Toward a Healthy Work Environment: Honoring the Voices of Frontline Nurses

Clear and concise communication is a key component of a professional work environment; especially in healthcare, where communication lapses can lead to patient safety events. Transparent two-way communication is a key part of establishing and maintaining a healthy work environment. A critical part of this transparency is giving a voice to frontline staff and valuing the input they provide.

An example of the impact of transparent, two-way communication and its link to a healthy work environment is the evaluation of the Johns Hopkins Nursing Professional Practice Model (JHNPPM). A professional practice model provides the framework to guide nursing practice and support frontline staff, but only if nurses are aware of it. A pilot evaluation of the JHNPPM was conducted to gauge nurses’ familiarity and engagement with the existing PPM. While nurses spoke eloquently about their practice, evoking similar themes contained in the PPM, few could speak to the model or its components.

Instead of creating an educational campaign around the existing PPM, which is the traditional approach according to the literature, the leadership of Johns Hopkins Nursing supported the revision of the PPM using the voices of frontline nurses. If the professional practice model was in their words, nurses would not have to learn about a model, they would simply speak to their practice.

To begin this task, nurses who volunteer as Magnet Ambassadors were asked to record informal conversations with peers on their units and talk about what it means to be a Hopkins nurse. Conversations were anonymized, transcribed, and a thematic analysis was performed on the qualitative data. Results of the analysis were vetted by the Magnet Ambassadors (MA’s) and brought to nursing leadership for input and clarification until a new PPM evolved.

The PPM workgroup consistently championed for the voices of the nurses to remain in the forefront of the process. By continuously reviewing progress with the MA’s, the workgroup increased their engagement in the process, and built a high level of trust with nurses who realized their voices were being heard and honored. MA’s commented on the increase in positivity in their units when nurses realized their voices were the driving force behind the new model.

Maintaining transparent, two-way communication has led to the creation of a meaningful professional practice model that supports a healthy work environment.