Speakers - 2027

Title: Code Lavender an emotional crisis intervention tool for nurses

Abstract

1. Healthy Work Environment Domain(s)

At King Faisal Specialist Hospital and Research Centre- Jeddah (KFSHRC-J), our commitment to creating a healthy and resilient work environment is exemplified through the implementation of the Code Lavender program. This innovative initiative was designed to provide immediate psychological support to nursing staff experiencing acute stress, thereby fostering a supportive workplace culture that prioritizes mental health, resilience, and overall well-being. By focusing on rapid intervention during moments of crisis, Code Lavender plays a pivotal role in reducing burnout, promoting emotional recovery, and enhancing staff retention and satisfaction. The Code Lavender program actively addresses the psychosocial work environment by providing immediate emotional and psychological support to nurses facing acute stress. KFSHRC-J, is a multicultural organization with 1,179 nurses, 58% of whom are expatriates. In addition to clinical demands, expatriates encounter cultural isolation, gender expectations, homesickness, and the physical toll of a hot climate (such as dehydration and exhaustion). Acknowledging these combined pressures, the Chief Nursing Officer (CNO) championed the implementation of structured wellness strategies.

Laying the Foundation

Prior to the introduction of Code Lavender, the CNO identified the connection between recruitment, retention, and staff well-being. In response, the Nurse Recruitment and Retention Officer role was established in October 2021. This position extended beyond workforce stability to emphasize staff wellness by monitoring morale, coordinating with Employee Wellness and Occupational Health, strengthening recruitment pipelines, and embedding resilience-building activities. The role served as a foundation for subsequent well-being programs, including Code Lavender.

Recruitment Context and Response

Global nursing shortages and local vacancy pressures, especially in high-acuity areas, were identified as significant contributors to workplace stress. At KFSHRC-J, the onboarding of international nurses introduced additional challenges related to relocation, cultural adaptation, and high clinical demands. The Nurse Retention Officer collaborated with Nursing Leadership, Employee Wellness, and Occupational Health to:

1. Strengthen recruitment pipelines and accelerate onboarding.
2. Embed psychological safety into orientation and pre-boarding.
3. Connect new hires to mentors and peer networks.
4. Integrate Code Lavender as an accessible support mechanism during high-stress phases of transition.

In 2021, the Nurse Retention Officer role was established to strengthen workforce stability and well-being. Responsibilities extended beyond hiring, embedding resilience activities, coordinating wellness, and establishing psychological support pathways. This role created a robust foundation for programs like Code Lavender, aligning staff retention and well-being with strategy.

Together, these measures demonstrate KFSHRC’s holistic approach to creating a healthy, resilient, and culturally congruent work environment.

2. Process and Development

The idea for Code Lavender originated after KFSHRC leaders attended the Magnet Conference in Philadelphia (2022), where the program was presented as an innovative stress-response intervention. A task force, led by the CNO (a certified coach), was established to contextualize the Cleveland Clinic model. Shared governance was used to engage Head Nurses and Nurse Leaders through consultation and information sessions. Staff voted in favor of piloting the initiative, and modifications were made to ensure cultural appropriateness (e.g., replacing pet-assisted therapy with alternative calming techniques).

First responders were carefully selected for trustworthiness and leadership capacity, including Nurse Retention and Well-being Specialists, Nursing Supervisors, Occupational Health Nurses, and Ethics Sub-council members. Training covered topics such as listening, de-escalation, privacy, and psychological first aid. The service officially launched in November 2023 and is accessible 24/7 to all Nursing Affairs staff.

3. Evaluation

Evaluation shows both immediate and lasting impact. Staff surveys indicate improved morale, reduced stress, and increased feelings of support. Nurses indicated that CL activations helped them regroup and finish their shift, and reinforced their sense of being valued.

Figure 1 shows monthly Code Lavender utilization compared with a 0.83% benchmark. In 2024, activations fluctuated between 0.30% and 0.84%, occasionally equaling or exceeding the benchmark (e.g., May and December 2024). In 2025, activations ranged from 0.08% to 0.61%, aligning with periods of heavy workload and new nurse onboarding. This trend reflects steady adoption and targeted use during stressful periods.

Figure 2 provides a cumulative view, confirming that activations are consistent month-to-month, which demonstrates that staff view CL as a trusted and reliable service rather than a one-off initiative. Leadership analyzed activation triggers, such as heavy workload, trauma codes, needle-stick injuries, and first patient deaths. These findings informed recruitment and retention strategies, targeting recurring stressors at the organizational level.

4. Sustainability

The program’s sustainability is ensured through:

• Integration into orientation: All new staff are introduced to Code Lavender during General Nursing Orientation.
• Code Lavender kits featuring lavender oil, tea, a stress ball, chocolate, and a CNO note are now available in a pocket-sized format for easy use.
• Leadership commitment: Dedicated resources, ongoing training, and continuous evaluation cycles are overseen by Nursing Affairs.
• Interest from non-nursing departments has prompted plans to expand the initiative hospital-wide under the corporate wellness office.

By linking Code Lavender to staff retention and recruitment, the program has evolved into more than an intervention; it has become a strategic tool for workforce stabilization, aligned with Magnet principles and the organization's culture.

Conclusion

The Code Lavender program at KFSHRC exemplifies an innovative, evidence-based, and culturally tailored approach to fostering a healthy work environment. It unites leadership vision, frontline participation, structured evaluation, and sustainability. By addressing the psychosocial needs of nurses, building resilience, and supporting retention, Code Lavender strengthens both staff experience and patient care quality. With strong cultural adaptation and organizational backing, Code Lavender is a reliable stress-response mechanism and a core component of long-term workforce well-being at KFSHRC-J