Saturday, December 10, 2011

What Do Nurses Want?

I received an email recently from a nurse friend and former co-worker from whom I hadn’t heard in a long time. Since we last communicated, she has had several jobs. What caught my attention, though, is why she left one job when it seemed perfect because of her expertise in maternal and child health.

She wrote that the clinic was poorly managed and the doctors treated the nurses poorly. The bottom line: she was afraid patients were going to suffer and she didn’t want to be blamed. Her work environment became intolerable so she left to protect herself, and that clinic lost a good nurse.

I think many nurses would agree that what makes them happiest is to know that their patients are well taken care of, but achieving this goal depends on several factors in the work environment:
• Do team members work well together?
• Are there lines for effective communication?
• Do all members of the medical staff exercise respect for all other members?
• Are adequate assistant resources available?
• Do nurses have a say in decisions?
• Are continuing education opportunities available?

A recent study headed by Maja Djukic, PhD, RN, of the New York University College of Nursing in New York City, confirms that when nurses rate their work environments high, they also believe that the quality of patient care is high.

The study was published recently online in Health Care Management Review. (The quality of care was not validated with measurements of actual outcomes.) The research was done in the context of the projected nurse shortage (250,000 nurses over the next 15 years) and how institutions may have to devise ways to improving work environments other than increasing the numbers of staff nurses.

For the study, a survey was first sent in 2006 (with follow-up surveys the following years) to nurses who had been licensed for the first time between Aug. 1, 2004 and July 31, 2005. Slightly more than 2,000 nurses answered, for a response rate of 68 percent. Nurse managers should take note of the results, the authors wrote.

"Our evidence demonstrates the importance of considering [nurse] work environment factors other than staffing when planning improvements that may affect patient care."

About four years ago, researchers at the same college of nursing conducted a study looking into factors that increased nurse-retention rates. They asked the same cohort of nurses about their “work-group cohesion.” Many reported the lack of adequate support from their supervisors; two-thirds said they had experienced verbal abuse. More than a third said they’d be looking for another job within the year, and those who had already left said they did so because of poor management and stressful work conditions.

I don’t think any of this is news to supervisors or management, and yet these adverse working conditions seem to persist in many institutions. It’s not surprising that these institutions may have problems filling their nursing positions, while hospitals with reputations as excellent work places actually have waiting lists.

What do you think nurses want most in the workplace?

What amenities do you think attract nurses to a hospital, clinic or long-term care facility?

Tell us about it.


Connie the Travelin' Woman! said...

I think nurses want to take excellent safe care of their patients.

Unfortunately, there are many stressors including doctors who are rude, nurse to nurse incivility, situations beyond our control re: meds, doctors' timing, etc. In addition, basics such as bathroom and lunch are often the casualties of a hectic shift.

The acuity of patients is on the rise; we have the same number of nurses dealing with much more sick patients.

All in all, it makes for an anxiety ridden environment. Younger nurses are not staying in this direct care model; they are moving on and out. Older nurses are retiring. And in the whole mix, many nurses area simply leaving jobs where we feel we can not provide safe, effective care anymore.

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Dave said...

Having viewed this blog, I realized that there is a more deeper meaning to being a nurse. It's not just the benefits, etc. But it's about the love you have for patient care. Thanks for the post.

Anonymous said...

I graduated from nursing school a year ago, and had to work in home health to earn income. dont get me wrong, i enjoyed home health, but wanted to work in a clinical setting. Eight months ago I began working on a very fast paced high acuity telemetry floor. I had three months training with a mentor,and was basically thrown out on the floor with, sometimes 7 patients. I work evenings, and feel as though i am being bullied regularly by the day shift, especially at shift report. I will go out of my way to make sure I have labs....and, each report I'll get asked some random question just to make me look incompetent. If I can't finish a task, and need to pass it on, I have experienced eye rolling, and rude remarks. I had a question about Lovenox, one nurse shouted in front of the rest of her team, "Anyone with a brain should know that." I find myself hoping to be called off. When I drive to work my stomach aches. I love my patients too, but its my fellow nurses who are hindering my career. Any advice/

David said...

wow! Hi anonymous! Don't worry, your just experiencing a stage in your life where you must be able to overcome. Don't let them be your hindrances, but let them be your stepping stones!

Anonymous said...

It is just now coming to light the type of bullying you are describing. It is not uncommon for more experienced nurses to put down those that are not in their circle. Though it is something that most new nurses have gone through it remains unacceptable, please find a kind nurse manager to discuss this with. This should be addressed by superiors as this is unprofessional conduct. Just because these types of occurences have been common place does not make it right!

Good Work and 5 Minds for the Future said...

Would it help if nurses had the opportunity to reflect with peers on the value of the work they perform? If surrounded by nurses with similar values, is it possible for nurses to perform good work in nursing: work that is excellent, ethical, and engaging.? I am interested in promoting a 'good work in nursing' global community.

LaCarla Holmes, MSN RN said...

Nurses just want to feel appreciated. At the present time, more emphasis is placed on other health care professionals such as physicians,practitioners, etc. I don't think enough emphasis is placed on the effort and committment nurses put into caring for patients. It takes a special person to care for individuals who are ill for the first time, or don't have a support system when facing a terminal illness. Our professions supports these patients and make sure they don't take this journey alone. We involve other disciplines in the planning phase of their plan of care and follow through to assure they receive the support needed to deal with this issue. We are also creatively paying attention to the families and offering support to them on a regular basis. Good nurses understand to treat patients, we must care for their families as well as the patient. Recognition and support would help recruit and retain nurses in today's society.