Sarah Montague, BSN, RN, ACM, Caritas Coach®, and Angelica Rincon, MSN, RN, NEA-BC, CNOR, Caritas Coach®, wanted to bring evidence-based interventions to the Kaiser Permanente San Rafael team to continue to foster an environment and culture of well-being for our nurses. Together, they conducted a literature search and found many articles with interventions that support well-being. After a rapid critical appraisal of the literature, it was determined that, rather than focusing on just one intervention, the project would focus on gratitude and the many ways we can express and receive gratitude in our work and personal lives.
Montague and Rincon brought the idea back to the professional governance council day, and the councils agreed it would be a fun and interactive way to engage our nursing teams across the medical center. The team decided to launch a 30-day Gratitude Challenge. Montague and Rincon “challenged” the professional governance nurses to help lead the initiative on their respective units. The project used a pre- and post-survey through Microsoft Forms with a QR code; no identifiers were collected. Twenty-six participants completed the survey; however, many more nurses participated in gratitude activities on their units.
Nurses expressed gratitude to colleagues during daily shift huddles. There were opportunities to post gratitude cards on the walls, to write thank-you notes, to post KP kudos, and to use electronic KP kudos to express gratitude. Additionally, some units took photos and created bulletin boards to share pictures of someone or something they are grateful for; some nurses chose to use a gratitude journal or mindfulness exercises throughout the day. Supplemental resources, links, and tools were created as a toolkit and distributed throughout the medical center to help nurses identify ways to express gratitude, such as a 30-day calendar with suggestions and links.
Dr. Jean Watson’s Human Caring Theory served as the theoretical framework for this project. The caritas processes were shared during the Voice of Nursing, Professional Governance Council Day, specifically, the Care Experience and Caring Science Core Council. Montague and Rincon presented the Gratitude Challenge initiative and explained how the Caritas Process 3 aligns with gratitude.
Comparing pre- and post-GQ-6 questionnaire results demonstrated improvement post-intervention. The culture of health index question “At work, my team regularly expresses gratitude for one another” improved from a baseline score of 83 on the People Pulse survey to 85.