EDITOR'S NOTE: Heather Stringer is a freelance writer.

The CNO, Jim Donnelly, BSN, MBA, RN, was at a Magnet conference in 2011 when he first heard about The DAISY Award®, which honors nurses who have provided extraordinary care. He approached the hospital’s practice environment nursing council about implementing the program, and they placed flyers and submission boxes near elevators and in the cafeteria, ED and on each unit. Within the first two weeks, 14 nurses had been nominated, and after three months, the number jumped to 100, he said.

When the CNO at the University of Pittsburgh Medical Center Hamot asked nurses to launch a new recognition program that relied largely on nominations from patients and families, the nurses wondered if anyone would be nominated.

High return on investment

At Tampa General Hospital in Florida, the program has been so successful that more than 200 nurses are nominated each month, but this number was much smaller in 2013 when the program began. The nurse-practice committee tasked with implementing the recognition program knew it was important to make patients and staff more aware of the award. In response, they included information about DAISY in the admission packets, and promoted it during governance meetings, said Janet Davis, DNP, RN, NE-BC, vice president and CNO at Tampa.

Mark and Bonnie Barnes launched the program at the facilities where Patrick had been a patient - the University of Washington Medical Center's Seattle Cancer Care Alliance. They continued visiting facilities to promote the program, and by 2009, 450 hospitals nationwide were giving the awards to nurses. At that point, Bonnie and Mark Barnes started hiring paid staff to run the rapidly growing program.

In recent years, The DAISY Foundation created awards for nursing faculty and students who embody compassion and commitment to the profession. The organization also has developed awards to recognize teams of two or more people led by a nurse who work together to do something extraordinarily compassionate for a patient or family. There also is a nurse leader award for nursing managers, directors, preceptors and other leaders who create an environment of compassion and recognition for others.

Origins of the program

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The program’s coordinators also have implemented changes based on feedback from nurses, Aasand said. Those who had been nominated early in the quarter were waiting two or three months to receive their nomination pins at the ceremony when the winner was announced, and the delay made the honor feel less poignant. In response, the coordinators started distributing the pins within two weeks of a nomination, Aasand said. Recently a nurse in the NICU at Portneuf Medical Center received The DAISY Award after caring for a couple’s son who had been born at 26 weeks. After he had spent two days in the NICU, the couple received a call that their son was not going to survive, and they rushed to the hospital.

The nurse, Amber Golson, RN, was performing chest compressions to keep the infant alive until the parents could say goodbye. Golson also attended the baby’s funeral. Two years later, the couple was in the NICU a second time when their son Colin was born at 35 weeks, and again they were impressed with Golson’s attentive and supportive communication and her reputation throughout the community.

Although the concept of rewarding high-quality work is not a new one, The DAISY Award is different from many recognitions because most of the nominations come from patients and families. “It’s a testament to a nurse’s skill and dedication, and a powerful reminder that their patients notice when they go above and beyond as caregivers,” Aasand said.

At Portneuf Medical Center in Pocatello, Idaho, where one nurse is selected per quarter from 80 to 100 nominees, the winners are featured on the hospital’s electronic billboard, website and in the local newspaper, said Charles Aasand, MBA, RN-BC, administrative director of behavioral health services and a DAISY program coordinator.

“Now the nurses talk about it all the time when they get nominated,” said Davis. The hospital honors two nurses per month with individual awards and recently started selecting two DAISY team awards per year.

Patients also seem to highly respect nurses who have received the recognition, said Erica Hendricks, RN, the program’s coordinator. “When patients see a nurse wearing a DAISY pin, it builds trust and confidence in their caregiver,” she said. “Patients will say that they feel lucky to have a great nurse.” Nurse administrators also appreciate the low cost of running the program, which ranges from $250 to $3,000 annually, depending on how many awards are given. “At the end of the day, it’s a very inexpensive program,” said Deb Wesley, MSN, RN, senior vice president of Children’s of Alabama in Birmingham, where one nurse is honored per month. “The return on investment is very high given the positive response from the nurses and families.”

“We weren’t prepared for the outpouring of public response for nurses,” said Janet Rice, RN-BC, an orthopedic nurse, who is part of the team that championed the program at UPMC Hamot. “The vast response let us know patients and families were hungry for a way to give feedback to the nurses.”

Each quarter, the hospital presents The DAISY Award to two nurses, who each receive their awards during a surprise presentation attended by administrators, colleagues and sometimes the patients who nominated the nurses. They are among the 20,000+ nurses who are honored each year by more than 4,000 hospitals that participate in the DAISY program nationally and internationally. There are hospitals from all 50 states and 25 countries outside the U.S. that recognize nurses in this way.

Although colleagues can nominate one another, the vast majority of nominations come from patients and families, making this honor particularly meaningful to nurses, said Rice. “What we found is that meaningful recognition is often why people stay in an organization,” she said.

Although the DAISY program was one of many changes that were implemented as part of the hospital’s journey to Magnet recognition, Rice said the award is likely one of the reasons the nurse satisfaction scores have been higher there in recent years.

Janet Rice, RN-BC

Janet Davis, DNP, RN, NE-BC

Charles Aasand, MBA, RN-BC

The desire to start giving patients an opportunity to honor nurses began in 1999 when Mark and Bonnie Barnes were in the hospital with Mark's son Patrick, who was suffering from an autoimmune disease called idiopathic thrombocytopenic purpura. After eight weeks in the hospital, Patrick died at the age of 33. Patrick’s wife, Tena, and his parents were interested in turning their grief into something positive, and they “kept coming back to the compassion expressed by the nurses every day, even when Patrick was sedated,” said Tena Barnes Carraher, co-founder of the DAISY Foundation and its vice president of marketing and communications. They decided to create The DAISY Award, an acronym for Diseases Attacking the Immune SYstem, to honor the memory of Patrick.