July 28, 2009 | | Comments 32
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Improve nurse satisfaction in a time of uncertainty

Improving nursing satisfaction is tough in bad economic times, when many hospitals are experiencing census dips and cost cutbacks that are forcing reductions in work force, benefits, hours, and pay. But the state of the economy doesn’t need to bring your nursing satisfaction scores down—there are ways to boost morale immediately.

For example, you can:

  • Begin nursing staff meetings by asking, “What was the best thing that happened to you today or during your last shift?” The meetings should focus on improving care and team-building.
  • Focus on improving the image of nursing by gathering a group of nurses to volunteer with a community or organization project.
  • Ask creative nurses to develop banners or posters that showcase nursing excellence and hang them around the unit or facility.
  • Thank nurses for their fortunate choice of profession. In Gallup’s annual honesty and ethics professional survey, nursing has been rated No. 1 for the past seven years.
  • Ask a nurse to create helpful hints on how to deal with stress and print them in your nursing or hospital newsletter.
  • Ask the CNO to visit each nursing unit to listen and discuss why he or she is encouraged and hopeful about the future. Now is the time for leadership to paint an accurate but hopeful picture for nurses.
  • Keep up the budget-friendly celebrations and recognitions for staff nurses. You can celebrate by handing out coffee coupons or recognizing a staff nurse during every unit meeting for his or her excellent patient care.

Entry Information

Filed Under: LeadershipRetentionStaff motivation


Rebecca Hendren About the Author: Rebecca Hendren is product manager for the nursing group at HCPro, where she oversees new product development focused on training and education resources for nurse managers and nursing professional development specialists. Contact Rebecca at rhendren@hcpro.com.

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  1. Nurses enter the healthcare profession because they want to help people, to make a positive difference. Unfortunately, that initial enthusiasm can grow dim at times. It’s so important to regularly provide ways for them to renew their passion for the work they do!

    Renee Ludwigs

  2. Is it me, or isn’t it a sad state of affairs when you have to ask a CEO/CNO-and any other “O” for that matter to come to the units? My experience is that “the first floor” people rarely get to the upper floors where hospital care occurs.
    I get frustrated by the “open door policy”-and would like to
    see the return of the “management by walking around.” And don’t get me started on Nurse Managers/Directors that sit in their office all day. Management isn’t magical-it’s about knowing, seeing, helping and mentoring staff. If you do that, you will be leading by example.Night shift is usually the most inexperienced portion of the staff, yet I’d hate to ask when they see their leadership. Can anyone relate?

  3. This is all great advice. And I agree that leadership has to get involved with the day to day needs of the nurses. There is so much that goes on that should be driving the decision making that to miss it is a major mistake.

  4. Rebecca,

    I teach RN to BSN students Leadership and Management. Could I have them blog on your site. I believe it would be an excellent learning experience. Thanks

  5. I can relate! For years our facility administration worked from their offices and were only seen when there was a problem. Managers mandated staff meetings but made them convenient for their schedules and not the staff (especially the 7p-7a staff that had just worked 12hours!).Morale was very low and travelers were very abundant. Thankfully, a new group has taken over. Not only do we “see” our CNO, COO, and CEO several times a day, they ask, “How’s it going?” “Are there any problems?” and “Is there anything I can do for you?” WOW! What a culture shock! It did, however, take a new administration for that to happen. It’s taken several years, but the difference is worth the effort.

  6. I agree with employers providing positive feedback to boost morale. From personal experience, this positive feedback provides fulfillment and motivates me to want to be even better. I also think that nurses can be a great support system for each other as well. Nobody understands a nurse as well as another nurse.

  7. I also feel that it is important to provide ways to improve nursing satisfaction but have found it to be tough to come up with ideas. On many of the units I work there are nurses who seem to be burned out and just plain tired and unhappy all the time. They say they love nursing but just don’t seem to get the fulfillment they once did. Our hospital has just recently sent out a survey to see what’s important to our employees. Some of the questions included: (1) is individual public recognition important to you and (2) is a letter of recognition important to you, just to name a couple. I was surprised when I read the questionnaire and thought it was a creative idea. I think this survey boosted morale a little. It made me feel like, hey, somebody cares what I think and wants to know what’s important to me! I think the idea about beginning meetings by asking, “What was the best thing that happened to you today?” is a great idea and could be a fun way to lighten people up.

