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Code Lavender: The Sweet Smell of Support

Wednesday, January 29, 2014
Rev. Amy Greene, Director of Spiritual Care, Cleveland Clinic In any hospital, “CODE” means something needs urgent attention. In an attempt to signal both urgency and calm, Cleveland Clinic uses the term “Code Lavender” to signal the need is urgent, but the point of the code is to try to bring some calming influence to a painful or stressful situation.

Since 2008, the Spiritual Care team (chaplains) and Healing Services holistic care nurses (now together on one team under the Office of Patient Experience) have been working together voluntarily on a holistic rapid response to crisis that we nicknamed “Code Lavender.” Though we didn't create the name, we heard it first from Cleveland Clinic’s first Office of Patient Experience director, Dr. Bridget Duffy, we have used it since in order to indicate both urgency and calm. We had prepared to launch a pilot, thinking we would mainly be administering to patients and their families, but a chaplain intern died suddenly on her first Sunday on duty, and our own team of chaplains became the first “test case” of a Code Lavender.

The other members of the team, holistically trained nurses and a social worker, all of whom had trained in Reiki and other forms of relaxation, came to the Spiritual Care department with water, aromatherapy lotions, healthy snacks, relaxing music and the message -- loud and clear: “You matter…and what you just went through matters. Take a breather…we’re here for you.”

That’s the essence of a Code Lavender, which we were soon taking up to units where other teams had taken a hard hit. Since anyone can call a Code Lavender, staff members were calling them when their teams were especially particularly pummeled. Examples include when more than one child died within a day or two in our special needs pediatrics hospital, and when a patient who was supposed to go home coded and died during discharge planning.

As I write this, my team is tending to our coworkers in the call center several miles from main campus because a beloved coworker there finally succumbed to cancer, and her teammates were devastated. Though hospital workers face crisis and death often, we are still human and still feel the loss – even caregivers need to be cared for.

These events caused trauma beyond the “normal” levels associated with working at one of the highest acuity hospitals in the world. Another example was when a school shooting occurred in the greater Cleveland community and family members and friends of the victims had to show up at work in one of the regional hospitals. The Code Lavender team, which had grown by that time to include volunteers from the other hospitals, went to provide support. As part of the process, we gave out lavender wrist bands to anyone who wanted one – to remind them to go a little easy on themselves for a while. Sometimes folks didn’t even want to stop – they just grabbed the bracelet and a hug.

The “Code” itself can include very little conversation and contact or longer conversations as needed by the persons involved. When the team shows up, they sometimes bring a massage chair. They can offer Reiki and healing touch. They can listen or just sit in silence with those who need to know that they can talk if they need to, tell stories of the incident, relate memories of the beloved coworker or patient, or let off some steam. It’s a simple idea whose time has come. Because we can’t shut everything down and “sit Shiva” (the Jewish custom of mourning) or have an impromptu memorial service, it allows some small space for our spirits to breathe and take in comfort from each other.

It's apparent when employees feel supported by the institution they work for, they experience less burnout, higher satisfaction, fewer call-offs and better interactions with patients. Patients receive better care and a better overall experience if their caregivers have more to give. Caring plus caring seems to add up to more caring, not less.

Not quite gone (but going) are the days when caregivers’ needs were seen to be at odds with those of their patients. There has existed for far too long a notion that compassion is a finite substance which cannot be “wasted” on employees lest there be none left for patients and their families. What Code Lavender and other holistic support services are showing us is that the whole patient/family/employee “ecosystem” is interdependent, and when one part of the whole is nourished and supported, all benefit.

Tags: culture, empathy
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