Glossary
EP - Exemplary Professional Practice

EP29: Diversity and Workplace Advocacy-Describe and demonstrate the organizations workplace advocacy initiatives for: Caregiver Stress, Diversity, Rights and Confidentiality

Caregiver stress

The emotional reaction to an adverse traumatic event can carry long-term consequences for the personal and professional development and well-being of nurses. Processes need to be established in order to assist the staff to handle these issues effectively. Maria Adams BSN, RN, CEN, Staff Nurse in the Emergency Department (ED) developed and implemented a process in the ED to help support staff after experiencing a traumatic event. Her project included the development of a Critical Stress Debriefing Team. This process involves the multidisciplinary team which includes physicians, nurse manager, psychiatrist or therapist, Director of the Emergency Department and staff members.

EP29-Table 1

The Nurse Manager frequently assembles the team when a critical incident occurs and insures that all team members are available for this session(s).

Jersey City MedicalCenter is the state designated PsychiatricScreeningCenter for HudsonCounty. The MedicalCenter has a highly trained Crisis Intervention Team associated with the Behavioral Health program. Team members are available to provide tailored training, education and consultation services. They frequently provide assistance to our employees when the need arises. They utilize an Incident Response Protocol which includes Reconnaissance, Incident Survivors, Management Consultation and Site Management (Appendix EP29-A). If time allows they will perform or schedule a Stabilization (Defusing) process for employees (Appendix EP29-B). For example, Silvana Gomez MA, DRCC, Certified Screener, Program Director of Psychiatric Emergency Screening Center, responded to the Medical Emergency Department following a sever motor vehicle accident. Two of the victims were children (ages 4 and 5) and several adults were in the car. The children were badly injured and unstable, and Ms. Gomez provided crisis intervention to the father. It was very difficult for the father to see his children injured so badly. The Emergency Room nurses were very distraught about the children. Because of the time limitations a group could not be immediately organized, so Ms. Gomez met individually with the nurses or in groups of two. A stabilization group could not be set-up right away, but one was planned for several days later. During this process, the employees have the opportunity to talk about the event, process the information and develop with self-care behaviors to help themselves. In another incident, Silvana Gomez responded to the Emergency Department following the violent death of a young child to provide crisis intervention and support to the ED staff.

Another service provided by Jersey CityMedicalCenter to assist staff with life challenges is the Liberty Health Assist Employee Assistance Program (EAP). This program provides staff, their dependents, and spouse with professional support services on grief, impact of disability, relationships, retirement planning, and employment stress. These are some of the challenges that EAP can assist staff with. All information is maintained confidential. Liberty Health does not receive staffs’ personal information. Staff can obtain EAP’s assistance 24 hours a day, seven days a week by phone, face to face counseling and online resources. (Appendix EP29-C).

The Nursing Wellness Initiative was developed to improve nursing satisfaction and enhance wellness. Meeting the needs of patients and the rigorous demands of bedside nursing can be stressful. Nurses dedicate their careers to the care of others and we often neglect our own health and wellness. Maylene Laguna BSN, RN is a trained yoga teacher with a strong background in health promotion. She felt compelled to find a way to add her expertise of yoga and health promotion as a tool to assist direct care nurses and patients. After using restorative yoga techniques with patients in Intensive Care Unit, she realized the same desirable results could be produced in staff. Rita Smith DNP, RN, NEA-BC, Chief Nursing Officer, staff nurses specialized in Reiki and meditation, and Ms. Laguna set out to create a schedule of health promotion activities throughout the work week. Supported by Ms. Smith, nurses will be able to take a 10 minute break in their day to attend meditation sessions, participate in our newly created walking club, and soon yoga will be an additional activity that will be available to staff. Our walking club starts at the lobby and walks to the scenic LibertyState Park. (See Appendix EP29-D for announcement of Walk). Meditation will be held in our nondenominational chapel, and yoga can be done both on our lawn as well as indoors in our conference rooms during inclement weather. Our goal is to create a supportive environment that provides nurses with the tools to effectively manage their levels of stress and improve their health. 

