Leadership NRP: Need a Revitalization Program for you and your team?

How to overcome mental fatigue, increase engagement, and build a positive powerpack team

Health care provider with gown and mask

US Navy Mass Communication Specialist 2nd Class Sara Eshleman, Public domain, via Wikimedia Commons

Effects of COVID on Nursing Staff

It’s not surprising that healthcare workers and systems have experienced unusual strain because of COVID-19. Now is the time to connect with staff and refocus on what the healthcare world looks like moving forward. Survey results from the American Nurses Foundation of more than 22,000 nurses found that 18% of survey respondents intend to leave their position in the next six months. The top reasons nurses intend to leave nursing are:

  • negative health/well-being,
  • insufficient staffing,
  • inability to deliver quality of care on a consistent basis
  • distrust of employers

With respect to mental health and wellness, survey results revealed that within the past 14 days, 72% of respondents reported that they felt exhausted, 64% felt overwhelmed, 57% anxious or unable to relax or irritable, and 38% felt sad.¹

The coronavirus pandemic has caused increased feelings of distress for many healthcare workers leading to post traumatic stress symptoms such as:

  • distressing dreams
  • suppressed feelings
  • avoidance of events
  • mental fatigue
  • sleep disturbances
  • irritability
  • difficulty concentrating

These unresolved symptoms lead to trauma, which has lasting adverse effects on healthcare workers’ ability to function. Additionally, trauma negatively affects their mental, physical, social, emotional, and/or spiritual well-being.² Addressing staff’s emotional needs, particularly post-covid, should be a priority for healthcare leaders across the country. Thankfully, evidenced-based tools and experts are available to help guide and facilitate healing after traumatic events like COVID-19.

Connecting, Using the Trauma Informed Approach

Kim Brown Sims, MBA, RN, FACHE, a workforce and career strategist, says it’s beneficial to use a trauma informed approach to build trust and collaboration between leadership and staff after the trauma of COVID-19, federal research agencies, academic institutions, and practice-research partnerships have created empirically-supported interventions to address trauma in a variety of settings, including healthcare. The six key guiding principles of a trauma-informed approach³ are:

  • Safety
  • Trustworthiness and transparency
  • Peer support
  • Collaboration and mutuality
  • Empowerment, voice and choice
  • Cultural, historical, and gender issues

In Kim’s words, “now is the time to take a pause, reset, acknowledge staff struggles and trauma, and create a shared vision for our future.” Simple conversations are the key to start building an environment of safety and trustworthiness. Ms. Sims suggests leaders take the time to discover what is important to each staff member, inquire about their personal goals, establish what success looks like for them, and ask how they are doing physically and emotionally. These conversations are great starting points to build a positive professional relationship. This positive relationship provides opportunities for creating a shared vision to enable goal achievement for the unit, organizational, and staff.

In an effort to create a foundation of safety, it is important to ensure a wellness program is available to support staff that may need additional services. This can include things like the EAP program, Code Lavender, health screenings, exercise programs and activities, and stress reduction programs. Coordinating groups of staff together to talk about their struggles creates an opportunity for collaboration and mutuality to facilitate healing. A partnership can grow and develop when staff and management connect on a personal level, share their experiences, and develop understanding from one another’s perspective.

Through the process of collaboration and partnership, barriers are broken and it leads to staff empowerment. Staff will begin to feel management understands their value when leaders and organizations focus on connecting with staff in a meaningful way. “Creating a shared vision for the day, the week, and the year is an effective way to connect,” states Sims. Support and encourage staff to create individual and unit goals to give them something to look forward to and eventually celebrate. This unity and shared vision brings energy, positivity, and inspiration to the unit, ultimately providing a foundation for prioritization of shared goals.

While being mindful of staff trauma and struggles, it is important to recognize biases and stereotypes (i.e. gender, race, ethnicity, sexual orientation, age, geography). In recent years, progress has been made with cultural, historical, and gender issues, yet there continues to be a hierarchical top-down, fear based model within the healthcare system. Leaders of today have the chance to combat the traditional model by showing humility and responsiveness to address issues at hand.

Utilizing the six principles of the trauma informed approach allows leaders the opportunity to effectively connect with staff to build a sense of trust, value, and respect. Research shows that organizations that avoid or misunderstand the impact of trauma may re-traumatize individuals and hinder the healing process.³ Additionally, unresolved trauma can be built into unit or organizational cultural norms, which perpetuates the trauma and challenges the possibility for staff to be happy and engaged. The safety and health of both patients and healthcare workers benefit from healthcare organizations mobilizing trauma resources and supporting their staff and providers.

K. Brown Sims
Medical staff listening with arms crossed

Navy Medicine from Washington, DC, USA, Public domain, via Wikimedia Commons

Practical Strategies for Building Engagement

There are many ways to create a positive environment, from upper management, shift leaders, charge nurses, or other informal leaders on the team. The process of connecting with staff and building engagement can be slow and it takes patience, persistence, kindness, positivity, energy, inspiration, and understanding, according to Sims. She suggests to start implementing some of the elements below to move your team into “Powerpack Mode”:

  • Celebrate, even for the smallest things! Handwrite notes to staff expressing appreciation or complimenting good catches. Either hand deliver to the recipient or mail the note to their home. Find opportunities to celebrate everything you can and bring fun back into the workplace.
  • Display goals set by staff on a visual management board, present their achievements, and define work to be done. Encourage your team to set two to three priorities per shift that will be the guiding tone for the shift. It is important to decide what the team will focus on each day.
  • Entertain with a social gathering. This can be done via zoom, at a restaurant, or on the unit. Make the gathering fun by having a theme to infuse joy into participants.
  • Focus on people’s amazing gifts. Everyone has unique gifts they bring to the unit so focus on people’s strengths rather than their weaknesses. Create a team that leverages everyone’s contributions that make the unit successful.
  • Lead by example by sharing positivity throughout the unit and in different interactions. Positivity creates a sense of energy and inspiration, which spreads easily when it comes from engaged leaders.

It is time to start implementing some of these practical strategies to heal trauma, increase engagement, and build a cohesive team with unifying goals.


Join us at the Synova 25th Anniversary Nurse Leadership Forum in Tucson, Arizona from November 14-18, 2021, for additional ideas and guidance on alleviating mental fatigue and trauma caused by the pandemic.