When members of the Portsmouth Regional Hospital Intensive Care Unit arrived at work on Feb. 13, they were devastated to learn that their colleague, Linda Huelsman, had been killed in a car accident on her way to work that morning.
Huelsman, a nurse for more than 30 years, had worked at the hospital since 2019 and was well-known, loved and respected by her peers. Known as the ICU’s “unit mother,” she made sure every new mom on her team had a handmade baby blanket and served as a mentor to young nurses.
So it was no surprise that colleagues across the unit and hospital struggled to go about their day after learning of her passing. It would become the most important use yet of a “Code Lavender” in the program’s two-year history at Portsmouth Regional Hospital.
Developed in Hawaii more than two decades ago, Code Lavender is a rapid response system that some hospitals have adopted as a way of providing emotional support to healthcare workers suffering from stress, trauma or burnout.
Rev. Karen Fleming-Caplette, the spiritual care coordinator and chaplain for Portsmouth Regional Hospital, had the idea to build a Code Lavender program at the hospital during the COVID-19 pandemic after attending a presentation on stress first aid from the National Center for PTSD.
“The two kind of came together in my head – like this would be a great tool for people to learn and to use within a program like Code Lavender,” she said.
Chief Nursing Officer Michelle Dodd had heard about the program being used in other healthcare settings and offered her support. Rev. Fleming-Caplette took the ball and ran with it, building a core team of colleagues that meets monthly to assess the program, which officially launched in 2023.
Code Lavender relies on volunteer responders who take training sessions on stress first aid. Volunteers sign in at the start of their shift and respond when and if the need arises, often due to the loss of a patient. On average, there are about one or two Code Lavenders called each month at Portsmouth Regional Hospital.
“The people who have taken the training and signed on to be a responder are all in,” Rev. Fleming-Caplette said.
If called, a responder will go to the unit in need, gather more information, determine whether a one-on-one or group huddle is needed, and then offer a support plan that could range from could range from a break with a hot cup of coffee and a snack to taking a walk and listening to the person share their experience.
“It was always my goal to build a team that supported one another in the moment,” Rev. Fleming-Caplette said. “It’s a totally different thing to hand somebody a card for the employee assistance program or nurse hotline versus showing up for them in that moment with whatever they need. To have a peer who is willing and able to take that time to check in can make a really big difference for the person struggling.”
Since its inception, the program at Portsmouth Regional Hospital has grown and been adopted by sister hospital Frisbie Memorial Hospital in Rochester, New Hampshire, and even to HCA Healthcare’s Gulf Coast Division after a leader from the division learned about the program while visiting Portsmouth Regional Hospital.
Rebecca Cole, cardiac surgery stepdown manager at Portsmouth Regional, said the program has been an enormous benefit to her unit.
Cole noted that many of her nurses are recent graduates who sometimes struggle to process the realities of caring for especially fragile or sick patients early in their career.
She recalled an incident when a young nurse lost a patient for the first time in her career.
“She took it really hard. She had been with this patient for several days. We found her sitting in a closet and initiated the Code Lavender,” Cole said.
Cole and nurse LuAnn Jones, a member of the core Code Lavender team, responded, bringing tissues, snacks and various items to help the nurse process the loss.
“We sat, had a moment, and then when she was ready, we went in to say goodbye to the patient,” she said. “It really helped her wrap her head around what had happened.”
In the case of Huelsman’s death, the need for support extended across the ICU team and throughout the hospital.
“The people who were here that day were finding out at the beginning of their shifts and having to work the whole day,” Rev. Fleming-Caplette said. “Especially in the ICU, they didn’t really have the opportunity to stop and grieve together.”
So Code Lavender responders set up shop in the break room throughout the day, offering support to all who needed it, whether it was a shoulder to cry on, a stuffed therapy dog to cling to or a friendly cup of coffee and a snack.
“We were experiencing shock, disbelief and grief all while trying to provide patient care,” said ICU nurse Linda Neyman. “The Code Lavender team gathered us together and provided a safe space to emote. They offered nourishment and continued support. Their presence helped us get through that tragic day.”
Later, the Code Lavender team helped to organize a memorial service for Huelsman where her ICU colleagues were able to share stories, readings or just express grief.
“Ice cream and hot chocolate were two of her favorite things so the cafeteria stood up an ice cream and hot chocolate bar for us with all the toppings,” Rev. Fleming-Caplette said.
Some wrote on scraps of paper what they wanted to say to Huelsman, or about her, which Rev. Fleming-Caplette took home and burned in her fire pit and buried in the earth.
“It was just a way that they could release something on their heart,” she said.
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