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EFFECTIVE STRATEGIES TO TACKLE WELL-BEING IN THE PERIOPERATIVE SETTING

Presented by JD Buchert

SAMPLE FOOTER TEXT

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MAY 19, 2025

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PRESENTER

J.D. Buchert, M.Ed., MS, MSN(s), RN, CNOR

Workforce Safety Manager

Parkland Health, TX

President- Texas Collaboration of Perioperative Registered Nurses (TCORN)

Board of Directors – Association of Perioperative Registered Nurses (AORN)

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DISCLOSURE

The speaker has no relevant financial relationships to disclose, and none of the planners for this activity have relevant financial information to disclose.

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OBJECTIVES

Upon the completion, participants will be able to identify mental and emotional stressors associated with their role in the perioperative setting.

Upon completion, participants will be able to understand the ramification that stress can play on their well-being and quality of life.

Upon completion, participant will be able to understand how aromatherapy can reduce stress.

Upon completion, participant will be able to understand the importance of stress reduction opportunities in facilities to better patient care and nurse retention.

Upon completion, participant will be able to understand the healthcare settings role in a healthy work environment.

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“THEY MAY FORGET WHAT YOU SAID, BUT THEY WILL NEVER FORGET HOW YOU MADE THEM FEEL.”

– Carl W. Buechner

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INTRODUCTION

Perioperative healthcare professionals, including nurses and surgical staff, face significant mental and emotional stressors in the operating room, including workload, time pressure, and the possibility of patient harm or death. These stressors can lead to fatigue, anxiety, and mental health issues, requiring individuals to develop coping mechanisms and seek support.

Specific Mental and Emotional Stressors:

Workload and Time Pressures: The fast-paced environment of the operating room, coupled with the need to maintain constant vigilance, can be overwhelming and lead to burnout (Yao & Zhang, 2024)
Patient Safety and Outcomes: The potential for patient harm, errors, or adverse events can cause significant emotional distress and anxiety (Tam et al, 2024)
Compassion Fatigue: Constant exposure to suffering, loss, and challenging situations can lead to emotional exhaustion and compassion fatigue (Queen Margaret University, 2024)
Burnout: The combination of high workload, time pressure, and emotional demands can contribute to burnout, characterized by emotional exhaustion, cynicism, and reduced professional efficacy (Sillero & Zabalegui, 2018)
Anxiety and Depression: The intense nature of the work and the constant threat of patient harm can increase the risk of developing anxiety and depressive disorders (Yao & Zhang, 2024)
Overtime and On-Call Demands: The unique demands of the operating room often require nursing staff to work continuous overtime and on-call, further exacerbating stress and fatigue (Yao & Zhang, 2024)
Lack of Support: Insufficient support from colleagues, managers, or the institution can amplify the impact of stressors and contribute to feelings of isolation and helplessness (Norouzi & Imani, (2021)
Traumatic Events: Exposure to trauma, such as witnessing a patient’s death or suffering, can trigger psychological trauma and require specialized support (Asimah Ackah & Adzo, 2023)
Communication Issues: Poor communication among team members can create additional stress and increase the risk of errors (Sillero & Zabalegui, 2018)
Lack of Control: Feeling powerless to change a situation or control the outcome can contribute to feelings of frustration and helplessness (Norouzi & Imani, 2021)
Uncertainty: The unpredictable nature of surgeries and the potential for unforeseen complications can create uncertainty and anxiety (nmsupport, 2022)

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NURSING IS HARD WORK!

Can have negative effects
Our health & quality of life

Immunity
Cardiovascular
Psychosocial
Relationships

This Photo by Unknown Author is licensed under CC BY-NC-ND

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THE USE OF AROMATHERAPY IN REDUCING NURSE STRESS

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PURPOSE

Project Start Date: 6/1/2021
Project End Date: 9/15/2021
326 Total Participants
7 Excluded (Not RN/LVN)
319 Remaining

The Parkland “Code Purple” aromatherapy project aims to focus on nurses experiencing mental or emotional stressors.

The most common found stressors were compassion fatigue, violence, time-pressures, exposure to infectious disease, needlestick injury, sleep deprivation, role ambiguity and conflict, understaffing, dealing with difficult or critically ill patients, or death.

The COVID-19 pandemic has brought many challenges to the field of nursing. Nurses are facing unprecedented patient acuities, burnout, fear, uncertainty, a continuously evolving workflow, and nursing shortage. Therefore, workplace-related stress has become one of today’s most serious occupational hazards. Aromatherapy can be a non-invasive, inexpensive, convenient method of stress relief.

Conceptual Framework: The Parkland “Code Purple” aromatherapy project aims to focus on nurses experiencing mental or emotional stressors. The most common found stressors were compassion fatigue, violence, time-pressures, exposure to infectious disease, needlestick injury, sleep deprivation, role ambiguity and conflict, understaffing, dealing with difficult or critically ill patients, or death.

