The holidays are a time for family and friends to gather and celebrate. Intensive care unit nurses know that this time is often more difficult. The holidays bring many joys, but for many health care providers, patients, and families, there are significant challenges.

The holidays may bring an increase in patients seeking elective surgery. Patients, who are far from home enjoying a holiday visit, may require emergent care in an unfamiliar setting. Emergencies and accidents know no holiday, resulting in often unexpected hospitalizations, which compound stress and disrupt planned events during the holidays.

This is certainly an important time to ask "what matters" to patients, families, and staff as they manage the many joys and challenges during the holiday season. Ellen Goodman, cofounder and director of the "The Conversation Project," emphasizes having a conversation on values-what matters to you, not what's the matter with you.1

There are conversations essential to help those we care for to find comfort in family, religion, and cultural traditions. Once you have an understanding of these values, you may be able to adjust to the needs of the patients and family more effectively. Some examples may include: offerring flexible visiting hours or finding hotels and respite areas for extended family. Staff may also direct loved ones to hospital chapels, healing gardens, or places of worship in the area. Caregivers may direct families to locations that provide cultural celebrations where traditional foods and activities allow them to honor their values. Other options include mobilizing technology hookups to arrange for virtual family hangouts, connections with pets, and access to family living in remote areas. Families are grateful when staff arrange for cultural and family traditions to be honored in the hospital settings, and even in some small way, at the bedside.

Health care leaders must also ask colleagues and staff "what matters" to them during this family season. Many leaders make arrangements for holiday meals, family calls, split shifts, and flexible alternatives to help staff manage family and work responsibilities. These forward questions are rich learning opportunities, but often difficult to respond to, as managers juggle with staffing issues, and daily operations, while also managing their own family responsibilities. Jess Perlo,2 a director at the Institute of Healthcare Improvement (IHI), reminds us-we must prepare to ask and respond in a meaningful way. Perlo tells us that the first step to improving joy in work and reducing stress is for leaders to engage colleagues to identify what matters to them in their work using "What matters to you?" conversations. She says, "Sounds simple enough, right? A short, 4-word question."2

The staff at the IHI have learned that these conversations are difficult, and providers often need signification preparation and education. The IHI provides many resources, including videos, and white papers to direct this work. These tools will get you ready to ask, "What matters to you?"-and help prepare you for the answer.3

At home, you may interact with family and address new concerns and questions. It may be the perfect opportunity to ask important questions about care wishes. Health care providers may be the ones to begin these conversations-as they are commonly the "go-to" people for medical questions at the family table. Take this opportunity to ask "what matters" to understand the context within the questions and to provide information that aligns with each person's values. Download the Conversations Starter Kit for ideas on how to support these conversations4 at https://goo.gl/PVrdEA.

Happy Holidays from the DCCN family!

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