Bill Klaproth (Host): This is a special AONL podcast, as we speak with session presenters from the AONL 2023 Conference. And with me is Beth Ann Pyle. She is the Director of Patient Care Services at Holtz Children's Hospital at Jackson Health System in Miami. Her session, Building Resilience Together: Peer Lead Approach to Nurse Manager Wellness.

Host: This is Today in Nursing leadership, a podcast from the American Organization for Nursing Leadership. I'm Bill Klaproth. Beth Ann, welcome to our podcast booth.

Beth Ann Pyle: Thank. you, Bill. I'm happy to be here today.

Host: Your session, Building Resilience Together: Peer Lead Approach to Nurse Manager wellness. Tell us what is the compelling leadership issue or problem that you addressed?

Beth Ann Pyle: Yes. So, the focus of this project was really on nurse manager wellness and resiliency. We know AONL tells us that nurse managers provide the foundation for organizational success. They do this by enhancing job satisfaction, retention, influencing the delivery of high quality patient-centered care. And most importantly, creating environments where teams can thrive and connect meaning to their work. And unfortunately, a recent study by AONL delivered some sobering statistics where we found out that one in three nurse leaders reported that they were not emotionally healthy. And if that isn't a call to action for our profession, I'm not sure what is.

Host: One in three leaders, that is a surprising statistic. I mean, we knew that all of nursing has been under a lot of pressure through the pandemic, certainly bedside nurses, but nurse leaders too. I mean, talk about the pressure, that is a surprising statistic. So, we're talking about nurse manager wellness then. For a nurse leader listening to this, who might be saying, "Yeah. I know what Beth Ann is talking about," what is important for them to think about when it comes to them maybe diagnosing this problem and approaching it with a solution?

Beth Ann Pyle: Right. So, it can feel like an overwhelming problem of course. It feels really large to fix nurse manager wellness. So, I would say know your team, that's the first and most important piece. There's no set playbook for this. So, what worked in my organization might not necessarily work in yours. I do believe that the basic foundation is applicable really to any setting in any team, but you might have to get flexible and get creative with the specific activities and interventions that will connect with your team and your people.

I also think it's really important to share your vision, tell the story, and get the support that you need. When I think back about this program, it was peer led. So, it really was nurse managers supporting fellow nurse managers. But we could not have been successful without the support of our senior leaders; our food and nutrition services, who provided us with smoothies that, you know, weren't on the cafeteria menu, but we made the ask and they delivered; and our amazing administrative assistant, Sabrina, who really bought into the vision and helped me bring it to life.

Host: So, Beth Ann, I think that's really good advice. Know your team and share your vision, as you said. So when we talk about nurse manager wellness and knowing that, what are the policies or programs or initiatives that you put in place to address this?

Beth Ann Pyle: Yeah. So, we took the approach of a five-week nurse manager wellness challenge. We had daily events over those five weeks. They included things such as journaling, taking walks around the hospital campus or in the neighborhood surrounding the hospital, following up those walks with those smoothies I talked about earlier. We tried to tap into artistic things. We tried cupcake decorating. We did yoga sessions, guided meditations. We did a book club for anyone who wanted to participate, sessions on stress management, really a variety. We tried to tap into something that would connect with each person on our team, recognizing that self-care looks different for everyone. And really, we wanted to do events that brought the team of managers together, building those relationships and, like I said, providing strategies that they could use not only during those five weeks, but that they could take away and bring with them into their future. And we walked away with a renewed sense of purpose as a team and sort of a common direction and pathway forward.

Host: I love that thought of the five-week program. And how did the nurse leaders, nurse managers think about this when you rolled it out? What was their initial reaction?

Beth Ann Pyle: So, initial excitement. of course, but it's hard.

Host: So, they were like, "Okay, we're in. This is great. We're open to this."

Beth Ann Pyle: So, it sounded great on paper. But, you know, those first few events, it was kind of like when you host a party and you're just waiting and hoping that people come. but they did. And, you know, it waxed and waned throughout the five weeks. So, some events, we had huge turnout. Other events maybe weren't as popular. But we had at least a few people at every event. And by the end of our five weeks, we can say that every one of our nurse managers and assistant nurse managers participated in at least one activity. Some took longer to get there. You know, it was kind of a hard sell because we were doing this from the point of, "Hey, we know you're overwhelmed. We know you have so much on your plate. Come to this 45-minute yoga session." And for some people, they just didn't necessarily see the value or how that would give them time back in their day. But as momentum spread and they heard people talking about it, we sent out a weekly recap of the events we had done that week with pictures of the events. And so, it caught on and it just spread and people got on board and it became part of our norm. We did five weeks in the beginning, but things continued. So, we would end meetings early when it was within our control to go take a walk together because that had been valuable to us during the program.

