Delaware - June 2022

Page 8 • DNA Reporter June, July, August 2022
How Applying the Concept of Authentic Leadership and Elevating the Culture
of Workplace Support Improves Nurses Physical and Mental Well-being
Theresa Latorre-Tegtmeier, DNP, APRN, NP-C
Theresa Latorre-Tegtmeier is a
palliative care nurse practitioner
at Bayhealth Medical Center.
She earned her ASN from
Delaware Technical and
Community College, her MSN
from Drexel University, and her
BSN and DNP from Wilmington
University. Theresa has extensive
experience in management
having worked in book sales for
10 years prior to transitioning to
nursing. She started her nursing
career as a medical-surgical
nurse in 2008 on 1A where
Theresa Latorre-
Tegtmeier
she initiated a mentoring program for her unit. Theresa
then transitioned to informatics where she helped develop
the informatics nursing department at Bayhealth. After
graduating with her MSN she went on to start the palliative
care department at Bayhealth in 2015. Theresa’s passion
for caring for patients with complex disease diagnoses and
uncontrolled symptoms is evident in the services that have
been provided to the population of Kent County. She has
helped grow the department from one APRN servicing
the Kent Campus to four APRN’s, one physician and the
support of the hospital chaplains servicing both Kent and
Sussex Campus, as well as an outpatient clinic in Dover, DE.
In preparation for her doctorate, Theresa recognized a lack
of palliative care support for patients with advanced heart
failure (AdHF) and studied the benefits of early palliative
care intervention in patients with AdHF. She is the president
elect for the Delaware Quality of Life Coalition (DQOLC)
and vice president for the Delaware Ballet. Theresa can be
reached by email at ttegtmeier@gmail.com.
In December of 2019, a number of patients in
Wuhan, China began to experience shortness of
breath and fever due to a pneumonia of unknown
etiology. On January 7, 2020, Chinese authorities
identified a novel coronavirus as the causative agent
and the Centers for Disease Control and Prevention
established the 2019-nCoV Incident Management
Structure. On January 20, 2020, the first US confirmed
case was detected in Washington State, and on
March 11, 2020, the World Health Organization
declared COVID-19 a pandemic (CDC, 2022). In the
United States alone, over 80 million people have been
infected by the rapidly spreading COVID-19 virus,
resulting in more than 984,000 deaths (NYT, 2022).
The medical and scientific professionals were not
prepared to deal with the magnitude of this disease.
By the end of 2020, there were still no approved
vaccinations to prevent further spread or treatments
to lessen the impact once contracted (Um-e-Rubbab
et al., 2021).
Healthcare Challenges
Though the challenges to the healthcare system
have been substantial: surge volume preparedness,
pandemic protocol development, personal protective
equipment (PPE) availability, and novel staffing
strategies; the impact on the personal well-being
of healthcare personnel, especially nurses, has been
momentous (Raso et al., 2021). Clinician burnout,
stress, and anxiety were an epidemic in nursing
prior to the pandemic; COVID-19 simply exacerbated
the issue. According to Melnyk et al. (2021), of the
nurses who participated in their study, more than
50% reported worsening physical and/or mental
health due to the pandemic. In addition, the majority
did not meet best practice recommendations
regarding disease preventative lifestyle behaviors
such as eating a balanced diet, daily activity, and
obtaining adequate sleep. Nearly 54% stated that
the pandemic made their physical health worse
and 79% reported worsening mental health. 38%
reported increased alcohol consumption and only
about 35% reported sleeping seven or more hours
per night. Unfortunately, these trends not only affect
the clinician but impact the quality of care that
they provide to their patients. (Melnyk et al., 2021).
Research shows that targeted interventions that are
implemented by managers who exhibit authenticity in
their leadership approach results in positive outcomes
for the individual clinician as well as the organization
as a whole.
Authentic Leadership
Authentic leadership is believed to be a critical
tool and has proven to improve patient safety and
clinical outcomes, nurse staffing and retention, and
improve the overall well-being of nurses. Authentic
leaders influence their teams through skilled
communication, effective decision-making, true
collaboration, and meaningful recognition. When
effectively implemented, it results in the creation and
sustainability of a healthy work environment.
Authentic leaders demonstrate four distinct
components that promote psychological and ethical
climates. These four components are:
1. Self-awareness: the ability to understand one’s
own strengths and weaknesses and how they
impact others, ability to read skills of one’s self
in relation to the actions and feelings of others
2. Balanced processing: soliciting opinions and
viewpoints prior to making decisions, applying
the concepts of shared decision making
3. Relational transparency: forthcoming in sharing
information; openly admits mistakes
4. Internalized moral perspective: maintaining a
high standard of ethical and moral conduct;
used to self-regulate behavior (Frasier, 2019).
Nurse leaders play a significant role in nurses’
physical and mental well-being, as well as their
working environment and work-related well-being.
By utilizing the above components, the authentic
leader will successfully develop a positive work climate
that would allow their team to feel more secure and
confident in their actions. In addition, the positive
emotions shared by authentic leaders may become
infectious, contributing to the overall well-being of
their team (Nelson et al., 2014).
Workplace Wellness Culture
In addition to strong leadership, organizational
support also showed statistical significance in the
overall health and wellness of clinicians. Studies
found that nurses who perceived their workplace as
supportive of their health and well-being showed
improvement in their overall physical and mental
health. They were five times more likely to get seven
or more hours of sleep, 16 times more likely to eat
five or more servings of fruits/vegetables per day, and
less likely to report a negative impact of the pandemic
on healthy behaviors. System reviews indicated that
effective interventions proven to benefit one’s mental
and physical health of physicians and nurses include:
practicing mindfulness; purposeful, deep abdominal
breathing; and gratitude (Melnyk et al., 2021).
Examples of these interventions are currently in practice
at Bayhealth:
1. Series of Mindfulness Workshops led by Dr. Jillian
Horton – these are one-hour webinars that lead
us through a practice of mindfulness and how
that benefits one personally and professionally
2. SKY Breath Meditation Courses – an empowering
technique that works as an instant stress reliever.
In as little as 10 minutes you will clear your mind
through calm breathing and guided meditation.
3. Code Lavender – rapid response to staff in
need of immediate support during a difficult
time/situation. Kits include a massage chair,
aromatherapy, adult coloring books, colored
pencils, relaxation techniques, and chocolate.
They are delivered to the person and left in place
for 24 hours to be used by anyone that needs to
take some time to decompress.
4. Weekly Faith, Spirituality, and Meditation Events
led by Rev. Carol Harris – Rev. Harris opens
with a short prayer and has a guest speaker
who presents on the topic of the week. It is
broadcasted through the Bayhealth Facebook
page for staff and the community.
5. Family Medicine Wellness Program led by Su
Chaffin, LPCMH
6. Pet Therapy Teams – Dogs and their trainers roam
the hospital providing short bursts of happiness