Toward a Healthy Work Environment: Honoring the Voices of Frontline Nurses, Lecture notes of Nursing

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Toward a Healthy Work

Environment: Honoring the

Voices of Frontline Nurses

Tracey Long, MSN-MPH, RN-BC, CPH Carolyn Cumpsty-Fowler, PhD, MPH Deborah Dang, PhD, RN Jenni Day, PhD, RN March 19, 2017

Disclosure Statement

There are no conflicts of interest to

disclose.

No sponsorship or financial support

was received for this presentation.

Tracey Long, MSN-MPH, RN-BC, CPH The Johns Hopkins Hospital

Overview

This presentation describes how honoring

the voices of frontline nurses impacted the

professional practice model evaluation at a

large academic medical institution.

Two-way Communication

Transparent two-way communication is one form of skilled communication and a key part of establishing and maintaining a healthy work environment. A critical part of this transparency is giving a voice to frontline staff and valuing their input.

Behaviors Present in

Transparent Two-way Communication

Communication is a broad concept and includes any behavior that conveys your thoughts and feelings.

• Read widely and often
• Talk to people and ask their opinions
• Ask questions and challenge assumptions
• Listen carefully to learn from others (http://www.broadvision.com/en/blog/improving-workplace-communication-transparency-accountability) (http://sa.berkeley.edu/sites/default/files/images/communicatingwithtransparency.pdf)

Key Points of Transparent

Two-way Communication

Communicating transparently is intentional. People who communicate honestly, openly, and authentically are more credible, more often heard, and considered more trustworthy. Clear, honest communication builds trust. Without trust, relationships can’t grow. (http://sa.berkeley.edu/sites/default/files/images/communicatingwithtransparency.pdf)

Communication in Healthcare

Clear and concise communication is a

key component of a professional work

environment; especially in healthcare,

where communication lapses can lead

to patient safety events.

Case study example

An example of the impact of

transparent, two-way communication

and its link to a healthy work

environment, is how the voices of

frontline nurses were captured during

the evaluation of the Johns Hopkins

Hospital Professional Practice Model

(JHHPPM).

• Johns Hopkins Hospital nursing leadership wanted to know how well nurses knew the professional practice model and its impact on nursing practice.
• A pilot evaluation of the JHHPPM was conducted to gauge nurses’ familiarity and engagement with the existing PPM so that it could be revised with their input.

The Why?

• We came to this approach because creating a healthy work environment is an organizational priority; leadership was committed to hearing the voices of frontline staff.
• Skilled communication is one of the American Association of Critical-Care Nurses (AACN)’s six essential standards for establishing and sustaining healthy work environments.
• Nurses must be as proficient in communication skills as they are in clinical skills. (AACN, January 5, 2017)

The How?

• The traditional approach, according to the literature, is to create an educational campaign to teach the PPM to staff
• Instead, Johns Hopkins nursing leadership supported the revision of the PPM using the voices of frontline nurses who live the PPM everyday
• Educational campaigns can be burdensome, short- lived, and may not result in lasting change; we chose an inclusive approach that did not create extra burden and supported long-lasting impact

Now what?

If the professional practice model was in their words, nurses would not have to learn about a model, they would simply speak to their experiences.

The A-Ha Moment

• Conversations were anonymized and transcribed
• Thematic analysis was performed on the qualitative data
• Results of the analysis were vetted with:
  • Peers in direct practice
  • Nursing leadership
  • Nursing PPM committees

The Details

What did we hear?

“it was very gratifying to see that how I felt as a Hopkins nurse aligned quite easily with my colleagues…the reason why we come to work every day is for our patients” “we’re not really aware of just how much pride there is when we say ‘I am a Hopkins nurse’…that was surprising to me” “the graphic really rings true to me because it is who we are in our own words and what it means to be a nurse here at Johns Hopkins”