The public image of nurse professionalism is important. Attributes of a professional nurse, such as caring, attentive, empathetic, efficient, knowledgeable, competent, and approachable, or lack thereof, can contribute positively or negatively to the patient experience. Nurses at a hospital in central northeast Pennsylvania offer their story as they considered the impact of a wide variety of individual uniform and dress choices. This article describes an evidence based practice project and survey created to increase understanding of patient perceptions regarding the professional image of nurses in this facility. Exploring patient perception of nurse image provided insight into what patients view as important. A team approach included the voice of nurses at different levels in the process. Ultimately, this work informed a revision of the health system nursing dress code. The study team also reflects on challenges, next steps in the process, and offers recommendations based on their experiences.

The authors examined physiologic changes in myocardial infarction patients during a family visit in the cardiac intensive care unit (CICU) and the relationship of these changes to illness variables, patient preference for visits, and patients' perceptions of the supportiveness of the visit. Forty-eight patients were studied for changes in heart rate, blood pressure, ST segment, and oxygen saturation. Patients who had the greatest physiologic changes were among those who had had more severe infarcts. However, many patients in the severe category did not show such changes. Examination of the reactive group revealed that, in addition to having more severe infarcts, it included a greater percentage of smokers than did the nonreactive group. Visit preferences were relatively low, but as visit preferences increased, so did cardiovascular changes. Supportiveness scores were quite high, and these were positively correlated with cardiovascular changes. Clinical and research implications are discussed.

The project was developed with a goal to decrease stress and create a better work-life balance for registered nurses (RN) and staff working within two hospitals and one outpatient clinic in northeast central Pennsylvania. A review of the literature for best practices in fostering such an environment was the first step. This led to three evidenced-based projects: Compassion Fatigue -Causes and Symptoms; Compassion Fatigue -Interventions; and Resilience -What Can Improve Resilience? The outcome of the literature evaluation led to the development of this research project to evaluate levels of compassion and resilience in nurses and unit staff, and whether interventions can improve and restore compassion. The purpose of this quasi-experimental study was to evaluate the effectiveness of a staff implemented activity plan as demonstrated by comparison of pre-and post-survey results. The Professional Quality of Life Scale and the Connor-Davidson Resilience Scale are two validated survey tools that were used to measure compassion and resilience before and after the implementation of a staff developed activity plan. A convenience sample of approximately 180 nurses and support staff were used. All RNs and support staff Licensed Practical Nurses (LPNs), Unit Desk Clerks (UDCs), Nursing Assistants (NAs), and Patient Access Representatives (PARS)) from five different units were invited to participate. Nurses and staff completed the two surveys as a baseline, then completed a self-developed activity plan, and again completed the two surveys after the project. Findings showed that a self-developed activity plan can improve levels of compassion and resilience. The results reflected the goal although not to a high degree of change. Satisfaction and resilience can improve, and burnout and trauma can decrease when nurses work on creating the change. The change must come from within and nurses must identify the actions that work for them as individuals. The next important aspect is that the activity plans must be seriously created and worked on daily. Degree of commitment and readiness to change is important for such a project to be effective. The overall goal was to provide staff with resources that would help to reduce levels of stress, create a better work-life balance, promote resilience and decrease levels of compassion fatigue.