Bill Klaproth (Host): This is Today in Nursing Leadership, a podcast from the American Organization for Nursing Leadership. I'm Bill Klaproth. And with me is Kristin Ray, Nursing Director for Children's Mercy, Kansas City, as we talk about workforce wellbeing. Kristin, welcome.

Kristin Ray, MSN, RN: Hi, Bill. Thanks so much for having me.

Host: You bet. Excited to talk to you. So, Kristin, let me start with this. What inspired you to prioritize wellbeing in your leadership role?

Kristin Ray, MSN, RN: Well, I've been in the nursing profession for about 20 years now. Just saying that out loud sounds crazy. But in those 20 years, I've spent about over half those years in leadership. And what I really felt like that developed over time was like this deeply personal passion for the wellbeing aspect of what we do. In my time in leadership specifically, I had oversight over units of large spans of control and small spans of control. And what I can tell you is I have watched far too many incredible nurses, and I mean, truly exceptional clinicians leave the profession, right? And the reasons are varied, but the themes were painfully consistent. When we look at working in healthcare, working in nursing, being in nursing leadership, and seeing people struggle with work-life integration challenges, burnout, disengagement, rigid scheduling practices, and overwhelming administrative burden. And I just couldn't stand by anymore and watch the profession that we love lose more of its brightest people. And so, I wanted to help, and I wanted to lead organizational efforts that could genuinely move the mark on wellbeing so nurses could come to work and experience joy and fulfillment and a sense of purpose in what they do every day.

Host: I really like that. So, you saw a common theme that was causing nurses to leave the profession and decided you wanted to do something about that. So, I'm sure other people recognize that. And we have talked a lot about work-life balance on this podcast, a lot about burnout and things just like this. So, Kristin, how can hospitals create structures that truly support nurse wellbeing?

Kristin Ray, MSN, RN: Sure. And I'll tell you, it doesn't need to be a bunch of additive, new, crazy, creative things. Hospitals can really embed wellbeing into the fabric and culture of their organization by doing small things that can make big differences, like reducing unnecessary burdens, like how many clicks does it take to chart something and how do we lessen those amount of clicks to get the nurses back to spending more time at the bedside and less hoops to jump through to do their job. We can offer more accessible resources. We can create policies that protect their time and protect some of those precious boundaries that we need for rest and recovery.

So, some structural support might include things like developing a peer support program, allowing some flexible scheduling pilots for different groups of people, and incorporate wellbeing programs into more of a mobile access so we can bring wellbeing to where the work is being done and stop trying to pull people away and hope they show up to these offerings. So, we need to really work on wellbeing being a part of the professional practice itself and not side pieces that we hope people choose to participate in.

Host: Right. So as you said, it doesn't need to be additive, so it's not like we have to install all of these new programs. You said small things can make a big difference. You know, less hoops, more resources, structural support, flexible scheduling, more mobile access. So, just doing little things like that certainly can decrease the burnout and the burden that nurses feel sometimes.

So, I know you're in leadership, so tell us then, from your point of view, what role does leadership play then in normalizing conversations about stress and burnout? Because I know you feel it and you said you saw it in your own nurses. So from your point of view, how does that look?

Kristin Ray, MSN, RN: Yeah, I mean, I feel it, I see it, and I know everyone listening today can understand where I'm coming from on this. And we as leaders set the tone for our team culture, okay? So if we can openly acknowledge the challenges as leadership, share our own coping strategies, be vulnerable, and encourage dialogue with staff to make them feel safer, not only discussing aspects of wellbeing, but raising their concerns about it. So, we know that leadership, visibility and authenticity are critical in our roles to do our jobs well. So if we do that, and then we also have our own teams of nurses seeing leaders prioritize wellbeing, it validates that caring for yourself is part of being a great nurse for your patients. So, we need to make it where it's not a culture of being optional. And when you have time, take some PTO for yourself. Reset. Absolutely. But how can we model that behavior? Are leaders sending out emails on their days off and at 11 PM outside of their working hours? Are we modeling what it looks like to take great care of ourselves so staff feel like they can do that too?

