The current state of health and well-being for nurses is cause for concern. Nurses experience high levels of workplace stress, which contributes to poor physical and mental health outcomes and professional burnout (American Association of Colleges of Nurses [AACN], 2020). Nurses are exposed to high levels of stress beginning in nursing school. When compared to non-nursing students, nursing students experience higher rates of stress-related illnesses including poor mental health and increased unhealthy lifestyle behaviors (Melnyk et al., 2021; Melnyk et al., 2023).
Additionally, nursing faculty report high rates of burnout, stress, and depression (Melnyk et al., 2021). The AACN recommends the academic leaders at school of nursing address professional burnout by proactively adopting wellness practices to reduce distress, support well-being, and encourage resilience in nursing students and nursing faculty (AACN, 2020).
Creating a wellness culture at schools of nursing is essential to address burnout and promote well-being in today’s complex healthcare environment. However, enhancing and sustaining a wellness culture is a complex initiative with multiple facets and requires a structured, coordinated approach. Faculty at the University of Maryland School of Nursing (UMSON) identified an opportunity to better understand the various elements of the school’s wellness culture by establishing a Culture of Well-being Committee.
Individual Well-being
Personal well-being is an essential component of individual health and wellness. While there is no agreed upon definition of well-being in the literature, well-being is an overall state where a person thrives, experiencing positive emotions and achieving their inherent potential through personal growth, self-awareness, and capacity building (Travia et al., 2022). Well-being is achieved by increasing a person’s capacity for engaging in health-oriented behaviors to promote optimal human functioning and life satisfaction (National Wellness Action Alliance Workgroup [NWAA], 2023). Supporting this capacity takes into consideration all domains of wellness: physical, mental/emotional, social, spiritual, intellectual, environmental, financial, and vocational. Therefore, the creation of wellness cultures in the workplace would establish a multidimensional, holistic approach to influencing well-being an and empower human behavior (Amaya et al., 2019). Nursing schools have an obligation to prioritize employee and student well-being by creating a wellness culture.
Culture of Wellness
Guided by the school’s strategic priorities, UMSON is committed to implementing new initiatives to promote a wellness culture. A wellness culture is a culture that encourages and enables individuals to engage in healthy lifestyles behaviors. Schools of nursing can use the socioecological framework to understand the personal, interpersonal, and institutional factors that influence a person’s health behaviors, especially while at work (Amaya et al., 2019). Personal factors, such as individual knowledge, skills, and attitudes, are needed to make healthy choices or avoid unhealthy behaviors. Social networks, including colleagues and supervisors, influence health practices and engagement in wellness programs offered by an organization. Institutional factors, including workplace beliefs, informal rules, policies, and physical environment, shape a workplace’s attitude toward wellness and well-being, which support or hinder a person’s health behaviors. In nursing, relevant professional trends related to resilience and equity, diversity, and inclusion (EDI) are important components to consider when creating a wellness culture.
Well-being and Equity, Diversity, and Inclusion
Well-being and EDI are inherently linked, as both seek to promote a healthy work environment and increase engagement in learning and working. The Office of EDI at UMSON seeks to create an inclusive environment that enhances interpersonal connections, builds social networks, and provides a sense of belonging. This type of environment promotes healthy lifestyle behaviors and relationships that foster well-being and mental health (Abelson et al., 2022). EDI efforts also seek to reduce health disparities. This is relevant to well-being, as some individuals experience barriers and inequity when accessing wellness resources, receiving wellness services, or navigating daily challenges that impact their well-being (Maese & Lloyd, 2022). Well-being must be viewed through the lens of EDI because creating a healthy work environment requires health equity.
Wellness Committees
Wellness committees offer a formal infrastructure to foster a wellness culture and improve well-being. Wellness cultures are created by embedding strategies to manage stress, cope with challenges, and encourage healthy behaviors into administrative, operational, and curricular processes and procedures (Amaya at al., 2019). Wellness committees can strategically guide wellness strategies by creating a framework to facilitate collaboration between individuals throughout an organization (NWAA, 2023). Without formal infrastructure, like wellness committees, well-being efforts become fragmented, duplicative, and less effective (Melnyk et al., 2023). Companies with wellness committees report employees’ experience increased motivation for well-being and enhanced relationships needed to overcome barriers to health-related behaviors, such as limited time or low motivation (Amaya et al., 2019). A wellness committee within a school of nursing will facilitate increased engagement in well-being initiatives for both students and employees.
The UMSON Culture of Well-being Committee
Developing a wellness committee at UMSON required a review of strategic priorities and organizational structures. The UMSON strategic priorities seek to support work-life harmony, promote healthy behaviors, and encourage engagement and belonging (UMSON, 2024). UMSON has various organizational structures to carry out these strategic priorities, including formal school councils. A wellness committee appropriately aligns with the mission and vision of the EDI Council, a council that supports initiatives from the Office of/for Equity, Diversity, and Inclusion. The faculty proposed the creation of Culture of Well-being Committee, under the EDI Council as an innovative, structured approach to address wellness and well-being at the school.
