Tennessee Nurse - May 2021

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Page 22 Tennessee Nurse May, June, July 2021 If This is Nursing continued from page 21 and caregiver burnout. This exposure to prolonged stress can have damaging effects if corrective mechanisms are not incorporated. The trajectory of a career in nursing is comparable to the general adaptation model created by Hans Selye in 1950. This model explains the body’s responses when exposed to prolonged periods of stress. The three phases of the general adaptation model include alarm, resistance, and exhaustion. Please see the image on the previous page for further explanation. The beginning is where new nurses are on fire for the profession, going to work every day driven by the thrill of saving lives. However, this is also the time when experience is lacking, and advanced nurses are heavily relied upon. If the quest for support is met with incivility, the new nurse enters the alarm phase, and the beginning of their career is only made more difficult. As the new nurse gains experience, the persistent stress leads to the resistance phase, and the nurse accepts the situation as normal. Outward displays of the resistance phase include frustration, irritability, and lack of focus. Continuing on, the exhaustion phase sets in. Signs and symptoms of the exhaustion phase include burnout, fatigue, anxiety, and decreased tolerance. Mental health suffers greatly during the exhaustion phase, resulting in lack of sleep, lack of self-care, and overall irritability. Now, this is the nurse who is being relied upon by the new nurses coming up behind them, and the support given is potentially aggressive and derogatory. All the aforementioned conclusions could then posit that incivility does not result from negative intent but rather a product of emptiness and burnout. So, what can be done to promote a civil culture among all levels of nursing? How to Combat Incivility Changing the norm must start at the beginning of the professional experience. As reported by Nickitas, Cynthia Clark recommends integrating civility training throughout the nursing curriculum. Suggestions include programs that can be purchased, creating scenarios where students can role play, developing codes of conduct that include expected behaviors, and positively reinforcing and recognizing demonstrations of civility (2014). However, this is just the beginning, and this endeavor must be carried into the workforce. At the bedside, the responsibility of promoting civility falls to the institution, management, peers, and self. Cynthia Clark also recommends that a commitment to civility be present in the mission, vision, and value statements of the institution (Nickitas, 2014). Furthermore, the institution and management should provide the following: comprehensive orientations, peer mentoring, offering advice and assistance to new nurses, structured positive reinforcement from senior/expert peers, offering conflict management services, offering civility education to management, and hosting social gatherings to promote collegial relationships (Smith, Andrusyszyn, & Laschinger, 2010). Additionally, peers can respond and support their colleagues in real-time. When an occurrence of incivility occurs, the target of the maltreatment can say a code word that alerts surrounding peers who can then come and stand behind or beside the target to offer support (Evans, 2017). The individual can complete assessment tools to aid in self-reflection and evaluation of behaviors in stressful moments. (Evans, 2017). According to the ANA position statement, all occurrences of incivility should be addressed immediately and privately with the offender, reported through the appropriate channels, and documented adequately (2015). Conclusion In conclusion, incivility is plaguing nursing, not from a place of maliciousness but from exhaustion. Commitments must be made from all levels to combat this issue before any real change can begin. Educators must arm the next generation with tools to handle this malady, institutions must commit on a global level and a managerial level to provide proper training and policies, and nurses must commit to demonstrating professional respect toward peers and self-reflection of behaviors. References American Nurses Association. (2015). Incivility, bullying, and workplace violence. American Nurses Publishing. Canevello, A., & Crocker, J. (2017). Compassionate goals and affect in social situations. Motivation and Emotion, 41(2), 158-179. doi: http://dx.doi.org/10.1007/s11031-016- 9599-x Evans, G. (2017). Training for toxic work culture should start in nursing school: Preparing for incivility, bullying, preventing violence. Hospital Employee Health, 36(5), 49–52. Samson-Mojares, R. (2014). Rising above the culture of incivility in nursing. Florida Nurse, 62(4), 16. Selye, H. (1950). Stress and the general adaptation syndrome. British medical journal, 1(4667), 1383–1392. https://doi.org/10.1136/bmj.1.4667.138 Smith, L. M., Andrusyszyn, M. A., & Laschinger, H. K. (2010). Effects of workplace incivility and empowerment on newly-graduated nurses’ organizational commitment. Journal of Nursing Management, 18(8), 1004-1015. doi:10.1111/j.1365-2834.2010.01165.x
