EP 40: How to Improve Nurse Well-Being and Retention

Coffee Break_Dr. Deborah Zimmermann: Audio automatically transcribed by Sonix

Coffee Break_Dr. Deborah Zimmermann: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Renee Thompson:
Plants thrive and grow in a peaceful, nourished environment, right? Well, it's the same with human beings. But what if that environment is not so peaceful? What if it's toxic? Welcome to Coffee Break: Breaking the Cycle of Bullying in Healthcare – One Cup at a Time. In this podcast, you'll get practical, evidence-based strategies to help you cultivate and sustain a healthy and respectful work culture by tackling an age-old problem in healthcare: bullying and incivility. I am your host, Dr. Renee Thompson.

Renee Thompson:
Hi everyone! Welcome back to another episode of the Coffee Break podcast. Whenever or wherever you're listening or watching, I hope you're having a really good week. Today, I'm extra excited because today I get to have a coffee chat with Dr. Deborah Zimmermann. Deb, welcome to the show.

Dr. Deborah Zimmermann:
Oh, thank you, Renee. I am absolutely delighted to be with you today.

Renee Thompson:
I am excited, too, and I know our listeners are going to be really excited because you've done some incredible work. You have really been a remarkable nurse leader, very well-known for the work that you've done. And just to give our listeners and watchers a little bit of background, Deb is the current CEO of the DAISY Foundation. She is the current president of the American Organization of Nurse Leaders. She has an amazing history, amazing background. She's been in the US Army. And Deb, thank you for your service. My husband was in the Army, too, and so I really respect and and honor the work that you've done there. You've been involved in Magnet, you've been a chief nurse executive at several organizations, and you're one of the nicest human beings I've ever met. I'm not kidding. I'm not kidding. I'll never forget, it was the first time I think I actually met you in person. So I had known of you, and it was at a conference. I actually can't remember what conference it was. It was either a Magnet, or I think it was something with Sigma Nursing, but I saw you, and I thought, Ooh, there's Deb Zimmermann, and I thought, I'm going to go introduce myself. I'm going to go and say hi to her. And I had to build up a little bit of courage to do that. And I walked over to you, and I said, Hi, Dr. Zimmerman, my name is Renee Thompson. And I went to shake your hand, and I even said, I don't, I'm sure you don't know me. I don't think you know me. She's like, Oh my gosh, yes, I know you. And you gave me a big hug, and I just thought you were the nicest person. So this, like I said, I've been following you for years and respected your work and just very honored that you're on my podcast.

Dr. Deborah Zimmermann:
Oh, thank you. And Renee, the feeling is likewise. Your efforts and passion come forth in all of your work and your dedication to our profession and the creation of a healthy work environment is a shared passion, and your work really resonates with those closest to our patients and families. So I thank you for your commitment.

Renee Thompson:
It is mutual, as you said. And you're right, a healthy work environment, a healthy workforce right now is probably the most important priority that we should all have. And what I'd love to talk to you about today is taking a look at what's really happening out there. I think of your role at the DAISY Foundation and at AONL, Deb, you have your finger on the pulse of truly what's happening across our country when it comes to leadership, when it comes to healthcare. Can you talk a little bit about the current nursing landscape? And okay, we've got to talk about the challenges. But one of the things that you said at the AONL conference this year was that, yes, there are challenges, but we have to shine a light on what is right. So I'd love to hear from you on what are those challenges, what are you seeing out there, but let's shine a light on what's right, too.

