An Evidence-based Approach to Improving Nurse Mental Health 

An Evidence-based Approach to Improving Nurse Mental Health 

At 22 years old, I became a charge nurse on a 27-bed step down unit at a large metropolitan hospital. The job demands were intense, and I regularly saw critically ill patients, distressed family members, and other difficult situations that I had little time, emotional bandwidth, or support to process. This experience drove me to join Trusted Health , where I work with a team to identify workforce solutions that make nursing a more sustainable career. Each year since 2020, we have published the annual Frontline Nurse Mental Health & Well-being Survey to gauge the collective health of our nursing workforce and advocate for solutions to support it.

After three years of primarily grim findings, however cautious, this year’s survey offers reason for optimism. Nurses’ self-reported mental health ratings have shown continued improvement since the darkest days of the pandemic, ascending from 5.4 in 2020 to 6.6 in 2023. Furthermore, adverse mental health outcomes have decreased across all categories over the past year. Although concerns such as burnout and depression persist, there have been notable reductions in the incidence of moral injury (-28%), compassion fatigue (-27%), and suicidal thoughts (-25%).

One dispiriting finding, however, has remained consistent since the survey’s inception: 95% of respondents said that their mental health was either not a priority for the healthcare industry or that it was a priority but that there were inadequate measures to support it. Given the attention paid to clinician mental health since the start of the COVID pandemic, most nurses see industry-wide efforts at improving their mental health as inadequate at best and lip service at worst.

This year, we set out to identify the exact programs and initiatives that have a positive impact on nurse mental health, bolstered by the fact that nurses who rated their overall mental health as positive were two and a half times more likely to be satisfied with the level of support their hospital provides relative to those who rated their mental health as negative.

My hope is that our findings provide the blueprint for a new, evidence-based approach to supporting nurse mental health. At the core should be an overhaul of nurse staffing, better support for new grads, and peer support programs.

It’s no secret that staffing continues to be one of the biggest – if not the biggest – challenges facing the healthcare industry, and this year’s survey highlights its deleterious effect on nurse mental health: fully 80 percent of respondents said that staffing levels or staffing shortages hurt their mental health. Hospitals must eschew rigid, outdated practices in favor of alternatives such as self-scheduling, variable shift lengths, and providing full-time, part-time, or gig-based employment opportunities.

More support must be given to new grad nurses who have taken on advanced responsibilities at an accelerated pace, often at the expense of their well-being. Disturbingly, 38% of nurses who assumed the role of preceptor or charge nurse a year or less into their career reported that it had a negative impact on their mental health. Hospitals need to incorporate educational and mentorship support into training for these nurses, and regular check-ins should be a core part of their experience for a minimum of six months. Moreover, these advanced responsibilities should always be voluntary, never forced upon nurses who aren’t ready or interested.

Lastly, this year’s research highlighted the power of peer support programs on nurse mental health: nurses who report positive overall mental health are twice as likely to work at a hospital with a peer support program than those who rated their mental health as negative. Not only can these positively impact nurse well-being, but they can also improve overall unit and hospital culture.

This year’s survey gives me hope after three years of findings where reasons for optimism were hard to come by. Now, it’s incumbent upon all of us to follow the evidence toward a path forward and find substantive ways to support the nurses who do so much to support us.

A Passion for Breast Cancer Advocacy and Unique Perspective on Survivorship: Meet The Pink Warrior 

A Passion for Breast Cancer Advocacy and Unique Perspective on Survivorship: Meet The Pink Warrior 

Being one of 240,000 are great odds if you’re playing the billion-dollar Powerball, but not when those odds are for being diagnosed with breast cancer.

According to the CDC, close to 240,000 cases of breast cancer  are diagnosed in women and about 2,100 in men each year, and Courtney Shihabuddin DNP, APRN-CNP, was one of those women in 2020.

Shihabuddin was diagnosed with breast cancer on February 13, 2020. Since her diagnosis, she’s become an educator and advocate for others, creating and founding The Pink Warrior to advocate for young women with breast cancer by sharing her personal story and working with national breast cancer organizations.

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Courtney Shihabuddin DNP, APRN-CNP, is a member of the American Association of Nurse Practitioners, educator and breast cancer survivor.

