Delaware - June 2022

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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
June, July, August 2022 DNA Reporter • Page 9 and time to destress for patients and staff 7. Reiki and Healing Touch – community practitioners come to the hospital and provide their services to the staff (Bayhealth, n.d.). The COVID-19 pandemic has changed the landscape of healthcare and has put immense pressure on the clinicians caring for patients. Ensuring managers are practicing authentic leadership and the organization is providing a supportive work environment has shown to improve the overall physical and mental well-being of clinicians. As a bonus, patients benefit as well through improved clinical outcomes. References Bayhealth. (n.d.). Bayhealth intranet. Center for Disease Control and Prevention. (2022, January 5). CDC museum COVID-19 timeline. https://www.cdc.gov/ museum/timeline/covid19.html Frasier, N. (2019). Preparing nurse managers for authentic leadership. The Journal of Nursing Administration, 49(2), 79-85. Melnyk, B. M., Hsieh, A. P., Tan, A., Teall, A., Weberg, D., Jun, J., Gawlik, K., & Hoying, J. (2021). Association among nurses’ mental/physical health, lifestyle behaviors, shift length, and workplace wellness support during COVID-19: Important implications for health care systems. Nursing Administration Quarterly, 46(1), 5-18. Nelson, K., Boudrias, J-S., Brunet, L., Morin, D., De Civita, M., Savoie, A., & Alderson, M. (2014). Authentic leadership and psychological well-being at work of nurses: The mediating role of work climate at the individual level of analysis. Burnout Research 1, 90-101. New York Times. (2022, April 10). Coronavirus in the US: Latest map and case count. https://www.nytimes.com/ interactive/2021/us/covid-cases.html Raso, R., Fitzpatrick, J. J., Masick, K., Giordano-Mulligan, M., & Sweeney, C. D. (2021). Perceptions of authentic nurse leadership and work environment and the pandemic impact for nurse leaders and clinical nurses. The Journal of Nursing Administration, 51(5), 257-263. Um-e-Rubbab, Farid, T., Iqbal, S., Saeed, I., Irfan, S., & Akhtar, T. (2021). Impact of supportive leadership during COVID-19 on nurses’ well-being: The mediating role of psychological capital. Frontiers in Psychology, doi:10.3389/fpsyg.2021.695091 American Lung Association’s “Zeroing in on Healthy Air” Report Delaware’s Data – Opportunities for our Nurses Earlier this year, the American Lung Association released the new “Zeroing in on Healthy Air” report, which revealed that a transition to zeroemission, electric vehicles would have a dramatic impact on the air quality and health of Delaware residents. In fact, a widespread transition to zeroemission vehicles powered by clean, non-combustion electricity would result in up to 462 avoided deaths and $5.1 billion in public health benefits here in Delaware over the next 30 years. On a national level, this transition would result in 110,000 avoided deaths, 2.79 million avoided asthma attacks, 13.4 million avoided lost workdays and $1.2 trillion in public health benefits across the United States. This report illustrates the potential health and climate benefits if all new passenger vehicles sold are zero-emission by 2035 and all new heavy-duty vehicles (such as big rigs, school buses, and shorthaul delivery vans) sold are zero-emission by 2040. The report also projects that the nation’s electric grid will be powered by clean, non-combustion renewable energy replacing dirty fossil fuels by 2035. The transportation sector is a leading contributor to air pollution and climate change, and too many Delawareans suffer health impacts because of vehicle emissions. Especially as Delaware faces the impacts of climate change such as worsening air quality and decreased access to clean drinking water, transitioning to electric vehicles is a powerful and practical opportunity to improve our health and our future. Despite decades of progress to clean the air, more than four in ten of all Americans still live in a community impacted by unhealthy levels of air pollution. Those impacted by polluted air face increased risk of a wide range of poor health outcomes. Further, climate change poses risks to everyone’s health. The combustion of fuels for electricity generation and transportation also create significant disparities in pollution burdens and poor health. Lower income communities and communities of color are often the most over-burdened by pollution sources today due to decades of inequitable land use decisions and systemic racism. The transition away from combustion technologies and toward zero-emission technologies in the transportation and electricity generation sectors can significantly reduce exposures to pollution, especially in communities with nearby highways, ports, warehouses, refineries or power plants. Thankfully, the technologies and systems are in place to make these benefits a reality. Accelerating the shift to zero-emission transportation and non-combustion electricity generation will generate major reductions in harmful