Applying Watson's Caritas Process to Increase RN Satisfaction and Retention

Monday, November 2, 2009: 2:00 PM

Marlienne Goldin, RN, BSN, MPA
Neuro Intensive Care Unit, Moses Cone Memorial Hospital, Greensboro, NC

Learning Objective 1: relate applying Caritas Processes at managerial level to increased staff satisfaction and retention

Learning Objective 2: relate individual Caritas Processes to practical managerial applications

Purpose:  Can the application of Jean Watson’s Caritas Processes increase nurse staff satisfaction, retention, and create a healthy work environment? A 14 bed Neuro ICU suffered from high turnover and low morale. Twenty full time RN vacant positions existed, a 74% vacancy rate.  Turnover was 44% for 2007. Relief nurses who had no loyalty to the department were filling nursing shifts in 4-hour blocks of time. Interdisciplinary communication was poor. If an institution is committed to a caring philosophy that philosophy must permeate the work place, and it must start with nursing administration (Nyberg).  When staff nurses feel valued and cared for by their supervisor, goal setting is mutual.  Nurses must be cared for (Quinn).   Implementing policies that reflect respect, love and care for nurses can help build healthy work places.

Description:   Watson’s Ten Caritas Processes were applied by a newly hired ICU Director who was well versed in the application of the Caring Theory in various settings.  Practicing loving kindness, staying within staff’s frames of reference, creating healing environments at all levels, developing caring, interdisciplinary relationships, and being authentically present to all ideas and suggestions from the staff are some examples of how the Caring Processes were applied. The focus was on nurturing new grads and establishing caring trusting relationships with all staff. We instituted initiatives suggested by staff, i.e. a 2 hour quiet time for patients, a staff panel who interview potential new hires using a Likert Scale Scoring Tool, hiring for attitude, and initiating a new orientation model to name a few.

Outcomes:  After 12 months the RN vacancy rate and satisfaction scores were measured and compared to the previous years’ scores. Using the Jackson Continuous Employee Perception Survey, (CEP), and the National Database Nursing for Quality Improvement, (NNDQI) as measurement tools, we found that applying the Caritas processes at the managerial level results in a marked increase in RN work environment satisfaction scores.  If applying the Caritas Processes at the managerial level is successful in retaining and attracting nurses in this ICU setting, it can be applied in other settings.