The demand for nurses is growing in response to an increasing patient load resulting from the Affordable Care Act and mandated health insurance. Consequently, nurses are stressed, and the retention of registered nurses (RNs) in the industry has decreased. Many nurses blame the relationship or behaviors of their nursing administrator as their reason for leaving the workforce (Feather, Ebright, & Bakas, 2014). Therefore, nursing administrators need to be aware of the behaviors that influence perceptions of their nursing staff, so they can better manage their staff’s needs.
Supporting and Encouraging a Good Practice Environment
Supporting and encouraging a good practice environment for nursing staff involves three key subjects: communication, respect and feeling cared for. According to a study by Feather, Ebright and Bakas, nurses in hospitals with higher than average retention rates voiced these behaviors are necessary to perceive nurse administrators as good leaders (2014).
The need for communication stems from nurses wanting to be part of the decision-making process, or at the very least, being aware of the process. Allowing nurses to be cognizant of decisions being made in administration allows them to also see consistency in the actions taken by leaders. Communication extends to listening to the needs of staff, both personally and professionally. Promoting open discussion and keeping confidentiality builds trust. Nurses also appreciate direct verbal communication that opens the channels for responses, which should be handled in a timely manner (Feather et. al, 2014). Many of the communication processes in dysfunctional environments occur, not because the decision-making process did not happen, but because a lack of communication with staff created a poor working environment.
Nursing administrators are not likely participating in purposefully disrespectful behavior, but RNs report needing respect in a good practice environment. A perception of respect, according to RNs, involves consistent appreciation and discipline. Praise must be given in order to provide balance to criticism. Fairness is perceived when all workers are treated the same in regards to accountability, and this includes administration. Nurse administrators should model behavior they’d like to see in their employees. In that regard, employees reciprocate the respect they see from their administrators (Feather et. al, 2014).
Lastly, nurses report that they need to feel that their administrators care. Administrators are often perceived as being disconnected from staff, and nurses complain to charge nurses or workers they feel can relate to their complaint. Nursing administrators should be present rather than constantly in a closed office or in meetings. They need to respond to stressful days by making sure busy nurses get breaks and meals (Feather et. al, 2014). This shows a caring environment where nurses feel the support they need from leadership
Hindering and Discouraging a Good Practice Environment
It is easy for nurse administrators to create a bad practice environment unintentionally by not responding to the needs of nursing staff. The absence of communication makes staff feel excluded, and they begin to lose trust in the organization. Confidentiality also builds trust that can easily be broken if disciplinarian actions are made public. Lastly, nursing administrators cannot engage in disruptive behavior, such as gossip (Feather et. al, 2014). The biggest hindrance to a good practice environment that a nursing administrator can create is a culture lacking trust, which eliminates the communication, respect, and caring required for a good environment.
Personal Leadership Style
In my own leadership style, I would incorporate all of the elements necessary to create a good practice environment, but one that stood out is being present. A nursing administrator cannot be everywhere at once, but he or she should have an open door as much as possible and visit the floor regularly to avoid disconnects. This also forces the two-way communication pathways that foster communication and respect. One notable complaint by a nurse in an article cited discouragement because the nurse administrator was never present on the night shift (Feather, et. al, 2014). I would make it my responsibility to oversee each shift at least once weekly to show presence and support, which would encourage staff with limited administrative figures.
Handling Disruptive Behavior in the Practice Environment
Disruptive behavior is harassment, bullying and gossip among other activities that negatively impact staff and patients. These behaviors occur amongst all workers in healthcare organizations including doctors, nurses and patients. Handling them involves clear guidelines and consistent discipline to create a culture where disruptive behavior is discouraged.
Clear guidelines come from a code of conduct that describes disruptive behavior and discusses how to report disruptive behavior. The disciplinary actions involves verification of the behavior, intervention, and then coaching or mentoring the problem to limit the chance of recurrence. Harsh disciplinary actions are a last resort but must be considered in some cases. The best defense in the case of disruptive behavior is a good offense, and that means preventing disruptive behavior. This can be done by educational initiatives that improve the working relationships between different types of workers, such as nurses and doctors (Longo, 2010).
Lifelong Learning and the Professional Administrator
Lifelong learning is essential to the career of the RN and the nursing administrator. Nurses are charged with performing best practices and being leaders in healthcare advancement and excellence. This is no light task and involves a constantly evolving body of knowledge that must be consistently studied.
Nurse administrators must obtain continuing education credits, but a nursing administrator must also attend conferences, read journals and network with other nurses to become a lifelong learner. The nurse administrator must be a lifelong learner and challenge staff to adopt the same lifelong learning goals.
- Feather, R.A., Ebright, P., and Bakas, T. (2014, Jan.) Nurse manager behaviors that RNs perceived to affect their job satisfaction. Nursing Forum. doi: 10.1111/nuf.12086
- Longo, J. (2010, Jan. 31). Combating disruptive behaviors: strategies to promote a healthy work environment. OJIN: The Online Journal of Issues in Nursing (15)1. doi: 10.3912/OJIN.Vol15No01Man05