Becker's Hospital Review

37 CMO / CARE DELIVERY Nurse managers' 4-day workweeks: How it's going at Mount Sinai By Mariah Taylor I n fall 2022, New York City-based Mount Sinai Health System launched its four-day workweek program for nurse managers. More than a year later, the program continues to improve staff engagement, satisfaction and has become an important retention strategy, Beth Oliver, DNP, RN, chief nurse executive for the system, told Becker's. Dr. Oliver added, experienced nurse managers play a critically vital role in supporting staff retention and engagement, championing organizational culture, and ensuring quality and safety of patient care. "It's the nurse manager that retains our staff," Frances Cartwright, PhD, RN, vice president of nursing at Mount Sinai Health System Oncology Services, told Becker's. "Our recent Your Voice Counts survey revealed that nurse managers were most at risk for burnout, and while the majority reported that they found great meaning in the work they do, they also found it difficult to decompress when they were home. When I collaborated with our system nursing leadership and examined the literature, it became obvious that a four-day, 10 hour workweek would go a long way in supporting their work-life balance." Although nurse managers may typically be scheduled to work five days a week, they can end up working more due to being on call. Giving managers the ability to completely disconnect was one of the aspects built into the four-day workweek at Mount Sinai. Each manager works four 10-hour days and has one day completely away from work responsibilities. at day is covered by another manager. e program also ensures there is a manager presence on the unit on both the morning and night shis and at the change of shi. "What we are learning is that nurse managers are able to be present and support best practice aligned with efficient workflows to advance safety, quality and coordination of care," Dr. Cartwright said. "Nurses feel supported on both shis. e nurse managers are very vigilant about scheduling the four days to ensure the units are covered as needed. Nurse managers have the option to work five days, and some managers prefer that schedule because they feel like they cannot complete all their work in only four." e new schedule was launched systemwide across more than 100 units and practices. e four-day workweek has improved employee engagement and the culture of safety for nurse leaders and nurses, Dr. Cartwright and Dr. Oliver said, who added that the program has received overwhelmingly positive feedback. e system's turnover rate for registered nurses is currently 17% and the vacancy rate is 7%, compared to the national rates of 22.5% and 15.7% respectively. Other systems are considering four-day workweeks for managers as part of their efforts to support nurse leaders. n Nursing group issues anesthesia protocols for weight loss medication users By Ashleigh Hollowell N ew anesthesia considerations for patients taking anti-obesity drugs like Ozempic has been released by the American Association of Nurse Anesthesiology. The rise in popularity of drugs like Ozempic and Wegovy can have certain pre-surgical risks that patients should be screened for, according to the group. "These medications have exploded in popularity, and CRNAs need to be prepared to see more patients actively take them," Micah Walden, DNP, CRNA, a member of the AANA's practice committee stated in a March 11 news release. "This means additional preparation for patients, anesthesia providers, and the surgical team to help minimize risks of complications during a procedure." The medications, which work by suppressing appetite, and they also slow down the process of gastric emptying. Because anesthesia procedures typically require fasting prior to them, the group notes that ensuring a patient's stomach is empty with ultrasound technology prior to surgery is also crucial. If a patient's stomach is full or still showing digestion in progress, surgeons must make the decision to delay the patient's surgery accordingly. Adjusting the doses prior to surgery is important because the medications can have a lasting effect on the body. To ensure the medication is out of the system, if a patient is prescribed a daily dose of a GLP-1 medication, the AANA advises adjusting this and requiring the patient not take the medicine one day prior to surgery. If a patient is receiving a weekly dose, the group advises patients stop taking the medication one week before their procedure. The American Society of Anesthesiologists published similar guidance in 2023, as did the American Gastroenterological Association. However, guidance from the two groups differs slightly and has sparked some debate about surgical prep for patients taking GLP-1 medications. n

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