Peer Support: How much do I really need it?

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    If you are a nurse, or any kind of health care practitioner, you have had a shift where you walk out of the hospital and you dread ever having to walk back through those doors. It doesn’t matter if it is because you had a really heavy assignment, an unexpected death of a patient, or bad news you had to break to a long-term patient, the end result is the same: you dread going back. What if there was a way to debrief your feelings before you walked out, throwing your stethoscope out the window?

    Peer Support: How much do I really need it?

    Due to the burnout rates of our profession, and because administrators are starting to realize the impact of the everyday physical, emotional, and ethical issues that we deal with daily, some hospitals are trying different methods to support staff nurses' emotional health and well being. The good news is that the hard work that we do is noticed and being appreciated, and that administrators are trying to help and assist with some of the stress that we endure due to our jobs. I know that most people think, if we get more staff, that will decrease our stress, and maybe it would, but shy of reimbursement costs changing, and staffing ratios dramatically increasing, what are some things that your hospital can do to help support you?

    Some hospitals have created anonymous peer support systems, which staff have reported finding really helpful and decreasing stress. So how does it work? Staff that are looked at as leaders, professionals, and generally well-liked and considered approachable, are tapped by their managers, Clinical Nurse Specialists, etc. to be asked if they would like to volunteer as part of the Peer Support Network. If they agree to this position, they get training on how to support and speak with other staff that have been in stressful situations, similar to laymen who volunteer on various support hotlines who do not have psych backgrounds, however are trained to empathize with others and lend support, and offer outlets for frustrations within the hospital system, if needed. If the peers coming for support have bigger issues than the peer supporter feels that they can handle themselves, they can consult the Employee Assistance Program to allow for a fully trained MD/RN/Social Worker to offer more intensive anonymous support. The Peer Support Networks are created to support staff who have worked a really difficult shift and need to debrief/unload, but instead of speaking to a friend or family member who might not understand the intricacies of hospital life, speak to a colleague who can understand. Someone who understands losing a patient that you've been taking care of for the past few months, they were ready to go home, but coded instead. Someone who understands that you had a patient whose family could not have been more difficult to deal with due to disagreements about care and disrespect to the nursing staff. Someone who understands working with a staff of varying personalities, yet you all depend on each other to get through a shift, and it seems like family at times....and families can have some serious disagreements, especially in stressful situations.

    The Peer Supporters are staff that are willing to volunteer to speak with another staff member who needs to talk on a break, after a shift, or via email, and they know that the conversations will go no further (unless there are concerns about mental disease, plans to hurt self, others, etc.) but the guidelines of the program are outlined and reiterated when staff first contact a Peer Supporter. Essentially, it allows you a friend (an ally) that can be from any area of the hospital, not even your unit, that you can speak to, and who will offer advice if you want it, and just listen to you, if that is all you need.

    When I first heard of programs such as this, I thought it was a good idea, but wondered if many staff would utilize the program? Sure enough, the support is there and being used. Not only are the staff that go for support reporting an increase in job satisfaction because they feel more supported, but the Peer Supporters actually have reported feeling good about what they are doing for their peers. I also wasn't sure that a lot of staff would agree to becoming a Peer Supporter; I knew that some would, and obviously as nurses we are all healers, but we've been healing all shift and we all need a break right? But there seem to be many volunteers in these programs, with minimal drop-outs.

    It's actually a pretty simple premise, that is easily implemented and recreated, and despite some possible extra pay for Peer Supporters that may stay after a shift to converse with colleagues needing help, this program is pretty cost neutral for hospitals to run, and the staff that utilize the programs seem to feel that they are useful and help to decrease their stress. Would you utilize a Peer Support Network to help you deal with stressful situations at work? Do you think this would be a helpful program at your hospital? It's surprising how some simple ideas can help to decrease staff stress and improve morale in the workplace, and it's nice to see that some hospitals are truly trying to help their staff deal with everyday stressors.
    Last edit by tnbutterfly on Jun 14, '18
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  3. by   HouTx
    This sounds like a great start. At least it would appear that your facility leaders have acknowledged that there may be some value in providing emotional support for staff who are exposed to high stress levels on a continuous basis. However, I am pretty skeptical of the fact that it is reliant on volunteers rather than being hardwired and fully funded. Do you also provide Critical Incident Stress Debriefing after significant events? If not, this may be a great next step, as CISD requires trained facilitators and adheres to an evidence-based process.
  4. by   Bridgid Joseph
    It is a great start and was a pilot, and has flourished into a true program at my hospital, however I know that other hospitals are struggling with their programs. We have CISD after true critical events and that is usually activated by a staff member escalating to the director or at the directors request. This peer support is more for every day frustrations that can occur...and if anything is too much for the trained volunteers, it quickly gets escalated tot eh experts