Host: So when people see leaders such as yourself validate wellbeing, like not emailing at nine at night and taking care of yourself, that sends a big message then.

Kristin Ray, MSN, RN: Absolutely.

Host: So, are there other small everyday practices that can help leaders and staff sustain wellbeing?

Kristin Ray, MSN, RN: Oh, a hundred percent. And I'll actually say that simple, consistent practices often make the biggest difference, because they're more likely to become habits over time. So, leaders have the ability to encourage short breaks, some simple gratitude practices, maybe some quick connection exercises at huddles to open up a team meeting and maybe even quick wellbeing check-ins when they're out rounding on the unit with teams, or if they have time to do one-on-one with their staff. So, even these small gestures like recognizing effort or listening intentionally and attentively, this can help staff feel seen and supported. And what I consider kind of these "micropractices" actually can boost wellbeing big time in the long run.

Host: I like how you said that the micropractices. So as you said, simple, consistent practice of these small things can really make a big difference.

Kristin Ray, MSN, RN: Absolutely.

Host: So, that makes a lot of sense. Okay. On the flip side then, how about a bigger program or an initiative that you've done? Do you have an example of that that's made a difference?

Kristin Ray, MSN, RN: I'm really proud of a new offering that I started over the past year at my hospital where we introduced the idea of commensality groups. and I knew that the nurse manager, nurse director role was the first role I wanted to target with hopefully finding some meaning in this work. So, commensality is a fancy word of saying, "Hey, we're going to get some people together for a shared meal and a protected time of reflection."

So, what we did was we spent six months where we would meet once a month over a lunch hour, okay? And talk about wellbeing-related concepts and how they were impacting their work here at the hospital. And so, this group of 10 nurse leaders together came together again for that once a month for six months in hopes that, by discussing these things and sharing not only shared experiences, but potentially solutions to some common things that were creeping up in these groups would reduce isolation and strengthen connection. And it did just that.

I had a few people remark on the fact that it was their favorite "meeting of the month." They would high five each other in the hallway when something really good happened or when one of them had a professional accomplishment. And they came excited to be there every time. And you and I both know, and all of our listeners know, you don't keep coming to something if it's not effective or it's not working. And I had great retention throughout the program. Really boosted morale, really boosted connection, which we know are directly related to wellbeing.

Host: Commensality, is that what you called it?

Kristin Ray, MSN, RN: Commensality. Yeah, commensality.

Host: Wow. I love that. That is replacing the term lunch and learn then, I guess.

Kristin Ray, MSN, RN: And it truly is.

Host: Commensality. I love it. That is so cool. So, thank you for sharing that. And earlier you mentioned a term embedding wellbeing, which I thought, "I've never heard that before." Embedding wellbeing. So, let me return to that. Since you're dropping all these new phrases on us, commensality--

Kristin Ray, MSN, RN: Trying to keep you on your toes, Bill.

Host: And you're doing it. You are accomplishing that. I love it. So, what advice would you give to new leaders about embedding wellbeing, that term, into their practice?

Kristin Ray, MSN, RN: The best advice I can truly give is to start small and be consistent. Some people feel the overwhelm of needing to fix a thing like burnout by redoing a bunch of things and large scale projects. And to be honest, no one has time or sustainable effort for that. So, we have got to find a way to start smaller and funnel and narrow the scope of some of these big ideas we have to impact wellbeing.

So, we can start small with activities like I mentioned before, really actively listening to what matters most to your staff. Taking the time for some small, meaningful recognition in your department or on your unit. And then, of course, modeling aspects of work-life integration that are healthy, and not telling your staff to do one thing, but you as the leader do something else. So if you can do these small things over time, they build that culture or they embed wellbeing into that culture, where it's actually woven into the leadership on your unit and not treated like such an add-on.