Daily Nurse spoke with Shihabuddin about her deep passion for breast cancer advocacy and her unique perspective on survivorship. What follows is our interview, edited for length and clarity.

Talk about what you do in your role as a certified nurse practitioner.

I work primarily as an assistant clinical professor at The Ohio State University’s College of Nursing. I teach in the graduate nursing program and am the specialty track director for the Adult-Gerontology Primary Care NP program and the Adult-Gerontology Clinical Nurse Specialist Program. So, I help run those two programs and teach the Adult Gerontology Primary Care Nurse Practitioner Program. I practice clinically at the Columbus Free Clinic on Thursday evenings, which is a clinic that serves the uninsured and underinsured population of the Columbus, Ohio area, providing primary care services and specialty services, including gynecology, urology, neurology, and psychiatry. We recently founded a Rainbow Clinic as well that exclusively serves members of the LGBTQ population. And so while I’m there, I’m precepting my nurse practitioner students and first and fourth-year medical students. And it’s just been a great experience. I love working there. I’ve been there for four years and serve on their board. I’m the medical director of quality, and it’s a big part of my job, work, and daily life.

Talk about being diagnosed with breast cancer in February 2020.

I have to start a little bit before that. My mom is a three-time breast cancer survivor, three separate new-growth breast cancers, not recurrence. And my father’s sister has had breast cancer twice. And so they both had genetic testing, and they’re both negative for any genetic abnormality that could indicate a genetic propensity to breast cancer. But when I was 24, I found my first one. And so, knowing my family history, I didn’t mess around with that at all. I had just started nursing school at that point. I did nursing as a second career. And so I didn’t have the level of knowledge that I have now. I knew something was wrong and wanted to get it checked out. And so I did, and it was a benign fibroadenoma, a benign fibrous growth. It was followed for a couple of years, and then I relocated, and my OBGYN recommended that I enroll myself in a high-risk screening program offered at the medical center. So I went into that program, which did surveillance every six months, either with a mammogram or an MRI. I stayed in that program when I lived in Oklahoma. Then, in 2018, when we moved to Columbus, I transitioned into the program that we have here at the James (The James Cancer Hospital and Solove Research Institute), our cancer hospital. And I went every six months as scheduled in August 2019. I had a normal mammogram. Then, in February of 2020, I had a grossly abnormal MRI compared to previous imaging. And so they did an ultrasound and biopsy. So we did all of that. I was diagnosed on February 13, 2020, with invasive lobular carcinoma in my right breast. In my left breast, I was diagnosed with lobular carcinoma in situ (LCIS), which is a pre-cancerous finding. According to the MRI imaging, the lobular carcinoma in situ was made up of greater than 50% of the breast tissue on my left side, so my only surgical option for treatment was a double mastectomy, which I was planning on doing anyway because I didn’t want to have to go through cancer more than once. Seeing that two of my first-degree relatives had had to do it more than once, I knew I didn’t want that option. And then, of course, COVID happened and complicated things tremendously. On March 31, 2020, my surgical oncologist called me and told me that my mastectomy was canceled because it was considered an elective procedure. And I nearly about lost my mind. My oncologist also felt that that was not an adequate treatment plan. My surgeon wanted me to start tamoxifen because I had hormone-positive cancer, and said then we’ll revisit this when this COVID thing is over. My oncologist said, ‘Absolutely not you need surgery. Your entire treatment plan is based on testing that we want to do on your tissue. And without surgery, you don’t have your tissue.’ So she moved it up to the following Monday. And I had my double mastectomy. I was very lucky because of the high-risk screening program that I was in. It was caught quite early. My tumor was just over two centimeters but had not spread into any of my lymph nodes. And so I was stage 1B. My treatment plan was surgery and then hormone suppression for ten years with tamoxifen. So, I’m currently three years into that ten-year journey on hormone suppression. I follow up every six months with my oncologist and pray that I never have any recurrence. I’ve had eight surgeries in the last three years, which is never fun being a mom. My husband is also an emergency room physician, so that meant going through treatment during a pandemic with an ER physician husband who can’t take any time off to take care of you when I had a one-year-old and a five-year-old was quite an experience. But we got through it. They say whatever doesn’t kill you makes you stronger. Now, I work hard to teach my students and patients about the risks that young women can have with breast cancer, being that I was 35 when I was diagnosed. I know many other women under the age of 40, who I know personally or who I’ve read about or interacted with on the internet, who have also been diagnosed at a much younger age and have often had care delayed because they’re too young. Or that’s not what breast cancer feels like. Or it’s probably benign. And we’ll check it in six months or something to that effect. Much of my advocacy work has to talk about self-advocacy as a patient and knowing your own body and what your normal is so that if you find something abnormal, you go to your provider, insist on some imaging, and advocate for yourself. In my personal and professional opinion, it’s always better to over-order than miss a potentially lethal diagnosis.

