Authentic Leaders Creating Healthy Work Environments for Nursing Practice

2006 ◽  
Vol 15 (3) ◽  
pp. 256-267 ◽  
Author(s):  
Maria R. Shirey
Keyword(s):  
Work Environment ◽  
Authentic Leadership ◽  
Nursing Practice ◽  
Healthcare Delivery ◽  
Work Environments ◽  
Nursing Workforce ◽  
Healthcare Delivery System ◽  
Healthy Work Environment ◽  
Healthy Work ◽  
Healthy Work Environments

Implementation of authentic leadership can affect not only the nursing workforce and the profession but the healthcare delivery system and society as a whole. Creating a healthy work environment for nursing practice is crucial to maintain an adequate nursing workforce; the stressful nature of the profession often leads to burnout, disability, and high absenteeism and ultimately contributes to the escalating shortage of nurses. Leaders play a pivotal role in retention of nurses by shaping the healthcare practice environment to produce quality outcomes for staff nurses and patients. Few guidelines are available, however, for creating and sustaining the critical elements of a healthy work environment. In 2005, the American Association of Critical-Care Nurses released a landmark publication specifying 6 standards (skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership) necessary to establish and sustain healthy work environments in healthcare. Authentic leadership was described as the “glue” needed to hold together a healthy work environment. Now, the roles and relationships of authentic leaders in the healthy work environment are clarified as follows: An expanded definition of authentic leadership and its attributes (eg, genuineness, trustworthiness, reliability, compassion, and believability) is presented. Mechanisms by which authentic leaders can create healthy work environments for practice (eg, engaging employees in the work environment to promote positive behaviors) are described. A practical guide on how to become an authentic leader is advanced. A research agenda to advance the study of authentic leadership in nursing practice through collaboration between nursing and business is proposed.

Implementing AACN’s Healthy Work Environment Framework in an Intensive Care Unit

2021 ◽  
Vol 30 (6) ◽  
pp. 426-433
Author(s):  
Kelly Kester ◽  
Heather Pena ◽  
Catherine Shuford ◽  
Corrie Hansen ◽  
Jason Stokes ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Work Environment ◽  
The United States ◽  
Work Environments ◽  
Staff Satisfaction ◽  
Nurse Turnover ◽  
Healthy Work Environment ◽  
Healthy Work ◽  
Healthy Work Environments

Background Bedside nurse turnover in the United States is 15.9%, representing a national challenge that has been attributed to poor work environments. Healthy work environments are associated with improved nurse satisfaction and retention as well as positive patient outcomes; unhealthy work environments have the opposite effects. Objectives To implement the American Association of Critical-Care Nurses (AACN) healthy work environment (HWE) framework in an intensive care unit and to evaluate staff satisfaction, turnover, and tenure 2 years later. Methods A pre-post study design was used to evaluate implementation of the HWE framework in an intensive care unit in a large academic medical facility. Interventions for each of the 6 HWE standards were performed. The AACN HWE assessment survey was used to measure skilled communication, true collaboration, effective decision-making, appropriate staffing, meaningful recognition, and authentic leadership in 2017 and in 2019. Results Nurse cohorts (n = 165 in 2017; n = 176 in 2019) had a mean age of 31 (median, 27; range, 23-63) years, were predominantly female (76%), and had a mean of 5 (median, 3) years of intensive care unit nursing experience. Statistically significant improvements were found in all standards except the skilled communication and overall measures. Registered nurse turnover remained stable and tenure increased by 79 days in this 2-year period. Conclusions Findings from this study suggest that interventions addressing the HWE standards are associated with improved staff satisfaction, turnover, and average tenure, further demonstrating the value of the HWE framework in improving retention.

