Empowering Nursing Staff to Improve Nurse Satisfaction by Owning their own Employee Engagement

Purpose:
NDNQI RN survey results indicated areas in need of improvement from adult intensive care units. An innovative approach to drilling down to the causes of nurse dissatisfaction was developed and engaged staff in the processes of improving nurse satisfaction through issue identification and resolution.

Significance:
Nurse satisfaction has been associated with a positive work environment that promotes nurse retention and optimal patient outcomes. Nurse dissatisfaction provides leadership opportunity to empower staff to own processes aimed at improving satisfaction; which, in turn, enhances employee engagement.

Strategy and Implementation:
Focus groups were interviewed across 4 adult intensive care units in a large Midwestern academic institution. Representation from all nursing staff was invited, including clerk techs, registered nurses (eligible and ineligible to participate in the NDNQI RN survey), and leadership. Participants explained their interpretation of Practice Environment Scale questions to determine workplace issues that influenced satisfaction. Analyses revealed several over-arching themes within and outside of staff control: communication, process consistency, and resource allocation/utilization. Staff were provided opportunity to prioritize 2-3 issues believed to be most significant to their unit. Department meetings provided the forum for staff to determine whether unit based councils or WorkOut™ teams would develop and implement action plans. Volunteers from all nursing staff were sought to participate in the WorkOuts™. Formative evaluations were conducted to gauge progress and engagement levels.

Evaluation:
Outcomes of these efforts will not be formally measured until commencement of the 2009 NDNQI RN survey. Formative evaluation outcomes revealed varying levels of ownership and engagement in the processes, providing opportunity for refining the processes to better suit the nursing staff on each unit.

Implications for Practice:
Efforts to individualize approaches to staff engagement and ownership in improving nurse satisfaction are multifaceted and must consider the unique culture of each patient care unit. Leadership plays a pivotal role in empowering staff but must also be supported in these endeavors to achieve success.