Any nurse knows a well-run unit has excellent staffing and dedicated workers. But such a cohesive environment also has something not so easily defined, says Dr. Jeannie Cimiotti, DNSc, RN, an associate professor at Rutgers University College of Nursing and the executive director of the New Jersey Collaborating Center for Nursing.
The key, she says, is the organization's climate, one that supports nurses and nursing work from the top down. Because you never know what might happen on any given day, adequate staffing is important, but what really makes a nurse's job easier isn't always the number of patients he or she is charged with or the number of hours worked every week. Rather, says Cimiotti, it is the feeling that your colleagues have your back and that your work as a nurse is valued throughout the organization.
While many places are starting to recognize how all these factors work together, nurses have known it, and lived it, for years. When Dr. Marlene Kramer studied nursing in the 1980s, she and her colleagues found the best run medical facilities have some of the same characteristics as the top corporations. “They had good work relationships and all worked together for the good of the organization or of the patient,” Cimiotti says. Simply put, if nurses are overworked and not supported, the quality of care suffers and costs increase.
What can you do if you don't feel supported by your organization or if, as a supervisor, you would like to see your unit operating more effectively?
Cimiotti suggests taking steps with your colleagues first and then branching out to eventually include the higher ups in your workplace. “You have to develop a culture on the unit and make sure everyone is working for the good of the patient,” she says. A supervisor can analyze satisfaction surveys and bring in the team to brainstorm ideas for improvement. Maybe patients are unhappy with something that can be easily fixed. As a staff nurse, you can bring attention to a procedure that can be done differently or follow up on a suggestion from a patient to improve care in some way.
Be sure the whole nursing team is involved including senior RNs, new nurses, LPNs, and aides. Everyone is vital to the team and when all nurses feel like their voices are being heard, they will work as a team of colleagues.
Once your unit is working cohesively, bring that to the attention of higher ups. Invite them to hear the nurses tell how they reduced their infection rate or increased the patient satisfaction surveys by several points. If you really want to get some attention, attach dollar amounts saved by new processes, because saving money while increasing patient satisfaction or being more efficient is a concrete way to show improvement.
In the end, any steps you can take to improve the organizational climate works in the favor of both nurses, who feel more supported, and patients, who receive the benefits of better quality of care.