How RNs View the Work Environment Results of a National Survey of Registered Nurses

  • Ulrich B
  • Peter C
  • Buerhaus I
 et al. 
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Objective: To determine registered nurses' (RNs') views of the workplace environment. Background: Numerous studies have shown rela-tionships between work environment, RN satisfac-tion and retention, and patient safety and outcomes. In 2002, NurseWeek Publishing and the American Organization of Nurse Executives completed a na-tional survey on the views of RNs on the nursing shortage, workplace environments, and their future career intentions, which revealed areas needing im-provement. Results from the follow-up survey con-ducted in 2004 provide new information on RNs' views of the work environment and a comparison of results to the previous survey. Methods: A nationally representative random sam-ple of 3500 RNs licensed to practice in the United States was surveyed. Results: In the views of RNs, there have been im-provements in a number of aspects of the work en-vironment of nurses. While there are no areas of de-cline, there are areas in which little or no progress is apparent. Conclusions/Implications: Some strategies designed to improve the work environment have resulted in positive outcomes, but creative solutions must be continuously developed and implemented to build on recent successes. Results of this survey help iden-tify areas for continued improvement efforts. The current nursing shortage began in 1998. With the aging of the nursing work force and enrollments in schools of nursing declining continuously since 1994, it was clear to many nurses and nurse leaders that a major problem loomed. Three major factors helped focus broader public attention on the prob-lem: research that showed a significant association between patient outcomes and the number of RNs; several grim supply-and-demand projections; and Institute of Medicine (IOM) reports on quality and patient safety that focused broader attention to the problem. Initially, many attempts to correct the shortage, especially in hospitals where the shortage was par-ticularly problematic, were focused on recruitment. Huge sign on bonuses, car giveaways, and the like were used to attract nurses. With a nurse labor force participation rate already exceeding 80%, it soon became obvious that attracting nurses could be only a part of the solution and the focus began to shift to retention. Retention efforts were aimed at ob-taining a better understanding of the environment in which nurses worked and modifying those environ-ments. Recommendations to improve the work envi-ronment have been frequent and consistent and ad-vanced from all quarters: nursing organizations, 1 the American Hospital Association, 2,3 the Joint Commis-sion on Accreditation of Healthcare Organizations,

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  • Beth T Ulrich

  • Che Peter

  • I Buerhaus

  • Karen Donelan

  • Linda Norman

  • Robert Dittus

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