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Nursing Practice force with more demand than supply of nurses and other healthcare providers, is a formula for the perfect storm of an unhealthy work environment. Nurses are all too familiar with the nursing workforce trends of the past decade, including supply and demand, aging of nurses, compensation, and higher acuity of patients. Even with the lack of supply of nurses to meet current demands, especially in specialties like oncology, several elements are within the control of nurse leaders to support and inspire a healthy work environment.
Based on the forces of magnetism identified by the ANCC, nurse managers should focus on three primary priority forces: organizational structure, management style, and interdisciplinary relationships. Elements of an unhealthy work environment Today’s healthcare environment is fraught with challenges such as unfilled staffing vacancies, staff dissatisfaction, hostile/volatile work environment, recruitment, and retention as well as issues surrounding patient safety resulting from inadequate staffing, stress, and caregiver fatigue. Work environments that lack trust, collaboration, and teamwork are at risk. Organizations that fail to recognize unhealthy work environments will have a revolving door of nursing staff as a result of staff distress, dissatisfaction, and burnout. Aspects of an unhealthy work environment start with relationships between employees. Inherent in any relationship are attributes of trust, integrity, open and honest communication, transparency, and intention. A lack of any one of these attributes can derail the workplace and lead to an atmosphere that unintentionally fosters workplace aggression, violence, and discord. A healthy work environment is integral to averting the perfect storm. The organization’s reputation as a good or bad place to work will affect its recruitment efforts. Transforming the workplace environment The first step in creating a healthy work environment is to recognize and understand the signs of an unhealthy work environment. Often underreported, some forms of workplace violence do not involve physical violence. In a survey by Hader, types of workplace violence included intimidation, angry outbursts, hypersensitivity to criticism, and harassment.15 The players involved, includ-
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ing healthcare staff, nurses, physicians, patients, and visitors, were categorized as either victims or perpetrators. Intimidating, aggressive, and disruptive behavior in the workplace can undermine a culture of safety. Nurses should take an introspective look at their behaviors and identify where they may be the victim or perpetrator in any given situation.
Transforming the work environment will require transforming the organization’s culture, which will require commitments from every level of organizational leadership. Nursing leadership can implement key strategies to create positive workplace initiatives, including improving staffing levels and initiating programs centered on employee health and wellbeing, dignity, and respect. These pro-
grams will need to address psychosocial health, shared decision-making, and empowerment.16-18 The organization must adopt a zero-tolerance policy of unhealthy behaviors by employees, physicians, patients, and visitors. In addition, the organization must adopt a fair and just culture that supports a no-blame and punitive-free reporting system. Some Continued on page 10
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