By Kelly Phillips, feature writer
Staff nurses formed the core of a recent Minnesota project aimed at improving
life in the nursing ranks.
Seven hospitals in the state participated in the Minnesota Organization of
Leaders in Nursing (MOLN) Work Environment Project, assigning teams of nurses to
tackle a given problem with the idea of keeping nurses in the profession.
"These types of projects to improve the retention of nurses are critical to
having a strong, vibrant work force," said Bruce Rueben, president of the
Minnesota Hospital Association, which partnered with MOLN on the project.
Fulfillment in work is critical to quality of life, he said.
"People get into health care because they want to help people. It’s a very
demanding job," Rueben said. "We want to make it as fulfilling as possible to
the people who choose it. Retaining professionals is critical to the future of
health care."
Each hospital team chose an area needing attention at its site. Projects
involved career ladders, changing standard procedures, improving communication
and discharge planning, among others.
The seven project sites recently reported results from their work over two
years.
Evaluations showed "very significant results," said Christine Milbrath, RN,
MSN, vice president of patient services at Gillette Children’s Specialty
Healthcare in St. Paul, Minnesota. As the MOLN representative on the steering
committee, Milbrath took the lead to design, organize and direct the project.
Six of the seven hospitals showed significant improvement in nursing
satisfaction and perception of the work environment, she said. The seventh
hospital hadn’t completed the rollout of its project early enough for a valid
evaluation, but "they believe they will have improvements" too, she added.
In addition to evaluations of individual projects, participants filled out
surveys about the overall project.
Three-quarters felt the project positively affected the work environment,
Milbrath said, pointing out that 80 percent of respondents were staff nurses.
Three-quarters also thought they developed a "best practice" idea that would
be applicable to other organizations, according to Milbrath.
MOLN also planned to present the results at the April 19 business meeting of
the American Organization of Nurse Executives Phoenix, Arizona.
The project grew out of a tumultuous time for nursing in Minnesota.
"In 2001, there was a lot of talk nationally and in our community about the
[challenging] work environment for nurses and how that was creating difficulty
for individual nurses to stay in the profession and for others to choose to go
into the profession," Milbrath said.
During the 2001 contract negotiations between 13 Twin Cities area hospitals
and nurses who were part of the Minnesota Nurses Association, "there was a lot
of talk among nurses that hospitals and administrators didn’t really understand
their work experiences and the challenges they faced," Rueben said.
While deep-seated problems often emerge during labor negotiations, "very
seldom are there real solutions," he said.
The Minnesota Hospital Association decided to wait until after negotiations
were over to devote a good amount of thought and time to solving problems.
The association wanted to provide resources, and wanted to make sure staff
nurses and leaders were well-represented. It enlisted the Minnesota Organization
of Leaders in Nursing to take the lead on the project to help "really create
change" at individual hospitals.
Organizers wanted to help hospitals find ways to improve the work environment
for nurses.
"There were many efforts at hospitals in our community," Milbrath said. "We
wanted to try to fast-track the learning so we could advance the work
environment more quickly and more successfully in this area."
Milbrath stressed the importance of the demonstration of commitment by both
the nursing community and the hospital organization.
"We thought it was very important for staff nurses to be visible and for them
to feel their voice was being listened to and counted," Milbrath said.
She added that the project architects wanted to make sure they addressed the
concerns of nurses already in the profession, who were reporting increasing
stress and overwhelming work loads.
"We believe word of mouth conversations about the profession are going to be
the best way to learn about the role of being a nurse," she said.
Rueben agreed: "If they feel valued in the job, they will tell others. That
is probably the most effective way for others to get involved."
It does little good to recruit new nurses if those already in the work force
are leaving because they don’t feel supported or if the work environment is too
difficult in the long term, Milbrath said.
"We looked at issues identified by the strongest and most experienced
employees [because we wanted] to attend to what they were saying," she added.
St. Elizabeth’s Medical Center in Wabasha, Minnesota, took on the issue of
discharge planning, which previously left both patients and nurses frustrated,
Rueben said.
"They tackled that and felt that it really improved the patients’
satisfaction as well as the nurses’ experience," Rueben said.
The other Minnesota hospitals that crafted work environment projects were:
Douglas County Hospital in Alexandria, Fairview Southdale Hospital in Edina,
Fairview Ridges Hospital in Burnsville, Fairview-University Medical Center in
Minneapolis, Glencoe Regional Health Services in Glencoe and Woodwinds Health
Campus in Woodbury.
The initial two-year projects are finished and hospitals now are free to
apply the same process to new problems or work force issues. Other hospitals
also might want to do similar projects, Rueben said.
Asked whether the nursing environment has improved since those tumultuous
negotiations in 2001, Rueben said anecdotal evidence says yes.
"My view is that things have improved since then," he said. "It’s a matter of
degree and [varies] from one place to another. Things seem to be a little better
than they were back then."
© 2004. AMN Healthcare, Inc. All Rights Reserved.