When Vickey Reiser was completing her advanced nursing degree at the University of Pittsburgh, she worked in a bone-marrow transplant unit caring for critically ill patients.
On that kind of floor, you tend to not only have very sick patients, but also patients that you develop very strong relationships with to the point where you feel like family, recalls Reiser. I was trained well to manage a patient medically, but I wasn't trained well to cope with being a secondary victim to trauma like that.
Though mental wellness among health workers has been an issue for years, covid has pushed the problem into the forefront. Prior to the pandemic, more than a third of nurses reported burnout, with a 17% annual turnover rate. Post-pandemic, the burnout rate is ~50% with a turnover rate of 20%-30%. The issue is an expensive one for hospitals: On average, the cost of turnover for a bedside RN is $40k+.
Reiser, who started teaching a resiliency course in grad school after her personal experience, is now tackling the issue through Resilient Seven, a 16-week mental health and personal development program designed for clinicians and nurses. Launched in March 2021, the courses are structured around seven pillars Reiser found to be key to resiliency: awareness, mindfulness, gratitude, self-care, meaningful relationships, moral courage, and purpose.
Partnered with Affective Health, Resilient Seven offers interactive, cloud-based programs that deliver micro experiences that easily fit into health care workers' busy schedules. Users are guided through themed sections of videos, audio, questions, and other materials about each core concept.
For instance, in the mindfulness section, users are guided through deep breathing exercises by audio, then receive instructions on how to integrate that technique into everyday life. In the gratitude section, users walk through the Three Good Things practice, where you learn to find good things in difficult situations and highlight your own positive role in various scenarios.
Each experience takes about an average of 2 minutes to complete, and text message reminders are sent throughout the 16 weeks to keep workers on track. Users also set goals in each core area and are prompted to log updates on how they're doing on every target.
Reiser says she created the program to target deep-rooted and long-standing issues in the health care industry. "The covid-19 pandemic brought out what was already there. The issues that create burnout already existed, covid really brought them to light."
So far, Resilient Seven has been used in medical surgical units and an emergency department at two hospitals in Tennessee. Reiser is in talks with multiple universities about implementing the program in nursing school curricula for students.
"Historically, there isn't anything like this to prepare a nurse for what they're going to experience," says Reiser. "That's why we see high rates of burnout in the first two years of nursing."
For individuals who want to use the program for themselves, Resilient Seven charges $50 for the 16-week program. For hospitals, Reiser has a tiered pricing model that takes into account the size of the hospital and its nursing staff. For universities, Reiser says the cost will model educational pricing for items like textbooks.
While the health care industry doesn't have a reputation for being at the forefront of employee mental health, Reiser says the tides are shifting and the stigma is lessening. "Burnout is a workplace phenomenon; it's not a problem with the person experiencing it," she points out.
Another selling point for Resilient Seven: Communication between staff and leadership is key for employee retention and productivity. By collecting employee input through the courses, hospital and university leadership can be more cognizant of how their staff is feeling. Reiser says employers often aren't aware of burnout until it's too late, and her courses aim to change that.
"This program allows us to create a flow of empathy between the front line and leadership," says Reiser. "If you have strong employee resilience, you not only keep employees where they are and keep them healthy, but there is data that it reflects back on patient outcomes and patient satisfaction as well."