Mural painted by critical care unit staff to honor patients who contracted COVID-19. The stars represent those who succumbed to the illness and the flowers those who were discharged from the hospital. Mural by the MedStar Montgomery ICU Team; photo by Cherri Walrath.

Self-care is not a panacea.

Since the start of the pandemic, AJN has received many manuscripts and queries related to self-care and resilience to prevent burnout. It’s not surprising, given that this has been a harrowing year for nurses.

But while self-care and resilience are important, and such articles are needed, all the self-care in the world can’t fully address the root of the problem—the systemic issues that lead to burnout. At some point health care administration needs to step in and become part of the solution and offer staff the help they need.

A CE feature in our May issue, “Providing Care for Caregivers During COVID-19,” highlights one hospital system’s efforts to do just that. The Care for the Caregiver program, which existed prior to the pandemic, was created to support ‘second victims,’ defined by the Center for Patient Safety as “healthcare providers who are involved in an unanticipated adverse patient event, medical error and/or a patient related injury and become victimized in the sense that the provider is traumatized by the event.”

Adapting an existing peer-support program.

The program utilizes the Scott Three-Tiered Integrated Model of Interventional Support, where trained peers provide support in tiers depending on the situation, with Tier 3 involving professional mental health counseling if needed.

Originally, help was offered reflexively upon receiving notification that a potentially distressing event had occurred. However, the pandemic led to a change in this procedure. According to the authors:

“The duration, unpredictability, severity, and consequences of the COVID-19 pandemic required us to rethink our formerly reactive approach and introduce a proactive strategy. Beginning in March 2020, instead of awaiting notification of an event or a request for services, we preemptively sought out clinicians and associates in the workplace to establish connections, realizing that in the current crisis most are enduring a degree of stress they had not previously experienced in their careers.”

Adjustments made to the Care for the Caregiver program include:

  • Having trained Tier 1 and Tier 2 peer supporters attending morning and evening safety huddles.
  • Converting empty visitor waiting rooms into “wellness spaces” where caregivers could stop and talk with peer supporters and other colleagues.
  • Offering live sessions on relaxation techniques, breathing exercises, and other stress-reducing strategies.
  • Creation of an internal webpage listing available Care for the Caregiver resources.
  • Allowing staff members to develop creative outlets for dealing with emotional difficulties related to caring for patients during the pandemic, such as a mural painted on the unit wall memorializing patients who survived and those patients who didn’t make it home (see illustration).

To hear more about this program, you can find my podcast with author Crystal Morales here in our Behind the Article podcast collection.

Christine Moffa, PhD, RN, APRN, PMHNP-BC, is AJN’s​ senior clinical editor