You have a full plate professionally and at home with two kids, but you’ve been busy advocating for others since your diagnosis. Talk about The Pink Warrior and your work with other national breast cancer organizations.

In October 2022, I launched The Pink Warrior, a website where I share my story. I offer resources for other people who may be caregivers or patients themselves, working through treatment, or how to talk to your family and tell your children. I also offer many external resources to assist them wherever they are throughout their treatment. I also created a small shop. That was my goal as a young woman with breast cancer. There wasn’t much geared towards a younger woman with cancer. Everything you see on television or read in popular culture about breast cancer is really for postmenopausal women. And there wasn’t this place where I felt I belonged in the breast cancer narrative. So, I tried to create that and inject some levity into the gravity of a cancer diagnosis. So I have snarky cards, a candle for tits and gigglesand fun little thingsI partner with an organization, and it changes every quarter. I donate 10% of the entire shop to that organization at the end of the quarter. So, for Q4, we’re partnering with the PSF Foundation, and they work to help people who cannot afford breast reconstruction find surgeons and then pay for their reconstruction because so much of treatment is what comes after so much.

Survivorship is that part that no one prepares you for. So many things happen in survivorship that are unaccounted for what I feel as a survivor and nurse practitioner. My oncologist certainly didn’t prepare me for hot flashes, menstrual abnormalities, intimacy with my husband, body image disorders, or any of the things that come with amputation of your breasts and multiple surgeries. And getting thrown into menopause at 35 and what that looks like. So that’s what I strive to do, to help normalize with the Pink Warrior. You have a place to go if you know somebody who has been diagnosed and you want to send them something that shows that you care that’s loosely related to breast cancer, but also to have conversations. People email or chat with me on Instagram in direct messages, constantly saying, ‘I’m so glad that I found your page, or thank you for sharing your story.’ Or ‘I was just diagnosed, and I feel like I’m drinking from a firehose,’ what questions should I ask? Even if I help one person, that’s so rewarding for me because I was completely lost. I had all of the medical knowledge, and I still felt like I was drinking from a firehose with a pandemic on top of it.

I was at an event with somebody who had their mastectomy two weeks ago, and they had just gotten their pathology results. And they had no idea what it meant and how to interpret it. They were told that they had ductal carcinoma. They showed me their path report, and they no longer had ductal carcinoma in situ; they had invasive ductal carcinoma, which spread to their lymph nodes, and no one had explained it to them. As a provider, I can’t imagine releasing a path report like that and not having a conversation with the patient but also not ensuring that by the time I hung up that phone, I knew my patient understood what that meant. Even if it wasn’t breast cancer and it was something else, I would want to make sure that my patient understood their diagnosis and give them time to ask questions. As a patient, you could ask all the questions at that moment and completely black out without recollection of that conversation. So, the benefit of the doubt to this person’s provider. So I sat down with her, and I explained what everything meant. I gave them my phone number and said if you have any questions or want me to come to an appointment with you, I’m happy to do that because that’s what advocacy is to me. It’s helping somebody else through their struggles in a way you can relate to.

Talk about nurse practitioners’ work in helping screen and treat women with breast cancer.

So, the program I teach in which I operate is primary care. Our goal as primary care providers is for prevention and screening. We should be counseling all of our patients over 40 that they should be getting annual mammograms, and we should be ordering those exams. We should be having conversations with our patients about their risks. And suppose they do have a family history. In that case, we should be screening them before age 40 and evaluating whether that be genetic testing, a screening, an ultrasound, or a referral into a high-risk program. That is our role. Their primary care is prevention, and we are there to help them stay in tune with their body, know their body, empower them, be aware of what they’re looking for, educate them, and help steer them in a path that is here towards the best possible outcome. And that means early detection.

