Creating healthy work environments is a passion that unites nurses across generations, practice settings and all levels of leadership. It has been an area of focus and woven throughout every stage of my career, even as a bedside nurse. It’s refreshing to hear the conversations, initiatives and research on healthy and inclusive environments evolving over time. Many leaders have made substantial progress in eliminating bullying, reducing violence and creating interprofessional collaborative environments for all health care workers. Yet, our work is not done.
The last couple of years highlight that creating a healthy work environment is more of a journey than a destination. In 2020, the U.S. Bureau of Labor Statistics reported that individuals working in health care and social services were five times more likely to suffer a workplace violence injury than overall workers. In August 2021, the AONL COVID-19 longitudinal study identified that nearly six in 10 nurse leaders are “not emotionally healthy.” Moreover, in January the National Commission to Address Racism in Nursing published the results of a national survey with more than 5,600 respondents. From the report, we learned 63% of those surveyed have personally experienced an act of racism in the workplace with transgressors being a peer (66%), a patient (63%) or a manager (60%). These statistics are alarming and serve as a reminder our efforts to create healthy work environments must continue.
The last couple of years highlight that creating a healthy work environment is more of a journey than a destination.
As nurse leaders, we are continuously pivoting and trying different strategies to address our current challenges and adapt to an ever-changing workforce. Emerging best practices and research, advances in technology, and social media are all factors we must consider as we work toward creating safe, inclusive and psychologically safe environments for our team. In my organization, Norton Children’s Hospital in Louisville, Ky., we are taking a multipronged approach to reduce workplace violence, support our leaders and create more joy.
Keeping our team safe from aggressive patients and visitors is a top priority. All staff, including physicians and security officers, were trained on verbal de-escalation strategies. A core group of individuals also was educated on nonviolent crisis intervention. We minimized possible entry points, stationed an off-duty police officer in our emergency department and have security officers situated at locations that remain open. We also implemented more thorough visitor screening and posted a pledge in all care areas to promote an environment of mutual respect and belonging.
To respond to research demonstrating that health care leaders are experiencing burnout and emotional distress at alarming rates, we modified some of our historic practices. Recognizing that a leader’s burnout has a direct impact on their team’s satisfaction and engagement, we put measures in place to promote work-life harmony. Where possible we’ve reduced the length of meetings, created protected time on calendars for rounding and put guardrails in place for responding to emails, text messages and phone calls. We also enacted a work-from-home day, allowing leaders uninterrupted time off-site to accomplish tasks that take dedicated thought and focus.
One of the fun ideas we’ve implemented is an initiative called The Happiness Challenge, started in January 2020. The concept came from a group of nurse leaders who attended AONL’s 2019 annual conference. Their ideas evolved and eventually we kick-started the program with the 100 Days of Happiness Challenge. It gained great momentum and sparked friendly competition as staff and physicians from across the hospital participated. Leveraging social media, we focused on five main themes: resilience, camaraderie, self-expression, playfulness and healthy living. Each day a unique challenge was posed to the team, ranging from sharing pictures of pets to sharing pet peeves and everything in between. It was great reminder that although we have serious responsibilities, we don’t have to take ourselves seriously all the time.
I would be remiss if I didn’t take the opportunity to highlight some of the resources AONL has to promote healthy work environments. Over the last several years, we have convened key partners and collaborators to develop education, tools and resources to support nurse leaders. Our library of guiding principles alone provides strategies for mitigating violence in the workplace, nurturing stronger relationships among nursing and support staff in the clinical setting, creating value and meaning for the next generation of early careerists, and most recently, achieving diversity, equity, inclusion and belonging. I encourage you to take advantage of these rich documents in creating a healthy work environments for your teams.
I want to thank the authors in this month’s issue of The Voice of Nursing Leadership for sharing the strategies they have utilized to improve their work environment. There are some great tactics for connecting with clinical nurses, managing bullying behavior and building a resilient workforce. I hope the articles provide some additional approaches for you to consider and generate some innovative ideas for your team.
In addition, I want to recognize all our 2022 annual award nominees — we had some exceptional submissions this year! It was uplifting and inspiring to read all the accomplishments and contributions nurse leaders from across the country are making to our profession and health care overall. Having the opportunity to notify the recipients was a true honor and one of the highlights of my presidency. A special congratulations to the award recipients, Maureen Swick (Lifetime Achievement), Reynaldo Rivera (Exemplary Nurse Leader), Daryl and Hunter Joslin (Honorary Members), Jessica Quintana (Pamela Austin Thompson Emerging Leader), Atrium Health (Prism Award), Nora Warshawsky (AONL Foundation Researcher of the Year) and the Organization of Nurse Leaders – MA, RI, NH, CT, VT (Affiliate Achievement Award).