Nursing Satisfaction, Part 1: Strategies for Improvement

 

My post this month is inspired by comments and feedback generated from previous blogs about patient satisfaction. It was not only the sheer number of comments that struck me, but also the passion in them that speaks directly to me as a clinical professional.

I personally (100%) agree: nursing satisfaction is essential for patient satisfaction. Period.

It is key, and not only for patient satisfaction. It is a central part of the overall healthy work environment, safety, quality of care, and employee (nurse) turnover.1

Nurses are involved in the full patient journey

Nurses are an essential member of the patient care team. Nurses spend significantly more time with patients and families than any member of the care team. And nurses also interact with patients throughout their acute care journey.

Unequivocally, nurse satisfaction plays a critical role in improving work environment and quality of care.

Kieft and associates’ descriptive qualitative study evaluated the correlation between nurses’ work environment and patient experience of quality of care.1  For this post, I would like to focus on nurse satisfaction, and share a couple of programs that are evidence-based and identified as solutions for improving the complex factors that impact nursing satisfaction.

Nursing as a career

Last year, Medscape (Yox, 2017) invited nurses to participate in an online survey about compensation and career satisfaction. Their goal was to gather insight from nurses on career satisfaction. More than 10,000 nurses participated in the survey. The findings were published early this year.

Overall results revealed that nurses were satisfied with their career choice, and 95% of respondents said they were glad they became a nurse.3

When asked if they would do it all over again, nurses responded differently. A lower percentage of nurses said “yes,” while nearly 1 in 5 nurses indicated no.3 These results echo what has been previously published; nurses love what they do, however, not all would choose to do it again.

Nursing rewards and challenges

When asked for the single most rewarding part of their nursing job, many participants were challenged with narrowing it down to just one single part. The outcome resulted in “the gratitude expressed by patients for their excellent care” being in the top tier of all responses, along with “proud to be a nurse”, “nursing care”, and “relationships with patients”.

Next came the question, “What is least satisfying aspect of your job?” The answer at the top of the list turned out to be amount of documentation. Others included: workload, insufficient staff or resources, and excessive regulations, along with consistent themes around lack of support and respect.3

This information is not surprising, and is not new, although nursing practice continues to change and transform with new technology and advances in practice.

That brings me to this question: is enough being done to improve nursing satisfaction?

Nursing satisfaction improvements

The list of diverse activities implemented by nurse leaders and department committees is long, and yet, still more can be done.

I would like to highlight two programs offering researched strategies that have demonstrated success in improving nursing satisfaction.          

Nurse Satisfaction Survey

Have you participated in a nursing satisfaction survey?

If you have been a nurse for any length of time, I am sure you have participated in a satisfaction survey. This can be a rather routine experience; However, it can have significant impact toward improving the work environment. It all depends on your organization and leadership team.

In my experience, nursing participation and feedback was a significant part of improving the work environment. Yet, there are two parts to getting meaningful results from the survey. First is participation, and second is feedback that was an accurate summation of the previous year.

Participation is a slippery slope based on how it is viewed by nursing leadership and employees participating. Usually, participation in a satisfaction survey is highly encouraged and desired by nursing administration.

On the other hand, nurses view participation with some trepidation. They question if their voices will be heard, and wonder if providing negative feedback will result in repercussions. Finally, they wonder if they will see positive improvements because of the feedback provided.

One constraint to the nursing satisfaction survey and employee Gallop is related to the human condition. Feedback and comments are often based on recent experiences, and are not a true reflection of the year. We are only human after all. When faced with a survey that is designed to gain information on overall experiences, it is natural to think about events that occurred recently, perhaps over the last few weeks.

Hospitals implement employee Gallop and nursing specific satisfaction surveys (such as NDNQI), to obtain information about the satisfaction of employees, and specifically nurses. In some organizations, these results are pushed up to the top executive leaders and board of directors.

Medical Directors, Nurse Directors and Nurse Managers own these results, share them with the nursing team, and together work to develop a meaningful action plans for improving these results. No matter the results, there are always opportunities to improve, and nursing participation is the only way for this program to be successful.

Magnet Recognition Program

Magnet is a credential awarded to hospitals that demonstrate nursing excellence. It is a recognition program.

It was intended to be a recognition program for nurses, operated by the American Nurses Credentialing Center (ANCC). It is considered the highest recognition for nursing excellence.4

One of the goals of the Magnet program is to promote quality in the health care environment that supports professional and clinical practice and provides a mechanism for disseminating best practice in nursing service.4

Magnet credentialing identifies excellence in the delivery of nursing services to patients. It focuses on a healthy work environment for nurses and improving the quality of the work place. A key portion of the program includes engaging direct care nurses in their practice with shared governance.

I’ve worked at a hospital that was on the Magnet journey, and then later worked at a Children’s Hospital with Magnet credentialing. I fully understand it is not a perfect program, and it requires a huge team effort. It requires restructuring of many existing beliefs, attitudes, and practice.

Without a doubt, it is a huge initiative, requiring engagement and commitment not only from nursing, but every discipline in the hospital. With that said, it is worth the effort and growing pains to build a healthier work environment.

Magnet credentialing is a complex process, and is not quick fix solution. It is a robust program that provides well researched, proven strategies to improve quality of care, healthy work environment, communication and ultimately nurse satisfaction.

Isn’t that what we’re all after?

Moving nursing satisfaction forward

How does your hospital currently address nursing satisfaction? If not enough is being done, be proactive and involved with your management and education team. Ask questions. Find positive ways to address the topic and bring it to the forefront.

Do you have ideas to share? I’d enjoy reading them. Share them in the comments section below.

 

REFERENCES

1. Kieft, RA, Brouwer, BB, Francke, AL., DeInoij, DM. How nurses and their work environment affect patient experiences of the quality of care: a qualitative study. BMC Health Services Research. 14:249.
2. Kutney-Lee, A, McHugh, M, Sloane, D., Cimiotti, J, Flynn, L., Neff, DF., and Aiken, L. Nursing: Key to patient satisfaction. Health Aff (Millwood). 2009;28(4):w669-w677.
3. Yox, SB., Stokowski, LA., McBride M., Berry, E. Medscape Nurse Career Satisfaction Report 2016. 2017.
4. American Nurses Credentialing Center. Magnet Recognition Program Overview. 20–.  nursecredentialing.org