The Role of Nursing Professional Development in Promoting a Healthy Work Environment

Friday, 22 February 2019

Karolyn M. Roberts, MSN, RN, CPN
Nursing Professional Development, University of Kentucky HealthCare, Lexington, KY, USA
Misty L. Whitaker, DNP, RN
Nursing Professional Development, University of Kentucky, Lexington, KY, USA
Marcia Alverson, MSN, RN
Nursing Staff Development, University of Kentucky, Lexington, KY, USA
Amy Elizabeth Richardson, MSN, RN
Nursing Staff Development, University Of Kentucky Medical Center, Lexington, KY, USA

A healthy work environment in health care promotes nurse engagement and satisfaction, and ultimately leads to safe and quality care. Without it, nurses will likely experience fatigue, disappointment, stress, and the desire to leave the work unit or health care altogether. In 2005, the American Association of Critical Care Nurses (AACN) advertised a call to action and released six standards for establishing and sustaining a healthy work environment: skilled communication, true collaboration, effective decision-making, appropriate staffing, meaningful recognition, and authentic leadership (AACN, 2016). Nursing Professional Development exists to support peers and front line nurses in their education, competency, and continued career development, so serving as advocates for a healthy work environment comes naturally. Utilizing the standards allows for promotion of education and acquiring the necessary skills to prevent the perpetuation of unacceptable conditions (AACN, 2005). A group of Nursing Professional Development educators for a large academic medical center were brought together to form the Healthy Work Environment (HWE) committee and promote the tenants of a healthy work environment in their peer group as well as the front line staff that is supported within the organization.

The best work and patient care takes place when colleagues, departments, and everyone within the health care system communicate effectively. Skilled communicators focus on finding solutions to problems, actively work to advance collaborative relationships, utilize and become proficient in technology, and continually seek input on their own communication styles in order to improve (AACN, 2016). The HWE committee worked to standardize communications that came from the Nursing Professional Development department, allowing for easily recognizable education delivery and reducing confusion. The committee took on a project to standardize class sign-ups, creating an easier registration process. A revised tool was created to guide progress meetings, and was shown to increase communication between preceptor, new nurse, and staff development specialist as well as ensure adequate learning and progression of the new nurse. Leadership’s communication with both staff and peers has been proven to be a vital part of a healthy work environment (Blake, Leach, Robbins, Pike & Needleman, 2013).

Along with communication, collaboration between health care professionals leads to patient and family needs being satisfactorily met in a modern and complex health system. True collaboration results in a culture where the new norm is communication and decision making that takes place among nurses and between nurses and other professionals. In order to achieve true collaboration, every team member must accept the standard as an ongoing process, and remain active in its development. Differing voices, personalities, and interests must be integrated (AACN, 2016). The HWE committee promotes true collaboration by sponsoring team building exercises within the department, holding events to allow Nursing Professional Development and Nurse Recruitment to mingle and ensure efficient and effective onboarding for new nurses, and encouraging a monthly meeting between Nursing Professional Development, Clinical Nurse Specialists, and Patient Education Specialists to discuss ongoing work and organization-wide initiatives.

Nurses are taught to care for others and consider a holistic approach. From day one, lectures depict a selfless career where nurses are involved in ensuring even the most basic of patient needs are covered according to Maslow’s Hierarchy. In the most recent courses and inclusions of enterprise learnings, nurses are instructed to incorporate patient families into their daily list of dependents with scripts and acronyms to serve as guides and reminders so that nothing is left out. However, who ensuring the nurse’s needs have be met and self-transcendence has occurred? When one feels as if their hard work is recognized, a sense of pride will be instilled that continues throughout the course of their career. When that recognition is meaningful, it will cause that spark to implode into a large flame of desire to grant that same feeling for others, be it patient or peer. This promotion of inclusive thinking is transcendent of human consciousness (Maslow, 1969). The HWE committee and its stakeholders within the enterprise hold their nurses in the highest respect and navigate to a more positive outlook. The individuals within the committee utilize positive affirmations before group meetings to promote teamwork and an inclusive atmosphere. The committee celebrates individual and group as well as enterprise goals and awards. The recognition of both personal and professional achievements helps to validate the nurse, promote work life balance, and foster a sense of well-being.

Enterprise leadership provides support and assistance to staff in the form of personal assistance, educational trainings, onboarding, and skilled communication. When leadership takes initiative to create healthier work environments, the results have been shown to increase trust, open communication barriers, decrease absenteeism, and increase the quality of patient care (Nayback-Beebe, et al., 2013). The HWE Committee was developed to help foster a more positive work environment while also assisting with the needs of staff and their peers in leadership. The committee has high visibility on the units, standing items on staff meeting agendas, and leadership buy in. Maintaining communication about the work and progress of the HWE can promote others to continue bringing issues to the table Brunges & Foley-Brinza, 2014). NPD meetings are held bi-monthly and the HWE has agenda items to review with peers, while the reciprocal relationship allows fellow leaders to bring issues or problems from unit level meetings to the table so that collaboration efforts can ensue. The role of the HWE committee in such efforts is to facilitate the dialogue between those involved, hear the requests of all parties, and assist in the development of a comprehensive solution. This approach to troubleshooting dilemmas reaches from the bedside to the boardroom and ensures that stakeholders are involved in day-to-day happenings. The bedside nurse gains a voice and leadership listens with a healthy ear.

Nurses must feel valued and must be involved in making decisions in patient care. Evidence suggests that involving nurses in decision-making is associated with improved satisfaction and positive outcomes for patients (Breau and Rheaume, 2014). The Professional Development department analyzes the results of the annual employee engagement survey. A needs assessment is performed and goals for the HWE committee are outlined. The enterprise uses a collection of values referred to as “living DIReCT” to drive decision-making and daily activities. The committee uses the “living DIReCT” values as a framework when implementing activities to foster employee engagement and empowerment. All members of the Professional Development department are invited to attend the HWE meetings and each person present is given the opportunity to share, ask questions, or make suggestions.

Appropriate staffing is paramount to nurse and patient well-being (Chana, Kennedy, & Chessell, 2015). The Nursing Professional Development department’s HWE committee is a support to ensure nurses at all levels can adequately focus on patient and family care. The committee utilized two interventions to ensure nurses orienting into the enterprise were proficiently oriented to their new roles. First, the committee encouraged each service-line staff development specialist to pair preceptors and new nurses based on personality, individual needs, and unit needs (Ward & McComb, 2017). Making rapport of the preceptor/preceptee a priority promotes satisfaction and decreased turnover. Currently the hospital has a first year retention rate greater than 90%. The second intervention to aide with appropriate staffing is the implementation of a tier-based orientation system to ensure that new nurses are competent with skills prior to moving on to more in-depth skills and higher acuity patients. It is important for service line staff development specialists to be engaged with the process and have the opportunity to share their experiences with tier-based orientation (Siller, Dolansky, Clavelle & Fitzpatrick, 2016). As the work continues on this project, the HWE committee communicates their progress, and invites instructors to share opinions and experiences with this approach.

In 2016, the AACN called upon nurses and other health care professionals to embrace their personal obligation to create healthy work environments, collaborate with others to develop work places where individuals could hold themselves and others accountable, and follow through until desired solutions have been realized (AACN, 2016). The goal of the HWE committee is to create and sustain a healthy work environment among nursing professional development peers, as well as for front line nurses throughout the enterprise. As one of the very few employee engagement ‘tier 1’ work units, it is the intention of this group to help others achieve similar status.

See more of: Poster Session 1
See more of: Oral Paper & Posters