Host: Yeah, I like that so start small, listen small, meaningful recognition goes a long way, et cetera. I think that's really good. I went to a-- It was at a healthcare marketing conference, and they had a speaker up there and he was talking about doctors' scores, and they had a doctor who was scored lowly that he didn't have much of a bedside manner. So long story short, they said basically start with the human, go to business, end with the human. And he's like, "This is not going to work. This is terrible." He did it. And he was amazed at the difference it made. And they said, "Do that with your own staff too. Start with the human. Don't just go right into business. How was your weekend? Did you do anything fun? How is the family? And then, just listen to that person." So, just a little thing like that, start with the human, can make a big difference. And I think that's exactly what you're saying, Kristin. This has really been fascinating.

Kristin Ray, MSN, RN: Yeah, Bill. And I love the human business, human model. I have read up on that. And as much as it is so important to start with that human aspect, ask them about the wedding they attended last weekend, asking how their new grandson is doing. I mean, it takes such minimal effort, but that connection is so directly related with people's intent to stay and positive team dynamic and cohesion. And then, of course, closing with the human aspect is just as important. How many times our meetings or huddles ended so abruptly to get back to everything we're doing? What can we do to finish those connections with something meaningful and purposeful? Again, not crazy hard and doesn't take a lot of effort, but yield significant outcomes on the backend.

Host: Great outcomes on the backend. We talk a lot about nurse retention, on this podcast, doing the things that you're talking about, Kristin, certainly helps with that too. We need to keep our nurses in the workforce. So, this is an added benefit of nurse retention too, is that right?

Kristin Ray, MSN, RN: Absolutely.

Host: Yeah, I think it's really good. Well, this has been awesome, Kristin. You have been dropping the knowledge on today. Thank you so much. So, let me ask you this last question. If our listeners listening right now remember one thing about workforce wellbeing, what should it be?

Kristin Ray, MSN, RN: Okay. In the simplest tagline I can possibly give for this answer, it is not an option. Supporting nurse wellbeing, supporting nurse leader wellbeing should no longer be optional. It is essential. If we want to keep great nurses in the workforce, if we want to keep great leaders in their role, if we want to continue to provide safe, high quality care that our patient's deserve, we need to create a thriving workforce with wellbeing at the center.

And I just want people to know, don't feel like you need to fix it all at once. There are going to be many things in the wellbeing landscape that, as a leader, will be out of your influence or control, and that's okay. We're going to make space for that stuff. Don't start there. Instead, ask yourself, "What can I do? What matters most to me as a nurse leader? What matters most to my team?" And don't assume. If you don't know, ask. And then, go on to say, "Okay, what can I do today that would make my day or week 10-15% better as a nurse leader? What would make my team's day or week 10-15% better if I did this?" Don't be afraid to try new things, and then keep moving in a positive direction.

Host: I love it. I'm ready to go.

Kristin Ray, MSN, RN: Bill, let's do it. We can change the world, Bill.

Host: I'm ready to come work for you. This is amazing. Oh my gosh. Drop the mic. This is not an option. It's essential.

Kristin Ray, MSN, RN: Oh, if I could drop the headset right now, I would.

Host: I love it. Not an option. It's essential. Kristin, this has been awesome. Can you come on like every quarter and just pump us up with your leadership tips? This would be awesome.

Kristin Ray, MSN, RN: Bill, my major is in nursing leadership, my master's degree. But if it was in being a hype girl and pumping people up, that would be my minor.

Host: I love it. I love it. Kristin, thank you so much. This has really been informative. And I know everyone listening definitely got something out of this. So, thank you again for your time. We appreciate it.

Kristin Ray, MSN, RN: Yeah. So happy to be here. Thanks again for having me.

Host: You bet. And once again, That is Kristin Ray. For more information, please just 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 at aonl.org/nursing-leadership-podcast. This is Today in Nursing Leadership. Thanks for listening.