The problems our profession is experiencing are closely related with the rapid and dramatic changes occurring within the healthcare system, the corporate response to the rising costs of healthcare, and the lack of knowledge healthcare CEO’s possess when it comes to harnessing the powerful potential of human capital. In a previous blog I wrote in answer to Dr. Sanjay Gupta I discussed three things that had to happen in order for patient care errors to be reduced: Enlightenment at the corporate levels of healthcare, the implementation of a “just culture” in every healthcare workplace, and maintaining an Interdisciplinary Model Of Care *wherever people are cared for*. Now, consider the problems nurses are having within the profession. A study published in 2005 showed “30% of new nurses left initial positions within one year and 57% left after two years.” The number one reason nurses gave for their departure from the profession? The work environment.
One does not need to perform an in depth root cause analysis to unearth the foundation of our problems with each other. All we need to do is look to the left and the right of ourselves to identify the culprit of our troubles—Nurses. Nurses from different generations… Nurses from different generations and cultures trying to cohabitate within enclosed nursing stations for 12 hours or more. Enough said right? Yes, but when it comes to improving our workplace the buck stops with us. Nurses are educated enough to problem solve and work together when it comes to conducting research studies or discovering new and innovative ways of caring for patients—we went to school to learn those skills and I would like to think that the education we received in our BSN programs wasn’t meant to be focused exclusively on tasks at the bedside. Sure, there is a list of external forces that impact our work environments, and yes—much of what sets the tone for our workplaces comes from over our heads. That being said, one still has to ask: why aren’t we taking a more proactive stance? Are we all waiting for things to change just because the American Nurses Association has “applauded” some new workplace recommendation or initiative it has come up with? Friendly reminder: Corporations don’t have to do a darn thing with those recommendations and initiatives, they aren’t bound to do so either.
So, what is a corporate nurse to do? Some of the major troubles nurses experience in the workplace can easily be remedied without the “process” of going through a nurse manager and the whole “it takes 100 miles and 100 committees to accomplish one change” speech I’ve heard before. If you can recall what we all learned in school about holistic assessments then you already have everything it takes to do something about some of the issues that affect all of us….as well as our ability to provide safe quality patient care. Times have changed and gone are the days where we just “show up” and do what we do at the bedside, expecting everything we need to do our jobs to be provided for us, that all the problems will fix themselves while we fix patients. We must establish a “workplace recovery” mentality. If we want better work environments we must do the work to achieve them. It’s what I equate to recovering a heart surgery patient—I get out of it what I put into it. Either I’m going to do 200% to get that patient out in less than 5 days to reduce any risk of infection or injury or I’m gonna just kick back and assume the next nurse will get the patient out of bed to ambulate on her shift.
Look at it another way, at the heart of our workplaces are human beings and everything that goes with the human condition. We were taught to understand concepts such as Maslow’s Hierarchy of Needs, nurse theory application, and what it means to provide holistic, transcultural, and spiritually competent patient care. Do you think the higher ups in a corporation were taught those things? We can’t expect corporate executives to understand the needs that come with working in environments saturated with humans if we don’t start using the tools in front of us to both educate and hold them accountable. Since the higher ups in our institutions are not likely to participate in an episode of “Undercover Boss” to better “get it,” social media is an excellent way to begin exerting ourselves a bit, a means of exercising the massive muscle potential our profession has.
The truth is, corporations will listen if you appeal to what their currency is: Staying ahead of the technology/innovation curve in a cutthroat competitive industry, establishing credibility and longevity for their brand image, and generating profit to improve upon and expand that brand. Corporate figures know all about the business side of things, but they didn’t go to medical school or nursing school. These executives don’t work in cramped nursing stations for long hours without adequate food or drink on some days. They don’t have to answer three call lights at once or triage which of the three “crises” to attend to first. Most importantly—they haven’t yet made the connection between investing in their human capital as a means of solving some of their biggest problems: Costly Patient Care Errors, low patient satisfaction scores, reducing daily operation costs, and generating profits to put back into the company and keep the hospital doors open.
I often wonder…have nurses in scrubs ever sat in on an executive board meeting to offer strategies for change? We are the largest expense a hospital has. The question should be—why aren’t we sitting in those board rooms shoulder to shoulder with the people who “aren’t” doing the work of caring for human beings every day? What hospital CEO doesn’t want to know how to maximize the money they are putting into a major resource? What hospital CEO doesn’t want to know what it will take to save them money at the end of a fiscal year so they can allocate money where it’s really needed (more staff) ? What hospital CEO doesn’t want to know how to reduce risk and retain qualified, talented staff? If we as nurses can’t walk into any board room and entice corporate executives to listen with the answers to those questions then we should save our bodies from prolonged stress, illness, and injury….We must first attend to “the self” and preserve our satisfaction with the career we worked so hard for and find employment elsewhere. Our voices matter, our education matters, our skills matter, our health matters…..WE MATTER.
Next up: A literature review on the impact of intergenerational nursing staff on workplace satisfaction and what each one of us can do to improve the workplace.