  8. I enjoyed this post. I am always looking for ways to boost morale on my unit. I have found that limiting the negative talk about management and upper-management can really help curb negativity. (Especially if you are management yourself.)
    Another thing our unit like to do is give out “thanks” in the form of a small gift card whenever an employee goes out of his / her way to be an excellent nurse. My facility also does a “Caught Red handed” campaign that acknowledges employees who have been “caught” doing their job well. Let’s all be caught being positive in our workplaces! 🙂

  9. NightNurse: you sound burned out! I am one of those “O” people you are speaking of. I round daily and spend 4-5 hours of my 10 hour day on the floor. I visit night shift and weekends. I agree with you that we “O” folks need to visible and show support. Communication is key…don’t just point the finger and complain. Get involved..all hospitals have multiple NSG teams to improve the work environment and other PI projects. We “O’s” do have an open door policy..USE IT… My guess is you are not involved. Pointing out problems is the easy part…getting involved for the improvement of all it hard and takes dedication.

  10. We seem to have morale “suffering” at our workplace too. In April we gained a new manager and many nurses have left. I see them leaving for day jobs or school obligations, she sees them leaving because of her. People can claim they don’t see the management on the night shift and feel detached, but given the response of the day shift employees when management does come around, do they really want to see management or is it an excuse? Management jobs are daytime jobs; hospitals are open 24/7. I’ve been considering some sort of incentive within my department to “stimulate” teamwork and positive attitudes. I want to hear all about the “Red Handed” thing, Erica. Sounds much like what I’m out to do.

  11. I have a new appreciation for management. I realize managing a unit is not an easy thing to do. They have to balance all their job requirements along with the employees satisfaction. Giving them credit, it seems at times to be a juggling act. I agree however, it is very important for the employees to feel they are being heard and appreciated. If it was not for the floor or unit nurses there would be no patient care. I like the ideas to help the morale. I also think it is important to see your manager. I have worked in an area where the manager would get out on the floor and go a step beyond, “how are you doing?” She would help us take care of the patients. This did not happen everyday, because her schedule did not permit, but it made a huge difference in the morale of the nursing staff.

  12. Great post! I think getting nurses together to boost morale is a great idea. This would create a time to share and promote bonding. Nurses should be able to rely on one another and support each other. I also, appreciate the idea of opening the meeting with a positive statement and focusing on team building. Sometimes, these meetings seem to be a battlefield between managers and staff nurses. I believe a more unified and empowering staff meeting would enhance the effectiveness of the team.

  13. I have been a RN for 25 yrs and a Assistant Nurse Manager for 2 yrs. I have a wonderful Nurse Manager who has a sincere vested interest in our staff. The morale on our unit recently has really started to dwindle. We can have a 40-50% ADT, on average, and our census can be like a yoyo. Our acuity continues to go up while our budgeted MH/stat goes down. We are looking at an acuity tool to help with the nurse to patient ratio and ease some of the workload. The Nurse Manager and myself work weekly scheduled shifts on our unit. We have done similar ideas but frankly our staff is getting burnt out and frustrated. We even have new grads who are wondering if they want to continue to be in nursing. It’s very difficult to see my Nurse Manager struggle with meeting the needs of our staff and meeting corporates requirements. She is generally a very positive and grounded person who sees the positive side of things. Does anyone have any ideas or suggestions for dealing with the changing face of nursing?

  14. I have been in management as an RN and in the military as an air traffic control supervisor. I find that the same principals of leadership apply to both realms. It is important for everyone to realize they are part of a “team”. It takes every position in our facility to provide a successful finished product – a satisfied customer (patient and family). While I do not claim to know what motivates each person in my department….I do know the names of their family members, their histories, the things in their lives that are important to them. I care about them and they know it. This, and the fact that I regularly participate in all aspects of our department means something to them. The people who work with me are independent thinkers who take pride in what they do and are able to show their concern for our patients.

  15. During bad economic times, managers get the short end of the stick because nurses on the floor are taking their complaints of getting overtime cut and issues because of less staffing and it’s not really the manager’s fault. The reasons behind the issues are those of the business side of the hospital and everyone feels it. It is so important to boost morale of nurses and managers who are dealing with hard times at work and possibly, at home. Being completely honest about possible changes at the hospital and taking suggestions from staff is essential to allow nurses to feel confident and positive about the work they are doing.

  16. I am a new graduate and have recently started working in a critical care unit. Our day-shift nurses, for the most part, seem to get along very well and keep negative comments about coworkers to themselves. Our charge nurses and nurse manager attend frequent leadership classes. When problems arise within the unit, private meetings are immediately held between management and involved parties, which prevents problems from “festering.” I have also noted that our charge nurses and nurse managers frequently pull nurses aside to make positive comments about their proficiency. Our hospital utilizes a “Strive for Five” program where small questionarres are left in various easy-to-find locations. Patients, visitors, and hospital employees are able to fill out a questionarre about hospital employees if they have done an exeptional job. The employee then recieves $10 on their next pay check. I believe that all of these practices serve to boost nurse moral, motivation, and enthusiasm in our unit.

