Promoting Nurse Wellbeing and Safety in Healthcare Environments

Supportive work environments are crucial for enhancing patient care and reducing nurse burnout. Improving nurse retention not only benefits patient outcomes but also creates a safer workplace. Addressing worker safety concerns in hospitals, including injuries and illnesses, is essential for a healthy workforce. Prioritizing the wellness of nurses contributes to a Healthy Nurse, Healthy Nation initiative, focusing on overall physical, emotional, and professional wellbeing.

• Nurse wellbeing
• Patient care
• Workplace safety
• Healthcare environment
• Supportive cultures

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1. New Jersey State Nurses Association Bally s Casino and Resort Atlantic City, New Jersey Creating Healthy Nurse Workplaces Dennis Sherrod, EdD, RN Professor and Forsyth Medical Center Endowed Chair of Recruitment & Retention Winston-Salem State University Winston-Salem, NC

2. Nurse Retention Improves Patient Care Supportive work environments are positively correlated with quality patient care (Aiken, Clarke, Sloane, Lake, & Cheney, 2008; Bogaert, Clarke, Vermeyen, Meulemans, & Heyning, 2009; Flynn, Thomas-Hawkins, & Bognar, 2016) Supportive work environments are negatively associated with burnout (Aiken, Clarke, Sloane, Lake, & Cheney, 2008; Bauklee, Fongkaew, Turale, Akkadechanunt & Sansiriphun, 2017; Hernandez, Stanley, & Miller, 2014) Nurses in hospitals with lower numbers of nursing staff more often reported nursing care quality as fair or poor (Aiken, Clarke, Sloane, Lake, & Cheney, 2008; Hill, 2017)

4. Worker Safety in Hospitals Hospital workers face higher incidence of injury and illness (6 cases per 100 FT workers) than manufacturing or construction Causes of injury Overexertion and bodily reaction (44%) Slips, trips, and falls (24%) Violence and other injuries by persons/animals (15%) Contact with objects or equipment (11%) Exposure to substances (5%) (OSHA, 2017)

5. Healthy Nurse,Healthy Nation Healthy Nurse: One who actively focuses on creating and maintaining a balance and synergy of physical, intellectual, emotional, social, spiritual, personal and professional wellbeing. (ANA, 2017)

6. ANA: Healthy Work Environment Top Health & Safety Risks Workplace stress (82%) Lifting/repositioning of heavy objects (42%) 75% have access to safe patient handling and mobility technology >50% report musculoskeletal pain at work Prolonged standing (37%) Needle sticks and other sharps injuries (35%) Blood-borne pathogens (33%) Infectious disease agents (30%) (ANA, 2014)

7. ANA: Healthy Work Environment Top Health & Safety Risks 60% reported working through their breaks and coming in early and/or staying late to accomplish work >50% reported usual shifts were 10 hours or longer Up to 50% had been bullied in the workplace Almost 25% had been assaulted at work Nearly 10% were concerned for their physical safety at work (ANA, 2014)

8. ANA: Healthy Work Environment Worksite Wellness Nearly 90% reported place of employment is tobacco-free Almost 70% had access to worksite wellness health promotion programs Less than 60% indicated they had access to healthy foods such as fruits, vegetables or whole grains during their work hours (ANA, 2014)

9. Maintain and Improve Your Health Exercise at least 30 minutes 4 to 5 times weekly Know family history Eat more fruits/vegetables and fewer processed foods Reduce stress Complete regular checkups, screenings, and immunizations Be a healthy workplace champion (Sherrod & Campbell, 2015)

10. Stress Busters Strengthen Your Hardiness Factor Commitment Control Challenge Boost Emotional Intelligence Self-Awareness Self-Management Social Awareness Supportive Relationships Appraise and Limit Engagement Clarify Competing Priorities (Sherrod & Campbell, 2015)

11. Personal Safety for Nurses Textile technology Fluid repellent and antimicrobial Better security Metal detectors Database flagging belligerent or aggressive patients Bulletproof glass Appropriate staffing Surveillance of pathogen exposures Participation in EPINet (International Safety Center s Exposure Prevention Information Network) (Harris, 2015)

12. WHO: Keys to Healthy Workplaces Leadership commitment and engagement Employee engagement Business ethics and legality Systematic, comprehensive process to ensure effectiveness and continuous improvement Sustainability and integration (WHO, 2010)

13. AACN Healthy Work Environment Standards Skilled Communication True Collaboration Effective Decision Making Appropriate Staffing Meaningful Recognition Authentic Leadership (AACN, 2017)

14. Creating and Sustaining Healthy Work Environments Quality Leadership Attributes and style Emotional intelligence Leadership competence Vision, advocacy, and messaging Relational Exchanges Leader-member engagement Communication Collaboration Teamwork (Shirey, 2017)

15. Creating and Sustaining Healthy Work Environments Relational Exchanges Shared decision making Respect and consideration Environmental Elements Supportive structures Access to resources Developmental opportunities (Shirey, 2017)

17. Work Engagement Engaged workers are energetic, enthusiastic, and absorbed by their work Relationships Fellow nurses Physicians Managers Teamwork improves engagement, job satisfaction, and retention Engaged nursing teams report better quality patient care (Van Bogaert, et al., 2013)

18. Be Passionate in Your Workplace Develop and maintain skills and competencies Build on experiences/expertise Identify areas for self-development Invest in yourself Maintain a passion for people

19. Bring Value to Your Workplace Objectively assess the value of what you do for your employer Be a problem solver Focus on strategic initiatives Quality patient care Patient satisfaction Quality improvement Patient centered care Developing a healthy workplace

20. Be Willing to Change Make change a part of your daily operation Be willing to try new things and develop new skills Imagine how the change will affect you to decrease feelings of uncertainty Many things people imagined they could not adjust to now we could never do without computers, Smartphones, copiers, voicemail, email, etc.

