Simple interventions can have a big payoff
You overhear a physician speaking disrespectfully to the triage nurse. A charge nurse complains about constantly feeling overworked. When you notice that a new staff nurse is often late, she acknowledges a problem with child care. The way you deal with everyday situations such as these can have a dramatic impact on the morale in your department, emphasizes Cynthia Russell, RN, MSN, director of the emergency department (ED) at Frederick (MD) Memorial Hospital. She credits morale-boosting activities with the ED’s vacancy rate of only 1.5% and low turnover rate of 2.5%. "Remember that nurses join organizations for a variety of reasons," says Russell. "However, the most common reason they leave is associated with the work culture, which is set by the manager."
Here are effective ways to boost morale of nursing staff:
1. Work with individual nurses.
Russell encourages you to directly approach staff when you notice a problem with job performance. There may be a simple solution, she says, but nurses may be reluctant to bring it up. "It may seem too minor a problem, a nurse may not want to ask for special favors, or sometimes the nurses just don’t want to admit that there is a limitation within themselves," she explains.
2. Plan social activities.
Russell reports that social activities are planned routinely in the ED, including monthly pizza parties and competitions with prizes. "You need to be sure that these happen on all shifts, not just the day shift," she notes. Russell says often pharmaceutical vendors agree to sponsor events in exchange for "a little air time." Activities often are linked to projects, such as a "pre-party" before an accreditation survey with drug representatives providing three meals so all shifts could participate. At the event, nurses took quizzes with sample survey questions, and names were entered into a drawing for gift certificates to local restaurants.
3. Have an individual in charge of morale.
Russell’s ED has a "chief morale officer," a.k.a. one of the charge nurses, who plans activities and checks in with the staff. "She is willing to come in on all shifts just to check on the staff. She asks what makes their job hard," she says. In addition, Russell says the charge nurse has a quarterly conference with every ED nurse. "This creates one-on-one time for staff to have with their direct supervisor and hear about any issues associated with their practice," she says. Together, Russell and the charge nurse monitor turnover rates, vacancy rates, and the number of staff complaints. (See list of responsibilities, below.)
| Here’s what a chief morale officer’ does
Here is a list of activities performed by the chief morale officer at the emergency department at Frederick (MD) Memorial Hospital:
|
4. Hold focus groups with ED nurses.
Russell has conducted three focus groups for nursing staff, held at the charge nurse’s home. "We have trained facilitators at our hospital, so I worked with one of them and conducted the meetings personally," she says.
Nurses were asked these three questions:
- Why did you come to work here?
- Why do you stay in our employment?
- Why would you leave?
"We learned that self-scheduling was highly valued, so we would never consider doing away with it," says Russell. "They also felt that they worked with friends who cared about them as people." The nurses were asked to name an obstacle that made their jobs harder, with an opportunity to give anonymous feedback. These three problems were identified:
— Poor communication with the physician staff. "We relayed the concerns to our chief, and he has been very supportive and addressing this issue with individual doctors," says Russell.
— Unavailability of blood pressure cuffs. "We now have a method in place to keep these reordered," Russell says.
— Triage and the ED’s acute care side being overloaded. As a result, the staffing model was reviewed and changed, Russell says.
The ED’s focus groups were so successful that the facility has implemented them hospitalwide, she reports.
5. Give staff flexible scheduling.
Because flexible schedules were identified by ED nurses as important, the charge nurse spends a significant amount of time working to meet the needs of individual nurses, says Russell. This includes matching up the schedule needs of nurses who need certain hours off with other nurses who can work those hours, she explains.
6. Offer support groups.
According to Terry Schneider, RN, BSN, CEN, an ED nurse at Tallahassee (FL) Memorial Healthcare, weekly support groups give ED nurses a feeling of connection with one another, which can increase productivity. He argues that nurses should be paid to attend support groups, and says it will result in improved morale, less burnout, and decreased staff turnover.
Schneider recommends that support groups have a maximum of eight nurses, with time allocated for each participant to discuss whatever he or she wants with the full attention of the group. The opportunity for discussion with a small group of co-workers doesn’t happen spontaneously in the ED, he says. "Yet, this is essential for maintaining emotional well-being in such a stressful working environment," he concludes.
Sources
For more information about staff morale, contact:
• Cynthia K. Russell, RN, MSN, Director, Emergency Department, Frederick Memorial Healthcare System, 400 W. Seventh St., Frederick, MD 21701. Telephone: (301) 698-3326. Fax: (301) 698-3946. E-mail: [email protected].
• Terry Schneider, RN, BSN, CEN, Tallahassee Memorial Healthcare, 1300 Miccosukee Road, Tallahassee, FL 32308. Telephone: (850) 431-7411. E-mail: [email protected].
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content