  17. Lauren, It seems your organization has it together by showing employees they are appreciated. At my place of work administration regularly sends out questionnaires but nothing is changed after the results have been tallied. This has been going on for years now. I believe it has caused morale in general to become even lower than it was. Kudos to those in management/leadership at your organization! Lisa

  18. I enjoyed reading this post. I agree that the nursing administration should give positive feedback and constructive direction to boost morale. Especially, a meeting focuses on improving quality of care and team-building. A nursing team is interdependent and mutually supportive, which decreases staff nurses’ stress and burnout level. Even though the economy is bad, when an effective team exists, there are chances to increase productivity. Also, I think the idea of having the CNO to visit each unit is great. This would not only show the CNO’s loving care and attention, but also shorten the distance between the CNO, nurse manager, and staff nurses.

  19. Night nurse: I have empathy for your point of view; however without working on your unit, I cannot honestly say I understand the situation. I have myself worked as project manager of multimillion dollar projects for an engineering firm, to operating my own business to being an RN for nearly 18 years, holding the position from CNA to ADON. What I am trying to point out is the one thing I learned from being a follower to being a leader is if you have a complaint, before you voice it, think critically. Anyone can complain and that just adds more to the problem. Develop a solution to your own complaint and then present it professionally to the appropriate individual or committee. Become the agent of change for your unit. It really does work. Good luck, I wish you the best.

  20. I agree that we should all be the change agent in our facility, but I see Night Nurse’s point of view. My manager does not arrive to work until after 8am and leaves by 4pm every day. I am also a “night shifter”, therefore I never see her. I used to work for a manager that picked a different morning every week to come in by 7:15. She was visible. I was more inclined to share my thoughts about our unit with her because I knew, by her actions, that she cared about our unit. Erica mentioned that a gift card is a good way to show your staff that you notice their hard work. The manager that I mentioned did that from time to time but the most meaningful thing she did was hand write thank you notes for our hard work. Coming on to a shift, finding that on your locker, starts the night on a great note! And Cynthia, keep up the good work as an “O”, sounds like you’re doing an awesome job. And I am making a conscious effort to become a more involved team member.

  21. This must truly be a difficult task to maintain one’s composure when dealing with the everyday life of a professional career. I have also really wanted to change several things at my present facility; however the need for change has to be apparent to everyone else before it’s accepted. The leadership and management tend to make decision based on the corporate view, not involving the Nursing personnel until its too late. This brings one specific event to mind at my facility. Administration is currently wanting to open up our additional unit that has eight beds for our overflow patients. The problem is not opening the unit, just not enough staff to cover it once it is officially up and running. Is it just me, or is there going to be potential problems if this is not thought thru carefully?

  22. Zelda
    Delphanie: I understand your concern about opening more beds without “seeing” where the extra staff will come from.Will the beds be used only for overflow patients?My hospital has a plan in place for overflow patients.Where do we get the staff? There is an overflow staffing plan made four months in advance.The plan is made for the 3-11 and 11-7 shifts.This plan has been in use for a couple of years and still is not without problems.When supervisors find themselves with more patients than beds and staff ,the plan is a good start.The corporate view is the bussiness side of healthcare,nursing administration leaders must be mindful of the business of patient care.

  23. I wish that my nurse manager would begin our staff meetings this way. It seems as if all we ever hear is “Do better”. There is no positive reinforcement in my department. No matter how hard I work, my unit manager is always telling me to work harder. We have been working short for years, economic downfall or not. Burnout is a big problem in my unit because we are over-worked. No nursing satisfaction is involved at our meetings it seems that we only care about the satisfaction of upper management and people who donate money to the facility. We feels as if no one cares about what we do. Every shift day in and out we work diligently to save the lives of our fellow man. Life saving measures are my job and yet all I ever hear about is the bad things that happen. How about a “go team” every once in a while? Is it truly too much to ask for a pat on the back? Nursing has always been a thankless job and I think that this mentality needs to change. I don’t want to hear people say “I’m just a nurse” because nurses make a difference and we need credit for such.

  24. When I began to work in my current workplace, I noticed a new event that was not occurring at my previous place of employment. On a daily basis administration would visit each department and ask, “Is there anything you need?” They would also ask, “Is there anything I can help you with?” If the answer to each question was no, they would still assess the situation to ensure that you are not just being courteous. Every day when this occurred I would say to myself, “They really care about us!” At times, when staff was low and administration was aware of it, they would visit and immediately we would receive assistance. For administration to not only visit, but take action to lift the morale of staff, speaks volume.

