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Background
Staff completed an assessment survey containing questions related to demographics, challenges and rewards of working with complex patients and families, environment, emotional exhaustion, stress and satisfaction. Bone marrow transplant patients are medically complex with a long length of stay leading to stress for both the families and the staff caring for them. Literature notes that direct care staff experiencing stress for a prolonged period of time with life and death outcomes can lead to compassion fatigue and burnout.
Program Description
Assessment results led to the development of a therapeutic relationships educational program addressing: professional boundaries, communicating with stressful families, communicating within interdisciplinary teams, stress and resiliency. RNs, unlicensed assistive personnel, social workers, care managers, and nurse practitioners were required to attend the 4 hour program. The instructional design ADDIE model (analysis, design, develop, implementation, evaluation) was used as a framework. Clinical scenarios were discussed to demonstrate the principles comprising a therapeutic relationship.
Strategies and link to EBP
The educational program was videotaped for staff unable to attend. During each live class a staff member facilitated a brainstorming session on developing standardized ways to implement a therapeutic relationship in the clinical environment. Having staff participate in developing implementation strategies enhanced accountability and staff satisfaction, leading to the goal of sustainability for building a therapeutic relationship with every patient. Each topic’s content was based upon current evidence in the literature and clinical expertise. Evaluation of the application of the principles of a therapeutic relationship will be conducted by re-administering the survey periodically to monitor burnout and stress levels in the clinical environment.