Preserve the ART of Human Caring with Micro-Practices
Karen White-Trevino explores how evidence-based, caring micro-practices can be integrated into the daily workflow of RNs working in the acute care setting. Caring micro-practices are actionable activities that operationalize the ethic of caring.
Featuring:
In August 2018, she began her transition into academia! She’s currently an Assistant Professor of Clinical Practice at the University of West Florida teaching online MSN-Nurse Executive program. She’s extensively studied Dr. Jean Watson’s Theory of Human Caring. She uses the theory to inform her personal & professional practice and is a certified Caritas Coach®.
She is passionate about creating a positive practice environment for nurses while promoting their health, wellness, and resilience. She is an active member of Sigma Theta Tau International as a faculty advisor with the Nursing Leadership Academies in Indianapolis, IN. She holds her ANCC Nurse board certification as a Nurse Executive which she received in 2011 and is still active.
Karen White-Trevino
Dr. Karen White-Trevino's nursing experience spans over 35 years. She has held various nursing leadership positions in her career which culminated in the Chief Nursing Officer (CNO) role at a large hospital in Pensacola, FL. She held the CNO position for 7 years. Leadership success at her hospital is demonstrated by the facility receiving ”Top 100 Hospital” from Truven Analytics in 2015, 2016, 2017 and the ANCC “Pathway to Excellence” initial designation in January 2018.In August 2018, she began her transition into academia! She’s currently an Assistant Professor of Clinical Practice at the University of West Florida teaching online MSN-Nurse Executive program. She’s extensively studied Dr. Jean Watson’s Theory of Human Caring. She uses the theory to inform her personal & professional practice and is a certified Caritas Coach®.
She is passionate about creating a positive practice environment for nurses while promoting their health, wellness, and resilience. She is an active member of Sigma Theta Tau International as a faculty advisor with the Nursing Leadership Academies in Indianapolis, IN. She holds her ANCC Nurse board certification as a Nurse Executive which she received in 2011 and is still active.
Transcription:
Bill Klaproth: So what is the art of human caring and how do we preserve this using micro-practices? Well, let's find out with Karen White-Trevino, an assistant professor of clinical practice at the University of West Florida, teaching online the MSN nurse executive program. This is Today in Nursing Leadership, a podcast from the American Organization for Nursing Leadership. I'm Bill Klaproth, Karen, thank you so much for your time. So first off, what is the art of human caring?
Karen White-Trevino: Thanks for the question, Bill. Yes, we as nurses we're taught, you know, right out of nursing school to balance the science of what we learn. And, within school, apply that into the healthcare settings that we work and balancing science with art. The art form is what nurses' kind of individualize, and they bring this within that art form of how they're caring for the patients and themselves and their team. They're taught to include elements of caring within that and they bring that forward. So they create this wonderful balance of the science of what they've learned within the nursing school with this art form and the art form is the caring and the compassion and how they individualize that care. When they care for a patient and then also how they care for, their teammates, you know, whatever that may be again, depending on the setting that they work and themselves.
Host: So then why is it important to preserve the art of human caring?
Karen: It's extremely important. I mean, it's foundational, you know, as far as our ethical core and it's important because prior to this whole COVID pandemic, we were seeing some erosion with our ability to keep that ethic of care within us as nurses and how did we see that? Well, we saw that with certain things that were happening within our environments. There's evidence to show whether it was a research pointing to burnout, to more depression, to compassion fatigue. We were seeing signs of this even prior to COVID. So we're seeing that erosion to the ability to care for ourselves, for the team, and for the patients was in jeopardy almost because nurses were really struggling with some occupational stressors of the job. And we were seeing this, like I said, in evidence, the National Academy for Medicine, put out a whole plan on how we take action. They not only included nurses, but physicians. We have the joint commission, who put a safety alert out about how nurses need to try to combat nurse burnout. It's this kind of a militaristic, how do we fight this, this event that's happening. So even prior to COVID and the pandemic we were seeing signs of this and it was, well-researched. I even saw, you know, myself in my years as a CNO. So it's important to at least bring a focus to this. And so we just have to really be able to understand this and be okay with having a conversation about it and be okay with saying, what can we do as Nurse leaders to try to mitigate this. What can we do as faculty to try to mitigate that for the nurses that were preparing to enter into the workforce? And so now I'm doing that because I've switched now from acute care nursing into the academia. And, I'm working with the faculty to do that with them now.