Diversity

Jersey City MedicalCenter is located in one of the most culturally diverse areas of the United States and maintains an organizational culture that sincerely embraces diversity, and inclusion is of utmost priority to us. Our mission is twofold: development of culturally competent healthcare providers, and to facilitate the delivery of culturally appropriate healthcare. Please see the Table below for patient/staff demographics:

EP29-Table 2

In 2010, Jersey CityMedicalCenter received an award from the American Conference on Diversity for our work with a diverse population. (Appendix EP29-E).
Diwali Celebration, 2011
 Diwali Celebration, 2011  

The is an independent organization who works with leaders and businesses, communities, government and social service agencies and schools to identify and address issues directly related to their needs.

To provide native dietary needs, our Food Services Department provides a diversity of meals for our patient population. These diverse menus include kosher, halol, Spanish, Indian, Arabic and vegetarian. Multi-cultural foods are also available to our nursing staff and different menus celebrate a variety of cultures.

Another important aspect is recognizing the different celebrations of the people who comprise our nursing staff. Celebrations include: Hanukah, Ramadan, Cinco de Mayo, Diwali, Eid, Kwanzaa and Saint Patrick’s Day.
Diwali Celebration, 2011
 Diwali Celebration, 2011  

These celebrations often include fool representative of the culture and staff and physicians are encouraged to dress in native costume. Other celebrations include Hispanic Heritage month, Black History month and the Chinese New Year. Jersey City MedicalCenter has a non-denominational Chapel and our patients and visitors are invited to utilize it and pray in their own way. Spiritual counseling is provided in many different faiths as well.

Rights

Jersey City MedicalCenter is an employee-centered work environment. Consistent with this commitment a grievance procedure (Reference OO20-D) is provided in order to allow personnel to have the opportunity to have their working conditions heard by management.

The grievance procedure is a four (4) step process which includes a timely reporting to the employee’s immediate supervisor, the department director, Vice President of Human Resources and finally to the Vice President of the Department. The issue must be thoroughly investigated by all involved and a written determination must be given to the employee.

The Exclusion from Care policy (Reference EP29-A) provides a means whereby employees may request not to participate in an aspect of patient care due to cultural values, ethics and/or religious beliefs. Employees must notify their immediate supervisor as soon as is feasible citing the specific aspect of care that they wish to be excused from, and the basis for the request.

The Equal employment Opportunity/Affirmative Action policy (Reference EP29-B) insures that all employees and job applicants will be afforded equal treatment in all interactions and without discrimination, according to their individual qualifications, abilities and experiences. Decisions to employ individuals are made without regard to race, creed, color, national origin, sex, age, disability veteran status, sexual orientation and marital or citizenship status.

The Rules of Behavior (Reference OO20-A)establishes the standards of behavior that serve the best interests of the Medical Center’s patient’s, visitors, staff and hospital employees. The expectation is that all staff members will adhere to the values established by the Medical Center which include trust, teamwork, accountability, communication and excellence. The Rules of Behavior insure that all employees will maintain a timely and professional demeanor and will uphold the regulations of the Medical Center to include, but not limited to: misuse of computer access, disorderly conduct of any kind, falsification of records, violation of the Medical Center’s anti-harassment and workplace violence policies and theft or possession without authorization of hospital property.

The Chain of Command policy (Reference EP29-C) provides guidelines for implementing the chain of command to address clinical/administrative/safety issues and/or breakdowns in communication or behaviors that affect patient care, patient safety, or delays in treatment. The initiation of the chain of command ensures that: the appropriate people are aware of the situation, issues progress from the level closest to the event and move up as the situation warrants, and accountability is maintained when issues are no longer being managed effectively.

Confidentiality

Jersey City Medical Center insures that all staff records are maintained in a confidential, private and secure manner. Managers maintain staff records, which may include trends of tardiness or absenteeism, corrective action plans, and staff evaluations, in a secure area. Staff competency outcomes are also maintained confidential. The staff member, Nurse Manager, and the unit Educator are privileged to this information and are presented to the Human Resource Department if requested as a source of evidence for a corrective action. The Human Resource Department also keeps staff records confidential and safe. These records include updated certifications, tuition reimbursement documentation, as well as any complaints/grievance about or from the staff member. Patients who are our employees are given the same patient rights, which are inclusive of providing them with a safe environment, effective communication, assistance with preparing an advance directive, personal privacy and confidentiality, access to health information and appropriate pain management. Data security provisions are in place, which include but are not limited to: unique access codes given to each authorized user, each user is authorized to have access to specific functions of the data base on a need-to-know basis, an alias is provided when requested, and protective measures are in place to foster data integrity and security.