Nurse engagement and empowerment are also valuable. “If you’re working to make things better, you’re more likely to stay,” she added. Triantos agres with empowering nurses to feel free to speak about their needs. Her organization has a “very robust shared governance” with nurses finding ways to reduce caregiver stress, she said. One example is a charge nurse who launched a research study on the effect of real time debriefing and its effect on compassion satisfaction, burnout, and secondary trauma. As a result, training now equips all charge nurses to recognize the signs and symptoms of stress in staff members and how to provide tiered layers of support, starting with a five to 10 minute debrief after every code. “Staff said they believe this is emotionally valuable and beneficial,” Triantos said. At St. Anthony, Goldstein promotes and models the same team concept. A “post-code pause” takes place after every code, acknowledging the event and allowing staff to express concerns and feelings. He says this builds resiliency. He also endorses speaking up when the stress builds. “It’s not a sign of weakness, it’s a sign of needing help,” Goldstein said. “It’s empowering our staff to care for each other. Any member of the team can say, ‘Hey, why don’t you take to break?’ or ‘Hey, you’re a little bit stressed.’” Goldstein shared an example. “I saw a nurse bang something down on a desk in frustration,” he said. “ I gave him a few minutes, then in private asked him what was happening.” The nurse let out his aggravation about an interaction with a co-worker. Goldstein recognized, in real time, that something needed to addressed.