Intimidated by the physician, a nurse does not question a medication order that seems incorrect. A medication error occurs.
A nurse notices an increase in ectopic beats, but doesn’t call the attending physician, who is notorious for ridiculing staff members. The patient goes into cardiac arrest and dies.
A nurse manager assigns obstetric nurses to the short-staffed critical care department. Patient care suffers.
These are just a few examples of unhealthy work environments. Evidence suggests that such work environments contribute to medical errors and ineffective care as well as conflict and stress among healthcare professionals, which ultimately affect nurse recruitment and retention. In fact, many experts believe the nursing shortage will only be resolved by developing healthy work environments for nurses.
Recognizing the relationship between quality work environments and quality nursing practice and patient outcomes, the American Association of Critical-Care Nurses (AACN) created an advocacy initiative to promote the development of healthy work environments wherever acute and critical care nurses practice. The AACN believes that all workplaces can be healthy, but to accomplish this, nurses and employers must address the physical working environment as well as less tangible obstacles to staff and patient safety. This requires an understanding of the factors that contribute to unhealthy work environments as well as a commitment to embracing solutions.
Six Standards that Set the Stage
To promote understanding of these factors, the AACN identified several components of healthy work environments. Within organizations, these standards set the stage for reflection and open dialogue about current work environments and how to improve them.
These are the six AACN Healthy Work Environments Standards and the skills that nurses need to create and sustain healthy work environments:
1. Skilled Communication: Nurses’ communication skills must be as sharp as their clinical skills.
2. True Collaboration: Nurses must pursue and foster true collaboration.
3. Effective Decision Making: Nurses must act as full partners in making policies, leading organizations, and evaluating patient care.
4. Appropriate Staffing: Staffing must carefully match patient needs with nurse competencies.
5. Meaningful Recognition: Nurses must receive recognition—and recognize others—for their value to the organization.
6. Authentic Leadership: Nurse leaders must commit to the goal of a healthy work environment, practice it, and encourage others to help achieve it.
These standards align directly with the Institute of Medicine’s core competencies for healthcare professionals. They also support the education of all healthcare professionals.
Mosby’s eLearning is committed to helping organizations develop healthy work environments. In partnership with AACN, Mosby’s eLearning developed an online version of the Healthy Work Environments Standards, which features discussion points to help nurses dialogue with their managers and educators about the work environment.
According to Stephanie Bennett, Clinical Editor for Mosby’s eLearning, “The lessons on healthy work environments standards provide practical information to help nurses address intimidating and disruptive behaviors as well as other issues that affect the provision of safe, quality patient care.”