As healthcare has become more complex, so has the profession of nursing. Let’s face it, nursing is a multi-faceted, sometimes stressful job that requires a highly dedicated workforce. With the current industry focus on issues like hospital-acquired infections and patient satisfaction scores, it’s more important than ever for frontline nurses to be able to deliver high quality care in a rapidly changing industry – and to play a critical role in transforming the way care is delivered.
A lot has been written on the topic of worker “engagement” in all industries. Engaged workers are defined as those who are fully involved in and enthusiastic about their work, and therefore will act in ways that will further the interests of their organization. In all industries, high worker engagement is usually correlated with higher productivity levels, creative problem solving, and innovation.
In nursing, engagement can be viewed as the exact opposite of burnout. When nurses are engaged, everyone wins. Floor nurses are more satisfied with their jobs and their work-life balance. Since they are less likely to leave a job or the nursing profession entirely from burnout, nurse managers spend less time recruiting and training new hires. And when nurses are engaged in their jobs, their patients also win: research published by Gallup indicates that the level of nursing engagement at a facility is a reliable predictor of mortality and complication rates.
So how do we go about building a culture that fosters and supports clinical engagement in nurses? There are three key stakeholders, as discussed below.
- The organization. The best hospitals deliberately support clinical engagement among nurses. The Magnet Recognition program, which recognizes hospitals for quality care and nursing excellence, has a strong focus on driving nurse engagement. Magnet hospitals tend to foster greater autonomy among nurses through shared decision making, greater collaboration with physicians, and more opportunities for professional development. Not surprisingly, research reveals that nurses at Magnet hospitals are significantly more engaged in their work than nurses at other hospitals, reporting greater job satisfaction.
- Nurse managers. In any industry, the employees’ direct manager is a key contributing factor to whether they love or hate coming to work. Nursing is no exception. An ineffective nurse manager can either build morale or break it on a unit, so engaged managers are crucial to building a culture of engagement. Effective nurse leaders never underestimate the importance of listening with empathy and the goal of understanding another point of view. They have acquired, either through education or experience, a sense of personal empowerment. They feel like important stakeholders in their workplace and the processes that keep it running. And they feel capable of identifying areas that need improvement and working to bring about transformation, for the benefit of both their staff nurses and the patients.
- Staff nurses. Engaged nurses are empowered to solve problems, advocate for patients, and embrace quality initiatives designed to elevate patient care. Research has demonstrated that rates of healthcare-associated infections drop when nurses are engaged – most likely because engaged nurses are more likely to comply with hand hygiene and other infection prevention protocols, and to more actively monitor patients with risk factors. Patient satisfaction scores are also affected. Both a Gallup study and Joint Commission research have found a strong correlation between engaged nurses and high patient satisfaction. Perhaps most importantly, when the majority of the nursing staff is engaged, each individual nurse can count on working with competent and supportive colleagues.
The Magnet Recognition Program helps to demonstrate the role of education in clinical engagement. Magnet hospitals have a high percentage of BSN-prepared nurses and that seems to contribute to a more engaged nursing workforce. A BSN program helps nurses to develop critical thinking skills and improve existing communication skills. It can open minds to new ideas and new models of care – resulting in the highest possible standard of patient care that you’re able to provide. Perhaps this is why such a large body of research has linked BSN-prepared nurses with better patient outcomes.
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