The Five Rights of a Healthy Work Environment

The Five Rights of a Healthy Work Environment

Several years ago, I gave a presentation at a northern California nursing conference on a healthy work environment for nurses. During my preparations, I spent much time pondering aloud about the scourge of nurse bullying and lateral violence and why healthcare workplaces lend themselves so readily to unhealthy work conditions.

There are many reasons that bullying and unhealthy workplaces have become so common, and I’m sure that you, dear Reader, can rattle off a few without even thinking for more than a nanosecond.

Stressful Dynamics

The stress level in the healthcare milieu has increased over the years. Higher patient acuity, staffing issues, bullying, and other factors cause some nurses to leave workplaces for greener pastures — others leave the profession altogether.

We hear stories of nurses whose 12-hour shifts are 13 hours (one hour without pay because it’s impossible to finish on time). We also hear about nurses who purposefully dehydrate themselves to avoid needing to use the restroom during a busy shift.

These and other dynamics make nursing a profession to be feared and avoided at a time in history when we need more trained nurses than ever. With a rapidly aging population coupled with an exponential increase in obesity, diabetes, hypertension, and other chronic and preventable illnesses, we need a trained nursing workforce that’s happy, healthy, engaged in their career, and ready to face the healthcare challenges of the 21st century.

Know Your Rights

Joe Strummer and his punk rock band The Clash once sang that you need to know your rights. So, nurses, you indeed need to know your rights and assert them every step of the way.

Do you remember the five rights of medication administration?

In case you forgot, they are the right patient, the right medication, the right time, the right dose, and the right route.

5 Healthcare Work Environment Rights

Well, did you know there are five healthcare work environment rights? (I just made them up, so I don’t blame you for not having heard of them yet – there will be a multiple-choice test at the end of this blog post, so be sure to study.)

The five rights of a healthcare work environment as created by yours truly are:

-Right practice

-Right relationships

-Right environment

-Right leadership

-Right livelihood

Now that we’ve established your five rights, let’s break this five-pack down into its constituent parts, shall we?

Right Practice

Right practice means you can practice nursing in a way that works for you. Right practice translates as practicing to the fullest extent of your license in a personally and professionally satisfying manner.

In right practice, no one is trying to strip you of your power, rob you of your authority, undermine you, or otherwise thwart your mission as a nurse and healthcare provider.

Right Relationships

Relationships mean a lot when working in a challenging healthcare environment that calls for collaboration and teamwork.

You have a right to work in healthy, supportive, kind, compassionate, symbiotic, cooperative, and collaborative relationships.

In right relationships, even when there is disagreement, respect holds sway. In right relationship, positive communication remains the behavioral touchstone.

Whether with physicians, maintenance staff, physical therapists, or radiologists, your relationships at work are imbued with respect and collegiality.

Right Environment

The third right pertains to your work environment. You have a right to a workplace free of bullying, violence, harassment, intimidation, discrimination, avoidance, authoritarian leadership, disrespect, and other aberrant behaviors that make you feel undervalued, distressed, or unhappy.

In terms of your physical work environment, you have a right to ergonomically conducive work spaces that prevent pain and injury, not cause them. You also have a right to the avoidance of high levels of noise pollution and exposure to chemical agents that can make you sick.

You have a right to sufficient break time, meals, and rest periods. We must also add that you have the right to have access to proper hydration and readily accessible toilet facilities.

Your work environment should be physically and psychologically healthy.

Right Leadership

You have the right to be led by leaders in your best interests. Right leadership is leadership focused on employee engagement and success.

In right leadership, personal and professional growth are valued and encouraged, and leaders take responsibility for providing growth opportunities.

Right leadership means a leader never turns a blind eye to negative behavior like bullying. Instead, an enlightened leader creates an environment where those who break the rules are held accountable, and those who adhere to the rules are valued.

Undoubtedly, you have a right to hold your leaders to a high standard of conduct and success.

Right Livelihood

Right livelihood means you are doing what you love to do in an environment that meets your needs (and hopefully exceeds your expectations).

In right livelihood, your workplace is free of violence, bullying is non-existent, leadership is effective, and you feel personally aligned with your workplace’s mission and values.

When you’re practicing nursing within a state of right livelihood, you feel like you’re in the right place at the right time with the right people. Your right livelihood as a nurse is a key to success and happiness, not to mention your professional satisfaction and overall well-being (physical, psychological, spiritual, and emotional).

