Medicine and Health Sciences Commons^™

Enhancing Nurse Manager Resilience With A Resilience-Enhancing Toolkit, Rosarina A. J. Pelikan

Doctor of Nursing Practice (DNP) Projects

Background: Nurse managers have one of the most stressful jobs in nursing leadership. They experience more burnout and are more likely to leave the job or leave the nursing profession altogether, leading to vacancies or burned-out leaders.

Local Problem: The organization experienced high nurse manager turnover. Of 12 positions, four have more than two years of experience, three have less than two years, and five are filled with interims.

Context: Strategies to address burnout are decreasing stressors or arming leaders with skills to withstand stressors. The organization offers programs that address burnout but are designed to be used outside of …

Community Health Worker Program: Adverse Childhood Experiences And Early Childhood, Arelis Sandoval

Doctor of Nursing Practice (DNP) Projects

Background: Adverse childhood experiences (ACEs) negatively affect childhood development and long-term health outcomes. Latino children face multiple adversities and social determinants of health compounded by ACEs. Community Health Workers (CHWs) have access to work with families to improve resilience and mitigate the effects of ACEs in this population.

Local Problem: In the Central Valley of California, CHWs provide support and resources to a largely Latino population with increased poverty rates, low educational attainment, lack of health insurance, and many chronic health issues, putting families at a higher risk for ACEs exposure. CHWs need further training to apply ACEs knowledge to …

Psychobiology Of Resilience, Rosarina A. J. Pelikan

DNP Qualifying Manuscripts

Nurse managers experience high levels of stress due to the complex bureaucratic and chaotic nature of the job, which can lead to burnout. In nurse managers, burnout negatively impacts the ability to meet the strategic goals of the quadruple aim: patient quality, patient satisfaction, cost savings, and employee well-being. Strategies to address burnout include minimizing or removing unnecessary causes of stress and provide the skills to protect against burnout. Resilience is a competency nurse leaders must have to withstand overwhelming job-related stress. Resilience-enhancing strategies have psychobiologic underpinnings and can be easily incorporated into nurse managers’ work schedules.

The Resilience Vaccine, Sara Horton-Deutch T. Duffy

Master's Projects and Capstones

Healthcare workers have been working in unprecedented circumstances since the declaration of the COVID-19 pandemic. Caregivers have been taxed with burnout. A large healthcare organization’s 26-bed, medical-surgical, telemetry, COVID-19 overflow unit was significantly impacted. Many healthcare organizations have adopted advocacy for attaining joy in work as an extra dimension of the Institute for Health Improvement’s Triple Aim. Adding this fourth aim supports averting caregiver burnout (CBO) while promoting joy in work.

This quality improvement project examined nurse leaders’ interventions that address CBO, promote healthy work environments, and promote joy in work. From June through August 2021, an 8-week resilience program …

Preparing Nurses In Management Positions For Bedside Care During Times Of Crisis, Trevor Murray

Doctor of Nursing Practice (DNP) Projects

Background

The purpose of this quality improvement project was to increase perceived self-efficacy in performing bedside skills among nurse leaders. As the demand for nurses increased, these leaders anticipated a direct role in providing patient care in the event of a patient surge due to COVID-19.

Problem

Due to the COVID-19 pandemic and Delta variant, hospital nursing leaders were and still are concerned with the challenge of providing enough competent nurses to deliver care. The DNP project prepared nurses who work in leadership roles to take or assist in taking a patient assignment.

Methods

Nurse leaders attended a skills lab …

Peer-To-Peer Emotional Support For Second Victims Of Hospital Adverse Events, Jessica L. Van Leuven

Master's Projects and Capstones

Abstract

Problem: Psychological impact of trauma on healthcare workers is profound, and if left unaddressed can debilitate its victims, depress morale, and undermine safety culture. When adverse events occur and focus is placed on providing care and support to patients and their families, the emotional support needs of healthcare workers must also be acknowledged.

Context: Frontline workers in the oncology unit of the medical center that is the setting for this project experience emotional distress as “second victims” of adverse patient events. Close relationships develop between providers and patients during long-term treatments. When unanticipated or adverse patient events there can …

Mental Health Outcomes Of Various Types Of Fear Among University Students Who Have An Undocumented Legal Status During The Donald Trump Presidency, Liliana Campos

Doctoral Dissertations

Having an undocumented legal status is a risk factor for mental health conditions such as depression and anxiety among university students. Much of the literature on the experiences of university students who hold an undocumented legal status has primarily focused on better understanding the educational, social, financial, and legal challenges among undergraduate students. The literature has addressed how some of these difficulties impact components of their social and mental health wellness. Yet, there is still a dearth of research focused on further understanding the experiences of students who hold an undocumented legal status from a psychological perspective, and specifically, with …

From Team Huddle To Team Cuddle: Rekindling Caring, Self-Compassion, And Joy In Work!, Amerizza Quemada

Master's Projects and Capstones

Problem: The healthcare industry suffers from a high level of burnout and unhealthy work environments, which has been heightened by the COVID-19 pandemic. The consequences of burnout may be expressed in both individuals and teams as a lack of caring, disengagement, incivility, and staff turnover.