21. Remain Positive Demonstrate a positive attitude Under promise over deliver Remind yourself of your past successes Identify things for which you are thankful Develop solutions Assist others to develop a plan of action Work on a personal goal that energizes you

22. Health Care Retention Model Health Care Quality Workplace Leadership Meaningful Work Retention Focus

23. Stimulating Meaningful Work People are the focus Autonomy to make decisions Appropriate workload and patient interactions Variety of work Valued as colleague as part of the team Resources and support Opportunity to learn Feedback Understanding significant contributions

24. Motivational Leadership Champion change and remain open to new ideas Inspire a shared vision of organizational direction Motivate and recognize contributions Develop others Model behavior that reflects organization values Incorporate recruitment, retention, and workforce planning perspective

25. Recognition, Reward & Renewal Retention Focus Say Thank you for a job well done Reinforce desired behaviors Create an emphasis and focus on a healthy workplace Build self-esteem Celebrate success Enhance camaraderie and teamwork Mentor! Coach! Groom!

26. What Makes People Happy at Work? Appreciation Respect Trust Individual growth A good boss Compatible co-workers A sense of purpose

27. Develop Leader Competencies Emotional Intelligence Leader Developing a Vision Lifelong Learning Implementing a Vision

28. Emotional Intelligence Communication skills Interpersonal skills Empathy Realistic self-assessment Openness Request opinions of others Good listening skills

29. Lifelong Learning Motivation Curiosity Drive Initiative Enthusiasm Adaptability Desire to grow, develop and learn

30. Developing a Vision Creating vision Seeking challenges Risk taking Commitment Ability to see big picture Openness to different solutions

31. Implementing a Vision Ability to motivate others Maximize others to use skills Openness to different solutions Commitment Optimism Celebrate victories Recognize others

32. Keep yourself stimulated, challenged, and working towards a goal. Remind yourself each day you are making a difference in people s lives. Dennis Sherrod

33. References Aiken, L. H., Clarke, S. P., Sloane, D. M., Lake, E. T., & Cheney, T. (2008). Effects of hospital care environment on patient mortality and nurse outcomes. Journal of Nursing Administration, 38(5), 223 229. American Association of Critical Care Nurses. (2017). What makes a work environment healthy? Retrieved from https://www.aacn.org/nursing-excellence/healthy-work- environments American Nurses Association. (2014). Executive summary. American Nurses Association health risk appraisal (HRA). Retrieved from http://www.nursingworld.org/HRA-Executive- Summary American Nurses Association (ANA). (2017). Healthy nurse: Healthy nation. Retrieved from http://www.nursingworld.org/HealthyNurse-HealthyNation

34. References Bauklee, P., Fongkaew, W., Turale, S., Akkadechanunt, T., & Sansiriphun, N. (2017). Unveiling the experiences of happiness at work through narrative inquiry: Advanced practice nurses perspectives. Pacific Rim Int J Nurs Res. 21(3), 206-219. Bogaert, P. V., Clarke, S., Vermeyen, K., Meulemans, H., & Heyning, P. V. (2009). Hospital nurse practice environment, burnout, job outcomes and quality of care: Test of a structural equation model. Journal of Advanced Nursing, 65(10), 2175 2185. Dresser, M. (June, 2017). Hospital workers: An assessment of occupational injuries and illnesses. Monthly Labor Review, U.S. Bureau of Labor and Statistics. Retrieved from: https://www.bls.gov/opub/mlr/2017/article/hospital-workers- an-assessment-of-occupational-injuries-and-illnesses.htm

35. References Flynn, L., Thomas-Hawkins, C., & Bognar, L. (2016). Work environment characteristics valued by outpatient hemodialysis unit nurse managers. Nephrology Nursing Journal. 43(5). 403- 408, 446. Harris, T. S. (2015). Personal safety for nurses. Minority Nurse. Retrieved from http://minoritynurse.com/personal-safety-for- nurses/ Hernandez, B., Stanley, B., & Miller, L. (2014). Job embeddedness and job engagement: Recommendations for a supportive social work environment. Human Service Organizations: Management, Leadership & Governance. 38, 336- 347. Hill, G. (2017). Do nurse staffing levels affect patient mortality in acute secondary care? British Journal of Nursing. 26(12), 698- 704.

36. References Sherrod, D., & Campbell, L. R. (2015). Mental health tips for nurse managers. Nursing Management: The Journal of Excellence in Nursing Leadership. 46(6), 40-45. Shirey, M. R. (May, 2017). Leadership practices for healthy work environments. Nursing Management, 43-50. Van Bogaert, P., Wouters, K., Willems, R., Mondelaers, M., & Clarke, S. (2013). Work engagement supports nurse workforce stability and quality of care: nursing team-level analysis in psychiatric hospitals. Journal of Psychiatric and Mental Health Nursing, 20, 679-686. World Health Organization. (2010). Five keys to health workplaces: No business wealth without workers health. Retrieved from http://www.who.int/occupational_health/5keys_healthy_workp laces.pdf