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Talking About Tough Topics Can Boost Well-Being

Thursday, February 18, 2021

Healthcare workers are accustomed to high-pressure, fast-paced, and everchanging workplace circumstances. Working in these conditions often wears on individuals’ physical, mental, and emotional states. Throughout this pandemic, these effects have been at times insurmountable. The amount of pressure has risen, the stakes are higher, and things have changed so frequently that healthcare workers’ resilience has been spread thin. With the weight of the world pressing in on all sides, something had to be done to support and care for these crucial caregivers.

A group was formed at Lee Health to take on the task of meeting the emotional, mental, and social needs of workers within a large healthcare organization. This group was a mix of clinical and nonclinical personnel who developed the idea of a weekly publication called Clinical Circle. This was an initiative to transparently show bedside issues, empower open dialogue, and improve the well-being of clinical staff for their unwavering commitment to excellence.

Clinical Circle addresses challenges that bedside staff face and how best to tackle them. It is a publication that illustrates a case study and provides holistic solutions to frontline healthcare issues in the forms of vlog, tips, tools and techniques that encourages peer-to-peer coaching.

Although many of the topics were not unique to the pandemic, any assault that happens during a high-stress situation seems to hurt worse, sting deeper, and last longer. Each Clinical Circle edition addressed one problem and was supported by an emotionally connected essay to shed light on a challenged faced by frontline staff in a solution-focused way. Each issue was further developed by adding a video that demonstrated two workers having a supportive and productive conversation about the topic. This content was then emailed to staff within the organization who were asked to respond to a survey that helped provide a forum for further discussion of the issue at hand.

The Clinical Circle core group was comprised of four bedside nurses and subject matter experts in the fields of leadership and organizational development, spiritual services, nurse resident development, behavioral health, and patient experience. We knew that providing support and a forum for discussion during a pandemic would be challenging. Not only has it become inappropriate to meet in person to have human connections of this caliber, but people have less of an emotional reserve to apply to these crucial but stressful conversations.


This core group aimed to evaluate the success of this intervention in three waves. Wave one measured reach by looking at the percentage of emails opened, the click rates within the publication, and the number of survey or email responses. Wave two measured how well the publication sparked dialogue by looking at how many open-ended responses were completed within the surveys and relied heavily on word-of-mouth reports regarding actual conversations happening in the workplace. Finally, Wave three measured improvements to staff well-being through metrics like turnover rates, employee engagement survey results, and trending changes in the number of people using employee assistance programs.

Metrics for wave one and wave two were easier to trace than those in wave three. The nature of improvement and change is that it is a process that takes time. Likewise, concrete numbers can be gleaned from the objective measures and are more reliable than some of the subjective measures that are the more sensitive indicators of emotional resilience, positive mental health and application of therapeutic conversations with peers. It is also important to note that many external factors may affect the metrics in wave three outside the scope of the publication.


As the program evolves, it is the goal that these publications be used as a tool to launch conversation on a departmental level. It provides an opportunity to gather a team, discuss the nuances of an issue, and uncover areas in which more support can be given. Ideally, co-workers can begin to have more meaningful and solution-focused conversations about issues they were not previously empowered to work through.

The program has overcome certain challenges to continue producing publications beyond the initial pilot phase. Integral to the sustainment of Clinical Circle has been the support of the organization’s leadership team.

Transparency is not always seen as acceptable, especially when it uncovers or highlights fractures in the organization, but unless these items are brought to light, little can be done to repair them.

About the Author

Monica Rembert is a wife, mother of four, full time graduate student, and a full time bedside nurse. She considers‘people as her passion and caregiving as both a blessing and an honor. She has been serving the Southwest Florida community for over seven years and is currently employed as a Staff Nurse and a charge nurse leader for the Surgical Progressive Care Unit (SPCU) at Lee Health.

Monica Rembert is the current chair for the Clinical Practice Council (CPC), which is the system-wide nursing shared governance council. In her role, Monica represents and advocates for over 5000 Nurses at Lee Health. As the chair for this system council, Monica helps to share the voice of the bedside nurses with leadership, facilitates discussions that produce recommendations for change that either impact or effect frontline work, and helps to bring a sense of systemness to all nursing departments. Her vision for CPC is to see a fully functioning shared governance body where the people who do the work not only have a say in what happens, but they are empowered to speak up for safety and make recommendations for change when and where it is needed.

Monica has also played a vital role in numerous safety, quality and process improvement projects. Her notable achievements include, rolling out Charge Nurse Leadership Program, creating an acuity tool for her department, producing the Clinical Circles publication, enhancing communication with senior leaders through hosting nursing-specific town halls and has been the bed-side voice for a number of initiatives across the system.

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