Please share some insight about what women need to know or should be asking. 

Breast cancer, in general, can be abstract. You can tell somebody what they’re looking for. You can tell somebody what’s normal or what’s abnormal. But to me, a picture’s worth 1000 words. And it’s so much easier to give somebody a visual than to explain something, especially if your patient’s first language is not English. There could be some misunderstanding or lack of knowledge from your communication. There is a charitable organization called Know Your Lemons. And they have a free app that teaches you how to perform a breast self-exam. It shows you how to do it feeling from just under your collarbone down over your sternum, all of your breast tissue, and up into your armpit, and it tracks your cycles and helps you equate anything that you may find with where you are in your cycle. It reminds you to do your self-exam. And the most important thing I think about the app is that it visually shows you the 12 Signs of Breast Cancer on lemons.

So it shows you what it would look like if there were warmth or a red spot, or what it would look like if there was an inverted nipple, or dimpling, or thickening of the skin, or discharge from the nipple. It visually shows you what all these things would look like. But on lemons, that makes it much more real to a layperson or a medical person, but a picture is much easier to understand. Oh, my breast looks like that lemon. I should get that checked out. It also helps translate. When you’re feeling your breasts, what if you feel something hard, like a lemon seed that’s fixed in the flesh of the lemon and hard to move around? That’s something that you want to be concerned about and get evaluated. Those are usually benign findings if you feel something that’s soft, like a pea or a kidney bean. They’re typically movable within the tissue. They’re usually soft and not as concerning as something hard like a lemon seed. And that’s how I explained it to my patients: here’s what you’re looking for. And I can always see this lightbulb moment. When you accept that you’re looking for something that’s hard, fixed, and doesn’t move, they have no idea what that means. But if you tell them, it’s like when you slice into a lemon, and that seed is like you can’t get that seed out. And it’s hard. That’s what you’re looking for. That’s what we’re worried about. It’s seeing their understanding and knowing, okay, I’ve empowered this person, and they know what they’re looking for now. My job here, I’ve accomplished that education. And I know now that I can move on to my next patient and do the same thing, knowing that they’ll know when to come to me if they find something abnormal.

Is there anything else to add about breast cancer and the need for early detection?

We must recognize our BIPOC community because our Black women are at a much higher risk and have a 40% higher chance of mortality from breast cancer. And that’s not because they have more breast cancer. It’s because of various health disparities. They’re often diagnosed when their cancers are later. Their cancers are usually quite aggressive. And, whether that’s because they didn’t seek care, or because they sought care and weren’t believed, or they were too young, or whatever it was, there is a problem with that statistic. We need to be better as healthcare providers in trusting our patients so that when they say, ‘This doesn’t feel right,’ we are taking them at their word, doing our exam, and ordering the necessary imaging to ensure that if this patient is telling me that they felt a lump, that we’re examining that lump because 40% risk of higher mortality is just unacceptable.

The other thing is that 80% of women under 40 find their breast cancer. That’s a pretty significant number, and that’s because we are saying there’s not a great screening for young women. Our breasts are dense, and mammograms don’t catch much. And so if you’re not feeling your breasts, if you’re not checking yourself, if you don’t know what’s normal for you, how do you know what’s abnormal? So, feel your breasts. I tell people to feel them on the first. It’s easy to remember the first of every month. It’s the same time every month, so you’re traditionally in the same part of your cycle because you’ll be the first one to tell if there’s something different.

From One Nurse to Another: How to Make Gift Bags Your Co-Workers Will Love

From One Nurse to Another: How to Make Gift Bags Your Co-Workers Will Love

Nurses spend their shifts caring for patients, communicating with doctors, and much more, so a great way to show your fellow healthcare professionals how much you care is with a gift bag.

So, how do you make gift bags for fellow nurses? What should you include in your bags? Here’s how to make gift bags your co-workers will love.

Buy Them or Take the DIY Route?

One of the first decisions is whether to make or buy gift bags. If you’re not crafty, buying gift bags is relatively inexpensive. You might even get a deal if you buy many bags for large nursing teams.

If you or someone you know is artistic and wants to make gift bags, that’s perfectly fine. But, for everyone else, buying gift bags costs a little more but saves lots of time.