You have a right to your right livelihood, and your workplace should have the fulfillment of the right livelihood of its employees as its mission. Moreover, true leaders know that happy, healthy, and satisfied healthcare workers will deliver better care. Thus patients will be positively impacted, not to mention the organizational bottom line.

Bringing It All Back Home

The five rights of a healthy work environment are not a given in every workplace. In some healthcare facilities, few of these rights are recognized, let alone operationalized or fulfilled.

In most industrialized countries, many rights (like the right to free speech) are constitutionally guaranteed and upheld by the rule of law. And when those rights are trampled, the people can (theoretically) hold their democratically elected leaders accountable for any violation thereto.

Agitate for Change

Using my proposed five rights as your template and launching pad, assess if your workplace fails to recognize any crucial employee rights you deem unassailable. If they indeed are, you have the right (and some would say the responsibility) to speak truth to power and agitate for recognizing those rights. You also have the right to exit stage left for greener pastures.

Healthcare workplaces should not see nurses and other staff members as so much disposable, replaceable cannon fodder. New nurses should not be thrown into the fire without even a moment in the frying pan. Instead, being respected and valued should be part and parcel of your work experience; if it’s not, you have a choice to make.

Remember these five rights, share them with your colleagues and leaders, and use them as leverage in your pursuit of right livelihood and personal and professional happiness.

Daily Nurse is thrilled to welcome Keith Carlson, “Nurse Keith,” a well-known nurse career coach and podcaster of The Nurse Keith Show as a guest columnist. Check back every other Thursday for Keith’s column. 

Is Your Workplace in Good Shape?

Is Your Workplace in Good Shape?

This online tool for nurses can assess the health of a range of work environments

What makes a work environment healthy? According to the American Association of Critical-Care Nurses (AACN), it’s a place where healthcare professionals can make their optimal contribution. For almost a decade, critical care nurses have been able to evaluate the health of their work environment with the association’s online assessment tool based on its Healthy Work Environment standards.

Now a new study finds that the tool has applications beyond critical care, and is effective for assessing the health of the work environment for interprofessional patient care teams throughout a hospital’s patient care settings.

“Although AACN’s assessment tool has been used primarily among acute and critical care nurses, our findings support consideration of wider use in multiple healthcare settings,” said the study’s principal investigator, Jean Anne Connor, PhD, RN, CPNP, director of nursing research, cardiovascular, and critical care patient services at Boston Children’s Hospital. “Clinical leaders understand that to safeguard the quality of patient care, attention must be focused on the performance of healthcare teams.”

The Interprofessional Team

The assessment tool is an 18-question survey designed to help organizations or departments identify areas for improvement. It assists in measuring the health of a work environment against AACN’s six Healthy Work Environment standards:

  • Skilled communication
  • True collaboration
  • Effective decision-making
  • Appropriate staffing
  • Meaningful recognition
  • Authentic leadership

The study, published in the American Journal of Critical Care, reports the results of a two-phase administration of the tool to 2,621 patient-care employees at Boston Children’s Hospital.

Researchers administered the survey using a test-retest, two-stage approach. First, the AACN Healthy Work Environment Assessment Tool was administered to all healthcare team members, including physicians, nurses, social workers, therapists, clinical assistants, and administrators.

The first wave of the survey received 1,030 responses from 2,621 potential employee participants. Three weeks later, a second survey was sent to a random sample of 200 potential respondents stratified by role (physician, nurse, and others), and the response rate was 83.5%. The results of the responses showed that the AACN Healthy Work Environments Assessment Tools is reliable and valid, supporting its use as an organizational measure, the researchers concluded.

Expanded Use

They noted that Boston Children’s Hospital has used the Agency for Healthcare Research and Quality’s Hospital Survey on Patient Safety Culture since 2010 to assess how employees perceive their work environment regarding patient safety. The hospital has also administered the AACN online assessment tool to interprofessional staff in critical care and cardiovascular programs annually since 2010 and recently expanded it to an enterprise-wide assessment.

The team said that study results have been used in the development of measurement benchmarks and led to use of the Healthy Work Environments Assessment Tool in a nurse-led consortium of 30 cardiovascular programs in freestanding children’s hospitals.

This story was originally posted on MedPage Today.