Creation of a Serenity Room in an Acute Care Hospital Setting:

Nurses face physical, emotional, and mental stress in their daily work. Job-related stress is linked to decreased job satisfaction and patient satisfaction. Researchers describe job-related stress as; burnout, compassion fatigue, and vicarious traumatization.(1,2, 10) Nurses at a community teaching hospital, through the EBP/nursing research forum, focused on the topic of nurse stress and burnout as a means of addressing job satisfaction, staff morale and patient satisfaction. The group formed the EBP practice forum group in the fall of 2014. The evidenced based practice project was discussed and decided upon. Seventeen nurses in an acute care hospital from varied backgrounds and area of specialty volunteered to appraise the evidence using the Johns Hopkins Nursing Evidence-Based Practice model. The team met on three occasions to discuss the assigned articles and synthesize evidence for recommendations.

The PICO question, “What self-care strategies are most effective for increasing job satisfaction/ morale of acute care nurses? A comprehensive literature search was conducted using PubMed and CINAHL data bases. The keywords were job satisfaction, morale, nurse, self-care, interventions, stress, stress-reduction, and burn out, compassion fatigue, wellness, and job stress. The initial search yielded sixty articles, of which twenty-six were relevant and reviewed by the team. The evidence appraisal of the twenty-six articles included: no Level I articles, two Level II articles (both with a B rating), five Level III articles (all with a B rating), no Level IV articles and eight Level V articles (all with B rating). Fifteen, of the twenty-six articles, were of good quality evidence; seven were research and eight were non-research article.

Consistent findings, through the literature review included; providing education about self-care, stress recognition, effects of stress, use of mindfulness based stress reduction programs and recognizing risk factors contributing to increased stress. The practice recommendations based on the findings; explore resources available within the healthcare system to provide help for nurses coping with job-related stress, moral distress and compassion fatigue/resiliency. Examples listed included; retreats, counseling, education, walk-in wellness clinics offering integrative therapies, meditation, spiritual development, physical activity, grief counseling, peer to peer support and Nurse Manager support of self-care. (5, 14)

Identification of strategies to reduced stress and increase in job satisfaction were compiled from the literature. The description of self-care strategies included, but not limited to; educational seminars, mindfulness programs, time off, yoga, regular exercise, nutrition, meal breaks, and improved communication. (5, 14) Institutional resources for nurses to cope with morale distress and compassion fatigue included, but not limited to; retreats, meditation, counseling, education and physical activity. Additional strategies included debriefing colleague support, serenity room and recognition of risk factors. (2, 7, 18, 23)

Implementation strategies were reviewed, discussed and based on analysis of feasibility related to financial impact and space constraints. The one strategy, the evidenced based practice group decided to focus on, to decrease stress and promote self-care, was the creation of a serenity room within the acute care hospital setting. This would create a space intended to provide a stress free environment for staff. A quiet haven away from caustic stress factors, such as; negativity, complaining, and blaming behaviors. (4, 6, 8, 9, 11, 15, 21, 24, 25) A tranquil space for self-reflection and recharging resiliency.

Following are primary points and potential challenges to creating a serenity room, after the decision to move forward is determined. The team championed the initiative by presenting the information passionately to hospital leadership. The CNO supported and provided the approval to find space. Understanding, space is a premium commodity in a landlocked facility. It took several months of due diligence to find a space that was vacated. The request for the space was taken through the appropriate channels and facility requirements for occupancy. The space was approved April 2015. The next steps involved finding charitable donors for the furnishings, books, music, electronics and necessary renovation. Construction time and talent was donated for the built-in bookcase, but there was a cost for the materials. There was an associated cost with the oversized chair due to the need for it to be reupholster with hospital grade fabric to meet Department of Health codes. The final cost of completion for everything, furnishings, renovation, books, electronics and a Keurig was under $1000.00, which was funded by the department of nursing.

July 2016, the serenity room open for staff use. Data has been and continues to be collected through badge swipe access. Only the numbers of swipes are collected. An aggregate number is compiled each month and graphically shared with Nursing Leadership. The percent of usage is calculated based on fifteen minute intervals, twenty-four hours per day and the number of days in the month. Overall access and use of the serenity room increased from July 2015 through January 2016. Interesting note, the highest access month was January 2016. A study on the effect of holiday stress and the increased need for self-care may be a future area of focus.

References:

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