Nurse Darleen Dagey remembers the toll the COVID-19 pandemic took on her and her colleagues at Sibley Memorial Hospital. Staffing challenges, long shifts, loss of control, and other stressors put nurses at risk for burnout at a time when they were expected to be more resilient than ever.
“So many health care workers were redeployed to other areas to help as needed, and the constant change wore people down,” Dagey says. “The baby nurses were taking care of adults and when the operating rooms were closed, the OR nurses were working in surgery, COVID units, or the ICU. Working out of their comfort zone was challenging.”
Today Dagey is helping Sibley, a Johns Hopkins Medicine partner hospital in Washington, D.C., to address the lessons learned from the pandemic and assess the ongoing needs of caregivers in her new role as resilience nurse. She is excited about the position, which is funded by philanthropy.
“In a way, I know it’s a little bit experimental. Sibley’s the only hospital within Hopkins that has a resilience nurse. I think it’s a great opportunity to really build something to help benefit this wellness path,” says Dagey, who started at Sibley 18 years ago as an operating room staff nurse.
As a resilience nurse, Dagey works to identify the root causes of caregiver burnout, including limited resources, ongoing change, and patient suffering — all of which were front and center during the pandemic. Even before COVID-19, the work environment for the nation’s 4.3 million registered nurses was challenging. According to the American Nursing Association, nurses were already under strain due to increased demand for health care from aging populations, inadequate workforce support, and retirements outpacing new entrants to the field.
While the nursing shortage is rebounding somewhat at Sibley, Dagey recognizes that there are open positions in every department. She also notes that many new nurses didn’t receive on-site clinical training during the pandemic, a stress factor for both them and the veteran nurses who help train and mentor them. Dagey views herself as their go-to so they can focus on their primary role of caring for patients. “Nurses are challenged every day and to have a support person available to them is important,” she says. “They are always caring for other people, putting them before their own needs.”
In addition to recognizing stressors, Dagey provides one-on-one coaching for nurses and other staff to build resiliency and helps them navigate options for issues outside of work, such as finding child care. She says some of the most effective wellness techniques are “easy to teach, learn, and practice even on the job.” These include deep breathing exercises, journaling, expressing gratitude, and especially important for caregivers, practicing self-compassion.
Dagey will work closely with nurse scholars who are transitioning from nursing school to the clinical environment to help prevent burnout. “There have been statistics indicating that nurses are leaving the profession during those first two years because it is very overwhelming,” she says. “What we experience in nursing school and the real world is very different, so being that extra support person is the goal.”
The resilience nurse will also coordinate with other nurse leaders at Sibley to assess morale within individual units. For Nurse Manager Gia Oliveira, the timing couldn’t be better. Recently, she started managing a 40-member team of mostly outpatient nurses, technicians, and registration staff. The team previously lacked structure and an understanding of hospital protocols and was feeling overwhelmed with a new manager and new policies. Dagey met with team members to better understand their frustrations and provide guidance for maintaining a positive mindset, navigating change, and communicating their needs professionally.
Oliveira recognizes the culture shift will take some time, but she’s optimistic. “Health care is going to continue changing. Every day there is something new,” she says. “Infusing tools that will assist staff with handling changes, improving culture, and enhancing moral resilience is extremely important.”
Dagey is pleased that nurses and other staff at Sibley are recognizing her role as resilience nurse. “I’ve built trust with people so they feel supported. They know they can come to me, and that feels really good.”
Topics: Faculty and Staff, Foundations, Friends of Johns Hopkins Medicine, Johns Hopkins Medicine, Promote and Protect Health
“Those on the front lines serving the needs of our country deserve our support, not just during the pandemic but every day. And that's the nurses, the doctors, the whole profession that's been hit particularly hard," says Brian McHugh, ManTech’s chief of staff.
Less than one month after treating its first COVID-19 patient, Suburban Hospital opened a temporary Resiliency Lounge, a calming space where nurses and other staff could refresh, de-stress, and recharge 24/7. Philanthropy later helped to make a permanent space possible.
Professor Cynda Rushton's work on moral distress in nurses has guided the creation of new programs and resources for nurses, hospitals, and researchers during the COVID-19 pandemic.