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.
Do mind if I use this with my executive committee.. we are currently with almost all new board members both in our union and on our exec. com. at our hospital. I think this says much of what I have been thinking and coalesces it much better than how it has been bumping around in my head!! Anyhow, glad to see that you seem well and I’m always still here for you my sister RN!
Excellent article that puts into words my own thoughts on the state of nursing. If we as nurses do not take steps to improve our work environment, nursing as a profession will go the way of the dodo bird. We are the only ones who can improve our work environment. I am speaking as one with many years experience in a wide variety of nursing fields and leadership positions. I believe the first step is realizing and understanding that we as nurses are educated to be leaders. Our work environments, however, expect us to be followers. So it is no wonder that nurses become disillusioned when they encounter this disconnect. Quite simply, semi- or non-professional environments are not conducive to professional leadership, problem-solving and solutions. When confronted with this reality nurses will do one of two things: they will either keep using the skills and thinking they were taught in school and encounter consequences or they will eventually just give up and just go along with the corporate program. At this point nursing becomes a job rather than a calling, and the disconnect between nursing education and reality lives on.
So how do we fix this? First of all don’t educate nurses to be transformational leaders without educating them in the reality of the workplace. They need to know what they will be up against when they enter the workforce. As it currently stands, most hospitals are still functioning in staff-management mode. This is more conducive to labor–union solutions than professional solutions. Nurses need to be thoroughly educated about labor unions and why they are often more successful in accomplishing change than Professional Associations in this type of environment.
There are many other ways we can address this but I am running out of time. Keep writing and keep getting the truth out there! You are right on target!
We aren’t at the corporate meeting table because we are not invited – or wanted. We are the worker bees – to be “managed”
I wholeheartedly agree with every word you posted! Perhaps you’d like to view a case history our CEO worked on with Beth Boynton. Beth is an organizational development consultant specializing in issues that impact nurses and other healthcare professionals. She is a national speaker, coach, facilitator & trainer for topics related to communication, conflict management, team building and leadership development and author of the book, Confident Voices: The Nurses’ Guide to Improving Communication & Creating Positive Workplaces. You may also find value in visiting her web site: http://www.confidentvoices.com/
Below is more information about Beth and a brief description of this very revealing case study of when a patient received the wrong medication from his nurse. You will find this movie and accompanying materials very interesting. Feel free to share with your blog audience and colleagues.
Summary:
This medication error took place on a 20 bed Dementia unit staffed with 1 RN and 2 LNA’s. An error was found at the end of the nurse’s shift when the narcotics count showed an extra Clonazepam and a missing Lorazepam. No harm was done to the patient. This RCA analyzes the incident in-depth and demonstrates how much can be missed by using the ‘typical” incident report, thus increasing the risk of recurrence.
http://www.reliability.com/confidentvoices/
Good luck with your journey in getting more respect for nurses for all their hard work and dedication to patient care. My son is an RN so I hear some of his stories about the ICU and ER. He’s now moved into the informatics department and likes it much better. Gee, I wonder why??
Hi Diane–thank you for your encouraging words and I will definetly look over that case! Thank you for sharing it
Have a great weekend.
You’re welcome! Now that I know about your blog I will share some more “nurse” and “patient care” related information with you and your readers. Good luck.