APNA 30th Annual Conference Session 2024: October 20, 2016 B UILDING - - PDF document

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APNA 30th Annual Conference Session 2024: October 20, 2016 Monroe 1

BUILDING AND SUSTAINING RESILIENCE FOR NURSE LEADERS

IN MENTAL HEALTH NURSING

Chelsie Monroe, MSN, APN, PMHNP-BC Audrey Nottke, MBA, MS, BSN RN PMH-BC

DISCLOSURES

The speakers have no conflict of interest to disclose.

LEARNING OUTCOMES

 Define resilience in nursing and relate its

implications to nursing management and leadership.

 Identify strategies to improve resilience as a

nurse leader and demonstrate how these tools can be implemented with staff to prevent burnout.

 Summarize how to apply these tools so that

retention and growth of the psychiatric mental health nursing workforce can be obtained.

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APNA 30th Annual Conference Session 2024: October 20, 2016 Monroe 2

WHAT IS RESILIENCE?

 Definition: the ability to survive and thrive in the

face of adversity (Cline, 2015).

 Resilience has been identified as an important

attribute of authentic leadership and employee engagement (Cline, 2015).

 It has been shown to increase longevity and

satisfaction in leadership roles and staff retention (Cline, 2015 & Wicks, 2006).

HEALTHCARE CULTURE

 Western healthcare culture – stress induced  Increase in crises with reduction in resources  Information overload, rapid advances in

technology

 Nurse managers are tasked to become patient

centered but must also drive quality, safety, and satisfaction metrics and remain a fiscal steward

• f the organization (Mac Leod Dyess, Prestia, Smith, 2015).

 The Nurse Manager role is perceived as

• verwhelmingly stressful (Shirey, 2004).

What drove us to become nurse leaders?

 Various stressors compete against each other,

causing nurse leaders frustration, emotional distress, anxiety, and apprehension (Stagman-Tyrer,

2014).

 Stress impact individual and organizational

performance, interpersonal communication, nursing recruitment, and retention rates (Pipe, Bortz,

& Dueck, 2009).

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APNA 30th Annual Conference Session 2024: October 20, 2016 Monroe 3

EFFECTS OF STRESS ON NURSES

 Health effects:  Sympathetic response  Cellular aging  Anxiety, depression  Eventual rather than immediate  Work satisfaction/staff satisfaction  Patient satisfaction scores  Poor patient outcomes  Ultimately turnover or attrition (Mac Leod, Prestia, Smith,

2015, Wicks, 2006, & Cline, 2015)

 Further exacerbate nursing shortage (Wicks, 2006)

The question is not whether stress will appear and take a toll on those working in healthcare; it is to what extent do professionals take essential steps to appreciate, minimize, and learn from this stress to continue – and even deepen – their roles as helpers and healers (Wicks, 2006).

 A literature review is used to summarize the

common themes in building a resilient nurse leader and staff. Key words included:

 Nurse leader resiliency  Mental health nurse resiliency  Burnout  Compassion fatigue  Secondary stress  Nursing leader roles  Resilience  Self care  Mental health nursing leadership  Stress management

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APNA 30th Annual Conference Session 2024: October 20, 2016 Monroe 4

QUALITIES OF A RESILIENT NURSE LEADER

 Honesty & Integrity  Accountability  Integrity  Authenticity  Hope  Optimism  Inspirational  Considerate  Equanimity  Courage  Self reliance  Perseverance

INTERVENTIONS TO IMPROVE LEADER

NURSE LEADER RESILIENCY

 Rethink how you define success  Balance between humanism and bureaucracy (Mac

Leod Dyess, Prestia, & Smith, 2015)

 Collaboration within organization and

community

 Shared leadership model  Regulate mood and affect, balance sympathetic

response and awareness of triggers

 Know who you are and what you stand for  Acknowledge lessons and be willing to try again

(Cline, 2015)

Avoid perfectionism Workaholics beware! Increase vulnerability and risk Self care Self reflection Ask for what you need, clarify

expectations

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APNA 30th Annual Conference Session 2024: October 20, 2016 Monroe 5

 Anticipate responses to adverse events and role

play

 Seek out feedback, receive graciously, and

incorporate suggestions in a visible way (Cline, 2015)

 Incorporate Jean Watson’s caring theory into

practice

 Time management and scheduled personal time  Mindfulness  Develop relationships and build social support

network

HOW DO WE IMPART RESILIENCY ON OUR

STAFF?

 Remove barriers that prevent staff from doing

their job

 Focus on culture, education, staff development,

flexibility, clinical improvement and professional standards in order to change mental health services (Holm & Severinsson, 2010).

 Follow values  Keep commitments  Insist on a culture that demonstrates positive

attitudes and looks for lessons in adverse experiences (Cline, 2015).

 Demonstrate what data means to staff  Employee rounding  Put the patient first. Ask yourself, “where is the

patient in this decision?” (Mac Leod Dyess, Prestia, & Smith,

2015).

 Senior staff members coach and mentor new staff

(Cline, 2015)

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APNA 30th Annual Conference Session 2024: October 20, 2016 Monroe 6

 Reinforce positive behavior  Don’t tolerate low performers  Role clarity  Assert shared governance and encourage creative

problem solving (Cline, 2015)

 Stop chasing the scores  Provide opportunity for venting  Spontaneously reward staff when spirits are high

• r low (Wicks, 2006)

 Compliment staff in front of colleagues,

supervisors, and patients

 Show personal concern for staff  Advocate for nursing

WHY DOES IT MATTER?

 Nurse leaders who are intentional in cultivating

and applying resilience will find that their relationships and leadership capabilities are enhanced and strengthened during challenging times (Cline, 2015).

 Benefits of resilience in a nurse leader(Cline, 2015):  Increase in longevity and satisfaction in leader roles  Greater work engagement from staff  Reduced staff turnover  Reduced cost  Improve quality outcomes through organizational

mindfulness

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APNA 30th Annual Conference Session 2024: October 20, 2016 Monroe 7

SUMMARY OF EVIDENCE

 The mental health nursing workforce relies on competent,

resilient nurses to care for our patient population.

 While resilience is sometimes an innate character or

personality trait, it can be proactively developed mentored, and coached (Cline, 2015).

 It is best to cultivate resilience early in leadership practices

to prevent further burnout and subsequent attrition in our workforce.

 Increased job satisfaction resulting from resiliency leads to

better patient care and longevity of our nursing workforce.

 Given the shortage of nurses and even more nurse

managers, it is essential to develop resilience to contribute to the nursing workforce (Shirey, 2004 & Wicks, 2006).

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