pollutants. “Zeroing in on Healthy Air” envisions widespread transitions to zero-emission transportation and non-combustion electricity generation over the coming decades, including 100 percent sales of zero-emission passenger cars by 2035 and of heavy-duty trucks by 2040, and shifting to non-combustion electricity generation by 2035. Strong investments and policies at the local, state and federal levels are needed to reduce harmful pollution and ensure all communities stand to experience cleaner air. Read the report at Lung.org/EV How to Save for Education Without Taking your Eye Off of Retirement It’s no secret that many American parents want to support their kids by paying for their college education. According to recent research from Student Loan Hero, 92 percent of parents today have already paid for or plan to assist with these costs. Furthermore, 68 percent of parents say they would consider withdrawing from their retirement savings, potentially delaying retirement, to help their kids pay for college. While the choice to delay retirement to pay tuition is understandable and even admirable, the reality is doing so may not be the wisest financial decision. If you are considering how to balance saving for college and retirement, read on for some perspective. Prioritize college bills or retirement? Although it may be hard to hear, saving for retirement should take priority over college tuition. To understand why, consider the following: • You may not get to choose your retirement date. Injury, caring for an aging parent, or a layoff are among the factors that could ultimately make the decision for you. • You don’t want to run out of money in retirement. If your savings come up short, you don’t have the ability to apply for scholarships, grants or financial aid to help bridge the gap. (Your child has access to these options to help pay for college.) Instead, your options are likely to be working longer, finding other sources of income or spending less on travel and other retirement dreams. While it’s imperative to focus on your own financial security in retirement, funding higher education is still an important goal for many parents. The key is striking the right balance between saving for both goals. Consider the following tips as a starting point: 1. Paying for college doesn’t have to be all-ornothing. Many parents choose to pay a percentage of the total bill, cover certain expenses (e.g. tuition, technology fees or room and board), pay for a set number of years, or contribute as much as they are able to save by the first day of school instead of funding the full cost. Revising your college savings goal in one of these ways could allow you to direct more money to retirement. 2. If your child has sights on graduate school, decide whether you will contribute to those bills too. This decision is particularly important if your child needs a graduate degree before entering his or her field of choice. If you intend to provide financial support, calculate how much the total cost will be so you have a clear savings target in mind. 3. Discuss your intentions with your child. No matter how much you contribute, talk to your child (if and when your child is old enough) about your financial commitment so he or she knows what to expect. Discuss how your contribution will look like at their preferred colleges. For example, if you agree to pay a set amount, perhaps this money will fully cover community college, a substantial amount at a state school, and leave a larger portion of the bill outstanding at a private college. Breaking down the costs for your child can help him or her make an informed decision about how much student debt (or scholarships, grants, etc.) is needed to cover the bill. No matter your financial situation, know that it is possible to make meaningful progress toward both goals, particularly if you are intentional about how to allocate your savings. Consult a financial advisor and tax professional if you want help setting specific savings goals and understanding the various investing options available to you. 1 Student Loan Hero survey, 2021 Christopher Malmstrom, CRPC, APMA, is a Financial Advisor with Point to Point Wealth Planning a private wealth advisory practice of Ameriprise Financial Services, LLC in Wilmington, DE. He specializes in fee-based financial planning and asset management strategies and has been in practice for 12 years. To contact him, visit his website www.ameripriseadvisors.com/ christopher.malmstrom or call 302-995-7526. His office is located at 5195 W Woodmill Drive, Suite 27, Wilmington, DE 19808-4067. Ameriprise Financial, Inc. and its affiliates do not offer tax or legal advice. Consumers should consult with their tax advisor or attorney regarding their specific situation. Investment advisory products and services are made available through Ameriprise Financial Services, LLC, a registered investment adviser. Ameriprise Financial Services, LLC. Member FINRA and SIPC. | © 2021 Ameriprise Financial, Inc. All rights reserved.
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