What tacos told me this week...and what they tell you too if you listen.

When Nurses Week is over, we move on. And quickly.

The flash of celebratory ice cream, ceremonies, and accolades for our esteemed profession dwindles as we resume business as usual. But through this week each year, watching organizations find ways to creatively honor and give back to their nurses is really heartwarming, don't you think? " 'Taco 'bout Awesome!' celebratory lunches with walking tacos and leaders scooping out sour cream, and 'You're my Jam' breakfasts with bagels and aproned CNO's... it's all so loving and kind. For a moment, we can really feel like the unified group that we are.

But now it's done, though senior leaders - please hold on to this sentiment throughout the year. And please know it doesn't require you to create elaborate recognition plans, banquets, or candy buffets. What seeing all of these tacos and festivities told me this week is that in fact, we LIKE getting out there and most leaders find immense satisfaction in it. And in fact, what we know from current literature is that nurses are JUST as happy if senior leaders walk on their unit, even without a taco, but definitely with a purpose. And not only does it make them as happy, it definitely changes outcomes.

Here's the thing: If most direct care leaders never been taught how to round, i.e. the people who should be doing it the most, do we really think their leaders got anything more than a crash course? Ask yourself: Do I have a process for getting out there, you know, walking the walk? Do I know what to say? Do I know how to say it? And do I see the impact of my walks on the outcomes we're trying to improve? Wait a minute... do I know the impact it can have when it is done right.

I'll tell you.

In organizations where senior leader rounds happen consistently over time and with an intentional and strategic structure, staff report improved perceptions of the culture of safety, improved sense of personal burnout, improved departmental "burnout climate," and no surprise that their patients' experience improvements too. Do less HAPI's or better PX scores sound good to you too? (Eamranond et al., 2022; Sexton et al., 2018).

Then read on.

Because it's not as easy as it sounds. Even when senior leaders ARE doing consistent rounds, one recent (and sizeable) study found that at least a quarter of those surveyed about the process of senior leader rounds weren't sure if they were occurring... when they were. So with Nurses Week over, make a commitment to just get out there... but do it right.

Here are some tips to make the most of this practice for you, the staff you serve, and the patients they care for. No tacos required.

1. Block TINY amounts of time to get out there. Big chunks are overwhelming, but showing up 1-2 times a week in different departments for 15-20 minutes is able to be accomplished more frequently and more consistently. That's the ticket. Staff have got to see you often enough to know they're not in trouble when you show up, and to know that this isn't just some quarterly system initiative, but that you actually care. (Bonus points if you track this, to be sure you're getting to the right places enough times!)
2. Make it public. I know some leaders just like to show up, as this is an unexpected - and generally pleasant - surprise. In fact, it's what I'm telling you to do in item #1. But - if you find yourself struggling with accountability to even get small amounts of senior leader rounds done - text someone that you are planning to round in their department at a certain time. Then you are more likely to do it. Go psychology!
3. Out with the old questions. There was a time when asking "Do you have everything you need to do your job?" or "Is there someone you'd like to recognize?" were not only standard, but helpful. But times have changed. No, they might not have everything they need. If we're truth telling, that's pretty normal. So let's hope that their direct leader is getting it for them. And yes, they are likely recognizing each other a lot. Most departments have this nailed. So what might be MORE potent is to ask:

What's something that you are proud of at work today? I'd love for you to be specific. ...Then celebrate them then and there with some specific feedback to them.

Then ask: If there were ONE thing we could be doing to make your employee experience better during this shift or your next shift (like right now!) what would it be? ...Then do it!

We don't need AI and new tools to get it done. And we definitely don't need tacos.

(But if you DO need a guide for this, you can download ours here. It's not sour cream... but it usually helps make rounds work.)

References:

Eamranond, A., Rodis, J.F., Rihard, K.E., Safer, A., Kunupakaphun, S., Grey, M.R., & Eamranond, P.P. (2022). Decade of patient experience improvement at a tertiary care urban hospital. Quality Management in Health Care, 31(2), 53-58. https://doi.org/10.1097/QMH.0000000000000326

Sexton, J. B., Adair, K. C., Leonard, M. W., Frankel, T. C., Proulx, J., Watson, S. R., Magnus, B., Bogan, B., Jamal, M., Schwendimann, R., & Frankel, A. S. (2018). Providing feedback following Leadership WalkRounds is associated with better patient safety culture, higher employee engagement and lower burnout. BMJ Quality & Safety, 27(4), 261–270. https://doi.org/10.1136/bmjqs-2016-006399