A consistent finding in the research over the last 25 years, is nurses put value on personal recognition that is written and individually provided by leaders they professionally respect, however, specific interventions were rarely evaluated (Blegen, 1992). The researchers also consistently reported that without professional meaningful recognition the nursing workforce would continue to feel devalued causing detrimental impacts on the provision of patient-centered care and organizational transformation (AACN, 2017).
This DNP project was based on implementing an innovative strategy for nurse leaders to infuse meaningful and motivational recognition into their daily workflow. A synthesis of Maslow’s Motivation Theory with Watson’s Caring Theory provided the theoretical framework necessary for developing a meaningful recognition program seeking to improve upon the engagement of the nursing workforce. The intervention was comprised of a well-timed and professionally meaningful thank you note, provided by a respected nurse leader. Each nurse manager was provided with a recognition kit which included staff members’ addresses, note cards, and stamps. The note cards were engraved with each manager’s name and professional credentials. The purpose of the kit was to provide the managers with the tools needed to easily send personalized, handwritten notes to staff members in recognition for outstanding work or exceptional performance that reflects the organization’s values.
Prior to implementation of the thank you notes a voluntary survey was completed by the RN’s on the four inpatient units participating in the project. The Healthy Work Environment (HWE) Survey (AACN, 2017), the Recognition Survey (Blegen, 1992) and a Demographic Survey comprised the pre-implementation survey with a 70% response rate achieved. The purpose of HWE survey was to obtain quantitative data on nurses’ perception of the health of their work environment and the meaningful recognition they receive. The purpose of the Recognition Survey was to obtain data on the methods of recognition that are meaningful to nurses. The demographic descriptor of the age of the participants was used to determine whether the various generations have any differences in the type of recognition they find most impactful and meaningful. At the completion of the three-month implementation, a brief post- implementation survey was administered. This survey was comprised of the demographic survey and the three questions from the HWE survey specific to meaningful recognition.
Data analysis and final evaluation of the project are currently underway. The surveys utilized in this project will help to determine two key points. The first is to determine the perception of the nurses surveyed on the health of their work environment and whether they perceive their work environment as one that supports and fosters excellence in patient care. The second point is to determine what behaviors of their nurse leaders the nurses find professionally meaningful. These perceptions will provide valuable insight into the individual nursing work environments and staff engagement in their work. It is the goal of the project to recognize what the nurses find meaningful and provide a tool to improve the amount of meaningful recognition being provided to the nurses on these units. The demographic data will offer the distinct opportunity to see if the various generations in the workforce view recognition any differently. This unique perspective may help guide the managers in providing meaningful recognition in a more personal manner.
For this DNP project, the evaluation will center on determining how effective the written thank you note will be on influencing the engagement and retention of the nursing workforce. Additional outcomes for this project will be measured through patient satisfaction scores, inclusive of the overall and the courtesy and respect scores as well as the percentage of unscheduled time off utilized by the staff RN’s.
The evaluation of the sustainability of the project will be assessed in whether the leadership team continues the commitment to improving the health of the workplace environment and culture. This would become evident by senior leaders in the organization adopting the use of thank cards into their daily work as an extension of the nurse managers. The results of the project would be shared with Nursing and Executive Leadership to encourage this adoption. Upward migration of the use of thank you notes is important as is the expansion to the full nursing workforce and to all other departments in the institution.
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