May, June, July 2021 Tennessee Nurse Page 23 Honoring Healthcare Heroes Through the Brave of Heart Fund Heather Nesle President, New York Life Foundation Vice President, New York Life Insurance Company Heather Nesle is president of the New York Life Foundation, the charitable foundation created by New York Life Insurance Company. In addition to her Foundation duties, she is vice president of New York Life’s Corporate Responsibility Department. In April 2020, New York Life announced that it has partnered with Cigna to launch, through their foundations, the Brave of Heart Fund. The Fund provides financial and emotional support to the families of healthcare workers and volunteers nationwide – including doctors, nurses, Heather Nesle technicians, orderlies, cafeteria workers, custodians – who lost their lives to COVID-19. Please see the FAQs at https://www. braveofheartfund.com/faqs for the complete definition of eligible healthcare workers. The Fund launched with initial contributions of $25 million each from the New York Life Foundation and Cigna Foundation. To further support the Fund, the New York Life Foundation also provided a dollar-for-dollar match on the first $25 million in individual donations received, and Cigna has committed to provide behavioral and emotional health support to the families to help them cope with grief. The Brave of Heart Fund is our way to honor these heroes by doing what New York Life and Cigna do best – supporting these individuals and their families with financial and emotional support and being there when we are needed most,” said Heather Nesle, President of the New York Life Foundation. “I think New York Life Chairman and CEO Ted Mathas said it best,” Nesle continued, “In tough times, true heroes are revealed. The heroes today are not only the courageous and selfless frontline healthcare workers and volunteers who, without hesitation and without question, have put themselves in harm’s way to help those who desperately need it, but also their families who are living with the anxiety and fear of what may happen to their loved ones in the days ahead.’” The Fund provides eligible families with initial charitable grants of $15,000 that seek to provide peace of mind by covering their immediate expenses and getting health and wellness services to them quickly. Eligible families of fallen healthcare workers will also be able to receive up to an additional $60,000 to aid their recovery. Grants will be made subject to a determination of need at the discretion of E4E Relief, a subsidiary of the public charity Foundation For The Carolinas, working in partnership with New York Life and Cigna. All contributions made to the Fund will go to providing monetary grants to the loved ones of eligible healthcare workers and volunteers who lost their lives battling COVID-19, including spouses, domestic partners, children, and parents. In a press release issued by E4E Relief, John Varkey, who recently lost his wife, Aleyamma John, a longtime Queens Hospital Center nurse, to COVID-19, said: “The generosity of the Brave of Heart Fund during what has been the toughest time of my life has made such a difference. I am so grateful to everyone who found it in the goodness of their hearts to think of the families of the heroes who gave the ultimate sacrifice caring for their fellow humans during these unprecedented times.” To date, the Fund has disbursed more than 555 grants worth more than $12.9 million to families of healthcare workers who lost their lives fighting the COVID-19 pandemic. The Fund has processed over 630 applications from 38 states and 385 unique grantees (many receive both Phase One and Phase Two grants). Thirty-five percent of the healthcare worker’s decedents represented in the Fund right now are in the nursing profession, and 82 percent of the nurses were the primary or the sole income provider in their households. It has been reported through various sources that there are nearly 4,000 U.S. healthcare workers who have died from COVID-related illness, so clearly, there are many more families to reach. While we have money to give, we need assistance in locating eligible families and getting them information about the Fund. For more information, please visit braveofheartfund.com, where individuals can start the grant process by verifying eligibility to apply for a Brave of Heart Fund grant. Additional bereavement resources can be found at newyorklifefoundation.org.
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Tennessee Nurse - May 2021

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