Dr. Deborah Zimmermann:
Oh, you are so right. So we all agree the last four years have been incredibly challenging, and we are now beginning to see a difference that's reflected in the data. For example, nursing shortages are seeming to ease somewhat in some organizations. Nurses are going back to more permanent types of positions. We're seeing small progress in clinician being. In fact, there's been a 6% improvement over the last year. Now, I'm not saying that is great and where we need to stop, but we're showing some improvement. Almost 80% of the nurses in recent surveys said that they reported to stay in the profession until they are retired, and the number of nurses who are employed has rebounded and now close to the number from pre-pandemic levels. So, we lost about 100,000 nurses during the pandemic. So that number has rebounded. Although nurses are not necessarily taking the same kinds of positions that they were pre-pandemic, many are doing gig work and part-time work and really want that flexibility in their workforce. Other good news is that nursing school enrollment, after a decline last year, now we're seeing that those numbers are back up, and over 70% of our nurses now hold a baccalaureate degree; that was something that we've been working on over the last ten, 20 years, and we are making some progress in that respect. And one number that I absolutely love is that the diversity of the students who are in school are much more reflective of the communities that we serve. 41% of students are, come from non-white backgrounds. 39% of our master's students are students of color, 36% of PhD students, and 39% of DNP students. And that's so important because researchers believe that the lack of diversity within our profession impedes our ability to really provide the healthcare and achieve the outcomes that are really necessary to really raise up the health, particularly in our more diverse communities.

Renee Thompson:
So there's some good news, right? So it sounds like we've stabilized a little bit. And so you mentioned about well-being. We had a 6% increase in employee well-being. I look at it. Yes, it's only 6%, but at least it's not dropping. Don't you agree? You have to stabilize. We always say you have to stop the bleeding. It sounds like we stopped the bleeding, but now it's the rebuilding. And you're so right about nurses are going back into practice, but not in the traditional ways they've done before. And the whole gig economy right now, people don't want to come in and work full-time hours in a hospital, shift work. I think it's important then for organizations, especially for nursing leaders, to look at alternative ways to actually keep nurses employed in a different way. And I just read an article actually yesterday about, there's a whole group of these retired nurses who would be willing to come back in, not full time, but they would be willing to come back to do things like mentoring, education. And I think, oh my gosh, this is a huge untapped resource. I hope organizations are looking at this.

Dr. Deborah Zimmermann:
Interestingly, they are. But we, just to highlight more of the good news, and then I want to get into some of the challenges, nurses want meaningful work, positive interactions; they want to work in a safe environment, and they want to be engaged as well as have the balance, and they want to feel like they're valued and they want to feel like they belong. And what we know is that some of the work, 97% of nurses say that some of the work can be delegated, which then allows us to look at how can we do the work differently and how can we bring back senior nurses who may have left or retired and really use that wisdom. The average, and this is where we get into some of the challenges, the average frontline nurse in an acute care facility has less than three years of experience. That has really given the complexity of healthcare today, pretty novice. So, to be able to match the novice nurse with an experienced nurse who not only understands the environment, but really can be a good coach to that novice nurse in the complexities of healthcare. And what we are seeing with the advent of virtual technology is that there is an opportunity to coach. In fact, AARP has, oh, I think they said 1.5 million nurses belong to AARP, and AARP wants to link with nurses to really help healthcare organizations to really provide that mentoring service. And what we do know is that many of our retired nurses or nurses who have been at the point of care for a long time want to be able to give back, and this is really a way that we can really give back to really help strengthen that bench strength at the front line.

Renee Thompson:
That's exciting news. And it's interesting, I remember hearing about this, gosh, this was years ago when I was still working full time for an organization, and I was responsible for all things professional development and most residency programs, preceptor programs, a student nurse experience, all of that, and we talked about these retired physicians. And there was a nursing school that actually would hire retired physicians to teach their nursing students how to do assessments. And it wasn't just the assessment, the tasks of heart, lungs, a head-to-toe assessment, but it was also teaching them how to communicate with physicians because, you know, when they're in nursing school, we don't let them talk to physicians, but as soon as they start working, we're like, call the physician, and they don't know what to say. They don't know how to say it. And it was a, back in those days, it was novel. Wow, you're going to bring in retired physicians, and they could pick whatever days and hours they wanted to work, but it was successful. And what you're describing is very similar. You bring them back; they have this incredible wealth of knowledge. And it's not even just the knowledge; it's the experience. Because the average nurse having three years experience out there right now is a little concerning.

