It’s the nature of ASCs to be fast-paced work environments that emphasize quality of care and safety. Nurses and others working in this setting run the risk of becoming stressed, overburdened, and burned out. However, ASC leaders can take various steps to prevent employees’ healthy stress from turning into counterproductive, or even destructive, stress and burnout. The following are a few strategies for establishing burnout prevention practices:

1. Know staff, signs of burnout, and engage in open communication.

Knowing staff’s needs helps, and one way to do this is through an open communication policy. Employees with concerns or issues are more likely to share them with the boss if open communication is an established policy.

Also, everyone in an ASC should be educated on how to identify burnout. They should know why it’s dangerous to let it proceed unchecked, says Jan Allison, RN, CHSP, senior director of regulatory at AmSurg, based in Nashville, TN.

“Keep communication open to prevent or overcome it,” she adds.

2. Recognize, acknowledge, and celebrate staff.

“Give employees the recognition they need and celebrate them,” Allison advises.

ASCs also could give staff necessary breaks during which employees could briefly recharge. Leaders could try new workflow strategies to improve efficiency and reduce individual workloads, Allison suggests.

“Provide an occasional lunch for employees,” she says. “I remember how we would have so many cases in a day, and there was an automatic free lunch that day.”

Small recognition and awards might include a $5 gift card to a coffee shop. Larger ASCs might provide bonuses when a fiscal year reaches its goals in volume. “This makes everyone excited to be busy,” Allison says. “It’s better to make it rewarding to be busy rather than just punitive if you don’t reach your goal.”

Another way to reward staff is to encourage creative solutions to any workflow or quality issues the ASC faces. For example, Allison has listened to employees complain about small problems, and she’d say, “Let’s get information and make a quality improvement project.”

Suddenly, the same disgruntled worker is happily working on a project.

“When people have ideas that they’re contributing to make a difference in the workplace, and you are implementing their idea, they’re happy,” she says. “Our doctors have given staff $100 gift cards to spend at the mall if they suggested an idea that was approved, implemented, and that made a difference.”

3. Set a zero-tolerance policy for workplace bullying.

“If you have someone who is negative and brings everyone down, it’s better to get rid of that person, letting everyone else work a little harder until you replace the person,” Allison says.

The best strategy here is prevention through wiser job interviewing.

“Hire the right person to start with, making sure you understand who the person is as a person and what the person’s values are,” Allison says. “Make sure they’re a right fit for the team.”

ASCs can improve their chances of weeding out the bad apples through team interviews. The ASC team can spend time with the new prospects and collectively decide whether that person would be a good fit. Employees would need to be coached on interviewing do’s and don’ts, regarding rules and regulations, but it’s worth the effort as another nurse’s gut feeling might be a sign that a particular prospect would be a troublemaker in the workplace.

“A person might have a gut feeling and find something no one else did,” Allison says. “I feel like different layers of interviewing is good.”

If this strategy fails and an employee is bullying others, then the best course of action is to deal with the bullying worker immediately, through corrective action or letting the person go, she advises. “Once you let an employee’s bullying go on for a long time, it becomes hard to deal with.”

A less obvious form of negativity is when a supervisor plays favorites, treating certain employees with more respect and understanding than others are treated.

“Everyone needs to be treated with respect and fairness. You can’t let it be obvious to everybody if you have a favorite,” Allison says.

It’s also possible that a physician is bullying nurses or staff, causing them to be too intimidated to speak up when they see a problem that could affect patient safety. When this occurs, managers must speak with staff and teach them skills on how to speak up for themselves and their patients.

“I’ve heard stories through the years of physicians who were so difficult they would have tantrums and even throw instruments in the operating room,” Allison recalls. “If things didn’t go their way, they would threaten to take their cases to the hospital, and those cases typically brought a lot of revenue. The loss of those cases would have a negative impact on the center, so no one wanted to speak up, thinking their job could be at stake if the physician left.”

This is why it’s important to teach nurses how to advocate for patients, even when it means dealing with a bullying authority, she says.

“Nurses need to be taught a skill set of what to do, and they should be backed by the governing body,” Allison says. “If a physician says, ‘I refuse to do a time out,’ the staff can say, ‘I refuse to proceed without a timeout,’ and the governing body needs to support that.”

4. Encourage healthy habits.

Some ASCs offer employees access to a fitness center and provide a wellness benefit that encourages healthy eating and exercise.

“Encourage people to work out,” Allison says.

The wellness benefit can work by giving staff discounts on their insurance premiums, she adds.