Changing the Work Environment in Intensive Care Units to Achieve Patient-Focused Care: The Time Has Come

2006 ◽  
Vol 15 (6) ◽  
pp. 541-548 ◽  
Author(s):  
Kathleen McCauley ◽  
Richard S. Irwin
Keyword(s):  
Critical Care ◽  
Work Environment ◽  
American Association ◽  
Care Delivery ◽  
Professional Community ◽  
Critical Care Nurses ◽  
Work Environments ◽  
Care Practice ◽  
Healthy Work ◽  
Healthy Work Environments

The American Association of Critical-Care Nurses Standards for Establishing and Sustaining Healthy Work Environments and the American College of Chest Physicians Patient-Focused Care project are complementary initiatives that provide a road map for creating practice environments where interdisciplinary, patient-focused care can thrive. Healthy work environments are so influential that failure to address the issue would result in deleterious effects for every aspect of acute and critical care practice. Skilled communication and true collaboration are crucial for transforming work environments. The American College of Chest Physicians project on patient-focused care was born out of a realization that medicine as currently practiced is too fragmented, too focused on turf battles that hinder communication, and too divorced from a real understanding of what patients expect and need from their healthcare providers. Communication as well as continuity and concordance with the patients’ wishes are foundational premises of care that is patient-focused and safe. Some individuals may achieve some level of genuine patient-focused care even when they practice in a toxic work environment because they are gifted communicators who embrace true collaboration. At best, most likely those efforts will be hit-or-miss and such heroism will be impossible to sustain if the environment is not transformed into a model that reflects standards and initiatives set out by the American Association of Critical-Care Nurses and the American College of Chest Physicians. Other innovative models of care delivery remain unreported. The successes and failures of these models should be shared with the professional community.

Healthy Work Environments, Nurse-Physician Communication, and Patients’ Outcomes

2007 ◽  
Vol 16 (6) ◽  
pp. 536-543 ◽  
Author(s):  
Milisa Manojlovich ◽  
Barry DeCicco
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Work Environment ◽  
Intensive Care Units ◽  
Medication Errors ◽  
Work Environments ◽  
Physician Communication ◽  
Practice Environment ◽  
Healthy Work ◽  
Healthy Work Environments

Background Adverse events and serious errors are common in critical care. Although factors in the work environment are important predictors of adverse outcomes for patients, communication between nurses and physicians may be the most significant factor associated with excess hospital mortality in critical care settings. Objectives To examine the relationships between nurses’ perceptions of their practice environment, nurse-physician communication, and selected patients’ outcomes. Methods A nonexperimental, descriptive design was used, and all nurses (N=866) working in 25 intensive care units in southeastern Michigan were surveyed. The Conditions for Work Effectiveness Questionnaire-II and the Practice Environment Scale of the Nursing Work Index were used to measure characteristics of the work environment; the ICU Nurse-Physician Questionnaire was used to measure nurse-physician communication. Nurses self-rated the frequency of ventilator-associated pneumonia, catheter-related sepsis, and medication errors in patients under their care. Results A total of 462 nurses (53%) responded. According to multilevel modeling, both practice environment scales accounted for 47% of the variance in nurse-physician communication scores (P=.001). Nurse-physician communication was predictive of nurse-assessed medication errors only (R2=0.11). Neither environment scale was predictive of any of the patient outcomes. Conclusions Healthy work environments are important for nurse-physician communication. In intensive care units, characteristics of the work environment did not vary enough to be significantly predictive of outcomes, suggesting that even in various types of critical care units, characteristics of the work environment may be more similar than different.

The Relationship Between Critical Care Work Environment and Professional Quality of Life

2020 ◽  
Vol 29 (2) ◽  
pp. 145-149 ◽  
Author(s):  
Marissa Monroe ◽  
Elizabeth Morse ◽  
Joseph M. Price
Keyword(s):  
Quality Of Life ◽  
Critical Care ◽  
Work Environment ◽  
Authentic Leadership ◽  
Compassion Satisfaction ◽  
Professional Quality Of Life ◽  
Healthy Work Environment ◽  
Professional Quality ◽  
Healthy Work

