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3 Ways CNOs Can Improve Workplace Culture

Analysis  |  By Jennifer Thew RN  
   November 22, 2019

From addressing workplace violence to fostering mentoring, CNOs are creating workplace cultures that support nurses and enable them to grow in their careers.

What kind of reputation does your organization have when it comes to workplace culture? This is a question to take seriously, as workplace culture can affect everything from recruitment and retention of staff to quality of nursing care.

Dissatisfaction with the work environment was the most commonly cited reason nurses leave their positions, according to the 2018 Press Ganey Nursing Special Report: Optimizing the Nursing Workforce: Key Drivers of Intent to Stay for Newly Licensed and Experienced Nurses.

The nurse work environment, and how nurse leaders can positively influence it, was one of the topics discussed during the 2019 HealthLeaders CNO Exchange at Ojai Valley Inn in Ojai, California, from November 13–15. CNOs are striving to address culture and create workplaces where nurses can excel professionally and deliver optimal patient care.

Here are three ways CNOs are developing healthy work environments and supportive nursing cultures to enable nurses to flourish and achieve professional success.  

1. Make personal connections with staff

Today's nursing workforce expects nurse executives to be visible, accessible, and approachable.

For Gloria Carter, MSN, RN, CNO at Dignity Health St. Mary Medical Center in Long Beach, California, this means connecting with staff in one-to-one meetings so she can get a sense of where nurses need assistance and how she can improve as a leader.

"I always say, 'How am I doing? What can I do to support you?' " she says.

These meetings help Carter identify and remove stumbling blocks so her staff can work at an optimal level.

"It's about figuring out the rocks in their shoes," she says.

Leaders must work quickly and efficiently to resolve issues that are throwing a wrench in nurses' workflow, says Katie Boston-Leary, PhD, MBA, NEA-BC, vice president and system CNO at University of Maryland Capital Region Health in Cheverly, Maryland.

"A nurse is only as good as their last shift," she says.

2. Create mentoring opportunities

The retirement of experienced nurses is a real issue facing CNOs. According to the AMN Healthcare 2017 Survey of Registered Nurses, the percentage of nurses planning to retire in less than a year was 27% in 2017.

Many nurse executives are interested in finding ways to help experienced nurses share decades of skills and knowledge with the younger generation of nurses.

Erin LaCross, DNP, NEA-BC, CENP, CNO at Parkview Health in Fort Wayne, Indiana, points to her organization's Emeritus Nurse program that is aimed at mitigating the effects of knowledge gaps as experienced nurses retire.

The program not only provides an alternative to retirement by offering flexible scheduling options, it also serves to create a mentoring environment to transfer knowledge to new nurses. By offering flexible work hours and roles designed to enhance mentorship, Parkview has rehired 21 nurses who retired between 2013 and 2016.

At Woodlawn Hospital in Rochester, Indiana, Paula McKinney, DNP, RN, FCN, NE-BC, vice president, patient services, is teaming up physicians with nurse residents. For example, a nurse resident may be paired with an orthopedic surgeon. The nurse will see patients in the physician's office before surgery, in the operating room, during recovery on the acute care unit, and then during postop follow-up visits in the physician's office. This allows the nurses to dive deeper into understanding the continuum of patient care.

3. Ensure safe workspaces

Workplace violence has been an issue of concern for CNOs over the past few years. And for good reason.

Almost half of emergency physicians and about 70% of emergency nurses have been physically assaulted at work, according to surveys by the American College of Emergency Physicians and the Emergency Nurses Association.

"We need to approach [workplace violence] with more than just force," said Theresa Murphy, RN, MS, CENP, CNO at USC Verdugo Hills Hospital in Glendale, California, says.  

Leadership must support employees by crafting policies and procedures to keep them safe. That includes seeking nurse input as CNOs develop these standards.

"There is a critical place at the table for nurses in talking about workplace violence, Murphy says.

In the case of violent attacks on staff members, nurse leaders should connect directly with employees and offer to listen and help them find resources of support if necessary. For example, if an employee is injured as a result of workplace violence, Boston-Leary says she sends a personal note to the employee and extends an invitation to meet with her for coffee.

The HealthLeaders CNO Exchange annually gathers leading hospital and health system CNOs for a custom dialogue on only the critical issues facing the future of nursing. For more information, please email exchange@healthleadersmedia

Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.

Photo credit: HealthLeaders 2019 CNO Exchange roundtable discussion. Photo by David Hartig.

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