10 Tips for Sustainability and a (temporary) farewell...

The Sustainability Blog will be taking a temporary hiatus in order to plan for the next phase of our project. Before we go, though, how about one last, chewy post for the road?

10 Tips for SANE Sustainability:

We've been fortunate in the course of the National SANE Sustainability Technical Assistance Project to learn a great deal being out in the field and talking with SANE Coordinators from around the country. In our work, with both individual programs and groups of SANEs and SART members, we've seen some commonalities that transcend geographic areas and program structure. Maybe we can't quite call them universal truths, but here are 10 tips for sustainability (in no particular order) that were repeatedly underscored throughout the three years of the project:
1. Don't forget the nurse in SANE: when hospitals and healthcare funders don't see the healthcare dividends provided by SANE programs they are less likely to provide long-term support. More importantly, only 10% of our patients will ever see the inside of a courtroom, but 100% of our patients will have the opportunity to develop healthcare sequelae from the sexual assault. Shouldn't that be our priority?
2. Rethink program structure: Is 24/7 coverage truly achievable in your program? If not, consider consistent, dependable coverage that's well understood by all community partners. Then invest some time into creating transfer agreements to other regional SANE programs or provide high quality training for area emergency department personnel to help fill in gaps when coverage is simply not available.
3. Recruit with specificity: If Labor and Delivery needs someone for weekend nights, they recruit personnel who can work those shifts. If the Emergency Department needs nurses who are already ACLS certified, they recruit with that skill set in mind. Why should SANE programs operate any differently? You know what shifts aren't being covered and what skill sets you need. Recruit based on the needs of your team. That ensures a better fit right from the beginning.
4. Look at the nexus between leadership and retention: Many SANEs who left programs told us their departures were directly related to poor leadership by program coordinators. This was illustrated by issues such as coordinators expecting more from staff than they were willing to do themselves; lack of any appreciable feedback; and poor communication between staff and the coordinator.
5. Invest in people, not things: New toys are fun, but they're often unnecessary. A new colposcope or expensive photography system may seem like something your program needs, but what's more important are competent, current clinicians. When you invest in people you help maintain an effective workforce and make it easier to recruit new team members. Continuing education, call and court pay, a raise in case fees--these help maintain a team that is reliable and knowledgeable. Will patient care be enhanced when you purchase the $20,000 piece of equipment versus the $500 one? Maybe not. Will patient care be enhanced when they encounter a nurse who is current and comprehensive in his or her practice? Definitely.
6. Learn and articulate SANE value: Do you know the economic worth of your staff and the services you provide? Hospitals and other funders speak in dollars and cents. If you want to be able to make a case for financial support you have to speak the language. This means writing a business plan. Don't know how? No problem--we have what you need right here to get started.
7. Let go of the "If I don't do it no one will" mentality: Is there a quicker path to burnout than non-stop call? I don't think so. Know when to say when and spend some time on Plan B--emergency department backup, triage and support by a neighboring SANE program, whatever it takes to give yourself the occasional break. Sustaining SANE programs starts with sustaining yourself.
8. Learn to ask for help: Today more than ever there are plentiful resources for assistance. Whether it's national resources like NSVRC and SAFEta, state resources, like statewide SANE Coordinators, or local resources, like community collaborators, chances are there are people in your world available to advise and assist on topics as diverse as grant writing and vicarious trauma. If you can, try to avoid waiting to ask for help until it's a crisis, though--think prevention, not cure.
9. Start looking for a replacement: You may have no plans to leave your position any time soon, but that doesn't mean you shouldn't consider who would take over if you left. Mentoring takes time and a program that hinges on a single individual simply isn't any more sustainable than a program that hinges on a single source of funding.
10. Nurture and celebrate your staff: The greatest assets you have to your program are the nurses who staff the SANE schedule. Maybe you can't compensate them in the ways you'd like. Perhaps sending everyone to the IAFN Annual Assembly is unrealistic. But celebrating the small triumphs, giving team members opportunities for recognition of their achievements at staff meetings, these are small gestures that pay big dividends. Whether it's a couple of movie passes for the nurse who saw the most patients in a month, or cupcakes to celebrate a new nurse getting off orientation and onto the schedule, even small victories deserve notice and help staff feel more engaged and appreciated.

I hope everyone will be able to take some time these next few months to nurture themselves. I know that's my goal. Thanks for reading and I look forward to connecting with many of you again this fall. Have a safe and peaceful summer, everyone!


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