Meaningful Recognition a Powerful Motivator for Nurses

The power of 'thank you' extends beyond the nurse and stimulates innovation, teamwork, retention, and clinical outcomes, says the CEO of The DAISY Foundation.

A simple "thank you" and recognition of a job well done creates far-reaching benefits for nurses, their patients, and healthcare organizations, says the CEO of an organization created on the premise of gratitude.

"I'm thrilled that the researchers have linked meaningful recognition to reductions in burnout, higher levels of job satisfaction, greater job commitment, higher levels of employee performance, and motivation," says Deborah Zimmermann, DNP, RN, NEA-BC, FAAN, who is CEO of The DAISY Foundation.

"And that's not just in the healthcare literature," she says. "That's in the literature at large and also supported in the nursing literature."

The DAISY Foundation partners with healthcare organizations to formally recognize clinical skills and compassion of nurses at the bedside. It was created in 1999 by the Barnes family to honor the memory of J. Patrick Barnes and to express gratitude for outstanding nursing care received prior to his passing.

Zimmermann, who began her role with the foundation last November, previously ran The DAISY Award® program when she was chief nursing officer (CNO) and vice president of Patient Care Services at Virginia Commonwealth University Health System.

HealthLeaders spoke with Zimmermann about the importance of meaningful recognition for nurses.

This transcript has been lightly edited for length and clarity.

HealthLeaders: Generally, what are the far-reaching benefits of nurse recognition?

Deborah Zimmermann: There's all different kinds of recognition and what I will speak to is meaningful recognition. It's powerful and it's high to purpose. I see meaningful recognition as an acknowledgement of one's behavior and how it has impacted on others.

In healthcare, meaningful recognition comes from our patients, families, peers, and leaders. It fills the cup of nurses and creates a reserve for the future. And researchers have been able to demonstrate that recognition can buffer the negative effects of burnout.

Recognition can lead to positive work environment, a culture of gratitude and trust, and when there is trust and positivity, there's teamwork, there's innovation, and then you have that desired healthy work environment and all of them tie to patient outcomes. So meaningful recognition is just key and when an organization builds a culture of recognition and positivity, the impact continues to grow in significance on the work. Healthcare is about people giving care to people and that's why those interactions and that positive feedback is so crucial to the work of nursing and so crucial to healthcare at large.

HL: I've read where nurses have said that recognition is more important to them than salary raises. Is that true?

Zimmermann: Recognition, unlike compensation and traditional incentives, provides some intrinsic value and fosters a cycle of engagement and reinforces what we're looking for in desired behavior. Salary is important, and of course, nurses should expect to be compensated fairly; however, compensation is typically not a motivator, particularly for nurses. Nurses are motivated by their ability to contribute—their ability to make a difference in the lives of their patients and in the health and wellness of their communities.

HL: In your former role as a CNO, how did you see nurse recognition make a difference for your nurses?

Zimmermann: The nurses asked to bring DAISY into the organization [because] they wanted a mechanism to recognize colleagues as extraordinary nurses and to provide families the opportunity to give feedback directly to the nurses who cared for them. So, I said "yes" and that was 12 years ago, and what I saw grow was fascinating.

We received over 200 nominations a month, and a team would review all nominations and select one. What was so interesting is that it wasn't just the one honoree that felt like they were a winner; it was the other 199 nurses who were nominated. They believed that they were winners because they received feedback—that the work they were undertaking was making a difference.

And I wrote notes to each of the 199 nurses who were nominated each month and I … would also include the letter that the patient wrote. It became the most revered recognition, and validated that their efforts were worthwhile, it nursed their soul, and it helped build their resiliency.

It also helped create a culture of recognition. And often, they would then go beyond just that DAISY Award; they would look at other data such as patient satisfaction data and then say, "How can we make it better?" And what they realized is that gratitude also was important, and that positive thinking was important, so they would have daily huddles where there was gratitude that was shared.

If somebody called in sick, they would not think, "I'm going to have a terrible day." They would turn it around so that positivity and gratitude became a habit.

It stimulated innovation, it stimulated teamwork, and it had an impact on recruitment and retention. Even clinical outcomes were impacted by all of it, so it was pretty incredible.

HL: What are some informal ways that nurse leaders can meaningfully recognize their nurses?

Zimmermann: Handwritten notes really do make a difference. Giving thanks to one another for teamwork in daily huddles or daily check-ins, or, organizationally, having something like Gratitude Fridays.

They can provide opportunities for professional growth and innovation. Continuing education is such a reward to nurses and the opportunity to participate and to be able to network with colleagues is positive.

HL: How does a hospital or health system get involved with the DAISY Awards to create more formal meaningful recognition?

Zimmermann:  If an organization is interested in honoring their nurses, they just contact us. It's incredibly reasonably priced and, in fact, we're a foundation so the cost of the awards is in part supported by our industry sponsors who help fund some of the awards so that the cost is not significant for healthcare organizations. And if a healthcare organization can't afford it, we will subsidize that for them.

HL: Why has there been such growth in the DAISY Award program?

Zimmermann: It is a tie to purpose. It lifts up not only the honoree but the entire unit, because the [winning] nurse will always say, "I am being honored, but it is because of you, my teammates, that makes this award possible."

Nurses often go from one thing to another, but the DAISY Award allows them to stop and think about the difference they make and the significant impact they have, [which is] why they chose to go into the profession. And it doesn't matter if the nurse has been a nurse for four years or 40 years; the impact it has on that nurse is profound.