The American Nurses Foundation is the philanthropic arm of the American Nurses Association. The United Health Foundation is the philanthropic foundation of UnitedHealth Group.
According to the ANF, the Nurse Well-Being: Building Peer and Leadership Support program reduced burnout among pilot site nurses by 28% over six months.
Monika Lam-Chi, BSN, RN, program director of system nursing at Indianapolis-based Indiana University Health, one of the program’s pilot sites, and Erin Gilfenbaum, program manager at the American Nurses Foundation, spoke to Becker’s about the results they have seen since starting the program.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What was the American Nurses Foundation’s inspiration for the project?
Erin Gilfenbaum: The extraordinary challenges that nurses faced during the pandemic really brought to light the need for culture change.
There are a lot of programs out there that focus on identifying burnout but then put the onus on the individual nurse to address it. We think this program is different because it aims to move the needle from identifying the burnout to really helping change the culture of organizations, and we have seen that culture shift at Indiana University Health.
The nurse well-being program uses the Stress First Aid model to give nurses tools to address stress before it leads to burnout. It provides a common language to talk about mental health, how to connect them with mental health resources at their organizations and a framework for how to have difficult conversations.
Q: How long have you been implementing the program at Indiana University Health?
Monika Lam-Chi: We started in 2023, so this is going to be our third year using the program. About 416 nurses have been trained on the Stress First Aid interventions. We’ve had about three to four different pilot sites come on board each year so that we can train people from different areas within our system.
Q: What outcomes or changes have you seen since implementing the program?
MLC: I get a lot of feedback from the regional leaders saying the program has really enhanced their culture, their trust, their collaboration and their teamwork. I even have some regions where the leaders wanted to start spreading the program outside of our pilot units before the curriculum had officially launched. Now that we have the implementation toolkit, we’re eager to see the program spread to other units outside our pilot sites.
From what I can see in the data that I’m pulling, about 11% of the time, team members are self-identifying and using the Stress First Aid tools to help themselves, and then the rest is peer-to-peer support. I’m really excited that not only are we seeing that peer-to-peer support, we’re also seeing nurses check in on themselves.
Q: What lessons have you learned about implementing the program?
MLC: After the training, nursing leaders really went back to their units to design how implementation would most make sense. For example, some units have adopted different stoplight methodologies, where we all get to our huddle, check in and say, “Here is where I am on the stress continuum,” while others are using QR codes.
We did not want to add extra layers of work but rather to build the processes into their workflow. I’ve seen different people take different approaches that make sense for their unit.
Q: What advice would you share to nursing leaders at other hospitals or health systems who are considering implementing the program or similar well-being initiatives?
MLC: The big one is leadership buy-in. We are a large system and oftentimes without leadership buy-in, initiatives can feel like more of push than a pull.
Once we started implementing the program, we had leaders reaching out saying, “I want that to come to my unit.” A lot of the sister units would ask for their unit to be next, which was really fun to see.
Additionally, we were blessed to have my role and others with protected time to really dig into the program and make sure that it was successful. I would encourage leaders to make sure that whomever is leading or supporting this work has protected time, because it is really great work. Protected time to focus on this was imperative for the success of the program.
EG: From the national perspective, we’ve heard from our pilot site nurses and focus groups that nurses really need their leaders to embrace the program for it to truly take hold. We found that many leaders have unique stresses to their job and face burnout themselves. Their teams need them to model healthy behaviors and make it OK to not be OK all the time.
When leaders themselves address their own burnout, it can create healthier teams. We actually developed a special supplemental training for leaders as part of this program.
Something else to keep in mind is that this program isn’t meant to solve every problem that a nurse will experience in their day. It’s meant to find some ways to support them. We still need to address some major issues in healthcare to alleviate that stress; there’s still work to be done.
Editor’s note: This article was updated March 4, 2025 at 10:56 am CST.