Abstract
How to deal with unhealthy work environments is a difficult question. Much has been written and said about unhealthy work environments and their effects on the quality of nursing care delivery. This paper provides a brief insight into the issue of healthy work environments and its implications for nursing. The history and relevance of the issue are discussed. The paper evaluates the effects of unhealthy work environments on patients, nurses, physicians, and other stakeholders. Pros and cons, as well as possible ways to resolve the issue are evaluated and discussed. The goal of the paper is to create an objective picture of the issue and its implications for nursing.
Introduction
Nurses operate in complex environments. Unfortunately, healthy work environments remain a serious nursing issue. A wealth of literature describes the importance and implications of healthy work environments for nurses. Nevertheless, many work environments remain unhealthy for nurses and make them leave their institutions and profession for good (Kupperschmidt, Kientz, Ward & Reinholz, 2010). This paper critically evaluates the issue of healthy work environments and their effects on nurses. The history of the nursing issue is discussed. The paper evaluates the pros and cons of the nursing issue and possible ways to resolve it. The goal of the paper is to create an objective picture of healthy work environments and its implications for nursing.
Main body
Nurses operate in complex environments. The complexity of nursing work was abundantly established (Ebright, 2010). Unfortunately, the reasons why intended outcomes are not achieved are poorly understood (Elbright, 2010). Healthy work environments exemplify a serious issue, since they cause heavy consequences on the quality of nursing care and patient safety. Healthy work environments are a nursing issue, because they are extremely important for nurses and patients (Kupperschmidt et al, 2010) and can help to reduce complexity and errors in nursing care environments (Ebright, 2010). Unfortunately, the gap in the nursing research regarding healthy work environments and their implications for patient safety continues to persist.
The issue of healthy work environments has far-reaching implications for nursing management and leadership. This is an important reason why nurses must recognize the relevance of the issue and assume a responsibility for creating healthy work environments.
The history of the issue dates back to the beginning of the new millennium. In 2005, the American Association of Critical Care Nurses developed and published six standards of healthy work environments in nursing care (Marquis & Huston, 2008). Before 2005, researchers and scholars in nursing had been increasingly concerned about the nature and implications of healthy work environments for nurses. Since 2003, researchers have been trying to identify, discuss, and evaluate the factors that challenge the provision of quality nursing care (Ebright, 2010).
The reasons and consequences of disruptive behaviors in nursing care have been discussed (Longo, 2010). Parse’s Theory of Human Becoming and a Five-Factor Model for Becoming a Skilled Communicator have been used to develop new conceptual frameworks (Kupperschmidt et al, 2010). Nevertheless, nursing work environments remain unhealthy and push nurses to leave their profession (Kupperschmidt et al, 2010).
The issue affects all stakeholders, including nurses and patients. According to Kupperschmidt et al (2010), “the negative outcomes of unhealthy work environments affect patient safety and nurses’ willingness to remain in the workplace”. Unhealthy work environments expose nurses to unnecessary stresses and psychological disorders (Longo, 2010). They threaten patient safety and wellbeing and break the line of collaboration and communication between them and practicing nurses (Longo, 2010). Unhealthy work environments reduce healthcare workers’ ability to pursue competence and professionalism in the workplace (Longo, 2010). Stresses and behavioral disturbances compromise the quality of nurse-physician relationships and lead to decreased communication, collaboration, and information transfer (Longo, 2010).
The pros and cons of the issue are obvious. On the one hand, unhealthy work environments create a challenging atmosphere and keep nurses focused on their tasks. On the other hand, unhealthy work environments pose a serious threat to patient safety and wellbeing. Unhealthy work environments affect all stakeholders, reduce patient safety, and create additional cognitive load in nurses (Ebright, 2010). They leave little room for quality nursing care and disrupt the stability of professional relationships within and between the nursing staff.
Possible ways to resolve the issue are numerous and varied. Kupperschmidt et al (2010) suggest that nurses must assume a responsibility for creating and maintaining a healthy work environment. Nurses must become skilled communicators (Kupperschmidt et al, 2010). They must become reflective, mindful, authentic, and candid (Kupperschmidt et al, 2010). It should be noted, that authentic leadership is an essential prerequisite for creating and sustaining healthy work environments: Marquis and Huston (2008) cite authentic leadership among the six basic standards of HWEs.
HWEs can be easily promoted, by eliminating system gaps that create complexity, implementing appropriate technologies, redesigning RN work, and supporting new RN as they are learning to take complex workplace decisions (Ebright, 2010). Nurses must develop policies and procedures to deal with disruptive behaviors and foster general communication skills (Longo, 2010). Nurses must be cognizant of their behaviors and the standards of appropriateness, to ensure that they do not cross the boundaries of acceptable behaviors in the workplace (Longo, 2010).
Conclusion
Healthy work environments exemplify a serious nursing issue. The history of the issue dates back to the beginning of the new millennium: in 2005, six standards of HWEs in nursing were published. Despite the growing body of literature, many nursing environments remain unhealthy and push nurses to leave their institutions and profession for good. Unhealthy work environments affect patient wellbeing and expose nurses to unnecessary stresses. They reduce collaboration and communication between nurses and physicians. It is high time nurses assumed a responsibility for developing and maintaining HWEs. Authentic leadership can become a relevant factor of sustained HWEs in nursing care.
References
Ebright, P.R. (2010). The complex work of RNs: Implications for healthy work environments. OJIN: The Online Journal of Issues in Nursing, 15(1), 4.
Kupperschmidt, B., Kientz, E., Ward, J. & Reinholz, B. (2010). A healthy work environment: It begins with you. OJIN: The Online Journal of Issues in Nursing, 15(1), 3.
Longo, J. (2010). Combating disruptive behaviors: Strategies to promote healthy work environment. OJIN: The Online Journal of Issues in Nursing, 15(1), 5.
Marquis, B.L. & Huston, C.J. (2008). Leadership roles and management functions in nursing: Theory and application. Philadelphia: Lippincott Williams & Wilkins.