with The DAISY Award

• Over 80,000 nurses honored

• Over 850,000 nurses nominated


Fundamental Principles of our Gratitude

• On-going recognition

• Simple to implement

• Flexible to meet organization needs and cultures• Criteria reflect each organization’s nursing model and

description of nursing excellence

• Compassionate care is key


Gratitude in Action

• Nurses are nominated with storiesof extraordinary care and compassion• Stories describe how nurses live

organization’s mission and values

• Honorees chosen by committee of peers


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DAISY Stories

April Cole, RNNorth MississippiMedical Center

Leena Sesay, BSN, RNChildren’s National

Medical Center


Discussion

• What was meaningful/extraordinary in these stories?

• Why? • What was the connection in these stories? (Wondering,

Following and Holding)



How do nurses feel when their stories are read

aloud, celebrated publicly?


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First, Shock Then, Pride


Surprise Celebration in

the Unit


Each DAISY Honoree Receives


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At Every DAISY Celebration


“I didn’t do anything special. I was just doing my job.”


BREAK10 MIN

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Meaningful Recognition:Evidence of Impact

Cindy Lefton, PhD, RN, CPXP



American Association of Critical-Care Nurses.AACN Standards for establishing and sustaining healthy work environments: A journey to excellence.

2nd Edition, 2016.

Principles & Elements of a Healthy Work Environment

Skilled Communication

True Collaboration

Meaningful Recognition

Authentic Leadership

Effective Decision-Making

Appropriate Staffing


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What is Meaningful Recognition?

• A powerful form of positive feedback that• Acknowledges how a person’s actions affect the life of another

• “Nurses desire recognition for their work and commitment to their patient. When recognition is meaningful, an individual’s true essence and uniqueness are recognized and honored.”

• Is relevant to the recipient• “Nurses consistently rate recognition from patients, families and other

nurses as the most meaningful”

• Is equivalent to his or her contribution• “Effective recognition programs do not occur automatically and

require formal structures and processes to ensure the desired outcomes”

American Association of Critical-Care Nurses. AACN Standards for establishing and sustaining healthy work environments: A journey to excellence.

2nd Edition, 2016.



Job

Embed-

dedness (Hayes et al, 2006)

Retention(Madden et al, 2012)

Benefits ofMeaningfulRecognition

What We Know - Meaningful Recognition Lit Review®Copyright The DAISY Foundation 2017

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Impact of Meaningful Recognition

• Catch Staff Doing Something Extraordinary

• Augments Patient Satisfaction Scores

• “Extraordinary is Ordinary” Shapes and Drives an Organization’s Culture

• Physiology of Extraordinary Nursing

and Positive Patient Experiences


What is the Patient Experience?

It reflects what patients appreciate


“Physiology” of Extraordinary Nurses:Patient/Family Perspective


Rank Theme # Noms

12 Teamwork 63

13 Exalted by patients 58

14 Keeps patients informed 58

15 Puts patient first 48

16 Provides inspiration 46

17 Demonstrates tenacity 45

18 Calm 39

19 Relentless Commitment 27

20 Communication 13

21 Nurse-Doctor Collaboration 8

22 Praises Others 3

]Tied

Rank Theme # Noms

1 Demonstrates genuinecompassion and caring

286

2 Reeks of professionalism 175

3 Contagious positive attitude 126

4 Accomplishes more than ever expected

102

5 Teaches others 97

6 Helpful 90

7 Calming/patience 79

8 Connects with family 77

9 Exalted by co-worker 69

10 Intentionally present 65

11 Tireless advocate for patients 64

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Catch the Extraordinary“She sat by our side as we battled the monsters that this condition

brought forth.”

“I know few things for sure, but one of these is that this woman

was put on earth to heal and comfort and God have mercy on anyone who stands in her way.”


Nominations Tell You the How and Why Behind Patient Satisfaction Ratings

“She gave me the will to live.”

“Just when I was ready to give up, she was there to give me the

extra nudge I needed to make it through.”


Meaningful Recognition

Authentic Leadership Appropriate

Staffing EffectiveDecisionMaking

TrueCollaboration

Skilled Communication

Interactions from patients, families and colleagues are the back door to meaningful recognition


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Patient Satisfaction

“…when a hospital explicitly rewards compassionate actsby its staff and supports its staff during tough times,

it is associated with patients more highly ratingthe care experience and being more likely

to recommend the hospital.“

McClelland & Vogus, 2014


Restoring Emotional Energy: Key components of Compassion Satisfaction

Positive Feedback “The times you get thanked stand out in your mind.”

Clinical Outcomes “Seeing a patient get better right before my eyes.”

Quality Teamwork“Knowing the people I work with have my back.”

Increasing One’s Self-Awareness“Recognizing that I am affecting you more than I realize.”


Surprise Inspiration

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Marie Manthey, on the right at age 5, with a friend…has always appreciated the importance of relationships!

Florence Marie Fisher----relationships were important to her too!

Meaningful Recognition“She never knew….”

Marie Manthey, MSN, RN, FAAN

Founder, CHCM

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Thank you

Mark Barnes, FAAN

Co-Founder, The DAISY Foundation

Questions?

References

• Bodenheimer, T. and Sinsky, C. From triple to quadruple aim: Care of the patient requires care of the provider. Annals of Family Medicine. 2014; 12(6):573-576.

• Chambliss, D. (1996) Beyond caring: Hospitals, nurses, and the social organization of ethics. Chicago: The University of Chicago Press.

