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

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.

Nurse Managers Leading the Way: Reenvisioning Stress to Maintain 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.

Envisioning an Ethical Climate in Nursing Education Programs

The importance of creating healthy and ethical work environments in the clinical setting has been a focus in nursing for several years. However, research has found that incidents of incivility and bullying occur in academia as well. Nurse educators often face complex situations in the academic workplace that have ethical implications, including relationships with each other, academic administrators, and students. A review of the evidence indicates that studies have considered the importance of creating an ethical environment in nursing practice, and incivility, but few have focused on healthy work environments in academia. This article presents the nine provisions of the ANA Code of Ethics for Nurses in the context of the nursing academic environment as a framework to discuss the philosophical and practical importance of envisioning an ethical environment within academic settings. Examples of relationships are provided that demonstrate a positive ethical climate or illustrate areas in need of reflection for improvement, with suggested implications for practice.

Increasing Critical Care Nurse Engagement of Palliative Care During the COVID-19 Pandemic

Background The coronavirus disease 2019 pandemic has led to escalating infection rates and associated deaths worldwide. Amid this public health emergency, the urgent need for palliative care integration throughout critical care settings has never been more crucial. Objective To promote palliative care engagement in critical care; share palliative care resources to support critical care nurses in alleviating suffering during the coronavirus disease 2019 pandemic; and make recommendations to strengthen nursing capacity to deliver high-quality, person-centered critical care. Methods Palliative and critical care literature and practice guidelines were reviewed, synthesized, and translated into recommendations for critical care nursing practice. Results Nurses are ideally positioned to drive full integration of palliative care into the critical care delivery for all patients, including those with coronavirus disease 2019, given their relationship-based approach to care, as well as their leadership and advocacy roles. Recommendations include the promotion of healthy work environments and prioritizing nurse self-care in alignment with critical care nursing standards. Conclusions Nurses should focus on a strategic integration of palliative care, critical care, and ethically based care during times of normalcy and of crisis. Primary palliative care should be provided for each patient and family, and specialist services sought, as appropriate. Nurse educators are encouraged to use these recommendations and resources in their curricula and training. Palliative care is critical care. Critical care nurses are the frontline responders capable of translating this holistic, person-centered approach into pragmatic services and relationships throughout the critical care continuum.

Esquierdo-Leal & Houmanfar (2020)

From a global pandemic to the killings of George Floyd, Breonna Taylor, Ahmaud Arbery, Rayshard Brooks and others in the Black community, the year 2020 has cast light on long-standing social injustices. With this has come a new social movement and a call for change. Specifically, a call for transformative solutions that address not only new challenges but centuries of systemic issues, such as systemic oppression and systemic racism. Leadership across the globe has scrambled to answer the call, some issuing statements committed to change, others engaging in necessary action. What is critical, however, is that leadership understands the cultural factors that have given rise to centuries of oppressive practices and that they are held accountable for the commitments they have expressed. Leadership must promote, create, and maintain prosocial, inclusive, and healthy work environments. This requires new cultural practices and a focused organizational model. Equally important is the need to resolve ambiguity and communicate effectively, with strategic consideration of constituent perspectives and needs. Therefore, the purpose of this paper is to discuss the contribution of behavior analysis in addressing systemic oppression as well as the pivotal role leadership communication plays in occasioning social change. It is our hope that this conceptual work will inspire behavior scientists to advance the field of behavior analysis and social movements in the direction of equitable, prosocial change that dismantles systemic oppression.

Employers as Shapers of Health

This chapter assesses the role of employers as Culture of Health mediators. With their significant influence over the lives of their workforce, employers have the authority to make choices that either promote or inhibit a Culture of Health within their organizations. They also may play important roles in building a Culture of Health in the communities in which they are located and where their employees live. The chapter then considers the approaches taken by three types of employers—Fortune 500 companies, a large retail chain, and the military. Two studies of Fortune 500 companies examine corporate transparency in reporting health-promotion policies and efforts to create healthy work environments and strengthen communities. Another study illustrates the feasibility of stabilizing work schedules of low-wage retail workers to benefit workers as well as store sales.

Guanxi HRM Practice and Employees’ Occupational Well-Being in China: A Multi-Level Psychological Process

Chinese employees may experience and respond to guanxi human resource management (HRM) practice (e.g., recruiting, selecting, inducting and appraising employees based on personal relationships). Little has been done to examine the linkage between guanxi HRM practice and employees’ occupational well-being. This study investigates the psychological process of how guanxi HRM practice affects employees’ occupational well-being. The theoretical model of this study proposes that employee psychological safety mediates the relationship between guanxi HRM practice and occupational well-being, while collectivistic team culture moderates the relationship between guanxi HRM practice and psychological safety. Multi-level data from 297 employees nested within 42 teams support all hypotheses. This study reveals the cross-level effects of guanxi HRM practice and providing practical suggestions for future research on psychologically safe and healthy work environments.

Workplace Bullying and It’s Impact and Remedies in the 21st Century Issues

This paper is prepared to see the concept of bullying and its impacts in the work place and suggest some remedies based on the empirical data. Then the rationale of this paper document is to address why and how businesses organization should promote healthy work environments, to stimulate awareness of WPB and its negative impact on employee health, to explore current and prospective anti-WPB laws, and to present employer and employee responsive strategies to combat this business challenge. This activity was performed by using introducing the topic, reviewing the existing literature and drawing conclusion which can help different organization to update their current position.