Context: One department in an integrated healthcare organization displayed a pattern of annual low employee engagement scores and alleged workplace bullying. Team members also observed that employees failed to speak up when experiencing incivility. The Clinical Nurse Leader (CNL) student determined that an improvement initiative was needed to create a culture of caring to improve …

Unaddressed Challenges For The “Most Honest And Ethical Profession:” A Pilot Study Of Web-Based Learning Strategies To Prevent Moral Distress, Kelly Straight

Doctor of Nursing Practice (DNP) Projects

Background: Nurses and nurse practitioners (NPs) face greater responsibility to address the ethical challenges that present during the course of patient care, due to advances in medical technology and pharmaceutical innovation, and because of widening disparities within the U.S. healthcare system. These ethical questions, which arise during the course of routine patient care, are increasing in both number and complexity in nearly every patient care setting. Even with codified ethical standards, unresolved and/or ongoing ethical questions and dilemmas pose further issues such as the development of moral distress. This pilot project was designed to help NPs and other healthcare workers …

Moral Distress: Unaddressed Challenges For The “Most Honest And Ethical Profession”, Kelly Straight

DNP Qualifying Manuscripts

Nurses and nurse practitioners (NPs) face greater responsibility to address the ethical challenges that present during the course of patient care, due to advances in medical technology and pharmaceutical innovation, and despite widening disparities within the U.S. healthcare system. These ethical questions, which arise during the course of routine patient care, are increasing in both number and complexity in nearly every patient care setting. Unresolved and/or ongoing ethical questions and conflicts encountered in patient care pose further issues such as the development of moral distress. The literature demonstrates that moral distress contributes to dissatisfaction, disengagement, and burnout which negatively affects …

Evaluating The Effectiveness Of Peer Engagement And Knowledge (Peak): A Community-Based Group Intervention For Youth In Hawai‘I, Jennifer T. T. Ho

Doctoral Dissertations

This study is a program evaluation with a mixed methods design that evaluated the effectiveness of Peer Engagement and Knowledge (PEAK), a six-week community-based group intervention that incorporates mindfulness-based interventions (MBIs) to address multiple health behaviors for multiracial youth in Hilo, Hawai‘i. A total of 51 youth, ages 12-23 years old, participated in this study which included pre-/posttest analyses of health risk factors such as substance use and depression and health promoting factors such as resilience, self-esteem, and mindfulness. Responses from two subsets of participants, who engaged in a focus group (n = 11) and composed gratitude letters ( …

Implementing Ihi Joy In Work Framework To Decrease Turnover Among Unit Leaders, Allison Reid

Doctor of Nursing Practice (DNP) Projects

Problem: A medical center in an integrated health care system in Northern California has experienced high turnover for unit level leaders employed in an acute care setting. The role of unit level leaders (managers, assistant managers, and supervisors) in this organization is complex, often stressful, and includes 24/7 accountability. These leaders must simultaneously deliver on organizational goals, patient safety, quality, budgets, and staff satisfaction (Loveridge, 2017). Increasing resilience can help these leaders cope with stress and find joy in their work, making them less likely to leave their leadership positions (Hudgins, 2016).

Context: According to Loveridge, the turnover rates of …

Caritas Intervention To Reduce Stress And Increase Resilience Among Caregivers, Randy L. Williams Ii

Doctor of Nursing Practice (DNP) Projects

Problem

Workplace stress and burnout consistently rank among the highest concerns in surveys of caregivers. A gap analysis was conducted among a group of patient care coordinators and medical social workers. The gap analysis identified a need for tools to address stress, feelings of being overworked, and irritability.

Context

The setting is an acute care trauma facility providing care to general medical–surgical adult patients, cardiac care, pediatrics, and maternal child care. This facility exists within a larger integrated health care system, consisting of more than 20 acute care facilities in Northern California. The participants were patient care coordinators and medical …

Aligning Theory And Evidence-Based Practices To Enhance Human Flourishing In Nurse Executives, Jim D'Alfonso

Doctor of Nursing Practice (DNP) Projects

Today’s nurse executives lead highly complex and bureaucratic organizations undergoing sweeping reform at an unprecedented rate of change. Change and high levels of stress are the norm in health care, and ineffective stress management can hinder organizational performance and adversely impact personal wellbeing. The risks of nurse executive burnout and unprecedented turnover led to the development of a 4-hour program to teach theory-guided and evidence-based stress management techniques. The program was intended to increase awareness, enhance effective stress management skills, and improve the nurse executive’s ability to flourish in high stress environments. A pre-intervention and 6-month post-intervention assessment (n …

The Health Consequences Of Adverse Childhood Experiences: Building Resilient Communities, Elizabeth S. Najmabadi

Master's Projects and Capstones

Studies have identified that trauma experienced as a child directly affects your health later in life. In Sonoma County, one in four children have experienced two or more Adverse Childhood Experiences (ACEs) before the age of 18. Twenty-two percent of Sonoma County adults reported experiencing four or more ACEs before the age of 18. With the high rates of ACEs in our community this fieldwork placement aimed to bring awareness and build community capacity to understand and address ACEs and foster resiliency. To raise awareness in our community we developed the ACES and Resiliency Fellowship Series, which trained 60 fellows …