• Staff Journal
  We have a journal book open in a quiet corner of our office where staff can stop by and write entries of a personal nature (not work) such as "My dog died today" or "I miss my kids today" or "I want to thank my colleague" or "Please pray for...". The result is that as we pause at the journal and read the entries we can be more sensitive to each other, supportive, and appreciative. It is regarded with respect and confidentiality. Anonymous, Portland, Oregon.
  
  
• Staff Support
  Once per month staff meets with an outside the agency facilitator for staff support. First 30-45 minutes are guided meditation and the remainder of the time is open for sharing. Administrastive staff answer the phones so all others can attend. Attendance is voluntary, but staff is paid. HospiceCenter, Bend, Oregon
  
  
• A Day at the Zoo
  We have a variety of stuffed animals in the department for staff use. Frequently, we'll find a teddy bear or frog or platypus being hugged or snuggled in a lap, easing the tension of very stressful days. The animals sometimes fly, too, in play. Anonymous.
  
  
• Elegant Eating
  Different staff and volunteers plan surprise lunches for all who attend IDG. The rest of us pass the donation basket at each luncheon. We look forward to IDG.   Hospice of Redmond and Sisters, Redmond, Oregon
  
  
• Breakfast of Champions
  When we need to have early a.m. staffings we all bring in breakfast goodies and have early breakfasts together while we staff. Hospice of Redmond and Sisters, Redmond, Oregon

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• Stress Buster
  Go to lunch with entire hospice team at least quarterly to have an hour together for just being together, alleviating stress, and laughing. Providence Hospice, Portland, Oregon
  
  
• CNA Appreciation Week
  Volunteers do special treats each day for CNAs and one day we have a special lunch for them. All this is done by volunteers. Hospice of Wichita Falls, Wichita Falls, Texas
  
  
• Christmas Party
  Each holiday time our Christmas party is full of skits–singing and talent. We start planning the party tow months before the party. There are three hours of eating, singing, and just coming together and enjoying one another. The party is videotaped and we can look back each year.   Central Oregon Hospice, Bend, Oregon
  
  
• Meeting of Recognition
  The day after the Colombine high school tragedy our hospice had an intervention to acknowledge that we are not unaffected by the tragedies that surround us, particularly because of the nature of the work we do. Willamette Valley Hospice, Salem, Oregon
  
  
• Secret Angels
  Names of our "Secret Angels"are drawn and then gifts are given just for fun. St. Vincent Hospice, Portland, Oregon

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• CNA Special Support Group
  Monthly (started 2 weeks as needs were urgent) meeting of all CNAs with Coordinator of Bereavement Services (willing counselor) to discuss any and all concerns, both personal and patient-related. The results were increased confidence, self-esteem, value as team member, and team building. They are now held PRN as the group has become strong and healthy and interactive with all others in IDT. These meetings are important because they provide a safe confidential environment. Blue Ridge Hospice, Winchester, Virginia
  
  
• Meetings Away From Work
  All of our staff meets once a month to support each other and promote teamwork. We meet at each other's houses or to dine out. We have found that this brings us closer together as a team and decreases stress. We have also acquired a chaplain/counselor to meet with us 1-2 times a month as needed for staff support. Hospice of the Hills, Lynchburg, Virginia
  
  
• Team Support
  We have scheduled support every month on Wednesdays. One meeting is a general staff meeting. The fifth Wednesday is always support by disciplines. The other two to three are by team. Our hospice is large and is divided into teams which each serve approximately 60-80 patients. Our teams usually do one formal, educational, creative support meeting and the other is informal and often includes food. This helps to resolve issues between disciplines and to provide team building. For all support on our team each discipline takes turns planning the support. Sometimes we meet at each others' homes. We honor each others' skills as a group or as individuals, we present ideas, share, and are all on the same level. Hospice of the Florida Suncoast, Largo, Florida
  
  
• Open Floor
  During staff meeting each week, the last 10-15 minutes are reserved for the staff to voice complaints, suggestions, etc. This time allows all staff to be heard; increases camaraderie, and hopefully breaks down barriers before they become walls.
  Mountain Community Hospice, Hazard, Kentucky
  
  
• Bereavement Remembrance
  Once a month, prior to IDG, we have a bereavement memorial service for the staff. We hold it the last Wednesday of each month to remember those that have died. The staff alternates in planning the service.We light a candle for each client and the staff is encouraged to say a few words. Special music, poems and/or stories are read. Guthrie Hospice, Towanda, Pennsylvania
  
  
• Memorial Table
  To encourage and support staff as well as memorialize the patient, light a candle and place name cards of each deceased patient on a special table each day. This tradition reminds support staff of our mission and helps clinical staff with their grief. Hospice Community Care, Rock Hill, South Carolina

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• Daily AM Team Support Meeting
  Short meeting of all team members at 8:00a.m., Monday through Friday, to a) Give team support, b) review on-call contacts since 5p.m. the day before so we know which families may need extra attention, c) review new admissions, 4) have prayer to remember families, staff, with special needs that day. The benefit is mostly team support and information sharing: All team members hear how other staff members deal with difficult situations, less experienced staff learn new ways to deal with situations like these and that it is OK to cry and to show anger at situations. It is kind of a protected environment/time for staff. Mercy Medical Hospice, Mobile, Alabama
  
  
• Hospice Heroes
  Our program sponsors a quarterly luncheon which recognizes a department (e.g., nursing, social work) for their hard work and contributions, and all team members express thanks and cite examples of terrific case outcomes and interventions by the department being honored. Allows each department to feel appreciated and rewarded versus recognizing individuals. Hospice Services of California, Culver City, California
  