Host: So the pressures and the stressors of the job affect the art of human caring. So in order to enhance the art of caring, you have to fight against nurse burnout, which is a big issue. So making sure that our nurses are not suffering from PTSD or stress or burnout, so that's kind of the mission, right?
Karen: Correct. Yep, that's exactly it.
Host: And then it seems like, obviously, the art of human caring is foundational to nursing. So through your experience as a CNO, how did you apply the art of human caring or how did you try to enhance it or foster it so it would remain and grow?
Karen: Oh, great great question, Bill. And this is something that different leaders, different CNOs are gonna find their way with this and individualize it for them too. But for me, what I can share that worked for me was, I have a theoretical framework, kind of my own personal mission. And the framework that I work from is Watson's theory of human caring. And so within that theory, there are certain kind of, they call Caritas processes. And what I did as a CNO was using the theory and having that theory guide my practice. So there were certain things that I would do and the leaders were able to take advantage of the impact of some of the caring practices that I used. And then I would see them use those caring practices within their teams. And so it's really as the CNO for me, it's applying the theory and kind of operationalizing that so that we can really have specific, tangible actions that we use and that we can sustain over time. And I've got some examples that I can show you and what Watson calls these are carrying micro-practices. So these are small practices and similar to the description when you throw a pebble in the pond, and then you see those, you know, those rings, that's what carrying micro-practices are, they're too small, small habits if you will, that you get into that people can rely on. They know that this is the type of leader that you are. You're really leading from within. You know, as far as being driven by this caring theory and then the nurse leaders can see how to operationalize that theory with specific actions, and then they can take those actions. They can individualize it to their kind of leadership style and mold that, and then, the nurses will be able to be impacted by that and also the patients.
Host: Right. So micro-practices, can you explain those a little bit more in-depth? Are those a series of little things or every day, or is it one thing once a week? How do you operationalize a micro practice?
Karen: So within the theory, there are 10 Caritas processes, and obviously, we don't have enough time to go over the micro-practices for each of those 10, but the first, Caritas process, that I can share with you Bill is really more towards self and kindness and self-compassion. And so some of those practices that we can emulate and then share with our team specifically as a CNO, some of the things I did, I'll give you four. I'll list, four, centering and mindfulness, some type of a respite room and, we call it all different things, but the break rooms, you know, how do we create those break rooms so it's really a sense of security, a sense of peace and just leave a quick haven for the nurses, even if it's for, you know, a two-minute break or whatever. Pet therapy or animal-assisted therapy and healing through arts, is something else. And so, as far as the centering in mindfulness, this is something, if I can go a little deeper into that one. You know, this is just really introducing those pauses, those mindful pauses, those before and entering patient rooms as washing hands. You know, when you have headings, we would huddle up all the time. I think there's daily huddles that we do safety huddles. You know, you can call them, you know, within those huddles, you can call the mission moments, you know, that different organizations might have different things, but some way it's centering and bringing us back together to the purpose of what we're doing. And coming up with, periods of gratitude, you know, that's, that's something else is what, what are we grateful for, and I would do a weekly, a weekly caring intention is what I called it and send it out to all of nursing. We had closed Facebook pages, we had intranet, you know, so there were ways that we could use technology that hit and, and reach all the nurses and provide them with weekly statements of gratitude.
Host: Yeah. Where can we learn more about micro-practices? If somebody wanted to really understand these and learn the 10, where can someone learn more about these?
Karen: Yep. Oh, you could go to a couple of places. Amazon would have some books written by Dr. Watson, Gene Watson, and the theory of human caring. You also have the opportunity to go to the website. Watson's caring science Institute and there's many resources. I believe there's a whole link on resources. And there are other Caritas coaches, I'm a coach, I've gone through a six-month training program to learn more about the theory and how to integrate the theory into our practice. And that website actually has some wonderful free resources that are available to anybody who wants to participate. Even in my coaching class, there were non-nurses there, there were physical therapists there, there were, some folks that were non-licensed, but they're involved with patient experience activities within their institutions and they were their learning. But, for quick reads, you could use the resource link on the website, like I said, or just search for some books, and Amazon has a wealth of those.
