Implementation and evaluation of a wellness resource for resiliency amongst emergency nurses in a rural Newfoundland site

Background: Emergency department (ED) nurses are at high risk of compassion fatigue (CF) because of repeated exposures to traumatic experiences of others. Due to the fast-paced nature of the ED, brief interventions are needed to help improve nurses’ resiliency. A wellness resource (Higdon, 2022), specifically developed for oncology staff at an urban hospital in NL was found to have supportive interventions that were potentially transferable to ED staff. Purpose: To implement a wellness resource with emergency nurses in a rural NL site and evaluate its impact on their resilience and wellbeing. Methods: Permission was granted by the original author to use this resource. The following steps were completed: a literature review helped to determine that the same interventions (e.g., self-care and debriefing) were effective for ED nursing staff as those originally provided for oncology staff, and identified appropriate methods of implementation and evaluation; consultations with four key stakeholders (including the clinical educator, unit manager, and two unit nurses), provided insight into staff needs and potential issues with fostering resiliency at this site; an environmental scan found relevant resources within the health authority and other organizations; and a needs assessment that explored participants’ years working as an ED nurse, preferred methods of education delivery, and appropriate timing for education sessions. Higdon’s (2022) PowerPoint presentation was adapted to include self-care methods, debriefing resources, and additional information pertinent to ED nursing and was delivered to ED nursing staff at the rural site. The Qualtrics software platform was used to distribute the Professional Quality of Life Score (ProQOL) instrument and the Connor Davidson Resiliency Scale (CD-RISC) to determine baseline and follow-up scores for participating nursing staff. Results: The most commonly used and effective interventions reported by participants included education regarding self-care, mindfulness-based stress reduction strategies, and debriefing opportunities using in-person or virtual formats. The environmental scan indicated staff would like the option to participate in-person, virtually, and as a pre-recorded session to be completed when they had the time. These strategies and methods of delivery aligned with the identified strategies in Higdon’s (2022) wellness resource. The initial scores for the ProQOL and CD-RISC scales ranged from mild to moderate levels of compassion fatigue and moderate levels of resiliency, respectively. Nine pre-intervention questionnaires were completed (n=9). Results from post-intervention questionnaires (n=5) indicated a positive improvement in ProQOL and CD-RISC scores. The intervention was well received by nursing staff who expressed a willingness to participate in other wellness activities. Conclusion: Repeated exposures to traumatic experiences and suffering of others can lead to compassion fatigue, burnout, and secondary traumatic stress. Increasing resiliency in nursing staff is one way to combat symptoms of compassion fatigue. There is an opportunity for nursing staff to improve their resiliency and reduce symptoms of compassion fatigue by implementing various strategies within their workday. This wellness resource is an evidence-based option with brief and potentially effective actions for ED nursing staff to use to improve their wellbeing