Nurses’ work environments are stressful. So what’s the plan?
There is mounting evidence that the overall patient satisfaction scores are directly related to nurses’ domain scores. Meaning, if the services delivered by nurses get high scores, the overall hospital scores will sure to be high.
Therefore, it is now understood in the healthcare industry that it is the nurse who impacts the patient’s care experience the most.
Patient satisfaction scores are progressively falling under the pay-for-performance programs, which means that the higher these scores are, the more secure the hospital revenue will be for the care provided.
This puts pressure on nurses at the bedside and all nurse leaders.
At the same time, the rate of clinical and work process changes in healthcare are going straight up for nurses, which impact nurses’ time and interpersonal availability with patients, which impact patient satisfaction scores.
So the question again is, what’s the plan?
There has been much work and large-scale advancements in creating healthy and productive work environments for nurses.
Several robust programs have advanced nursing’s effectiveness and professionalism over the past decades, the Magnet Recognition Program, Transforming Care at the Bedside, Relationship-Based Care, Care Innovation and Transformation and others. These have significantly raised nurse satisfaction levels throughout hundreds of hospitals and clinical settings.
Strong nurse satisfaction does correlate to higher patient satisfaction.
And yet here we are at the crossroads of the patient experience being spotlighted and healthcare demands rising, with all eyes on nurses.
This is an opportunity for nurse leaders to step back and refresh.
The patient experience is highly dependent on nurse engagement and at times deep engagement, where the nurses’ authentic presence creates a caring moment and event, when it counts for patients and families, and, as it turns out, for nurses.
These caring moments are career sustaining events for nurses.
These events bring meaning to nursing.
These events are critical for nurses and patients.
There has been much discussion in nursing literature on what makes a caring moment between a nurse and patient, where the nurse is authentically present with caring consciousness.
What we know about these authentic caring moments is that they cannot be enacted by policies, procedures, programs or job descriptions.
Productive and healthy work environments do make a difference in nurse engagement.
Yet despite all the structural and professional elements that enhance work environments, nurse engagement does not occur on the level hoped for.
This is heard from nurses who long for meaning in their practice and personal satisfaction. We hear it in nurse burnout. “Burnout doesn’t happen because we care too much, it’s because we wall ourselves off from love and nourishment and human connectedness” (*Jean Watson). Nurses often see their work environments as not conducive for caring moments. The stress and the rapid changes are too much to integrate the clinical demands and the deep interpersonal.
Our healthcare work environments are not going to get easier.
Caring moments and events are interpersonal moments between a nurse and a patient. They do require skills; skills as critical as clinical skills. These skills are inward. And they do require nurturing, growth and development.
To date, we as nurse leaders have relied on individual nurses to nurture their own inward skills.
But the stage is bigger now.
This is an opportunity like no other.
Our Call to Action is to integrate the nurses’ clinical world and their caring consciousness world.
*Jean Watson. Caring Science, Mindful Practice class on Canvas Network. 2016.