Work engagement is key to organizational efforts to retain nurses and mitigate future nursing shortages. In their dual role as caregivers and organization “keepers,” nurses may already have the key to creating a culture of engagement. “The characteristics and benefits of “engaging” work environments are captured in nursing professional practice models, as evidenced by a quarter century of research on Magnet hospitals and professional practice. (ANA 2004) An inflection point, providing an opportunity for transformational change in the nursing work environment, may be generated by a critical need for nurses and a call for healthcare delivery system redesign. “In 2001, the American Association of Critical-Care Nurses (AACN) made a commitment to actively promote the creation of healthy work environments that support and foster excellence in patient care wherever acute and critical care nurses practice. (ANA 2004) This commitment is based on the Association’s dedication to optimal patient care and the recognition that the deepening nurse shortage cannot be reversed without healthy work environments that support excellence in nursing practice. There is mounting evidence that unhealthy work environments contribute to medical errors, ineffective delivery of care, and conflict and stress among health professionals. Negative, demoralizing and unsafe conditions in workplaces cannot be allowed to continue.
The creation of healthy work environments is imperative to ensure patient safety, enhance staff recruitment and retention, and maintain an organization’s financial viability. “AACN is strategically committed to bringing its influence and resources to bear on creating work and care environments that are safe, healing, humane and respectful of the rights, responsibilities, needs and contributions of all people–including patients, their families and nurses. ” (Aiken 2002) Six standards for establishing and sustaining healthy work environments have been identified.
Putting forth these six essential standards for establishing and sustaining healthy work environments is an important step in meeting our commitment. The standards uniquely identify systemic behaviors that are often discounted, despite growing evidence that they contribute to creating unsafe conditions and obstruct the ability of individuals and organizations to achieve excellence. “The American Association of Critical-Care Nurses recognizes the inextricable links among quality of the work environment, excellent nursing practice and patient care outcomes. (Aiken 2002) The standards represent evidence-based and relationship-centered principles of professional performance. Each standard is considered essential since studies show that effective and sustainable outcomes do not emerge when any standard is considered optional. The standards align directly with the core competencies for health professionals recommended by the Institute of Medicine. They support the education of all health professionals “to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics. (Aiken 2002) “With these standards, AACN contributes to the implementation of elements in a healthy work environment articulated in 2004 by the 70-member Nursing Organizations Alliance. ” (Taylor 2001) The standards further support the education of nurse leaders to acquire the core competencies of self-knowledge, strategic vision, risk-taking and creativity, interpersonal and communication effectiveness, and inspiration. The standards are neither detailed nor exhaustive.
They do not address dimensions such as physical safety, clinical practice, clinical and academic education and credentialing, all of which are amply addressed by a multitude of statutory, regulatory and professional agencies and organizations. The standards are designed to be used as a foundation for thoughtful reflection and engaged dialogue about the current realities of each work environment. Critical elements required for successful implementation accompany each standard. Working collaboratively, individuals and groups within an organization should determine the priority and depth of application required to implement each standard.
The standards for establishing and sustaining healthy work environments are: Skilled Communication: Nurses must be as proficient in communication skills as they are in clinical skills. True Collaboration: Nurses must be relentless in pursuing and fostering true collaboration. Effective Decision Making: Nurses must be valued and committed partners in making policy, directing and evaluating clinical care and leading organizational operations. Appropriate Staffing: Staffing must ensure the effective match between patient needs and nurse competencies.
Meaningful Recognition: Nurses must be recognized and must recognize others for the value each brings to the work of the organization. Authentic Leadership: Nurse leaders must fully embrace the imperative of a healthy work environment, authentically live it and engage others in its achievement. A personal experience I have used for effective communication with my fellow co-workers is to constantly ask questions and maintain a friendly positive attitude no matter how busy or short staff we may be. We use or status board on the computer to update notes to communicate with doctors.
Ex: can pt eat? Or pt ready to go? We do this when the doctor is busy in and out of rooms and so are the nurses so it’s easy to continually pass each other. It works well for communication and process of patient flow and satisfaction. In Conclusion to foster staff retention, organizations need to develop environments in which nurses want to work. Among other things, nurses want safe workplaces that promote quality health care. It’s the role of the nurse executive and nurse manager to establish a work environment that supports professional practice.
That’s one key piece to retention. It’s also important that nurses play an active role in shaping their environment. Nurses want to work in a place that brings high quality to patients and know they have a role in the process. Creating such an environment is not easy. By following the set of principles the Nursing Organizations Alliance developed is a great way to help hospitals and other health care entities create positive work environments. Reference: Aiken, L. , Clarke, S. , Sloane, D. , Sochalski, J. , & Silber, J. (2002).
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