  
• Monthly Team Spirit Days
  Builds and strengthens interdisciplinary team cohesiveness. Fun activities are used to show our team spirit. First started by our mission and values team in an effort to increase awareness of mission and values and to build team cohesiveness. Examples of activities: a) secret special friend week. We reveal who special friends are at the end of the week. b) Character day--shirts, caps, etc. c) Strawberry Shortcake Day. We also have staff retreats twice per year. Tip Hospice Program, Cairo, Illinois
  
  
• Staff Meeting
  We have a meeting every month for the staff nurses, so that they are able to express feelings of sorrow, frustrations, anger over losing the patients they have cared for. The staff chaplain oversees this meeting and the Director can only attend every other one. Medical Center Hospice, Johnson City, Tennessee
  
  
• Monthly Breakfast Business and Team Meeting
  This "Town Hall" type meeting for all staff is paid for by the program and led by the agency director. Hand in Hand Hospice, Gainesville, Georgia

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• Spirit Kit
  There may be times when we might find ourselves feeling a little "dis-spirited". This Spirit Kit is designed to help us all keep a focus on the small-but-so-very-important things. In your Spirit Kit you will find: 1. A soft fuzzy cotton ball to rub when you need to remember the gentleness of the human heart. 2. A rubber band to remind you that you are very flexible and can stretch to fit just about any demand or challenge. 3. A band-aid to remind you that, even though there may be times when you feel hurt for what you are trying to do, you will heal and be even stronger. 4. Two tissues, one for you and one for a colleague when you have faced a tough time together and need some emotional support. 5. A safety pin to remind you that you are bright and sharp and utterly indispensable. 6. Five pennies to remind you of the song by Danny Kaye called "Five Little Pennies." If you know the song, you will remember that one penny was to dream on, one was to wish on, one was for dancing, one was to laugh on, and the last and most important one was to love on. The song ends with these words, "There's just five little pennies, but with these five pennies you'll be a millionaire." How very true! 7. A balloon to celebrate your accomplishments! 8. And last but not least, Hershey's Hugs and Kisses--for when you need them. Hospice of Ulster County, Kingston, New York
  
  
• Final Friday
  Our hospice invites all staff and volunteers (and their families, if they want) to meet at a family friendly restaurant the last Friday of the month after work. Most people bring either spouse or children. It gives staff and volunteers an opportunity to get to know each other better and in a non-clinical atmosphere. It provides time for support for each other, discuss or laugh about situations. We have good participation. American Heartland Hospice, St. Louis, Missouri
  
  
• Camp Out/Retreat
  We sponsor a Camp out/retreat for paid staff and volunteer staff to foster a spirit of camaraderie. It culminates in an open air worship service. Home Hospice, Sherman, Texas

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• Monthly Support Group for Staff
  Director, assistant director, staff nurses, volunteer coordinator, social worker and office staff supervisor attends, using outside facilitator. Not mandatory; meeting two hours paid time for staff. St. Agnes Hospice Hope, Fond Du Lac, Wisconsin
  
  
• Ways a State Association Can Help Staffs Deal with Change and Stress
  Our state association decided to help hospice staffers deal with the recent stresses and strain by 1) An audio tape explaining to staff how larger health changes are what is causing strain and how. 2) Highlighting at annual meeting how some programs support staff. Most popular was: Staff rituals in change, celebration or problems; Individual "Comfort" rituals. Anonymous
  
  
• Brown Bag Lunches
  Reinstatement of Brown Bag lunches every other week to provide staff support, sharing, relationship building across clinical teams, disciplines, field staff and office staff etc in order to foster agency identity as a "team". Optional activity. Participants determine focus and/or topic of discussion for gatherings. Hospice of Peace, Denver, Colorado
  
  
• Care for Caregivers (Staff)
  To assist in preventing burnout of hospice staff, plan to share birthdays with cake or cookies. We share soup or chili during the winter and celebrate holidays so that there is at least one special celebration each month. We have also celebrated the lives of "special" patients with memorial services and "squares" for the memorial quilt and birthday cake! Hospice of Ponca City, Inc., Ponca City, Oklahoma
  
  
• A True Team Retreat
  Rather than having only staff retreat annually, this year we also included representation from each area of volunteering, for example bereavement, patient family, fundraising, group facilitators, board members, etc. This allowed for a true "team retreat." Very beneficial to all and great input for consideration as we go forward. Hospice of Frederick County, Frederick, Maryland
  
  
• Candles and Appreciations
  Team Support - Team care coordinator gives candle to each team discipline member. Lighting the leaders candle first I stated that I was to guide them and light their way. Next I took that lit candle to each team members candle and stated at least one thing I felt was a valuable contribution to the team. After they were all lit I explained each could operate individually - to give off light and warmth. But we all together lit a big Hospice candle and it was pointed out as we came together how much brighter the light and warmth was as a team. Reminded them also if their candle went out the team members would be there to relight their candle. Anonymous
  
  
• Staff Retaining Program
  Development of a staff retaining program which meets monthly - our newest ideas are: 1) Weekly yoga classes that are free to all Hospice staff that are held after we go on service and last 45 minutes - 1 hour. 2) Morale committee "hosts" monthly breakfasts at the Hospice office for all staff: the purpose is " a good breakfast, a time for all team members to join and enjoy time together and serves as a break in the middle of the week. Hospice of Citrus County, Lecanto, Florida

©2011 Dale G. Larson, Ph.D.