Background Professional quality of life is the quality a person feels in relation to work. For critical care nurses, it is composed of compassion satisfaction and compassion fatigue. Professional quality of life is affected by work environment. The American Association of Critical-Care Nurses (AACN) has identified 6 standards for a healthy work environment. Objective To explore which of the AACN healthy work environment standards have the strongest impact on professional quality of life in critical care nurses. Methods In an exploratory, cross-sectional survey of nurses working in 4 adult critical care units of a single health care facility, professional quality of life was assessed using the Professional Quality of Life Scale (ProQOL), and work environment was evaluated using the AACN Healthy Work Environment Assessment Tool. Results Participants reported compassion satisfaction and burnout levels as average and secondary traumatic stress levels as high. The composite average for all 6 AACN healthy work environment standards was good. A multiple regression analysis revealed true collaboration, effective decision-making, and authentic leadership as significant predictors of compassion satisfaction. Authentic leadership was the only predictor of burnout. Appropriate staffing, meaningful recognition, and authentic leadership were predictors of secondary traumatic stress. Conclusion Authentic leadership is the strongest predictor of compassion satisfaction, burnout, and secondary traumatic stress. Therefore, improving leadership should be a priority in intensive care units seeking to improve nurses’ professional quality of life.

Nurse Managers Leading the Way: Reenvisioning Stress to Maintain Healthy Work Environments

2021 ◽  
pp. e1-e7
Author(s):  
Kimberly Dimino ◽  
Amy E. Learmonth ◽  
Christiam C. Fajardo
Keyword(s):  
Critical Care ◽  
Work Environment ◽  
Nurse Managers ◽  
American Association ◽  
Critical Care Nurses ◽  
Work Environments ◽  
The Real ◽  
Experience Of Stress ◽  
Healthy Work ◽  
Healthy Work Environments

Background Stress among nurses is well documented, and in the midst of the coronavirus disease 2019 pandemic, it has reached record highs. Problem Under normal conditions, nurse managers and frontline nurses face stressors that come with the territory of their profession, but the coronavirus disease 2019 pandemic has greatly added to their burden. Nurse managers are being called not only to help their organizations manage the crisis operationally, but also to help the nurses they supervise mentally, emotionally, and even ethically. Discussion This article provides recommendations for how nurse managers can use the American Association of Critical-Care Nurses Healthy Work Environment standards and make the experience of stress more productive. Conclusion Stress comes with the territory in nursing, but nurses can work together to make stress their ally and not their enemy. The real enemies are coronavirus disease 2019, burnout, and the aftermath of uncontrolled stress. When nurses keep stress in perspective and focus on what they can control, they contribute to developing healthier work environments.

scholarly journals Critical Care Nurse Work Environments 2018: Findings and Implications

2019 ◽  
Vol 39 (2) ◽  
pp. 67-84 ◽  
Author(s):  
Beth Ulrich ◽  
Connie Barden ◽  
Linda Cassidy ◽  
Natasha Varn-Davis
Keyword(s):  
Job Satisfaction ◽  
Critical Care ◽  
Work Environment ◽  
Critical Care Nurses ◽  
Work Environments ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Healthy Work Environment ◽  
Healthy Work ◽  
Nurse Outcomes

BACKGROUNDThe health of critical care nurse work environments affects patient and nurse outcomes. The results of the 2018 Critical Care Nurse Work Environment Study are reported here with comparisons to previous studies and recommendations for continued improvement.OBJECTIVETo evaluate the current state of critical care nurse work environments.METHODSAn online survey was used to collect quantitative and qualitative data for this mixed-methods study. A total of 8080 American Association of Critical-Care Nurses (AACN) members and constituents responded to the survey.RESULTSThe health of critical care nurse work environments has improved since the previous study in 2013; however, there are still areas of concern and opportunities for improvement. Key findings include documented absence of appropriate staffing by more than 60% of participants; an alarming number of physical and mental well-being issues (198 340 incidents reported by 6017 participants); one-third of the participants expressed intent to leave their current positions in the next 12 months; and evidence of the positive outcomes of implementing the AACN Healthy Work Environment standards.CONCLUSIONEvidence of the relationship between healthy nurse work environments and patient and nurse outcomes continues to increase. The results of this study provide evidence of the positive relationship between implementation of the AACN Healthy Work Environment standards and the health of critical care nurse work environments, between the health of critical care nurse work environments and job satisfaction, and between job satisfaction and the intent of critical care nurses to leave their current positions or stay.

Sign in / Sign up

Export Citation Format

Share Document