1. Increasing morale through peer recognition
Erin A. Pate, RN, MSN, CCRN

2. Objectives
Recognize the importance of improving and maintaining nurse morale
Recognize the benefits of peer-led initiatives in staff recognition programs

3. Outline Why is nurse morale important to the organization?
Why use Peer Recognition?
Integrating Peer Recognition into the Unit
Lessons Learned

4. Introduction The problem with low morale… Who are Change Agents?
Peer-led recognition to the rescue!
When morale is low, nurse satisfaction and retention decrease. This keeps a unit in constant flux, can negatively affect patient outcomes, and decreases the stability of an organization. Due to these factors, it is imperative that an employer places an emphasis on maintaining employee morale. There are multiple ways that morale can be improved and maintained. Many strategies involve implementing change at the management level. This leaves the largest portion of the nursing work force untapped. What can be done at the staff nurse level to improve morale? Would a peer-led recognition program be effective in fulfilling this need?

5. Background and Significance
High rates of nurse turn-over
Patient outcomes
Cost to the organization
What can be done to break the cycle?
In 2013, the national nurse turnover rate averaged 14.7% with a range of 8.7% to 31.7% (Thompson, 2014).
High turnover has been linked to decreased morale, non-collaborative work environments, and employees feeling undervalued and disrespected. Turnover weakens the organization due to the loss of experienced staff and has a substantial financial cost.
Recruiting, hiring, and training a medical-surgical nurse costs approximately $92,000, while the cost for a specialty unit nurse is around $145,000 (Wilson, Diedrich, Phelps, & Choi, 2011).
According to the All Employee Survey, VA Sierra Nevada Healthcare System (VASNHCS) has one of the highest exhaustion rates and lowest morale within the VISN and the Veterans Administration (VA) System (VHA Support Service Center, 2015a
Find resources highlighting pt outcomes vs staff turn over
With the established link between low morale and high employee turnover, which increases costs, what can be done to break the cycle?

6. The Untapped Masses… Peer-to-peer recognition
VASNHCS Inpatient Mental Health Unit on trial…
Research regarding peer-to-peer recognition…Tap into available programs….VASNHCS has many ways to recognize staff. Some of these programs are underutilized by staff due to lack of knowledge
The staff have previously been “non-participators.” In the past 5 years, there have not been enough complete any survey for the unit to have any individual data. Interestingly enough, research shows that non-participation when given the chance is one way people send a message. The message they are sending is one of distrust, fear, feeling nothing will change….In hind sight, maybe not the best group for a trial, but I was ambitious and saw a group who needed a change
Talk about project conducted in 2 units ICU and MHU with varying success
What are the perceived problems (questions asked of staff)

7. Leading the Change Informal Recognition Formal Recognition
Two part process- prepare staff (ensure unity- team activities, group buy in- informal) getting staff to acknowledge each other
Formal- recognition and awards

8. Peer-to-peer recognition needs continual reinforcement
Increase team work through use of group activities needs continual reinforcement
ICU more successful because the team was more co-hesive (social outside of work)
Lessons Learned…

9. Questions?