Meaningful recognition is considered a simple form of feedback that may involve providing praise or simply saying “thank you”. This kind of acknowledgment not only encompasses the individual’s behavior, but also the impact that the specific behavior has had on other parties.

Organizations that support and encourage this type of recognition among their staff are considered to be more supportive, and the employees tend to feel more valued. Meaningful recognition is an essential strategy that supports a healthy work environment, engages the nursing staff, and, undoubtedly, impacts the patient experience positively. In attempts to provide a healthy workplace environment, as well as to foster staff engagement, healthcare organizations seek to implement programs and activities designed to nurture recognition and increase job satisfaction.

Implementing the DAISY Award for Extraordinary Nurses is a powerful way to recognize positive nursing experiences identified by patients, family members, and staff. This program, established in 1999 by the Barnes family, provides a straightforward, yet heartwarming, approach to recognizing the direct care nurse. After their son past away from an autoimmune disease, this grieving family wanted to say “thank you” to the amazing nursing staff that went “above and beyond” in caring for their son. The DAISY Foundation, which stands for Diseases Attacking the Immune System, has become the gold standard for nurse recognition programs. The platform has secured a strong foothold in the American Nurses Credentialing Center’s Magnet Designated Organizations, as well as the Pathways to Excellence designation. Since its inception, the program has blossomed to include over 3700 healthcare facilities and schools of nursing in the United States and twenty-one other countries.

In a cost-effective way, the foundation provides step-by-step instructions for initiating, promoting, and executing a successful DAISY recognition program. This includes educating your facility regarding the program’s mission and process; templates for certificates, banners, pins; and a how-to guide” for conducting a DAISY Award Ceremony.

Experiences from a DAISY Coordinator

My journey with the DAISY Award program began nearly 4 years ago. As a staff nurse who participates in my facility’s shared governance council, our group had been looking for ways to recognize and support the nursing staff. While visiting a sister hospital’s shared governance program, I came across a DAISY Nomination Form. I asked a few questions, and the staff members boasted about how much their coworkers enjoyed the program, and looked forward to their monthly DAISY recognition events. I presented my findings to the members of our nursing leadership council. After investigating the foundation and discovering the cost for the facility, nursing administration approved, and I was appointed the coordinator for the task force.

With the help of the DAISY Foundation and hospital leadership, instruction regarding the new program’s purpose, its intended audience, and the execution process ensued. We provided education throughout the hospital to include leadership, staff, patients, and their families; we began displaying DAISY ballot boxes and nomination forms in key areas of the facility. Within 30 days of the rollout, we executed the first award ceremony, unveiling our first DAISY recipient. The ceremony, which we know now as our DAISY Parade, involves a surprise visit to the unit while the clinical nurse is working. I, our chief nursing officer, members of nursing leadership, and the staff nurse’s manager participate in the parade. This component of the program is vital because it provides the staff with validation that our nursing leadership is committed to recognizing positive patient experiences.

The person who nominated the nurse and shared their story of DAISY-worthy care is also invited to attend the ceremony. Generally, tears begin and tissues are needed, which, by the way, are part of your DAISY supplies. There is the explanation of the DAISY Foundation’s inception, along with awarding the winner with a DAISY Award pin, a DAISY Award certificate, and a bouquet of daisies. Also included is a statue known as “Healer’s Touch”. This statue is hand carved and helps 22 artists in Zimbabwe, which in turn, support hundreds of family members. The foundation believes that nurses are reaching around the world, putting food on the tables of these gifted artists and their families.

The ceremony culminates with an invitation for the recipient’s coworkers to enjoy warm cinnamon rolls. In the early days of his illness, Patrick could not tolerate much, but he did enjoy his cinnamon rolls. One morning Mark, Patrick’s dad, brought a Cinnabon in for his breakfast. Patrick asked for a bite and ended up eating the whole thing. That night, he asked his dad to bring him a Cinnabon the next morning—and enough for all the nurses. The DAISY Foundation asks that at every DAISY ceremony, nurses are reminded that when you smell the cinnamon then “you should realize you are not just doing a job, you are impacting your patients’ lives, every day”. The philosophy behind the DAISY Award is so impactful that although I have been reciting the purpose of sharing the cinnamon rolls since our first ceremony, I still tear up, and must take a pause to complete Patrick’s story. The recipient’s picture is posted along with the nomination story in our cafeteria for families and visitors to enjoy.

One of my favorite aspects of DAISY is distributing nomination pins to the staff nurses who have been nominated during the current month. This portion of the program allows the hospital to reward all the nurses who have had positive patient experiences. Generally speaking, unit huddle discussions tend to revolve around HCAHPS scores and patient satisfaction, which can be portrayed negatively. There is never anything negative about DAISY! I love walking up behind a staff nurse who is working hard and announce, “You have a DAISY nomination!”, and watch their face light up.

There have been countless times that the nominee will say, “Wow, thank you, I needed this today”, or “This is awesome, thanks, who nominated me?” The nominee receives a copy of the original nomination letter to read and keep, with the hope that they may use it for inspiration. It gives me personal satisfaction to know that, in that moment, I have made a positive impact in their hectic day.