  25. I love this post. The economy is in a state of flux, and we feel the effects, especially in the workplace. Memo’s are posted weekly on ways to be more cost-efficient for the organization, but nothing posted on boosting nurse morale. With budget cuts and heavier workloads, it is important for administration to provide positive reinforcement and motivation to their staff. I know that being a manager can be a difficult task, but nursing can be extremely challenging at times. Nurses are working harder than ever, due to changes in staffing guidelines. Sometimes, it is as simple as saying ” good job”, or giving a “pat on the back ” to express your appreciation. I believe that nurses would not have a negative attitude towards administration, if administration would offer support, encouragement, and recognition of their nursing staff.

  26. The concepts of this post are fantastic! I have always felt like being around positive people strongly reduces the impact of negative situations. In regards to the economy, we are all in this thing together and it is important to let each other know that it is okay to vent. However, vent in the right place with the appropriate people. I used to have this personal game called “Stupidly Nice Day” that I would play. I know the name is silly but the concept was to be ridiculously positive and overly complimentary to everyone I came in contact with for a whole day (if possible!). Even people that caught on to the fact I was being over the top got a laugh out of it. Who knows, maybe they had needed that laugh for a long time. I guess my point is that everyone can find something to complain about or point out a downfall but it takes no more effort to let someone know that they are appreciated. So why don’t we try and take the positive lead, even if it is something as ridiculous as The “Stupid Nice Game”!

  27. I understand exactly what you’re talking about! I am a new nurse, I graduated in May of this year, and I work night shift and am frequently the “charge nurse.” I’m left to my own devices and knowledge. I recently learned that my co-workers consider me “arrogant” and was shocked. I only oriented for two weeks before being left to fend for myself and I think that I do a great job. I’m in a very small rural hospital and hardly ever even have a house supervisor to call if I don’t know how to handle something. When a tough situation arises, I do the best I can and what I believe to be correct from what I was taught in school and according to hospital policy. Usually that’s good enough but when it’s not, I’m paged overhead to the boss’s office for that walk of shame in the morning. I’m promptly told what I did incorrectly and how it should be handled in the future. Luckily, I have a forgiving boss but I feel like she should be more available. She doesn’t like to be called after 2000. I get really angry about that sometimes but recently, I started my preceptor for a Leadership in Nursing class for my BSN. My boss is the program director for mental health and we don’t yet have a program manager so ALL issues fall back to her. In my preceptor, I’ve learned what program directors do. They sit in dreadful meetings all day and discuss money and politics regarding the hospital. It’s a truly miserable job. I can understand now her “hands off” approach to management. She really doensn’t have time to worry about why I decided to give a haldol injection at 0500 when I know they are having a family therapy session at 0800.

  28. I totally understand the frustrations of the night nurse. Having worked both 7a and 7p shift, rarely is administration or the nurse manager seen on the night shift unless there is a problem. At the facility where I am presently employed, the CEO and the CNO is visible on the nursing floor daily. Both often ask “How are you?”, “How are things going?”, but I never heard either of them ask “What can we as a team do to make things better?” Teamwork is critical to the success of any organization. If administration made nurses believe they are part of a team and that their input is valued, I believe it will increase the morale of nurses and positively impact the attitudes of nurses.

  29. Dowanda,
    I totally agree with your input. Last weekend I had to make an executive decision about staffing. I called the DON about the matter. He did not want to be bothered with the situation. There was a severe shortage of the mental health techs and there seemed to be no one concerned about it. This became very frustrating. I was the only RN in the facility. I work weekends only so I never get to talk to the CEO about the weekend that I encounter every weekend. Well I, like you, would like my CEO to ask what can we do as a team ot make things better. But he never asks this question. When I am the charge nurse, I emphasize teamwork to the fullest. My team appreciates the hard work that I do. I thank my team several times a day for all their help. I also tell them what a great job they have done. At this facility, there is such a high turnover. Every nurse in the city of Dothan knows all about the facility that I work at. I always tell people that it is not as bad as it seems. If upper management would just encourage the nurses it would definitely improve the morale of all the nurses and positively impact the attitudes of all the nurses.

  30. All of the above advice is wonderful…but as managers, we need to remember that a positive attitude starts and ends at the unit level. If staff are feeling overwhelmed, low morale, we have to ask what we can do to ease their burdens. Leadership has their own issues, stresses, etc. Too often staff forget that management and leadership alike are often stressed as well.

  31. Hello, the whole thing is going perfectly here and ofcourse every one is sharing facts, that’s truly good, keep up writing.

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