Dr. Deborah Zimmermann:
And how to prioritize. When you look at all of the information that comes into a clinician who is working at the point of care, and then because we're working with sick humans, the need to prioritize and reprioritize multiple times a day, having a senior nurse who understands how to really help a nurse learn to prioritize, that really just is so beneficial.

Renee Thompson:
I think you're spot on because even with new nurse leaders, we've had several conversations with nurse executives about the fact that a lot of their nurse leaders right now, maybe even up to 50% of them, became leaders during COVID when we were in constant crisis mode. And so prioritizing was actually done for them. You were putting out fires after fires all day long. Now that the quote-unquote crisis is over, they don't know how to prioritize the work. They don't know what's urgent, what needs to be done now, and what can be done later. It's the same thing for the nursing leaders, and so your point is very well taken. And in addition to helping these bedside nurses, also taking a look at maybe a retired nurse executive who can be a mentor to some of the newer nurse managers that are out there right now.

Dr. Deborah Zimmermann:
Yes, you are absolutely right. When you think of the current situation, that kind of leads to some of the workplace violence issues, right? You have young nurses with less than three years experience who often were educated with simulation, right, because they were educated during the midst of the pandemic. You have new leaders who also came into their leadership roles during the pandemic, where it was a command type of environment. So what you don't have is that experience in handling those complex situations like workplace violence, and that is one of the reasons that we think that although we're making strides in so many areas, workplace violence, we have not yet seen the improvements that we really need in order to create a healthy work environment.

Renee Thompson:
Wow. So you had mentioned a little earlier about there are good things happening, we are making progress, but there are challenges. And I know workplace violence is one of those challenges. Maybe, Deb, we can shift a little bit and talk about some of those challenges. What are you seeing?

Dr. Deborah Zimmermann:
Well, I think although we've seen improvements in so many areas, we're not seeing an improvement, like I said, in workplace violence. It is global, and it is a public health issue. The incidence of violence to healthcare workers has steadily increased since 2011. And in fact, a study, I think it's from the Department of Labor or Department of Health, I'm not sure, but every hour, three nurses are assaulted. That is unacceptable, and we need to really expose it, and then, to really ensure that we are putting forth comprehensive plans because it's not safe for our healthcare workers, saying those that are leaving the profession one of the prime reasons is that there is a feeling of lack of safety. And do our patients and families really feel safe, in fact, if we don't really have, if we don't have a safe environment? So, what we have to make explicit is that violence is not part of the job. We must, organizations must have a comprehensive plan that is comprised of healthcare workers and frontline workers. We have to have data, and nurses have that responsibility really to report violence. And we need to make policy decisions and really put forth a comprehensive plan involving the frontline workers to ensure that they have the resources really to take the appropriate action, and we need to put in place mechanisms to really prevent workplace violence.

Renee Thompson:
Yes. It can't be a one-and-done. It can't be, Oh, let's bring everybody together and do a workshop on workplace violence prevention. It has to be something more comprehensive. And I do want to talk specifically about the term workplace violence. A lot of people think it's just the physical violence from maybe patients and family members. But really, workplace violence is an umbrella term that includes physical violence, bullying, incivility, and it's more of a comprehensive view of the issue and not just one thing. And I know AONL has done a good job with this. There are a lot of associations right now, a lot of organizations taking a look at how can we provide really good support, really good data outcomes, strategies to help our healthcare professionals actually mitigate workplace violence, prevent, as you mentioned, Deb, report? Because I, we've done some work with patient and family abuse. And we did some of this work in a cancer center. And if you're a nurse in a cancer center and one of your patients or maybe their family member was abusive towards you, and you can define what that is verbally or physically, they tend to just ignore it because their wife was just told she had cancer. They have cancer; we understand it. Or this patient is under the influence of alcohol, or they're not mentally healthy, so we just let it go. But to your point, it's not part of the job. And that's hard to get nurses to actually speak up and say, This is not okay, because there's a ripple effect when we ignore those types of behaviors.