Hypothesis: Does the use of lavender scented aromatabs reduce nurse work related stress levels after wearing a therapeutic patch?

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RESEARCH PLAN

Nurse identified by:

Leadership
Self-identified
SPARKS member

Process

Identified nurse will be informed and consented regarding the study.
An aromatherapy sticker will be given to the nurse.
They placed the aromatherapy sticker on their uniform top to allow for continuous exposure to the scent.
Four (4) hours later – nurse completes survey as to the effects of the aromatherapy sticker using a QR code.

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DATA COLLECTION

Method

Paired T-test used to evaluate difference in Likert scale questions (0-10) BEFORE and AFTER Aromatherapy.

Survey Questions (QR Code Based)

Are you an RN or LVN?
Gender
Age
How would you rate your stress level BEFORE use of Aromatherapy?
Please select the most applicable reason for your stress today.
What was your experience using Aromatherapy?
Would you recommend the use of Aromatherapy to co-works?
How would you rate your stress level AFTER the use of Aromatherapy?

Unit location

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DEMOGRAPHICS

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YEARS OF NURSING EXPERIENCE

Years of Experience	Average Stress Level Before Use�(Out of 10)	Average Stress Level After Use�(Out of 10)	Reduction in Stress Level	Paired T-test p-value
0-3	5.8	3.7	36.2%	<0.01
3-6	6.1	3.1	49.2%	<0.01
6-10	6.1	3.8	37.7%	<0.01
10-20	6.4	4.2	34.4%	<0.01
>20	5.5	3.8	30.9%	<0.01

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MOST COMMON STAFF STRESSORS

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SPECIFIC STRESS REDUCTION

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FINDINGS

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OTHER WELL-BEING OPPORTUNITIES

Community & onsite fitness
Smoking cessation (especially surgical smoke)
Weekly, monthly, annual nurses runs/walks
Wellness Grand Rounds
Structured Curriculum for mental health and resilience
Encourage regular exercise, health eating, better communication, self-awareness, emotional intelligence, social activities, and meditation
Peer-support program

Recommendations

Exercise is an excellent opportunity to focus on your own well-being rather is be walking, tai chi, yoga, aerobics or others forms of exercise and fitness.
Hopefully we all know the effects smoking can play on the body and break the habit if started. Don’t forget surgical smoke can have the same effects as smoking cigarettes.
How about getting your surgical team together for a run or walk weekly, monthly, or annually. This also allows for team building and comradery.
Wellness Grand Rounds: when was the last time your leader walked around to check on your well-being, just to check in and see how you are doing? Research shows that the visibility of leadership valuing wellness and promoting programming for protected time dedicated to wellness was greatly appreciate by staff. Having resources available for staff that may be struggling is essential. My facility has a trifold that included resources for mental health, physical health, financial health, childcare, legal support, and many other resources that are exclusive to workforce members.
The ANA has curriculum on their website to strengthen individual and team well-being in the healthcare setting. This gives an opportunity for staff to learn techniques that can support and build their focus on well-being. Finding programs like this and integrating them into your healthcare setting can increase retention rates because a staff member who feels supported is going to stay!
It is important to lead by example with exercise, eating healthy, using good communication skills, being self-aware, using emotional intelligence, creating opportunities for social engagement, and even a space for meditation or stress release (we have a meditation station for our staff)
Peer-support programs can be a great asset for individuals in a healthcare setting. One of the successes in our organization is SPARKS (supporting Parkland staff) it is a confidential peer support program made up of 60 peer supporters (I am one of them) that rotate being on call 24/7 to support our workforce’s mental health needs when in distress.

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WHY IS UNDERSTANDING STRESS IMPORTANT?

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PROFESSIONAL DEVELOPMENT AND STRESS REDUCTION

CE and skill enhancement
Mentorship & Peer support
Setting goals and expectations
Work-life balance

Professional development plays a crucial role in stress reduction for nurses. By continually enhancing our skills and knowledge, nurses can feel more confident and competent in our roles, which naturally reduces stress levels.

Continuing education and skill enhancement could include attending workshops and conferences related to your specialty, pursuing additional certifications or advanced degrees, or staying updated on the latest research and best practices in nursing, like your incredible journal club.
Mentoring programs and peer support can include participation in formal mentorship programs, wither as a mentor or mentee, joining a professional nursing organization like AORN for networking and support, or engaging in regular peer-to-peer discussions about challenges and solutions.
Setting realistic career goals and expectations can be difficult, but adjustment is okay. What about developing a clear, career path with achievable milestones, regularly reassessing and adjusting the goals as needed, and celebrating small victories and progress along the way.
Creating a work-life balance strategy for nurses is crucial! Set clear boundaries between work and personal life, use time management techniques to ensure adequate time for personal activities, and practice saying “no” to additional responsibilities when necessary.

