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. 2022 Mar 17;10:851001. doi: 10.3389/fped.2022.851001

TABLE 1.

Recommendations for Nursing Unit and Organizational Leadership.

The work itself, respect as a professional, and finding meaning
Intentional debriefs throughout complex cases to reduce the spread of false or unproductive info
Ongoing transparency around unit level and organizational level decision making that impacts frontline staff
Swift and transparent addressing of unit-based issues by management, particularly when it comes to staff safety/respect issues with patients and families
Regular debriefing with support from a bioethics team/consultation both during and after difficult cases
Thoughtful patient assignments taking into account the nurses’ previous shift experience
Transparency in assignment selection
Benefits and compensation
Proper compensation for extra hours worked (particularly for charge/clinical support team members who regularly leave late)
Focus on fostering unit level relationships (among nurses as well as among nurses and the interdisciplinary team)
Recognition of critical care as a unique group of nurses when it comes to compensation, for example, providing increased compensation, more mental health days, formal mental health check-ins
Initiate compensation based retention strategies for nurses in order to keep talent within the organization
Separation as preservation
Ensuring nurses get breaks during their shifts
Ensure staffing levels are sufficient so there is a reduced need for staff to work overtime.
Provide the opportunity for, and reduce a culture of guilt around, taking mental health days
Make designated mental health days 12 h instead of 8 h in order to benefit the frontline staff who have to most exposure to stress/trauma
Ability to ask for an assignment change or break from a specific assignment
Provide an on-site 24/h wellness space where nurses can take a break when needed
Identity
Ensure nurses only float to other critical care areas rather than throughout the hospital
Implement a resource nursing team to assist with staffing needs throughout the hospital
Acknowledge that critical care work and workflow is different from other areas of the hospital by ensuring consultation with critical care nurses prior to implementation of hospital-wide policies and interventions
Investment in growth and development
Provide opportunities for task rotation (e.g., opportunities to engage in project work)
Provide opportunities for advanced training at the bedside (e.g., certify on Continuous Renal Replacement Therapy (CRRT) and Extracorporeal Membrane Oxygenation (ECMO)
Provide opportunities for professional development and advancement