Dr. Deborah Zimmermann:
I am still surprised at the number of nurses who believe it's part of the job and make excuses because of the patient population that they're serving, and it really is up to us as nursing leaders to be explicit that it's not acceptable. And we do understand that there are conditions, substance abuse withdrawal, delirium, mental health crises, and the list goes on, where they're complex issues that we need to really help mitigate. But that doesn't mean we don't report it. And we also need to have the support of senior leaders, we need to have support of security and others so that when it is reported, it's taken very seriously. That's why, I actually worked with the Joint Commission many years ago, not many, about 5 or 6 years ago, to, with the standards that really require organizations to have a comprehensive assessment and program in place to really bring to light the issues, because, as you just said, it's not just, one, it's not just patients and families. There's racism that we know is prevalent among the professions and also between patients, and families, and clinicians, and how we deal with them is different. So, it just can't be a very simple answer. But we have to start with reporting. It has to be explicit from the leadership that there has to be trust among the clinicians and those on the front lines that their situations are serious and they need to be part of the planning on what, how an organization really approaches each, the types of situations that occur within their healthcare organization in their community.

Renee Thompson:
Deb, I'm curious to know if you've seen differences in either regulations or expectations based on state because I know, for example, California, it is mandated. You have to have workplace violence training and education, and you have to have a series of things, and they will hold you accountable to that. But I don't know that other states have done that. Do you think that's going to be something that we'll see across the country? I'm really curious to know if you've seen any.

Dr. Deborah Zimmermann:
I do think that there are differences. AONL, about two weeks ago, we had our Advocacy Day, and I had the opportunity to talk to nurses from 37 different states. And the stories break your heart that nurses who have been out for six months because of an assault that, and when it was reported to the police in their community, they were told, it was, This is to be expected from the patients and families, and it is part of your job. So what we have seen is a great deal of variety. I happen to live in Virginia. And in Virginia, it is not a felony. In fact, in most of the country, it is not a felony to assault a healthcare worker. And the American Hospital Association and American Organization for Nursing Leadership is leading with federal legislation that, called the Save Act that would make it a federal offense to assault any healthcare worker. And primarily, that is to really raise up and let the public know about the issue and then to really have the community help address it. In here, in Virginia, we've been able to work with the legislators, and it's actually now part of a public campaign that this is an issue and the expectations of the community when they are receiving care in any kind of healthcare organization because it's not just physical assault, it's also verbal assault. And some nurses have said to me, I just thought I couldn't hang up from a telephone call because it was part of our patient satisfaction scores. That's something that we really need to overcome.

Renee Thompson:
Yeah, you're absolutely right. Nurses are caught between a rock and a hard place. If I say to my patient, I'm not willing to communicate with you until you're willing to communicate with me in a respectful manner, I'm not going to tolerate your behavior, I'm going to hang up on you, but then the patient and their satisfaction surveys give us a low score, and so we're hesitant to do that. And I think sometimes we feel like we're abandoning our patient. Because I remember being a young nurse, I was told, You cannot refuse to take a patient; that's abandoning them. If I have a patient, even though they're being physically, verbally abusive, and I say I'm not willing to care for this patient, there's that ethical part of me and that caring part of me as a nurse that feels like I'm not doing what I'm supposed to be doing as a nurse, and I think we have to address that as well as a lot of these other factors. And I told you my husband was in the army. He was a military police officer, and then he worked law enforcement his entire career and has done a lot with workplace violence prevention for decades. And he always says, said, Verbal violence always happens before physical violence. And so, we need to intervene earlier when these patients are getting verbally abusive. That's the time that we pull the team together to say, Hey, red flag, this guy is starting to escalate. You don't wait until something happens, and then it's making sure everybody in the department knows, even people who are coming into your department providing service like radiology or pharmacy or phlebotomy, making sure that they know that this patient has started escalating so that, as you said, Deb, it's not any one thing. It's a lot of different things, but it has to be comprehensive. Again, it can't just be bring everybody together and do a workshop on workplace violence.