Our DAISY Award program has had such a positive effect on our nursing staff and has been so successful that we recently expanded it to include a DAISY Leader Award and DAISY Team Award. These designations, which we award once per year, are quickly rolled out for a  nominal fee through the DAISY Foundation. In our facility, we celebrate them during our shared governance luncheon in December.

Since it’s initiation in October 2015, through December of 2018, our DAISY Award program has recognized 651 nurses, conducted two DAISY Leader Award programs, as well as two DAISY Team Awards. When there is an occasion where the nomination form is completed for a non-nurse, our internal employee recognition program is notified, thus promoting acknowledgment to other team members of the hospital staff. This has permitted the facility to provide appreciation to other departments that have contributed to positive patient experiences.

In 2018, we celebrated nurse’s week with the DAISY Foundation in an amazing way. Thanks to the senior leadership team, we conducted a dedication ceremony of the life-size “Healer’s Touch” Statue. This piece of art is prominently displayed in the lobby, which allows patients, visitors, and staff to appreciate its beauty and meaning as soon as they arrive at the entrance. Besides leadership, we invited every DAISY nominee to participate in the event, and we even had cinnamon rolls for dessert. A feeling of genuine support and connectivity were palpable to all who attended. It was simply wonderful. We needed plenty of tissues that day.

Excerpts from DAISY Award Nomination Stories

The most challenging part of the process can be choosing the newest beneficiary of the DAISY Award. Each month, the ballots are collected, the nominees’ names, as well as their unit, are removed, and the task force attempts to select the next DAISY recipient. The taskforce reads each nomination story aloud and scores it based on our facility’s nursing philosophy and professional practice model of caring, leadership, autonomy, resourcefulness, and accountability (CLARA). Many times, “goose bumps” are felt, and tears are shed as the stories are read, making the selection process difficult.

Here are a few excerpts from actual DAISY Award Nominations stories that have been published on the DAISY Foundation website:

“I write this recommendation for Nurse Lim because of her exceptionally outstanding care during her entire shift. I truly believe her prompt assessment aided in saving my child’s life. My daughter received crucial care in the treatment of P.E. in both lungs. She explained each phase of the care in a matter we easily understood. As a mom, this was the type of care that put me at ease. She even paid a visit after her shift to simply stop by my daughter’s room in ICU and say “Hi!” I truly state this Lady is the type of nursing professional that make your hospital stellar forever in my mind.”

“I can honestly say Brianna my nurse was the best. When I came in I was scared. She comforted me and put my mind at ease. She explained everything and always made me feel like I was part of her family. She was on top of my meds and explained why I needed them, and that helped a lot. When I left, she explained everything and how to continue care at home. I can say she is the BEST NURSE by far. Thank you, Brianna, for all you did.

“Steven made a difficult day easier for us. His kindness and care will always be remembered. At the end of his shift, he asked if he could play a song for us that brought him comfort when he thought of his own deceased mother. He played “I Can Only Imagine” by Merci Me on his phone. I was holding my mother’s hand and when the song ended my mom took her last breath. It was a beautiful passing and we were given a gift of divine consolation.”

“My sister was in, as doctors described as “ICU Psychosis”. She attempted numerous times to hit Nicole. This nurse never wavered from her kind, compassionate, utmost care for my sister. I can go on and on about all the horror stories my sister put the nurse Nicole through and how this nurse was able to act as if nothing was array were amazing. Nicole demonstrated the true meaning and definition of the word/meaning of a nurse.”

A positive force

I have seen first-hand how recognizing an employee for a “job well done” can elevate the morale on the entire unit. In this fast paced, technologically advanced world of healthcare, organizations must seek out creative ways to say “thank you” and provide meaningful recognition for their employees. Encouraging a patient or family member to express their positive experiences, for example, through the use of the DAISY Nomination, may reinforce those positive feelings associated with their current hospitalization and provide an affirming opinion for the healthcare system at large.

Acknowledging the staff in a meaningful way, such as with a DAISY Award, where coworkers and the recipient celebrate alongside nursing leadership, allows for a sense of connectedness within the organization. Organizations that consistently recognize and reward employees for positive patient experiences may foster self-esteem and subsequently impact their job performance in a positive way.

Donna Feinblum BSN RNC-LRN is the DAISY Coordinator at Clara Maass Medical Center in Belleville, New Jersey.

Selected references

Barnes B, Barnes M, Sweeney C. Putting the “meaning” in meaningful recognition of nurses. J Nurs Admin. 2016;46(10):508-12.

Barnes B, Lefton C. The power of meaningful recognition in a healthy work environment. AACN Adv Crit Care.2013;24(2):114-6.

Brunges M, Foley-Brinza, C. Projects for increasing job satisfaction and creating a healthy work environment. AORN J. 2014;100(6):670-81.

Kalisch BJ, Lee H, Rothman M. Nursing staff teamwork and job satisfaction. J Nurs Manag. 2010;18(8):938-47.

Lefton C. Strengthening the workforce through meaningful recognition. Nurs Econ.2012;30(6):331-8, 355.

Raso R. It’s all connected! Patient experience and healthy practice environments.Nurs Manag. 2016;47(8):24-9.