Choosing a Theme

While it’s not something you must do, some people like their gifts to have a theme. Do you need help coming up with theme ideas? We have you covered. Here’s a quick list of nursing gift bag themes:

  • A nurse theme: Since your gift recipients are nurses, why not use nursing-themed gift bags, wrapping paper, and cards?
  • Nursing-related holidays: Nursing holidays  happen all year round. National Nurses Week is one of the most popular times to celebrate nurses from May 6th to 12th.
  • Your nurse’s interests or hobbies: As many work teams do, nursing staff have shared hobbies or interests. For instance, movie theater gift cards can be great for nurses who go to the movies together. You could also order food from their go-to restaurant.
  • Empowerment: Another excellent theme idea doesn’t require it being a specific time of year. You can include gift bags and cards featuring positive words of encouragement.

Essential Items to Include in Nurse Gift Bags

Whether you choose a theme or not, your bags now need gifts. Here are perfect gift ideas for nurses they’ll all love.

1. Snacks

Eating food gives the body fuel. And nurses need lots of fuel to care for patients. Because of that, snacks are great things to include in a gift bag. Everyone loves a snack.

Snacks are great gift ideas because you have many options. Companies make healthy snacks for the health-conscious crowd, but sweets are ideal for nurses with a sweet tooth.

2. Foot Care

Nursing is challenging on the feet. That’s why a few toe socks are excellent gift bag additions. Fortunately, there are many benefits of toe socks, especially for nurses. Toe socks let toes move independently and can help reduce foot pain.

A bag of scented Epsom salts is great for soothing sore feet. Foot creams and balms will also be well-received additions to any gift bag.

3. Spa Packages

We all know it to be true: Being a nurse is an active job that can leave anyone aching after a 12-hour shift. Help your fellow nurses get the relief they seek with vouchers for a local spa.

Let them spend their time off enjoying a spa’s saunas, massages, wraps, mud baths, and more. After these treatments, you’ll likely notice a refreshed nursing team ready for anything.

4. Pens

We spend lots of time writing. Whether for charting, updating patient reports, or something similar, nurses use a lot of pens. Pens are always big hits with nurses, especially if you need something small to put in a gift bag.

Premium pens with comfortable grips work well for preventing annoying hand cramps nurses know all too well.

5. Makeup

Recent United States Census Bureau data found that 75% of all nurses are female. With that in mind, you’ll likely know a handful of people who love cruelty-free and vegan makeup.

To be all-inclusive, offer gender-neutral skin or hair care products.

Including a Handwritten Note or Card

The last step is also the most important: include a handwritten note. You don’t have to overthink this step. A small handwritten message detailing how much you appreciate your fellow nurses is perfect. But feel free to write longer messages, too.

From one nurse to another, we know the value our fellow healthcare professionals provide for communities everywhere. No matter the occasion, we hope our tips help you create stunning gift bags for the nurses in your life.

Pilates for Posture: Strengthening Your Core, Aligning Your Spine, and Targeting Neck Strength

Pilates for Posture: Strengthening Your Core, Aligning Your Spine, and Targeting Neck Strength

Poor posture and being on your feet all day puts a lot of strain on your back, and it’s estimated that 74% of all nurses  will have at least one episode of low-back pain a year. Fortunately, pilates can improve posture and prevent pain — individuals with chronic low-back pain who participated in a pilates-based core exercise program achieved a better quality-of-life score than people with back pain who didn’t do pilates, a recent study in the Journal of Bodywork and Movement Therapies found.

Since pilates can strengthen your core, improve alignment, and bolster neck strength, it can help you to maintain good posture and form and prevent pain and injury as a busy nurse.

Strengthening your Core

Pilates is all about core strength. With a strong core, you’ll find it easier to maintain good posture and form throughout the working day, keeping back pain at bay. Inactive women who started doing one hour of pilates a week experienced improved core strength, flexibility, muscle mass, and balance. Leg circles, in particular, are a simple yet effective core-strengthening move.

To perform this exercise:

  1. Start by lying on your back with your arms at your sides.
  2. Bend your right knee, and place your right foot flat on the ground.
  3. Raise your left leg and draw a circle out to the side, down to the ground, and back to the original starting position.
  4. Aim to make the circle as big as possible while ensuring your lower back stays connected to the ground.
  5. Perform five reps before reversing the circle and performing for another five reps.
  6. Repeat in both directions on the other leg.