Dr. Deborah Zimmermann:
Yeah, I'm seeing more and more healthcare organizations creating a code of conduct that is approved by their patient advisory councils and posted. There is a partnership in, with security and part of daily huddles if there are any high-risk patients so that there can be de-escalation strategies. The team is all aware and it's not just nursing, it is all the professions really understand high-risk populations. We also need to be proactive with those populations that tend to have a higher incidence of violence. How often are patients admitted from the emergency departments with some kind of psychiatric illness, and their medications are not continued because the primary diagnosis for admission is other than that psychiatric diagnosis? We don't typically put in place plans to reduce the risk of delirium. We don't prevent it. We don't, for those who we know are at risk for withdrawal from some kind of substance abuse, we don't necessarily put those measures in place. I think we, as a care team, need to really understand the causes and the populations that are creating these situations and then be proactive. We know that prolonged waiting in the emergency department; that is a risk factor or a trigger for some group. We collectively, as a community, as a profession, need to really make this a very high priority, particularly if we really want to create healthy work environments and healthy healing environments for our patients and families.

Renee Thompson:
Absolutely. Because when we take a look at how we originally started this conversation about staffing and the staffing shortages are easing and we're making small progress and employee well-being, we're going to plateau unless we do something to make sure that even there's no way you can say 100%, no violence will ever happen. However, we can do a better job decreasing that risk and creating a more safe environment for our healthcare professionals. And yes, lots of work that still needs to be done in this area. But what I want to do now is talk about, okay, meaningful recognition. Your work with the DAISY Foundation, and I've been a fan since the moment I think I met Bonnie and Tina at a conference. I'm like, okay, I'm a fan, I'm a lifer. I have my daisies out on my lanai. I got the little packet of seeds from AONL, and they're growing. Excited about that. But anyway, can you talk to us a little bit about organizations, especially nurse leaders, because most of the people who listen to this podcast are nurse leaders. What they can do to really create meaningful recognition? And I say this, and please forgive me; I don't want to shame anyone if you're listening and you do this, but just buying pizza for everyone is not meaningful recognition. If you want to buy pizza, just buy pizza for people. Don't have it be attached to, Oh, you guys worked really hard today because you're going to get them on gluten free, and I don't eat that, and it's not really meaningful. Deb, can you talk about what meaningful recognition means to you and how our listeners can actually start really focusing on creating that recognition-rich environment for them?

Dr. Deborah Zimmermann:
Yeah, thank you for asking something related to my passion. In 2005, the American Association of Critical Care Nurses identified the six elements for healthy work environment, of which one of those is meaningful recognition. And what is meaningful recognition? It is recognition that comes from those that are tied to our purpose. We, as nurses, chose this profession because we wanted to raise up the health and wellness of the communities, of the individuals, and to receive feedback from patients, families, and colleagues is our tied to purpose. It reinforces, for the new nurse, it reinforces that they have made the right career choice and that they are having an impact because of their care on that patient. For a nurse who's been in practice 40 years, it means they still are making a difference. And it helps prevent the cynicism and the crust that we sometimes develop over the course of time. It keeps us centered, and it really is our joy. Because when you hear the feedback from patients and families, in general, they expect that we're going to be skilled, we're going to be expert. It's the compassion, it's that connection, it's the understanding that sometimes we have poo-pooed as a profession is something that is not really seen as scientific, but it is something that our patients and families value. It helps connect them to our organizations, to us, and it is something that the researchers have actually examined and feel that it builds compassion satisfaction. It builds a reserve for those tough days that we know every clinician experiences. So, it is part of a healthy work environment. It is tied to our purpose, and it comes from patients, families, and colleagues. So we, as leaders, need to ensure that we have those mechanisms in place for patients, families, and colleagues to really provide that feedback, that those stories are celebrated, that the actions associated with those stories are celebrated and honored. The nurse who purchases a pair of shoes for a homeless patient; that should be celebrated just as much as the nurse who saves a patient's life during an RBT. That is the art and science of our profession. Now, you asked a question, and I'm often asked this. If there, I have a unit, let's say, that is filled with cynicism, how do I really create the openness to really receiving this feedback? I've had, as a chief nursing officer, the opportunity to really see the magic of DAISY. That's how I actually became involved with DAISY. I saw how that feedback really made a difference, and I also saw units be able to break that cynicism by starting with themselves at daily huddles, giving positive feedback to the team who made that difference. Even post-it notes filling a bucket that's up on the wall. Duke has a wonderful, on their website, they have a wonderful kind of information that I actually can make available to you that's free of charge on different tactics that leaders can bring to their units to actually share. But it really, when you start with one another, giving that positive feedback, inviting and creating and celebrating the feedback that you get from patients and families, you are able to create a culture that then spreads on and can even expand to huddles that you have at an organizational level when, before I left my position as a Chief Nursing Officer, there were Grateful Fridays where organizations, as different departments, would share their thanks to one another for help that they received over the course of a week.

