Creating a Healthy Work Environment

Abstract

“In Our Unit” highlights unique practices, innovations, research, or resourceful solutions to commonly encountered problems in critical care areas and settings where critically ill patients are cared for. If you have an idea for an upcoming “In Our Unit,” send it to Critical Care Nurse, 101 Columbia, Aliso Viejo, CA 92656; fax, (949) 362-2049; e-mail, ccn@aacn.org. The atmosphere of the units has begun to change ... from one of “why bother” to “we can do it!” Over the past year, I have become acquainted with the American Association of Critical-Care Nurses’ Standards for Establishing and Sustaining Healthy Work Environments (www.aacn.org/hwe) as our manager and staff strive to make our critical care units better places to work. I am a staff nurse and can already see the changes taking place in unit morale and staff retention. Our hospital has 2 critical care units that are separate from one another but share the same manager, educator, and clinical nurse specialist. One unit is a 15-bed intensive care unit (ICU) with medical-surgical-neurological patients. The other unit is an 18-bed adult critical care (ACC) unit—it was originally a progressive care unit but now the staff have been educated and trained to care for ICU patients. Staffing the 2 units requires a number of nurses and, consequently, we have many different personalities and skill levels providing nursing care for patients, in 2 distinct, high-stress environments. The ICU primarily deals with higher acuity patients and the ACC unit deals with more patient demands because a significant number of the ACC patients do not receive mechanical ventilation nor do they require the same level of care. Patient turnover is high, especially in the ACC unit, and the acuity is high enough on the ICU that frequently nurses on both units are not able to take lunch breaks. Adding to the complex, stressful environment is the reality that the 2 units will be merged into 1 unit within the next 5 years upon the completion of a new building at our suburban campus. In our shared governance committee, nurses, physicians, and other health care professionals can discuss problems and celebrations. The physicians, for the most part, have high regard for the nurses and vice versa. However, we needed to do more to ensure a healthy work environment for our staff. Our manager noticed that morale was low and that there was poor communication among employees and low satisfaction among the staff, particularly nurses. In order to help solve this problem, and to ease the transition to one combined unit, she suggested and helped us implement several strategies to make our work environment healthier.