Host: Sounds great. Well, as we wrap up, Karen, thank you so much for your time. Any final thoughts on preserving the art of human caring using micro-practices?
Karen: I think the only final thought Bill is just that we as leaders, you know, where the role models out there. So let's model the way and so that our nurses can stay resilient in the field. And, and maybe just pick one or two practices that you can, as leaders be, be consistent with so that we can model the way for our nurses.
Host: Well, Karen, this has really been informative and interesting. Thank you so much for your time, we appreciate it.
Karen: Thank you, Bill, I appreciate the opportunity to share with you today.
Host: That's Karen White-Trevino and for more information please visit AONL.org. And if you found this podcast helpful please share it on your social channels and check out the full podcast library for topics of interest to you. This is Today in Nursing Leadership, thanks for listening.
Bill Klaproth: So what is the art of human caring and how do we preserve this using micro-practices? Well, let's find out with Karen White-Trevino, an assistant professor of clinical practice at the University of West Florida, teaching online the MSN nurse executive program. This is Today in Nursing Leadership, a podcast from the American Organization for Nursing Leadership. I'm Bill Klaproth, Karen, thank you so much for your time. So first off, what is the art of human caring?
Karen White-Trevino: Thanks for the question, Bill. Yes, we as nurses we're taught, you know, right out of nursing school to balance the science of what we learn. And, within school, apply that into the healthcare settings that we work and balancing science with art. The art form is what nurses' kind of individualize, and they bring this within that art form of how they're caring for the patients and themselves and their team. They're taught to include elements of caring within that and they bring that forward. So they create this wonderful balance of the science of what they've learned within the nursing school with this art form and the art form is the caring and the compassion and how they individualize that care. When they care for a patient and then also how they care for, their teammates, you know, whatever that may be again, depending on the setting that they work and themselves.
Host: So then why is it important to preserve the art of human caring?
Karen: It's extremely important. I mean, it's foundational, you know, as far as our ethical core and it's important because prior to this whole COVID pandemic, we were seeing some erosion with our ability to keep that ethic of care within us as nurses and how did we see that? Well, we saw that with certain things that were happening within our environments. There's evidence to show whether it was a research pointing to burnout, to more depression, to compassion fatigue. We were seeing signs of this even prior to COVID. So we're seeing that erosion to the ability to care for ourselves, for the team, and for the patients was in jeopardy almost because nurses were really struggling with some occupational stressors of the job. And we were seeing this, like I said, in evidence, the National Academy for Medicine, put out a whole plan on how we take action. They not only included nurses, but physicians. We have the joint commission, who put a safety alert out about how nurses need to try to combat nurse burnout. It's this kind of a militaristic, how do we fight this, this event that's happening. So even prior to COVID and the pandemic we were seeing signs of this and it was, well-researched. I even saw, you know, myself in my years as a CNO. So it's important to at least bring a focus to this. And so we just have to really be able to understand this and be okay with having a conversation about it and be okay with saying, what can we do as Nurse leaders to try to mitigate this. What can we do as faculty to try to mitigate that for the nurses that were preparing to enter into the workforce? And so now I'm doing that because I've switched now from acute care nursing into the academia. And, I'm working with the faculty to do that with them now.
Host: So the pressures and the stressors of the job affect the art of human caring. So in order to enhance the art of caring, you have to fight against nurse burnout, which is a big issue. So making sure that our nurses are not suffering from PTSD or stress or burnout, so that's kind of the mission, right?
Karen: Correct. Yep, that's exactly it.
Host: And then it seems like, obviously, the art of human caring is foundational to nursing. So through your experience as a CNO, how did you apply the art of human caring or how did you try to enhance it or foster it so it would remain and grow?
