Perceptions of a Healthy Work Environment Through the Eyes of Student Nurse Externs

By 2020, the nursing shortage among Registered Nurses has been predicted to grow by 29%, thus making nurse retention a critical issue. Further, by 2020, The Bureau of Labor Statistics, U.S. Department of Labor predicted that 1.2 million nurses would be needed. Programs implemented to assist nursing students’ transition to challenging workplace environments are vital. The literature has successfully established the importance of hospital-based nurse externship programs, which have been shown to improve nurse retention and reduce costs. Nurse Externship programs assist with bridging the gap between the academic setting and clinical practice. These programs help facilitate recruitment as well as integrate new graduate nurses into the nursing profession. During this transitional period, nurse externs begin to learn nursing practice standards, adopt new languages, and develop new decision making skills that support successful progression through the stages of reality shock. Thus, it is crucial that organizations promote healthy work environments.

Research has illustrated employee satisfaction and retention as well as positive patient outcomes by utilizing the American Association of Critical-Care Nurses six essential standards of Healthy Work Environments (HWEs). HWEs display professionalism, honesty, open communication where colleagues are empowered, respected, encouraged and accountable for their actions. As a result, positive environments improve quality of patient care. The Healthy Work Environment Model serves as a guide to cultivate a positive work environment and promote professional behaviors. Hence, the introduction of HWEs should occur before licensure or during the pre-licensure phase. Therefore, the purpose of this project will be to evaluate the perceptions of HWEs among student nurse externs as they complete an eight-week nurse externship program.

The nurse externs will attend a biweekly thirty-minute brown bag lunch session centered on the Healthy Work Environment Model: PEOPLE and PRACTICE. These sessions will address the core professional behaviors: positive reinforcement and recognize contributions and accomplishment, mutual respect, accountability for oneself and others, care for oneself and others, trust and teamwork, identify and deal with problems as they occur, clear, collaborative communication, and exhibit positive role modeling. A survey will be emailed to the nurse externs at the end of the eight-week program to assess perceptions of a HWE. The anticipated outcome will be retention of 50% or more of nurse externs transitioning as nurse interns at the conclusion of the project. Further, the nurse interns will become graduate nurses within three months of graduation. An earlier introduction of HWEs will be crucial in promoting excellence at the bedside and retention of future nurses.