Renee Thompson:
Oh my gosh, I love everything you just said. So, I'm going to go back to a few things. You're spot on when it comes to the recognition. I look at it as, so the organization needs to have it baked into their culture. Like at this organization, we recognize our employees and not just nurses everyone in these ways. I think of that nurse manager in a department, maybe a med surge department or in the emergency department, making sure that's part of their process, that they have meaningful recognition. Patients and family members: as I get recognition from a patient or a family member, I'm good. I can handle anything now because, yeah, just reinforces that I was meant to be a nurse, and I think a lot of us feel that way, but also peer-to-peer and your daily huddles. It's one of the things that we do at the Healthy Workforce Institute with all the work that we do. All right, Deb, let's face it. We deal with bad behavior every day. Okay, every day, this is what we're dealing with. And we're helping organizations to actually address disruptive behaviors so they can grow the good behaviors. Part of our strategy is to give the positive feedback. And you're so right, there's some crests out there, and there's cynicism and people who are resistant and negative, but all it takes, because I've seen this happen, you just start by recognizing people for stepping up and doing the right thing, recognizing people for helping each other, recognizing people, whether it's at a huddle or during a staff meeting, and there is a positive ripple effect that happens. And you said something that I think is incredibly powerful, and it's human beings; we love stories. And I think that's what DAISY does really well. It tells the story. And I know myself when I read some of the stories, I'm like, I want to go back to the bedside. I want to be a nurse. I want to take care of patients again because I want to have that experience that those nurses can have, like just being nurses, being caring and compassionate. Most of us got into this profession because we wanted to make a difference in the lives of other people. We wanted to end suffering. We wanted to feel like we had something to do with a positive outcome. And I'm going to go tie it back to workplace violence. It's not any one thing. It's a lot of different things, but it has to be a priority. For you, if you're listening and you're in a leadership role, or if you're an executive and you're responsible for your organization's strategic plans and priorities, meaningful recognition is a must-have, and to do it. Oh my gosh, Deb, thank you for your great work in both of these areas. It's like the opposite ends of the spectrum. You've got the workplace violence over here. You've got the meaningful recognition over here. Sometimes, you feel like you're playing like ping pong. It's like, yeah, boom, who am I going to show up as today? What am I going to focus on today? Because you're really, it's the opposite ends of the spectrum.

Dr. Deborah Zimmermann:
But they're so connected, aren't they?

Renee Thompson:
Yes, they are really connected. All right, as we start wrapping up, okay, let's say we have a nurse leader who's listening or watching, and everything that you said is really ticking the boxes. Oh my gosh, yes, we don't really have a comprehensive plan for workplace violence. Yes, we don't really have a comprehensive plan for meaningful recognition; we are bringing in donuts and pizza. If they want to just start, and you can either pick workplace violence or meaningful recognition, I'll let you decide, but where would they begin? What's an action that anybody who's listening right now can take?

