The key to a great nurse work culture is giving nurses a voice in decision-making and having leaders who build a personal relationship with staff, six nursing leaders told Becker's.
In August, Nurse Journal, a career and education resource website, ranked 15 hospitals as the top for nurses to work at. They determined the top 15 hospitals by using rankings from CMS, the American Nurses Credentialing Center Magnet Recognition Program, and the Hospital Consumer Assessment of Healthcare Providers and Systems Patient Survey as well as the following criteria: patient satisfaction scores, safe staffing levels, hospital safety measures, nursing career opportunities, benefits, workplace environment and ratings from nurse reviewers.
Here, six leaders from the top hosptitals name the initiative systems should implement to create a great work culture:
Margarita Baggett, MSN, RN. Chief Clinical Officer for UC San Diego Health: The turnover and vacancy rate for nursing at UC San Diego Health are consistently well under 10%. This is attributed to many factors associated with being an academic medical center and strong enculturation of nursing professional governance. However, one recent effort is to empower all nurses to be chief retention officers. I have encouraged all of our nurses and nurse leaders to identify and escalate issues and implement strategies targeted to the specific needs and feedback of nurses in local areas. Using a culture of safety, providing a great place to work, and engaging the nursing teams ensures UC San Diego Health will continue to be a top hospital for nurses.
Dina Dent, DNP, RN. Vice President and Chief Nursing Officer at Inova Health System (Falls Church, Va.): A great culture. By this I mean a culture where every team member (clinical and nonclinical alike) knows they are respected, seen and heard. I believe that senior leader visibility is paramount and, for me, getting out from behind my desk whenever possible is always time well spent. I particularly enjoy mentoring and connecting with what I call our "informal leaders," those star-in-waiting nurses we all have in our hospitals, to solicit their best ideas and encourage them on their personal career journeys. They may not be leaders yet, but they soon will be, and we need to grow and support them.
One of the great lessons for me from COVID-19 was to remember to stay humble. We all had to rethink everything during that time. As leaders we learned sometimes we just didn't have the answers. From that experience, our leadership team here tries to remember — and to employ — those hard lessons we learned. We understand that the next big obstacle is right around the corner, and the next one after that. But I firmly believe that when a hospital is able to create and nurture a great culture that is rooted in relation-based leadership, there's really no challenge we can't surmount together.
Brandee Fetherman, MSN, RN. Chief Nursing Officer at Morristown (N.J.) Medical Center: Morristown Medical Center has shared governance across all departments that brings all team members to the table in order to be involved in the decision-making that directly impacts their practice. We also have a multidisciplinary (nursing, human resources, pharmacy, transport) Nursing Workforce Environment and Staffing Council that meets regularly and works together to improve all team members' work environment. One of the council's goals is to have all professionals work at the top of their license. This encourages new and novice nurses to strive for a similar goal of continuing their professional development, knowing that they have the full support of leadership and their peers. We believe this is one of the reasons we are consistently recognized for our exemplary nursing program.
Ryannon Frederick, MSN, RN. Chief Nursing Officer at Mayo Clinic (Rochester, Minn.): Have your leaders lean in and experience what your staff is facing. Over the last three years, we've been intentional about having our leadership — at all levels — work side by side with their staff. Walking in our staff's shoes makes a tremendous difference in improving the work environment.
For example, during COVID, I worked in our swab clinics and encountered our staff's challenges with our electronic systems and label printing. Experiencing these struggles firsthand has improved my work as a leader. I can be a better advocate and influence the changes needed to improve the nurses' work environment, allowing them to spend less time in the electronic system and more time with their patients.
Joye Gingrich, BSN, RN. Chief Nursing Officer and Vice President of Patient Care Services at UPMC Harrisburg (Pa.): Leaders must build meaningful relationships with nurses. Routine purposeful leader rounding on nurses creates a forum for nurses to share peer recognition, career goals and ideas for improvement. In addition, the opportunity develops a personal relationship with each other and appreciation for each other's contributions. This in turn, provides an opportunity to have open dialog, build trust and create a culture where nurses feel empowered and heard. Work environments tend to be great when leaders and nurses have positive relationships.
Mary Beth Thoburn, BSN, RN. Chief Nursing Officer of Cleveland Clinic Fairview Hospital: It is imperative that every organization grow and nurture a culture where all caregivers feel supported to speak up when they identify or experience a condition that threatens the safety of our patients or caregivers. We cannot improve that which we don't know. Engaging workers at all levels to protect one another and our patients is foundational to high-quality care and patient outcomes. Our CEO encourages all of us to treat one another as family and the organization as our home. If we are successful in doing that, our patients will receive the best care possible!