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HEALTHCARE SETTINGS ROLE IN HEALTHY WORK ENVIRONMENT

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THIS CAN BE BROKEN DOWN IN FOUR THEMES

Theme 1:

The need for effective nursing leadership

Theme 2:

Effective communication as central to enhancement of a healthy environment

Theme 3:

Effective teamwork as an integral part of a healthy work environment

Theme 4:

The need for professional atonomy

Theme 1: Of the 12 best practice guidelines, 11 guidelines considered nursing leadership as playing an important role in creating a healthy work environment (Mobana et al, 2022). Creating an empowering work environment through evidence-based transformational leadership is one of the leadership practices which depends on a relationship that is built on trust and respect. An empowering work environment is characterized by providing access to information, support, resources, and opportunities to learn and grow, which must occur in a setting that encourages professional autonomy as well as institutional support. An empowering work environment encourages mutual learning and an increased responsibility and accountability among nurses, while at the same time it prevents and mitigates nurse fatigue.

Theme 2: Effective communication is demonstrated as being central to organizational practices, teamwork and relationships, and is referred to as the foundation of a healthy work environment. Effective communication includes “openness, honesty, respect for each other’s opinions and effective communication skills’ by nurses, including nurse leaders or managers. This enhances working relationships, knowledge translation, and reduces conflict that is responsible for errors. But also, communication promotes cultural diversity as it encourages individual health care professional to be aware of different communication styles that influence a culture of communication in culturally diverse setting. As we now have five generations working in the healthcare setting, do you think we have the opportunity to also learn on a generational aspect?

Theme 3: The concept of teamwork emerged as one of the practices that organizations cannot function without. Teamwork is defined as ‘a product of collaboration, which includes a process of interactions and relationships between health professionals’ working in a team environment, creating and sustaining a healthy work environment (Mobana et al, 2022). In a collaborative work environment, safety and quality patient care depend on teamwork which includes health professional, patients, and their families to enhance each professional’s care expertise, and extends to include teamwork between employers and unions.

Theme 4: Professional autonomy is a vital component of a health work environment because nurses felt empowered by autonomous practice and is defined as ‘the freedom to act on what you know, to make independent clinical decisions and to act in the best interest of the patient.’ which promotes independent decision-making within one’s scope of practice. It also refers to making timely decisions, which is based on health professionals’ expert judgement that requires them to act ethically, with expertise, and to take responsibility and accountability.

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DELIVERING WITH IMPACT

Keeping your audience engaged through effective techniques

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SO WHY IS WELL-BEING IMPORTANT?

Employee engagement
Bring the A-game
Improved employee performance
Encompasses all aspects of their life
Creates a positive work environment
Creating an atmosphere for high performance

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REFERENCES

Asimah Ackah, V., & Adzo Kwashie, A. (2023). Exploring the sources of stress among operating theatre nurses in a ghanaian teaching hospital. International Journal of Africa Nursing Sciences, 18, 100540. https://doi.org/10.1016/j.ijans.2023.100540
Babapour, A.-R., Gahassab-Mozaffari, N., & Fathnezhad-Kazemi, A. (2022). Nurses' job stress and its impact on quality of life and caring behaviors: A cross-sectional study. BMC Nursing, 21(1). https://doi.org/10.1186/s12912-022-00852-y
Morris, G. (2023). How to manage stress as a nurse. Nurse Journal. https://nursejournal.org/articles/how-to-manage-stress/
NeuroLaunch. (2024). Nurse stress management: essential strategies for well-being in a demanding profession. https://neurolaunch.com/stress-management-for-nurses/
Norouzi, N., & Imani, B. (2021). Clinical education stressors in operating room students: A qualitative study. Investigación y Educación en Enfermería, 39(1). https://doi.org/10.17533/udea.iee.v39n1e08
Nurses and Midwife Support. (2022). Stress. nmsupport.org. https://www.nmsupport.org.au/mental-health/stress#:~:text=Aspects%20of%20nursing%20and%20midwifery,exposure%20to%20trauma%20and%20suffering
Queen Margaret University. (2024). What are the effects of stress on nurses? qmu.as.uk. https://online.qmu.ac.uk/blogs/what-are-the-effects-of-stress-on-nurses/#:~:text=Nurses%20frequently%20deal%20with%20emotionally,emotional%20exhaustion%20and%20compassion%20fatigue.
Sillero, A., & Zabalegui, A. (2018). Organizational factors and burnout of perioperative nurses. Clinical Practice & Epidemiology in Mental Health, 14(1), 132–142. https://doi.org/10.2174/1745017901814010132
Tam, A., Bateman, S., Buckingham, G., Wilson, M., Melendez-Torres, G. J., Vine, S., & Clark, J. (2024). The effects of stress on surgical performance: A systematic review. Surgical Endoscopy, 39(1), 77–98. https://doi.org/10.1007/s00464-024-11389-3
Yao, L., & Zhang, L. (2024). Study on the psychological health status and influencing factors of operating room nursing staff. Medicine, 103(29), e38780. https://doi.org/10.1097/md.0000000000038780

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THANK YOU�Q & A

J.D. Buchert

jdbuchert@att.net

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