Dr. Deborah Zimmermann:
Our joy is our ability to connect, to make a meaningful difference in the lives of those that we serve. Caring and compassion is what brings joy and is tied to purpose. So, for leaders that are listening, celebrating meaningful connections gives permission for work that goes beyond the physical needs of patients and has been shown in the research to build resilience and foster a culture of joy. What can you do as a leader? You can start to give thanks at huddles. You can have a brown bag lunch where you're sharing a book that's built on gratitude. You can give, bring to your chief nursing officer or other leaders a way to express gratitude during hospital huddles or larger meetings. So that's one. As far as workplace violence it is, ask the questions and make sure that your teams know that they must, for the patients, colleagues, and themselves, bring forward the challenges with workplace violence so that they can be adequately addressed and measured.

Renee Thompson:
Oh my gosh, spot on. Love your advice. And like I said, I feel like our listeners got like two for one. You got workplace violence strategies and actions. You've got meaningful recognition. So what I would recommend is just do something, just start paying attention even to what people are doing. We have this whole negativity bias. We're always looking for what's wrong and looking for the negative. There's plenty of goodness out there, so start raising your own awareness, and identify the goodness, and celebrate the goodness. And I'm sure you would agree, Deb, but when you do that as a leader, you celebrate the goodness in someone else, it comes back to you because it makes you feel better too. Especially, I know if I compliment someone or I'll say, Oh my gosh, you're so good at fill in the blank, or you really handled that well, and their reaction is, Oh, thank you. It makes, it fills my cup a little bit too. So it's, definitely. All right, if our listeners want to connect with you, what would be the best way for them to do so?

Dr. Deborah Zimmermann:
The fact you can reach me really in any of those mechanisms that you're making available the quickest though is my, by email. So that's DebZimmermann, two M's, two N's, @DAISYFoundation.org. But any of those, I promise you I will respond. It's really my honor to really get that feedback and anything that I can do to help. My passion is our profession.

Renee Thompson:
See? I told you she was one of the nicest human beings I've ever met. And Deb, despite being how busy she is, that you're very responsive in email, you know that? I send you an email, and you reply, like sometimes in five minutes; other times, at least within an hour or so. You're very responsive. So, we will have the link to Deb's LinkedIn profile in the show notes. We'll have her email in the show notes in case you forgot about the two M's and two N's. We'll also have the link to the DAISY Foundation and also AONL. And Deb, as we conclude, I want to thank you for your good work to really help advance the profession of nursing in a meaningful way, for reminding us that joy needs to be a part of our work because we are never going to keep nurses doing the good, sacred work that they do if we can't create opportunities for them to feel that joy. And we need to, as nurse leaders, create that opportunity for them to really be celebrated and to bring joy back. And for your work in addressing workplace violence, it's incredibly important right now. Thank you for being a guest on our show. I so appreciate you.

Dr. Deborah Zimmermann:
I got you. Thank you, thank you, Renee. My honor.

Renee Thompson:
Thank you, our listeners who are either listening or watching, thank you for being here. And if you really like this podcast, please, if you could rate it, post a review, and share it with someone who actually might need to hear our conversation today. I want to thank you all for being here, and for all the great work that you're doing to cultivate healthy work cultures. Take care everyone.

Renee Thompson:
Thank you for listening to Coffee Break: Breaking the Cycle of Bullying in Healthcare – One Cup at a Time. If you found this podcast helpful, we invite you to click the Subscribe button and tune in every week. For more information about our show and how we work with healthcare organizations to cultivate and sustain a healthy work culture free from bullying and incivility, visit us at HealthyWorkforceInstitute.com. Until our next cup of coffee, be kind, take care, and stay connected.

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