Throughout the COVID-19 pandemic, the American Nurses Foundation (ANF) has monitored its effect on the nursing profession through a series of surveys, the most recent of which collected specific information on staffing, scheduling, organizational support, and solutions. More than 11,000 nurses contributed to the survey, but those who identified as retired were not included in the data analysis. As I read the findings, the report’s subhead—Nurses Not Feeling Heard, Ongoing Staffing and Workplace Issues Contributing to Unhealthy Work Environment—caught my attention. How does one confirm feeling heard?
The report’s details show that, as with the previous surveys, respondents to the 2022 survey identified critical concerns about their work environment. When asked about staffing levels, more than 50% of acute care hospital nurses indicated that their unit did not have the needed number of nurses and that ancillary staff were often unavailable. Not surprisingly, nurses also reported being asked to work extra shifts or beyond their shift time and encountered difficulty getting requested time off.
The ANF’s Mental Health and Wellness Survey from September 2021 revealed why employers must make staff’s mental health a priority. In my discussions with nurse leaders in cancer centers, I hear their concern for nurses and quality patient care and their frustration as they try to find solutions to a problem that is bigger than them.
Findings from the ANF’s Pulse on the Nation’s Nurses Survey Series have given voice to nurses, but they also show that nurses’ voices haven’t been heard. Some of the conditions nurses identified on the surveys existed prior to the pandemic but are now augmented. For example, bullying and incivility increased, whether from patients, family members, or colleagues. According to respondents, creating an antibullying policy or no-tolerance workplace violence policy would improve their satisfaction. In my experience, these policies, if adhered to, do make a difference. If your organization doesn’t have those policies, collaborate with your human resources department to develop them. Volunteering to help with the solution can lead to positive outcomes.
In these surveys, the summarized data give a general picture of the issues. However, each workplace is unique, and interventions to improve the environment will vary. The solution is not one size fits all. We’ve seen how actions that began as appreciation and support for nurses and other staff in the early months of COVID-19 turned negative as resilience-building activities and pizzas no longer mitigated a stressful workplace or were appreciated. Developing the mechanisms for staff to be heard and receive answers to their concerns shows greater appreciation.
Solving systemic issues takes a long view and commitment to understand the problems and become open to change. Trust among staff and leadership is central to improving the work environment. Leaders must listen and respond to what is currently happening in health care. Paying attention to what the staff are saying or experiencing is critical to building trust. Feeling heard means that staff use their voice and see that their thoughts and ideas matter. It, too, is critical to building a sense of trust.
To use a modified advocacy adage, the surveys let us see global, but action must be local. I encourage you to read the ANF surveys and familiarize yourself with what your nursing colleagues shared. Solving a specific organization’s issues requires nurses to raise their voices and leadership to truly hear them.