What nurses say about nursing and what needs to vary

An modern approach supported by artificial intelligence allowed us to discover problems and develop recommendations.

There have been many articles in regards to the current challenges in nursing and what may be done to enhance the nursing workplace and retain nurses. While nurses have proven to be resilient long before, during, and after the COVID-19 pandemic, without changes to the systems during which they work, even essentially the most resilient nurses will burn out.

Recent report notes that the unoccupied rate amongst registered nurses is nearly 10% and the national turnover rate amongst hospital nurses is 20%. Surveys state known reasons: heavy and intense workload, insufficient staffing, bullying and lack of support.

From 2021 R³:Maryland Resilient Nurses Initiative creates and provides free resources to support nurses and nursing students in coping with stress and challenges in healthcare. The initiative recently leveraged a novel platform, Slow conversationto generate discussions with nurses about their perspectives on nursing and what they imagine must occur for nurses to practice in a way that reflects their training and commitments. As a result report was funded by a Nurse Support Program II grant administered by the Maryland Higher Education Commission and funded by the Health Services Cost Review Commission.

Participants included 78 nurses representing 20 institutions across Maryland, including 50% clinical nurses, faculty, and nursing students. They used the app to interact in 15 moderated small group discussions through the Slow Talk platform. The sessions explored what nurses thought of their occupation, how they felt others viewed nursing, what was missing from the general public narrative/what the narrative of the occupation should appear to be. Participants’ real-time conversations were recorded, transcribed, and analyzed; themes and suggestions were then developed using artificial intelligence, generating each quantitative and qualitative data.

Finds

Three fundamental themes emerged:

• Though transactional issues (workload, compensation, skilled development) remain a significant concern, the fundamental theme that emerged as essential to retaining nurses was “the importance of being heard, supported, and aligned with the organization’s values ​​for job satisfaction, retention, and performance.” Nurses described feeling undervalued and “forced into a mechanical, task-oriented mode of operation that compromises personalized patient care and overall job satisfaction.”
• Another theme was that although no specific intergenerational conflict was identified, there have been concerns in regards to the lack of advantages of seniority, lack of mentoring for younger nurses, and concerns in regards to the risks/advantages of social media for the occupation.
• Finally, despite many challenges and stressors, nurses expressed confidence of their occupation and the idea that “they are skilled and competent professionals who have the potential to contribute to change.”

The report’s key recommendations include:

• Leaders need to higher relate to and support nurses of their multiple roles. Building trust by being visible, engaged, listening and taking nurses’ concerns seriously, and being transparent in decision-making is vital. Leaders need to bolster the worth nurses bring to the system to drive organizational change that increases nurses’ voice in decision-making.
• Nurse practitioners are resilient and there are methods to proceed to develop their resilience potential. However, the report makes it clear that “it is clear that you are already resilient, despite the challenges you face. . . . The work you do should be valued, supported and rewarded appropriately. You should feel heard and understood in your workplace and community. You deserve to feel joy and balance in your working life.”

Read the highlights and access the total report Here.

Maureen Shawn Kennedy, MA, FAAN, retired editor-in-chief, American Journal of Nursing; contributing editor, JAMA Health Forum. Disclosure:The writer is a member of R³ Advisory board; had no role within the design, conduct, or evaluation of this research.