Achieving a Neutral Spine

Achieving a neutral spine is necessary for performing pilates exercises safely and correctly. Neutral alignment ensures each of your spine’s natural curves — cervical (neck), thoracic (middle), and lumbar (lower back) — are in perfect alignment with minimal stress placed on supportive tissue. Adopting a neutral spine can improve posture and keep injuries at bay.

So, to achieve a neutral spine, lie on your back on the floor and bend your knees with your feet hip-width apart. Your knees, legs, hips, and feet should be parallel. Take slow, deep breaths, and allow your body to relax. Envision your back melting into the floor. Then, perform a pelvic tilt.

Tighten your abdominal muscles, exhale, and press your lower spine into the floor. Inhale and release. Once you’ve familiarized yourself with the neutral spine position, your goal is to maintain this posture throughout your pilates practice.

Improving Neck Strength

Don’t let neck pain ruin your shift. Repetitive tasks like reaching, pulling, and pushing — activities nurses perform continually — are a key cause of neck pain. Maintaining good neck posture while you work is an effective way to treat and prevent chronic pain.

The kneeling shoulder shrug is a simple yet effective pilates move that can specifically strengthen the upper trapezius muscle — a large muscle that covers the base of your neck, your shoulders, and the middle of your back. In turn, you’ll minimize strain on your neck, strengthen your upper body, and find it easier to maintain good neck posture.

So, begin in a stable kneeling position:

  1. Press your shins and feet into the ground, push your pelvis forward, and engage your core.
  2. Grab a pair of light dumbbells (anywhere between one and five pounds is great), and hold your arms out at about 45 degrees with your palms facing behind you.
  3. Slowly shrug your shoulders up to the top corners of the room and pause for a couple of seconds before lowering them down again.

You want to achieve a full range of motion in a fluid, easy, and pain-free manner. Repeat for around ten to fifteen reps. Remember, if you experience headaches or migraines, you may need to start this exercise without weights.

Pilates is essential to staying healthy and preventing back pain as a busy nurse. By strengthening your core, achieving a neutral spine, and improving your neck strength, you’ll improve your alignment and posture and keep pain at bay.

Cedars-Sinai Expands Nurse-Led Workplace Wellness Initiative with Serenity Lounge

Cedars-Sinai Expands Nurse-Led Workplace Wellness Initiative with Serenity Lounge

Fall marks the start of influenza season—a time of year that fills up hospitals and gives healthcare workers an extra layer of stress, but at Cedars-Sinai Medical Center , however, patient care staff can step into a “Serenity Lounge,” a break room equipped with massage chairs, aromatherapy oils, artwork and other amenities to provide a soothing respite from their demanding work.

“Historically, studies have shown that nurses’ well-being affects job satisfaction and performance, along with the quality of care we can provide to patients,” said Melanie Barone, RN, MSN, associate nursing director and co-creator of the medical center’s Serenity Lounge initiative.

The 24/7/365 Serenity Lounges, a culmination of ideas backed up by research from Cedars-Sinai nurses, was a valuable resource for employees needing a 10- to 20-minute respite.

Since the first Serenity Lounge opened during the COVID-19 pandemic, 13 additional lounges have opened throughout the medical center. Cedars-Sinai nurse Florida Pagador, RN, MSN, conceptualized the idea as a solution to her need for relaxation during breaks.

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Florida Pagador, MSN

“Being at patients’ bedsides can be mentally, emotionally, and physically challenging,” said Pagador. “I needed a place to relax and recharge, so I pitched the idea, and we got to work.”

Pagador and Barone found an underutilized locker area, gave it a makeover, and established the first lounge. As the pandemic continued, more nursing teams carved out space for their Serenity Lounges.

In a study by Pagador and Barone that was published in the American Journal of Nursing, Cedars-Sinai nurse investigators found that nurses who used a massage chair in a quiet room for as little as 10 minutes experienced mental and emotional relief, allowing them to return to patient care better equipped to handle the stress.

“If we see a colleague having a bad day, we ask them if they need to go for a walk or if they need to take 10 minutes in the lounge,” Barone said. “Our culture is to support each other and recharge, no matter what kind of day you’re having.”

