Finding a healthy balance between personal care and the demands of a job are a part of every worker’s life. When your job is to care for others and even to save a life, it is easy and often necessary to put your own needs aside in the midst of stressful, demanding situations.
However, this is not a sustainable approach in healthcare—the costs of chronic stress and fatigue are high for not only care providers but for the entire system around them. This includes their patients, their colleagues, and the organization for which they work, as well as for their friends, family, and community outside of work.
One of the ways that stress and fatigue are addressed in healthcare is through the use of planned breaks for rest and rejuvenation so staff members are ready and able to resume work. Unfortunately, there are barriers to quality break-taking, including individual and community beliefs about work, the structural/operational demands of healthcare work itself, as well as the quality of the built environment in which that work is being performed.
An interdisciplinary team of researchers from Spectrum Health and Nurture by Steelcase in Grand Rapids, Michigan, were interested to see how the built environment, in particular, could be used to help improve the quality of the break-taking experience and its possible related outcomes.
To do so, we underwent a human-centered design research project where we could work with healthcare staff to envision and evaluate new break room experiences in the inpatient hospital.
An extreme break room makeover?
The project began with a Spectrum Health staff satisfaction survey where break rooms were identified as an opportunity area for improvement. Leveraging a bit of a pop culture phenomenon, the organization held an “Extreme Break Room Makeover Competition” so staff could nominate areas to participate in the project.
More than 60 units within the health system submitted applications; three units were chosen to not only get makeovers but to participate in the research and design for their spaces: a perioperative unit, a medical-surgical nursing unit, and a health information management unit.
Following Nurture’s human-centered design approach, the units’ delegates began with secondary research around the nature of healthcare workplace stress and fatigue, and qualities that support rest and rejuvenation.
Impact on individuals
It is widely recognized that nurses have some of the highest rates of work-related injury in the United States. While the physical toll can be high, there is also an emotional toll. According to the work of Karl and Peluchette, “Recent studies of various healthcare professions indicate that emotional exhaustion and job burnout are common problems associated with such occupations and that emotional detachment, increasing caseloads of patients, close interaction with patients, and emotional strain are prominent sources of emotional exhaustion. The intensity of emotional exhaustion tends to be highest in acute care situations.”
When staff do not have the opportunity to decompress in a safe, appropriate, and comforting environment, they carry their emotional and physical burdens with them throughout and beyond their shift.
Impact on colleagues and patients
The repercussions of this can be serious and far reaching. Perhaps the main concern regarding staff rest in healthcare is the impact on patient safety. Rogers, Hwang, and others (Rogers, 2004) studied the relationship of working hours of hospital staff nurses to error. The odds of making an error were three times as great when the shift was longer than 12.5 hours compared to when it was 8.5 hours or less.
Working overtime was associated with increased error regardless of the length of the scheduled shift. With the changes in reimbursement policy around “never events,” increased attention is being paid to ways to reduce the potential for error.