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Nurse Retention: Work Environment Issues for Nurses

Written by LeAnn Thieman, CSP, April 15th, 2014

Nurses report communication difficulties, workplace bullying and violence as serious work environment ethical concerns. This negatively affects nurse retention and nurse recruitment.

“The hierarchy or work structure do not encourage conversations,” said Carol Pavlish, RN, PhD, FAAN, associate professor at the UCLA School of Nursing in Los Angeles, who has studied early indicators of ethical challenges nurses face and has developed some strategies for helping.

“We are looking for ways that it becomes a community obligation to the patient, with collaNurse Retention Tools boration in answering questions and talking about issues,” Pavlish said.

Patient safety and staffing issues also fall into the work environment category. Pavlish found nurses reporting they do not have time to do what they intend for patients – helping them recover or adapt, or addressing patients’ emotional needs.

“They felt compromised and that some their moral obligations were not recognized by the system,” Pavlish said. Therefore, nurses often come away from a situation feeling they did not do good for those patients who did not receive optimal care.

Social media and personal boundaries also are part of the work environment concerns. Technology keeps evolving, blurring traditional rules about privacy and boundaries. Social media is a difficult problem for nurses, as to what they post and their relationships they with patients.

To learn more about creating safe positive environments for nurses, and how to increase nurse retention and nurse recruitment, check out SelfCare for HealthCare™. Please CONTACT ME to discuss customizing this powerful program for your nurses and healthcare staff.

3 responses to “Nurse Retention: Work Environment Issues for Nurses”

  1. Being able to communicate and collaborate on all levels helps the workplace environment. Also keeping the patient in that communication loop is a great reminder. Thank you for sharing, LeAnn.

  2. So what is the role of Nurse Leaders? the root cause of this issues is that nurse leaders apparently are those that get the job by “whom they know rather than what they know”. Some of the nurse leaders do not have the basic skill set of being a role model and fix unit level issues for nurses.

  3. Takeshi Rai says:

    Sounds like there are underlying issues at multiple levels. If “the hierarchy or work structure do not encourage conversations,” then, the structure at organizational level may not be aligned well for communication. I wonder how the decision making power and responsibilities are allocated.

    There are probably issues with work designs, too. The work has to be designed in a way that relys on interdependence or there is no point communicating and collaborating. Also, if the individual work responsibility is too narrow and small to make visible impacts on the final deliverable (e.g., peeling onions alone doesn’t show you a visible influence on making beef stew), you don’t really see the meaning in your work. If you don’t see how your work makes difference, you’ll eventually stop caring enough to communicate with people to improve the work because it’s a waste of time.

    Work environment issues are cultural/climate issues. Culture/climate starts from the top. Explicit message that what kind of environment the leader wants must be communicated. Leading by example is important too. But are the leaders doing good job on these?

    What about selection of the nurse leaders as Shobha mentioned? If there is a perceived injustice in terms of career opportunities, that is a big motivation killer, too. Not only to get the right person at the right position, you need fair and structured selection system to promote fairness in the workplace or people can easily get complacent. You don’t feel safe to practice open communication at workplace with unfairness, either.

    Also, the nurse who takes the leadership position has to get organizational support to get prepared for it; development system has to be institutionalized to always support the potential new leaders. You cannot just throw someone a new responsibility without sufficient guidance, training, and resources.

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