Serenity Lounge benefits have stretched far beyond Cedars-Sinai, garnering attention and inquiries from nursing professionals throughout the U.S.

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David Marshall, JD, DNP, RN

“Our nurses are the backbone of compassionate patient care, and their well-being is paramount,” says David Marshall, JD, DNP, RN, senior vice president, chief nursing executive, and the James R. Klinenberg, MD, and Lynn Klinenberg Linkin Chair in Nursing in honor of Linda Burnes Bolton.

“The Serenity Lounges stand as a testament to our commitment to provide an environment that empowers and nurtures our nursing family.”

Infection Control and Prevention: 7 Dos & Don’ts of Surgical Attire

Infection Control and Prevention: 7 Dos & Don’ts of Surgical Attire

The awareness of medical professionals for infection control is high. But, the pandemic taught us that an even higher level of vigilance is to control and prevent infection, and disinfecting your scrubs is part of the challenge.

One of the fronts of the war on infection is the sterile processing of scrub uniforms  worn on the job. Surgical attire needs special attention to ensure that medical professionals are part of the solution and not part of the problem! So, this post details seven dos and don’ts of surgical attire to ensure we’re effective in our struggle against the spread of infection in clinical settings.

Let’s review the process of getting your scrubs to “sterile.”

1. DO Wash Scrubs Separately

Infection control starts at home, so separate your scrubs from other household laundry using a specific hamper (preferably one with a lid and a plastic liner that can be regularly wiped clean with an antibacterial agent). Immunocompromised family members should use protective gloves when doing the laundry to prevent the transfer of pathogens.

Don’t wash your scrubs with other laundry. And if you change into your street clothes before leaving work, place your scrubs in a sealed bag where they should stay until wash day.

2. DO a Stain Check

Don’t just throw those scrubs in the machine when wash day arrives. Give them a good going over first to check them for stains. You must get those stains out, whether blood or coffee! Your surgical attire should be pristine to inspire patient confidence, sending a message of trustworthy sterility.

Treat stains before washing with diluted bleach or vinegar (blood) or one part vinegar and two parts water (coffee).

3. DO Two-Stage Washing

Your first stage of disinfecting surgical attire is a cold water wash in the normal setting. Turn your scrubs inside out to prevent deterioration of the fabric’s right side. If stains are still evident, don’t move on to stage 2, a hot water wash that will set any residual stains. Instead, soak garments in water-diluted bleach to remove the residue.

Only proceed to the hot water wash once all stains are gone.

4. DON’T Use Undiluted Bleach

Bleach will remove blood stains, but using it on your scrubs without diluting it with water is a recipe for disaster. The fibers in your scrubs will deteriorate. Bleach can also cause discoloration when not properly diluted before use.

Use bleach in your washer, but add it to the water before the clothes go in!

5. DO Dry On a High Heat

Heat is disinfection’s best friend because heat goes where other disinfecting agents can’t! So, when you dry your surgical attire, use the highest setting on your dryer. Thirty minutes on a high heat kills bacteria and other pathogens that may still cling to the wet fabric.

Wait to dry for 30 minutes.

6. DON’T Skip Ironing

Ironing your scrubs (again, on the highest setting the fabric will bear) is the final step to ensuring they’re sterile and ready for use. As I said above, heat is disinfection’s BFF, so iron your scrubs thoroughly.

7. DO Secure Your Disinfected Scrubs

Securing your scrubs once disinfected ensures that your work is not in vain. Place them immediately into a secure, non-permeable bag like a large ziplock. Don’t remove your scrubs until it’s time to put them on.

One Final Step

Your washing machine has been exposed to bacteria and other pathogens, so it must be sterilized like all other equipment exposed to contaminants. Your family’s clothes get washed in there, too, so this is a measure of protection you should take.

Using a bleach/water solution of 1-10, fill a spray bottle and spray the entire inside of your washer. With the scrubbing side of a dish sponge, thoroughly scrub the lid of the machine and the tub. When you’re done, run the machine on a brief, hot cycle, using more bleach and water to finish.

Scrubs are essential to hospital and clinical dress codes, but if they’re not disinfected correctly, you could undermine the work of sterile processing professionals in your facility. These simple steps will keep you on the right side of the war on infection at home and work.