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Code Lavender: Healthcare Providers Caring for Themselves

Fighting Provider Burn Out with Code Lavender
Kim Marie Smith/

Healthcare providers are among the most compassionate people. They selflessly take care of others during some of the most challenging times of people’s lives. Unfortunately, this compassionate caregiving often comes with a price. Healthcare workers are suffering from emotional burnout and compassion fatigue at alarming rates. While various strategies have been developed to combat healthcare related stress, one innovative tool may help to offer immediate relief from acute stress in the healthcare field.

Hospitals codes are utilized throughout the world to alert staff to urgent situations. Various emergency scenarios are assigned a color to indicate what type of emergency is occurring. For example, “Code Blue” is used to alert medical personnel that a person is in cardiopulmonary arrest, or otherwise requires urgent medical help. “Code Red” is used to indicate a fire. Less well-known, but arguably equally as important, is the “Code Lavender.”

What is a Code Lavender?

Stress is an inherent part of working in the health care system. While health care providers become accustomed to the daily stressors involved in their jobs, some moments arise that push caregivers past their emotional limits. Whether these situations consist of the death of a colleague, a stressful interaction between two health care providers, a difficult patient situation, or a variety of other stress-inducing situations, “Code Lavender” may be just what the doctor ordered.

Upon initiation of Code Lavender, a Rapid Response team of trained specialists responds to the Code within 30 minutes. The responders typically include a member of the spiritual care team as well as board-certified holistic nurses.

The team arrives at the scene equipped with various emotional and physical tools to assist those in need. This multimodal approach may include massage therapy, Reiki, music, meditation, breathing exercises, prayer, sustenance in the form of food and drink, and emotional support. At some organizations, a lavender wristband is given out as a visual cue to remind the staff member or their colleagues to be gentle.

Code Lavenders can be called to assist an individual, a group, or an entire unit. The team tailors each Code to the needs of the person or department in crisis. While each Code is unique, the message behind it remains constant:  Our work is stressful. You are not alone. You have the love and support of the organization.

Why Lavender?

The origin of the Lavender plant goes back approximately 2500 years and can be traced to the Egyptians who used it for embalming and cosmetics. Several studies have confirmed a link between the use of lavender and reduced anxiety. Lavender is calming and has been said to have a soothing effect on headaches, nervous disorders, and exhaustion. As lavender is considered a calming color, it made sense to choose this color to depict a Code that would reduce anxiety and create a soothing atmosphere.

History of Code Lavender

Earl Bakken, a physician and Board Chairman at the North Hawaii Community Hospital in Waimea, first coined the term “Code Lavender” in 2004. This small 35-bed hospital focuses on holistic care in which individuals are treated for mind, body, and spirit. While the Code Lavender program was initially created for the use of patient and families, it quickly became a tool utilized by employees as well.

In 2008, Code Lavender was launched in 2008 at the world-renowned Cleveland Clinic. Dr. Brenda Duffy, a colleague of Dr. Bakken, introduced the concept to Cleveland Clinic. Led by the Healing Services Team, this successful program has had very positive feedback. In fact, 98% of employees who utilized the services said that it met or exceeded their expectations, while 96% reported that they would recommend it to their peers. The Code Lavender team has grown at Cleveland Clinic to include four holistic nurses and ten Chaplains.

Code Lavender is now being utilized by several organizations across the country including Keck Medical Center of USC,  Johnson City Medical Center, Tampa General Hospital,  OSF St. Joseph Medical Center.

Barriers to Code Lavender

Healthcare providers, and more specifically physicians, are trained not to be vulnerable. Dr. Dike Drummond, the author of Stop Physician Burnout, discusses the idea that doctors are programmed through their conventional medical training to be workaholic superheroes. He points out that while the Code Lavender program does have some positives, many people will not utilize it due to fear of being stigmatized. There is likely truth to his message, as very few Physicians have utilized the Code Lavender services.

How to Implement a Code Lavender Program?

Barb Picciano, BSN, RN, HN-BC, Manager of Healing Services at the Cleveland Clinic, offers some advice on how to successfully implement a Code Lavender Program:

  • Conduct and Internal Assessment: Many organizations have support systems in place that can already be built upon.
  • Gain Leadership Buy-In: The initiative is only possible if leaders and stakeholders strongly support and endorse it.
  • Sell the Program: How does the program enhance your safety and quality initiatives as related to your organization’s mission, vision, and values? Linking the program to the mission of the organization will help gain buy-in.
  • Train Your Team Members:  The program is only as successful as those who are running it.
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About Sheramy Tsai

Sheramy Tsai is a registered nurse and freelance writer. She holds a BA from Middlebury College and a BSN from the School of Nursing at Johns Hopkins University. Throughout her career she has worked in various nursing specialties and most recently managed a Post Anesthesia Care Unit at a large teaching hospital. Prior to becoming a nurse, Sheramy was a successful recruiter for WinterWyman in the Boston area. When she’s not busy with her blended family of five children, she takes the time to pursue her passion for all things related to natural health and wellness.

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