Karen: Oh, great great question, Bill. And this is something that different leaders, different CNOs are gonna find their way with this and individualize it for them too. But for me, what I can share that worked for me was, I have a theoretical framework, kind of my own personal mission. And the framework that I work from is Watson's theory of human caring. And so within that theory, there are certain kind of, they call Caritas processes. And what I did as a CNO was using the theory and having that theory guide my practice. So there were certain things that I would do and the leaders were able to take advantage of the impact of some of the caring practices that I used. And then I would see them use those caring practices within their teams. And so it's really as the CNO for me, it's applying the theory and kind of operationalizing that so that we can really have specific, tangible actions that we use and that we can sustain over time. And I've got some examples that I can show you and what Watson calls these are carrying micro-practices. So these are small practices and similar to the description when you throw a pebble in the pond, and then you see those, you know, those rings, that's what carrying micro-practices are, they're too small, small habits if you will, that you get into that people can rely on. They know that this is the type of leader that you are. You're really leading from within. You know, as far as being driven by this caring theory and then the nurse leaders can see how to operationalize that theory with specific actions, and then they can take those actions. They can individualize it to their kind of leadership style and mold that, and then, the nurses will be able to be impacted by that and also the patients.
Host: Right. So micro-practices, can you explain those a little bit more in-depth? Are those a series of little things or every day, or is it one thing once a week? How do you operationalize a micro practice?
Karen: So within the theory, there are 10 Caritas processes, and obviously, we don't have enough time to go over the micro-practices for each of those 10, but the first, Caritas process, that I can share with you Bill is really more towards self and kindness and self-compassion. And so some of those practices that we can emulate and then share with our team specifically as a CNO, some of the things I did, I'll give you four. I'll list, four, centering and mindfulness, some type of a respite room and, we call it all different things, but the break rooms, you know, how do we create those break rooms so it's really a sense of security, a sense of peace and just leave a quick haven for the nurses, even if it's for, you know, a two-minute break or whatever. Pet therapy or animal-assisted therapy and healing through arts, is something else. And so, as far as the centering in mindfulness, this is something, if I can go a little deeper into that one. You know, this is just really introducing those pauses, those mindful pauses, those before and entering patient rooms as washing hands. You know, when you have headings, we would huddle up all the time. I think there's daily huddles that we do safety huddles. You know, you can call them, you know, within those huddles, you can call the mission moments, you know, that different organizations might have different things, but some way it's centering and bringing us back together to the purpose of what we're doing. And coming up with, periods of gratitude, you know, that's, that's something else is what, what are we grateful for, and I would do a weekly, a weekly caring intention is what I called it and send it out to all of nursing. We had closed Facebook pages, we had intranet, you know, so there were ways that we could use technology that hit and, and reach all the nurses and provide them with weekly statements of gratitude.
Host: Yeah. Where can we learn more about micro-practices? If somebody wanted to really understand these and learn the 10, where can someone learn more about these?
Karen: Yep. Oh, you could go to a couple of places. Amazon would have some books written by Dr. Watson, Gene Watson, and the theory of human caring. You also have the opportunity to go to the website. Watson's caring science Institute and there's many resources. I believe there's a whole link on resources. And there are other Caritas coaches, I'm a coach, I've gone through a six-month training program to learn more about the theory and how to integrate the theory into our practice. And that website actually has some wonderful free resources that are available to anybody who wants to participate. Even in my coaching class, there were non-nurses there, there were physical therapists there, there were, some folks that were non-licensed, but they're involved with patient experience activities within their institutions and they were their learning. But, for quick reads, you could use the resource link on the website, like I said, or just search for some books, and Amazon has a wealth of those.
Host: Sounds great. Well, as we wrap up, Karen, thank you so much for your time. Any final thoughts on preserving the art of human caring using micro-practices?
Karen: I think the only final thought Bill is just that we as leaders, you know, where the role models out there. So let's model the way and so that our nurses can stay resilient in the field. And, and maybe just pick one or two practices that you can, as leaders be, be consistent with so that we can model the way for our nurses.
Host: Well, Karen, this has really been informative and interesting. Thank you so much for your time, we appreciate it.
Karen: Thank you, Bill, I appreciate the opportunity to share with you today.
Host: That's Karen White-Trevino and for more information please visit AONL.org. And if you found this podcast helpful please share it on your social channels and check out the full podcast library for topics of interest to you. This is Today in Nursing Leadership, thanks for listening.