• Consumer Reports. How not to get sick(er) in the hospital. February 2015. 32-37.

• Doyle, C., Lennox, L., and Bell, D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open .2012

• Hachem, Fadi; Canar, Jeff; Fullam, Francis MA; Gallan, Andrew S. PhD; Hohmann, Samuel; and Johnson, Catherine (2014) The relationships between HCAHPS communication and discharge satisfaction items and hospital readmissions, Patient Experience Journal: Vol. 1: Iss. 2, Article 12. Available at: http://pxjournal.org/journal/vol1/iss2/12

• Gawande, A. (2014) Being mortal: Medicine and what matters in the end. New York: Henry Holt and Company.

• Halpern, J. (2001) From detached concern to empathy: Humanizing medical practice. New York: Oxford University Press.

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References

• Kleinman, A. (1980). Patients and healers in the context of culture. Berkley, CA: University of California Press

• Koloroutis, M. and Trout, M. (2012) See me as a person: Creating therapeutic relationships with patients and their families. Minneapolis: Creative Health Care Management.

• Koloroutis, M. ed. (2004) Relationship-Based Care: A model for transforming practice. Minneapolis: Creative Health Care Management.

• Remen, N. (1980) The human patient. Garden City, New York: Anchor Press.

• Schenck, D. and Churchill, L. (2012) Healers: Extraordinary clinicians at work. New York: Oxford Press

• Siegel, D. (2007) The mindful brain: Reflection and attunement in the cultivation of well-being. New York: W.W. Norton,

References- Cindy Lefton• American Association of Critical-Care Nurses. Standards for Establishing and Sustaining

Healthy Work Environments: A Journey to Excellence, 2nd edition, 2016.

• Barnes B, Lefton C. The Power of Meaningful Recognition in a Healthy Work Environment. American Association of Critical-Care Nurses, April-June 2013; 24(2), 114-116.

• Barnes B, Koloroutis M, Sweeney C. Inspiring nurses to see the extraordinary in their ordinary. California, March 2015.

• Beach M, Inui T. Relationship-centered care: A constructive reframing. J Gen Intern Med, 2006; 21(S1), S3–S8.

• Coetzee SK, Klopper HC. Compassion fatigue within nursing: A concept analysis. Nurse Health Sci, 2010; 12(2), 235-243.

• Epstein R, Siegel D, Silberman J. Self-monitoring in clinical practice: A challenge for medical educators. J Contin Ed Health Prof, 2008; 28(1), 5-13.

• Grepmair L, Mitterlehner F, Loew T, et al. Promoting mindfulness in psychotherapists in training influences the treatment results of their patients: A randomized, double-blind, controlled study. Psychother Psychosom, 2007; 76(6), 332-338.

• Jenkins B, Warren NA. Compassion fatigue and effects upon critical care nurses. Crit Care Nurs Q, 2012; 35(4), 388-395.

• Kelly L, Runge J, Spencer C. Predictors of Compassion Fatigue and Compassion Satisfaction in Acute Care Nurses. J Nurs Scholarsh, November 2015; 47(6), 522-528.

• Koloroutis, M, editor. Relationship-Based Care: A model for transforming practice. Minneapolis, MN: Creative Health Care Management, 2004.

References – Cindy Lefton• Koloroutis M, Trout M. See Me as a Person: Creating therapeutic relationships with patients

and their families. Minneapolis, MN: Creative Heath Care Management, 2012.

• Lefton C. Strengthening the Workforce Through Meaningful Recognition. Nurs Econ, November-December 2012; 30(6), 331-338.

• Lefton C, Kelly L. Effect of Meaningful Recognition on Registered Nurses’ Compassion Satisfaction and Compassion Fatigue. California, January 16, 2016.

• Malloch K, Sluyter D, Moore N. Relationship-centered care: Achieving true value in healthcare. J Nurs Admin, 2000; 30(7-8), 379-385.

• McClelland LE, Vogus TJ. Compassion practices and HCAHPS: Does rewarding and supporting workplace compassion influence patient perceptions? Health Serv Res, 2014; 49(5), 1670-1683.

• Ortman J, Velkoff VA, Hogan H. An aging nation: The older population in the United States. Population estimates and projections current population reports. May 2014; 25-1140. Available from: https://www.census.gov/prod/2014pubs/p25-1140.pdf

• Shapiro S, Carlson L, Astin J, et al. Mechanisms of mindfulness. J Clin Psychol, 2006; 62(3), 373–386.

• Simon CE, Pryce JG, Roff LL, Klemmack D. Secondary traumatic stress and oncology social work: Protecting compassion from fatigue and compromising the worker’s worldview. J Psychosoc Oncol, 2005; 23(4), 1-14.

• Siegel D. The neurobiology of “we”: How relationships, the mind, and the brain interact to shape who we are [CD]. Louisville, CO: Sounds True, 2008.

https://www.census.gov/prod/2014pubs/p25-1140.pdf

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Traci Hanlon, MN, RNCreative Health Care Management

[email protected]

Cindy Lefton, PhD, RN, CPXPPsychological Associates

[email protected]

Bonnie and Mark [email protected]

www.daisyfoundation.org

mailto:[email protected]

http://www.chcm.com/


http://www.q4solutions.com/


http://www.daisyfoundation.org/

PowerPoint Presentation · PDF fileNursing and Positive Patient ... Hospitals, nurses, and the social organization of ethics. Chicago: The University of Chicago Press. ... PowerPoint

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