Host: Yeah, that is really cool. So, what are the results then? Have you've been able to measure this? Have you know satisfaction improved at all? What have you found?

Beth Ann Pyle: Yes. So, we started really with subjective data. We started all of our nursing management council meetings with just sort of a check-in. Sometimes that would be a get-to-know-you-better. You know, what's your favorite ice cream? The best vacation spot you ever went to? But other times, we would use it as a check-in with our team, just sort of a how-are-you-feeling-today, so that we could get a pulse before diving into the content on, you know, reducing falls in nursing satisfaction, all things that are important. But if our team wasn't there that day, we probably wouldn't be productive.

So prior to this wellness challenge, you know, we had the word cloud through the polling app up on the screen. And the things that we were seeing, the most common responses were things like, "I'm tired today," "I'm hungry," "I'm overwhelmed," or "I'm content." Whereas after, we did the same question in a followup meeting, same meeting, same group of people, but their responses were "Grateful," "Great," "Better," "Energized." And so, we really saw that shift subjectively just in how our team members, our managers were feeling.

In addition to that, we did of course collect some data and we did see a 36% reduction in manager transitions in the 12 months prior to this program compared to the 12 months after, which just ended in April. So, happy to say that there's been an improvement there as well.

Host: Yeah. What a great program focused on self-care, reflection, team building and gratitude. And I love what you just said there, how earlier the responses were, when you did the check-in, "I'm tired." And then, it became "Grateful," "Excited," "Better." I mean, that had to make you feel really good, like we're getting somewhere.

Beth Ann Pyle: You know, it did. It was my peer group. So, of course I had a vested interest and I benefited from it and I wanted to see others benefit from it as well. That was great to see.

Host: So, what is your key takeaway? If you could boil all of this down to one thing for a nurse leader listening to this, what is your key takeaway?

Beth Ann Pyle: Yes. I would say a few. I think one aha moment for us throughout this was the improved team dynamics. We weren't necessarily expecting to see that because I think we thought we had great team dynamics. But one thing that was really eye-opening through this program was we had had a lot of new team members join our team in the two years prior. So, we were in the pandemic and in a setting of virtual meetings for our new team members. So, the impact of them, you know, some people came to these activities and said, "Oh, I didn't realize how tall you were." And for those of us who had been there, it was a realization that some of these people have never met in person and they've been here maybe 3, 6, 9 months. So, not only did that impede their ability to integrate into the team, but also for us to welcome them into the team. So, that was really important and kind of just gave us a, "Yes, we have to be safe and follow social distancing, but how can we form those relationships differently in the future if we're faced with something like this?"

In addition, I would say just key takeaways, start somewhere and stay focused. Like I said in the beginning, it can feel overwhelming to tackle something as large as manager wellness. But if you just start somewhere and gain that traction, take those small wins in the beginning, you'll get there. And even if it's just a little step at a time, it's still a step in the right direction.

And then, staying focused. If you do this, you will be asked to expand it to other groups in your organization. But I would just encourage anyone setting out on a journey like this to stay focused on your vision and the group that you started with. By all means, share what you're doing and help other departments replicate a similar program, but don't lose sight of your nurse manager groups that you're focused on pouring into. Focus on them, stay focused on them, and then expand when the timing feels right.

Host: Yeah. I like how you said even a little step at a time is a step in the right direction, I like how you put that. And I like how you also said this has provided improved team dynamics, where you said, you know, "I thought we had a really cohesive team, but we learned, oh, maybe we could have been doing things better," and this brought that to the forefront as well. Well, this has been great, Beth Ann. Thank you so much for your time. As we wrap up, any final thoughts, any additional thing you'd like to add?

Beth Ann Pyle: You know, I would say just keep it simple, don't overcomplicate it and don't forget to have fun with it as well.

Host: That's a great point as well. Well, Beth Ann, thank you so much for your time. We appreciate it.

Beth Ann Pyle: Thank you so much.

Host: Yeah. 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.