The Engaged Caregiver by Joseph Cabral

Author:Joseph Cabral
Language: eng
Format: epub
Publisher: McGraw-Hill Education
Published: 2020-03-21T16:00:00+00:00

Caring for Our Nurse Caregivers

To design a successful strategy for improving nurse engagement, leaders must understand the totality of the nurse experience. Start by understanding patient needs, since these influence the caregiver experience. The Compassionate Connected Care™ model, based on a qualitative survey of caregivers and developed to help reduce patient suffering, is composed of themes in four categories: connectedness, clinical excellence, operational excellence, and culture.23 Because the relative importance of each of these categories may vary by caregiver type, care setting, department, or unit, leaders should assess engagement data in depth to gauge how well their organization is meeting patient needs and to design improvement plans targeting specific subpopulations. To this end, leaders can use the strategies for data gathering, goal setting, and change management described earlier in the book. Leaders can customize these strategies by asking questions about the definition of nursing excellence, the organization’s position on the journey, and the infrastructure that exists to enable, measure, and report on engagement.

In the early stages of planning, leaders should identify key stakeholders and partners. The first question to consider: “Who owns nurse engagement?” While the answer should be self-evident (nurse engagement is a shared responsibility), unit-level nurse managers can often feel that they bear sole responsibility for nurse engagement.

Nurse leaders should adopt a broader perspective and identify who in the organization is best positioned to influence nurse engagement. As indicated earlier, nurse engagement derives from a positive work environment, and stakeholders include senior and mid-level nurse leaders, clinical staff, physicians, and other clinical professionals. Looking beyond nursing, senior administrative leaders such as the chief operating officer and chief financial officer strongly influence nurse engagement, as they decide how to allocate financial and other resources.

To improve engagement, leaders should enlist subject matter experts with deep understanding of and experience with engagement, recruitment, and retention. Leaders should also build a solid partnership between nursing and HR by sharing expertise; aligning around nurse engagement, recruitment, and retention; and establishing accountability. Establishing clear ownership and accountability among stakeholders was a game changer for one large academic medical center on the West Coast. Nursing and HR leaders worked together to develop goals around RN engagement, recruitment, and retention. They instituted nursing retention councils, enhanced interdisciplinary rounds and partnerships, developed a workplace violence steering group, and increased their focus on caregiver retention. Over a two-year period, the health system achieved significant gains in RN engagement scores and an estimated return on investment of $3.2 million through increased revenue, cost avoidance, and cost reduction.

The outcomes of unit- and department-level gap assessments should inform goal setting for enhanced nurse engagement, while a focused and detailed operational plan should determine execution. Internal initiatives, such as those described earlier, and external programs can help frame the engagement journey and key milestones. External programs include the American Nurses Credentialing Center Magnet Recognition Program®, its Pathway to Excellence Program®, and the American Association of Critical-Care Nurses Beacon Award for Excellence. All of these programs use evidence-based standards informed by a substantial body of research into healthy and positive work environments.

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