Unhealthy work environments can lead to a litany of problems for hospitals as they allow for the tolerance of disruptive behaviors from staff and physicians, poor communication, bullying, and little-to-no collaboration. This results in bad outcomes for patients and poor engagement and retention of staff. For example, when a staff member is bullied by another staff member or physician, the recipient of the bullying is hesitant to ask for help or creates a work-around situation rather than seeking help on behalf of a patient to obtain the necessary intervention or help required to deliver care to a patient. Everyone loses, especially the patient.
How do we create a healthy work environment?
Creating a healthy work environment, especially in healthcare, requires focused intent. Here are three critical ways to foster a healthy work environment as defined by the AACN.
(1) Require leaders and staff to learn and use skilled communication
When The Joint Commission (TJC) analyzed the root cause of sentinel events (death or permanent loss of function to a patient, TJC 2012) from 2004 through 2011, communication was the second highest root cause in hospitals.
Communication is a foundation of teamwork and quality care. “Nurses must be as proficient in communication skills as they are in clinical skills” (AACN, 2005).
In nursing school we are not taught how to respond to rude physicians or lateral violence, two serious issues that are barriers to effective patient care. We must learn to communicate effectively, professionally, and redirect the other person in those situations in order to solve the problem or get the needed assistance to care for our patient. It takes a team to care for a patient. No one can do it alone. In my workplace, I teach skilled communication to all my nurses (including new graduates) to support a healthy work environment and assist nurses in navigating the complex work of delivering nursing care.
“Skilled communication is the lubricant for true collaboration.” AACN (2005)
(2) Embed true collaboration within the culture as an expectation
True collaboration exists when all health care team members work as colleagues with the best interest of the patient at the center of care.
“Nurses must be relentless in pursuing and fostering true collaboration.” AACN (2005)
True collaboration does not tolerate hidden agendas, ineffective teamwork or disruptive behavior. When true collaboration exists, everyone wins. True collaboration is one of the six attributes of a healthy work environment according to the AACN (2005).
(3) Role model authentic leadership from nurse leaders (AACN, 2005)
Authentic leadership is another of 6 attributes of a healthy work environment identified by the AACN (2005).
“Nurse Leaders must fully embrace the imperative of a healthy work environment, authentically live it and engage others in its achievement” (AACN, 2005).
Nurse leaders hold the responsibility of empowering nurses to advocate for patients, fostering collaboration with all team members, and championing the attributes of a healthy work environment.
American Association of Critical-Care Nurses. (2012). AACN Standards for Establishing and sustaining healthy work environments: A journey to excellence. Retrieved from http://www.aacn.org/WD/HWE/Content/hwehome.content?menu=hwe
The Joint Commission. (2012). Sentinel Event Data, Root Causes by Event Type, retrieved from http://www.jointcommission.org/assets/1/18/Root_Causes_Event_Type_2004-2011.pdf