The design of the Culture of Well-being Committee will utilize a population health framework to understand employee and student well-being at UMSON. Logic models are a population health framework to visually map out relationships between an initiative’s resources, activities, and desired outcomes (University of Wisconsin Madison [UWIM], n.d.). Using three separate logical models, the committee will assess and evaluate the current efforts that promote or hinder a culture of well-being. The outcome for each logic model aligns with a different UMSON strategic priority related to well-being. The first logic model will focus on promoting the core value of well-being and expanding the wellness culture at UMSON. The second logic model will focus on promoting work-life harmony and healthy behaviors for UMSON employees, which includes both faculty and staff. The third logic model will focus on promoting student well-being within and beyond the learning environment. Faculty proposed the goals and structure of this committee to the EDI Council. The EDI Council approved this committee as an ad hoc committee for the 2024-2025 academic year.
The committee recruited faculty and staff using a survey and word of mouth promotion. Announcements at EDI Council meetings encouraged attendees to join the committee. A faculty member facilitating a workshop on supporting student well-being also encouraged attendees to join the committee. Individuals invited to the first committee meeting included both survey respondents and those who directly e-mailed the committee organizer.
The inaugural meeting of the Culture of Well-being Committee occurred in the summer prior to the start of the 2024-2025 academic year. During this meeting a committee chair was appointed by attendees per the process outlined in the EDI Council bylaws. The committee chair will be responsible for using best practices to facilitate meetings, document information for the logic models, and present findings.
Discussion
Establishing a Culture of Well-Being Committee is a feasible and essential step in improving well-being at UMSON. Other universities have successfully implemented wellness committees to guide well-being for students and employees (Amaya et al., 2019). Findings will inform future actions needed to utilize resources, leverage human capital, and measure impact on well-being more effectively. However, the infrastructure created by the ad hoc committee is temporary as the committee will be dissolved upon delivering its recommendations. UMSON must consider developing future infrastructure to continue this work. Melnyk (2023) advocates universities appoint a Chief Wellness Officer as a dedicated leader to guide coordinated efforts to sustain wellness cultures. While the committee chair is an ad hoc leader for well-being at UMSON, UMSON should consider this recommendation and create a formal position responsible for advancing wellness and well-being at the school.
Participating in the committee has the potential to improve individual wellness for faculty and staff attendees. Attending committee meetings will help participants become more aware of available wellness resources. Awareness can motivate resource utilization for self or encourage resource utilization for others (Melnyk et al., 2021). Additionally, participating in wellness committees offers accountability, peer support, and a sense of community that encourages wellness behaviors (Amaya et al., 2019). However, there is currently no protected time or workload associated with participation, which may impact engagement. Committee participation is on a voluntary basis and there are no attendance requirements. Although individuals are encouraged to follow-up on assigned tasks as a professional courtesy, providing committee members with protected time or workload can serve as meaningful incentive for sustained participation (Amaya et al., 2019). Because the committee aligns with UMSON strategic priorities and the school’s core values, it may be possible to link participation to annual evaluations and support future promotions. This is an opportunity worth exploring in the future.
In the future, the Culture of Well-being seeks to increase student participation. Student involvement is an essential element in success of enhancing a wellness culture (Amaya et al., 2019). The student voice is necessary to create meaningful change to foster an inclusive, healthy learning environment (Abelson et al., 2020). Per the EDI Council bylaws, students are permitted to participate in all EDI Council committees. However, the Culture of Well-being committee has not yet formally recruited student members. The committee plans to explore opportunities to increase student involvement.
Wellness committees offer a feasible, formal approach to improving employee and student well-being at schools of nursing. The UMSON Culture of Well-being Committee serves as a framework for other institutions who seek to enhance a wellness culture. Without this type of infrastructure, institutions risk costly inefficiencies associated with fragmented efforts, ineffective interventions, and unmet goals (Abelson et al., 2020). Schools of nursing must consider strategic priorities and organizational resources when designing a wellness committee. Implementing a wellness committee has the potential to transform well-being for employees and students at schools of nursing. Prioritizing well-being has a positive impact on the nursing workforce and supports nurses to be healthy, happy and feel fulfilled as a member of the nursing profession.
Marisa Astiz-Martinez MS, RN, CNE1; Kelsey Bradford MD, MPH1; Amanda Willey EdD, MSN, BSN2; Yvette Conyers, DNP, RN, FNP-C, CTN-B, CFCN, CFCS, CNE, CWCN-AP1 1. University of Maryland School of Nursing 2. Salisbury University School of Nursing
